Integrated tool for inserting bioactive compound(s) that release pellets into a treatment area of ​​an individual who requires such treatment.

Description

1 / 22 Integrated tool for inserting bioactive compound(s) that release pellets into a region to be treated. TREATED BY AN INDIVIDUAL WHO NEEDS SUCH TECHNICAL FIELD

[001] The present description refers to a surgical tool, in particular a laparoscopic tool, designed to insert a pellet of a bioactive molecule into a region to be treated. The present description also refers to a surgical method that uses such a tool. FUNDAMENTALS

[002] Several surgical steps are required to obtain a positive result in a treatment that uses a locally implanted bioactive molecule (e.g., in a pellet formulation), all requiring the sequential insertion of specific laparoscopic tools. In addition, to administer the molecule precisely, given that the area to be treated is often narrow, a complex image-guided procedure is necessary, with continuous three-dimensional localization of the instrument tips.

[003] Consequently, this procedure involves inserting and removing various tools from the patient. This multiplicity of insertions increases the risk of injury to the patient (especially in the vicinity of critical organs, such as the liver or vascular beds). Finally, it is necessary to ensure that the pellet remains in the area to be treated. Petition 870250090987, dated 06 / 10 / 2025, page 14 / 45 2 / 22 treated after its insertion into the correct anatomical location. This final step requires additional interventions and the use of complementary tools.

[004] Therefore, there is a need for a unique tool, suitable for laparoscopy and capable of depositing a bioactive molecule in a target region to be treated, without the extraction and reinsertion of multiple tools into the patient's abdominal cavity. Additionally, because it is a unique tool, its mobility must be superior to that of a conventional laparoscopic forceps, and it is mandatory that it has the capability of remote direction of its terminal end. SUMMARY

[005] The present application aims to provide a unique surgical tool, suitable for laparoscopic surgery and capable of performing various tasks without the need for extraction and reinsertion of the tool into the patient.

[006] For this purpose, the present description refers to a laparoscopic tool comprising: - an axis comprising a proximal end and a distal end; - a point; - a movable part positioned between the distal end of the shaft and the tip, the movable part being attached to both Petition 870250090987, dated 06 / 10 / 2025, page 15 / 45 3 / 22 distal end as to the tip, the said movable part being configured to allow movement of the tip relative to the axis; wherein the tip comprises a cylindrical part and a tapered part extending from the cylindrical part to an outlet; the cylindrical part being affixed to the movable part; the cylindrical part comprising a central channel surrounded by at least two peripheral channels; the central channel and the peripheral channels extending along the cylindrical part of the tip wherein the central channel comprises a pellet together with a foldable retaining element in the folded position; the first peripheral channel comprising an opening in the tapered part, the first peripheral channel comprising a first dissection tool capable of projecting from the tip; a blind peripheral channel comprising a locating sensor configured to be detected by an external locator in order to continuously locate the tip.

[007] The invention is advantageously complemented by the following features, considered individually or in any technically feasible combination thereof: - the cylindrical part comprises a second peripheral channel containing a second dissection tool that is capable of projecting from the tip, the second dissection tool being adapted to perform a Petition 870250090987, dated 06 / 10 / 2025, p. 16 / 45 4 / 22 dissection different from that implemented by the first dissection tool; - the first dissection tool is an electrosurgical dissection tool and the second dissection tool is a hydrodissection tool, the second peripheral channel being adapted to conduct a hydraulic jet from a hydraulic jet generator connected to the laparoscopic tool; - the electrosurgical dissection tool comprises an electrode that projects from a centering piece that is folded into the first peripheral channel and unfolds out of the first peripheral channel, the electrosurgical electrode being disposed over an upper part of the centering piece, so that the electrosurgical electrode is always centered in relation to the tip when unfolded, the electrosurgical dissection tool being adapted to extend the electrosurgical electrode out of the tip and to retract the electrosurgical electrode into the first peripheral channel; - It comprises, at the proximal end, a first cable adapted to operate the first surgical tool and a second cable adapted to control a pellet release; - It includes, at the proximal end, a rotating button adapted to control the direction of the tip; - The rotary knob is adapted to hold the Petition 870250090987, dated 06 / 10 / 2025, page 17 / 45 5 / 22 tip direction without any locking mechanism; - The shaft is rigid and comprises a cavity that extends along the shaft, from the proximal end towards the distal end, the cavity housing guide mechanisms to control both the surgical tool and a pellet release; The folding retaining element is configured to be folded into the central channel and to be activated when moved out of the tool, so as to prevent the pellet from returning to the tool after its release.

