• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    An elongate axis medical drive module for a robotic system comprising: - a moving assembly rotatably mounted relative to a base about an axis of rotation (23), and defining a receiving space for the elongated medical device, and comprising a rotational drive system (38) comprising an elongate medical passage zone (105) corresponding to the passage location of the elongated medical organ through the moving assembly and a plurality of rotational drive portions (38a-d) distributed about the axis of rotation (23), an access opening (93) having an angular aperture of at least 30 °.
    公开号:FR3032622A1
    申请号:FR1651123
    申请日:2016-02-12
    公开日:2016-08-19
    发明作者:Philippe Bencteux；Sebastien Deboeuf；Jacques Marignier
    申请人:Robocath；
    IPC主号:
    专利说明:

    [0001] 1 Elongated medical organ training module. The present invention relates to drive modules of robotic catheterization systems.
    [0002] Manual insertion of a catheter into a patient is a relatively conventional surgical procedure. However, this act being monitored under X-rays, the surgeon in charge of this act is subjected to a significant irradiation if he performs such an operation on many patients.
    [0003] In order to reduce the risks for the surgeon, we try to robotize such insertion. This robotization is complex because the prehension of the catheter is complex. This one bathes indeed in liquid of conservation and must remain sterile. Moreover, it is desired to be able to alternately control translational and rotational movements of the catheter. It goes without saying that the reliability of these robotic systems must be absolute. Recently, it has been proposed in US 7,927,310 a drive system managing both the translation and the rotation of the catheter. The catheter is held on a rotatable plate relative to a base for rotational drive. The wafer itself comprises a drive mechanism in translation. In addition, remote motors are used, permanently on the frame, and movement transfer systems to the catheter. Indeed, it is preferred not to have the engines on board, for reasons of power supply, congestion and sterility. A residual problem, however, remains the emergency removal of the catheter from the mechanism. Indeed, one wants to be able to uncouple as easily as possible the catheter mechanism, in case of emergency, so that the doctor can resume the operation by hand. In the above document, with the catheter passing through closed shafts, such uncoupling is not expected. In addition, this possibility of uncoupling must not have a detrimental influence on the normal operation of the robot. In other words, it must not reduce the handling capabilities or reliability of the robot.
    [0004] The present invention is intended to overcome these disadvantages. For this purpose, according to the invention, there is provided an elongate medical drive module along an axis of elongation for a robotic system comprising: a base carrying at least one rotary drive control member; a movable assembly rotatably mounted relative to the base about an axis of rotation, and defining a receiving space for the elongated medical device, the movable assembly comprising a rotational drive system comprising a elongate medical passageway corresponding to the passage location of the elongated medical organ through the moving assembly, and a plurality of rotational drive portions distributed about the axis of rotation, adapted to cooperate each with at least one rotational drive control member, the rotational drive portions being disposed in drive configuration such that at least one rotat drive portions are provided; ion cooperates with at least one of rotational drive control members regardless of the relative orientation of the moving assembly and the base about the axis of rotation, an access opening extending from the receiving space between two adjacent rotational driving portions, and whereby the elongated medical member is radially movable between a use pattern where it extends into the receiving space, and an outer configuration where it is external to the drive module, the access opening comprising an angular aperture of at least 30 ° measured projected in a plane normal to the axis of rotation between two straight lines extending from the passage zone to each of the two adjacent drive portions in access configuration. Indeed, when we must provide easy removal of the catheter mechanism, it is necessary to provide a withdrawal opening in the mechanism. Thus, a system requiring only a few operations to uncouple the catheter from the mechanism is realized. This applies to a catheter, but also any suitable elongated flexible medical organ, such as a guide, an interventional catheter, etc. In preferred embodiments of the invention, it is possible to in addition use one and / or the other of the following provisions: - the drive module further comprises a drive system in translation of the elongate medical device, carried by the mobile equipment, comprising at least one surface adapted to be brought into contact with the elongate medical device, and adapted to be set in motion relative to the moving assembly for translational translation of the elongate medical device along the axis of elongation said surface being further adapted to grip the elongate medical member to rotate the same about the axis of rotation; the movable element comprises a frame supporting at least one rotating member of the drive system in translation, the rotary drive system being integral with the frame; the access opening is a first access opening, in which the frame carries the translation drive system, the translation drive system comprising an elongated medical passage zone corresponding to the passage location 3032622 4 the elongate medical device through the moving equipment, and a plurality of translation drive portions distributed around the axis of rotation, each adapted to cooperate with at least one control member 5 d translational drive of the base, the translation drive portions being arranged in the drive configuration so that at least one of the translation drive portions cooperates with at least one drive control device. 10 translation regardless of the relative orientation of the moving assembly and the base around the axis of rotation, a second access opening extending from the receiving space between two p adjacent translation drive, the second access opening comprising an angular aperture of at least 30 ° measured projected in a plane normal to the axis of rotation between two straight lines extending from the passage zone to each two adjacent drive portions in access configuration; - The first and second access openings are superimposed in projection normally to the axis of rotation, regardless of the relative orientation of the movable assembly 25 and the base; the rotational drive system comprises a joining portion, and at least two arms extending on either side of the receiving space and each connected to the joining portion; at least one of or even each access opening has an angular aperture at least equal to 45 °, in an access configuration, or even at least equal to 90 °; the rotational drive control member comprises a drivable belt for traversing a path along the base, said path including an arcuate portion centered on the axis of rotation, and of angular extent greater than the angular aperture, and less than 360 ° minus the angular aperture; 5 - the mobile equipment comprises a suitable removable plug,. in the assembled position, to close the access opening and prevent radial displacement of the elongated medical member between its use configuration and its external configuration, and in disassembled position, to open the access opening and allow this displacement; the removable cap comprises a suitable rotational driving surface, in an assembled position, to cooperate with at least one rotational drive control element in drive configuration; the plug is held mobile on the moving equipment between the assembled configuration and the disassembled configuration. According to another aspect, the invention relates to an elongate axis of an elongate axis for a robotic system comprising: a base carrying at least one rotational drive member; a movable assembly rotatably mounted relative to the base about an axis of rotation, and defining a receiving space for the elongate medical device, the mobile assembly comprising a rotational drive system adapted to cooperate with at least one rotational drive control member, regardless of the relative orientation of the moving assembly and the base around the axis of rotation, the movable assembly comprises a suitable removable cap 3032622 6 - assembled position, for closing an access opening to the receiving space, and preventing the radial displacement of the elongate medical member between its use configuration and its external configuration, and 5 - in disassembled position to open the access opening and allow this movement. In particular, the plug carries part of the drive system according to the degree of freedom. Other features and advantages of the invention will become apparent from the following description of ten of its embodiments, given by way of non-limiting example, with reference to the accompanying drawings. In the drawings: FIG. 1 depicts an example of a robotic arteriography device, FIG. 2 is an exploded perspective view of a training module according to a first embodiment, FIG. 4 is a partial view of the system of FIG. 3, FIG. 5 is a top view of the system of FIG. 3, FIG. 6 is a perspective view of the system of FIG. 3 is a rear perspective view of the system of FIG. 2, FIGS. 8a, 8b and 8c are front views of the system of FIG. Figure 9 through 13 are partial perspective views from behind respectively from second to sixth embodiments, and Figures 14a and 14b are views similar to Figure 9 for a seventh mode. in two separate configurations, FIGS. 5 and 16 are partial perspective views from behind respectively of an eighth, ninth embodiment; FIG. 17 is a view similar to FIG. 8a for a tenth embodiment. In the different figures, the same references designate identical or similar elements.
