Modular Laparoscopic Tool with NOTES Delivery
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Solution Overview
Problem
Current surgical techniques face challenges in navigating and manipulating tools through the tortuous paths of the GI tract and peritoneum during natural orifice transluminal endoscopic surgeries (NOTES), requiring flexible and controllable devices that are stiff enough for tissue manipulation but flexible enough for passage, which poses a learning curve for surgeons accustomed to laparoscopy.
Innovation Solution
The development of modular laparoscopic surgery tools with small shafts that can connect to larger diameter working tips, allowing for precise control and actuation, and the use of a connector that enables the transfer of various forms of energy and signals, enabling the tools to be used through natural orifices while maintaining the benefits of laparoscopic techniques.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If flexible endoscopes are used to navigate tortuous paths in the GI tract, then the ability to access peritoneal space through natural orifices is improved, but the stiffness required for effective tissue manipulation during surgery deteriorates
Solution Approach 1:
The surgical tool is divided into multiple segments or sections that can articulate relative to each other, allowing the distal end to navigate tortuous anatomical paths while the proximal shaft maintains sufficient stiffness for manipulation. The segments connect through joints that enable bending and articulation without compromising overall structural integrity.
Solution Approach 2:
Different portions of the surgical tool have different mechanical properties - the distal end is made more flexible to navigate curved paths through the GI tract, while the proximal shaft maintains higher stiffness for effective tissue manipulation. This gradient in mechanical properties allows the tool to satisfy both contradictory requirements simultaneously.
2Strength
If larger diameter working tips are used for effective surgical manipulation, then the effectiveness of tissue manipulation is improved, but the ability to pass through small natural orifices deteriorates
Solution Approach 1:
The larger diameter working tip is nested within a delivery catheter or sheath that has a smaller outer diameter, allowing it to pass through narrow natural orifices. Once positioned at the target site, the working tip is deployed or extended from the delivery catheter to perform surgical manipulation with its full diameter and effectiveness.
Solution Approach 2:
The working tip transitions from a compressed or retracted state during delivery to an extended or deployed state during surgery. This dynamic transformation allows the tool to fit through small openings when needed while providing full functionality when positioned for tissue manipulation.
3Ease of operation
If rigid laparoscopic tools are used for precise manipulation, then the precision of surgical control is improved, but the ability to pass through natural orifices without external puncture deteriorates
Solution Approach 1:
The rigid laparoscopic tool is segmented into a flexible delivery catheter and a rigid working component. The flexible catheter portion allows passage through natural orifices and tortuous paths, while the rigid working component provides precise surgical control when deployed at the target site.
Solution Approach 2:
A flexible delivery catheter or sheath acts as an intermediary that facilitates the passage of rigid surgical tools through natural orifices and curved anatomical paths. The catheter protects the rigid tool during navigation while allowing it to reach the peritoneal space without external puncture, after which the tool can be deployed for precise manipulation.
Data Source
AI summary
Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.