• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    This surgical instrument (100) comprises: a first holding or fixing portion (102) extending around a first straight axis (A1) and having a proximal end for holding or fixing (104) around this first rectilinear axis (A1); a second deflection portion (106) extending without degree of freedom from the first portion (102) in the main direction of a second straight axis (A2) away from the first straight axis (A1); a third functional support portion (108) extending without a degree of freedom from a distal end (110) of the second portion (106) about a third straight axis (A3) different from the second straight axis ( A2) and having a functional distal end or functional support (112). The third portion (108) is shaped, by its length and by the orientation of the third straight axis (A3), so that the first straight axis (A1) around which extends the first portion (102) passes through the functional distal end or functional support (112) of the third portion (108).
    公开号:FR3066378A1
    申请号:FR1754390
    申请日:2017-05-18
    公开日:2018-11-23
    发明作者:Olivier Sterkers；Yann Nguyen；Mathieu Miroir；Stephane Mazalaigue
    申请人:Collin；
    IPC主号:
    专利说明:

    The present invention relates to a surgical instrument with deviated portions and a robotic installation comprising such an instrument.
    More specifically, it relates to a surgical instrument comprising:
    - a first holding or fixing portion, extending around a first rectilinear axis and having a proximal holding or fixing end around this first rectilinear axis,
    a second deflection portion, extending without degree of freedom from the first portion in the main direction of a second rectilinear axis moving it away from the first rectilinear axis, and
    - A third portion of functional support, extending without degree of freedom from a distal end of the second portion around a third rectilinear axis different from the second rectilinear axis and having a functional distal end or functional support.
    Such instruments are generally used in precision surgery or microsurgery and make it possible to offset the axis of the holding or fixing portion relative to that of the portion intended to carry the functional end, to clear the field of vision of a user and facilitate the surgical procedure. Especially in situations where the conditions of access to the intervention area are difficult and the field of vision very limited, it is important that the observation axis, often the same as that of the third portion of functional support, is different from the one from which the instrument is held and moved, either manually or using an electronically controlled robot.
    Bayonet-shaped instruments are thus known in microsurgery, in particular in the field of otological surgery. Their third offset axis is generally parallel to the first retaining or fixing axis, in accordance with a well-known configuration of bayonets. But although this effectively clears the axis of observation, the displacements of the functional end which must be as precise as possible are complex and not very intuitive, especially when they involve rotations.
    It may thus be desired to design a surgical instrument with deviated portions which makes it possible to overcome at least some of the above problems and constraints.
    A surgical instrument is therefore proposed comprising:
    - a first holding or fixing portion, extending around a first rectilinear axis and having a proximal holding or fixing end around this first rectilinear axis,
    a second deflection portion, extending without degree of freedom from the first portion in the main direction of a second rectilinear axis moving it away from the first rectilinear axis, and
    a third portion of functional support, extending without degree of freedom from a distal end of the second portion around a third rectilinear axis different from the second rectilinear axis and having a distal functional or functional support end, in which the third portion is shaped, by its length and by the orientation of the third rectilinear axis, so that the first rectilinear axis around which the first portion extends passes through the functional distal or functional support end of the third portion.
    Thus, by bringing the functional distal end or functional support end of the third portion into the axis of the first holding or fixing portion, the movements of this functional end are simplified by creating a pivot point there. In particular, any rotation of the instrument around the first axis of the first holding or fixing portion generates the same rotation of the functional distal or functional support end of the third portion around the same first axis and the pivot point remains fixed. In particular, in otological surgery, such a conformation of the instrument is very advantageous for an intervention in the middle ear of a patient through a speculum by means of a surgical robot remotely controlled by a surgeon or any other form of assistance tool such as a micromanipulator.
    Optionally, the first, second and third portions consist, with the possible exception of the proximal end for holding or fixing and the functional distal end or functional support, of a single rod having two cubits .
    Also optionally, the first rectilinear axis and the third rectilinear axis have an angle between them of between 2 and 10 degrees, preferably between 2 and 4 degrees.
    Also optionally, the distance between the proximal end for holding or fixing the first portion and the functional distal end or functional support for the third portion is between 10 and 20 cm, preferably between 10 and 15 cm.
    Also optionally, the first rectilinear axis and the second rectilinear axis have an angle between them of between 2 and 10 degrees, preferably between 2 and 4 degrees.
    Also optionally, the distal end of the third portion is a functional end of the trocar, micro-hook, micro-tip, micro-false, suction cannula or forceps type.
