Device for Supporting and Positioning of a Surgical Instrument and/or an Endoscope for Use in Minimal-Invasive Surgery and a Surgical Robotic System

Abstract

The invention describes a mounting and positioning device of a surgical instrument and/or an endoscope for minimally-invasive surgery, in particular for use within a surgical robot system, comprising a first axis of rotation ( 3 ), around which a support element ( 4 ) is rotatably arranged, wherein the first axis of rotation ( 3 ) intersects with the longitudinal axis ( 11 ) of at least one surgical instrument ( 9; 17 A, 17 b ) and/or an endoscope ( 9; 17 A, 17 b ) in a pivot point ( 13 ), as the result of a deviation drive ( 5 ) being fixed on the support element ( 4 ), said deviation drive arranging an instrument drive unit ( 15 ) in rotatable fashion around a pivot point ( 13 ), and wherein a telescopic device ( 8 ) is provided at an instrument drive unit ( 15 ), which allows for the translatory movement of the surgical instrument ( 9; 17 A, 17 b ) and/or the endoscope ( 9; 17 A, 17 B) into the body, along its longitudinal axis ( 11 ) using a guide device ( 10, 10 s ) in such fashion that the longitudinal axis ( 11 ) of the surgical instrument ( 9; 17 A, 17 b ) and/or the endoscope ( 9; 17 A, 17 b ) is variably adjustable in relation to the telescopic device ( 8 ).

1 . Mounting and positioning device of a surgical instrument and/or an endoscope for minimally invasive surgery, in particular for use within a surgical robot system, comprising
 a first axis of rotation ( 3 ), around which a support element ( 4 ) is rotatably arranged, wherein the first axis of rotation ( 3 ) intersects with the longitudinal axis ( 11 ) of at least one surgical instrument ( 9 ;  17 A,  17   b ) and/or an endoscope ( 9 ;  17 A,  17   b ) in a pivot point ( 13 ), as the result of a deviation drive ( 5 ) being fixed on the support element ( 4 ), said deviation drive arranging an instrument drive unit ( 15 ) in rotatable fashion around a pivot point ( 13 ),   and wherein a telescopic device ( 8 ) is provided at an instrument drive unit ( 15 ), which allows for the translatory movement of the surgical instrument ( 9 ;  17 A,  17   b ) and/or the endoscope ( 9 ;  17 A,  17 B) into the body, along its longitudinal axis ( 11 ) using a guide device ( 10 ,  10   s ) in such fashion that the longitudinal axis ( 11 ) of the surgical instrument ( 9 ;  17 A,  17   b ) and/or the endoscope ( 9 ;  17 A,  17   b ) is variably adjustable in relation to the telescopic device ( 8 ).   
     
     
         2 . Mounting and positioning device according to  claim 1 , characterized in that the instrument drive unit ( 15 ) on the telescopic device ( 8 ) by means of an instrument pivot point ( 56 ) is pivoted so that the longitudinal axis of the telescope ( 58 ) of the telescopic device ( 8 ) is variable in relation to the longitudinal axis ( 11 ) of the surgical instrument ( 9 ;  17 A,  17   b ) and/or the endoscope ( 9 ;  17 A,  17   b ) in dependence on the deviation drive ( 5 ). 
     
     
         3 . Mounting and positioning device according to  claim 1  or  2 , characterized in that the telescopic device ( 8 ) comprises several telescope elements ( 8 U,  8 V,  8 W), wherein the instrument pivot point ( 56 ) is arranged on the telescope element ( 8 W) with the largest range of telescopic adjustment. 
     
     
         4 . Mounting and positioning device according to one of the preceding  claims 1  to  3 , characterized in that the guide device ( 10 ,  10   s ) comprises at least one instrument guide ( 10   s ), through which the shaft of the surgical instrument ( 9 ;  17 A,  17   b ) and/or the endoscope ( 9 ;  17 A,  17   b ) extends. 
     
     
         5 . Mounting and positioning device according to one of the preceding  claims 1  to  4 , characterized in that the deviation drive ( 5 ) is arranged on the telescopic device ( 8 ) by means of a deviation drive position point ( 55 ), in such fashion that the rotation of the instrument drive unit ( 15 ) around the pivot point ( 13 ) is the result of a coupling device ( 6 ,  7 ) comprising a coupling pivot point ( 6 ) which is firmly connected with the support element ( 4 ). 
     
