RU2720830C1 - Assisting surgical complex - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to assisting surgical complexes (2000) for high-precision minimally invasive surgical operations. Complex comprises an actuating console of the patient, an operator input console and a numerical program control system (2200). Executive console comprises combined manipulator (2310) with a surgical instrument mounted thereon, camera manipulator (2320) with a camera mounted thereon for viewing the surgical site, manipulator positioning system (2340) and apparatus for calculating and evaluating forces acting on a surgical instrument. Input console includes an operator's controller (2110) for controlling movement of the surgical instrument with possibility of switching to the camera control mode using the control pedal and digital control unit (2150). Combined manipulator comprises a mechanism with driving elements and a portal mechanism in the form of modules of transverse and longitudinal movement, respectively. Mechanism with drive elements is installed on module of transverse displacement with possibility of movement along it in transverse direction. Module of transverse movement is installed on module of longitudinal movement with possibility of movement along it in longitudinal direction. Tools for calculating and evaluating forces include top and bottom three-axis strain gauges and made in form of a current sensor for the electric motor of the tool drive a sensor for capturing the force of the tool and surgical instrument rotation moment sensor. Operator controller comprises delta robot and strain platform arranged between movable platform and fixed support platform of delta robot. Control handle is attached to the movable platform to be covered by the operator's hand and configured to control and convert the operator's hand motion digital signal into three rotational degrees of freedom and force action on the strain platform by three linear degrees of freedom.

EFFECT: higher accuracy of control, a more complete set of robot-surgical functions with the possibility of controlled rotation of the camera during operation on any permissible angle of rotation with simultaneous correction taking into account this rotation of the coordinate system of instruments and controller, as well as reducing preparatory-final operation time.

6 cl, 15 dwg

Description

FIELD OF THE INVENTION

The invention relates to the field of mechanical engineering, and in particular to mechanisms - mechatronic complexes designed to solve technological problems using tools fixed in manipulators, which are controlled in manual mode using a digital operator controller and / or in automatic mode when the control commands are set by the system numerical program control (CNC). Mechatronic complex can be applied in the following areas: robotization, teleoperation, minimal invasive surgery, simulators and others. More specifically, the invention may relate to the field of assisting robotic surgical complexes for minimally invasive surgeries and for simulating such surgeries in a virtual environment.

BACKGROUND OF THE INVENTION

Increasing demands on the quality of surgical treatment require a significant improvement in surgical technology. Traditional surgical treatment technologies have largely exhausted the opportunity to be improved, and cannot solve the tasks. This is primarily due to the physiological capabilities of the person / surgeon, limited accuracy of movement of his hands, tremor of hands, limited visual acuity, significant size of hands, limited speed of hands and other factors. A fundamentally new surgical technology capable of overcoming the listed limitations and shortcomings is required, which opens up new frontiers for the significant improvement of surgery. The most significant parameter of the development of surgery is an indicator of the accuracy of manipulation of a surgical instrument. Traditionally, when the instrument is held by the surgeon in his hands, this value is limited to 0.1 mm. And this is with the best surgeons. However, the limit / boundary of the development of surgery for this parameter is in the range of 0.01 mm, which corresponds to the size of a large cell. The closer surgical technology approaches this border, the more advantage it will have, namely, it will allow minimizing the surgical field, thereby minimizing tissue injury during surgery, preserving nerve endings, suturing small vessels, completely removing small ones, up to size cells, neoplasms and more.

The most actively developing alternative to traditional surgery today is robotic surgery. Robotic surgery is an innovative, previously inaccessible surgical technology, which has become possible in many respects due to the development of mechatronics and information technology, has proven its worth in world clinics and provides new, high-quality medicine.

Using a robot in surgery, or rather, an assisting mechatronic complex, allows you to get functionality and quality that were previously inaccessible to a doctor: the ability to penetrate difficult areas and operate on them; higher accuracy and a given speed of movement of miniature tools; lack of tremor; stiffness and more. Robot-assisted surgeries have many advantages over traditional surgeries: for example, they can significantly reduce the amount of intraoperative blood loss and reduce the frequency of blood transfusions. Procedures of this kind are less traumatic, and therefore, in the rehabilitation period, the pain syndrome in patients is not as pronounced as with the traditional approach.

A traditional robotic surgical complex implements surgical technology in which a mini-tool controlled by a manipulator acts on the surgical field, being delivered to it through small punctures in the patient’s body. The ability to see the surgical field provides a camera that transmits a signal to a 3D monitor. The camera, like the instrument, is inserted through a puncture and controlled by a separate manipulator. Actions / commands to instruments and the camera through the manipulators are set by the operator's controller, controlled by the surgeon's hands. The surgeon’s workstation consisting of two controllers and a 3D monitor is located at a considerable distance from the surgical table. This creates a difference and significant advantages compared to traditional laparoscopic surgery. The surgeon operates while sitting, in a comfortable position, gets tired less and does not lose concentration. Also, unlike laparoscopy, the movement of the control movements of the surgeon's hands can be multiplied when transferred to the manipulator and instrument with a coefficient greater than or less than 1.

Robotic surgery is being actively introduced to clinics around the world, primarily thanks to the DA VINCI robot from Intuitive Surgical Inc. Many companies are trying to create competition for him and also enter the market.

For example, a surgical robot developed by the Spanish company Tecnalia and the University of Malaga is disclosed in WO2017220822 A1. The aim of the project is to provide hospitals with affordable robotic surgery, which offers high precision operations, in the range of laparoscopy requirements. The robot consists of three six-axis (six-degree) manipulator arms that can function together or separately, in accordance with the requirements of the operation. Robotic manipulators were selected for this project because of their simple programming system, which allows engineers to adapt their software to the specific needs of surgical operations. Each arm weighs no more than 18 kilograms, which makes it easy to install them on a vertical support, which was adapted to avoid the need for a long cable and thereby allowing free and unhindered movement of medical workers throughout the operating room. The robot also includes a screen for 3D Vision, which allows the surgeon to expand his field of view to better control the work of a pair of joysticks that mimic laparoscopy tools.

When comparing already completed developments and patented technical solutions, it is important to determine from which positions and in what parameters to perform such a comparison. Regardless of the type or type of technical implementation, robotic surgery technologies have their own basic features that form them and the primary parameters / features. They are: removal of tremor, accuracy of instrument movement, including superior to traditional laparoscopy, and functionality / features. It is from the standpoint of comparing these parameters that it is advisable to analyze patents of robotic surgical complexes.

At the end of September 2019, Medtronic introduced the Hugo robotic surgical platform, which has been under development for many years. The company promises that a new robot surgeon with a modular configuration system will reduce the cost of many operations and expand the scope of surgical robotics. The platform of the module consists of the open console of the surgeon, imaging system and robotic manipulators with surgical instruments. At the same time, the imaging system and many instruments, such as surgical staplers, can be used in both robotic and laparoscopic procedures, and various components can be updated as the hospital becomes financially capable.

In mid-November 2019, a robot surgeon at Corindus, which Siemens had bought a few weeks earlier, performed its first neurovascular surgery. The procedures were performed over a 5G wireless network, dedicated fiber optic connections and commercial public networks, by a doctor who was 3,000 miles from the patients. The networks provided low latency connectivity and the successful implementation of remote procedures. The CorPath GRX system enabled the physician in real time to monitor the actions of the robot from a remote location. The results will allow interventional cardiologists to use robotic technologies for the safe and effective remote execution of coronary procedures anywhere in the country. Such an approach will reduce the waiting time for surgery and expand access to highly qualified medical care. This technology is disclosed in international application WO2019222641 A1.

The analysis of already created, created or patentable robotic surgical complexes only allows us to note both their innovative differences and draw attention to significant shortcomings and comments. Known from the prior art solutions do not allow in one design of a robotic surgical complex to solve the following set of problems:

1. To realize one of the most important advantages of robotic surgery is to create conditions that allow the surgical instrument to move / position relative to the tissues of the surgical field during the operation in the accuracy range exceeding the accuracy of the surgeon’s hand, especially in automatic control without compensating commands from the doctor.

2. To realize another major advantage of robotic surgery - to create new, previously non-existent surgical and technological techniques, thereby significantly enriching and expanding the surgeon’s functional arsenal.

3. Provide conditions for the automated and automatic execution of robotic surgery.

4. To provide ease of movement of the controller to control the surgical robot over the entire amplitude of the surgeon's hands.

5. To ensure the conversion of teams from moving hands to scaled movements of a surgical instrument, while:

the scale is not limited and depends only on the tasks for the operation;

scaling can occur both upward and downward.

6. To reduce, in comparison with traditional robotic surgery, the preparatory-final operation time.

These problems reduce the effectiveness of the robotic surgery complex and do not provide the opportunity to fully realize the advantages of robotic surgery technologies.

It is the solution to these problems that this application is dedicated to.

The essence of the invention

The technical problem and the achieved technical result of the present invention are to create an assisting surgical complex that surpasses the key requirements of robotic surgery prototypes and analogues based on the new architecture, made possible by the new properties of the key blocks and the new structure of their interaction, which provides:

- the ability to achieve accuracy values that exceed the capabilities of the surgeon’s hands, without compensating doctor’s commands for management;

- a more complete set of robotic surgery functions implemented by the complex, including functions performed automatically;

- the ability to receive on the hand holding the controller of the operator, tactile sensations from the patient’s tissues when the instrument touches them during the operation;

- convenience and ease of operation of the surgeon when controlling the operator’s controller at the full amplitude of the hand movement to form teams that have scaled (proportionally increased or decreased in magnitude) tool movements, while the scale has no limitations;

- automated and automatic movement of the tool and other elements of the complex according to a given command from the system of numerical program control (CNC);

- the possibility of controlled rotation of the camera during the operation at any acceptable angle of rotation with simultaneous correction taking into account this rotation of the coordinate system of the tools and the controller;

- a significant reduction in the preparatory-final operation time.

At the same time, the developed assisting surgical complex should also be universal and adapt / localize to various types of surgical intervention.

In order to solve the tasks, an assisting surgical complex was developed, which is described in detail below.