[008] The tool is capable of performing the following tasks without the need for extraction and reinsertion into the patient: • continuous location of the tool tip, preferably in relation to external tracks, regardless of the degree of curvature of the tip of said tool; • Performing an opening of an area (e.g., peritoneal fascia) through electrosurgical dissection, preserving the underlying structure; • Dissection of the connective tissue around the area to be treated (e.g., around the portal vein structure), preserving nerve tissue or other structures. Petition 870250090987, dated 06 / 10 / 2025, page 18 / 45 6 / 22 delicate, by means of hydrodissection • insertion of the pellet containing the bioactive molecule into the bed created in the previous step; • unfolding of a retention element attached to the distal part of the pellet to prevent pellet extraction.

[009] According to one embodiment, the tool is for single use and manufactured partially from surgical-grade plastic, and before insertion into a cavity, it must be connected to: • a known electrosurgical generator, which can be activated by a foot pedal; • a hydraulic jet generator, which can be operated manually or electrically, given that the dissection volume is limited to less than 20 / 30 cm3 (for the bed size specified in this application) and considering that the dissection is performed on loose connective tissue; • an internal electromagnetic locator attached to the steerable tip and operating in conjunction with a reference sensor located on the patient, an electromagnetic field generator, and appropriate software to analyze the signals from the mobile sensor and the reference sensor in relation to a computed tomography image of the region to be treated.

[0010] The surgical tool operation is performed Petition 870250090987, dated 06 / 10 / 2025, page 19 / 45 7 / 22 via cables with manual triggers that allow the projection and retraction of the various components of the tool, along with a manual button used to control the directionality of the tool tip. The tool is advantageously introduced into the patient's cavity via a laparoscopic cannula and, since the tool is capable, through the movement of the laparoscopic cannula axis, of performing significant movement in relation to the region to be treated, the directionality of the tip is limited to two dimensions, thus simplifying the mechanism operated by the rotary button mentioned above.

[0011] In a preferred embodiment, the present description refers to a laparoscopic tool designed to insert a pellet of a bioactive molecule near the wall of the portal vein, the bioactive molecule being developed to restore the functionality of the portal glucose sensor, which is significantly compromised in individuals with insulin resistance. The tool facilitates the insertion of the pellet into a precise area, difficult to access laparoscopically and with potential adverse surgical outcomes. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Other features and advantages of the present description will appear in the following detailed description. The embodiments of the invention will be described with reference to Petition 870250090987, dated 06 / 10 / 2025, page 20 / 45 8 / 22 drawings: • Figure 1 illustrates the general architecture of the tool, according to one modality; • Figure 2 illustrates the tip of the tool, according to one modality; • Figure 3 illustrates an electrosurgical electrode in position (top) and pellet release (bottom), according to a modality; • Figure 4 illustrates the insertion of the pellet and the associated method to prevent self-extraction of the pellet, according to one embodiment; • Figure 5 illustrates the steps of a method for releasing a pellet, according to one modality. DESCRIPTION General description of the tool

[0013] Figure 1 schematically illustrates a surgical scenario 1 in which a pellet is to be inserted into a region R to be treated in a patient P. For example, as will be detailed below, this region is located near the portal vein, for the treatment of insulin resistance and / or the restoration of glycemic homeostasis in patient P. The region R to be treated is accessed by means of a laparoscopic cannula C introduced into patient P. This cannula C defines a lumen L for the introduction of a Petition 870250090987, dated 06 / 10 / 2025, page 21 / 45 9 / 22 Laparoscopic tool 10 that integrates several functionalities. To control the movement of the laparoscopic tool 10, an image I of the region to be treated is displayed, and the laparoscopic tool 10 is located in real time in relation to this image I. In this way, the surgeon visualizes the tool along the image of the region to be treated for precise access to that region.

