Device and method for assisting laparoscopic surgery—rule based approach

1 . A surgical controlling system, comprising:

at least one surgical tool configured to be inserted by way of a laparoscopic incision into a surgical environment in an insufflated hollow organ or cavity of a human body for assisting a surgical procedure,

an endoscopic camera configured to be laparoscopically inserted into the surgical environment to provide real-time images of said surgical environment

a controller having a processing means communicable with a controller's database, said controller configured to control the spatial position of said at least one surgical tool;

and the controller's database configured to store a predetermined set of rules according to which allowed and restricted movements of said at least one surgical tool are determined, each detected movement being determined as either an allowed movement or as a restricted movement according to said predetermined set of rules

a processor configured to perform real-time image processing of the said real-time images to

(i) detect said surgical tool in said real-time images and to estimate the 3D spatial position of said at least one surgical tool from said real-time images; and

(ii) automatically segment, in said real-time images, soft-tissue anatomical structures comprising nerves or blood vessels in an area around the surgical tool and classify regions in the area as prohibited areas or preferred areas based on the location of the segmented nerves or blood vessels as prohibited areas or preferred areas, wherein the endoscopic images used for (i) are the same real-time images used for (ii) and wherein allowed movements are movements directing said surgical tool towards preferred areas and wherein restricted movements are movements directing said surgical tool to a position that is within a predetermined distance from a prohibited area.

2 . The surgical controlling system according to claim 1 , wherein said predetermined set of rules comprises at least one rule selected from a group consisting of: most used tool rule, right tool rule, left tool rule, field of view rule, no fly zone rule, a route rule, environmental rule, operator input rule, proximity rule; collision prevention rule, history-based rule, tool-dependent allowed and restricted movements rule, preferred volume zone rule, preferred tool rule, movement detection rule, tagged tool rule, go-to rule, change of speed rule and any combination thereof.

3 . The surgical controlling system according to claim 2 , wherein said route rule comprises a communicable database storing predefined route in which said at least one surgical tool is configured to move within said surgical environment; said predefined route comprises n 3D spatial positions of said at least one surgical tool; n is an integer greater than or equal to 2; said allowed movements are movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions of said predefined route, and said restricted movements are movements in which said location of said at least one surgical tool is substantially different from said n 3D spatial positions of said predefined route.

4 . The surgical controlling system according to claim 2 , wherein said environmental rule comprises a communicable database; said communicable database configured to receive at least one real-time image of said surgical environment and is configured to perform real-time image processing of the same and to determine the 3D spatial position of hazards or obstacles in said surgical environment; said environmental rule is configured to determine said allowed and restricted movements according to said hazards or obstacles in said surgical environment, said restricted movements being movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said allowed movements are movements in which the location of said at least one surgical tool is substantially different from said 3D spatial positions; further wherein said hazards or obstacles in said surgical environment are selected from a group consisting of tissue, a surgical tool, an organ, an endoscope and any combination thereof.

5 . The surgical controlling system according to claim 2 , wherein said operator input rule comprises a communicable database; said communicable database is configured to receive an input from the operator of said system regarding said allowed and restricted movements of said at least one surgical tool; said operator input rule converts an allowed movement to a restricted movement and a restricted movement to an allowed movement; further wherein at least one of the following is being held true (a) said input comprises n 3D spatial positions; n is an integer greater than or equal to 3; wherein at least one of which is defined as allowed location and at least one of which is defined as restricted location, said allowed movements being movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions, and said restricted movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions; (b) said input comprises at least one rule according to which allowed and restricted movements of said at least one surgical tool are determined, the spatial position of said at least one surgical tool being controlled by said controller according to said allowed and restricted movements; said predetermined set of rules comprises at least one rule selected from a group consisting of: most used tool, right tool rule, left tool rule, field of view rule, no fly zone rule, route rule, environmental rule, operator input rule, proximity rule; collision prevention rule, preferred volume zone rule, preferred tool rule, movement detection rule, history-based rule, tool-dependent allowed and restricted movements rule, go-to rule and any combination thereof.

6 . The surgical controlling system according to claim 2 , wherein said proximity rule is configured to define a predetermined distance between at least two surgical tools; said allowed movements are movements which are within the range or out of the range of said predetermined distance, and said restricted movements which are out of the range or within the range of said predetermined distance.

7 . The surgical controlling system according to claim 2 , wherein said proximity rule is configured to define a predetermined angle between at least three surgical tools;

said allowed movements are movements which are within the range or out of the range of said predetermined angle, and said restricted movements which are out of the range or within the range of said predetermined angle.

8 . The surgical controlling system according to claim 2 , wherein said collision prevention rule is configured to define a predetermined distance between said at least one surgical tool and an anatomical element within said surgical environment; said allowed movements are movements which are in a range that is larger than said predetermined distance, and said restricted movements are movements which is in a range that is smaller than said predetermined distance; wherein said anatomical element is selected from a group consisting of tissue, organ, another surgical tool and any combination thereof.

