CN103930064B - 用于将多个关节式器械退回入口导管串联地移动的方法和系统 - Google Patents
用于将多个关节式器械退回入口导管串联地移动的方法和系统 Download PDFInfo
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Abstract
医疗机器人系统包括伸出入口导管的远端的关节式器械。在枢转所述入口导管以对其和所述器械进行重新定向之前,所述器械退回所述入口导管串联地移动。提供触觉提示和速度限制,以在所述器械的缩回过程中协助操作员。在缩回之后,所述入口导管随后可以进行枢转,而不用担心所述器械会伤害患者组织。所述器械退回所述入口导管的串联移动也可以通过耦合控制模式发生,同时所述入口导管被固持在固定位置和定向上。
Description
相关申请案的交叉引用
本申请案是2010年5月14日提交的标题为“具有耦合控制模式的医疗机器人系统(Medical Robotic System with Coupled Control Modes)”的第12/780,071号美国申请案的部分继续申请案,该美国申请案是2007年6月13日提交的标题为“微创手术系统(Minimally Invasive Surgical System)”的第11/762,200号美国申请案的部分继续申请案,这两个美国申请案中的每一个由引用并入本文。
本申请案也是2009年11月5日提交的标题为“针对伸出入口导管的远端的可关节式器械提供包括运动范围限制的辅助视图的医疗机器人系统(Medical Robotic SystemProviding an Auxiliary View Including Range of Motion Limitations forArticulatable Instruments Extending Out of a Distal End of an Entry Guide)”的第12/489,566号美国申请案的部分继续申请案,该申请案由引用并入本文。
本申请案也是2009年11月5日提交的标题为“在移入以及移出入口导管期间的关节式器械的控制器协助的重新配置(Controller Assisted Reconfiguration of anArticulated Instrument During Movement Into and Out of an Entry Guide)”的第12/613,328号美国申请案的部分继续申请案,该美国申请案是2009年8月15日提交的标题为“具有不同工作空间情况的跨区域关节式器械的平滑控制(Smooth Control of anArticulated Instrument Across Areas with Different Work Space Conditions)”的第12/541,913号美国申请案的部分继续申请案,这两个美国申请案中的每一个由引用方式并入本文。
技术领域
本发明一般涉及医疗机器人系统,尤其,涉及一种用于将多个关节式器械退回入口导管串联地移动的方法和系统,所述多个关节式器械伸出所述入口导管。
背景技术
例如执行微创外科手术时所使用的遥操作系统等医疗机器人系统提供优于传统开腹手术技术的许多益处,包括减少疼痛、缩短住院时间、快速恢复正常活动、伤疤微小、减少恢复时间以及对组织伤害较小。因此,对此类医疗机器人系统的需求非常强烈且不断增长。
此种医疗机器人系统的一个实例是来自美国加利福尼亚州森尼威尔的直觉外科公司(Intuitive Surgical,Inc.)的达芬奇手术系统(DA VINCI Surgical Syste),其为微创机器人手术系统。DA手术系统具有多个机械臂,所述机械臂移动附接医疗设备,例如,图像捕获设备和直觉外科公司专有的关节式手术器械,以响应通过由手术部位的图像捕获设备捕获的外科医生观察图像操作的输入设备的移动。医疗设备中的每一个通过其自身的微创切口插入到患者体内并且经定位以在手术部位执行医疗程序。切口围绕患者身体安置,以使得手术器械可用来协作地执行医疗程序并且图像捕获设备可以观察所述医疗程序。
然而为了执行某一医疗程序,使用进入患者体内的单个孔例如,微创切口或人体自然孔口来执行医疗程序是有利的。例如,入口导管(也称为“导管”)可以首先被插入、定位且固持在入口孔中的适当位置。器械例如关节式器械即多个关节式手术工具可用于执行医疗程序,然后其可以被插入到入口导管的近端,以便伸出其远端。因此,入口导管提供用于多个器械的单个入口孔,同时在进入导管引导仪器进入工作部位时,使器械保持捆绑在一起。
U.S.2009/0326318 Al描述了视觉提示,所述视觉提示有助于操作员重新定位入口导管的定向,以使得可以将延伸出其远端的关节式器械的运动范围最优化。U.S.2011/0040305 Al描述了在关节式器械移入以及移出入口导管期间的关节式器械的控制器协助的重新配置。U.S.2011/0201883 Al描述了一种用于单端口手术系统中的多个器械的入口导管。U.S.2008/0071288 Al描述了微创手术导管、可伸出导管的关节式器械以及用于控制导管和器械的移动的控制器。
除了最优化关节式器械的运动范围之外,有必要改变入口导管的定向并且因此改变设置在其中的关节式器械的定向,以使得所述关节式器械中的一个或更多个可以到达或者进入患者体内将执行医疗程序的位置。然而当改变入口导管的定向时,应该注意的是,确保伸出其远端的关节式器械不会撞击和伤害周围组织或者患者的其他内部组织构造。而且,可以提供触动觉以在入口导管重新定向过程期间协助外科医生。
发明内容
因此,本发明的一个或更多个方面的一个目标是医疗机器人系统以及在其中实施的便于改变入口导管的定向的方法,关节式器械是以避免伤害患者的方式穿过所述入口导管可延伸的。
本发明的一个或更多个方面的另一目标是医疗机器人系统以及在其中实施的便于改变入口导管的定向的方法,关节式器械是以快速且有效的方式穿过所述入口导管可延伸的,所述方式将由医疗机器人系统的操作员执行的步骤减到最少。
本发明的一个或更多个方面的再另一目标是医疗机器人系统以及在其中实施的方法,所述方法便于操作员控制作为重新定向入口导管的过程的一部分或在其他应用中将一个或更多个关节式器械缩回入口导管中,在所述其他应用中此种受控制的缩回是有用的。
本发明的一个或更多个方面的又另一目标是医疗机器人系统以及在其中实施的用于将多个关节式器械退回入口导管串联地缩回的方法,所述多个关节式器械伸出所述入口导管。
通过本发明的各个方面可实现这些和额外的目标,其中简单来说,一个方面是用于将多个关节式器械退回入口导管串联地移动的方法,所述方法包括:仅响应于将所述多个关节式器械以大于从初始位置的缩回距离的距离退回入口导管串联地移动的一个或更多个命令,使得所述多个关节式器械能够采取缩回配置。
另一方面是用于对具有伸出入口导管的多个关节式器械的入口导管进行重新定向的方法,所述方法包括:产生沿着入口导管的纵轴在缩回方向上以超过从初始位置的锁止距离的距离平移地移动入口导管的第一命令;响应于第一命令,使得用于枢转入口导管的接合处能够被锁定在适当位置;产生沿着入口导管的纵轴在缩回方向上以大于从初始位置的缩回距离的距离平移地移动入口导管的第二命令,其中所述缩回距离大于锁止距离;响应于第二命令,使得多个关节式器械能够采取缩回配置并且退回入口导管串联地缩回;在多个关节式器械已退回入口导管以某一距离缩回之后,使得用于枢转入口导管的接合处能够被解锁,所述距离允许入口导管的枢转,而不会使多个关节式器械中的任一个伤害任何患者组织;产生将入口导管枢转到不同定向的第三命令;以及响应于第三命令,使得用于枢转入口导管的接合处能够枢转入口导管。
