EP1876942A4 - Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique - Google Patents

Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique

Info

Publication number
EP1876942A4
EP1876942A4 EP06728279A EP06728279A EP1876942A4 EP 1876942 A4 EP1876942 A4 EP 1876942A4 EP 06728279 A EP06728279 A EP 06728279A EP 06728279 A EP06728279 A EP 06728279A EP 1876942 A4 EP1876942 A4 EP 1876942A4
Authority
EP
European Patent Office
Prior art keywords
endoscope
zoom
wireless transmitter
surgeon
key
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP06728279A
Other languages
German (de)
English (en)
Other versions
EP1876942A2 (fr
Inventor
Mordehai Sholev
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MST Medical Surgery Technologies Ltd
Original Assignee
MST Medical Surgery Technologies Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by MST Medical Surgery Technologies Ltd filed Critical MST Medical Surgery Technologies Ltd
Priority to EP10150239.1A priority Critical patent/EP2181645B1/fr
Priority to EP15178988.0A priority patent/EP2992811B1/fr
Publication of EP1876942A2 publication Critical patent/EP1876942A2/fr
Publication of EP1876942A4 publication Critical patent/EP1876942A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00011—Operational features of endoscopes characterised by signal transmission
    • A61B1/00016—Operational features of endoscopes characterised by signal transmission using wireless means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00149—Holding or positioning arrangements using articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/74—Manipulators with manual electric input means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00221—Electrical control of surgical instruments with wireless transmission of data, e.g. by infrared radiation or radiowaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00982—General structural features
    • A61B2017/00991—Telescopic means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A61B2017/3405—Needle locating or guiding means using mechanical guide means
    • A61B2017/3409—Needle locating or guiding means using mechanical guide means including needle or instrument drives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms

Definitions

  • the present invention generally relates to means and methods for improving the interface between the surgeon and an endoscope system for laparoscopic surgery. Moreover, this present invention discloses a camera holder mechanism for laparoscopic surgery and/or a device useful controlling an endoscope system for laparoscopic surgery, in which the endoscope is inserted through a small incision in the abdomen or chest.
  • the laparoscope is a sterile surgical instrument that has special optics that allows small amounts of light to be transmitted effectively. Carbon dioxide gas is pumped through a channel in the laparoscope into the abdomen. This creates a space within which the surgeon can look or operate. A laparoscopy is performed under a general anesthetic. A small cut measuring 1 to 2cm is made in or just below the belly-button. Through this cut, the laparoscope is gently introduced into the abdomen. Additional surgical instruments are often required.
  • US patent 6714841 discloses an automated camera endoscope in which the surgeon is fitted with a head mounted light source that transmits the head movements to a sensor, forming an interface that converts the movements to directions for the mechanical movement of the automated assistant.
  • Alternative automated assistants incorporate a voice operated interface, a directional key interface, or other navigational interfaces.
  • the above interfaces share the following drawbacks: a. Single directional interface that provide limited feedback to the surgeon b. Cumbersome serial operation for starting and stopping movement directions that requires the surgeon's constant attention. Research has suggested that these systems divert the surgeons focus from the major task at hand. Therefore technologies assisted by magnets and image processing have been developed to simplify interfacing control. However these improved technologies still fail to address another complicating interface aspect of laparoscopic surgery, they do not allow the surgeon to signal to both the automated assistant and to surgical colleagues, which instrument his attention is focused on.
  • each surgical device is fitted with a wireless transmitter.
  • the mechanism comprises a manipulating endoscope mechanism (1); comprising a telescopic arm, cables , springs and rods; a force carriage system (2) comprising cables, chains, rods; and, a manipulating system actuator (3) comprising motors and linear actuator.
  • the manipulating endoscope mechanism comprises a rotating link (12); linear links (11 a, b, c, d); gimbals ring mechanism (14); zoom leading bars (15); zoom and rotation endoscope mechanism (16); and cables tubes (13).
  • Another aspect of the present invention is a method of improving the interface between the surgeon and an endoscope system for laparoscopic surgery, controlling automated endoscope assistant, and/or holding a laparoscopic camera.
  • the method useful for surgeon-automated assistant interfacing comprises key depressing on the wireless transmitter in a certain fashion, transmitting a generic code received by the receiver, communicating said signal to the computer producing an temporary onscreen graphic symbol indicator on a random instrument, thereon repeating the depression of the key thereby shifting the indicator from onscreen one depiction of surgical instrument to another until the desired instrument is selected, achieving a selection input for the computer and directing it to maneuver the endoscope providing a camera view focused on the selected instrument area.
  • a method for controlling the spatial position of endoscope tube to any orientation in laparoscopic surgery comprises: manipulating the endoscope system to get an optimal field view; zooming the wanted region to get more precisions; rotating the endoscope around its length; and, analyzing the stable image shown at the monitor without the help of assistants.
  • the method comprises controlling the rotation angle of the endoscope along its long axis by changing the total length of said telescopic arm.
  • the method comprises performing a zoom movement into and out of the abdomen cavity, by shortening cable of said manipulating endoscope mechanism and by extending the length of said cable, without changing the endoscope orientation.
  • the method comprises disassembling the endoscope out of the zoom mechanism without changing any degree of freedom of the spatial position of said endoscope, by activating said endoscope independently of other moving parts of the mechanism, such that the entire system does not have to be re-positioned.
  • FIG. 1 is a general schematic view of an enhanced interface laparoscopic system that relies on a single wireless code signal to indicate the instrument on which to focus the endoscope constructed in accordance with the principles of the present invention in a preferred embodiment thereof;
  • FIG. 2 is a general schematic view of an enhanced interface laparoscopic system that relies on at least two wireless signals to indicate the instrument on which to focus the endoscope;
  • FIG. 3 is a schematic view of the method in which the single wireless code signal choice instrumentation focus is represented on the viewing apparatus;
  • FIG. 4 is a schematic view of the method in which multiple wireless code signal choice of instrumentation is operated
  • FIG.5 a is a schematic view of a wireless system
  • FIG.5b represents the relative position of each tool in respect to the mechanism
  • FIG.5c is a schematic view of the mechanism of the enhanced interface laparoscopic system
  • FIG.5d is a schematic cut view of the first part of the mechanism of the enhanced interface laparoscopic system
  • FIG.5e, 5f represent schematic different views of the entire mechanism of the enhanced interface laparoscopic system
  • FIG.5g schematically illustrates a mechanism with only one curved guide
  • FIG.5h schematically illustrates the four degrees of freedom of the mechanism
  • FIG. ⁇ a is a schematic view of the second part of the mechanism of the enhanced interface laparoscopic system
  • FIG.6b is a schematic view of the telescopic guide
  • FIG. 7a, b, c schematically present an illustrating example of a camera holder mechanism for laparoscopic surgery
  • FIG. 8 illustrates the way in which the endoscope is inserted through a small incision in the abdomen or chest
  • FIG. 9 a, b, c present a schematic illustration of U.S Pat 6,714,841 which describes prior art technologies
  • FIG. 10 presents a schematic and illustrated drawing of the entire system according to one embodiment of the present invention which comprises three main parts a manipulating endoscope mechanism (1); a force carriage system (2); and a manipulating system actuator (3);
  • FIG. 11 presents a schematic illustration of the endoscope system according to one embodiment of the present invention
  • FIG. 12 is a schematic view of the endoscope system illustrating the motion of the orientation ring relatively to the basis ring;
  • FIG. 13 is a schematic view of the zoom mechanism according to one embodiment of the present invention.
  • FIG. 14 is a schematic view of the orientation ring different position;
  • FIG. 15 presents a schematic description of the rotation mechanism;
  • FIG. 16 represents the portable feature of the mechanism;
