Patent Application
20160335919
The present invention relates generally to a user interface device for a surgical simulation system, and more specifically to an interface for an endoscopic simulator.
In recent years, systems for surgical simulations have become increasingly more used, in order to train physicians various surgical procedures without putting live patients at risk. In particular in the field of minimally-invasive surgery, such as laparoscopy, endoscopy, colonoscopy, etc., such simulation systems have gained significant acceptance. During minimal-invasive surgery the physician typically relies on an image on a screen rather than on an actual view of the patient, and with powerful image rendering available today, such an image can be simulated with a very high degree of realism.
During actual surgery the instrument, such as a Pentax i10 series endoscope, comprises a handle with controls, signal interfaces and an insertion tube. The insertion tube of the instrument is maneuvered into the body of the patient by longitudinal and rotational movement of the instrument, as well as manipulation of the controls. There is natural resistance as the insertion tube is maneuvered in and among the walls of the internal organs. A system for simulating endoscopic surgery preferably comprises a similar interface and a fixture for receiving the interface when in use. The handle may comprise controls similar to the actual surgical instrument, which via a signal interface provide input to a simulation system that renders an operator viewable image of a simulated surgical procedure, wherein manipulation of the controls result in a rendered simulated response corresponding to manipulation of the controls of an actual surgical instrument. The maneuvering of the tube is detected by sensors in the fixture which provide the simulation system with signals corresponding to the longitudinal and rotational movements of the instrument. In such a fixture there are preferably also actuators which provide the operator with a tactile feedback emulating the resistance occurring in actual surgery.
An example of such an apparatus is described in U.S. Pat. No. 6,926,531, wherein an apparatus for use in training an operator in the use of an endoscope system is disclosed. In this apparatus a rotatable disc is arranged with a plurality of rollers to surround the axis of rotation of the disc. One force feedback motor is provided to resist rotation of the disc and further force feedback motors are provided to resist rotation of rollers. Similar separate arrangements of rollers are provided together with sensors claimed to provide independent linear and rotary detection. Accordingly, the apparatus is claimed to be less sensitive to detection loss which may occur when force feedback is provided and the insertion tube is maneuvered in a manner such that the rollers slip.
Another example is disclosed in US 2012/0178062 where a combination of electrical motors and passive brakes are used to cover a range of forces. The electrical motors are used to simulate the lower ranged of forces and a power brake and a mechanical brake are used if respectively torques or forces applied on the endoscope are too strong to be maintained by the motors. This design allows motion in one direction while impeding the other.
The arrangement of individual sensor- and feedback mechanisms requires a relatively large amount of space, leading to a bulky and possibly expensive design. Furthermore, there is also a problem of friction induced by each rotating component, resulting in an inherent resistance even when the force feedback motors are not operated.
It is an object of the present invention to address the shortcomings of the prior art, and to provide an improved user interface which is robust in function and cost effective to manufacture. Another object is to provide a user interface which in use provides the user with an experience more closely resembling that of an actual surgical instrument.
According to an embodiment of the invention, these and other objects are achieved by a user interface for a tactile feedback endoscopic simulation executed on a computer system comprising an instrument having a handle and a tubular member, a frame, a support arrangement, being rotatably arranged in relation to the frame, and being arranged to receive the tubular member along an axis A. The support arrangement comprises two friction wheels resiliently pressed toward each other. The friction wheels are in frictional contact with opposing sides of the tubular member when the tubular member is received in the support arrangement, a first rotational sensor, arranged to detect a rotation of at least one of the two friction wheels, and at least one actuator which is operatively connected to the friction wheels.
The user interface further comprising a force sensor, arranged to detect a force between the support arrangement and the frame, and a controller arranged to receive a desired tactile feedback from the computer system and a sensor signal from said force sensor representative of an applied force, and arranged to control the actuator to operate the friction wheels to provide the desired tactile feedback.