另一方面是机器人系统,其包括:至少一个输入设备;入口导管;多个关节式器械,所述关节式器械伸出所述入口导管的远端;多个器械操纵器,用于操纵所述多个关节式器械中的对应者;以及处理器,所述处理器适用于:响应于从至少一个输入设备接收到的将多个关节式器械以大于从初始位置的缩回距离的距离退回入口导管串联地移动的一个或更多个命令,命令多个器械操纵器操纵多个关节式器械,从而采取缩回配置。
从对本发明优选实施例的以下描述中,将明白本发明的各种方面的额外目标、特征和优点,所述描述应结合附图进行。
附图说明
图1示出利用本发明的多个方面的医疗机器人系统的示意图。
图2和图3分别示出利用本发明的多个方面的在医疗机器人系统中有用的床旁支撑系统的替代实施例。
图4示出利用本发明的多个方面的与医疗机器人系统中的入口导管的操纵相关联的参考坐标系和自由度。
图5示出利用本发明的多个方面的用于在医疗机器人系统中的操纵入口导管的入口导管操纵器的部件的框图。
图6示出利用本发明的多个方面的在医疗机器人系统中有用的外科医生控制台的正视图。
图7示出利用本发明的多个方面的在医疗机器人系统中的具有关节式器械的入口导管的远端立体图,其中关节式器械伸出所述入口导管。
图8示出利用本发明的多个方面的在医疗机器人系统中有用的入口导管的截面图。
图9示出利用本发明的多个方面的在医疗机器人系统中有用的关节式器械的近段的立体图。
图10示出利用本发明的多个方面的在医疗机器人系统中有用的与关节式器械配合并且致动关节式器械的器械操纵器的致动器组件的片段的立体图。
图11示出利用本发明的多个方面的安装在医疗机器人系统中与机械臂组件耦合的平台上的关节式器械组件的第一立体图。
图12示出利用本发明的多个方面的安装在医疗机器人系统中与机械臂组件上耦合的平台上的关节式器械组件的第二立体图。
图13示出利用本发明的多个方面的用于控制医疗机器人系统的输入设备并且选择性地将可控制设备与所述输入设备相关联的部件的框图。
图14示出利用本发明的多个方面的在医疗机器人系统中的枢转入口导管的侧视图,其中关节式器械伸出所述入口导管的远端。
图15示出利用本发明的多个方面的在医疗机器人系统中的枢转入口导管的侧视图,其中关节式器械缩回到入口导管中。
图16示出利用本发明的多个方面的用于重新定向入口导管的方法的流程图,其中至少一个关节式器械设置在所述入口导管中。
图17示出利用本发明的多个方面的在具有关节式器械的耦合控制的入口导管模式下的医疗机器人系统的部件的框图。
图18A至18C示出利用本发明的多个方面的在将关节式器械缩回到医疗机器人系统中的入口导管中的各个级中的入口导管的俯视图。
图19示出利用本发明的多个方面的用于将多个关节式器械退回入口导管串联地移动的方法的流程图。
图20示出在利用本发明的多个方面的用于退回入口导管移动至少一个关节式器械的方法中可用的力与命令的位置变化的关系。
图21示出在利用本发明的多个方面的用于退回入口导管移动至少一个关节式器械的方法中可用的速度与命令的位置变化的关系。
图22示出利用本发明的多个方面的在具有关节式器械的耦合控制的相机模式下的医疗机器人系统的部件的框图。
图23示出利用本发明的多个方面的在具有关节式器械的耦合控制的器械跟随模式下的医疗机器人系统的部件的框图。
图24示出利用本发明的多个方面的用于将多个关节式器械退回入口导管串联地移动的替代方法的流程图。
图25示出在利用本发明的多个方面的用于退回入口导管移动至少一个关节式器械的替代方法中可用的力与命令的位置变化的关系。
图26示出在利用本发明的多个方面的用于退回入口导管缩回至少一个关节式器械的替代方法中可用的速度与命令的位置变化的关系。
具体实施方式
图1作为示例,其示出医疗机器人系统2100的示意图,其中器械经由通过入口导管的单个入口孔插入患者体内。系统的通用架构类似于其他此类系统的架构,例如,直觉外科公司的DA手术系统和手术系统。三个主要部件是外科医生控制台2102、床旁支撑系统2104以及影像系统2106,所有部件通过所示的有线或无线连接2108互连。
床旁支撑系统2104包括落地安装型结构2110,或可替代地由交替线示出的顶置式结构2112。所述床旁支撑系统还包括设置臂组件2114、入口导管操纵器(EMG)2116、平台2118、入口导管(EG)2000,以及一个或更多个器械组件2500。结构2110可以是可移动的或固定的(例如,固定到地板、天花板或操作台等的其他设备)。在一个实施例中,设置臂组件2114包括两个示例性无源旋转设置接合处2114a、2114b,这在释放耦合链环的制动器时允许耦合链环的手动定位。臂组件2114与结构2110之间的无源柱状设置接合处(未示出)可以用于允许较大的竖直调节。
入口导管2000耦合到平台2118上,进而耦合到入口导管操纵器2116上,以使得入口导管操纵器2116可以枢转平台2118,进而使得入口导管2000能够围绕远程中心(RC)点枢转。如图4中所示的入口导管2000的透视图,入口导管2000的形状通常为圆柱形并且具有沿着其长度在中心延伸的纵轴X'。RC点用作具有所示出的X、Y和Z轴的固定参考坐标系以及具有所示出的X'、Y'和Z'轴的入口导管参考坐标系两者的原点。当系统2100处于“入口导管”模式下时,响应于命令围绕Z轴(该轴保持固定在空间中)在RC点处以偏航角ψ的此种枢转的一个或更多个相关联的输入设备的移动,入口导管操纵器2116枢转入口导管2000。此外,响应于命令围绕Y'轴(该轴与入口导管2000的纵轴X'正交)以俯仰角θ的此种枢转的一个或更多个输入设备的移动,入口导管操纵器2116枢转入口导管2000;响应于命令围绕其纵轴X'以横滚角Ф的此种旋转的一个或更多个输入设备的移动,旋转入口导管2000;以及任选地,响应于命令沿着其纵轴X'在插入/缩回或输入/输出“I/O”方向上的此种移动的一个或更多个输入设备的移动,线性地移动入口导管2000。注意,与固定在空间中的Z轴不同,X'和Y'轴与入口导管2000一起移动。
入口导管操纵器2116包括示例性有源(即,可致动的)偏航接合处2116a和有源俯仰接合处2116b。接合处2116c和2116d用作平行机制,以使得在使用设置臂组件2114执行医疗程序之前,通过平台2118固持的入口导管2000可以围绕定位在入口端2120处的RC点例如,患者2122的肚脐以偏航和俯仰方式枢转。在一个实施例中,有源柱状接合处2124可以用于插入并且缩回入口导管2000。一个或更多个器械组件2500例如,用于手术器械和内窥镜成像系统的组件独立地安装到平台2118上,以便其设置在入口导管2000内并且穿过所述入口导管是可延伸的。
因此,当患者2122位于可移动工作台2126上的多个位置中时,设置臂组件2114用于将入口导管2000定位在患者2122的入口端2120中。在设置入口导管2000之后,器械组件2500安装在平台2118上,以使得它们的关节式器械延伸到入口导管2000中。随后,入口导管操纵器2116可以用于围绕RC点以俯仰和偏航方式枢转入口导管2000以及设置在其中的关节式器械。然而,通过入口导管操纵器2116进行的入口导管2000的旋转和/或入口导管2000的插入/缩回未必会引起设置在其中的关节式器械的对应移动。
