Mechanism for manipulating surgical instruments

Abstract

An actuation mechanism (200) for a surgical instrument (100) includes: - a sleeve (202) configured to receive the surgical instrument and including one or more components (208, 210, 226), wherein a plurality of pins (250, 252) are provided on one or each component, only on some components, or even distributed across all components; - at least two wheels (204, 206) mounted on the sleeve on either side of one or more components, wherein each wheel has at least one (242) groove and a mechanical transmission element (244), the at least one groove of each wheel movably receiving one of the plurality of pins in the groove; - at least two drive shafts (212, 214), each drive shaft having a first mechanical transmission element (254) engaging with the mechanical transmission element (244) of one of the wheels.

Description

Technical Field

[0001] The present invention relates to an actuation mechanism for a surgical instrument intended for use in a surgical robot platform, specifically for ophthalmic surgery. Background Technology

[0002] Technically, vitreoretinal surgery, or routine eye surgery, is performed on a patient by a doctor using a cannula or trocar placed in the front of the eye, through which surgical instruments are inserted. This trocar defines a passage that specifically allows us to pass through the vitreous humor and reach the back of the eye where the retina resides.

[0003] "Instrument" refers to, for example Figure 1 The device shown. Typically, a typical instrument 100 for eye surgery includes a handle 102, a grip 104, a sheath 106, and a tool 108.

[0004] The handle 102 is configured to fit the operator's hand, providing a good grip. A grip portion 104, located in an extension of the handle 102, is designed for the operator to position his or her fingers thereto manipulate the instrument 100. Furthermore, the grip portion 104 may deform due to pressure applied by the operator. Deformation of the grip portion 104 causes displacement of the actuator element 110 located within the conical head 112, actuating the sheath 106. The sheath 106 slides along the tool 108 located at its end, thereby allowing actuation of the sheath when the tool 108 is used for clamping functions such as pliers or scissors. A return member, such as a spring, is accommodated in the head 112 and cooperates with the actuator element 110, allowing the actuated tool 108 to return to its initial configuration when pressure on the grip portion 104 is released.

[0005] Tools are the functional part of instruments and can take many forms. A tool can be forceps, scissors, a knife, a vacuum cleaner, a laser, a cryoprobe, or any other tool that can be used in surgery.

[0006] In one embodiment, the gripper 104 is equipped with a sliding system that performs translational motion to actuate the tool 108.

[0007] In another embodiment, the device 100 is recoil-type and the grip 104 is equipped with a button to allow suction action to be performed with the tool 108.

[0008] Operators manipulate instruments in space, but must be extremely dexterous in order to generate very small amplitude movements of only tens of micrometers.

[0009] However, manual intervention poses many risks to patients, mainly due to operator errors.

[0010] To provide greater comfort, precision, and safety during eye surgery, automation of this procedure is being considered. To achieve this, it is necessary that the mechanisms used to manipulate and actuate surgical instruments reproduce movements similar to those of a practitioner using the instruments.

[0011] In document WO 2019 / 183236 A1, surgical instruments are mounted on a base that allows for rotational and translational movement. However, this device has the disadvantages of being bulky and impractical because it requires, for example, pre-installing a collar on the instrument and does not allow the operation of all types of tools that can be used for eye surgery. Furthermore, the device does not eliminate the risk of the instrument sliding toward the eye when detached from its base. Summary of the Invention

[0012] The present invention aims to address at least one of the aforementioned drawbacks. Specifically, the present invention aims to provide a mechanism that allows for the safe, practical, precise, and efficient manipulation and actuation of surgical instruments.

[0013] Therefore, the present invention proposes an actuation mechanism for surgical instruments, comprising:

[0014] A sleeve, which is equipped with a longitudinal axis X, is configured to receive a surgical instrument and includes one or more components that extend substantially in a plane perpendicular to the longitudinal axis X, and a plurality of studs extending along the longitudinal axis X are disposed on the or each component, only on some components, or distributed on different components.

[0015] At least two wheels are mounted on a sleeve along the longitudinal axis X on either side of one or more components. Each wheel is equipped with at least one groove and a mechanical transmission element. The at least one groove of each wheel is movably received in the groove in one of the plurality of studs.

[0016] At least two drive shafts, the first drive shaft being equipped with a first mechanical transmission element that cooperates with a mechanical transmission element of one of the two wheels, and the second drive shaft being equipped with another first mechanical transmission element that cooperates with a mechanical transmission element of the other of the two wheels.

[0017] Therefore, this invention ensures that the movement of surgical instruments is identical to the ordinary movements performed by a practitioner. This mechanism allows surgical instruments to be manipulated in multiple degrees of freedom, specifically in rotation and translation, and also allows for any variation in the gripping portion of the actuating instrument. The advantage of this is the ability to use a wide range of standard, off-the-shelf surgical instruments without requiring hardware modifications.

[0018] Furthermore, this invention ensures increased patient safety. In fact, the mechanism allows surgical instruments to maintain high precision during forward displacement, thereby preventing any accidental slippage of the instruments toward the patient, particularly toward the eyes.

[0019] Similarly, the present invention ensures improved integration of the manipulation mechanism and thus ensures a small workspace clutter, allowing the practitioner to keep the patient in his or her field of vision, and also allowing the use of other nearby equipment, such as microscopes or other equipment similar to the present invention.

[0020] The actuation mechanism according to the invention may include one or more of the following features, individually or in combination with each other:

[0021] The groove is provided on the first surface, and the mechanical transmission element is located on the second surface of each wheel.

[0022] The groove and the mechanical transmission element are located on the same surface of the wheel;

[0023] The sleeve includes an inner abutment extending radially at a horizontal position at a first end of the sleeve, and a flexible tongue extending axially at a horizontal position at a second end.