An assisting surgical complex for performing highly accurate minimally invasive surgical operations contains an executive console for the patient, which includes at least one combined manipulator with a surgical instrument mounted on it for performing a surgical operation, at least one camera manipulator with a camera fixed to it for viewing the surgical field, providing its movement in three translational degrees of freedom; at least one manipulator positioning system mounted on at least one longitudinal side of the surgical table and configured to store at least one manipulator under the surgical table in the idle position and automatically independently extend and move each of the manipulators in a given area of the operating area in the working position , means for calculating and evaluating the forces acting on the distal end of the surgical instrument, and the forces acting on other working parts of the surgical instrument, an operator input console, which includes: at least one operator controller for controlling the movement of the surgical instrument mounted on the specified combined manipulator configured to provide independent seven degrees of freedom when appropriate control forces and / or movements from the side of the operator’s hand occur to rotate and / or move the controller by the operator’s hand, the operator’s scooter is configured to switch to the camera control mode using the control pedal; and a digital control unit for the controller of the operator, which for each degree of mobility of the controller of the operator generates a signal of movement of the hand of the operator and converts it into a control signal for subsequent control of the combined manipulator and / or surgical instrument and / or camera manipulator, a numerical control system for the assisting surgical complex with at least one combined manipulator, a camera manipulator, with means for calculating and evaluating forces, with a positioning system for manipulators, with a digital controller control unit, configured to simultaneously and independently control all elements of the complex as a whole, to generate control signals characterizing the force action for each degree of mobility of the surgical instrument and / or the impact calculated on the basis of a given model, and the transmission of these signals to the digital control unit of the operator controller to convert them into mechanical movements of operator controller elements,

moreover, the combined manipulator includes a mechanism equipped with drive elements and made in the form of a fixed supporting platform and a movable platform interconnected by means of three rods, the movable mechanism platform is capable of placing a surgical instrument on it, and a portal mechanism made in the form of a transverse movement module and a module longitudinal movement, each of which is equipped with a drive unit,

while the drive elements and drive units are configured to transmit and / or receive data from the numerical control system of the assisting surgical complex,

wherein the mechanism is mounted on the lateral movement module with the possibility of moving along it in the transverse direction, and the lateral movement module is mounted on the longitudinal movement module with the possibility of moving along it in the longitudinal direction;

moreover, all elements of the positioning system are equipped with servo drives and controllers, configured to receive and transmit control commands from the numerical control system of the assisting surgical complex to perform elements of the system of coordinated movements,

moreover, the means for calculating and evaluating the forces include a three-axis lower strain gauge located on the support of the manipulator in the place of attachment of the trocar and in direct contact with it, for measuring the forces applied to the instrument and directed along the x and y axes, a three-axis upper strain gauge located on the support of the manipulator under the drive of the surgical instrument, for measuring the force applied to the instrument and directed along the z axis, a sensor for gripping the executive surfaces of the instrument, made in the form of a current sensor for the electric drive of the instrument, which compresses the executive surfaces of the instrument, the moment of rotation of the surgical instrument made in the form of a current sensor for the electric drive of the instrument, providing rotation of the surgical instrument around its longitudinal axis,

moreover, the strain gauge sensors are connected to the respective digital data processing modules, and the pickup force sensor and the torque sensor are connected to the respective motor control systems,

digital processing modules and electric motor control systems are connected to the processing module, which is programmed to carry out the calculation by group processing and synchronization of signals from strain gauges, torque sensor and gripping force sensor: forces directed along linear axes, tool torques along x and y axes relative to the point of entry of the trocar into the patient’s body, the moment of rotation of the instrument along the z axis relative to the point of entry of the trocar into the patient’s body, the compression force of the executive surfaces of the instrument, the processing module is adapted to transmit data to the numerical control system of the assisting surgical complex,

moreover, the operator’s controller includes a delta robot, driven by a drive mechanism, each link of which is made in the form of a crank mechanism, driven by a servo-drive with a ball screw; a strain gauge installed between the movable platform and the fixed support platform of the delta robot, and strain gauges associated with each ball screw transmission are located on the tensile platform; at the same time, a control handle is attached to the movable platform with the possibility of its coverage by the operator’s hand and configured to control and convert into a digital signal of the movement of the operator’s hand with at least three rotational degrees of freedom and force impact on the tensile platform in three linear degrees of freedom,

at the same time, the signal formed on the load cells is transmitted to the digital control unit of the controller, which calculates and transmits to the servo drive of the corresponding link of the drive mechanism commands for weight compensation and / or movement along the planned path calculated on the basis of the received data,

moreover, the system of numerical control of the assisting surgical complex is made with the possibility of motion compensation when controlling the movement of the camera.

In some embodiments, the control handle of the operator controller includes a wrist controller that provides two rotational degrees of freedom in orthogonal planes, and a brush controller that provides two other rotational degrees of freedom.

In some embodiments of the invention, the brush controller is equipped with a handle and finger grips.

In some embodiments of the invention, at least one drive element and a rotation sensor are installed inside the handle of the brush controller.

In some embodiments of the invention, the wrist controller is equipped with at least one drive element and a rotation sensor.

In some embodiments of the invention, at least one manipulator in an idle position is located beneath the surgical table in the leg portion.

Theoretical justifications confirming the achievement of the technical task and technical result when using an assisting surgical complex.

One of the main and undoubtedly demanded advantages of robotic surgery is significant, inaccessible with the previous techniques of operations (open or laparoscopic), technological capabilities of the instrument for performing the operation. The most significant technological capabilities essential for robotic surgery are: movements along seven (three turns, three linear movements and one opening jaws) and more than the axes of the executive surfaces of the surgical instrument during surgery; moving the surgical instrument, if necessary, during the operation with an accuracy exceeding the maximum permissible accuracy of the surgeon's hand. The last indicator includes both the accuracy of the movement of the surgeon's hand holding the instrument and the indirect effect on this indicator due to the presence of tremor of the hand.

Modern robotic surgery has two distinct directions of development:

According to the robotic type of movement of a surgical instrument, there are seven axes of displacement of the executive surfaces of the instrument. According to the laparoscopic type of movement of the surgical instrument, there are four (three linear displacements and one opening of the jaws) axes of displacement of the executive surfaces of the instrument.

For surgical robots that have entered or are entering the market, the declared (passport) accuracy of tool movement is inferior to that of the surgeon's hand. This fact significantly reduces the functionality of such robots and does not allow to reveal the full potential of robotic surgery.

This situation has a general trend for all robots being developed as a functional competitor of the Da Vinci robot. The main reason for this situation is associated with the complexity of the design of robotic surgical complexes having a significant number of links / elements that affect accuracy. It is possible to overcome this barrier only by fundamentally changing the architecture of the surgical robot. The new architecture should contain both a new structure (architecture) and the composition of mechatronic blocks and elements and mechanical connections between them, as well as a new, fully digital architecture for controlling the robotic surgical complex.

This application aims to propose a new architecture for an assisting complex, potentially capable, if necessary, of a surgeon, to overcome the accuracy barrier and remove the limitations of the development of robotic surgery.

The task and technical result are achieved due to the fact that the complex uses as modular elements new blocks developed for the tasks of robotic surgery that make up the assisting surgical complex, as well as more advanced architectures for their mechanical and informational connections, while the information interaction of all elements of the complex is completely digital, in a single digital environment.

1. The achievement of accuracy values exceeding the capabilities of the surgeon's hands is ensured as a result of a combination of properties and features of the blocks of the surgical complex that interact during operation. In this case, the individual blocks, the properties and features of which create the conditions for solving the problem, are:

A. The combined manipulator of the assisting surgical complex, which affects the achievement of the task by the increased structural rigidity and dynamic accuracy due to the construction of the manipulator in the form of a two-component spatial mechanism, which is an improved tripod in combination with the portal mechanism of its linear movements over the work area. Such a kinematic scheme allows for sufficient mobility of the surgical instrument and an angle of rotation of the surgical instrument.

B. The controller of the operator of the assisting surgical complex, which influences the achievement of the task and the technical result, the increased accuracy of determining the position of the hands of the operator / surgeon in the entire possible range of their movement due to the use of the delta-robot mechanism of the tensor platform located between the movable and fixed platforms of the delta robot mechanism and the digital controller control unit.

C. The positioning system of the assisting surgical complex manipulator, which affects the achievement of the task and the technical result due to the rigidity of the structure and the possibility of mounting the manipulator directly on the operating table to standard points of attachment of additional equipment, which ensures the minimum number of links / elements, the accuracy of which affects the accuracy of movement tool.

D. The system of numerical program control (CNC) of the assisting surgical complex, which affects the achievement of the task and the technical result due to the control, correction and compensation of the position of the instrument when it is moved and deviates from the desired position specified by the surgeon. The CNC system provides the transformation of the coordinates of each element of the controller of the operator when it is controlled by the surgeon into the coordinates of the actuator, which is a manipulator with a surgical instrument fixed to it and / or the surgical instrument itself. The CNC system also generates drive control signals for each degree of mobility of the actuator so that its movement corresponds to the direction in which the operator-surgeon acted on the control controller mechanism, and it was intuitive for him.

E. A system for evaluating efforts on a robotic surgical instrument of an assisting surgical complex that affects the achievement of the task and the technical result due to the identification of the nature, direction and magnitude of the forces acting on the surgical instrument during operation (during a surgical operation) based on measuring the magnitude of the movement of the instrument in the area of used multiaxial strain gauge sensors, one of which is located on the support of the manipulator under the drive of the surgical instrument, and the other is in the place of attachment of the trocar, and each of which is connected to the digital processing module of the incoming data.

2. Achieving a more complete set of robotic surgery functions implemented by the proposed surgical complex, including functions performed automatically, is ensured as a result of a combination of properties and features of the complex blocks interacting during operation. At the same time, the properties and features of individual blocks that create the conditions for solving the task and the technical result are:

The combined manipulator of the assisting surgical complex, which affects the achievement of the task and the technical result by the fact that its design is designed to fully implement robotic surgery technologies, while the unit is fully mechatronic and digital and has a direct and feedback circuit.

The controller of the operator of the assisting surgical complex, which affects the achievement of the task and the technical result by the fact that its design is designed to fully implement robotic surgery technologies, while the unit is fully mechatronic and digital and has a direct and feedback loop.

The positioning system of the manipulator of the assisting surgical complex, which affects the achievement of the task and the technical result by the fact that it has the ability to position the manipulators in various positions necessary for performing robotic operations, while being fully mechatronic and digital and has a direct and feedback loop .

The system of numerical program control (CNC) of the assisting surgical complex, which affects the achievement of the task and the technical result by providing fully digital control of both individual blocks and nodes, and the complex as a whole.

