SURGICAL CAMERA APPARATUS AND METHOD

Abstract: A device adapted to receive a surgical camera useable in a patient and having means to detect rotational and/or longitudinal movement of a camera relative to a reference point in, on or about the patient is described. The reference point is preferably a surgical port means, and the device is preferably adapted to conjoin with the port means. By detecting and/or measuring any rotational and/or longitudinal measurement of the camera relative to a reference point, the surgeon can be made aware of desired or undesired movement of the camera during surgery as referenced to the reference point. Such information would be particularly useful in laparoscopic or endoscopic surgery.

Description: Surgical Camera Apparatus and Method The present invention relates to a device and method for use with a surgical camera, particularly but not exclusively a laparoscopic camera. During certain forms of surgery, e.g. laparoscopic surgery, a camera is used to provide vision for the surgeon. However, the surgeon does not usually operate the camera, such that he relies upon the co-ordination of an assistant to control the movement and direction of vision of the camera, whilst he conducts the surgery. However, when conducting a laparoscopic procedure with a manually held laparoscopic camera, the assistant can easily allow the camera to 'drift'. Accidental rotational drift is the commonest problem, thereby leading to orientational error as the surgeon attempts to maintain co-ordination of the monitored display of camera information, with his own surgical procedure. It is an object of the present invention to provide visual feedback to the surgical team by means of a graphical display indicating additional positional information of the laparoscopic camera relative to a laparoscopic port and patient alignment. Such visual data can be overlaid on the visual laparoscopic image. According to one aspect of the present invention, there is provided a device adapted to receive a surgical camera useable in a patient and having means to detect rotational and/or longitudinal movement of the camera relative to a reference point in, on or about the patient. The device may also be able to measure any rotational and/or longitudinal movement of the camera relative to the reference point. In one embodiment of the present invention, the reference point is the or one of the surgical points of entry into the patient, e.g. a surgical port means. By detecting and/or measuring any rotational and/or longitudinal measurement of the camera relative to a reference point, e.g. the patient and/or a port, the surgeon can be made aware of desired or undesired movement of the camera as referenced to the patient and/or the port. The device may be integral with the camera and/or port, or be formed as a separate unit adapted to be fitted to or otherwise conjoin with known camera and port apparatus. The device may be releasably conjoinable therewith. The detection means for use with the present invention includes any suitable apparatus, device, means or unit adapted to detect effective movement between two parts . The means may involve any, or any combination of, electrical, electromagnetic, optical and/or mechanical apparatus , etc . The detection means may include one or more sensor means, such as an optical transmitter/receiver. The sensor means may be able to detect camera movement directly. In one embodiment of the present invention, the detection means includes intermediate means such as one or more belts or rollers, or one or more cog wheels such as a gear train, the movement of which relates to movement of the camera relative to the patient. The camera and/or any such intermediate means as described herein before may be graded or graduated, the passage of which is what is detected. In another embodiment of the present invention, the device includes a sleeve coaxial with a surgical port, either therewithin or therewithout, and movement of the sleeve is proportional to the rotational and/or longitudinal movement of the camera relative to the port. According to a further embodiment of the present invention, the device includes control means, encoder means and/or information relay means . Preferably relative-motion information from the device can be relayed to a visual display unit, e.g. the existing visual display means showing the surgical e.g. laparoscopic image from the camera. The device of the present invention may also include a visual and/or audible alarm means or alarm- initiator means adapted to provide a visual and/or audible alarm signal in the event of an undesired and/or (possibly) predetermined rotational and/or longitudinal movement of the camera relative to the port being detected. The device of the present invention can be constructed and made to any suitable size, shape and design. In one embodiment, the device can be made sufficiently simply to be disposable. The device is usable in any form of surgery using a camera, e.g. laparoscopy and endoscopy. According to a second aspect of the present invention, there is provided a method to detect rotational and/or longitudinal movement of a surgical camera useable in a patient relative to a reference point in, on or about the patient, wherein a device as defined herein before is conjoined with the camera in use and detects the relative movement. Preferably, there is a method of detecting and/or measuring rotational and/or longitudinal movement of a camera relative to a surgical port means, wherein the device is adapted to mate with the camera and the port has means adapted to measure and/or detect such movement. Part of the camera is preferably inserted through the device in use . Embodiments of the present invention will now be described by way of example and in relation to the accompanying diagrammatic drawings in which: Fig 1 is a perspective view of a device according to one embodiment