  • FIG. 17 is a schematic view of the mechanism placed beside a bed;
  • FIG. 18a, b, 19a, b, 20 represent three different options for the zoom mechanism: 18 a and b with parallelogram rods, 19 a and b with a ring zoom and 20 a and b with a reduction force device;
  • FIG. 21 presenting a schematic section view of the pulley blocks located on the endoscope motion mechanism
  • FIG. 22 is a three-dimension schematic view of figure 21;
  • FIG. 23 is a schematic view of the zoom mechanism obtained by rotating cable which turns a central screw with joins in different directions;
  • FIG. 24 presents a schematic and illustrated drawing of the entire system according to one embodiment of the present invention which comprises three main parts a manipulating endoscope mechanism (1); a force carriage system (2); and a manipulating system actuator (3);
  • FIG. 25 presents a schematic illustration of the manipulating endoscope mechanism
  • FIG. 26 presents a schematic cut view along the sliding links 1 Ia, b, c of figure 25;
  • FIG. 27 presents the zoom mechanism, according to another embodiment of the present invention.
  • FIG. 28a schematically presents the principle mechanism that controls the linear movement of the endoscope according to another embodiment of the present invention
  • FIG. 28b, c schematically present the rotation mechanism according to another embodiment of the present invention
  • FIG. 29 schematically presents the envelope of the endoscope range of movement
  • FIG. 30 schematically presents the way the mechanism acts to controls one angle of the endoscope by changing the total length of the telescopic arm
  • FIG. 31 schematically presents the way the mechanism acts to controls another angle ( ⁇ ) of the endoscope by rotating telescopic arm;
  • FIG. 32a schematically presents the portable feature of the mechanism
  • FIG. 32b schematically presents an upper view of the position abilities of the system: the rotation angle ⁇ , and the horizontal position X slider.
  • the present invention can be also utilized to improve upon the interface between surgeon and mechanical and human assistants by communicating the surgeon's current instrument of choice thereby directing the endoscope to focus on the choice.
  • the technology relies on marrying a conventional laparoscopic system with data obtained button operated small wireless transmitters.
  • a single wireless emission code is utilized and choice is achieved by a visible graphic representation upon the conventional viewing screen.
  • each instrument is fitted with a unique code wireless transmitter, and selection is achieved by depressing its button.
  • the present invention discloses also an interface device to be married with conventional camera assisted laparoscopic surgery systems comprising at least one wireless transmitter that may or may not be attached to the maneuvering control end of surgical instruments.
  • a generic or a unique code is transmitted to a receiving device connected to a computer that presents the selection on a connected video screen.
  • Confirmation of the selection by the depression of at least one button on wireless transmitter transmits a code to the receiver connected to the computer that instructs the automated surgical assistant to move the endoscope achieving a view on the screen that is focused on the selected instrument area.
  • an enhanced interface laparoscopy device comprising: a. At least one wireless transmitter with at least one operating key. b. At least one wireless receiver. c. At least one conventional laparoscopy computerized system loaded with conventional surgical instrument spatial location software, and conventional automated assistant maneuvering software. d. Software loaded onto to the conventional laparoscopy system that enables a visual response to the depression of at least one key on the wireless transmitter as well as an interface with the conventional automated assistant maneuvering software so as to achieve movement of the endoscope. e. At least one video screen. f. At least one automated assistant.
  • the wireless transmitter or transmitters are either freestanding or attached to the maneuvering end of the surgical instruments and emit the same single code that upon the depression of at least one key on them emits a signal to the receiver that communicates with the connected computer that superimposes a graphic symbol upon a random choice of one of the onscreen surgical instruments depicted by the computer on the connected computer screen.
  • the surgeon repeats the depression of at least one key resulting in a shift in the superimposed graphic designator from one onscreen depiction of surgical instrument to another until the desired instrument is reached and thereby selected.
  • the computer directs the automated assistant to focus the endoscope on the desired instrument area.
  • the selection of the instrument requires confirmation by varying the form of click on at least one key, such as a prolonged depression. Only upon confirmation is the computer authorized to instruct the automated assistant to focus the endoscope on the desired instrument area.
  • each relevant surgical instruments is fitted at its maneuvering control end with a wireless transmitter with at least one key that transmits a unique code.
  • the surgeon identifies each of the instruments to the computerized system by depressing at least one key on each of the wireless transmitters fitted to the surgical instruments and matching their characteristics with a prepared database, thereby forming within the computerized system a unique signature for each of the transmitters.
  • the receiver upon depression of at least one key on the wireless transmitter attached to each surgical instrument, the receiver receives the unique code communicates it to the computer that identifies it with the preprogrammed signature and instructs the automated assistant to move the endoscope so as to achieve the desired focus.
  • the selection is signified on the connected screen by superimposing a graphic symbol upon the onscreen depiction of the surgical.
  • the selection is confirmed by an additional mode of depression of at least one key on the wireless transmitter, such as a prolonged depression of the key, authorizing the computer to instruct the automated assistant to change view provided by the endoscope.
  • the device of the present invention has many technological advantages, among them:
  • FIG 1 is a general schematic view of an enhanced interface laparoscopic system comprising one or more button operated wireless transmitters 12a, that may or may not be attached to the maneuvering end of surgical instruments 17b and 17c, which once depressed aerially transmit a single code wave 14 through aerial 13 to connected receiver 11 that produces a signal processed by computer 15 thereby assigning a particular one of two or more surgical instruments 17b and 17c as the focus of the surgeons attention.
  • a conventional automated endoscope 21 is maneuvered by means of conventional automated arm 19 according to conventional computational spatial placement software contained in computer 15 .
