Medical endodevice

Abstract

A medical endodevice for an intervention inside a human or animal body includes an elongated liaising structure having a distal end arrangeable inside a body of the human or animal being and a proximal end arrangeable outside the body while the distal end is inside the body. The endodevice has an intervention tool arranged to manipulate a target tissue inside the human or animal body. The intervention tool is arranged at the distal end of the liaising structure. The endodevice further includes a positioning unit having a moving formation arranged to dislocate the intervention tool relative to the target tissue, and an anchoring formation arranged to fix the moving formation to a fixing tissue inside the human or animal body such that the target tissue is positioned in a workspace of the intervention tool.

Claims

1. A medical endodevice for an intervention inside a human or animal body, comprising: an elongated liaising structure having a distal end arrangeable inside a body of a human or animal being and a proximal end arrangeable outside the body while the distal end is inside the body, a positioning unit mounted at the distal end of the liaising structure, and an intervention tool arranged to manipulate a target tissue inside the human or animal body, wherein the intervention tool is arranged at the positioning unit at the distal end of the liaising structure, and wherein the positioning unit has a moving formation arranged to dislocate the intervention tool relative to the target tissue, the moving formation being configured to allow the positioning unit to perform defined movement in three to five degrees of freedom, and wherein the positioning unit has an anchoring formation arranged to fix the moving formation to a fixing tissue inside the human or animal body such that the target tissue is positioned in a workspace of the intervention tool, and a decoupling structure arranged to decouple the positioning unit once it is fixed to the fixing tissue.

2. The medical endodevice of claim 1, comprising a laser arrangement, wherein the intervention tool is a laser beam propagating structure of the laser arrangement.

3. The medical endodevice of claim 2, wherein the laser beam propagating structure of the laser arrangement comprises an adjustable optics arranged to direct the laser beam in various directions.

4. The medical endodevice of claim 2, wherein the laser arrangement comprises an optical fiber connectable to a laser source, the optical fiber has a distal end from which the laser beam is ejectable, and the laser beam propagating structure of the laser arrangement comprises the distal end of the optical fiber of the laser arrangement.

5. The medical endodevice of claim 1, wherein the anchoring formation of the positioning unit comprises a leg with a foot portion fixable to the fixing tissue.

6. The medical endodevice of claim 5, wherein the moving formation of the positioning unit has a first rail, a first slide and a first arm, wherein the first slide is mounted to the first rail such that it is movable along the first rail, and the first arm is at one end region rotatably mounted to the first slide and at an opposite other end region rotatably mounted to the leg.

7. The medical endodevice of claim 6, wherein the anchoring formation of the positioning unit comprises a further leg with a foot portion fixable to the fixing tissue.

8. The medical endodevice of claim 7, wherein the moving formation of the positioning unit has a further first rail, a further first slide and a further first arm, wherein the further first slide is mounted to the further first rail such that it is movable along the further first rail, and the further first arm is at one end region rotatably mounted to the further first slide and at an opposite other end region rotatably mounted to the further leg.

9. The medical endodevice of claim 6, wherein the liaising structure comprises at least one navigation wire connected to the moving formation of the positioning unit.

10. The medical endodevice of claim 9, wherein the at least one navigation wire of the liaising structure is mounted to the first slide of the moving formation of the positioning unit.

11. The medical endodevice of claim 1, wherein the positioning unit comprises a sensor arranged to localize the positioning unit.

12. The medical endodevice of claim 11, wherein the sensor is an optical sensor.

13. The medical endodevice of claim 1, comprising a robot arrangement connected to the intervention tool and the positioning unit via the liaising structure.

14. The medical endodevice of claim 1, wherein the decoupling structure is arranged to recouple the positioning unit after being decoupled.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The medical endodevice according to the invention are described in more detail hereinbelow by way of an exemplary embodiment and with reference to the attached drawings, in which:

(2) FIG. 1 shows an overview of an embodiment of a medical endodevice according to the invention in use, wherein a section comprising a positioning unit is additionally shown in an enlarged presentation;

(3) FIG. 2 shows a first perspective view of the positioning unit of the endodevice of FIG. 1;

(4) FIG. 3 shows a second perspective view of the positioning unit of the endodevice of FIG. 1;

(5) FIG. 4 shows a top view of the positioning unit of the endodevice of FIG. 1; and

(6) FIG. 5 shows top views illustrating movements of the positioning unit of the endodevice of FIG. 1.

DESCRIPTION OF EMBODIMENTS

(7) In the following description certain terms are used for reasons of convenience and are not intended to limit the invention. The terms “right”, “left”, “up”, “down”, “under” and “above” refer to directions in the figures. The terminology comprises the explicitly mentioned terms as well as their derivations and terms with a similar meaning. Also, spatially relative terms, such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like, may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions and orientations of the devices in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. The devices may be otherwise oriented (rotated 90 degrees or at other orientations), and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes include various special device positions and orientations.

