Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00002—Operational features of endoscopes
  • A61B1/00039—Operational features of endoscopes provided with input arrangements for the user
  • A61B1/00042—Operational features of endoscopes provided with input arrangements for the user for mechanical operation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00112—Connection or coupling means
  • A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00112—Connection or coupling means
  • A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
  • A61B1/00128—Connectors, fasteners and adapters, e.g. on the endoscope handle mechanical, e.g. for tubes or pipes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00131—Accessories for endoscopes
  • A61B1/00133—Drive units for endoscopic tools inserted through or with the endoscope
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00147—Holding or positioning arrangements
  • A61B1/00149—Holding or positioning arrangements using articulated arms
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00147—Holding or positioning arrangements
  • A61B1/0016—Holding or positioning arrangements using motor drive units
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/005—Flexible endoscopes
  • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
  • A61B1/0052—Constructional details of control elements, e.g. handles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
• • 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
  • A61B34/35—Surgical robots for telesurgery
• • 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
  • A61B34/70—Manipulators specially adapted for use in surgery
  • A61B34/74—Manipulators with manual electric input means
• • 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
  • A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes

Definitions

• the present invention relates to a system for motorized control of a standard colonoscope.
• Embodiments of the present invention relate to a control system that includes a control interface and linked motorized drive units and adaptors for retrofitting a standard colonoscope.
• Colonoscopy is a medical procedure in which a flexible endoscope, or colonoscope, is advanced into a patient's lower GI tract for diagnostic examination and/or surgical treatment of the colon.
• a standard colonoscope is typically 135-185 cm in length and 12-19 mm in diameter and includes a control head and a flexible shaft with a maneuverable tip that includes a camera or an optic fiber bundle.
• the head is connected to a light source via an ‘umbilical’ cord, through which pass other tubes transmitting air, water and suction, etc.
• the working channel is used for the passage of diagnostic or therapeutic tools.
• Two one on the top of another mounted rotatable knobs are mounted on the side of the control head and are used for up/down and right/left movement of the shaft tip.
• the colonoscope is manually advanced within the lower GI tract by pushing and pulling the control head and shaft.
• the lower colon is highly torturous and the colonoscope rubs against the mucosal surface of the colon along the outside of each turn as the colonoscope is advanced within the colon. Friction and slack in the colonoscope build up at each turn, making it more and more difficult to advance and withdraw the colonoscope.
• a colonoscope can be maneuvered through torturous anatomy however, such maneuvering requires experience and use of both hands rendering simultaneous control over any other instrument (e.g. diagnostic or therapeutic tool positioned through the working channel) impossible.
• control unit which enables an operator to remotely control the tip of a flexible endoscope as well as the advancement of the colonoscope shaft.
• the present invention provides a control system for a colonoscope having a shaft deflectable via two rotatable knobs, the control system comprising: a first drive unit mounted externally to a housing of the colonoscope, said first drive unit includes a first drive mechanism for engaging the two rotatable knobs or gears replacing the two rotatable knobs; a second drive unit being attachable to the shaft of the endoscope, said second drive unit being capable of linearly translating the shaft forward and backward; and a user interface including a first interface being mounted on a pivotal support, the first interface being engageable by a palm of a hand, the user interface being for controlling the first drive unit and optionally the second drive unit.
• the control system can also include a third drive unit being attachable to the shaft of a ‘baby tool’, the third drive unit is capable of linearly translating the ‘baby took shaft forward and backward; and activate the end effector at the distal end of the ‘baby took shaft.
• Fig. 1 illustrates the present system in an operating room setting.
• Fig. 2 illustrates the present system mounted on a cart.
• Figs. 3a-i illustrate a standard colonoscope (Figure 3a) fitted with standard control knobs ( Figures 3d-f) or adaptor gears ( Figures 3g-i).
• Figs. 4a-l illustrate a shaft deflection drive unit of the present invention and its components, a ‘baby tool’ is shown in Figure 4e, a baby tool drive module is shown in Figures 4f4.
• Figs. 5a-c illustrate the shaft push/pull drive unit of the present invention.
• Figs. 6a-c illustrate the finger interface (Figure 6a) and the various control states thereof ( Figures 6b-c).
• Figs. 7a-c illustrate endoscope shaft and ‘baby tool’ interfaces of the present invention.
• Figs. 8a-h illustrate add on module and interface, allowing the control endoscope shaft roll movement.
