DE102014016823B4 - A method of controlling a mechatronic assistance system coupled to a support arm - Google Patents

Abstract

Method (1000) for controlling a mechatronic assistance system (200) coupled to a holding arm (1) for navigation during a surgical treatment, comprising the steps of: - coupling (1004) a mechatronic assistance system (200) to a second interface (8) of the Holding arms (1) at its distal end (4); - transmitting (1006, 1008) electrical energy and signals from a first interface (6) of the support arm (1) at its proximal end (2); - wherein the transmitting (1006, 1008) by means of a transmission means (76, 78) which is arranged within the holding arm (1) and the first interface (6) with the second interface (8) for transmitting energy and signals between the interfaces (6, 8), characterized by the steps of: - detecting, by means of a recognition unit, an instrument introduced into an operating area; Providing data on the first interface (6) representing and indicating that the instrument has been introduced into the operating area, detecting, by means of a recognition unit, an instrument executed from the operating area; and - providing data to the first interface (6) representing and indicating that the instrument was executed from the operating area; to determine at which time which instrument is introduced into the operating area and whether it has left the operating area again.

Description

The invention relates to a method for controlling a mechatronic assistance system coupled to a holding arm, in particular by using such a holding arm.

Retaining arms of the type mentioned are already known for a long time and are used in surgery in particular to relieve an operator of static holding work. Such a support arm is used to hold a mechatronic assistance system and / or a surgical instrument, such as a manipulator, an endoscope, a clamp, and the like. In particular, for holding endoscopes, the above-mentioned retaining arms have proven. In endoscopic surgery, an operator typically operates an instrument with both hands, while an assistant holds the endoscope to visualize the surgical field via a screen. Holding the endoscope for an extended period of time is very tedious. For this reason, more support arms are used.

Such a support arm is for example off DE 195 26 915 B4 known. The disclosed medical device includes a connector and a surgical tool holder and an arm disposed between the holder and the connector. The arm is connected to the holder and the connecting part or to an adjacent arm via a joint and coupled to a pneumatically actuated device for selectively fixing and releasing the joints, this device fixing the joints under the action of a mechanical force exerting a braking force on the joint and wherein the device is pneumatically transferable against the force of this spring in a state releasing the joint. On the holder at the proximal end of the arm, an actuator is arranged, by means of which a valve can be opened, so that the individual joints of the arm can be adjusted. When you release the actuator, the valve is closed again, so that the joints are fixed.

A similar arm is in EP 1 958 587 B1 disclosed. The holding arm disclosed there likewise has a plurality of joints, and a contact-sensitive sensor is provided for actuating the joints. This sensor is located on the support arm adjacent to the medical instrument so that upon grasping the medical instrument, the operator comes into contact with the touch-sensitive sensor, thereby releasing the joints of the support arm.

Both of the above-mentioned holding arms are so-called passive holding arms, which have only braked joints, but no active drives in the joints. The joints are releasable due to the operation of the control device and locked when you release this again.

Another such arm is in DE 10 2011 004 926 A1 disclosed. The holding arm has a plurality of arm segments and a plurality of joints, by means of which the individual arm segments are coupled together. The arm according to DE 10 2011 004 926 A1 further includes a first interface at the proximal end for coupling the support arm to a standard rail of an operating table. The first interface is essentially designed in accordance with a clamp. In addition, the support arm has an interface at the distal end, which is also designed as a clamp and serves to receive an endoscope. Although this arm is generally well suited for the mere holding of endoscopes, there is still a need to make the field of use of such support arms more flexible, in particular to adapt to different tasks. Further, it is desirable to improve the safety of such retaining arms such that a risk of injury to a patient during surgery using the retaining arm is reduced.

Another arm is in US Pat. No. 7,841,979 B2 disclosed. The holding arm holds at its front end an endoscope and is coupled in a middle section with a screen. By moving the support arm and / or the screen, the endoscope and the screen are swiveled in the same direction, so that the orientation of the screen corresponds to the orientation of the endoscope.

Consequently, it is an object of the present invention to provide a method whose range of application is greater, which is particularly flexible and which is improved in terms of safety aspects.

There is disclosed a support arm of the initially mentioned type having a first interface at the proximal end for connecting the support arm to a power source and an external control unit for transferring signals to and from the support arm; a second interface at the distal end for coupling the support arm to the assistance system for controlling the assistance system; and a transmitter disposed within the support arm and connecting the first interface to the second interface for transferring power and signals between the interfaces.

As assistance systems in the sense according to the invention, any type of mechatronic manipulators used in surgery are understood, in particular endoscopes, exoscopes, laparoscopes, trocars and the like. The second interface at the distal end of the support arm is adapted to both mechanically couple with the assistance system to hold this in a defined position to the support arm, as well as the necessary other connections, such as in particular a connection for electrical energy and a connection for transferring of signals, in particular actuating signals. Within the holding arm, a transmission device is formed, which preferably has a bus system. Furthermore, the transmission device has means for transmitting electrical energy. As a result, all the cables required to transfer electrical energy and / or data from the first interface to the second interface are located inside the support arm and thereby protected during operation of the support arm. Means are further provided at the first interface for coupling the support arm to a power source and an external control unit such as a computer and / or an operating system. As a result, the range of use of the support arm is increased, and this can be used flexibly for various assistance systems. At the same time, the safety is improved, since the attachment of additional cables or the like is not required, but the assistance system is only to couple with the second interface at the distal end and the arm itself in turn via the first interface at the proximal end with a power source and an external control unit coupled.

Particularly preferably, the first interface has a connection for an external accumulator. As a result, the holding arm is independent of a stationary power supply, and cables can still be avoided. Also, the support arm is so in the event of a power failure continue to operate, whereby the security is improved. The first interface preferably has a connection for connecting the holding arm to a navigation device, in particular an operating navigation device. In modern operating theaters, several robotic systems are usually used. By having a connection to such a navigation system, the support arm is able to transmit and receive position data, and thus a collision with other robotic systems can be avoided. Further preferably, the first interface comprises a Bluetooth ^® - on, a USB, an RS-232, and / or an optical connection. By means of a Bluetooth ^® connection, it is possible, for example, to transmit signals to the holding arm and to provide them via the transmission device at the second interface, where these are then transferred to a surgical mechatronic assistance system, such as a manipulator. The same applies to USB and RS-232 interfaces. USB and RS-232 interfaces are particularly suitable for connecting conventional PCs or surgical systems to the support arm.

In a further preferred embodiment, the first interface has a connection for an x-ray device, an ultrasound device or a medical laser, and the transmission device is designed to transmit x-rays, ultrasound signals and / or a medical laser beam, and the second interface is adapted to X-rays, ultrasound signals and / or laser beams to a surgical field, or to provide a surgical mechatronic assistance system. This also makes it possible to use the holding arm flexible, and wiring in the operating area can be largely avoided. X-ray devices, ultrasound devices and medical lasers can be arranged distally to the patient and transmitted and provided by means of the holding arm to the surgical field.

The support arm has a plurality of arm segments and a plurality of joints, by means of which the arm segments are hinged together. Preferably, the support arm has at least six arm segments and at least six joints. The arm segments themselves are substantially rigid and preferably substantially rod-shaped. The term "rod-shaped" here comprises both substantially straight arm segments and slightly to strongly curved arm segments. In such a support arm arm segments and joints always alternate. The holding arm is preferably designed as a so-called passive holding arm and therefore has only actively braked joints, but no driven joints, as is often the case with robotic holding arms. Each joint is therefore only released and locked, but not drivable. As a result, the holding arm is simple and requires no complex control to its operation. The support arm can be manually adjusted by the individual joints are adjusted against the braking force of the brakes.