[0014] This figure represents the general architecture of the laparoscopic tool 10 comprising, to the left of the tool 10, a tip 100 affixed to a steerable part 101 (or a movable part), which is affixed to a shaft 102 and, to the right of the tool 10, a control assembly 103, from which extend various connections 107, 108, 109 to allow interaction of the tool 10 with the surgeon (not shown), including various actuators 104, 105, 106 to be actuated by means of the surgeon's cable.

[0015] The shaft 102 comprises a proximal end 1021, close to the surgeon, and a distal end 1022, intended to be introduced into the lumen L formed in the patient P by means of the laparoscopic cannula C. The tip 100 comprises several functions that can be controlled by the surgeon. These functions replace several tools for each function.

[0016] In particular, tool 10 comprises at least one dissection tool, preferably two. Petition 870250090987, dated 06 / 10 / 2025, page 22 / 45 10 / 22 dissection tools for accessing the area to be treated, as well as a pellet to be released into the area. When tool 10 comprises two dissection tools, each is configured to implement a specific type of dissection.

[0017] The laparoscopic tool 10 is preferably for single use and manufactured partly from surgical grade plastic, also comprising metal parts, for example, for connecting the tool. Additionally, the tool 10 is advantageously stored in a sterile envelope, requiring connection before insertion into the patient.

[0018] As illustrated in figures 2 and 3, the tip 100 comprises a cylindrical part 1001 and a tapered part 1002 extending from the cylindrical part 1001 to an outlet 1003. The cylindrical part 1001 is affixed to the movable part 101 and comprises a central channel 1004 surrounded by at least two peripheral channels, preferably three peripheral channels 1005, 1006 and 1007. The central channel 1004 and the peripheral channels 1005, 1006 and 1007 extend along the cylindrical part 1001 of the tip 100. The channels of the tip 100 are in communication with corresponding channels on the shaft 102.

[0019] One of the peripheral channels is a blind peripheral channel 1005 and comprises a location sensor 30 Petition 870250090987, dated 06 / 10 / 2025, p. 23 / 45 11 / 22 configured to be detected by an electromagnetic field generator 31 acting as an external locator to continuously locate the tip 100 relative to a reference sensor 32 positioned on patient P. The location is therefore performed based on this reference sensor 32, even if the patient is in motion. In particular, the location sensor 30 is an electromagnetic locator. This location sensor 30 is connected to a processing unit 33 (connected to a computer, not shown) via a connection 109 extending along axis 102. This processing unit 33 comprises suitable software for analyzing the signals from the tool tip location sensor 30 and detecting the reference sensor 32. The processing unit is also connected to the external electromagnetic field generator 31.The localization is performed based on a computed tomography (CT) scan of the patient's treatment area, so that the 100 tip can be visualized in real time during the procedure. The use of an electromagnetic sensor allows for precise localization of the tip, which is directional.

[0020] The central channel 1004 contains a pellet 20 together with a bent retaining element 21, attached to a release wire 126 that allows control of the pellet release in the patient. The pellet 20 has, for example, a length of 10 millimeters and a diameter of 4.6 millimeters. Petition 870250090987, dated 06 / 10 / 2025, page 24 / 45 12 / 22 The release of pellet 20 is achieved by means of a release wire 126 located in the central channel 1004, which can be activated by a first cable 106 at the proximal end 1021 of the tool 10. The diameter of the central channel 1004 is suitable for the size of pellet 20. The length of the release wire 126 allows the release of pellet 20 together with the retention element 21. The retention element 21 prevents the pellet 20 from returning to the tool 10 after its extraction from the tool and its release in the patient. In particular, the retention element 21 is designed to remain folded until it reaches its resting size, preventing the extraction of pellet 20 from the area to be treated. The retention element 21 has a foldable shape consisting of a shape memory wire and can be stored in a small volume.