如图5所示,入口导管操纵器(EGM)2116具有:四个致动器501-504,用于致动入口导管2000的四个自由度移动(即,偏航角ψ、俯仰角θ、横滚角Φ以及输入/输出I/O);以及用于实施致动器的四个对应组件511-514。EGM偏航组件511包括偏航旋转接合处2116a以及一个或更多个链环,所述链环通过入口导管操纵器2116的其他部分将组件耦合到平台2118上,以使得当EGM偏航致动器501(例如,电动机)致动(例如,旋转)偏航旋转接合处时,入口导管2000围绕固定的Z轴在RC点处以偏航角ψ旋转。EGM俯仰组件512包括俯仰旋转接合处2116b以及一个或更多个链环,所述链环通过入口导管操纵器2116的其他部分将组件耦合到平台2118上,以使得当EGM俯仰致动器502(例如,电动机)致动(例如,旋转)俯仰旋转接合处时,入口导管2000围绕固定的Y'轴在RC点处以俯仰角θ旋转。EGM横滚组件513包括齿轮组件,所述齿轮组件将入口导管2000耦合到EGM横滚致动器503上,以使得当EGM横滚致动器503(例如,电动机)致动(例如,其转子旋转)时,入口导管2000围绕其纵轴X'旋转以作为响应。在一个实施例中,EGM I/O组件514包括柱状接合处,所述柱状接合处耦合到EGM I/O致动器504上,以使得当EGM I/O致动器504(例如,电动机)致动(例如,其转子旋转)时,旋转动作沿着其纵轴X'被传递到入口导管2000的线性位移上。在另一实施例中,响应于EG I/O命令,设置在入口导管2000中的所有关节式器械在插入/缩回方向上移动,而不是在插入/缩回方向上移动入口导管2000。
图2和图3作为示例,其示出床旁支撑系统2104的替代实施例。支撑件2150是固定的(例如,落地安装型或顶置式)。链环2152在无源旋转设置接合处2154耦合到支撑件2150上。如图所示,接合处2154的旋转轴与RC点2156对齐,RC点通常是入口导管(未示出)进入患者体内(例如,在用于腹部手术的肚脐处)的位置。链环2158在旋转接合处2160耦合到链环2152上。链环2162在旋转接合处2164耦合到链环2158上。链环2166在旋转接合处2168耦合到链环2162上。入口导管通过链环2166的末端2166a安装到侧面。平台2170通过柱状接合处2172和旋转接合处2174支撑且耦合到链环2166上。随着柱状接合处2172沿着链环2166滑动,所述柱状接合处插入且缩回入口导管。接合处2174包括固持“C”形环状悬臂的轴承组件。由于“C”环穿过轴承滑动,因此其围绕在“C”内部的中心点旋转,由此横滚入口导管。“C”中的开口允许入口导管进行安装或交换,而不会移动上覆的操纵器。平台2170支持用于手术器械和成像系统的多个器械操纵器2176,如下所述。
这些示例性机械臂组件(即,设置臂组件和入口导管操纵器)用于,例如,包括刚性入口导管的器械组件并且经操作以关于远程中心(RC)点移动。如果不需要围绕远程中心的运动,那么机械臂组件中的某些设置以及有源接合处可以被省略。应理解,设置以及操纵器臂可以包括链环、无源和有源接合处(可以提供多余的DOF)的各种组合,以实现手术所需的多种姿势。
再次参考图1,例如,对于手术部位的所捕获内窥镜成像数据和/或来自患者外部的其他成像系统的手术前或实时图像数据,影像系统2106执行图像处理功能。影像系统2106将处理后的图像数据(例如,手术部位的图像,以及相关控制和患者信息)输出到外科医生控制台2102处的外科医生。在一些方面,处理后的图像数据被输出到对其他操作室人员可见的可选外部监视器,或者远离操作室的一个或更多个位置(例如,在另一位置的外科医生可以监视视频;直播视频可以用于培训;等等)。
图6作为示例,其示出外科医生控制台2102的正视图,外科医生或其他用户操作所述外科医生控制台,用于控制控制系统2100的入口导管以及关节式器械的移动。外科医生控制台2102具有左输入设备41和右输入设备42,用户可以分别用其左手和右手握紧左输入设备和右输入设备,以优选地以六自由度操纵相关联的设备,例如,入口导管和关节式器械。具有脚趾和脚后跟控制件的脚踏板44提供于外科医生控制台2102上,以使得用户可以控制与脚踏板相关联的设备的移动和/或致动。处理器43提供于外科手术控制台2102中,用于控制和其他目的。尽管被示为位于外科医生控制台2102的底座中的单个处理器,但是处理器43可以被实施为分布在外科医生控制台2102中以及医疗机器人系统2100的其他部分中的多个协作的处理器。立体镜45也提供于外科医生控制台2102中,以使得用户可以从由关节式相机器械的立体相机捕获的图像中以立体视觉观察工作部位。左目镜46和右目镜47提供于立体镜45中,以使得用户可以分别利用用户的左眼和右眼观察观察器45内部的左2D显示屏和右2D显示屏。
外科医生控制台2102通常与患者2122位于同一房间内,以使得外科医生可以直接监视程序,如果有需要亲自上场并且能够直接与手术室中的任何助手交谈,而不需要通过电话或其他通信媒体。然而,应理解,外科医生也可以位于不同房间中、完全不同的建筑物中,或者允许远程手术程序的远离患者的其他位置中。
如图7所示,入口导管2000具有关节式器械,例如,关节式手术工具器械231、241以及伸出入口导管的远端的关节式立体相机器械211(或其他图像捕获设备器械)。相机器械211具有一对立体图像捕获设备311、312以及容纳在其顶端的光缆313(在其近端耦合到光源上)。手术工具231、241具有末端执行器331、341。尽管仅示出两个工具231、241,但是入口导管2000可以按要求引导额外工具,用于在患者中的工作部位处执行医疗程序。例如,如图8所示,通道351可用于穿过入口导管2000延伸另一关节式手术工具并且穿过其远端伸出。通道431、441和321分别由关节式手术工具器械231、241以及关节式相机器械211使用。在工具跟随模式下,手术工具231、241中的每一个与输入设备41、42中的一个相关联。外科医生通过操纵输入设备41、42执行医疗程序,以使得控制器43引起它们分别相关联的手术工具231、241的对应移动,同时由于工作部位的图像由关节式相机器械211捕获,外科医生在工作台立体镜45上以3D形式观察工作部位。
优选地,输入设备41、42将配备有至少与它们的相关联的工具231、241相同的自由度,以向外科医生提供输入设备41、42与工具231、241一体化的远程呈现或感性认识,以使得外科医生具有直接控制工具231、241的强烈意识。为此,立体镜45也位于所示的外科医生的手附近,以使得立体镜将显示投影图像,所述投影图像经定向以使得外科医生感觉其实际上直接俯视工作部位并且工具231、241的图像呈现为实质上位于外科医生的手所处的位置。
此外,立体镜45上的实时图像优选地被投射到立体图像中,以使得外科医生可以通过他们的对应输入设备41、42操纵工具231、241的末端执行器331、341,就像实质上真正在场观察工作部位一样。通过真正在场,这意味着图像的呈现是模仿操作员视点的真实立体图像,所述操作员物理地操纵末端执行器331、341。因此,处理器43将末端执行器331、341的坐标变换到感觉到的位置,以使得在立体镜45上示出的立体图像是在外科医生直接位于末端执行器331、341后方的情况下,外科医生能够看到的图像。
