201208637 六、發明說明： 【發明所屬之技術領域】 的外科手術 本發明係關於用於導引外科手術儀器 儀器導引裝置。 ° 在外科手術業界中，通常需要相對於人體内一曰挪 來定位外科手術工具或儀器，以便執行外科 ^ 統藥物注射、針灸治療以及先進的微創外科 = 都產生對此的需求。現在，大部分這種外科手 ^ 或用精準度不夠高的簡單工具來執行。此外 = 這些簡單工具已經難以深入病患體内的目標。 用 在現在技術的幫助之下，可透過病患體表上的 口，查看、診斷與治療病患體内某些小但是重 LΪίΪ年f，利用針來執行許多複雜醫療程序的次 f之醫療程序、攜帶雷射光纖到病患體内射 二從病患體内重要器官取得組= 多*Ϊ 序，以及在病患體内使用針灸工具的 使用二來執行針灸治療之醫療程序。不過’ 當成用於診斷與4:有=有用的針刺程序’ 【發明内容】 201208637 本發明目標在於提供導引外科手術儀器之裝置。 一般來說，本發明的第一態樣提出一種外科手術儀 器導引裝置，用來定義一長形外科手術儀器（通常為大型 外科手術工具的一部分，例如有把手的工具）的路徑。該 裝置包含一裝置導引機構，用來定義該外科手術儀器要 沿著其長度方向移動之一縱向路徑（當該等裝置正在使 用時，例如手術中，則該儀器可沿著其路徑手動移動， 或可提供一驅動機構來沿著該路徑驅動該儀器）。該導引 裝置包含兩機構，分別控制該裝置導引機構相對於該裝 置中央轴的位置的兩個自由度，其一般用來指引朝向外 科手術的標的物：（i) 一裝置擺動機構，設定該縱向路 徑與該中央轴之間的角度；以及(ii) 一裝置旋轉器，設 定該縱向路徑繞著該中央轴的旋轉位置。換言之，使用 該裝置旋轉器，該縱向路徑可繞著該中央軸掃過一圓錐 表面，而使用該裝置擺動機構就可選擇該圓錐的半垂直 角度。因此，該裝置根據圓錐座標操縱該縱向路徑。 本發明的第二態樣提出一種裝置導引機構，用來沿 著一縱向路徑導引一外科手術儀器，該機構包含兩管狀 護鞘：一内護鞘，用於插入該外護鞘的一末端。 因此，該裝置導引機構可用於例如根據本發明第一 態樣的裝置，並且提供容易清潔或拋棄式裝置導引機 構，使其可在消毒不足情況下執行外科手術或其他程 序。 提供一深度控制機構，來控制該兩護鞘的套疊程 度。該深度控制機構與該裝置導引機構中之一個可提供 5 201208637 一止擋11 ’放置在包括該外科手術儀ϋ的外科手術工具 之表面上，如此限制該儀器沿著該裝置導引機構所定義 的路徑之移動。 該外科手術儀器可為用於腹腔鏡外科手術的儀 器、用於活喊檢4的馳織切緣或者用來透過病患 身體上的小傷口來執行診斷與治療程序之儀器。該等裝 置可用來透過直經範圍從〇.5mm到20mm的小針孔，在 三度空間内移動該外科手術儀器或工具至一目標。 該等裝置可用於下列應用： ⑷移動實心針頭朝向目標位置，進行針灸治療。 W移動中空針頭朝向目標位置，投與藥物進行疾 病治療’例如投與放射株至前列腺腺體進行焦點治療。 ⑷1縱注射器執行可編程的靜脈注抽 活組織檢查。 次 …（d)餘微創‘療的儀器，例如餘斜科手術的 儀器。 ⑷操縱切片檢查針，進行人 織檢查祕和活纟議檢4。 抵活組 (f)提供3D空間内活組織檢查裝置位置的導引。 【實施方式】 一具二— :儀;為二手= 巴 用來沿著裝置100所定義路徑移動 201208637 該外科手術儀器。 100的-部分ί俯mrr透視圖”-(b)圖為裝置 106襄也置括—長形、大體上管狀的裂置導引機構 m ㈣料科手術儀11縱⑽㈣㈣ 咳裳置‘二7動㈣絲維持料科手術儀器沿著 引機構長度方向之直線移動；換言之，用 供:二器在一筆直軌道内。該滑動護鞘用來提 仏扁給该外科手術儀器，避免交互感染。 ㈣⑻圖所示，該裝置導引機構1G6所定義的該 縱向路徑位於裝置⑽的中央轴116，但是如底下所述， 可由中央軸116取代。該裝置導引機構1〇6通 軸116上的支點214。 於〒央 裝置100另包括一裝置擺動機構104,用於擺動該縱 y向路徑遠離或朝向中央㈣6，也就是在时該縱向路 徑與中央軸116的平面内，相對於支點214樞轉該裝置導 引機^冓106 (如第一（b)圖内所示）。因為該裝置導引機構 106定義該外科手術儀器的路徑，該路徑與該裝置導引 機構106—起傾斜。 裝置100另包括一裴置旋轉器102，用於旋轉該裝置 導引機構106繞著中央軸116旋轉36〇度。此中央軸116可 延伸通過病患身體上的小傷口。因此，該縱向路徑掃過 一圓錐表面，像是第一(a)圖内虚線所顯示者。此圓錐表 ，具有中央軸116當成其軸。該圓錐的半垂直角度(也就 是’圓錐虛線側邊表面與中央軸116之間的角度，其交 201208637 士於「支點214上）由該裴置擺動機構1〇4選擇性固定（請注 意，「半垂直」這個說法屬於數學概念，並非暗示該中 央軸116垂直；通常並不垂直，事實上，使用時該中央 轴116通常將近水平）。 、 該裝置另包括 衮置深度控制機構108,用來調整 從該，置導引機構突出該外科手術儀器之程度，因此在 一個犯例中，該裝置深度控制機構1〇8係調整該外 術儀器插入病患身體内的深度。 該裝置另包括超音波探針固定器形式的-褒置定 ?!/° ’其為手持式框架’具有一個直線定位機構 來固疋與定位-超音波探針。該裝置旋轉器1G2 擺動^1G4、裝置深度控職構1_該«置定位框架 110中母-個都可由個別手動控制器手動控制，但是每 -機構也可包含個別伺服馬達。每一機構102、104、 =8 11G都可由個別手動控制器或個別伺服馬達分別控 =。知注意，在本發明的其他具體實施例中，可只提供 手動控制器及對應的伺服馬達中之一個。 該裝置另包括一裝置控制器112,其利用控制該個 別祠服馬達’來控制該裝置旋轉㈣2、裝置擺動機構 刚、裝置深度控制機構⑽以及該裝置定位框架110之 -或多個的移動。該裝置控制器112可包含一平板電 腦、從-成像裝置(例如超音波系統)娜影像的一訊框 抓取器以及-動作控制模組。有_外科㈣的資訊可 與對使用者友善的⑽-起顯示在該裝置控制器112的 彩色觸錢幕監視n上，幫科科 雜的外 201208637 科手術。更進一步來說，所執行的該外科手術的程序可 儲存在β亥裝置控制益112内’用於重複的手術或進一步 治療評估。 參閱弟一 (b)圖以及第二(a)圖至第九圖，更詳細說明 s亥裝置旋轉器1 〇2、裝置擺動機構1 〇4、裝置導引機構 106、裝置深度控制機構1〇8、裝置定位框架11〇以及該 裝置控制器112。 第二(a)圖為該裝置旋轉器1〇2的透視圖。第二(匕)圖 和第二(c)圖分別為該裝置旋轉器102的側剖面圖和後剖 面圖。 如第二(a)圖至第二(c)圖所示，該裝置旋轉器1〇2包 括一基座202,用於固定該裝置旋轉器1〇2其他部分及固 定該裝置定位框架110。該裝置旋轉器102也包括兩纜線 固定器208和216。 該裝置旋轉器102另包括一第一擺動部分218，其用 來固定該裝置導引機構106，而該裝置導引機構1〇6導引 該外科手術儀器。該第一擺動部分218配置成相對於當 成傾斜支點的部分214來傾斜。有關該部分214當成支點 而言’配置兩固定支撐轉軸來固定該部分214的位置。 該裝置旋轉器102也包括用於旋轉該裝置擺動機構 104 (因此旋轉該裝置導引機構1〇6)的一蝸輪212,以及 用於驅動該蜗輪212的一蝸桿210。該裝置旋轉器102另 包括配置在該基座202上的一伺服馬達206和一把手 204 °該伺服馬達206和把手204配置成分別驅動該蝸桿 210。換言之，該蜗桿210可由該伺服馬達206驅動，或 201208637 m玄？:,204手動旋轉。該蝸桿210嚙合該蜗輪 並且當該旱210旋轉時，該蜗輪212跟著旋轉， ㈣ri G靜止時’該堝輪212鎖定在靜止位置。 &用5亥蝸桿210確保只有在該伺服馬達2〇6通電或 虽^t204轉動時’該裝置導引機構綱才會旋轉。 二了(a)，為該裝置擺動機構104的切開透視圖。第 价、σ第三(c)圖分別為該裝置擺動機構104的側剖面 圖和俯視剖面圖。 勹二第二(a)圖至第三(c)圖所示，該裝置擺動機構104 ^ 第一擺動部分3〇8 ,其用來固定該裝置導引機構 繼J ^機構㈣該外科手術儀11。該第二擺動部分 配置成相對於該支點214傾斜。如第一(b)圖所示，該 ^ 動機構104的該第二擺動部分3〇8配置在該裝置 ^轉器102的該第—擺動部分218内。該第二擺動部分 另配置成可在該第—擺動部分218内滑動，讓第-擺 動邻刀218與5玄第二擺動部分3〇8 —起傾斜。這也允許該 第一擺動部分308沿著和該第一擺動部分218相同的中 央線移動。這維持該外科手術儀器的軌道沿著單一軸 線。 、該裝置擺動機構104另包括用來移動該第二擺動部 分308的一直線移動機構304。該直線移動機構304與該 第一擺動部分308配置在一起，使得當該直線移動機構 304沿著一軸直線移動時（由第三（幻圖至第三（c)圖中所 示一直線導引310所定義），該第二擺動部分3 〇 8沿著該軸 往該直線移動機構304的移動方向傾斜。該裝置擺動機 201208637 構104另包括驅動該直線移動機構304的一伺服馬達 306 0 如第三(a)圖至第二(c)圖所示’該裝置擺動機構^ 另包括一側邊區塊302，其包括一彎曲支揮插槽312。第 四（a)圖為根據本發明一具體實施例的該震置導引機構 106之透視圖，而第四（b)圖為該裝置導引機構的側剖 面圖。在一個範例中，該裝置導引機構1〇6為單一用途 組件’並且在使用之前密封在消毒袋内。 如第四（a)圖和第四（b)圖所示’該裝置導引機構 為滑動護躺的形式’其包括一外護靭402和一内護鞘 404。該内護鞘404配置成可在該外護鞘4〇2内滑動，並 且利用在該外護鞘402内滑動該内護鞘404，可調整該裝 置導引機構106的長度。 該内護鞘404配置成可插入該外護鞘4〇2的一端，並 且§玄裝置導引機構106另包括覆蓋該外護勒402的該端 之一保護構件410。該保護構件410會在該内護鞘404插 入之前移去。該保護構件41〇用來確保在該外護鞘402插 入該第一擺動部分218期間，該外護鞘402的内部維持消 毒。 該裝置導引機構106也包括一第一鎖定機構4〇6,以 將該外護鞘402鎖定至該裝置旋轉器1〇2的該第一擺動 部分218 ’以及包括一第二鎖定機構412,將該内護鞘404 鎖定至該裝置深度控制機構丨〇8的一止擋器（稍後詳細說 明）。 該裝置導引機構1〇6也包括一插入導引416,用來導 201208637 引該内護鞘404插入該外護鞘402 β如此確保該内護· 404正確插入該外護勒402内。在一個範例中’該插入 引416位於該内護勒404上’並且配置成可沿著該 404滑動。 ι稍 因為該内與外護鞠402、404以及該第一和第二鎖 機構406、412都經過消毒，該裝置導引機構1〇6可提供 消毒環境給通過的該外科手術儀器。該裝置導引機& 106也用來將該外科手術儀器維持在—直線執道内，並 且若該外科手術儀器為非常細微的針時，特別有 在一個範例巾，該裝置導引機構Γ〇6組裝 打開消毒袋之後，將該外護鞘402連同該保護構件 410,由第一（b)圖箭頭(Α)所指示方向，一起插入該裝置 旋轉器102的該第一擺動部分218内。然後使用該第一鎖 定機構406，將該外護鞘402與該保護構件410固定至該 裝置旋轉器102的該第一擺動部分218。 接下來，從該外護鞠402的該端移去該保護構件 410。然後使用該插入導引416將該外護鞘402與該内護 鞘404對準。接下來’將該内護鞘4〇4插入該外護鞘4〇2， 並且此插入驅使該插入導引4丨6沿著該内護鞘4 〇 4滑動。 然後使用該第二鎖定機構412將該内護鞘404鎖定 到該裝置深度控制機構108的一止擋器之上，使得該内 護鞠404可隨該止擋器一起移動（稍後詳細說明）。這允許 該内護勒404於該止擋器移動時在該外護鞘402内滑 動’，此改變該裴置導引機構106的長度。 第五(a)圖為根據本發明一具體實施例的裝置深度 12 201208637 控制機構108之透視圖。第五(b)圖為該裝置深度控制機 構108的側剖面圖。如第五(a)圖和第五(b)圖所示，該裝 置深度控制機構1〇8包括一止擋器508，其配置成透過該 第二鎖定機構412與該裝置導引機構1 〇 6的該内護鞘4 〇 4 鎖定在一起’以便當該止擋器508移動時，驅使該内護 勒404在該外護朝402内滑動。