Patent Publication Number: US-2023157686-A1

Title: Surgical System Providing a Reversible Connection Between Two Implants or Between an Implant and a Tool of the Surgical System

Description:
FIELD 
     The present invention relates to a surgical system comprising two elements, which are either two surgical implants or a surgical implant and a surgical instrument, and which incorporate respective arrangements for the reversible connection thereof. 
     BACKGROUND 
     During various operations carried out in connection with a surgical procedure, it is necessary to connect to each other, in a reversible manner, either surgical implants or a surgical implant and a surgical instrument. When placing a surgical implant e.g. in the body of a patient, the surgeon uses an ancillary device for successively connecting the implant to the ancillary device, positioning, by force where appropriate, the implant in the body of the patient by manipulating the ancillary device, and then detaching the implant in place from the ancillary device. In practice, various embodiments are known for the respective arrangements of the two surgical elements, providing the reversible connection between the latter. 
     One of the embodiments, which is currently widespread, consists of a threaded connection between the surgical elements: one of the two elements thus incorporates a mechanism having a threaded projecting rod, while the other element is provided with a threaded hole into which the threaded rod is to be screwed so as to provide the connection between the two elements. However, such a threaded connection is not satisfactory in several respects. First, the surgeon is forced, while screwing the threaded rod into the tapped hole, to hold the two elements in place, while rotating the rod for a plurality of turns. The corresponding movements of the surgeon are thus relatively complicated, generally by mobilizing both hands, and take a considerable intraoperative time. The threaded connection then carries the risk of not being sufficiently secured: during the surgical intervention, the two elements have a risk of accidental detachment from each other and/or the connection therebetween has a risk of breaking if large forces are applied, e.g. during bending or impaction. Finally, such a threaded connection comes with constraints when made by additive manufacturing: when the surgical elements are produced by additive manufacturing, the latter generally does not make it possible, for lack of precision, to directly obtain the thread and the tapping of the threaded connection, to the extent that it is necessary to alter the manufactured elements, by implementing conventional rework or alteration operations, e.g. machining operations using a tool. Such additional alteration or rework operations can be complex to implement, carry the risk of contaminating the surgical elements, e.g. by cutting oils, and entail a significant additional cost. 
     SUMMARY 
     The purpose of the present invention is to propose a new surgical system in which the reversible connection of two elements is both simpler to operate, more secure and with less manufacturing constraints, in particular when the elements are made by additive manufacturing. 
     To this end, the invention relates to a surgical system, comprising first and second elements that are either two surgical implants, or a surgical implant and a surgical instrument. The first element has a first bearing face and a first helical surface extending from the first bearing face. The second element includes a second bearing face, which is complementary to the first bearing face, and a second helical surface, which extends from the second bearing face and which is congruent with the first helical surface so that the first and second helical surfaces form a first helical connection between the first and second elements, centered on an axis. The second element also includes a mechanism for controlling reversible connection between the first and second elements, the mechanism being suitable for being actuated successively: along a first movement, which includes a translation along the axis without involving rotation about the axis and by which the mechanism causes the first and second helical surfaces to mesh with each other until the first and second bearing faces are axially juxtaposed against each other, and 
     along a second movement, which includes a rotation about the axis and by which the mechanism locks the first helical connection while the first and second bearing faces are pressed axially against each other. 
     One of the ideas underlying the invention is to seek to provide the connection of the two elements of the surgical system not by a threaded connection, but by a helical connection the helical surfaces of which forming the helical connection do not have to be a conventional thread and a conventional tapping. In the system according to the invention, the helical connection is formed by two helical surfaces that are delimited by one and the other of the two elements, respectively, extending from respective bearing faces of the two elements. Moreover, the system according to the invention, comprises a mechanism which is integrated into one or the other of the two elements and which is designed to be actuated according to two simple and rapid movements made by the surgeon, typically with one hand, namely a first movement which includes a translation along the axis of the helical connection, without involving any rotation about the axis, and a second movement which includes a rotation about the axis, potentially being combined with a translational component along the axis. The mechanism and the two helical surfaces of the helical connection are configured such that when the mechanism is actuated according to the first movement, the mechanism acts on the helical connection by meshing the two helical surfaces with each other until the aforementioned bearing faces of the two elements come into axial abutment and then when the mechanism is actuated according to the second movement, the mechanism acts on the helical connection for locking same while the two bearing faces are pressed firmly against each other along the axis, which secures the connection between the two elements. Insofar as the two helical surfaces do not have to be produced in the form of a conventional thread and a conventional tapping, which would form a threaded connection, the two helical surfaces and, more generally, the two elements of the system can be made by additive manufacturing without requiring any alteration or rework, in particular by machining. In practice, since the two surgical elements of the system according to the invention are either two implants, or an implant and an instrument, the helical connection and the mechanism acting on the latter impart a great suitability of use to the elements, in particular in relation to the patient operated on and/or the surgical approach and/or the surgical technique. 