• Figs. 9a-g schematically illustrate a sequence of interface inputs and corresponding shaft advancement within the colon.
• Fig. 10 illustrates one of many possible setup configurations of the system.
• Fig. 11 is flow chart outlining setup of the present colonoscope control system and a workflow enabling switching between motorized and manual modes.
• Figs. 12a-h illustrate bench-testing of a prototype constructed in accordance with the teachings of the present invention.
• the present invention is of a colonoscope control system which can be used to control a standard colonoscope. Specifically, the present invention can be used to remotely control a standard colonoscope and enable a surgeon to accurately maneuver a colonoscope through the lower GI as well as operate ‘baby tools’ positioned through a working channel of the endoscope.
• colonoscope control system that enables accurate and intuitive control over colonoscope maneuvering within the lower GI tract.
• the present control system can be retrofitted to existing standard colonoscope and enable switching between motorized and manual control over shaft advancement and/or deflection.
• a control system for a colonoscope having a shaft deflectable via two rotatable knobs.
• the control system of the present invention includes a first drive unit mounted externally to a housing of the colonoscope.
• the first drive unit includes a first drive mechanism for engaging the two rotatable knobs of the colonoscope or an adaptor that includes gears that replace the two rotatable knobs.
• the gears are mounted on the shafts of the two rotatable knobs.
• the control system also includes a second drive unit that is attachable to the shaft of the endoscope, via, for example, rollers.
• the second drive unit is capable of linearly translating the shaft forward and backward and operates shaft advancement through the lower GI tract.
• the control system also includes a user interface that includes a first interface mounted on a pivotal support (e.g., gimbaled) and engageable by a palm of a hand of the user. Such an interface can be used to control the first drive mechanism operating up/down and left/right deflection of the shaft.
• a pivotal support e.g., gimbaled
• Such an interface can be used to control the first drive mechanism operating up/down and left/right deflection of the shaft.
• the user interface can also include a second interface for controlling the second drive mechanism.
• the second interface can include a slider interface for linearly translating the shaft forward and backward.
• the user interface can also include a third interface pivotally attached to the first interface.
• This interface can be operated by one or more fingers of a hand (e.g., pads simultaneously operable via thumb and index finger of said hand) and is used to control the endoscope shaft grasping mechanism of the linear shaft forward and backward motion.
• the user interface can also include a fourth interface that includes a slider button for linearly translating the ‘baby took shaft forward and backward and a fifth interface operable by one or more fingers of a hand (e.g., pads simultaneously operable via thumb and index finger of said hand) for actuating a tool (e.g., grasper, lasso) positioned through the working channel of the colonoscope.
• a fourth interface that includes a slider button for linearly translating the ‘baby took shaft forward and backward and a fifth interface operable by one or more fingers of a hand (e.g., pads simultaneously operable via thumb and index finger of said hand) for actuating a tool (e.g., grasper, lasso) positioned through the working channel of the colonoscope.
• a tool e.g., grasper, lasso
• a typical layout of the control system of the present invention includes a first drive unit attached to the colonoscope control knobs (or shafts thereof via the geared adaptor), a second drive unit attached to the shaft (via, for example, rollers) and a user interface positioned remotely from the colonoscope and connected to the drive units via a wired or wireless connection).
• the user interface can be positioned inside the operating room in close proximity to the colonoscope and patient or outside the operating room (e.g., telemedicine) in which case the patient and colonoscope can be visualized via a remote camera feed.
• Figures 1 and 2 illustrate a typical operating room setup ( Figure 1) and cart layout ( Figure 2) of the present system which is referred to herein as system 10.
• a monitor 12 can be used by surgeon 14 to monitor the procedure.
• system 10 is positioned near the patient 700 using cart 20.
• the modules of system 10 are placed on different articulated shelves 22 in an optimal layout (further described below with reference to Figures 10- 11).
• the surgeon operates colonoscope 24 through user interfaces 400 and 401.
• Figures 3a-c illustrate an off the shelf colonoscope 24 (Pentax EC-3831L Flexible Video Colonoscope Endoscope), having body 26 fitted with manual knobs 28 and 30. Surgeon 14 can deflect distal tip 32 of shaft 33 by rotating knobs 28 and 30 to a desired orientation. A camera cable and light source 34 with attached adapter 36 are also connected to body 26 of colonoscope 24.
• Figure 3b illustrates adapters 40 and 42 that replace manual knobs 28 and 30.
