WO2018041211A1 - Système chirurgical endoscopique à orifice unique - Google Patents

Système chirurgical endoscopique à orifice unique Download PDF

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Publication number
WO2018041211A1
WO2018041211A1 PCT/CN2017/099872 CN2017099872W WO2018041211A1 WO 2018041211 A1 WO2018041211 A1 WO 2018041211A1 CN 2017099872 W CN2017099872 W CN 2017099872W WO 2018041211 A1 WO2018041211 A1 WO 2018041211A1
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WO
WIPO (PCT)
Prior art keywords
module
flexible
arm body
tool
transmission unit
Prior art date
Application number
PCT/CN2017/099872
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English (en)
Chinese (zh)
Inventor
徐凯
戴正晨
赵江然
阳志雄
张兆宇
刘欢
陈煜阳
刘增辉
Original Assignee
北京术锐技术有限公司
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.)
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Publication date
Priority claimed from CN201610798103.6A external-priority patent/CN106175851B/zh
Priority claimed from CN201610795893.2A external-priority patent/CN106420058B/zh
Application filed by 北京术锐技术有限公司 filed Critical 北京术锐技术有限公司
Publication of WO2018041211A1 publication Critical patent/WO2018041211A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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

Definitions

  • the invention relates to a medical device, in particular to a single-hole laparoscopic surgical system.
  • Manual multi-invasive laparoscopic minimally invasive surgery can reduce postoperative pain, reduce the probability of complications, shorten recovery time and improve postoperative scars.
  • the doctor can assist the doctor to complete the porous laparoscopic minimally invasive surgery.
  • the present invention provides a single-hole laparoscopic surgical system that includes a flexible surgical tool, an imaging tool, a catheter body, and a driver.
  • the flexible surgical tool includes a first flexible arm body, a surgical actuator associated with a distal end of the first flexible arm body, and a first drive transmission unit associated with a proximal end of the first flexible arm body;
  • the imaging tool includes a second flexible arm body, an imaging illumination module associated with a distal end of the second flexible arm body, and a second drive transmission unit associated with a proximal end of the second flexible arm body;
  • the catheter body includes a catheter for guiding the first flexible arm body to And a multi-lumen tubular body for guiding the second flexible arm body;
  • the drive body includes a skeleton associated with the catheter body, and is fastened to the bobbin and respectively coupled to the first drive transmission unit a plurality of driving modules associated with the second driving transmission unit; the driving module realizes overall feeding degree and overall rotation of the first flexible arm body by the first driving transmission
  • the multi-lumen tubular body includes a closed flexible surgical tool through a lumen, the catheter body further including a catheter support structure and a proximal end of the multi-lumen tubular body and the catheter support structure a distally fixedly connected connection interface; the catheter is secured to the catheter support structure, the distal end is in communication with the flexible surgical tool through a lumen, and the proximal end has a plurality of divergently distributed catheter inlets, the first flexible arm The distal end of the body is inserted through the lumen of the catheter through the catheter inlet and extends through the lumen.
  • the multi-lumen tube further includes an open imaging tool through the lumen, the catheter body further comprising an outer sleeve over the outside of the multi-lumen tube; the catheter support structure and the connection interface
  • An open imaging tool mounting notch that is matched to the imaging tool through the lumen is provided to enable the second flexible arm body to be mounted by the notch direction to the imaging tool through the lumen and the imaging tool mounting gap
  • the outer sleeve can be sleeved on the outer surface of the multi-lumen tube with the end surface of the imaging illumination module attached to the distal end surface of the multi-lumen tube, and is fixedly connected to the connection interface.
  • the catheter may be a planar arc plus a linear shape
  • a linear module in the drive module associated with the flexible surgical tool is disposed parallel to an axial direction at the catheter inlet, and with the imaging tool
  • a linear module of the associated drive module is parallel to the imaging tool through an axis of the lumen, and the first flexible arm body is capable of entering a straight portion of the catheter.
  • the multi-lumen tubular body includes a closed flexible surgical tool through a lumen, the catheter body further comprising a distal end plate and a proximal end plate coupled together, and respectively associated with the multi-lumen tubular body a connection interface fixedly connected to the distal end and the distal end plate; the distal end of the catheter is fixed to the connection interface and communicates with the flexible surgical tool through the lumen, and the proximal end is fixed to the proximal end plate and A plurality of divergently distributed catheter inlets are enabled to enable the first flexible arm body to be inserted through the catheter inlet and extend through the flexible surgical tool through the lumen.
  • the multi-lumen tube may further include an open imaging tool through the lumen, the catheter body further comprising an outer cannula sheathed outside the multi-lumen tube; the proximal end of the proximal plate is fixedly connected
  • An extension structure is provided on the extension structure with an imaging tool mounting notch such that the second flexible arm body can be mounted by the notch direction to the imaging tool through the cavity and the imaging tool mounting notch,
  • the outer sleeve can be sleeved on the outer surface of the multi-lumen tube with the end surface of the imaging illumination module attached to the distal end surface of the multi-lumen tube, and is fixedly connected to the connection interface.
  • the catheter may be planarly tangentially curved with two segments, and the axis of the catheter inlet on the proximal plate and the flexible surgical tool in the multi-lumen tube pass through the lumen axis Parallel, a linear module of the drive module associated with the flexible surgical tool is parallel to an axis of the catheter inlet on the proximal plate, and in the drive module associated with the imaging tool The linear module is parallel to the imaging tool through the axis of the lumen.
  • the multi-lumen tube may also include more than one closed multi-functional lumen.
  • the flexible surgical tool further includes a first drive input interface at a proximal end of the first drive transmission unit; the imaging tool further includes a second drive at a proximal end of the second drive transmission unit input interface.
