CN101443162B - 用于实施微创医疗手术的机器人手术系统 - Google Patents

用于实施微创医疗手术的机器人手术系统 Download PDF

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CN101443162B
CN101443162B CN2007800117390A CN200780011739A CN101443162B CN 101443162 B CN101443162 B CN 101443162B CN 2007800117390 A CN2007800117390 A CN 2007800117390A CN 200780011739 A CN200780011739 A CN 200780011739A CN 101443162 B CN101443162 B CN 101443162B
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伊米莉奥·鲁伊斯莫拉莱斯
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    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25J—MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J9/00—Programme-controlled manipulators
    • B25J9/02—Programme-controlled manipulators characterised by movement of the arms, e.g. cartesian coordinate type
    • B25J9/04—Programme-controlled manipulators characterised by movement of the arms, e.g. cartesian coordinate type by rotating at least one arm, excluding the head movement itself, e.g. cylindrical coordinate type or polar coordinate type
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25J—MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J9/00—Programme-controlled manipulators
    • B25J9/02—Programme-controlled manipulators characterised by movement of the arms, e.g. cartesian coordinate type
    • B25J9/04—Programme-controlled manipulators characterised by movement of the arms, e.g. cartesian coordinate type by rotating at least one arm, excluding the head movement itself, e.g. cylindrical coordinate type or polar coordinate type
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/71—Manipulators operated by drive cable mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

Abstract

一种用于实施微创医疗手术的机器人手术系统(10)，该系统包括用于腹腔镜器械(18)的机器人操作器(14)。所述操作器具有操作器的臂部(26)，由臂部支撑的操作器腕部(28)及由腕部支撑的效应器单元(30)。所述操作器的臂部提供三个自由度(DOF)用于定位所述腕部。所述腕部提供两个DOF。所述效应器单元(30)包括腹腔镜器械作动器(LIA：120、1120)并通过转动的第六关节(J6)提供一个自由度，用于设置LIA的滚动角。所述LIA包括用于将器械杆适配器(300、1300)装配到所述效应器单元上的底座(130、1130)，以及与所述器械杆适配器配合的用于作动连接在所述适配器上的腹腔镜器械的驱动机构(400、1400)。所述效应器单元包括6DOF的力/扭矩传感器和6DOF的加速度计。

Description

用于实施微创医疗手术的机器人手术系统
技术领域
本发明涉及医疗设备领域并且更具体地涉及用于实施微创医疗手术、特别是腹腔镜手术的机器人手术系统。
背景技术
众所周知，不同于剖腹手术，微创医疗手术具有在诊断或外科手术过程中减少外部组织损伤的优点。该优点产生较短的患者恢复周期、更少的不舒适及有害副作用，以及更少住院费用。目前，在普通外科、泌尿科、妇科及心脏科，由诸如腹腔镜手术的微创技术完成的手术操作的数量有所上涨。
然而，一般的微创技术并且特别是腹腔镜手术确实对外科医生实施手术提出了更高的要求。外科医生以不舒适且易疲劳的姿势、有限的视野、受限制的运动自由度及差的触觉感受进行操作。对于这些问题增加了一个事实，即外科医生经常必须每天完成几个连续介入手术，每个介入手术持续例如从30分钟到几个小时。尽管有这些困难，由于人口老龄化及医疗领域花费的压力，微创手术的趋势大概将在未来几年显著增加。
在腹腔镜手术中，显然要求外科医生的动作与在剖腹手术中一样精确。用在器械入口端的支点、即在患者体内的切口处周围减少到四个自由度的运动自由度操作长杆器械不会减轻该任务。所需姿势相当容易疲劳并且减少了已被限制的对器械和组织间作用力的感知这一事实尤其会引发并发症。例如，当外科医生站在患者旁边时，他必须举起并保持伸长他的一个手臂以保持在患者另一侧插入的器械。结果，通常20-30分钟后外科医生的活动能力衰减了，从而除此之外还出现发抖、缺乏精确性并缺乏触觉感知，导致对患者产生危险。因而，出现了诸如机器人辅助腹腔镜手术的新技术，它们的目标在于提高介入手术的效率、质量及安全性。
鉴于上述情况，机器人辅助的腹腔镜手术自从九十年代早期已显著发展。两种代表性的可商业获得的医疗机器人系统为：由加利福利亚的桑尼维尔市的Intuitive Surgical有限公司开发的商标名为“DA VINCI”的手术系统，及最初由加利福利亚的戈拉塔市的Computer Motion有限公司开发的商标名为“ZEUS”的手术系统。除此之外，名为“DA VINCI”的手术系统已被Moll等人公开在US6659939、US6837883及其他具有相同受让人的专利文件中。名为“ZEUS”的手术系统已被Wang等人公开在US6102850、US5855583、US5762458、US5515478及其他属于加利福利亚的Goleta的Computer Motion有限公司的专利文件中。
使用控制台上的可视反馈，这些远程操作的机器人系统允许从手术室直接或从远处控制手术插入。在其他情形中，消除了外科医生易疲劳的姿势。
这两种系统均为心脏手术专门设计，其中拓扑解剖恒定，工作空间小，并且因而仅在有限空间内要求准确的器械移动及灵敏性。为了提高在该有限空间内的能达到性及灵敏性，已经设计了大量在器械尖端提供一个或多个附加自由度的特定专用器械，分别用于这些系统。关于这些专用的复杂器械，它们的高购买费用及由于消毒引起的短寿命增加了整体维护费用。根据有经验的腹腔镜手术医生，有关节的器械对大部分手术来说不是必须的，并且标准器械的使用将带来，除其他外，维护费用的明显降低。
发明内容
因此，在此提出的本发明的一个目的在于提供一种用于实施微创医疗手术的机器人手术系统，其包括机器人操作器，该操作器构造为使其允许使用为传统人工手术设计的可获得标准腹腔镜器械。
为了实现该目的，如下文所公开的，提供了一种用于实施微创医疗手术的机器人手术系统，其包括机器人操作器，用于机器人辅助操作腹腔镜器械，机器人操作器具有操作器臂部、由操作器臂部支撑的操作器腕部及由操作器腕部支撑的效应器单元。依照本发明一个方面，操作器臂部通过第一关节、第二关节及第三关节提供三个自由度，每个关节具有相关联的作动器用于机械地定位腕部。操作器腕部通过第四关节和第五关节提供两个自由度，第四和第五关节为转动关节并且具有相关联的作动器用于分别相对于操作器臂部机器人地设置效应器单元的偏航角及俯仰角。效应器单元包括腹腔镜手术器械作动器并通过转动的第六关节提供一个自由度，该第六关节具有相关联的作动器用于机械地设置腹腔镜手术器械作动器的滚动角。换句话说，作动的第六转动关节不仅允许旋转器械，还旋转效应器的整个器械作动器部分。此外，依照本发明另一方面，腹腔镜手术器械作动器包括一个底座，具有相关的耦合或锁定机构用于将器械杆适配器装配到效应器单元上，以及与器械杆适配器配合的作动机构用于作动连接在适配器上的腹腔镜器械，优选地通过线性驱动。效应器单元构造为使转动的第六关节的旋转轴与腹腔镜手术器械的纵轴一致，腹腔镜手术器械通过器械杆适配器装配在效应器单元上，且效应器单元包括具有6个自由度(DOF)的力/扭矩传感器及6个自由度的加速度计的传感器组件。该传感器组件将腹腔镜手术器械作动器机械地连接到第六转动的关节上。换句话说，传感器组件布置在腹腔镜器械作动器及第六转动关节的驱动侧之间，使得其和腹腔镜器械作动器一起旋转。这首先适合人工操作模式，其中使用传感器组件作为输入设备控制作动机器人操作器的六个关节而手动定位并定向整个腹腔镜手术器械作动器。
由于机器人地作动的6个自由度用于操作器械，机器人操作器在装配的腹腔镜手术器械上提供可以与外科医生的手相比的一定程度的灵活性，而不需要任何多余关节。通过设计作为器械杆适配器的底座和耦合机构，腹腔镜器械作动器提供通用接口用于各种设计用于手动腹腔镜手术的现有标准型腹腔镜手术器械。另外，传感器组件，布置在机器人操作器连接的器械和第六关节之间，在外科医生控制台上的触摸界面上提供精确的力反馈从而向外科医生提供相应于器械的手工操作的知觉感知。将会意识到的是，使用线性和角加速度计以补偿对力-扭矩传感器的重力和加速度影响。这些特征允许将相对不贵的标准型器械(例如抓取器、解剖器、剪刀、凝结器、夹子、填充器、持针器、电手术刀、吸引/冲洗器械等等)可使用在在此描述的机器人操作器上。
将会意识到的是，该系统用最少数目的关节提供所需要的灵活性，即仅用6个关节提供6个自由度。不提供其他多余关节。特别地，不需要具有铰接的器械末端的特殊器械。另外，所有关节是作动关节就是说在机器人操作器中不存在被动或自由旋转关节，借此显著改善了机器人控制。通常在现有系统中使用的用于避免套管应力的多余被动关节的消除，除了别的以外，是通过在第六关节和腹腔镜手术器械作动器之间的接口处提供传感器组件而实现的。传感器组件的这种布置使力的测量和约束限制不仅在器械尖端的水平而且在套管针的水平。事实上，将发现的另外一个特性，其中腕部和效应器单元的关节为全旋转，即在这些部分不提供棱柱关节。
