WO2015157621A1 - Rétracteur robotique ayant un actionneur renforcé par des fibres - Google Patents

Rétracteur robotique ayant un actionneur renforcé par des fibres Download PDF

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Publication number
WO2015157621A1
WO2015157621A1 PCT/US2015/025280 US2015025280W WO2015157621A1 WO 2015157621 A1 WO2015157621 A1 WO 2015157621A1 US 2015025280 W US2015025280 W US 2015025280W WO 2015157621 A1 WO2015157621 A1 WO 2015157621A1
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WO
WIPO (PCT)
Prior art keywords
soft actuator
actuator
soft
tissue
handle
Prior art date
Application number
PCT/US2015/025280
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English (en)
Inventor
Andrew Harris
Panagiotis POLYGERINOS
Arthur MOSER
Conor Walsh
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President And Fellows Of Harvard College
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Publication of WO2015157621A1 publication Critical patent/WO2015157621A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A61B2017/0225—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery flexible, e.g. fabrics, meshes, or membranes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
    • A61B2017/308—Surgical pincettes without pivotal connections holding by means of suction with suction cups

Definitions

  • MIS minimally invasive surgeries
  • pancreaticoduodenectomy or Whipple procedure pancreaticoduodenectomy or Whipple procedure
  • the current solution involves tilting the patient at a slightly upright angle that allows gravity to assist in retracting the colon.
  • surgeons often use ad hoc tools, such as gauze, to prop up the colon on a "pedestal". This practice introduces a misuse of current tools, while not fully creating a clear view behind the colon. The colon may then fall off this pedestal, causing the surgeon to perform the retraction process again before continuing the surgery.
  • laparoscopy is primarily used as a diagnostic and staging tool in several procedures, such as pancreatic cancer removal.
  • the pancreatic cancer removal procedure after the abdomen is insufflated, the colon must be mobilized—that is, connective tissue from the colon must be removed so that the organ can be manipulated.
  • soft MIS laparoscopic organ retraction tools can improve surgery times and reduce complications due to trauma caused from conventional rigid retraction devices.
  • Retractors are used by surgeons and surgical assistants to gain better view and access to tissues by adjusting the position of organs in front of those tissues.
  • a second type of retraction device uses a multi-jointed rod that can change shape intracorporeally to create a surface on which to rest tissue.
  • This type of retractor described in US 6,248,062 Bl, is generally used for long-term retraction of large organs.
  • the leading product in this category of retractor is the ENDOFLEX retractor, developed by Professor McMahon and Peter Moran at Surgical
  • This type of retractor consists of a series of links that are actuated by an internal cable.
  • the device is inserted into the body in a straight configuration. Once inside the body, the surgeon rotates an actuating mechanism at the proximal end that pulls the cable and causes the shaft to change shape.
  • the links change position to form a closed geometric shape at the distal end of the shaft (see FIG. 5). Because this device is used for long-term organ retraction during surgery, it proximal end of the device is anchored to the patient's bed.
  • the shaft of the retractor occupies one trocar port throughout the surgery.
  • a third method for tissue retraction is through inflation.
  • Inflatable retraction devices take one of two forms: (a) those which remain attached to the inflation source throughout the duration of the surgery and (b) those that are inserted with an infusion source that is removed once the retractor has been inflated.
  • An example of the first type (described in US 5,439,476) is in the form of a rigid rod with a balloon affixed to the distal tip. This balloon is fabricated with a stiff plastic, such that it inflates in only one direction. The outer surface is smooth and can be covered in a soft nylon mesh so as to ensure that the device is able to retract tissue atraumatically. For this device, the balloon covers several perforations at the distal tip of the rod for inflation and is not designed to facilitate its removal.
  • An example of the second type includes an inflatable balloon and a detachable manipulator that is used for inflation.
  • the balloon is rolled to fit through a trocar port and is then inflated intracorporeally using the manipulator. As the balloon inflates, it elevates and tilts the desired organs so as to displace them during surgery. When the balloon is maximally inflated, the inflation manipulator can be removed.