• Adapters 40 and 42 have a keyhole pattern designed to engage the ends of shafts 44 and 46 that serve to mechanically transmit knob inputs to the articulation mechanism of colonoscope 24.
• Adapter 40 has a round base 48 and adapter 42 has a round base 50. Round bases 48 and 50 serve as stoppers for manual knobs 28 and 30 or the mechanical gears retrofitted in place thereof.
• Figure 3b also illustrates valve buttons 52 and 54 of colonoscope 24 that provide an interface for suction and air/water (respectively) through tunnels 51 and 53 (respectively).
• FIG 3c illustrates adapters 40 and 42 attached to shafts 44 and 46 (the keyholes prevent sliding of adapters 40 and 42).
• Figures 3 d-f illustrate an embodiment of the present invention in which manual knob 28 is coupled to adapter 42 and manual knob 30 is coupled to adapter 40. Such coupling still enables colonoscope 24 to be manually operated through knobs and facilitates rapid switching between manual and motorized operation of colonoscope 24.
• Figures 3g-i illustrate coupling of gear 60 is coupled to adapter 40 and gear 62 is coupled adapter 42. Following such coupling, colonoscope 24 can be fitted with a drive unit 66 for actuating articulation through gears 60 and 62. Additional functions of colonoscope 24 (various valves and buttons) can also be coupled to other drive/control mechanisms thereby converting colonoscope 24 from manual to fully motorized operation.
• FIGS 4a-k illustrate the components of drive unit 66.
• Drive unit 66 is attached to an external surface of body 26 of colonoscope 24.
• Motors of drive unit 66 are coupled to knobs 40 and 42 of colonoscope 24 (or shafts thereof through gears) enabling conversion of any standard manual colonoscope into a motorized (e.g., robotic) colonoscope.
• Figure 4a illustrates coupling of motors 68 and 69 to gears 60 and 62 fitted on colonoscope 24.
• Housing 70 of drive unit 66 is secured to colonoscope body 26 via bracket 72.
• Motors 68 and 69 attached along a vertical plate 78 of chassis 70 are coupled to gears 60 and 62 via worm gears 74 and 76.
• Potentiometers 80 and 82 are also attached to vertical plate 78 and coupled to worm gears 74 and 76 via gears 61 and 63.
• Motors controller 75 is secured colonoscope body 26 via bracket 72.
• Figure 4c-e illustrate a drive unit which is referred to herein as drive unit 132 that can be used to control ‘baby tool’ advancement and actuation through a working channel of colonoscope 24.
• Colonoscopy oftentimes requires sampling or treatment of tissue during the procedure.
• sampling or treatment can be carried out using a ‘baby tool’ that is inserted through a working channel of colonoscope 24, and is positioned out of a distal end of colonoscope shaft 33 such that an end effector thereof is in proximity to a desired tissue.
• the surgeon can then use the end effector (e.g., grasper, or lasso or any other tool), in order to treat or retrieve a tissue sample.
• Tool 110 includes a thin flexible shaft 112 (typically 1.2 - 3.1 mm in diameter with a length of 60-210 cm).
• Tool 110 includes an end effector 114 at a distal end of shaft 112.
• End effector 114 is typically manually operated, using fixed handle 118 and slider button 127. Pushing slider button 127 over handle 118 toward distal end of shaft 112 opens the jaws of tool 110 and vice versa.
• Figure 4c illustrates an adapter 130 connected to housing 70.
• Adapter 130 connects a tool 110 push/pull drive unit 132 to housing 70 using screws (not seen) that pass-through holes 134.
• Port 136 in body 26 provides access to the working channel of colonoscope 24.
• Figure 4d illustrates the basic components of drive unit 132 of tool 110.
• shaft 112 In order to translate shaft 112 in an out of the working channel and accurately position end effector 114 at a desired anatomical landmark, shaft 112 is inserted into groove 142 of adapter 130 and is secured via knob 144.
• Adapter 130 is connected to slider 148 having a typical movement range of 50 mm.
• slider 148 is driven via a screw mechanism that includes screw 156, a motor (not seen) and a gear 158 that is coupled to gear 160.
• FIG. 4f illustrates drive unit 132 connected to housing 70 via adapter 130, groove 142 is aligned with the center of port 136.
• Figure 4g illustrates a motorized mechanism 170 for motorized activation of suction valve 52, and air/water valve 54.
• Housing 70 includes a protrusion 180 that serves as an enclosure for solenoids 182 and 184 that activate valves 52 and 54 (respectively). The surgeon controls the state of each valve via switches as is further described hereinbelow with reference to Figure 7b.
