JPH03121064A - Robot for operation - Google Patents

Abstract

PURPOSE:To automatically operate a biopsy needle, observing the CT image information, by installing a jig feeding mechanism for shifting a needle-shaped jig in the axial direction and an oscillation mechanism for turning the jig feeding mechanism installed at the top edge part of the following link of a link mechanism. CONSTITUTION:A stick-in part 2 is shifted on a supposed spherical surface having a prescribed radius by a body part 1, and the axis direction of a biopsy needle is changed by the stick-in part 2, and further shifted in parallel to the axis direction. Accordingly, a link mechanism 16 is arranged on a turntable 13. Further, the link mechanism 16 is turned, together with the turntable 13, by a stepping motor 14, having a rotary shaft L as axis. Accordingly, the position of the top edge part of a link 165 can be controlled in the supposed spherical surface, having one point on the revolution axis L as center, by controlling each revolution quantity of the stepping motor 14 and a servomotor 18. The direction of the axis of the biopsy needle 3 can be directed in free direction within an angular range which is set, centering around the top edge part of the link 165 as an approximate center.

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention is applicable to medical applications such as stereotactic brain surgery, implantation of electrodes into the ear pot and cow's shell, depth-controlled spinal cutting surgery, and visceral surgery. The present invention relates to equipment, and particularly to a surgical robot suitable for performing a biopsy or surgery within a CT gantry without obtaining intraoperative X-ray CT image information.

[Prior art and problems to be solved by the invention] Conventionally,
In neurosurgical medicine, stereotactic brain surgery is performed to treat cerebrovascular disorders, brain tumors, etc., or perform biopsies. Since the brain is an organ that hardly moves, this stereotaxic brain surgery is performed by confirming the lesion site in the brain using X-ray CT, etc., and then using a needle-like jig to reach the lesion site while the skull is fixed. It was designed to do this.

For example, a biopsy is the collection of a portion of tumor tissue, etc., for histopathological examination. Generally, the head is fixed to a fixation ring with an origin (marker) set, and X-ray CT Based on the image information obtained, the three-dimensional coordinates of the lesion site with respect to the origin are determined, a small hole with a diameter of about 10 cm is made in the skull, and a stereotactic neurosurgical device that supports the biopsy needle is connected to the fixation ring. The direction of the biopsy needle is fixed to the stereotactic neurosurgery device, and the biopsy needle is manually inserted through the small hole to a depth determined from the positional coordinates of the lesion site to collect a tissue piece.

However, with the above method, even though the location of the lesion site can be accurately measured using X-ray CT, it is not possible to directly know the state inside the brain when the biopsy needle is actually inserted. There is a problem that the burden on the operator increases.

On the other hand, if stereotaxic brain surgery can be performed while obtaining X-ray C7 image information and the state inside the brain can be known during the surgery, it will be easier to accurately reach the lesion site with -1 insertion. Able to perform accurate and appropriate treatment. Furthermore, in procedures such as brain tumor removal, it is necessary to know the state of the brain during the procedure.

However, since conventional stereotactic neurosurgery devices manually operate the biopsy needle, etc., it has not been possible to obtain X-ray C7 image information during surgery, considering the harmful effects of X-rays on the operator.

Therefore, there is a need for an apparatus that can perform stereotactic brain surgery while automatically operating a biopsy needle or the like within a CT gantry to obtain an X-ray C7 image.

In addition, the position of making the small hole through which the biopsy needle is inserted is determined by the operator's judgment in order to take the safest route to the lesion site in the shortest possible distance, taking into account the brain tissue, etc., so it can be operated automatically. In order to do this, it is necessary to be able to set the biopsy needle in any direction that suits the case.

An object of the present invention is to provide a surgical robot that can automatically operate a biopsy needle and the like within a CT gantry so that stereotactic brain surgery can be performed while obtaining X-ray C7 image information.

[Means to solve the problem]

The surgical robot of the present invention, which was made to solve the above problems, has a link mechanism in which the distal end of a follower draws an arcuate trajectory around one point, and a rotation mechanism that rotates this link mechanism around a rotation axis. a moving mechanism, a jig feeding mechanism that reciprocates a needle-shaped jig in its axial direction, and a jig feeding mechanism that is attached to the tip of the follower and that moves the jig's axial direction in a predetermined direction including the center of the arcuate trajectory. and an oscillating mechanism that rotates the jig feeding mechanism so that the jig feeding mechanism is within a certain angular range.