  • the device is not deployable, it does have separate inflation and inflator elements. The ability to separate these two elements may provide insight into how to inflate a deployable device intracorporeally.
  • a robotic retractor device with a fiber-reinforced actuator and methods for using it ⁇ e.g., in surgery are described herein, where various embodiments of the apparatus and methods may include some or all of the elements, features and steps described below.
  • a robotic retractor includes an elongated handle; a fiber-reinforced soft actuator mounted at an end of the elongated handle; and a pump coupled in fluid communication with the inflatable chamber and configured to pump fluid into the inflatable chamber.
  • the soft actuator comprises an elongated elastomeric body that defines an inflatable chamber; a fiber reinforcement wrapped around the elongated elastomeric body; and a strain-limiting layer extending along one side of the soft actuator, wherein the strain-limiting layer is configured to cause the soft actuator to bend toward the side of the strain-limiting layer.
  • the robotic retractor can further include a biocompatible sheath covering the elongated elastomeric body and the fiber reinforcement.
  • the soft actuator and the handle can have dimensions of 15 mm or less orthogonal to the elongated axis; and the handle can be 5-50 cm long or within the expected range for laparoscopic minimally invasive instruments.
  • the soft actuator has a hemi-circle-shaped cross- section with a straight side and a convex side, wherein the strain-limiting layer is positioned along the straight side.
  • the soft actuator can also includes a latch at an end of the soft actuator opposite from where the soft actuator is mounted to the handle.
  • the robotic retractor can also include a suction device coupled with an end of the soft actuator and detachably coupled with the handle and configured to generate a suction by which the soft actuator can be adhered to a surface when the suction device is detached from the handle.
  • the robotic retractor can include at least one magnet at an end of the soft actuator by which the soft actuator can be adhered to a surface.
  • a method for retracting bodily tissue uses a robotic retractor comprising an elongated handle and a fiber-reinforced soft actuator mounted at an end of the elongated handle.
  • the method includes using the handle to insert the soft actuator inside a body of an organism ⁇ e.g., a human); positioning the soft actuator alongside tissue ⁇ e.g., a colon) to be retracted inside the body; pumping fluid into the soft actuator, bending the soft actuator around the tissue to grasp the tissue; and retracting the grasped tissue with the soft actuator to displace the grasped tissue.
  • the grasped tissue is displaced toward an inner wall of human skin.
  • the tissue is displaced during a surgical operation.
  • the soft actuator can be inserted into the body through a trocar port. Further, the soft actuator further can include a strain-limiting layer along a side along which the soft actuator bends.
  • the apparatus described herein can provide long-term retraction of tissues or organs during minimally invasive surgery (MIS) using soft robotics technology.
  • soft elastomeric fiber-reinforced actuators can be utilized that use air pressure to deform (curl), providing a number of advantages over traditional mechanical retractors.
  • soft actuators do not require motors and can more easily be made soft so as to comply with tissue/organs.
  • FIG. 1 shows an embodiment of a soft retractor 12 with a magnified cut-away view of the soft actuator 16.
  • FIG. 2 shows a soft fiber-reinforced bending actuator 16 in an unpressurized state with a magnified cut-away view of the fiber reinforcements 28.
  • FIG. 3 shows the soft fiber-reinforced bending actuator 16 of FIG. 2 in a pressurized state.
  • FIG. 4 is a partially sectioned illustration of an embodiment of a soft fiber- reinforced actuator 16
  • FIG. 5 is a schematic illustration of stages of the soft fiber-reinforced actuator fabrication process.
  • FIG. 6 shows an embodiment of a soft retractor 12 with a suction device 50 that attaches to an inner abdomen wall in the body interior 36 to free the trocar port 28.
  • FIG. 7 shows an embodiment of a soft retractor 12 with suction devices 50 to attach to the inner abdomen wall at both ends of the soft actuator 16, thereby freeing the trocar port 28.
  • FIG. 8 shows an embodiment of a soft retractor 12 with a soft actuator 16 that has pre-programmed bending motions at various locations along its length to hold the retracted organ 40against the abdomen well.