3. The achievement of the ability to receive on the hand of the surgeon holding the controller, tactile sensations from the patient’s tissues when the instrument touches them during surgery, is ensured as a result of a combination of properties and features of the complex units interacting during operation. In this case, the properties and features of the individual blocks that create the conditions for solving the problem are:

The combined manipulator of the assisting surgical complex, which affects the achievement of the task and the technical result by the fact that it is fully mechatronic and digital and has a circuit both direct and feedback.

The controller of the operator of the assisting surgical complex, which affects the achievement of the bed task and the technical result set by the fact that it is fully mechatronic and digital, and has a circuit both direct and feedback.

The system of the numerical program control system (CNC) of the assisting surgical complex, which affects the achievement of the task and the set technical result by providing fully digital control of the operator controller, manipulator and system for evaluating the force on the instrument, separately for each unit and during their interaction.

A system for evaluating the effort on a robotic surgical instrument, which affects the achievement of the task and the technical result due to the assessment of efforts on the instrument and increasing the reliability of identifying their sources, as well as due to the presence of the following properties in the design: the ability to evaluate the forces acting on the surgical instrument of a robotic surgical system, applied to any part of its structure; the ability to uniquely determine the direction and numerical value of the force applied to the surgical instrument; the possibility of uninterrupted operation of the force assessment system under the conditions of using electrocoagulation with a surgical instrument; the ability to measure the gripping force that occurs when closing the jaws of a surgical instrument; providing the ability to transmit data on measured forces to external control systems of the robotic surgical complex; immunity to electromagnetic interference from a household network; the possibility of using measuring sensors of various types and operating principles for different degrees of freedom.

4. Achieving the convenience and ease of operation of the surgeon when controlling the controller at the full amplitude of the hand movements for generating commands of scaled (proportionally increased or decreased in magnitude) movements of the tool at a scale that does not have restrictions is ensured as a result of a combination of properties and features of the complex blocks interacting during work. In this case, the properties and features of the individual blocks that create the conditions for solving the problem are:

The combined manipulator of the assisting surgical complex, which affects the achievement of the task with the increased characteristics of the rigidity of the structure and its dynamic accuracy.

The controller of the operator of the assisting surgical complex, which affects the achievement of the task by a fully digital mechatronic realized design that allows the operator / surgeon to interact by hand, in any range of their movement, with the surgical complex and directly with the manipulator included in the complex, as if giving him a command, and getting back reactions in response.

Numerical control system (CNC) of an assisting surgical complex, which affects the achievement of the task due to the fully digital control system and the algorithm for calculating the movement of the manipulator, converting it into commands for the manipulator.

5. Achieving a significant reduction in the preparatory-final operation time is ensured as a result of a combination of properties and features of the complex units interacting during operation. In this case, the properties and features of the individual blocks that create the conditions for solving the problem are:

The combined manipulator of an assisting surgical complex, which affects the achievement of the task by the fact that it is compact, has a low weight, is fully mechatronic and digital.

The positioning system of the assisting surgical complex manipulators, which affects the achievement of the task due to the rigidity of the manipulator mounting, while increasing the possible position of the manipulators relative to the patient and increasing the speed and reducing the time the manipulators move to the working position (working area) and back to the storage area located under the foot tabletops of the operating table in such a way as to preserve the traditional functional capabilities of the table, which allows you to quickly interrupt the robotic surgery and continue it in the cavity operation mode.

The system of numerical program control (CNC) of the assisting surgical complex, which affects the achievement of the task by the fact that it provides fully digital control of the positioning system of the manipulator and the combined manipulator, both individual units, and their joint work.

6. The achievement of automated and automatic movement of the tool and other elements of the complex at a given command from the system of numerical program control (CNC) is ensured as a result of a combination of properties and features of the complex blocks interacting during operation. In this case, the properties and features of the individual blocks that create the conditions for solving the problem are:

A. The combined manipulator of the assisting surgical complex, which affects the achievement of the task in that it is fully mechatronic and digital

B. The controller of the operator of the assisting surgical complex, which affects the achievement of the task by a fully digital mechatronic realized design.

C. The positioning system of the assisting surgical complex manipulator, which affects the achievement of the task in that it is fully mechatronic and digital.

D. The system of numerical program control (CNC) of the assisting surgical complex, which affects the achievement of the task due to the fully digital control system of the manipulator, operator controller and complex positioning system.

7. Achieving the possibility of controlled rotation of the camera during an operation at any permissible rotation angle with simultaneous correction taking into account this rotation of the coordinate system of the tools and the controller is ensured as a result of a combination of properties and features of the complex units interacting during operation. In this case, the properties and features of the individual blocks that create the conditions for solving the problem are:

A. The combined manipulator of the assisting surgical complex, which affects the achievement of the task in that it is fully mechatronic and digital

B. The controller of the operator of the assisting surgical complex, which affects the achievement of the task in that it is a fully digital mechatronic realized design.

C. The camera compensation system of the assisting surgical complex, which affects the achievement of the task by the fact that it is fully mechatronic and digital and has a special unit for races and control.

The objects and advantages of the present invention will become more apparent to those skilled in the art after consideration of the following detailed description and drawings.

Brief Description of the Drawings

The accompanying drawings, which are incorporated in and constitute a part of the present description, illustrate embodiments of the invention and, together with the above general description of the invention and the following detailed description of embodiments, serve to explain the principles of the present invention.

FIG. 1 depicts a structural model of a robosurgical complex that is used for the present invention.

FIG. 2 illustrates a schematic representation of a specific embodiment of an assisting surgical complex.

FIG. 3 illustrates a perspective view of a controller for controlling an operator with mechatronic devices of an assisting surgical complex.

FIG. 4 illustrates a developed model of an operator controller with a positioning unit made in the form of a delta robot.

FIG. 5 illustrates an operator controller positioning unit.

FIG. 6 illustrates a general view of the construction of a manipulator.

FIG. 7 depicts a general view of a tripod model with a surgical instrument mounted on its movable platform.

FIG. 8 illustrates a general view of the construction of a manipulator with a surgical instrument mounted on its movable platform.

FIG. 9 illustrates a schematic representation of a surgical instrument located on a support mounted on a manipulator.

FIG. 10 depicts the architecture of a force assessment system.

FIG. 11 illustrates the mechanism of the positioning system of the manipulators and its attachment to the operating surgical table.

FIG. 12 illustrates a general view of an assembly of a manipulator positioning system in a working position.

FIG. 13 reflects a block diagram of the algorithm of the automatic control system of the camera manipulator.

FIG. 14 illustrates the interaction of the surgeon's hands with a control controller for nephrectomy.

FIG. 15 illustrates the most frequent position of the surgeon's hands during surgery.

Terms and Definitions

For a better understanding of the present invention, the following are some of the terms used in the present description of the invention. Unless defined separately, technical and scientific terms in this application have standard meanings generally accepted in the scientific and technical literature.

In the present description and in the claims, the terms “includes”, “including” and “includes”, “having”, “equipped”, “containing” and their other grammatical forms are not intended to be interpreted in an exclusive sense, but, on the contrary, used in a non-exclusive sense (ie, in the sense of “having in its composition”). As an exhaustive list, only expressions of the “consisting of” type should be considered.

In these application materials, the terms “robotic technological complex”, “robotic system”, “robotic complex”, “robotic surgical complex”, “robotic surgical system”, and “assisting surgical complex” mean complex systems or complexes in surgery using a robot assistant in operation time. “Robot-assisted systems” or “robot-assisted surgical systems” are robotic systems designed for medical operations. This is not a stand-alone, automatic device, the robot-assisting systems during the operation are controlled by surgeons.

In these application materials, the term “mechatronic complex” or “mechatronic system” is understood to mean a complex or system with computer control of movement, which is based on knowledge in the field of mechanics, electronics and microprocessor technology, computer science and computer control of the movement of machines and assemblies.

In this application, the term "operator" means the surgeon performing the operation. The signs "operator" and "surgeon" in the present description of the invention are synonymous.

In the present application materials, the term “manipulator” is understood to mean a mechatronic mechanism designed to fasten and move (reposition) a surgical instrument during a surgical operation in accordance with specified commands from the control system of the robotic surgical complex.

In the present application materials, the term “portal mechanism” is understood to mean the mechanism of a robotic system consisting of two support (portal) frames, which can, on command from the control system of the robotic surgical complex, move one relative to the other along axes located at an angle of 90 ° relative to each other.

In the present application materials, the terms “longitudinal displacement module” and “transverse displacement module” are understood to mean mechanisms providing mutually perpendicular movement of one or another element relative to each other.

In this application, the term "surgical instrument", "instrument" is understood to mean a special tool of small size, which is fixed in a surgical robot for operations. During surgery, instruments can move, rotate and rotate in a much wider range and much more accurately than a human hand. Depending on the type of operation, an appropriate tool is used that allows it to be performed most efficiently. A miniature robotic surgical instrument performs tissue dissection, tissue movement, clamping, suturing, etc. that allows you to work with hard-to-reach areas of organs without the risk of damage to healthy tissues.

In the present application, the sign “executive surfaces of the tool”, “executive part of the tool” is understood to mean the surface of the tool or part of the tool with which the tool performs its official purpose. As a rule, executive surfaces, for example, branches, are located at the end of the instrument introduced into the patient’s body and perform complex movements initiated and controlled by the surgeon.

Under the term “universal” in terms of its use, the controller is raised in this document with respect to the controller, which “digitizes” - translates the position of the operator’s hand moved into numerical values / coordinates and allows you to integrate and manage a new tool into the complex, without subsequent changes to the controller’s design. Having mastered the controller once, the operator uses it for a long period of his practice, due to the controller’s ability to integrate (“represent” the surgeon’s hand) in various, including remote mechatronic devices.

Pot the term "absolute position" in this document understand the coordinate defined relative to a fixed structural element.

The term "rotation sensor" in this document refers to a device designed to convert the angle of rotation of a rotating object into electrical or analog signals, allowing to determine the angle of rotation. To determine the value of the angle of rotation of an element, in principle, all types of angle sensors are suitable. However, in the majority of used sensors, it is necessary, first of all, to constantly register and save current data on the rotation of the element. Rotary encoders can be used based on incremental and absolute encoders. The sensors have digital output signals Linedriver (TTL, RS422), Push-Pull (HTL), SSI, CAN, Profibus, Profinet and others. Sensors based on analogue angle sensors and / or magnetic angle sensors can also be used.

The term “connected” means functionally connected, any number or combination of intermediate elements between the connected components (including the absence of intermediate elements) can be used.

In addition, the terms “first”, “second”, “third”, etc. they are used simply as conditional markers, without imposing any numerical or other restrictions on the enumerated objects.