of the present invention; Fig 2 is a perspective view of the device in Fig 1, with mating camera and laparoscopic port; Fig 3 is a perspective view of a device according to a second embodiment of the present invention; Fig 4 is a perspective view of the internal workings of the device shown in Fig 3; Figs 5a and 5b are top and side views of the means shown in Fig 4 ; Fig 6 is a side view of a device according to a third embodiment of the present invention with attached port and camera; Fig 7 is a perspective view of parts of a device according to a fourth embodiment of the present invention; Fig 8 shows a schematic perspective view of parts of a device according to a fifth embodiment of the present invention; Fig 9 shows a schematic view of a visual data display having on-screen graphics provided from information from a device of the present invention; Fig 10 is a schematic flow diagram of analysis of information from means of the present invention. Referring to the drawings, Figure 1 shows a general device 2 according to one embodiment of the present invention. Fig 2 shows a general laparoscopic port 1 which can be inserted into a patient, and is designed for use with for example a trocar. Attached to the port 1 is the device 2, and attached to the device 2 is a general laparoscopic camera 3. Figure 3 shows a second general device 4 according to the present invention, whose internal mechanism is shown in Figures 4, 5a and 5b. As shown in these Figures, the primary drive of the laparoscopic camera device 4 is manual. A laparoscope (not shown) is inserted into the orifice 6, and this orifice 6 also forms the gaiter 8, which provides frictional rotational drive for the laparoscopic camera control system. The gaiter 8 is bonded to the primary wheel 12 of a gear train mechanism. The gear train mechanism is mounted on an internal chassis 13. The gear train mechanism provides transmission of rotary movement of the camera to a 180-impulses incremental disk 14. The rotational movement of this reflective disk 14 is sensed or detected by an optical transmitter/receiver 16 (Figure 5b) which is mounted on a printed circuit board 18. These components are also assembled on the internal chassis 13. Electronic signals are transmitted via lead 20 to an information processing device (not shown) which provides software graphic and display and data recording. The information from the device 4 is preferably electronically conditioned to provide signals appropriate for interfacing to a computer. The computer preferably provides a textual and graphical display, and permits the surgeon to: 1. Set up a datum cursor to his preferred angle of view of the laparoscopic camera display. 2. Activate a dynamic cursor driven by the laparoscopic camera rotation. 3. Observe any deviation of the dynamic cursor from the datum cursor. An audible alarm is sounded outside the angular tolerance set by the operator. The visual display could be superimposed on the laparoscopic video image of the surgical procedure thereby providing an "artificial horizon". An example of this is shown in Fig 9. Fig 6 shows a third device 22 according to the present invention. The device 22 is around a laparoscopic port 23. The device 22 has a frame 26 supporting a sleeve 24, camera mating part 25 and a shaft 28. On the shaft 28 is a stator 30 and encoder 32. Around the stator 30 and a bush 31 at the top of the sleeve 24 is an intermediate mechanical drive belt pulley 34. Attached to the encoder 32 is a connector 36, again connectable to an information relay means, e.g. a lead to a computer and/or a visual display means. In use, the device 22 is attached to the port 23 after the port 23 has been inserted into the patient. A laparoscopic camera or laparoscope 40 is then inserted into the mating part 25, and the optics are guided through the sleeve part 24. The camera 40 and sleeve 24 can be mated using any suitable means, e.g. through friction or a pin and slot arrangement, to rotate together. Thus, any rotational movement of the camera 40 in use will also cause rotation of the sleeve 24 and the bush 31, and, as a consequence, rotation of the pulley belt 34 and stator 30. This motion of the stator 30 can be detected by the encoder 32, and the information relayed via the connector 36 to the visual display means. The encoder 32 may also be able to measure the degree of rotational movement, which information could also be suitably relayed. Fig 7 shows schematic means for a possible fourth device according to the present invention, using a toothed wheel 44 journalled on a sleeve part or a camera shaft 46, with associated optical reading device and chip 48 able to provide a direct reading of movement of the wheel 44. Alternatively there is a graded bar alongside the camera shaft 46, or the camera shaft 46 itself is graded, and the longitudinal movement of the shaft 46 is readable by an optical reading device. Fig 8 shows schematic means for another possible device, using the arrangement of the device shown in Fig 7, with additional longitudinal motion detecting means based on a frictioned wheel 50 on a sleeve 52. The wheel 50 is set to rotate upon longitudinal movement of the sleeve etc 52, and relate its movement to another toothed wheel 54, thereby providing both rotational and longitudinal movement detection and/or measurement. The longitudinal means could act directly on the shaft of a laparoscope or other camera. The present invention provides an important advance in assisting surgeons in endoscopic and laparoscopic surgery to maintain visual understanding of the in situ surgical procedure. Such visual understanding is very dependent upon the position of the camera, which is then dependent upon the handling ability of the human camera operator. The present invention allows the surgeon to maintain and track camera movement with the position of his surgical instruments with considerably more control.