[0024] At least one component is a gripper, which is mounted between the guides so as to be translatable relative to the guides, the guides themselves being fixed relative to the sleeve;

[0025] At least one component is a guide that is fixedly mounted relative to the sleeve;

[0026] The mechanical transmission element is a pulley driven by gears or belts;

[0027] The groove has a radial distance that varies along the groove relative to the center of the wheel;

[0028] The groove has a constant radial distance relative to the center of the wheel along the groove;

[0029] The groove has a variable depth along the groove;

[0030] Each wheel includes at least one first groove having a radial distance relative to the center of the wheel that varies along the first groove and having a variable depth along the first groove, and at least one second groove different from the first groove having a radial distance relative to the center of the wheel that is constant along the second groove and having a variable depth along the second groove.

[0031] The present invention also relates to a module characterized in that it includes an actuation mechanism as described above, which is housed in a protective compartment to maintain the interaction of the components of the actuation mechanism.

[0032] A module according to the invention may include one or more of the following features, individually or in combination with each other:

[0033] It includes a removable container configured to receive a protective compartment, which is attached to one end of the device;

[0034] At least two parallel drive shafts are mechanically connected to a motorized element and protrude from the end of the device, each shaft being configured to cooperate with a second mechanical transmission element of one of the at least two drive shafts of the actuation mechanism;

[0035] The protective cover is integrated into the container so that it surrounds the portion opposite the module;

[0036] Containers, compartments, mechanisms, and caps are sterile, single-use devices.

[0037] The present invention also relates to a method for implementing the actuation mechanism as described above, the method being carried out outside the patient's body, wherein rotation of the wheels in the same direction causes rotation of the sleeve about its longitudinal axis.

[0038] The present invention also relates to a method for implementing the actuation mechanism as described above, the method being carried out outside the patient's body, wherein rotation of the wheels in opposite directions causes radial translation of at least one component, such that the component applies pressure to the surgical instrument.

[0039] The present invention also relates to a method for implementing the actuation mechanism as described above, the method being carried out outside the patient's body, wherein rotation of the wheels in opposite directions causes at least one component to translate longitudinally along the surgical instrument.

[0040] The present invention also relates to a method for implementing the actuation mechanism as described above, the method being carried out outside the patient's body, wherein the rotation of the wheels in opposite directions simultaneously causes longitudinal and radial translation of at least one component, such that the component applies pressure to the surgical instrument while moving longitudinally along the surgical instrument.

[0041] The present invention also relates to a method for implementing the actuation mechanism as described above, the method being carried out outside the patient's body, wherein rotation of the wheels in opposite directions simultaneously causes at least one component to translate longitudinally along the surgical instrument and at least another component to translate radially, such that the other component applies pressure to the surgical instrument. Attached Figure Description

[0042] Further features and advantages of the present invention will become apparent from the following detailed description, with reference to the accompanying drawings for understanding these features and advantages, wherein:

[0043] [ Figure 1 ] Figure 1 It is a schematic outline diagram of standard surgical instruments;

[0044] [ Figure 2 ] Figure 2 It is a carrying device according to an embodiment of the present invention for use in carrying out Figure 1 A schematic three-dimensional diagram of the actuation mechanism module of a surgical instrument;

[0045] [ Figure 3 ] Figure 3 yes Figure 2 A schematic diagram of the decomposition process;

[0046] [ Figure 4 ] Figure 4 It is a schematic cross-sectional view of the actuation mechanism housed in the protective compartment;

[0047] [ Figure 5 ] Figure 5 yes Figure 4 A schematic 3D diagram;

[0048] [ Figure 6A ] Figure 6A This is a schematic diagram of a differential cam mechanism in the gripper open position according to an embodiment of the present invention;

[0049] [ Figure 6B ] Figure 6B yes Figure 6A A schematic diagram of the mechanism after the wheels have rotated a quarter turn in opposite directions simultaneously;

[0050] [ Figure 6C ] Figure 6C yes Figure 6A A schematic diagram of the mechanism after the wheels have rotated a quarter turn simultaneously in the same direction;

[0051] [ Figure 7A ] Figure 7A This is a schematic diagram of a differential cam mechanism in its initial position according to an embodiment of the present invention;

[0052] [ Figure 7B ] Figure 7B It is along Figure 7A A schematic diagram of the cutting axis;

[0053] [ Figure 7C ] Figure 7C After the wheels rotate a quarter turn in opposite directions simultaneously, along... Figure 7A A schematic diagram of the cutting axis;

[0054] [ Figure 8 ] Figure 8 This is an exploded schematic perspective view of an actuation mechanism according to another embodiment; and

[0055] [ Figure 9 ] Figure 9 This is an exploded schematic perspective view of the actuation mechanism in another embodiment. Detailed Implementation

[0056] In the following detailed description, reference is made to a device intended for use during surgery. It should be noted that the examples of the described embodiments are all performed outside of any surgical procedure and therefore outside the patient's body.

[0057] The following text references texts similar to those above. Figure 1 The instruments described herein are standard surgical instruments.

[0058] Now for reference Figures 2 to 5 These figures illustrate a mechanism for actuating surgical instruments according to one embodiment.

[0059] Surgical procedures involving the eyes can be performed with the aid of a device or robotic platform. The device includes motorized elements that allow it to move in multiple degrees of freedom. To manipulate and actuate the surgical instrument 100 as desired by the practitioner, the device may be equipped with a module 600 containing a mechanism 200 for actuating the instrument 100, which may be included in a protective compartment 300 attached to a container 400 located at an end 500 of the device.

[0060] The actuation mechanism 200 also includes a sleeve 202; at least two movable wheels 204, 206; at least one component 208, 210 which will be referred to as a gripper; and at least two drive shafts 212, 214.

[0061] The sleeve 202 includes a generally cylindrical body 216 that extends along a longitudinal axis X. The body 216 is recessed along the axis X and opens at an upstream end 218 and a downstream end 220 to receive the instrument 100.

[0062] The upstream end 218 of the sleeve 202 includes axially extending tongues 222 radially distributed around the longitudinal axis X. The tongues 222 are flexible, allowing them to deform and move apart as the instrument 100 passes through the sleeve 202.

[0063] The downstream end 220 of the sleeve 202 forms an annular constriction and has a radially extending internal abutment 224. This abutment 224 allows the surgical instrument 100 to remain forward when inserted into the sleeve 202.