    [0005] Figure 1 depicts an example of a medical facility. A patient 1 is installed on an examination table, and a medical staff 2 proceeds to a robotic catheterization. The catheterization is robotized via a computerized unit 3 comprising a central unit 4 (processor, logic, or other) remotely controlling a robot 5. The robot 5 is adapted to move an elongated flexible medical organ 6 to the 1, under the control of the computerized unit 3. The term "elongated flexible medical device" denotes an elongate flexible member 20 in a longitudinal direction, and can be introduced into a patient's canal, particularly in an artery. or a patient's vein, such as a catheter in the conventional sense, a guidewire guiding such a catheter, a fibroscope, an interventional catheter provided with medical equipment such as a balloon, a tool-type tool. The robot 5 can be controlled by the computerized unit 3 according to a predefined program, or by the medical staff 2 via a user interface 7 such as a mouse, keyboard , jo ystick, or whatever. Such catheterization is performed under imaging, in particular under X-ray imaging. Thus, an X-ray source 8, emitting an X-ray beam 9 towards a patient, and a detector 10 of 10 can be provided. X-ray disposed beyond the patient, capable of detecting the transmission of the X-ray beam through the patient. The imaging system may be connected to the computer unit 3 so that the image obtained by the imaging system is visible on the screen 11 of the computer unit. Alternatively, the radiographic image is displayed on a dedicated screen. The medical staff 2 can thus control the catheterization while viewing on the screen 11 the position of the flexible medical organ elongated within the patient, in relation to the various organs of the patient, which allows him to order various movements of the elongated flexible medical organ, using the robot 5, such as in particular the two main movements that are the translation of the elongate flexible medical organ 15 along its longitudinal direction, in one direction or in the other (advancing or withdrawing) and / or rotating the flexible medical organ elongated about its longitudinal direction (in one direction or the other). The robot 5 will be described in more detail below. The latter mainly comprises a receptacle 12 in which the elongate flexible medical organ can be sterile contained. For example, this receptacle 12 is an open-ended tube in which is contained the elongate flexible medical organ bathed in a sterile liquid, such as a physiological fluid. The elongated flexible medical organ exits through one end of the receptacle 12, and cooperates with a drive module 13, carried by the robot 5, which will be described in more detail below. The drive module 13 can receive two commands from the computerized unit 3, which are a translation drive control along the longitudinal direction of the elongated flexible medical device, and a drive command. in rotation around this direction. It should be noted that, where appropriate, each command received by the robot comprises a combination of a translation control and a rotation control, in different proportions, and that a judicious combination of two commands allows, if necessary, to control a pure translational movement or a pure rotational movement of the elongated flexible medical organ by the simple resolution of mathematical equations. Note that, if necessary, the robot 5 may be more complex. In particular, the robot 5 can be used to control two medical organs, such as an elongated flexible medical member (as described above) and a guide passing inside the elongated flexible medical organ. Thus, it is expected that the robot 5 comprises, in addition to the first system 14 described above, comprising both the container 12 and the drive module 13, a second system 15, comprising a receptacle 16 and a module. training 17 of the medical organ contained in the receptacle 16. Similarly, it is expected that the second system 15 cooperates with the first 14, in that the end of the second system 15 is connected to the receptacle 12 of the first system 14, and more particularly at the rear end of the elongate flexible medical organ 6. Thus, the guide 18 can be moved within the elongated flexible medical organ 6. The training module 17 is similar to the module drive 13, apart from the adaptation to the diameter of the member to be driven, and will not be described in particular. The robot 5 is controlled by the computerized unit 3 so that the drive module 17 controls the translation of the guide 18 along its longitudinal direction, and its rotation around this direction. The receptacle 16 is, for example, a bowl receiving a preservation liquid capable of retaining the guide 18. If necessary, a third system, not shown, may be used in a similar design, embedded in the second.
    [0006] Referring now to FIG. 2, a first exemplary drive module 13 will be described. The drive module 13 has the particularity of not having onboard motors. Thus, the motors are permanently arranged and the movements to be imparted to the elongated flexible medical member are transmitted by a transfer system. Two motors 19 and 20, independently controllable by the computerized unit 3, are thus provided. The motor 19 aims to control the rotation of the elongate flexible medical organ 6. The motor 20 aims at controlling the translation of the flexible medical organ 6. Moreover, the drive module 13 has the feature that a single module controls both the rotational and translational movements of the elongate flexible medical device. This is achieved in practice by providing for the drive module a fixed base 21 secured to the motors 19 and 20. The fixed base carries a movable assembly 22 adapted to rotate about the base 21 about an axis 23 '. extending in the main direction. In the present example, the axis 23 coincides with the longitudinal direction of the elongated flexible medical member to be driven. As will be explained in more detail below in various embodiments, the movable assembly carries a gripping system 120 of the elongate flexible medical member that may not be driven, in which case the rotation of the moving assembly relative to the base causes rotation of the flexible medical organ elongate around the main direction, or be driven, resulting in the translation of the flexible medical organ elongate in the main direction.