  • the driving body may further include a skeleton sterile barrier connected between the skeleton and the duct body, the driving module comprising a plurality of linear modules and a plurality of motor group modules, the linear a module is fixedly connected to the skeleton, and a slider in each of the linear modules is fixedly connected to a motor module; a distal end of each of the motor module modules is connected with a sterile barrier on the sterile barrier Provided with a sterile barrier drive interface associated with the first drive input interface / the second drive input interface; the linear module drives the motor block module, the sterile barrier, and the slider by the slider The overall anterior-posterior feeding of the flexible surgical tool/the imaging tool, thereby achieving the overall feeding freedom of the first flexible arm body/the second flexible arm body; the motor unit module is transmitted through the sterile barrier Moving and converting the motion into movement and alignment of the first flexible arm body/the second flexible arm body in any direction by the first drive transmission unit/the second drive transmission unit Surgical execution The overall anterior-pos
  • the driving body may further include a skeleton sterile barrier connected between the skeleton and the duct body, and the driving module includes a plurality of linear modules, a plurality of motor group modules, and a linear module motor group.
  • the linear module is integrated on an outer circumference of the skeleton, and the linear module motor group is located at one end of the skeleton and connected to each of the linear modules; a slider in each of the linear modules and a motor module a fixed connection, and a plurality of the motor block modules are arranged in parallel with each other; a distal end of each of the motor block modules is connected with a sterile barrier, and the sterile barrier is provided with the first drive input interface/the a sterile drive actuation interface associated with the second drive input interface; the linear module drives the motor set module, the sterile barrier, and the overall forward and backward feed of the flexible surgical tool/the imaging tool through the slider And thereby achieving an overall feed freedom of the first flexible arm body/the second flexible arm body; the motor unit
  • sterile barrier of the skeleton and the sterile barrier are connected with a sterile membrane for the unsterilized
  • the skeleton and the drive module are isolated from the remaining sterilized catheter body, the flexible surgical tool, and the imaging tool.
  • the flexible surgical tool can further include a first drive input interface at a distal end of the first drive transmission unit; the imaging tool further including a distal end of the second drive transmission unit The second drive input interface.
  • the distal end of the skeleton of the driving body is fastened to the proximal end of the catheter body
  • the driving module includes a plurality of linear modules and a plurality of motor module modules, and the linear module and The skeleton is fixedly connected, and a slider in each of the linear modules is fixedly connected to a motor unit module; a proximal end of each of the motor module modules is provided with the first driving input interface/the first a driving interface associated with the input interface;
  • the linear module drives the motor module and the flexible surgical tool/the imaging tool to feed back and forth through the slider, thereby implementing the first flexible arm body/ An overall feed freedom of the second flexible arm body;
  • the motor unit module transmits motion through the drive interface, and converts the motion into a motion by the first drive transmission unit/the second drive transmission unit Movement of the first flexible arm body/the second flexible arm body in any direction and driving of the surgical actuator/the imaging illumination module; the motor module further drives the flexible surgery Tool whole Rotation, thus achieving overall rotational freedom of the first
  • the skeleton of the driving body and the proximal end of the catheter body are tightly connected, and the driving module comprises a plurality of linear modules, a plurality of motor module modules and a linear module motor group, and the linear module is integrated
  • the linear module motor group is located at one end of the skeleton and is connected to each of the linear modules;
  • the slider in each of the linear modules is fixedly connected to a motor module, and
  • the motor module modules are arranged in parallel with each other;
  • a proximal end of each of the motor module modules is provided with a drive interface associated with the first drive input interface / the second drive input interface;
  • a slider drives the overall forward and backward feed of the motor module and the flexible surgical tool/the imaging tool to achieve an overall feeding freedom of the first flexible arm body/the second flexible arm body;
  • the motor module transmits motion through the drive interface and converts the motion into the first flexible arm body / the second flexibility by the first drive transmission unit / the second drive transmission unit Movement of the body in any direction and driving
  • the motor module module associated with the flexible surgical tool is provided with a flexible arm body passage hole through which the first flexible arm body of the flexible surgical tool enters through the flexible arm body In the catheter.
  • the imaging lighting module includes two cameras and a plurality of illumination devices.
  • the first flexible arm body and the second flexible arm body include at least one knuckle and a flexible cover sleeved over the knuckle, each of the knuckles including a fixed disk and a spacer disk And structural bones, each of the plurality of sections The spacers are spaced apart in the structure, one end of the structural bone is fixed to the fixed disc, and the other end is sequentially fastened to the first drive transmission unit or the In the second drive transmission unit.
  • the structural bone is a rod-shaped or tubular structure, and the number is three or more; when the number of the number of sections is more than two, each of the sections is connected in series, that is, away from a structural bone of the first drive transmission unit or the second drive transmission unit passes through a fixed disk and a spacer disk adjacent to a section of the first drive transmission unit or the second drive transmission unit If the structural bone adjacent to the section of the first drive transmission unit or the second drive transmission unit adopts a tubular structure, the structure of the section away from the first drive transmission unit or the second drive transmission unit The bone passes through a structural bone proximate the section of the first drive transmission unit or the second drive transmission unit.
  • the flexible surgical tool further includes a first rigid arm for associating the first flexible arm body and the first drive transmission unit; the imaging tool further comprising for associating the second flexible arm body And a second rigid arm body of the second drive transmission unit.
  • first rigid arm body and the second rigid arm body are straight rod-shaped rigid structures, and the first rigid arm body and the second rigid arm body each include a plurality of intervals.
  • the single-hole laparoscopic surgical system enables a plurality of flexible surgical tools and an imaging tool to reach the surgical department through the same multi-lumen tube, which not only ensures the size limitation of multiple tools when passing through a single surgical incision, but also Meet the spatial arrangement requirements of the corresponding drive module in vitro.
  • FIG. 1A is a schematic structural view of a flexible surgical tool according to an example of the present invention.
  • FIG. 1B is a schematic structural view of a flexible surgical tool in accordance with another example of the present invention.
  • FIG. 2 is a schematic view showing the structure of a flexible arm body in a flexible surgical tool according to an example of the present invention.
  • 3A and 3B are schematic structural views of an image forming tool according to an example of the present invention.
