Surgical equipment

Abstract

The surgical equipment (100) comprising: a multifunctional laparoscopic instrument (1) provided with: at least one manipulation member (2) adapted to be manually held by an operator; o at least one working tool (3) associated with the manipulation member (2) and adapted to be inserted within a surgical site (C) for the execution of a surgical-laparoscopic operation; o actuation means (4) associated with the manipulation member (2) and configured to operate the working tool (3); - a remote robotic instrument (R) provided with an additional tool (18) adapted to operate at the same surgical site (C) as the working tool (3), the remote robotic instrument (R) comprising at least one joint (19) operable to move the additional tool (18) and provided with a predefined number of degrees of freedom; where the laparoscopic instrument (1) comprises command means (5) associated with the manipulation member (2), which can be activated by the operator and configured to operate the remote robotic instrument (R) and comprises switching means (9) associated with the manipulation member (2) and adapted to activate / deactivate the command means (5), wherein the switching means (9) comprise safety sensors (10) adapted to detect the position of the manipulation member (2) with respect to said surgical site (C) and to generate at least one position signal and it comprises at least one electronic control unit (11) configured to activate the command means (5) depending on the position signal.

Description

[0001] SURGICAL EQUIPMENT

[0002] Technical Field

[0003] The present invention relates to surgical equipment.

[0004] Background Art

[0005] It is well known that surgical procedures have evolved considerably over the years from wide parietal cuts to minimally invasive techniques via laparoscopic approach. Robotic technology has offered surgeons incomparable possibilities in terms of precision, dexterity, stability, imaging quality and ergonomics, overcoming many limitations of both open and laparoscopic techniques.

[0006] In recent years, both laparoscopy and robotics have evolved towards reduced or scarless surgical techniques and towards lighter, simpler and more cost-effective technologies for robot-assisted surgery.

[0007] Even more recently, new trends move towards hybrid techniques in which surgeons and assistive robotic platforms both work together in close proximity to the patient. The “hybrid robotic” or “roboscopic” approach lets surgeons perform a standard laparoscopic surgical procedure standing at the operating table, while robotic platforms perform assistive tasks such as holding endoscopes or lifting organs.

[0008] In such a hybrid approach, it is the same surgeon who, in addition to manipulating his / her own working instrument must also operate the robotic instrument remotely. This means that the surgeon must stop the activity, leave the working instrument and manipulate a separate control instrument to operate the robot.

[0009] This operative methodology does, however, have some drawbacks related to the fact that it requires frequent interruptions, instrument changes and operator movements which can cause a lengthening of the surgical procedure timeline and the occurrence of possible complications. In addition, the need to change the instrument used can result in excessive stress for the surgeon and possible difficulties in concentration.

[0010] Some surgical equipment is known from WO2014 / 176052A1 and US10258419B2.

[0011] Description of the Invention The main aim of the present invention is to devise surgical equipment which allows a surgeon to control a robotic platform consisting of one or more assistive instruments autonomously and remotely during the performance of a laparoscopic procedure without the need to leave the instruments in his hand.

[0012] Another object of the present invention is to devise surgical equipment which allows making the laparoscopic procedure quick and manageable independently by the surgeon.

[0013] Another object of the present invention is to devise surgical equipment which allows the aforementioned drawbacks of the prior art to be overcome within the framework of a simple, compact, easy and effective to use as well as affordable solution.

[0014] The aforementioned objects are achieved by this surgical equipment having the characteristics of claim 1.

[0015] Other characteristics and advantages of the present invention will become more apparent from the description of a preferred, but not exclusive, embodiment of a multifunctional laparoscopic instrument, illustrated by way of an indicative, yet non-limiting example in the attached tables of drawings in which:

[0016] Figure 1 is a schematic representation of surgical equipment according to the invention, while performing a minimally invasive robotic-assisted endolaparoscopic procedure;

[0017] Figure 2 is a schematic representation of the multifunctional laparoscopic instrument of the surgical equipment in Figure 1;

[0018] Figure 3 is a schematic representation of the multifunctional laparoscopic instrument in Figure 2, in a direct operating mode, when used in its ordinary laparoscopic configuration and thus capable of directly manipulating organs and tissues;

[0019] Figures 4 and 5 are schematic representations of the multifunctional laparoscopic instrument in Figure 2, in a remote operating mode, when used as a command device of one or more robotic instruments with different functions;

[0020] Figure 6 is a block diagram depicting the operational connection between the components of the surgical equipment in Figure 1.