Preferably, the holding arm has an operating device for bringing the holding arm into a desired pose, wherein the operating device is set up to release the associated joint upon contact between an operator and one of the first and second arm segments. It is therefore preferably provided that the operating device is set up to release the first joint upon contact between an operator and the first arm segment, and upon contact between an operator and the second Arm segment to release the second joint. It is therefore preferably provided that when an operator with a corresponding arm segment only the associated joint is released. This makes it possible to intuitively move individual joints and to adjust the holding arm so segmentally and bring in a desired pose. This allows more accurate positioning, as each segment can be incrementally adjusted separately. It is also possible to contact several segments at once so that multiple joints are released simultaneously and are thus adjustable. This makes it possible to transfer the support arm in a simple manner, in particular intuitively, in a desired pose. For this purpose, a contact means may be provided on the holding arm, in particular on the segments, which cooperates with the operating device such that the operating device releases an associated joint upon contact between the operator and the contact means.

According to a further preferred embodiment, the joints brakes, by means of which the joints are releasable and lockable. The brakes serve to brake or prevent a movement of the arm segments relative to one another, that is to say a movement of the joints. When the brakes are released, the joints are released.

Preferably, the brakes are biased in a resting state such that the joints are locked. As a result, the arm is in a locked state when it is in a rest state, which improves the safety of the support arm for use in the medical field. If, for example, due to a fault, a failure of a power supply, the holding arm is in a locked state, and the pose of the support arm remains. Furthermore, an energy requirement of the support arm is reduced by such a design of the bias voltage.

Particularly preferably, the brakes are designed as electromagnetic brakes and each have a permanent magnet which biases the brakes in the de-energized state in the locked state. This is a particularly useful design of the brakes. To release the brakes are to energize, so that a brake element is released against the force of the permanent magnet. If a power supply fails, the brake closes again due to the permanent magnet, so that the joint is then in the locked state. Electromagnetic brakes have the advantage that they can exert a high holding force or a high holding torque in relation to their weight compared to Federdruckbremen.

According to a further preferred embodiment, the holding arm has six degrees of freedom. Particularly preferably, the holding arm on seven degrees of freedom. While six degrees of freedom are sufficient to reach every point in the room, with seven degrees of freedom it is possible to reach each point with different poses so that the support arm can always be aligned so that, for example, the operating field is easily accessible. Therefore, it is particularly preferred that the holding arm has seven degrees of freedom.

According to a preferred embodiment, the holding arm has seven arm segments and seven joints, wherein each arm segment is associated with a joint. Each joint preferably has a degree of freedom according to this embodiment, so that the holding arm has a total of seven degrees of freedom. It is also possible that each joint has two or more degrees of freedom, joints with one degree of freedom being preferred because of their stability. Preferably, all joints are designed as rotational joints. Preferably, some of the joints are designed as rotatory joints and some as translational joints. Preferably, when all of the joints are rotationally arranged, the joints are arranged in the holding arm such that axes of successive joints along the holding arm, in each case perpendicular to one another, from the proximal to the distal end of the holding arm.

In a further preferred embodiment, the holding arm in at least one joint on a position sensor, for detecting a position of the joint. Preferably, a position sensor for detecting the position of a joint is arranged in each joint. Such a position sensor may be formed, for example, as a capacitive displacement sensor, which mechanically absorbs a movement path of the joint, and thus determines an angular position, or as an acceleration sensor, which determines a movement of the joint in space. Additionally or alternatively, motion sensors are provided in the arm segments, so that the position of the arm segments in space can be determined. In this way, a pose of the holding arm can be determined, which in turn can be provided via the first and / or second interface to the assistance system and / or to the external control unit. This is particularly advantageous when an OP navigation system is used and this uses the information about the pose of the support arm to coordinate navigation. Furthermore, it can be determined via the pose of the holding arm, whether a collision threatens with other devices or the arm itself. As a result, the safety of the support arm is further improved.

If an acceleration sensor is used as a position sensor, it is also possible to detect a movement of the holding arm as a whole, without changing the pose. For example, if the operating table is moved during the operation, the holding arm can detect this movement. It can be provided that the holding arm is set up at a certain inclination of the operating table, for example from 15 degrees, to output a warning signal. If an inclination of the operating table is set too steeply, it is possible for a patient to slip on the operating table, which can cause injuries. For example, if an endoscope is arranged at the distal interface of the support arm, which is introduced, for example, in the nose of a patient, and then the inclination of the table is adjusted, the support arm detected by means of the motion sensors on the one hand the inclination of the table, on the other hand due to torque sensors in the Also hinge a change in load on the endoscope, which may also suggest a slipping of the patient on the operating table. The holding arm is preferably set up to output a signal, for example a signal tone, when predetermined limit values are exceeded. It can also be provided that the holding arm emits a signal, for example to an operating system or directly to an operating table, when the holding arm is coupled by means of the proximal interface to an operating system or the operating table such that movement of the table is blocked when located on the distal interface endoscope is in the situs. Furthermore, it can be provided that after a detected patient movement or a table movement relative to the holding arm, a previously approached position of an assistance system, in particular an endoscope, relative to the patient may no longer be approached. Even so, an injury can be avoided.

If, in addition, an operating navigation system is present, it is also possible, by means of the holding arm according to the invention, to integrate non-navigated instruments, which have no locators associated with the navigation system, via the holding arm into the navigation system. By means of the holding arm, it is possible to determine the position of a non-navigated instrument which is arranged on the distal interface of the holding arm. For this purpose, a locator is arranged on the holding arm or on the base with which the holding arm is coupled, so that the position of the holding arm in the navigation system is known. The support arm can transmit data representing the position of the instrument via the proximal interface to the navigation system, which can process the data and thus integrate the non-navigated instrument into the navigation. In addition to acceleration sensors, other position and gyroscope sensors are also preferred. By holding instruments which themselves have no sensors or the like (such as surgical clips and the like) by means of the holding arm, their position relative to the table is known. Often, operating tables consist of individual segments that can be manually adjusted. For example, a top plate can be raised, tilted or moved. This often changes the relative position of the patient to instruments, which can cause injury. By having position sensors, the support arm can detect a movement of the operating table or segments of the operating table and thus warn of a relative movement of the patient to the assistance system (for example the surgical clamp) by outputting a signal in such a detected relative movement. It is also possible that the support arm via the proximal interface data on its pose to other systems such as C-arms (for example, the system Artis zeego Siemens AG, Erlangen, Germany), which collisions can be avoided.

In a further preferred embodiment, a torque sensor for detecting a torque acting on the joint is arranged in at least one joint. Preferably, such a torque sensor is arranged in all joints. By detecting torques acting on the joints, it is possible to determine a force acting on the distal end of the support arm. As a result, on the one hand a weight of an assistance system can be determined, which is coupled to the distal end. On the other hand, even when using the holding arm on these acting forces can be determined. For example, it is conceivable that an endoscope is arranged at the second interface. In manipulating the endoscope, for example inserting the endoscope into a body opening of a patient, a resistance can be determined which is encountered by the endoscope. This indicates whether an injury to the patient is imminent. As a result, the security is further improved. Preferably, the detected torque data is provided at the first and / or second interface.

Thereby, the torque data can be processed at the external control unit, and this can output a warning signal or the like, for example, in the above-mentioned case of the collision of an endoscope with a resistance in the body of a patient.