处理器43在系统2100中执行各种功能。处理器执行的一个重要功能是经由通信构件2108通过控制信号将转化并且传递输入设备41、42的机械运动,以在它们相关联的操纵器中致动致动器,以使得外科医生可以有效地操纵设备,例如,工具器械231、241、相机器械211以及入口导管2000。另一功能是将执行各种方法并且实施各种控制器以及本文中描述的耦合逻辑。
尽管描述为处理器,但是应了解,处理器43可以由硬件、软件和固件的任何组合实施。而且,本文中所述的功能可以由一个单元执行或者在不同部件之间进行划分,其中每一个进而可以由硬件、软件和固件的任何组合实施。此外,尽管被示为控制台2102的一部分或与控制台2102物理相邻,但是处理器43还可以包括分布在整个系统中的多个子单元。
对于例如本文中所述的医疗机器人系统的各个方面的构造和操作的额外细节参见,例如,U.S.6,493,608“微创手术设备的控制系统的各个方面(Aspects of a ControlSystem of a Minimally Invasive Surgical Apparatus)”;U.S.6,671,581“微创手术设备中的引用相机的控制(Camera Referenced Control in a Minimally InvasiveSurgical Apparatus)”;以及U.S.2008/0071288 Al“微创手术导管(Minimally InvasiveSurgery Guide Tube)”,这些申请案中的每一个由引用并入本文中。
现在参考图9至图12描述利用插入到入口导管2000中的器械组件2500的工作端将器械组件2500安装到平台2118上。如图9所示,关节式器械2402包括耦合到器械主体管2406的近端上的传输机制2404。为清晰起见,主体管2406的远端2408处的部件被省略并且可以包括如图7所示的可致动接合处以及工作端。在所示的示例性实施例中,传输机制2404包括六个接口盘2410。盘2410中的每一个可以与关节式器械2402的自由度(DOF)相关联。例如,一个盘可以与器械主体横滚DOF相关联,并且第二盘可以与末端执行器夹持DOF相关联。如图所示,出于紧凑的目的,一个实例中,盘被布置在六角形栅格中,在这种情况下,六个盘呈三角形形状。可以使用其他格网型或更多个任意布置。传输机制2404内部的机械部件(例如,齿轮、杠杆、平衡环、缆线等)将盘2410上的横滚力矩传输到,例如,主体管2406(用于横滚)以及耦合到远端机制上的部件。控制远端DOF的缆线和/或缆线和海波管组合穿过主体管2406延伸。在一个实例中,主体管直径约7mm,并且在另一实例中,主体管直径约5mm。当与相关联的致动器盘配合时,偏心地间隔开的凸起栓2412提供适当的盘2410定向。一个或更多个电子接口连接器2414在器械2402与其相关联的致动器机制之间提供电子接口。电子接口还可以包括用于,例如,电灸末端执行器的电源。可替代地,此种电源连接可以位于器械2402上的其他位置(例如,位于传输机制2404的外壳上)。可以包括用于,例如,光纤激光器、光纤远端弯曲或力传感器、冲洗、吸入等的其他连接器。如图所示,传输机制2404的外壳大体上为楔形或饼形,以允许所述外壳紧密定位到类似外壳,如下文所说明。
图10是与手术器械2402中的部件配合且致动所述部件的致动器组件2420(本文中也称为器械“操纵器”)的一部分的立体图。致动器盘2422经布置以与接口盘2410配合。盘2422中的孔2424经对齐以仅在单个360度的方向上接收栓2412。每个盘2422通过相关联的旋转伺服电动机致动器2426转动,所述伺服电动机致动器接收来自其相应控制器的伺服控制输入,如下文所描述。经定形以对应于器械2402的传输机制外壳的大致楔形的安装托架2428支撑盘2422、伺服电动机致动器2426以及与器械2402的接口连接器2414配合的电子接口2430。在一个实例中,器械2402通过弹簧夹(未示出)相对于致动器组件2420固持,从而便于移除。如图10所示,致动器组件外壳2428的一部分2432被截短以允许器械主体管2406穿过。可替代地,孔可以被安置在致动器组件中,以允许主体管穿过。
图11是示出安装微创手术器械以及在设置/操纵器臂的末端处的它们的相关联的致动器组件的各个方面的图解立体图。如图11所示,手术器械2502a安装在致动器组件2504上,以使得传输机制与上文所描述的致动器组件配合。器械2502a的主体管2506延伸穿过致动器组件2504并且进入刚性入口导管2508中的端口中。如所描述,主体管2506尽管实质上是刚性的,但是在传输机制外壳与入口导管之间略微地弯曲。这种弯曲使得入口导管中的器械主体管钻孔能够以更接近另外允许的它们的传输机制的尺寸的方式间隔开。由于刚性器械主体管中的弯角小于柔性(例如,松软的)器械主体的弯角,因此缆线可以比柔性主体中的缆线硬。由于在器械中受到控制的远端DOF的数目,因此高缆线硬度是重要的。此外,刚性器械主体比柔性主体更易于插入到入口导管中。在一个实施例中,弯曲是有弹性的,以使得当器械从入口导管中取出时,主体管采取其直线形状(主体管可以由永久的弯曲形成,这将防止器械主体横滚)。致动器组件2504安装到入口导管2508内的控制主体管2506的插入的线性致动器2510(例如,受伺服控制的导螺杆以及螺母或滚珠螺杆以及螺母组件)上。第二器械2502b用如图所示的类似机制安装。此外,成像系统(未示出)可以类似地进行安装。
图11进一步示出入口导管2508可拆卸地安装到支撑平台2512上。这种安装可以,例如,与用于将套管固持在DA手术系统操纵器臂上的安装类似。可拆卸以及可替换入口导管允许设计用于与不同程序一起使用的不同入口导管将与同一远距离操纵系统一起使用(例如,具有不同截面形状或多种数目和形状的工作以及辅助通道的入口导管)。致动器平台2512又使用一个或更多个额外的致动器机制(例如,对于俯仰、偏航、横滚、插入)安装到机器人操纵器臂2514(例如,4DOF)上。如上文参考图1中的入口导管操纵器2116所描述,操纵器臂2514又可以安装到无源设置臂上。
图12示出图11所示的从不同角度并且关于患者的各个方面的图解立体图。在图12中,臂2514和平台2512经定位,以使得入口导管2508在肚脐处进入患者腹部。这种进入说明各种自然通道和切口进入,包括经皮和经腔(例如,经胃、经结肠、经直肠、经阴道、经直肠子宫(直肠子宫陷凹)等)切口。图12还说明对于每一个器械/成像系统,通过示出已插入的成像系统2518和已取出的器械2502a、2502b,线性致动器如何单独地操作。可以看到,在一些实例中,操纵器臂2514移动,在入口端处的远程中心(RC)2520附近将入口导管2508旋转或枢转入患者体内。然而,如果中间组织限制远程中心附近的移动,那么臂可以将入口导管2508维持在适当位置。