  • 3C is a schematic structural view of an imaging tool according to another example of the present invention.
  • 4A-4E are schematic structural views of a catheter body according to an example of the present invention.
  • 4F-4G are schematic structural views of a catheter body according to another example of the present invention.
  • 5A and 5B are schematic views showing the structure of a driving body according to an example of the present invention.
  • Fig. 5C is a schematic structural view of a driving body according to another example of the present invention.
  • FIG. 5D is a schematic structural view of a surgical tool driving module in a driving body according to an example of the present invention.
  • 5E is a schematic structural view of an imaging tool driving module in a driving body according to an example of the present invention.
  • FIG. 5F is a schematic structural view of a driving body according to still another embodiment of the present invention.
  • FIG. 5G is a schematic overall structural view of a single-hole laparoscopic surgical system including the driving body shown in FIG. 5F.
  • 6A-6G are flowcharts showing the installation of a single-hole laparoscopic surgical system in accordance with an example of the present invention.
  • FIGS. 7A-7F are flowcharts showing the installation of a single-hole laparoscopic surgical system in accordance with another example of the present invention.
  • a single-hole laparoscopic surgical system can include a flexible surgical tool, an imaging tool, a catheter body, and a driver.
  • the distal end refers to the end of the component that is away from the operator but close to the surgical part, and may also be referred to as the front end; and the proximal end refers to the proximity of the component to the operator. But away from the end of the surgery, the following can also be called the back end.
  • the flexible surgical tool 10 can include a surgical actuator 101, a first flexible arm body 102, a first rigid arm body 103, a surgical tool drive transmission unit 104, and a drive input interface 105.
  • the surgical actuator 101 is fastened to the distal end of the first flexible arm body 102, which may be a mechanical surgical actuator such as a surgical forceps, scissors, a hemostat, etc., or an energy surgical actuator such as an electric cutter. , electric coagulation head, etc.
  • the first flexible arm body 102 is a flexible structure having a plurality of degrees of freedom of bending.
  • the first flexible arm body 102 can have two sections and can achieve four degrees of freedom of bending.
  • the proximal end of the first flexible arm body 102 is coupled to the surgical tool drive transmission unit 104 by a first rigid arm body 103.
  • the first rigid arm body 103 can be a straight rod-shaped rigid structure, and its length can be adjusted according to functional requirements. It should be noted that in certain cases, the first flexible arm body 102 can also be directly coupled to the surgical tool drive transmission unit 104, thereby omitting the first rigid arm body 103.
  • the surgical tool drive transmission unit 104 can convert the motion received by the drive input interface 105 into a bending motion of the first flexible arm body 102 over a plurality of degrees of freedom.
  • the motion received by the drive input interface 105 can be a rotational motion or a linear motion.
  • the motion is a rotational motion.
  • the drive input interface 105 can be located at the proximal end of the surgical tool drive transmission unit 104 as shown in FIG. 1A, or at the distal end of the surgical tool drive transmission unit 104 as shown in FIG. 1B.
  • the first flexible arm body 102 can include a first structural section 201, a second structural section 202, and a flexible cover 209 that is sleeved on the exterior of the first flexible arm body 102.
  • the cover 209 can improve the insertion flexibility of the first flexible arm body 102. A portion of the cover 209 at the front end of the first flexible arm body 102 has been hidden from the drawing.
  • the first constitution 201 may include a first structured spacer disk 204, a first structured fixed disk 205, and a first structured structural bone 203.
  • the plurality of first structured spacer discs 204 are spaced apart from each other in the first constitution 201 to prevent the first constituent structural bone 203 from being destabilized when being pushed and pulled.
  • One end of the first structural structure bone 203 is fixed to the first fixed section fixing disk 205, and the other end is sequentially fixed to the surgical tool driving transmission unit 104 through the first constitutional spacer disk 204 and the first rigid arm body 103. In this way, the first section 201 can be bent in any direction by cooperatively pushing and pulling the first section structure bone 203.
  • the second formation 202 can include a second gusset spacer disk 207, a second knuckle fixation disk 208, and a second knuckle structure bone 206.
  • the plurality of second segment spacer disks 207 are spaced apart from each other in the second segment 202 to prevent the second segment structure bone 206 from being destabilized when being pushed and pulled.
  • One end of the second segment structure bone 206 is fixed to the second segment fixing plate 208, and the other end sequentially passes through the second segment spacer disk 207, the first segment fixing plate 205, the first segment spacer disk 204, and the first portion.
  • the rigid arm body 103 is then affixed to the surgical tool drive transmission unit 104.
  • the second section 202 can be bent in any direction by cooperatively pushing and pulling the second section structure bone 206.
  • the first rigid arm body 103 may also include spaced apart spacer disks and a cover that is sleeved over the exterior of the first rigid arm body 103. Unlike the first flexible arm body 102, the outer cover of the first rigid arm body 103 can be rigid.
  • the number of sections of the first flexible arm body 102 may be one or more than two.
  • the structural bone of each segment may be a rod-shaped or tubular structure, and the number is three or more.
  • the sections can be connected in series.
  • the second articulated bone 206 away from the second section 202 of the surgical tool drive transmission unit 104 can be secured from the first section of the first section 201 of the surgical tool drive transmission unit 104 and the first configuration.
  • the section spacer 204 passes through.
  • the second section structure bone 206 away from the second section 202 of the surgical tool drive transmission unit 104 can also be The first section structure bone 203 of the first section 201 of the surgical tool drive transmission unit 104 is passed through.
  • imaging tool 30 can include imaging illumination module 301, second flexible arm body 302, second rigid arm body 303, imaging tool drive transmission unit 304, and drive input interface 305.
  • the imaging illumination module 301 is fastened to the distal end of the second flexible arm body 302, which can integrate two or more cameras 306 and a plurality of illumination devices 307 for realizing stereo vision as shown in FIG. 3A.
  • the proximal end of the second flexible arm body 302 is coupled to the imaging tool drive transmission unit 304 by a second rigid arm body 303.