• Figure 4h illustrates a configuration in which drive unit 132 and drive unit 66 share a common enclosure 192.
• Rail 194 forms a part of enclosure 192 and serves as a connector for an open/close module 198 for tool 110 (Figure 4i).
• Module 198 may be releasably connected to drive unit 132, via connector 200.
• Connector 137 is part of chassis 210.
• handle 118 is inserted into module 198 with shaft 112 directed towards drive unit 132.
• Button 127 of tool 110 is clamped into the open/close mechanism of module 198 and cover 206 is slide over chassis 210 in order to close module 198.
• Figure 4j illustrates the open/close mechanism of module 198.
• Handle body 118 is clamped into housing 218 and into housing 222, with the sliding button 127 clamped into the arms of rotating lever 224.
• Lever 224 is connected to a servomotor 226 that is in turn connected via slider 228 to chassis 210.
• Slider 228 of servomotor 226 is used for optimizing the point of rotation of lever 224, enabling the use of various types, length and shapes, of different baby tools.
• lever 224 rotates in a forward direction
• handle 127 is pushed forward.
• Handle 127 is connected to end effector 114 through a push/pull wire.
• the jaws mechanism of end effector 114 causes the jaws to open.
• a backward movement of sliding button 127 will cause jaws of end effector 114 to close.
• Figure 4k illustrates a typical configuration of drive units 66, 132 and module 198.
• Drive unit 132 is connected to drive unit 66.
• Module 198 which activate the open close of baby tool distal end effector 114 is connected to drive unit 132.
• Figure 41 illustrates drive units 66 and 132 and module 198 assembled in housing 217. Vacuum pads 237 are used to secure housing 217 to any flat surface, as is further described hereinbelow.
• Figures 5a-c illustrate a drive unit 300 for advancing/retracting a flexible shaft 33 of an endoscope 24.
• FIG. 5a is a perspective view of drive unit 300.
• Drive unit 300 includes a motorized linear mechanism 302 that drives linearly slider 304 having a linear travel range of 100 mm, and 2 grasping actuators 308 and 310. Rollers 312 and 314 flank arm 315 with groove 316 positioned therebetween. The roller and grove setup lead flexible shaft 33 into grasping actuator 310.
• a cover 344 is connected to plate 22 typically via vacuum pads 330. Plate 22 is connected to cart 20 via arm 402.
• a button 340 on cover 344 controls both grasping actuators (308 and 310).
• a surgeon clicks button 340 to open grasping actuators 308 and 310 flexible shaft 33 can then be placed between the jaws of grasping actuators 308 and 310 and locks flexible shaft 33 within grasping actuators 308 and 310 by clicking the button 340 again.
• FIG. 5b illustrates the components of drive unit 300.
• Body 350 includes a screw-based linear drive mechanism that drives slider 304 over body 350 (from point P indicating proximal position to point D indicating distal position).
• Grasping actuator 308 is attached to slider 304.
• Grasping actuator 308 travels linearly with slider 304 and is referred to hereinunder as the ‘moving grasping actuator’.
• Grasping actuator 310 is attached to the proximal end P of body 350 and is referred to hereinunder as the ‘fixed grasping actuator’ .
• Both grasping actuators 308 and 310 have covers 368 designed to optimal contact with flexible shaft 33, enabling the use of various types, length coating material and diameters, of different endoscopes types.
• Figure 5c illustrates grasping actuators 308 and 310.
• Body 360 includes motor 361 and a screw based linear mechanism.
• the linear mechanism drives arm 362 and arm 364 along rail 366.
• FIGS 6a-c and 7a-b illustrate the user interface (hereinunder interface 400) of drive unit
• a surgeon grasps palm rest 402 of body 404 of interface 400 ( Figure 7a) with the index finger and thumb engaging finger pads 406 and 408 of finger interface 405 ( Figures 6b-c). Finger pads 406 and 408 can be actuated between the open state shown in Figure 6b and the closed state shown in Figure 6c.
• Fingers pads 406 and 408 control grasping actuator 308 and 310.
• the jaws of grasping actuator 308 are open.
• the jaws of grasping actuator 308 are closed and apply a frictional force to flexible shaft 33. This frictional force enables the surgeon to control push/pull of flexible shaft 33.
• Control interface 400 also controls distal articulation 32 of flexible shaft 33 and suction and air/water valves.
