EP2588019A1 - Instrument chirurgical notamment pour chirurgie peritoneale - Google Patents
Instrument chirurgical notamment pour chirurgie peritonealeInfo
- Publication number
- EP2588019A1 EP2588019A1 EP11727993.5A EP11727993A EP2588019A1 EP 2588019 A1 EP2588019 A1 EP 2588019A1 EP 11727993 A EP11727993 A EP 11727993A EP 2588019 A1 EP2588019 A1 EP 2588019A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- surgical instrument
- inner tube
- outer tube
- tool holder
- stand
- 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- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/062—Needle manipulators
-
- 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
- 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
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3201—Scissors
-
- 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
-
- 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
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- 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
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
- A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2908—Multiple segments connected by articulations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
- A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
Definitions
- the invention relates to a surgical instrument, in particular for peritoneal surgery. It is recalled that a peritoneal intervention is an intervention located inside the abdominal cavity.
- Surgical instruments having an elongated body which are terminated by a tool holder and which are intended to be introduced into the peritoneal cavity by a trocar are known.
- this type of surgical instrument then allows only one rotation of the tool around the longitudinal axis of the surgical instrument. You can also tilt the instrument, taking the trocar as support, move the tool inside the abdominal cavity. However, these possibilities of movement are limited and do not allow the realization of complex gestures, such as suturing.
- Other instruments have intracorporeal joints but these are operated manually through cables and joysticks generating inaccuracy and fatigue on the part of a user.
- the object of the invention is to increase the number of movements that can perform a tool carried by the tool holder of a surgical instrument including to perform with this tool complex operations such as suturing.
- a surgical instrument in particular for peritoneal surgery, comprising an elongate body which is terminated by a tool holder and which is intended to be introduced into the peritoneal cavity by a trocar.
- the body comprises: an inner tube which extends along a longitudinal axis of the body and which is terminated by a foldable crutch;
- an outer tube extending around the inner tube coaxially with the inner tube and mounted to rotate around the inner tube; the outer tube being terminated by a bellows which extends around the stand and which carries at its end the tool holder.
- the tool carried by the tool holder of the surgical instrument is made very mobile thanks to the following movements:
- the ability to switch the instrument using the trocar as a bearing also moves the tool.
- the surgical instrument notably allows the rotation of the tool around its own axis, rotation particularly interesting since it is a movement necessary for suturing.
- the instrument is particularly compact because the tubes can be very thin section and the stand and bellows, because of their pliable nature, are easily inserted into the patient's body even through a small incision.
- Figure 1 is a schematic perspective view of a surgical instrument according to a particular embodiment of the invention, the instrument being disposed on a trocar which is "screwed" on the abdominal wall of a patient;
- Figure 1a is a perspective view with cutaway of a detail of the surgical instrument illustrated in Figure 1 at a slightly different angle;
- Fig. 1b is a slightly enlarged perspective view of a detail of the surgical instrument shown in Fig. 1 at a slightly different angle;
- Figure 1c is an enlarged longitudinal sectional view of a detail of the surgical instrument illustrated in Figure 1;
- FIGS. 2a, 2b, 2c, 2d and 2e are partial views of the surgical instrument illustrated in FIG. 1, schematizing various possible movements of the surgical instrument;
- Figure 3 is a partial sectional view of the lower part of the surgical instrument according to a second particular embodiment of the invention.
- Figure 4 is a partial sectional view of the lower part of the surgical instrument according to a third particular embodiment of the invention.
- the surgical instrument comprises an elongate body 2 which is terminated by a toolholder 3 carrying a tool, here a pair of scissors 200.
- the surgical instrument is used for peritoneal surgery.
- the surgical instrument is introduced into service in the peritoneal cavity of a patient by a trocar T.
- the body 2 comprises an inner tube 4 which extends along a longitudinal axis A of the body 2.
- the inner tube 4 is terminated by a foldable crutch 5.
- An outer tube 6 extends around the inner tube 4 coaxially with it, being able to rotate around the inner tube 4.
- the outer tube 6 is terminated by a bellows 7 which extends around the stand 5 and which leads to its end the tool holder 3.
- the two tubes 4, 6 are for example stainless steel.