[0021] Embodiments of the Invention

[0022] With particular reference to these figures, reference numeral 100 globally denotes a piece of surgical equipment comprising: at least one multifunctional laparoscopic instrument 1 and at least one remote robotic instrument R.

[0023] The laparoscopic instrument 1 comprises: at least one manipulation member 2 adapted to be manually held by an operator; at least one working tool 3 associated with the manipulation member 2 and adapted to be inserted within a surgical site C for the execution of a surgical- laparoscopic operation; actuation means 4 associated with the manipulation member 2 and configured to operate the working tool 3.

[0024] The remote robotic instrument R is in turn provided with an additional tool 18 adapted to operate at the same surgical site C as the working tool 3.

[0025] According to the invention, the remote robotic instrument R comprises at least one joint 19 operable to move the additional tool 18, where the joint 19 has a predefined number of degrees of freedom.

[0026] Specifically, the additional tool 18 has a distal end 18a intended to be inserted within the surgical site C.

[0027] Then, the laparoscopic instrument 1 comprises command means 5 associated with the manipulation member 2, which can be activated by the operator and configured to operate the remote robotic instrument R.

[0028] Advantageously, the command means 5 are operationally connected to the joint 19.

[0029] More particularly, the remote robotic instrument R comprises an additional trocar device T2 for the insertion of the additional tool 18 within the surgical site C and the joint 19 is positioned, in use, between the additional trocar device T2 and the distal end 18a. The distal end 18a is then movable within the surgical site C at least according to the predefined number of degrees of freedom proper to the joint 19 with respect to the additional trocar device T2.

[0030] The term “in use” as used here means during the use of the remote robotic instrument R, that is, when the distal end 18a is inserted within the surgical site C.

[0031] Preferably, the remote robotic instrument R comprises two joints 19 so that the additional tool 18, and particularly its distal end 18a, is provided with at least four degrees of freedom. In more detail, the two joints 19 are arranged with each other in succession along the additional tool 18.

[0032] More particularly, the distal end 18a is provided with four degrees of freedom given by the joints 19 and with two additional degrees of freedom due to the movement (shift and rotation) of the remote robotic instrument R as a whole with respect to the surgical site C, thus totaling six degrees of freedom.

[0033] In actual facts, this laparoscopic instrument 1 incorporates both the means required to operate the working tool 3 and the means that enable the command of the remote robotic instrument R. As a result, during a laparoscopic procedure, the surgeon is able to perform both operations substantially concurrently and without the need to have to leave the laparoscopic instrument 1 in order to adjust the remote robotic instrument R.

[0034] In detail, the laparoscopic instrument 1 is usable in a direct operating mode, in which it is employable as a traditional laparoscopic instrument and allows direct operation by the surgeon using the working tool 3, and a remote operating mode, in which it is employable to operate one or more remote robotic instruments R. In the remote operating mode, the surgeon transfers to the remote robotic instrument R the movements directly imparted to the manipulation member 2.

[0035] The manipulation member 2 has an ergonomic design which allows it to be conveniently gripped but also allows easy operation on the command means 5. For example, the manipulation member 2 may comprise a handle possibly provided with an opening for the operator’s fingers to be inserted.

[0036] The working tool 3 is mounted at one end of the manipulation member 2. The working tool 3 is of the type known to the technician in the field and may be, e.g., of the type of a fenestrated grasper, a needle holder, a dissector or the like. In use, the working tool 3 is inserted within the surgical site C e.g. through a trocar device Tl.

[0037] The actuation means 4 are configured to move and operate the working tool 3 during the direct operating mode.

[0038] The actuation means 4 can, therefore, be of various types, depending on the type of working tool 3 used. For example, in the case of a grasper, the actuation means 4 can be configured to open / close the beak of the grasper itself.

[0039] Conveniently, the actuation means 4 may comprise at least one mechanical actuating member 13 kinematically connected to the working tool 3. In such a case, the movement and / or actuation of the working tool 3 is done manually.