• distal articulation 32 control by interface 400 reference is made now to Figure. 7b.
• Figure 7b illustrates the structure and components that allow the surgeon to simultaneously control the articulation of flexible shaft 33 and the valves 52,54 of the suction and air/water functions via buttons 154 and 156 (respectively).
• the surgeon rotates interface body 404 to the desired side and elevation.
• Potentiometers 170 172 measure the orientation of body 404 (as demonstrated in Figure 7b), and their electric signals are converted by electric controller 75 into rotation commands to motors 68 and 70.
• motors 68 and 69 rotate, worm gear 74 and 76 rotates resulting in rotation of the shafts of the distal articulation mechanism. While rotating, worm gears 74 and 76 also rotate gears 61 and 63. Gears 61, 63 are coupled to rotational potentiometers 80, 81.
• the signal from potentiometers 80,81 are send to controller 75 and compared to the signals from orientation potentiometers 170, 172 of body 404, resulting controller 75, to send the next rotation commands to the motors, until the measurements of the processed signals from the potentiometers 80, 81 of the motors and the potentiometers 170, 172 of control interface body 404 are equal, or in the range of allowed difference.
• the above cycle of measurements and movement may be sampled in frequency of 100Hz or more insuring fast reaction of the articulation mechanism without any delay.
• Body 404 is connected to housing 412 as is shown in Figure 7a.
• Housing 412 may slide linearly between proximal end 414 (p) and distal end 416 (d) of housing 418.
• a linear potentiometer is positioned in housing 418, when the surgeon slides housing 412 along slider housing 420, a linear potentiometer 415 slider measures the position and direction of interface body 404.
• the combined measurements of body 404 of interface 400 and the state of finger’s pads 406 and 408 enable the surgeon to control drive unit 300, as will be described in details in Figs. 9a-g.
• a potentiometer slider measures the position of interface body 407.
• the position signals from the potentiometer are send to controller 75, that translate the signals into motion commands to module 132 that drives ‘baby tool’ shaft 112.
• Controller 75 measures the state of the finger’s pads 406 and 408, and activate accordingly open-close module 198, enable the surgeon to control the position of ‘baby tool’ shaft 112 distal end and to control the activation of end effector 114 simultaneously.
• Figures 8a-h illustrate add on motorized module enabling roll movement of the flexible shaft along its long axis.
• the roll movement can be used by the surgeon to better position the distal end of the flexible shaft while it’s advanced in the GI.
• module 500 is connected to push/pull module 300 via connector 510, positioning point C, the center of the flexible shaft at the center of arc 508.
• Arc 508 is hingbly connected to frame 502.
• Arc 508 includes gear 507 at its distal end that meshes with worm gear 506.
• Motor 504 rotates worm gear.
• push/pull module 300 rotates around points C, as is shown in Figures 8c-d.
• Figs. 8e-h illustrates add on rotating frame module 600.
• Module 600 is comprised of fixed base 606 having vacuum legs 604.
• Frame 608 is hingbly connected to fixed frame 606 through hinges 603 and 605.
• Rotation sensor 602 is connected to hinge 605 and measure continuously angle a.
• interface 400 is attached to surface 607 of rotating frame 608 via vacuum pads 150.
• the surgeon tilts the interface thereby similarly rotating frame 608.
• Rotation sensor measurements serve as input for motor 504 that rotates module 300 around center point C.
• Figures 8g-h exemplify tilt positions of frame 608.
• Such an interface configuration enables the surgeon to control simultaneously and intuitively the push/pull movement of flexible shaft 33, the articulation (up/down left/right) of distal end 32 and the roll angle of flexible shaft 33.
• Figures 9a-g schematically illustrate a sequence of interface 400 inputs and the corresponding mechanical outputs of drive unit 300.
• Figure 9a schematically Figure flexible shaft 33 with its distal end located at point A in the lower GI tract of the patient. Finger pads 406 and 408 are in an open state and grasping actuator 308 is likewise open. Grasping actuator 310 is closed in order to eliminate any undesired movement of colonoscope shaft 33.
• Figure 9b illustrates finger pads 406 and 408 in the closed state, grasping actuator 308 is likewise closes and grasps flexible shaft 33.
• Grasping actuator 310 is open however, shaft 33 does not move since the surgeon has not moved palm rest 404.
• grasping actuator 308 moves toward point D. Since grasping actuator 310 is open flexible shaft 33 is translated from point A to point B in the GI tract of the patient.