许多现有医疗机器人系统缺乏力反馈因而使外科医生不能感知施加在患者组织上的力。因此，外科医生只能依赖于他移动的视觉反馈以限制器械在组织中的插入。事实上，在使用机器人用于外科腹腔镜手术时，力反馈明显有利于提高安全性。此外，触觉感受与触诊器官有关，用于使用非内窥镜领域的一个器械固定粘滞性器官，用于施加适当张力至缝合处并避免线断裂，用于检测施加到器官的多余外力并因而停止或限制移动，用于限制施加到套管切口上的力等等。在由B.Kübler，U.Seibold和G.Hirzinger于2004年10月8-9日在德国慕尼黑的Jahrestagung der DeutschenGesellschaft für Computer-und Roboterassistierte Chirurgie(CURAC)上提出的“Development of actuated and sensor integrated forceps for minimally invasiverobotic surgery”；已经介绍了安装在在器械尖端的小型化6DOF力/扭矩传感器。这个概念有一些缺点，其中包括增加器械成本、缺乏消毒强度以及在与电动器械一起使用时的EMI防护问题。不能由安装在器械杆上的传感器处理的另外一个问题是测量施加到形成患者切口处的工具入口的套管针上的外力。事实上，这些力磨损切口并使套管针的连接变松。因此有时在介入手术期间套管针意外地从切口拉出。众所周知，这种事故除了有害于患者组织外还导致腹腔气压的缺失并且由于需要恢复该情况因而增加了介入手术时间。借助于在效应器单元上的力/扭矩传感器，可实现用于避免套管针脱离的自动过程。
在R.Bauernschmitt，E.U.Schirmbeck等于2005年9月发表在Int.J.Medical Robotics and Computer assisted Surgery的文章“Towards robotic heartsurgery：Introduction of autonomuous procedures into an experimental surgicaltelemanipulator system”中，(可从www.roboticpublications.com获得)，作者认为缺少力传感及力反馈能力是目前可获得系统的主要缺陷。该文章中公开的系统包括工业机器人，从Intuitive Surgical有限公司获得的设计用于“DA VINCI”系统的器械装配在该机器人上。为了提供力感测，改变了该器械。其在器械杆上靠近远端处装配有变形测量器传感器。该系统，与当前公开的系统相反，仅允许在垂直于器械轴的平面测量力并要求使用昂贵的设计用于机器人系统的并且在远端提供另外三个自由度的专用器械。
另一个相关的方面是医疗机器人系统的多功能性。现有医疗机器人系统通常设计用于特定类型的介入手术。例如“DA VINCI”和“ZEUS”系统特别设计用于心脏手术。因此，如上所述，这些系统设计用于特殊的关节器械。此外，由于在心脏介入手术中的有限空间，器械移动通常根据外科医生在这些系统的触觉接口处的命令比例缩减。在普通腹腔镜手术中(包括妇科、泌尿科和普通外科手术)，操作空间比心脏手术大，解剖结构拓扑可变(甚至有时不可预知)，并且组织和器官的机械特性是不同的。更大的空间意味着更大的器械移动包络且需要1:1的移动比例。作为结果，在普通腹腔镜手术中，需要增加的移动动力学以精确地跟随外科医生手的移动。从实验测试中已经发现外科医生的手在小空间产生高速度，并且因此产生相当高的加速度。速度沿着枢轴螺旋俯仰(pitch)和偏航(yaw)轴可达到100°/s，及穿刺方向上200mm/s。以1:1移动比例及在已提到的状况中，上述系统显示了振动、摆动及损失精确性。下面将更详细描述的机器人操作器，设计用于减少这些问题并且从而适合用于普通腹腔镜外科手术的各种介入手术。
关于特定有关节腹腔镜器械的另一个缺陷是基于铰接器械尖端的控制的远程操作显示比有经验的腹腔镜外科医生所期望的更不直观。
另外，许多现有系统除了内窥镜的操作器外仅具有两个用于手术器械本身的操作器。这导致由于频繁及复杂的器械更换程序而增加介入手术的时间。在典型的介入手术中，外科医生使用5-7个不同种类的工具并经常需要更换它们几十次。通常，器械更换需要5到10秒，取决于外科医生助手的技能，并且这些更换操作实质地占有了总体插入时间(大约为10-20％)。许多现有机器人系统还不易于适用于要求三或四个器械入口的传统介入手术。其他系统限制用于通常短时间(约20分钟)并且经常不在意机器人系统的费用的诊断介入手术。理想地，机器人手术系统应当模块化并具有管理多至四个器械入口及一个内窥镜入口的能力。关于适当操作器的设计的一个重要的约束是一些入口可以仅仅相隔几厘米，并且各工具可能需要定位为近似平行或者一个在另一个的上面。另外，希望操作器不过分地限制外科医生关于患者身体及入口的视野。通过下面描述的各种其他特征并考虑发明本身，医疗机器人系统首先解决了后者的问题。
在机器人操作器的优选实施例中，效应器单元构造为使6DOF力/扭矩传感器的诸如法向轴的一个传感器轴，及6DOF加速度计的诸如法向轴的一个传感器轴与第六关节的旋转轴一致。该测量有利于力反馈计算。
优选地，当腹腔镜器械作动器包括具有底座布置在其中的接近表面及将壳连接到传感器组件的接口凸缘的壳时，其还包括将接近表面连接到接口凸缘用于加强壳连接到接口凸缘上的刚度的逐步加固肋。因而，即使腹腔镜手术器械作动器的横截面比传感器安装盘的横截面小得多，扭矩和力更准确地转移到传感器组件上。
为了提高人机工效，外壳通过具有与优选地基本平的接近表面相反的基本半圆柱状的表面而为半圆柱状。半圆柱状表面优选地与50-135mm的圆柱状包络面符合，优选地为约90mm的直径并且与第六关节的旋转轴同轴。在该实施例中，进一步优选地，壳、凸缘、加固肋及传感器组件尺寸设置为适合于该圆柱状包络面。此外，分段适配的(step adapted)器械优选地设计为在装配到操作器上时适合于相同包络面。
在优选的构造中，腹腔镜器械作动器的底座包括细长的基本为半圆柱状凹槽，该凹槽基本与第六关节的旋转轴同轴地布置在腹腔镜器械作动器的接近表面，底座和耦合或锁定机构构造为通过绕平面中的支点的枢轴运动而用于装配并移除器械杆适配器，该平面基本垂直于器械杆，即关于第六关节的旋转轴的径向上。半圆柱状凹槽在适配器连接时向其提供自动定心。另外，该构造，结合手动作动第六关节转动的能力及在通常状况下结合用于移动器械靠近入口的自动程序，使器械能够侧面安装和移除并且因而消除在穿刺方向上相对于患者的插入及拔出运动。另外，为外科医生助手改善了人机工效并相对于现有系统减少了器械更换时间。
在耦合机构的优选实施例中，耦合机构包括至少一个磁性装置，例如电磁或永磁体或两者的结合，各自布置在半圆柱状凹槽的每个侧面。磁性装置，优选地设置在接近表面并与其齐平，能通过磁力吸引将器械杆适配器紧固在腹腔镜器械作动器上。该耦合机构减少了在介入手术期间损坏包裹腹腔镜器械作动器的无菌包裹的风险，因为后者在这种情况下不需要消毒。
在另一个简单并可靠的实施例中为能够侧面装配并移除器械，底座包括径向加深半圆柱状凹槽的纵向槽用于接收布置在器械杆适配器侧面的耦合件，并且其中耦合机构构造为包括布置在纵向槽中用于啮合耦合件的可滑动闩的闩锁机构。这种类型的底座和锁定机构协同相应的适配器，提供机械简单、直观的并可靠的快速耦合连接。
有利地，用于诸如抓取器或解剖钳、剪刀等被作动器械的作动机构包括构造为用于啮合地接收并用于线性地滑动装配在效应器单元上的器械杆适配器的滑块销的滑座。如果底座沿着第六关节的旋转轴延伸，滑座优选地布置在底座的侧面，即与轴向延长部分相反地在底座的侧面。因此，可实现效应器单元长度的减少。另外，作动机构有利地包括力传感器，其将滑座连接到驱动件上。这种力传感器允许测量滑座施加或施加在其上的力。
在优选实施例中，腹腔镜器械作动器进一步包括存在检测器用于检测器械杆适配器是否正确地装配在效应器单元上。优选地，腹腔镜手术作动器包括多个感应存在传感器用于通过在器械杆适配器上提供的感应识别材料模式而识别装配在效应器单元上的器械。
在优选实施例中，机器人手术系统构造为在手动模式下操作，其中腹腔镜器械作动器可由机器人操作器使用传感器组件的6DOF力/扭矩传感器读出的信息进行定位及定向，并进一步包括布置在腹腔镜器械作动器上用于将系统切换为这种手动模式的开关件。
所要求的发明的另一方面关于前述腹腔镜器械杆适配器，用于将任何可获得的手动腹腔镜器械的杆装配到如在此描述的机器人手术系统中的机器人操作器上。该适配器包括具有布置在前端的杆连接器的延长罩及耦合件或布置在罩侧面的部件。该杆连接器与手动腹腔镜器械的杆的插座配合并且构造为可使该处的连接分开。耦合件依次与机器人操作器的腹腔镜器械作动器的底座配合。
为了手动介入手术，可获得许多不同腹腔镜器械用于多种用途。大部分这种器械可分成设想可由外科医生操作的手柄部分及杆部分，即一端具有器械本身而另一端具有连接至手柄的插座的细长腹腔镜管或轴。如在此描述的提供有相应的连接器的适配器允许在如上述机器人操作器上使用任何类型的这种器械的杆部分。适配器具有非常简单的不贵的且坚固的设计。因而，结合标准的相对不贵的器械，该器械杆适配器减少了与上述机器人系统联合使用的医疗工具的购买及维护费用。
在杆适配器的优选实施例中，它的耦合件包括半圆柱状表面，或替换地，整个罩可具有基本圆柱状的形状，可能具有与杆连接器相对的圆形端部。在两种情况下，形状或表面与上述机器人操作器的腹腔镜器械作动器中底座的半圆柱状凹槽一致。这允许将器械杆适配器的中心定在第六关节的旋转轴上。
对于具有驱动杆的腹腔镜器械，例如抓取器或解剖钳、剪刀等，腹腔镜器械杆适配器优选地包括内部圆柱形中空部分，作为用于手动腹腔镜器械的活塞的导杆，该手动腹腔镜器械的活塞布置为在导杆中滑动。其进一步优选地包括通孔用于使滑块销横向连接到活塞上并从罩上突出用以操作活塞。该滑块销构造为啮合腹腔镜器械作动器的滑座并且活塞配合连接到适配器的腹腔镜器械的内驱动杆用于操作腹腔镜器械尖端的工具。适配器和相应腹腔镜器械作动器的这种构造提供简单并可靠的运动传递并此外还消除了用于当将器械安装到效应器单元或从其上移除时建立运动传递的附加手动步骤。通过适配器的和相应耦合在机器人操作器的设计的优点，减少了器械交换时间，其有助于减少整体介入手术时间。
为了通过磁性装置产生的磁力吸引而将器械杆适配器紧固到腹腔镜器械作动器上，优选地耦合件包括布置在罩任一侧的至少一个铁磁元件，该铁磁元件分别配合相应的腹腔镜器械作动器上耦合机构的磁性装置。在该实施例中，器械杆适配器优选地进一步包括用于将适配器从腹腔镜器械作动器上分离的杠杆。
为了允许使用前述感应存在传感器而识别器械，适配器可包括提供在器械杆上的可感应识别模式。此外，适配器可包括相对于所述耦合件布置的电连接器用于将电力传输到连接到所述杆连接器的器械连接器。
附图说明
参考附图，根据对非限制性实施例的下列描述，本发明的上述方面及其他方面和目的将变得更显然，其中：
图1是用于手术室中普通腹腔镜手术的医疗机器人系统的透视图，其中在患者躺在其上的手术台周围放置了三个机器人操作器；
图2是用于具有五个机器人操作器的普通手术腹腔镜的医疗机器人系统的透视图；
图3是图1和图2中医疗机器人系统的机器人操作器的透视图，示出主坐标系；
图4是部分分解成其主要部分的图3中机器人操作器的透视图；
