1. Technical Field
The present disclosure relates generally to an apparatus for demonstrating the use of a laparoscopic, endoscopic or other minimally invasive surgical instrument. In particular, the disclosure relates to an apparatus for simulating visual and tactile operating conditions under which the instrument may be used for minimally invasive surgery.
2. Background of Related Art
Laparoscopic surgery, sometimes referred to as minimally invasive surgery (MIS), is a procedure in which a small incision or puncture is made in the abdominal wall of a patient's body. A cannula is then inserted into a body cavity through the incision, which provides a passageway for inserting various surgical devices such as scissors, dissectors, retractors, or similar instruments. To facilitate operability through the cannula, instruments adapted for laparoscopic or endoscopic surgery typically include a relatively narrow, elongated shaft extending distally from a housing, and supporting an end effector at a distal end thereof. Arranging the shaft of such an instrument through the cannula allows a surgeon to manipulate actuators on the housing from outside the body to induce the end effector to carry out a surgical procedure at a remote internal surgical site. To view the end effector of a laparoscopic instrument within an internal body cavity, a viewing scope may be inserted through an additional puncture in the abdomen. The viewing scope may transmit images to an external monitor that may be viewed by the surgeon. This type of minimally invasive procedure has proven beneficial over traditional open surgery due to reduced trauma, improved healing and other attendant advantages.
Devices and techniques have been developed for the use of an artificial human abdomen in which a laparoscopic surgical procedure may be simulated for demonstration, training or other purposes. These devices typically include a simulated abdominal wall, which obstructs a view of a simulated operative site, and a mechanism for remotely viewing the simulated operative site. A simulator may be constructed to represent the conditions expected for a particular procedure on a particular type of patient. Since each surgical procedure is unique, various techniques may be practiced more readily on a simulator that is adjustable to accommodate a unique expected operating environment.
The present disclosure describes a surgical simulation system for demonstrating the operation of a laparoscopic surgical instrument. The system includes a frame defining an internal cavity therein, a mount configured to support an object simulative of human tissue within the cavity, and at least one wall coupled to the frame and obstructing a view of the cavity from a surgical vantage point. The at least one wall is constructed of three adjacent layers including an outer layer simulative of skin tissue that is coupled to the frame by a first fastener, an intermediate support layer intimately coupled to the frame, and an inner layer simulative of abdominal tissue that is coupled to the intermediate support layer by a second fastener such that the inner layer is selectively removable from the intermediate support layer independently of the outer layer. At least one aperture is defined through the three adjacent layers to provide entry of the endoscopic surgical instrument into the cavity. A camera is mounted to receive light from within the cavity, and a monitor is mounted in a position visible from the surgical vantage point. The monitor is coupled to the camera such that the monitor displays images of the cavity.
The second fastener may include a hook-and-loop fastener, and the outer layer may be constructed of a sheet of silicone rubber. The inner layer may be constructed of a closed cell polyethylene foam, and the polyethylene foam may exhibit a density in the range of about 1.8 pcf to about 2.2 pcf.
The at least one wall may be generally curved around the cavity, and the frame may define first and second open sides with the at least one wall defined therebetween. The frame may define a first height when the frame is supported along the first open side and a second height when the frame is supported along the second open side, the second height being substantially greater than the first height.
The at least one aperture defined through the three adjacent layers may include at least one surgical port, such as those ports sold under the trademark SILS™ (Single Incision Laparoscopic Surgery™) by Covidien AG, the surgical port opening having a diameter of at least about 1.1 inches. The at least one aperture defined through the three adjacent layers may include a self closing opening defined through the outer layer to obstruct a view through the opening, the self closing opening formed by intersecting slits defined through the outer layer. The at least one aperture defined through the three adjacent layers may include a plurality of openings spaced from one another by about by about 1.95 inches in a first direction and by about 2.8 inches in a second direction. An illumination source may be defined within the internal cavity.
According to another aspect of the disclosure, an apparatus for simulating a surgical environment includes a mount configured to support an object simulative of human tissue. A shroud for obstructs a view of object simulative of human tissue from a surgical vantage point, and includes first and second open sides with at least one wall defined therebetween. The shroud defines a first height when the shroud is supported along the first open side and a second height when the shroud is supported along the second open side. The second height is substantially greater than the first height. A camera is mounted within the shroud to capture a view of the object simulative of human tissue.