    [0007] The drive module 13 comprises a housing 24 which receives the base 21 and the moving assembly 22, and protects it roughly from external pollution. The housing 24 comprises a lower receptacle 25 and a lid 26 associated. Receptacle 25 and cover 26 are associable (interlocking or otherwise) to enclose an almost closed space in which base 21 and movable assembly 22 are held. Receptacle 25 includes two passages 27 and 28 through which passing, respectively, a rotation control shaft 33 and a translation drive shaft 71 connected, respectively, to the rotation motor 19 and to the translation motor 20. The base 21 comprises a portion of a motion control system In particular, the rotational movement control system 29 imparts to the moving element 22 a rotational movement about the axis 23. This system 29 is particularly visible in FIG. 7. In particular, according to FIG. this embodiment, this system 29 comprises a closed continuous belt 30 movable along a path comprising a driving portion 15 in an arc 30 ', the center of the arc being merged with the 23. A guide system 31 guides the belt 30 along this path. A mechanical transfer system 32 is provided to drive the belt 30 along its path. In particular, it is possible, for example, to provide that the end of the rotation control shaft 33 comprises a gear 34 engraining with a gear 35 driving the belt 30. In particular, a mechanical transfer system 32 comprising a angle of 90 °.
    [0008] The moving element 22 comprises a frame 39 extending between two end faces 36a (FIG. 7) and 36b (FIG. 3) along the main direction. The frame 39 is integral with a plate 90. The plate 90 comprises, for example, distinct drive surface portions 38a-d of cylindrical rotation about the axis 23, e + cooperating with the belt 30, and forming a system By cooperating means, it is possible, for example, to provide that the belt 30 has a drive face, and that the distinct drive surface portions 38a-d have a complementary surface. The belt drive face 302 and a drive surface portion 38a-d are in driving relation so that the movement of the belt 30 causes the frame 39 to rotate about the axis 23. The Plate 90 5 thus comprises, in the example shown, four arms 91a-91d extending from a junction zone 92. In the position shown, the junction zone 92 is provided below the axis 23, and the arms extend therefrom substantially radially to a respective driving surface portion 38a-38d. Thus, there are provided on the periphery four driving surface portions separated in pairs from four open zones, each approximately an angular opening of the order of 45 ° in projection in a plane normal to the axis. Since junction 92 is not central, the angular aperture of the different zones can vary. In particular, one of these open areas opens onto the receiving space of the elongate medical organ, and is called the access opening 93. The elongated flexible medical organ passes through the plate 90 into a zone passage 105, materialized in dotted lines, which extends in this example around the axis 23. The access opening 93 is defined by two straight lines D1 and D2 extending, in projection in a plane normal to the axis 23, from the passage zone 105, to each of the neighboring drive surface portions 38a, 38d. The access opening 93 has at least a = 30 ° of angular opening, or even at least 45 °, and can be up to 90 °. Note that two of the arms 91b and 91c of the plate 90 each have an attachment zone 93b, 93c to the frame 43 of the frame, shown in dashed lines, which will be described in more detail below. Referring again to Figure 2, frame 39 defines a receiving space 40 extending substantially between the two end surfaces 36a and 36b. In particular, the receiving space 40 extends continuously in the main direction. In particular, the receiving space 40 extends continuously with the access opening 93 provided between the two adjacent discrete portions 38a, 38d of the drive surface. The receiving space 40 is sufficiently wide to allow insertion or radial withdrawal of an elongate flexible medical organ 6 through a use configuration where it is inserted into the receiving space and an external configuration where it is external to the module 13. Furthermore, it can be provided on the cover 26 two lips 41 of elastomeric material closing the access to the inner space 40, to close the access against the entry of pollution, but deformable for insert or remove a flexible medical organ elongated therebetween. Referring now to FIGS. 5 and 6, a translational drive system 106 of the elongate flexible medical device 6 according to an exemplary embodiment will be described. The translation drive system 20 comprises a frame 43 of the frame 39. The frame 43 comprises a set of arms or other structural elements defining bearings for the various shafts carried rotating by the frame. The frame 43 receives on one side a rotation drive system and on the other side a portion of a drive system in translation. These two sides are separated along the axis 23. On the rotation side, the frame 43 comprises two fixing portions 94b, 94c respectively fixed to the attachment zones 93b, 93c previously described.
    [0009] The frame carries a drive shaft 44 through an end bearing 45 and a second end bearing 46 at the opposite end. The drive shaft 44 extends in the main direction, substantially parallel to the axis 23, offset from it in a transverse direction. It extends between a first end rotating in the end bearing 45, and a second end projecting out of the bearing 46. Furthermore, the shaft 44 comprises at least one gear 47 concentric with the axis of the shaft 44, for rotating a member 48 for driving in translation of the elongate flexible medical member. In the present example, the translation drive member 48 of the elongated flexible medical device is a shaft rotatably mounted on the frame 43 about an axis normal to the main direction, that is to say according to the transverse direction. The translation drive member 48 is operatively coupled to an applicator surface 49 disposed in contact with the elongated flexible medical member 6 so that rotation of the translation drive member 48 about the transverse direction results in the translation of the elongated flexible medical organ 6 along the axis 23. In the example presented, application surfaces 49 are especially used, which are carried by belts 50 and 51 arranged on both sides. Other of the elongated flexible medical device 6. The belts 50 and 51 are endless continuous belts driven by the respective rotation of a translation drive member 48, 52. For example, a translation drive member 48, as described above, for driving the belt 50, and another similar member 52 for driving the belt 51 is used. diagonal of the member 48 relative to a rectangle whose two other vertices comprise driven pulleys 53 and 54. Thus, on one side, the translation drive member 48 and the driven pulley 53 receive the belt 50. On the other side, the drive member 52 and the driven pulley 54 receive the belt 51. The translational drive member 52 also co-operates with the shaft 44 via a Transfer gear 154 carried by the shaft 44. In a variant, a belt system is not necessarily used and the member 48 and a counter-member disposed directly on either side of the belt are used directly. elongated flexible medical member 6 for translational driving. Above, the main direction 23 has been described as that of the translation drive shaft of the elongated flexible medical member. The transverse direction has been defined as that of the axis between the stage of the shaft 44 and the stage of the elongated flexible medical organ 6. A third, so-called lateral direction may be defined forming a trihedron with the other two directions. It is possible to provide a lateral displacement system 55 for the elongate flexible medical member 6. For example, a spacer 56 is provided, displaceable in the lateral direction, and comprising a thrust surface 57 cooperating with an inner face of the belt 49. The displacement in the lateral direction of the spacer 56 will laterally move the applicator surface 49 of the belt 50. Thus, the elongated flexible medical member 6 can be clamped between the two belts and / or offset the axis in which the Elongated flexible medical member extends between the applicator surfaces relative to the axis 23 (while keeping these 25 parallel axes) to improve the rotational drive. The spacer 56 also comprises a tensioning surface 58 adapted to tension the belt 50. The spacer 56 comprises, for example, in the lateral direction, a front face carrying the thrust surface 57, and a rear face opposite to the front face. . The rear face carries the tensioning surface 58, which cooperates with the return side belt. Thus, regardless of the lateral offset imposed by the spacer 56 in the dedicated interval, the belt remains tight.
