CA2248364C - Instrument for compensating for hand tremor during the manipulation of fine structures - Google Patents
Instrument for compensating for hand tremor during the manipulation of fine structures Download PDFInfo
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- CA2248364C CA2248364C CA002248364A CA2248364A CA2248364C CA 2248364 C CA2248364 C CA 2248364C CA 002248364 A CA002248364 A CA 002248364A CA 2248364 A CA2248364 A CA 2248364A CA 2248364 C CA2248364 C CA 2248364C
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Abstract
The invention relates to an instrument for the manipulation of fine structures, said instrument detecting hand tremor and compensating for this hand tremor by effecting counter-movements of the working tip.
The main area of application will probably lie in the field of microsurgery, since the operations performed in said field can be made difficult by the hand tremor of the operating surgeon. Here, the tremor is detected by movement sensors, by repeated analysis of the position of the handheld part (1) of the instrument, or by deriving electromyographie signals from the forearm of the operator. Intentional and unintentional movements are differentiated from one another on the basis of one or more criteria, such as movement amplitude, speed, frequency and direction. To compensate for undesired movements, signals are sent to an arrangement of actuators (3) which cause deflections of the movable part (4) of the instrument, which deflections at the tip of the instrument compensate for the hand tremor. When the instrument is used as a needle holder in surgery, the actuators (3) can also be controlled by push button in such a way that, by oscillations, they facilitate the penetration of the suture needle into the area being worked on.
The main area of application will probably lie in the field of microsurgery, since the operations performed in said field can be made difficult by the hand tremor of the operating surgeon. Here, the tremor is detected by movement sensors, by repeated analysis of the position of the handheld part (1) of the instrument, or by deriving electromyographie signals from the forearm of the operator. Intentional and unintentional movements are differentiated from one another on the basis of one or more criteria, such as movement amplitude, speed, frequency and direction. To compensate for undesired movements, signals are sent to an arrangement of actuators (3) which cause deflections of the movable part (4) of the instrument, which deflections at the tip of the instrument compensate for the hand tremor. When the instrument is used as a needle holder in surgery, the actuators (3) can also be controlled by push button in such a way that, by oscillations, they facilitate the penetration of the suture needle into the area being worked on.
Description
3, SEP. 1998 15: 39 F~RRESTER & HOEHhaER T NR. 3536 S. 3!21 Iaetruaeat for compeaeating for hand tremor during the manipulstioa of fine structures ~escripti_o~
Manual work oa fine structures is made much more S difficult by the contraction of antagonistic muscles occurring involuntarily, and in largely rhythmic succession, and referred to ae tremor. This ie noticeable particularly in microsurgery when suturing fine nerves or vessels, prolongs the duration of the operation and reduces the quality of the result.
However. is order to be able tv perform filigree work, use is made, for example, of supports for the hands, or micromarsipulatore, which convert relatively rough movemento into fine deflections.
The object of the invention is to make available a handheld instrument for the manual manipulation of fine structures, in which undesired movements, for example tremor, have no effect, or at least less effect, on the manipulation.
The invention is based on the concept of evaluating the undesired movements of handheld instruments and of deflecting, by means of actuators, the working tip of the instrument (in surgical applications this would be, for example, a needle holder) in order to provide compensation, so that the hand tremor cannot be observed at the tip.
Since the physiological tremor takes place ~.n a range of between about 5 and 15 strokes/second, it can be differentiated from slower -voluntary movements, for example by frequency-selective filtering.
Movement detectxoa According to the invention, one or more devices can be provided for detecting movements on the part of the user, in particular for detact~.ag movements of the instrument sensed by the user, for example active or passive measurement transducers, by means of which SEP 08 1998 09 35 +49 89 347010 PRGE.03 8. SEP. 1998 15:39 FORRESTER E~ I~OEHIvfERT :VR. 3536 S. x/21 . z .
undesired movements oa the part of the user, or movements of the instrument caused by the user, can be detected.
The output signals from these devices ,are used, if appropriate after suitable evaluation and processing, to trigger actuators of the instrument for the purpose of compensating for the undesired movements.
To detect the movement of the instrum~nt, a number of possibilities can be selected in principle, and these can be eombiaed with one another:
1.. Acceleration and angular velocity sensors are arranged on one or more sections of the instrument, which sensors supply a mechanical or electrical signal correlated with the movement of the instrument.