DETAILED DESCRIPTION OF THE INVENTION

The description of exemplary embodiments of the present invention below is provided by way of example only and is for illustrative purposes and is not intended to limit the scope of the invention disclosed.

The present solution relates generally to an assisting surgical complex, the general structure of which is depicted in FIG. 1. The robotic surgical complex includes three main nodes. The first node is the controllers that serve as the master device and with which the surgeon interacts directly. The second executive unit is the manipulators on which medical instruments are installed. Depending on the procedure performed, it is possible to change the medical instrument to a more suitable one. The third node of the robotic surgery complex is a computing unit, with the help of which all system interactions are carried out. The robotic surgical complex can be used in various surgical interventions, including in urology, gynecology, abdominal, neuro- and cardiac surgery.

In more detail, the robotic surgical complex 1000 consists of three interconnected main units: the patient's trolley (actuator) 1300, the automatic control system 1200 and the control console (master) 1100, which receives commands from the surgeon 1130 to further convert them into movement of the surgical tools or to ensure the generation of control commands from the surgeon for other blocks of the robotic surgical complex.

Also, one of the nodes in the robotic surgical complex is a stereo imaging system (imaging system), which includes a camera 1400 to obtain an image of the surgical field 1330 and a monitor of the imaging system 1140 to display a three-dimensional image of the surgical field received from the camera. The effectiveness of the operation depends on the quality of the image received by the surgeon. The modern development of mechatronic systems and the continuous improvement of robotic surgery presents new requirements for the developed devices of the imaging system.

The control console 1100 is located outside the sterile area of the surgical unit and is configured to control: manipulators 1310, 1311, 1312 with surgical instruments attached to them; a manipulator 1320 with a camera 1400 mounted on it; directly by the surgical instruments themselves. The controller includes a controller 1110, controlled by the hands of the surgeon, and pedals 1120, controlled by the legs of the surgeon.

Typically, manipulators with surgical instruments and a camera are mounted on a patient trolley, which is designed to support them and position them relative to the patient. It should be understood that the robotic surgical complex can have any number of manipulators, for example, one or more manipulators. In FIG. 1 shows three manipulators 1310, 1320, 1330, made with the ability to move in three planes and rotate in three planes, as well as the manipulator 1320 of the camera 1400. All the manipulators indicated on the structural diagram and which are part of the patient’s cart have common mechanical characteristics and design features . Each manipulator has a body and a connecting node for the manipulator, to which a surgical instrument or camera can be removably attached, the movement and position of which can be changed by the surgeon by manipulating / controlling using a control controller that digitizes the movement of the surgeon's hands.

The control controller 1110 of the surgeon (operator controller) allows you to control surgical instruments and the camera located inside the patient during the surgical operation. The controller of the operator 1110 converts the mechanical movements of the surgeon's hand over the entire natural range of motion along six degrees of freedom to generate control commands for the robotic surgical complex.

The surgeon's control controller (operator controller) 1110 generates a command to move the surgical instrument. In addition, the controller controls the turning and opening-closing of the jaw on the surgical instrument. The surgeon 1130 has the ability to generate at least three translational and three rotational degrees of freedom and an additional at least one degree of freedom when closing / opening jaws, which is sufficient to control a surgical instrument performing a surgical operation.

By pedal 1120 in this application is meant a contact switching device (mechanical or electronic) capable of turning on / off the passage of current in a circuit. As such a device, a pedal, button, switch, switch, and the like can act. Hereinafter, in the framework of this application, the pedal 1120 is a foot pedal switch that closes the electric circuit when the surgeon presses the pedal with his foot. There may be several pedals in the control console. The pedals are designed to change the operating modes of the control controller, or to switch additional functionality, such as coagulation, laser, and the like. Foot pedal switches allow the surgeon to control the camera, instruments, electrosurgical instruments.

The automatic control system 1200, based on the data received from the controllers 1110 and the signal from the pedals 1120, generates control commands that can be sent to manipulators 1310, 1311, 1312 with surgical instruments, as well as to a manipulator 1320 in which the camera is fixed. Pressing and holding the foot switch 1120 disconnects the controllers 1110 from the control of surgical instruments (from the control of manipulators 1310, 1311, 1312 with surgical instruments) and turns on and allows to control the movement of the manipulator 1320 with camera 1400. In this mode, both controllers 1110, right and left work at the same time. When pedal 1120 is released, controllers 1110 will again control surgical instruments. In this case, the automatic control system 1200 receives data from the control controller 1110 about three translational and three rotational degrees of freedom and generates on their basis three translational and three rotational movements of the manipulator with the surgical instrument.

Since the surgeon can control the movement and orientation of surgical instruments without actually holding surgical instruments directly in his hands, he (the surgeon) can operate the complex in both a sitting and standing position. As a device for a sitting position, the complex can be provided with a chair.

A preferred embodiment of the assisting surgical complex 2000 according to the present invention is depicted in FIG. 2. The complex consists of the following main components:

2110 - The surgeon's control controller (operator controller) used in the complex according to the present invention, which receives commands from the surgeon, converts them into the movement of the surgical instrument inside the patient’s body during the surgical operation and / or provides all control commands from the surgeon with components of the robotic surgical complex.

2150 - Digital control unit for the operator controller.

2200 - The automatic control system, made in the form of a numerical control system (CNC) of an assisting surgical complex, and providing numerical control of the entire complex and individual units, such as an operating field monitoring system, surgical instrument, auxiliary processing equipment, operating table, equipment.

2310 - Manipulator of a surgical instrument used in the complex according to the present invention.

2340 - Positioning system of the manipulator relative to the operated.

2320 - Camera manipulator, which allows you to get an image of the surgical field during a surgical operation.

At the same time, the control controller (operator controller) 2110 interacts with the mechanical manipulator 2320, which is part of the robotic surgical complex, with a camera fixed on it, so as to reduce or remove the total number of compensation movements performed by the surgeon when controlling the camera, thereby reducing the duration of the operation , reducing the risks of surgeon errors, as well as reducing the surgeon’s fatigue based on the most intuitive, clear camera control procedure.

Also in the power feedback loop of this robotic surgical complex is integrated a system for assessing the forces acting on tissues and organs of a patient by an instrument during a robotic surgical operation. Using such a system allows you to realize tactile sensations for the surgeon from the contact of the instrument surfaces with the patient’s tissues, without creating sensations from the instrument’s contact with the trocar, which are forced to arise in the form of friction and various lateral forces when moving the instrument in the trocar during operation.

Below is a detailed description of the design of the advanced units, which are the constituent elements of an assisting surgical complex, as well as their informational connections with each other.

Operator Controller 3000  (Fig. 3) belongs to the class of mechanisms that provide conversion into electronic digital signal of commands that a person sets with a movement of his hand. A general view of the operator controller is shown in FIG. 3. The controller of the operator 3000 as a whole consists of a control knob 3100, a block-platform positioning 3200 and a digital control unit (not shown in the drawing).

The specified controller 3000 has a direct communication loop in order to give commands from the operator (surgeon) through the movement of his hand to the mechatronic device, and a feedback loop for transmitting feedback commands from the mechatronic device in the reverse order to the operator’s hand. The controller feedback loop 3000 is designed to transmit tactile sensations to the hand.

The contact of the controller 3000 with the hand is realized on the control knob 3100. The control knob 3100 as a whole consists of a brush controller 3110 and a wrist controller 3120, each of which provides two rotational degrees of freedom of the controller 3000.

The 3200 controller’s positioning block platform is a hand controller that provides three translational degrees of freedom of the controller 3000 by reciprocating the movement of the controller 3000 along three mutually orthogonal axes. At the same time, the wrist controller 3120, which is part of the control handle of the controller 3100, is fixed on the hand controller 3200. Thus, the controller of the operator 3000 controls and converts the six degrees of freedom into a digital signal of hand movement.

In FIG. 4 is a perspective view of a mechatronic device control controller that allows reading six degrees of freedom and consisting of a hand controller, a wrist controller, and a hand controller.

The hand controller (or block positioning platform) 3200 consists of at least two platforms — a fixed support and a movable one — and a positioning block. A movable platform is attached to the fixed supporting platform by means of a weight compensation mechanism including a positioning unit made on the principles of a parallel structure, preferably based on a delta type mechanism (delta robot or deltapod), and a drive mechanism that drives the delta robot while ensuring minimal backlash.

The parallel structure mechanism can be used by anyone. In a preferred embodiment of the controller, the positioning unit is a closed kinematic chain consisting of constant-length rods arranged in pairs parallel to each other and connected at one end to the respective actuators mounted on a fixed support platform, and at the other ends to a movable platform. Delta mechanisms have increased maneuverability and an extended border of the working area.

Moreover, a controller based on a parallel structure mechanism, in comparison with serial structure controllers and other controllers, has significantly less weight and size, while at the same time more accuracy, rigidity and power.

The delta robot (Fig. 5) is a view of a parallel robot, which consists of three levers 410 located at an angle of 120 ° relative to each other and attached to the supporting platform 420. The advantage of the design of the delta robot is the use of parallelograms 440 containing rods of constant length, arranged in pairs in parallel and interconnected by cardan joints 450. Parallelograms 440 are connected at one end by respective levers 410, and at the other end are connected to a movable platform 430. This design allows you to maintain the spatial orientation of the robot mechanisms. In this case, the movable platform 430 is always parallel to the supporting platform 420.

The levers 410 are connected to the support platform 420 through the upper bearing assemblies 460 to provide the necessary angles for the initial state of the delta robot. The upper bearing assemblies 460 are mounted on a support platform 420. The levers 410 mounted on the upper bearing assemblies 460 at the connection centers form an equilateral triangle whose angles affect the size of the useful working area of the delta robot. For movements along the Z axis, levers 410 are responsible. Increasing the length of the lever 410, the stroke along the Z axis increases. The dimensions when moving along the X and Y axes are specified by parallelograms 440.

The drive mechanism of the controller, which drives the positioning unit of the controller, in particular, levers 410, can be made in the form of any known mechanism that provides a reduction in accuracy losses due to backlash during operation of the mechanism. In a preferred embodiment of the controller, the drive mechanism may be configured as a crank mechanism. It is driven by a ball screw transmission, performing rotational movements due to a servo drive with a built-in electromagnetic brake and an angle position sensor. Servo drive is an electromechanical device that performs dynamic movements with constant control of the angle of rotation of the shaft, and also provides the ability to control angular speeds in various actuators. Depending on the value of the control parameter received at the controlled input of the servo drive as a result of comparing this parameter with the value of the angle sensor (encoder) or with a mathematical model (the calculation algorithm is sewn into the memory of the frequency converter), the parameters of the electric drive are changed and some corrective action is taken for the servo motor (or series of actions), for example, rotation of the shaft, acceleration or deceleration, so that the value from the position sensor becomes as close as possible to the value of the external control parameter. The type of servo used can be any. In some embodiments, the controller uses an integrated servo.