    [0010] On the opposite side to the spacer 56 from the elongated flexible medical device 6, the lateral displacement system 55 comprises a pusher 59. The pusher 59 may be movable in the lateral direction. The pusher 59 includes a thrust surface 60 opposite the thrust surface 57. The elongated flexible medical member 6 is taken through the belts 50 and 51 between these two thrust surfaces 57 and 60. The lateral shifting the axis of the elongated flexible medical organ, imposed by the spacer 56, can cause the pusher 59 10 to move in the lateral direction via the elongate flexible medical organ, against a means recall not shown. On the same opposite side, there are two tensioning pulleys 61 and 62 which, together with the thrust surface 60, tension the belt 51. The two tensioning pulleys 61 and 62 are rotatably mounted about the transverse direction relative to the frame 43. Thus, as can be understood from the above description, the installation of the elongate flexible medical member 6 in the moving assembly comprises providing the elongated flexible medical member 6 between the two belts 50. and 51. The tightening of the elongate flexible medical organ 6, and the lateral axis offset of the elongate flexible medical organ with respect to the axis 23 are obtained by adjusting the lateral displacement system, that is, that is to say, in particular by adjusting the lateral position of the spacer 56, by a not shown adjustment system (for example manually before the intervention). Once the position of the flexible medical organ 30 elongated 6 and its clamping according to the expected, the drive of the flexible medical organ elongated along the axis 23 is controlled by simple rotation of the shaft 44 d 'training. Indeed, the rotation of the drive shaft 44 relative to the frame 43 about its axis, parallel to the axis 23, causes the rotation of at least 3032622 17 the rotating drive member 48 around its own axis (transverse axis) by engrainement. In practice, in this case, the rotation of the drive shaft 44 relative to the frame 43 about its axis, parallel to the axis 23, also causes rotation of the rotary drive member 52. around its own axis (transverse axis) by engrainement. The rotational driving member 48 drives the belt 50, whose applicator surface is then subjected, at the level of the interaction with the elongate flexible medical device 6, to a translation movement parallel to the axis 23. The rotational driving member 52 drives the belt 51, whose applicator surface is then subjected, at the level of the interaction with the elongated flexible medical organ 6, to a translation movement parallel to the axis 23. These two movements are generated in the same direction of translation for the applicator surfaces (that is to say in opposite directions of rotation of the two belts). The movement of the belts translates the elongated flexible medical device into translation.
    [0011] To generate a translational movement of the elongate flexible medical organ 6, it is therefore sufficient to rotate the shaft 44. However, the shaft 44 describing a rotation about the axis 23 due to the rotation of the moving element 25 around this axis, while the translation motor 20 remains fixed relative to the frame, there must be a transfer system 63 which permanently connects the shaft 44 to the motor 20, whatever the position of the moving equipment 22 with respect to this direction. The transfer system 63 comprises an indwelling part 64, carried by the base 21, and a nomadic part 65, carried by the moving equipment 22. A first exemplary embodiment will be given with reference to FIGS. 2 and 3. In this first embodiment, the dwell portion 64 includes a belt 66 which is guided along a closed continuous path. A guide is provided for the belt. The belt 66 has a circular arc portion 68, centered on the axis 23. The circular arc portion 68 has a minimum extension, which will be explained in more detail below, and a maximum extension which is strictly inferior. at 360 °. In particular, the belt 66 defines an access opening 69 wide enough to allow the elongated flexible medical organ 6 to pass therethrough. In the particular example shown, the arcuate portion 68 of the belt 66 has an angular extension of about 180 °. The belt 66 also has a drive portion 70. The drive portion 70 receives drive control 15 from the drive motor 20. For example, as shown in FIG. shaft 71 connected to the motor 20, passing through the passage 28, and driving in rotation about the vertical axis a gear 72. The latter engages by conical engraining with a gear 73 of axis parallel to the axis 23. This gear 73 cooperates with the driving portion 70 of the belt as shown in FIG. 4. The indwelling portion 64 comprises a set of pulleys adapted to guide the belt 66 to move along a path 74 comprising both the portion of the belt. drive 70 and the portion 68 in an arc. For example, pulleys 75a, 75b, 75c of parallel axes are provided and arranged so as to form a rectangle with the gear 73. The trajectory 74 comprises three sides 30 of this rectangle, and the arcuate portion 68 provided instead of the fourth side. Note that the inner face 76 of the belt 66 is designated to cooperate with the gear 73 to transmit the movement by cooperation of form, engrainement or other.