151 The function of the sensors can be based oa purely mechanical, electromagnetic, capacitive, piezoelectric yr piezoresistive principles. The sensors have to detect the movement with suf~iciant sensitivity and accuracy. In this connection, it ie conceivable to use sensors which have their maximum sensitivity is the frequency range in which the undesired movements take place and thereby deliver an output signal correlated with the tremor. The sensors can be arranged in such a way that they can detect both translationa7, movements and rotational movements v~ the instrument.
Manual work oa fine structures is made much more S difficult by the contraction of antagonistic muscles occurring involuntarily, and in largely rhythmic succession, and referred to ae tremor. This ie noticeable particularly in microsurgery when suturing fine nerves or vessels, prolongs the duration of the operation and reduces the quality of the result.
However. is order to be able tv perform filigree work, use is made, for example, of supports for the hands, or micromarsipulatore, which convert relatively rough movemento into fine deflections.
The object of the invention is to make available a handheld instrument for the manual manipulation of fine structures, in which undesired movements, for example tremor, have no effect, or at least less effect, on the manipulation.
The invention is based on the concept of evaluating the undesired movements of handheld instruments and of deflecting, by means of actuators, the working tip of the instrument (in surgical applications this would be, for example, a needle holder) in order to provide compensation, so that the hand tremor cannot be observed at the tip.
Since the physiological tremor takes place ~.n a range of between about 5 and 15 strokes/second, it can be differentiated from slower -voluntary movements, for example by frequency-selective filtering.
Movement detectxoa According to the invention, one or more devices can be provided for detecting movements on the part of the user, in particular for detact~.ag movements of the instrument sensed by the user, for example active or passive measurement transducers, by means of which SEP 08 1998 09 35 +49 89 347010 PRGE.03 8. SEP. 1998 15:39 FORRESTER E~ I~OEHIvfERT :VR. 3536 S. x/21 . z .
undesired movements oa the part of the user, or movements of the instrument caused by the user, can be detected.
The output signals from these devices ,are used, if appropriate after suitable evaluation and processing, to trigger actuators of the instrument for the purpose of compensating for the undesired movements.
To detect the movement of the instrum~nt, a number of possibilities can be selected in principle, and these can be eombiaed with one another:
1.. Acceleration and angular velocity sensors are arranged on one or more sections of the instrument, which sensors supply a mechanical or electrical signal correlated with the movement of the instrument.
151 The function of the sensors can be based oa purely mechanical, electromagnetic, capacitive, piezoelectric yr piezoresistive principles. The sensors have to detect the movement with suf~iciant sensitivity and accuracy. In this connection, it ie conceivable to use sensors which have their maximum sensitivity is the frequency range in which the undesired movements take place and thereby deliver an output signal correlated with the tremor. The sensors can be arranged in such a way that they can detect both translationa7, movements and rotational movements v~ the instrument.
2. According to the invention, one or more devices can be provided for repetitive or continuous detection of the position of certain sections of the instrument in one, two or three dimensions, in particular of a handheld-aectioa and/or a section of the instrument which is movable in relation to the handheld section. By repetitive or continuous detection o! the position and orientation of certain sections of the instrument, their movement can be followed. The detection can take place in one, two or three dimensions. This can be done by wireless means via a transmitter/receiver eyst~m on the instrument sad at reference points which are located SEP 08 1998 09:36 +49 89 34?010 PRGE.04 8. SEP. 1998 15:39 FJRRESTER ~ BOEcIIv!ERT '.VR. 3536 S. 5!21 _ 3 .
at fixed positions in apace or on the area being worked on.
=t is also possible, particularly for use in microsurgery, to follow the movement of the section of the instrument shown in thn operating microscope.
The microscope faiage is delivered to an image-recording unit which determines the positions, in the image, of certain features or optical markings oa the instrument and caleulatee the movement on the basis of the consecutive position data. To do this, tracking procedures can also be used.
xf, in addition, the movemmnt of the tissue being worked on is also detected, this movement likewise being shown under the operating microscope, the 'r 151. movemment of this eiesue caused, for example, by the tremor on the part of the pats~at can be included in the compensation procees.
at fixed positions in apace or on the area being worked on.
=t is also possible, particularly for use in microsurgery, to follow the movement of the section of the instrument shown in thn operating microscope.
The microscope faiage is delivered to an image-recording unit which determines the positions, in the image, of certain features or optical markings oa the instrument and caleulatee the movement on the basis of the consecutive position data. To do this, tracking procedures can also be used.
xf, in addition, the movemmnt of the tissue being worked on is also detected, this movement likewise being shown under the operating microscope, the 'r 151. movemment of this eiesue caused, for example, by the tremor on the part of the pats~at can be included in the compensation procees.