     According to advantageous additional features of the surgical system according to the invention, taken individually or according to all technically possible combinations: 
     The first helical connection between the first and second elements has a helix angle comprised between 6° and 45°. 
     The first helical surface extends recessed inside the first bearing face, and the second helical surface is arranged protruding from the second bearing face. 
     The second element includes:
     a shaft, which is centered on the axis and which externally delimits the second helical surface, and   a support which delimits the second bearing face, on which the shaft is mounted both in a fixed manner along the axis and so as to freely rotate about the axis, and on which the mechanism is mounted movable so as to be actuatable according to the first and second movements and to rotate the shaft about the axis with respect to the support when the mechanism is actuated in translation along the axis.   

     The shaft externally delimits a third helical surface, which is distinct from the second helical surface, and the mechanism delimits a fourth helical surface which is congruent with the third helical surface so that the third and fourth helical surfaces form a helical connection between the shaft and the mechanism. 
     The mechanism includes an actuating ring, which is guided in motion with respect to the support according to the first and second movements, and the mechanism further includes a drive slide that is:
     linked to the support, in rotation about the axis, while being free in translation along the axis with respect to the support,   linked to the actuating ring, in translation along the axis, while being free to rotate about the axis with respect to the actuating ring, and   suitable for rotating the shaft about the axis with respect to the support when the actuating ring is moved in translation along the axis with respect to the support.   

     The fourth helical surface is delimited by the drive slide. 
     The shaft has, at least in the longitudinal part thereof delimiting the second helical surface, a cross-section the contour of which is non-circular and, if appropriate, asymmetrical. 
     The second movement combines a rotation about the axis and a translation along the axis. 
     The support includes at least one cam, which rolls around the axis, preferentially with a helix angle greater than 84°, and which guides the mechanism in motion according to the second movement. 
     The first and second elements cooperate mechanically with each other so as to be locked in rotation about the axis relative to each other when the first and second helical surfaces mesh with each other. 
     One of the first and second elements includes at least one recessed pattern while the other of the first and second elements includes at least one protruding pattern that cooperates by shape matching with the recessed pattern(s) so as to lock in rotation the first and second elements. 
     The first and second elements form a second helical connection between therebetween, which, jointly with the first helical connection, locks the first and second elements in rotation relative to each other, and the mechanism is designed for acting simultaneously and in the same way on the first and second helical connections between the first and second elements. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention will be better understood upon reading the following description, given only as an example and referring to the drawings, wherein: 
         FIG.  1    is a perspective view of an embodiment of a surgical system according to the invention; 
         FIG.  2    is a view similar to  FIG.  1   , partially illustrating the surgical system at a different angle of view from the angle of  FIG.  1   ; 
         FIG.  3    shows together an insert a), which is a longitudinal section of the system shown in  FIG.  1   , an insert b), which is a section along the line b-b shown on the insert a), and an insert c), which is a section along the line c-c shown on the insert a); 
         FIGS.  4  and  5    are views similar to  FIG.  3   ,  FIGS.  3  to  5    correspondingly illustrating three configurations successively implemented when using the surgical system; 
         FIG.  6    is a perspective view illustrating various embodiments for a part of the surgical system; 
         FIG.  7    is an plan view also illustrating various embodiments for a part of the surgical system; and 
         FIGS.  8  and  9    are perspective views, from different angles of observation, of a second embodiment of the surgical system according to the invention. 