  • FIG 2 is a is a general schematic view of an enhanced interface laparoscopic system comprising one or more button operated wireless transmitters 12b and 12c are attached respectfully to the maneuvering means at the end of surgical instruments 17b and 17c, which once depressed aerially, each transmit a unique code wave 14b and 14c through aerial 13 to connected receiver 11 that produces a signal processed by computer 15 thereby assigning a particular one of two or more surgical instruments 17b and 17c as the focus of the surgeons attention.
  • a conventional automated endoscope 21 is maneuvered by means of conventional automated arm 19 according to conventional computational spatial placement software contained in computer 15 .
  • figure 3 is a is a schematic view of the method in which single wireless signal code choice of instrumentation focus is achieved, by means of video representation 35b and 35c of the actual surgical instruments (not represented in fig.3) superimposed by graphic symbols.
  • a light depression of the button on generic code emitting wireless transmitter 12a transmits a code that is received by receiver aerial 13 communicated through connected receiver 11 to computer 15 that shifts the graphically superimposed symbol of choice 35b on video screen 30 from instrument to instrument until the required instrument is reached.
  • a prolonged depression of the button on transmitter 12a confirms the selection thereby signaling computer 15 to instruct the automated mechanical assistant (not represented in fig. 3) to move the endoscope (not represented in f ⁇ g.3) and achieving a camera view of the instrument area on screen 30.
  • FIG 4 is a schematic view of the method in which multiple wireless signal code choice of instrumentation focus is achieved, by means of video representation 35b and 35c of the actual surgical instruments (not represented in fig.4) superimposed by graphic symbols.
  • buttons on unique code emitting wireless transmitters 12b and 12c attached respectfully to actual operational instruments superimposes graphic symbol 35b on respectful video representation 37b.
  • a prolonged depression of the button on transmitter 12a confirms the selection thereby signaling computer 15 to instruct the automated mechanical assistant (not represented in fig. 4) o move the endoscope (not represented in fig.4) and achieving a camera view of the instrument area on screen 30.
  • FIG. 5a illustrating an example of a wireless system.
  • the wireless device attached to the tool transmits three action codes to the camera holder positioning sensors array: zoom up, zoom down, change position to get better view of a tool.
  • FIG. 5b illustrating the relative position of each tool in respect to the mechanism: while performing the surgery the surgeon often changes the position of his tools and even their insertion point.
  • the wireless switches then may be use to locate the relative angle in which each tool is being held in respect to the camera holder mechanism.
  • This is another advantage of the system that is used to calculate the position of the tool in the frame captured by the video camera. In that manner the surgeon does not have to inform the system where the insertion point of every tool is.
  • the exact location of the wireless switch does not measured: the information about the relative positions of the tools in respect to each other contains in most cases enough data for the software to maintain the matching between the switches and the tools.
  • the positioning sensors of the system are placed near or on the camera holder so the signals they receive can be utilize in order to calculate the vectors Vl V2 ...Vn representing the range and the 3 angles needed to define a point in a 3D space .
  • many well known technologies may be used. For example if the switches emit wireless signals then an array of antennas may be used to compare the power of the signal received at each antenna in order to determine the angle of the switch and it's approximate range to the camera holder mechanism. If the switch emits ultra sound wave then US microphones can be used to triangulate the position of the switch. The same is for light emitting switch. At any case this position system does not included in the scope of this invention.
  • FIG. 5c illustrating the mechanism of the system which enables the positioning of an endoscope while performing a laparoscopy surgery .
  • the system consists on two main components: the first part has an arc shape in which the endoscope can be driven back and forth and at the same time can be move from side to side; the second part is characterized by zoom and rotation properties.
  • the mechanism allows the moving and the positioning of the endoscope in the angles of 0°-180° back and forth and O 0 - 180° side to side.
  • the first consists of arc shape housing which moves a gimbal mechanism along an arc shape guide.
  • the base of the arc includes a housing containing a lead screw that moves a nut back and forth.
  • the moving nut is connected to the gimbal with rigid links that transfer the linear nut movement to the gimbals mechanism resulting its movement back and forth along the arc shape guide.
  • the lead screw housing (back forth screw housing) is connected to another mechanism which rotates the first part from side to side around the long axis of the lead screw. This mechanism also supply the moments needed to rotate the lead screw.
  • This design allows the motors that move the first part to be connected from a distance preferably by flexible shafts. The separation is a very useful feature because at that manner the presence of the mechanism becomes minor.
  • FIG. 5d illustrating a cut view of the first part.
  • Rotating the lead screw cause the linear movement of the moving nut.
  • the nut moves forward, it pushes the link that is connected to.
  • the link movement is guided by tiny wheels that are placed in the curved guide way.
  • the movement of the link is passed to the outer gimbal directly via a connector or like in fig. 5c via another link.
  • the second part includes a tiny mechanism enabling the movement of the endoscope in two other manners: a zoom movement, where the endoscope moves along its long axis and a rotation movement of the endoscope around its long axis.
  • the mechanism In order to produce the zoom movement, the mechanism consists of a wire and spring.
  • the spring moves the endoscope in the upper direction and the wire which is wrapped on the drum pull the endoscope downward.
  • the exact position is determined by the length of the wire and the force applied by the spring causing the wire to be streched at any desired position.
  • a worm gear transmission is used to convert the rotation of the flexible shafts into a change of the wire length.
  • the telescopic guide serves the two purpose of preventing a possible rotation of the housing of the mechanism and centering the outer spring.
  • the camera holder comprises a motor house 301 and a zoom and roll mechanism 302, a sliding DF, a rotating DF, arms for polling the slider (300) and tubes with flexible wire that transmit the rotation moment to the component of the zoom mechanism (303).
  • the present invention generally relates to means and methods of controlling an endoscope system for laparoscopic surgery, in which the endoscope is inserted through a small incision in the abdomen or chest as illustrated in figure 8.
