FR2994818A1 - Laparoscopy system for use in abdominal wall in body of patient, has fixing unit comprising proximal part and distal part, where proximal and distal parts are interconnected by intermediate part to pass through abdominal wall - Google Patents

Abstract

The system has an image collecting device (10) arranged in an abdominal cavity (44), and comprising a camera with an optic unit that is fixed at a support (12). A sensor and the optic unit define a field of view (16), and a lighting unit i.e. LED, illuminates the field of view. A fixing unit (40) is fixed at an abdominal wall (42) that limits the cavity. The fixing unit comprises a proximal part (50) and a distal part (52), where the proximal and distal parts are respectively arranged outside and inside the cavity and interconnected by an intermediate part (54) to pass through the wall.

Description

LAPAROSCOPIC SYSTEM The invention relates to a laparoscopic system. US application 2008/0033450 A1 relates to surgical access with an integrated camera. The surgical access includes a cannula and a trocar inside the cannula. The cannula includes a wall in which a camera is integrated near its tip at the distal end. The camera is not mutable independently of a surgical instrument that is inserted into the cannula during an operation. WO 2008/103212 A2 relates to a system for a surgical operation comprising a console provided with a display outside the body of the patient. A robot is arranged on the other side of the patient's abdominal wall, which includes a camera and several surgical instruments. The position of the camera is difficult to control from the outside. The purpose of the application is to provide a laparoscopy system that overcomes the disadvantages of the state of the art, in particular by offering easy maneuverability and being inexpensive. This object is achieved, according to the invention, by a laparoscopic system comprising: a device for capturing images, which is adapted to be arranged in an abdominal cavity, the device being provided with a support, a camera that includes an optics attached to the support and a sensor for capturing images through the optics, the sensor and optics defining a field of view, and - at least one illumination means for illuminating the field of view. view which is attached to the support; and - a fixation means, which is adapted to be fixed immovably to an abdominal wall limiting the abdominal cavity, and which includes a proximal portion adapted to be arranged outside the abdominal cavity, and a distal portion, adapted to be arranged inside the abdominal cavity, the distal portion and the proximal portion being connected to each other by an intermediate portion adapted to pass through the abdominal wall. According to advantageous features: the device for capturing images is removably attached to the distal portion of the fixing means; - The proximal portion and / or the distal portion of the attachment means are adapted to be supported by the abdominal wall; - The intermediate portion is resilient to form a clamp such that the securing means is adapted to wedge the abdominal wall between the distal portion and the proximal portion, the elastic intermediate portion including in particular a spring; the fixing means comprises a rod and a support means provided with an opening in which the rod is adapted to be engaged, in that the proximal part of the fixing means comprises both a proximal portion of the rod and the support means, said support means being adapted to be fixed on an outer surface of the abdominal wall, in that the distal portion comprises a distal portion of the stem, and in that the intermediate portion comprises a portion of the stem between its distal and proximal parts; the stem is a means of perforation, for example a needle, a blade and / or a perforation tip being arranged at the proximal end of the rod; a head, in particular a flat head, is attached to the distal end of the shaft for pushing the shaft proximally and / or for receiving the camera support; the optics and the lighting means or means are covered together by a transparent material; the or each lighting means is a light emitting diode (LED); the device comprises a plurality of lighting means which are arranged circumferentially around the optics; the laparoscopy system further comprises both a controller which is connected to the sensor and capable of providing an image received from the sensor to a display screen, and a support for the display screen, which is suitable for being arranged in a position above the abdominal wall; and / or the controller is able to generate an image from the image received from the sensor according to the relative positioning between the sensor and the display screen. Other characteristics and advantages of the present invention will emerge from the description given below, with reference to the drawings, which illustrate an embodiment having no limiting character and in which: FIG. 1 is a schematic view of a device for capturing images; - Figure 2 is a schematic sectional view along line II-II of Figure 1; FIG. 3 is a sectional view of a laparoscopic system according to one embodiment of the invention; FIG. 4 is a sectional view of another embodiment of a laparoscopic system; FIG. 5 is a perspective view of a support plate for the system of FIG. 4; - Figure 6 is a perspective view of a support plate with a gripping means; and - Figure 7 is a schematic top view of a laparoscopic system. In the present invention, the terms "inner" and "outer" refer to their position relative to an abdominal cavity, for example if a means is placed inside or outside the abdominal cavity. The terms "proximal" and "distal" are used to define the ends of the system or part thereof, the proximal end being outwardly directed while the distal end is directed inwardly of the abdominal cavity when the use of the system. Figures 1 and 2 are described together and show a device 10 for capturing images. The device 10 comprises a support 12 having a substantially planar surface 14 in the direction of a field of view 16. An optic 18 which defines an optical axis XX is arranged on the surface 14, substantially in the center of the support 12. The optic is arranged above a sensor 20 in Figure 2. The sensor 20 has, in one embodiment, six to twelve megapixels. The optic preferably has a diameter between 1.5 to 5 mm, for example a diameter around 3 mm. The optics 18 and the sensor 20 together define the field of view 16.