  • FIG. 9 shows an embodiment of the soft retractor 12 inserted through a trocar port 38 through the skin 34 into the interior 36 a human body.
  • FIG. 10 shows the soft retractor 12 of FIG. 9 with the soft actuator 16 inflated to conform around the colon 40.
  • FIG. 11 shows the soft retractor 12 of FIGS. 9 and 10 retracting the colon 40.
  • FIG. 12 shows a simulation of colon retraction conducted in-vitro.
  • Percentages or concentrations expressed herein can represent either by weight or by volume. Processes, procedures and phenomena described below can occur at ambient pressure ⁇ e.g., about 50-120 kPa— for example, about 90-110 kPa) and temperature ⁇ e.g., -20 to 50°C— for example, about 10-35°C) unless otherwise specified.
  • first, second, third, etc. may be used herein to describe various elements, these elements are not to be limited by these terms. These terms are simply used to distinguish one element from another. Thus, a first element, discussed below, could be termed a second element without departing from the teachings of the exemplary embodiments.
  • the various components identified herein can be provided in an assembled and finished form; or some or all of the components can be packaged together and marketed as a kit with instructions ⁇ e.g., in written, video or audio form) for assembly and/ or modification by a customer to produce a finished product.
  • Soft robotic actuators such as the soft retractor 12 discussed below, can use air pressure (or other fluids) to deform elastomer joints, providing a number of advantages over traditional mechanical actuators. For example, soft robotic actuators do not require motors and can more easily be made soft so as to comply with tissue.
  • FIG. 1 An embodiment of the soft retractor 12 can be seen in FIG. 1 connected to a laparoscopic handle 14 for ease of positioning and retraction.
  • the elongated handle 14 can be, e.g., 10-50 cm long.
  • the soft retractor 12 comprises a fiber-reinforced actuator 16 that, when deflated, fits through a 15 mm trocar port 38, and a locking mechanism (latch) 18 that secures the actuator 16 in place when the tissue/ organ is retracted.
  • Pressurization of the actuator 16 and hence bending can be achieved through a proximal handle 14 that incorporates a pump 20 configured for manual pumping action ⁇ e.g., incorporating a medical grade syringe or a reciprocating manual pump) or, alternatively, an active pumping mechanism 20 ⁇ e.g., connecting the handle 14 to an external pressure source or having an automated on-board pump), as shown in FIG. 1.
  • the locking mechanism 18 can be in the form of one or more magnets that automatically lock the actuator 16 in place when pressurized.
  • the soft actuator 16 can be seamlessly integrated with existing laparoscopic tools and handles 14 ⁇ e.g., swapping it in place of an existing rigid retractor).
  • the soft actuator 16 can be programmed to achieve the desired bending radius, while its size (width and length) can be tuned during fabrication to retract organs with variable weight and size.
  • An advantageous feature of the technology is the ability to stably position the retractor 12 at the desired location and subsequently retract a tissue or organ without having to create contact or pinch using rigid tools that can potential cause raptures and bleeding of organs or other tissue. This reduced risk of injury is achieved through partial pressurization of the actuator 16 during positioning, thereby changing the stiffness of the actuator 16 and enabling the actuator 16 to be safely pushed through tissue.
  • Another advantage of this design is the ability to pressurize the actuator 16 in a confined space, such as in the abdomen, and achieve full actuator bending without causing any internal organ damage thanks to the inherent compliance and flexibility of the actuator 16, thereby ensuring that the retractor 12 can create a secure and soft loop around the organ even when there is no room for the laparoscopic tool to reach.
  • the soft actuator 16 can be activated by
  • the reinforced actuator 16 can be made from an elastomeric polymer ⁇ e.g., a hyper-elastic silicone); and it defines an inflatable chamber 22 and includes a flexible strain-limiting layer 30 (including, e.g., inextensible fibers or fabric) adhered to a side of the reinforced actuator 16.
