Operating device for medical-technical system workplaces

The invention is related to an operating device for apparatus combinations of medical-technical system workplaces, especially for the minimal invasive surgery. The individual apparatus of the apparatus combination are connected to a computer (28) having a monitor (30) and driven by way of foot-actuated actuating members. In order to improve the usability and flexibility, an actuating member fashioned to be a foot roller (56) provides computer compatible signals, while at least one further actuating member is formed to be a foot switch (58,60) and can be assigned to one of the apparatus-specific functional elements software-controlled by the actuation of the foot roller (56). A switch assignment field (88,90) assigned to the foot switch (58,60) for the symbolic display of the functional element assigned to the foot switch (58,60) at that time is provided on the monitor (30).

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
The invention relates to an operating device for apparatus combinations of 
medical-technical system workplaces, especially for open or minimal 
invasive surgery, comprising at least one computer which is connected to 
individual apparatus of the apparatus combination, a monitor, and an 
actuating structure provided for driving apparatus-specific functional 
elements and having a plurality of foot-actuatable actuating members. 
2. Description of the Prior Art 
In modern surgery medical-technical system workplaces a plurality of 
apparatus of different functions are simultaneously used. In the past, the 
antiseptically prepared surgeon could control the operation of the 
apparatus only by oral orders to auxiliary medical personnel. 
Misinterpretations of the orders and erroneous operation of the apparatus 
cannot always be avoided, especially if the personnel is inexperienced and 
unmotivated. Newly acquired and often complicated apparatus in the minimal 
invasive surgery field further complicate this situation. 
An improvement in this respect has already been achieved by the use of foot 
switches, by the use of which the surgeon can drive individual, 
predetermined functional elements of the apparatus combination. Even so, 
assigning new tasks to the actuating members is possible only by the use 
of additional operating elements which are not actuatable by foot. 
SUMMARY OF THE INVENTION 
It is the object of the present invention to provide an operating device of 
the type described above, which permits the surgeon to dependably operate 
even complicated system workplaces having a plurality of 
apparatus-specific functional elements exclusively by foot-actuation 
without the help of auxiliary personnel. 
The solution according to the invention is based on the foot-actuated 
actuating structure serving to drive apparatus-specific functional 
elements as well as being formed as an input device for the computer for 
transmitting computer-compatible control signals. The computer comprises 
program routines which are alternatively selectable by way of the 
actuating structure and are used for configuring selected functional 
elements, for alternatively assigning individual actuating members to 
configured functional elements, and for driving the functional elements by 
way of their assigned actuating members. To this end, the individual 
functional elements are connected to the computer by way of a bus system. 
The configuration is realized by assembling the required functional 
elements as well as by their parameterizing for a specific use. 
The measures according to the invention enable the surgeon to work 
effectively using the available functional elements as well as possible, 
without the need of assistance. If the need arises, the required 
functional elements may at any time be newly configured or parameterized, 
arbitrarily assigned to the individual actuating members, and driven by 
these. During this, the hands of surgeon remain free for working in the 
antiseptic region. 
On the other hand, in this type of multifunctional assignment of actuating 
members the simplicity of operation and the comprehensibility of the 
chosen setting should not be lost. In order to achieve this, according to 
an advantageous embodiment of the invention the actuating structure 
further comprises at least two foot switches and a foot roller which can 
be rotated as well as axially displaced. The operating device should 
preferably have at least one digitizing device which is coupled to one of 
the actuating members and which serves to generate computer-compatible 
output signals. The digitizing device coupled to the foot roller serves, 
for instance, for the software-supported motion control of a cursor on the 
monitor. To this end, an incremental transducer, which is dependent on the 
angle and direction of rotation, is advantageously connected to the roller 
in a non-rotatable manner. The incremental transducer may for instance 
comprise a two-track holed or slotted disk which is scanned by way of a 
fork-type light barrier or a toothed roller which is made of a 
magnetizable material and which can be scanned inductively. 
In order to be able to implement two-dimensional cursor movements on the 
monitor using the foot roller, two switching members which are actuatable 
in both directions by an axial movement of the foot roller and which serve 
to transmit computer-compatible control signals are additionally provided 
according to the invention. In this, the switching members which are 
actuatable by the axial movement of the foot roller may be connected to a 
switching structure for triggering a single switching impulse or a 
time-delayed series of switching impulses when the actuation is continuous 
(auto repeat function). The switching members may be formed to be limit 
switches, proximity switches or analog or digital path-measuring systems 
having a potentiometer function. In order to avoid errors in the axial 
actuation of the foot roller, the foot roller may be provided with lateral 
roller flange disks. 