     
    
    
     DETAILED DESCRIPTION 
       FIGS.  1  to  5    show a surgical system  1  comprising an implant  10  and an instrument  20 . As discussed in detail thereafter, the implant  10  and the instrument  20  incorporate fittings for connecting same directly to each other, in a reversible manner. 
     The implant  10  includes a body  11  that, for the purpose of the connection thereof to the instrument  20 , delimits a bearing face  12  and a helical surface  13  extending recessed out from the bearing face  12 . In the figures, the body  11  is shown very schematically, apart from the bearing face  12  thereof and the helical surface  13  thereof, without illustrating the multitude of conceivable embodiments related to the surgical purpose of the implant  10 . In practice, the specificities of the implant  10 , which are related to the functions thereof other than the function of the reversible connection thereof to the instrument  20 , are not limiting, so that the body  11  of the implant can have, apart from the bearing face  12  and the helical surface  13  thereof, multiple and various fittings, not illustrated in the figures. 
     In all cases, the helical surface  13  is centered on a geometric axis X 13  about which this helical surface winds, extending inside the body  11  from the bearing face  12 . The helical surface  13  thus forms inside the body  11 , a cavity  14 , which is centered on the axis X 13 , and which opens axially onto the bearing face  12 . The cavity  14  makes the implant  10  a female element. 
     According to an advantageous arrangement, the interest of which will appear thereafter, the body  11  of the implant  10  further includes one or a plurality of recessed patterns  15 , herein in two copies, distinct from the cavity  14 . In the example of embodiment considered in the figures, the recessed patterns  15  extend from the bearing face  12  of the body  11 . Each recessed pattern  15  occupies a portion of the body  11  about the axis X 13 , the two recessed patterns  15  here being diametrically opposite one another with respect to the axis X 13 . 
     The instrument  20  includes a shaft  30 , which can be well seen in  FIGS.  3  to  5    and which is only marginally visible in  FIGS.  1  and  2   . 
     The shaft  30  defines a geometric axis X 30 , on which the shaft is centered and along which the shaft extends in length. As can be seen clearly in  FIGS.  3  to  5   , the shaft  30  delimits externally, i.e. on the external lateral face thereof, two helical surfaces  31  and  32  distinct from each other, which are centered on the axis X 30  and which are wound about the shaft  30 , by forming respective portions of the outer lateral face therein. The helical surfaces  31  and  32  occupy respective longitudinal parts 30.1 and 30.2, which are distinct from each other, being distributed on the shaft  20  along the axis X 30 . The longitudinal part 30.1, which delimits the helical surface  31 , forms a longitudinal end part of the shaft  20 , while the longitudinal part 30.2, which delimits the helical surface  32 , forms either a longitudinal end part of the shaft, axially opposite the longitudinal part 30.1, or an intermediate longitudinal part of the shaft. 
     The helical surface  31  is congruent with the helical surface  13  of the implant  10  so that, when the helical surfaces  31  and  13  are made coaxial with each other and are rotated about the axes X 30  and X 13  thereof, the helical surfaces  31  and  13  mesh, or mate, with each other, inducing the relative axial displacement thereof, in a reversible way. In other words, the helical surfaces  31  and  13  form a helical connection between the implant  10  and the instrument  20 , more precisely between the body  11  of the implant and the shaft  30  of the instrument. 
     The instrument  20  further include a support  40  on which the shaft  21  is mounted so as to be apt to move, as discussed in detail hereinafter. 
     In the example of embodiment considered in the figures, the support  40  has a generally tubular shape, inside which the shaft  30  is mounted coaxially. Whatever the shape of the support  40 , the shaft  30  is mounted on the latter both in a fixed manner along the axis X 30  and so as to rotate freely about the axis X 30 . In other words, the shaft  30  and the support  40  are fixedly connected in translation to one another along the axis X 30 , while being free to rotate about said axis with respect to each other. In practice, various embodiments are conceivable for providing the connection between the shaft  30  and the support  40 . In the non-limiting example considered in the figures, the shaft  30  has shouldered surfaces that are arranged in axial abutment against matching shouldered surfaces, provided inside the tubular wall of the support  40 , without the inner face of the tubular wall interfering with the shaft  30  along a direction peripheral to the axis X 30 . In practice, the relative rotational movements between the shaft  30  and the support  40  are advantageously guided, e.g. by one or a plurality of bearings or similar fittings, so as to set the position of the axis X 30  with respect to the support  40  when the shaft  30  is mounted on the support. 
