WO2009000939A1 - Simulateur pour chirurgie laparoscopique - Google Patents

Simulateur pour chirurgie laparoscopique Download PDF

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Publication number
WO2009000939A1
WO2009000939A1 PCT/ES2007/000377 ES2007000377W WO2009000939A1 WO 2009000939 A1 WO2009000939 A1 WO 2009000939A1 ES 2007000377 W ES2007000377 W ES 2007000377W WO 2009000939 A1 WO2009000939 A1 WO 2009000939A1
Authority
WO
WIPO (PCT)
Prior art keywords
simulator
laparoscopic surgery
surgery according
board
operating table
Prior art date
Application number
PCT/ES2007/000377
Other languages
English (en)
Spanish (es)
Inventor
Jorge Potti Cuervo
Carlos G. Illana Alejandro
Bernardo Sierra Picon
Original Assignee
Gmv, S.A.
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 Gmv, S.A. filed Critical Gmv, S.A.
Priority to PCT/ES2007/000377 priority Critical patent/WO2009000939A1/fr
Publication of WO2009000939A1 publication Critical patent/WO2009000939A1/fr

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Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas

Definitions

  • the present invention relates to a simulator for the training of laparoscopic surgery which aims at the faithful reproduction of the real conditions that a surgeon must face in an operation of this type in order to practice the different techniques, develop the skills precise, etc.
  • laparoscopy which consists of performing surgical interventions without opening the patient, only making a small incision called the portal, where it will penetrate the instruments required to perform operations on a specific organ.
  • a camera is used that is introduced into the patient, which shows, through an external screen, the images of the different operations and maneuvers that the surgeon performs internally.
  • the laparoscopic surgery simulator described below solves the problems outlined above, since it allows a simulation that is faithful reproduction of the real conditions that the surgeon must face, including instruments of real size and location and the possibility of moving the patient on the table and thereby also move the internal organs of the body.
  • the simulator object of the present invention basically comprises the following components:
  • a physical model of the patient on which the appropriate instruments will be placed such as tweezers, scissors, stapler, separator, etc. with its corresponding haptic device responsible for transmitting to the control unit the position thereof in the X, Y and Z axes, as well as producing a sense of touch through a feedback of forces that will be reflected in the instrument controls. All these devices will be integrated into the physical model of the patient, so that only those that in a real operation will be those that the surgeon finds, that is, the instrument itself and the camera, thus faithfully reproducing reality.
  • said instruments will faithfully reproduce all the characteristics of a real instrument, both in size and manageability and in the position they occupy between them and with respect to the patient, so that the simulation reproduces the same characteristics as a real operation.
  • the patient's physical model will also faithfully reproduce a human body, both in dimensions and in appearance, being also interchangeable and independent of the operating table (6) to be able to represent different patient models such as adults, children, etc. according to the occasion.
  • a camera Ia which simulates a real one in shape, dimensions and functions, so that if the camera penetrates, the objective is close to the object and the virtual result is an approach to the image, otherwise, if the camera is displaced in the axes of coordinates X, Y, or there is a rotation of the Z axis, the latter corresponding to the penetration, the virtual representation reacts in the same dimension and direction in synchronism with the movements of the camera.
  • a visualization system whose mission will be to represent on a screen the images virtually collected by the camera, as well as the images generated from the manipulation of the instruments.
  • An articulated operating table whose mission is to support the physical model of the patient, as well as on the one hand, incorporate the mechanisms responsible for positioning the board on which said patient model rests according to the surgeon's requirements, and on the other , incorporate the necessary means to measure the position in the space of said board and transmit it to the control unit so that it is in charge of sending the images of the organs to the visualization system as they are affected by the field plane gravitational in relation to the inclination of the tabletop.
  • a specific software in charge of the simulation that, from the data provided by the instruments and the operating table, will generate the three-dimensional simulation position of the same with respect to the simulated three-dimensional scenario that will be represented in the visualization system.
  • a central processing unit or CPU in charge of controlling all system parameters, housing the necessary databases such as those of anatomical and instrumental models, medical records, etc., as well as running the simulation software and Manage the operation of all devices connected to it.
  • the system based on the information stored in the databases used and the movements of the instruments, operating table or others, the system, through the specific software, is capable of generating virtual images that correspond to what would happen in reality. if said instrumental, table, etc. were used in that way, reproducing reality so faithfully and turning the system into a powerful training tool.
  • Figure 1 shows a schematic view of the elements comprising the simulator of the present invention.
  • Figure 2. Shows a perspective view in which a possible physical model of the patient is represented, which has both the camera and the instruments attached.
  • Figure 3 shows a bottom perspective view of the operating table of the simulator of the invention, on which the physical model of the patient has been located.
  • Figure 4.- Shows two elevational views of that of the operating table of the simulator of the invention.
  • Figure 5. Shows a view 5a of the cavities on which the feet of the haptic devices are placed on the board of the operating table of the simulator of the invention and another 5b of detail of said feet.
  • Figure 6. It shows a block diagram where the relationship between the different parts of the simulator managed by the software is schematically represented.