     
         6 . Mounting and positioning device according to one of the preceding  claims 1  to  5 , characterized in that the instrument drive unit ( 15 ) moves the surgical instrument ( 9 ;  17 A,  17   b ) and/or the endoscope ( 9 ;  17 A,  17 B) in several degrees of freedom, wherein the activation of the instrument drive unit ( 15 ) is controlled by the surgeon with a control unit ( 44 ), by means of control and supply lines, which are guided through the support element ( 4 ) and the deviation drive ( 5 ). 
     
     
         7 . Mounting and positioning device according to one of the preceding  claims 1  to  6 , characterized in that the first axis of rotation ( 3 ) is formed in that a drive unit ( 1 ) is provided that can be mounted on a robotic arm, wherein a pivot joint ( 2 ) is provided between the drive unit ( 1 ) and the support element ( 4 ). 
     
     
         8 . Mounting and positioning device according to one of the preceding  claims 1  to  7 , characterized in that a coupling element ( 12 ) is arranged on support element ( 4 ), which is rotatably connected at the distal end at the pivot point ( 13 ) with the instrument guide ( 10   s ). 
     
     
         9 . Mounting and positioning device according to one of the preceding  claims 1  to  8 , characterized in that several surgical instruments ( 17   a,    17   b ) are guided through a single trocar ( 18 ) into the body, wherein a separate instrument drive unit ( 15   a,    15   b ) is provided for each surgical instrument ( 17   a,    17   b ), and wherein in particular the surgical instruments ( 17   a,    17   b ) are curved in a longitudinal direction. 
     
     
         10 . Mounting and positioning device according to one of the preceding  claims 1  to  9 , characterized in that the support element ( 4 ) and/or the drive unit ( 1 ) can be adjusted by means of a pre-positioning device in its starting position, wherein the pre-positioning device comprises one or more pre-positioning elements ( 30 ,  32 ,  34 ,  37 ), the position of which is adjustable in at least one axis, wherein in particular four pre-positioning elements ( 30 ,  32 ,  34 ,  37 ) can be preset with positions that are in series and variable in relation to one another. 
     
     
         11 . Surgical robot system with multiple mounting and positioning devices according to one of the  claims 1  to  10 , wherein at least two mounting and positioning devices are arranged on a mounting support system ( 19 ,  20 ,  21 ,  22 ,  23 ,  24 ) that essentially runs transversely to the mounting and positioning devices, wherein the mounting support system ( 19 ,  20 ,  21 ,  22 ,  23 ,  24 ) is constructed from one coupling point ( 22   a - d ) for each mounting and positioning device, and wherein the coupling points ( 22   a - d ) are connected rigidly or via joints ( 23 ,  24 ) with each other. 
     
     
         12 . Surgical Robot System according to  claim 11 , characterized in that the mounting support system ( 19 ,  20 ,  21 ,  22 ,  23 ,  24 ) by means of a coupling support connection is connected to an essentially vertically running main support device ( 39 ,  40 ), for support in relation to a fixed bearing ( 42 ), which is movably arranged or predefined in relation to a fixed or movable operating table ( 48 ). 
     
     
         13 . Surgical Robot System according to  claim 11  or  12 , characterized in that a central control unit ( 46 ) is provided, which is connected with each of the mounting and positioning devices with the appropriate surgical instruments ( 9 ;  17 A,  17   b ) and/or endoscopes ( 9 ;  17 A,  17   b ) and is coupled with a control panel ( 44 ) for entering commands in the form of control data provided by a surgeon, which by means of a visualization unit ( 53 ) provides image data from one or multiple endoscopes ( 9 ;  17 A,  17   b ). 
     
     
         14 . Surgical Robot system according to one of the  claims 11  to  13 , characterized in that the control unit ( 46 ) and the control panel ( 44 ) are coupled with a movable operating table ( 48 ), wherein both the image data as well as the control data are processed in dependence of the given positions of the mounting and positioning device and the operating table ( 48 ).