[0064] It should be understood that the surgical instrument 100 can be inserted into the cannula 202 via its upstream end 218. Furthermore, the diameter of the downstream end 220 of the cannula is substantially smaller than the diameter of the base of the head 112 of the instrument 100, ensuring that the instrument 100 does not detach from the mechanism 200 during use. This has the advantage of ensuring patient safety. In fact, the surgical instrument 100 is held forward by its internal abutment seat 224, thereby preventing any accidental slippage of the instrument 100 toward the patient, and particularly toward his / her eyes.

[0065] The sleeve 202 also includes at least one guide 226, which is fixedly mounted relative to the sleeve 202, for example, from the same material as the sleeve 202 (integrated with the sleeve 202), and extends substantially in a plane P perpendicular to the longitudinal axis X. In the embodiment shown here, the sleeve 202 includes two guides 226 equidistantly distributed around the sleeve 202. Each guide 226 is equipped with two planar tracks 230 extending along an axis perpendicular to the longitudinal axis X on either side of the sleeve 202. Each track 230 of the guide 226 faces the track 230 of the other guide 226, such that the tracks 230 are parallel.

[0066] The sleeve 202 also includes at least one peripheral opening 232 located on the periphery of the body 216. In the embodiment shown here, the sleeve 202 includes two openings 232. These openings 232 are equidistantly distributed around the sleeve, extend circumferentially between the guides 226, and lie in the same vertical plane P as the guides 226. The width of the openings 232 may be substantially equal to or substantially greater than the width of the track 230 of the guides 226.

[0067] Two movable annular wheels 204, 206 are axially mounted on the sleeve 202 on either side of the guide 226. It should be understood that the guide 226 also acts as a spacer between the wheels 204, 206. Each wheel 204, 206 has a longitudinal axis coinciding with the longitudinal axis X of the sleeve 202. Each wheel 204, 206 also includes a concentric inner peripheral edge 234 and an outer peripheral edge 236 centered on the longitudinal axis X, a first surface 238, and a second surface 240 opposite to the first surface and oriented along the longitudinal axis X. The first surface 238 includes at least one groove 242, which is recessed into a non-zero section of the thickness of the wheel 204, 206 and faces the guide 226. The groove 242 includes two ends and describes a trajectory. This trajectory may, for example, but not exclusively, be an arc concentric or non-concentric with the wheels 204, 206. The second surface 240 is equipped with a mechanical transmission element 244. In the embodiment shown here, element 244 is a gear, but it could also be configured as a pulley driven by a belt.

[0068] In one embodiment not shown here, the groove 242 and the mechanical transmission element 244 may be located on the same surface 238 of the wheels 204, 206. It should be understood that the groove 242 and the mechanical transmission element 244 are located on the same surface 238, which is positioned opposite to at least one guide 226.

[0069] In another embodiment not shown, the mechanical transmission element 244 may be located on the outer periphery 236 of the wheels 204, 206.

[0070] At least one gripper 208, 210 extends substantially in a plane P perpendicular to the longitudinal axis X. Grippers 208, 210 are mounted on sleeve 202 such that they can translate relative to at least one guide 226. Grippers 208, 210 also include two opposing tracks 246, each track located on one of the grippers 208, 210 and having a width substantially equal to the thickness of the gripper 208, 210. Tracks 246 of the grippers 208, 210 mate with tracks 230 of the guide 226. In other words, tracks 246 of the grippers 208, 210 slide on tracks 230 of the guide 226.

[0071] It should be understood that the width of the gripper track 246 is substantially less than or equal to the width of the guide track 230. The width of track 246 is also substantially less than the width of opening 232. In other words, the width of opening 232 is substantially greater than the thickness of grippers 208 and 210.

[0072] In the embodiment shown here, mechanism 200 includes two grippers 208, 210, which are equally distributed between guides 226.

[0073] The first gripper 208 includes a stud 250 oriented in a first axial direction on at least one of its faces, the stud being received in at least one groove 242 of the first wheel 204.

[0074] The second jaw 210, similar to the first jaw 208, includes a second axially oriented stud 252 on at least one of its faces, which is received in at least one groove 242 of the other wheel 206.

[0075] The first gripper 208 may include another stud 252 on its other side, which is axially oriented in the extension of the first stud 250 and received in the second groove 242 of the other wheel 206.

[0076] The second gripper 210 may include another stud 250 on its other side, which is axially oriented in the extension of the second stud 252 and accommodated in the second groove 242 of the first wheel 204.

[0077] It should be understood that each jaw 208, 210 may include one or more studs 250, 252 extending parallel to the longitudinal axis X of the sleeve 202. In one embodiment, each jaw 208, 210 includes a stud 250 on a first face or a stud 252 on a second face. If a first jaw 208 includes a stud 250 on its first face, then a second jaw 210 includes a stud 252 on its second face, and vice versa. In a second case, each jaw 208, 210 includes a stud 250 on its first face and a stud 252 on its second face; in other words, one stud 250, 252 per face. Furthermore, each jaw 208, 210 may mate with one or both of the two wheels 204, 206 via one or more studs 250, 252, with each stud mates with a groove 242.

[0078] The width of the groove 242 is substantially equal to or greater than the cross-section of the studs 250 and 252 of the grippers 208 and 210. The studs 250 and 252 cooperate with the groove 242 to follow the path formed by the groove 242 when the wheels 204 and 206 rotate. Therefore, the studs 250 and 252 can move within the groove 242. In other words, a groove cam mechanism is used, specifically a differential cam drive, which facilitates the displacement of the grippers 208 and 210.

[0079] Therefore, it should be understood that the actuation mechanism 200 includes one or more grippers 208, 210 mounted to be movable relative to the sleeve 202, thereby being translatable relative to at least one guide 226. The grippers 208, 210, or each gripper, also include one or more studs 250, 252, such that at least one recess 242 of each wheel 204, 206 movably receives the stud 250, 252.

[0080] Mechanism 200 also includes at least two drive shafts 212, 214, each mechanically connected to a motorized element. The first drive shaft 212 is equipped with a first mechanical transmission element 254 cooperating with a mechanical transmission element 244 of wheel 204, and the second drive shaft 214 is equipped with another first mechanical transmission element 254 cooperating with a mechanical transmission element 244 of another wheel 206. In the example shown here, each mechanical transmission element 254 of drive shafts 212, 214 is a gear cooperating with a gear 244 of wheels 204, 206.