    Also optionally, the functional distal end of the third portion is designed as a removable insert.
    Also optionally, the first, second and third portions are hollow and the proximal end for holding or fixing the first portion has an internal rod, extending to the functional distal or functional support end of the third portion and longitudinally movable inside the first, second and third hollow portions.
    Also optionally, the proximal end for holding or fixing the first portion comprises a push button carrying the internal rod, this push button being actuable longitudinally along the first rectilinear axis in a recess of this proximal end.
    It is also proposed a robotic surgical intervention installation comprising:
    - a robot with an electronically movable carrier arm,
    - a surgical instrument according to the invention, and
    - means for fixing the proximal end of the first portion of the surgical instrument to a free end of the robot carrying arm.
    The invention will be better understood with the aid of the description which follows, given solely by way of example and made with reference to the appended drawings in which:
    FIG. 1 schematically represents in longitudinal view the general structure of a surgical instrument according to a first embodiment of the invention,
    FIG. 2 schematically represents in longitudinal view the general structure of a surgical instrument according to a second embodiment of the invention,
    FIG. 3 schematically represents in longitudinal view the general structure of a surgical instrument according to a third embodiment of the invention,
    FIG. 4 schematically represents in longitudinal section an embodiment of a proximal end for holding or fixing a surgical instrument according to the invention, such as that of FIG. 2, and
    - Figure 5 schematically illustrates a robotic surgical intervention installation including the surgical instrument of Figure 1.
    The surgical instrument 100 illustrated in longitudinal view in FIG. 1 is intended to be used in precision surgery or otological microsurgery.
    It comprises a first holding or fixing portion 102, extending around a first rectilinear axis A1 and having a proximal holding or fixing end 104 around this first rectilinear axis A1. The proximal end 104 is holding when it is intended to be directly held by a user and fixing when it is intended to be fixed to another device such as an electronically controlled robot arm.
    The surgical instrument 100 further comprises a second deflection portion 106, integral with the first portion 102, extending without degree of freedom from the first portion 102 in the main direction of a second rectilinear axis A2 moving it away of the first rectilinear axis A1. The angle between the axes A1 and A2 is for example between 2 and 10 degrees, preferably between 2 and 4 degrees, to give a very elongated shape to the surgical instrument 100 with minimal lateral bulk.
    The surgical instrument 100 further comprises a third portion of functional support 108, integral with the second portion 106, extending without degree of freedom from a distal end 110 of the second portion 106 around a third rectilinear axis. A3 different from the second rectilinear axis A2 and bringing it closer to the first rectilinear axis A1. This third portion 108 has a functional distal end or functional support 112. The distal end 112 is functional when it is intended to include a functional (micro) surgery tool and functional support when it is intended to receive a tool functional (micro) surgery as an add-on. The angle between the axes A1 and A3 is for example between 2 and 10 degrees, preferably between 2 and 4 degrees. It must be sufficient to clear the field of vision of a user and facilitate the surgical gesture, while limiting the lateral dimensions of the surgical instrument 100. In accordance with the general principles of the present invention, the third portion 108 is shaped, by its length and by the orientation of the third rectilinear axis A3, so that the first rectilinear axis A1 around which the first portion 102 extends passes through the functional distal end or functional support 112 of the third portion 108.
    More specifically, in the illustration of FIG. 1, the distal end 112 is functional. It has a trocar and it is at the free end of the tip of the trocar that the point P intersects the axes A1 and A3. This point P forms a pivot point in the event of rotation of the first portion 102 about its axis A1.
    The three portions 102, 106 and 108 of the surgical instrument 100 may consist, with the possible exception of the proximal end for holding or fixing 104 and the functional distal end 112, of a single rod ( simple cylindrical rod of circular, square or rectangle section, or linkage) having two cubits: the first cubit at the junction of the first and second portions 102, 106; the first cubit at the junction of the second and third portions 106, 108, that is to say at the distal end 110 of the second portion 106. Furthermore, all the components of the surgical instrument 100 described above can be made of plastic, metal, stainless steel, titanium or other rigid materials or combinations of materials suitable for surgical application in otolaryngology. They can also be hollow, in particular the tocart 112, for the passage of fluid, rod or any other aid system for surgical intervention.
