WO2016142279A1

WO2016142279A1 - Device and method for dispensing sterile instruments

Info

Publication number: WO2016142279A1
Application number: PCT/EP2016/054607
Authority: WO
Inventors: Joël PYNSON
Original assignee: PYNSON JOëL
Priority date: 2015-03-10
Filing date: 2016-03-04
Publication date: 2016-09-15
Also published as: FR3033488A1; FR3033488B1

Abstract

The invention relates to a device (1) for dispensing sterile instruments (2), especially for eye surgery, said device (1) comprising a base (3), a tray (4) mounted on the base (3), which comprises a sterile supporting wall (5) with a plurality of compartments (6) for receiving sterile instruments (2), means for driving said tray (4) in relation to the base (3) about a rotational axis (Z), each receiving region (6) having an angular position defined in relation to the base (3), and means for controlling the driving means so as modify the angular position of said receiving compartments (6) in relation to said base (3).

Description

DEVICE AND METHOD FOR DISTRIBUTING STERILE INSTRUMENTS

TECHNICAL FIELD AND PRIOR ART The present invention relates to the surgical field and, more particularly, to the field of medical equipment specially adapted for surgery. The invention aims more particularly at assisting a surgeon during an ocular intervention of the cataract type. GENERAL PRESENTATION OF THE INVENTION

During surgery, a surgeon uses sterile instruments, such as forceps, knives or scissors, to perform a procedure on a patient. These sterile instruments are chosen according to the intervention and preferences of the surgeon. Conventionally, the instruments necessary for an intervention are prepared before the intervention and placed in a sterile tray resting on a table of the intervention room also called "sterile field".

It is known that during an intervention the surgeon is assisted by a surgical assistant who transmits the instruments he needs at the moment of his request. In order to reduce the costs associated with an intervention, it has been proposed to no longer resort to operating aid. Also, more and more surgeons take the instruments themselves.

During an ocular intervention, the surgeon performs a precision work on a patient 's eye and uses an operating microscope for this purpose. In order to pick up an instrument, it must look towards the tray to grab the desired instrument, and then put one's eyes back in front of the microscope's eyepieces. These stages are time - consuming and disrupt the surgeon 's work during the procedure which can not remain focused continuously on the eye to be operated. In addition, since a surgeon 's work space is already very crowded with other medical equipment, the surgeon must place the tray containing the instruments at a distance from his intervention position, which forces the surgeon to move whenever he needs an instrument and is also a waste of time. In order to overcome these drawbacks, it is known from US patent application 2003216836 A1, an assistance device comprising a robotic arm adapted to identify an instrument in a tray and distribute it to the surgeon. Such assistance robot is commanded vocally by the surgeon so that it does not have to move. However, such a support robot is complex and expensive to set up. In addition, the instruments that the robotic arm present to the surgeon being often sharp, the surgeon can not take them blindly, which forces the surgeon to move his eyes and causes the disadvantages presented above. Moreover, as several instruments are seized one after the other by the robotic arm, there is also a risk as to the sterility of said instruments.

The invention therefore aims to overcome these disadvantages by providing a device for dispensing sterile instruments to assist a surgeon during a surgical procedure in a practical manner.

GENERAL PRESENTATION OF THE INVENTION

To this end, the invention relates to a device for dispensing sterile instruments, in particular for ocular surgery, the device comprising a base, a tray, mounted on the base, which comprises a sterile support wall and comprising a plurality of housings for receiving sterile instruments, means for driving said plate relative to the base about an axis of rotation, each receiving housing having an angular position with respect to the base, and means for controlling the means for drive to change the angular position of said receiving housing relative to the base.

Thanks to the device according to the invention, the distribution of sterile instruments to a surgeon is easy thanks to the rotating plate for distributing different instruments near his place of intervention. This allows the surgeon to order an instrument and to grasp it easily without moving. Such a device is simple to set up and inexpensive.

Preferably, the plate has a substantially circular shape to have a constant space during its rotation. Preferably, the plate has a diameter of between 30 and 40 cm in order to accommodate all the sterile instruments generally required for an operation while having a limited space. Preferably, the tray is removable from said base. Thus, the tray can be sterilized independently of the base.

Preferably, the tray is disposable to ensure optimal hygienic conditions.

Preferably, the support wall is inclined, preferably, with an inclination of between 10 and 30 ° relative to the plane transverse to the axis of rotation. Thus, the housing is more easily accessible to the blind by a user located laterally to the dispensing device. Preferably, the support wall has a conical shape.

Preferably, the support wall comprises a slip-resistant material to prevent the fall of sterile instruments during rotation and when the support wall is inclined.