[0081] Each shaft 212, 214 is housed in a generally cylindrical sleeve 256, within which shafts 212, 214 can rotate. A first mechanical transmission element 254 is located at one end of the sleeve 256. A second mechanical transmission element 260 is located at the other end of the sleeve 256. In this example, elements 254 and 260 are gears.

[0082] In an embodiment not shown here, elements 254 and 260 may be pulleys. Element 254 may be a pulley with a drive belt for actuating the mechanical transmission element 244 of wheels 204 and 206. In this case, the mechanical transmission element 244 of wheels 204 and 206 is a belt-driven pulley. Mechanical transmission element 260 may also be a belt-actuated pulley.

[0083] In another embodiment, the mechanical transmission elements 244, 254, 260 may be belt-driven gears and / or pulleys.

[0084] In another embodiment not shown here, mechanism 200 is the same as described above, except that mechanism 200 is equipped with a single gripper 208, 210. In this embodiment, grippers 208, 210 include studs 250, 252 on each of their faces, such that a first stud 250 is movably mounted in at least one recess 242 of a first wheel 204, and a second stud 252 is movably mounted in at least one recess 242 of another wheel 206.

[0085] The aforementioned mechanism 200 can be housed in compartment 300. This compartment 300 also allows the different elements of the actuation mechanism 200 to be held in place, so that these elements interact with each other and contribute to the compactness of the device.

[0086] The compartment 300 includes an upper shell 302 and a lower shell 318 designed to cooperate with each other.

[0087] The upper shell 302 is further composed of an upstream portion 302a and a downstream portion 302b. Each portion 302a, 302b is integral and has a generally rectangular shape, including outer surfaces 304a, 304b and inner surfaces 306a, 306b, within which circular openings 308a, 308b are provided. Each portion 302a, 302b also includes cylindrical recesses 310a, 310b on the inner surfaces 304a, 304b along the axis of the openings 308a, 308b, these recesses being designed to receive one of the wheels 204, 206. Each portion 302a, 302b includes, at its base, semi-circular recessed protrusions 312a, 312b extending in a plane perpendicular to the openings 308a, 308b and adapted to cover the first gear 254 of the drive shafts 212, 214. The recessed sections of the protrusions 312a and 312b are connected to the recesses 310a and 310b, so that the first gear 254 is matched with the gear 244 of the wheels 204 and 206.

[0088] Therefore, it can be understood that the diameters of the cylindrical recesses 310a and 310b are substantially greater than or equal to the diameters of the wheels 204 and 206. It should also be understood that the upstream portion 302a and the downstream portion 302b are mounted around the upstream end 218 and downstream end 220 of the sleeve 202, respectively. In other words, the diameter of the opening 308a of the upstream portion 302a is substantially equal to or greater than the diameter of the body 216 of the sleeve 202, and the diameter of the opening 308b of the downstream portion 302b is substantially equal to or greater than the diameter 220 of the downstream end.

[0089] The downstream portion 302b also includes at least two pins 314 on its inner surface 306b and at least two other pins (not visible in the figure) on its lower slice 316b. The upstream portion 302a also includes at least two blind holes on its inner surface 306a (not visible in the figure) and includes at least two pins on its lower slice 316a. The pins 314 of the downstream portion 302b are configured to mate with the blind holes located on the inner surface 306a of the upstream portion 302a.

[0090] The lower shell 318 is an integral assembly including a base 320 and at least two protrusions 322. The base 320 is substantially planar and rectangular and includes an upper surface 324 and a lower surface 326. At least four blind holes 328 are provided in pairs on the upper surface 324. At least four tenons 330 are evenly distributed on the edge of the lower surface 326 of the base 320.

[0091] Cylindrical protrusions 322 are positioned as protrusions on the lower surface 326. Each of these protrusions 322 is recessed and open at both ends, such that one end opens through an aperture 332 to the upper surface 324 of the base 320. The protrusions 322 are configured to receive drive shafts 212, 214.

[0092] The upper housing 302 is mounted on the lower housing 318 such that the pins of each of the upstream portion 302a and the downstream portion 302b are engaged in the blind hole 328 in the base.

[0093] In this way, the actuating mechanism 200 is protected and held in place by the protective compartment 300. This allows different components to move within the compartment 300, making it easier to integrate them together.

[0094] The container 400, configured to receive the previously described compartment 300, can be attached to the end 500 of the device. The container 400 is also removable, meaning it can be removed from the end 500.

[0095] The container 400 includes a socket 402 corresponding to the footprint of the lower shell 318 of the compartment 300, so that the compartment 300 can be snapped into place.

[0096] It should be understood that the socket 402 includes at least two openings 404 designed for the passage of the cylindrical protrusion 322 and at least four mortises 406 designed to mate with the tenon 330 of the lower housing 318. The cross-section of the mortises 406 is substantially equal to or smaller than the cross-section of the tenon 330, allowing the latter to force its way into the mortises 406. In this way, the compartment 300 is secured to the container 400. It should also be understood that the compartment 300 is removable from the container 400.

[0097] The container 400 may also include a protective barrier in the form of a lid at its base 408, designed to cover and restrict part of the device, specifically the portion of the non-carrying module 600, thereby isolating it from the sterile area surrounding the patient. This lid may be sterile.

[0098] In one embodiment not shown here, compartment 300 has a screw attachment device. In this case, a threaded through hole replaces the tenon 330 and mortise 406. However, this attachment device makes tool changing take longer than the clamp solution described above.

[0099] During operation, a standard, readily available surgical instrument 100 can be inserted into the sleeve 202 of the actuation mechanism 200. Specifically, the instrument 100 can be manually removed by the practitioner during the surgical procedure and replaced by another instrument different from the first instrument.