图13作为示例,其示出用于控制床旁支撑系统2104上的关节式器械并且选择性地使所述关节式器械与外科医生控制台2102的操作员操纵的输入设备41、42相关联的部件的框图。各种手术工具,例如,夹持器、切割机以及针可以用于在患者体内的工作部位处执行医疗程序。在此实例中,三个关节式手术工具器械(工具1、工具2、工具3)2231、2241、2251用于机械性地执行程序以及关节式成像系统器械(IS)2261用于观察该程序。在其它实例中,可以使用更多或更少的器械。成像系统2261可以是立体相机器械,例如,相机器械211,或者另一类型的成像系统,例如,单视场相机器械或超声波探头器械。工具2231、2241、2251以及成像系统2261可以设置在入口导管(EG)2000中,以便可延伸出入口导管2000的远端。入口导管2000可以通过使用机器人臂组件的设置部分穿过入口孔例如,微创切口或自然通道插入到患者体内,并且其由入口导管操纵器(EGM)2116朝向将执行医疗程序的工作部位进行调遣。
设备2231、2241、2251、2261、2000中的每一个都由其自身的操纵器进行操纵。具体而言,成像系统(IS)2261由成像系统操纵器(PSM4)2262进行操纵、第一手术工具(工具1)2231由第一工具操纵器(PSM1)2232进行操纵、第二手术工具(工具2)2241由第二工具操纵器(PSM2)2242进行操纵、第三手术工具(工具3)2251由第三工具操纵器(PSM3)2252进行操纵,并且入口导管(EG)2000由入口导管操纵器(EGM)2116进行操纵。
器械操纵器2232、2242、2252、2262中的每一个是机械组件,所述机械组件含有致动器并且提供机械无菌接口,以将运动传输到其相应的关节式器械上。关节式器械2231、2241、2251、2261中的每一个是机械组件,所述机械组件接收来自其操纵器的运动并且借助于缆线传输,将运动传播到其远端官关节(例如,接合处)。此类接合处可以是柱状的(例如,线性运动)或旋转的(例如,所述接合处围绕机械轴枢转)。此外,器械可以具有内部机械约束(例如,缆线、齿轮装置、凸轮、皮带等),所述机械约束迫使多个接合处以预定方式一起移动。每一组在机械上受到约束的接合处实施特定轴线的运动,并且约束可以经设计以使旋转接合处成对(例如,啮合接合处)。还应注意,以此方式,器械可以比可用致动器具有更多接合处。
在直接控制模式下,输入设备41、42中的每一个可以通过多路复用器(MUX)2290选择性地与设备2261、2231、2241、2251、2000中的一个相关联,以使得相关联的设备可以通过其控制器和操纵器由输入设备控制。例如,外科医生可以通过外科医生控制台2102上的图形用户界面(GUI)2291对于左输入设备41和右输入设备42指定相关性以分别与第一手术工具2231和第二手术工具2241相关联,所述第一手术工具和所述第二手术工具通过它们相应的控制器2233、2243和操纵器2232、2242以遥控机器人的方式受到控制,以使得外科医生可以对患者执行医疗程序,同时手术工具2251、成像系统2261以及入口导管2000各自通过它们相应的控制器软锁在适当位置。如果外科医生想要通过使用输入设备41、42中的一个控制手术工具2251的移动,那么外科医生可以简单地通过将输入设备与其当前相关联的设备解除关联并且使所述输入设备替代地与工具2251相关联来实现。同样地,如果外科医生想要使用输入设备41、42中的一个或两个控制成像系统2261或入口导管2000的移动,那么外科医生可以简单地通过将输入设备与其当前相关联的设备解除关联并且使所述输入设备替代地与成像系统2261或入口导管2000相关联来实现。
作为使用GUI 2291以向MUX 2290提供选择输入SEL的替代实施例,输入设备41、42与设备2251、2241、2231、2261、2000的选择性相关性可以通过外科医生使用由语音识别系统理解的语音命令,或者通过外科医生按下输入设备41、42中的一个上的按钮,或者通过外科医生按下外科医生控制台2102上的脚踏板,或者通过外科医生使用任何其他熟知的模式切换技术来执行。尽管此种模式切换在本文中被描述为由外科医生执行,但是所述模式切换可以替代地由助理在外科医生的指导下执行。
控制器2233、2243、2253、2263、2273中的每一个包括主/从控制系统,所述主/从控制系统包括用于其相应关节式器械的每一个接合处或在入口导管2000的情况下,用于其操纵器2116的每一个接合处的接合处控制器。为了简化本文中以及权利要求中的描述,术语“接合处”应理解为两个连环之间的连接(平移或旋转),并且可以包括齿轮(或柱状接合处)以及可耦合到线性驱动机制的任何其他可控制部件,所述线性驱动机制可以用于控制机器人臂组件。此种控制系统的实例在先前由于引用并入的标题为“微创手术设备中的引用相机的控制(Camera Referenced Control in a Minimally Invasive SurgicalApparatus)”的第6,424,885号美国专利中描述。
直接控制模式是控制模式,其中用户对特定从属操纵器进行直接控制。所有其他从属操纵器(即,未连接到输入设备上的操纵器)可以进行软锁(即,所有它们的接合处通过它们相应的控制器固持在适当位置)。作为示例,在例如本文中所述的单端口系统中,三个直接控制模式被限定为:直接“工具跟随”模式,其中两个可手动操作的输入设备与两个工具从属操纵器以及它们的相应工具相关联;直接“成像系统”模式,其中可手动操作的输入设备中的一个或两个与成像系统相关联;以及直接“入口导管”模式,其中一个或两个可手动操作的输入设备与入口导管相关联。
在耦合控制模式中,响应于直接受控制的从属操纵器的命令的运动,外科医生直接控制相关联的从属操纵器(例如,操纵器2232、2242、2252、2262、2116中的一者)的移动,同时间接控制非相关联的从属操纵器中的一个或更多个的移动,以实现第二目标。通过经由耦合控制模式自动地执行第二任务,通过减少外科医生对切换到另一直接模式以手动地实现所需第二目标的需要来增强系统的可用性。因此,耦合控制模式使得外科医生能够更好地集中于执行医疗程序并且更少地注重管理系统。
由外科医生使用以指定输入设备41、42和设备2231、2241、2251、2261、2000的相关性的GUI 2291还可以由外科医生使用,以指定耦合控制模式的各个参数。例如,外科医生可以使用GUI 2291,以选择哪一个设备操纵器参与各个耦合控制模式并且限定和/或优先考虑与耦合控制模式相关联的第二目标。
在“入口导管”模式下,当外科医生用立体镜45观察最初通过相机211捕获的处理后的图像时,两个输入设备41、42可以用于移动入口导管2000。引用图像的控制在入口导管控制器2273中实施,以使得控制器2273控制入口导管2000的移动,同时外科医生留下他/她正移动由相机211捕获的图像的印象。尤其,外科医生给人以下感觉:其正用自己的左手和右手正紧握显示在观察器45上的图像,并且围绕工作部位将图像移动到所期望的视点。应注意,在这种控制下,响应于输入设备41、42的移动,观察器45上的图像显示为在相反方向上移动。例如,当输入设备41、42移动到左侧时,图像移动到右侧(并且反之亦然)。而且,当输入设备41、42向下移动时,图像向上移动(并且反之亦然)。入口导管的枢转通过使用“虚拟手把”来实现,其中左输入设备41和右输入设备42的枢转点限定穿过枢转点的手把轴。然后入口导管偏航命令可以通过外科医生向前移动一个输入设备,同时向后移动另一输入设备而产生。另一方面,入口导管俯仰命令可以通过外科医生围绕手把轴在相同方向上(向上以上仰或向下以俯冲)枢转两个输入设备而产生。入口导管横滚命令可以通过外科医生向上移动一个输入设备,同时向下移动另一输入设备而产生。插入命令可以通过外科医生向后移动两个输入设备而产生并且缩回命令可以通过外科医生向前移动两个输入设备而产生。