  • the present device is cheap, easily install and disassemble, comfortable to use, not limiting the dexterity of the surgeon and having small physical dimension.
  • the small size of present invention is achieved by applying the following steps:
  • FIG 11 presenting a schematic illustration of the entire device according tone embodiment of the present invention.
  • Said device inter alia comprising a grasp ring (1); Zoom mechanism (2); Orientation ring (3); Cables Li and L 2 (4); a spring (5); and a basis ring (6).
  • (7) Described the pinhole in the operated body.
  • the orientation ring is moved relatively to the basis ring and get to an equilibrium point as illustrated in fig.12.
  • the mechanism includes an additional zoom option that acts independently of cable lengths L 1 , L 2 , L 3 .
  • the zoom action is the endoscope movement in front and backward without changing the orientation.
  • the zoom mechanism is schematically described in figure 13.
  • the different lengths of the three cables, when tensing fix the place of the orientation ring as illustrated in figure 14.
  • the mechanism controlling the cables length allows a shifting of the orientation cable and an inclination of the tube to a wanted angle.
  • the endoscope has to rotate around its length axis when the surgeon operates without changing the orientation.
  • figure 15 presenting a schematic description of the rotation mechanism.
  • a tiny motor wraps the Z cable.
  • the stake system allows on one hand a reduction of the required force that compress the spring , and one the other hand an augmentation of the zoom movement sensibility. In order to obtain a small zoom movement, many windings are required.
  • the realization of the zoom mechanism can be done by rotating cable which turns a central screw with joins in different directions as illustrated in figure 23.
  • the device comprises inter alia a manipulating endoscope mechanism (1); a force carriage system (2); and a manipulating system actuator (3).
  • FIG 25 presenting a schematic illustration of the manipulating endoscope mechanism (1).
  • the mechanism comprises inter alia a rotating link (12); linear links (11 a, b, c, d); gimbals ring mechanism (14); zoom leading bars (15); zoom and rotation endoscope mechanism (16); cables tubes (13).
  • the pinhole in the operated body is illustrated by 70, where the endoscope (4) passes through into the abdomen cavity.
  • FIG 26 presenting a schematic cut view along the sliding links l la,b,c.
  • the cable head 17 is mounted in a hole at the head of link 11a.
  • the links 11a is pulled by cable 18 it slide into links lib against the pushing force of springs 19 a, b and therefore the distance between the center of the gimbals 14 and the center of the rotating link 12 becomes shorter.
  • springs 19 push links 1 Ia out of links 1 Ib and 1 Ib out of links l ie, and the distance between the center of the gimbals 14 and the center of the rotating link 12 becomes longer, in both cases the gimbals is moved relatively to the pinhole and changes the orientation of the endoscope.
  • the zoom action is the endoscope movement into (zoom in) and out of the abdomen cavity (zoom out), without changing the endoscope orientation.
  • the "zoom in” action is obtained by shortening cable 16a
  • the "zoom out” action is obtained by extending the length of cable 16a.
  • the springs 19a and 19b tend to increase the angle between the pair of links 15a 15b, and the pair 15c 15d and so to produce the "zoom out” movement.
  • the length of cable 16a determines the amount of the "zoom in”.
  • Box 16 contains two separate mechanisms that control the linear movement of the endoscope e.g. "zoom in”, "zoom out” and the rotation angle of the endoscope along the long axis.
  • figure 28a presenting schematically a principle mechanism that controls the linear movement of the endoscope e.g. "zoom in”, “zoom out” by changing the length of cable 16a length.
  • the ability to rotate about the endoscope along its long axis is essential in laparoscopic surgery. While rotating the endoscope through the insertion point (7) in order to change the endoscope orientation e.g. combination of angle ⁇ and angle ⁇ shown at figure 29, a component of the angular change may be not along the long axis of the endoscope. This angular component may cause undesirable rotation of the endoscope, which in result, cause annoying rotating movement of the picture as viewed on the surgeon's video screen.
  • the person that holds the endoscope intuitively, makes the needed changes to keep the operation scenery without uii desirable rotation e.g., keeping the moving picture parallel to it self at all time.
  • FIG 28b and figure 28c presenting the rotation mechanism, filling the needs mentioned above, and also allowing fast removal of the endoscope in order to clean its lens.
  • the cog-wheel 163 allows the endoscope rod 4 to cross through its center and to make roll and sliding movements.
  • the peg 164 arises from cog-wheel 163 upper surface.
  • a disk 165 is tightened to the endoscope rod 4. While assembling the endoscope the upper wall of the box 16 is opened and the endoscope is entered through cog-wheel 163 center, into a hole in the lower wall and through ring e.g. gimbals 14 until the peg 164 is threaded into aperture 166 of disk 165.
  • the upper wall of box 16 is closed, keeping the endoscope from moving out of box 16, to ensure coupling between the endoscope and the entire zoom mechanism.
  • the rotation of the endoscope along is achieved by rotating the screw 162 that moves cog-wheel 163 and the endoscope 4 via coupled disk 165.
  • the source of the movement of screw 162 can be a rotating cable transmitting the rotation movement from "remote" motor or small motor placed in or near box 16.
  • FIG 30 presenting schematically the way the mechanism acts to controls one angle of the endoscope by changing the total length of the telescopic arm.
  • Activating the sliding mechanism causes the movement of gimbals rings 14 from point A to point B causing endoscope 4 to rotate about the insertion point 70, to a desired position Pl .
  • the distance between gimbals 14 and the insertion point 70 changes, causing an undesired zoom movement.
  • the distance of this movement can be calculated and compensated by a controlled zoom motion.
  • FIG 31 schematically presenting the way the mechanism acts to controls another angle e.g. ⁇ of the endoscope by rotating telescopic arm.
  • Figure 31 shows the angular movement of endoscope 4 that was at starting position P 0 .
  • Activating the rotating mechanism causes the movement of gimbals rings 14 in a radial movement, from point A to point B e.g. angle ⁇ , causing endoscope 4 to rotate about the insertion point 70, by angle ⁇ , to a desired position Pl.
  • the distance between gimbals 14 and the insertion point 70 changes, causing an undesired zoom movement.
  • the distance of this movement can be calculated and compensated by a controlled zoom motion.
  • the combination of the two independent movements of the mechanism arm enables the surgeon to move the endoscope to any orientation, and reach any desired point within the working envelope.
  • FIG 32a shows schematically from upper view, the position abilities of the system: the rotation angle ⁇ , and the horizontal position X slider.

