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CN1155833A - Articulated arm for medical procedures - Google Patents

Articulated arm for medical procedures Download PDF

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Publication number
CN1155833A
CN1155833A CN95194664A CN95194664A CN1155833A CN 1155833 A CN1155833 A CN 1155833A CN 95194664 A CN95194664 A CN 95194664A CN 95194664 A CN95194664 A CN 95194664A CN 1155833 A CN1155833 A CN 1155833A
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China
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mentioned
articulated arm
medical instrument
carriage
driven unit
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CN95194664A
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Chinese (zh)
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伍云升
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Individual
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Individual
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Abstract

An articulated arm can be used to firmly support and position a variety of medical tools, including surgical or diagnostic instruments flexibly in spce. Through some of its subassemblies may be computer controlled, thus autonomous in accordance to some pre-programmed sequence, manual control is also possible. The articulated arm is a universal computer assisted holder for a wide range of medical tools, in particular endoscopes for treatment of urological disorders.

Description

The articulated arm that is used for medical care
The present invention relates to be used for carrying out the articulated arm of medical care, the present invention especially (only being not) relates to and is suitable for performing the operation, treat or the robot system of medical application such as diagnosis.This articulated arm can be used to provide reliable supporting for the treatment of a certain class or diagnostic tool.
At present, computer and robotics are applied to many industrial circles like a bomb, and this point shows particularly remarkable in the field that requires to finish multiple renaturation (thereby numerous and diverse), high accuracy or dangerous task rapidly.Because its advantage aspect location repeatability, reliability, accuracy and elaboration has a good application prospect on the medical instrument location technology of robot in the operation theater.And operate minimized requirement for invasive, robotics more will demonstrate great potentiality.
Being used for the ESWL (extracorporeal shock-wave lithotripsy) of broken renal calculus and high-strength ultrasonic is typical Noninvasive operation.At present, reach in the invasive surgical opposite with it in this class operation, the area of computer aided navigation system has been used to find accurately surgical target.Surgical target and can be carried out in that the patient is external the operation of first line of surgical target with operation tool in patient's body.
Yet, the minimized operation technique of most of invasives (MIS) all needs to use the medical instrument (or several are called as the low power sight glass of endoscope) with following characteristic: it can be rigidity or flexible body, can enter on the patient body little nature mouthful or cutting mouth and via these openings the lesion of patient's intracorporeal organ is handled.Above-mentioned scene can be seen from eyepiece, also can be presented at (so-called image operation) on the television indicator for the consideration of visual effect and ratio amplification.Yet these have only related to the environment that operation technique directly touches by the image that endoscope directly obtains.Operative doctor can't clearly obtain the situation beyond the image thus.Operative doctor is just to confirm own operation progress after displaying cutting and organizing, does obvious relatively danger like this, and for this reason, operative doctor must possess enough skills and experiences.
Some modern medical imaging methods have appearred at present, as CR (CT), NMR (Nuclear Magnetic Resonance)-imaging (MRI) and ultrasonic imaging.These methods have brought up the probability of area of computer aided three-dimensional imaging, that is, use the plane monitor to show the 3-D view of processed or observed organ.Above-mentioned image is added on the patient body (effect is similar to a secondary special eyepiece and observes) so that guide operative doctor in MIS.Owing to obtained the picture rich in detail of operative site, used said method will shorten excision and stitching institute's time spent.The three-dimensional image data file of being set up by computer can be used for pictorial display, in addition, by means of the corresponding supervision and the control software of kinetic control system, these data also can be used to control the motion of scalpel/endoscope's (being contained on the mechanical hand with appropriate configuration).Like this, operative doctor and computer system just can obtain operation technique and directly touch zone information in addition.
The example that adopts mechanical hand initiatively to get involved in the MIS operation has a lot, as TURP (transurethral prostatic resection), and self-action colonoscopy, stapedectomy and ENT (otorhinolaryngology) operation.Implantation/the replacing of no cement hipbone is a kind of incision surgery operation of adopting mechanical hand to get involved, its mode is to mill out a size and positional precision all than higher accurate cavity in femur with an industry mechanical arm that is loaded with milling cutter, cooperates predetermined implantation thus.
EP0,416,863 (WICKHAN) have introduced a kind of frame structure that is used for medical instrument location and guiding, and this medical instrument can be the resectoscope that is used for the Noninvasive operation on prostate.This frame structure is made of framing component (10,50) and annular element (15,57), and the motion of annular element is limited to the axle rotation that centers on self in being parallel to the framing component plane.The arched member (18,65) that passes annular element is loaded with the mount pad (20,66) of medical instrument, and the method for control medical instrument motion is: mount pad is moved along arched member, make annular element do moving with respect to framing component simultaneously.By annular element radius, arched member radius of curvature and the medical instrument top-end distance to arched member rationally is set, medical instrument just can the side away from arched member scan out two zones that are roughly taper around the annular element and the motion of passing arched member on annular element.If used medical instrument is a resectoscope, so less taper zone is a part (thereby leaving over next tapered hole) cut on the prostate.Frame structure can be installed on the stand by clamping device, also can be fixed tightly on a certain suspension arrangement.The rotation of annular element, the medical instrument surgical action round and medical instrument on arched member all can be driven by motor.
As EP0,416,863 described frame structures are difficult to adapt to the treatment task except that electrocautery in TURP or TURP through repacking.Say that definitely mount pad (20,66) is unsuitable for loading the medical instrument of other pattern, and because the motion of medical instrument is subjected to the restriction of the ring surface area of annular element, the kind that medical instrument can be installed on the frame structure will be restricted also.In addition, EP0,416,863 described frame structures must be installed or be connected on the operating board, and this has further limited function and the repacking probability of using other pattern medical instrument.The work difficulty that presets this frame structure in the operation theater is very big.For mount pad (20,66) is docked with carriage on the resectoscope, need an assistant moves the ball-joint constraint that is subjected to mounting bracket with manual method entire system.This assistant also needs after butt joint is finished with two ball-joints of manual method locking.Assistant's existence may bring sterile zones to be subjected to interferential problem.In addition, this frame structure does not possess change manually operated function rapidly under emergency condition.Because the framework design aspect, there is the irrational problem of cabling in electric drive scheme, and this may hinder operation, also is potential safety hazard simultaneously.
The objective of the invention is to make articulated arm can be equipped with the various various medical instruments of pattern, thereby make it competent a greater variety of operation technique tasks.