图5是包括关节J1至J6的图3的机器人操作器运动构造的示意图；
图6是具有五个机器人操作器的机器人手术系统的顶视图，示出包围操作器元件的2D碰撞检测箱；
图7是基于图3的机器人操作器底部的透视图；
图8是医疗机器人系统的顶视图，示出基于2D激光的检测以检测外科医生助手关于机器人操作器的远近；
图9是图3中机器人操作器的关节J1、J2以及J3的内部元件的透视图；
图10是图3中机器人操作器的关节J2的内部元件的透视图；
图11是包括关节J4和J5的操作器腕部的内部元件的第一透视图；
图12是包括关节J4和J5的操作器腕部的内部元件的第二透视图；
图13是包括关节J4和J5的操作器腕部的内部元件的第三透视图；
图14是示出图3中机器人操作器的效应器单元及将连接到效应器单元的合适器械的透视图；
图15是图14中效应器单元的主要内部元件的透视图；
图16是支点参考系的透视图；
图17是器械杆适配器(ISA)及相应器械杆的透视图；
图18是如图14所示的腹腔镜器械作动器(LIA)的放大透视图；
图19是在图18的LIA中的驱动组件的透视图；
图20是示出图18中所示LIA的其他内部元件的底部透视图；
图21是示出图18中所示LIA的其他内部元件的上部透视图；
图22是示出用于图18所示的LIA中的耦合机构的透视图；
图23是依照图3具有变化的操作器腕部的机器人操作器的透视图；
图24是用于具有四个依照图23的机器人操作器及一个依照图3的机器人操作器的普通手术腹腔镜的医疗机器人系统的透视图；
图25是用于图14所示的效应器单元的腹腔镜器械作动器(LIA)的替换实施例的透视图；
图26是图24中LIA的透视图，其中器械杆适配器(ISA)的备选实施例连接在LIA上；
图27是用于图24中LIA的替换驱动组件的透视图；
图28是图26所示的ISA的另一透视图；
图29是如图26和图28所示的ISA的局部分解透视图；
图30是具有不同器械连接到适配器上的如图26和图28所示的ISA的另一局部分解透视图。
在这些图中，同样的参考数字记始终用于标识相同部分。
具体实施方式
图1示出用于普通手术腹腔镜的医疗机器人系统，通常由附图标记10标识。覆盖着消毒被单的患者P躺在手术台12上，围绕手术台12布置了多个机器人操作器14。在图1的范例中，医疗机器人系统10设置用于骨盆区域的介入手术。外科医生S操作手术主控制台15，而外科医生助手A靠近手术台12站立，并靠近具有一套适合的腹腔镜器械18的盘子16。机器人操作器14设计用于定位并定向效应器单元，其支撑并可能作动各种腹腔镜器械18。在手术期间，机器人操作器14由一个或多个外科医生S通过一个或多个连接到控制单元(未示出)的手术主控制台15远程操作。将会意识到的是，医疗机器人系统10为模块化并且可依照外科介入手术的类型而构造，通常具有上至5个操作器且一般最小的构造为2个操作器。具有5个操作器14的医疗机器人系统10’的构造例如在图2中示出。图1中所示的系统10装配有位于每个机器人操作器14底部的激光测距扫描器22。激光测距扫描器22用于确保手术辅助人员在手术室的安全。图3为形成机器人手术系统10的一个机械单元的机器人操作器14的三维示图。机器人操作器14装配在底部24上，该底部24可连接到手术室地板上并且在未连接时可移动。三个坐标系同样在图3中示出，即底部、工具凸缘(TF)及腹腔镜器械尖端(LIT)坐标系。如图3所示，机器人操作器14包括操作器的臂部26及操作器腕部28。图4中示出机器人操作器14的主要部分。臂26具有基本垂直部分27及基本水平部分29。臂26在垂直部分27上的第一端将连接到底部24，而腕部28将连接到臂26的第二端，即水平部分29的末端。用于适当的腹腔镜器械18的效应器单元30将连接到腕部28的工具凸缘32。如图3中箭头所指示，臂26具有三个自由度(DOF)而腕部28具有两个DOF。相应地，机器人操作器14基本上为5DOF的机器人操作器。用于使装配在效应器单元30上的腹腔镜器械18绕它的纵轴旋转的辅助DOF由效应器单元30提供。机器人操作器14的DOF及效应器单元30的布置从下面对图5的描述将变得更显然。
如图5的几何模型最佳所示，臂26通过为滑移动(P)关节(或直线棱柱关节)的第一关节J1而关节连接到底部24。第一关节J1通过底部连结L0连接到底部24并沿着基本垂直的轴提供平移DOF。该第一关节J1因而允许垂直定位第一基本垂直的连结L1及后续元件相对于底部24及连结L0连接到后者。换句话说，关节J1确定了垂直部分27的高度。第二关节J2为转动(R)关节，将第一连结L1连接到臂26的第二基本水平的连结L2。转动关节J2的旋转轴基本垂直。关节J2允许设置连结L2和其在水平面的初始角位置之间的相对角度。第三棱柱滑动(P)关节J3将连结L2连接到第三基本水平的连结L3。关节(P)J3沿着基本水平的轴提供平移自由度并允许通过相对于连结L2水平移动连结L3而调整臂26、更精确地为水平部分29的臂长或范围。连结L2和L3连同(P)关节J3形成机器人操作器14的基本水平的可扩展臂(jib)或可伸支臂(boom)。
由于两个(P)关节和一个(R)关节如图5所示布置，臂26具有一个关于基本垂直的轴可旋转DOF，并在该处联合两个沿着两个垂直轴的平移DOF。相应地，机器人操作器14的臂26具有圆柱状构造，即操作器14的运动构型属于PRP(移动-转动-移动)型圆柱状机器人的分类。更精确地，在前三个J1、J2及J3中的每个关节各自符合圆柱坐标(z，ρ，r)：z为海拔(或高度)坐标，ρ为旋转(或方位)坐标，而r为径向伸长(或径向)坐标。
图5进一步示出，腕部28包括两个转动关节J4、J5，而效应器单元30包括一个转动关节J6。转动关节J2、J4、J5、J6各自确定连接到效应器单元30的适当的腹腔镜器械18的方向。转动关节J4将连结L3连接到连结L4并允许连结L4与后续部分绕平行于关节J2的旋转轴的基本垂直轴旋转。因此，转动关节J4允许与关节J2的实际设置结合设置效应器单元30的偏航角。应当注意转动关节J4的旋转轴与转动关节J2的旋转轴及棱柱关节J3的平移轴形成的面共面。转动关节J5将连结L4连接到工具凸缘32并允许沿着垂直于关节J4的旋转轴的基本水平的轴旋转工具凸缘32及后继部分。因此，转动关节J5允许设置效应器单元30的俯仰角。效应器单元30通过连结L5连接到工具凸缘32。转动关节J6的旋转轴基本垂直于关节J5的旋转轴并将连结L5连接到连结L6。转动关节J6的旋转轴与连结L6对齐并确定连结L6关于它初始角位置的相对角。适当的腹腔镜器械18连接到连结L6。由连结L7表示的器械18与连结L6对齐。连结L7的端点表示器械尖端17。
操作器26的圆柱状PRP运动构型具有多种的优点，其中：
操作器结构在手术台上占用相对小的容纳空间；
这一事实：操作器底部离手术台足够远(由于水平部分29的最小连结偏移量为800m)以有利于外科医生接近手术台以及患者从手术台或向手术台转移；
简单且快速的操作器内的碰撞检测计算。
通过下面的段落，这些及其他方面将变得更显然。机器人操作器的臂部26的所选PRP运动构型带来的优势在于简化多个操作器14之间的碰撞检测的计算，所述多个操作器14具有交叉空间地布置在手术台12的周围(图1和2)。由于圆柱状构造，机器人操作器14在二维(2-D)水平面上可近似于简单平面几何形状。如图6最佳所示，臂26的机械连结可由矩形包络，该矩形具有各自对应于(J3+L2+L3)及对应于J2的可变长度及方向；矩形包络的宽度由机械连结几何形状加上由，其例如取决于使机器人从最高速度减速至停止的所需空间加上安全阈值来决定的边缘余量。矩形包络的每个侧边的边缘余量可依照移动的方向及速度动态改变大小，例如，包络侧方向上的速度越高，该包络侧的边缘余量越大。腕部28近似为矩形，其包络连结L4的主体及部分连结L5，并具有由关节J4的当前角位置给定的可变平面方向。相似地，效应器单元30可近似于矩形，其包络它在2-D水平面上的投影，其中投影角对应于关节J5的当其角位置。相同的原理应用到连接在效应器单元30的器械18的杆上。这种简单几何二维结构允许建立用于基于它们的线交叉的碰撞检测的简单且高效的算法。在第一阶段，碰撞检测方法包括检测在2-D水平投影中的碰撞。只有当这些2-D图中任一个与来自不同的机器人操作器14的图冲突时，那么随后通过包括第三维度核实出真正碰撞的实际风险。将会意识到的是，因此仅仅是机器人操作器14的相关部分的交叉侧需要执行3-D计算。在这种简化的3-D计算中，例如以三角模型包络相关部分。作为结果，可容易地实现快速插入方向的运算，例如，那些在由Moller发表在1997年的Journal of Graphics Tool，2(2)上的“A Fast Triangle-Triangle Intersection Test”中所建议的。在实践中，器械18的杆之间的碰撞检测尤其与保护内窥镜免受电动器械的伤害相关。
为了获得机器人操作器14之间碰撞检测的精确结果，在手术室中定位机器人操作器14之后，通过校准程序确定所有机器人操作器14关于共同参考坐标系的位置和方向。从功能性的角度来看，在碰撞风险检测后，控制系统必须中断相关的操作器14并且通过主控制台15上的适当显示信息和/或排斥力反馈警告外科医生S。然后外科医生S可通过在安全方向上远程操作操作器中的一个而简单地实现恢复。在进一步改进中，通过使用具有用于诸如臂26、腕部28、效应器单元30和/或器械18的部分的组中每个的不同边缘余量的至少两个包络而实现几个碰撞安全级别。使用更突出的包络检测碰撞风险后，外科医生S命令的在碰撞方向上的移动在边缘余量区域中的穿刺功能急速按比例减小。
关于臂26构造的另一个优点是关于提高结合在关节J1、J2、J3上的作动器的可控性。当与其他类的机器人(例如球形或关节机器人)相比时，并且作为臂构造的结果，由于J1、J2、J3和J4不承受变化的重力负载并且由于J1、J3和J5不具有变化的惯性负载，这些作动器的控制得到改善。这能简化地优化控制循环(例如具有前馈的PID)并实现例如仅少数电动机编码器计数的非常低的位置动态循迹误差。除了已述的优势，机械设计应当考虑连结L2和L3使用刚性但重量轻的结构以在关节J1和/或J2进行突然移动时限制它们的偏转和摆动。
应当注意机器人操作器14的几何形状的另外两个优势。第一，操作器底部24位于离手术台12足够远的地方(例如至少600mm远)并且臂26设计为使其可用手绕关节J2转动(其中制动器释放)到停止位，外科医生S可容易并快速接近手术台12用于诸如注气、解剖器官移除、最终缝合等的手动任务。另外，可迅速将患者P转移到手术台12上或者从其上面移走。第二，与SCARA几何形状相比其用于例如现有的商品名为ZEUS的操作器的臂部中、具有连接两个长度相同的共面连结以达到一定的水平位置的肘部旋转关节，操作器14的圆柱状构造具有单一径向伸长关节J3，其相当大程度地减少将腕部28放置在患者P身体上方所需的空间。如图2所示，如果腕部和效应器单元的尺寸足够小，即在患者身体上方的可利用空间占用足够的包含空间，那么该特征允许将五个操作器14和更多的操作器定位在手术台12上。
下面的段落将参考图7-15对机器人操作器14的结构进行更详细的描述。
