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With laparoscopic surgery, incisions are just millimeters long. This is good news for patients, but creates an additional challenge for surgeons, who can no longer directly see the surgical site. Fluorescence imaging, which consists of injecting markers that are concentrated in the area of interest and that emit infrared light, could give surgeons more detailed information about what they are seeing. However, fluorescence imaging is currently not compatible with laparoscopic surgery. Laparoscopic surgery presents the added challenge of giving surgeons extremely tight spaces to work within. Endocontrol developed an endoscopic fluorescence imaging system combined with a surgical cobot to make laparoscopic surgery safer and more precise. The first step was to develop an endoscopic imaging system capable of displaying the areas of interest in color and fluorescence. This entailed miniaturizing the fluorescence imaging system and coming up with an endoscope compatible with the two types of imaging. The surgical cobot leveraged an innovative shared control mechanism. The surgeon picks up an instrument, which is also held by a robotic arm. The surgeon uses the traditional technique, and the robot serves as a guide, enhancing the surgeon's stability and precision. Endocontrol worked on the robotics component of the project. The laparoscopic surgery systems developed will address: digestive, bariatric, and urological surgery, which all include complicated coelioscopy, which has much to gain from robotic assistance; as well as gynecological, cardiac, pulmonary, and vascular surgery. The laparoscopic surgery market was estimated at €14.8 billion in 2008 and was expected to grow 7.8% per year to reach €23 billion by 2014, according to the 2009 BCC Research Report, "The market for Minimally Invasive Medical Devices." There are an estimated 100,000 laparoscopic surgeons worldwide (not including India and China) according to the MedTech Insight and Frost & Sullivan reports on endoscopic surgery (2006). The number of centers potentially interested in this solution could therefore be between 30,000 and 40,000.

L'histoire du produit

The FluoRoMIS project looked at an endoscopic fluorescence imaging system (including a 3D version) and a surgical cobot. The end goal was to combine the two systems to guide the surgeon's hand, making laparoscopic surgery safer. The concept was to extract the information required to control the robot from the fluorescence images. The first step was the endoscopic fluorescence imaging system. This type of imaging is used in open surgery. To use it in laparoscopic surgery required new optical systems compatible with the difficult conditions of laparoscopic surgery (miniaturization, lighting, image quality). Next came the cobot, with the goal of developing a robotic arm capable of enhancing the surgeon's technique without interfering. Finally, image-based control rules were developed. The first two steps were completed in parallel, and resulted in the development of two separate, fully operational systems suitable for different markets. The complete system combining the two is designed to respond to the fundamental problem in laparoscopic surgery: seeing the areas of interest and using the surgical instruments with precision.