Abstract

La présente invention concerne un moyen et des procédés qui permettent d'améliorer l'interface entre le chirurgien et un système d'endoscope dans le cadre de la chirurgie laparoscopique, de maintenir une caméra laparoscopique et/ou de commander un assistant d'endoscope automatisé. Le moyen comprend au moins un émetteur sans fil doté d'au moins une clé opératoire; au moins un récepteur sans fil; au moins un système informatisé de laparoscopie classique dans lequel est chargé un logiciel de localisation spatiale de l'instrument chirurgical classique et un logiciel de manoeuvre d'assistant automatisé classique, le logiciel chargé dans le système laparoscopique classique permettant d'obtenir une réponse visuelle à l'abaissement d'une touche située sur l'émetteur sans fil; ainsi qu'une interface dotée du logiciel de manoeuvre d'assistant automatisé classique de manière à assurer le déplacement de l'endoscope, et au moins un écran vidéo.
EP06728279A 2005-04-18 2006-04-20 Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique Withdrawn EP1876942A4 (fr)

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EP10150239.1A EP2181645B1 (fr) 2005-04-18 2006-04-20 Dispositif d'amélioration de chirurgie de laparoscopie
EP15178988.0A EP2992811B1 (fr) 2005-04-18 2006-04-20 Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique

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US67201005P 2005-04-18 2005-04-18
US70519905P 2005-08-04 2005-08-04
US71695305P 2005-09-15 2005-09-15
US71695105P 2005-09-15 2005-09-15
PCT/IL2006/000478 WO2006111966A2 (fr) 2005-04-18 2006-04-20 Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique

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EP15178988.0A Division EP2992811B1 (fr) 2005-04-18 2006-04-20 Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique

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EP15178988.0A Not-in-force EP2992811B1 (fr) 2005-04-18 2006-04-20 Moyen et procedes permettant d'ameliorer la chirurgie laparoscopique
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EP10150239.1A Active EP2181645B1 (fr) 2005-04-18 2006-04-20 Dispositif d'amélioration de chirurgie de laparoscopie

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JP (2) JP2008538314A (fr)
CN (1) CN101184429A (fr)
BR (1) BRPI0607526A2 (fr)
CA (2) CA2621738A1 (fr)
WO (1) WO2006111966A2 (fr)