[0021] A first peripheral channel 1006 comprises an opening 1008 in the tapered part 1002 and comprises a first dissection tool 12 that is capable of projecting from the tip 100. In a preferred embodiment, a second peripheral channel 1007 comprises an opening 1009 and houses a second dissection tool 13 that is capable of projecting from the tip 100.

[0022] The first dissection tool 12 is an electrosurgical dissection tool, and the second dissection tool 13 is a dissection tool. Petition 870250090987, dated 06 / 10 / 2025, p. 25 / 45 13 / 22 Hydrodissection. These dissection tools allow for different types of dissection, depending on the area to be dissected. In particular, the type of dissection depends on the robustness of the area to be dissected, the anatomical structures surrounding the area to be dissected, etc. For example, the F fascia (which consists of the mesenteric part of the peritoneum) is robust and can be dissected with the electrosurgical dissection tool, while connective tissue can be dissected with the hydrodissection tool. Additionally, the hydrodissection tool is used when vital structures are present around the area to be treated. This is particularly the case for the dissection of connective tissue around the portal vein, which should not be damaged.

[0023] According to one embodiment, the electrosurgical dissection tool 12 is capable of projecting from the first peripheral canal 1006. According to one embodiment, the electrosurgical dissection tool is initially located outside the peripheral canal 1006 and can be retracted into that canal only after use. The electrosurgical dissection tool 12 comprises an electrosurgical electrode 120 with its insulation projecting from a centering piece 121, which is folded when positioned inside the first peripheral canal 1006 and unfolds. Petition 870250090987, dated 06 / 10 / 2025, page 26 / 45 14 / 22 outside this channel. The electrosurgical electrode 120 is positioned on the upper part 124 of the centering piece 121, so that the electrosurgical electrode 120 is always centered in relation to the tip 101 when unfolded. The electrosurgical electrode 120 is connected, via a connection 107, to a conventional electrosurgical generator operated by a foot pedal (not shown). Additionally, a second cable 105 is connected to the electrosurgical electrode 120, allowing its projection and retraction outwards and inwards from the tool.

[0024] The first peripheral channel 1006 is larger than the second peripheral channel 1007. The second peripheral channel 1007 is therefore smaller than the first peripheral channel 1006 and is intended for the hydrodissection tool, in particular for the hydraulic jet flow from a hydraulic jet generator connected to the tool 10 by means of a flexible tube 108.

[0025] The tapered part 1002 of the tip 100 serves to center the various extractable elements contained in the central and peripheral channels. The inner side of the tapered part 1002 is hollow to facilitate the expansion or retraction of the centering piece 121 of the electrosurgical electrode and the partial extension of the retention element 21. The opening 1003 of the tip 10 is the size of the pellet, preferably with a difference of 100 μm to facilitate insertion into Petition 870250090987, dated 06 / 10 / 2025, page 27 / 45 15 / 22 region to be treated.

[0026] The tool 10 comprises, at its proximal end 1021, a button 104 for controlling the direction of the tip 100, since the moving part 101 is controlled by the button 104. For example, the tip 100 is attached to the moving part 101 by means of two wires that wind and unwind on the same coil after the movement of the button 104, which is directly connected to the coil, or by means of a 90° mechanism, so that the button 104 is projected at 90° from a longitudinal geometric axis of the shaft 102, the shaft 102 extending along this longitudinal geometric axis. The friction of the button 104 is designed so that, after the movement of the button 104, it maintains, by itself, the angle imposed on the moving part 101, without any locking mechanism. In one embodiment, the moving part 101 consists of a classic semi-cured interlaced tube made of flexible plastic suitable for one-dimensional movement which, preferably, is in the direction perpendicular to the longitudinal geometric axis AA.