[For production]

In the surgical robot of the present invention, the link mechanism in which the distal end of the follower draws an arcuate trajectory with one point as the center is rotated by the rotation mechanism, so the distal end of the follower of this link mechanism is centered on the one point. It becomes possible to move on the virtual spherical surface. In addition, the jig feeding mechanism is rotated by a swinging mechanism attached to the tip of the follower so that the axial direction of the needle-like jig is within a certain angle range including the virtual center of the virtual spherical surface. Ru.

Therefore, the needle-like jig can be reciprocated by the jig feeding mechanism from any position on the virtual spherical surface surrounding the virtual center toward the virtual center at an angle within a certain range of angles.

Therefore, for example, when the surgical robot is connected to a predetermined position with respect to a fixation device that fixes the cranium in stereotactic neurosurgery, the needle-shaped jig attached to the jig feeding mechanism It is possible to reciprocate toward the virtual center within a certain range of angles from a virtual spherical surface that is equidistant from a virtual center point such as the cranial center determined in advance.

(Embodiment) FIG. 1 is a diagram showing a surgical robot according to an embodiment of the present invention. For example, in stereotactic brain surgery, the head is assumed to be a spherical surface as shown in FIG. 8, and a concentric virtual A spherical surface is set, and a biopsy needle, for example, is operated on this virtual spherical surface. Note that Figure 1(b) is similar to Figure 1(a).
) is shown. Moreover, this device is arranged on the body axis on the parietal side as shown in FIG.
It is connected at a predetermined position to a fixing device (not shown) that fixes the skull.

In FIG. 1, 1 is a main body having a link mechanism and a rotation mechanism, 2 is an insertion part to which a biopsy needle is attached,
As will be explained later, the insertion part 2 is moved by the main body part 1 on a virtual spherical surface of a predetermined radius, and the biopsy needle is axially moved by the insertion part 2 within a predetermined angular range with respect to the radial direction of the virtual spherical surface. The direction is changed and the biopsy needle is also translated in its axial direction.

In the main body 1, a bearing plate 12 is installed upright on a base 11.
In 1.12□, a U-shaped rotating table 13 is pivotally supported. When the stepping motor 14 is driven, the rotation table 13 is rotated about the rotation axis.For example,
It is rotated in the left and right directions by 90 degrees each, that is, within a range of 180 degrees.

Bearings 15□ and I5□ whose axes are perpendicular to the axis of the bearing plate 12112□ are arranged on the rotary table 13, and these bearings 15. ．． A link mechanism 16 is provided which is driven using fixed fulcrums A and B at 15□.

The link mechanism 16 includes five links 161 to 165 and bearings 1.5. ．． The fixed spacing of 15□ constitutes a six-bar linkage mechanism called a Duron mechanism. Link 1
61 and link 162 are bearings 15+ and 15z, respectively.
fulcrum A respectively.

The free end C of the link 161 and the link 162 are connected by a link 163. Also,
A follower link 165 is connected to the other end of the link 164 whose one end is connected to the connection point C of the links 161 and 1.63 and to the free end E of the link 162. and,
A worm gear 17 supported by a bearing 15 is fixed to the link 161, and the worm gear 17 is driven by a servo motor 18 fixed to the rotary table 13 through a worm 19 as shown by the arrow ■ in the figure. is rotated to Also, bearing 15. ．． Each fulcrum A and B at 15□
is set to be on the rotation axis of the rotation table 13.

FIG. 3 is a diagram illustrating the operation of the link mechanism. When the worm gear 17 is rotated as described above, the link 161 is rotated, and the tip P of the link 165 is connected to the rotary table 1.
The robot moves on a circular arc trajectory in a fixed plane including the rotation axis, centering on a point (virtual center) 0 on the rotation axis of No. 3.

On the other hand, the link mechanism 16 is rotated about a rotation axis together with the rotation table 13 by the driving of the stepping motor 14 .

Therefore, the stepping motor 14 and the servo motor 1
By controlling the amount of rotation from a predetermined position with respect to the rotating table 8, the position of the tip P of the link 165 can be controlled within a virtual spherical surface centered on one point (virtual center) on the rotating wheel. By controlling the rotation of 13 within a range of 90 degrees to the left and right, the tip P can be moved to an arbitrary position on substantially the A-spherical surface of the virtual spherical surface.