     Moreover, whatever the embodiment of the support  40 , the latter delimits a bearing face  41 . In the mounted state of the shaft  30  on the support  40 , the bearing face  41  is arranged transversely to the axis X 30  and the longitudinal end part 30.1 of the shaft  30  emerges axially from the bearing face  41 , as is clearly visible in  FIGS.  1  to  3   . Thus, the helical surface  31  extends from the bearing face  41 , being arranged so as to protrude from the latter, which makes instrument  20  a male element. 
     The bearing face  41  matches the bearing face  12  of the implant  10 . As a result, when the helical surfaces  31  and  13  mesh with each other in such a way that the axial displacement thereof, induced by the mating thereof, brings the implant  10  and the instrument  20  axially closer to each other, the bearing faces  41  and  12  move axially toward each other until same cooperate with each other by matching shapes: the aforementioned axial approach coming closer between the bearing faces  41  and  12  results in the bearing faces  41  and  12  being juxtaposed against each other as in  FIG.  4   , then being pressed axially against each other as in  FIG.  5   , thus being pressed firmly against each other, which leads in particular to a rigid attachment effect between the support  40  and the implant  10 , by rubbing contact between the bearing faces  41  and  12 , and which tends to eliminate any residual play between the bearing faces. 
     According to an advantageous arrangement, the support  40  further includes one or a plurality of protruding patterns  42 , herein two. The protruding patterns  42  match the recess patterns  15  of the implant  10  so that, when the helical surfaces  31  and  13  mate with each other so as to bring the bearing faces  41  and  12  closer to each other, the protruding patterns  42  cooperate by matching shapes with the recessed patterns  15  so as to lock in rotation the support  40  and the implant  10  with respect to each other, about the axis X 30 . Such cooperation by matching shapes, between the protruding patterns  42  and the recessed patterns  15  consists herein, in that the protruding patterns  42  are axially received inside the recessed patterns  15  in an adjusted way therebetween, as shown diagrammatically in  FIGS.  4  and  5   . It is understood that the geometrical specificities of the protruding patterns  42  and of the recessed patterns  15  are not limiting as long as the protruding patterns  42  and the recessed patterns  15  are shaped so as to cooperate by matching shapes for the purpose of locking in rotation the support  40  and of the implant  10  with respect to each other, about the axis X 30 . According to a practical embodiment, which is implemented in the example illustrated in the figures, the protruding patterns  42  extend from the bearing face  41 . 
     The instrument  20  further includes a mechanism  50  for controlling the reversible connection between the implant  10  and the instrument  20 . The mechanism  50  is designed for acting on the helical connection formed by the helical surfaces  13  and  31  between the implant  10  and the instrument  20 , as explained hereinafter. 
     In the embodiment considered in the figures, the mechanism  50  includes an actuating ring  60  and a drive slide  70 . 
     The actuating ring  60  is mounted on the support  40  while being guided in motion with respect to the support  40  according to two distinct movements that are implemented successively when the mechanism  50  is actuated, namely: 
     a first movement, by which the actuating ring  60  moves, with respect to the support  40 , from position thereof shown in  FIG.  3    to the position thereof shown in  FIG.  4   , and which includes a translation movement along the axis X 30  without involving any rotation about said axis, and a second movement, by which the actuating ring  60  moves, with respect to the support  40 , from the position thereof shown in  FIG.  4    to the position thereof shown in  FIG.  5   , and which combines a rotation about the axis X 30  and a translation along said axis. 