    [0012] The nomadic portion 65 comprises a support disc 77 integral with the frame 43. The support disc 77, the frame 43, and any other integral part, in particular the frame 39, of the moving assembly 22 are generally designated together by "support 121. Support disc 77 carries a plurality of gears 78a, 78b, 78c and 78d. These gears 78a-d are each rotatably mounted relative to the support disc 77 about an axis parallel to the main direction. Furthermore, these gears 78a-78d are arranged on a circle centered on the axis 23 (thus concentric with the arcuate portion 68 of the belt 66). The radius of this circle is less than the radius of the arcuate portion 68 of the belt 66. Each gear 78a-d has a clean radius, so that the sum of the radius of the circle and the radius of the gear 78a d corresponds to the radius of the arcuate portion 68 of the belt 66. Furthermore, each gear 78a-d is in gearing relation with the shaft 44 passing through the support disk 77. a direct engraining relation, as is the case for the two gears 78a and 78d which are in direct contact with the head 79 of the shaft 44. It is also possible to envisage an indirect engraining relation, as This is the case for the two gears 78b and 78c which are in contact with the head 79 of the shaft 44 via the two gears 78a and 78d. Furthermore, it is also possible to provide a system for transferring movement between the so-called indirect gears 78b and 78c and the so-called direct gears 78a and 78d, so that all these rotate in the same direction.
    [0013] Thus, there may be an intermediate gear 80a between the gears 78a and 78b and an intermediate gear 80b between the gears 78c and 78d. Thus, the support disc 77 carries a mechanized system 78a-78d, 80a-80b, which has an access opening 81 aligned with an access opening 82 of the support disc 77. The access opening 81 comprises a passage zone 107 where the elongated medical flexible member goes into normal operation. The access opening 81 is defined by two straight lines D3 and D4 extending in projection in a plane normal to the axis 23 from the passage zone 107 to each of the driving surface portions 78b. 78c neighbors. The access opening 81 has at least a = 30 ° angular opening, or even at least 45 °. In contrast to the example shown, care should be taken to minimize the intrusion of moving component support surfaces, such as the support disk 77 where the hoods 84 in the access opening 81 (such a variant is visible in FIG. ). In the present case, the mechanized system has gears arranged generally in a U-shape, the open side of the U defining the access opening 81. A first leg of the U comprises, aligned, the gears 78a, 80a and 78b . A second branch of the U comprises, aligned, the gears 78d, 80b and 78c. The gears 78a and 78d are disposed on either side of the head 76 of the shaft 44 to form the base of the U. In the position shown in Figure 4, the gears 78a and 78d are engaged with the belt. 66, in the arcuate portion 68 of the belt. In this position, to translate the elongated flexible medical device 6 in translation along the axis 23, the gear 73 drives the belt 66. The belt 66 causes the gears 78a and 78d to rotate about their own axis by relative to the support disc 77 (it is assumed here to fix the ideas that the support disc 77 is fixed during this operation). The gears 78a and 78d rotate the shaft 44 through the head 79. The rotation of the shaft 44 causes the translation of the elongate flexible medical organ by the mechanism described above.
    [0014] As can be seen in FIG. 3, in practice, the various mechanisms are concealed and guided by covers 83 and 84 respectively of the indwelling portion and the movable portion. The covers have the same access openings as previously described, and define bearings for the shafts of the different gears. On the other hand, since the inner face 76 of the belt is designed to engrain with the gear 73, and the opposite outer face 88 is designed to engrain with the gears 78a-d, each is shaped for the gearing, e.g. being provided with teeth corresponding to the teeth of the different gears. Figure 8a shows an initial position of the drive module. During a preparation phase, the single access opening 89, constituted by the various access openings 93, 81, 82 aligned, allows the insertion of the elongate flexible medical device into the module, into the module. interior space 40 in particular between the belts 50 and 51. In the rotational drive system, the elongated flexible medical member passes through the passage zone 105, and at the translational drive system, Elongated flexible medical organ passes through the passage zone 107. To generate a pure translation drive movement, the rotational drive motor 19 is blocked. The drive of the translation drive motor 20 generates movement of the belt 66 along its path. The arcuate portion 68 causes the gears 78a and 78d to rotate about their axis, resulting in the translation of the elongate flexible medical organ along the axis 23. The elongate flexible medical organ 6 may be removed at at any time via the access apertures 93, 81 and 82. To generate a rotational driving motion, the rotation motor 19 rotates the belt 30, which causes rotation of the moving assembly 22 around of the axis 23. The driving surface portions 38a-38d are arranged such that, irrespective of the relative orientation of the moving element 22 and the base 21, at least one of these portions 38a 38d is in cooperation relation with the belt 30. For example, starting from the starting position of FIG. 7, the portions 38b and 38c are engaged with the belt 30. During a control of a rotational movement in the clockwise direction in this figure, the portion 3 8c will gradually come out of engagement with the belt 30, until the portion 38b alone ensures the transmission of movement. Then, the portion 38a will begin to cooperate with the belt 30, arriving at the position where the portion 38b is in FIG. 7. Thus, the angular extent of the arcuate portion 30 'is at least equal to However, it is at most equal to 360 ° minus the angular aperture of the opening 93, so as not to be narrower than the opening 93 itself. During this same movement, the gears 78a and 78d roll on the belt 66, until one of the gears, here the gear 78d, comes out of the arcuate portion 68. Moreover, one can wish prohibit translational movement of the elongate flexible medical organ during rotational control. In this case, it is arranged that the relative orientations of the shaft 44 and the elongate flexible medical member 6 in the moving assembly are unchanged (i.e. shaft 44 relative to frame 43). This can be achieved by controlling the translation motor so that the belt 66 travels a corresponding distance to avoid rotation of the gears 78a-d relative to the support disk 77.
    [0015] This is particularly noticeable by comparing FIGS. 8a and 8b, where arrow markers have been added to the various moving components, to illustrate their orientations relative to the different positions.