Claims: CLAIMS 1. A device adapted to receive a surgical camera usable in a patient and having means to detect rotational and/or longitudinal movement of the camera relative to a reference point in, on or about the patient. 2. A device as claimed in Claim 1 wherein the means is also able to measure the rotational and/or longitudinal movement of the camera. 3. A device as claimed in Claim 1 or Claim 2 wherein the reference point is the or one of the surgical points of entry into the patient. 4. A device as claimed in any one of Claims 1 to 3 wherein the reference point is a surgical port means. 5. A device as claimed in Claim 4 wherein the device is adapted to conjoin with the port means. 6. A device as claimed in Claim 5 wherein the device is adapted to releasably conjoin with the port. 7. A device as claimed in Claim 4 wherein the device is integral with the port. 8. A device as claimed in any one of the preceding claims wherein the device includes a friction fitting through which the camera or a part of the camera is insertable . 9. A device as claimed in any one of the preceding claims wherein the detection means includes one or more sensor means . 10. A device as in claimed in Claim 9 wherein the sensor means is an optical transmitter/ receiver. 11. A device as in claimed in Claim 9 or Claim 10 wherein the sensor means is adapted to directly detect movement of the camera. 12. A device as claimed in any one of Claims 9 to 11 wherein the detection means includes one or more intermediate means adapted to relay movement of the camera to the or each sensor means. 13. A device as claimed in Claim 12 wherein the intermediate means comprises a gear train mechanism. 14. A device as claimed in any one of the preceding claims wherein the camera and/or the intermediate means are angularly and/or longitudinally graded or graduated. 15. A device as claimed in any one of the preceding claims wherein the device includes one or more of the following: control means, encoder means and information relay means. 16. A device as claimed in any one of the preceding claims wherein the device is connectable to a visual display unit. 17. A device as claimed in any one of the preceding claims wherein the device includes a visual and/or audible alarms means . 18. A device as in claimed in any one of the preceding claims for use in laparoscopic or endoscopic surgery. 19. A method to detect rotational and/or longitudinal movement of a surgical camera useable in a patient relative to a reference point in, on or about the patient, wherein a device as defined in any one of Claims 1 to 18 is conjoined with the camera in use and detects the relative movement. 20. A method as claimed in Claim 19 wherein the device is also able to measure rotational and/or longitudinal movement of the camera. 21. A method as in claimed in Claim 19 or Claim 20 wherein the device is conjoined with a surgical port means . 22. A method as claimed in any one or Claims 19 to 21 wherein the camera is inserted through the device . 23. A laparoscopic device substantially as herein described and with reference to Figures 1-8.

Inventors: GALLAGHER ANTHONY GERALD, NEIL WILLIAM JOHN, GALLAGHER, ANTHONY, GERALD, NEIL, WILLIAM, JOHN
Applicants: GALLAGHER ANTHONY GERALD, NEIL WILLIAM JOHN, SCOPE LTD G, G. SCOPE LIMITED, GALLAGHER, ANTHONY, GERALD, NEIL, WILLIAM, JOHN
Application year: 2000
Main classification: A61B1
IPC codes: A61B1, A61B17