The desired force feedback that should be experienced by the user is determined in the simulation executed in the computer system. The controller controls the actuator to provide this feedback force, but there is also a resistance created by the friction wheels. As the operator maneuvers the instrument, the actual force exerted on the frame is detectable by the force sensor, and based on this feedback, the controller can adjust the force applied by the actuators accordingly. The system will therefore be able to provide a resistance more closely corresponding to the resistance felt during actual surgery, down to no resistance or even a pull on the instrument.
The arrangement according to the invention enables compensation of any friction along the axis A, and therefore allows application of a comparably large bilateral force to improve friction between the tubular member and the friction wheels. This reduces the risk of slip, while allowing the operator to experience low or no resistance since the actuators can assist movement of the instrument in the direction of a detected force.
According to one embodiment the two friction wheels and the at least one actuator have a rotational resistance which is translated to a translatory resistance along said axis A when the tubular member is received in the support arrangement. The controller may therefore be further arranged to control the at least one actuator to operate the friction wheels to eliminate the translatory resistance along the axis A. The control may be based on the sensor signal from the force sensor that is representative of the applied force.
In other words the controller is consequently arranged with a regulating feedback loop signal which is representative of the applied force and the controller may drive the actuators so that the friction wheels pull or push the tubular member in the direction of the applied force, substantially eliminating translatory resistance that is inherent in the support arrangement. This allows the friction wheels to be pressed against the tubular member with a larger bilateral force, which reduces the risk of slip between the tubular member and the friction wheels. Consequently the rotational sensors are more accurate to the movement of the tubular member, providing a more robust function. The elimination of the inherent resistance may be implemented without negatively impacting the force feedback from the simulation as the signal from the force sensor may be compared to the desired force feedback.
Each friction wheel may be arranged on a pivotable arm, so that said friction wheel is movable into contact with said tubular member. The support arrangement can thereby accept a variety of diameters on the tubular member, and thicker tubular members which are generally used in endoscopy with higher level of axial forces will advantageously be sandwiched between the friction wheels with a higher bilateral pinching force.
According to one embodiment, each pivotable arm is operatively connected to a linkage mechanism comprising a slider being slidably arranged along said axis A, and two link brackets, each link bracket having a first end pivotally connected with said slider, and a second end pivotally connected to one of said arms, respectively, so that, when the slider is moved along axis A, the friction wheels are pressed against the tubular member.
Such a linkage mechanism ensures a symmetrical force exerted by either friction wheel. The force can be adjusted by adjusting the slider. Alternatively, the slider may be spring loaded, which allows self adjustment of the pressure of the friction wheels. Furthermore, such a mechanism may enable adjustment to wear of the tubular member.
This linkage mechanism can be advantageous also independently from the present invention, i.e. also in a user interface without the above disclosed force feedback control. The linkage mechanism should thus be considered a separate inventive concept, which may be made subject of a divisional patent application.
The inventors realized that a constant pressure of the friction wheels to the tubular member results in varying resistance over the length of the tubular member due to varying wear, production tolerances and/or material tolerances. A spring loaded or dynamic force exerted by the friction wheels on the tubular member according to at least one embodiment of the invention may take account for such differences.
According to one embodiment the user interface further comprises at least one spring interconnecting the friction wheels such that the friction wheels are resiliently pressed toward each other with a predetermined force against the tubular member when the tubular member is received in the support arrangement. While one of the objects is to reduce slip, there is also a desire to maintain a requirement for the output of the actuators so that they may be kept size and cost effective, and the same goes for any spring used. There is consequently a balance between friction that may be achieved by e.g. treading pattern and/or material on the friction wheels versus bilateral force affected by e.g. a resilient spring. The predetermined force of each of the friction wheels against the tubular member may advantageously be equal to or greater than 5N, or equal to or greater than 30N. The predetermined force of each of the friction wheels against the tubular member may be in the range of 10-50 N, or in the range of 35-45 N, or in the range of 38-42 N.