As described herein, proposed a kind ofly to finish the articulated arm of medical care with medical instrument, it comprises:
Be contained in arcual component on the first movable support member with sliding type;
Medical instrument is clamped in the tool clamp holder of certain operating position, and this tool clamp holder is loaded on the arcual component; And
Be located at first driven unit on above-mentioned first supporting member, its effect is that above-mentioned arcual component and above-mentioned tool clamp holder are slided, it is characterized in that above-mentioned tool clamp holder can move along arc trajectory, thereby the operating position of medical instrument is changed by predetermined way.
As preferred version, this articulated arm also comprises second driven unit that joins with above-mentioned tool clamp holder, and its effect is that above-mentioned tool clamp holder is slided along straight path, above-mentioned straight path and a certain axes intersect by the above-mentioned arc trajectory center of curvature.Arcual component is contained on above-mentioned first supporting member with removable form, and its feature also is: if desired, can be contained on first supporting member with the slip form by the arcual component that another radius of curvature is different.
As preferred version, this articulated arm also comprises and mechanically is connected on above-mentioned first supporting member, and therefore makes it the 3rd driven unit around first drive shaft turns, like this, also can be by the above-mentioned tool clamp holder of arcual component supporting around above-mentioned first drive shaft turns.
As preferred version, link to each other with the 3rd driven unit by adapter on above-mentioned first supporting member, this adapter can make the certain side-play amount of formation between above-mentioned first driving shaft and the above-mentioned first supporting member longitudinal axis, when work, the axis that is clamped in the medical instrument in the tool clamp holder will be intersected with above-mentioned first driving shaft, determine the center of rotation of medical instrument thus.
As preferred version, above-mentioned adapter should have detachability, changes different adapters and can obtain different side-play amounts, reaches the purpose of holding the different medical instrument thus.
As preferred version, this articulated arm also comprises second supporting member that is used for supporting above-mentioned the 3rd driven unit, this second supporting member is provided with and is used for making above-mentioned the 3rd driven unit to move assembly along the 4 wheel driven that rectilinear direction moves, like this, when its work, above-mentioned tool clamp holder also will move along above-mentioned rectilinear direction together with arcual component.
Following description will mainly be conceived to the application of articulated arm in TURP (transurethral prostatic resection), TURP is a kind of operation method that is widely known by the people, and its status in benign prostatic hyperplasia (BPH) Therapeutic Method is similar to the gold standard in the economic field.This description is the surgical cut pattern of supposition with the technology of fulgerizing.Medical instrument among the TURP has urinary system endoscope and resectoscope, and what need mention especially at this is resectoscope, and it comprises afocal lens, electrode, shell and the working cell of being furnished with standard type spring charging handle.The use occasion that it may be noted that this articulated arm is not limited in TURP, the utilization that it can be succeedd in other many surgical medical equally.In addition, the medical instrument that this articulated arm can load is not limited in urinary system endoscope, and it can load the medical apparatus of other numerous species fully.
For the purpose of the convenience, be example only to introduction general of the present invention with a certain embodiment of articulated arm below in conjunction with accompanying drawing, wherein:
Fig. 1 is the projection view of each assembly of expression articulated arm;
Fig. 2 is articulated arm and the projection view that is used for the balanced support system of TURP operation in operating room;
Fig. 3 represents the vertical driven unit of preferred articulated arm pivot, also contains preferred tool clamp holder among this figure;
Fig. 4 represents to adopt the C shape carriage assembly of tool clamp holder shown in Figure 3;
Fig. 5 represents the mounting means of per urethra ultrasound probe on the tool clamp holder of the vertical driven unit of pivot;
Fig. 6 represents the mounting means of per urethra ultrasound probe on the tool clamp holder of the vertical driven unit of pivot;
Fig. 7 is the perspective view of the movement in a curve driven unit of articulated arm;
Fig. 8 is the cutaway view of the movement in a curve driven unit of articulated arm;
Fig. 9 represents a kind of form of the circulatory motion driven unit of articulated arm;
Figure 10 represents can be used for a certain adapter of articulated arm;
Figure 11 represents a kind of form of the headstock walking driven unit of articulated arm;
Figure 12 represents to contain the head tree assembly of table system and counterweight;
Figure 13 represents to use the balanced support structure of articulated arm;
Figure 14 represent X, Y and Z arm in the balanced support system used lock continuous hawser;
Figure 15 grass has been painted the barrel-shaped profile traces of resectoscope outside focus of articulated arm clamping;
Figure 16 represents the modular structure of operative doctor interface software, and its design function can guarantee that articulated arm works in incident bootstrap mode;
Figure 17 is the functional block diagram of whole system, the figure shows system's constituent element and internal relation thereof and control relation.
Fig. 1 represents a certain preferred embodiment of articulated arm as described herein.This mechanical hand comprises the dome element (see figure 7) that resembles arched member 124, and arched member 124 is contained on the first such expansion bearing element of arched member bearing 300 and can slides thereon.The tool clamp holder (see figure 3) that resembles carriage 137 is housed on the arched member 124, and its effect is to make medical instrument remain on the operating position.Above-mentioned arched member bearing 137 is provided with first driven unit that resembles arched member driven unit 302 (see figure 8)s, it can make arched member 124 and above-mentioned carriage 137 slide and therefore carriage be moved along arching trajectory, thereby makes medical instrument conversion operating position in the intended manner.Carriage 137 is furnished with second driven unit that resembles the vertical driven unit 304 of pivot, and it makes carriage move along straight path.For easy to operate, the track of carriage moving linearly should intersect with the center-of-curvature line of arched member 124 cylinders.
The arched member bearing 300 of articulated arm is subjected to resembling the supporting of the second expansion bearing element of plumb post 84 again by adapter 275.Pillar 84 resembles annular driven unit 306 with one the 3rd driven unit links to each other, and the drive axis 180 of this driven unit is the revolution pivot of adapter 275.The existence of adapter 275 makes and has formed side-play amount 272 between arch support spare 300 longitudinal axis 308 and annular driven unit 306 gyroaxises 180.Annular driven unit 306 is connected again on the moving assembly of 4 wheel driven that resembles the headstock walking driven unit 310 (seeing Figure 11), and the moving assembly of this 4 wheel driven is positioned at the base position of pillar 84.Above-mentioned all driven units one that headstock walking driven unit can make arched member bearing 300, arched member 124 and comprise annular driven unit 306 moving linearly on the direction of level substantially that coexists.