201208637 VI. Description of the Invention: [Technical Field of the Invention] The present invention relates to an instrument guiding device for guiding a surgical instrument. ° In the surgical industry, it is often necessary to locate surgical tools or instruments relative to the body to perform surgical drug injections, acupuncture treatments, and advanced minimally invasive surgery. Nowadays, most of these surgical hands are performed with simple tools that are not accurate enough. In addition = these simple tools have been difficult to penetrate into the target of the patient. With the help of current technology, it is possible to view, diagnose and treat some small but heavy diseases in the patient's body through the mouth on the patient's body surface, and use the needle to perform the medical procedures of many complicated medical procedures. The medical procedure of performing acupuncture treatment is carried out by carrying the laser fiber to the patient, taking the second part from the vital organs of the patient, and using the acupuncture tool in the patient. However, it is used for diagnosis and 4: there is a useful acupuncture procedure. [Invention] 201208637 The object of the present invention is to provide a device for guiding a surgical instrument. In general, a first aspect of the present invention provides a surgical instrument guide for defining the path of an elongate surgical instrument (typically a portion of a large surgical tool, such as a tool with a handle). The device includes a device guiding mechanism for defining a longitudinal path along which the surgical instrument is to be moved (when the devices are in use, such as during surgery, the instrument can be manually moved along its path) Or a drive mechanism can be provided to drive the instrument along the path). The guiding device comprises two mechanisms for controlling the two degrees of freedom of the position of the guiding mechanism of the device relative to the central axis of the device, which is generally used to guide the subject facing the surgery: (i) a device swinging mechanism, setting An angle between the longitudinal path and the central axis; and (ii) a device rotator that sets a rotational position of the longitudinal path about the central axis. In other words, using the device rotator, the longitudinal path can sweep across a conical surface about the central axis, and the device can select the semi-vertical angle of the cone using the device oscillating mechanism. Thus, the device manipulates the longitudinal path in accordance with the conic coordinates. A second aspect of the invention provides a device guiding mechanism for guiding a surgical instrument along a longitudinal path, the mechanism comprising two tubular sheaths: an inner sheath for inserting the outer sheath End. Accordingly, the device guiding mechanism can be used, for example, in accordance with the first aspect of the present invention, and provides an easy-to-clean or disposable device guiding mechanism that can perform a surgical or other procedure in the event of insufficient sterilization. A depth control mechanism is provided to control the degree of nesting of the two sheaths. One of the depth control mechanism and the device guiding mechanism can provide 5 201208637 a stop 11 'placed on the surface of the surgical tool including the surgical instrument, thus limiting the instrument along the device guiding mechanism The movement of the defined path. The surgical instrument can be an instrument for laparoscopic surgery, a woven margin for a live squirt 4, or an instrument for performing diagnostic and therapeutic procedures through small wounds on the patient's body. These devices can be used to move the surgical instrument or tool to a target in a three-dimensional space through small pinholes ranging from 〇.5mm to 20mm. These devices can be used in the following applications: (4) Acupuncture treatment is performed by moving the solid needle toward the target position. W moves the hollow needle toward the target position, and the drug is administered for disease treatment, for example, by administering a radiation strain to the prostate gland for focus treatment. (4) 1 longitudinal syringe performs a programmable intravenous injection biopsy. The second ... (d) the minimally invasive 'therapeutic instruments, such as the instruments of the extravasation surgery. (4) Manipulating the biopsy needle and performing the biopsy examination and the live examination 4 . The activating group (f) provides guidance on the location of the biopsy device in the 3D space. [Embodiment] One with two:: instrument; used second-hand = bar used to move along the path defined by device 100 201208637 The surgical instrument. 100-partial elevation mrr perspective"-(b) Figure is the device 106襄 also includes - long, generally tubular split guiding mechanism m (four) material surgery instrument vertical (10) (four) (four) coughing set 'two 7 The moving (four) wire maintains the surgical instrument in a straight line along the length of the guiding mechanism; in other words, the device is used in a straight orbit. The sliding sheath is used to lift the surgical instrument to avoid cross-infection. (4) As shown in the figure (8), the longitudinal path defined by the device guiding mechanism 1G6 is located at the central axis 116 of the device (10), but may be replaced by a central shaft 116 as described below. The device guiding mechanism 1〇6 is transmitted through the shaft 116. The fulcrum 214. The central device 100 further includes a device oscillating mechanism 104 for oscillating the longitudinal y-direction path away from or towards the center (four) 6, that is, in the plane of the longitudinal path and the central axis 116, relative to the fulcrum 214 The device guide 106 is turned (as shown in the first (b) diagram). Since the device guiding mechanism 106 defines the path of the surgical instrument, the path is inclined with the device guiding mechanism 106. The device 100 further includes a placement rotator 10 2, for rotating the device guiding mechanism 106 to rotate 36 degrees about the central axis 116. The central shaft 116 can extend through a small wound on the patient's body. Therefore, the longitudinal path sweeps over a conical surface, like the first One (a) is shown by the dotted line in the figure. This cone table has the central axis 116 as its axis. The semi-vertical angle of the cone (that is, the angle between the side surface of the conical dotted line and the central axis 116, 201208637 The "pivot point 214" is selectively fixed by the swaying mechanism 1 〇 4 (note that the term "semi-vertical" is a mathematical concept and does not imply that the central axis 116 is vertical; usually not vertical, in fact, The central shaft 116 is typically near horizontal when in use. The device further includes a device depth control mechanism 108 for adjusting the extent to which the surgical instrument is protruded from the guiding mechanism, so that in one case, the device depth control mechanism adjusts the external technique The depth of the instrument inserted into the patient's body. The device also includes an ultrasonic probe holder in the form of a ? 定 ! ! ! ! 手持 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 The device rotator 1G2 swings ^1G4, the device depth control structure 1_the «the positioning frame 110 can be manually controlled by an individual manual controller, but each mechanism can also include an individual servo motor. Each mechanism 102, 104, = 8 11G can be individually controlled by an individual manual controller or an individual servo motor. It is noted that in other embodiments of the invention, only one of the manual controller and the corresponding servo motor may be provided. The apparatus further includes a device controller 112 that controls the movement of the device (4) 2, the device swing mechanism, the device depth control mechanism (10), and the movement of the device positioning frame 110 by controlling the individual servo motor'. The device controller 112 can include a tablet computer, a frame grabber for a slave imaging device (e.g., an ultrasound system), and an action control module. The information of the _surgery (4) can be displayed on the color touch screen monitor n of the device controller 112 with the user-friendly (10)--to help the department of the 201208637 surgery. Still further, the procedure for performing the surgical procedure can be stored within the beta device control benefit 112 for repeated surgery or further therapeutic evaluation. Referring to the first (b) and second (a) to ninth drawings, the sigma device rotator 1 〇 2, the device oscillating mechanism 1 〇 4, the device guiding mechanism 106, and the device depth control mechanism 1 更 are described in more detail. 8. Device positioning frame 11A and device controller 112. The second (a) diagram is a perspective view of the device rotator 1〇2. The second (匕) and second (c) views are a side cross-sectional view and a rear cross-sectional view, respectively, of the device rotator 102. As shown in the second (a) to second (c), the device rotator 1 〇 2 includes a susceptor 202 for fixing the other portions of the device rotator 1 〇 2 and fixing the device positioning frame 110. The device rotator 102 also includes two cable holders 208 and 216. The device rotator 102 further includes a first oscillating portion 218 for securing the device guide mechanism 106, and the device guide mechanism 1-6 guides the surgical instrument. The first oscillating portion 218 is configured to be inclined with respect to the portion 214 that is a slanted fulcrum. Regarding the portion 214 as a fulcrum, the two fixed support shafts are disposed to fix the position of the portion 214. The device rotator 102 also includes a worm gear 212 for rotating the device swing mechanism 104 (and thus the device guide mechanism 〇6), and a worm 210 for driving the worm gear 212. The device rotator 102 further includes a servo motor 206 and a handle 204 disposed on the base 202. The servo motor 206 and the handle 204 are configured to drive the worm 210, respectively. In other words, the worm 210 can be driven by the servo motor 206, or 201208637 m? :, 204 manual rotation. The worm 210 engages the worm gear and the worm gear 212 rotates as the drought 210 rotates. (4) When the ri G is stationary, the wheel 212 is locked in the rest position. & 5 worm worm 210 ensures that the device guide mechanism will only rotate when the servo motor 2 〇 6 is energized or when tt 204 is rotated. Second, (a) is a cutaway perspective view of the device swinging mechanism 104. The first price, σ, and (c) are respectively a side cross-sectional view and a top cross-sectional view of the device swinging mechanism 104. As shown in the second (a) to third (c) diagrams, the device swinging mechanism 104 ^ the first swinging portion 3 〇 8 is used to fix the device guiding mechanism following the J ^ mechanism (4) the surgical instrument 11. The second swinging portion is configured to be inclined with respect to the fulcrum 214. As shown in the first (b) diagram, the second oscillating portion 3 〇 8 of the urging mechanism 104 is disposed in the first oscillating portion 218 of the device rotator 102. The second swinging portion is