     In the example considered in the figures, the actuating ring  60  surrounds the tubular wall of the support  40 , at an intermediate part of the latter along the axis X 30 . For the purpose of guiding the actuating ring  60  in motion with respect to the support  40  according to the first and second movements, the inner face of the actuating ring  60  cooperates by contact with the outer face of the tubular wall of the support  40 : to this end, the inner face of the actuating ring  60  is e.g. provided with one or a plurality of protruding pins  61 , herein in two diametrically opposite units along the inner periphery of the actuating ring  60 , the protruding pins  61  being correspondingly engaged in guide tracks, delimited by the outer face of the tubular wall of the support  40  and each including both a rectilinear slide  43  which extends parallel to the axis X 30  and which guides the actuating ring  60  according to the first movement, and a cam  44  which rolls around the axis X 30  and guides the actuating ring  60  according to the second movement. For reasons which will appear thereafter, the cams  44  preferentially have a helix angle greater than about 84° so that the translational component of the second movement has a much smaller value than the value of the rotational component of the second movement; i.e. when the actuating ring  60  travels the total stroke thereof following the second movement, the ring mainly performs a rotational movement about the axis X 30  and marginally a translational movement along said axis. Moreover, according to a preferred design, each cam  44  rolls around the axis X 30  over less than 360°, or preferentially less than 180°, so that when the actuating ring  60  travels the total stroke thereof following the second movement, the ring makes less than one revolution on itself, even preferentially less than a half-turn on itself: in this way, when the mechanism  50  is actuated, the user can rotate the actuating ring  60  with a single hand and with one movement, so that said actuating ring  60  then travels the entire stroke thereof following the first movement and then the second movement. 
     The embodiment that has just been described for the guide tracks associating the rectilinear slides  43  and the cams  44  is not limiting. Multiple embodiments are conceivable for guiding the actuating ring  60  in motion with respect to the support  40  according to successively the first and second movements, or more generally, for actuating the mechanism  50  successively according to the first and second movements, in particular with the second movement which is mainly rotational and the total angular travel of which is less than 360°, preferentially less than 180°. 
     The drive slide  70  is mounted on the support  40  both fixed in rotation about the axis X 30  and apt to translate freely along said axis. The drive slide  70  is thus linked in rotation to the support  40 , about the axis X 30 , while being free in translation along the axis X 30  with respect to the support  40 . To this end, in the embodiment considered in the figures, the drive slide  70  is axially slipped into the support  40 , being arranged radially on both sides of the tubular wall of the support  40 , where it should be noted that, as clearly visible on the inserts c) shown in  FIGS.  3  to  5   , the drive slide  70  includes transverse portions which are received in through passages of the annular wall of the support  40 , which blocks the drive slide  70  in rotation about the axis X 30  with respect to the support  40 . Of course, multiple other embodiments are conceivable in this respect. 
     Moreover, the drive slide  70  is mounted on the actuating ring  60  so as to be linked in translation along the axis X 30  to the actuating ring  60  while being free to rotate about the axis X 30  with respect to the actuating ring. For this purpose, in the example considered in the figures, the drive slide  70  is mounted inside the actuating ring  60 , being received in a notch delimited by the inner periphery of the actuating ring so as to be apt to rotate freely therein with respect to the actuating ring while being in axial abutment against the axial ends of the aforementioned notch. Here again, of course, multiple embodiments, which are alternatives to the embodiment which has just been described, are conceivable in this respect. 
     Furthermore, the drive slide  70  cooperates by contact with the shaft  30  so as to rotate the shaft  30  about the axis X 30  with respect to the support  40  when the drive slide  70  is moved in translation along the axis X 30  with respect to the support  40 , in other words, when the actuating ring  60  is translated along the axis. To this end, in the example considered in the figures, the drive slide  70  delimits, herein internally, a helical surface  71  which is congruent with the helical surface  32  of the shaft  30  so that, when the helical surfaces  71  and  32  are made coaxial with each other and rotated about the axis X 30 , the helical surfaces  71  and  32  mesh with each other, inducing the relative axial displacement thereof, in a reversible way. In other words, the helical surfaces  32  and  71  form a helical connection between the shaft  30  and the drive slide  70 , in other words, more generally, a helical connection between the shaft  30  and the mechanism  50 . 
     Here again, although embodiments such as the embodiment described hereinabove are preferred, in which a helical connection is provided between the shaft  30  and the mechanism  50 , other embodiments are conceivable for rotating the shaft  30  about the axis X 30  with respect to the support  40 , when the mechanism  50  is actuated in translation along the axis X 30 . 