Have four freedoms of motion on the independent, direction as the described articulated arm of preferred embodiment.They are: headstock traffic direction 1, pivot are vertical 2, arch course bearing 3 and annular gyratory directions 4.Articulated arm is center of rotation 182 (Fig. 1 and 15) with the center of curvature of arched member 124 on the arch driven unit 302 generally.The axis of the medical instrument of clamping on mechanical hand should be preferentially by above-mentioned center of rotation, and center of rotation also preferably can drop on the annular axis of rotation 180.For this reason, should keep side-play amount 272 between arched member and the arched member driven unit.Treatment or diagnostic tool can be connected on (Fig. 3) on the articulated arm via carriage 137.In general, the axis (or desirable axis) of above-mentioned medical instrument is reached at any time can both be by above-mentioned center of rotation under any duty.Like this, the medical instrument axis just becomes the longitudinal axis of arched member.Although center of rotation is fixed with respect to arched member 124, it is variable with respect to the position of medical instrument body.This point is essential for the optimization of operation plan hereinafter described.
Device near the patient is the vertical driven unit 304 of pivot (Fig. 3).This assembly is by constituting with the lower part: carriage 137, motor cover 144, servomotor 139, printed circuit board (PCB) 140, guide rail 145, ball-and-socket 143, locking bar 150, paired limit screw 147 and tooth bar 135 and gear 136.The configuration of carriage should leave the spacing/eccentric throw 134 that can walk around Glans penis and resectoscope body.The centrage of carriage (also being the central axis of resectoscope) is answered alignment ring shape centre of gyration line 180.
Carriage 137 is to be bearing on the guide rail 145 with the ball-and-socket 143 that covers in the motor cover.Can clearly be seen that by Fig. 3 servomotor 139 is enclosed in the case because of stretching out partly under the driving axial.The cooperation of tooth bar 135 and gear 136 can make motor 139 driven brackets seesaw.With three screw 298 (see figure 7)s the slit 142 of motor cover 144 is fixed tightly on the lug 299 that mills out on the arched member 124, makes motor cover keep static relatively thus.Any motion of arched member all can make the vertical driven unit 304 of whole pivot together move with it.
The differential type line driver that is contained on the printed circuit board (PCB) 140 can weaken the influence of noise to code device signal.This circuit board is installed in motor cover 144 next doors, can get rid of electromagnetic interference to circuit board (it may be noted that the device of fulgerizing commonly used tends to produce electromagnetic interference in the operation theater) with the adequate shielding method.The sort circuit plate is provided with electric connection, thereby can change from motor easily.
Carriage 137 is provided with the locating slot 138 that is split into by shape shown in Figure 3 more than two pairs.Wherein specific a pair of locating slot can be used to connect C shape carriage 151.Which can select locating slot to be connected C shape carriage with respect to the desired location of resectoscope body 179 according to center of rotation 182 with.C shape carriage 151 (see figure 4)s are fixed semipermanently and seal tight a certain suitable position on resectoscope 179 with screw.C shape carriage 151 is respectively the part of carriage assembly with another C shape carriage 157.When two parts of carriage assembly were assembled in the cylinder position of medical instrument (as endoscope), the existence in gap can make assembling obtain enough banding reliably between two parts.Equally, other shape carriage that is used for fixing on other non-cylinder medical instrument also can be manufactured out easily.
As shown in Figure 4, the protuberance of carriage 157 is provided with guide groove 159, can penetrate the axle 154 of respective diameters in the guide groove.The both sides of protuberance thickness direction are provided with dimple 160.The locking key 156 that one pair is made of two one side of something can be pushed to guide groove 159 or therefrom withdraw from (see figure 4) under the effect of manual or spring.The axle 154 that has been contained in retractor (as Green's fort formula retractor) top-end portion can slip in the guide groove 159 of protuberance.For ease of packing into, the porch of guide groove has little chamfering.Axle 154 is provided with keyway 155.Can make keyway just in time aim at locking key 156 by live spindle or C shape carriage.After the aligning, locking key is pushed away (using manual mode) downwards, make it to embed in the keyway 155 that mills out on the axle, perhaps the effect by spring pushes locking key 156 in the keyway 155.To limit two degree of freedom 286 and 287 like this, so will not have relative motion between endoscope and the tool clamp holder.Therefore, can only carry out according to the working method of tool clamp holder the manipulation of endoscope.The method for dismounting of endoscope is very simple, as long as upwards mention locking key 156, makes it to break away from keyway and gets final product.Like this, the axle that just can pull down tool clamp holder in protuberance and the endoscope and join with it.
Have semi-circular groove 152 on the C shape carriage 151, its effect is when C shape carriage embeds locating slot 138 on the carriage 137 carriage assembly to be locked.Has the planar section 149 that is milled in a certain suitable length scope of locking bar 150 bodies.Locking bar is to be inserted in the hole that is drilled to 146, and the position in hole 146 should be by following principle setting: by locking bar 150 being rotated to a certain special angle direction, the planar section of locking bar is flushed with locating slot 138, thereby realize the interlocking of C shape carriage.Locking bar is furnished with the dog screw 147 of locking usefulness.After C shape carriage is in place, locking bar is rotated about 90 degree, so that its column part charges into out in the semi-circular groove 152 on C shape carriage, thereby carriage 137 is pinned.
Fig. 8 represents a certain embodiment of arched member driven unit.As shown in Figure 8, this driven unit is by constituting with the lower part: driving shaft 130; Bearing 118 and 129; Differential type optical encoder 106 (or position sensor of other pattern); Electromagnetic brake 131 (recommending to use normally closed type); Bearing block 117 and elongated portion 113; And servomotor 119.Bearing block 117 and elongated portion 113 together constitute arched member bearing 300.Have on the circular surface of bearing block 117 and be used for axial channel (Fig. 8 does not add expression) that lead is passed through.These leads itself (limit switch and other adnexa) are drawn from arched member drive motors 119, encoder 106, brake 131 and arched member 124, they are at recess 288 place's boundlings, and from another strand lead of the vertical driven unit of pivot also herein by electric connection 108 and termination.The lead of guiding the vertical driven unit of pivot into is clustered in the insulated sleeve 115 of a high flexibility, and for adapting to moving of arched member 124, strand and respective sleeve should have the abundant length that overhangs.
Be clustered in lead in the recess 288 and all need pass the centre bore 112 of shell elongated portion 113, and the end of elongated portion 113 is provided with another electric connection 109.As mentioned above, using electric connection is in order to change adapter 275 at Different Diameter easily to side-play amount 272 and medical instrument length.The another set of pipe that stretches out from shell elongated portion 113 (Fig. 7 and 8) end has flexibility, insulating properties and shielding, and its length that overhangs should be enough to guarantee the stroke of gyration, and this sleeve pipe strand that it is inner is loosely introduced in the column 84 (Fig. 4).