[0040] In accordance with the embodiment shown in the figures, for example, the mechanical actuating member 13 is of the type of a lever associated with the manipulation member 2. Still with reference to the embodiment shown in the figures, the actuation means 4 may also comprise a rotational member 16 configured to move the working tool 3 in rotation on itself.

[0041] Alternatively, the actuation means 4 may comprise at least one automatic actuating member operationally connected to the working tool 3. In such a case, the movement and / or the actuation of the working tool 3 are carried out by means of electrical actuation or of another type, e.g., an electric motor operated by pressing appropriate push-buttons.

[0042] It is also possible to provide for actuation means 4 comprising both mechanical actuating members 13 and automatic actuating members, e.g., to allow manual positioning of the working tool 3 (rotation / shift with respect to the surgical site) and its automated actuation (opening / closing of the beak, electrification, etc.). Appropriately, the laparoscopic instrument 1 also comprises at least one electronic control unit 11 configured to control the electronic components of the laparoscopic instrument itself.

[0043] The electronic control unit 11 can be built into the assembly comprising the manipulation member 2 and the working tool 3 or be made as a separate component therefrom.

[0044] The command means 5 are, therefore, configured to move the remote robotic instrument R with respect to the surgical site C and, if necessary, to operate the corresponding additional tool 18.

[0045] Advantageously, the command means 5 comprise: sensor means 6 adapted to detect the position and the movement of the manipulation member 2 and to generate a corresponding reference signal for the remote robotic instrument R; and a communication system 7 configured to transmit the reference signal to the remote robotic instrument R.

[0046] Appropriately, the remote robotic instrument R comprises a receiving system 20 adapted to receive the reference signal and configured to operate the joint 19. In other words, as a result of the reference signal emitted by the command means 5, the receiving system 20 is configured to receive and process such reference signal and to transmit the signal so processed to the joint 19 in order to command the movement thereof.

[0047] The additional tool 18 of the remote robotic instrument R can be of a similar type as the working tool 3, such as a fenestrated grasper, a needle holder, a dissector or the like.

[0048] The sensor means 6 and / or the communication system 7 can be built into the assembly comprising the manipulation member 2 and the working tool 3 or be made as separate components and associated with a separate electronic control unit.

[0049] In accordance with one possible embodiment, the reference signal is sent to the electronic control unit 11, which is configured to operate the communication system 7 in order to send the reference signal. Alternatively, the communication system 7 can be configured to transmit the reference signal continuously and the electronic control unit 11 can be configured to control the sensor means 6 and, therefore, the generation of the reference signal.

[0050] Conveniently, the command means 5 also comprise at least one command member 15 built into the manipulation member 2 and configured to command the transmission of the reference signal by the communication system 7. The command member 15 can be of the type of a push-button or the like. The sensor means 6 are substantially configured to detect the position and the movement in a continuous maimer but the reference signal is only transmitted by actuation of the command member 15. This ensures that the remote robotic instrument R is not operated by mistake and that the laparoscopic procedure is performed correctly and safely at all times.

[0051] Conveniently, the sensor means 6 comprise at least one sensor selected from the list comprising: inertial sensor, potentiometric sensor, vision sensor. Different types of sensor known to the engineer in the field cannot however be ruled out. In detail, inertial sensors allow detecting the movement of the laparoscopic instrument 1 within the space, the potentiometric sensors allow detecting the movement of the manipulation member 2 with respect to the working tool 3 and the vision sensors allow detecting the position and the movement of the laparoscopic instrument 1 by image acquisition.

[0052] The electronic control unit 11 may comprise a multiplexer unit which enables individual communication with all sensors.

[0053] The communication system 7 comprises radio wave transmission devices. For example, the communication system 7 may comprise a Bluetooth transmission board. It cannot, however, be ruled out that the communication system 7 may be of a different type and / or e.g. comprise a wired connection.

[0054] The command means 5 may also comprise at least one actuating device 17 configured to operate the tool of the remote robotic instrument R, such as, e.g., beak opening / closing, electrification, etc. The actuating device 17 may be e.g. of the type of a push-button or a lever.

[0055] In accordance with a possible embodiment, the actuating device 17 coincides with the actuating member of the actuation means 4.

[0056] Then, the laparoscopic instrument 1 comprises switching means 9 associated with the manipulation member 2 and adapted to activate / deactivate the command means 5.