[0100] A motorized element drives at least two drive shafts 502a, 502b housed within the device. The non-motorized ends of these shafts 502a, 502b protrude from end 500, and each shaft is equipped with a mechanical transmission element 504a, 504b. These elements 504a, 504b are configured to cooperate with element 260 of the drive shafts 212, 214 of the actuation mechanism 200 and transmit rotational motion to that element 260. The drive shafts 212, 214 cooperate with the mechanical transmission element 244 of the wheels 204, 206 and drive them to rotate about the longitudinal axis X.

[0101] The motorizing element allows shafts 502a and 502b to rotate in either direction, and each of shafts 502a and 502b can rotate in the same or opposite directions. As a result, wheels 204 and 206 can rotate in the same or opposite directions.

[0102] Referring now to Figures 6 and 7, these figures illustrate diagrams of cams that generate the desired motion for actuating the surgical instrument 100.

[0103] In the exemplary embodiment shown here, each wheel 204, 206 includes two identical, diametrically opposed recesses 242 or cams 242, but may also include one or more. Thus, wheel 204 includes a recess 242a and wheel 206 includes a recess 242b. In operation, the first wheel 204 and the second wheel 206 cooperate with at least one gripper 208, 210 such that the studs 250, 252 of at least one gripper 208, 210 engage with the cams 242a of the first wheel 204 and 242b of the second wheel 206. The positions of the studs 250, 252 of the grippers 208, 210 substantially correspond to the intersection of the projections of the cam 242a of the first wheel 204 and the projection of the cam 242b of the second wheel 206, which is inverted in the same plane as the first wheel 204.

[0104] The simultaneous rotation of movable wheels 204 and 206 actuates cam 242, causing the grippers 208 and 210 to move. This movement is predetermined by the path shape of cam 242 and the rotation direction of wheels 204 and 206.

[0105] First option: Rotate or clamp

[0106] exist Figures 6A to 6C In the design, cams 242a and 242b delineate non-concentric arcs with respect to wheels 204 and 206. The first ends 1a and 1b of cams 242a and 242b are located near the inner periphery 234 of wheels 204 and 206, while the second ends 2a and 2b are located near the outer periphery 236 of wheels 204 and 206. In other words, the distance between grooves 242a and 242b and the center of wheels 204 and 206 varies along grooves 242a and 242b.

[0107] In this configuration, cams 242a and 242b follow a helical trajectory defined by the following equation:

[0108] [Mathematical Expression 1]

[0109]

[0110] Where r represents the position of the helix of grippers 208 and 210 within the interval [a0, a1] which belongs to real numbers, Φ represents the angle, and n represents the number of turns of the helix.

[0111] The simultaneous rotation of each wheel 204, 206 in a given direction generates differential transmission, the operation of which is given by the following equation:

[0112] [Mathematical Expression 2]

[0113]

[0114] [Mathematical Expression 3]

[0115] θ=(θ1-θ2)π

[0116] Where θ1 and θ2 represent the angular positions of the movable wheels 204 and 206, θ is the angular position of the grippers 208 and 210, ρ is the radial position of the grippers, and η is the clamping percentage of the grippers 208 and 210 within the allowable range [a0, a1] at the intersection of the helices of the cams 242a and 242b.

[0117] This means that in the differential cam drive system: the weighted sum (θ1+θ2) of the rotations of wheels 204 and 206 produces a first movement of grippers 208 and 210 relative to the predetermined shape of cam 242, and the weighted difference (θ1-θ2) of wheels 204 and 206 produces a second rotational movement of grippers 208 and 210 about the rotation axes of wheels 204 and 206.

[0118] In other words, selective displacement of the grippers 208 and 210 becomes possible. In practice, rotation of wheels 204 and 206 in opposite directions about the longitudinal axis X causes radial translation of the grippers 208 and 210 without causing displacement of the grippers 208 and 210 about the axis X. Rotation of wheels 204 and 206 in the same direction causes displacement of the grippers 208 and 210 about the longitudinal axis X. Since the grippers 208 and 210 are located between guides 226 fixed relative to the sleeve 202, the guides being made of the same material as the sleeve 202, their movement forces the sleeve 202 to follow the same movement by means of a drive. In other words, rotation of wheels 204 and 206 in the same direction causes rotation of the sleeve 202 and thus rotation of the surgical instrument 100, thereby allowing reorientation of the manipulated tool 108. Furthermore, rotation of wheels 204 and 206 in the same direction does not cause any radial displacement of the grippers 208 and 210.

[0119] exist Figure 6A In the middle, the jaws 208 and 210 are in a position called open, wherein the distance between the studs 250 and 252 of each jaw 208 and 210 and the inner periphery 234 of the wheels 204 and 206 is L, such that the jaws 208 and 210 are located between the outer periphery 236 and the inner periphery 234.

[0120] For each wheel 204, 206, it can be along with... Figure 6B In the opposite direction or along with Figure 6C Perform a quarter-turn rotation in the same direction.

[0121] When they rotate a quarter turn simultaneously in opposite directions, grippers 208 and 210 are in a position known as closed, such as... Figure 6BAs shown, the distance between the studs 250, 252 of each gripper and the inner periphery 234 is l. At this position, the diameter of the circular space is reduced by means of 208, 210 protruding from the edge.

[0122] The grippers 208 and 210 therefore move radially corresponding to the difference between distance L and distance l. 208 and 210 slide on the track 230 of the guide 226 and engage in the peripheral opening 232 of the sleeve 202. The radial translation of the grippers 208 and 210 allows pressure to be applied to the surgical instrument 100 coiled within the sleeve 202. Specifically, at the end of the translation, the grippers 208 and 210 press against the gripping portion 104 of the instrument, thereby allowing actuation of the surgical instrument 108, as described above. Figure 1 As described herein. Therefore, this embodiment is particularly useful when the surgical tool 108 is forceps or scissors.

[0123] As they rotate simultaneously a quarter turn in the same direction, grippers 208 and 210 remain in their initial positions, open or closed, and do not shift radially. Instead, grippers 208 and 210 are driven to rotate about axis X, as... Figure 6C As shown. It should be understood that the rotation of the sleeve 202 can occur before or after the actuation of the surgical instrument 108.