Arched member driven unit 302 supports and is driving the arched member in the arch assembly (seeing Fig. 7 and 8).The arch assembly is by constituting with the lower part: circular arc (having suitable radius and subtended angle), and its periphery has external tooth form 120; Rigid member 121 and 125; Transverse axis 126; Bevel gear pair 128; Block 297; Supporting base holding screw 301; Limit switch 294 (being positioned at firm shape member 125 inside, invisible); And bearing block 127.As previously mentioned, on the lug 299 of arched member 124 the vertical driven unit of pivot can be installed.Movement in a curve drive motors 119 can pass to arched member 124 via bevel gear secondary 128 and 120 with the gyration of its driving shaft 130.The medical instrument that is contained on the carriage 137 of the vertical driven unit of pivot can be in the motion of the effect lower edge in respective drive source arching trajectory, then drops on a certain longitudinally appropriate position of medical instrument body as the arched member center of curvature of center of rotation.The method of adjusting this position is, with the vertical driving method movable support bracket 137 of pivot, perhaps, with manual mode with C shape carriage with medical instrument be contained on the carriage 137 existing another on the locating slot 138.
Carriage 137 is provided with and is limited to some to locating slot 138 in its length range, and under manual mode, the operator can select the wherein suitable a pair of C of installation shape carriage.Another kind have automatically and the locate mode of program control characteristics in, the vertical driven unit of pivot can make the medical instrument that is contained on it do motion with respect to arched member and center thereof.In addition, after articulated arm had been locked in the balanced support system, the absolute spatial position that also can make center of rotation that moves of headstock walking driven unit 310 obtained adjusting.
The effect of rigid member 121,125 is to improve the bearing strength of arched member 124 and provide slick sliding bearing face for it.Have on the arched member body along certain radian hole group 293 and 294 spaced apart.Can be screwed into rigid block in the hole 293 and surpassed distance not take place to guarantee arched member 124.Can recommend to adopt two rigid blocks so that the stroke of arched member on two directions of motion all is restricted.Wherein the position of a certain block is constant, and simultaneously the position of the installing hole of another block then is according to the size of surgical object and selected under software tip.So just realized the controllability of arched member total kilometres.Long stroke require will to need to adopt have than large angle and (or) dome element of different curvature radius.The radius of curvature of practical dome element can be that 5mm is to the arbitrary value between infinitely great (latter refers to be roughly linear dome element, and the tool clamp holder movement locus under this kind occasion also is a straight line).For the operation on prostate of TUR, the optimum stroke of arched member should be the degree of 0 to 40 under 250 to 300 radius of curvature.
Except the dome element that adopts multiple radius of curvature, the method for another kind of compatible different radii is to adopt tool clamp holder or the carriage 137 that has elongated portion thereby more locating slots 138 can be set.Wherein, radius of curvature can be installed on the different locating slot and require different medical instruments.
Introduce a certain preferred embodiment of annular driven unit below in conjunction with Fig. 9.This assembly comprises with the lower part: motor 96; Bearing 98 and 105; Housing 94; Power transmission shaft 97 and 100; Position sensor 103; Gear train 95 and 102; And brake 104.The annular driven unit is supporting arched member bearing 300, arched member 124 and even the vertical driven unit of pivot by adapter 275 (Figure 10).The scope of annular driven unit gyration is limited to ± 180 degree, and it can realize the variation (Figure 15) of medical instrument with respect to patient's position, angle 181 to the revolution driving effect of arched member driven unit and the vertical driven unit of pivot.The lead 289 that comes from annular driven unit is threaded in the sleeve pipe 290 with insulation and shielding and is terminated at the bottom of column 84.
For saving spatial consideration, the arched member bearing longitudinal axis 308 is arranged in the same plane 285 (Fig. 1) with the vertical driven unit longitudinal axis of pivot.When annular driven unit moved, plane 285 can produce rotation and press from both sides at an angle with the plane that comprises headstock driven unit axis and annular driven unit axis.Has modifiable side-play amount 272 between these two planes.
The change of side-play amount 272 is by means of adapter shown in Figure 10 275.The elongated portion 113 of arched member bearing 300 is inserted in non-rotating mode in the inside groove 274 of adapter 275, and the power transmission shaft 100 of annular driven unit also is inserted in the inside groove 273 of adapter in non-rotating mode simultaneously.Like this, the hinged gyration that makes adapter 275 has just been brought up in axle 100 rotation, and this gyration has formed arched member bearing and related accessories thereof the circular motion around annular driven unit axis 180.Can change the orbit radius (that is side-play amount 272) of circular motion by the adapter 275 of changing different length easily.In other words, the side-play amount of being introduced has controllability because of variable-length.
The length of arched member bearing 300 extension arms 113 can change according to the difference of medical instrument length.Can use telescopic extension arm.Adapter inner chamber 274 can adapt to insertion extension arm wherein length variations within the specific limits.In addition, modularized design provides the multiple alternative extension arm 113 with different length.But, it is that the deflection displacement of fulcrum is excessive that long extension arm can make with ball-joint 163, is worthless therefore.Although can to ball-joint 163 carry out size and (or) architecture advances to be to satisfy above-mentioned needs, will make the processing cost of articulated arm reach the degree that is difficult to accept like this.
Be located at the headstock walking driven unit of column 84 bottoms at last in conjunction with Figure 11 introduction.This headstock walking driven unit is by constituting with the lower part: motor 89; Position coder (not adding expression among the figure); Tooth bar 81 and gear 91; Guide rail 79; End plate 87; Shell 83; Limit switch 86 and substrate 88 (Figure 11).Headstock walking driven unit makes all component work mentioned above horizontal motion (shown in arrow among Fig. 1 1) with respect to the patient.To help to handle different prostate length like this.Terminating at all leads on the column 84 and sleeve pipe and column vertical four or five sockets joins.The corresponding plug that is contained on the Y arm of balanced support system can be connected on the above-mentioned socket in order to automatic remote control.
Column 84 tops are provided with bolt and the bulb 164 that is fixed tightly in together.Bulb 164 can embed in a certain ball-joint assembly 312, and it is in order to simplify the mounting or dismounting (Figure 11) of articulated arm in the balanced support system that this assembly is set.Be provided with movable positive stop 78 in the headstock stroke, like this, both just error appearred in the drive software of headstock stroke motor, and block 78 can not walked out safe limit by the medical instrument that clamping screw 85 and limit switch are guaranteed to be contained on the mechanical hand yet.
