 ROBOTISE MODULE OF SOFT MEDICAL MEDICAL TRAINING
专利摘要:
The elongated flexible medical robot training module comprises a pair (33) of drive members (24, 24 ') in a drive configuration. The pair (33) of driving members (24, 24 ') is movable between first and second positions. A control member (18, 11) controls a movement of the drive members (24, 24 ') in drive configuration from the first to the second position. the driving surfaces (34, 34 ') of the driving members (24, 24') are engaged with the elongate flexible medical member by means of a continuous film (42) 公开号:FR3036972A1 申请号:FR1655248 申请日:2016-06-08 公开日:2016-12-09 发明作者:Bruno Fournier；Sebastien Deboeuf；Jacques Marignier；Ines Ouali；Philippe Bencteux 申请人:Robocath； IPC主号:
专利说明:
[0001] ROBOTISE MODULE FOR MEDICAL TRAINING OF SOFT MEDICAL MEMBER. The present invention relates to robotized training modules for elongated flexible medical organs. Manual insertion of a catheter or guide 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. 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 difficult. This one bathes indeed in liquid of conservation and must remain sterile. Moreover, it is desired to be able to control reciprocating and / or simultaneous translation and rotation movements of the catheter. The reliability of these robotic systems is a determining factor. 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. Although this configuration is very satisfactory, it is always sought to simplify this type of mechanism in order to increase its reliability. To this end, according to the invention, there is provided an elongated flexible medical robot drive module comprising: - a base, - a pair of drive members each having a driving surface, the pair of driving members being alternately locatable in a driving configuration in which the driving surfaces of the driving members of the pair of driving members are engaged with the flexible medical member elongated at driven and arranged on either side of it, and in a free configuration in which the driving surface of the drive members of the pair of drive members is not engaged with the member flexible medical elongated, the pair of drive members being movably mounted relative to the base according to a degree of freedom between a first and a second positions, a control member adapted to repeatedly control cycl it moves relative to the base of the driving members of the pair of driving members in drive configuration from the first to the second position, thereby causing the flexible medical member elongated with respect to the base, and moving relative to the base of the drive members of the pair of free-form drive members from the second to the first position without driving the flexible medical member elongate with respect to the base. Thanks to these arrangements, the drive of the elongated flexible medical device, even on long and complex trajectories, can be implemented by a repetition of simple elementary displacements on the scale of the robot. The operation of the robot is therefore possible regardless of the path to be traveled to the catheter. In preferred embodiments of the invention, one or more of the following arrangements may also be used: the displacement relative to the base of the driving members of the invention; the first position in the second position comprises a combination of: a translation of the drive members relative to the base in a direction parallel to the local longitudinal direction of the elongated flexible medical member, a translation of the drive members by in a direction transverse to the local longitudinal direction of the elongated flexible medical organ and in opposite directions, a translation of the drive members relative to the base in a direction transverse to the local longitudinal direction of the base; flexible medical organ elongated and in the same direction, a translation of the drive members 20 relative to the base in a direction transverse to the local longitudinal direction of the elongated flexible medical organ and in the same direction; - one, two or three members of the combination are void; The degree of freedom between the first and second positions is a first degree of freedom, in which the pair of drive members is also mounted movable relative to the base in a second degree of freedom different from the first degree of freedom between the first and third positions, the control member being adapted to cyclically repeat a movement with respect to the base (132) of the drive train drive members from the first to the third position, 35 thereby causing the flexible medical organ elongated at the base, and a displacement relative to the base of the free-form drive members from the third to the first position without causing the flexible medical organ relative to the base ; the displacement relative to the base of the drive members from the first position to the position and the displacement relative to the drive members from the first to the position comprise two distinct combinations a translation of the drive members relative to at the base in a direction parallel to the local longitudinal direction of the elongate flexible medical organ, a translation of the drive members 15 relative to the base in a direction transverse to the local longitudinal direction of the elongated flexible medical organ and in opposite directions, a translation of the drive members relative to the base in a direction transverse to the local longitudinal direction of the elongated flexible medical organ and in a same direction, a translation of the drive members relative to the base in a