图7示出底部24的几个特征。底部24包括主底盘40并且通过安装在主盘40的角落处的开口中的四个轮子42布置成可移动结构。每个轮子42装在壳43中，该壳43具有一个开口，用于作为拔出或缩回轮子42的柄的通路。当轮子42缩回时，底部24通过轮子42的衬垫支撑(未示出)稳定地安置在手术室地板上。拔出轮子42后，包括机器人操作器14的底部24可由手移动。在不同的设计中，底部24可装配在可移动或固定的线性轨轴上或者装配在设计用于支撑几个底部24及关联的操作器14的手推车上。主底盘40设计为使其在需要时可固定在地板上，例如通过使用孔44进行螺纹连接，以便于向机器人操作器14提供附加稳定性。机器人操作器14通过螺纹孔45中的螺钉连接到底部24。在底盘40中，加工了几个高精度孔46。这些孔46用于支撑光学校准反射器，其用于通过光学测量系统确定底部24的位置和方向，所述光学测量系统如由R.Bernbardt及S.Albright于1993年在ed.Chapman&Hall上发表的“Robot calibration”中所描述。应当注意机器人操作器14在工厂装配过程中校准以便于精确地确定其几何学模式。此外底部包括外壳48，用于供电及伺服驱动无刷电动机、信号调节装置、用于安装有臂传感器的局部处理装置及通向远程系统控制单元的通信通道。如图1所示并且最佳参见图8，2D激光测距扫描器22安装在底部24上，更精确地安装在外壳48上，以在连结L2和L3周围的安全周界内进行例如助手A的进入检测。
应当注意通常在医疗机器人系统10中使用两种不同类型的机器人操作器14。尽管两种类型的机器人操作器14基本具有相同几何形状及运动学PRP构造的臂26，第一种类型优选地特别布置为操作用于可视化的内窥镜而第二种类型布置为操作用于手术本身的任何不同种类的适合的腹腔镜器械18。对于腹腔镜手术，通常使用一个第一种类型的机器人操作器14，而使用几个第二种类型的机器人操作器14。在医疗机器人系统10中，这两种类型的机器人操作器14之间的主要区别在于：
由于关节J3要求绕它的入口360°旋转(通常为了检测的目的)，关节J3的路径比内窥镜操作器(大约750mm)长。
由于关节J4要求绕它的入口360°旋转，关节J4的路径对于内窥镜操作器是无限的。这通过使用J4轴上的信号收集器而实现。
内窥镜操作器不需要关节J6，即内窥镜可直接连接到关节J5上。
内窥镜操作器的效应器单元30通常包括内窥镜及力/扭矩传感器以检测外力。
由于仅仅需要定位内窥镜的能力，对于内窥镜操作器来说所有关节对速度/加速度的要求至少降低60％。
考虑到这些差别，本描述的重点在于第二种类型的机器人操作器14，因为后者具有更严格的设计要求。
下面参考图9给出关于操作器的臂部26的关节J1至J3，包括它们各自的作动器的构造细节。
如相关的线性作动器，用于臂升高的(P)关节J1包括滚珠丝杆线性轴50(例如由德国奥芬堡&英国普尔的Parker Hannifin、ElectromechanicalDivision生产的ET系列的合适型号)。滚珠丝杆线性轴50由装配有增量电动机位置编码器及制动器的无刷伺服电动机51驱动。线性轴50另外还提供有位于输出级的额外的绝对线性位置传感器(未示出)，限位开关和机械行程端缓冲器(未示出)。垂直线性导向52操作地与线性轴50关联从而保证轴线性及扭矩强度。线性轴50连接到托架53上用于将臂26装配在底部24上。引导信号及电线进入关节J1的壳内的垂直电缆轨道中(未示出)。如图3最佳所示，外壳54包围平移(P)关节J1的元件。可注意到关于关节J1的作动器组件，设置电动机/负载的减速比率从而使得在电动机制动器未接合或当伺服电动机51不供电时阻止水平部分29的不希望的下降。此外，紧急停止按钮(未示出)设置在外壳54上，其用于在紧急时停止所有机器人关节的运动。如图9所示，操作器的臂部26的前述元件组成它基本垂直的部分27。
图9还示出形成臂26的肩关节的(R)关节J2。如图10最佳所示，关节J2包括与Harmonic Drive
Figure G2007800117390D0015132843QIETU
型齿轮62同轴的无刷伺服电动机61组件以驱动负载。所述无刷电动机61装配有位置编码器及故障安全制动器。另外，作动器组件包括另一个由连接到齿轮62的输出级的带66驱动的绝对旋转位置传感器65，以及机械行程终端缓冲器和限位开关(未示出)。按键开关(未示出)提供在壳64上，这允许在关节J2、J3、J4、J5和J6各自的电动机停止供电时释放它们的制动器。这允许用手将臂26及效应器单元30移动进入停止位。来自下游关节J3-J6及效应器单元30的信号及电力电缆通过在壳64内通过的柔性电缆导管(未示出)从J3引到J1。可选地，可例如通过合适的齿轮和电动机组件的空心轴引导这种电缆。
图9还示出包括(P)关节J3的臂26的水平部分29的设计，所述(P)关节J3用于设置径向延伸，即水平部分29的范围。关节J3包括例如滚珠丝杆线性轴的线性圆柱轴70，作为关联的线性作动器。例如，由前述的公司生产的ET型号作动器，由装配有电动机位置编码器的无刷伺服电动机71驱动并且使用故障安全制动器。线性圆柱轴70的杆移动构造为矩形管并装配在线性引导73的台车上的横梁72。这种结构允许减少线性偏转。线性圆柱轴70在输出级附加地提供其他绝对线性位置传感器，提供限位开关和行程终止机械缓冲器(未示出)。信号和电线引导进入水平放置的电缆链。罩74固定在形成第二连结L2的部分并包围(P)关节J3的元件，尤其是线性作动器70和线性导向73。如图9所示，形成连结L3部分的横梁72构造用于分别伸缩进出罩74。因此臂26提供缩小到极端的水平部分29，其仅需要有限量的患者P上方空间。另外，优选地在罩74的后上方提供灯以可视地指示供电及驱动状态。
下面通过参考图11-13将具体的描述腕部28、尤其是关节J4和J5的构造。
图11-13所示的(R)关节J4的机械和作动设计包括支承盘80，其上垂直装配有无刷伺服电动机81。该伺服电动机81在电动机轴上提供有位置编码器82及霍尔传感器。作为伺服电动机81，例如使用瑞士Sachseln的MAXON MOTOR A.G.的EC电动机系列的适合型号。(R)关节J4还包括传送机构，通过耦合在伺服电动机81的齿轮83和通过传动带84及带轮85系统以驱动耦合在连接凸缘87上的负载轴带轮86。附加的绝对单圈传感器88连接到带轮89上，其同样由传动带84驱动并连接到支承盘80的底侧。为了容易将电缆从J5引到J4，包括负载轴带轮86及连接凸缘87的组件，具有空心轴及连接凸缘87上的侧窗。支承盘80通过两个装配盘90牢固地连接在横梁72上。如图14所示，壳92用于保护关节J4的部分。壳内，来自效应器单元30、关节J5和J4的的电缆提供有连接器以为了维护的目的使腕部28可分离。紧急停止按钮提供在关节J4的壳92上。故障安全制动器优选地装配在伺服电动机81的轴上。为了减少侧向偏移O1，其在多机器人的构造中可构成一个限制因素，电动机可同样与负载轴带轮86及传感器88的轴对齐。在这种情况下，支承盘80优选地具有围绕负载轴带轮86的圆形边界。
(R)关节J5的机械和驱动设计同样在图11-13中更详细地示出。基本L形的支撑件100将关节J5连结到关节J4，其中水平部分连接到关节J4而垂直部分作为关节J5的固定框架。其包括例如为MAXON MOTOR A.G.的合适的EC型号的无刷伺服电动机101，在电动机轴上具有位置编码器102及霍尔传感器。如图13所示，伺服电动机101横向装配在支撑件100上。如图12和13所示，(R)关节J5进一步包括传送机构，通过耦合在电动机101上的齿轮103及通过传动带104以及带轮105系统以驱动负载轴带轮106。附加绝对单圈传感器108连接在带轮109上，带轮109同样由传动带104驱动，并连接在支撑件100的内侧。为了易于将电缆从效应器单元30传送到关节J4上，包括多个特征。具有支撑件100中提供两个孔110和112、带轮106及工具凸缘32中的中空的中心通道114、及用于带轮106的电缆引导支撑件116。L形支撑件100具有侧面加固件以提供用于通过工具凸缘32支撑效应器单元30的坚固结构。如果需要，(R)关节J5优选地包括限位开关及故障安全制动器(未示出)。当提供的时候，后者优选地装配在由传动带104驱动的带轮上从而减少侧向偏移O2，其可在多机器人构型中制定限制因素。
图14和15示出效应器单元30，设计用于连接到关节J5的工具凸缘32，具有三个主要部分：腹腔镜器械作动器120、包括6DOF力/扭矩传感器及6DOF线性/角度加速度计的传感器组件122，以及用于关节J6的壳124。关节J6连接到传感器组件122。腹腔镜器械作动器120提供有用于将适合的腹腔镜器械18装配到机器人操作器14上的底座130。为了缓和，腹腔镜器械作动器120和包括力、扭矩及加速度测量传感器的传感器组件122分别由首写字母的缩写LIA和FTAS表示。效应器单元30的元件排列成这样的方式，关节J6使适合的腹腔镜器械18绕后者的对称纵轴旋转，从而该轴与FTAS122的法向(normal)Z轴一致。选择效应器单元30相对于(R)关节J5的旋转轴的位置位于效应器单元30的平衡点从而当关节J5停止或不供能时防止发生倾斜。因此，连接到腕部28的效应器单元30的主支撑框架140，构造为使组装的效应器单元30在(R)关节J5的旋转轴上平衡。对关节J5的电动机/负载的减速比同样对倾斜阻力产生作用。
图15示出关节J6的构造。在主支撑框架140(将连接到工具凸缘32)上装配具有增量编码器142及齿轮组件143的无刷电动机141。连接到电动机141上的电动机带轮145通过带144耦合到负载带轮146。负载带轮146提供关节J6的旋转DOF。附加的绝对位置传感器148装配在负载带轮146的轴上，与(R)关节J6的轴一致。位置编码器148具有用于传递LIA120及FTAS122的信号和供电线到“滑环”或滑动接触型的旋转收集器150的中空轴。滑环150使关节J6能进行无限轴旋转。负载带轮146通过连接凸缘152连接到FTAS122。用于LIA120及FTAS122的供电和信号线的电缆通过连接凸缘152中的中空通道引导进入壳124内。将会意识到的是，机器人操作器14作为整体提供有内部通道中以确保例如关节J1-J6和诸如LIA120和FTAS122的效应器单元30元件的所有信号和电线的受保护引导。在又一改进(未示出)中，关节J6构造实现下面两个更改：第一，通过将电动机-齿轮-带轮组件141、143、144、145定位成与图15所示的方向成-90度而减少偏移O3。第二，通过配置电动机-齿轮组件141、143以定位更靠近LIA120而减少偏移O4。
将会意识到的是，在当前实施例中关节J4、J5及J6的旋转轴相交在空间的同一点。因此消除了连结L5产生的潜在偏移。
如图23和图24所示，替代设计无论如何都由于连结L5而存在偏移O5，例如，以便于防止两个适当的腹腔镜器械18插入到靠近布置的套管针(入口20)时提高可操作性。例如，图23和24示出的特殊设计提供具有由于连结L5引起的负偏移O5的修改的操作器腕部28’。该负偏移O5允许将第一机器人操作器14的效应器单元30放置在第二机器人操作器14的效应器单元30上方而腕部28’之间没有冲突。然而这种修改的构造要求关节J3具有增加的延伸及关节J2、J3和J4具有更高的速度与加速度能力。正如从图24所意识到的，腕部28’的构造有利于在多个靠近布置的入口20(套管针200)处操作。应当理解如图23所示的J6和J4旋转轴之间的偏移O5的优选值大约为LIA120在其最大横截面处的直径。