[0124] It should be noted that the shape of the cam shown here is not restrictive. In fact, the cam can take any shape that results in a trajectory that allows at least one gripper to translate or rotate radially.

[0125] For example, the cam can be in the form of a straight line, wherein the first end of the straight line is located near the inner periphery 234 of the wheels 204, 206, and the second end of the straight line is located near the outer periphery 236 of the wheels 204, 206.

[0126] In another example, the cam can be continuous, i.e., the grooves form a ring. This ring can be substantially elliptical or substantially star-shaped. In the star-shaped case, the apex of each branch is the furthest point from the center of wheels 204, 206, while the recess separating each branch is the closest point. This ring configuration may be of interest when cyclic motion is required, as the frequency of the cycle can be determined by the type of ring.

[0127] It should be understood that the radial distance between the grooves 242a and 242b and the center of the wheels 204 and 206 is variable along the grooves 242a and 242b. In other words, the grooves 242a and 242b are not concentric with the wheels 204 and 206.

[0128] Second option: Rotate or translate

[0129] exist Figures 7A to 7CIn another embodiment shown, cam 242 delineates an arc concentric with wheels 204, 206 and has a variable depth along this arc. In other words, the first ends 1a, 1b and the second ends 2a, 2b of cams 242a, 242b are equidistant from the inner periphery 234 and outer periphery 236 of wheels 204, 206, respectively. Therefore, it can be understood that the radial distance relative to the center of wheels 204, 206 along grooves 242a, 242b is constant.

[0130] Furthermore, the depth of cam 242a at end 1a is greater than the depth of cam 242a at end 2a. In other words, a depth gradient is obtained between the two ends 1a and 2a of cam 242a. Cam 242b is similar to cam 242a, therefore the depth of cam 242b at end 1b is less than the depth of cam 242b at end 2b. Therefore, a depth gradient is also obtained between the two ends 1b and 2b of cam 242b.

[0131] In this configuration, cams 242a and 242b follow circular trajectories, and their depth along the axis X is defined by the following equation:

[0132] [Mathematical Expression 4]

[0133]

[0134] Where z represents the position of the helix of the grippers 208 and 210 relative to the cams 242a and 242b within the real number interval [a0, a1], Φ represents the angle, and n represents the number of revolutions of the circle.

[0135] The differential transmission described in the previous embodiments by equations [Mathematical Formula 2] and [Mathematical Formula 3] also applies here, except that η is the percentage of translation allowed by the inclined surfaces of cams 242a and 242b in the range of [u0, u1].

[0136] In other words, selective displacement of the grippers 208 and 210 becomes possible. In fact, the rotation of wheels 204 and 206 in opposite directions around the longitudinal axis X produces longitudinal translation of the grippers 208 and 210 without producing displacement of the grippers 208 and 210 around the axis X. As mentioned earlier, the rotation of wheels 204 and 206 in the same direction allows the sleeve 202 to rotate without causing longitudinal displacement of the grippers 208 and 210.

[0137] In this embodiment, due to the fact that cams 242a and 242b each draw an arc concentric with wheels 204 and 206, grippers 208 and 210 are positioned to contact surgical instrument 100 and remain in that position during various rotations.

[0138] It is possible to perform a quarter turn simultaneously in opposite or the same direction for each wheel 204, 206.

[0139] As they rotate simultaneously by a quarter turn in the same direction, the grippers 208 and 210 are driven to rotate about axis X. As previously described, sleeve 202 rotates about its longitudinal axis X.

[0140] Now for reference Figure 7B and 7C They show grippers 208 and 210 along... Figure 7A Positioning of the cutting axis T in the process.

[0141] exist Figure 7B In the first position, the centers of the grippers 208 and 210 are at their initial positions and separated from the surface 238 of the wheel 204 by a certain distance W. The studs 250 and 252 of the grippers 208 and 210 engage with the cam 242a of the wheel 242B at the horizontal position of end 2a, and with the cam 242b of the wheel 206 at the horizontal position of end 2b. During the simultaneous rotation of the wheels 204 and 206, the studs 250 and 252 of the grippers 208 and 210 follow the concave movement of the cams 242a and 242b in the opposite direction.

[0142] exist Figure 7C In the process, when a quarter turn is completed, the studs 250 and 252 are located at the ends 1a of cam 242a and 1b of cam 242b. Furthermore, the centers of the grippers 208 and 210 have shifted and separated from the surface 238 by a distance w, which is substantially less than the distance W.

[0143] Therefore, as they rotate a quarter turn simultaneously in opposite directions, the grippers 208 and 210 shift longitudinally along an axis parallel to the longitudinal axis X. The grippers 208 and 210 can thus translate a distance corresponding to the difference between distance W and distance w, and generate a sliding motion on the gripping part 104.

[0144] It should be noted that the shape of the cam shown here is not restrictive. In fact, the cam can take any shape that results in a trajectory that allows at least one gripper to translate or rotate longitudinally.

[0145] Third option: clamping with rotation or translation.

[0146] In another embodiment, cam 242 traces an arc non-concentric with wheels 204, 206 and has a variable depth along this arc. The first ends 1a, 1b of cams 242a, 242b are located near the inner periphery 234 of wheels 204, 206, while the second ends 2a, 2b of the cams are located near the outer periphery 236, and the depth of cams 242a, 242b varies along the trajectory. In other words, this embodiment is a combination of the first two embodiments described above, and cams 242a, 242b follow a trajectory defined by equations [Mathematical Formula 1] and [Mathematical Formula 4]. Therefore, the cams follow a helical trajectory in three dimensions.

[0147] In this case, η is simultaneously the clamping percentage of the grippers 208 and 210 in the range of [a0,a1] and the translation percentage of the grippers 208 and 210 in the range of [u0,u1], which are allowed by the physical constraints imposed by the intersection of the cams 242a and 242b.

