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WO2019074360A1 - Instrument laparoscopique - Google Patents

Instrument laparoscopique Download PDF

Info

Publication number
WO2019074360A1
WO2019074360A1 PCT/NL2018/050663 NL2018050663W WO2019074360A1 WO 2019074360 A1 WO2019074360 A1 WO 2019074360A1 NL 2018050663 W NL2018050663 W NL 2018050663W WO 2019074360 A1 WO2019074360 A1 WO 2019074360A1
Authority
WO
WIPO (PCT)
Prior art keywords
actuator rod
laparoscopic instrument
instrument according
flexural
rod
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/NL2018/050663
Other languages
English (en)
Inventor
Tim Horeman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Technische Universiteit Delft
Original Assignee
Technische Universiteit Delft
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 Technische Universiteit Delft filed Critical Technische Universiteit Delft
Publication of WO2019074360A1 publication Critical patent/WO2019074360A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in 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
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod
    • 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
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic

Definitions

  • the invention relates to a laparoscopic instrument comprising a fixed or replaceable tool and a fixed or replace- able handle, which tool and handle are mounted or mountable on opposite sides of an actuator rod that is housed in a tube, wherein the handle is equipped to actuate the tool and wherein an adjustment mechanism is provided that operates on the actuator rod to provide a compensatory force to the actuator rod that supports actuation of the tool by the handle, the adjustment mechanism comprising symmetrically placed flexural elements on opposite sides of the actuator rod providing a pressurizing force on the actuator rod.
  • WO03/026519 provides several examples of an adjustment mechanism that incorporates springs as flexural elements.
  • the force of said springs is substantially equal to the force necessary for actuating the tool, which means that the force for actuating the tool is substantially completely compensated by the springs of the adjustment mechanism.
  • the stiffness of the springs compensates the stiffness of the tool resulting in a more or less zero stiffness as sensed in the handle when the tool is actuated. This is desirable for a surgeon to have an optimal feel when operating the laparoscopic instrument .
  • the springs or flexural elements in the embodiments of WO03/026519 have adjustment knobs that are positioned on the side of the actuator rod in order to impart a variation to the load of the springs or flexural elements which will not be the same for the flexural elements on opposite sides of the actuator rod. Accordingly, although the object of WO03/026519 is to provide a better laparoscopic instrument with improved sensory perception for the surgeon, this object is not
  • the invention has as an object to provide a workable laparoscopic instruments with improved feel for the surgeon, and to this end the laparoscopic measurement of the invention has the features of one or more of the appended claims.
  • the flexural elements are loaded by at least one longitudinally along the actuator rod movable tuning wheel. With this measure it is possible to load the flexural elements perfectly symmetrically with reference to the actuator rod so as to avoid that lateral forces will act on the actuator rod which would inadvertently result into undesirable friction of the actuator rod with reference to the tube in which it is housed.
  • the at least one tuning wheel engages a longitudinally along the actuator rod movable pressure organ which has wedge shaped portions on opposite sides of the actu- ator rod that in a one-to-one relation engage the flexural elements on opposite sides of the actuator rod.
  • the wedge-shaped portions of the pressure organ are an effective and simple means for symmetrically transferring the load imparted by the tuning wheel on the flexural elements on both sides of the ac- tuator rod.
  • each flexural element is mirror symmetric with reference to a plane perpendicular to the actuator rod. This is particularly preferable in an embodiment wherein the flexural elements are loaded by two longitu- dinally along the actuator rod movable tuning wheels, which wheels are provided on opposite sides of the flexural elements.
  • one tuning wheel is proximate to the handle, whereas the other tuning wheel is distant from the handle, and that the proximate tuning wheel is for pre-setting the adjustment mechanism and the distant tuning wheel is for fine-tuning the adjustment mechanism.
  • the two tuning wheels each engage longitudinally along the actuator rod movable pressure organs, wherein each of the two pressure organs has wedge shaped portions on opposite sides of the actuator rod, and wherein each wedge-shaped portion of each pressure organ engages one flexural element.
  • the flexural elements are at a location proximate or distant from the handle secured against lon- gitudinal movement along the actuator rod.
  • a most performed embodiment there are two flexural elements that are provided on opposite sides of the actuator rod, both being substantially mirror symmetric with reference to a plane perpendicular to the actuator rod, and each flexur- al element being loaded by the two tuning wheels that are movable along the actuator rod, wherein the load is provided through the wedge shaped portions of the two pressure organs engaging the flexural elements.
  • each flexural element acts on the actuator rod through an intermediate pressure rod or rods.