For considering that easily the vertical driven unit of pivot should be to have disassembled stand independent action, autonomy.Therefore, can adopt the mechanized tool clamper that comprises Elmed formula retractor to come the vertical driven unit of clamping pivot, so just can make it to finish the practical task that resembles urodynamics research and so on, in this generic task, diagnostic probe must move by accurate fixed step size.These rectilinear motions can be realized by the vertical driven unit of pivot separately.Above-mentioned modularized design principle also sees the independence or the aggregate motion of other degree of freedom of articulated arm.
In a preferred embodiment of the invention, articulated arm is to be suspended in the balanced support system (Figure 13) by a ball-joint 164 (Fig. 1) by the artificial locking of handle.The balanced support system provides three linear degrees of freedom 8 (X), 7 (Y), 6 (Z) and a rotational degree of freedom 5 (R).The latter shakes out a whole set of mechanical hand rapidly in the time of can needing manual intervention under emergency rating.
Z is (the seeing Figure 12) that compensated by an amount of dead weight 248 that is contained in the main body column 28 to motion 6.The balanced support system comprise the Y that hangs articulated arm to X to horizontal boom 17,18 and vertical body column 28.By suitable rotation, Y is to just obtaining balance with X to the gross weight of horizontal boom 17,18 and articulated arm (Fig. 2).Therefore, be that the mobile required workload hand-manipulated of each assembly is seldom in the upright instrument process of frame.
The motion of X, Y, Z direction is successive on its respective seat parameter in the balanced support system.Its concrete configuration is as follows: the X cantilever is by the Y cantilever support, and the Y cantilever is then by the gyro black assembly supporting of column, and the gyro black assembly of column is supported on the Z cantilever on the main body column 28 via rocking bracket assembly 19 (seeing Figure 13).Load on support rails 30a and 30b (Figure 12) and 240a and 240b (Figure 14), thereby make it to have born moment of flexure and moment of torsion.In rocking bracket assembly 19, Y cantilever 17 is rotation (Figure 13) on the sliding bearing at center with rotary arm shaft 29 at one.Different with the motion mode on the straight line axes of coordinates, the gyration on the corner axes of coordinates is a step-by-step system.Can insert in a series of taper hole 39 by spring-loaded jumper bar 36, thereby realize locking very reliably.Want to remove locking state, can be by starting solenoid 35 or jumper bar being risen from its jack by lower plunger button 32, so just can make the Y cantilever 17 of level freely swing (Figure 13).
Each assembly in X, Y cantilever 17,18 and the main body column 28 all is respectively equipped with the device that articulated arm is moved in X, Y and Z direction.X cantilever cutaway view shown in Figure 14 has represented to have the preferred embodiment of above-mentioned migration.Wherein used hawser and pulley system comprise and are located at cantilever two ends and the endless cable 239 on the deflector roll 237.The slide assemblies 240b and the line slideway 240a that are furnished with erection support have the sliding fit relation, and the ball-joint adnexa 241 on it joins with ball-joint 312.Slide assemblies 240b and hawser 239 are affixed, and its slip on line slideway 240a is subjected to the restriction of rubber block 243.One or two retaining mechanism that is provided with according to haul distance is housed on the hawser track.As a fail soft measure, hawser and load thereof with static be standing state.Adopted clamping bar 268, pivot pin 266 and spring 269, hawser 239 is to be clamped by clamping bar under the resilient force of the distance of pivot shown in 265 for this reason.The locking state of hawser can be removed by electronic solenoid 236 (Figure 14), this solenoid by the clamping bar on the hawser is drawn back with its relieving.Manually substitute handle 34 and be to dealing with the manual operation that power-fail or other fortuitous event be provided with and substitute device.Only need do seldom change (in fact being meant the haul distance aspect) just applicable to the transmission (seeing solenoid 249 and manual clamping bar 247 among Figure 12) of other all rectilinear directions of native system with the upper cable and the pulley kind of drive.
State among the embodiment in the present invention, the balanced support system is moved or deposits with the form that the wheel tackle system is arranged.Are furnished with the cabinet 25,26 and 27 (Figure 13) that microcomputer, operating theater instruments and kinetic control system frame can be gone into wherein on the coaster.The liftable pedestal of coaster can make a complete set of system that comprises a whole set of mechanical hand drop on the ground via four footing.System weight has passed through check, has both made the Y cantilever present sizable overhang, and system still can keep rigidity and the stability with respect to the patient fully in the one or many operation process.When operation is finished or do not need to perform the operation, a whole set of mechanical hand and coaster thereof (balanced support) system will remove with the wheel load form.Need foot rest 254 reinforcings promoting pedestal for this reason, thereby make wheel 257 kiss the earths and support the weight of a complete set of system.
In the operation initialization process of transurethral resection, be the joint portion-seminal colliculus of ejaculatory duct and prostate-urethra as the surgical target of a whole set of position of manipulator benchmark.Seminal colliculus is confirmed by endoscope is directly perceived.In case the affirmation seminal colliculus, corresponding tool clamp holder (as Greenberg formula and Elmed formula retractor) is just can decide the locus of endo/cystoscopy/resectoscope.It may be noted that the direction of endoscope when seminal colliculus is identified is arbitrarily, it promptly is connected on the articulated arm after the location.
The balanced support system mainly changes direction and the position of articulated arm with respect to the patient by the driving and the ball-joint of three linear degrees of freedom, before this, must remove the locking state of each degree of freedom by starting corresponding solenoid (as solenoid 236,249), and should utilize weight in patients or by means of the position of suitable binding method immobilized patients.First kind of localization method is to be handled by operative doctor to move, move down, tiltedly move on the articulated arm or make it around the ball-joint swing, (see figure 3) till C shape carriage 151 embeds in the locating slot on the carriage 137 of articulated arms.Another kind method is not used clamping device passively, makes articulated arm and tool clamp holder near after the endoscope, by near the little displacement the reference position endoscope being connected on the carriage 137; After this, reaffirm the position of seminal colliculus by articulated arm and endoscope the moving of (freedom of motion that does not change a whole set of mechanical hand) that be integrated.Above-mentioned two kinds of methods are all share, and select what person to depend on the preference and the technical ability of operative doctor.
The photographic head that several and X cantilever are in same horizontal level can be set on the equalization frame.Photographic head will be used for observing labelling or the striped that is located at according to certain rules on the robot device, can obtain optimum precision by observed result by the suitable demarcation to photographic head.Because rotation or translation that can be by each joint of computer picture direct observation mechanical hand, and the kinesiology of mechanical hand and geometric features also be known, moves in a predetermined safe working range from start to finish so can guarantee the end of scalpel.Any motion that exceeds this scope all will cause the time-out of motor process and the user will be given the alarm.