By means of the torque sensors, furthermore, a weight of an assistance system arranged on the distal interface can be determined. The support arm is preferably designed to pose poses, in which a certain torque threshold of a joint would be exceeded due to a weight of the assistance system blocked. For example, if a relatively heavy endoscope is placed on the distal end of the support arm, a pose in which the support arm projects very far from the base, and thus a very high moment in a proximal hinge, is blocked. An operator can not move the support arm into such a pose, as brakes in joints previously prevent the support arm from entering such a pose. As a result, the safety of the support arm is further improved. It is also conceivable that the weight of the assistance system is not determined by the holding arm, but the assistance system transmits its own weight to the second interface at the distal end and the holding arm stores data representing this weight and processes it accordingly. Additionally or alternatively, it is preferably provided that a signal tone is output when certain threshold values are exceeded. In addition, it is preferred that illuminants are provided at the joints, which light up when a predetermined threshold value of a joint is exceeded. Thus, if a joint is loaded with too high a torque, a light source is triggered at this joint and a surgeon can thus perceive which joint requires relief in order to achieve a stable pose.

To transmit this data, the first and / or second interface preferably comprise transmission means for transmitting the data acquired by the sensor or the sensors. This transfer means preferably includes the above-mentioned interfaces, such as in particular Bluetooth ^®, USB, RS-232 or similar.

According to a further preferred embodiment, the holding arm has a recognition unit for recognizing an assistance system coupled to the second interface, wherein the operating device is adapted to release or lock the joints as a function of the assistance system coupled to the second interface. Such a recognition unit preferably has a barcode scanner, a QR code scanner or an RFID scanner. Preferably, an assistance system coupled to the second interface is equipped with a corresponding barcode, QR code or an RFID chip which contains an identification of the assistance system and preferably information about it. As a result, the holding arm is able to recognize which assistance system is coupled to the second interface and thus partially or completely prevent the release of certain joints. For example, an endoscope is arranged on the second interface. The RFID chip of the endoscope contains information about this endoscope, in particular the geometrical dimensions of the endoscope. This information is recognized by the recognition unit and passed on to the operating device of the support arm and / or the external control unit. The operating device is designed to prevent such poses of the holding arm, in which the endoscope would collide with the holding arm. Furthermore, the operating device may additionally be designed to prevent such positions of the holding arm, in that the endoscope collides with, for example, an operating table or other objects.

The recognition unit is preferably further adapted to recognize an instrument which is introduced into the operating area and to provide data representing this instrument at the first interface. The recognition unit is preferably further adapted to recognize an instrument which is removed from the surgical area and to provide data representing that instrument at the first interface. For this purpose, the instrument preferably has a transmitter, for example an RFID chip, which communicates by means of a corresponding receiver, for example an RFID sensor, which is provided in the detection unit. This makes it possible to determine at which time which instrument is introduced into the operating area and whether it has left the operating area again. If, for example, it is found at the end of a surgical procedure that seven instruments have been brought to the surgical area, but only six have been removed from it, this can be an indication that there is still an instrument in the operating area, whereby a risk for the patient can be caused.

According to a further preferred embodiment, the holding arm has a camera, which is preferably arranged at the distal end, wherein the camera is intended to observe an operating field and is coupled to the first interface for transmitting image data at the first interface. As a result, the surgical field can be observed in an advantageous manner. The camera is arranged by the coupling to the holding arm particularly close to the surgical field and has "free view" on the surgical field. In addition, their position is adjustable by means of the holding arm. The camera can also be used to observe objects such as other surgical instruments and the like near the support arm to prevent collision therewith. If the camera realizes, for example, that the holding arm is brought too close to an instrument located in the operating field, it can be provided that the operating device locks one or more joints, so that a collision is prevented. In such a case, it is preferable that the Operating device has a controller that is equipped with a dedicated image recognition software. The camera can be integrated into the holding arm itself and firmly connected to it, or the camera is part of an exoscope, which is coupled to the second interface. The camera is preferably designed as a full HD camera or as a 3D camera. If the camera is part of an exoscope, it is connected to a voltage interface, an optical fiber interface and a data interface at the second interface. In use, the camera of an exoscope is typically positioned about 25 cm to 75 cm away from an operating field. By the camera of the exoscope is coupled directly to the distal interface, data can be transmitted at the proximal interface, for example to an operating room system. Now a user can view images captured by the camera via a corresponding 2D or 3D monitor of the surgical system. Since it is possible to position the camera or the lens of the camera relatively close to the surgical field by means of the holding arm, large magnifications of, for example, 12x magnification are easy to realize when using appropriate monitors. Thus, it is no longer necessary to use a large and cumbersome surgical microscope, only the arm, which is equipped with a camera or an exoscope, is sufficient to observe the surgical field. In that the holding arm additionally has sensors for determining the pose of the holding arm, when using the holding arm according to the invention, the position from which the images are recorded by means of the camera or the camera of the exoscope is also known. The recorded image data can be assigned temporal position information. Thus, it is possible to assign viewing angle and gaze position to each individual image after completion of the operation. From this, postoperative conclusions can be drawn for the documentation, from which perspective which operative strategy was chosen.

Preferably, the holding arm further comprises a microphone, which is coupled to the controller and / or operating device, and the controller and / or the operating device has a corresponding speech recognition software, so that received by the microphone audio signals are converted into control signals for the holding arm , Thus, upon receipt of a corresponding audio signal via the microphone, it is preferable to control a camera arranged on the holding arm or integrated therewith so that it takes a still image, a so-called snapshot, and transfers it to the holding arm at the second interface, so that data representing this snapshot can be transferred to a system at the first interface of the support arm. This allows the operator to issue an instruction during the operation, such as saying the word "snapshot" and sending a signal from the controller to the camera through voice recognition software provided in the controller, taking a snapshot, and recording data. which represent these to provide at the second interface. Position data can also be transferred to these snapshots by the holding arm.

If a navigation system is also present in an operating room in which the holding arm is used, the holding arm can be connected to this navigation system via the first interface. Such navigation systems are available for example from the company Karl Storz GmbH & Co. KG, Tuttlingen, Germany or the company Olympus Germany GmbH, Hamburg, Germany. In such a case, an optical locator, which cooperates with the navigation system, is preferably attached to the base of the support arm. The navigation camera of the navigation system thus detects the holding arm and also the surgical field. The patient is also equipped with localizers, so that a patient situation in the room can be detected by the navigation system. However, the defined working spaces of a navigation system are usually limited. If a camera or an exoscope is now provided on the holding arm, it is possible to position the camera or the exoscope outside the working space of the navigation system and to determine the position of the camera or of the exoscope by means of the holding arm. As a result, the limited working space of the navigation system can be kept free of additional tools and the navigation system can be used better. Furthermore, position data of the camera to the data representing the captured images can be stored and linked with data of the navigation system. In a further preferred embodiment, a securing element is provided on the second interface, which is coupled to the operating device, such that the operating device locks all joints when the securing element indicates a faulty coupling between the assistance system and the second interface. Such a securing element can be designed as an electronic security element or as a mechanical securing element. For example, it can be provided that, with correct coupling between the assistance system and the second interface, a circuit is closed. In an alternative, a magnet is arranged on the assistance system, and the second interface has a corresponding sensor which is set up to detect the magnetic field of the sensor arranged on the assistance system. Other alternatives are conceivable here. This also further improves the safety of the support arm. Is an assistance system not correct with the second Coupled interface, all joints are locked, and the support arm can not be moved. The risk of a holding arm with an incorrectly coupled assistance system being used during an operation can thereby be reduced.