9 . The surgical controlling system according to claim 2 , wherein said go-to rule comprises a communicable database; the communicable database is configured to receive an input comprising n 3D spatial positions; n is an integer greater than or equal to 1 said allowed movements being either movements in which said endoscope is re-directed to focus on at least one of said n 3D spatial positions, or movements in which said surgical tool is re-directed to position at least a portion of said tagged tool on at least one of said n 3D spatial positions.

10 . The surgical controlling system according to claim 2 , wherein at least one of the following is being held true (a) said system additionally comprising an endoscope; said endoscope is configured to provide real-time image of said surgical environment; (b) at least one of said surgical tools is an endoscope configured to provide at least one real-time image of said surgical environment.

11 . The surgical controlling system according to claim 10 , wherein at least one of the following is being held true (a) said right tool rule is configured to determine said allowed movement of said endoscope according to the movement of the surgical tool positioned to right of said endoscope; further wherein said left tool rule is configured to determine said allowed movement of said endoscope according to the movement of the surgical tool positioned to left of said endoscope; (b) said tagged tool rule comprises means configured to tag at least one surgical tool within said surgical environment and to determine said allowed movement of said endoscope to constantly track the movement of said tagged surgical tool; (c) said field of view rule comprises a communicable database comprising n 3D spatial positions; n is an integer greater than or equal to 2; the combination of all of said n 3D spatial positions provides a predetermined field of view; said field of view rule is configured to determine said allowed movement of said endoscope within said n 3D spatial positions so as to maintain a constant field of view, said allowed movements being movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said restricted movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions; (d) said preferred volume zone rule comprises a communicable database comprising n 3D spatial positions; n is an integer greater than or equal to 2; said n 3 D spatial positions provides said preferred volume zone; said preferred volume zone rule is configured to determine said allowed movement of said endoscope within said n 3D spatial positions and restricted movement of said endoscope outside said n 3D spatial positions, said allowed movements being movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said restricted movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions; (e) said preferred tool rule comprises a communicable database, said database stores a preferred tool; said preferred tool rule is configured to determine said allowed movement of said endoscope to constantly track the movement of said preferred tool; and any combination thereof; (f) said most used tool rule comprises a communicable database counting the amount of movement of each of said surgical tools; said most used tool rule is configured to constantly position said endoscope to track the movement of the most moved surgical tool; (g) said movement detection rule comprises a communicable database comprising the real-time 3D spatial positions of each of said surgical tool; said movement detection rule is configured to detect movement of said at least one surgical tool when a change in said 3D spatial positions is received, said allowed movements being movements in which said endoscope is re-directed to focus on the moving surgical tool; (h) in said change of speed rule, said system constantly monitors distance between said endoscope's tip and at least one object within a surgical environment, speed of said endoscope varying as a function of said distance; (i) said go-to rule comprises a communicable database; the communicable database is configured to receive an input comprising n 3D spatial positions; n is an integer greater than or equal to 1 said allowed movements being either movements in which said endoscope is re-directed to focus on at least one of said n 3D spatial positions or movements in which a tagged tool is re-directed to position at least a portion of said tagged tool on at least one of said n 3D spatial positions; and any combination thereof.

12 . The surgical controlling system according to claim 2 , wherein said no fly zone rule comprises a communicable database comprising n 3D spatial positions; n is an integer greater than or equal to 2; said n 3D spatial positions define a predetermined volume within said surgical environment; said no fly zone rule is configured to determine said restricted movement if said movement is within said no fly zone and allowed movement if said movement is outside said no fly zone, said restricted movements being movements in which said at least one of said surgical tool is located substantially in at least one of said n 3D spatial positions, and said allowed movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

13 . The surgical controlling system according to claim 1 , wherein said system further comprising a maneuvering subsystem communicable with said controller, said maneuvering subsystem is configured to spatially reposition said at least one surgical tool during a surgery according to said predetermined set of rules;

further wherein said system is configured to generate an alert when the classification indicates that the surgical tool is within said predetermined distance of a nerve or blood vessel segmented from the real-time images; wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

14 . The surgical controlling system according to claim 2 , wherein said history-based rule comprises a communicable database storing each 3D spatial position of each of said surgical tool, each movement of each surgical tool being stored; said history-based rule is configured to determine said allowed and restricted movements according to historical movements of said at least one surgical tool, said allowed movements being movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said restricted movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

15 . The surgical controlling system according to claim 2 , wherein said tool-dependent allowed and restricted movements rule comprises a communicable database; said communicable database is configured to store predetermined characteristics of at least one of said surgical tool; said tool-dependent allowed and restricted movements rule is configured to determine said allowed and restricted movements according to said predetermined characteristics of said surgical tool;

allowed movements being movements of said endoscope which tracks said surgical tool having said predetermined characteristics; wherein said predetermined characteristics of said surgical tool are selected from a group consisting of: physical dimensions, structure, weight, sharpness, and any combination thereof.

16 . The surgical controlling system of claim 2 , wherein, in said change of speed rule, said system constantly monitors the distance between said surgical tool 's tip and a nerve or blood vessel segmented from the real-time images and varies, the speed of said surgical tool as a function of said distance.