  • the simulator for laparoscopic surgery of the invention comprises a physical model (1) of the patient, capable of being exchanged for others of different morphology as it might correspond in real life, on which the instruments are located (2) adequate entering the patient through the corresponding portals (3), as well as the camera (4).
  • an articulated operating table (6) which incorporates means (7) to position the board (19) tilting it both transversely and longitudinally, that is, both in a left-right movement around the longitudinal axis as anterior - posterior around the transverse axis.
  • said operating table (6) has devices for measuring angular displacement, such as "encoders", position sensors, etc., which will measure the position of the table (6) to be transmitted to the control unit (9) so that the latter is responsible for sending to the monitor (5) the images of the organs as they are affected by the plane of the gravitational field, in relation to the inclination of the board of said table (9).
  • the operating table (6) comprises a board (19) preferably made of a rigid material that has a plurality of cavities (20), of different depth , whose purpose is to house the foot (21) of the different haptic devices to place them in the correct position, height and orientation according to the use of the exercise being developed.
  • Said cavities (20) are made up of housing cylindrical on which another internal cavity (22) is placed in the form of a rectangular prism as a keyway that serves for the angular orientation of said foot (21) of the haptic device (13).
  • the height situation of the haptic device (13) will be a function of the depth of the cavity itself (20), as can be seen in Figure 5 a , where cavities with different depths appear.
  • said internal cavity (22) there is at least one presence sensor (23) or the like capable of detecting the occupation of the cavities (20) by a haptic device (13), and even identifying the latter.
  • rotating supports (24) preferably located in the longitudinal axis to the board (19) and joined by its axes to a rocker (26) so that allow the rotation around said longitudinal axis, that is, the left-right rotation of said board.
  • a device (25) for measuring angular displacement such as an encoder or the like capable of measuring the degree of lateral inclination of said board (19) is also coupled.
  • Said rocker (26) also incorporates a pin (31) that serves as a pivot point and mooring at one of the ends of the second actuator (32) or servo responsible for producing an angular displacement of said rocker (26) at the pivot points. (30) so as to allow rotation around the transverse axis of the board (19), that is, the anterior-posterior rotation of said board (19), said angular displacement being measured by a second device (29) integral with the rocker arm (26) and connected to the mentioned pivot points (30).
  • control unit (9) or processing unit or CPU it will be in charge of controlling all the system parameters, housing the necessary databases, running the simulation software and managing the operation of all the devices to It is connected, not only to those previously mentioned, but to any other peripherals connected to the system, such as a keyboard (10) to enter data into the system, navigate through menus or screens, or pedals (11) similar to those used in real surgery to be operated by the foot, being responsible for controlling functions such as cauterization, cutting, image capture, etc.
  • the user (12) is the person who interacts with the simulator through the simulated physical instruments (2) and who receives visual responses through the visualization system (14) through the PC and haptic sensations through the haptic devices (13 ) real
  • One of them is the software application that allows the user (12) to interact with the system by planning the simulation in a visual, interactive and friendly way, counting among its functionalities with that of selecting the exercises, accessing the historical results, interacting with the tutorials and homework descriptions, etc.
  • the other functional software entity that incorporates the display system (14) is that of the graphics generator engine, which is a high performance library for the visualization of 3D graphics and the simulation sequence on the monitor (5).
  • the simulated physical instrument (2) that mimics the surgical instruments: tweezers, probes, cameras and that is coupled to the haptic devices (13) through which they simulate their operational functionality, being said haptic devices (13) retracted or hidden completely within the physical model (1) so that they do not hinder the surgeon's task and faithfully reproduce a real situation.
  • the system also has a simulation core (15) whose function is to direct, control and manage the flow of the simulation at all levels: graphic, haptic and operational. That is, this module coordinates the rest of the remaining modules and elements and acts as an interface between the simulator and the software application that allows the user (12) to plan the simulation.
  • a simulation core (15) whose function is to direct, control and manage the flow of the simulation at all levels: graphic, haptic and operational. That is, this module coordinates the rest of the remaining modules and elements and acts as an interface between the simulator and the software application that allows the user (12) to plan the simulation.
  • the system also has a touch and sound software module (16) that converts the simulated user actions (12) into haptic and sound responses, that is, it acts as a bridge between the action user simulated (by example, milling) and the sensory response of the hardware (collision sensation of the milling cutter and noise of milling).
  • a touch and sound software module (16) that converts the simulated user actions (12) into haptic and sound responses, that is, it acts as a bridge between the action user simulated (by example, milling) and the sensory response of the hardware (collision sensation of the milling cutter and noise of milling).
  • the set is completed with an evaluation system (17) that allows monitoring different aspects of the execution of the simulation exercises with the objective of being able to evaluate the actions of the users (12) in the execution of the different exercises.
  • training case library of static support for the simulation, that is, databases, XML files or similar, graphic models etc. such as anatomy and / or instrumental models, medical records, teaching sequence and objectives to be fulfilled within a training, etc.