In a preferred aspect, the tray comprises a main body, mounted on the base, and an auxiliary casing, mounted on the main body, the auxiliary casing having the sterile support wall of said tray. Thus, it is sufficient to replace / sterilize the envelope to obtain a sterile support wall. Preferably, the auxiliary casing is disposable, preferably made of plastic.

In one aspect, the control means comprises a manual control module, preferably a pedal. In another aspect, the control means comprise a voice control module.

The invention also relates to a method of dispensing a sterile instrument to an operator by means of a dispensing device as presented above, sterile instruments being received in the receiving housing and the operator being at an angular position of predetermined distribution with respect to the base, the method comprising a step of selecting by the operator of a housing, the housing selected being at a first angular position relative to the base, a step of driving the plate in rotation about said axis of rotation until the selected housing is at a second angular position relative to the base corresponding to the position angular predetermined distribution.

With the method according to the invention, the surgeon, located near the dispensing position, can control an instrument and enter it without moving his gaze.

Advantageously, the selection step is done by manual control, preferably by means of a pedal, or by voice command.

PRESENTATION OF FIGURES

The invention will be better understood on reading the description which follows, given solely by way of example, and referring to the appended drawings in which:

FIG. 1 is a schematic view of a first embodiment of a dispensing device according to the invention,

FIG. 2 is a schematic side view of the device of FIG. 1, FIG. 3 represents a second embodiment of a dispensing device according to the invention,

FIG. 4 represents a third embodiment of a dispensing device according to the invention, and

- Figures 5 and 6 show, seen from above, a plate of a dispensing device following its training.

It should be noted that the figures disclose the invention in detail to implement the invention, said figures can of course be used to better define the invention where appropriate. DESCRIPTION OF ONE OR MORE MODES OF REALIZATION AND IMPLEMENTATION

According to one embodiment of the invention, with reference to FIGS. 1 to 2, there is shown a device 1 for dispensing sterile instruments 2 enabling a CHIR surgeon to seize a sterile instrument 2, such as a forceps, a knife or scissors, during a surgical procedure on a patient, in particular during a ocular intervention, cataract type, on the patient's eyes. Such an intervention requiring precision work, the surgeon CHIR places his eyes in front of the eyepieces of an operating microscope. The dispensing device 1 according to the invention is generally in the form of a table comprising a base 3 on which is mounted a plate 4 comprising receiving receptacles 6 of sterile instruments 2.

The dispensing device 1 further comprises drive means of said plate 4 relative to the base 3 about an axis of rotation, each receiving housing 6 having a defined angular position relative to the base 3. In addition, the dispensing device 1 comprises means for controlling the drive means in order to modify the angular position of said receiving housings 6 with respect to the base 3.

As illustrated in FIGS. 1 and 2, the base 3 has a substantially cylindrical shape and extends longitudinally along an axis Z. The base 3 comprises a lower fixing end 31 and an upper mounting end 32 on which the plate 4 is mounted. The attachment end 31 is adapted to fix the base 3 to either a foot (not shown) so that the dispensing device 1 is placed on the ground, or to a medical equipment of the intervention room such as a operating microscope so that the dispensing device 1 is close to the surgeon CHIR.

It has been presented a base 3 of cylindrical section, but it goes without saying that other forms of section could be suitable.

Still with reference to FIGS. 1 to 2, the plate 4, also called "sterile field", has a substantially circular flat shape and extends substantially horizontally in a plane transverse to the axis Z. Preferably, the diameter D of the plate 4 is between 30 cm and 40 cm in order to accommodate all the sterile instruments 2 generally necessary for an operation while having a limited space.

With reference to FIG. 1, the distribution plate 4 comprises a support wall 5 which is sterile and which comprises a plurality of instrument receiving housings 6 sterile 2 angularly distributed about the Z axis and extending radially. Referring to Figures 5 and 6, the housing 6 have a shape of angular section.

Preferably, the receiving housings 6 are homogeneously distributed around the Z axis. By way of example, the support wall 5 comprises six receiving housings 6 spaced from each other by an angular interval of 360 / 6 = 60 °. It goes without saying that the number of receiving houses 6 could vary according to the preferences of the surgeon CHIR, in particular, the tray 4 could comprise less than six receiving houses 6 or more than six reception rooms 6. Similarly, the dimensions and the shapes of the receiving houses 6 could be different.