  • the imaging tool drive transmission unit 304 can convert the motion received by the drive input interface 305 into a bending motion of the second flexible arm body 302 over a plurality of degrees of freedom.
  • the motion received by the drive input interface 305 can be a linear motion or a rotational motion.
  • the motion received by the drive input interface 305 is a spin.
  • the drive input interface 305 can be located at the proximal end of the imaging tool drive transmission unit 304 as shown in FIG. 3B or at the distal end of the imaging tool drive transmission unit 304 as shown in FIG. 3C.
  • the second flexible arm body 302 and the second rigid arm body 303 in the imaging tool 30 can be similar to the first flexible arm body 102 and the first rigid arm body 103 in the flexible surgical tool 10, respectively. It is the cross-sectional shape and length.
  • the catheter body 40 can include a distal multi-lumen tube 401, a proximal catheter support structure 403, an outer cannula 402, a connection interface 407, and a catheter 410.
  • the multi-lumen tube 401 can include three closed surgical tools through the lumen 404, an open imaging tool through the lumen 405, and four closed multi-functional lumens 406, as shown in Figures 4B and 4C.
  • FIG. 4B is merely an example, and the present disclosure is not limited thereto.
  • the outer cannula 402 can be placed over the multi-lumen tube 401 such that the open imaging tool is closed through the lumen 405.
  • connection interface 407 is fixedly coupled to the multi-lumen tubular body 401, the outer sleeve 402, and the catheter support structure 403, respectively.
  • the catheter 410 can be a curved conduit that is secured to the catheter support structure 403, the distal end being in communication with and communicating with the surgical tool in the multi-lumen tubular body 401, and having a plurality of diverging catheter inlets 409 at the proximal end. .
  • the catheter 410 can guide each of the first flexible arm bodies 102 together with the corresponding surgical tool drive transmission unit 104 in different directions in the space to prevent the respective surgical tool drive transmission units 104 from interfering with each other, and can be as shown in FIG. 5A.
  • the size of each drive module is as small as possible.
  • the imaging tool 30 since the distal end of the imaging tool 30 is an imaging illumination module 301 having a larger diameter than the flexible surgical tool 10, it may not pass through a closed lumen having a diameter slightly larger or smaller than the second flexible arm 302. . Therefore, in a state where the outer sleeve 402 is not mounted, the imaging tool can be an open structure through the lumen 405. At the same time, an open imaging tool mounting notch 408 is provided on the catheter support structure 403 and the connection interface 407 that matches the imaging tool through the lumen 405.
  • the second flexible arm body 302 and the second rigid arm body 303 in the imaging tool 30 can be mounted directly into the imaging tool through the lumen 405 and the imaging tool mounting notch 408 by the notch direction.
  • the end surface of the imaging illumination module 301 can be attached to the distal end surface of the multi-lumen tubular body 401 to form a closed cylinder.
  • the outer sleeve 402 can also be fixedly coupled to the connection interface 407.
  • a plurality of flexible surgical tools 10 and an imaging tool 30 are employed because the catheter body 40 employs a catheter support structure 403 that enables a plurality of guiding lumens to converge at a distal end and a divergent distribution at the proximal end.
  • the multi-lumen tube 401 can be reached to the surgical department, and the multi-lumen tube 401 can also be provided with a plurality of multi-functional lumens 406, which can effectively ensure the size limitation of multiple tools in a single-hole operation through a single surgical incision.
  • the flexible surgical tool and the drive module portion of the imaging tool in vitro can be spaced apart from each other to avoid mutual motion interference.
  • FIGs 4F and 4G illustrate a catheter body 40' provided in accordance with another embodiment of the present invention.
  • the catheter body 40' includes a multi-lumen tubular body 401, an outer cannula 402, a connection interface 407, a catheter 410', a distal end plate 411, and a proximal end plate 412.
  • the multi-lumen tube 401 can include three closed surgical tools through the lumen 404, an open imaging tool through the lumen 405, and four closed multi-functional lumens 406 as shown in Figures 4B and 4C.
  • the outer sleeve 402 can be placed over the multi-lumen tube 401 such that the open imaging tool is closed through the lumen 405.
  • connection interface 407 is fastened to the distal end plate 411 and is detachably connectable to the multi-lumen tubular body 401 and the outer sleeve 402, respectively.
  • the distal end plate 411 and the proximal end plate 412 can be integrally connected by a plurality of support structural rods 413.
  • the distal end of the catheter 410' is secured to the connection interface 407 and is in communication with and communicates with the surgical tool through the lumen 404.
  • the proximal end of the catheter 410' is secured to the proximal end plate 412 and has a plurality of divergently disposed catheter inlets 409'.
  • the catheter 410' can guide each of the first flexible arm bodies 102 together with the corresponding surgical tool drive transmission unit 104 in different directions to avoid mutual interference of the surgical tool drive transmission units 104, and can cause each surgical tool as shown in FIG. 5G.
  • the volume occupied by the drive module 503 is minimized as much as possible.
  • the catheter body 40' has an open structure through the lumen 405 in a state where the outer cannula 402 is not mounted.
  • an open imaging tool mounting notch 408' is provided on the distal end plate 411, the proximal end plate 412, and the connection interface 407 that match the imaging tool through the lumen 405.
  • the second flexible arm body 302 and the second rigid arm body 303 in the imaging tool 30 can be mounted directly into the imaging tool through the lumen 405 and the imaging tool mounting notch 408' by the notch direction.
  • the end surface of the imaging illumination module 301 can be adhered to the distal end surface of the multi-lumen tubular body 401 to form a closed columnar structure.
  • the outer sleeve 402 can be directly sleeved outside the multi-lumen tubular body 401, so that the imaging tool forms a closed cylinder through the lumen 405, so that the hermetic package can be effectively realized.
  • the outer sleeve 402 can also be fixedly coupled to the connection interface 407.
  • the catheter body 40' and the catheter body 40 each include a multi-lumen tube body 401, an outer sleeve 402, and a connection interface 407, and the interconnection relationship is unchanged.