  • the actuator 16 also includes a wrapping of a strain-limiting fiber reinforcement 28 (formed, e.g., of a para-aramid fiber, such as KEVLAR fiber from DuPont) to restrict expansion of the chamber 22 in certain directions ⁇ e.g., radially) and is covered with a flexible outer protection layer (sheath) 26 (formed of a biocompatible composition, such as silicone).
  • FIG. 2 A cross- sectional model of a basic soft bending fiber-reinforced actuator 16 can be seen in FIG. 2, exhibiting the inner chamber 22, the structural elastomer, the strain-limiting fiber wrapping 28, the strain-limiting layer 30, and the protective outer layer 26.
  • the fiber reinforcements 28 and stain-limiting layer 30 are also shown separately above and below the composite structure.
  • FIGS. 3 and 4 respectively, show a fiber- reinforced soft actuator 16 in unpressurized and pressurized states. Additional discussion of suitable structures for the soft actuator 16 can be found in
  • PCT/US14/62844 (Harvard / Kevin Galloway, et a/.).
  • the soft fiber-reinforced bending actuator 16 can be fabricated using a multi- step molding process and can comprise the following four parts: (i) a hemi-circle elastomeric polymer (including caps at the distal and proximal ends), (ii) circumferential fiber windings 28 that run along the length of the actuator 16, (iii) an inextensible base layer 30, and (iv) a soft coating material (sheath) 26 that
  • the circumferential reinforcement provided by the fibers 28, limits radial expansion and promotes linear extension, while the strain- limiting layer 30 at the base restricts linear extension on one face of the actuator 16. Therefore, as the actuator 16 is pressurized, part of it expands while the strain- limited portion restrains any linear expansion along one surface, producing a bending motion.
  • an inner rubber layer is molded to form the body of the actuator 16.
  • the molds 42 for the actuator 16 were 3D printed with an Objet Connex 500 printer.
  • the inner rubber layer formed of ELASTOSIL M4601 A/B from Wacker Chemie AG, Germany
  • the molded rubber was then allowed to set for 24 hours.
  • Woven fiberglass (S2-6522 from USComposites of Florida, USA) was glued to the flat face of the inner rubber layer to serve as a strain-limiting layer 30 that restricts linear expansion on that side of the actuator 16 while allowing for expansion on an opposite side of the actuator 16 (to enable bending) and that can provide for pre-programmed actuation motion, as shown in illustration (b) of FIG. 5.
  • fiber reinforcements 28 to prevent radial expansion were added to the surface, as shown in illustration (c) of FIG. 5.
  • a single KEVLAR fiber of 0.38 mm diameter was wound in a double helix pattern around the length of the actuator body 24. Raised features in the mold 42 were transferred to the actuator surface to define the fiber path for consistency of fiber placement.
  • the fiber reinforcements 28 were further secured (and prevented from moving upon inflation of the actuator 16 by placing the entire assembly into another mold 42 to encapsulate the actuator body 24 in a 1.0-mm-thick silicone layer 26 (formed, e.g., of ECOFLEX 0030 or DRAGON SKIN 20 silicone from Smooth-on Inc., of Pennsylvania, USA), as shown in illustration (d) of FIG. 5.
  • the actuator body 24 was then removed from the mold 42 and the half round steel rod 46.
  • the first open end was capped by placing it into a small cup of uncured silicone. Once this end cured, a vented screw 32 (shown in FIG. 3 and 4) was fed through the 15 mm thick silicone cap to form the mechanical connection for the pneumatic tubes coupled with the pump for supplying and removing actuating fluid to and fro the chamber 22 of the soft actuator 16.
  • the other open end was capped in a similar manner.
  • the actuator design can be tuned by varying a number of geometrical parameters including the wall thickness of the actuator 16, the length of the actuator 16, the diameter of the hemi-circle sectional shape, as well as the fiber winding pitch and orientation (see FIGS. 2 and 3). Changing any of these parameters will result in different performance. Furthermore, the shape of the cross section can also significantly affect the response of the system as the magnitude of the area
  • the retractor 12 can incorporate a suction cup device or an array of suction cups 50 (such as an
  • the fiber-reinforced actuator 16 is programmed to hold the weight of the organ without requiring a locking mechanism.