further configured to be slidable within the first swinging portion 218 to tilt the first swinging knife 218 and the fifth swinging second swing portion 3A8. This also allows the first swinging portion 308 to move along the same center line as the first swinging portion 218. This maintains the track of the surgical instrument along a single axis. The device swing mechanism 104 further includes a linear moving mechanism 304 for moving the second swinging portion 308. The linear moving mechanism 304 is disposed with the first swinging portion 308 such that when the linear moving mechanism 304 moves linearly along an axis (by the third (the magical to third (c) diagram shown in the straight line 310) As defined, the second oscillating portion 3 〇 8 is inclined along the axis toward the moving direction of the linear moving mechanism 304. The device oscillating machine 201208637 structure 104 further includes a servo motor 306 0 that drives the linear moving mechanism 304. 3(a) to 2(c) show that the device swinging mechanism further includes a side edge block 302 including a curved branch slot 312. The fourth (a) diagram is in accordance with the present invention. A perspective view of the shaking guide mechanism 106 of the specific embodiment, and a fourth (b) view is a side cross-sectional view of the device guiding mechanism. In one example, the device guiding mechanism 1〇6 is a single-purpose component. 'and sealed in the sterilized bag before use. As shown in Figures 4(a) and 4(b), 'the device guiding mechanism is in the form of a sliding lie' which includes an outer sheath 402 and an inner a sheath 404. The inner sheath 404 is configured to slide within the outer sheath 4〇2, And the length of the device guiding mechanism 106 can be adjusted by sliding the inner sheath 404 in the outer sheath 402. The inner sheath 404 is configured to be inserted into one end of the outer sheath 4〇2, and The guiding mechanism 106 further includes a protective member 410 covering the end of the outer guard 402. The protective member 410 is removed before the inner sheath 404 is inserted. The protective member 41 is used to secure the outer sheath The interior of the outer sheath 402 is maintained sterile during insertion of the first swing portion 218. The device guide mechanism 106 also includes a first locking mechanism 4〇6 to lock the outer sheath 402 to the device rotator The first swinging portion 218' of 1〇2 and a second locking mechanism 412 lock the inner sheath 404 to a stopper of the device depth control mechanism 8 (described in detail later). The guiding mechanism 1 6 also includes an insertion guide 416 for guiding the 201208637 to insert the inner sheath 404 into the outer sheath 402 β to ensure that the inner guard 404 is correctly inserted into the outer guard 402. 'The insertion guide 416 is located on the inner guard 404' and configured Sliding along the 404. ι slightly because the inner and outer shins 402, 404 and the first and second lock mechanisms 406, 412 are both sterilized, the device guide mechanism 1-6 can provide a sterile environment for passage. The surgical instrument. The device guide & 106 is also used to maintain the surgical instrument in a straight line, and if the surgical instrument is a very fine needle, particularly in an exemplary towel, the device After the guiding mechanism 组装6 assembles and opens the sterilizing bag, the outer sheath 402 and the protective member 410 are inserted into the first of the device rotator 102 together with the direction indicated by the arrow (Α) of the first (b). The swing portion 218 is inside. The outer sheath 402 and the protective member 410 are then secured to the first oscillating portion 218 of the device rotator 102 using the first locking mechanism 406. Next, the protective member 410 is removed from the end of the outer shin guard 402. The outer sheath 402 is then aligned with the inner sheath 404 using the insertion guide 416. Next, the inner sheath 4〇4 is inserted into the outer sheath 4〇2, and this insertion urges the insertion guide 4丨6 to slide along the inner sheath 4〇4. The inner guard 404 is then locked to a stop of the device depth control mechanism 108 using the second locking mechanism 412 such that the inner guard 404 can move with the stop (described in more detail later) . This allows the inner guard 404 to slide within the outer sheath 402 as the stop moves, which changes the length of the intrusion guide 106. The fifth (a) diagram is a perspective view of the apparatus depth 108 201208637 control mechanism 108 in accordance with an embodiment of the present invention. Figure 5(b) is a side cross-sectional view of the device depth control mechanism 108. As shown in the fifth (a) and fifth (b), the device depth control mechanism 1 8 includes a stopper 508 configured to pass through the second locking mechanism 412 and the device guiding mechanism 1 The inner sheath 4 〇 4 of the lock 6 is locked together to urge the inner guard 404 to slide within the outer guard 402 as the stop 508 moves.