The at least one spring may be arranged to maintain at least one of a distance and a force between said friction wheels when the tubular member is received and forced offset laterally from the axis A in the support arrangement. The arrangement allows both friction wheels to maintain contact with the tubular member even if it is not aligned with the axis A, reducing the risk of slip between the tubular member and the friction wheels. More specifically reducing the risk of slip between the tubular member and one of the friction wheels, which the tubular member is offset away from if it is not aligned with the axis A.
According to one embodiment of the invention the frame may further comprise a base and a cradle for suspending the support arrangement, wherein the force sensor is provided between the base and the cradle. The force sensor may be arranged to detect a longitudinal force along axis A between said support arrangement and said frame.
The at least one actuator may advantageously be connected to at least one of the pair of friction wheels with at least one transmission, to enable a larger torque to be applied.
The invention also relates to a method for controlling haptic feedback in a system for simulating an endoscopic procedure, comprising determining a desired feedback force, detecting an actual force applied to the tubular member, comparing the desired feedback force with the actual force, to provide an error signal, and based on the error signal, controlling an actuator operatively connected to friction wheels in frictional contact with the tubular member, to thereby provide the desired feedback force.
The present invention will be described in more detail with reference to the appended drawings, showing currently preferred embodiments of the invention.
The user interface 1 comprises a movable instrument 5 comprising a handle 7 and a tubular member 8. The instrument is intended to resemble an actual endoscopic instrument, such as a Olympus GIF-HQ190, and the tubular member 8 is similar to or may alternatively be an actual surgical insertion tube, such as the insertion tubes used with Olympus GIF-HQ190 series endoscopic instruments. The user interface further comprises a signal interface 6 into which the tubular member 8 is insertable.
Two friction wheels 19a, 19b are biased against the tubular member 8, with sufficient force to avoid slipping. The friction wheels are actuated by actuators 22a, 22b, and their rotation is detected by at least one rotational sensor 25a. The sensors and actuators are connected to a controller 9.
As shown in
In use, the computer system 3 executes simulation software for simulating a surgical procedure. The current state of the simulation is based on parameters that are pre-loaded into the simulation software and of the actions of an operator since the start of the simulation. Parameters could for example be the type of operation, such as gastrointestinal surgery or other endoscopic surgery, providing a virtual coordinate system with boundaries and properties corresponding to the organs and cavities in the body of a virtual patient. Previous actions of the operator provide, for example, the current location and heading of a virtual endoscopic tube in this coordinate system. The operator's maneuvering of the instrument 5 results in an input to the simulation.
More specifically, translational movement of the instrument 5 is detected by the sensors 25a, 25b, and communicated to the computer 3 via the controller 9. Based on the simulation executed in the computer 3, a desired tactile force (or resistance) is calculated, and returned to the controller 9. The controller interacts with the actuators 22a, 22b to provide force feedback to the user. The actuators may provide resistance in both directions, as well as immobility (hard brake).
The controller further receives a signal from the force sensor 15 corresponding to the actual force applied to the cradle 14. This force is the force that the operator is actually experiencing. The controller is configured to implement a suitable control scheme, e.g. proportional-integral-derivative control, to control the electrical power output to the actuators so that the force detected by sensor 15 is equal to the desired tactile force.
It is important to note that the friction wheels 19a, 19b themselves may cause a non-negligible resistance force. Therefore, during some periods of the simulation, the required resistance (from the simulation) will be smaller than the friction force created by the friction wheels. During such periods, the controller will control the actuators 22a, 22b to assist the movement of the instrument 5. During other periods, the required resistance will be greater than the friction force created by the friction wheels. During such periods, the controller will control the actuators to increase the resistive force.
Of course, it is also possible that the required resistance precisely matches the force created by the friction wheels, in which case the actuators are controlled to be neutral.
Details of the signal interface, and the arrangement of sensors and actuators, will now be described in more detail.
In the illustrated example, the cradle 14 comprises two vertical members 14a, 14b which suspend the support arrangement 11 between a pair of ball bearings 16a, 16b, so that it is rotatable around an axis A. The ball bearings 16a, 16b are hingedly connected to the vertical members 14a, 14b, which in combination with a hinged connection of one of the vertical members 14b proximal to the base allows a larger tolerance in misalignment from the axis A when an operator maneuvers the instrument 5.
