This document discusses the history and types of minimally invasive surgery. It describes how minimally invasive surgery uses small incisions rather than large cuts, and how endoscopes allow surgeons to see inside the body. The main types of minimally invasive surgery are endoscopy, laparoscopy, and robot-assisted surgery. The document then provides details on the invention of the first endoscopic devices in the early 1800s, how modern endoscopes work, and important early patents for laparoscopic instruments and robotic surgery systems. It concludes by discussing challenges around patents in the surgical robotics field.

1. Design of
Minimal Invasive
Surgical Devices
Shajed Ahmed

2. What is Minimal
Invasive Surgery?
• Minimal invasive surgery uses tiny cuts
in the skin — or no cuts at all — rather
than the large cuts often needed in
traditional surgery.
• There are many kinds of minimally
invasive surgery. Each involves the
surgeon using an endoscope.
• This is a thin tube with a light and tiny
video camera on the end. The
endoscope lets the surgeon see inside
the body and use very small surgical
tools in the area.

3. The Types of Minimally Invasive Surgery
Endoscopy: The surgeon uses the endoscope itself to do the procedure. The
endoscope goes in through the body's natural openings, without the surgeon
making any cuts.
Laparoscopy: Using small cuts (sometimes called "keyhole" cuts or incisions),
the surgeon guides the endoscope and special surgery tools into the body.
Robot-assisted surgery (robotic surgery): The surgeon makes several small
cuts to guide the endoscope and robotic tools into the body. From there, the
surgeon controls the surgery while sitting at a nearby computer console.

4. First Endoscopic Device
Invented and Designed in 1806 by
Philipp Bozzini, the light conductor, or
Lichtleiter, consisted of two parts:
• the light container with the optical
device
• the mechanical part with the viewing
tubes which are fitted to
accommodate the anatomical access
of the organs to be examined.

5. How do Modern Endoscopes Work?
1. Light illuminates the cavity where the
endoscope is inserted
2. Light bounces along the walls of the
cable into the body cavity
3. The light illuminates the injured part
4. The light reflects off the body part
and travels back up a separate fiber-
optic cable
5. Light shines into the physician’s
eyepiece to see what is happening,
sometimes this is connected to a
television monitor

6. First Endoscope
Patent
• In early 1950s Harold Hopkins and
Narinder Kapany developed the basic
technology behind the modern
endoscope, which are optical fibers.
These long, thin, highly flexible, rope-like
tubes are efficient in transmitting light.
• In the mid-1950s, Basil Hirschowitz,
Lawrence Curtiss, and C. Wilbur Peters
used optical-fiber technology to build an
instrument called a gastroscope that
could be used to see inside a patient's
stomach.
• The same technology was later used to
study other body cavities.

7. Laparoscopic Surgery
• Laparoscopic surgery is a surgical technique in which short, narrow tubes (trochars) are
inserted into the abdomen through small (less than one centimeter) incisions.
• The surgeon uses these instruments to manipulate, cut, and sew tissue.

8. Laparoscopic Instrument Patents
Inventor: Benedetto Iacovelli
Patent No: US5350391A
Date Filed: 1992-10-19
Expiration: 2012-10-19
Inventor: Flex Dex Inc.
Patent No: US9869339B2
Date Filed: 2016-10-05
Expiration: 2036-10-05

9. Robot Assisted Surgery - Intuitive Surgical
• Allows doctors to perform many types of
complex procedures with more precision,
flexibility and control than is possible with
conventional techniques.
• The da Vinci system has over 5,300 systems
installed worldwide and supports revenues of
over $3 billion dollars annually.

10. Intuitive Surgical Patent – Past and Present
Inventor: Intuitive Surgical Inc.
Patent No: US5792135A
Date Filed: 1997-05-16
Expiration: 2017-05-16
Inventor: Intuitive Surgical Inc.
Patent No: US9358074B2
Date Filed: 2012-06-01
Expiration: 2034-06-24

11. Issues in Surgery Robot Patents
• The Intuitive Surgical and their da Vinci system
has dominated the surgical robotics market
practically uncontested since its launch in
1999/2000.
• In 2003, they merged with their chief rival,
Computer Motion, Intuitive has owned powerful
patents which allowed them to exclude all other
players from the surgical robotics market.
• However, patents have a maximum term of 20
years, and the protection provided by the
original patent portfolio has started to expire.

12. CMR Surgical - Versius
• Versius is different to other robotic surgery
systems as it uses modular design allowing it to
be easily moved between operating rooms and
hospitals and set up quickly.
• The system’s individually cart-mounted arms
mimic the human arms, giving surgeons control
over instruments through a range of ergonomic
operating positions.
• Lifetime cost of traditional robot is $8 million
USD and CMR intends to reduce lifetime cost by
30 to 40 percent by supplying the system as a
service for a fixed annual cost.

13. Questions?