在一個範例中，該外科手術儀器突出該裝置導引機 構106之外的程度’對應至該外科手術儀器插入病患體 内的所要深度。在此範例中，該外科手術儀器的一端已 經插過該裝置導引機構1〇6 (從第一（a)圖中由左到右的 方向）’直到該外科手術工具包括該外科手術儀器的部分 抵住该止擋器5〇8。因此，該外科手術儀器突出該裝置 導引機構106之外的程度取決於該裝置導引機構1〇6的 長度，而該長度取決於該内護鞘4〇4在該外護鞘402内的 滑動。因此，該止擋器508用來當成指示器，以調整該 外科手術儀器插入病患體内的所要深度。 A 該裝置深度控制機構108另包括用來移動該止擋器 508的一直線移動構件5〇2。該直線移動機構5〇2配置 由一伺服馬達504驅動。 泫裝置深度控制機構1〇8配置成隨著該裝置擺動 構104的該第二擺動部分遍傾斜。如第五⑷圖和第五 圖所示，該裝置深度控制機構1〇6另包括一擺動導引 506。該擺動導引5〇6配置成可在該裝置擺動機構咖 該側邊區塊302的該彎曲支撐插槽312内滑動，如第一 圖所示。利用該伺服馬達3〇6上的—編Μ，可測量^ 13 201208637 擺動導引5 06的位置。此時呈現兩個支撐點，—個八 該裝置擺動機構1 〇 4的該第二擺動部分3 〇 8盥节側^ 7 塊302之間’另一個介於該裝置擺動機構1〇4之該側 塊302的該彎曲支樓插槽312與該裝置深度控制機彳% = 的該擺動導引506之間，來提高裝置iq〇的可靠性與 度。該擺動導引506另配置成透過一支撐部分51〇與該 置擺動機構104的該第二擺動部分3〇8合作，以隨 二擺動部分308傾斜該裝置深度控制機構1〇8。 該裝置旋轉器102、裝置擺動機構⑽以及該裂 度控制機構⑽可被統稱為外科手術手腕（ wrist) 〇 第六⑷圖為該裝置定位框架11()的透視圖。第六 圖顯示可放置在該裝置定位框架11()上的—範例超 =探針’及第六⑷圖顯示該裝置定位框架削的側剖面 圖。 如第六（c)圖所示，該裝置定位框架11〇另包括一直 元件’其由1服馬達_驅動。該直線移動元 延#笛 >齒輪61G與—齒條612。該直線移動^件配置成 六刚和第六咖所示的_6，直線移動該裝 夂位框架110的一移動構件6〇4，1 置導弓I機構106的長戶Η #興°亥裝 、、盖搞m 度垂直。如第六（c)圖所示的一縱向 門胃纟列在該移動構件604與該直線移動元件之 二鎖定r:置定 統的超音波探針這類成像裝置 201208637 608，如第六（b)圖所示）固定至該裝置定位框架u〇。這 允許可相對於該裝置旋轉器102移動該成像裝置之動 作。該成像裝置用來獲取病患_的影像。病患體内所 要目標的位置可位於所獲取影像上，並且可透過校正 統併入實體座標系統。 第七（a)圖為根據本發明一具體實施例的該裝置控 制器112之透視圖，並且第七（b)圖為該裝置控制器112的 俯視剖面圖。 如第七（a)圖和第七（b)圖所示，該裝置控制器112包 括一控制電腦702，其可為具有一觸控螢幕監視器7〇4的 ，板電腦形式。該裴置控制器112另包括一機器人控制 系統，而該系統包括一伺服馬達控制系統以及一成像獲 取系統。一盒子706用來固定該控制電腦702和該機器人 控制系統。 第八圖為根據本發明一具體實施例的該裝置控制 器112之組件概觀。該控制器112的核心組件為該控制電 腦702。該裝置控制器112另包括用於接收使用者輸入的 一整合式使用者介面。該整合式使用者介面接著包括該 觸控螢幕監視器704、一鍵盤及/或滑鼠802、一圖形使用 者介面（graphic user interface，GUI)、一語音介面（包括 一語音控制器804)以及一搖桿介面（包括一搖桿控制器 8〇6)。該觸控螢幕監視器7〇4和該鍵盤及/或滑鼠802可整 合至該平板電腦，當成該控制電腦7〇2。 該裝置控制器112另包括動作控制模組814形式的 —伺服馬達控制系統，用來控制該裝置旋轉器102、裝 15 201208637 置擺動機構104、裝置深度控制機構1〇8以及該裝置定位 框架110中之一或多個之移動。然後控制該外科手術儀 器的移動。在如第八圖所示的一個範例中，該動作控制 模組控制一四通道伺服動作系統81〇 ,該系統包括分別 為該裝置旋轉器102、裝置擺動機構104、裝置深度控制 機構106以及該裝置定位框架H0的伺服馬達206、306、 504和602 。 進一步來說，該裝置控制器112包括訊框抓取器812 ，式的一成像獲取系統，用來從一醫療成像系統，例如 是超音波系統，擷取影像信號。該等影像信號可用來進 行該外科手術儀器的三維(three-dimensiona卜3D)動作追 縱和定位。 在一個範例中，該控制電腦702根據該使用者輸入 以及掏取的影像信號來控制該動作控制模組8〇8。某些 應用程式可預先載入該控制電腦7〇2，並且可根據來自 該等應用程式的輸出控制該動作控制模組8〇8。該等應 用程式可以3D模型化與規劃或人工智慧系統為基礎。該 等應用程式也可提供即時回饋。例如，可使用該等應用 ，式處理該等使用者輸入與該等擷取的影像信號，以決 =该外科手術儀器距離該目標多遠，以及該外科手術儀 态應該如何移動至該目標。這些輸出可依序用於控制該 動作控制模組808，其接著控制該裝置旋轉器、裝置 擺動機構104、裝置深度控制機構108和該裝置定位框架 1 中之一或多個的移動，將該外科手術儀器的路徑移 動至該目標。 16 201208637 如第八圖所示，該裝置控制器112也可包括一網路 攝影機818和一放大器820，用來放大來自該動作控制模 組808的該等信號。此外，該裝置控制器112包括一直流 電源供應器822，用來提供電源給該訊框抓取器812、動 作控制模組808以及該放大器820。 第九圖為使用具有B&K 8553探針608 (如第六作)圖 所示）的裝置100來進行乳房活組織檢查之範例。如第九 圖所示，B&K超音波探針608配置成與該裝置旋轉器1〇2 起，使付其相對於该裝置旋轉器1 02，沿著與該震置 導引機構106的長度垂直之軸移動。在一個範例中 ，音波探針608固定在該裝置定位框架11〇上，用來獲取 ^像。使用此B&K超音波探針6〇8所獲取的該等影 傳輸至該裝置控制器112 ’並且該目標可顯示在該裝 控制器112的該觸控螢幕監視器7〇4上。如此可進二入 編程的乳房活組織檢查。 70王 _在了個範例中，使用裝置100以及超音波探針608執 行下列乳房活組織檢查的步驟。 (i)從消毒袋中取出該裝置導引機構106,並且將該 又置導引機構丨〇 6的該外護鞘4 〇 2插入該裝置旋轉器1 〇 2 =該第-擺動部分218‘然後使用上述該第—鎖 ^ 6，將該外護勒4 〇 2連同該裝置導引機構i g 6的該保 件410固定在該裝置旋轉器1〇2的該第_擺動部分 (11)然後從該外護鞘402的該端取出該保護構件 41〇，如上述將該内護鞘4〇4插入該外護鞘4〇2内。利用 17 201208637 插入之動作驅使該插入導引416沿著該内護鞘404自由 滑動。 (iii)然後超音波探針608的超音波系統獲取乳房内 部的影像。運用這些影像，找出乳房内的目標（可例如為 腫瘤）。 (i v)然後外科醫師使用該裝置控制器丨i 2的該觸控 榮幕監視器704或該鍵盤及/或滑鼠8〇2，確認目標位置。 另外，外科醫師可使用該裝置控制器112的該整合式使 用者介面之任何其他組件，來確認目標位置。 (v)然後，根據下列步驟，使用裝置1〇〇將活組織檢 查針插入乳房，直到到達乳房内的目標位置。 (V—1)首先將裝置100的該第一擺動部分218對 準乳房表面上的插入點。 (ν·ι〇然後該裝置旋轉器1〇2旋轉該裝置擺動 機構104，直到該裝置擺動機構1〇4的該擺動平面通 ，該目標，換言之，直到該目標與沿著該第二擺動 部分308傾斜的平面交錯。請注意，該裝置導引機 構1〇6和該裝置深度控制機構1〇8都與該裝置擺動 機構104—起旋轉。 (v-iii)然後邊裝置擺動機構1〇4擺動（例如傾In one example, the extent to which the surgical instrument protrudes beyond the device guiding mechanism 106 corresponds to the desired depth of insertion of the surgical instrument into the patient. In this example, one end of the surgical instrument has been inserted through the device guiding mechanism 1〇6 (from left to right in the first (a) diagram) until the surgical tool includes the surgical instrument Partially against the stopper 5〇8. Accordingly, the extent to which the surgical instrument protrudes beyond the device guiding mechanism 106 depends on the length of the device guiding mechanism 1〇6, and the length depends on the inner sheath 4〇4 in the outer sheath 402. slide. Thus, the stopper 508 is used as an indicator to adjust the desired depth of insertion of the surgical instrument into the patient. A. The device depth control mechanism 108 further includes a linear moving member 5〇2 for moving the stopper 508. The linear movement mechanism 5〇2 is driven by a servo motor 504. The 泫 device depth control mechanism 〇8 is configured to be tilted with the second oscillating portion of the device oscillating structure 104. As shown in the fifth (4) and fifth figures, the device depth control mechanism 1-6 further includes a swing guide 506. The swing guide 5〇6 is configured to slide within the curved support slot 312 of the side swing block 302 of the device swing mechanism, as shown in the first figure. Using the -editing on the servo motor 3〇6, the position of the ^13 201208637 swinging guide 506 can be measured. At this time, two support points are presented, that is, the second swinging portion 3 〇 8 of the swinging mechanism 1 〇 4 of the device is between the two blocks 302, and the other is between the swinging mechanism 1〇4 of the device. The curved branch slot 312 of the side block 302 is between the swing guide 506 of the device depth control unit %= to improve the reliability and degree of the device iq. The swing guide 506 is further configured to cooperate with the second swing portion 3〇8 of the swinging mechanism 104 through a support portion 51 to tilt the device depth control mechanism 1〇8 with the second swing portion 308. The device rotator 102, the device oscillating mechanism (10), and the severance control mechanism (10) may be collectively referred to as a surgical wrist. The sixth (4) view is a perspective view of the device positioning frame 11 (). The sixth figure shows a side elevational view of the positioning frame of the apparatus which can be placed on the positioning frame 11() of the apparatus - the example super = probe ' and the sixth (4) diagram. As