The axis A is arranged at an angle to a plane defined by the base 13 in the exemplary embodiment of the invention shown in
As illustrated in more detail in
Each friction wheel 19a, 19b is arranged on a pivotable arm formed by a pair of levers 20a, 21a, 20b, 21b. The arm allows movement of the friction wheel to make contact with the tubular member 8 through the respective opening 18a, 18b. When the tubular member 8 is inserted into the tube 17, the two friction wheels 19a, 19b will sandwich the tubular member 8. The respective pairs of levers 20a, 21a, 20b, 21b resiliently press the friction wheels 19a, 19b against the tube 8, providing a flexibility of the friction wheels 19a, 19b to move laterally in relation to the axis A in a resilient manner. The levers 20a, 20b, 21a, 21b are arranged at a sufficient distance from the tube 17 to avoid collision.
Each friction wheel 19a, 19b is connected to an actuator, such as an electric motor 22a, 22b. The connection may be a suitable drive belt 24a, 24b. In the illustrated example, the motors 22a, 22b are arranged with their drive axis 23a, 23b aligned with the rotation axis of the levers 20a, 20b, so that the movement of each friction wheel 19a, 19b describes part of an arched trajectory with a centre of rotation at the drive axle 23a, 23b of the respective electric motor 22a, 22b. The fixed distance between the friction wheels 19a, 19b and the motors 22a, 22b will ensure that the tension of the drive belts 24a, 24b is consistent.
In
A rotational sensor 25a, 25b is arranged to detect rotation of each friction wheel 19a, 19b. The sensors 25a, 25b are here arranged at the drive axle 23a, 23b of each motor 22a, 22b to provide a signal indicative of the rotation of the friction wheels 19a, 19b and inherently the linear movement of the tubular member 8.
Primarily with reference to
As the slider 28 is pulled along the tube 17, the link brackets 30a, 30b will laterally move the friction wheels 19a, 19b in a cooperative manner, pressing them towards the tubular member 8 inside the tube in a spring loaded manner.
It is noted that there is preferably an identical linkage mechanism on the opposite side of the tube 17, although this is not clearly visible in
The at least one spring 135 being arranged on the levers 120a, 120b so that the friction wheels 119a, 119b are resiliently pressed toward each other. When in use the resilient suspension of the friction wheels 119a, 119b on the levers 120a, 120b allows the tubular member 8 to be inserted at an angle to the axis A and/or off-set from said axis so that the tubular member 8 is mainly pressing towards one of the friction wheels 119a, 119b, wherein the at least one spring member 135 allows the other one of the friction wheels 119a, 119b to maintain pressure on the tubular member 8. Consequently, friction may be maintained.
Each set up with levers 120a, 120b, friction wheel 119a, 119b and at least one spring 135 is formed so that each friction wheel applies a force of at least 30N on the tubular member 8 when it is in use. The parameters of for example form and length of the levers 120a, 120b; Shape, size and groove tread of the wheels 119a, 119b and spring coefficient and pretension of the spring 135 may be chosen so that each friction wheel applies a force of for example 40N+/−2N on the tubular member 8.
Furthermore, similarly to the embodiment illustrated in
The pinching frictional grip of the friction wheels 19a, 19b on the tubular member 8, provides a translation of rotational movement of the tubular member 8 to the rotatable support arrangement 11. In order to provide force feedback in the rotational direction an actuator 32 is arranged on the frame 10, connected to a cog wheel (not shown) arranged around the tube 17 with a drive belt (not shown). A further rotational sensor 33 is also arranged to detect the rotational movement B of the support arrangement 11 around axis A. The rotational sensor 33 may advantageously be arranged on the drive axle of the actuator 32.
Additionally, a further rotational sensor 34 may be arranged in contact with the end of the tubular member 8 extending outside the tube 17 (when sufficiently inserted). The rotational sensor 34 is arranged to detect rotation of the tubular member 8, which may additionally be used in comparison with signals from the rotational sensor 33 to detect slip between the tubular member 8 and the friction wheels 19a, 19b.