According to the invention, the object mentioned at the outset is achieved by a method for controlling a mechatronic assistance system coupled to a holding arm for navigation during a surgical treatment, comprising the steps of: coupling a mechatronic assistance system to a second interface of the holding arm at its distal end; Transmitting electrical energy and signals from a first interface of the support arm at its proximal end; wherein the transferring is carried out by means of a transfer device which is arranged inside the support arm and connects the first interface to the second interface for transferring energy and signals between the interfaces; and wherein the method further comprises the steps of: detecting, by means of a recognition unit, an instrument inserted into an operating area; Providing data at the first interface representing and indicating that the instrument has been inserted into the operation area, detecting, by means of a recognition unit, an instrument executed from the operation area; and providing data at the first interface representing and indicating that the instrument was executed from the operation area; for determining at what time which instrument is introduced into the operating area and whether it has left the operating area again (claim 1).

It should be understood that the retainer arm disclosed herein and the method of the invention have the same and similar sub-aspects. In this respect, for individual embodiments of the support arm and for the advantages of the method to the above description to the disclosure of the support arm is fully referenced.

By means of such a method for controlling a mechatronic assistance system coupled to a holding arm, in particular the safety of a used holding arm and the safety of surgical steps executed therewith are improved.

Preferably, the method further comprises the steps of: detecting positions of joints of the support arm; Determining a pose of the support arm using the sensed position of the joints; and providing data representing the particular pose at the first interface. The data provided at the first interface are preferably transferred by means of this to an external control unit in which the data is further processed and / or evaluated. Such an external control unit can be designed, for example, as a conventional PC, or as an operating room system.

Furthermore, it is preferred that the method comprises the steps of: detecting torques acting on joints of the holding arm; Determining a force acting on the distal end of the support arm; and providing data representing the determined force at the first interface. These data are also preferably transferred to an external control unit. The external control unit can further process and / or evaluate this data. For example, the external control unit may output a signal when a limit value of a force acting on the holding arm is exceeded.

In a further preferred refinement, the method comprises the steps of: detecting an assistance system coupled to the second interface; Releasing and locking joints of the support arm depending on the recognized assistance system; Providing data representing the recognized assistance system at the first interface. These steps further enhance the safety of the support arm and the use of this support arm in a surgical procedure. As soon as a critical and / or "impermissible" pose with the holding arm is achieved or the holding arm is moved into such a pose, corresponding joints are locked, so that this critical or "inadmissible" pose can not be achieved. As a result, the safety of the support arm is further improved.

According to the invention, the method comprises the steps of: detecting, by means of a recognition unit, an instrument introduced into an operating area; Provide data at the proximal interface that represents the instrument and indicates that the instrument has been inserted into the surgical field. According to these method steps, instruments that are not coupled to the distal end of the support arm are detected by the recognition unit.

For this purpose, the detection unit preferably has a receiver, for example an RFID sensor, while the instrument (s) brought into the operating area have a transmitter, such as an RFID tag. It is also possible that the holding arm has a near-field sensor, and the instrument has a near-field chip. Likewise, other transmitter-receiver models are possible. Consequently, this method recognizes when an instrument is introduced into the surgical area. In the process, data is created at the first interface which represent the instrument and indicate which instrument it is, as well as data indicating that the instrument has been introduced into the surgical field. Preferably, these data are stored.

It is further provided that the method comprises the steps of: detecting, by means of a recognition unit, an instrument executed from the operating area; Provide data to the first interface that represents the instrument and indicates that the instrument was executed from the operation area. Here, the above description applies accordingly. However, according to these method steps, it is recognized here whether and when the corresponding instrument was executed from the operating area. If there is a discrepancy between imported and executed instruments after the operation has been completed, this indicates that instruments are still in the operating area. This can reduce the risk of surgery.

In a preferred embodiment, the method comprises the steps of: acquiring image data of an operating field; and providing the image data at the first interface. The image data comprise both two-dimensional and three-dimensional image data and are preferably detected by means of a camera which is arranged at the distal end of the holding arm.

In a preferred embodiment, the image data are linked to position data of the assistance system. The assistance system preferably has a camera. By linking the image data with position data of the assistance system, in particular metadata of the image comprising data about the position of the camera, it is possible to determine from which position the corresponding image was taken.

In a preferred embodiment of the method, this has the steps of: detecting an audio signal by means of a microphone; Recognizing a voice command in the audio signal; Converting the voice command into a control signal for the assistance system; and providing the actuating signal at the second interface. Preferably, a known speech recognition software is used to process the audio signal. Certain voice commands may be associated with certain control signals. It is thus possible, for example, for a voice command: "screenshot" to be associated with an actuating signal which causes a camera arranged on the second interface to take a picture. Other control signals are conceivable and preferred.

Furthermore, it is preferred that the method further comprises the following steps: determining whether the assistance system is correctly coupled to the second interface; Locking all joints of the support arm if the assistance system is not correctly coupled to the second interface. This also further improves safety. In addition, it can be provided that the method has the step of outputting an alarm signal if the assistance system is not correctly coupled to the second interface. Such an alarm signal may be formed, for example, as an audio signal or visual signal.

In a preferred embodiment of the method, the latter furthermore has the step of displaying a representation of data transferred at the first and / or second interface. Such a representation may include, for example, displaying an identification of an assistance system located at the distal end. Information about this assistance system may be displayed, such as capabilities, restrictions, adjustment parameters, and the like. Furthermore, it is also possible to represent a pose of the holding arm or forces acting on individual joints.

In a further preferred embodiment, the method comprises the steps of: storing the data provided at the first interface; Create an operation log using the stored data. Preferably, all collected and provided data are stored and created based on this data, the operation log. The collected data includes position and location data of the joints, as well as forces acting on the distal end. Based on this data, it is possible to reconstruct each individual pose of the support arm during an operation and thus to know the position of an assistance system arranged in the support arm in the room during the entire operation process. From this it is understandable how the assistance system was moved relative to the patient and thus, what steps have been taken. In accordance with this aspect of the invention, it is therefore not necessary for an operator to record each individual step, which can be done afterwards by reading out the data and processing this data. As a result, the security is further improved because the risk of protocol errors is reduced.

Furthermore, the method preferably comprises the steps of: storing all data provided at the first interface; Generating a DICOM file based on the stored data. A DICOM file is a well known data exchange format for surgical systems and can be used by a variety of systems to post-parse and post-process an operation. A DICOM file can also be used to print in to be filed in an electronic patient file. Preferably, these steps are performed automatically upon completion of an operation.

The invention will be explained in more detail below by means of an embodiment and with reference to the attached figures. Showing:

1 a side view of a support arm, in which the contact means are visible;

2 a partially broken view of the support arm 1 ;

3 a schematic representation of the fourth arm segment;

4 a further schematic representation of the fourth arm segment;

5 the holding arm 1 coupled with an external control unit;

6 a plan view of the interface at the proximal end of the support arm;

7 a perspective view of an external energy storage;

8th a perspective schematic view of the first arm segment with a mechanical interface for coupling the support arm to a standard rail of a surgical table;

9 a perspective view of the seventh arm segment, including interface at the distal end;

10 a plan view of the interface at the distal end of the support arm;

11a an embodiment of the support arm with a partially structured surface;

11b an embodiment of a support arm with a partially colored surface;

12 a partial section through a brake in a joint of the support arm;

13 a flowchart of a method according to a first embodiment; and

14 a flowchart of a method according to a second embodiment.

1 shows a holding arm 1 for medical purposes, in particular for holding a surgical mechatronic assistance system and / or surgical instrument. The holding arm 1 has a proximal end 2 and a distal end 4 on. At the proximal end 2 are a first interface 6 and a mechanical interface 7 formed, which with respect to the 6 and 8th be described in more detail. the interface 7 serves to hold the arm 1 to attach to a base, in particular to an operating table. the interface 7 serves to transfer energy and to couple the support arm 1 with an external control unit (cf. 5 ). At the distal end 4 is a second interface 8th provided via the a mechatronic assistance system and / or a surgical instrument, in particular a manipulator, to the support arm 1 can be coupled. Preferably, a manipulator for holding and manipulating an endoscope is arranged here.