[0027] The 102 shaft is preferably rigid and comprises a cavity with six subchannels: two for the wires used for tip guidance, one for the mobile electrosurgical electrode, one for the hydraulic jet dissection channel, one for the wire used to obtain position data from the locator sensor, and one for the wire used for extraction. Petition 870250090987, dated 06 / 10 / 2025, page 28 / 45 16 / 22 of the pellet and its retaining element, like an umbrella-type retaining element.

[0028] On the surgeon's side, the tool 10 comprises a housing 103, preferably made of plastic, connected to the shaft 102, and contains all the connection and mechanism for the steerable tip, in addition to the cables 105 and 106.

[0029] Figure 3 illustrates the extension and retraction capabilities of the electrosurgical electrode (top) and the extension procedure of the pellet and the umbrella-shaped barrier retention element (bottom). The electrosurgical electrode 120 can be projected after activation of the second cable 105 of the tool 10. Because the electrode 120 has a significantly smaller diameter than the pellet 20, it needs to be centered using the centering piece 121 in a flexible cage shape that expands due to the elasticity of the plastic wires (with memory capacity) when it is no longer stored in the tool body (see bottom of Figure 3). The size of the centering piece 121 is preferably a compromise between that required for proper centering and that required for adequate visualization of the tip of the electrode 120 by the surgeon.

[0030] Once the tip 100 of tool 10 is inserted into the area to be treated and after careful hydrodissection of the connective tissue, the pellet 20 is extracted from Petition 870250090987, dated 06 / 10 / 2025, p. 29 / 45 17 / 22 your storage container along with your folded umbrella upside down 21.

[0031] Figure 4 illustrates the pellet insertion step before instrument removal. The pellet 20 is inserted into a region 130 to be treated (e.g., near the portal vein PV) and, preferably, into the connective tissue C surrounding this region, within a volume 132 created by hydraulic jet dissection. This is achieved by partially inserting the tool tip into the region to be treated after applying electrosurgical current, while the electrode tip is protruding. Pellet extraction is associated with the unfolding of the retention element 21, which is preferably an inverted umbrella-type anchor, preferably consisting of a memory-capable wire. The spiral shape of the anchor wire explains why it expands both perpendicularly to the pellet and within the pellet's major geometric axis.This provides proper anchoring while allowing for a limited storage volume, suitable for a laparoscopic instrument. Method for releasing a pellet using a laparoscopic tool.

[0032] In operation and in relation to figure 5, the surgeon introduces tool 10 into a laparoscopic cannula, as described above (step E1). During the intervention, Petition 870250090987, dated 06 / 10 / 2025, page 30 / 45 18 / 22 the tip 100 of tool 10 is continuously positioned (step E2) and tool 10 is manipulated by means of cable 105 and button 104 to position tip 10 precisely (step E3).

[0033] Once tool 10 is introduced close to the area to be treated, the surgeon controls the extension of the electrosurgical electrode 120 (see figure 3, top) (step E4) and triggers a dissection of the tissues around the area to be treated, while manipulating tool 10 through the cable 105 (step E5). Alternatively, the electrosurgical electrode 120 is already out of the tip 100 and therefore step E4 is not implemented. For example, fascia F (see figure 1) is dissected using the electrosurgical electrode 120.

[0034] Once the tissues around the region have been dissected, the surgeon retracts the 120 electrosurgical electrode (step E6, see figure 3, bottom).

[0035] Next, the surgeon performs hydrodissection of the C-connective tissue (see figure 1) to define the region where the pellet needs to be inserted (step E7). As can be seen in figure 1, the C-connective tissue surrounds the portal vein PV.

[0036] After hydrodissection of the connective tissue, the area to be treated can be accessed and the surgeon activates the extraction of pellet 20 using cable 105 (step E8 and see Petition 870250090987, dated 06 / 10 / 2025, page 31 / 45 19 / 22 figure 4).