The surface 14 and, more generally, the support 12 have a substantially circular shape in a plane substantially orthogonal to the optical axis X-X. In other embodiments, the surface 14 and / or the support 12 may also have other shapes. The diameter of the support 12 is between 0.5 and 1.5 cm, for example around 1 cm. In one embodiment, the support 12 is formed by a plate and / or a printed circuit.

A plurality of lighting means 24, for example seven lighting means, is arranged on the surface 14, these lighting means being distributed around the optical 18 or the optical axis XX to illuminate the field of view 16. The illumination means 24, in particular their wavelength, are adapted to a sensitivity band of the sensor 20. In the embodiment shown in FIG. 1, the lighting means 24 are arranged circularly around each other. optics. In other embodiments, the device 10 is provided with more or less lighting means, for example the device 10 may comprise between one and ten lighting means. The lighting means are, for example, light emitting diodes (LEDs). The optics 18 and the lighting means 24 are covered together by a transparent cover 26. The transparent cover has, in one embodiment, a generally convex shape. For example, the transparent cover 26 is a hollow cover, glued or welded to the edge of the surface 14. In another embodiment, a transparent mass is applied to the surface 14 to form the transparent cover 26. In addition, device 10 is provided with a cable 28 for the power supply of the device 10 and for the transmission of the images captured by the sensor 20. In one embodiment, the support 12 is provided with attachment means for removably attaching the device 10 to a fixing means which will be detailed later. For example, the attachment means are means for snapping the device onto the aforementioned fixing means so that the surface 30 of the support 12 opposite to the surface 12 along the optical axis XX bears on the means of attachment. fixation. In another example, the surface 30 is glued to the fastening means. In other embodiments, the surface 30 is provided with means for adjusting the orientation of the support 12 on the aforementioned fixing means, for example a male or female adjustment means, when a means of adjustment complementary is provided on the fastening means. This device 10 is used to capture images in an abdominal cavity according to the embodiments shown in FIGS. 3 to 7. FIG. 3 shows a first embodiment of a fastening means 40 for fixing the device 10 to a wall abdominal wall 42 has an inner face 46 and an outer face 48. The attachment means 40 comprises three parts, namely a proximal portion 50 outside the abdominal cavity. 44, a distal portion 52 within the abdominal cavity 44 and an intermediate portion 54 connecting the proximal portion 50 to the distal portion 52.

The proximal portion 50 comprises a first rigid arm 60, for example in the form of a plate bearing against the outer face 48 of the abdominal wall 42. The distal portion comprises a second rigid arm 62 bearing against the inner face 46 of the abdominal wall 42. The support 12 of the device 10 is carried by this second rigid arm 62 so that the field of view 16 is directed towards the inside of the abdominal cavity 44. For example, the second rigid arm is rigidly connected to the In another embodiment, the camera support 12 is removably connected to the second arm 62. The intermediate portion 54 of the attachment means 40 includes a spring 46 or other resilient means connected to the arms 60 and 62. to clamp arms 60 and 62 together.

In use, the intermediate portion passes through an incision 66 in the abdominal wall 42.

When using the laparoscopy system according to FIG. 3, the system cooperates with the incision 66, previously made to pass trocars, so that the proximal portion 50 of the fixing means is arranged outside the body. abdominal cavity and the distal portion 52 is arranged inside the abdominal cavity.