Families Citing this family (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9943372B2 (en) 2005-04-18 2018-04-17 M.S.T. Medical Surgery Technologies Ltd. Device having a wearable interface for improving laparoscopic surgery and methods for use thereof
US9789608B2 (en) 2006-06-29 2017-10-17 Intuitive Surgical Operations, Inc. Synthetic representation of a surgical robot
US10008017B2 (en) 2006-06-29 2018-06-26 Intuitive Surgical Operations, Inc. Rendering tool information as graphic overlays on displayed images of tools
US10258425B2 (en) 2008-06-27 2019-04-16 Intuitive Surgical Operations, Inc. Medical robotic system providing an auxiliary view of articulatable instruments extending out of a distal end of an entry guide
US9718190B2 (en) 2006-06-29 2017-08-01 Intuitive Surgical Operations, Inc. Tool position and identification indicator displayed in a boundary area of a computer display screen
EP2073685B1 (fr) 2006-09-21 2024-02-14 Great Belief International Limited Système de positionnement endoscopique
US9289266B2 (en) 2006-12-01 2016-03-22 Boston Scientific Scimed, Inc. On-axis drive systems and methods
US9089256B2 (en) 2008-06-27 2015-07-28 Intuitive Surgical Operations, Inc. Medical robotic system providing an auxiliary view including range of motion limitations for articulatable instruments extending out of a distal end of an entry guide
US8620473B2 (en) 2007-06-13 2013-12-31 Intuitive Surgical Operations, Inc. Medical robotic system with coupled control modes
US9469034B2 (en) 2007-06-13 2016-10-18 Intuitive Surgical Operations, Inc. Method and system for switching modes of a robotic system
EP2170204A2 (fr) 2007-07-02 2010-04-07 M.S.T. Medical Surgery Technologies Ltd Système de positionnement d'un endoscope et autres instruments chirurgicaux
GB2454017A (en) * 2007-10-26 2009-04-29 Prosurgics Ltd A control assembly
JP2009136538A (ja) * 2007-12-07 2009-06-25 Univ Of Tokyo 眼科手術支援装置及びこれを用いた眼科手術支援システム
EP2323538A4 (fr) * 2008-08-14 2013-10-30 Mst Medical Surgery Technologies Ltd Système man uvrable de laparoscopie à n degrés de liberté (ddl)
US10507071B2 (en) * 2009-05-11 2019-12-17 Carefusion 2200, Inc. Hand actuated, articulating device having an electric force enhancement system
US9492927B2 (en) 2009-08-15 2016-11-15 Intuitive Surgical Operations, Inc. Application of force feedback on an input device to urge its operator to command an articulated instrument to a preferred pose
CN101947150B (zh) * 2010-09-11 2012-02-08 山东科技大学 实现多自由度假肢对随机目标进行空间定位的方法
KR101598773B1 (ko) * 2010-10-21 2016-03-15 (주)미래컴퍼니 수술용 로봇의 움직임 제어/보상 방법 및 장치
EP2648603B1 (fr) 2010-12-08 2020-02-05 The Board of Regents of the University of Nebraska Système de laparoscope portable
JP6021353B2 (ja) 2011-08-04 2016-11-09 オリンパス株式会社 手術支援装置
JP6000641B2 (ja) 2011-08-04 2016-10-05 オリンパス株式会社 マニピュレータシステム
JP6081061B2 (ja) 2011-08-04 2017-02-15 オリンパス株式会社 手術支援装置
JP6009840B2 (ja) 2011-08-04 2016-10-19 オリンパス株式会社 医療機器
JP5953058B2 (ja) 2011-08-04 2016-07-13 オリンパス株式会社 手術支援装置およびその着脱方法
CN103648425B (zh) 2011-08-04 2016-10-19 奥林巴斯株式会社 医疗用机械手和手术支援装置
JP5931497B2 (ja) 2011-08-04 2016-06-08 オリンパス株式会社 手術支援装置およびその組立方法
JP6021484B2 (ja) 2011-08-04 2016-11-09 オリンパス株式会社 医療用マニピュレータ
EP2740434A4 (fr) 2011-08-04 2015-03-18 Olympus Corp Manipulateur médical et procédé de commande associé
JP5841451B2 (ja) 2011-08-04 2016-01-13 オリンパス株式会社 手術器具およびその制御方法
JP5936914B2 (ja) 2011-08-04 2016-06-22 オリンパス株式会社 操作入力装置およびこれを備えるマニピュレータシステム
JP6005950B2 (ja) 2011-08-04 2016-10-12 オリンパス株式会社 手術支援装置及びその制御方法
WO2013027202A2 (fr) * 2011-08-21 2013-02-28 M.S.T. Medical Surgery Technologies Ltd. Dispositif et méthode pour assister une approche fondée sur des règles de chirurgie laparoscopique
US9204939B2 (en) 2011-08-21 2015-12-08 M.S.T. Medical Surgery Technologies Ltd. Device and method for assisting laparoscopic surgery—rule based approach
US10866783B2 (en) 2011-08-21 2020-12-15 Transenterix Europe S.A.R.L. Vocally activated surgical control system
US9795282B2 (en) 2011-09-20 2017-10-24 M.S.T. Medical Surgery Technologies Ltd Device and method for maneuvering endoscope
US10507066B2 (en) 2013-02-15 2019-12-17 Intuitive Surgical Operations, Inc. Providing information of tools by filtering image areas adjacent to or on displayed images of the tools
DE102013108228A1 (de) * 2013-07-31 2015-02-05 MAQUET GmbH Assistenzeinrichtung zur bildgebenden Unterstützung eines Operateurs während eines chirurgischen Eingriffs
DE102013109677A1 (de) * 2013-09-05 2015-03-05 MAQUET GmbH Assistenzeinrichtung zur bildgebenden Unterstützung eines Operateurs während eines chirurgischen Eingriffs
GB201320238D0 (en) * 2013-11-15 2014-01-01 Laflamme Eric K Pneumatically actuated computer mouse system
CN104287844B (zh) * 2014-10-28 2016-08-17 高宏 蛇形扶镜器
KR101666103B1 (ko) * 2015-02-02 2016-10-13 하이윈 테크놀로지스 코포레이션 내시경의 위치를 결정하는 방법 및 이에 사용되는 위치 결정 보조장치
CN104605924A (zh) * 2015-02-12 2015-05-13 济南华奥医药科技有限公司 一种双驱动自动化内窥镜手术操作系统
CN107920863B (zh) * 2015-08-13 2021-12-31 西门子医疗有限公司 用于控制包括成像模态的系统的设备和方法
CN105832420A (zh) * 2016-05-17 2016-08-10 遵义医学院附属医院 一种带自动定位显像功能的单孔腔镜操作装置及其操作方法
CN105769328A (zh) * 2016-05-17 2016-07-20 遵义医学院附属医院 一种带自动定位显像功能的腔镜操作装置及其操作方法
CN106371374A (zh) * 2016-11-07 2017-02-01 福州幻科机电科技有限公司 一种微创内窥镜四自由度定位机的智能控制电路系统
CN106859766B (zh) * 2017-01-23 2019-03-26 深圳市人民医院 用于骨干骨折髓内复位的导航系统
CN108760632B (zh) * 2018-05-25 2021-04-23 于佳骏 茶树精细化栽培生育性状实时监测方法
WO2020059007A1 (fr) * 2018-09-18 2020-03-26 オリンパス株式会社 Système d'entraînement endoscopique, dispositif de commande et support d'enregistrement
CN111658126A (zh) * 2020-05-29 2020-09-15 杭州电子科技大学 一种组织识别的自动切换功率手术系统
CN114305703B (zh) * 2022-03-11 2022-06-17 极限人工智能(北京)有限公司 多功能通道器和微创手术机器人
CN115445039B (zh) * 2022-09-19 2023-09-29 无锡仁诺科技发展有限公司 自动位移自动搜寻声门并置入气管导管的智能插管系统