[0057] The switching means 9 ensure controlled actuation of the command means 5 so that the position and the movement of the manipulation member 2 can determine the movement of the remote robotic instrument R only when required.

[0058] Conveniently, the switching means 9 comprise a switch member 12 operable by the operator and adapted to determine the activation / deactivation of the command means 5.

[0059] In a particular embodiment, the switching means 9 are configured to allow alternating actuation of the actuation means 4 and of the command means 5. For example, the switch member 12 can result in mechanical locking / unlocking of the actuation means 4 and / or in their electronic deactivation / activation (depending on the type of actuation means 4) and, at the same time, result in electronic activation / deactivation of the command means 5, respectively.

[0060] According to the invention, the switching means 9 comprise safety sensors 10 adapted to detect the position of the manipulation member 2 with respect to the surgical site C and to generate at least one corresponding position signal. The safety sensors 10 ensure that the command of the remote robotic instrument R is carried out only when the working tool 3 is moved away from the surgical site C or is otherwise not operable, so as not to damage the surgical site itself.

[0061] Also according to the invention, the electronic control unit 11 is configured to activate the command means 5 depending on the position signal generated by the safety sensors 10. More particularly, the electronic control unit 11 is configured to compare the position signal received from the safety sensors 10 with a predefined reference position and to activate the command means 5 when the detected position of the manipulation member 2 corresponding to the position signal is at a preset distance from the reference position, thereby identifying a safety position.

[0062] The safety sensors 10 may be of the type of distance sensors adapted to detect the distance of the manipulation member 2 from the surgical site C, e.g., with respect to the trocar device Tl. Specifically, the safety sensors 10 are of the type of time- of-flight (TOF) laser sensors.

[0063] According to a preferred operating mode, before proceeding with the activation of the command means 5, the laparoscopic instrument 1 is placed at a safety position. The safety position prevents any possible damage to the surgical site during the remote control of the robotic instrument. For example, as shown in the figures, at the safety position, the end of the working tool 3 is arranged in the trocar device Tl. It is easy to appreciate that the safety position may be different from what is described herein.

[0064] Appropriately, the electronic control unit 11 is configured to enable the switch member 12 when a predefined position of the manipulation member 2 is achieved identified by the safety sensors 10. In other words, when the position of the manipulation member 2 corresponds to a preset value, e.g. a safety position, the electronic control unit 11 enables the actuation of the switch member 12.

[0065] Appropriately, the switching means 9 also comprise at least one release system positioned between the manipulation member 2 and the working tool 3 and operable to mechanically release the latter ones. For example, the release system may comprise a set of mechanical locks or brakes associated with the actuation means 4.

[0066] As a result of the activation of the release system, the manipulation member 2 is then mechanically released from the working tool 3, which is not operable through the actuation means 4, while as a result of the deactivation of the release system, the manipulation member 2 is mechanically connected to the working tool 3, which is operable through the actuation means 4.

[0067] Advantageously, the switch member 12 is configured to activate / deactivate the release system.

[0068] In more detail, due to the activation of the release system, the manipulation member 2 is movable with respect to the working tool 3. Thus, more degrees of freedom can be given to the manipulation member 2.

[0069] Specifically, the laparoscopic instrument 1 comprises movement means 8 positioned between the working tool 3 and the manipulation member 2.

[0070] This implementation solution provides for the release system to be associated with the movement means 8. In detail, the manipulation member 2 is movable with respect to the working tool 3 by means of the movement means 8 as a result of the activation of the release system.

[0071] In this way, it is possible to move the manipulation member 2 while keeping the working tool 3 stationary and avoiding any possible damage to the surgical site C.

[0072] The movement means 8 are adapted to determine the rotation of the manipulation member 2 around at least two axes of rotation. In this way, the manipulation member 2 and, consequently, the remote robotic instrument R are provided with six degrees of freedom in space.

[0073] Preferably, the movement means 8 comprise a movement system selected from the list comprising: two-axis joint, cardan joint, articulated joint, ball joint. It cannot, however, be ruled out that the movement means may be of different type and the degrees of freedom may be different depending on the construction preferences.

[0074] The moment the release system is deactivated, the movement means 8 are blocked so that the manipulation member 2 can no longer be moved with respect to the working tool 3.