[0037] Tool 10 is then removed (step E8). The tool is used to insert bioactive compounds that release from pellets near the portal vein to treat insulin resistance and / or restore glucose homeostasis in an individual in need.

[0038] Glucose homeostasis after a meal depends on the integration of glucose sensing mechanisms in the portal vein (Soty et al., 2017). This sensor is markedly impaired in a preclinical model of insulin resistance due to reduced expression of the GLP-1r receptor, essential for glucose sensing (Malbert et al., 2021). Restoration of GLP-1r density is feasible using locally administered dihydrotestosterone at a concentration of 1 / 10 or less of the parenterally administered hormone. More importantly, restoration of GLP-1r density at the periportal level is associated with recovery of insulin sensitivity in the same preclinical model of insulin resistance.

[0039] Several surgical steps are required to achieve the positive treatment outcome obtained with the local administration of bioactive molecules, all of which require the sequential insertion of dedicated laparoscopic instruments. Furthermore, since the portal structure requiring restoration with GLP-1r is narrow, Petition 870250090987, dated 06 / 10 / 2025, page 32 / 45 20 / 22 The entire procedure involves image guidance of the instrument tips, a solution that precludes the use of flexible laparoscopic instruments, since the uncertainty regarding the tip's location is considerable. This makes inserting the pellet containing the bioactive molecule somewhat technically challenging, as the portal structure and the instrument axis are nearly parallel (or at a limited angle to each other), preventing easy insertion of the forceps tip that holds the pellet. An additional pitfall in periportal pellet insertion is related to creating a suitable surgical site for pellet insertion. This procedure requires the use of a dissector, whose tip is not easily visible directly, with potentially harmful consequences, especially in a fragile structure like the portal vein.A somewhat blind dissection is also likely detrimental to the intricate nerve network that extends along the connective tissue surrounding the portal structure. Finally, the movements of the portal system associated with changes in the position of the stomach and intestine after a meal are strong enough to extract the pellet from its surgically prepared housing. Closure of the inner peritoneal layer that supports the periportal connective tissue is therefore mandatory. This is complicated by the use of surgical sutures that fail to adequately secure the peritoneal layer, which would otherwise be secure. Petition 870250090987, dated 06 / 10 / 2025, pp. 33 / 45 21 / 22 minuscule. The alternative option used so far has been to glue, with surgical glue, a piece of dacron mesh blocking the peritoneal orifice, thus avoiding unwanted pellet extraction.

[0040] The use of a laparoscopic cannula that allows for a large-bore shaft diameter (up to 30 mm) without significant gas leakage makes it possible to use the single-use laparoscopic instrument as described above.

[0041] The present description, as explained, aims to provide a single surgical instrument suitable for laparoscopy and capable of performing the following tasks without extraction and reinsertion into the abdominal cavity: • Continuous positioning of the tip relative to external tracks, regardless of the curvature of the instrument tip; • Opening of the peritoneal fascia through electrosurgical dissection, preserving the underlying structure; • Dissection of the connective tissue surrounding the portal structure, preserving the nervous tissue through hydrodissection. This is possible by inserting the instrument tip (after retraction of the electrosurgical tip) into the gap in the peritoneal fascia created during the previous step; • insertion of the pellet containing the bioactive molecule Petition 870250090987, dated 06 / 10 / 2025, pages 34 / 45 22 / 22 in the bed created in the previous step; • Opening of a retaining element fixed to the distal part of the pellet to prevent pellet extraction. References Soty et al., 2017: Soty, M., Gautier-Stein, A., Rajas, F., & Mithieux, G. (2017). Gut-Brain Glucose Signaling in Energy Homeostasis. Cell Metab, 25(6), 1231-1242. Malbert et al, 2021: Malbert, C.-H., Chauvin, A., Horowitz, M., & Jones, K. L. (2020). Glucose-Sensing Mediated by Portal GLP-1 Receptor is Markedly Impaired in InsulinResistant Obese Animals. Diabetes. Petition 870250090987, dated 06 / 10 / 2025, pages 35 / 45

