FR2718941A1 - Optical simulator for movements involved in abdominal surgery - Google Patents

Abstract

The organ to be operated upon is simulated by an object (4) mounted on a support (13) and illuminated by a lamp (14) in the open front of the box (9). The top and rear wall (10) constitute a sliding and locking system on which a converging lens (1) and a plane mirror (2) can describe a quadrant of a circle about the centre of the object. The surgeon introducing instruments through the sidewalls sees a magnified upright image in another plane mirror (3) hinged (11) to a telescopic mount (12).

Description

The present invention relates to a device intended for training in laparoscopic surgery and for acquiring the gestures necessary for performing this surgery.

Laparoscopic surgery does not require the opening of the various caultes and spaces of the human body by an incision, sometimes very large, to operate the organ in question under the open sky.

She uses blank instruments and a magnifying camera with a cold light which are introduced through small orifices carefully chosen on the skin. The instruments and the camera thus introduced make it possible to operate the organ in question without having to resort to the opening of the different spaces by a large incision. Laparoscopic surgery is therefore closed surgery ".

The surgeon no longer directly controls his gestures and his instruments as is the case in conventional surgery. The control is done indirectly through the screen of a monitor with a large magnification thanks to the camera thus introduced into the different caltés of the human body. This indirect control of the instruments and operating gestures is the main technical obstacle for the control of this new surgery.

Current laparotrainers use the same equipment as for real operations, save a camera and a monitor. Their high cost and their size constitute a major obstacle deu training the Young chirurglens.

The device according to lluentuent makes it possible to remedy these disadvantages: it uses neither camera nor monitor and consequently its cost will be modest, and it will be easily transportable. It uses a simple optical assembly, formed by a lens and two mirrors following the optical diagram of FIG. 1. It allows sufficient magnification and therefore simulates the same working conditions of a real operation. The surgeon controlled his gestures indirectly thanks to a mirror acting as a monitor screen. Note that surgeons currently use to perform sutures and knots inside the abdomen special clips and pliers for ease and speed of use, but the price of roll is very high.

Once the surgeon has the necessary agility, he can use a normal thread for the same purpose while eliminating the extension of the operating time.

Agility therefore lowers the cost of the operation. The optical diagram (Figure 1) helps to understand the operating principle of the device. The converging lens (I) with center C and focal point F gives a non-inverted uirtual image A'B '(5) of an object 118 (4) placed between C and F. R'B' (5) is more great than RH.

The plane mirror (2) gives an image fl "B- (6) of the same size and not renuersed of R'B '(5). R" B "(6) acts as an object in relation to the plane mirror ( 3). The plane mirror (3) in turn gives fl8 "(6) an image A" 'B "' 17) of the same size and not reduced. R "'B" '17) is the same size and same direction as A'H' (5). The final image R "'6"' (7) is consequently larger and in the same direction as the object RB (4). R indicative, it was chosen for the example of Figure 1 a magnification of 1.7. It is this image R "'B"' (7) that the eye sees (8) of the user and which by means of the characteristics of the lens (diopter and magnification) represents an Image similar to that which the user would have due to using the equipment of the operating room: camera and monitor.

According to a first characteristic, the device indeed comprises a shoemaker having four faces: a super-posterior, a lower and two lateral ones (Figures 2, 3 and 4).

The upper posterior face (19) is a sliding and locking system. A converging lens (11 and a plane mirror (2) are attached to the sliding system. A second plane mirror (3) is fixed on a support (12) of adjustable length and integral with the boot (9).

The inclination in the anteroposterior plane of the two plane mirrors as well as of the support is adjustable by an articulated adjustment system (11).

The two side walls and the upper posterior wall are designed with a suitable substance (rubber for example) allowing, through holes, the introduction of chirur gicauz instruments inside the housing. The object simulating the organ to be operated (4) is placed on a support (13) which is fixed inside the case on its underside.

The lens (1) can describe in its path thanks to the sliding system (18) a quarter of circumference whose center is the object (4) to operate. Thus the user can see the object (4) from different angles following the position of the lens (1). The radius of the quarter of circumference described by the lens (1), which represents both the distance object (4) - lens (1) is smaller than the focal distance of the lens (1).

It is judiciously chosen according to the characteristics of the latter (diopter and magnification) so that the image of the object has the best magnification and the best sharpness. The object (4) is illuminated by a light source (14) located inside the housing. The image (5) of the object (4) formed by the lens (1) is thus transmitted to the eye of the surgeon (8) thanks to the two plane mirrors (2 and 3).

By sliding the "tandem1 Lens (l) -mirolr (2), the user can then choose the angle at which he wishes to work by blocking the sliding system (knock). Adjusting the inclination of the two mirrors (2 and 3) and the support (12) as well as its length allows the user to bring the final image back into his field of vision. Consequently, the user can see the final image through the second mirror (3 ) as on the screen of a monitor and this therefore allows him to control through his mirror (3) his gestures and his surgical instruments.

According to particular embodiments - the mirror support (3) acting as a monitor screen can be detachable from the housing; - the position of the lens (l) being fixed, the support (13) of the object (4) can, thanks to a sliding and blocking system 1C} describe a path of a quarter of circumference, the center of which is the lens (1) according to FIGS. 5 and 6. This system then makes it possible to view the object from different angles. The housing can for example have 5 faces an upper, a lower, a posterior and two lateral.