C shape carriage 151 is fixed in resectoscope/endoscope in advance and is together disinfected.The method of tightening up to C shape carriage 151 and even endoscope is to avoid its locating slot from carriage 137 to get loose by screwing two handles 150.After this, lock X, Y and R direction degree of freedom in the balanced support system by discharging corresponding solenoid 236,249 and 35.The motion of each degree of freedom is locked when solenoid cuts off the power supply, and this have the fail safe guaranteeing role with locking for the processing of setting up state.Thereafter, release handle 156 also makes the axle 154 C shape carriage that slips away, and therefore retractor just can be removed.So just, the operation initialization process is through with.More than be target with the seminal colliculus about the narration of transurethral resection initialization process, it may be noted that for confirming by endoscope and the operation technique of localized other target and other kind that above-mentioned pre-setting method can demonstrate its superiority equally.
As other existing arm-and-hand system, articulated arm of the present invention also is controlled by motion controller 47, and this controller is controlled by portable minisize computer 48 (seeing Figure 17) by RS232 communication bus 76 again.Kinematic parameter 73 on each degree of freedom (position, speed, acceleration and harmony) is to be controlled by the conventional PID control ring based on multifreedom motion control system 47, and this control loop possesses digitizing function because of adopting microprocessor technology.Use the position sensor such as differential type optical encoder 71 to provide position and velocity information for control loop.This kinetic control system also has the function 59 of some signals of input and output.These so-called I/O functions generally function as follows: the state of catching limit switch 74,75 for " playback "; Make the equipment that is relevant to arm-and-hand system be in operation or stopped status; Give the alarm or luminous indication is provided at critical or other critical event.Above-mentioned kinetic control system is a kind of common and very easily commercial product, at this not to its Jie that known clearly.
Barrel-shaped cavity configuration is a kind of typical operation plan form that can be guaranteed by the articulated arm designing institute, as shown in figure 15.In this operation plan, arbitrary moment all can relate to the motion of one or more degree of freedom.The collaborative of movement in a curve and pivot lengthwise movement should be followed the tracks of so-called desirable edge 185.The computer reconstruction of ultrasonography is helped to determine a series of edges on the clock form circle diagram 181.The existence of circulatory motion axis makes resectoscope can arrive at the position of above-mentioned each edge.In the operation of fulgerizing, along the tracking of edge direction and excision action with clockwise-anticlockwise mode repeats and progressively moves laterally, until the cyst membrane 279 (Figure 15) that arrives field of operation.In per urethra prostate laser ablation art (as VLAP, be that art is cut in visual prostate laser erosion) in, online (promptly dynamic) control can be carried out to laser fibers retraction speed and dimensional energy pattern thereof, thereby the optimum excision effect that manual operation can't realize can be obtained.Above-mentioned operation principle is equally applicable among the TUNA (per urethra prostate pin erosion art), and in this class operation, operation needle must be done the flexible of different depth in different polar coordinates positions, and carries out energy with manually-operated and control also very trouble.
Circuit block diagram shown in Figure 17 has been represented to link to each other with mechanical hand, has also been worked in coordination with it and realize effectively and the critical piece of safety operation that these parts are:
Uninterrupted power source 45 for system's continued power.When power supply trouble occurring, it can keep operations (capacity that depends on reserve battery 44) at least 10 minutes of system.
The 4DOF motion controller 47 that can be interrupted work and have input-output function 59.This controller can use separately, also can be contained on the expansion slot of microcomputer 48.Can connect by RS232 line and microcomputer when using separately, then utilize its this machine bus when being inserted in the microcomputer.
Microcomputer 48.It has following configuration: display 58; Hard disk 58; Floppy disk; RAM and ROM managing internal memory; Operating system; Printer 57; And the standby peripheral hardware memory device such as minidisk driver and CD drive.
Ultrasonic diagnosis scanning system 49.Wherein can simultaneously or be equipped with transrectal probe or transurethral probe separately.The grabgraf device 62 that is contained on the microcomputer 48 can be caught ultrasonography from ultrasonic scanner by an auxiliary video signal coaxial cable.Communications portal between ultrasonic scanner and the computer is chosen wantonly, but it should meet by IEEE488 the 77 GPIB standards that limit.
Videocassette recorder 50.Its effect be in perioperatively and average of operation periods to ultrasonic involving (or) endoscopic images files.
Long-range light source 51.It is that the capture region of operative site and CCD formula (the charging connection is joined formula) video camera 69 provides high efficiency cold light illumination by optical fibers.Image is processed and enhancing with the form of electronic signal, appears at last on the display screen 70 of endoscope.
Form the energy 52 of excision effect.Electrosurgery is referred to as diathermanous unit.In laser surgery, it is the electromotor that can produce the high intensity laser beam source.
Mandatory safety monitor 53.Programmable logic system wherein can monitor the logic state of each key parameter, also can send the interrupt signal of suspending manipulator behavior or the signal that gives the alarm to the user occur when unexpected in operation.
Can move the interface software 191 of APUI (prostatectomy automatic user interface) by name on the microcomputer, the task executive mode of this software as shown in figure 16.Because adopt pop-up window and pull-down menu to carry out the versatility option, this user interface can make the task design process realize on one page screen.
Back-up system 192 shows to come locking/release movement comprehensive or subitem control balanced support system by the screen of being carried out by control knob and state cell.It also can show in the balanced support system removes B, the locking state of each degree of freedom outside 200 (be X, 201, Y, 202, A, 203, R, 204, they correspond respectively to 8,7,6 and 5DOF of balanced support shown in Figure 13 system) motion.
Mechanical hand playback batch processing before and after the operation initialization process is by HOME by name, and 193 interface subprogram is carried out.This subprogram makes mechanical hand arrive suitable reference position on each degree of freedom direction, and this benchmark is relevant with the size and the direction of mechanical hand effective object.HOME takies one page display screen, and for strengthening the versatility of option, HOME also is provided with pop-up window and pull-down menu.
The respective image that is obtained by ultrasonic scanner can be caught and transmit to grabgraf device card F.GRB62 and biaxial cable.Flame Image Process has been used image processing software general and customization simultaneously.Last result is used to guide the operation technique of being carried out by articulated arm.
Items such as the folding of predetermined unidirectional or compound motion (point to and reach patient district of intravital assigned work) and power supply, adjusting are compiled into the instruction that can be discerned by motion controller, and microcomputer sends instruction by RS232 (or serial) line 76.The program of handling above-mentioned conversion is collected in the BARREL program groups.