关于机器人操作器14和它的元件的设计的一些其他方面和优点将在下面具体介绍。
关于用于腕部28和效应器单元30的传送和电动机的所述构造，同样可使用其他构造，例如，作为传动手段的电缆和带轮或具有扭矩电动机的小型齿轮-电动机-制动器组件。然而作为传送手段的电缆和带轮更难实施及维护，同时基于扭矩电动机的组件通常不那么紧凑。为了所述系统的安全，选择伺服作动器具有“动态制动器”功能以在紧急停止的情况下允许停止电动机51、61、71、81、101、141。机器人操作器14的外壳由适合的可清洁塑料材料制成并可能部分为铝，但所有外部传导部分连接到电性地。所有内部元件屏蔽关于接收和发射的EMI。关于手术室中的消毒，通常使用无菌塑料袋完全覆盖机器人操作器14，即从效应器单元30到底部24。
关于作动，上述机器人操作器14的设计显示了两个其他优势：第一，机器人操作器14的关节可手动驱动，除了关节J1因为它具有高的静摩擦力反向惯性。换句话说，当释放所有的制动器时，在凸缘32上装配在腕部28的效应器单元30可通过仅用少于5kg的推力(在水平方向)手动驱动关节J2、J3、J4、J5和J6而由手移动。第二，通过知觉冗余增加系统安全性。如上所述，关节J1-J6中每一个具有位于电动机轴上的位置编码器及测量各自关节有效运动输出的附加位置传感器(例如65、88、108、148)。实际上，这种知觉冗余用于检测故障(例如，电动机导线的、带的或者伺服作动器的故障)。
此外，该设计避免关节J1-J6中每一个发生运行到头(end-of-motion)的情形。当一个关节跑到它的运动限制之外时发生运行到头，并且特别在远程操作的机器人手术中属于关键状况，因为对于外科医生S来说在器械18插入到患者P体内时获得恢复是困难并且麻烦的。为了避免运行到头的情形，臂26的棱柱关节J1、J3设计为具有足够的行程并且效应器单元30的滚动关节J6设计用于无限旋转。作为结果，运行到头情形的避免仅要求期望的某些预先确定的初始构造和期望的设置条件。
图16示意性地示出套管针200及它在患者P体外的工作空间202。通过z轴大约平行于重力方向向上的笛卡尔坐标系(x，y，z)，在图16中同样示出支点参照系FRF。套管针200通常通过一个在204处标识的患者P的腹部的小的切口进入腹腔。套管针200与切口一起形成如图1和2中所示的入口20。为了到达其中将要执行手术的器官或区域，由z’标识的套管针200的纵轴在工作空间202中绕FRF的原点、即转动点206枢轴转动。换句话说，该原点确定了套管针200的支点。该支点优选地确定在患者P的腹壁和皮肤之间，在最小倾斜阻力的位置，以便于减少拉出套管针200的风险。
下面最大的力和扭矩范围实验性地记录在放置在修改后的腹腔器械手柄处的6DOF力/扭矩传感器上(参见由J.Rosen等发表的“Surgeon-ToolForce/Torque Signatures-Evaluation of Surgical Skills in Minimally InvasiveSurgery”-Proceedings of Medicine Meets Virtual Reality，MMVR-7，IOS Press，加利福利亚旧金山，1999年1月)：
·力：  Fx，Fy＝±10N；Fz＝±30N；
·力矩：Mx，My＝±1Nm；Mz＝±0.1Nm。
此处Fi表示沿着相应轴i＝x，y或z的力，而Mi表示关于图16中FRF的相应轴i＝x，y或z的力矩。FTAS122中的力-扭矩传感器的操作范围应当考虑这些值加上LIA120的重量、运动的动态负载及施加在套管针200上的枢轴转动和穿刺阻力。实际上，FTAS122中的力-扭矩传感器用于力/扭矩反射，即力/扭矩反馈到由外科医生S操作的触觉界面，用于采用FTAS122作为操纵杆而手动驱动效应器单元30，并用于监控与连接到效应器单元30上的器械18的相互作用的力/扭矩，例如位于器械18尖端或位于图4中枢轴转动点206的力/扭矩。FTAS122中的线性和径向加速度计用于补偿对力/扭矩传感器信息的重力和加速度影响。FTAS122中的加速度计和力/扭矩传感器的测量轴几何上一致。
在手术期间，腹腔镜器械18通过套管针200插入。对于大多数手术程序，外科医生S在下面绕图16的FRF的角度工作空间和速度的最大范围内操作器械18：
表1
支点 最大行程 最大速度
偏航支点 +/-70° 100°/s
俯仰支点 [+10°-80°] 60°/s
穿刺 [0 200mm] 200mm/s
滚动 [-360°+360°] 300°/s
在一些现有技术的机器人操作器的设计和构造中，套管针200的转动支点在腕部安装后将保持固定，这是因为腕结构绕固定点转动的机械设置(例如参见由Taylor等发表的“Remote center of motion robot”-美国专利号No.5667323-1995年5月)。其他现有技术的设计具有沿着转动轴的机械顺从性以便于限制施加在套管针上的力(例如参见由Wang等发表的“Medicalrobotic system”-美国专利号No.6102850，2000年8月)。与之相反，在此提出的机器人操作器14设计为既没有机械顺从性也没有运动中心，而是依靠绕由特定程序确定的支点206的精确绝对运动，及对依靠对施加在效应器单元30上的力和扭矩的实时控制，从而优化支点206的位置。此外，该特征在外科医生S需要时可提供柔性以平移支点206以便于提高腹内工作空间。另一个优点为适应例如由于腹腔压减少时而引起的支点206的绝对位置变化的能力。
显然，机器人操作器14应当具有一定的运动能力以向效应起单元30提供可以与外科医生手动处理腹腔镜器械相比的灵巧性。基于表1给出的运动状况，已发现的用于该特定实施例中的关节J1-J6的优选运动能力总结在表2中。滚动、倾斜及偏航角度可相对于绝对参考系确定，例如，在支点上。
表2
关节 最大行程 最大速度 最大加速度
J1-升高 700mm 600mm/s 4m/s2
J2-肩部 +/-90° 60°/s 400°/s2
J3-径向 600mm 600mm/s 4m/s2
J4-偏航 [-360°+360°] 260°/s 1900°/s2
J5-俯仰 [-60°+180°] 75°/s 500°/s2
J6-滚动 无限 250°/s 2400°/s2
根据各个关节的速度和加速度能力，表1给出的值相对较高从而要求牢固的作动器、臂26和腕部28的坚固结构及通过底部24的适当的地板固定。显然，可选择导致较少要求的较低的值，但这是以在转动点206的动力学减少作为代价的。
另一相关方面，尤其在具有力反射的远程操作的机器人手术中，是操作器14的精确度要求。足够的精确度有助于减少套管针切口处的应力，并允许执行精确的力/扭矩补偿。
在选择的设计中，操作器14在与效应器单元30连接处的静态精确性，即在工具凸缘32处(见图4)，对于定位应当优于±2mm而对于在FRF(见图16)处的定向优于±0.1°。此处假设在连接的腹腔镜器械18的尖端具有1.5kg的外部负载，并假设FRF在离关节J5的轴280mm处。动态精确度对于定位应当优于±4mm而对于在FRF处的定向优于±0.5°。这些特征首先是通过零件结构的精确机械加工、连结L1-L6和关节J1-J6的刚度、位置传感器的足够分辨率、PID电动机控制环适当的调整、操作器的动态校准等获得的。
在本文中，提供在关节J1-J6中每个的出口处的前述绝对位置传感器(例如65、88、108、148)具有下面优点：
·归位机器人操作器14的关节J1-J6而不驱动关节；这意味着用于控制电动机的增量传感器的初始值由绝对传感器提供。如果不能获得绝对传感器，可执行归位程序而在给定方向移动每个关节以寻找参考信号。在启动时没有为了归位的自动移动确保快速组织程序并提高安全性。
·实时确定效应器单元30的位置和方向避免由传动机构引起的关节弹性误差；
·监控机器人操作器14从FRF的偏移；
·通过使用在每个关节J1-J6提供的各个电动机编码器显示的位置而监测数据一致性以检测关节传动机构故障(例如带断裂)或者其他硬件故障。
机器人技术的另一个方面为用于控制机器人操作器14的数学模型。与机器人操作器14的理论模型不同，有效且精确的“具体”模型，必须在标定过程中确定包括诸如动力学布置的偏移量、关节J1-J6的弹性、连结L1-L7的弹性、作动器无效行程(backlash)及其他线性误差的参数。使用已确定的“具体”操作器模式用于三个目的：第一，使用具有实时关节偏移量和连结长度的运动控制器(其简化了逆向运动学计算)中的理论模型提高机器人操作器14的精确性；第二，实时通过前向公式精确地计算6-DOF FTAS122以及已经连接的负载的位置和方向，(这些值要求补偿重力和加速度负载)；第三，实时通过前向公式确定器械尖端的位置和方向并推出力反射(例如器械18的穿刺)需要的参数。
下面的段落给出腹腔镜器械作动器(LIA)120的更详细的描述。
如图14和15所示，LIA120形成效应器单元30的部分。LIA120提供一般驱动界面用于由机器人操作器14使用诸如抓取器/解剖钳、剪刀、吸引/冲洗工具等标准腹腔镜器械。因此，LIA120形成操作器14的末端并且作为它的把手部分，因为它模仿外科医生的手部动作。LIA120包括外壳154，其后端形成用于连接到FTAS122的接口凸缘156，而其前端形成机器人操作器14的末端。在效应器单元的一个不同构造中，LIA可包括关节J6。然而该构造要求器械适配器的更复杂的机械设计，其应当包括旋转机构以及开-关机构和电力传输。另外，即便具有旋转机构也应当保持无菌区域。
图14-15和图18-22所示的LIA120适合与任何标准腹腔镜器械一起使用，所述腹腔镜器械可分成位于一侧的手柄及位于另一侧的杆。此处杆定义为相对细长的管，在其尖端具有例如力/剪刀爪插入物、吸引/冲洗件、诸如刀的基本工具或电烧灼/切割装置。与尖端相对的末端包括设计用于将杆连接到外科医生的手柄上的窝。
通过LIA120的设计和相应器械杆适配器的设计获得机器人操作器14与标准器械的兼容性，在下面由手写字母缩写ISA标识，其中图17的局部剖视图示出其一个实施例。
图17示出器械杆302能连接在其上的ISA(器械杆适配器)300。ISA300通过将其装配在图15所示的底座130中而可连接到LIA120。为此目的，ISA300包括具有基本圆柱状外表面的壳303。如图17所示，ISA300设计为常规(腹腔镜)器械的器械杆302和LIA120之间的耦合件。为此目的，ISA300在其前端包括杆连接器304。杆连接器304设计用于连接到杆302的特定类型的插座306，其取决于实际器械。最初，插座306设计用于连接到腹腔镜器械手柄(未示出)。如图17所示，杆连接器304再现了杆302设计用于的原始手柄的连接器。ISA300还包括耦合装置，耦合件308用于固定连接到LIA120上。耦合件308侧向布置在壳303上并径向从那里突出从而当ISA300装配在LIA120上时阻止它的旋转。在耦合件308中包括小金属块309以便于提供用于LIA120的感应存在的开关(比较下面描述的部分404)的金属检测表面。线性可滑动活塞310布置在ISA300内部的圆柱状导向312中。圆柱状滑块销314横向连接在活塞310上并且从壳303向外突出用于操作活塞310。活塞310的滑动操作作动器械杆302中的棒用于操作器械杆302尖端的工具。将会意识到的是，ISA300再现原先连接在杆302上的手柄关于操作器械杆302的功能，同时将连接界面与LIA120一起提供到机器人操作器14。