    [0016] Thus, if the operator wishes to control a pure rotational movement of the elongate flexible medical organ 6, the two motors 19 and 20 are controlled in predetermined ratios. During the rotation of the moving assembly 22, the elongated flexible medical organ 6 remains captive between the belts 50 and 51 which transmit to it the rotational movement imparted to the moving assembly. Of course, it would be possible to simultaneously control a translation and a rotation of the elongate flexible medical member 6, in which case only the rotation motor 19 can be controlled, or the two motors 19 and 20 are controlled in a different ratio than the predetermined ratio allowing pure rotation. As can be seen in FIG. 8b, in this position the removal of the elongated flexible medical organ 6 via the access openings 89, 93 is not possible because they are closed respectively by the belt 66 and the belt 30 of the indwelling party. However, the access opening remains unique. Also, to remove the elongate flexible medical member 6 from the module from this position, the rotation motor is controlled to rotate in the proper direction, for example towards the position of Fig. 8a. If removal of the elongate flexible medical member 6 from the module is to be effected without translational movement thereof within the patient, the translation motor is also controlled in the predetermined ratio to generate the pure rotation movement. If, in the position of FIG. 8b, it is desired to drive the elongate flexible medical device 6 in translation, the rotational drive motor 19 is blocked, and the translation drive motor 20 is controlled as explained previously. In the position shown, the arcuate portion 68 in the belt 66 causes rotation of the gear 78a and the gear 78b, but more than that of the gear 78d as before. Regardless of the relative orientation of the moving assembly 22 and the base 21, it is expected that at least one gear 78a-d will be in driving relationship with the circular arc portion 68 of the belt 66. This property defines the minimum angular range of the arcuate portion 68 of the belt 66 according to the number and arrangement of the gears 78a-78d. Thus, in the square configuration, the minimum angular extent of the arcuate portion 68 of the belt 66 is at least 90 °. To ensure, in the example presented, 180 ° is provided. The following figures represent other embodiments. These embodiments are not again represented in their entirety, and there is shown mainly the portion that replaces the plate 90, or even the belt 30, as the case may be. FIG. 9 thus represents a second embodiment. This embodiment has the particularity of having two distinct configurations, an access configuration and a drive configuration. The plate 90 is replaced by a disk 95 having an access opening 96 communicating with the interior space 40. The access opening 96 has any desirable angular aperture. The disk 95 has no drive portion. A drive ring 97 is attached to the disk 95, for example by clamping. The ring 97 comprises an outer peripheral surface 97b intended to cooperate with the belt 30. The ring 97 is made in two portions 98a and 98b removable 35 relative to each other. For example, a first portion 98a, made permanently on the disk 95, does not close the access opening 96. A second portion 98b is associable with the first portion 98a in a drive configuration. In this configuration, the second portion 98b closes the access opening 96. By "plugging" the access opening, it is meant that a catheter is not insertable into / removable from the interior space 40 radially via the access opening. It can thus be considered that this second portion 98b forms a plug.
    [0017] The combination of the second portion 98b and the first portion 98a is removably by any appropriate means, such as for example by clipping. In the access configuration, shown, where the two portions are not assembled, the two ends of the portion 98a define an access opening 93 whose angular opening is at least 30 °, and may be the order of 180 °, as shown, or more. Thus, when it is desired to remove the elongated flexible medical device, it suffices to disassemble the removable portion 20 of the drive ring to allow access to the interior space via the access opening. In the configuration of use, the training surface is continuous over 360 °, guaranteeing a good training. Alternatively, as shown in Fig. 16, the second portion 98b is not necessarily attached directly to the first portion, but to the plate 95 itself. As can be seen in this figure, in this variant, the angular aperture of the access opening 93 may be small.
    [0018] Alternatively, as shown in FIG. 10, a belt 30 having a large radius of curvature at its arcuate portion 30 'is not necessarily used. The plate 95 carries four rollers 99a-99d whose centers are arranged on a circle centered on the axis 23.
    [0019] Each roller itself has a radius, so that the sum of this radius and the circle above corresponds to the radius of the arc of the arcuate portion 30 'of the belt 30. Two rollers 99a and 99d disposed on either side of the access opening 93 are spaced apart by an angular opening at least equal to 30 °, but not too high to ensure that at least one of the rollers co-operates always with the belt 30, regardless of the relative orientation of the base 21 and the moving element 22.
    [0020] Figure 11 shows a variant of Figure 7, with six drive portions 38a-38f instead of four. The embodiment of FIG. 12 differs from the previous embodiments in that a belt 30 is no longer used. This belt is replaced by two separate rotary drive control members 100a, 100b. where appropriate enslaved to each other. These two members 100a, 100b are, for example, small friction rollers driven in rotation by the gear 35 either directly or indirectly. The plate 95 comprises a peripheral driving surface 38 cooperating with the two rollers 100a and 100b. An access opening 93 of wide angular opening allows removal / insertion of the catheter. The angular difference between the rollers 100a, 100b, seen from the axis 23, is greater than the angular aperture of the access opening 93. Thus, regardless of the relative orientation of the moving assembly 22 and of the base 21, at least one of the rollers 100a, 100b is in contact with the driving surface 38, in particular when the other of the rollers is facing the access opening 93. According to yet another embodiment of embodiment, as shown in FIG. 13, described with reference to the embodiment of FIG. 12, the two rollers 100a and 100b are replaced by a belt 30. The angular aperture 35 of the arcuate portion of the belt 30 is 3032622 27 greater than the angular aperture of the access opening 93. Thus, whatever the relative orientation of the moving element 22 and the base 21, a portion of the belt 30 is in contact with the surface of the training 38.
    [0021] The embodiment of FIGS. 14a and 14b is based on the principle of a ring 97 which can be placed in two configurations: a drive configuration (FIG 14b) where it has a closed peripheral drive surface 38, and a configuration of FIG. access (Fig. 14a) where it has a wide access opening 93. One difference from the embodiment of FIG. 9 is that portion 98b of the ring, alternately closing or allowing radial access to the catheter, is not fully removable, and remains assembled to portion 98a in the configuration of the catheter. 'access. The portion 98b may thus have two edges 101a, 101b projecting axially relative to a main body of the portion 98b, and each retained in a groove 102a, 102b, forming a slide, respectively, of the portion 98a of the plate 95, in the access configuration. Note that such a cap system could optionally be used to alternately close or open the access to the interior space elsewhere than at the level of the rotational drive system, for example at the level of the control system. translation training. Figure 15 shows an alternative embodiment to the belt or roller drive 100a, 100b. Here two discs 103a, 103b are provided axially offset from one another and defining between them a slot 104 in which the disc 95 is inserted. The two discs 103a and 103b are concentric, and can be rotated by the gearing 35. A spring 104 'presses them towards each other. Their rotation about the axis of the gear 35 frictionally drives the rotation of the disc 95 about the axis 23. If the opening 93 is extended as shown, another disk system 103a and 103b elsewhere, not shown, as is done with the rollers 100a and 100b. The connection areas 93a-c to the frame are identified. 5
    权利要求:
    Claims (14)
    [0001]
    REVENDICATIONS1. An elongate axis medical drive module according to an axis of extension for a robotic system 5 comprising - a base (21) carrying at least one rotational drive control member (30), - a rotatably mounted mobile assembly relative to the base (21) about an axis of rotation (23), and defining a receiving space (40) for the elongated medical device, the movable assembly (22) comprising a drive system rotation (38) adapted to cooperate with at least one rotational drive control member (30), regardless of the relative orientation of the moving gear (22) and the base (21) around the rotation axis, the movable assembly (22) comprises a removable removable cap (98b), - in assembled position, for closing an access opening (93) to the receiving space (40), by which the elongate medical member is radially movable between a use pattern where it extends into the receiving space (40 ), and an outer configuration where it is external to the drive module, and prevent the radial displacement of the elongated medical member between its use pattern and its external configuration, and - in disassembled position, to open the opening access (93) and authorize this move. 30
    [0002]