    When the proximal holding or fixing end 104 is an insert on the rod mentioned above, it may consist of a substantially cylindrical sleeve comprising a bore along the axis A1 to receive the proximal end of the rod. Similarly, when the functional distal end 112 is an insert on the above-mentioned rod, it may comprise a cylindrical projection intended to be received in a bore along the axis A3 in the distal part of the rod. The advantage of a functional distal end 112 designed as an insert is that the rest of the surgical instrument 100 can be manufactured in a standard manner, as a “universal” instrument, and supplied with a set of removable distal ends. for different surgical functions: trocar, micro-hook, micro-tip, micro-false, suction cannula, forceps, etc.
    In terms of dimensions and conformations, the surgical instrument 100 must generally be of total length (between the proximal end and the pivot point P) of between 10 and 20 cm, preferably between 10 and 15 cm, for use in surgery. otologic. For example, when this length is close to 14 cm with an angle between the axes A1 and A3 of approximately 3.2 degrees, this allows the lateral viewing distance to be offset by 1 cm, when the user's eye is 18 cm from the pivot point P, that is to say about 4 cm in longitudinal distance from the proximal end of the instrument 100 along the axis A1. This configuration is found to be satisfactory in use. Furthermore, a cylindrical rod diameter of between 1 and 2 mm is also suitable. It should be noted, however, that these values are given as an indication and that they could in particular be smaller, for example for use in ophthalmological surgery, or larger, for example for use in surgery of the larynx or paranasal sinuses, in depending on the intended applications.
    The surgical instrument 200 illustrated in longitudinal view in FIG. 2 is also intended to be used in precision surgery or otological microsurgery. It conforms in all points to the instrument 100 with the exception of its proximal 204 and distal 212 ends. It therefore has the same elements 102, 106, 108, 110 around the same axes A1, A2 and A3. As regards the proximal end for holding or fixing 204, it will be detailed with reference to FIG. 4. As regards the functional distal end 212, the trocar is replaced by forceps forceps. The surgical instrument 200 is also shaped so that the pivot point P is on the common axis of rotation of the two jaws of the forceps forceps.
    The surgical instrument 300 illustrated in longitudinal view in FIG. 3 is also intended to be used in precision surgery or otological microsurgery. It conforms in all points to the instrument 100 with the exception of its distal end 312. It therefore has the same elements 102, 104, 106, 108, 110 around the same axes A1, A2 and A3. Regarding the distal end 312, it is represented as standard, that is to say of universal design, and fulfills a function of functional support for the connection of different surgical tools which can then be added from the point pivot P.
    FIG. 4 illustrates a detailed longitudinal section of the proximal holding or fixing end 204. An internal rod 220, carried by a push button 222 operable longitudinally along the axis A1 in a recess 224 produced inside the the receiving bore of the cylindrical rod of the first portion 102 in the interior volume of the proximal end 204, is fixed and clamped in the push button 222 using two lateral screws 226. Two lateral holes are arranged in the the proximal holding or fixing end 204 for access to the two screws 226. The internal rod 220 extends to the functional distal end 212 inside the cylindrical rod to actuate, in a manner known per se, opening and closing the forceps forceps. Return means 228, for example a simple spring or any other equivalent return device, are advantageously added in the recess 224 to bring the push button 222 by default to the retracted position for closing the forceps clamp. This type of proximal end 204 is more generally suitable for any distal surgical function that can be actuated using a rod. An outside diameter of less than 5 mm for a length of 9 mm or more is suitable.
    Finally, the displacement and positioning of the surgical instrument 100, 200 or 300 advantageously being made with reference to the main direction of its axis A1, this also makes it easily compatible with a robotic installation for otolaryngology surgical intervention.
    Such an installation is illustrated very schematically in FIG. 5. It comprises a robot 500 provided with a support arm 502 which can be moved on electronic control. When a proximal end of a surgical instrument such as that illustrated in FIG. 4 is desired, that is to say with push button 222, the arm 502 is hollow and a rod movable in translation by sliding is provided at the interior of hollow arm 502 also electronically controlled. An example of a robot compatible with an installation according to the invention is given in the article by Nguyen et al, entitled "From conception to application of a tele-operated assistance robot for middle ear surgery", published in Surgical Innovation, volume 19 ( 3), pages 241-251, September 2012.
    The installation illustrated in FIG. 5 also includes:
    the instrument 100, the distal end of which 112 is a trocar, and
    - means for fixing the proximal end 104 of the first portion 102 of the surgical instrument 100 to the support arm 502 of the robot 500.