当外科医生在“入口导管”模式下操作以同时重新定向入口导管2000连同那时所述入口导管内的所有关节式器械时,当入口导管围绕其远程中心(RC)枢转时,外科医生可能不经意地用关节式器械撞击和伤害患者的组织,所述关节式器械伸出入口导管的远端。例如,参考图14,关节式器械1400在初始定向处以实线形式示为伸出入口导管2000的远端并且在围绕RC点枢转之后,以虚线形式示为撞击患者组织1410。尽管在此实例中,关节式器械的远端被示为撞击患者组织,但是实际上应了解,由于器械的关节式性质,关节式器械的其他部分,例如,关节式器械211、231、241的更邻近(即,更靠近入口导管)的链环还可能潜在地撞击患者组织。此外,由于邻近的链环可以处于相机器械211的视野之外,因此在用立体镜45观察工作部位时,外科医生是难以预见此种撞击。因此,为了避免不经意地撞击和伤害患者组织,在对入口导管2000的定向做出较大调节时,建议在重新定向入口导管之前,将所有关节式器械缩回到入口导管中,例如图15中所示。
当存在伸出入口导管2000的多个关节式器械时,例如图7所示,外科医生执行以下操作是繁琐且费时的:在“入口导管”与“工具跟随”模式之间改变模式、将关节式器械一次一个地放置成缩回配置(即,其中器械可以被缩回到入口导管中的配置),同时必要时改变输入设备与器械之间的相关性以及在重新配置之后将关节式器械中每一个缩回到入口导管2000中。因此,在“入口导管”模式期间提供耦合控制结构是非常有用的,在所述耦合控制结构中,入口导管控制器2273耦合到器械控制器2233、2243、2253、2263上,以使得控制器2233、2243、2253、2263自动地重新配置并且在从入口导管控制器2273中接收到执行操作的指示时,缩回它们相应的关节式器械。在这种情况下,可以在外科医生的控制下或通过系统自动地按顺序(或者当安全时同时地)执行关节式器械的重新配置和缩回,同时避免器械之间的碰撞以及与它们的外界的碰撞。
现在描述耦合控制结构的实例,其中图16示出包括用于对具有设置在入口导管内的多个可延伸关节式器械的入口导管进行重新定向的方法的流程图,并且图17示出耦合控制结构,所述耦合控制结构包括用于实施图16中的方法的各个方面的一个或更多个耦合逻辑块。
参考图16,在块1601中,例如,如参考图13所描述,方法接收已进入“入口导管”模式的指示。在块1602中,响应于操作员命令执行该操作,所述方法同时将伸出入口导管的远端的所有关节式器械完全地缩回到入口导管中或至少到达所述关节式器械无法伤害患者组织的点而缩回到入口导管中,同时入口导管围绕远程中心(RC)枢转点进行枢转。图18A至18C用于说明在块1602中执行的缩回的普遍方面。
在图18A中,其示出入口导管2000的俯视图,其中如图7立体图中所示的伸出入口导管2000的远端的关节式器械231、241、211。在图18B中,以关节式器械的缩回配置示出关节式器械231、241、211,其中它们的链环排成行,以便可缩回到入口导管2000中的对应腔或空间中。在图18C中,关节式工具器械231、241被示为完全缩回到入口导管2000中,同时关节式相机器械211被示为仅部分缩回的(或者交替缩回的,以便刚好位于入口导管内部),以使得当入口导管2000围绕RC枢转点进行枢转时,其仍可以捕获远端外的视图,同时不会具有伤害患者组织的风险。替代地,关节式器械231、241、211可能未完全缩回到入口导管2000中,但是仅足以当入口导管2000随后围绕远程中心(RC)枢转以重新定向入口导管2000时,所述关节式器械都不会伤害(或放置在某一位置以引起非故意的伤害)任何患者组织。应注意,在这种情况下,只要接触不会导致伤害患者组织,就可以允许关节式器械231、241、211接触患者组织。
尽管图18A至图18C所示的顺序表明在缩回开始前进行重新配置,在实践本发明时,多个关节式器械的缩回和重新配置的顺序可以同时执行或取决于某些条件以及所采用的方法以不同次序执行。
作为缩回和重新配置顺序的第一方法,如果多个关节式器械的最邻近接合处(例如,在图18A中的关节式相机器械211的接合处323)与入口导管2000的远端的距离最小,那么允许缩回可以与利用矫直速度的重新配置同时发生,所述矫直速度与缩回速度成比例(受最大速度限制)。在重新配置和缩回期间,重新配置和/或缩回器械之间的碰撞应通过系统预测到并且被避免,以及应避免伤害患者组织。关节式器械可以进行缩回和/或重新配置的速度优选地是在缩回和/或重新配置期间,外科医生推挤控制输入设备上正提供的任何触觉反馈的力度的函数。如果多个关节式器械的最邻近接合处(当时不处于入口导管2000中)在入口导管的关节式器械已完全被重新配置到其缩回配置之前,到达入口导管2000的远端,那么多个关节式器械的进一步缩回由系统阻止,直到完成最邻近接合处的关节式器械到其缩回配置的重新配置为止。这种要求将避免对关节式器械和/或入口导管2000造成损坏。在这种情况下,用于重新配置的速度仍然是外科医生推挤控制输入设备上正提供的任何触觉力的力度的函数,但可能具有不同增益。离入口导管2000的远端的最小距离,在远端的最小距离处,可能同时发生缩回和重新配置,这一点可以通过考虑若干因素来确定。一个因素是关节式器械被命令的串联移动的速度(例如,命令的缩回移动越快,则最小距离越大;并且重新配置移动越快,则最小距离越小)。另一因素是关节式器械的初始配置。例如,多个关节式器械的初始配置越接近它们的缩回配置,则最小距离越短,且反之亦然。此外,由于在重新配置期间,关节式器械的远端不需要向前伸出它们的初始位置,因为这样可能会不经意地伤害患者组织,因此需要在缩回方向上补偿此种延伸。因此,此种延伸补偿量仍然是确定最小距离的另一因素。
作为缩回和重新配置顺序的另一且更简单方法,可以在重新配置之前进行缩回。例如,多个关节式器械可以串联地缩回,直到关节式器械中的一个的最邻近接合处(已不处于入口导管中)到达入口导管2000的远端为止,因此系统阻止进一步缩回并且使关节式器械的重新配置开始到其缩回配置。在完成关节式器械的重新配置之后,随后多个关节式器械可以再次串联地缩回,直到关节式器械中的一个的最邻近接合处(已不处于入口导管中)到达入口导管2000的远端为止,因此系统再次阻止进一步缩回并且如果必要,使关节式器械的重新配置开始到其缩回配置。上述所述顺序随后将继续,直到所有多个关节式器械已因此重新配置且缩回到入口导管2000中。
返回参考图16,在块1603中,响应于操作员命令执行操作,所述方法围绕RC枢转点将入口导管2000枢转到新的定向。在完成入口导管2000的重新定向之后,在块1604中,响应于操作员命令执行操作,关节式器械231、241、211随后可以重新插入,并且在块1605中,操作员可以退出“入口导管”模式并且进入“工具跟随”模式,以使得操作员(例如,外科医生)可以利用重新定位的入口导管2000和关节式器械231、241、211对患者执行或继续执行医疗程序。