The first height may be about 8.7 inches for simulation of typical laparoscopic procedures and the second height may be about 12.1 inches for simulation of bariatric procedures. The camera may be configured to receive and transmit audio signals to a storage device.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present disclosure and, together with the detailed description of the embodiments given below, serve to explain the principles of the disclosure.
Referring initially to
The sample tray 14 includes a flat bottom 42 and rim 44 projecting from a perimeter of the flat bottom 42. The flat bottom 42 of the tray 14 may support a tissue sample (not shown) or other specimen to be dissected or manipulated in a surgical simulation. The rim 44 permits the tray 14 to contain liquids associated with the sample, or errant portions of the tissue sample generated by the simulation. The tray 14 may be constructed of metal or plastic such that the tray 14 may be easily cleaned once the simulation is complete.
The frame 20 of the shroud 16 includes an arrangement of extruded aluminum bars 48a, 48b and 48c. In the configuration depicted in
The sidewalls 22 facilitate obstructing the view of the sample tray 22 and are curved along one edge to facilitate the maintenance of curvature in the simulated abdominal wall 28. Various materials may be employed for the construction of the sidewalls 22 including aluminum, ABS plastic or an acrylic. Aesthetic considerations may be incorporated into the sidewalls 22 such as various designs or colors.
The simulated abdominal wall 28 is constructed to exhibit a curvature approximating the shape of an insufflated abdomen in a laparoscopic procedure. As described with greater detail below with reference to
The visualization system 30 includes camera 32 positioned to receive light and sound from within the shroud 16 and mounted to the frame 20 by a mounting arm 56. The mounting arm 56 is configured to position the camera 32 appropriately to ensure that a tissue sample supported in the sample tray 14 is captured in the field of view of the camera 32. The angle of the camera 32 with respect to the sample tray 14 may be adjusted by a hinged connection between the camera 32 and the mounting arm 56. Various commercially available cameras, such as the Logitech® Pro 9000 webcam, may be employed as the camera 32, and the camera 32 may be equipped with pan, tilt, and zoom capabilities.
The visualization system 30 is supported by a pair of lighting strips 34 fastened to one or both of the extruded aluminum bars 48b comprising the frame 20. The lighting strips 34 may comprise adhesive strips of LED lighting elements commercially available from Elemental LED of Emeryville, Calif. These Elemental LED adhesive lighting strips 34 may be cut to an appropriate length, and may be powered by a 12V DC adapter plugged into a standard electrical outlet. In some embodiments, lighting strips 34 may be configured for connection to a USB port of a computer 72 (see
Referring now to
The second configuration of the apparatus 10 is depicted in
The two separate configurations of the apparatus 10 permit a user to practice or demonstrate each type of surgical procedure with little or no adjustment to the shroud 16. The shroud may simply be rolled from one side to another. The leveling mounts 52, and the camera 32 may be duplicated to accommodate each configuration of the apparatus, or alternatively, the leveling mounts 52 and camera 32 may be repositioned. The two configurations permit demonstration or training of various techniques that require varying angles of attack and alternate instrumentation.
Referring now to
The laptop computer 72 includes a processor (not shown) and may be loaded with software to provide a user interface for the camera 32. The user interface may incorporate a plurality of software programs that work together to streamline the operation of the camera. For example, upon booting up the laptop computer 72, the user may be prompted to simultaneously launch multiple software applications by selecting a single button (not shown) with the use of a macro or batch file. The individual software applications may include webcam software such as the Logitech® Webcam Software available with the camera 32. The webcam software provides control over every variable function of the camera 32 and displays a window 76 on the computer 72 that allows the user to control pan, tilt, zoom and focus features of the camera 32. A webcam companion software such as those available from ArcSoft, Inc. may also be launched. The webcam companion software may specialize in capturing feed from an external camera and providing an optimal refresh rate and may provide a full-screen view 78 of the simulated operating environment.
The laptop computer 72 may also be configured to record and archive both audio and video signals transmitted from the camera 32. Audio signals often represent commentary of the user that may be useful to review in evaluating the surgical simulation at a later time.
Referring now to
A larger opening 88 is centrally disposed on the outer layer 82 and is configured to receive a surgical port, such as a port sold under the trademark term and referred to as a SILS™ (Single Incision Laparoscopic Surgery™) Port. The outer layer 82 may be constructed of a relatively flexible sheet of silicone rubber to simulate skin tissue. A sheet of silicone rubber having a thickness of about ⅛ inch may be suitable.