  • the retractor 12 enters the body through a trocar port 38.
  • a suction device 50 attaches from the body interior 36 to the interior side of abdominal skin 34, where the actuator 16 engages to form a hook.
  • the colon 40 is placed in the hook created by the fiber-reinforced actuator 16.
  • the retractor 12 can incorporate a suction cup device or an array of suction cups 50 or magnets to attach to the inner abdomen wall from both ends of the soft actuator 16 and free the trocar port 38.
  • the retractor 12 again enters the body through a trocar port 38.
  • a suction device 50 attaches to the interior side of abdominal skin 34 to form a surgical band with two fixture points that holds up the colon 40.
  • the fixture point proximal to the handle 14 incorporates a one way valve that, upon detachment from the handle 14, enables the actuator 16 to preserve its pressure and shape.
  • a side view of the colon 40 contained in the band is shown at right.
  • the retractor 12 can incorporate preprogrammed bending motions (flexible joints) at various locations along its length to hold a retracted organ against the abdomen wall.
  • the soft actuator 16 enters the body through a trocar port 38.
  • the surgeon moves a second section of the actuator 16 into place with the aid of an end effector 52; then fluid pressurization changes the stiffness of the soft actuator section enabling the actuator 16 to retract and hold the organ in the desired position.
  • the surgeon then moves a first section of the actuator 16 into place with the aid of the end effector 52; then the same pressurization process starts again.
  • the retractor 12 may not obscure as much of the working area as a traditional retractor because the retractor 12 of this embodiment need not be completely straight when it is fully jammed and can conform to the shape of the tissue.
  • Pancreatic cancer is both difficult to discover and to treat; for over 80% of patients, by the time of discovery, the tumor has already spread so extensively that it cannot be completely removed. The cancer has a very low survival rate and 95% of the people diagnosed do not survive beyond five years.
  • pancreatic cancer surgery the head of the pancreas, the gallbladder, part of the small intestine, the pylorus, and the lymph nodes near the area of surgery are removed. The area is then reconstructed so that the pancreatic digestive enzymes, bile, and stomach contents will flow to the small intestine.
  • pancreaticoduodenectomy or Whipple procedure. Due to the friable nature of the pancreas, injury to the organ is easily incurred, which can cause complications during surgery; and, therefore, adequate retraction of surrounding tissue is essential.
  • the soft retractor 12 with a fiber-reinforced actuator 16 described herein is well suited for minimally invasive surgery.
  • Use of a retractor 12 to retract the colon 40 to allow the surgeon to see and operate on the pancreas without causing any bleeding to the organ or the surrounding tissue is illustrated in FIGS. 9-12.
  • FIG. 9 a retractor 12 inserted through a trocar port 38.
  • the soft actuator 16 is then inflated, safely conforming around the colon 40, as shown in FIG. 10.
  • the colon 40 is then retracted, as shown in FIG. 11.
  • a simulation of the retraction in-vitro is provided in FIG. 12, where, in a first step (top left), the soft actuator 16 is pushed against the colon 40. In a second step (top right), the soft actuator 16 is inflated to curl around the colon 40. In a third step (bottom left), a laparoscopic tool is used to lock the actuator 16 in place. In a fourth step (bottom right), the colon 40 is safely retracted by the retractor 12.
  • the soft retractor 12 can be configured to achieve the following performance standards for colon retraction and laparoscopic surgery: a) colon retraction: (1) able to lift 1,500 grams, (2) can maintain a stable grasp for 7-9 hours, (3) can be set up in less than 45 minutes, (4) can be repositioned in less than 10 minutes, (5) can be released from the colon 40 in less than 15 seconds, (6) conforms to the colon 40, and (7) distributes force evenly over large area so as not to damage the tissue; and b) laparoscopic surgery: (1) deployable through a 15-mm-inner-diameter trocar 38, (2) removable through a 15-mm-inner-diameter trocar 38, and (3) manipulatable by one manual or da Vinci laparoscopic tool (from Intuitive Surgical, Inc., of Sunnyvale California, US) post set-up.