(8) To avoid repetition in the figures and the descriptions of the various aspects and illustrative embodiments, it should be understood that many features are common to many aspects and embodiments. Omission of an aspect from a description or figure does not imply that the aspect is missing from embodiments that incorporate that aspect. Instead, the aspect may have been omitted for clarity and to avoid prolix description. In this context, the following applies to the rest of this description: If, in order to clarify the drawings, a figure contains reference signs which are not explained in the directly associated part of the description, then it is referred to previous or following description sections. Further, for reason of lucidity, if in a drawing not all features of a part are provided with reference signs it is referred to other drawings showing the same part. Like numbers in two or more figures represent the same or similar elements.

(9) FIG. 1 shows an overview of a first embodiment of an endodevice 1 according to the invention in operation. The endodevice 1 comprises an endoscope 2 as liaising structure equipped with a positioning unit 3 at its distal end and an arm robot 4 guiding and controlling the endoscope 2.

(10) The endodevice 1 is used for an intervention in a knee of a patient 5. The endodevice 1 comprises an arm robot 4 and an endoscope 2 with a positioning unit 3. The endoscope 2 extends into the interior space of the knee as body cavity via an opening cut near a femur 51, a tibia 52 and a patella 53 of the patient 5.

(11) The positioning unit 3 has a base body 31 fixed to a lower extremity of the femur 51 as fixing tissue. As described in more detail below, the positioning unit 3 is equipped with a moving formation 32 for moving the base body 31 along the femur 51. The base body 31 houses adjustable mirrors as intervention tool in form of a laser beam propagating structure of a laser arrangement of the endodevice 1. The adjustable mirrors are arranged to direct a pulsed laser beam suitable to ablate and cut the lower extremity of the femur 51 as target tissue (not visible in FIG. 1). The laser beam pulses are guided towards the positioning unit 3 and the adjustable mirrors via an optical fibre of the endoscope 2.

(12) In FIG. 2 the positioning unit 3 mounted to the distal end 23 of the endoscope 2 via a joint 21 is shown in more detail. It comprises the base body 31, the moving formation 32 and an anchoring formation 33. The anchoring formation 33 comprises a post-like straight vertical leg 331 which at its bottom end, i.e. its foot portion, is provided with a tip. The tip can be attached to the lower extremity of the femur 51 as fixing tissue. Like this, the positioning unit 3 can be fixed to the femur 51 close to the location of its lower extremity to be cut by the laser beam.

(13) The moving formation 32 has straight horizontal arms 321, slides 322 and rails 323. The arms 321 comprise a first arm 3211 and a second arm 3212 which at a first longitudinal end are rotatably mounted to a top end of the leg 331 of the anchoring formation 33. Thereby, the first and second arms 3211, 3212 can be pivoted about a longitudinal axis of the leg 331.

(14) The slides 322 comprise a first slide 3221 mounted on a first rail 3231 of the rails 323 and a second slide 3222 mounted on a second rail 3232 of the rails 323. The first and second rails 3231, 3232 extend along the base body 31 from the endoscope 2 to a longitudinal end 35 of the positioning unit 3. The first rail 3231 is positioned on top of and parallel to the second rail 3232.

(15) A second longitudinal end of the first arm 3211 is rotatably mounted to the first slide 3221 and a second longitudinal end of the second arm 3212 is rotatably mounted to the second slide 3222. By moving the first and second slides 3221, 3222 the first and second arms 3211, 3212 are pivoted about the leg 331 which is fixed to the femur 51. Thereby, as described in more detail below, the position of the base body 31 together with the intervention tool can be adjusted.

(16) For moving the slides 322 along the rails 323 they are connected to navigation or guiding wires 22 of the endoscope 2. Each of the wires 22 is at one end attached to one of the slides 322 and at its other end connected to the arm robot 4 for control. Furthermore, between each of the slides 322 and the longitudinal end 35 of the positioning unit 3 an elastic cable 34 as spring is arranged pulling the respective slide 322 towards the longitudinal end 35. In order to move one of the slides 322 towards the distal end 23 of the endoscope 2 it is pulled by the respective wire 22. If no or a reduced force acts on the wire 22, the respective slide 322 is moved towards the longitudinal end 35 by the respective elastic cable 34.

(17) At a lower side of the positioning unit 3 a laser propagator 6 is mounted as an intervention tool. The laser propagator 6 comprises a beam redirection element 61 such as a mirror, a lens, a combination thereof or the like which directs a laser beam 62 towards the femur 51. The beam redirection element 61 can be dislocated by the movement formation 32 relative to the femur 51. In addition thereto, the beam redirection element 61 can be moved relative to the positioning unit 3 in order to precisely direct beam 62 to and along the femur 51. For example, particularly in embodiments where the beam redirection element is or has a mirror, the mirror can be tilted or turned relative to the positioning unit 3.