应当理解图17中示出的ISA300的特定实施例设计用于要求机械作动的器械，诸如用于器械尖端开/关功能，例如，具有或不具有单极或双极电力传输的剪刀和抓取器。本公开同样包含多种其他类型的模拟适配器，每个适配器适合特定类型的腹腔镜器械，即，特定类型的杆(例如302)，其将连接到LIA120。相应地，根据器械的要求，ISA包括：例如用于作动器械的爪的线性滑块销314、例如用于单极或双极烧灼电源等的一个或多个连接器318，以及/或者例如用于冲洗或吸引器械的一个或多个管道连接器。尽管图17中示出具有电连接器318，应当理解，对于纯机械器械18，不需要提供形成电连接器18的ISA300的部分(图17中的细线宽度画出)。应注意任何类型的ISA的组成材料应当选择使其可例如通过蒸气高温灭菌器而被消毒。实际上，由于LIA120的设计，ISA是医疗机器人系统10中需要消毒的唯一部分(当然除了器械杆)。在操作期间，LIA120的外壳154及效应器单元30的其他部分装入无菌塑料罩中。尽管没有示出，显然的是，对于诸如电手术刀或电刀的非机械作动但电供能的器械，ISA不需要具有滑块销314及关联的机械传输。对于诸如冲洗或抽吸管道的器械，ISA装配有两个由机器人控制系统通过电阀电作动而远程支配的两个导管。
图18中示出的LIA120设计为较轻(例如不到800g的总重量)并且使其适合进入直径大约90mm或优选为75mm的相对较小的圆柱状包络以增加具有邻近入口20的两个相邻工具之间的可用工作空间。LIA120的总长度(在特定实施例中约130mm)主要由ISA300长度确定。使LIA120的长度最小化从而限制关节J5的旋转轴和FRF的支点206之间的距离(见图17)。事实上，距离偏移量确定所有操作器关节J1-J5的行程范围和速度/加速度能力。然而建议LIA120的长度至少为6cm从而允许在手动模式中用手抓住LIA120(即用连接到FTAS122上的外壳154作为“操纵杆”)。
如图18所示，外壳154的外表面具有光滑的边缘。其由容易清洁、重量轻并且非导电材料制成。此外，LIA120具有关于采用ISA300装配的适当的器械18的杆302而局部旋转对称的设计。当ISA300正确地连接到LIA120上时，杆302的轴与关节J6的滚动轴及FTAS122的垂直轴一致。
进一步如图18所示，如将在下面详细描述的，LIA120的外壳154包括线性作动机构400用于作动通过ISA300装配的器械18。底座130在LIA120的接近表面401构成凹入的细长半圆柱状凹进处以便于ISA300的插入和拔出。用于接收ISA300的底座130与关节J6的旋转轴近似同轴并沿着外壳154的中心轴延伸。将会意识到的是，ISA300关于LIA120的装配和移除方向径向相对于关节J6的旋转轴。LIA120构造为使从接近表面401上方的整个半平面可到达底座130。如图18所示，底座130包括加深底座130径向进入LIA120的体内的纵向槽402。附加槽402构造用于接收ISA300的耦合件308。与底座130相关的锁定机构406的啮合部分布置在槽402中并与耦合件308配合。底座130形成为与ISA300的壳303的外圆柱形状一致的具有圆形末端部分的半圆柱状凹进处。存在检测器404，例如感应存在的开关，布置在底座130中用于通过感应机械块309(见图17)进行ISA300的存在检测。安全停止(dead-man)开关按钮408允许将机器人操作器14的控制系统切换为手动模式。在手动模式中，LIA120(以及，如果连接的话，器械18)通过机器人操作器14使用由助手处理LIA120的外壳154产生并由FTAS122读出的信息进行定位及定向。手动模式尤其对通过套管针插入或拔出器械有用。
线性驱动机构400的细节最佳参见图20。驱动机构400包括通过变速箱412及带轮414、416连接到滚珠丝杆420的微型无刷电动机411，带轮414、416由带418耦合。该滚珠丝杆420与布置在其上的螺母422配合从而将旋转转化为线性运动，如图19所示。螺母422由线性导向424引导从而减少滚珠丝杆420上的横向作用力。感应限位开关426和428放置在螺母422的行程末端处并连接到用于限制驱动机构400行程的控制单元。
如图19所示，作动机构400将线性运动传达给LIA120的滑座430，如下面将要详细描述的。在优选实施例中，下面参数选择用于作动机构400：
·滑座430的最大机械行程：7mm(通常5mm足够用于标准器械，但已发现相同类型的几个杆可具有上至2mm的行程长度变化)；
·行程速度范围：1mm/秒至20mm/秒；
·最大驱动力：200N；
优选地避免在LIA120中使用步进电动机，因为它们产生的振动将是FTAS122的相当大的噪声源。因此，使用微型的装配有轴位置编码器的无刷电动机411。这种电动机例如可从德国Schoenaich的Faulhaber GmbH获得。然而不排除其他诸如电缆-驱动传动的不振动的线性运动机构。图20示出用于电动机411的供能及控制单元440，该电动机411嵌入在LIA120的外壳154中并且供应例如24VDC的电能。为了进一步减少外壳154的直径，供能及控制单元440可放置在附加外壳中，附加外壳或者在凸缘156与FTAS122之间，或者在FTAS122及关节J6(未示出)的连接凸缘之间，或者在关节J6的罩124内，例如，在靠近电动机141的滑环连接器80后。供能及控制单元440设计尤其用于以对应于接收到的位置指令的给定速度剖面作动滑座430、用于根据用户需求限制电动机电流、用于管理基于来自限位开关426、428的信号的运动、用于使用限位开关使电动机归位，以及用于监控外壳154上的存在检测器404。其他安全性功能，例如紧急停止功能，同样使用电动机411的伺服误差以及电动机411的热防护实现，电动机411的伺服误差即目标位置减去有效位置。为了减少LIA120需要的空间，线性驱动机构400不配备绝对位置传感器。然而，通过使用限位开关426、428作为内部传感器确保自动归位程序。在手术期间，滑座430的绝对位置可周期地记录在例如机器人控制系统中的适当内存中，用于在停电或发生故障后快速恢复系统。ISA300的存在，即无论它是否正确地装配在LIA120上，将通过布置在底座130中的感应存在的开关404(见图18)感测。感应存在的开关404的输出供应给控制单元440的可用的输入。
最好参见图17和19，作动机构400的滑座430适合接收ISA300的滑块销314。通过电动机411的作用，滑座430被重新定位从而驱动已连接的ISA300的滑块销314。滑块销314依次作动活塞310以操作杆302(未示出)尖端的例如爪开/关机构的工作件或工具。换句话说，线性驱动机构400和ISA300的结合模拟手柄的作用，该手柄已从杆302移除并被ISA300代替。由于倾斜的引导表面434，滑块销314便于插入到滑座430中。
图21和22更详细地示出在图18中仅仅部分示出的LIA120锁定机构406的构造。锁定机构406构造为闩锁并且包括布置在底座130的槽402(图18所示)中的可滑动闩450。应当理解闩450由槽402中合适的装置引导。槽402，与可滑动闩450一起，构造用于啮合地接受图17中所示的ISA300的耦合件308。闩450包括用于啮合两个突出316的两个前端452，所述突出由耦合件308中的槽形成(见图17)。耦合件308的边缘为圆形的以容易插入到槽402中并从其中移除。
闩450的设计最好参见图22。弹簧454弹性地将闩405推向FTAS122。线性导向的旋钮456允许旋转耦合在线性引导闩450上的枢轴458以当ISA300将被移除时手动将闩450从耦合件308上脱离。闩450的前端450倒角从而允许仅仅通过推动而插入ISA300。根据相配轮廓，前端452及突出316的啮合部分为圆形以限制对用于覆盖LIA120的无菌塑料罩的损伤。应当理解，可同样使用其他等效的耦合或锁定机构，例如使用使用金属盘安装在LIA中的永磁体及装配在ISA上基于凸轮的杠杆以代替闩锁机构。优选地，例如锁定机构406和耦合件308的固定机构，设计为确保ISA300在其装配到LIA120上时可抵抗下述的力和力矩而不从LIA120上脱离：
·100N的牵引力和压缩力；
·对应于在器械尖端的15N径向力的扭转力矩；
·上至5Nm的弯曲力矩。
将会意识到的是，LIA120和每个配合ISA(例如300)设计为能由外科医生助手A快速并容易手动安装及移除适合的腹腔镜器械18，即与ISA(例如300)组装的杆(例如302)。上述基本圆柱状的ISA300外形、它的耦合件308、底座130、槽402及锁定机构406提供ISA300到LIA120上的引导插入及简单连接程序。该设计确保在通过少数几次手动移动的ISA插入及拔出程序时需要的刚度。通过该设计，可基本用与手动手术程序相同的速度完成适合的腹腔镜器械18(即杆和ISA)的插入和拔出，其中助手在大约6-9秒中为外科医生替换传统器械。
应当注意，包括ISA(例如300)和杆(例如302)的适合的腹腔镜器械18的插入和移除可在两种情况下安全完成：当器械在患者P体外时或者当器械插入在患者P内体时。当滑块销314被驱动时同样可能完成移除。
将适合的工具装配到LIA120上之前，应当符合多个初步条件。第一，如果器械部分插入到套管针(不超过套管针长度)，LIA120应当预先通过操作器14定位及定向到教导的位置，其将效应器单元30(关节J6)的旋转轴与套管针对齐。第二，滑座430应当由机器人控制系统放置在“插入参考位置”，例如，最靠近接口凸缘156的位置。当移除ISA(例如300)时，滑座430应当由机器人控制系统自动移入到该“插入参考位置”。如上所述，ISA的存在、缺席或者不正常释放可由存在检测器404检测。第三并且如果存在，ISA(例如300)的滑块销(例如314)应当在对应于滑座430的“插入参考位置”的“插入参考位置”。滑块销314的该位置优选地确定为使器械处于“闭合”构造，例如，镊子/剪刀器械的爪松驰地、但足以在该位置闭合。
最佳如图14所示，包括ISA(例如300)和杆(例如302)的适合的腹腔镜器械18的插入程序可通过根据箭头460的仅一次手动移动而实现，所述移动包括将ISA(例如300)放置在底座130上并包括在ISA上沿着相同的方向轻轻推动以将耦合件308和锁定机构406啮合。存在检测器404在耦合件308正确安装在槽402中时给出表示肯定的输出。在插入程序的期间，如果已经符合前述条件，滑座430啮合滑块销314而不需要进一步测量。
当外科医生S通过他的主控制台15要求器械更换时，通常由机器人控制系统自动执行四个程序。第一，机器人控制系统控制器械18以释放任何组织。第二，其移动器械沿着器械轴线方向靠近套管针入口。第三，使例如器械爪的工具尖端成为避免钩住套管针上的尖端的构型。第四，其释放关节J6的电动机从而使外科医生助手A能自由地旋转LIA120以便于将器械从LIA120上移除。在这些操作之后，适合的腹腔镜器械18的移除可在任何时候以两个简单移动安全地完成。