The holding arm 1 according to 1 has seven arm segments 10 . 12 . 14 . 16 . 18 . 20 . 22 which are each substantially rod-shaped and except for the last arm segment 22 all of substantially equal length. The seven arm segments 10 . 12 . 14 . 16 . 18 . 20 . 22 are each with joints 11 . 13 . 15 . 17 . 19 . 21 . 23 coupled together, the zeroth joint 11 the holding arm 1 with the base (in 1 not shown, s. 7 ) couples. The joints 13 . 15 . 17 . 19 . 21 . 23 are all formed according to this embodiment as a rotary joints, each with a degree of freedom. According to this embodiment, the zeroth segment 10 the zeroth joint 11 assigned, the first arm segment 12 the first joint 13 assigned, the second arm segment 14 the second joint 15 assigned, the third arm segment 16 the third joint 17 assigned, the fourth wrist joint 18 the fourth joint 19 assigned, the fifth arm segment 20 the fifth joint 21 assigned, and the sixth arm segment 22 is the sixth joint 23 assigned. The joint 11 is designed as a translational joint, so that the arm segment 10 telescopically extendable so as to support arm 1 to adjust in height, as with reference to later 8th will be explained. The joints 13 . 15 . 17 . 19 . 21 . 23 each have pivot axes A ₁ , A ₂ , A ₃ , A ₄ , A ₅ , A ₆ , in each case adjacent joints have pivot axes which are perpendicular to each other. This will provide easy positioning of the distal end 4 reached in the room.

The holding arm 1 according to 1 also has an operating device 28 on. By means of the operating device 28 is the holding arm 1 be brought into a desired pose, wherein the operating device 28 is adapted to release the associated joint upon contact between an operator and one of the seven arm segments. For this purpose, the operating device 28 according to this embodiment, seven contact portions 30 . 32 . 34 . 36 . 38 . 40 . 42 on, being on each arm segment 10 . 12 . 14 . 16 . 18 . 20 . 22 one contact agent each 30 . 32 . 34 . 36 . 38 . 40 . 42 is arranged. So is the zeroth arm segment 10 a zeroth contact agent 30 arranged on the first arm segment 12 a first contact means 32 , on the second arm segment 14 a second contact means 34 , on the third arm segment 16 a third contact 36 , on the fourth arm segment 18 a fourth contact agent 38 , on the fifth arm segment 20 a fifth contact 40 and on the sixth arm segment 22 a sixth contact agent 42 arranged.

Further, according to this embodiment, it is provided that each contact means 30 . 32 . 34 . 36 . 38 . 40 . 42 each two substantially oppositely disposed contact center elements 30a . 30b . 32a . 32b . 34a . 34b . 36a . 36b . 38a . 38b . 40a . 40b . 42a . 42b having. The contact means 30 . 32 . 34 . 36 . 38 . 40 . 42 serve to contact an operator with the appropriate arm segment 10 . 12 . 14 . 16 . 18 . 20 . 22 capture. When grasping an arm segment 10 . 12 . 14 . 16 . 18 . 20 . 22 the operator comes into contact with both contact means elements 30a . 30b to 42a . 42b , and only when in contact with both Kontaktmittelelementen 30a . 30b to 42a . 42b a contact agent 30 to 42 the associated joint is released. That is, when grasping the first arm segment 12 and simultaneously contacting the two contact means elements 32a . 32b is through the operating device 28 the first joint 13 Approved. This makes it possible for the operator to hold the support arm 1 or the arm segments 12 to 22 can pivot about the axis A ₁ . When releasing one of the two or both contact center elements 32a . 32b becomes the joint 13 locked again, and a pivoting about the axis A, is no longer possible. Even with an unintentional contact only one of the two contact means elements 32a . 32b For example, with one arm or elbow of the operator, the joint becomes 13 not released, and the holding arm 1 stays in the locked state and keeps his pose.

The same applies to the second arm segment 14 , Again, the second contact means 34 two contact center elements 34a . 34b substantially circumferentially opposed to the arm segment 14 are provided. When grasping this arm segment 14 and contacting with the two contact means elements 34a . 34b this contact is made by the operating device 28 captured, and that the arm segment 14 associated joint 15 Approved. Now a pivoting about the axis A _{2 is} possible, so that the distal end 4 , based on 1 , can be swiveled up or down. At the same time all other joints remain 13 . 17 . 19 . 21 . 23 arrested so that there is no movement in them.

The operating device 28 may for this purpose comprise a controller or microprocessor, which is adapted to a contact between contact center elements 30a . 30b to 42a . 42b to capture and transmit in electrical signals.

The contact means 30 or the contact means 30a . 30b to 42a . 42b are formed according to this embodiment as a touch-sensitive sensors and detect a pressure of a contact between the operator and the corresponding contact means element 30a . 30b to 42a . 42b , Preferably, the contact means elements 30a . 30b to 42a . 42b designed as capacitive touch-sensitive sensors.

In the illustrated arm 1 it is also possible for an operator to have two arm segments, for example the arm segment 14 and the arm segment 18 , simultaneously grips and so at the same time the contact means elements 34a . 34b and 38a . 38b contacted. Consequently, the joints become 15 and 19 released, and a pivoting about both the axis A ₂ and about the axis A ₄ is possible. With this simultaneous release, it is possible an angular orientation of the arm segments 18 and 20 in the room while only the arm segments 34 . 36 be pivoted. So too is a translational movement of the distal end 4 possible. In a preferred embodiment of the support arm are in the simultaneous contacting of two arm segments, according to this example of the arm segments 14 and 18 not the joints 15 and 19 released, but all between these arm segments 14 and 18 lying joints, so according to this embodiment, the joints 17 and 19 , The joint 15 remains locked. The holding arm 1 can now be changed in his pose that a rotation about the axis A ₃ and the axis A _{4 is} possible. This is a particularly intuitive operation of the support arm. Accordingly, for example, in the contact between the operator and the Haltearmsegmenten 12 and 20 , the joints 15 . 17 . 19 and 21 Approved.

Furthermore, in the 1 to recognize that the holding arm 1 via a weight compensation device 50 features. The weight compensation device 50 has according to this embodiment, a gas spring element, which with the arm segment 14 and the arm segment 12 is coupled. Alternatively, the weight compensation device may also have a cable pull and / or a balanced counterweight. At the arm 1 according to 1 weighs on the joint 15 around its axis of rotation A2 the biggest moment. Consequently, it is preferred exactly this joint 15 by means of the weight compensation device 50 support. When releasing the joint 15 by contacting the arm segment 14 , so will a weight, which is on the arm segment 14 weighs, due to the other arm segments 16 . 18 . 20 . 22 and one at the interface 8th arranged manipulator by the weight compensation device 50 supported so that the distal end 4 when grasping the segment 14 not immediately "sagging".