Referring to Figure 2, the distribution plate 4 further comprises a mounting hole 41 adapted to cooperate with the upper end 32 of the base 3. In this example, the plate 4 is removably mounted on the base 3 , which makes it possible to change board 4 before each intervention. The hygienic conditions are thus optimal. Preferably, the dispensing device 1 comprises locking means of the plate 4 relative to the base 3 such as screws, clips, magnetic locking means, etc. A tray 4 having a mounting hole 41 has been shown, however, it is understood that other mounting means may be suitable. For example, with reference to FIG. 4, the plate 4 could comprise a cylindrical portion 42 adapted to fit on the upper mounting end 32 of the base 3. According to another embodiment, with reference to FIG. , the plate 4 has a support wall 5 whose radial section is inclined, the inclination Θ of the support wall 5 being between 10 and 30 ° relative to the horizontal plane. Preferably, the support wall 5 is conical, so that the plurality of receiving housings 6 is more easily accessible laterally. Thus, a surgeon CHIR positioned laterally to the dispensing device 1 can easily grab a sterile instrument 2 placed in a receiving housing 6.

It has been presented a plate 4 extending transversely to the axis Z which extends vertically but it goes without saying that the Z axis could be inclined relative to the vertical direction. When the support wall 5 is inclined or when the plate 4 is inclined, it is advantageous to cover the support wall 5 with a non-slip coating so as to prevent the sterile instruments 2 from slipping out of the receiving receptacles 6.

According to another embodiment illustrated in FIG. 4, the plate 4 comprises a main body 40 mounted on the base 3 and an auxiliary envelope 42, comprising the support wall 5, which is removably mounted on the main body 40. Such an auxiliary envelope 42 is easy to change before each intervention, which makes it possible to benefit from a sterile support wall 5 by replacing only a part of the plate 4.

It has been presented a tapered tray 4 in two parts in Figure 4 but it goes without saying that the invention also applies to a flat plate 4 in two parts.

In order to modify the angular position of the receiving housings 6, the distribution device 1 comprises drive means mounted in the base 3. For example, the drive means comprise a motor which is adapted to drive in rotation around the Z axis the upper mounting end 32 of the base 3 in the direction M with respect to its lower fixing end 31. The rotation of the plate 4 moves the receiving housing 6 relative to the base 3 to position the receiving housing 6 to the desired angular position. There has been presented drive means including a motor, but it goes without saying that any other drive means could be suitable.

In order to allow the CHIR surgeon to select the instrument 2 to be dispensed, the dispensing device 1 further comprises control means (not shown) of the drive means. Preferably, the control means comprise a voice recognition module connected to the motor of the base 3. Thus, the surgeon CHIR can, as it did with a surgical aid, speak aloud the instrument 2 he needs, the control means for retranscribing the voice message into a control message of the motor so as to cause the rotation of the plate 4 in order to move the receiving housing 6. In a manner that preferred, the control means comprise a database associating a plurality of voice messages with a plurality of control messages in order to move each housing to a predetermined angular position relative to the base 3. Advantageously, the control means allow the surgeon CHIR to choose the sterile instrument 2 he needs by not touching any non-sterile items with his hands. In addition, he does not have to remove his eyes from the microscope eyepieces, the sterile instruments can be taken blind. Optionally, a camera system, filming the plate 4, could allow the CHIR surgeon to view the plate 4, in particular by displaying a superimposed video in the microscope eyepieces to allow the CHIR surgeon to keep his eyes permanently in the microscope. the eyepieces.

It has been presented control means comprising a voice recognition module but it goes without saying that other control means could be suitable, for example, a manual control module including a foot control.

Preferably, the control means are configured according to a reference angular position AREF defined with respect to the base 3. Following a command, the selected reception housing 6 is moved to the reference angular position AREF.

In practice, the plate 4 also comprises a reference housing 6REF which is aligned with the reference angular position AREF during the mounting of the plate 4 on the base 3. In order to obtain an adequate mounting, it is advantageously provided coding means between the plate and the base 3.

In this exemplary embodiment, the reference angular position AREF corresponds to the position of the housing 6 accessible by a surgeon CHIR from its intervention position as illustrated in FIG. 5. Thereafter, the reference angular position AREF is also designated distribution position.

It has been presented a dispensing device 1 to a CHIR ocular surgeon, but it goes without saying that the device could also be used by any type of CHIR surgeons using an operating microscope, including ENT surgeons, neurosurgeons, etc. An implementation of a distribution of sterile instruments 2 by means of the dispensing device 1 according to the invention will now be presented with reference to FIGS. 5 to 6.

Prior to a surgical procedure, for example of the cataract type, the tray 4 is cleaned and sterilized in order to place sterile instruments 2 in a plurality of receiving receptacles 6. Subsequently, the receiving receptacles 6 are indexed as 6-0 tallow; 6-1; 6-6 to Figures 5 ef 6. A base 3 is placed in the operating room, either on the ground, thirsty attached to medical equipment in the operating room to be as close as possible of the surgeon CHIR during the operation and thus minimize the movements of the surgeon CHIR.