shown in the sixth (c) diagram, the device positioning frame 11 further includes a constant element 'which is driven by a motor. The linear moving element extends the #笛 > gear 61G and the rack 612. The linear movement member is configured as _6 shown by Liu Gang and the sixth coffee, and a moving member 6〇4,1 of the mounting frame 110 is linearly moved, and the long Η of the bowing mechanism I is disposed. #兴°亥Install and cover the m degree vertically. A longitudinal portal valve as shown in FIG. 6(c) is arranged in the moving member 604 and the linear moving member to lock r: an imaging device such as a supersonic probe, such as an imaging device 201208637 608, such as the sixth ( b) shown in the figure) is fixed to the device positioning frame u〇. This allows the action of the imaging device to be moved relative to the device rotator 102. The imaging device is used to acquire an image of a patient. The location of the target in the patient's body can be located on the acquired image and can be incorporated into the physical coordinate system through the calibration system. Figure 7(a) is a perspective view of the device controller 112 in accordance with an embodiment of the present invention, and a seventh (b) view is a top cross-sectional view of the device controller 112. As shown in Figures 7(a) and 7(b), the device controller 112 includes a control computer 702, which may be in the form of a tablet computer having a touch screen monitor 7〇4. The device controller 112 further includes a robot control system including a servo motor control system and an imaging acquisition system. A box 706 is used to secure the control computer 702 and the robot control system. The eighth figure is a summary of the components of the device controller 112 in accordance with an embodiment of the present invention. The core component of the controller 112 is the control computer 702. The device controller 112 further includes an integrated user interface for receiving user input. The integrated user interface then includes the touch screen monitor 704, a keyboard and/or mouse 802, a graphical user interface (GUI), a voice interface (including a voice controller 804), and A rocker interface (including a rocker controller 8〇6). The touch screen monitor 7〇4 and the keyboard and/or mouse 802 can be integrated into the tablet as the control computer 7〇2. The device controller 112 further includes a servo motor control system in the form of a motion control module 814 for controlling the device rotator 102, loading 15 201208637 swinging mechanism 104, device depth control mechanism 1 〇 8 and the device positioning frame 110 One or more of the movements. The movement of the surgical instrument is then controlled. In an example as shown in the eighth figure, the motion control module controls a four-channel servo motion system 81, which includes the device rotator 102, the device swing mechanism 104, the device depth control mechanism 106, and the The device positions the servo motors 206, 306, 504 and 602 of the frame H0. Further, the device controller 112 includes a frame grabber 812, an imaging acquisition system for capturing image signals from a medical imaging system, such as an ultrasound system. These image signals can be used to perform three-dimensional (3D) motion tracking and positioning of the surgical instrument. In one example, the control computer 702 controls the motion control module 8〇8 based on the user input and the captured image signal. Some applications can preload the control computer 7〇2 and control the motion control module 8〇8 based on the output from the applications. These applications can be based on 3D modeling and planning or artificial intelligence systems. These applications also provide instant feedback. For example, the applications can be used to process the user input and the captured image signals to determine how far the surgical instrument is from the target and how the surgical posture should be moved to the target. The outputs may be sequentially used to control the motion control module 808, which in turn controls movement of one or more of the device rotator, device swing mechanism 104, device depth control mechanism 108, and the device positioning frame 1 The path of the surgical instrument is moved to the target. 16 201208637 As shown in the eighth diagram, the device controller 112 can also include a network camera 818 and an amplifier 820 for amplifying the signals from the motion control module 808. In addition, the device controller 112 includes a DC power supply 822 for providing power to the frame grabber 812, the motion control module 808, and the amplifier 820. The ninth figure is an example of a breast biopsy using a device 100 having a B&K 8553 probe 608 (as shown in the sixth). As shown in the ninth figure, the B&K ultrasonic probe 608 is configured to mate with the device rotator 1 2 relative to the device rotator 102, along with the oscillating guide mechanism 106. The axis of the vertical axis moves. In one example, the sonic probe 608 is attached to the device positioning frame 11A for acquiring an image. The images acquired using the B&K ultrasonic probes 6〇8 are transmitted to the device controller 112' and the target can be displayed on the touchscreen monitor 7〇4 of the controller 112. This allows for a programmed breast biopsy. 