图19作为示例,其示出用于将多个关节式器械退回入口导管串联地移动的流程图,该方法可以通过图17中的耦合控制结构实施并且用于执行在图16的块1602中关节式器械缩回。
在块1901中,所述方法接收在与入口导管的插入轴X'平行的方向上对入口导管2000的位置(qIO)上命令的变化的信息。在这种情况下,命令的位置变化与用作初始位置的RC点相关,从所述初始位置确定位置变化。在一个实施例中,当系统处于“入口导管”模式下时,命令的位置变化(qIO)可以通过外科医生命令入口导管2000沿着其插入轴X'移动而实现。然而在这种情况下,代替沿着其插入轴X'移动入口导管2000,伸出入口导管2000的远端的所有关节式器械根据命令的位置变化(qIO)缩回。
在块1902中,所述方法确定命令的位置变化(qIO)是否大于限制距离(IOLIM)。如果确定是“否”,那么方法环回到块1901以接收另一命令的位置变化(qIO)的信息。另一方面,如果在块1902中的确定是“是”,那么在块1903中,所述方法引起施加到控制机制上的触觉力,操作员使用所述触觉力来产生命令的位置变化(qIO),其方式为使得随着通过操作员操纵控制机制产生的沿着插入轴X'的位置变化命令逐渐超过限制距离(IOLIM),力逐渐增强,例如,如在图20的力与命令的位置变化(qIO)函数中所述。在这种情况下,控制机制可以包括外科医生控制台2102的输入设备41、42中的一个或两个。
在块1904中,所述方法确定命令的位置变化(qIO)是否大于锁止距离(IOLOCK),其中锁止距离大于限制距离。如果确定是“否”,那么方法环回到块1901以接收另一命令的位置变化(qIO)的信息。另一方面,如果块1904中的确定是“是”,那么在块1905中,所述方法使得入口导管操纵器(EGM)2116的枢转接合处通过使用它们相应的接合处控制器而被软锁在适当位置。
在块1906中,所述方法确定命令的位置变化(qIO)是否大于缩回距离(IOON),其中缩回距离大于锁止距离。如果确定是“否”,那么方法环回到块1901以接收另一命令的位置变化(qIO)的信息。另一方面,如果在块1906中的确定是“是”,那么在块1907中,所述方法使得关节式器械的臂(例如,接合处和链环的组合)能够伸直,以便处于适当的缩回配置中,而同时在块1908中,由于命令的位置变化(qIO)逐渐超过缩回距离,因此根据所述方法关节式器械的缩回易遭受逐渐增加的速度限制,例如,如在图21中的速度与命令的位置变化(qIO)函数中所述。
在块1909中,所述方法确定命令的位置变化(qIO)是否大于最大距离(IOMAX),其中最大距离大于缩回距离。如果确定是“否”,那么方法环回到块1901以接收另一命令的位置变化(qIO)的信息。另一方面,如果在块1909中的确定是“是”,那么在块1910中,由于命令的位置变化逐渐超过最大距离,因此关节式器械的缩回易遭受最大速度限制(VMAX),例如,如在图21中的速度与命令的位置变化(qIO)函数中所述。
在块1911中,所述方法确定先前伸出入口导管2000的远端的所有关节式器械现在是否处于入口导管2000中的它们的缩回位置中。在这种情况下,缩回位置未必表示器械完全缩回到入口导管2000中。如图18C所示,例如,关节式相机器械211仍可以具有暴露在入口导管2000外部的图像捕获端,以使得当通过围绕RC点枢转入口导管2000而对所述入口导管进行重新定向时,所述关节式相机器械可以获得周围区域的更好视图。这样使得外科医生能够观察入口导管2000进行重新定向所朝向的患者组织的部分。只要其他关节式器械的延伸部分在入口导管2000枢转期间不会撞击并且伤害患者组织,其他关节式器械仅可以部分地被缩回。
如果块1911中的确定是“否”,那么方法环回到块1901以接收另一命令的位置变化(qIO)的信息。另一方面,如果块1911中的确定是“是”,那么在块1912中,所述方法使得入口导管操纵器(EGM)2116的枢转点不再通过它们相应的接合处控制器被软锁在适当位置。此时,入口导管2000可以连同设置在所述入口导管内的所有关节式器械一起重新定向并且器械随后可以伸出入口导管2000,以便经定位以执行或继续执行对患者的医疗程序。
参考图17,参考图16和图19所述的方法可以在以下项中的一个或更多个中实施:EG耦合逻辑1700、PSM1耦合逻辑1701、PSM2耦合逻辑1702以及PSM4耦合逻辑1704,例如,其中关节式器械2231、2241、2261设置在入口导管2000内。如果更多或更少的关节式器械穿过入口导管2000是可延伸的,那么图17的耦合结构可以相应地进行修改。尽管被示为单独部件,但是耦合逻辑1700、1701、1702、1704可以通过例如将所有逻辑并入EG耦合逻辑1700中而被构造成单个逻辑块,或者所述耦合逻辑可以通过例如消除EG耦合逻辑1700并且分布在PSM1耦合逻辑1701、PSM2耦合逻辑1702以及PMS4耦合逻辑1704之间的处理而以分布处理方式进行构造。此外,尽管被示为与它们相应的控制器分离,但是耦合逻辑块中的每一个可以被一体化到它们相应的控制器中,例如,EG耦合逻辑1700被一体化为入口导管控制器(CNTLG)2273的一部分。此外,处理器43可以使用存储在系统2100的存储器单元中的计算机程序代码来实施图17中所示的所有控制和耦合逻辑。为了简化图,块2274表示入口导管操纵器2116和入口导管2000的组合。块2264表示成像系统器械操纵器2262和成像系统器械2261的组合。块2234表示工具器械操纵器2232和工具器械2231的组合。块2244表示器械操纵器2242和工具器械2241的组合。
尽管上文关于重新定向入口导管2000描述了关节式器械211、231、241退回入口导管2000的串联移动,但是在其他应用中,多个关节式器械退回入口导管的串联移动也是有用的,例如,在完成医疗程序之后。在这些情况下,不是切换到“入口导管”模式,而是系统可以停留在“成像系统”模式中并且利用例如图22中所说明的耦合控制逻辑将关节式器械211、231、241退回入口导管2000串联地移动。同样地,系统可以停留在“工具跟随”模式中并且利用例如图23中所说明的耦合控制逻辑将关节式器械211、231、241退回入口导管2000串联地移动。在任一种情况下,关节式器械退回入口导管2000的串联移动以类似于先前参考图19至21所述的方式执行,除了入口导管2000的枢转接合处不需要被锁住。这是因为在“成像系统”模式和“工具跟随”模式这两种模式下,入口导管2000已被锁定在适当位置(例如,如在图22、23中通过从入口导管和入口导管操纵器组合块2274到入口导管控制器2273的“软锁”反馈所说明)。因此,图24至图26示出了用于将多个关节式器械(例如,211、231、241)退回入口导管2000串联地移动的方法,所述方法可以在“成像系统”和“工具跟随”模式期间执行,其中图24以与关于图19所述实质上相同的方式执行,除了与将入口导管锁在适当位置有关的块1904、1905、1912被删除,并且图25、26分别与图20、21基本上相同,除了与将入口导管锁在适当位置有关的点IOLOCK已被删除。
尽管关于优选实施例已描述了本发明的各个方面,但应理解,本发明有权充分保护所附权利要求的全部范围。