Surgical instruments can be inserted from the upper, posterior or lateral sides - the optical system may not only provide an image-to-object magnification ratio of 1.

In this eas, the lens (1) can be eliminated or replaced by a simple transparent non-magnifying optical system; - the lens (1) can be replaced by a more powerful optical system. The magnification obtained is greater. By way of example, it is possible to add to the lens (1) another additional convergent lens.

The resulting focal length of this system is then smaller than that of the lens (1) but the magnification is greater - in order to obtain an additional magnification, the plane mirror (2) and / or the plane mirror (3) can be replaced by spherical mirrors.

Figures 2 and 3 give an overview of the device according to the inuentlon. Figure 4 shows in section the device showing the interior of the housing. FIGS. 5 and 6 represent a variant of the device.

With reference to these drawings, the device comprises a kicker (9) designed with suitable material (rubber for example) for the introduction of surgical instruments through its walls. The upper posterior wall of the housing represents a sliding and blocking system (18) on which are fixed a lens (1) and a plane mirror (2). The inclination of the mirror (2) is adjustable thanks to an articulated adjustment system (11) connected to the drainage system (tB). A second plane mirror (3) acting as a monitor screen is connected to a support (121 of adjustable length and which is integral with the housing. The inclination in the anteroposterior plane of the mirror (3) and the support (12) is ensured by an articulated adjustment system (11). A support (13) is fixed inside the casing on its lower wall. The object simulating the organ to be operated (4) is placed on the support (13) in such a way that it forms the center of the quarter of circumference, representing the path that the lens (1> and the mirror (2) can travel thanks to the sliding system (18). quarter of circumference which is at the same time the distance object (4) - lens (i) is smaller than the focal distance of the lens (1). A light source (14) inside the case illuminates the object ( 4).

According to a variant not shown, the support (12) of the mirror (3) is detached from the housing.

In the embodiment according to FIGS. 5 and 6, the object (4), placed on a support 113), can describe, by a sliding and blocking system (16), a quarter of the circumference of the center of the lens (1). The housing can then have different shapes.

R by way of example, FIG. 5 represents a rectangular shape.

Figure 6 shows the interior of the housing.

According to a variant not shown, the lens (1) is replaced by a simple transparent non-magnifying optical system or simply eliminated. The image-object magnification ratio is then equal to 1.

 According to another uariante not illustrated, the conuergent lens (1) is replaced by a transparent system, not magnifying or simply eliminated, the flat mirrors (2 and 3) are both or one replaced by mirrors spherical, the magnification therefore depends on the latter two.

According to a last variant also not illustrated, the lens (1) can be replaced by a magnifying optical system. The flat mirrors (2 and 3) can be both or one of them replaced by spherical mirrors, the final magnification is then more important.

R by way of nonlimiting example, the box will have dimensions of the order of 29 centimeters in width, 35 centimeters in length and 26 centimeters in height.

The device according to the invention is particularly intended for training in laparoscopic surgery.

Claims (6)

REUENDICATIONS 1- Device for training in laparoscopic surgery, characterized in that it comprises a housing (9) having four sides, one super-posterior (16), one lower and two lateral. Its lateral and upper-posterior faces are designed with suitable material (for example rubber) allowing, through holes, the introduction of surgical instruments inside the housing. Its super-posterior face (111) constitutes a sliding and blocking system. An eonuerqente lens (1) and a plane mirror (2) are integral with the sliding system (18). A second plane mirror (3) is fixed on an adjustable length support (12) which is integral with the housing 19). The inclination in the anteroposterior plane of the mirrors (2 and 3) and of the support (12) is adjustable by means of an articulated adjustment system (11). The object simulating the organ to be operated (4) is placed on a support (13) fixed inside the case on its lower wall. The object (4) is in fact the center of the quarter of circumference presenting the possible paths traveled by the lens (1) and the mirror (2) thanks to the sliding system (16). The distance object (4) - lens (1) which represents at the same time the radius of the quarter of circumference traversed by the lens (1) and the mirror (2) is smaller than the focal distance of this lens (1). It is judiciously chosen according to the characteristics (diopter and magnification) of the lens (1) so that the image has better magnification and sharpness. R inside the housing, a light source (14) illuminates the object (4). 2- Device according to reuendicatlon 1 characterized in that the support (12) on which the mirror (3) is fixed is detached from the housing. 3- Device according to FIG. 5 and 6 characterized in that the position of the "tandem" lens (1) and mirror (2I is fixed but the support (13) and consequently the object 14) can be described thanks to a sliding system and blocking (16) a path of a quarter of circumference from the center of the lens (1). 4- Device according to any one of the preceding rouendications characterized in that the final magnification ratio object image is equal to 1. The lens (1) is replaced by a transparent and non-magnifying or eliminated optical system. 5- Device according to reuendicatlons 1,2,3 characterized in that the lens (1) is replaced by another more magnifying optical system (for example two converging lenses). 6- Device according to whatever one of the preceding claims characterized in that one of the two plane mirrors (2 and 3) or the two assemblies are replaced by spherical mirrors.