    2. Drive module according to claim 1, wherein the plug (98b) carries a portion of the rotational drive system (38).
    [0003]
    3. An elongate medical drive module according to claim 1 or 2 wherein the rotational drive system (38) comprises an elongate medical passage area (105) corresponding to the passage location of the elongated medical organ through the moving assembly (22), and a plurality of rotational drive portions (38a-d) distributed about the axis of rotation, adapted to cooperate each with at least one a rotational drive control member (30), the rotational drive portions (38a-d) being disposed in a drive configuration such that at least one of the rotational drive portions (38a-d) d) cooperates with at least one of the rotational drive control members (30) irrespective of the relative orientation of the moving assembly (22) and the base (21) about the axis of rotation, access opening (93) extending from the receiving space (40) between two portions rotating drive (38a-d).
    [0004]
    An elongate medical unit driving module according to claim 3, wherein the access opening (93) comprises an angular aperture of at least 30 ° measured measured in a plane normal to the axis of rotation (23) between two straight lines (D1, D2) extending from the passage zone (105) to each of the two adjacent drive portions (38a, 38d) in access configuration. 25
    [0005]
    5. Drive module according to one of claims 1 to 4, further comprising a translation drive system (106) of the elongated medical device, carried by the movable assembly (22), comprising at least one surface (49, 51) adapted to be brought into contact with the elongate medical device, and adapted to be set in motion relative to the movable element (22) to translate the elongate medical organ in translation along the the axis of elongation, said surface (49, 51) being further adapted to grip the elongate medical device to drive it 3132622 31 ci in rotation about the axis of rotation (23).
    [0006]
    6. Drive module according to claim 5, wherein the moving element (22) comprises a frame (39) supporting at least one rotating member (44, 48, 78a-d, 80a-b) of the system drive in translation, the rotary drive system (38) being integral with the frame (39).
    [0007]
    The drive module of claim 6, wherein the access opening (93) is a first access opening, wherein the frame (39) carries the translation drive (106), the translational drive system (106) including an elongate medical passage zone (107) corresponding to the passage location of the elongate medical organ through the moving assembly (22), and a plurality of translation drive portions (78a-78d) distributed around the axis of rotation (23), each adapted to cooperate with at least one translational drive control member (66) of the base (21), the translational drive portions (78a-78d) being disposed in a driving configuration so that at least one of the translation drive portions (78a-78d) cooperates with at least one of the drive control members in translation (66) regardless of the relative orientation of the crew movable (22) and base (21) about the axis of rotation (23), a second access opening (81) extending from the receiving space (40) between two drive portions translation (78b, 78c) adjacent, the second access opening (81) comprising an angular aperture of at least 30 ° measured projected in a plane normal to the axis of rotation (23) between two straight lines (D3, D4 ) extending from the passage area (107) to each of the two adjacent drive portions (78b, 78c) in the access configuration. 3032622 32
    [0008]
    A drive module according to claim 7, wherein the first and second access openings (93, 81) are superimposed in projection normally to the axis of rotation (23), irrespective of the relative orientation of the the moving element (22) and the base (21).
    [0009]
    9. Training module according to one of claims 5 to 8, wherein the plug is adapted to alternately close or open access to the interior space at the translation drive system.
    [0010]
    The drive unit according to one of claims 1 to 9, wherein the rotational drive system (38) comprises a junction portion (92), and at least two arms (91a-91d) extending on either side of the receiving space (40) and each connected to the joining portion (92).
    [0011]
    11.Drive module according to one of claims 1 to 10, wherein at least one or even each access opening (93, 81) has an angular aperture at least equal to 45 °, in configuration access, or at least equal to 90 °.
    [0012]
    A drive unit according to one of claims 1 to 11, wherein the rotational drive control member (30) comprises a drivable belt for traversing a path along the base (21), said path comprising an arcuate portion (30 ') centered on the axis of rotation (23), and of greater angular extent than the angular aperture, and less than 360 ° minus the angular aperture.