(18) As can be seen in FIG. 3 and FIG. 4, the moving formation 32 and the anchoring formation 33 are mirror-symmetrically formed. In particular, they comprise a further first arm 3213, a further second arm 3214, a further first slide 3223, a further second slide 3224, a further first rail (not visible in the FIGS.), a further second slide 3234 and a further leg 332. Similar as described above, the further first and second arms 3213, 3214 are at one end rotatably mounted to the further leg 332 and at the other end rotatably mounted to the further first and second slides 3223, 3224. The further first and second slides 3223, 3224 are slidably mounted to the further first and second slides 3234, respectively.

(19) FIG. 5 shows the positioning unit 3 of the endodevice 1 in five different positions i to v in order to illustrate the operation of the moving formation 32 and the fixing formation 33. In position i, in FIG. 5 this is the left most position, the slides 322 are at a maximum distance to each other such that the arms 321 are stretched. In particular, the first and second slides 3221, 3222 are moved along the respective rails 3231, 3232 apart from each other, such that the first and second arms 3211, 3222 are pivoted about the leg 331 to be at almost 180° to each other. Analogously, the further first and second slides 3223, 3224 are moved along the respective further first and second rails 3234 apart from each other, such that the further first and second arms 3213, 3214 are pivoted about the further leg 332 to be at almost 180° to each other. In position i, the leg 331 and the further leg 332 are retracted towards the base body 31. Like this, the positioning unit 3 is folded such that it requires comparably little space and that it can conveniently be forwarded into the body of the patient 5 by means of the endoscope 2.

(20) In position ii, in FIG. 5 this is the second left position, the positioning unit 3 is at a target location. There, the distance between each pair of the slides 322 is reduced such that an angle between the respective arms is reduced. Thereby, the legs 33 are laterally moved in an outward direction. There, they are fixed to the target tissue, i.e. the lower extremity of the femur 51. The positioning unit 3 is decoupled from the endoscope such that it is independently fixed to the femur 51.

(21) In position iii, in FIG. 5 this is the middle position, the base body 31 is axially or straightly moved in a forward direction. This is achieved by simultaneously moving the slides 322 along the rails 323. The legs 33 are still fixed to the femur 51.

(22) In position iv, in FIG. 5 this is the second right position, the positioning unit 3 is laterally moved to the right. For that, the angle between the first arm 3211 and the second arm 3212 is increased by moving the first and second slides 3221, 3222 towards each other as well as, simultaneously, the angle between the further first arm 3213 and the further second arm 3214 is decreased by moving the further first and second slides 3223, 3224 apart from each other.

(23) In position v, in FIG. 5 this is the right most position, the positioning unit 3 is pivoted clock-wise by appropriately adjusting the angle between the first and second arms 3111, 3112 in coordination with the angle between the further first and second arms 3113, 3114.

(24) As can be seen in FIG. 5, the moving formation 32 allows the positioning unit 3 to be moved in three degrees of freedom, i.e. a forward-backward or axial movement, a left-right or lateral movement and a pivoting movement. This allows for precisely positioning the intervention tool in relation to the femur 51 in order that, together with the mirrors, a sophisticated intervention can be applied.

(25) This description and the accompanying drawings that illustrate aspects and embodiments of the present invention should not be taken as limiting the claims defining the protected invention. In other words, while the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of this description and the claims. In some instances, well-known circuits, structures and techniques have not been shown in detail in order not to obscure the invention. Thus, it will be understood that changes and modifications may be made by those of ordinary skill within the scope and spirit of the following claims. In particular, the present invention covers further embodiments with any combination of features from different embodiments described above and below.

(26) The disclosure also covers all further features shown in the FIGS. individually although they may not have been described in the afore or following description. Also, single alternatives of the embodiments described in the figures and the description and single alternatives of features thereof can be disclaimed from the subject matter of the invention or from disclosed subject matter. The disclosure comprises subject matter consisting of the features defined in the claims or the exemplary embodiments as well as subject matter comprising said features.

(27) Furthermore, in the claims the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single unit or step may fulfil the functions of several features recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. The terms “essentially”, “about”, “approximately” and the like in connection with an attribute or a value particularly also define exactly the attribute or exactly the value, respectively. The term “about” in the context of a given numerate value or range refers to a value or range that is, e.g., within 20%, within 10%, within 5%, or within 2% of the given value or range. Components described as coupled or connected may be electrically or mechanically directly coupled, or they may be indirectly coupled via one or more intermediate components. Any reference signs in the claims should not be construed as limiting the scope.