In a prefered constructive embodiment of the operating device, the foot 
roller is positioned on a hollow shaft in a non-rotatable and axially 
moveable manner, the hollow shaft being borne on a pedestal in a manner 
which permits rotation about a horizontal axis and carrying the 
incremental transducer of the digitizing device, and inside of which a 
push rod which is rigidly coupled to the foot roller is positioned, the 
push rod being axially moveable and spring-centered, and bearing an 
actuating element, preferably formed to be a reflector disk, for the 
switching members. In order to avoid contamination, the foot roller and/or 
the push rod are sealed with respect to the hollow shaft in a fluid-tight 
manner. 
In order to increase t he clarity of the display one switch assignment 
window which is assigned to each of the foot switches is provided on the 
monitor for the symbolic display of the functional element assigned to the 
foot switches at that time. 
The reassignment of the foot switches may be performed simply and quickly 
if a function field is assigned to each apparatus-specific function 
element within a menu window alternatively displayed on the monitor, the 
menu window preferably being a scroll-down menu, and if the function 
fields are driveable by the cursor on the monitor by way of actuating the 
foot roller and selectable by actuating the affiliated foot switch, 
whereby the corresponding function symbol is transposed into the switch 
assignment window, so that a functional connection is established between 
the foot switch and the functional element symbolically displayed in the 
switch assignment window. It is of advantage when a symbol field which may 
be displayed together with the menu window is provided on the monitor for 
displaying the function symbol of the function element which is selected 
in the menu window at that time and which is to be transposed into the 
switch assignment field during the selection. For the selection of the 
program routines the foot switches or a pair of foot switches or the 
switching members which are actuatable by the axial movement may for 
instance be actuated within a predetermined small time interval. A similar 
effect may be achieved when two of the foot switches are actuated 
synchroneously in a predetermined time interval. In this manner the 
connection between a foot switch and the affiliated functional element may 
be created or acknowledged. 
In order to increase the clarity of the display and to improve the control 
of important data during the surgery, a status window for permanently 
displaying selectable operational and patient data is provided on the 
monitor. 
Especially during endoscopic surgery and laparoscopic surgery it is 
imperative to provide an image window for video images on the monitor, 
wherein a cursor which is controlled by the foot roller should be moveable 
in the image window in two dimensions. Of course the image window is also 
suited to view images from the central computer which were previously 
stored for the purpose of documentation or of images from an external 
storage medium. 
In order to be able to continue or finish undergoing surgery during a 
computer malfunction or a power failure, a safety circuit is provided 
which switches the foot switches and/or the foot roller through to the 
predetermined, apparatus-specific function elements during the computer 
malfunction or power failure.

DESCRIPTION OF THE PREFERRED EMBODIMENTS 
The systematic workplace schematically shown in FIG. 1 is located in an 
operating room having an operating table 10 and is intended to be used in 
minimal invasive surgery. The technique of minimal invasive surgery is 
used primarily in abdominal and thorax surgery, gynecology and urology. 
The systematic workplace comprises a collection of apparatus having a 
plurality of instruments, such as a laser surgery instrument 12, a 
HF-surgery apparatus 14, a cold light source 16, an irrigation and suction 
pump 13, an insufflator 20, an ultrasonic measuring device 22, a diagnosis 
device 24, and a camera control device 26. The apparatus 12 to 26 are 
connected to an input-output port of a computer 28 by way of a bus-system 
27, a monitor 30 having a screen 32 additionally being connected to the 
computer, which further makes data exchange with an external data archive 
34 possible. 
The actuation of the apparatus 12 to 26 and of the data exchange with the 
data archive 34 is softwarecontrolled by way of a foot-actuated 
operational control 36 through the bus system 27 common to all the 
apparatus. The operational control element 36 is se t up on the floor in 
the immediate vicinity of the operating table 10 and is foot-actuated by 
the surgeon 38. In laparoscopic surgery the operation is performed using 
an elongated instrument 46 inserted into the abdominal cavity through a 
metallic sheath. The operation site in the patient 40 is viewed using a 
video camera and an endoscope 42 and transmitted to an image window 44 of 
the screen 32 by way of the camera control device 26. The necessary 
illumination of the operation site is done by the cold light source 16 
which is connected to the endoscope 42. 