Abstract

L'invention concerne un simulateur pour chirurgie laparoscopique visant à reproduire fidèlement les conditions réelles auxquelles un chirurgien est confronté pendant une opération de ce type, et permettant de pratiquer les différentes techniques et d'améliorer la précision des manipulations. Ce simulateur comprend essentiellement un modèle physique (1) du patient, sur lequel se trouve l'instrumentation (2) et une caméra (4), un moniteur (5) permettant de visualiser la simulation de l'opération, une table d'opération (6) articulée dont le mouvement peut être transmis aux images des organes internes du patient, une unité de commande (9) destinée à commander tous les paramètres du système, ainsi que des périphériques connectés au système en vue de l'introduction de données dans celui-ci.
PCT/ES2007/000377 2007-06-22 2007-06-22 Simulateur pour chirurgie laparoscopique WO2009000939A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/ES2007/000377 WO2009000939A1 (fr) 2007-06-22 2007-06-22 Simulateur pour chirurgie laparoscopique

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/ES2007/000377 WO2009000939A1 (fr) 2007-06-22 2007-06-22 Simulateur pour chirurgie laparoscopique

Publications (1)

Publication Number Publication Date
WO2009000939A1 true WO2009000939A1 (fr) 2008-12-31

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Country Status (1)

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Cited By (31)