  • an intermediate pressure rod or rods Theoretically one could apply a single pressure rod but it is preferred to apply two parallel pressure rods to provide overall stability to the design.
  • the intermediate pressure rod or rods has or have conically shaped extremities that are received in conically shaped receptacles, which receptacles leave room to the conically shaped extremities of the pressure rod or rods to enable the pressure rod or rods to assume without hindrance an oblique position with reference to a plane perpendicular to the actuator rod. It is this possibility to assume without hindrance an oblique position that supports the feature of the instrument of the invention that in a broad operational range of the tool a surgeon can experience a zero stiffness when operating the tool of the instrument by actua- tion of the handle.
  • each flexural element provides a pressurizing force on the actuator rod via an intermediate load distribution piece. It is then preferred that both the flexural elements and the load distribution piece are provided with the recepta ⁇ cles for the pressure rod or rods.
  • -figure 1 shows a laparoscopic instrument according to the invention
  • -figure 2 shows an open view at a first adjustment mechanism forming part of the laparoscopic instrument of figure 1 ;
  • FIG 1 a laparoscopic instrument is shown according to the invention and depicted with reference 1.
  • This instrument 1 comprises a fixed or replacea- ble tool 2 and a fixed or replaceable handle 4, which tool 2 and handle 4 are mounted or mountable on opposite sides of an actuator rod within a tube 6 (a small part of which actuator rod 5 is shown in the detailed view of figure 2) .
  • the handle 4 is equipped to actuate the tool 2 and an adjustment mechanism 3 is provided that operates on the actuator rod 5 to provide a compensatory force to the actuator rod 5 that is notable to a surgeon handling the instrument 1 and which force supports actuation of the tool 2 by the handle 4.
  • the ad- justment mechanism 3 comprises symmetrically placed flexural elements 7, 8 on opposite sides of the actuator rod 5 providing a pressurizing force on the actuator rod 5.
  • the flexural elements 7 , 8 are loaded by at least one, and preferably two longitudinally along the actuator rod 5 movable tuning wheel 9, 10, which are provided on opposite sides of the flexural elements 7, 8.
  • tuning wheel 9 is proximate to the handle 4, whereas the other tuning wheel 10 is distant from the handle 4.
  • the proximate tuning wheel 9 is for pre-setting the adjustment mechanism 3 at a proper position along the actuator rod 5, and the distant tuning wheel 10 is for fine-tuning the adjustment mechanism 3.
  • each pressure organ 11, 12 has wedge shaped portions 11', 11'' and 12', 12'' respectively on opposite sides of the actuator rod 5 that in a one-to-one relation engage the flexural elements 7, 8 on opposite sides of the actuator rod 5, such that each single wedge-shaped portion 11', 11'', 12', 12'' engages only one flexural element 7, 8.
  • each flexural element 7, 8 is mirror symmetric with reference to a plane perpendicular to the actuator rod 5. At the position of this plane intermediate pressure rod or rods 13, 14 are provided wherein each flexural element 7, 8 indirectly acts on the actuator rod 5 through said intermediate pressure rod or rods 13, 14.
  • the intermediate pressure rods 13, 14 guide the pressure from the flexural elements 7, 8 to intermediate load distribution pieces 16, 17 on opposite sides of the actuator rod 5.
  • each rod has conically shaped extremities like the extremities 14', 14'' of rod 14. These extremities are received in conically shaped receptacles 8' , 16' , which receptacles leave room to the conically shaped extremities 14', 14'' of the pressure rod 14 to enable the pressure rod 14 to assume without hindrance an oblique posi- tion with reference to a plane perpendicular to the actuator rod 5.
  • the receptacle 16' is provided in an intermediate load distribution piece 16.
  • a similar load distribution piece 17 is provided on the opposite side of the actuator rod 5 as shown in figure 2 and figure 3.
  • the load distribution pieces 16, 17 are provided so that each flexural element 7, 8 can provide a pressurizing force on the actuator rod 5 via these intermediate load distribution pieces 16, 17.
  • FIGS 2 and 3 show the intermediate pressure rods 13, 14 guide the pressure from the flexural elements 7, 8 to the intermediate load distribu- tion pieces 16, 17. Consistent therewith both the flexural elements 7, 8 and the load distribution pieces 16, 17 are provided with receptacles for the pressure rods 13, 14.
  • Figure 5 shows an embodiment in which the pressure rod 13 as applied according to figure 2, is replaced by a plate 20 with oblique end pieces 21, 22 that cooperate with a correspondingly shaped receptacle 23 in the load distribution piece 17, and a correspondingly shaped receptacle (not shown) in the flexural element 7.
  • a similar construction is possible with reference to the pressure rod or rods 14 of figure 2, which can also be replaced by such a plate with oblique end pieces and correspondingly shaped receptacles in the load distribution piece 16 and the flexural element 8.
  • the flexural elements 7, 8 are shown to have a pin slot connection 18, 19 with a constructional element 20 which is fixed after moving into a desired position relative to the actuator rod 5 by means of the tuning wheel 9. Said pin slot connection 18, 19 provides that the flexural elements 7, 8 are secured against longitudinal movement along the actuator rod 5.