  • the catheter body 40 includes a catheter support structure 403 having a particular spatial configuration that allows the flexible surgical tools to be radially arranged with a certain angle to each other; and the catheter body 40' includes a plurality of support structures.
  • the rods 413 are coupled into an integral distal plate 411 and a proximal plate 412 such that a plurality of flexible surgical tools are distributed in parallel and spaced apart from each other by a certain distance.
  • Both catheter bodies are effective in ensuring the size constraint of multiple tools in a single-hole laparoscopic procedure through a single surgical incision, and can avoid mutual interference of the extracorporeal driving portions of the flexible surgical tool 10 during operational motion.
  • the proximal end of the proximal plate 412 is fixedly coupled with an extension structure 414 on which an imaging tool mounting notch 408' can be opened.
  • the driver 50 can include a skeleton 501, a surgical tool drive module 503, and an imaging tool drive module 504.
  • the distal end of the skeleton 501 can be coupled to the catheter body 40 through the skeleton sterile barrier 502.
  • Three surgical tool drive modules 503 and one imaging tool drive module 504 can be fixed on the skeleton 501. It should be understood in the art that the number of illustrated driving modules is merely an example, and the present invention is not limited thereto.
  • the surgical tool drive module 503 can include a linear module 505 and a surgical tool motor set module 506.
  • the linear module 505 can be fixedly coupled to the skeleton 501, and the slider in the linear module 505 can be fixedly coupled to the surgical tool motor module 506.
  • the front end of the surgical tool motor set module 506 can be quickly coupled to the surgical tool sterile barrier 507.
  • the surgical tool sterile barrier drive interface 508 is detachably disposed (e.g., rotationally disposed, or slidably disposed, the present invention is not limited in this arrangement) on the surgical tool sterile barrier 507 that receives the surgical tool motor set module 506
  • the motion is transmitted and transmitted through a drive input interface 105 in the flexible surgical tool 10 coupled thereto (e.g., rotational motion, or linear motion, the present invention does not limit the form of motion). Therefore, the linear module 505 can drive the surgical tool motor module 506, the surgical tool sterile barrier 507, and the flexible surgical tool 10 to feed back and forth as a whole, thereby achieving the overall feeding freedom of the first flexible arm body 102.
  • the surgical tool motor set module 506 can transmit motion through the surgical tool sterile barrier 507, and the surgical tool drive transmission unit 104 can convert the motion into a first flexible arm body 102 that is bent in any direction (in this embodiment, four One degree of freedom of rotation) and drive to the surgical actuator 101.
  • the surgical tool motor set module 506 can drive the surgical tool sterile barrier 507 and the flexible surgical tool 10 to rotate integrally, and thereby achieve the freedom of rotation of the first flexible arm body 102 itself.
  • the surgical tool drive module 503 can achieve at least six degrees of freedom of movement of the flexible surgical tool 10. It should be noted that the arrangement of the linear module 505 and the surgical tool motor set module 506 is required to ensure that the first flexible arm body 102 can smoothly enter the catheter 410 through the catheter inlet 409 when the linear module 505 drives the flexible surgical tool 10.
  • the imaging tool driving module 504 can achieve five degrees of freedom of the imaging tool 30.
  • the five degrees of freedom may include four degrees of freedom of rotation of the second flexible arm body 302 and the overall degree of freedom of the imaging tool 30.
  • the arrangement of the linear module 505 and the imaging tool drive module 504 needs to ensure that when the linear module 505 drives the imaging tool 30, the second flexible arm body 302 and the second rigid arm body 303 can be smoothly installed in the imaging tool.
  • the notches 408, 408' and the imaging tool move back and forth through the lumen 405.
  • a sterile membrane (not shown) is attached to the exterior of the sterility sterile barrier 502, the surgical tool sterile barrier 507, and the imaging tool sterile barrier 512.
  • the sterile membrane can have the unsterilized skeleton 501, the surgical tool drive module 503, the imaging tool drive module 504, and the remaining sterilized catheter body 40, the flexible surgical tool 10, and the imaging tool. 30 isolation, which can effectively ensure the feasibility of clinical surgery.
  • the conduit 410 can be a planar arc plus a straight line shape.
  • the linear module 505 in the surgical tool driving module 503 is arranged parallel to the axial direction at the catheter inlet 409 to ensure that the flexible surgical tool 10 can smoothly enter the catheter body 40 under the driving of the surgical tool driving module 503.
  • the corresponding surgical tool in the lumen 401 passes through the lumen 404 and achieves a smooth feed.
  • the spatial shape of the catheter 410 can be adjusted based on the spatial position and orientation of the surgical tool drive module 503 such that a portion of the first rigid arm body 103 in the flexible surgical tool 10 can enter a straight portion of the catheter 410.
  • the linear module 505 in the imaging tool drive module 504 can be parallel to the axis of the imaging tool through the lumen 405 to ensure that the imaging tool 30 can smoothly enter the multi-lumen tube of the catheter body 40 driven by the imaging tool drive module 504.
  • the imaging surgical tool in body 401 passes through lumen 405 and achieves a smooth feed.
  • FIG. 5C is a schematic view showing the structure of a driving body according to another embodiment of the present invention.
  • the driver 50' can include a skeleton 501', a surgical tool drive module 503, and an imaging tool drive module 504.
  • the distal end of the skeleton 501' can be securely coupled to the proximal end plate 411 of the catheter body 40' shown in Figure 4F.
  • Three surgical tool drive modules 503 and one imaging tool drive module 504 are fastened to the skeleton 501'.
  • the three surgical tool drive modules 503 and one imaging tool drive module 504 are each disposed parallel to the central axis to correspond to the spatial position and orientation of the catheter inlet 409' in the catheter body 40'.
  • the driving body 50' shown in FIG. 5C can effectively realize the single-hole cavity mirror by arranging the three surgical tool driving modules 503 and the imaging tool driving module 504 in parallel. A compact arrangement of the extracorporeal drive portion of the surgical system.