The holding arm 1 (see. 2 ) has a recognition unit 52 to detect one with the second interface 8th coupled assistance system, wherein the operating device 28 adapted to the joints 11 . 13 . 15 . 17 . 19 . 21 . 23 depending on the second interface 8th to release or lock the coupled assistance system. Such a detection unit 52 preferably has a bar code scanner, a QR code scanner or an RFID scanner. Preferably, one is at the second interface 8th coupled assistance system equipped with a corresponding barcode, QR code or RFID chip, which contains an identification of the assistance system and preferably information about this. This is the holding arm 1 able to recognize which assistance system at the second interface 8th is coupled and so releasing certain joints 11 . 13 . 15 . 17 . 19 . 21 . 23 partially or completely prevented. For example, at the second interface 8th an endoscope arranged. The RFID chip of the endoscope contains information about this endoscope, in particular the geometrical dimensions of the endoscope. This information is recognized by the recognition unit and sent to the operating device 28 of the support arm 1 and / or the external control unit. The operating device 28 is designed to pose for the support arm 1 to prevent in which the endoscope would collide with the support arm. Furthermore, the operating device 28 additionally designed to be such poses of the support arm 1 in which the endoscope would collide with, for example, an operating table or other objects.

In 2 are at the holding arm 1 in addition to those already in 1 shown elements the brakes 60 . 62 . 64 . 66 . 68 . 70 . 72 represented by means of which the joints 11 . 13 . 15 . 17 . 19 . 21 . 23 are releasable and lockable. The same and similar elements are denoted by the same reference numerals as in FIG 1 and to that extent, reference is made to the above description in its entirety. Even if in 2 the reference numerals on the contact center elements of the contact means 30 . 32 . 34 . 36 . 38 . 40 . 42 are not shown for reasons of clarity, these are nevertheless present, as can be seen from a comparison of 1 and 2 results.

Every joint 11 . 13 . 15 . 17 . 19 . 21 . 23 is each a brake 60 . 62 . 64 . 66 . 68 . 70 . 72 assigned. The joint 11 is the brake 60 assigned to the joint 13 the brake 62 , the joint 15 the brake 64 , the joint 17 the brake 66 , the joint 19 the brake 68 , the joint 21 the brake 70 and the joint 23 the brake 72 , All brakes 60 to 72 are designed as electromagnetic brakes with a permanent magnet, such that they are biased without being energized in a locked state. The permanent magnet is designed so that it can lock the respective joint alone and the pose of the support arm 1 is held. In the zeroth arm segment 10 is an electronic control unit 74 intended. This is via a bus system 76 (in 2 only in the arm segment 10 shown; see. 3 and 4 ) with all means of contact 30 to 42 the operating device 28 as well as with all brakes 60 to 72 coupled. To power the brakes 60 to 72 as well as the contact agent 30 to 42 is also a power line 78 provided through the interface 6 at the proximal end 2 of the support arm 1 can be coupled with an energy source.

The 3 and 4 show two different embodiments of an arm segment, wherein in the 3 and 4 each exemplarily the fourth arm segment 18 is shown. It should be recognized that the other arm segments 10 . 12 . 14 . 16 . 20 . 22 can also be designed.

The arm segment 18 has an arm segment body 90 on (in the 1 and 2 Not shown; It should be understood that each arm segment 10 to 22 has an arm segment body), which according to the 3 and 4 is substantially rod-shaped or cylindrical. Inside, the arm segment body 90 a cavity 92 in which different elements, such as the brake 70 , are arranged. Schematically represented in the 3 and 4 are the joints 19 . 21 as well as the two pivot axes A ₄ , A _{5 of} the joints 19 . 21 , each with the arm arm segment 18 interact. The arm arm segment 18 is the joint 19 assigned (see above description of the 1 and 2 ). The arm segment body 90 has an outer surface 93 on, which is formed substantially cylindrical. The arm segment body 90 is for example made of a metal such as in particular aluminum or titanium of an alloy based on aluminum or titanium, or a fiber composite material, such as some GFRP or CFRP, formed and preferably designed in lightweight construction.

The arm segment 18 according to the 3 and 4 the contact agent 38 on which part of the operating device 28 is (cf. 1 and 2 ). The contact agent 38 has two contact means elements 38a . 38b on, which are designed as touch-sensitive sensors and flush in the outer surface 93 of the arm segment 18 are arranged. The two contact means elements 38a . 38b are arranged substantially opposite to the axis A ₅ , so that an operator when gripping the arm segment 18 in contact with both contact means elements 38a . 38b comes as described above.

The two contact means elements 38a . 38b are by means of cables 94a . 94b with the bus system 76 coupled. About the bus system 76 are the contact means elements 38a . 38b with the electronic control unit 74 (see. 2 ) and this in turn with the brake 70 so the brake 70 through the operating device 28 is released when an operator with the contact means elements 38a . 38b comes into contact.

Beside the bus system 76 are inside the arm segment body 90 an energy transfer system 78 and a cable channel 80 and a working channel 82 arranged. By means of the energy transfer system 78 are the contact means elements 38a . 38b as well as the brake 70 connected to a power supply.

Alternatively or additionally, in each arm segment is an electronic module 96 arranged, which over a line 96a with the bus system 76 is coupled. In such a case, the contact means elements act 38a . 38b which over the line 94a . 94b with the data bus system 76 are connected, only with the electronics module 96 together, which by the contact means elements 38a . 38b detected contact in a control signal for the brake 70 converts and this actuating signal via the bus system 76 to the brake 70 sends to release the joint 19 , Is in each arm segment such an electronic module 96 arranged, is a substantially modular structure of the support arm 1 realized, and the individual arm segments 10 to 22 are independent of the electronic control unit 74 , which in the proximal arm segment 10 is arranged.

The cable channel 80 serves to connect cables from the proximal end 2 to the distal end 4 especially to the interface 8th to be able to lead. The working channel 82 serves to accommodate hoses or light guides and the like, depending on the type of manipulator attached to the interface 8th is arranged, needed. Is for example at the interface 8th arranged an endoscope, is preferably through the working channel 82 a light guide guided, which can transmit an image, which accommodates an endoscope camera. The working channel 82 thus serves to accommodate depending on the application area appropriate means of transmission.

Furthermore, in the arm segment 18 a sensor 98 arranged. Preferably, in each arm segment 10 to 22 a sensor is arranged, and it should be understood that the sensors in the arm segments 10 . 12 . 14 . 16 . 20 and 22 can be designed as the sensor 98 in the arm segment 18 , The sensor 98 is preferably designed as an acceleration sensor. By providing such an acceleration sensor in each arm segment, it is possible at any time for the pose of the support arm 1 to determine. This is the sensor 98 over a line 98a with the data bus system 76 coupled so that the from the sensor 98 collected data to the electronic control unit 74 be transmitted, which then from all sensor data from all arm segments, the pose of the support arm 1 certainly. Further, by providing such a sensor 98 also the absolute and relative position of one at the interface 8th arranged end effector or manipulator determined. It is also possible if the holding arm 1 is arranged on an operating table to detect a movement of this operating table. If all the sensors in all arm segments register a movement in the same direction, this is an indicator that the entire support arm 1 was moved while maintaining his pose, for example, by the fact that the operating table or an operating table plate was rotated or moved relative to a column of the operating table. Such a movement is also by means of the sensors 98 detectable. Furthermore, external impulses, such as impacts on the holding arm 1 , are recorded.

According to 4 is also in the arm segment 18 according to 3 a memory element 100 provided and an energy generating device 102 , The storage element serves to store electrical energy, so that sensors provided in the specific arm segment can also be supplied with power in a state disconnected from the power supply. This is particularly necessary if, for example, bump sensors of a camera or the like are provided, which also have to function in a resting state of the holding arm in order to prevent possible damage to the holding arm 1 to detect. The power generation facility 102 serves to provide energy for, for example, a laser, an ultrasound machine or the like, which are coupled to the support arm. Additionally or alternatively, the energy generating device 102 also a device for supplying the memory element 100 have, for example, an energy harvesting element, which kinetic energy or energy due to a magnetic field, for example, inductively, in electrical voltage for the memory element 100 converts.

