The invention relates to a surgical instrument, in particular for peritoneal surgery. It will be noted that a peritoneal intervention is an intervention carried out within the abdominal cavity.
Surgical instruments are known that comprise an elongate body and that end with a tool carrier and are intended to be introduced into the peritoneal cavity by way of a trocar.
However, this type of surgical instrument allows only a single rotation of the tool about the longitudinal axis of the surgical instrument. By tilting the instrument, it is also possible, taking the trocar as the bearing, to move the tool inside the abdominal cavity. However, these possibilities of movement are limited and do not permit complex maneuvers, for example suturing. Other instruments have intracorporeal articulations, but these are actuated manually by way of cables and levers, which lead to imprecision and fatigue on the part of a user.
The object of the invention is to increase the number of movements that can be performed by a tool carried by the tool carrier of a surgical instrument, especially in order to perform complex procedures with this tool, for example suturing.
In order to achieve this object, a surgical instrument is proposed, in particular for peritoneal surgery, comprising an elongate body, which ends with a tool carrier and which is intended to be introduced into the peritoneal cavity by way of a trocar.
According to the invention, the body comprises:
Thus, the tool carried by the tool carrier of the surgical instrument is made highly mobile by virtue of the following movements:
In addition, the possibility of tilting the instrument by using the trocar as a bearing also permits movement of the tool.
The surgical instrument permits in particular the rotation of the tool about its axis proper, which rotation is particularly advantageous since this is a movement required for suturing. In addition, the instrument takes up very little space since the tubes can be of very thin cross section, and since the stand and the bellows, by virtue of being bendable, can be easily inserted into the body of the patient even through a small incision.
The invention will be better understood in light of the following description of a specific and non-limiting embodiment of the invention.
Reference will be made to the attached figures, of which:
a is a perspective and partially cut-away view of a detail of the surgical instrument illustrated in
b is a slightly enlarged perspective view of a detail of the surgical instrument illustrated in
c is an enlarged and longitudinal cross-sectional view of the surgical instrument illustrated in
a, 2b, 2c, 2d and 2e are partial views of the surgical instrument illustrated in
With reference to
In the example illustrated, the surgical instrument is used for a peritoneal surgical intervention. To this end, the surgical instrument is introduced into the peritoneal cavity of a patient by way of a trocar T.
According to the invention, the body 2 comprises an internal tube 4, which extends along a longitudinal axis A of the body 2. The internal tube 4 ends with a bendable stand 5. An external tube 6 extends about the internal tube 4, coaxially with respect to the latter, and is able to rotate about the internal tube 4. The external tube 6 ends with a bellows 7, which extends about the stand 5 and which, at its end, bears the tool carrier 3. The two tubes 4, 6 are made of stainless steel, for example. The bellows 7 is made of nickel, for example.
Here, the stand 5 comprises a succession of elements articulated on axes perpendicular to the longitudinal axis A of the body 2 and are parallel to one another.
With reference to
By virtue of the surgical instrument of the invention, a surgeon can perform as many movements with the scissors 200 as he could if he were working directly on the organ on which surgery is to be carried out. The components of the instrument are still of suitable dimensions: the tubes 4, 6 can be of small dimensions, and the unit composed of stand 5 and bellows 7 is deployed only once introduced into the body of the patient.
With reference to
To this end, the instrument comprises a first actuator in the form of a first motor 8, which is integral with the trocar T. This avoids the surgeon having to carry the motor 8 when holding the instrument. More precisely, the motor 8 is arranged here in a casing 9 that is designed to be clipped onto the trocar T. The motor 8 is offset from the external tube 6 and drives in rotation a sleeve 10 extending about the external tube 6. Here, the sleeve 10 and the external tube 6 are grooved, such that the rotation of the sleeve 10 drives the external tube 6 in rotation while at the same time permitting a longitudinal movement of the external tube 6 and therefore of the body 2. Preferably, the casing 9 also encloses the tubular component 10.
The instrument likewise comprises a second actuator in the form of a second motor 11, here integral with the external tube 6. In contrast to the first motor 8, which is integral with the trocar T, the second motor 11 is designed to move along with the body 2 during a longitudinal movement of said body 2. The rotor of the second motor 11 rotates the internal tube 4 relative to the external tube 6 about the longitudinal axis A of the instrument, for example by way of a toothed wheel here.
The two motors 8, 11 arranged in this way on the instrument are controlled so as to cause a joint rotation of the two tubes 4, 6 or a differential rotation of the two tubes 4, 6, in such a way as to produce, respectively, a rotation of the scissors 200 about the longitudinal axis A of the instrument and a rotation of the scissors 200 about their own axis of rotation.
Advantageously, the motors 8, 11 are integrated on a part of the instrument that remains outside the body of the patient.
The instrument comprises a third actuator, here for example in the form of two wires 100, 101, which are made of shape-memory alloy and which are attached to the last element of the succession of articulated elements of the stand 5. Thus, a contraction of one or other of the wires causes a bending of the stand 5 and therefore a movement of the scissors 200 in the plane of flexion of the stand 5.
According to a preferred embodiment, the surgical instrument comprises a handle 12, which is here joined to the outer end of the internal tube 4 by way of a connection of the ball-and-socket type (the surgeon only having to manually perform movements of translation and of tilting of the instrument). The ball-and-socket connection thus permits great freedom of movement of the handle 12 with respect to the body 2, making it easier for the surgeon to grip and maneuver the tool.
Here, the handle 12 integrates means for controlling the actuators of the scissors 200. The surgeon can operate the control means, for example by pressing buttons 13 arranged on the handle 12, and thus easily manage the movements of the instrument other than the movements of translation and of tilting.
Preferably, the control means communicate remotely with the two motors 8, 11 and the drive members. The handle 12 is then simply clipped onto the internal tube 4 and can be separated from the body 2. Thus, the handle 12 can be kept, even when the instrument is to be disposed of at the end of an operation.
The invention is not limited to what has just been described and instead covers all variants that fall within the scope defined by the claims.
In particular, although the tool carrier here is carried directly by the bellows 7, it is also conceivable that the tool carrier 3 is mounted pivotably on the end of the stand 5. In addition, the instrument will be able to comprise at least one actuator, for example a wire 102 made of shape-memory alloy and extending along the body 2 as far as the tool carrier 3, in order to actuate a tool carried by the tool carrier 3. With reference to
Number | Date | Country | Kind |
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10 55254 | Jun 2010 | FR | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP11/60871 | 6/29/2011 | WO | 00 | 3/12/2013 |