In some embodiments of the controller, any known backlashless gearbox with zero mechanical backlash, for example, a backlashless precision gearbox, preferably a wave type or planetary gearbox with an angular backlash of less than 6 ’, can be used as a drive mechanism in some embodiments of the controller.

In a preferred embodiment, the drive mechanism includes a ball screw servo 510 and a crank mechanism. Depending on the pitch of the ball screw and the radius of the crank, you can increase or decrease the gear ratio of the drive mechanism.

On the cylindrical guides 570 between the movable platform 430 and the guide platform (not shown in the drawing), a strain platform 610 is installed and fixed, which is configured to receive digital information in three-dimensional space about the applied force, the vector of application of force and the acceleration of the application of force transmitted to the brush from the forearm and other upstream parts of the operator’s hand while operating the mechatronic complex. Strain gauge 610 is equipped with strain gauge sensors 600 to accurately and efficiently determine the forces applied by the operator, which are attached to the strain gauge via bearing assemblies 620. Strain gauges 600 convert the strain to an electrical signal.

The load cell 600 is connected on one side to the support bearing housing 620 by its movable end and, on the other hand, connected to the load platform 610 through the bearing assembly of the load platform 660. The load cells 600 are located on the load platform 610 and are coupled to each ball screw transmission, namely, ball screw shaft, through the bearing support units 620.

When there is effort on the part of the operator, the mechanical force exerted by the operator and transmitted from the forearm to the operator’s hand passes through the movable platform 430 of the hand controller along parallelogram rods 440 of equal length located in pairs parallel and connected by one end behind the crank mechanism. The crank mechanism, in turn, is connected to a ball screw transmission. In particular, the lever 410 is connected to the upper bearing assembly 460 and through a connecting rod to the lower bearing assembly. Thus, the rotational movements of the lever 410 are translated into translational movements of the guide platform, on which the lower bearing assemblies and the ball screw nut are mounted. The translational movements from the nut are transferred to the rotational movements of the ball screw shaft, which acts on the support bearing assembly 620. Therefore, through the ball screw transmission, the crank mechanism acts on the bearing-bearing assembly 620. The installed strain gauge 600 on the load platform 610 with its movable end connected to the housing of the support bearing 620. The strain gauge 600 converts the strain to an electrical signal and transfers it through its outputs to a digital controller control unit (not shown in the drawing).

The digital control unit of the controller, in turn, on the basis of the received signal according to a given program, calculates the trajectory of the delta robot along three linear coordinates and with the help of servo drives moves the positioning unit to the desired position. For example, the digital control unit can be configured to compare the obtained value of the deformation signal, and therefore of the movement, with a predetermined value that determines the position of the delta robot in equilibrium and supply such a control signal to the servo so that the value from the position sensor angles became as close as possible to the value of the external control parameter. Such a mechanism makes it possible to implement a mechanism of controlled counteraction to the natural lowering of the delta robot under the influence of gravity of the moving parts of the controller - the “virtual weight” system (UHV). UHV allows you to adjust the weight felt by a person on the control handle of the controller in the range from actual (100%) to 0% - “zero buoyancy”.

The “virtual weight” system multiplies the amount of force applied by the operator’s hand to the control handle of the controller, which allows you to individually select and always provide a comfortable and constant force for a person when acting on the controller, regardless of the size and weight of the parts that make up the controller.

The digital controller control unit is configured and constructed in such a way that it allows you to focus maximum efforts on high-level control algorithms, freeing the user from the need to develop and debug devices and applications for controlling individual servos. The digital controller control unit has the ability to record all control commands and transfer them to the numerical control system (CNC) of the assisting surgical complex, which can be performed on a computer basis.

Thus, the configuration of the hand controller allows you to move it with the operator’s hand in three linear coordinates, without spending significant forces on the operator’s hand, compensating for the lacking power by the operation of executive motors controlled by signals from the controller’s digital control unit to obtain the exact coordinates of the brush position from moving the forearm and other upstream , parts of the hand of the surgeon operator for at least three degrees of freedom, and compensation for the weight of the hand controller in static or during movement.

The wrist controller 3120 is attached to the movable platform of the brush controller (Fig. 4). The main purpose of the 3120 wrist controller is to make contact and interact with the wrist of the operator and provide at least two rotational degrees of freedom, both for realizing the orientation of the mechatronic complex element in response to the rotation of the wrist of the operator, and for transferring forces to the wrist of the operator when simulating one or another actions for operator training.

The wrist controller 3120 is configured to most accurately determine the angle of rotation of the wrist in two orthogonal directions relative to a given center of rotation (relative to the location of the wrist controller to the controller of the hand) to obtain digital information about the turns in the wrist of the operator during control of the mechatronic complex. The design of the wrist controller is limited and set by the physiological angle of the possible rotation of the wrist of the brush in these planes.

The wrist controller 3120 has at least two units: a rotation mechanism unit and a movable console unit, each of which provide two degrees of freedom of the wrist, and at least one control unit of the wrist controller.

The rotation mechanism block is mounted on the brush controller 3110 in such a way as to be able to rotate relative to the longitudinal axis of the brush controller, while providing one degree of freedom for the brush controller. The block structure of the movable console provides one degree of freedom relative to the block of the rotation mechanism.

The use of at least one sensor for determining the angle of rotation for each rotational degree of freedom allows you to determine the absolute position of the angle of inclination of the wrist controller. In some embodiments, in addition to the rotation sensors for determining the absolute position of an element included in the controller, these elements can be equipped with tachometers, acceleration meters and load force indicating elements, each of which can provide electrical signals related to speed, acceleration and force applied to the corresponding element.

To read data from the sensors for determining the angle of rotation and the rotation of the block of the movable console and / or block of the rotation mechanism, the brush controller includes drive elements.

To determine the coordinates of the surgeon’s wrist apparatus as part of the operator’s controller 3000 for controlling the mechatronic complex, the brush controller 3110 is used. The brush controller 3110 is designed to contact and interact with the surgeon’s brush and most precisely, controls at least one angle of rotation of the hand and movement, relative position of at least two fingers relative to each other, converting this information into a digital signal.

In addition, the brush controller 3110 provides a minimum weight load on the operator’s brush when controlling, has and implements a feedback channel from an element of a robotic technological complex or a control system as a whole.

The brush controller 3110 is characterized in that it comprises a handle with finger grips. The handle has a housing that is covered and held by the operator during operation. Finger grips are arranged to position the operator’s fingers on them during operation. The hand controller includes finger grip rotation sensors to determine the absolute position of the finger grips relative to the axis of rotation of the finger grips and a handle rotation sensor for determining the absolute position of the handle relative to its longitudinal axis, actuator elements of the handle and finger grips, and the wrist controller control unit.

If there is an effort on the part of the operator, the brush controller 3110 monitors and digitizes the deviation of the operator’s brush, as well as the position (approach / close / remove) of at least two fingers covering the handle of the brush controller with the operator’s brush in the area of finger grips.

When the handle is rotated by the operator’s hand, the handle rotation sensor generates a digital signal about the angle of rotation and transmits it to the control unit of the brush controller, which calculates the angle of deviation of the handle relative to its longitudinal axis and transmits this information to the digital control unit of the controller, which is capable of transmitting the received signals to a numerical control system (CNC) of an assisting surgical complex, which can be performed on a computer basis.

Finger tongs work in combination. In one embodiment, one finger grip is made integrally with the handle body and is stationary relative to it. Another finger grip is movable and has one rotation, rotating around its axis, coinciding with the longitudinal axis of the handle. During operation, the finger grip rotation sensor reads the rotation angle of the movable finger grip around its axis of rotation and transmits a digital signal to the brush controller control unit, which calculates its position relative to the fixed finger grip and transmits this information to the digital controller, which is capable of transmitting the received signals to a numerical control system (CNC) of an assisting surgical complex, which can be performed on a computer basis.

When efforts are made by the operator, the wrist controller monitors and digitizes the deviation of the wrist relative to the anteroposterior axis located in the sagittal plane (abduction or adduction of the hand, which is also sometimes called radial deviation of the hand), as well as the rotation of the wrist around a predetermined center, repeating the rotation of the radius with a brush around the ulnar bone relative to the longitudinal axis of the operator’s arm.

When the movable console unit deviates by the wrist of the operator from the anteroposterior axis lying in the sagittal plane, the rotation sensor of the movable console unit generates a digital signal about the angle of rotation and transmits it to the control unit of the wrist controller, which calculates the angle of deviation of the console and transfers this information to the digital control unit a controller that is configured to transmit the received signals to the numerical control system (CNC) of the assisting surgical complex, which can be performed on a computer basis.

When the rotation mechanism block is rotated around a predetermined center by the operator’s wrist, the rotation sensor of the rotation mechanism block generates a digital signal about the angle of rotation and transmits it to the control unit of the wrist controller, which calculates the angle of deviation of the block relative to the longitudinal axis of the operator’s hand and transmits this information to the digital control unit a controller that is configured to transmit the received signals to the numerical control system (CNC) of the assisting surgical complex, which can be performed on a computer basis.

Based on the obtained data, the digital control unit of the controller plans the rotation path of the handle and / or finger grips and / or the block of the rotation mechanism and / or the block of the mobile console and by supplying a control signal to the handle drive element and / or the finger gripper element and / or a drive element of the rotation mechanism block and / or the movable console block, moves the handle and / or finger grips and / or the rotation mechanism block and / or the movable console block and directly the wrist and / or wrist of the operator to the desired position.

The control units of the brush controller and / or the control of the wrist controller, the strain gauge platform, the digital controller control unit can be interfaced with the digital controller control unit via a common data bus. The digital controller control unit is configured to record data on received / transmitted commands. The digital control unit of the controller, in turn, through the common data bus is connected to the CNC system of the assisting surgical complex.

Thus, the digital controller control unit has the ability to repeat / demonstrate the movement of the recorded commands both in free mode and transmitting movements to the operator’s hand on the controller’s handle.