An intermediate layer 90 is constructed of a relatively stiff sheet of polystyrene plastic, which may exhibit a thickness of about 0.15 inches, and provides support to the outer layer 82. The intermediate layer 90 includes bolt holes 94 corresponding the bolt holes 84 of the outer layer 82, and thus, the intermediate layer 90 may be affixed to the frame 20 (
An interior layer 102 is constructed of closed cell polyethylene foam to simulate fat or muscle tissue. A foam having a density in the range of about 1.8 pcf to about 2.2 pcf may be suitable. The interior layer 102 is provided with strips of hook-and-loop fasteners 104 securely applied thereto by an adhesive or similar mechanism. The hook-and-loop fasteners 104 permit attachment of the interior layer 102 to corresponding strips of hook-and-loop fasteners (not shown) disposed on an underside of the intermediate layer 90. Since the interior layer 102 is provided with the hook-and-loop fasteners 104, the interior layer 102 may be removable from the shroud 16 (
Referring now to
A first set of leveling mounts is provided on the first side of the shroud 16 for supporting the shroud 16 in the first configuration (see
Although the foregoing disclosure has been described in some detail by way of illustration and example, for purposes of clarity or understanding, it will be obvious that certain changes and modifications may be practiced within the scope of the appended claims.
This application claims the benefit of and priority to U.S. Provisional Application No. 61/325,597, filed on Apr. 19, 2010, the entire content of which is incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
1749165 | Stanton | Mar 1930 | A |
5149270 | McKeown | Sep 1992 | A |
5403191 | Tuason | Apr 1995 | A |
5425644 | Szinicz | Jun 1995 | A |
5518406 | Waters | May 1996 | A |
5571126 | Dorsey, III | Nov 1996 | A |
5620326 | Younker | Apr 1997 | A |
5707351 | Dorsey, III | Jan 1998 | A |
5722836 | Younker | Mar 1998 | A |
5775916 | Cooper et al. | Jul 1998 | A |
5947743 | Hasson | Sep 1999 | A |
6267599 | Bailey | Jul 2001 | B1 |
6659776 | Aumann et al. | Dec 2003 | B1 |
6857878 | Chosack et al. | Feb 2005 | B1 |
6887082 | Shun | May 2005 | B2 |
7023423 | Rosenberg | Apr 2006 | B2 |
7837473 | Koh | Nov 2010 | B2 |
7931471 | Senagore et al. | Apr 2011 | B2 |
7997903 | Hasson et al. | Aug 2011 | B2 |
8007281 | Toly | Aug 2011 | B2 |
20040024418 | Irion et al. | Feb 2004 | A1 |
20050181340 | Haluck | Aug 2005 | A1 |
20050214727 | Stoianovici et al. | Sep 2005 | A1 |
20060040245 | Airola et al. | Feb 2006 | A1 |
20070166682 | Yarin et al. | Jul 2007 | A1 |
20070275359 | Rotnes et al. | Nov 2007 | A1 |
20080032272 | Palakodeti | Feb 2008 | A1 |
20080299529 | Schaller | Dec 2008 | A1 |
20090142739 | Wang et al. | Jun 2009 | A1 |
20090176196 | Niblock et al. | Jul 2009 | A1 |
20090263775 | Ullrich | Oct 2009 | A1 |
20090326518 | Rabin | Dec 2009 | A1 |
20100081875 | Fowler et al. | Apr 2010 | A1 |
20100114033 | Fischvogt | May 2010 | A1 |
20100120006 | Bell et al. | May 2010 | A1 |
20100167250 | Ryan et al. | Jul 2010 | A1 |
20100167252 | Miller | Jul 2010 | A1 |
20100209899 | Park et al. | Aug 2010 | A1 |
20110087269 | Stokes et al. | Apr 2011 | A1 |
20110238057 | Moss et al. | Sep 2011 | A1 |
20110269109 | Miyazaki | Nov 2011 | A2 |
20120015337 | Hendrickson et al. | Jan 2012 | A1 |
20120082970 | Pravong et al. | Apr 2012 | A1 |
20120164616 | Endo et al. | Jun 2012 | A1 |
Entry |
---|
Song et al., “Elasticity of the Living Abdominal Wall in Laparoscopic Surgery” Journal of Biomechanics 39 (2006) pp. 587-591. |
Number | Date | Country | |
---|---|---|---|
20120202179 A1 | Aug 2012 | US |
Number | Date | Country | |
---|---|---|---|
61325597 | Apr 2010 | US |