    These fixing means comprise for example a clamping ring 504 disposed at the free distal end of the support arm 502 of the robot 500, this support arm 502 itself being intended to receive by insertion the proximal end 104. A longitudinal notch 506 may be provided in the external surface of the proximal end 104 so as to accompany and angularly guide its insertion into the support arm 502 of the robot 500.
    All known fixing means compatible with the configuration of the installation illustrated in FIG. 5 can be envisaged, in particular any means making it possible to fix the surgical instrument 100 so that its main axis A1 corresponds to the intervention axis of the robot 500. Furthermore, the locking system defined in French patent application FR 2 998 344 A1 is suitable for making such a fixing of the proximal end 104 of the surgical instrument 100 to the support arm 502 of the robot 500.
    Obviously, the surgical instrument 100 can be replaced by the instrument 200 or 300 in the installation of FIG. 5.
    It clearly appears that a surgical instrument such as one of those described above makes it possible to facilitate the surgical gesture, in particular during an otological surgery operation in which the precision of the gesture accompanied by careful observation by the surgeon is d 'major importance, whether the instrument is used manually or integrated in a robotic installation. This makes it possible to exceed the limits of conventional interventions in a restricted operating space with incomplete visibility.
    In addition, the fact that the functional distal end can be designed as a removable insert makes it easier to manufacture and market the surgical instrument. In fact, it is possible to produce and distribute the standard part of the instrument without its functional end, this standard part comprising for example standard means of attachment to robotic surgical intervention installations or adapted for manual use, while the functional part can be declined in a multiplicity of different variants, with possibility of custom manufacturing in certain applications, independently of the manual or robotic intervention which will use it.
    Thus, the standard and functional parts of the surgical instrument can be packaged and supplied together or separately. They can also be designed, one or the other or both, for single use by being packaged after sterilization.
    Note also that the invention is not limited to the embodiments described above. It will appear to those skilled in the art that various modifications can be made to the embodiments described above, in the light of the teaching which has just been disclosed to him. In the claims which follow, the terms used should not be interpreted as limiting the claims to the embodiments set out in the present description, but should be interpreted to include all the equivalents which the claims aim to cover by virtue of their formulation and whose forecasting is within the reach of those skilled in the art by applying his general knowledge to the implementation of the teaching which has just been disclosed to him.
    权利要求:
    Claims (10)
    [1" id="c-fr-0001]
    1. Surgical instrument (100; 200; 300) comprising:
    a first holding or fixing portion (102), extending around a first rectilinear axis (A1) and having a proximal holding or fixing end (104; 204) around this first rectilinear axis (A1), a second deflection portion (106), extending without degree of freedom from the first portion (102) in the main direction of a second rectilinear axis (A2) moving it away from the first rectilinear axis (A1), and a third functional support portion (108), extending without degree of freedom from a distal end (110) of the second portion (106) around a third rectilinear axis (A3) different from the second rectilinear axis (A2) and having a functional distal or functional support end (112; 212; 312), characterized in that the third portion (108) is shaped, by its length and by the orientation of the third rectilinear axis (A3), so that that the first rectilinear axis gene (A1) around which the first portion (102) extends passes through the functional distal end or functional support (112; 212; 312) of the third portion (108).
    [2" id="c-fr-0002]
    2. The surgical instrument (100; 200; 300) according to claim 1, in which the first (102), second (106) and third (108) portions are formed, with the possible exception of the proximal end for holding or attachment (104; 204) and the functional distal end or functional support (112; 212; 312), of a single rod having two cubits.
    [3" id="c-fr-0003]
    3. The surgical instrument (100; 200; 300) according to claim 1 or 2, wherein the first rectilinear axis (A1) and the third rectilinear axis (A3) have an angle between them of between 2 and 10 degrees, preferably between 2 and 4 degrees.
    [4" id="c-fr-0004]
    4. Surgical instrument (100; 200; 300) according to any one of claims 1 to 3, wherein the distance between the proximal end for holding or fixing (104; 204) of the first portion (102) and the functional or functional distal end (112; 212; 312) of the third portion (108) is between 10 and 20 cm, preferably between 10 and 15 cm.
    [5" id="c-fr-0005]
    5. Surgical instrument (100; 200; 300) according to any one of claims 1 to 4, wherein the first rectilinear axis (A1) and the second rectilinear axis (A2) have an angle between them between 2 and 10 degrees , preferably between 2 and 4 degrees.
    [6" id="c-fr-0006]
    6. Surgical instrument (100; 200) according to any one of claims 1 to 5, in which the distal end (112; 212) of the third portion (108) is a functional end of the trocar type (112), micro -hook, microtip, micro-scythe, suction cannula or clamp (212).
