Abstract
Thirty years ago, the emergence of endoscopic technology opened up the way to minimal access surgery. This new approach strongly decreases the size of incisions and scars, reducing per- and post-operative traumatism and risk of infection. Advantages in terms of pain and esthetics played a large part in the quick expansion of laparoscopy in urology, gynecology and digestive surgery. But whereas this technique offers many advantages to the patient, it complicates surgical gestures. In particular, manual manipulation of the laparoscope poses many ergonomics problems. Our goal is to design a robotic scope-holder that allows the surgeon to teleoperate the laparoscope. Starting from this initial demand, this thesis sets out to study laparoscopic surgery into detail, in collaboration with practitioners. Through the clarification of problems that they encounter, performance specifications are established. Subsequently, main choices of the robot's structure are layed down. Design of device's subsets follows a rational process until realization of a functional prototype. Particular attention is paid to general ergonomics of the system and its control interface. An experimental clinical trial ends this work and validates the principle of solution. We finally propose a few design improvements and a series of possible complementary studies and trials, and go back over objectives identified initially, in the light of results achieved and experience acquired in the course of this research.