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Publication number Priority date Publication date Assignee Title
WO2012044753A3 (fr) * 2010-10-01 2012-05-31 Applied Medical Resources Corporation Dispositif d'apprentissage portatif pour laparoscopie
WO2013096632A1 (fr) * 2011-12-20 2013-06-27 Applied Medical Resources Corporation Simulation chirurgicale avancée
CN103976786A (zh) * 2013-09-04 2014-08-13 上海市东方医院 经脐入路腹腔镜手术操作力学评估平台
EP2922048A4 (fr) * 2012-11-13 2015-10-07 Eidos Medicine Llc Dispositif d'entraînement médical hybride pour laparoscopie
US9218753B2 (en) 2011-10-21 2015-12-22 Applied Medical Resources Corporation Simulated tissue structure for surgical training
US9449532B2 (en) 2013-05-15 2016-09-20 Applied Medical Resources Corporation Hernia model
US9548002B2 (en) 2013-07-24 2017-01-17 Applied Medical Resources Corporation First entry model
US9898937B2 (en) 2012-09-28 2018-02-20 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US9922579B2 (en) 2013-06-18 2018-03-20 Applied Medical Resources Corporation Gallbladder model
US9940849B2 (en) 2013-03-01 2018-04-10 Applied Medical Resources Corporation Advanced surgical simulation constructions and methods
US9959786B2 (en) 2012-09-27 2018-05-01 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US10081727B2 (en) 2015-05-14 2018-09-25 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
US10121391B2 (en) 2012-09-27 2018-11-06 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US10198966B2 (en) 2013-07-24 2019-02-05 Applied Medical Resources Corporation Advanced first entry model for surgical simulation
US10198965B2 (en) 2012-08-03 2019-02-05 Applied Medical Resources Corporation Simulated stapling and energy based ligation for surgical training
US10223936B2 (en) 2015-06-09 2019-03-05 Applied Medical Resources Corporation Hysterectomy model
US10332425B2 (en) 2015-07-16 2019-06-25 Applied Medical Resources Corporation Simulated dissectible tissue
US10354556B2 (en) 2015-02-19 2019-07-16 Applied Medical Resources Corporation Simulated tissue structures and methods
US10395559B2 (en) 2012-09-28 2019-08-27 Applied Medical Resources Corporation Surgical training model for transluminal laparoscopic procedures
PL424841A1 (pl) * 2018-03-09 2019-09-23 Laparo Spółka Z Ograniczoną Odpowiedzialnością Człon manipulacyjno-pomiarowy trenażera laparoskopowego
US10490105B2 (en) 2015-07-22 2019-11-26 Applied Medical Resources Corporation Appendectomy model
US10535281B2 (en) 2012-09-26 2020-01-14 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US10679520B2 (en) 2012-09-27 2020-06-09 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US10706743B2 (en) 2015-11-20 2020-07-07 Applied Medical Resources Corporation Simulated dissectible tissue
US10720084B2 (en) 2015-10-02 2020-07-21 Applied Medical Resources Corporation Hysterectomy model
US10796606B2 (en) 2014-03-26 2020-10-06 Applied Medical Resources Corporation Simulated dissectible tissue
US10818201B2 (en) 2014-11-13 2020-10-27 Applied Medical Resources Corporation Simulated tissue models and methods
US10847057B2 (en) 2017-02-23 2020-11-24 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
CN112535533A (zh) * 2020-12-06 2021-03-23 西安交通大学 一种利用3d打印病灶模型帮助远程手术的配套装置
US11030922B2 (en) 2017-02-14 2021-06-08 Applied Medical Resources Corporation Laparoscopic training system
US11120708B2 (en) 2016-06-27 2021-09-14 Applied Medical Resources Corporation Simulated abdominal wall

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US9218753B2 (en) 2011-10-21 2015-12-22 Applied Medical Resources Corporation Simulated tissue structure for surgical training
US11158212B2 (en) 2011-10-21 2021-10-26 Applied Medical Resources Corporation Simulated tissue structure for surgical training
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PL424841A1 (pl) * 2018-03-09 2019-09-23 Laparo Spółka Z Ograniczoną Odpowiedzialnością Człon manipulacyjno-pomiarowy trenażera laparoskopowego
CN112535533A (zh) * 2020-12-06 2021-03-23 西安交通大学 一种利用3d打印病灶模型帮助远程手术的配套装置

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