3. with surface electrodes arranged vn the skin of the person operating the instrument, the action potentials of the underlying muscle can be recorded (so-called electromyography). If a control system recogaizea the movement which the corresponding muscle causes on innervation - for example through the ability tv adapt - it is possible, by eoa~biniag the electrode gigaale, to draw conclusions regarding the deflection the inatrumeat is expected to make.
In this method, the actual use of the iaetrument '.
would be preceded by a "learning phase" in which the signal processing unit correlates the electro-myographic signals with results of other movement-recording methods, and -thus adapts to individual features of the operator and to the positioning of the reference electrodes.
Signal processing If the movement detection has not already supplied a signal which corresponds to the ~oaovement attributed to the tremor and is thus suitable for directly triggering the actuators, the signal is SEP 88 1998 09 36 +49 89 347010 PAGE.05 8, SEP. 1998 15:40 FORRESTER & HOEHIJERT '~R. 35?6 S, 6!21
In this method, the actual use of the iaetrument '.
would be preceded by a "learning phase" in which the signal processing unit correlates the electro-myographic signals with results of other movement-recording methods, and -thus adapts to individual features of the operator and to the positioning of the reference electrodes.
Signal processing If the movement detection has not already supplied a signal which corresponds to the ~oaovement attributed to the tremor and is thus suitable for directly triggering the actuators, the signal is SEP 88 1998 09 36 +49 89 347010 PAGE.05 8, SEP. 1998 15:40 FORRESTER & HOEHIJERT '~R. 35?6 S, 6!21
- 4 -processed.
In general, it will first be necessary to amplify the sensor eigual. This is followed by as~alyeis which differentiates between intentional and unintentional movements on the basis of criteria such as frequency, amplitude, speed and direetiou. The criteria can be predefined, adjusted, or adapted automatically. On the basis of the data, a signal is obtained with which the actuators are triggered eo that said actuators execute.
at. the working tip of the instrument, relative movements for compeaBating for the undesired deflections of the handheld section.
~lctuatoro 'r The actuators can be both purely mechanical arrangements and also electrical coutrole which are based. for example, on electromagnetic, capacitive or piezoelectric principles. Thm actuators execute relative movements between the handheld section and the movable section of the instrument. They must be able to execute the desired moveiaeats with sufficient speed, power and precision. The actuators can be arranged is such a way that they can effect both traaslational movements and rotational movements. For certain requirements, it may be desirable that the actuators can also temporarily bring about a rigid connection between the handheld section and the movable section. The working tip of the instrument can be mounted in a fixed manner or can be designed to be exchangeable. Actions, such as the opening and closing of grippers or forceps, which must necessarily be done from the handheld section of the instrument, can be triggered via a flexible power transmission, for example a flexible push rod, which dose not impede the a~ctuatore, or via electrically operated adjustment members on the moved section.
Prdditioaal functions It u~ay be uae~ul, especially for use in microsurgery, to trigger the actuators already present is~
SEP 08 1998 09-36 +49 89 347010 PRGE.06 8. SEP. 1998 15:40 FORRESTER c~ HOEHI~fERT :~IR. 35?6 S. ?!21 -s-the instrument by means of a push buttoa in such a way that they cause the working tip of the instrument to oscillate at frequencies in the soaie or uleraeonie range, and, for example, when used as a needle holder, facilitate the penetration of the suture needle into tissue. ag a result of the rapid micro-movements.
Illustrative e~bodimsat An illustrative embodiment of the invention is explained in greater detail below, with reference to the attached drawings.
In Fig. 1, reference (1) designates the handheld section of a medical instrument. Groups of acceleration meters and angular velocity sensors (2) sit on this section. A movable section t4) is connected to the handheld section (1) via a flexible connection (5), and on this movable section (~) the working tip is, for example, a needle holder. The movable section can be moved relative to the handheld section (1) by the arrangement of piezoelectric actuators (3). The actuators (3) are arranged in such a way that they can bring about deflections in all directions transverse to the main axis of the instrument.
A coatrol unit fed by a battery is located in the handheld section (1), said control unit amplifying the data supplied by the sensors (2), continuously analyzing this data and comparing it.
On the basis of adaptable criteria such ae acceleration, frequency, direction and amplitude of the movement, the control unit differentiates between desired movements and the hand tremor-of the operator.