Data transmission tools are selected from devices designed to implement the communication process between different devices via wired and / or wireless communication, in particular, such devices can be: GSM modem, Wi-Fi transceiver, Bluetooth or BLE module, GPRS module, Glonass module, NFS, Ethernet, etc.

The operator's controller is used to control the manipulator with surgical instruments or the camera. Therefore, any movement of the hand or wrist or hand of the surgeon leads to the movement of manipulators or surgical instruments. The control signals from the digital control unit of the controller are fed to the CNC system of the assisting surgical complex, to the digital control unit of the positioning system of the manipulators and directly to the drive elements, the drive blocks of the manipulators to set them in motion.

Combined manipulator 4000 (Fig. 6), used in an assisting surgical complex, is a two-component spatial mechanism, or rather, an improved tripod design in combination with a portal mechanism of its linear movements over the working area. Such a hybrid kinematic scheme allows you to create a manipulator with the necessary mobility and the angle of rotation of the output link, on which the surgical instrument is finally installed.

In the general case, the combined manipulator 4000 includes a mechanism 4100 provided with drive elements 4200 (tripod or tripod type) and a portal mechanism for providing movement of the mechanism 4100 along two linear axes, equipped with drive units 4400. In this case, drive elements 4200 and drive units 4400 made with the possibility of transmitting data to the control system of the robotic surgical complex (CNC system of the assisting surgical complex) when moving elements or receiving control signals from the control system of the robotic surgical complex (from the CNC system of the assisting surgical complex) to move the output link of the manipulator to the desired position according to the calculated data.

Tripod 4100 consists of two platforms: a fixed support platform (base) 4110 and a movable platform 4120, which are interconnected by means of three rods 4130 of constant length.

Three rods 4130 are connected at one end through a bearing assembly to respective drive elements 4200, and the other ends of the rod 4130 are connected via hinges to a movable platform 4120. The rods 4130 are universal shafts, and the hinges in the preferred embodiment of the invention are cardan joints (Hooke hinges), which provide two degrees of freedom at the attachment point (two rotational degrees of freedom).

The tripod type mechanism 4100 is driven by the drive elements 4200. By controlling interconnectedly three drive elements 4200 according to a certain law, it is possible to carry out the movement of the manipulator tripod platform 4120 in space (two turns and one linear movement). The mobile platform 4120 tripod is its final link, therefore, is the output link of the tripod.

In some embodiments, the implementation of the manipulator, the drive element 4200 can be made in the form of any known mechanism that provides a reduction in accuracy losses due to backlash. For example, any known servo drive can be used as a drive element 4200 together with a backlashless gearbox with zero mechanical play, for example, a backlashless precision gearbox, preferably a wave type, or with a planetary gearbox with an angular play of less than 6 ’.

In a preferred embodiment, the drive element 4200 includes a dynamic and accurate synchronous ball screw servo. Depending on the pitch of the ball screw, the gear ratio of the drive element can be increased or decreased.

The design of the portal mechanism provides an additional two linear displacements for the tripod 4100 in space - longitudinal and transverse. The portal mechanism consists of a transverse movement module along which the tripod 4100 moves in the transverse direction and a longitudinal movement module along which a transverse movement module moves in the longitudinal direction. Module designs are located in parallel planes. Each of the modules is made in the form of a rectangular frame.

The drive unit 4400 of the portal mechanism can be made in the form of any known mechanism that provides a reduction in accuracy losses due to backlash during operation.

In a preferred embodiment of the manipulator, each of the linear axes of the portal mechanism is driven by an accurate synchronous servo drive 4410 in conjunction with a belt drive. The 4410 servo drive is paired with the 4411 precision planetary gearbox. It is needed to increase the motor torque and load capacity of the structure. As a gearbox 4411, any known gearbox with zero mechanical play can be used. A polyurethane toothed belt paired with toothed pulleys 4412 is used as a belt drive. These drive belts do not stretch due to the pressed cord, and thus are not subject to permanent deformation. The elongation caused by peripheral forces and pretension is extremely small. This solution is suitable for high power gears and providing the necessary accuracy.

The result is a manipulator, as a combination of a kinematic solution in the form of a tripod mechanism 4100 and a portal mechanism for its linear movements. Tripod has two rotational and one translational degrees of freedom. The forward movement (Z axis) is ensured by the synchronous operation of three servomotors in one direction. The tripod linear displacement mechanism provides an additional two degrees of freedom (along the X, Y axes).

Thus, the developed manipulator allows you to most accurately, with the maximum required angles of rotation, with the minimum weight and size of the structure, ensure the movement of the output link (mobile tripod platform) around the remote center of motion - point "0".

A surgical instrument 4500 is installed at the output link of the combined manipulator (Fig. 7), for example, made in the form of an end effector 4510 with branches and a drive 4550 for controlling the end effector of a surgical instrument. The drive 4550 is mounted on a platform of a surgical instrument (not shown not in the drawing), for the movement of which a separate drive element 4600 is provided along one linear axis.

The drive element 4600 can be made in the form of any known mechanism that provides a reduction in accuracy losses due to backlash during operation. In a preferred embodiment of the manipulator, the surgical instrument platform, together with the surgical instrument, is driven by a linearly accurate synchronous servo motor 4610 in conjunction with a belt drive. It provides an additional Z-axis stroke to the 4500 surgical instrument at times when movement along that axis due to the simultaneous operation of the 4210 servo motors of the 4100 tripod is insufficient, undesirable, or impossible.

To carry out the linear movement of the surgical instrument 4500 along the Z axis described above, a platform 4620 with a linear guide 4630 mounted on it along which a carriage (not shown in the drawing) with a surgical instrument platform mounted on it is rigidly connected to a movable tripod platform 4120 4500.

Such a kinematic scheme allows the instrument to be inserted into the patient’s body at point “0” (the entry point of the surgical instrument into the patient’s body) and, using the developed mathematical apparatus of the control system, to ensure the movement of the entire mechanism around this point.

When it becomes necessary to move the manipulator, the surgeon moves the “handle” of the operator’s control controller. A digital signal is generated and transmitted to the digital control unit of the controller, and then to the CNC system of the assisting surgical complex. The CNC system provides the transformation of the coordinates of all elements of the controller of the operator in the coordinates of the actuator (manipulator). It carries out the formation of drive control signals for each degree of mobility of the actuator so that its movement corresponds to the direction in which the operator-surgeon acted on the mechanism of the control controller, and it was intuitive for him. Possible movements of the combined manipulator are shown in Fig. 8.

Blocks of drives (drive elements) of the manipulator and surgical instrument are connected with the CNC system. They are interfaced via a common data bus. The CNC system is configured to record data on received commands. Data transmission tools are selected from devices designed to implement the communication process between different devices through wired and / or wireless communication, in particular, such devices can be: GSM modem, Wi-Fi transceiver, Bluetooth or BLE module, GPRS module, NFS, Ethernet etc.

Force assessment system.

To measure the forces acting on a surgical instrument during a robotic surgery, and to transmit information containing the results of measurements, the force assessment system is used in a complex. The system is an integral part of the actuator of the robot-assisted surgical complex and implements the measurement functionality for the implementation of the tactile feedback complex. The force assessment system used in the power feedback loop should have the following functions:

• Measurement of data applied to the tool forces using several multi-axis strain gauge sensors;

• Primary processing of data on the applied forces to ensure conditions for limiting the frequency characteristics of the signals in order to reduce the measurement noise and suppress the influence of electromagnetic interference;

• Transfer of processed data in real time to a higher-level control system using a wired or wireless communication interface.

In FIG. 9 is a schematic representation of a surgical instrument attachment structure. The attachment design is a support configured to position and secure the trocar thereon and secure the instrument by securing the instrument drive. For accurate positioning of the instrument, a trocar holder is used in the attachment structure. In FIG. 9 figures indicate the following structural elements: 5100 - three-axis strain gauge (upper strain gauge); 5200 - three-axis strain gauge sensor (lower strain gauge); 5300 - holder of a trocar. The accepted symbols in FIG. 9: O1 - the point of entry of the trocar into the patient’s body, around which two turns of the instrument introduced into the trocar during the operation are performed (zero point), the point is inside the trocar, A is the position of the end of the surgical instrument that is inserted into the patient’s body, B is the position of the opposite the end of the surgical instrument installed in the drive of the surgical instrument. Orientation angles (rotation angles) of the surgical instrument in the horizontal plane and tilt are considered relative points of rotation (zero point). The zero point O1 is defined as the origin.

The mechanical interaction of the tool elements, the mounting design of the surgical instrument and the manipulator elements is realized through two multi-axis strain gauge sensors, one of which is located at one end of the instrument under the drive of the instrument, and the other at the fastening point of the trocar. The location of the strain gauges is shown in Fig.9.

This arrangement of strain gauges has the following advantages:

• Physical distance of the sensitive elements of the sensors from the zone of interference of electrocoagulation;

• Provides the ability to use various tools without changing their design;

• Allows you to evaluate forces on several degrees of freedom.

As multiaxial strain gauge sensors, bend sensors based on strain gages, capacitive strain gauges or sensors of any other operating principle can be used, which make it possible to measure the force applied to them.

In a preferred embodiment of the invention, strain gauges with a sensing element in the form of a strain gauge can be used as strain gauge sensors. Sensors of this type have a high output resistance, and the signal has low power, which limits its distribution in space.

The design allows you to implement the following features:

• Evaluate the forces acting on the tool in at least five degrees of freedom using two three-axis strain gauge sensors (three linear degrees of freedom along the X, Y, Z axes and rotational moments around the X and Y axes);

• Evaluate the gripping force (compression force), controlling one degree of freedom (degree of freedom during gripping, compression of the executive surfaces of the surgical instrument);

• Evaluate the rotational / torsional force acting on the tool (three rotational degrees of freedom around the axes X, Y, Z);

• When assessing forces, take into account forces arising at the site of contact of the trocar with the patient’s body;

• Ensure sufficient reliability of the data on the efforts in the conditions of electromagnetic interference created by electrocoagulation.

During operation, the executive surfaces located at the end of the instrument inserted into the patient’s body (the executive part of the instrument) perform complex movements initiated and controlled by the surgeon. When resistance occurs to the movement of the executive part of the instrument or when the parts of the instrument come into contact with the patient’s tissue, a bending of the sensing element of the strain gauge along the corresponding axis occurs. Since the instrument, located in the mounting structure of the surgical instrument, is in contact with the manipulator at two points, one of which is the location area of the trocar, and the other is the location area of the surgical instrument’s drive, efforts are measured at both points and further joint processing of these signals.