第一拔出移动包括推动旋钮456以使锁定结构406解锁。第二拔出移动包括通过绕垂直于杆轴的轴旋转而绕杆的尖端转动ISA(例如300)及杆(例如302)，从而将两者从底座130上移除，并且随后，如果仍然插入，使杆(例如302)从患者P体内拔出。
从上述插入和移除程序显而易见的是，即使在适合的腹腔镜器械18的杆(例如302)仍然通过套管针200(见图16)而部分插入在患者P体内时，LIA120和ISA(例如300)的设计使器械能插入或拔出。将会意识到的是，拔出所需要的移动不在关于患者P的穿刺方向上，因为它们包括垂直于底座130纵轴的枢轴移动及随后的拔出移动。另外，为了防止在给定枢轴方向上的移动会伤害患者，该方向可通过由手LIA穿过关节J6旋转LIA120而改变。此外，如果出现供电故障，ISA(例如300)与其杆(例如302)一起可手动释放及拔出。
关于上述的LIA120，将会意识到的是，许多现有的标准腹腔镜器械可通过简单的器械杆适配器(ISA)(例如300)用于机器人系统10中。LIA120结合相应的ISA代替给定腹腔镜器械的手柄部分而不损失驱动或供电能力。LIA120是一般性地设计的，即独立于将要耦合到机器人操作器14的器械类型。因此，只有ISA(例如300)需要根据器械要求而特定设计。如上所述，LIA120能提供尤其下列功能：
·使用线性作动机构400对例如器械爪的器械工具尖端的“开/关”作动；
·使适应每种类型的器械所要求的“开/关”行程长度；
·通过机器人操作器14的动作操作诸如手术刀的非作动器械。
另外，由于一些因素，LIA120允许机器人腹腔镜中有益的成本效果。第一，与由于器械和关联的作动器组装为单一外壳中的单一单元因而每个操作器要求几个作动器的现有技术的设备相反，每个操作器14只需要一个LIA120。这允许节省尤其在作动器上的费用。第二，通过使用标准腹腔镜器械的杆(例如302)和简单构造的相应器械杆适配器(例如300)而减少了器械费用。因此，用于LIA120的适合的器械18的费用几乎与标准手动腹腔镜器械(即包括手柄)的费用相同。第三，器械维护费用基本与那些标准腹腔镜器械相同，因为ISA(例如300)的设计对于消毒循环是坚固(robust)的。
回到图25，将描述LIA120的替换实施例。由于在此描述的LIA的许多方面和优点同样可应用于LIA1120，下面只详细介绍主要特征和区别。
图25所示的LIA1120具有半圆柱状的外壳154，其具有上部基本平的接近表面1401，用于便于ISA的装配到LIA1120上和从其上移除。外壳1154的相对的表面1155为与和J6的旋转轴同轴的圆柱状包络一致的半圆柱状。选择半圆柱状表面1155的直径符合人体工程学允许由人类操作者操作，例如在50-135mm的范围内，优选地为约90mm，尤其用于在上述手动模式中支配机器人操作器14。由于半圆柱状外壳具有基本小于接口凸缘156的横截面，LIA1120通过该凸缘连接到FTAS122上，外壳1154还包括逐步加固肋1157。该加固肋具有从接近表面1401直到接口凸缘156的上边缘逐步即平稳地增长的形状。该加固肋1157还进一步弯曲以符合半圆柱状表面1155的圆柱状包络。加固肋1157将接近表面1401连接到接口凸缘156并且因而加强及增加外壳1154连接到接口凸缘156上的刚度。因此，加固肋1157确保将力和扭矩更精确地从ISA经过LIA1120传动到FTAS122。应当注意相似的加固肋同样提供在图14的LIA120中。
图25进一步示出用于将器械杆适配器装配到LIA1120上并从而装配到效应器单元30上的替换耦合机构。在LIA1120中，如在LIA120中一样，底座1130构成为在LIA120的接近表面1401中凹入的细长半圆柱状凹进处，以提供适配器在J6的旋转轴上的自定心。另外，耦合机构包括多个磁性装置1423，两个位于滑座1430的侧面且一个位于底座1130的另一侧，后者布置在离开接近表面1401的高处1425。高处1425提供在装配的适配器的轴方向上的附加保持约束并允许通过朝接近表面1401的倾斜而在适配器的轴方向上进行自调整定位。应当理解，可以是电磁体、永磁体或两者的结合的磁性装置1423，确保通过磁性吸引使相应设计的ISA紧固。机械扣入连接的避免消除了对用于包围操作器14或至少效应器单元30的无菌塑料罩损伤的风险。
图25示出多个感应存在传感器1431，用于通过在ISA上提供的感应可识别材料模式(pattern)识别装配在效应器单元30上的器械。在使用二进制码(4位字节)时，基于面对感应存在传感器1431的ISA上一行相应位置的感应材料的存在或缺席，四个感应存在传感器1431排列成行并允许辨别和识别16个器械类型。另外，如果对应于缺席器械的模式编码(4位字节)用于该目的，即当没有感应材料面对任何感应传感器1431时，感应存在传感器1431同样允许存在检测。啮合件1433单独地在图25中示出。啮合件1433是包括滑座1430的作动机构的一部分并具有倾斜的抓取表面1434，其引入用于啮合ISA的滑块销314的缝。倾斜的表面1434便于ISA的滑块销314插入。将会意识到的是，啮合件1433可从滑座1430上脱离并由消毒兼容材料制成。啮合件因而可仅仅在无菌罩盖在LIA1120后就可安装在滑座1430上。由于限制了滑座1430的运动范围，不会出现对无菌罩的损伤。
图26示出装配在图25的LIA1120上的ISA1300的替换实施例。该ISA1300设计为与LIA1120的替换设计一致并且将在下文中详细介绍。ISA1300的尺寸设置为使它的底部限制在接近表面1401。ISA1300的功能与图17示出的ISA300的功能相同，也是提供接口允许在机器人操作器14上使用标准手动腹腔镜器械的杆302，而不损失任何在手动插入中可用的功能。图26还示出提供在LIA1120上的开关按钮408，用于将系统切换到手动模式。ISA1300提供有杠杆1301，用于简单的手动拆卸，即将ISA1300与LIA1120分开。ISA1300同样具有电连接器1308用于将电动器械(即凝固或切割器械)直接连接到电源上而不需要经过LIA1120的电线。
从图25和26显而易见的是，该设计使包括外壳1154、凸缘156、加固肋1157、FTAS122传感器组件的LIA1120的所有元件，，及包括杠杆1301的装配的ISA1300的所有部分，位于由半圆柱状表面1155确定的圆柱状包络中。这减少了当LIA1120被J6旋转时碰撞和损伤的风险。不同于图19的机构的设计，图27示出替换的作动机构1400用于将线性运动传输到滑座1430。其包括通过变速箱1412及滚珠丝杆或蜗轮1430连接到螺母件1422的微型无刷电动机1411。滑座1430通过力传感器1427的媒介而固定在螺母件1422上。力传感器1427允许测量由滑座1430施加在滑块销314上的力，反之亦然。同样将会意识到的是，通过将滑座1430装配到纵向底座1130的侧面带来的优势，电动机1411和连接的齿轮可平行于ISA1300和杆302的纵轴布置。这允许使LIA1120的总长度最小化，由此减少了对一些关节(例如J4)的作动器动力学要求。另外，将会意识到的是，这种作动机构1400在产生有害振动方面得以最优化。驱动机构1400的其他方面和优势类似于在此之前描述的机构400。
图28示出当图26的ISA1300从LIA1120脱离时的其底侧。ISA1300包括在其前端(见图30)具有杆连接器1304的细长壳1303。杆连接器1304允许在提供任何类型的可分离连接时，可移动连接至固定在标准手动腹腔镜器械的杆302(仅部分示出)上典型的插座306。当然，连接器和插座可分别定位在杆及ISA上。类似于壳303，壳1303在其底侧具有半圆柱状表面，用于与底座1330配合。如图28所示，侧翼1305从壳1303的任一侧突出。侧翼1305具有平的较低表面，与LIA1200上的接近表面1401(例如，同样与高处1425)成对。在滑块销314上的一个翼1305中提供切除空间1307用于提供可见性和接近性，例如当ISA1300耦合到LIA1120上时用于手动移动滑块销314。图28同样示出平板铁磁件1311，布置在位于壳1303任一侧上的每个翼1305中。铁磁件1311形成分别与如图25所示的LIA1120上相应的磁性装置1423配合的耦合装置。在区域1313，在ISA1300上提供感应识别模式，用于通过图25所示的感应传感器1431识别使用的器械。在图25所示的该实施例中，全金属盘对应于给定的4位字节(例如1111或0000)，而在其他适配器空间中可提供空间，例如通过在面对感应传感器1431的一个或多个位置钻孔而给出不同位字节用于识别。
图29示出图28所示的ISA的局部剖视图。如图29所示，ISA1300具有内部中空结构，作为一些手动腹腔镜器械的活塞310的圆柱状引导1312。活塞310典型地用于手动器械用于将运动从器械手柄传输到在杆302中引导的轴。将会意识到的是，现有的手动器械的活塞可布置为在引导1312中滑动。如图28所示，椭圆形通孔1315提供在壳1303中以允许横向连接到活塞310的滑块销314从壳1303上突出，并在壳1303的轴方向上向前及向后移动用以操作活塞310。图29所示的活塞310为手动双极器械的原始部分，用于提供双极电力给器械并用于锁定/解锁器械。
图30示出可使用相同类型的适配器以适应不同类型的商业可获得的用于手动插入的腹腔镜器械的不同活塞，例如如图30所示的用于单极手动器械的活塞1310。因而可以得出结论，诸如ISA1300(或ISA300)的适配器允许任何可商业获得的相对不贵的手动器械的基本部分用在机器人操作器14上。图29同样示出杠杆1301的两个凸榫1317中的一个及在其上面转动的轴1319。通过向下推动杠杆1301，凸榫1317举起ISA1300的较低的表面，尤其是铁磁件1311，离开ISA1120的接近表面1401从而可在垂直于J6旋转轴、即器械杆的轴的方向手动移动ISA1300。
除了上面描述的方面，医疗机器人系统10还呈现下面特征：
- 利用它们的设计，机器人操作器14可容易且快速地缩回以允许外科医生S靠近手术台12或允许安装放射设备；
- 利用它们的设计并使用来自外部传感器的信息，机器人操作器14可在插入期间容易地适应手术台12的角度变化，而插入时间没有明显增加，用于患者的(反)特伦德伦堡体位(-/+20-35度)或者侧面体位；
- 利用它们的设计并使用来自外部传感器的信息，机器人操作器14可容易地处理由于腹内压的变化引起的套管针位置的变化；
- 医疗机器人系统10允许减少器械更换的时间从而使整个介入手术时间最小化，LIA120、1120及机器人操作器14的设计使器械更换时间基本与手动腹腔镜手术中的时间一样短(范围为6至9秒)，当与内窥镜一起使用时，机器人操作器14的设计同样使能够实现快速内窥镜拔出及重新插入，例如为了清洁光学系统；
- 医疗机器人系统10允许快速和简单设置系统，包括围绕在手术台12的多个机器人操作器14的构造；
- 机器人操作器14设计为通用的从而适合诸如微创手术、整形外科、或活组织切片检查、经皮治疗、皮肤切割、超声诊断等多种应用。
虽然提交的本专利申请原则上涉及如随附的权利要求所确定的发明，但是本领域技术人员将容易理解本专利申请包含对其他发明的定义的支持，其可例如要求作为本申请的修改权利要求的主题或作为在分案申请和/或继续申请中的主题。这种主题可由在此公开的任何特征或特征的结合而确定。