5 illustrates again the holding arm 1 which already with reference to the 1 and 2 has been described. In 5 is the holding arm 1 in a system shown integrated. At the distal end 4 is by means of the interface 8th a surgical mechatronic assistance system 200 arranged, which with the interface 8th via an interface 201 is coupled. Both the surgical mechatronic assistance system 200 as well as the interface 201 are in 5 shown only schematically. It should be understood that the surgical mechatronic assistance system 200 for example, as an endoscope or laparoscope or the like may be formed. The assistance system 200 has a working section 202 on, which may be, for example, the tip of the endoscope. At the proximal end 2 is the holding arm 1 according to 5 over the mechanical interface 7 with a base 204 coupled. The base 204 is also shown here only schematically. It can be designed, for example, as a standard rail of a surgical table.

The first interface 6 is according to this embodiment with an external control unit 206 coupled. This is the interface 6 by means of a cable 208 with the external control unit 206 connected. The external control unit 206 is formed according to this embodiment as an operating room system, which has for example a conventional computer and an input-output interface for operating the operating room system. The surgical system preferably includes software components adapted to receive data from the support arm 1 at the interface 6 be passed, store and process.

Depending on the design of the interface 6 can also be provided that this wirelessly with the surgical system 206 communicate, for example via Bluetooth ^®, Wi-Fi ^® or the like.

According to this embodiment, the holding arm 1 Furthermore, a display means 55 on, which is formed according to this embodiment as an LCD display. The display means 55 is connected to a control unit and displays representations of data at the first interface 6 or second interface 8th be handed over. For example, on the display means a weight of an assistance system 200 which is at the interface 8th coupled is displayed. Alternatively, a representation of the pose of the support arm is shown on the display means, with corresponding loads on individual joints. Other possibilities are conceivable here. It is also conceivable that warnings are displayed here.

the interface 6 (S. 6 ) has a connection 77 for the bus system 76 on. About this connection 77 are data obtained from sensors (cf. 3 u. 4 ) and the contact means elements (see. 2 - 4 ) to the bus system 76 be given to the external control unit 206 transferable. The connection 77 may be designed as a USB interface, RS-232 interface, Bluetooth ^® interface, Wi-Fi ^® interface or the like. Centered on the interface 6 is also a connection 79 provided for transmitting electrical energy. By means of this connection 79 is the holding arm 1 with a power source, such as the power grid, coupled. Furthermore, at the interface 6 three outlets 80a . 80b . 80c of the cable channel 80 (See the above description of the 2 . 3 , u. 4 ) intended. About these outlets 80a . 80b . 80c are cables, which are in the cable channel 80 are guided, accessible. In addition, in the interface 6 three outlets 82a . 82b . 82c of the working channel 82 intended. About the outlets 82a . 82b . 82c is the working channel 82 accessible. For example, using the interface 6 a hose through the outlet 82b in the working channel 82 feasible and through this to the distal interface 8th (see. 10 ) feasible.

At a peripheral area of the arm segment 10 are in the area of the interface 6 mechanical coupling agent 210a . 210b intended. The coupling agents 210a . 210b correspond with coupling agents 212a . 212b an external energy store 214 (S. 7 ). The external energy storage 214 has a housing 216 which is formed so that it is proximal to the arm segment 10 can attach. The external energy storage 214 has inside cells for storing electrical energy (in 7 Not shown). The external energy storage 214 has an interface 218 on that with the interface 6 of the support arm 1 corresponds. the interface 218 has a connection 220 on, by means of which in the external energy storage 214 stored electrical energy via the connection 79 the interface 6 to the support arm 1 is transferable. Furthermore, the interface has 218 a connection 221 on that with the interface 77 corresponds, for passing signals of the bus system 76 , Furthermore, the external energy storage has passages 222a , b, c, 224a , b, c, on, with the outlets 80a , b, c and 82a , b, c of the interface 6 correspond, so through the cable channel 80 guided cables also through the energy storage 214 are feasible as well as the outlets 82a . 82b . 82c of the working channel 80 as well on the energy storage 214 are accessible.

8th illustrates the arm segment 10 which is the proximal end 2 of the holding arm forms, and in particular the mechanical interface 7 , At the first interface 6 is the external energy storage 214 (see. 7 ), so that the holding arm 1 according to this embodiment ( 8th ) can be operated autonomously without the need to connect it to an external energy source. A connection to a control unit 206 may nevertheless be provided and is preferred. The arm segment 10 has a contact agent 30 which two contact center sections 30a . 30b has, on (see also 2 ). the interface 7 is according to this embodiment as a recess 226 formed on the outer contour of the base 204 , which is designed here as a standard rail of a surgical table corresponds. The base 204 is in the recess 226 feasible, and on the arm segment 10 are mechanical clamping means 228 provided for clamping the arm segment 10 against the base 204 , The clamping means have a linearly guided clamping body 230 up, over a linkage 232 with a lever 224 is drivable. The joint 11 which via the contact means 30 the operating device 28 is releasable, is therefore as a translational joint 11 aligned. The operating device is to an electric adjusting means, which in 8th not shown, with the lever 228 coupled so that the clamping means 230 disengaged from the base 204 can be brought.

The 9 and 10 Finally, illustrate the second interface 8th at the distal end 2 of the support arm 1 , While 9 the interface 8th in a perspective view together with the arm segment 22 shows, shows 10 the interface 8th in a frontal view.

the interface 8th is essentially corresponding to the interface 6 educated. At lateral sections of this, on the arm segment 22 , are two security elements 240a . 240b arranged. By means of the fuse elements can be determined whether one at the interface 8th coupled assistance system 200 (S. 5 ) correctly with the interface 8th is coupled. The security elements 240a . 240b at the same time serve as mechanical coupling means for mechanical coupling with the assistance system 200 , for example, medium clamping or latching.

At the interface 8th is also a connection 277 arranged with the connection 77 the interface 6 corresponds. The connection 277 is with the bus system 76 coupled so that data and signals from the port 77 over the bus system 76 to the connection 77 are transferable and vice versa. Likewise is a connection 279 at the interface 8th provided by means of which electrical energy from the interface 8th on the assistance system 200 is transferable. The connection 279 corresponds to the connection 79 the interface 6 , and the two connectors 279 and 79 are by means of the transmission means 78 coupled, for transmitting electrical energy between these two terminals 79 . 279 ,

Further, at the interface 8th outlets 280a . 280b . 280c of the cable channel 80 provided so that through this guided cable at the interface 8th are accessible. The same applies to the working channel 82 of which at the interface 8th three outlets 282a . 282b . 282c are provided. Through this interface 8th is an assistance system 200 in an advantageous manner with the support arm 1 coupled without additional transmission means or wiring to the support arm 1 must be provided.

The 11a and 11b show two further embodiments of the support arm 1 essentially according to the first embodiment according to the 1 and 2 is trained. In addition to the features described there, the holding arm according to the 11a . 11b respectively alignment indicators 310 . 312 . 314 . 316 . 318 . 320 . 322 . 330 . 332 . 334 . 336 . 338 . 340 . 342 on. According to 11a are the alignment indicators 310 . 312 . 314 . 316 . 318 . 320 . 322 formed as a surface structure. The individual arm segments 10 . 12 . 14 . 16 . 18 . 20 . 22 , which have a substantially cylindrical basic shape, have a structuring approximately along half a cylindrical surface. The structuring according to this embodiment is arranged such that the orientation indicators 310 . 312 . 314 . 316 . 318 . 320 . 322 of the support arm 1 in a basic pose of the support arm 1 as they are in 11a is shown, are aligned to the surgical field. Through the structuring, which serves as an orientation indicator 310 . 312 . 314 . 316 . 318 . 320 . 322 , an operator can tactilely determine if there is an arm segment 10 . 12 . 14 . 16 . 18 . 20 . 22 is aligned in the basic pose, or whether the support arm is inverted, that is, with the structured surface of the surgical field is aligned. This can be important for weight compensation.