  • the surgical tool drive module 503 can include a linear module 505 and a surgical tool motor set module 506.
  • the linear module 505 can be securely coupled to the skeleton 501, 501' and the slider in the linear module 505 can be fixedly coupled to the surgical tool motor module 506.
  • a flexible arm body passage hole 514 can be formed in the surgical tool motor module 506.
  • the proximal end of the surgical tool motor set module 506 is detachably disposed (including a rotational setting and a sliding setting, in this embodiment a rotational setting) with a drive interface 508.
  • the first flexible arm body 102 in the flexible surgical tool 10 illustrated in FIG. 1B can pass through the flexible arm body in the surgical tool motor module 506 through the aperture 514 into the catheter 410, 410'.
  • the drive interface 508 can receive motion generated by the surgical tool motor module 506 and transmit motion through the drive input interface 105 such that the flexible surgical tool 10 can be driven.
  • the surgical tool drive transmission unit 104 can convert the motion input via the drive input interface 105 into a motion in which the first flexible arm body 102 is bent in an arbitrary direction (in this embodiment, four bending degrees of freedom) and perform the operation on the surgery.
  • Surgical tool motor set module 506 can drive a flexible surgeon
  • the device 10 has an overall rotation and further realizes the degree of freedom of rotation of the first flexible arm body 102 itself.
  • the linear module 505 can drive the surgical tool motor module 506 and the flexible surgical tool 10 to feed back and forth as a whole through the slider that is tightly coupled to the surgical tool motor module 506, thereby achieving overall feed of the first flexible arm 102.
  • Degree of freedom
  • the surgical tool drive module 503 can achieve at least a total of six degrees of freedom of movement of the flexible surgical tool 10. It should be noted that the arrangement of the linear module 505 and the surgical tool motor module 506 needs to ensure that when the linear module 505 drives the flexible surgical tool 10, the first flexible arm body 102 can smoothly enter the catheter 410 via the catheter inlets 409, 409', 410'.
  • the spatial shape of the catheters 410, 410' can be adjusted according to the spatial position and orientation of the surgical tool drive module 503.
  • the catheter 410' can be a two-section arc that is tangential to the plane, such as two arcs that communicate with each other, such that the axis of the catheter inlet 409' is parallel to the axis of the surgical tool in the multi-lumen tubular body 401 through the lumen 404.
  • sufficient spacing can be created to avoid motion interference between the surgical tool drive module 503 and the imaging tool drive module 504.
  • the overall feed direction of the surgical tool motor module 506 can be parallel to the axis of the catheter inlet 409'.
  • the structure of the imaging tool drive module 504 is similar to that of the surgical tool drive module 503.
  • the imaging tool drive module 504 can include a linear module 505 and an imaging tool motor set module 509.
  • the imaging tool motor set module 509 can implement the imaging tool 30 in five by a match between the drive interface 511 at its proximal end and the drive input interface 305 at the distal end of the imaging tool 30 as shown in Figure 3C, along with the linear module 505. Movement on freedom.
  • the five degrees of freedom may include four degrees of freedom of rotation of the second flexible arm body 302 and the overall degree of freedom of the imaging tool 30.
  • the axis of the second rigid arm body 303 in the imaging tool 30 can be offset from the axis of the imaging tool drive transmission unit 304 since no overall rotation is required. Therefore, the second flexible arm body 302 can pass from the outside of the imaging tool motor module 509 without opening a through hole in the middle of the imaging tool motor module 509, thereby effectively reducing the difficulty of the arrangement of the motor inside the imaging tool motor module 509. . In this way, not only can the effect of the sterile but ineffectively sterilized imaging tool motor module 509 on the sterilized imaging tool 30 be reduced.
  • the arm body passes through the hole.
  • the flexible surgical tool 10 and imaging tool 30 are located at the proximal end with the drive input interfaces 105, 305 shown in Figures 1A, 3B
  • the corresponding drive modules 503, 504 are located at the proximal end of the tools 10, 30 (e.g. As shown in FIG. 6F, the flexible arm bodies 102, 302 need not pass through the drive modules 503, 504, thereby eliminating the need to begin through holes in the corresponding motor block modules 506, 509.
  • the sterile barriers 502, 507, 512 can also be provided as shown in FIG. 5A to effectively improve the single Clinical feasibility of a laparoscopic surgical system.
  • the flexible surgical tool 10 is located at the distal end.
  • the imaging tool 30 since the respective drive modules 503, 504 are located at the distal end of the tool 10, 30 (as shown in Figure 7F), and the surgical tool 10 requires a rotational motion about the entire axis of the tool, and the imaging tool 30 does not need to be performed.
  • the rotational movement of the whole body about its own axis the corresponding surgical tool motor module 506 needs to start the flexible arm body through hole 514 (as shown in FIG. 5D), and the corresponding imaging tool motor group module 509 does not need to open a through hole (as shown in the figure). 5E)).
  • the flexible surgical tool and the imaging tool can conveniently insert and match the corresponding driving module from the proximal end, the installation and operation of the single-hole laparoscopic surgical system can be effectively improved.
  • the arrangement of the linear module 505 and the imaging tool motor module 509 needs to ensure that when the linear module 505 drives the imaging tool 30, the second flexible arm body 302 and the second rigid arm body 303 can smoothly install the gap in the imaging tool.
  • the 408, 408' and imaging tools move back and forth through the lumen 405.
  • FIG. 5F illustrates a driver body 80 provided in accordance with yet another embodiment of the present invention.
  • the driver 80 can include a skeleton 801, a skeleton sterile barrier 802, a linear module motor group 803, a surgical tool sterile barrier 507, a surgical tool motor module 506, an imaging tool motor module 509, and an imaging tool.
  • Sterile barrier 512 wherein the skeleton sterile barrier 802 is located at the distal end of the driver body 80 and is connectable to the skeleton 801 and the catheter bodies 40, 40'.
  • the skeletal sterile barrier 802 can be rapidly coupled to the extension structure 414 in the catheter body 40'.