    [0013]
    13.Drive module according to one of claims 1 to 12, wherein the removable cap (98b) comprises a drive surface (97b) in rotation adapted, in the assembled position, to cooperate with at least one control member driving in rotation (30) in drive configuration. 3032622 33
    [0014]
    14. The drive module according to one of claims 1 to 13, wherein the plug (98b) is kept movable on the moving element between the assembled configuration and the disassembled configuration. 5
    类似技术:
    公开号 | 公开日 | 专利标题
    FR3032622A1|2016-08-19|MEDICAL MEMBER TRAINING MODULE EXTENDED
    WO2014135808A1|2014-09-12|Module for driving a robotic catheterisation system
    EP1189539B1|2003-09-10|Endoscopic surgical instrument
    EP1792638B1|2009-06-03|Winder/unwinder for catheters and system of arteriography comprising such a winder/unwinder
    WO2014096731A1|2014-06-26|Module for driving a catheterization system
    EP2567670A1|2013-03-13|Module and method for driving elongate flexible medical instruments and associated robotic system
    EP0097086B1|1986-12-30|Linearly guided examination table
    EP2822446B1|2016-12-07|Motorised and modular instrumentation device and endoscopy system comprising such a device
    EP2964306A1|2016-01-13|Medical robot in particular for guiding elongate flexible medical parts
    EP3154465A1|2017-04-19|Robotized module for guiding an elongate flexible medical device
    WO2006061356A1|2006-06-15|Valve for a surgical or medical instrument
    EP3399937A1|2018-11-14|Robotizable module for driving an elongated flexible medical member, medical robot and system including such a module
    FR2462904A1|1981-02-20|HEADREST FOR TREATMENT CHAIR, IN PARTICULAR DENTAL ARMCHAIR
    FR2875123A1|2006-03-17|POSITIONING SYSTEM ON A PATIENT OF AN OBSERVATION AND / OR INTERVENTION DEVICE
    FR2872446A1|2006-01-06|Sealed double-door transfer system e.g. for confinement chamber has doors fitted with internal actuators and peepholes for viewing
    EP3307194A1|2018-04-18|Robotic method for driving a catheter and a catheter guide
    FR3081317A1|2019-11-29|DEVICE AND PINCH ARRANGEMENT FOR A MEDICAL INSTRUMENT
    FR2610562A1|1988-08-12|Articulated handling gripper with five degrees of freedom
    EP3954311A2|2022-02-16|Device for guiding a medical needle
    FR3081318A1|2019-11-29|HOLDING DEVICE AND METHOD FOR LOCKING THE HOLDING DEVICE
    FR3095942A1|2020-11-20|Device for guiding a medical needle
    EP3624724A1|2020-03-25|Protective envelope for a robotic module for drivinga flexible elongate medical element with guide track
    FR2602664A1|1988-02-19|Radiographic film holder for dentistry
    EP3307195A1|2018-04-18|Chain for transmitting movement between actuators and the base of a member for driving a movable element
    BE473864A|
    同族专利:
    公开号 | 公开日
    FR3002852B1|2016-04-01|
    FR3002852A1|2014-09-12|
    US20170239004A1|2017-08-24|
    FR3032622B1|2021-09-24|
    US9687304B2|2017-06-27|
    US10149728B2|2018-12-11|
    WO2014135813A1|2014-09-12|
    US20160008077A1|2016-01-14|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    WO2005117596A2|2004-06-03|2005-12-15|Navicath Ltd.|Transmission for a remote catheterization system|
    EP1792638A2|2005-11-30|2007-06-06|Philippe Bencteux|Winder/unwinder for catheters and system of arteriography comprising such a winder/unwinder|
    US20090082722A1|2007-08-21|2009-03-26|Munger Gareth T|Remote navigation advancer devices and methods of use|
    WO2009137410A1|2008-05-06|2009-11-12|Corindus Ltd.|Catheter system|
    US20110130718A1|2009-05-25|2011-06-02|Kidd Brian L|Remote Manipulator Device|
    IL123646A|1998-03-11|2010-05-31|Refael Beyar|Remote control catheterization|
    US6817973B2|2000-03-16|2004-11-16|Immersion Medical, Inc.|Apparatus for controlling force for manipulation of medical instruments|
    EP1442720A1|2003-01-31|2004-08-04|Tre Esse Progettazione Biomedica S.r.l|Apparatus for the maneuvering of flexible catheters in the human cardiovascular system|
    US20050004579A1|2003-06-27|2005-01-06|Schneider M. Bret|Computer-assisted manipulation of catheters and guide wires|
    US7620476B2|2005-02-18|2009-11-17|Irobot Corporation|Autonomous surface cleaning robot for dry cleaning|
    US7389156B2|2005-02-18|2008-06-17|Irobot Corporation|Autonomous surface cleaning robot for wet and dry cleaning|
    US9833293B2|2010-09-17|2017-12-05|Corindus, Inc.|Robotic catheter system|
    FR3002852B1|2013-03-07|2016-04-01|Robocath|MEDICAL MEMBER TRAINING MODULE EXTENDED|FR3002852B1|2013-03-07|2016-04-01|Robocath|MEDICAL MEMBER TRAINING MODULE EXTENDED|
    US20140276936A1|2013-03-15|2014-09-18|Hansen Medical, Inc.|Active drive mechanism for simultaneous rotation and translation|
    FR3022788A1|2014-06-27|2016-01-01|Robocath|ROBOTIC SYSTEM FOR ARTERIOGRAPHY, ROBOT AND FLEXIBLE ORGAN EXTENDED FOR SUCH A SYSTEM|
    FR3037269B1|2015-06-12|2017-07-14|Robocath|MOVEMENT TRANSMISSION CHAIN BETWEEN ACTUATORS AND A DRIVE MEMBER BASE OF A MOBILE ELEMENT|
    EP3417901A1|2017-06-20|2018-12-26|Siemens Healthcare GmbH|Autonomous catheterization assembly|
    NL1043050B1|2018-10-23|2020-06-02|Soteria Medical B V|Device for moving and rotating an elongated body such as a catheter under remote control|
    法律状态:
    2016-02-22| PLFP| Fee payment|Year of fee payment: 4 |
    2016-07-12| PLFP| Fee payment|Year of fee payment: 5 |
    2016-11-25| PLSC| Publication of the preliminary search report|Effective date: 20161125 |
    2017-01-06| CA| Change of address|Effective date: 20161202 |
    2017-01-26| PLFP| Fee payment|Year of fee payment: 5 |
    2018-01-29| PLFP| Fee payment|Year of fee payment: 6 |
    2019-01-30| PLFP| Fee payment|Year of fee payment: 7 |
    2020-01-29| PLFP| Fee payment|Year of fee payment: 8 |
    2021-02-24| PLFP| Fee payment|Year of fee payment: 9 |
    2022-02-23| PLFP| Fee payment|Year of fee payment: 10 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1352062A|FR3002852B1|2013-03-07|2013-03-07|MEDICAL MEMBER TRAINING MODULE EXTENDED|
    FR1651123A|FR3032622B1|2013-03-07|2016-02-12|ELONGATED MEDICAL ORGAN TRAINING MODULE|FR1651123A| FR3032622B1|2013-03-07|2016-02-12|ELONGATED MEDICAL ORGAN TRAINING MODULE|
    [返回顶部]