There is a need to provide electrical connection between the motors 22a, 22b, sensors 25a, 25b and a controller 9 with minimal wear on wiring caused by the rotation of the support arrangement, this may be solved for example by providing sufficient wiring to allow some rotations, or a wire harness coiled in a similar manner to a clock spring. However, as such a solution limits the number rotations a rotating slip ring connector 26 is arranged around the tube 17 to provide an electrical interface fixed relative to the support arrangement 11 interconnected to another electrical interface fixed relative to the frame 10.
The person skilled in the art realizes that the present invention by no means is limited to the preferred embodiments described above. On the contrary, many modifications and variations are possible within the scope of the appended claims. For example, other types of sensors and encoders may be used, for detection of rotation as well as translation. For example, hall effect sensors or piezoelectric sensors. Further, the instrument 5 represents an actual surgical instrument for use in endoscopic surgery, as such there are several varieties of endoscopic surgical instruments that may be emulated. A person skilled in the art will realize that the invention according to at least one embodiment will accept a certain variation in for example insertion tube diameter or that the invention according to at least one embodiment may be adapted to a specific insertion tube. Furthermore, while the handle according to at least one embodiment of the invention is an interactive dummy of a handle such as a Olympus GIF-HQ190 series endoscope the invention is equally suited for a handle emulating any kind of endoscopic instrument.
According to at least one exemplary embodiment the cradle is suspended on the base by flexible members, some of which comprise a force sensor, such as a strain gauge. However, it is also possible that all of the flexible members comprise force sensors or only one of them. The number of sensors, relative sensor geometry and the individual arrangements of the sensors may be adapted to achieve a varying degree of freedom in terms of direction, amplitude and/or torque. For example, one force sensor may be arranged to sense an exerted force in the longitudinal direction as the instrument is pushed or pulled relative to the frame and support arrangement, while a plurality of sensors in combination may be arranged at various positions between the base and the cradle to detect longitudinal, rotational and/or lateral forces. Thus, with a force sensor arranged to detect rotational and/or lateral forces the skilled person realizes that the invention may be equally suited to comprise pinching friction wheels for the detection of the rotational movement of the instrument and subsequent use of the rotational and/or lateral force signals in a regulating control feedback loop, analogously to what is described for the translatory longitudinal movement. The same variations and advantages are applicable.
Alternatively the cradle may be arranged to the base along a rail or plurality of rails, having force sensors detecting the force along the rail. Yet another solution would be to arrange the cradle on a low friction surface on the base.
The skilled person realizes that the use of two ball bearings for rotational suspension of the support arrangement represents one possible embodiment, it would also be possible to have a single, central bearing or several bearings along the axis A. The configuration of the friction wheels in relation to the actuators may be varied, as well as the number of actuators and the use of transmission direct drive. For example one actuator may be used to operate both friction wheels. Similarly, the actuator for the force feedback on rotational movement of the tubular member may for example be a brake actuator.
The pinching force exerted by the friction wheels on the tubular member may be achieved without spring loaded pretension, for example an actuator may adjust the position of the wheels, a clock spring connecting friction wheel and motor may provide individual suspension for each friction wheel or the wheels may be interconnected by at least one spring. Similarly to vehicular wheels, the friction wheels may have varying patterns to improve friction depending on for example the type or size tubular member. The shape or depth of the circumferencing groove may also be varied. The diameter of the friction wheels may be adapted. Furthermore, the belt drive transmission that is connecting the friction wheels to the actuators may be replaced with for example a chain drive, gear drive etc. without limiting the invention.
The tube 17 may with some adaptations easily be replaced by a lattice structure or profile of similar format and dimension.
| Number | Date | Country | Kind |
|---|---|---|---|
| 14152548.5 | Jan 2014 | EP | regional |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/EP2015/051390 | 1/23/2015 | WO | 00 |