[0075] The electronic control unit 11 can also be configured to prevent the actuation of the release system when the position of the manipulation member 2 does not correspond to the predefined reference position.

[0076] Appropriately, the safety sensors 10 may also comprise inductive sensors adapted to detect the activation / deactivation of the release system.

[0077] Conveniently, the laparoscopic instrument 1 may comprise alarm means 14 operationally connected to at least one of the sensors 6,10 and configured to signal nonconformity to the operator.

[0078] For example, the alarm means 14 may be configured to alert the operator if, in the remote operating mode, the laparoscopic instrument 1 is displaced from the safe position. Or, the alarm means 14 may signal a component malfunction.

[0079] The alarm means 14 can be of the audible (acoustic signal), visual (light signal) and / or mechanical (vibratory signal) type.

[0080] The laparoscopic instrument 1 is conveniently of the wireless type and is provided with a battery-powered system which allows powering the electronic components.

[0081] This laparoscopic instrument 1 can be made as a sterile and entirely disposable instrument, or it can provide a removable disposable portion and a reusable portion.

[0082] In accordance with a possible embodiment, the working tool 3 is associated with the manipulation member 2 in a removable maimer. In this way, the working tool 3, which is intended to come into direct contact with the surgical site C, can be sterilized or disposed of, while the manipulation member 2 can be reused for a later surgical operation.

[0083] In addition, such a solution allows replacing the working tools 3 of different type for use with the same manipulation member 2.

[0084] The operation of the laparoscopic instrument 1 in accordance with a possible embodiment is as follows.

[0085] In direct operating mode, the laparoscopic instrument 1 allows actions to be performed similarly to traditional laparoscopic instruments.

[0086] In detail, the working tool 3 is inserted into the surgical site C through the trocar device T1 and can be positioned with respect thereto by the operator and manipulated by means of the actuating members and / or the rotational member 16.

[0087] To switch to the remote operating mode, the laparoscopic instrument 1 is brought to the safety position. The safety sensors 10 detect the correct positioning of the laparoscopic instrument 1 and the electronic control unit 11 may signal the safety status to the operator and activate the switch member 12.

[0088] At this point, the operator can operate the switch member 12 to activate the command means 5 and possibly to activate the release system.

[0089] The manipulation member 2 is, therefore, released from the working tool 3 to allow control of the degrees of freedom required for the manipulation of the robotic instrument R and thus for remote operation.

[0090] The operator is now able to operate the movement means 8 and the sensor means 6 detect the movement thereof and generate a corresponding reference signal. The reference signal is sent from the communication system 7 to the robotic instrument R by pressing the command member 15.

[0091] Any actuation of the tool of the remote robotic instrument R is carried out by means of the actuating device 17. In case the manipulation member 2 is not at a safe position, the signal transmission is blocked.

[0092] In order to switch back to the direct operating mode, the release system is deactivated, thus blocking the movement means 8 accordingly, e.g., by operating on the switch member 12. After that, the laparoscopic instrument 1 can be moved with respect to the safety position.

[0093] According to a further aspect, the present invention also relates to a piece of laparoscopic equipment comprising at least one multifunctional laparoscopic instrument 1 according to one or more of the aforementioned embodiments and at least one remote robotic instrument R adapted to operate at the same surgical site C. The remote robotic instrument R is operable by the multifunctional laparoscopic instrument 1 according to the previously disclosed maimers.

[0094] It has in practice been ascertained that the described invention achieves the intended objects, and in particular, the fact is emphasized that the surgical equipment according to the invention allows the surgeon to control a robotic platform consisting of one or more assistive instruments autonomously and remotely during the performance of a laparoscopic procedure without the need to leave the instruments in his or her hand.

[0095] Specifically, the presence of the safety sensors allows the activation of the command means, and thus the movement of the robotic instrument remotely, only under safe conditions, that is, when the position of the manipulation member with respect to the surgical site is such that there is no risk to the surgical site itself.

[0096] In addition, the present multifunctional laparoscopic instrument allows the laparoscopic procedure to be made manageable independently by the surgeon.

[0097] This is made possible by built-in command means and an electronic system configured to manage and detect the movement of the instrument itself.

