WO2022112859A1 - Commande d'un instrument chirurgical - Google Patents

Commande d'un instrument chirurgical Download PDF

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Publication number
WO2022112859A1
WO2022112859A1 PCT/IB2021/056463 IB2021056463W WO2022112859A1 WO 2022112859 A1 WO2022112859 A1 WO 2022112859A1 IB 2021056463 W IB2021056463 W IB 2021056463W WO 2022112859 A1 WO2022112859 A1 WO 2022112859A1
Authority
WO
WIPO (PCT)
Prior art keywords
surgical instrument
spi
proximity sensors
support
current position
Prior art date
Application number
PCT/IB2021/056463
Other languages
English (en)
Inventor
Alessandro Carmelo ROTILIO
Marco SOLBIATI
Original Assignee
R.A.W. S.R.L.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by R.A.W. S.R.L. filed Critical R.A.W. S.R.L.
Publication of WO2022112859A1 publication Critical patent/WO2022112859A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2061—Tracking techniques using shape-sensors, e.g. fiber shape sensors with Bragg gratings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles

Definitions

  • the present invention relates to a control of a surgical instrument.
  • the present invention relates to a control of a surgical instrument achieved by exploiting detection sensors.
  • Estimating surgical needle deflection with printed strain gauges [Hammond et al., 2014] describes a system for the manufacture of 500 micron strain gauges printed in large numbers directly on needles, and thus capable of detecting the deformations thereof along the needle itself. All of these methods are based on the use of sensors integrally fixed along the body of the surgical instrument.
  • the general object of the present invention is to provide a control of a surgical instrument that overcomes the problems of the prior art.
  • a specific object of the present invention is to provide a control of a surgical instrument that simplifies the interaction between the surgical instrument and ultrasound images produced during the practical use of the instrument.
  • Another object of the present invention is to provide a control of a surgical instrument that simplifies the use of the instrument by medical personnel.
  • a further object of the present invention is to provide a control of a surgical instrument that makes it possible to reduce the surgical risks for a patient.
  • the invention as described allows an efficient interaction between a surgical instrument and instruments which generate images for guiding surgical interventions, for example an ultrasound scan, in order to overcome the problems described while achieving the following technical effects:
  • Figure 1 represents a perspective view of a support apparatus according to the invention.
  • Figure 2 represents a front view of a support apparatus according to the invention.
  • Figure 3 shows a general block diagram of a device for detecting the current position of a surgical instrument comprising the support apparatus in figures 1 and 2, according to the invention.
  • Figure 4 represents a front perspective view of a functional assembly comprising the support apparatus in figures 1 and 2 and the device in figure 3, according to the invention.
  • Figure 5 represents a rear perspective view of a functional assembly comprising the support apparatus in figures 1 and 2 and the device in figure 3, according to the invention.
  • the invention regards in general a functional assembly, in particular a displacement sensor, through which a bending is derived, applied externally (around) the proximal part of a needle, so as to estimate the bending thereof on the basis of the force detected by the fulcrum of the lever composed of the needle itself.
  • the invention regards a “collar’Vsupport made of deformable material, which has some proximity sensors, in particular pressure or bend sensors, associated with it, in particular fixed to it.
  • the deformable support is then radially surrounded by a rigid outer support, so as to render the inner support deformable only in the point of contact, thus avoiding phenomena of stretching thereof.
  • the collar is then anchored to the handle or to other support structures so as not to come into contact with the shaft of the needle in the “rest” condition.
  • One example is a rubber collar on which strain gauges are radially applied; the latter undergo strain due to the contact and the pressure exerted by the needle when it is bent as a result of the force applied to it.
  • the repeatability of the measurement is given by the repeatability of the deformation of the material of the collar.
  • Other sensors make use of optical fibre segments that are arranged radially around the needle and fixed onto the collar and, once compressed by the needle, detect a change in the passage of light.
  • the operation may be schematically illustrated as follows.
  • a support apparatus 1 according to the invention is shown.
  • the apparatus 1 comprises a support made of deformable material 10 which defines a geometric reference axis X.
  • the support made of deformable material 10 comprises a collar structured so as to transversely surround a surgical instrument, in particular a needle.
  • the apparatus 1 further comprises a support made of rigid material 30 provided externally and in contact with the support made of deformable material 10 so as to prevent an outward deformation thereof.
  • the pressure sensors comprise an optical fibre.
  • a device for detecting the current position POSACT of a surgical instrument 100 is schematically shown.
  • the device according to the invention comprises the described support apparatus 1 , which is configured to support the surgical instrument 100.
  • the described support apparatus 1 is configured to support the surgical instrument 100 in such a way that the geometric reference axis X of the apparatus coincides with a longitudinal axis X1 of the surgical instrument 100.
  • the device further comprises a processing unit 50 in data communication with the apparatus 1.
  • processing unit 50 is presented as divided into distinct functional modules (memory modules or operating modules) for the sole purpose of describing the functions thereof in a clear and complete manner.
  • the processing unit can, in one case, consist of a single electronic device, suitably programmed to perform the functions described, and the different modules can correspond to hardware entities and/or routine software forming part of the programmed device.
  • said functions can be carried out by a plurality of electronic devices over which the aforesaid functional modules can be distributed.
  • the processing unit 50 can further rely on one or more processors to execute the instructions contained in the memory modules.
  • the aforesaid functional modules can also be distributed over various local or remote computers based on the architecture of the network they reside in.
  • the processing unit 50 is configured to control the operation of the detection device.
  • the processing unit 50 is configured to receive, as input, characteristic dimensions DIM-ioo of the surgical instrument 100 and a predefined deformation law LAWDEF of the surgical instrument 100.
  • the deformation law LAWDEF of the surgical instrument 100 is defined as a function of the characteristic dimensions, in particular at least the length, calibre and material of the surgical instrument and, if available, experimental tests.
  • the processing unit 50 is further configured to calculate a current position POSact of a portion 101 of the surgical instrument 100 on the basis of the characteristic dimensions DIM-ioo, the current entity of deviation ADXACT and the deformation law LAWDEF.
  • the processing unit comprises a second calculation module 52 configured to receive, as input, the characteristic dimensions DIM-ioo, the current entity of deviation ADXACT and the deformation law LAWDEF, and to calculate the current position POSact of the portion 101 of the surgical instrument 100.
  • a functional assembly 200 is described with reference to figures 4 and 5, as a third aspect of the invention.
  • the functional assembly 200 comprises the surgical instrument 100 and the device for detecting the current position POSACT of the surgical instrument 100.
  • the functional assembly 200 comprises a grip 40 designed to engage with the surgical instrument 100 so as to enable a movement thereof by an operator.
  • the main axis of extension X1 of the surgical instrument 100 in a non- deviated condition, substantially coincides with the geometric reference axis X and the apparatus 1 is fitted over the surgical instrument 100 transversely to the main axis of extension X1.
  • the device for detecting the current position POSACT is designed to detect the current position of a portion 101 of the surgical instrument 100.
  • the portion 101 comprises one end of the surgical instrument 100, more in particular a tip.
  • the surgical instrument 100 comprises a needle.
  • the surgical instrument comprises a probe or an applicator.
  • a software application must carry out a calibration in relation to the resistance exerted by the needle by virtue of the force that is released at the collar/fulcrum of the support apparatus 1 : every force detected by the sensors corresponds to an amount of bending measurable with an angle.
  • a software application determines the radial position of the contact, locating it on the basis of the location of the strain gauge(s) concerned.
  • a software application calculates, in real time, a region in space wherein the position of the tip can be traced.
  • a control of a surgical instrument has been described in relation to the multiple functions thereof and interacting components.
  • the invention as described enables an efficient interaction between a surgical instrument and instruments which generate images to guide surgical interventions, for example an ultrasound scan, thereby achieving the following technical effects: - it simplifies the interaction between the instrument and the ultrasound images produced;