The outputs of the strain gauge sensors are connected directly to the digital processing modules, which amplify the signals and convert them to digital form. Digital processing modules can be located directly next to strain gauges. The specified location is optional and can be changed if necessary, for example, when using strain gauges with a signal amplification board. However, the location of the digital signal processing module of the strain gauge sensors in close proximity to each used strain gauge sensor is preferred, since a high signal-to-noise ratio and resistance to external electromagnetic disturbances are provided.

To measure the force of capture / compression on the Executive surfaces of a surgical instrument, for example, jaws, current sensors can be used for engines that implement capture / compression. The principle of measuring the compression force is to increase the current consumption of the motors when resistance to the movement of the exciting elements of the tool structure occurs. Compression motors are part of the surgical instrument drive.

To measure the rotational moment around the Z axis, an electric motor current sensor can be used to ensure rotation around this axis. The principle of measuring torque is to increase the current consumed by the electric motor when resistance to movement occurs. Engines that rotate around the Z axis are part of the surgical instrument drive.

In a preferred embodiment of the invention, electric motors (electric motors) are used as motors. Each of the current sensors of the surgical drive motors can be connected to an electric motor control system.

Digital processing modules and motor control systems are connected to the processing module via a data bus. The data bus may be an RS485, CAN, Bluetooth, or some other wired or wireless data interface. The processing module is designed for group processing and synchronization of signals from strain gauges, a torque sensor and a gripping force sensor. Using a separate device as a processing module is optional. It can be combined with any digital processing module or with a control system. The control system (CNC system of the assisting surgical complex) uses the data received from the processing module to further organize feedback and transmit signals to the surgeon. The architecture of the force assessment system is shown in FIG. 10.

Data from the data processing module is sent to the control system of the robotic surgical complex (CNC system of the assisting surgical complex) and transmitted to the digital control unit of the surgeon's controller.

The surgeon holds the controller in his hands and, moving it, generates a digital signal, with the help of which the tool is controlled through the robot-complex complex control system and the manipulator. When the instrument comes into contact with the patient’s tissues or trocar, forces appear that act on the instrument. The force assessment system determines these forces, converts the information into a digital signal, which is transmitted through the control system of the robotic surgical complex in the reverse order to the surgeon's controller. The surgeon's controller is designed in such a way that it receives these signals and converts them into mechanical movements of the controller in the direction opposite to the movements of the surgeon's hand controlling the tool.

The resulting resistance creates a feeling on the hand, as if it was touching the tissues. The movement of the instrument that is intuitive and coincides with the movements of the hand, as well as the tactile touch of the tissue with the instrument, makes the surgeon feel that he is holding the instrument directly in his hand during surgery on a robotic surgical complex.

Positioning system by manipulators.

The positioning system of the manipulators secures the manipulators to the operating table and increases the number of possible positions of the manipulator relative to the patient, and, in addition, allows the manipulators to be removed from the operating area as soon as possible in an automated or manual mode.

The mounting mechanism (see Fig. 11) of the positioning system of the manipulators to the surgical table, in general, consists of two aprons 6007, each of which has the ability to be attached to the side of the surgical table in a removable manner so that on the opposite sides of the table there is one apron 6007 (further the description of the system design is in relation to one of the aprons, while the design of the second apron and its systems is identical).

In general, at least one guitar 6006 can be installed on one apron 6007, and on it at least one telescopic vertical column 6008, each of which has its own positioning arm (positioning mechanism) with a fixed manipulator (not shown in the drawing). In FIG. 11 shows an example with a single column 6008 and, accordingly, with one arm positioning. A detailed description of the above elements is given below.

On the apron 6007, rails 6011 are fixed vertically relative to the table, which are used to withdraw the manipulators from the storage area to the working area and along which the horizontal element 6006 moves vertically, which will be called the “guitar” 6006 in the application materials.

The guitar 6006 is attached to the installation platform on one side and provided with rails 6012 on the other. Installation platform 6022 is connected to the respective carriages mounted on the rails 6001 of the apron 6007. The installation platform can be moved along the rails 6011 of the 6007 apron under the influence of any type of drive (electric, hydraulic, pneumatic, etc.). The drive of FIG. 11 is not shown. Guides 6012 guitars 6006 installed throughout the length of the guitar 6006.

At least one vertical column 6008 is located on the guitar 6006 and is horizontally movable along the guitar 6006. The vertical column 6008 is a telescopic two-component stand. Moreover, the components of the rack are identical and symmetrical. The component oriented towards the guitar 6006 is the inside of the vertical column 6008, and the component oriented away from the surgical table is the front side of the vertical column. Each side is provided with guides extending along the entire length of the vertical column 6008, and drive mechanisms in the form of a ball screw 6013 with a drive 6009. On the inner side of the column 6008, there are single guides, and on the front side of the column 6008 rails 6016 are installed.

A vertical column 6008 is connected to a guitar 6006 as follows. On guides 6012 of the guitar 6006, carriages 6010 are installed. On carriages 6010, a connecting module 6015 is installed that performs the function of moving the positioning system along the surgical table. The 6015 connection module consists of two parts, which together form a reliable, rigid quick coupler. Coupling module 6015 is mounted on one side to carriages 6010, and on the other side of coupling module 6015, carriages 6014 are mounted on it. Carriages 6014 are included in the rails, which in turn are mounted on the inside of the vertical column 6008. The vertical column 6008 moves horizontally in one the whole with the connecting module 6015 along the guides 6012 of the guitar 6006 under the influence of a drive mechanism made in the form of a drive 6009 and a ball screw transmission (ball screw) 6013 located on the guitar.

On a vertical column 6008, a positioning mechanism on a serial structure, which consists of two consoles and a rotary platform 6003 for fastening and positioning the manipulator 6018, is fixed by means of a connecting element 6004 (see FIG. 12). A connecting member 6004 is attached via guides 6016 on the front of the column 6008 in such a way that it forms a kinematic pair with a positioning mechanism on a sequential structure. At the same time, several independent actuators with position sensors are located in the joint of element 6004 and console 6002, and several independent actuators with position sensors are also located in the joint of console 6002 and console 6005. The listed drives form a drive unit 6017. An independent drive with position sensors is also located at the junction of the console 6005 and platform 6003. The connecting element 6004, thanks to the carriages, has the ability to make vertical translational movements along the rails 6016 on the front side of the vertical columns 6008, and the column 6008 itself is able to move vertically along the connecting module 6015 along the rails. Movements can be performed jointly or alternately.

The positioning mechanism of the manipulator moves in the plane of the surgical table, turning relative to the connecting element. The pivoting consoles 6002 and 6005 are rotatable in a horizontal plane so that the console 6002, being above the surface of the surgical table in the working position, makes a full rotation of 360 degrees and has the possibility of limited rotation below the table surface in an idle state. On the indicated console 6005, a mounting and positioning unit 6003 of the manipulator 6018 with a surgical instrument is mounted, made with the possibility of rotation around its axis to bring the manipulator 6018 to its working position (see Fig. 12).

The drive mechanisms can be made in the form of any known mechanism that provides linear displacements and provides a reduction in accuracy losses due to backlash. In a preferred embodiment, the positioning systems of the manipulators for all the above-described movements along the guides are responsible for ball screw gears (ballscrews) 6013, which drive the servomotors 6009, each of which is connected to its gear.

As a drive unit 6017, a servo drive is used together with any known gearboxes with zero mechanical play, for example, backlashless planetary gearboxes. Such drive mechanisms used on rotary axes in the design of the mechanism provide high precision positioning of the manipulators.

The set of movements of the entire mechanism provides the necessary movement of the positioning system along the vertical plane of the lateral surface of the surgical table and returns the manipulators to the storage area.

The advantage of this design is the provision of linear movements along the lateral surface of the surgical table, the implementation of the necessary volume of movement for positioning the manipulator, and the creation of a rigid skeleton structure to achieve high accuracy. This arrangement of linear displacements provides a large coverage of the surgical field, while it has a more compact overall dimension of the entire positioning mechanism.

Camera compensation system.

In one of the manipulators of the assisting surgical complex, a camera is fixed to monitor the surgical field during the surgical operation. The image of the operated area, broadcast by a stereoscopic camera, is available to the surgeon on the monitor of the visualization system.

The camera is widely defined in this application as any device structurally configured with the possibility of forming a stereo image, being inserted into the patient’s body. The image of the surgical field can be obtained optically using fiber optics, lenses and miniaturized imaging systems, for example, using a video endoscope (hereinafter referred to as the endoscope).

The camera is introduced into the body through an opening in the patient's body. The entry point / plane is defined as a “zero point”, since all movements of the instrument or camera in the patient’s body are provided with two rotational degrees of freedom relative to this point and one linear degree of freedom. At the “zero point” is a trocar for additional fixation of instruments and the camera. There is also a “camera zero point” in the local coordinate system of the camera, with respect to which the camera position vector changes with the beginning at the “zero point” and with the end coinciding with the actual position of the camera end. The camera has a field of view, depending on the characteristics of the camera lens. The camera transmits an image of only that part of the surgical field that fell into the field of view.

The field of view of the camera may have an area configured to be visible by the camera at any given time.

When the camera moves, the area of the field of view moves with the camera, which allows you to visually examine the operating area. The change in the scope also depends on the features of the camera’s movement. In this case, the surgeon should be guaranteed unambiguity in understanding the movement of the camera and the associated movement / change in the field of view within the surgical field.

The automatic control system (CNC system of the assisting surgical complex) is configured to implement camera movement compensation, namely, to implement a method for controlling the movement of the camera manipulator, which is part of a robotic surgical system, to reduce the number of movements of a stereo camera visualizing the surgical area in the surgical field.

Detailed steps of the claimed method are presented below.

и трех вращательных координат

.The local coordinate system associated with the control controller contains information about the position of the controller in the form of three translational Cartesian coordinates

and three rotational coordinates

.

От левого контроллера хирурга в систему автоматического управления передаются вектора

From the right controller of the surgeon (operator controller) to the automatic control system are transmitted vectors

From the left controller of the surgeon, vectors are transferred to the automatic control system

обнуляются: When the camera manipulator pedal is pressed, the camera control mode is turned on, the signal from the pedal is transmitted not only to the automatic control system, but also to controllers that block the rotational degrees of freedom, and the vectors

reset to zero:

. Three translational degrees of freedom described by a vector are enough to control a chamber manipulator

.