As can be seen from FIGS. 2 and 3, the operational control 36 consists 
mainly of a foot roller 56 rotatably supported on a horizontal axis 52 on 
the pedestal 48 and two foot switches 58, 60 positioned next to each other 
on the pedestal. The foot roller 56 is disposed in a non-rotatable and 
axially moveable manner on a hollow shaft 54 which in turn is rotatably 
support by bearings 50 of the pedestal 48. Located inside the hollow shaft 
54 is an axially moveable push rod 61, which is rigidly couplable to the 
foot roller 56 by way of a bolt 62 and which is held in a springcentered 
center position by two springs 64 in its neutral state. The bolt 62 
extends radially through a slot 66 in the hollow shaft 54, wherein the 
ends of the slot 66 form limit stops 68 for the guide roller 56 and the 
push rod 61 during the axial movement with respect to the hollow shaft 54 
in both directions. An increment disk 72 having slit-like openings (not 
shown) is positioned on the end of the hollow shaft 54 extending into the 
casing part 70 of the pedestal 48, the slit-like openings of the increment 
disk 72 forming together with the fork-type light barrier, which is 
rigidly mounted on the pedestal, an incremental transducer for the angle 
and direction of rotation of the foot roller 56. A plate-like reflecting 
disk 76 is disposed on the push rod 61, the reflecting disk cooperating 
together with the two reflecting-type light barriers 78 and an analyzing 
circuit in the sense of a proximity switch for the left and right movement 
of the foot roller 56. 
The two foot-switches 58, 60 are preferably formed to be push buttons, 
which close an electric circuit when pushed down against the force of a 
spring and which are therefore suited to execute electric switching 
functions. Their distance from one another is chosen such that they may 
also be actuated mutually by one foot. 
The incremental transducer 72, 74 responding to the rotation of the foot 
roller 56 is used for the one dimensional (vertical) motion control of a 
cursor 80 on the monitor screen 32, while the proximity switches 76, 78 
which are activated by the axial movement of the foot roller 56 are used 
for the step-wise lateral movement of the cursor 80, if need be 
incorporating an auto-repeat function. 
As can be seen from FIG. 1, the screen is subdivided during the operation 
of the systematic workplace into an image window 44, a permanently 
displayed status window 82 for the display of important apparatus and 
patient data, a menu window 84 having a scroll menu 86 driven by the foot 
roller, and a symbol field 87 as well as two permanently displayed switch 
assignment fields 88, 90 which are assigned to the two foot switches 58, 
60. 
The screens schematically shown in FIGS. 4a to f illustrate how a 
reassignment of the foot switches 58, 60 is performed with the aid of the 
foot roller 56. 
Initially the menu is called up by a corresponding program routine, for 
instance by the simultaneous actuation of the two foot switches 58, 60, 
and displayed on the screen 32. The momentary switch assignment is 
depicted by the symbols in the switch assignment fields 88, 90. As a 
comparison with FIG. 5 shows, the functions momentarily assigned to the 
foot switches 58, 60 are "CUT MONO" (monopolar cutting) on the one hand 
and "COAG.MONO" (monopolar coagulation) on the other hand. The cursor bar 
80 is located in the menu field "CUT MONO" (monopolar cutting), so that 
the corresponding symbol is displayed in the symbol field 87. When 
scrolling through the menu 86, the functional symbol displayed in the 
symbol field 87 changes in the sense of the assignment according to FIG. 
5. In order to reprogram the left foot switch 58 to correspond to the 
functional element "SUCTION", first the menu field shown in FIG. 4c is 
chosen and the corresponding symbol is then taken over from the symbol 
field 87 into the switch assigment window 88 by pushing down on the left 
foot switch 58. If additionally the foot switch 60 is to be assigned to 
the functional element "IRRIGATION", the menu field in question is elected 
(FIG. 4d and e) and the corresponding symbol is taken over from the symbol 
field 87 into the right switch window 90. For the final programming both 
foot switches 58, 60 are actuated together in a predetermined time 
interval of maximal 300 ms. The establishment of the functional connection 
is indicated by the disappearance of the menu window 84 (FIG. 4f). 
Apart from the functions shown in the scroll down menu according to FIGS. 
4a to e, the images from the image window 44 can be recorded (freeze) or 
recalled from the memory and displayed in the image window 44 (view) by 
way of the scroll down menue (cf. FIG. 5). 
In order to be able to finish an undergoing surgery in the case of a 
computer malfunctions there is provided a safety circuit (not shown) which 
ensures that in such a case the foot switches 58, 60 are each switched to 
one predetermined functional element independent from the software. 
In summary, the following can be stated: The invention is related to an 
operating device for apparatus combinations of medical-technical system 
workplaces, especially for the minimal invasive surgery. The individual 
apparatus of the apparatus combination are connected to a computer 28 
having a monitor 30 and driven by way of foot-actuated actuating members. 
In order to improve the usability and flexibility, an actuating member 
fashioned to be a foot roller 56 provides computer compatible signals, 
while at least one further actuating member is formed to be a foot switch 
58, 60 and can be assigned to one of the apparatus-specific functional 
elements software controlled by the actuation of the foot roller 56. A 
switch assignment field 88, 90 assigned to the foot switch 58, 60 for the 
symbolic display of the functional element assigned to the foot switch 58, 
60 at that time is provided on the monitor 30.