Then, the restoring force of the spring 64 wedges the abdominal wall 42 between the first rigid arm 60 and the second rigid arm 62, which immobilizes the fastening means 40 on the abdominal wall. In one embodiment, the device 10 is attached to the attachment means 40 before the insertion of the second rigid arm 62 into the incision 66. In another embodiment, the device 10 is attached to the second rigid arm 62 after fixing the attachment means 40 on the abdominal wall 42. The cable 28 exits for example by the same incision. Before or after the surgeon has set up the laparoscopy system according to Figure 3, he inserts a trocar into the incision 66. This trocar is then used to enter other instruments, such as surgical ancillaries. FIGS. 4 to 6 show another embodiment of a laparoscopy system, which comprises a fixing means 80 which is different from the means 40 of FIG. 3. The same reference numerals designate the same characteristics as in the method of FIG. realization of Figure 3.

The securing means 80 includes a proximal portion 82 outside of the abdominal cavity 44, a distal portion 84 within the abdominal cavity 44, and an intermediate portion 86 connecting the proximal portion 82 to the distal portion 84. proximal portion 82 includes a gripping means 90 and a support means 92 in the form of a support plate. The support plate 92 is adapted to bear on the outer face 48 of the abdominal wall 42 and to be removably attached thereto. In one embodiment, the backing plate 92 is adhered to the outer face 48. For example, a glue strip or an adhesive tape is applied to an outer edge of the backing plate 92. The backing plate 92 includes a or more slots 94, 96 which are shown in Figures 5 and 6. The embodiment of Figures 5 and 6 provides two slots arranged in a cross. The slots 94 and 96 have respective longitudinal shapes, which are substantially orthogonal to each other. In another embodiment, the angle between the two slots 94 and 96 is between 45 ° and 135 °, in particular between 70 ° and 110 °. At least one lateral side of the slots 94 and 96 is notched. For example, each slot 94 and 96 is provided with four to ten notches 98.

The fixing means 80 further comprises a rod 100. The rod 100, in particular its intermediate portion, is adapted to be engaged in one of the notches 98 of the slots 94 and 98 so as to retain the rod 100 with respect to the support plate 92. The rod 100 has a diameter of about 0.5 and 3 mm, for example around 1.5 mm.

The slots 94 and 96 have a width slightly greater than the rod 100, for example to slide therein the rod 100. In one embodiment, the slots have a width between 0.5 and 4mm. In Figure 4, the shaft 100 passes through an incision 102 in the abdominal wall 42. The incision 102 is, for example, made using the rod 100, as explained later.

For this purpose, the rod 100 carries at its proximal end a blade and / or a piercing tip. In one embodiment, the shaft 100 is a needle. The gripping means 90 is removably attached to the proximal end of the shaft 100, for example to cover the blade or piercing tip. In another embodiment, the blade or tip is covered by another means of protection, to allow a surgeon to manipulate the shaft 100 from its proximal end without danger. The distal portion 84 of the fixing means 80 comprises a head 104, for example in the form of a plate, which is fixed to the distal end of the rod 100. In one embodiment, the head 104 is integral with the rod. 100. The head 104 has, for example, a diameter corresponding to the diameter of the support 12. The support 12 is removably attached to the head 104, for example by the attachment means, so that the field of view 16 is directed to the interior of the abdominal cavity 44. When using this laparoscopic system, the rod 100 provided with the support head 104 is inserted into the abdominal cavity 44 by a sufficiently wide incision. For example, it is inserted by an umbilical incision which is used in particular to set up an insufflation needle and / or a trocar. In one embodiment, the device 10 is attached to the head 104 before insertion into the abdominal cavity 44. A surgeon passes a finger into the abdominal cavity with the shaft 100, the head 104 and the device 10 on the head 104 it then perforates the abdominal wall 42 from the inside outwards with the proximal end of the stem 100. Then, the support plate 92 is slipped on the rod 100, so that the stem is in position one of the slots 94 and 96. In the next step, the support plate 92 is immobilized, in particular fixed or glued, on the outer face 48 of the abdominal wall 42. Finally, the gripping means 90, for example a handle , is slid over the proximal end of the rod 100 and is fixed or locked therein. The rod 100 is then manipulated using the gripping means 90 and fixed in one of the notches 98 of the slots 94 and 96. The abdominal wall 42 having great flexibility, the rod can have different orientations while being fixed. in position relative to the support plate 92. Thus, the device 10 then remains in a precise predetermined position and / or orientation. The cable 28 then exits the abdominal cavity 44 through the incision through which the device 10 has been inserted, for example the umbilical incision. In one embodiment, the rod 100 and the head 104 are disposable, but the device 10 is reusable.