The vectors obtained by the automatic control system are processed using an algorithm for differentiating and combining motion. The control is carried out using the relative movement of the controller from the moment the camera control starts, initialized by pressing the pedal. Thus, the flexibility of the control system is increased.

The camera is controlled by both controllers simultaneously. Thus, the relative displacement of each of the controllers is summarized below:

можно масштабировать, инвертировать, вращать вокруг ортогональных осей, составлять композиции поворотов. Любую из перечисленных математических операций можно осуществить при помощи векторного произведения.Received Vector

You can scale, invert, rotate around the orthogonal axes, make up the composition of the turns. Any of the above mathematical operations can be carried out using a vector product.

и строки

, содержащей коэффициенты масштабирования для каждой координаты.Then carry out scaling. Scaling is a vector product

and lines

containing the scaling factors for each coordinate.

The scaling operation takes place in the scaling and integration unit. The scaled increment of the surgeon's controller signals obtained at the previous stage is added to the current position of the chamber manipulator in its local Cartesian coordinate system.

Thus, the calculated position of the chamber manipulator in the local Cartesian coordinate system enters the motion compensation block in the plane.

To control the manipulator, it is necessary to translate the calculated Cartesian coordinates into spherical. In this regard, the operations of translating vectors from one coordinate system to another are important. The translation from the Cartesian to the spherical coordinate system is carried out by the following algebraic transformations:

и

. Расхождение средней линии кадра с линией горизонта вычисляется в блоке компенсации горизонта согласно формуле:In addition to the algorithm for compensating the movement of the manipulator in the plane, it is also necessary to implement an algorithm for comparing the horizon line with the center line of the frame, which consists in calculating the angle of difference between the horizon line and the center line of the frame, depending on the tilt angles

and

. The discrepancy of the midline of the frame with the horizon line is calculated in the horizon compensation block according to the formula:

At the final stage of the method, the obtained data is simultaneously transmitted to the motion control unit of the manipulator with a camera mounted on it, for its movement inside the patient in order to display the surgical field. At the same time, the manipulator with the camera performs both translational movements to compensate for the movement of the camera and controllers, and rotates around its longitudinal axis to level the horizon line and the midline of the frame of the image received from the camera. The above steps of the proposed method, carried out using an automatic control system for the camera manipulator, are described according to the block diagram shown in figure 13.

First, data about the movement of the right and left surgeon controllers is obtained. In the next step, it is determined whether the signal from the pedal has been received. In the event that the signal from the pedal that switches the controllers to the camera control mode is input to the automatic control system, a signal is triggered about the start of the automatic control system of the camera manipulator.

At the next stage, the actual data received from the controller are fed sequentially to the computing unit of the derivatives for the right and left controllers, the increment of which is the total movement.

At the next stage, this movement is necessarily scaled taking into account the distance of the endoscope from the zero point.

,

, на основе которых на следующем этапе вычисляют величину компенсации линии горизонта

. Полученный набор данных

,

передают на манипулятор камеры. После чего этапы повторяют.Next, the obtained increment is integrated with the position of the manipulator in its Cartesian coordinate system. This compensated movement plane is translated into spherical coordinates of the manipulator

,

on the basis of which at the next stage the horizon line compensation value is calculated

. The resulting dataset

,

transmit to the camera manipulator. Then the steps are repeated.

The proposed method for controlling the movement of the camera adds an intuitive interaction with the robotic complex and increases the efficiency of the robotic surgery.

An example implementation of an assisting surgical complex.

An experimental robotic surgery on an animal was performed - nephrectomy. A video was taken of the workplace of the surgeon operator to track the location of the hands at various stages of the operation for subsequent analysis of the convenience of control and interaction. The optimal landing of the operator-surgeon for the control console was made in such a way that excludes the possibility of placing hands in anatomically unnatural poses, which lead to increased fatigue.

The design of the control controller allows movement and rotation along predetermined axes, while ensuring the maximum amplitude of movement in the surgeon's working area. The work area does not hinder the surgeon's movements, design features allow, if necessary, to use the entire space limited by the width of the scope of the hands, in depth - the length of the hands, in height - the distance to the knees.

Ergonomically advantageous solutions, such as maximizing the use of space above the surgeon’s knees and the absence of protruding structural elements, preventing possible collisions, guarantee ease of use, which is an important factor for long-term operations.

The six degrees of freedom of the controller that are implemented make it possible to fully realize the minimum necessary surgical operations for carrying out a robotic surgery — tissue grabbing, resection, suturing. The interaction of the surgeon with the controller when performing a nephrectomy on a pig is shown in Fig. 14.

After surgery, it was revealed that:

• the surgeon did not have to make additional efforts to perform surgical procedures;

• the surgeon’s working field was not limited by the controller design - all necessary movements and rotations were carried out with maximum amplitude;

• ergonomic design has reduced fatigue and fatigue compared to peers during long-term operations;

• the proposed controller design increased the convenience of controlling the robotic surgical complex in comparison with analogues;

• more than 50% of the time the surgeon’s wrists are in the position shown in Fig. 15.

Although the present patent application relates to what is defined in the appended claims, it is important to note that this patent application contains the basis for the wording of other inventions that may, for example, be claimed as an object of the amended claims of the present application or as an object of the claims in the highlighted and / or a continuing application. Such an object may be characterized by any feature or combination of features described herein.

Claims (41)

1. Assisting surgical complex for performing highly accurate minimally invasive surgical operations, containing executive console of the patient, which includes at least one combined manipulator with a surgical instrument mounted thereon for performing a surgical operation, at least one camera manipulator with a camera fixed to it for viewing the surgical field, ensuring its movement along three translational degrees of freedom; at least one manipulator positioning system mounted on at least one longitudinal side of the surgical table and configured to store at least one manipulator under the surgical table in the idle position and automatically independently extend and move each of the manipulators in a given area of the operating area in the working position , means for calculating and evaluating the forces acting on the distal end of the surgical instrument, and the forces acting on other working parts of the surgical instrument, operator input console, which includes at least one operator controller for controlling the movement of a surgical instrument mounted on the specified combination manipulator, configured to provide independent seven degrees of freedom when appropriate control forces and / or movements from the side of the operator’s hand occur to rotate and / or move the controller by the operator’s hand, while the operator’s controller is configured to switch to camera control mode using the control pedal; a digital control unit for the operator’s controller, which for each degree of mobility of the operator’s controller generates an operator’s hand signal and converts it into a control signal for subsequent control of the combined manipulator and / or surgical instrument and / or camera manipulator, a numerical control system for an assisting surgical complex associated with at least one combined manipulator, a camera manipulator, means for calculating and evaluating forces, a positioning system for manipulators, and a digital controller control unit, made with the possibility of simultaneous and independent control of all elements of the complex as a whole, and for generating control signals characterizing the force action for each degree of mobility of the surgical instrument and / or the effect calculated on the basis of a given model, and transmitting these signals to the digital control unit of the operator controller to convert them into mechanical movements of the operator controller elements, moreover, the combined manipulator includes a mechanism provided with drive elements and made in the form of interconnected by three rods of a fixed support platform and a movable platform, the movable platform of the mechanism is made with the possibility of placing a surgical instrument on it, and a portal mechanism made in the form of a transverse movement module and a longitudinal movement module, each of which is equipped with a drive unit, while the drive elements and drive units are configured to transmit and / or receive data from the numerical control system of the assisting surgical complex, wherein the mechanism is mounted on the lateral movement module with the possibility of moving along it in the transverse direction, and the lateral movement module is mounted on the longitudinal movement module with the possibility of moving along it in the longitudinal direction; moreover, all elements of the positioning system are equipped with servo drives and controllers, configured to receive and transmit control commands from the numerical control system of the assisting surgical complex to perform elements of the system of coordinated movements, moreover, means for calculating and evaluating forces include - a three-axis lower strain gauge located on the support of the manipulator in the place of attachment of the trocar and in direct contact with it, to measure the forces applied to the tool and directed along the x and y axes, - a three-axis upper strain gauge located on the support of the manipulator under the drive of the surgical instrument, for measuring the force applied to the instrument and directed along the z axis, - a sensor of the gripping force of the executive surfaces of the tool, made in the form of a current sensor for the electric drive of the tool, providing compression of the Executive surfaces of the tool - a torque sensor of a surgical instrument, made in the form of a current sensor for an electric drive of the instrument, providing rotation of the surgical instrument around its longitudinal axis, moreover, the strain gauge sensors are connected to the respective digital data processing modules, and the pickup force sensor and the torque sensor are connected to the respective motor control systems, digital processing modules and electric motor control systems are connected to a processing module that is programmed to carry out calculations by group processing and synchronizing signals from strain gauge sensors, a torque sensor and a gripping force sensor: - forces directed along linear axes, - rotational moments of the instrument along the x and y axes relative to the point of entry of the trocar into the patient’s body, - the torque of the tool along the z axis relative to the entry point of the trocar into the patient’s body, - efforts to compress the Executive surfaces of the tool, a processing module is configured to transmit data to a numerical control system of an assisting surgical complex, moreover, the operator controller includes a delta robot, driven by a drive mechanism, each link of which is made in the form of a crank mechanism, driven by a servo-drive with a ball screw; a strain gauge installed between the movable platform and the fixed support platform of the delta robot, and strain gauges associated with each ball screw transmission are located on the tensile platform; at the same time, a control handle is attached to the movable platform with the possibility of its coverage by the operator’s hand and configured to control and convert into a digital signal of the movement of the operator’s hand with at least three rotational degrees of freedom and force impact on the tensile platform in three linear degrees of freedom, at the same time, the signal formed on the load cells is transmitted to the digital control unit of the controller, which calculates and transmits to the servo drive of the corresponding link of the drive mechanism commands for weight compensation and / or movement along the planned path calculated on the basis of the received data, moreover, the system of numerical control of the assisting surgical complex is made with the possibility of motion compensation when controlling the movement of the camera. 2. The complex according to claim 1, characterized in that the control handle of the operator controller includes a wrist controller that provides two rotational degrees of freedom in orthogonal planes, and a brush controller that provides two other rotational degrees of freedom. 3. The complex according to claim 2, characterized in that the brush controller is equipped with a handle and finger grips. 4. The complex according to claim 3, characterized in that at least one drive element and a rotation sensor are installed inside the handle of the brush controller. 5. The complex according to claim 2, characterized in that the wrist controller is equipped with at least one drive element and a rotation sensor. 6. The complex according to claim 1, characterized in that at least one manipulator in the inoperative position is located under the surgical table in the part for the location of the legs.

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