• the scale between the linear movement of palm rest body 404 and the travel of the distal end of flexible shaft 33 can be selected at any time during the procedure by surgeon according to his needs.
• a typical scale can range between 1 :0.5, to 1 :4.
• System 10 of the present invention can be used in a lower GI procedure (e.g., colonoscopy) as follows.
• Figure 10 illustrates a typical setup of system 10 that can be used in lower GI procedure.
• a patient 700 lays on his/her side with his/her back facing system 10.
• a distal end of flexible shaft 33 is inserted into the lower GI of the patient through the anal orifice.
• Drive unit 300 is moved to a desired position and flexible shaft 33 is installed into drive unit 300 and grasped by both grasping actuators (308 and 310).
• Drive units 66, 132 and 198 having common cover 192, assembled into base 217, located on shelve 22 are moved by arms 422 and 423, to an optimal position with respect to drive unit 300.
• the slack of flexible shaft 33 is handled by leading wheels 312,314.
• Colonoscope control interface 400 and baby tool control interface 401 are positioned on different plates to fit the convenience of the surgeon.
• the surgeon holds both interfaces 400 and 401 and moves flexible shaft 33 through the lower GI.
• the surgeon can use interface 400 to position the distal end of flexible shaft in an optimal position and articulation orientation with respect to patient anatomy, while simultaneously controlling the position and the activation of the baby tool end effector, using interface 401.
• the surgeon may operate the suction/irrigation system and the air system by pressing button buttons 154 and 156 (shown in Figure 7b) located at the front of interface body 404.
• the surgeon may choose to disconnect the endoscope and the baby tool from the motorized modules in order to control the movement of flexible shaft 33 and/or the baby tool manually, in cases where, for example, haptic feedback is needed.
• Figure 11 is block diagram describing work mode selection with a colonoscope fitted with, and optionally controlled by, the present system.
• the surgeon When the surgeon prepares the colonoscope for a procedure he/she may choose the preferred mode of work at start. If the surgeon prefers to start with a manual mode (left branch of the diagram) he/she installs the manual knobs on the adapters. If the surgeon prefers to start with the motorized mode (right branch of the diagram) he/she install gears on the adapters and then installs the motorized drive units described hereinabove.
• the surgeon may alternate between motorized and manual modes. For example, if the surgeon works in manual mode and wishes to switch to motorized mode, he/she simply removes the manual knobs and installs gears, adaptors and drive units. This procedure can be reversed in cases where the surgeon wants to switch to manual mode.
• Figures 12a-b demonstrate flexible shaft interface 400 with the hand of the operator grasping body 404 of interface 400.
• Distal part 32 of flexible shaft 33 is articulated according to the orientation of body 404 - right in Figure 12a and up in Figure 12b.
• Push pull module 300 is also demonstrated in these Figures. With pads 406, 408 of the fingers interface in the open position (and grasper 308 open and fixed grasper 310 closed).
• FIG. 12c A GI simulator (designated 499) was used for testing maneuvering of the flexible shaft ( Figures 12c-g).
• Figure 12c demonstrate movement of flexible shaft 33 with distal portion 32 in the GI simulator.
• Figure 12d demonstrates distal end of ‘baby tool’ shaft 112 and grasper 114 of baby tool 110 delivered from the distal end of shaft 33 distal portion 32.
• Figure 12e demonstrates the articulation control capabilities of the present system, showing distal portion 32 beings articulated and navigated out of the GI simulator.
• Figure 12f demonstrates the ability to control baby tool 110 (shaft 112 and end effector 114) while navigating flexible shaft 33 out of the GI simulator.
• Figure 12g demonstrates control of the distal articulation 32 of flexible shaft 33 with concomitant control of the baby tool 110.
• Figure 12h demonstrates manual control over flexible shaft 33 with graspers 308 and 310 in the open position.

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• 2021
  • 2021-02-24 JP JP2022549937A patent/JP7804583B2/ja active Active
  • 2021-02-24 CN CN202180022587.4A patent/CN115334952A/zh active Pending
  • 2021-02-24 EP EP21761572.3A patent/EP4110160A4/en active Pending
  • 2021-02-24 WO PCT/IL2021/050211 patent/WO2021171292A1/en not_active Ceased
  • 2021-02-24 US US17/801,814 patent/US12433474B2/en active Active
• 2025
  • 2025-09-09 US US19/322,762 patent/US20260000269A1/en active Pending

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