  • the outer circumference of the skeleton 801 can be integrated with four linear modules 807.
  • a linear module motor set 803 can be located at the proximal end of the backbone 801 and coupled to four linear modules 807.
  • the sliders in the linear module 807 can be fixedly coupled to the surgical tool motor module 506 and the imaging tool motor module 509, respectively.
  • the surgical tool sterile barrier 507, the surgical tool motor module 506, the imaging tool sterile barrier 512, and the imaging tool motor module 509 are substantially the same in structure and function as the previous embodiment, and are not described herein again.
  • the driving body 80 also realizes the parallel arrangement of the three surgical tool motor module 506 and the imaging tool motor module 509. Different from the driving body 50' shown in FIG. 5C, by integrating the respective linear modules 807 of the motor group modules 506, 509 on the outer circumference of the skeleton 801, the driving body 80 can make the external driving portion of the single-hole laparoscopic surgical system The arrangement is further compact, as shown in Figure 5G.
  • the driving body 80 illustrated in FIG. 5F is suitable for the flexible surgical tools located at the proximal end of the driving input interfaces 105, 305 shown in FIGS. 1A and 3B. 10. Imaging tool 30.
  • the driving body 80 can be appropriately modified, for example, the sterile barriers 802, 507, 512 are not disposed, so that the corresponding linear modules of the motor module modules are integrated into the driving body of the outer periphery of the skeleton. It can also be applied to the flexible surgical tool 10, the imaging tool 30, which is located at the distal end of the driving input interfaces 105, 305 shown in FIG. 1B and FIG. 3C, that is, suitable for driving the front single-hole laparoscopic surgical system.
  • the single-hole laparoscopic surgical system can include a surgical tool 10 as shown in Figure 1A, an imaging tool 30 as shown in Figure 3B, as shown in Figure
  • the catheter body 40 shown in FIG. 4A and the driving body 50 shown in FIG. 5A, and the assembly process may roughly include the following steps.
  • the catheter body 40 without the outer cannula 402 is mounted to the skeleton 501 via the skeleton sterile barrier 502 outside the surgical recipient, and the surgical tool sterile barrier 507, imaging tool is sterile.
  • Barriers 512 are mounted to three surgical tool motor set modules 506 and one imaging tool motor set module 509, respectively.
  • the surgical tool sterile barrier 507, the imaging tool sterile barrier 512, and the skeleton sterile barrier 502 can be interconnected by a sterile membrane (not shown) such that a barrier can be formed to unsterile the skeleton 501 in the system.
  • the linear module 505, the surgical tool driving module 503, and the imaging tool driving module 504 are isolated from the remaining sterilized portions, thereby effectively ensuring the clinical feasibility of the single-hole laparoscopic surgical system.
  • the imaging tool 30 is coupled to the imaging tool sterile barrier 512, and the second flexible arm body 302 and the second rigid arm body 303 in the imaging tool 30 are mounted to the catheter without the outer cannula 402.
  • the imaging tool in body 40 is mounted in gap 408 through lumen 405 and imaging tool.
  • the end surface of the imaging illumination module 301 can be adhered to the distal end surface of the multi-lumen tube body 401 in the catheter body 40 to form a closed columnar structure.
  • the outer diameter of the imaging illumination module 301 can be less than or equal to the diameter of the imaging tool in the multi-lumen tubular body 401 through the channel 405.
  • the outer sleeve 402 having an inner diameter larger than the outer diameters of the imaging illumination module 301 and the multi-lumen tube 401 is sleeved from the distal end to the multi-lumen tube 401, and the proximal end of the outer sleeve 402 is fast with the connection interface 407. connection.
  • the imaging illumination module 301 protrudes from the distal end of the outer sleeve 402 and is attached to the front end of the catheter body 40, which together can be a closed columnar structure. At this point, the single-hole laparoscopic surgical system is installed in vitro.
  • the skeleton 501 can be moved to drive the overall movement of the single-hole laparoscopic surgical system in the embodiment, and the imaging illumination module 301 and the distal end of the catheter body 40 in the working state are inserted through the sheath fixed to the single surgical incision. The body of the surgeon.
  • the second flexible arm body 302 of the imaging tool 30 can be fed forward integrally until the imaging lighting module 301 and at least a portion of the second flexible arm body 302 extend.
  • the imaging tool exits the channel 405 and is rotated to the appropriate position.
  • the suitable location can be, for example, such that the imaging illumination module 301 reaches a predetermined viewing angle and is capable of escaping the exit of the surgical tool through the lumen 404 in the multi-lumen tube 401.
  • the flexible surgical tool 10 is coupled to a surgical tool sterile barrier 507.
  • the first flexible arm body 102 at the distal end of the flexible surgical tool 10 can be inserted through the lumen 404 through a catheter 410 inserted into the multi-lumen tube 401 via a catheter 410 in the catheter body 40.
  • each surgical tool driving module 503 the first flexible arm body 102 of each flexible surgical tool 10 can be fed forward integrally until the surgical actuator 101 and at least a portion of the first flexible arm body 102 extends the surgical tool through the lumen 404 and bends into a posture as in the drawing to enable a single-port laparoscopic surgical procedure.
  • the body of the single-hole laparoscopic surgery receiver can include a second flexible arm body 302 and its carrying imaging illumination module 301, three first flexible arm bodies 102 and their carrying Mechanical or energy surgical actuator 101 and partial catheter body 40.
  • a plurality of multifunctional channels 406 may also be included in the catheter body 40.
  • the single-hole laparoscopic surgical system of the present example includes a detachable catheter body, an imaging tool, a flexible surgical tool, a sterile barrier, a skeleton, an imaging tool driving module, and the like.
  • the spatial configuration of the catheter body and the tissue structure of the driver body can be adjusted according to different tool sizes, driving module motion characteristics, etc., thereby not only meeting the size constraint of multiple tools through a single surgical incision in a single hole surgery, It also ensures that the spatial arrangement of the extracorporeal drive portion of the single-hole surgical system is as compact as possible.