  • a) colon retraction (1) able to lift 1,500 grams, (2) can maintain a stable grasp for 7-9 hours, (3) can be set up in less than 45 minutes,
  • parameters for various properties or other values can be adjusted up or down by l/100 th , l/50 th , l/20 th , l/10 th , l/5 th , l/3 rd , 1/2, 2/3 rd , 3/4 th , 4/5 th , 9/10 th , 19/20 th , 49/50 th , 99/100 th , etc. (or up by a factor of 1, 2, 3, 4, 5, 6, 8, 10, 20, 50, 100, etc.), or by rounded-off approximations thereof, unless otherwise specified.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (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)
  • Surgical Instruments (AREA)

Abstract

Un tissu corporel (par exemple, un côlon) est rétracté au moyen d'un rétracteur robotique comprenant une poignée allongée et un actionneur souple renforcé par des fibres monté au niveau d'une extrémité de la poignée allongée. La poignée est utilisée pour insérer l'actionneur souple à l'intérieur d'un corps d'un organisme ; et l'actionneur souple est positionné le long du tissu à rétracter à l'intérieur du corps. Du fluide est pompé dans l'actionneur souple, pliant l'actionneur souple autour du tissu pour saisir le tissu ; et le tissu saisi est déplacé par l'actionneur souple.
PCT/US2015/025280 2014-04-10 2015-04-10 Rétracteur robotique ayant un actionneur renforcé par des fibres WO2015157621A1 (fr)

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US61/977,769 2014-04-10

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WO2017075602A1 (fr) * 2015-10-31 2017-05-04 Children's National Medical Center Outils chirurgicaux souples
IT201600120800A1 (it) * 2016-11-29 2018-05-29 Sebastiano Sciarretta Dispositivo interfaccia tra strumenti chirurgici o laparoscopici ed organi o visceri
CN109330700A (zh) * 2018-07-31 2019-02-15 深圳市精锋医疗科技有限公司 从操作设备组件及手术机器人
US11530621B2 (en) 2019-10-16 2022-12-20 General Electric Company Systems and method for use in servicing a machine
EP4233765A1 (fr) * 2022-02-24 2023-08-30 Max-Planck-Gesellschaft zur Förderung der Wissenschaften e.V. Dispositif à enroulement

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WO2017075602A1 (fr) * 2015-10-31 2017-05-04 Children's National Medical Center Outils chirurgicaux souples
CN108366720A (zh) * 2015-10-31 2018-08-03 儿童国家医疗中心 软手术工具
CN108366720B (zh) * 2015-10-31 2021-07-02 儿童国家医疗中心 软手术工具
US11135028B2 (en) 2015-10-31 2021-10-05 Children's National Medical Center Soft surgical tools
IT201600120800A1 (it) * 2016-11-29 2018-05-29 Sebastiano Sciarretta Dispositivo interfaccia tra strumenti chirurgici o laparoscopici ed organi o visceri
WO2018100593A3 (fr) * 2016-11-29 2018-07-12 Gabriele Valenti Dispositif d'interface entre des instruments chirurgicaux ou des laparoscopes et des organes ou viscères
US11259790B2 (en) 2016-11-29 2022-03-01 Gabriele Valenti Interface device between surgical instruments or laparoscopes and organs or viscera
CN109330700A (zh) * 2018-07-31 2019-02-15 深圳市精锋医疗科技有限公司 从操作设备组件及手术机器人
CN109330700B (zh) * 2018-07-31 2020-10-09 深圳市精锋医疗科技有限公司 从操作设备组件及手术机器人
US11530621B2 (en) 2019-10-16 2022-12-20 General Electric Company Systems and method for use in servicing a machine
EP4233765A1 (fr) * 2022-02-24 2023-08-30 Max-Planck-Gesellschaft zur Förderung der Wissenschaften e.V. Dispositif à enroulement
WO2023161186A1 (fr) * 2022-02-24 2023-08-31 MAX-PLANCK-Gesellschaft zur Förderung der Wissenschaften e.V. Dispositif enroulé

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