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Robotics (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un appareil de support (1) comprenant un support en matériau déformable (10) et au moins 3 capteurs de proximité (Spi; i=1..n) fixés au support (10), les capteurs de proximité (Spi; i=1..n) étant adaptés pour générer des signaux de référence (Si; i=1..n) définis en fonction d'une référence radiale détectée (RRADJ). L'invention concerne également un dispositif de détection de la position actuelle (POSACT) d'un instrument chirurgical (100) comprenant l'appareil de support (1). L'invention concerne en outre un ensemble fonctionnel (200) comprenant un instrument chirurgical (100) et le dispositif de détection de la position courante (POSACT). L'invention concerne également un procédé de détection de la position actuelle (POSACT) de l'instrument chirurgical (100).
PCT/IB2021/056463 2020-11-27 2021-07-16 Commande d'un instrument chirurgical WO2022112859A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT202000028742 2020-11-27
IT102020000028742 2020-11-27

Publications (1)

Publication Number Publication Date
WO2022112859A1 true WO2022112859A1 (fr) 2022-06-02

Family

ID=74874949

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2021/056463 WO2022112859A1 (fr) 2020-11-27 2021-07-16 Commande d'un instrument chirurgical

Country Status (1)

Country Link
WO (1) WO2022112859A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20010034501A1 (en) * 2000-03-23 2001-10-25 Tom Curtis P. Pressure sensor for therapeutic delivery device and method
US20050059883A1 (en) * 2003-09-12 2005-03-17 Peterson Thomas Herbert System and method for determining the position of a flexible instrument used in a tracking system
US20130204124A1 (en) * 2012-02-03 2013-08-08 Intuitive Surgical Operations, Inc. Steerable flexible needle with embedded shape sensing
US20160287241A1 (en) * 2015-03-31 2016-10-06 Cae Healthcare Canada Measurement ring and monitoring
EP3431025A1 (fr) * 2017-07-18 2019-01-23 Globus Medical, Inc. Système et procédé d'insertion d'un outil chirurgical au moyen d'une force multiaxiale et d'une rétroaction de moment

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20010034501A1 (en) * 2000-03-23 2001-10-25 Tom Curtis P. Pressure sensor for therapeutic delivery device and method
US20050059883A1 (en) * 2003-09-12 2005-03-17 Peterson Thomas Herbert System and method for determining the position of a flexible instrument used in a tracking system
US20130204124A1 (en) * 2012-02-03 2013-08-08 Intuitive Surgical Operations, Inc. Steerable flexible needle with embedded shape sensing
US20160287241A1 (en) * 2015-03-31 2016-10-06 Cae Healthcare Canada Measurement ring and monitoring
EP3431025A1 (fr) * 2017-07-18 2019-01-23 Globus Medical, Inc. Système et procédé d'insertion d'un outil chirurgical au moyen d'une force multiaxiale et d'une rétroaction de moment

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
LEHMANN THOMAS ET AL: "A virtual sensor for needle deflection estimation during soft-tissue needle insertion", 2015 IEEE INTERNATIONAL CONFERENCE ON ROBOTICS AND AUTOMATION (ICRA), IEEE, 26 May 2015 (2015-05-26), pages 1217 - 1222, XP033168561, DOI: 10.1109/ICRA.2015.7139346 *

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