Figure 7 shows a top view of a patient 110 in which the laparoscopy system is used. The device 10 is connected by the cable 28 to a controller 112 which is placed next to the patient. The controller 112 processes the images received by the sensor 20. In addition, a screen 114 is placed on the patient. The screen 114 may be in the form of a tablet and provided with a wired or wireless connection to communicate with the controller 112. In the embodiment of FIG. 7, the controller 112 communicates with the screen 114 by a wireless link, for example a WiFi or Bluetooth connection. The screen 114 is placed on a dedicated support, to allow it to be positioned above the patient 110 (outside the abdominal cavity 44) approximately at the position of the device 10 which is positioned inside the abdominal cavity 44. In one embodiment, the controller 112 is adapted to send an image according to the offset between the screen and the device 10 within the abdominal cavity 44 of the patient 110. For example, the controller 112 is clean to send an image as if the surgeon were looking through an incision below the screen 114.

In one embodiment, the screen 114 is a touch screen for manipulating the images, for example to select the device 10 if a plurality of devices are positioned in the abdominal cavity 44, to zoom, to make a recording, and so on.

Claims (12)

REVENDICATIONS1. Laparoscopic system comprising: - a device (10) for capturing images, which is adapted to be arranged in an abdominal cavity (44), the device being provided with - a support (12), - a camera which comprises an optics (18) fixed to the support (12) and a sensor (20) for capturing images through the optics, the sensor and the optics defining a field of view (16), and - at least one means illumination device (24) for illuminating the field of view (16) which is attached to the support (12); and - a securing means (40; 80), which is adapted to be fixed immovably to an abdominal wall (42) limiting the abdominal cavity (44), and which includes a proximal portion (50; 82) adapted to arranged outside the abdominal cavity, and a distal portion (52; 84) adapted to be arranged within the abdominal cavity, the distal portion and the proximal portion being connected to each other by an intermediate portion ( 54; 86) adapted to pass through the abdominal wall (42). The laparoscopic system as claimed in claim 1, characterized in that the image sensing device (10) is releasably attached to the distal portion (52; 84) of the attachment means (40; 80). Laparoscopic system according to one of the preceding claims, characterized in that the proximal portion (50; 82) and / or the distal portion (52; 84) of the fixation means (40; 80) are adapted to be supported. by the abdominal wall (42). 4. Laparoscopic system according to one of the preceding claims, characterized in that the intermediate portion (54) is resilient to form a clamp so that the fixing means (40) is able to wedge the abdominal wall (42). between the distal portion and the proximal portion, the elastic intermediate portion including in particular a spring (64). 5. Laparoscopic system according to one of claims 1 to 3, characterized in that the fixing means (80) comprises a rod (100) and a support means (92) provided with an opening (94, 96). wherein the shank is adapted to engage, in that the proximal portion (82) of the securing means comprises both a proximal portion of the shank (100) and the support means (92), which support means is adapted to be attached to an outer surface (48) of the abdominal wall (42), in that the distal portion (84) comprises a distal portion of the shaft (100), and that the intermediate portion (86) comprises part of the stem between its distal and proximal parts. The laparoscopic system according to claim 5, characterized in that the shaft (100) is a perforation means, for example a needle, a blade and / or a perforation tip being arranged at the proximal end of the shaft. 7. laparoscopy system according to one of claims 5 or 6, characterized in that a head (104), in particular a flat head, is attached to the distal end of the rod (100) to push the rod into proximal direction and / or to receive the camera support (12) 8. Laparoscopic system according to one of the preceding claims, characterized in that the optic (18) and the one or more lighting means (24) are covered together by a transparent material (26). 9. Laparoscopic system according to one of the preceding claims, characterized in that the or each lighting means (24) is a light emitting diode (LED). The laparoscopy system according to one of the preceding claims, characterized in that the device (10) comprises a plurality of illumination means (24) which are arranged circumferentially around the optics (18). The laparoscopy system according to one of the preceding claims, further comprising both a controller (112) which is connected to the sensor (20) and adapted to provide an image received from the sensor to a display screen (114) , and a support for the display screen, which is adapted to be arranged in a position above the abdominal wall (42). Laparoscopy system according to claim 11, characterized in that the controller (112) is capable of generating an image from the image received from the sensor as a function of the relative positioning between the sensor (20) and the display screen. display (114).