     Other features and advantages of the surgical system  1  will appear hereinafter in the description of an example of using the surgical system to directly connect the implant  10  and the instrument  20  to each other. Such use is typically performed by a surgeon during the intraoperative time. 
     The implant  10  and the instrument  20  are initially considered to be separated from each other. A surgeon then handles the instrument  20  so as to align the axes X 30  and X 13  and to axially introduce the free end of the longitudinal end portion 30.1 of the shaft  30  inside the cavity  14  of the implant  10 . The surgical system  1  is then in the configuration illustrated in  FIG.  3   . In the configuration shown in  FIG.  3   , the actuating ring  60  occupies a position corresponding to the starting point of the total stroke thereof following the first and second successive movements described hereinabove. In other words, herein, the pins  61  of the actuating ring  60  are correspondingly located at the axial end of the rectilinear slides  43 , opposite the cams  44 . 
     The surgeon then actuates the mechanism  50  according to the first aforementioned movement, moving the surgical system  1  from the configuration shown in  FIG.  3    to the configuration shown in  FIG.  4   . More precisely, the surgeon moves the actuating ring  60  according to the first movement, i.e. exclusively in translation along the axis X 30 , which translates drive slide  70  in a corresponding manner and hence rotates the shaft  30  about the axis X 30 . Such setting in rotation of the shaft  30  leads to the mating of the helical surface  31  thereof with the helical surface  13  of the implant  10  and, as a result, the axial displacement of the implant  10  toward the instrument  20 , by bringing the bearing faces  12  and  41  axially toward each other. Herein, the relative axial displacement between the implant  10  and the instrument  20  further leads to the cooperation of the recessed patterns  15  and of the protruding patterns  42 , which, without any additional intervention from the surgeon, locks in rotation the implant  10  and the instrument  20  with respect each other, about the axis X 30 , in order to prevent an ineffective mating of the helical surfaces  31  and  13 . 
     When the actuating ring  60  has traveled the entire rectilinear stroke thereof according to the first movement, i.e. when the pins  61  of the actuating ring reach the end of the rectilinear slides  43 , turned toward the cams  44 , the surgical system  1  is in the configuration shown  FIG.  4   . In such configuration, the bearing faces  12  and  41  are juxtaposed axially against one another, forming a contact interface that is arranged transversely to the axis X 30 . Thus, when the mechanism  50  is actuated according to the first movement, the mechanism  50  mates the helical surfaces  13  and  31  with each other until the bearing faces  12  and  41  are juxtaposed axially against each other. 
     The surgeon then actuates the mechanism  50  according to the second aforementioned movement, moving the surgical system from the configuration shown in  FIG.  4    to the configuration shown in  FIG.  5   . More precisely, the surgeon moves the actuating ring  60  according to the second movement, i.e. in a combined manner, mainly in rotation about the axis X 30  and marginally in translation along the axis X 30 . The rotational component of the second movement angularly shifts the actuating ring  60  with respect to the support  40 , thereby preventing the axial displacement of the actuating ring in a direction opposite to the direction of the first movement and thereby preventing the helical surfaces  13  and  31  from disengaging. At the same time, the translational component of the second movement induces, according to the same considerations as those developed hereinabove for the first movement, an additional mating of the helical surfaces  13  and  31  and, consequently, an axial pressing of the bearing faces  12  and  41  against each other; in other words, the shaft  30  is tensioned along the axis X 30 , by axially pulling the implant  10  in tight abutment against the support  40  of the instrument  20  at the contact interface between the bearing faces  12  and  41 . 
     When the actuating ring  60  has traveled the stroke according to the second movement, i.e. when the pins  61  of the actuating ring  60  reach the end of the cams  44  opposite the rectilinear slides  43 , the surgical system is in the configuration shown in  FIG.  5   . In the configuration shown in  FIG.  5   , the helical surfaces  13  and  31  are prevented from disengaging, thus locking the corresponding helical connection, and the bearing faces  12  and  41  are pressed firmly against each other in the direction of the axis X 30 . Thus, when the mechanism  50  is actuated according to the second movement, following the first movement, the mechanism  50  locks the helical connection between the implant  10  and the instrument  20 , while axially pressing the bearing faces  12  and  41  against each other. 