  • the imaging tool can be waterproofly packaged and can be sterilized.
  • the sterilized flexible surgical tool, the catheter body and the imaging tool can be respectively connected with the surgical tool driving module, the driving body skeleton, the imaging tool driving module, etc. through the sterile barrier to separate the sterilized part and the remaining unsterilized. Partial isolation allows for effective implementation of clinical procedures.
  • the single-hole laparoscopic surgical system can include the surgical tool 10 shown in Figure 1B, the imaging tool 30 shown in Figure 3C, the catheter body 40' as shown in Figure 4F, and Figure 5C.
  • the drive body 50' is shown, and the assembly process can generally include the following steps:
  • the catheter body 40' to which the outer cannula 402 is not attached is attached to the skeleton 501' outside the surgery recipient before surgery.
  • the slider in the linear module 505 carries the surgical tool motor module 506 and the imaging tool motor module 509 in an initial state farthest from the catheter body 40'.
  • the imaging tool 30 is mounted to the imaging tool motor set module 509. Simultaneous mounting of the second flexible arm body 302 and the second rigid arm body 303 in the imaging tool 30 to the catheter body 40' in the state in which the outer cannula 402 is not mounted passes through the lumen 405 and the imaging tool mounting notch 408' . At this time, the end surface of the imaging illumination module 301 can be attached to the distal end surface of the multi-lumen tube body 401 in the catheter body 40'.
  • the outer diameter of the imaging illumination module 301 can be less than or equal to the diameter of the multi-lumen tubular body 401, the outer cannula 402 can be sleeved from the distal end to the multi-lumen tubular body 401, and the proximal end of the outer cannula 402 can be coupled to the connection interface 407. Quick connection.
  • the imaging illumination module 301 can protrude from the distal end of the outer sleeve 402 and be attached to the distal end of the catheter body 40', which together can be a closed columnar structure. So far, the extracorporeal part of the single-hole laparoscopic surgical system has been installed.
  • the movable skeleton 501' is driven to drive the overall movement of the single-hole laparoscopic surgical system in the embodiment, and the imaging illumination module 301 and the distal end of the catheter body 40' in the working state are fixed to the sheath of the single surgical incision.
  • the sleeve is inserted into the body of the recipient of the surgery.
  • the second flexible arm body 302 of the imaging tool 30 can be driven by the imaging tool driving module 504.
  • the overall advancement is advanced until the imaging illumination module 301 and at least a portion of the second flexible arm body 302 extend beyond the imaging tool through the lumen 405 and are turned into position.
  • the proper position means that the imaging illumination module 301 reaches a predetermined angle of view and allows the surgical tool in the multi-lumen tube 401 to pass through the outlet of the channel 404.
  • a plurality of flexible surgical tools 10 are mounted from the proximal end to the surgical tool drive module 503.
  • the first flexible arm body 102 at the distal end of the flexible surgical tool 10 can be inserted through the flexible arm body on the surgical tool drive module 503 through the hole 514 and the catheter 410' in the catheter body 40' into the multi-lumen tube body 401.
  • the surgical tool passes through the lumen 404.
  • the first flexible arm body 102 of each flexible surgical tool 10 can be advanced as a whole under the driving of each surgical tool drive module 503 until the surgical actuator 101 and at least a portion of the first flexible arm body 102 extends the surgical tool through the lumen 404 and bends into a posture as shown in the drawings to enable a single-port laparoscopic surgical procedure.
  • the body of the single-hole laparoscopic surgery can include a second flexible arm body 302 and the imaging illumination module 301 carried therein, the three first flexible arm bodies 102 and the body thereof as shown in FIG. 6G.
  • a mechanical or energy surgical actuator 101 and a portion of the catheter body 40' are carried.
  • the flexible surgical tool and the imaging tool can be placed.
  • the proximal end of the corresponding drive module In this way, the flexible surgical tool and the imaging tool can conveniently insert and match the corresponding driving module from the proximal end, thereby effectively improving the simplicity of installation and operation of the single-hole laparoscopic surgical system.

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Abstract

L'invention concerne un système chirurgical endoscopique à orifice unique, comprenant un instrument chirurgical flexible (10), un outil d'imagerie (30), des corps de cathéter (40, 40') et des corps d'entraînement (50, 50'). L'instrument chirurgical flexible (10) comprend un premier corps de bras flexible (102), un exécuteur chirurgical (101) et une première unité de transmission d'entraînement (104). L'outil d'imagerie (30) comprend un second corps de bras flexible (302), un module d'éclairage d'imagerie (301) et une seconde unité de transmission d'entraînement (304). Chaque corps de cathéter (40, 40') comprend un cathéter (410, 410') et un corps de cathéter à lumières multiples (401). Chaque corps d'entraînement (50, 50') comprend un squelette (501, 501') relié au corps de cathéter (40, 40') et une pluralité de modules d'entraînement (503, 504) reliés de manière fixe au squelette (501, 501'). Les modules d'entraînement (503, 504) réalisent un degré de liberté d'alimentation global, un degré de liberté de rotation global et un degré de liberté de virage du premier corps de bras flexible (102) par l'intermédiaire de la première unité de transmission d'entraînement (104) reliée aux modules d'entraînement, et réalisent un degré de liberté d'alimentation global et un degré de liberté de rotation du second corps de bras flexible (302) par l'intermédiaire de la seconde unité de transmission d'entraînement (304) reliée aux modules d'entraînement.
PCT/CN2017/099872 2016-08-31 2017-08-31 Système chirurgical endoscopique à orifice unique WO2018041211A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN201610795893.2 2016-08-31
CN201610798103.6A CN106175851B (zh) 2016-08-31 2016-08-31 一种基于柔性臂体的单孔腹腔镜手术系统
CN201610795893.2A CN106420058B (zh) 2016-08-31 2016-08-31 一种驱动前置的单孔腹腔镜手术系统
CN201610798103.6 2016-08-31

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