Alternatively to this shows 11b an embodiment in which the alignment indicators 330 . 332 . 334 . 336 . 338 . 340 . 342 are designed as a color mark. To the sides of the arm segments facing the surgical field 10 . 12 . 14 . 16 . 18 . 20 . 22 a color gradient is provided that is visually perceptible by an operator. This allows the surgeon to recognize directly in which orientation the arm 1 located.

12 schematically shows a partial sectional view of an exemplary brake, as for example as a brake 64 in joint 15 is provided. It should be understood that the other brakes 60 . 62 . 66 . 68 . 70 . 72 can be trained accordingly. The brake 74 is according to this embodiment ( 12 ) is designed as an electromagnetic permanent magnet brake. A first joint element 400 , designed here as a shaft, is rigid with the arm segment 12 connected, and a second hinge element 402 is rigid with the arm segment 14 connected. It should be understood that this may be the other way around. The second joint element 402 is about a screw 404 firmly with a housing 406 the brake 64 coupled. A flange hub 408 is correspondingly firm with the first joint 400 coupled. In the case 406 is a permanent magnet 410 arranged, which serves an anchor 412 , in turn, stuck to the flange 408 is connected, against the housing 406 to squeeze. As a result, a static friction is caused, which acts as a braking force. In the case 406 is also a field winding 414 arranged in the energized state of a field of the permanent magnet 410 causes a counteracting field. By a spring element 416 which is the anchor 412 biased in a ventilated state, this is from the housing 406 lifted and so is the brake 64 ventilated. A rotation of the second joint element 402 around the first joint element 400 around the axis A2 is possible.

13 shows a method 1000 for controlling a on a holding arm 1 coupled mechatronic assistance system 200 according to the first embodiment. The procedure 1000 according to this embodiment comprises five steps, which are carried out successively or partly simultaneously. At the first step 1002 becomes the holding arm 1 attached to a standard rail of an operating table and put into operation. This will be the first interface 4 with an operating system 206 (see also 5 ), so that data and electrical energy at the first interface 6 to the support arm 1 be transmitted. In step 1004 becomes a mechatronic assistance system 200 with a second interface 8th of the support arm 1 at its distal end 4 coupled. The following steps 1006 to 1010 are then preferably carried out simultaneously. In step 1006 be electrical energy and signals from the first interface 6 of the support arm 1 transmitted to the support arm at a proximal end. From the first interface 6 the data and electrical energy are turned off by means of a transmission device 76 . 78 within the support arm 1 to the second interface 8th transfer. At the second interface at the distal end, data and electrical energy are then incremented 1010 transferred to the assistance system, so that the assistance system 200 can be operated.

In 14 is another embodiment of the method 1000 shown. The steps 1002 to 1010 are according to the embodiment according to 13 is formed and in this respect, reference is made in full to the above description. After step 1004 now leads a branch in this process (see 14 ) to step 1012 , In step 1012 Positions are detected by joints of the support arm. From the detected positions of the joints is in step 1014 a pose of the support arm determined using the detected position of the joints. Then, data representing the particular pose is taken at step 1016 provided, at the first interface 6 and will be in step 1006 transfer. As a result, the pose of the holding arm at the first interface can be transferred to an operating system and can be used there.

In a similar manner, the further preferred embodiments of the method described above are formed, wherein the steps may each be carried out substantially simultaneously and continuously.

Claims (12)

Procedure ( 1000 ) for controlling a holding arm ( 1 ) coupled mechatronic assistance system ( 200 ), for navigation during a surgical procedure, comprising the steps of: - coupling ( 1004 ) of a mechatronic assistance system ( 200 ) with a second interface ( 8th ) of the holding arm ( 1 ) at its distal end ( 4 ); - Transfer ( 1006 . 1008 ) of electrical energy and signals from a first interface ( 6 ) of the holding arm ( 1 ) at its proximal end ( 2 ); - wherein the transferring ( 1006 . 1008 ) by means of a transmission device ( 76 . 78 ), which within the holding arm ( 1 ) and the first interface ( 6 ) with the second interface ( 8th ) for transferring energy and signals between the interfaces ( 6 . 8th ), characterized by the steps of: - detecting, by means of a recognition unit, an instrument introduced into an operating area; - Providing data at the first interface ( 6 ) representing and indicating that the instrument has been introduced into the operating area, - detecting, by means of a recognition unit, an instrument executed from the operating area; and providing data at the first interface ( 6 ) that represent the instrument and indicate that the instrument was executed from the operating area; to determine at which time which instrument is introduced into the operating area and whether it has left the operating area again. The method according to claim 1, wherein the recognition unit has a receiver, in particular an RFID sensor or a near-field sensor, and the instrument introduced into the operating area has a transmitter, in particular an RFID tag or a near-field chip. Method according to claim 1 or 2, comprising the steps: - To capture ( 1012 ) of positions of joints ( 11 . 13 . 15 . 17 . 19 . 21 . 23 ) of the holding arm ( 1 ); - Determine ( 1014 ) a pose of the support arm ( 1 ) using the detected positions of the joints ( 11 . 13 . 15 . 17 . 19 . 21 . 23 ); - Provide ( 1016 ) of data representing the particular pose at the first interface ( 6 ). Method according to claim 1, 2 or 3, comprising the steps: - detecting on joints ( 11 . 13 . 15 . 17 . 19 . 21 . 23 ) of the holding arm ( 1 ) acting torques; Determining one at the distal end ( 4 ) of the holding arm ( 1 ) attacking force; Providing data representing the determined force at the first interface ( 6 ). Method according to one of claims 1 to 4, comprising the steps of: - detecting one with the second interface ( 8th ) coupled assistance system ( 200 ); - releasing and locking joints ( 11 . 13 . 15 . 17 . 19 . 21 . 23 ) of the holding arm ( 1 ) depending on the recognized assistance system ( 200 ); Providing data representing the recognized assistance system ( 200 ) at the first interface ( 6 ). Method according to one of claims 1 to 5, comprising the steps of: - acquiring image data of an operation field; Providing the image data at the first interface ( 6 ). A method according to claim 6, wherein the image data with position data of the assistance system ( 200 ) are linked. Method according to one of claims 1 to 7, comprising the steps of: - detecting an audio signal by means of a microphone; - recognizing a voice command in the audio signal; Conversion of the voice command into a control signal for the assistance system ( 200 ); and - providing the actuating signal at the second interface ( 8th ). Method according to one of claims 1 to 8, comprising the steps: - determining whether the assistance system ( 200 ) correctly with the second interface ( 8th ) is coupled; - locking all joints ( 11 . 13 . 15 . 17 . 19 . 21 . 23 ) of the holding arm ( 1 ), if the assistance system ( 200 ) not correctly with the second interface ( 8th ) is coupled. Method according to one of claims 1 to 9, comprising the step: - displaying a representation of at the first and / or second interface ( 6 . 8th ) transferred data. Method according to one of claims 1 to 10, comprising the steps of: - storing at the first interface ( 6 provided data; - Create an operation log using the stored data. Method according to one of claims 1 to 11, comprising the steps of: - storing all at the first interface ( 6 provided data; - Create a DICOM file based on the stored data.

Images