     As long as the surgical system  1  is in the configuration shown in  FIG.  5   , the implant  10  is firmly rigidly attached to the instrument  20 , being totally immobilized with respect to the latter and being used for the transmission of stresses therebetween via the interface formed by the bearing faces  12  and  41 . As a non-limiting example, the surgeon can then move the instrument  20  in space, so as to implant the implant  10  in the body of a patient, in particular by accurately positioning the implant  10  in the body of the patient and, where appropriate, by forcefitting or wedging the implant at an anatomical structure of the patient. In this respect, in the embodiment considered in the figures, the support  40  includes, in the region thereof axially opposite the bearing face  41 , an impaction face  45  against which the surgeon can apply impaction forces for the purpose of implanting the implant  10  in the patient’s body. 
     When the surgeon so wishes, in particular once the implant  10  is implanted in the patient’s body, the instrument  20  is disconnected from the implant  10 , in particular without modifying the position of the latter with respect to the patient’s body. To this end, the surgeon actuates the mechanism  50  in a reverse manner compared to the actuation performed for connecting the implant  10  and the instrument  20  to each other. Thus, the mechanism  50  is first actuated along an inverse movement to the second aforementioned movement, which moves the surgical system from the configuration shown in  FIG.  5    to the configuration shown in  FIG.  4   , then the mechanism  50  is actuated in an additional movement, inverse to the first aforementioned movement, which moves the surgical system  1  from the configuration shown in  FIG.  4    to the configuration shown in  FIG.  3   . The instrument  20  is thus released from the implant  10 . 
     Taking into account the explanations given so far, it is understood that the surgical system  1  is particularly easy to handle for the surgeon. Moreover, when the surgical system  1  is in the configuration shown in  FIG.  5   , the connection between the implant  10  and the instrument  20  is secured. Moreover, when the implant  10  and the instrument  20  are disconnected, they can be easily cleaned and/or decontaminated; for this purpose, the shaft  30 , the support  40  and the mechanism  50  can be designed for being easily disassembled. 
     Such performance of the surgical system  1  is obtained without the system needing to use any threaded connection. On the other hand, the connection between the implant  10  and the instrument  20  is achieved by the helical connection formed by the helical surfaces  13  and  31 , which are not a thread and a tapping of a standardized threaded connection. The same applies to the helical connection between the shaft  30  and the mechanism  50 , formed by the helical connections  32  and  71 . In particular, according to a preferred design which makes the surgical system  1  work as described hereinabove, the helix angle of the helical connection between the implant  10  and the instrument  20  and/or of the helical connection between the shaft  30  and the mechanism  50  is comprised between 6° and 45°, preferentially between 10° and 40°, preferentially between 15° and 45°. In practice, the helix angle of the helical connection between the implant  10  and the instrument  20  can be identical to or different from the helix angle of the helical connection between the shaft  30  and the mechanism  50 . When the two helix angles are different, the helix angle of the helical connection between the implant  10  and the instrument  20  is preferentially greater than the helix angle of the helical connection between the implant  10  and the instrument  20 . In all cases, the non-threaded helical shape of the aforementioned helical connections makes it possible to produce, by additive manufacturing, typically by 3D printing, the helical surfaces  13 ,  30 ,  31  and  71  and, more generally, a part or even all of the implant  10  and/or of the instrument  20 . 
     In the extension of the foregoing considerations,  FIGS.  6  and  7    illustrate the multitude of embodiments possible for the part of the shaft  30  delimiting the helical surface  31 , i.e. herein, the longitudinal end part 30.1 of the shaft. Of course, the multitude of embodiments is found, by congruence, for the part of the cavity  14  delimiting the helical surface  13 . Thus, as illustrated by  FIGS.  6  and  7   , the cross-section of the part of the shaft  30 , delimiting the helical surface  31 , advantageously has a non-circular contour, as shown in the first four examples of  FIG.  6   , wherein the contour is square, multilobed, pentagonal and hexagonal, respectively. Such cross-section can even have an asymmetrical contour, as illustrated in the last two examples of  FIG.  6   : such asymmetry then acts as a foolproof means for the engagement of the helical surface  31  with the helical surface  13 . Moreover, as an optional fitting illustrated in  FIG.  7   , the shaft  30  can be fluted, i.e. provided with a spline  33  crossing axially right along it. 