    [7" id="c-fr-0007]
    7. The surgical instrument (100; 200) according to claim 6, wherein the functional distal end (112; 212) of the third portion (108) is designed as a removable insert.
    [8" id="c-fr-0008]
    8. Surgical instrument (200) according to any one of claims 1 to 7, in which the first (102), second (106) and third (108) portions are hollow and the proximal end for holding or fixing (204) of the first portion (102) comprises an internal rod (220), extending to the functional distal or functional support end (212) of the third portion (108) and movable longitudinally inside the first ( 102), second (106) and third (108) hollow portions.
    [9" id="c-fr-0009]
    9. surgical instrument (200) according to claim 8, wherein the proximal end for holding or fixing (204) of the first portion (102) comprises a push button (222) carrying the internal rod (220), this push button (222) being actuatable longitudinally along the first rectilinear axis (A1) in a recess (224) of this proximal end (204).
    [10" id="c-fr-0010]
    10. Robotic surgical intervention installation comprising:
    a robot (500) provided with an electronically movable support arm (502), a surgical instrument (100; 200; 300) according to any one of claims 1 to 9, and fixing means (504, 506) from the proximal end (104; 204) of the first portion (102) of the surgical instrument (100; 200; 300) to a free end of the support arm (502) of the robot (500).
    类似技术:
    公开号 | 公开日 | 专利标题
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    FR2694180A1|1994-02-04|Laparoscopic forceps with angulation.
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    FR2821738A1|2002-09-13|SURGICAL FORCEPS
    FR2948596A1|2011-02-04|MANIPULATOR HAND HELD AND SYMMETRIC PRETENSION
    EP2046232A1|2009-04-15|Adjustable stop device for dentistry instrument
    FR3102062A1|2021-04-23|Otological surgery robotic instrument and installation for capturing and maintaining a cochlear implant electrode holder
    FR3055793A1|2018-03-16|ENDOSCOPIC NEEDLE HOLDER
    EP1970017A1|2008-09-17|Unit with handles, in particular for an endoscopic surgical instrument
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    FR2474303A1|1981-07-31|Articulated handpiece for micro-surgery - has scissor-type tip with branches articulating with linkage sliding inside supporting sleeve
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    同族专利:
    公开号 | 公开日
    FR3066378B1|2021-12-24|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US20040127887A1|2002-12-30|2004-07-01|Zinkel John L.|Surgical instrument with near-axial geometry|
    EP1842500A2|2006-04-06|2007-10-10|Olympus Medical Systems Corp.|Instrument for endoscope|
    WO2009073577A2|2007-11-29|2009-06-11|Surgiquest, Inc.|Surgical instruments with improved dexterity for use in minimally invasive surgical procedures|
    DE202009007592U1|2008-12-05|2009-08-13|Olympus Winter & Ibe Gmbh|Laparoscopic instrument with elongated shaft|
    WO2015132401A1|2014-03-07|2015-09-11|Nsk France|Ultrasonic surgical instrument|FR3100970A1|2019-09-24|2021-03-26|Collin|Robotic surgical intervention device with articulated arm carrying an instrument|
    WO2021064331A1|2019-10-04|2021-04-08|Collin|Robotic surgical intervention device with controlled articulated arm for tracing a path|
    FR3102062A1|2019-10-22|2021-04-23|Collin|Otological surgery robotic instrument and installation for capturing and maintaining a cochlear implant electrode holder|
    法律状态:
    2018-05-24| PLFP| Fee payment|Year of fee payment: 2 |
    2018-11-23| PLSC| Publication of the preliminary search report|Effective date: 20181123 |
    2019-05-21| PLFP| Fee payment|Year of fee payment: 3 |
    2020-05-19| PLFP| Fee payment|Year of fee payment: 4 |
    2021-05-17| PLFP| Fee payment|Year of fee payment: 5 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1754390|2017-05-18|
    FR1754390A|FR3066378B1|2017-05-18|2017-05-18|SURGICAL INSTRUMENT WITH DEVIATED PORTIONS AND ROBOTIC INSTALLATION COMPRISING SUCH AN INSTRUMENT|FR1754390A| FR3066378B1|2017-05-18|2017-05-18|SURGICAL INSTRUMENT WITH DEVIATED PORTIONS AND ROBOTIC INSTALLATION COMPRISING SUCH AN INSTRUMENT|
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