To compensate for the hand tremor, the arrangement of the actuators (3) is triggered in combination in such a way that these effect relative movements of the movable part (4) which are adapted in direction, speed and amplitude, and the undesired movements of the hand grip (1) cannot be observed at the working tip of the instrument holder (4). For opening and closiag needle holders, forceps oz scissors, use ie made SEP 08 1998 09 37 +49 89 347010 PRGE.07 8; SEP. 1998 15:40 F~RRESTER ~ BOEHI~ERT NR. 35?6 S, 8!21 of a push rod (7) which flexibly designed in the area of the flexible connection (5) and which extends through the inside of the movable section (4). The push rvd is operated vin a lever (6). A flexible membrane (e) on the end face of the handheld section (1) is used to seal off the mechanism.
The function of the instrument is additionally shown in Fig. 2.
A rapid and unintentional pitching movement of the handheld section (4), caused by tremor, would lead to an undesired deflection of the working tip (11) of the instrument. In order to prevent this, the actuators (3) are triggered for compensation eo that the movable section (4) ie moved in the opposite direction, and the 15~ working tip (11) remains at rest.
SEP 08 1998 09 37 +49 89 347010 PRGE.08
In general, it will first be necessary to amplify the sensor eigual. This is followed by as~alyeis which differentiates between intentional and unintentional movements on the basis of criteria such as frequency, amplitude, speed and direetiou. The criteria can be predefined, adjusted, or adapted automatically. On the basis of the data, a signal is obtained with which the actuators are triggered eo that said actuators execute.
at. the working tip of the instrument, relative movements for compeaBating for the undesired deflections of the handheld section.
~lctuatoro 'r The actuators can be both purely mechanical arrangements and also electrical coutrole which are based. for example, on electromagnetic, capacitive or piezoelectric principles. Thm actuators execute relative movements between the handheld section and the movable section of the instrument. They must be able to execute the desired moveiaeats with sufficient speed, power and precision. The actuators can be arranged is such a way that they can effect both traaslational movements and rotational movements. For certain requirements, it may be desirable that the actuators can also temporarily bring about a rigid connection between the handheld section and the movable section. The working tip of the instrument can be mounted in a fixed manner or can be designed to be exchangeable. Actions, such as the opening and closing of grippers or forceps, which must necessarily be done from the handheld section of the instrument, can be triggered via a flexible power transmission, for example a flexible push rod, which dose not impede the a~ctuatore, or via electrically operated adjustment members on the moved section.
Prdditioaal functions It u~ay be uae~ul, especially for use in microsurgery, to trigger the actuators already present is~
SEP 08 1998 09-36 +49 89 347010 PRGE.06 8. SEP. 1998 15:40 FORRESTER c~ HOEHI~fERT :~IR. 35?6 S. ?!21 -s-the instrument by means of a push buttoa in such a way that they cause the working tip of the instrument to oscillate at frequencies in the soaie or uleraeonie range, and, for example, when used as a needle holder, facilitate the penetration of the suture needle into tissue. ag a result of the rapid micro-movements.
Illustrative e~bodimsat An illustrative embodiment of the invention is explained in greater detail below, with reference to the attached drawings.
In Fig. 1, reference (1) designates the handheld section of a medical instrument. Groups of acceleration meters and angular velocity sensors (2) sit on this section. A movable section t4) is connected to the handheld section (1) via a flexible connection (5), and on this movable section (~) the working tip is, for example, a needle holder. The movable section can be moved relative to the handheld section (1) by the arrangement of piezoelectric actuators (3). The actuators (3) are arranged in such a way that they can bring about deflections in all directions transverse to the main axis of the instrument.
A coatrol unit fed by a battery is located in the handheld section (1), said control unit amplifying the data supplied by the sensors (2), continuously analyzing this data and comparing it.
On the basis of adaptable criteria such ae acceleration, frequency, direction and amplitude of the movement, the control unit differentiates between desired movements and the hand tremor-of the operator.
To compensate for the hand tremor, the arrangement of the actuators (3) is triggered in combination in such a way that these effect relative movements of the movable part (4) which are adapted in direction, speed and amplitude, and the undesired movements of the hand grip (1) cannot be observed at the working tip of the instrument holder (4). For opening and closiag needle holders, forceps oz scissors, use ie made SEP 08 1998 09 37 +49 89 347010 PRGE.07 8; SEP. 1998 15:40 F~RRESTER ~ BOEHI~ERT NR. 35?6 S, 8!21 of a push rod (7) which flexibly designed in the area of the flexible connection (5) and which extends through the inside of the movable section (4). The push rvd is operated vin a lever (6). A flexible membrane (e) on the end face of the handheld section (1) is used to seal off the mechanism.
The function of the instrument is additionally shown in Fig. 2.