- the bellows 7 is for example nickel.
- the stand 5 comprises a series of elements articulated along axes perpendicular to the longitudinal axis A of the body 2 being parallel to each other.
- the scissors 200 are made very mobile thanks to the following movements:
- a differential rotation of the two tubes 4, 6 causes a rotation of the scissors 200 about an axis B defined by the tool holder 3.
- This axis B is called its own axis of rotation scissors 200;
- a translation of the instrument along the longitudinal axis A causes a translation to the identical of the assembly 5-bellows crutch 7 and therefore scissors 200;
- the surgical instrument of the invention With the surgical instrument of the invention, a surgeon can perform as many movements with the scissors 200 as if he worked directly on the organ to operate.
- the elements of the instrument remain of reasonable dimensions, the tubes 4, 6 being able to be of small dimensions and the stand 5-bellows assembly 7 being deployed only once introduced into the body of the patient.
- the surgical instrument comprises three internal actuators for respectively controlling the bulk rotation of the inner and outer tubes 6, the differential rotation of the inner tubes 4 and 6 and the folding of the stand 5.
- the surgeon then has to manually perform translational movements of the instrument through the trocar T and tilting of the instrument around the trocar T which are the movements the wealthiest to produce.
- the motorization of the clean rotation of the scissors 200 is particularly interesting, the rotation of the scissors 200 around their own axis being a very useful movement for suturing but generally impossible to achieve in manual.
- the instrument comprises a first actuator in the form of a first motor 8 which is integral with the trocar T.
- the motor 8 is here disposed in a housing 9 which is adapted to be clipped on the trocar T.
- the motor 8 is offset from the outer tube 6 and rotates a sleeve 10 extending around the outer tube 6.
- the sleeve 10 and the outer tube 6 are grooved so that the rotation of the sleeve 10 rotates the outer tube 6 while leaving free a longitudinal displacement of the outer tube 6 and thus the body 2.
- the housing 9 also includes the tubular element 10.
- the instrument also comprises a second actuator in the form of a second motor 11, here secured to the outer tube 6.
- the second motor 11 is arranged to move with the body 2 during a longitudinal displacement of said body 2.
- the rotor of the second motor 11 rotates the inner tube 4 relative to the outer tube 6 about the longitudinal axis A of the instrument, for example here by means of a wheel toothed.
- the two motors 8, 11 thus arranged on the instrument are controlled to cause a bulk rotation of the two tubes 4, 6 or a differential rotation of the two tubes 4, 6 so as respectively to produce a rotation of the scissors 200 around the longitudinal axis A of the instrument and a rotation of the scissors 200 about its own axis of rotation.
- the motors 8, 11 are integrated on a part of the instrument which remains outside the body of the patient.
- the instrument comprises a third actuator, for example here in the form of two shape memory alloy wires 100, 101 which are coupled to the last element of the series of articulated elements of the stand 5.
- a contraction of the one or the other son causes a folding of the stand 5 and thus a displacement of the scissors 200 in the bending plane of the stand 5.
- the surgical instrument comprises a handle 12 which is here linked to the outer end of the inner tube 4 by a rotary-type connection (the surgeon only needs to perform manually translational movements and tilting of the instrument).
- the rotational connection thus allows great freedom of movement of the handle 12 relative to the body 2, facilitating the grip and maneuvering of the tool by the surgeon.
- the handle 12 includes control means of the actuators of the scissors 200.
- the surgeon can control the control means by pressing for example buttons 13 disposed on the handle 12 and thus easily manage the movements of the instrument other than the movements translation and tilting.
- control means communicate remotely with the two motors 8, 11 and the drive members.
- the handle 12 is then simply clipped on the inner tube 4 and can be separated from the body 2.
- the handle 12 may be retained even if the instrument must be discarded at the end of an operation.
- the tool holder is carried directly by the bellows 7, it may also be envisaged that the tool holder 3 is pivotally mounted at the end of the stand 5.
- the instrument may comprise less an actuator, for example a shape memory alloy wire 102 extending along the body 2 to the tool holder 3, to actuate a tool carried by the tool holder 3.
- the shape memory alloy wire 102 makes it possible to open and close the scissors 200.