Articulated arm also can be controlled by manual method, the control stick and the foot-propelled of ECDC removing the work office, refers to that switch has constituted the manual type flexible control system at robot movement.The switching of being carried out by program MAN199 can make the control model of control stick class interrupt.
Patient's physiological data is obtained by the PAT196 program of APUI.These data can be excision amounts, mute time, patient age of cut tissue or the like, and they can be used for relevant researcher.Compiled statistical tool software various standards or customization among the PAT196.
The power supply situation of arm-and-hand system is partly to be monitored by the PWR.M197 among the APUI.When power supply trouble occurring, this part can guarantee that arm-and-hand system moves by necessary operation under the state that the power decay does not take place.System can enter the fail soft stage through after a certain time limit.
Exception handles 195 can handle foreseeable fault (to internal memory overflow, the processing of conventional fault such as communication disappearance) and chance failure (abnormality processing).For first kind fault mode, can come the running status of restoring system by the startup of recovery routine.Also will make the trial that starts recovery routine to chance failure, shut down but generally all finally carry out protectiveness.Program 195 also comprises the security monitoring program.For example, when tool clamp holder lengthwise movement does not take place, be used to cause the power source of excision effect not to be opened.
In order to find medical instrument or the working area of other aid (being contained on the mechanical hand) in the corrective surgery position accurately, simultaneously also in order to determine the scope of this working area, must be to the in addition image guiding of certain form of articulated arm.Ultrasonography (per rectum or per urethra all can) is suitable and safe for this task.Change for handling the patient body position, that is operation is preceding and the problem of intra-operative (comprising the operation back sometimes) view data coupling, preferably makes image processing system and arm-and-hand system share the coordinate benchmark.This means that perioperative Flame Image Process should be furnished with the adapter between image probe and medical instrument (or other aid).Intra-operative, the size of target and position finding should momentarily be finished fast, so that reduce Flame Image Process shared time scale in the whole surgery process most possibly.
This purpose can be reached by computer image processing technology.
For strengthening the function of said method, the present invention also comprises following preferred content, that is should compatible per urethra and per rectum dual mode to the average of operation periods interscan of target.Transurethral scanning can be realized as follows: will stay in patient's body attached to the endoscope's shell on the articulated arm carriage (tool clamp holder), per urethra ultrasound probe 186 (see figure 5)s are replaced by in effective working cell.Only mobile headstock stroke assembly during scanning obtains required transversal scanning data by making in the probe discrepancy patient body.Change probe with the working cell behind the end of scan, thereby realize sharing of coordinate benchmark.In whole scanning process, arched member rests on its zero-bit or horizontal level constantly.
The per rectum scan function is to realize by an adnexa (see figure 6) with expanding section 188 can matching with endoscope's shell and sonde body 190 carriages 187 respectively in the two ends of this expanding section.Expanding section is adjustable, regulates side-play amount 189 and can make probe enter rectum exactly.Can change sonde body according to the difference of preset condition and patient's situation and on its length direction, be subjected to clip position.Similar with the transurethral scanning method, only mobile headstock stroke assembly when carrying out per rectum scanning, and must change probe and expanding section with the working cell behind the end of scan.
In the prostate removal surgery at benign prostatic hyperplasia, the information that is obtained by ultrasonic scanning is the boundary coordinate value of so-called operation tunicle.Should avoid exceeding the cutting of operation tunicle scope, because this may cause patient's incontinence, sexual impotence or massive hemorrhage.Preceding two kinds of complication occurring is owing to be damaged because of cutting near tunicle a large amount of teleneurons behind.The reason that massive hemorrhage occurs clearly-often there is big vascular in the tunicle outside.
When carrying out lateral ultrasonic wave scanning, often can not promptly be identified by membrane boundary.Can survey by membrane boundary with trained range estimation mode, but the result often is not sufficiently complete, accurately.The articulated arm ultrasonic scanning in the phase that can semi-automatic or automatically undergo surgery as described in the present invention.Program 194 is suitable for realizing this purpose.When carrying out semi-automatic scanning, operative doctor must go out by membrane boundary with the digitizer frame of mouse one class.When carrying out automatic scam, above-mentioned work is finished (should be confirmed by operative doctor certainly) by image analysis algorithm.Should weigh convenience and safety when selecting scan pattern, but the two should not add long operating time.
Should recommend to adopt the measure that before operation, all driven units is wrapped up with sterile package.Can parcel be tightened on the pillar construction 84 of headstock driven unit simply.The sagging space of sterile bag enough guarantees the motion of articulated arm in the intra-operative that still keeps disinfection.A complete set of system arranges by mode shown in Figure 2 that preferably wherein, the articulated arm system is suspended in the balanced support system, and computing equipment and operating theater instruments are lived by its coaster formula workbench frame by the balanced support system.Endoscope's scene occurs on display 259, and the supporting form 21 of display 259 should be convenient to display is checked freely.
Be safety and the ease-to-operate that guarantees system most possibly, on the track platform (see figure 2) computer console 258 near be provided with control panel 218.Visual detector on the control panel is showing the mode of operation of displacement controller on each degree of freedom.A certain emergency button can cut off the power supply of motor when starting, but except cutting off the electricity supply, all other parts of system still are in operable state.Even so, its mandatory keyboard interrupt pattern of submitting to by user interface program that still is higher than.The keyboard interrupt pattern still can start after arbitrary or some motor rotation.Any key that knocks computer keyboard can make all motors stop or hang.
More than introduce the optimum object of prostate being classified as articulated arm, but in fact as can be seen, this mechanical hand also is suitable for other object, as capsule, abdominal part or the like.And operative model also is not limited only to electrocautery, also can comprise other such as laser, high-strength ultrasonic TUNA operative model such as (transurethral needle erosion arts).The design object of this articulated arm is: but the medical apparatus of clamping many types, and the accuracy of the interior operation technique of raising operating room.By means of program control driving, native system can load a plurality of operation tools (whenever next) and implement effective operation technique.Like this, it is all being finished the work the assisted surgery operator aspect time, skill, accuracy and even the safety of operation satisfactorily.In addition, the advantage of native system also shows the reduction of mortality rate and sickness rate, the minimizing of assistant and nurse's number and shorten on the low cost and low-risk bring because of operating time.
Generally make driven unit possess modular characteristics when designing above-mentioned mechanical hand.Like this, as long as existing driven unit of replacing and supporting member just can change the motion of mechanical hand comprehensively.Self-contained its corresponding lead of driven unit, control and driving instruction arrive or leave driven unit by joint.