70 King _ In one example, the following breast biopsy steps are performed using device 100 and ultrasonic probe 608. (i) removing the device guiding mechanism 106 from the sterilization bag, and inserting the outer sheath 4 〇 2 of the re-directing guiding mechanism 6 into the device rotator 1 〇 2 = the first oscillating portion 218' Then, using the first lock 6, the outer guard 4 〇 2 together with the retaining member 410 of the device guiding mechanism ig 6 is fixed to the first oscillating portion (11) of the device rotator 1 然后 2 and then The protective member 41 is removed from the end of the outer sheath 402, and the inner sheath 4〇4 is inserted into the outer sheath 4〇2 as described above. The insertion guide 416 is free to slide along the inner sheath 404 by the action of the insertion of 17 201208637. (iii) The ultrasonic system of the ultrasonic probe 608 then acquires an image of the inside of the breast. Use these images to find the target within the breast (which can be, for example, a tumor). (i v) The surgeon then uses the touch screen monitor 704 of the device controller 丨i 2 or the keyboard and/or mouse 8〇2 to confirm the target position. Additionally, the surgeon can use any other component of the integrated user interface of the device controller 112 to confirm the target location. (v) Then, according to the following procedure, the biopsy needle is inserted into the breast using the device 1 直到 until reaching the target position within the breast. (V-1) The first oscillating portion 218 of the device 100 is first aligned with the insertion point on the surface of the breast. (ν·ι〇 then the device rotator 1〇2 rotates the device swinging mechanism 104 until the swinging plane of the device swinging mechanism 1〇4 is turned on, the target, in other words, until the target and along the second swinging portion The inclined planes of the 308 are staggered. Note that both the device guiding mechanism 1〇6 and the device depth controlling mechanism 1〇8 rotate together with the device swinging mechanism 104. (v-iii) Then the device swinging mechanism 1〇4 Swing (eg tilt
斜1該裝置導引機構106。該裝置深度控制機構1〇J 與该裝置導引機構106 —起傾斜。此搖擺會執行直 到通過該裝置導引機構106的—中央線（即是軸 過該目標為止。 (VMV)然後如上述方式，移動該裝置深度控制 201208637 機構108的該止擋器508，來將該裝置導引機構ι〇6 的該内護鞘404滑動進入該裝置導引機構ι〇6的該 外護鞘402,以設定活組織檢查針插入乳房的所 深度。 (v-v)然後將該活組織檢查針的第一端通過該 裝置導引機構106插入乳房’直到該活組織檢查針 相對於該第一端的第二端完全進入該裝置導引機 構106。如此活組織檢查針剛好停在乳房内的目桿 之上。 不 (vi)然後外科^•生裝上一市面上的活組織檢查裝 置，例如Bard活組織檢查系統至該活組織檢查針。&後 使用該Bard活組織檢查系統取得活組織樣本。 凊注意，遠裝置定位框架11〇的該直線移動元件允 許該超音波探針60 8與該裝置旋轉器i 〇 2之間相對移動 (與該裝置擺動機構104、裝置導引機構1〇6以及該裝置深 度控制機構108—起）。 " 裝置100提供下列優點。 裝置100用來當成一電腦化外科手術儀器操縱器， 能夠更安全並且更準確移動外科手術儀器至目標\° 裝置100由包括該四個伺服馬達206、306、504和602 的一伺服動作系統所驅動，以將該外科手術儀器的尖端 放置在病患體内立體空間中的目標上。這提供裝置1〇〇 四個自由度（four degrees of freedom，4DOF)。因此，當 使用裝置100時就可控制该外科手術儀器的速度、力量 與放置範圍。如此可使用裝置100操縱外科手術儀器， 19 201208637 以執行高定位精準度的複雜外科手術。 目前的外科手術儀器操縱器，裝置100提供 : :、，扁:呈程序，幫助外科醫生更快並且更佳地執行外 於機器人僅模仿外科醫生操縱外科手術儀 i該穿罟枷刖巧術系、统，因4裝置100使用可預先載入 儀器Λ，、其中^等應用程式來控制該外科手術 串體内^Λ等應用程式可根據使用者輸人及/或來自病 ===信號來運行，所以裝置100可達到更 提供:=。如此降低人為=== 操縱外錐座標操作，因此更容易讓人 内的目椁；2主移動該外科手術儀器至病患體 步來說使操縱也可更精準。更進-術儀器建到圓錐動作模組’讓外科手 代之:r;r_，二==的：度取而 工具 整該裳置旋轉第，置來移動，因此可調 間之巧也就是===與病患身體 裝置可比手動操縱外科手術儀器達到更高2 201208637 度與精準度。總體來說，其提供基本平台，彌補現代技 術之間的縫隙，因此讓許許多多病患獲利。 在本發明的範疇内可有許多具體實施例的變化，精 通技術的讀者就可了解。例如：可提供其他驅動機構(含 手動控制器及/或伺服馬達），一起移動所有機構102、 104、108，藉此移動支點214以及中央軸116。如此， 該支點可移動到相對於病患所要的位置。 21 201208637 【圖式簡單說明】 本說明查中 視圖 本發明的具i實::為例而參考下列附圖，來說明 第（a)圖為根據本發明一具體實施例的裝置之透 第二i 為第一(a)圖裝置的一部分的俯視剖面圖。 第- 团為第一（a)圖裝置的裝置旋轉器之透視圖。 •為第二(a)圖裝置旋轉器的側剖面圖。 第=(a)圖為第二(a)圖裝置旋轉器的後剖面圖。 透視圖 圖了勻圖為第一（a)圖裝置的裝置擺動機構之切開 ^:^圖為第三刚裝置擺動機構的側剖面圖。 圖為第三(a)圖裝置擺動機構的俯視剖面圖。 圖 )圖為第一（a)圖裝置的裝置導引機構的透視 =四(b)圖為第四⑷圖裝置導引機構的側剖面圖。 透視^五(_為第—_裝置的裝置深度控制機構的 圖 圖 第五(b)圖為第五(幻圖裝置深度控制機構的側剖面 第/、（a)圖為第一（a)圖裝置的裝置定位框架的透視 例超為放置在第六⑻圖裝置定位框架上的範 圖 第六(c)圖為第六(a)圖裝置定位框架的側剖面The device guide mechanism 106 is inclined 1 . The device depth control mechanism 1〇J is tilted together with the device guiding mechanism 106. This sway will be performed until the center line through the device guide mechanism 106 (i.e., the shaft passes the target. (VMV) and then moves the device depth control 201208637 to the stop 108 of the mechanism 108 as described above. The inner sheath 404 of the device guiding mechanism ι 6 slides into the outer sheath 402 of the device guiding mechanism ι 6 to set the depth at which the biopsy needle is inserted into the breast. (vv) then the activity The first end of the tissue inspection needle is inserted into the breast through the device guiding mechanism 106 until the biopsy needle fully enters the device guiding mechanism 106 with respect to the second end of the first end. Thus the biopsy needle just stops at Above the mast in the breast. No (vi) then surgical ^• raw on a commercially available biopsy device, such as the Bard biopsy system to the biopsy needle. & after the use of the Bard biopsy The system obtains a living tissue sample. 