- the toolholder 3 can wear a tool other than scissors 200, for example a needle 300 for a suturing operation.
- the second motor 11 is secured to the outer tube 6 and cooperates with the inner tube 4 to rotate the inner tube 4 relative to the outer tube 6
- the second motor 11 may of course be secured to the inner tube 4 and cooperate with the outer tube 6 to rotate the inner tube 4 relative to the outer tube 6.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR1055254A FR2961682B1 (fr) | 2010-06-29 | 2010-06-29 | Instrument chirurgical notamment pour chirurgie peritoneale |
PCT/EP2011/060871 WO2012001026A1 (fr) | 2010-06-29 | 2011-06-29 | Instrument chirurgical notamment pour chirurgie peritoneale |
Publications (1)
Publication Number | Publication Date |
---|---|
EP2588019A1 true EP2588019A1 (fr) | 2013-05-08 |
Family
ID=42751638
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP11727993.5A Withdrawn EP2588019A1 (fr) | 2010-06-29 | 2011-06-29 | Instrument chirurgical notamment pour chirurgie peritoneale |
Country Status (4)
Country | Link |
---|---|
US (1) | US20130172860A1 (fr) |
EP (1) | EP2588019A1 (fr) |
FR (1) | FR2961682B1 (fr) |
WO (1) | WO2012001026A1 (fr) |
Families Citing this family (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9869339B2 (en) | 2008-04-11 | 2018-01-16 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
US9629689B2 (en) | 2008-04-11 | 2017-04-25 | Flexdex, Inc. | Attachment apparatus for remote access tools |
US10405936B2 (en) | 2008-04-11 | 2019-09-10 | The Regents Of The University Of Michigan | Parallel kinematic mechanisms with decoupled rotational motions |
US9629633B2 (en) * | 2013-07-09 | 2017-04-25 | Covidien Lp | Surgical device, surgical adapters for use between surgical handle assembly and surgical loading units, and methods of use |
US10753439B2 (en) | 2015-04-03 | 2020-08-25 | The Regents Of The University Of Michigan | Tension management apparatus for cable-driven transmission |
CN108712886B (zh) | 2015-10-02 | 2021-06-04 | 弗莱克斯德克斯公司 | 提供无限制滚转的手柄机构 |
US11896255B2 (en) | 2015-10-05 | 2024-02-13 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
BR112018006826A2 (pt) * | 2015-10-05 | 2018-10-16 | Flexdex Inc | dispositivos médicos que têm juntas multi-cluster que se articulam suavemente |
CN110236701A (zh) * | 2019-07-22 | 2019-09-17 | 青岛市妇女儿童医院(青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心) | 一种腹腔镜术中组织固定装置 |
JP2023528860A (ja) | 2020-06-02 | 2023-07-06 | フレックスデックス,インク. | 外科用ツールおよびアセンブリ |
CN112716596B (zh) * | 2020-12-23 | 2021-11-19 | 赣州市人民医院 | 一种带电凝功能的吸引器 |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5318528A (en) * | 1993-04-13 | 1994-06-07 | Advanced Surgical Inc. | Steerable surgical devices |
US8721630B2 (en) * | 2006-03-23 | 2014-05-13 | Ethicon Endo-Surgery, Inc. | Methods and devices for controlling articulation |
US8105350B2 (en) * | 2006-05-23 | 2012-01-31 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
-
2010
- 2010-06-29 FR FR1055254A patent/FR2961682B1/fr not_active Expired - Fee Related
-
2011
- 2011-06-29 WO PCT/EP2011/060871 patent/WO2012001026A1/fr active Application Filing
- 2011-06-29 US US13/807,533 patent/US20130172860A1/en not_active Abandoned
- 2011-06-29 EP EP11727993.5A patent/EP2588019A1/fr not_active Withdrawn
Non-Patent Citations (1)
Title |
---|
See references of WO2012001026A1 * |
Also Published As
Publication number | Publication date |
---|---|
FR2961682B1 (fr) | 2013-03-15 |
FR2961682A1 (fr) | 2011-12-30 |
US20130172860A1 (en) | 2013-07-04 |
WO2012001026A1 (fr) | 2012-01-05 |
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Effective date: 20140507 |