Claims (28)

1.用于实施微创医疗手术的机器人手术系统，包括用于机器人辅助操作腹腔镜器械(18)的机器人操作器(14)，所述机器人操作器具有操作器的臂部(26)，由所述操作器的臂部支撑的操作器腕部(28)及由所述操作器腕部支撑的效应器单元(30)，其中：
所述操作器的臂部(26)通过第一关节(J1)、第二关节(J2)和第三关节(J3)提供三个自由度，所述第一关节具有关联的第一作动器(51)，所述第二关节具有关联的第二作动器(61)，所述第三关节具有关联的第三作动器(71)，用于定位机器人手术系统的所述操作器腕部；
所述操作器腕部(28)通过第四关节(J4)和第五关节(J5)提供两个自由度，所述第四和第五关节为转动关节，并且所述第四关节具有关联的第四作动器(81)，所述第五关节具有关联的第五作动器(101)，用于分别设置机器人手术系统的所述效应器单元的偏航角及俯仰角；
所述效应器单元(30)包括腹腔镜器械作动器(120、1120)并通过转动的第六关节(J6)提供一个自由度，所述转动的第六关节具有关联的第六作动器(141)用于设置机器人手术系统的所述腹腔镜器械作动器的滚动角；
所述腹腔镜器械作动器包括底座(130、1130)，具有用于将器械杆适配器(300、1300)装配到所述效应器单元上的关联的耦合机构(406、1423)，以及与所述器械杆适配器配合的用于作动连接在所述适配器上的腹腔镜器械的作动机构(400、1400)；
所述效应器单元(30)构造为当通过所述器械杆适配器装配在所述效应器单元上时，使腹腔镜器械的纵轴与所述转动的第六关节(J6)的旋转轴一致；及
所述效应器单元包括具有六个自由度的力/扭矩传感器和六个自由度的加速度计的传感器组件(122)，所述传感器组件(122)将所述腹腔镜器械作动器(120、1120)连接到所述转动的第六关节(J6)。
2.根据权利要求1所述的机器人手术系统，其中所述效应器单元(30)构造为使所述6DOF力/扭矩传感器(122)的一个传感器轴及6DOF加速度计(122)的一个传感器轴与所述转动的第六关节的旋转轴一致。
3.根据权利要求1所述的机器人手术系统，其中所述腹腔镜器械作动器(120、1120)包括具有所述底座(130、1130)布置在其中的接近表面(401、1401)的外壳(154、1154)，将所述外壳连接到所述传感器组件(122)上的接口凸缘(156)以及将所述接近表面连接到所述接口凸缘用于加固所述外壳连接在所述接口凸缘上的刚度的逐步加固肋(1157)。
4.根据权利要求3所述的机器人手术系统，其中所述外壳(1154)为半圆柱状，具有相对于所述接近表面(1401)的基本半圆柱状表面(1155)，所述半圆柱状表面与直径为50-135mm且与所述转动的第六关节(J6)的旋转轴同轴的圆柱状包络一致，并且其中所述外壳(1154)、所述凸缘(156)、所述加固肋(1157)及所述传感器组件(122)尺寸设置为适合所述圆柱状包络。
5.根据权利要求4所述的机器人手术系统，其中所述半圆柱状表面与直径为90mm且与所述转动的第六关节(J6)的旋转轴同轴的圆柱状包络一致。
6.根据权利要求1至5中任一项所述的机器人手术系统，其中所述底座包括细长的基本半圆柱状凹进(130、1130)，其基本与所述转动的第六关节(J6)的旋转轴共轴布置在所述腹腔镜器械作动器(120、1120)的接近表面(401、1401)，所述底座和所述耦合机构构造为用于通过垂直于所述转动的第六关节(J6)的旋转轴的运动而装配和移除器械杆适配器(300、1300)。
7.根据权利要求6所述的机器人手术系统，其中所述耦合机构包括分别布置在所述半圆柱状凹进(1130)的任一侧上的至少一个磁性装置(1423)，用于通过磁性吸引将器械杆适配器(1130)紧固到所述腹腔镜器械作动器。
8.根据权利要求7所述的机器人手术系统，其中所述磁性装置是永磁体或电磁体。
9.根据权利要求1至5中任一项所述的机器人手术系统，其中所述作动机构(400、1400)包括滑座(430、1430)，其构造用于啮合地接受并线性滑动装配在所述效应器单元上的器械杆适配器(300、1300)的滑块销(314)，所述底座(130、1130)沿着所述转动的第六关节的旋转轴线延伸并且所述滑座(430、1430)布置在所述底座侧部。
10.根据权利要求9所述的机器人手术系统，其中所述作动机构(400、1400)包括力传感器(1427)，其将所述滑座(430、1430)连接到驱动机构上，用于测量由所述滑座施加或施加在其上的力。
11.根据权利要求10所述的机器人手术系统，其中所述滑座(1430)包括可从所述滑座脱离的啮合件(1433)，并具有倾斜的抓取表面(1434)用于啮合所述滑块销(314)。
12.根据权利要求7所述的机器人手术系统，其中所述作动机构(400、1400)包括构造为用于啮合接受以及用于线性滑动安装到所述效应器单元的器械杆适配器(300、1300)的滑块销(314)的滑座(430、1430)，所述底座(130、1130)沿着所述转动的第六关节的旋转轴线延伸并且所述滑座(430、1430)布置在所述底座侧部。
13.根据权利要求12所述的机器人手术系统，其中所述作动机构(400、1400)包括力传感器(1427)，其将所述滑座(430、1430)连接到驱动机构上，用于测量由所述滑座施加或施加在其上的力。
14.根据权利要求13所述的机器人手术系统，其中所述滑座(1430)包括可从所述滑座脱离的啮合件(1433)，并具有倾斜的抓取表面(1434)用于啮合所述滑块销(314)。
15.根据权利要求1至5中任一项所述的机器人手术系统，其中所述腹腔镜器械作动器(120、1120)包括存在检测器(404、1431)用于检测器械杆适配器(300、1300)是否正确地装配在所述效应器单元上。
16.根据权利要求15所述的机器人手术系统，其中所述存在检测器包括多个感应存在传感器(1431)用于通过提供在器械杆适配器上的可感应识别模式(1313)识别装配在所述效应器单元(30)上的器械。
17.根据权利要求14所述的机器人手术系统，其中所述腹腔镜器械作动器(120、1120)包括存在检测器(404、1431)用于检测器械杆适配器(300、1300)是否正确地装配在所述效应器单元上。
18.根据权利要求17所述的机器人手术系统，其中所述存在检测器包括多个感应存在传感器(1431)用于通过提供在器械杆适配器上的可感应识别模式(1313)识别装配在所述效应器单元(30)上的器械。
19.根据权利要求1至5中任一项所述的机器人手术系统，其中所述系统构造为在手动模式中操作，其中可通过所述机器人操作器使用从6DOF力/扭矩传感器读出的信息定位及定向所述腹腔镜器械作动器，并且所述系统还包括布置在所述腹腔镜器械作动器(120、1120)上的开关件(408)用于将所述系统切换为手动模式。
20.根据权利要求17所述的机器人手术系统，其中所述系统构造为在手动模式中操作，其中可通过所述机器人操作器使用从6DOF力/扭矩传感器读出的信息定位及定向所述腹腔镜器械作动器，并且所述系统还包括布置在所述腹腔镜器械作动器(120、1120)上的开关件(408)用于将所述系统切换为手动模式。
21.构造为装配在如权利要求1至20任一项所述的机器人手术系统的机器人操作器(14)上的腹腔镜器械杆适配器(130、1130)，用于使用所述机器人操作器上的手动腹腔镜器械的杆(302)，所述适配器包括具有布置在前端的杆连接器(304、1304)的细长壳(303、1303)以及布置在所述壳的侧部的耦合件(308、1311)，所述杆连接器(304、1304)构造用于可脱离连接至手动腹腔镜器械的杆(302)，并且所述耦合件(308、1311)与所述机器人操作器的腹腔镜器械作动器上的耦合机构(406、1423)配合。
22.根据权利要求21所述的腹腔镜器械杆适配器，其中所述耦合件(308、1311)包括半圆柱状表面，所述表面与所述机器人操作器的腹腔镜器械作动器(120、1120)中的底座(130、1130)的半圆柱状凹进一致，用于将器械杆适配器(300、1300)定心在所述转动的第六关节的旋转轴上。
23.根据权利要求21所述的腹腔镜器械杆适配器，包括圆柱状内部中空部分作为用于手动腹腔镜器械的活塞(310、1310)的引导(312、1303)，所述活塞可布置为在所述引导中滑动，以及通孔(1315)用于将滑块销(314)横向连接到所述活塞并从所述壳上突出用以操作活塞。
24.根据权利要求21所述的腹腔镜器械杆适配器，其中所述耦合件包括至少一个布置在所述壳(1303)任一侧的铁磁件(1311)，所述铁磁件分别与相应的在所述腹腔镜器械作动器上的耦合机构的磁性装置(1423)配合，用于通过磁性吸引将所述器械杆适配器紧固到所述腹腔镜器械作动器上以及其中所述器械杆适配器包括用于将所述适配器(1300)从所述腹腔镜器械作动器上分离的杠杆(1301)。
25.根据权利要求21所述的腹腔镜器械杆适配器，进一步包括提供在器械杆适配器上的感应可识别模式(1313)，用于识别装配在所述适配器上的器械。
26.根据权利要求21所述的腹腔镜器械杆适配器，进一步包括相对于所述耦合件布置的电连接器(308、1308)，用于将电能传输到连接在所述杆连接器上的器械。
27.用于机器人辅助操作腹腔镜器械(18)的机器人操作器(14)，所述机器人操作器具有操作器的臂部(26)，由所述操作器的臂部支撑的操作器腕部(28)及由所述操作器腕部支撑的效应器单元(30)，其中：
所述操作器的臂部(26)通过第一关节(J1)、第二关节(J2)和第三关节(J3)提供三个自由度，所述第一关节具有关联的第一作动器(51)，所述第二关节具有关联的第二作动器(61)，所述第三关节具有关联的第三作动器(71)，用于定位所述操作器腕部；
所述操作器腕部(28)通过第四关节(J4)和第五关节(J5)提供两个自由度，所述第四和第五关节为转动关节，并且所述第四关节具有关联的第四作动器(81)，所述第五关节具有关联的第五作动器(101)，用于分别设置所述效应器单元的偏航角及俯仰角；
所述效应器单元(30)包括腹腔镜器械作动器(120、1120)并通过转动的第六关节(J6)提供一个自由度，所述转动的第六关节具有关联的第六作动器(141)用于设置所述腹腔镜器械作动器的滚动角；
所述腹腔镜器械作动器包括底座(130、1130)，具有用于将根据权利要求17的器械杆适配器(300、1300)装配到所述效应器单元上的关联的耦合(406、1423)；
所述效应器单元(30)构造为当通过所述器械杆适配器装配在所述效应器单元上时，使腹腔镜器械的纵轴与所述转动的第六关节(J6)的旋转轴一致；及
所述效应器单元包括具有六个自由度的力/扭矩传感器和六个自由度的加速度计的传感器组件(122)，所述传感器组件(122)将所述腹腔镜器械作动器(120、1120)连接到所述转动的第六关节(J6)。
28.根据权利要求27所述的机器人操作器，其中所述效应器单元(30)构造为使所述6DOF力/扭矩传感器(122)的一个传感器轴及6DOF加速度计(122)的一个传感器轴与所述转动的第六关节的旋转轴一致。
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