FIG. 2 is a diagram showing the insertion part 2, which is attached to the tip P of the link 165.

For installation, the board 21 has two wooden arms 21 a+ and 21 a.
It is fixed to the link 165 with Z coming out ahead of the tip P,
A rectangular ring-shaped first rotating frame 22 is pivotally supported on an axis ρ1 by bearing pieces 21b+ and 211)z formed on the arm portions 21a+ + 2132, respectively. Further, an ultrasonic motor 23 is fixed to one of the bearing pieces 21a, and the first rotation frame 22 is rotated around the rotation shaft by driving of the ultrasonic motor 23.

A rectangular ring-shaped second rotation frame 24 is disposed within the first rotation frame 22 so as to intersect 11↑ with the rotation axis λ1. Rotation axis lI of rotation frame 22
The ultrasonic motor 25 is pivotally supported by opposite sides 22a and 22b facing in a direction perpendicular to the first rotation frame 22, and rotates around the rotation axis 12 with respect to the first rotation frame 22 by driving an ultrasonic motor 25 fixed to one side 22a of the opposite sides. be done.

Rotation axis I of the second rotation frame 24! . ．． ．． 26□ is attached to this guide rail 261.

The tip of 26□ is fixed by a fixing plate 26a.

Further, a DC coreless motor 27 is disposed within the second rotation frame 24, and a guide rail 26. ．． A ball screw 28 parallel to 26□ passes through one side 24a of the second rotating frame 24, has one end connected to the DCC coreless morph 2 power shaft, and has the other end pivotally supported by a fixed plate 26a.

Guide rail 26. ．． 26□ has a groove 29a1.29
A nut member 29 fitted with a2 is slidably arranged, and this nut member 29 is screwed onto the ball screw 28.

A holder 29b for attaching the biopsy needle 3 is fixed on the nut member 29, and the biopsy needle 3 attached to the holder 29b is moved by the feeding mechanism of the DC coreless motor 27, the ball screw 28, and the nut member 29 as shown in the figure. The needle is reciprocated in the axial direction as shown by the arrow ■. A vibrator-shaped guide 24c through which the biopsy needle 3 is passed is formed in the second rotation frame 24, and the biopsy needle 3 is guided along the guide rail 26 by this guide 24c. ．．
It is always held parallel to 26□ and pole screw 2.

As described above, due to the rotational movement of the first rotational frame 22 and the rotational movement of the second rotational frame 24, the direction of the axis of the biopsy needle 3 is determined by the link 1 with respect to the coordinate system based on the link 165.
It can be oriented in any direction within a preset angular range with the tip P of 65 approximately at the center.

FIG. 4 is a diagram for explaining the angular range of the biopsy needle 3 with respect to the link 165, and the diagram is simplified for simplicity.

FIG. 5A is a side view of the link 165, in which the first rotation frame 22 is connected to the rotation shaft 2. By rotating around the axis, the tip of the biopsy needle 3 is lowered, and the angle between the biopsy needle 3 and the axial direction of the link 165 is 95°.
It is possible to change up to.

FIG. 2B is a front view of the tip end P side of the link 165, showing a state in which the first rotation frame 22 has been rotated 90 degrees from the state shown in FIG. By rotating around the rotation axis 2 □, the biopsy needle 3 can be moved with its tip facing downward within a range of at least 45 degrees left and right.

(C) is a diagram seen from above the link 165, and the first
The rotating frame 22 is in the state shown in FIG. 2, and the second rotating frame 2
4 is designed to be able to change within a range of at least 45 degrees left and right.

By the way, the small hole through which the biopsy needle is inserted during stereotactic neurosurgery is generally located 30 minutes from the external surface of the skull where the lesion is located.
If the biopsy is up to the size of a dish, the biopsy needle will be inserted at the shortest distance above the lesion, but if the lesion is deep, the path of entry for the biopsy needle will be determined by taking into consideration the blood vessels and nerves in the brain. , the foramen is generally not located at the shortest distance, but as shown in Figure 7, the lesion is located in the radial direction R, which passes from the center 0 to the lesion site X, assuming that the cranial surface S is spherical. It can be opened within a range where the solid from part X is approximately 90°.