More than describe a preferred embodiment in detail about articulated arm, however except that above mentioned, under the prerequisite that does not break away from basic conception of the present invention, this area professional person also may propose radio-opaque distal marking type and modified model.All these variations and modified model all should be considered to belong to scope of the present invention, and feature of the present invention is then limited by above description and claims.

Claims (20)

1. one kind is carried out the articulated arm of medical care with medical instrument, and it comprises:
Be contained in arcual component on the first movable support member with sliding type;
Medical instrument is clamped in the tool clamp holder of certain operating position, and this tool clamp holder is loaded on the arcual component; And
Be located at first driven unit on above-mentioned first supporting member, its effect is that above-mentioned arcual component and above-mentioned tool clamp holder are slided, it is characterized in that above-mentioned tool clamp holder can move along arc trajectory, thereby the operating position of medical instrument is changed by predetermined way.
2. articulated arm as claimed in claim 1; it is characterized in that: also comprise second driven unit that joins with above-mentioned tool clamp holder; its effect is that above-mentioned tool clamp holder is slided along straight path, above-mentioned straight path and a certain axes intersect by the above-mentioned arc trajectory center of curvature.
3. as claim 1 or the described articulated arm of claim 2, it is characterized in that: above-mentioned arcual component is contained on above-mentioned first supporting member with removable form, if desired, can be contained on first supporting member with the slip form by the arcual component that another radius of curvature is different.
4. articulated arm as claimed in claim 1, it is characterized in that: above-mentioned tool clamp holder comprises the slidably carriage that is provided with a pair of locating slot, dismountable medical instrument installation bracket of can packing in the locating slot, each locating slot is furnished with and is used for the medical instrument installation bracket is locked at locking bar on the carriage slidably, above-mentioned locking bar is provided with the planar section that vertically distributes along it, like this, as long as rotating rod lock, its planar section is flushed with corresponding locating slot, and the medical instrument installation bracket just can be loaded onto easily or be pulled down.
5. articulated arm as claimed in claim 4 is characterized in that: above-mentioned a pair of locating slot is some a pair of in the locating slot on the carriage slidably, the position that can change the medical instrument installation bracket thus, thus change the operating position of medical instrument.
6. articulated arm as claimed in claim 4 is characterized in that: above-mentioned medical instrument installation bracket is the C shape carriage of a certain carriage assembly of formation half one, and second half of carriage assembly is the clamping carriage, and it can be clamped in C shape carriage on the medical instrument body.
7. articulated arm as claimed in claim 4, it is characterized in that: be furnished with tooth bar-gear train that it is slided along above-mentioned guide rail with the above-mentioned slidably carriage that sliding type is contained on the pair of guide rails, for driving this tooth bar-gear train to realize the slidably slip of carriage, tool clamp holder also should comprise motor.
8. articulated arm as claimed in claim 1 is characterized in that: above-mentioned first supporting member is provided with first and second rigid members, and above-mentioned arcual component just is subjected to sliding bearing between the two.
9. articulated arm as claimed in claim 8 is characterized in that: above-mentioned arcual component is provided with external tooth form, and above-mentioned first driven unit contains the motor that joins with aforementioned external teeth shape, can realize the slip of above-mentioned arcual component along above-mentioned arc trajectory thus.
10. articulated arm as claimed in claim 2 also comprises and mechanically is connected on above-mentioned first supporting member, and therefore makes it the 3rd driven unit around first drive shaft turns, like this, also can be by the above-mentioned tool clamp holder of arcual component supporting around above-mentioned first drive shaft turns.
11. articulated arm as claimed in claim 10, it is characterized in that: link to each other with the 3rd driven unit by adapter on above-mentioned first supporting member, this adapter can make the certain side-play amount of formation between above-mentioned first driving shaft and the above-mentioned first supporting member longitudinal axis, when work, the axis that is clamped in the medical instrument in the tool clamp holder will be intersected with above-mentioned first driving shaft, determine the center of rotation of medical instrument thus.
12. articulated arm as claimed in claim 11 is characterized in that: above-mentioned adapter has detachability, changes different adapters and can obtain different side-play amounts, reaches the purpose of holding the different medical instrument thus.
13. articulated arm as claimed in claim 10 also comprises second supporting member that is used for supporting above-mentioned the 3rd driven unit, this second supporting member is provided with and is used for making above-mentioned the 3rd driven unit to move assembly along the 4 wheel driven that rectilinear direction moves, like this, when its work, above-mentioned tool clamp holder also will move along above-mentioned rectilinear direction together with arcual component.
14. articulated arm as claimed in claim 13 is characterized in that: above-mentioned first, second, third and the moving assembly of 4 wheel driven all contain drive motors, above-mentioned each driven unit is all by the microprocessor control based on the multifreedom motion control system.
15. articulated arm as claimed in claim 13 is characterized in that: above-mentioned second supporting member is suspended in one can provide X at least, and Y is in the balanced support system of Z and four freedoms of motion of R.Freedom of motion R can guarantee to replace articulated arm by manually-operated rapidly under emergency condition.
16. articulated arm as claimed in claim 15 is characterized in that: above-mentioned balanced support system is provided with vertical each other first, second supporting arm and plumb post.The three can guarantee the motion of articulated arm at X, Y and Z degree of freedom respectively.
17. articulated arm as claimed in claim 16, it is characterized in that: above-mentioned articulated arm is installed on above-mentioned first supporting arm with sliding type by above-mentioned second supporting member, above-mentioned first supporting arm is installed on above-mentioned second supporting arm with sliding type, and above-mentioned second supporting arm is installed on the above-mentioned pillar with sliding type, and its feature also is: above-mentioned first, second supporting arm and above-mentioned second supporting member are respectively by corresponding first, second, third locking device locking, location.
18. articulated arm as claimed in claim 17 is characterized in that: the slip of each supporting arm realizes that by hawser-pulley system above-mentioned locking device comprises cable clamp in the above-mentioned balanced support system.
19. articulated arm as claimed in claim 16 is characterized in that: the slide of above-mentioned second supporting arm is provided with the rocking bracket assembly, can make thus second supporting arm around its on pillar slide and horizontally rotate.
20. articulated arm as claimed in claim 19 is characterized in that: above-mentioned balanced support system also comprises as several shelves that are used for supporting miscellaneous equipment on the chassis of plumb post mounting base and the chassis.
CN95194664A 1995-06-20 1995-06-20 Articulated arm for medical procedures Pending CN1155833A (en)

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