[0148] In other words, selective displacement of the grippers 208 and 210 becomes possible. In practice, the rotation of wheels 204 and 206 in opposite directions about the longitudinal axis X simultaneously produces radial and longitudinal translation of the grippers 208 and 210, without producing displacement of the grippers 208 and 210 about the axis X. Rotation of wheels 204 and 206 in the same direction causes displacement of the grippers 208 and 210 about the longitudinal axis X, and thus causes displacement of the sleeve 202, as described above. Furthermore, rotation of wheels 204 and 206 in the same direction does not cause any radial or longitudinal displacement of the grippers 208 and 210.

[0149] This embodiment may be of interest in cases where the practitioner needs to operate the slider on the gripper 104 instead of pressing it to actuate the tool 108. This is because longitudinal translation of the slider is required. The simultaneous radial displacement of the grippers 208, 210 on one side and longitudinal displacement on the other side allows the gripper 104 to be gripped and the grippers 208, 210 to move longitudinally on the slider that subsequently actuates the surgical tool.

[0150] The aforementioned motion options relate to a mechanism 200 equipped with two grippers 208, 210. It should be noted that the number of grippers 208, 210 is not limiting. The same result can be obtained using a mechanism 200 equipped with a single gripper 208, 210. In this embodiment, the grippers 208, 210 include studs 250, 252 on each of their faces, such that the first stud 250 is movably mounted in a first recess 242a and the second stud 252 is movably mounted in a second recess 242b.

[0151] Now for reference Figure 8 This illustrates another embodiment of the actuation mechanism 200.

[0152] In this embodiment, the actuation mechanism 200 is generally similar to that described above. It includes a sleeve 202, wheels 204, 206, at least one gripper 208, 210 equipped with one or more studs 250, 252, and drive shafts 212, 214. The wheels 204, 206, at least one gripper 208, 210, and drive shafts 212, 214 are similar and mounted as described above.

[0153] Sleeve 202 includes an upstream end 218 and a downstream end 220 that are separable from each other. In other words, sleeve 202 is not integral. The upstream end 218 includes at least one first guide 262, which is fixedly mounted relative to the upstream end 218, for example, from the same material as the end 218. The downstream end 220 includes at least one second guide 264, which is fixedly mounted relative to the downstream end 220, for example, from the same material as the end 220.

[0154] At least one first guide 262 at the upstream end 218 includes a recess oriented in the direction of the downstream end 220. At least one through hole 266 is provided in at least one first guide 262.

[0155] At least one second guide 264 at the downstream end 220 includes a stud 268 on a first surface and a stud 270 on a second surface, the stud 270 being configured to pass through a hole 266 in at least one first guide 262. Furthermore, at least one second guide 264 is axially engageable with a recess in at least one first guide 262. It should be understood that the dimensions of the guide 264 are substantially smaller than the dimensions of the guide 262, such that the guide 264 is adjustably fitted into the recess of the guide 262.

[0156] The stud 268 of the guide 264 is configured to be movably mounted in the groove 242 of the wheel 204. The stud 270 is configured to be movably mounted in the groove 242 of the wheel 206.

[0157] During operation, wheels 204 and 206 are actuated as described above. Figure 8 In the example shown, each wheel 204, 206 includes two sets of grooves 242. In the first set of identical and radially opposite grooves 242, the radial distance of each groove 242 relative to the center of the wheel 204, 206 varies along the groove 242. In the second set of identical and radially opposite grooves 243, each groove 243 has a constant radial distance along the groove 243 relative to the center of the wheel 204, 206. Each groove 243 may have a depth gradient along the groove 243.

[0158] For each wheel 204, 206, the first set of grooves 242 is engaged with at least one jaw 208, 210 by means of studs 250, 252, and the second set of grooves 243 is engaged with at least one second guide 264 by means of studs 268, 270.

[0159] As previously stated, the rotation of wheels 204 and 202 in the same direction causes sleeve 202 to rotate about the longitudinal axis X.

[0160] Simultaneous rotation of one of wheels 204 and 206 in opposite directions actuates cams 242 and 243, resulting in simultaneous movement of grippers 208 and 210 and the downstream end 220 of sleeve 202. As previously described in the first option, at least one gripper 208 or 210 translates radially to apply pressure to the gripper 104 of the surgical instrument 100. As previously described in the second option, the downstream end 220 of sleeve 202 translates longitudinally. It should be understood that this embodiment is a variation of the third option described above.

[0161] The advantage of this design is that it can accommodate the instrument 100, and the instrument head 112 translates when pressure is applied to the gripper 104. In fact, the translation of the head 112 requires the downstream end 220 of the sleeve 202 to move along with the translation, which holds the instrument 100 forward.

[0162] Now for reference Figure 9 This illustrates another embodiment of mechanism 200. In this embodiment, one or more components 280 are fixedly mounted relative to sleeve 202. The component or each component 280 may, for example, be made from the same material as sleeve 202. The component or each component 280 includes one or more studs 268, 270 extending along the longitudinal axis X of sleeve 202, such that at least one groove 242 of each wheel 204, 206 movably receives the studs 268, 270.

[0163] exist Figure 9 In the example shown, component 280 is equipped with studs 268 and 270 on each of its faces. Stud 268 faces wheel 204 and stud 270 faces wheel 206. Therefore, it can be understood that stud 268 engages in a recess 242 in wheel 204, and stud 270 engages in a recess 242 in wheel 206. At least one spacer 290 can be mounted in the same plane perpendicular to the longitudinal axis X of sleeve 202 as component 280. This spacer 290 maintains a fixed axial spacing between wheels 204 and 206. Furthermore, the thickness of spacer 290 is substantially greater than the thickness of component 280.

[0164] During operation, the surgical instrument 100 is inserted into the sleeve 202. As described in the previous second option, each wheel 204, 206 includes at least one groove 242, i.e., having a variable depth along the groove 242 and a constant angular position relative to the center of the wheel 204, 206. In the same manner as in the second option, the rotation of the wheels 204, 206 specifically in opposite directions produces a longitudinal translation of the sleeve 202 driven by the component 280.

[0165] It should be understood that the longitudinal translation of the sleeve 202 allows for the translation of the surgical instrument 100. This may be particularly interesting when the instrument 100 includes a syringe and a puncture action is required.