FIG. 6 is a diagram showing the positional relationship among the virtual spherical surface F, cranial surface S, lesion site X, and small hole H in the example.

Here, the depth from the skull surface S to the lesion site X is Y, the distance from the virtual center 0 to the pivot point P' of the biopsy needle 3 attached to the insertion part 2 is 150 mm, and the virtual center O
When the distance from to the cranial surface S is 100 mm, and the small hole H is opened at the farthest position from the radial direction R passing through the lesion site X, the pivot point P' of the biopsy needle 3 is
, the angle θ formed by the straight line passing through the small hole H and the lesion site X (intrusion direction of the biopsy needle 3) and the straight line from the rotational fulcrum P' toward the virtual center 0 (the angle of inclination of the needle fulcrum) is calculated as follows. It became like this.

As mentioned above, if the lesion site is within 30 mm from the outer surface of the skull, the small hole H will be drilled at the shortest distance above the lesion position, so if it is shallower than 30 spinal cords, there is no need to consider θ. , as seen from the table above, the maximum value of θ is 2
It can be set to about 0°.

The device of the embodiment has the following characteristics: the movement position and angle of the link 165 of the link mechanism 16, and the biopsy needle 3 in the insertion section 2.
The rotation range is set to cover the above range.

In the above example, the robot was explained as a robot for stereotactic brain surgery, but this robot can also be applied to surgery for implanting electrodes into the ear pot and cow shell, surgery for cutting the spine with controlled depth, and surgery for internal organs. can.

〔Effect of the invention〕

As explained above, according to the present invention, there is provided a link mechanism in which the tip of the follower draws an arcuate trajectory around a point on the extension of the top of the head, and a rotation mechanism that rotates this link mechanism around a rotation axis. A surgical robot is constructed by a mechanism, a jig feeding mechanism that reciprocates a needle-like jig such as a biopsy needle in its axial direction, and a swinging mechanism that rotates this jig feeding mechanism. The jig feeding mechanism can be moved on a virtual spherical surface with the center point of the skull as the virtual center, and can be moved back and forth within a certain range of angles toward the virtual center by the swinging mechanism.

Therefore, by connecting the fixation device in stereotactic neurosurgery to a predetermined position on the body axis on the parietal side, it becomes possible to set the biopsy needle etc. in a free direction according to the case, and the CT gantry It is possible to obtain a stereotactic neurosurgery robot device that can automatically operate a biopsy needle, etc. within the device, and it can be used when performing stereotactic neurosurgery while obtaining X-ray CT image information.

It can also be applied to surgery for implanting electrodes into the cow's shell for ear pots, spinal cutting surgery with controlled depth, and internal organ surgery.

[Brief explanation of drawings]

Fig. 1 is a diagram showing a surgical robot according to an embodiment of the present invention, Fig. 2 is a diagram showing an insertion section in the embodiment, Fig. 3 is a diagram illustrating the operation of the link mechanism in the embodiment, and Fig. 4 is a diagram showing the operation of the link mechanism in the embodiment. Figure 5 is a diagram illustrating the angular range of the biopsy needle in the example. Figure 5 is a diagram showing an example of the usage state in the example. Figure 6 is a diagram showing the positional relationship between the virtual spherical surface, the cranial surface, the lesion site, and the small hole in the example. FIG. 7 is a diagram explaining the position of the small hole in stereotactic brain surgery according to the embodiment, and FIG. 8 is a diagram conceptually showing the shape of the head according to the embodiment. DESCRIPTION OF SYMBOLS 1... Main body part, 2... Insertion part, 3... Biopsy needle, 13... Rotating table, 16... Link mechanism, 22... First rotating frame, 24...・Second rotation frame, 0・
... virtual center, P... tip of follower. (0) (C) 4th Figure 477-

Claims (1)

[Scope of Claims] A link mechanism in which the distal end of a follower draws an arcuate trajectory with one point as the center, a rotation mechanism that rotates this link mechanism around a rotation axis, and a needle-like jig that rotates around the rotation axis. a jig feeding mechanism that is attached to the tip of the follower and moves the axial direction of the jig within a predetermined angular range including the center of the arcuate trajectory; A surgical robot comprising: a swinging mechanism for rotating; and a surgical robot.