     Although not illustrated, considerations similar to those developed in the preceding paragraph apply for the part of the shaft  30  delimiting the helical surface  32  and, congruently, for the part of the drive slide  70  delimiting the helical surface  71 . 
       FIGS.  8  and  9    show an alternative embodiment to the surgical system  1 , which is referenced by  1 ′. The surgical system  1 ′ comprises an implant  10 ′ and an instrument  20 ′, which are functionally or structurally similar to the implant  10  and the instrument  20 , while being differentiated from the latter by the way in which the implant and the instrument are locked in rotation with respect to each other, about the axis X 30 . More precisely, the implant  10 ′ and the instrument  20 ′ do not have any recessed and protruding patterns such as the recessed patterns  15  and protruding patterns  42  of the implant  10  and of the instrument  20 . At the same time, the instrument  20 ′ does not include only one shaft, like the shaft  30 , but has two shafts  30 ′, which are each functionally or structurally similar to the shaft  30  and the respective axes X 30 ′ which are parallel to each other. In particular, each shaft  30 ′ delimits a helical surface  31 ′ which is functionally, or even structurally similar to the helical surface  31  of the shaft  30 . Correspondingly, the implant  10 ′ includes two cavities  14 ′, each of which is functionally or even structurally similar to the cavity  14  and in each of which the implant  10 ′ delimits a helical surface  13 ′, which is functionally or even structurally similar to the helical surface  13 . Thus, the helical surfaces  31 ′ are correspondingly congruent with the helical surfaces  13 ′ and form with the latter, two helical connections between the implant  10 ′ and the instrument  20 ′, each of the two helical connections being functionally, or even structurally similar to the helical connection between the implant  10  and the instrument  20 . Due to the presence of the two helical connections, the latter lock the implant  10 ′ and the instrument  20 ′ in rotation with respect to each other, about each of the axes X 30 ′, when the helical surfaces  31 ′ mesh, or mate, with the helical surfaces  13 ′. 
     In practice, the instrument  20 ′ includes a mechanism, not shown in the figures, which is functionally similar to the mechanism  50  of the instrument  20 , with the advantageous specificity that said mechanism of the instrument  20 ′ is designed for acting simultaneously and in the same way on the two helical connections between the implant  10 ′ and the instrument  20 ′. 
     Finally, various fittings and variants of the surgical systems  1  and  1 ′ described up to now are further conceivable. Examples include: 
     the male/female relation between the implant  10  or  10 ′ and the instrument  20  or  20 ′ can be reversed; the same is true for the recessed patterns  15  and the protruding patterns  42 ; and/or   other types of manufacturing than additive manufacturing can be used to manufacture all or part of the implant  10  or  10 ′ and/or the instrument  20  or  20 ′; and/or   rather than the second aforementioned movement combining rotational and translational components, like in the example described hereinabove, the second movement can be provided as exclusively rotational, i.e. rotational about the axis X 30 , X 30 ′ without being a translation along said axis; in such case, the mechanism  50  is suitable so that the actuation thereof according to the second exclusively rotational movement locks the helical connection between the implant  10  and the instrument  20 , preventing the disengagement of the helical surfaces  13  and  31 , while ensuring that, at the end of the second exclusively rotational movement, the bearing faces  12  and  41  are pressed axially against each other, such abutment of the bearing faces  12  and  41  being either reached at the end of the first movement and maintained during the second movement, or obtained progressively during the second movement, in both cases through ad hoc fittings of the mechanism; and/or   rather than the two components of the surgical system  1  or  1 ′, which can be directly connected to each other, being a surgical implant and a surgical instrument, such as the implant  10  or  10 ′ and the instrument  20  or  20 ′, the two elements of the surgical system can be two surgical implants which are e.g. to be connected directly to each other during a surgical intervention.