[0166] Finally, for the different embodiments described above, a plurality of studs extending along the longitudinal axis X are disposed on the component or each component, or only on some components (see [reference]). Figure 4 , 5 In cases like 9, where the studs are either on the guide or on the jaws, or even distributed across different components (see [reference]). Figure 8 (The case where there are studs on both the guide and the gripper).

[0167] The container 400, protective cap, protective compartment 300, and various components constituting the actuation mechanism 200 listed above can be disposable and sterile. Plastic materials can be used. This has the major advantage of maintaining a sterile environment around the patient during the procedure, protecting the patient from infection. Because these components are interchangeable and disposable, they can be easily and specifically installed via clamping at the end of the device at the start of the surgery and discarded after the procedure. If a specific mechanism 200 as described above is required, the compartment 300, including mechanism 200, can be replaced during the procedure. A second advantage is the low cost of these plastic components, which makes them easy to replace.

[0168] Furthermore, the mechanism 200 allows the surgical instrument 100 to move with multiple degrees of freedom, specifically rotation and translation, but also allows pressure to be applied or sliding to the gripper 104 of the instrument 100. This provides the advantage of being able to use a wide range of standard off-the-shelf surgical instruments without requiring hardware modifications to existing instruments.

[0169] Finally, the actuation mechanism 200 is simple in construction and does not occupy a large volume because it allows the motorized elements to be offset in a part outside the module 600, a fixed part, or a part that does not require complex movement. In fact, the increased compactness of the mechanism 200 allows for reduced clutter in the workspace, allows the practitioner to keep the patient in his or her field of vision, and also allows for the use of other nearby equipment, such as microscopes used for routine vitreoretinal surgery or other equipment similar to that of the present invention.

[0170] It should also be noted that, although not part of this invention, the aforementioned device can be used in conjunction with a control interface and / or a software module that translates the movement of the interface into the movement of an actuating mechanism. Specifically, the control interface can reproduce the surgeon's movements with very high precision, enabling him or her to perform actions at a distance from the patient.

Claims

1. An actuation mechanism for a surgical instrument, comprising: - a sleeve equipped with a longitudinal axis, configured to receive the surgical instrument and comprising one or more components extending substantially in a plane perpendicular to the longitudinal axis, a plurality of studs extending along the longitudinal axis being provided on the one or more components, the plurality of studs being provided only on some components when the number of components is multiple, or distributed over different components; - at least two wheels mounted on the sleeve on either side of the one or more components along the longitudinal axis, each wheel being equipped with at least one groove and a mechanical transmission element, the at least one groove of each wheel receiving in a movable manner one of the plurality of studs in the groove; - at least two drive shafts, a first drive shaft being equipped with a first mechanical transmission element cooperating with the mechanical transmission element of one of the two wheels, a second drive shaft being equipped with another first mechanical transmission element cooperating with the mechanical transmission element of the other of the two wheels.

2. The actuation mechanism of claim 1, wherein, The sleeve comprises an internal abutment extending radially at the level of a first end of the sleeve, and a flexible tongue extending axially at the level of a second end.

3. An actuation mechanism as claimed in any one of the preceding claims, wherein, The at least one component is a jaw mounted between guides to be translatable relative to the guides, the guides themselves being fixedly mounted relative to the sleeve.

4. The actuation mechanism of any one of claims 1 or 2, wherein, The at least one component is a guide fixedly mounted relative to the sleeve.

5. The actuation mechanism of claim 3, wherein, The mechanical transmission elements are gear wheels or belt drive pulleys.

6. The actuation mechanism of claim 1, wherein, The groove has a radial distance with respect to the center of the wheel that varies along the groove.

7. The actuation mechanism of claim 1, wherein, The groove has a radial distance with respect to the center of the wheel that is constant along the groove.

8. The actuation mechanism of claim 1, wherein, The groove has a variable depth along the groove.

9. The actuation mechanism of claim 1, wherein, Each wheel comprises at least one first groove having a radial distance with respect to the center of the wheel that varies along the first groove and having a depth that is variable along the first groove, and at least one second groove different from the first groove having a radial distance with respect to the center of the wheel that is constant along the second groove and having a depth that is variable along the second groove.

10. A module characterized in that, The module comprises an actuation mechanism as claimed in claim 1, housed in a protective compartment, maintaining the interaction of the elements of the actuation mechanism with each other.

11. The module of claim 10, wherein, A removable container configured to receive the protective compartment is included, the removable container being attached to one end of the device.

12. The module of claim 11, wherein, At least two parallel drive shafts mechanically connected to motorized elements are positioned to protrude from the end, each drive shaft being configured to cooperate with a second mechanical transmission element of one of the at least two drive shafts of the actuation mechanism.

13. The module of claim 11, wherein, A protective cover is integrated into the removable container, so that the protective cover surrounds the portion opposite the module.

14. The module of claim 13, wherein, The removable container, the protective compartment, the actuation mechanism and the protective cover are aseptic, disposable devices.

15. A method for implementing the actuation mechanism of claim 1, said method being performed outside the patient's body, wherein, Rotation of the wheels in the same direction causes rotation of the sleeve about its longitudinal axis.

16. A method for implementing the actuation mechanism of claim 6, the method being performed outside the patient's body, wherein, Rotation of the wheels in opposite directions causes radial translation of at least one component such that the component exerts pressure on the surgical instrument.

17. A method for implementing the actuation mechanism of claim 7, wherein the groove has a variable depth along the groove, the method being performed outside the patient's body, wherein, Rotation of the wheels in opposite directions causes longitudinal translation of at least one component along the surgical instrument.

18. A method for implementing the actuation mechanism of claim 6, wherein the groove has a variable depth along the groove, the method being performed outside the patient's body, wherein, Rotation of the wheels in opposite directions simultaneously causes longitudinal translation and radial translation of at least one component such that the component exerts pressure on the surgical instrument while being displaced longitudinally along the surgical instrument.

19. A method for implementing the actuation mechanism of claim 9, said method being performed outside the patient's body, wherein, Rotation of the wheels in opposite directions simultaneously causes longitudinal translation of at least one component along the surgical instrument and radial translation of at least another component such that the another component exerts pressure on the surgical instrument.

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