Landscapes

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

Abstract

L'invention concerne un instrument laparoscopique comprenant un outil fixe ou remplaçable et une poignée fixe ou remplaçable, l'outil et la poignée étant montés ou pouvant être montés sur des côtés opposés d'une tige d'actionneur, la poignée étant équipée pour actionner l'outil et un mécanisme de réglage étant disposé qui agit sur la tige d'actionneur pour fournir une force de compensation à la tige d'actionneur qui supporte l'actionnement de l'outil par la poignée, le mécanisme de réglage comprenant des éléments de flexion placés de manière symétrique sur des côtés opposés de la tige d'actionneur fournissant une force de mise sous pression sur la tige d'actionneur, les éléments de flexion étant chargés par au moins une direction longitudinale le long de la roue de réglage mobile de tige d'actionneur.
PCT/NL2018/050663 2017-10-11 2018-10-09 Instrument laparoscopique Ceased WO2019074360A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2019702A NL2019702B1 (en) 2017-10-11 2017-10-11 Laparoscopic instrument
NL2019702 2017-10-11

Publications (1)

Publication Number Publication Date
WO2019074360A1 true WO2019074360A1 (fr) 2019-04-18

Family

ID=60183086

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/NL2018/050663 Ceased WO2019074360A1 (fr) 2017-10-11 2018-10-09 Instrument laparoscopique

Country Status (2)

Country Link
NL (1) NL2019702B1 (fr)
WO (1) WO2019074360A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4332580A1 (de) * 1993-09-24 1995-03-30 Deutsche Aerospace Vorrichtung zur Nachbildung oder Simulation des Tastsinns in einem chirurgischen Instrument
US20030040737A1 (en) * 2000-03-16 2003-02-27 Merril Gregory L. Method and apparatus for controlling force for manipulation of medical instruments
WO2003026519A1 (fr) 2001-09-26 2003-04-03 Sentitic Forceps
US20140358163A1 (en) * 2011-07-11 2014-12-04 EON Surgical Ltd. Laparoscopic graspers

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4332580A1 (de) * 1993-09-24 1995-03-30 Deutsche Aerospace Vorrichtung zur Nachbildung oder Simulation des Tastsinns in einem chirurgischen Instrument
US20030040737A1 (en) * 2000-03-16 2003-02-27 Merril Gregory L. Method and apparatus for controlling force for manipulation of medical instruments
WO2003026519A1 (fr) 2001-09-26 2003-04-03 Sentitic Forceps
US20140358163A1 (en) * 2011-07-11 2014-12-04 EON Surgical Ltd. Laparoscopic graspers

Also Published As

Publication number Publication date
NL2019702B1 (en) 2019-04-19

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