At the beginning of the intervention, the plate 4 is mounted on the mounting end 32 of the base 3 by the mounting hole 41.

With reference to FIG. 5, the surgeon CHIR esf at his intervention station and uses the eyepieces of the operating microscope The housing 6-0, which comprises a knife esf at the reference angular position AREF.

To make an incision, the CHIR surgeon grasps the knife in its 6-0 slot without leaving the eyes of its microscope eyepieces since the scalpel is located close to it and at a known distance. Once the incision is complete, the CHIR surgeon rests the knife in his 6-0 slot.

Then the CHIR surgeon wants to use a pair of scissors. For this purpose, the surgeon CHIR controls the rotation of the plate 4 so that the housing 6-1 in which is housed the pair of thirsty scissors aligned with the reference angular position AREF.

In this example, the command is vocal and the surgeon CHIR speaks aloud, either the name of the sterile instrument 2 thirsty the reference related to the receiving housing 6-1 in which esf is the pair of scissors. Alternatively, a manual control, for example foot, could be suitable. The control means then activate the drive motor so as to cause the rotation M of said plate 4 until the housing 6-1 is aligned with the reference angular position AREF as illustrated in FIG. a pair of scissors is positioned in place of the knife relative to the surgeon CHIR without it having to move or lift the eyes of the microscope eyepieces.

As the instrument 2 which the surgeon CHIR needs is always in the same position, the surgeon CHIR can seize the instrument 2 without having to move his eyes and this without risk since the instrument is placed on a wall 5.

After having used the pair of scissors, the surgeon CHIR can put it in its receiving housing 6-1 then seize another instrument 2 after having ordered the distribution.

After the procedure, the tray 4 and the instruments 2 are cleaned in order to be reused after sterilization. In the case of a tray 4 for single use, the tray 4 is discarded after each intervention. When the sterile wall 5 of the plate 4 is formed by a removable auxiliary envelope 42, only the latter is replaced.

With the dispensing device 1 according to the invention, an eye surgeon can easily enter different sterile instruments 2 without having to move or move his eyes from the microscope eyepieces, which reduces the difficulty. Such assistance by a dispensing device according to the invention is inexpensive and easy to set up. In addition, the dispensing device adapts to the environment of a surgical procedure.

With the device 1 according to the invention, the sterility of the instruments 2 is ensured during the intervention, which reduces the health risks.

Claims

1. Device for dispensing (1) sterile instruments (2), in particular for ocular surgery, the device (1) comprising:

A base (3),

A tray (4), mounted on the base (3), which has a sterile supporting wall (5) and having a plurality of sterile instrument receiving housings (6) (2),

Driving means of said plate (4) relative to the base (3) about an axis of rotation (Z), each receiving housing (6) having a defined angular position relative to the base (3), and

Means for controlling the drive means to change the angular position of said receiving housing (6) relative to the base (3).

2. Dispensing device (1) according to claim 1, wherein the plate (4) has a substantially circular shape.

3. Dispensing device (1) according to claim 2, wherein the plate (4) has a diameter (D) of between 30 and 40cm.

4. Dispensing device (1) according to one of claims 1 to 3, wherein the support wall (5) is inclined, preferably, an inclination (Θ) between 10 and 30 ° relative transversely to the axis of rotation (Z).

Dispensing device (1) according to one of claims 1 to 4, wherein the support wall (5) has a conical shape.

Dispensing device (1) according to one of claims 1 to 5, wherein the plate (4) comprises a main body (40) mounted on the base (3) and an auxiliary casing (42) mounted on the main body (40), the auxiliary envelope (42) comprising the sterile support wall (5) of said plate (4).

7. Dispensing device (1) according to claim 6, wherein the auxiliary envelope (42) is disposable.

8. Dispensing device (1) according to one of claims 1 to 7, wherein the control means comprise a manual control module, preferably a foot control.

9. Dispensing device (1) according to one of claims 1 to 8, wherein the control means comprise a voice control module.

10. Dispensing device (1) according to one of claims 1 to 9, wherein the drive means comprise a motor.

1. A method of dispensing a sterile instrument (2) to an operator by means of a dispensing device (1) according to one of the preceding claims, wherein sterile instruments (2) are received in the receiving housings ( 6) and the operator being at a predetermined distribution angular position (AREF) with respect to the base (3), the method comprising:

A step of selecting by the operator of a housing (6), the selected housing (61) being at a first angular position relative to the base (3), A step of driving the platform (4) in rotation ( M) about said axis of rotation (Z) until the selected housing (6) is at a second angular position relative to the base (3) corresponding to the predetermined angular distribution position (AREF).