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5184601A (en) * 1991-08-05 1993-02-09 Putman John M Endoscope stabilizer
US5571072A (en) * 1995-04-28 1996-11-05 Kronner; Richard F. Dual-axis endoscope holder
WO2003092518A1 (fr) * 2002-05-02 2003-11-13 Gmp Surgical Solutions, Inc. Appareil de positionnement d'un instrument medical par rapport a un patient
US20030229338A1 (en) * 2000-11-03 2003-12-11 Irion Klaus M. Device for holding and positioning an endoscopic instrument

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5417210A (en) * 1992-05-27 1995-05-23 International Business Machines Corporation System and method for augmentation of endoscopic surgery
US5279309A (en) * 1991-06-13 1994-01-18 International Business Machines Corporation Signaling device and method for monitoring positions in a surgical operation
JPH0663003A (ja) 1992-08-20 1994-03-08 Olympus Optical Co Ltd スコープホルダー
US6714841B1 (en) 1995-09-15 2004-03-30 Computer Motion, Inc. Head cursor control interface for an automated endoscope system for optimal positioning
DE10025285A1 (de) * 2000-05-22 2001-12-06 Siemens Ag Vollautomatische, robotergestützte Kameraführung unter Verwendung von Positionssensoren für laparoskopische Eingriffe
JP2002306504A (ja) * 2001-04-18 2002-10-22 Olympus Optical Co Ltd 外科手術システム
FR2839440B1 (fr) 2002-05-13 2005-03-25 Perception Raisonnement Action Systeme de positionnement sur un patient d'un dispositif d'observation et/ou d'intervention
JP4236436B2 (ja) * 2002-09-19 2009-03-11 オリンパス株式会社 内視鏡外科システム

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5184601A (en) * 1991-08-05 1993-02-09 Putman John M Endoscope stabilizer
US5571072A (en) * 1995-04-28 1996-11-05 Kronner; Richard F. Dual-axis endoscope holder
US20030229338A1 (en) * 2000-11-03 2003-12-11 Irion Klaus M. Device for holding and positioning an endoscopic instrument
WO2003092518A1 (fr) * 2002-05-02 2003-11-13 Gmp Surgical Solutions, Inc. Appareil de positionnement d'un instrument medical par rapport a un patient

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO2006111966A2 *

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CA2606476A1 (fr) 2006-10-26
WO2006111966A3 (fr) 2007-11-01
CA2621738A1 (fr) 2006-10-26
BRPI0607526A2 (pt) 2014-04-08
WO2006111966A2 (fr) 2006-10-26
EP2181645A1 (fr) 2010-05-05
EP2992811B1 (fr) 2018-03-07
EP2181645B1 (fr) 2014-09-03
CN101184429A (zh) 2008-05-21
JP2008155031A (ja) 2008-07-10
EP2992811A1 (fr) 2016-03-09
JP2008538314A (ja) 2008-10-23
EP1876942A2 (fr) 2008-01-16

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