INSTRUMENT FOR CONTROLLING AND MOVING LAPAROSCOPIC INSTRUMENTS AND TO DRIVE PRECISION BIOPSIES UNDER ECOGRAPHIC OR FLUOROSCOPIC GUIDANCE

摘要

The basic structure is formed by three to five self balanced arms, of which at least three bear six Degrees of Freedom (DOF) arms, while the two optional bear 5 DOF. The central arm and the two 5 DOF are passive, convertible into active, the first being dedicated to moving and reorienting the endoscope, while the remaining two will be five DOF arms, which can be used as active arms to help the doctor during the surgery. Passing to the last 6 DOF arms, the first DOF are passive and lockable, while the sixth is integral part of the position control system of the laparoscopic instrument, that allows also rotating the instrument's sheet about an axis perpendicular to the 6th DOF, and perpendicular to the sheet itself, maintaining fixed the point of insertion in the patient's skin. Moreover this system allows rotating the instrument with respect to the sheet, changing its depth of penetration into the body, and finally actuating the instrument, every movement being controlled by the doctor sitting at the console, using the manual instrumentation present in the hospitals. The presence of a quasi - haptic interface able to inform the doctor on the level of forces exerted is also foreseen. The description of a new multi-use instrument for laparoscopy able to open the blades symmetrically and to tilt the head in two mutually perpendicular directions, is given. Finally two more end effectors are presented, able to guide precision biopsies under ecographic or fluoroscopic control.