Claims

CLAIMS1) Surgical equipment (100) comprising: a multifunctional laparoscopic instrument (1) provided with: o at least one manipulation member (2) adapted to be manually held by an operator; o at least one working tool (3) associated with said manipulation member (2) and adapted to be inserted within a surgical site (C) for the execution of a surgical-laparoscopic operation; o actuation means (4) associated with said manipulation member (2) and configured to operate said working tool (3); a remote robotic instrument (R) provided with an additional tool ( 18) adapted to operate at the same surgical site (C) as said working tool (3); where said laparoscopic instrument (1) comprises command means (5) associated with said manipulation member (2), which can be activated by said operator and configured to operate said remote robotic instrument (R) and comprises switching means (9) associated with said manipulation member (2) and adapted to activate / deactivate said command means (5), characterized by the fact that said remote robotic instrument (R) comprises at least one joint (19) operable to move said additional tool (18) and provided with a predefined number of degrees of freedom, by the fact that said switching means (9) comprise safety sensors (10) adapted to detect the position of said manipulation member (2) with respect to said surgical site (C) and to generate at least one position signal and by the fact that it comprises at least one electronic control unit (11) configured to activate said command means (5) depending on said position signal.2) Surgical equipment (100) according to claim 1, characterized by the fact that said command means (5) comprise: sensor means (6) adapted to detect the position and the movement of said manipulation member (2) and to generate a corresponding reference signal; and a communication system (7) configured to transmit said reference signal tosaid remote robotic instrument (R) and by the fact that said remote robotic instrument (R) comprises a receiving system (20) adapted to receive said reference signal and configured to operate said at least one joint (19).3) Surgical equipment (100) according to claim 2, characterized by the fact that said sensor means (6) comprise at least one sensor selected from the list comprising: inertial sensor, potentiometric sensor, vision sensor.4) Surgical equipment (100) according to claim 2 or 3, characterized by the fact that said communication system (7) comprises radio wave transmission devices.5) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said command means (5) comprise at least one command member (15) built into said manipulation member (2) and configured to command the transmission of said reference signal by said communication system (7).6) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said electronic control unit (11) is configured to compare said position signal received from said safety sensors (10) with a predefined reference position and to activate said command means (5) when the detected position of said manipulation member (2) corresponding to the position signal is at a preset distance from said reference position, thereby identifying a safety position.7) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said switching means (9) comprise a switch member (12) operable by said operator and adapted to determine the activation / deactivation of said command means (5).8) Surgical equipment (100) according to claim 6 and 7, characterized by the fact that said electronic control unit (11) is configured to enable said switch member (12) when said safety position is achieved.9) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said switching means (9) comprise at least one release system positioned between said manipulation member (2) and saidworking tool (3) and operable to mechanically release the latter ones.10) Surgical equipment (100) according to claim 7 or 8 and claim 9, characterized by the fact that said switch member (12) is configured to operate said release system.11) Surgical equipment (100) according to claim 9 or 10, characterized by the fact that it comprises movement means (8) positioned between said working tool (3) and said manipulation member (2), said manipulation member (2) being movable with respect to said working tool (3) by means of said movement means (8) as a result of the activation of said release system.12) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said command means (5) are operationally connected to at least one joint (19).13) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said remote robotic instrument (R) comprises two of said joints (19) adapted to give said additional tool (18) four degrees of freedom.14) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said remote robotic instrument (R) comprises an additional trocar device (T2) for the insertion of said additional tool (18) within the surgical site (C), that said additional tool (18) comprises a distal end (18a) intended to be inserted within the surgical site (C) and by the fact that at least one joint (19) is positioned, in use, between said additional trocar device (T2) and said distal end (18a), the latter being movable within the surgical site (C) according to said predefined number of degrees of freedom with respect to said additional trocar device (T2).15) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said actuation means (4) comprise a mechanical actuating member (13) kinematically connected to said working tool (3).16) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said actuation means (4) comprise an automatic actuating member operationally connected to said working tool (3).17) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that it comprises alarm means (14) operationally connected to at least one of said sensors (6,10) and configured to signal nonconformity to said operator. 18) Surgical equipment (100) according to one or more of the preceding claims, characterized by the fact that said working tool (3) is associated with said manipulation member (2) in a removable maimer.

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