A rapid and unintentional pitching movement of the handheld section (4), caused by tremor, would lead to an undesired deflection of the working tip (11) of the instrument. In order to prevent this, the actuators (3) are triggered for compensation eo that the movable section (4) ie moved in the opposite direction, and the 15~ working tip (11) remains at rest.
SEP 08 1998 09 37 +49 89 347010 PRGE.08
Claims (15)
1. Instrument for the manual working of fine structures, consisting of (a) a handheld section (1), (b) a section (4) which le movable in relation to the handheld section (1), (c) actuators (3), and where (d) the actuators (3) are designed to effect relative movements between the handheld section (1) and the movable section (4), which relative movements compensate at least partially for movements of the handheld section (1).
2. Instrument according to Claim 1, characterized in that one or more sensors (2) are arranged on the handheld section (1), said sensors (2) detecting the movement of the handheld section (1), sad their output signal being used to trigger the actuators (3).
3. Instrument according to Claim 1 or 2, characterized is that one or more sensors are arranged on the movable section (4), said sensors detecting the movement of the movable section (4), and their output signal being used to trigger the actuators (3).
4. Instrument according to one of Claims 1 through 3, characterized in that one or more sensors are arranged on the handheld section (1) or on the movable section (4) or between the handheld section (1) and the movable section (4), said sensors detecting the relative movement between the handheld section (1) and the movable section (4), and their output signal being used to trigger the actuators (3).
5. Instrument according to one of Claims 2 through 4, characterized in that at least one sensor detects the acceleration.
6. Instrument according to one of Claims 1 through 5, characterized is that one or more sensors are provided for repetitive or continuous detection of the position of the handheld section (1) is one, two or three dimensions.
7. Instrument according to one of Claims 1 through 6, characterized in that one or more sensors are provided for repetitive or continuous detection of the position of the movable section (4) in one, two or three dimensions.
8. Instrument according to Claim 6 or 7, characterized is that the position of the instrument is detected optically via the ray path of an operating microscope.
9. Instrument according to one of Claims 1 through 8, characterized in that a control or regulating unit triggers the actuators on the basis of the data from the sensors for position detection and/or movement detection.
10. Instrument according to one of Claims 1 through 9, characterized in that a control or regulating unit triggers the actuators on the basis of a repetitive or continuous position detection.
11. Instrument according to one of Claims 1 through 10, characterized in that electromyographically detected potentials are used to trigger the actuators.
12. Instrument according to one of Claims 1 through 11, characterized in that when movements of the handheld section or movable section occur, the compensation movements take place in a predetermined or adjustable or automatically adapting frequency range.
13. Instrument according to one of Claims 1 through 12, characterized is that when movements of the handheld section or movable section occur, the compensation movements take place in a predetermined or adjustable or automatically adapting amplitude range.
14. Instrument according to one of Claims 1 through 13, characterized in that the actuators (3) can be triggered in such a way that a rigid connection is obtained between the handheld section (1) and the movable section (4).
15. Instrument according to one of Claims 1 through 14, characterized in that the actuators (3) can be triggered is such a way that they can generate oscillations of the movable section (4).
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DEDE19700402.4 | 1997-01-08 | ||
| DE19700402A DE19700402C2 (en) | 1997-01-08 | 1997-01-08 | Instrument to compensate for hand tremors when manipulating fine structures |
| PCT/DE1998/000043 WO1998030165A1 (en) | 1997-01-08 | 1998-01-07 | Instrument for compensating hand trembling in the manipulation of fine structures |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2248364A1 CA2248364A1 (en) | 1998-07-16 |
| CA2248364C true CA2248364C (en) | 2006-03-28 |
Family
ID=36123392
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002248364A Expired - Lifetime CA2248364C (en) | 1997-01-08 | 1998-01-07 | Instrument for compensating for hand tremor during the manipulation of fine structures |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA2248364C (en) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2007535773A (en) | 2004-04-30 | 2007-12-06 | ヒルクレスト・ラボラトリーズ・インコーポレイテッド | Free space pointing device and pointing method |
| US8137195B2 (en) | 2004-11-23 | 2012-03-20 | Hillcrest Laboratories, Inc. | Semantic gaming and application transformation |
| CN113017830A (en) * | 2021-02-23 | 2021-06-25 | 刘睿 | Microsurgery anastomosis operation scoring system based on video identification |
-
1998
- 1998-01-07 CA CA002248364A patent/CA2248364C/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| CA2248364A1 (en) | 1998-07-16 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKEX | Expiry |
Effective date: 20180108 |