凊 Note that the linear moving element of the distal device positioning frame 11〇 allows relative movement between the ultrasonic probe 60 8 and the device rotator i 〇 2 (with the device oscillating mechanism 104, The guiding mechanism 1〇6 and the device depth control mechanism 108. The device 100 provides the following advantages. The device 100 is used as a computerized surgical instrument manipulator to move the surgical instrument more safely and accurately. The target \° device 100 is driven by a servo motion system including the four servo motors 206, 306, 504, and 602 to place the tip of the surgical instrument on a target in a three-dimensional space within the patient's body. The device has four degrees of freedom (4DOF). Thus, the speed, force and placement of the surgical instrument can be controlled when the device 100 is used. Thus the device 100 can be used to manipulate the surgical instrument, 19 201208637 To perform complex surgical procedures with high positioning accuracy. The current surgical instrument manipulator, device 100 provides: :,, flat: a program that helps the surgeon perform faster and better than the robot only mimics the surgeon's manipulation Surgical instrument i should be worn by the system, because the 4 device 100 can be used to preload the instrument, etc. The application to control the surgical string and other applications can be run according to the user input and/or from the disease === signal, so the device 100 can achieve more: =. So reduce the artificial === manipulation Cone coordinates operation, so it is easier to see inside; 2 main movement of the surgical instrument to the patient's body step can make the operation more precise. More advanced - surgery instrument built into the cone action module 'Let the surgeon Instead: r; r_, two ==: the degree is taken and the tool is set to rotate, set to move, so the adjustable room is also === with the patient body device can be achieved by manually operating the surgical instrument Higher 2 201208637 degrees and accuracy. In general, it provides a basic platform to bridge the gap between modern technologies, thus making many patients profitable. Variations of many specific embodiments are possible within the scope of the invention, and will be understood by those skilled in the art. For example, other drive mechanisms (including manual controls and/or servo motors) may be provided to move all of the mechanisms 102, 104, 108 together, thereby moving the fulcrum 214 and the central shaft 116. As such, the fulcrum can be moved to a desired position relative to the patient. 21 201208637 [Simplified illustration of the drawings] The present invention is described in the following: FIG. 1(a) is a second embodiment of the device according to an embodiment of the present invention. i is a top cross-sectional view of a portion of the first (a) diagram device. The first group is a perspective view of the device rotator of the first (a) diagram device. • A side cross-sectional view of the device rotator of the second (a) diagram. Figure = (a) is a rear cross-sectional view of the device rotator of the second (a) diagram. The perspective view shows the cutting of the device swinging mechanism of the first (a) drawing device. The figure is a side sectional view of the third rigid device swinging mechanism. The figure is a top cross-sectional view of the device swinging mechanism of the third (a) diagram. Fig. 1 is a perspective view of the device guiding mechanism of the first (a) drawing device = four (b) is a side sectional view of the device guiding mechanism of the fourth (4) drawing. Perspective ^5 (the figure of the device depth control mechanism of the device is the fifth (b) is the fifth (the side profile of the magic device depth control mechanism / (a) is the first (a) The perspective view of the device positioning frame of the drawing device is super-normally placed on the positioning frame of the sixth (8) device. The sixth (c) figure is the side profile of the sixth (a) device positioning frame.
22 S 201208637 第七（a)圖為第 一 (a)/si ® λα 第七⑻圖為第七⑻置控制器之透視圖。 弟八圖為第七⑻圖裝置控制器的組件之概觀。 第九圖為使用第一（a)圖裝置具有第六圖範例超 音波探針來進行乳房活組織檢查之範例。 【主要元件符號說明】 100 裝置 102 裝置旋轉器 104 裝置擺動機構 106 裝置導引機構 108 裝置深度控制機構 110 裝置定位框架 112 裝置控制器 116 中央軸 202 基座 204 把手 206 伺服馬達 208 纜線固定器 210 蝸桿 212 蜗輪 214 支點 216 纜線固定器 218 第一擺動部分 302 側邊區塊 3〇4 :直線移動機構 3〇6 :伺服馬達 308 :第二擺動部分 31〇 :直線導引 312 :彎曲支撐插槽 402 :外護鞘 404 :内護鞘 406 :第一鎖定機構 41〇 ··保護構件 412 :第二鎖定機構 416 :插入導引 502 :直線移動構件 504 :飼服馬達 506 :擺動導引 508 :止擋器 510 :支撑部分 6〇2 :伺服馬達 604 :移動構件 23 201208637 606 :軸 806 : 608 : B&K 8553 探針 808 ： 610 :齒輪 810 ： 612 :齒條 統 614 :縱向溝槽 812 : 702 :控制電腦 814 ： 704 :觸控螢幕監視器 818 ： 706 :盒子 820 ： 802 :鍵盤及/或滑鼠 822 ： 804 :語音控制器 搖桿控制器 動作控制模組 四通道伺服動作系 訊框抓取器 動作控制模組 網路攝影機 放大器 直流電源供應器 2422 S 201208637 The seventh (a) is the first (a) / si ® λα The seventh (8) is the perspective view of the seventh (8) controller. Figure 8 is an overview of the components of the seventh (8) device controller. The ninth figure is an example of performing a breast biopsy using the first (a) diagram device with the sixth example sample ultrasound probe. [Main component symbol description] 100 device 102 device rotator 104 device oscillating mechanism 106 device guiding mechanism 108 device depth control mechanism 110 device positioning frame 112 device controller 116 central axis 202 pedestal 204 handle 206 servo motor 208 cable holder 210 worm 212 worm gear 214 fulcrum 216 cable holder 218 first oscillating portion 302 side block 3 〇 4 : linear moving mechanism 3 〇 6 : servo motor 308 : second oscillating portion 31 〇 : linear guide 312 : curved support Slot 402: outer sheath 404: inner sheath 406: first locking mechanism 41 保护 · protective member 412 : second locking mechanism 416 : insertion guide 502 : linear moving member 504 : feeding motor 506 : swinging guide 508: stopper 510: support portion 6〇2: servo motor 604: moving member 23 201208637 606: shaft 806: 608: B&K 8553 probe 808: 610: gear 810: 612: rack system 614: longitudinal groove Slot 812: 702: Control Computer 814: 704: Touch Screen Monitor 818: 706: Box 820: 802: Keyboard and/or Mouse 822: 804: Voice Controller Shake The controller controls the operation of four channel modules servo operation based operation control information frame grabber module webcam DC power supply amplifier 24