Claims (10)
1.一种机器人系统,其包括:
至少一个输入设备;
入口导管;
多个关节式器械,所述多个关节式器械伸出所述入口导管的远端;
多个器械操纵器,用于操纵所述多个关节式器械中的对应的关节式器械;以及
处理器,所述处理器适用于:
接收来自所述至少一个输入设备的一个或更多个命令,所述一个或更多个命令指示所述多个关节式器械将被串联地移动退回所述入口导管;
随着来自所述至少一个输入设备的所述一个或更多个命令将所述多个关节式器械串联地移动退回所述入口导管逐渐超过距初始位置的限制距离,使得触觉力以某一方式被施加到所述至少一个输入设备,以致力逐渐增强;
在所述至少一个输入设备命令所述多个关节式器械串联地移动退回所述入口导管大于距所述初始位置的缩回距离的距离时,使得正施加到所述至少一个输入设备上的所述触觉力突然减小,其中,所述缩回距离大于距所述初始位置的所述限制距离;以及
响应于从所述至少一个输入设备接收到的将所述多个关节式器械串联地移动退回所述入口导管大于距所述初始位置的缩回距离的所述距离的所述一个或更多个命令,命令所述多个器械操纵器操纵所述多个关节式器械中的每个,从而呈现缩回配置。
2.根据权利要求1所述的系统,其进一步包括:
入口导管操纵器,所述入口导管操纵器具有用于枢转所述入口导管的多个接合处;
其中所述处理器适用于:
在从所述至少一个输入设备接收沿着所述入口导管的纵轴在缩回方向上以超过距所述初始位置的锁止距离的距离平移地移动所述入口导管的命令时,使得所述入口导管操纵器的所述多个接合处被锁定在适当位置,其中所述锁止距离大于所述限制距离并且小于距所述初始位置的所述缩回距离;并且
根据从所述至少一个输入设备接收到的沿着所述入口导管的纵轴在所述缩回方向上平移地移动所述入口导管的命令,产生将所述多个关节式器械串联地移动退回所述入口导管的命令。
3.根据权利要求2所述的系统,其中所述处理器适用于在所述多个关节式器械已缩回到所述入口导管中之后,使得所述入口导管操纵器的所述多个接合处被解锁。
4.根据权利要求2所述的系统,其进一步包括:
观察器,用于显示源自关节式相机器械的处理后的图像;
其中所述处理器适用于:以某种方式响应于来自所述至少一个输入设备的命令,命令所述多个器械操纵器操纵所述多个关节式器械,以便串联地移动退回所述入口导管,从而给所述至少一个输入设备的操作员提供以下印象:所述操作员正在推开显示的处理后的图像,同时所述操作员正在观察所述观察器并且以使得命令所述入口导管沿着其纵轴在所述缩回方向上平移地移动的方式操纵所述至少一个输入设备。
5.根据权利要求4所述的系统,其中所述至少一个输入设备包括:左输入设备和右输入设备,所述左输入设备和所述右输入设备分别由所述操作员的左手和右手操作;所述左输入设备和所述右输入设备的枢转点限定穿过所述枢转点的手把轴,并且所述处理器适用于:响应于在所述入口导管操纵器的所述多个接合处被锁定在适当位置之前,第一输入设备和第二输入设备在相对的向前和向后方向上的移动,命令所述入口导管操纵器使所述入口导管围绕第一轴旋转;响应于在所述入口导管操纵器的所述多个接合处被锁定在适当位置之前,所述第一输入设备和所述第二输入设备在相对的向上和向下方向上的移动,命令所述入口导管操纵器使所述入口导管围绕第二轴旋转;响应于在所述入口导管操纵器的所述多个接合处被锁定在适当位置之前,使所述第一输入设备和所述第二输入设备在相同的角方向上围绕所述手把轴枢转,命令所述入口导管操纵器使所述入口导管围绕第三轴旋转;以及响应于一致地向前以及向后移动所述左输入设备和所述右输入设备,而不管所述入口导管操纵器的所述多个接合处是否锁定在适当位置,命令所述至少一个器械操纵器在与所述入口导管的纵轴平行的共同方向上移动所述多个关节式器械。
6.根据权利要求1所述的系统,其中所述处理器适用于:如果所述多个关节式器械中的每一个各处于允许内缩回到所述入口导管中的配置中或所述多个关节式器械中的每一个距所述入口导管的远端为最小距离,那么响应于将所述多个关节式器械串联地移动退回所述入口导管的所述一个或更多个命令,使得所述多个关节式器械移动退回所述入口导管。
7.根据权利要求6所述的系统,其中所述处理器适用于:随着来自所述至少一个输入设备的将所述多个关节式器械串联地移动退回所述入口导管超过距所述初始位置的所述缩回距离的命令,命令所述至少一个器械操纵器操纵所述多个关节式器械,以便串联地移动退回所述入口导管易遭受逐渐增大的速度限制。
8.根据权利要求7所述的系统,其中所述处理器适用于:在来自所述至少一个输入设备的将所述多个关节式器械串联地移动退回所述入口导管超过距所述初始位置的最大距离的命令之后,命令所述多个器械操纵器操纵所述多个关节式器械,以便串联地移动退回所述入口导管易遭受最大速度限制,其中所述最大距离大于距所述初始位置的所述缩回距离。
9.根据权利要求6所述的系统,其中所述多个关节式器械中的一个是具有图像捕获端的关节式相机器械,所述多个关节式器械中的其他关节式器械是具有工作端的关节式工具器械,并且所述处理器适用于:响应于将所述多个关节式器械串联地移动退回所述入口导管的所述一个或更多个命令,命令所述多个器械操纵器操纵所述多个关节式器械,以便通过操纵所述关节式相机器械使所述关节式相机器械串联地移动退回所述入口导管,从而使得所述多个关节式器械移动退回所述入口导管,直到所述图像捕获端进入所述入口导管为止。
10.根据权利要求9所述的系统,其中所述处理器适用于:甚至在所述关节式器械的工作端进入所述入口导管之后,响应于将所述多个关节式器械串联地移动退回所述入口导管的所述一个或更多个命令,命令所述至少一个器械操纵器操纵所述多个关节式器械,以便通过操纵所述其他关节式器械中的每一个而使所述其他关节式器械串联地移动退回所述入口导管,从而使得所述多个关节式器械移动退回所述入口导管。
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JP6153936B2 (ja) | 2017-06-28 |
EP2775951A4 (en) | 2015-08-26 |
CN103930064A (zh) | 2014-07-16 |
US20160045272A1 (en) | 2016-02-18 |
US9138129B2 (en) | 2015-09-22 |
WO2013071057A1 (en) | 2013-05-16 |
US20120059392A1 (en) | 2012-03-08 |
JP2015502198A (ja) | 2015-01-22 |
EP2775951B1 (en) | 2021-01-06 |
EP2775951A1 (en) | 2014-09-17 |
US9629520B2 (en) | 2017-04-25 |
CN106901837A (zh) | 2017-06-30 |
KR102032853B1 (ko) | 2019-10-16 |
KR20140096342A (ko) | 2014-08-05 |
CN106901837B (zh) | 2019-11-08 |
JP2017153998A (ja) | 2017-09-07 |
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