Claims

1 / 4 CLAIMS 1. Laparoscopic tool (10), characterized in that it comprises: - a shaft (102) comprising a proximal end (1021) and a distal end (1022); - a tip (100); - a movable part (101) disposed between the distal end (1022) of the shaft (102) and the tip (100), the movable part (101) being affixed to both the distal end (1022) and the tip (100), said movable part (101) being configured to allow movement of the tip (100) relative to the shaft (102); wherein the tip (100) comprises a cylindrical part (1001) and a tapered part (1002) extending from the cylindrical part (1001) to an outlet (1003); the cylindrical part (1001) being attached to the movable part (101); the cylindrical part (1001) comprising a central channel (1004) surrounded by at least two peripheral channels (1005, 1006, 1007);the central channel (1004) and the peripheral channels (1005, 1006, 1007) extending along the cylindrical part (1001) of the tip (100) wherein the central channel (1004) comprises a pellet (20) together with a retaining element (21) foldable in the folded position; the first peripheral channel (1006) comprising an opening (1008) in the tapered part (1002), the first peripheral channel (1006) Petition 870250090987, dated 06 / 10 / 2025, page 36 / 45 2 / 4 comprising a first dissection tool (12, 13) capable of projecting from the tip (100); a blind peripheral channel (1005) comprising a location sensor (30) configured to be detected by an external locator (31) in order to continuously locate the tip (100).

2. Laparoscopic tool, according to claim 1, characterized in that the cylindrical part comprises a second peripheral channel (1007) comprising a second dissection tool (12, 13) that is capable of projecting from the tip (100), the second dissection tool (13) being adapted to perform a dissection different from that implemented by the first dissection tool.

3. Laparoscopic tool, according to claim 2, characterized in that the first dissection tool is an electrosurgical dissection tool (12) and the second dissection tool is a hydrodissection tool (13), the second peripheral channel (1007) being adapted to conduct a hydraulic jet from a hydraulic jet generator connected to the laparoscopic tool.

4. Laparoscopic tool, according to claim 3, characterized in that the electrosurgical dissection tool (12) comprises an electrode Petition 870250090987, dated 06 / 10 / 2025, page. 37 / 45 3 / 4 (120) projecting from a centering piece (121) that is folded into the first peripheral channel (1005) and unfolds out of the first peripheral channel (1005), the electrosurgical electrode being disposed on an upper part (124) of the centering piece (121), so that the electrosurgical electrode (120) is always centered in relation to the tip (100) when unfolded, the electrosurgical dissection tool being adapted to extend the electrosurgical electrode (120) out of the tip (100) and to retract the electrosurgical electrode (120) into the first peripheral channel.

5. Laparoscopic tool, according to any one of claims 1 to 4, characterized in that it comprises, at the proximal end (1021), a first handle (105) adapted to operate the first surgical tool and a second handle (106) adapted to control a pellet release (20).

6. Laparoscopic tool, according to any one of claims 1 to 5, characterized in that it comprises, at the proximal end (1021), a button (104) adapted to control the direction of the tip (100).

7. Laparoscopic tool, according to claim 6, characterized in that the button (104) is adapted to maintain the direction of the tip without any locking mechanism. Petition 870250090987, dated 06 / 10 / 2025, page 38 / 45 4 / 4 8. Laparoscopic tool, according to any one of claims 1 to 7, characterized in that the shaft (102) is rigid and comprises a cavity (1023) extending along the shaft (102), from the proximal end (1021) towards the distal end (1022), the cavity (1023) housing guide mechanisms for controlling both the surgical tool and a pellet release.

9. Laparoscopic tool, according to any one of claims 1 to 8, characterized in that the foldable retaining element (21) is configured to be folded within the central channel and to be actuated when moved out of the tool, so as to prevent the pellet from returning to the tool after its release. Petition 870250090987, dated 06 / 10 / 2025, pp. 39 / 45

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