direction transverse to the local longitudinal direction of the elongated flexible medical organ and in the same direction second base of the third among: - the translation of the drive members relative to the base in a direction transverse to the local longitudinal direction of the elongate flexible medical organ and in opposite directions is adapted to allow a rolling of the flexible medical organ lying on the driving surfaces around the local longitudinal direction of the medial organ elongated soft callus; the pair of drive members is movable from its free configuration to its drive configuration by relative movement of the drive members relative to the base; the first and second positions define a first degree of freedom, wherein the pair of driving members is also movably mounted relative to the base in a third degree of freedom from its free configuration to its driving configuration; the base is a first base, the pair of drive members is a first pair of drive members, the robotic module further comprising: a second base, a second pair of driving members each having a driving surface, the second pair of driving members being alternately locatable in a driving configuration in which the driving surfaces of the driving members of the second pair of driving members are engaged with the elongated flexible medical member to be driven and arranged on either side thereof, and in a free configuration in which the driving surface of the drive of the second pair of drive members is not engaged with the elongated flexible medical member, the second pair of drive members being movably mounted relative to the second base according to a degree of freedom between first and second positions,. the control member being further adapted to repeatedly cyclically control a displacement relative to the base of the driving members of the second pair of driving members in a drive configuration from the first to the second position thereby causing the flexible medical organ elongate with respect to the second base, and moving relative to the second base of the drive members of the second pair of free-standing drive members from second to first position without causing the medical flexible member 3036972 6 relative to the second base; the first base and the second base are integral or common; the control member is adapted to control the movements of the drive members of the first pair and of the second pair in a synchronized manner; the control member is adapted to place the driving members of the first pair and of the second pair simultaneously in drive configuration; - The control member is adapted to place the drive members of the first pair and the second pair simultaneously in free configuration; the control member is adapted to simultaneously place the drive members of the first pair and of the second pair for one in training configuration and for the others in free configuration; the second pair of drive members has certain characteristics described above; The robotic drive module further comprises a expendable disposable continuous film comprising an attachment portion for each drive member, and flexible portions between two adjacent attachment portions, each drive member being attached to an attachment portion of the continuous film, the drive surfaces being engaged with the elongate flexible medical member through the continuous film; the robotic drive module comprises a closed housing including the base and the drive members, and having an upstream lumen and a downstream lumen through which the elongate flexible medical organ extends; the housing also comprises a connecting member of any drive member to an external motor 3036972 7 to the housing; the housing comprises a receptacle and a lid movable relative to the receptacle between a closed configuration where an access by an operator to the elongate flexible medical organ inside the housing is prohibited, and an open configuration where access by a operator to the flexible medical organ elongated inside the housing is possible; - The case is a disposable consumable. According to another aspect, the invention relates to an arteriography robot comprising a container, an elongated flexible medical organ at least partially contained in the container, a robotic drive module attached to the container, and adapted for training. of the flexible medical organ elongated out of the container. Other features and advantages of the invention will become apparent from the following description of one of its embodiments, given by way of non-limiting example, with reference to the accompanying drawings. [0002] In the drawings: FIG. 1a is a schematic side view of a robotic arteriography device. FIG. 1b is a top view of part of FIG. 1a; FIG. 2 is a diagrammatic view from above of a robot used in the installation of FIGS. 1a and 1b; FIGS. 3a-3c are illustrative diagrams of the modes of movement of the members to be driven, - Figures 4 and 5 are simplified kinematic diagrams of the actuation of a drive member, - Figure 6 is a schematic perspective view of a portion of a 7a to 7e are simplified diagrams illustrating a translational driving cycle of the catheter according to one embodiment; FIGS. 8a to 8e are simplified diagrams illustrating a rotation cycle of the catheter 5 according to one embodiment, - Figures 9a to 9f are simplified diagrams illustrating a translational drive cycle of the catheter according to one embodiment, - Figure 10 is a sim FIG. 11a is a front plan view of a module according to one embodiment, FIG. 11b is a top plan view of the module of FIG. 11a, FIG. FIG. 13 is a diagrammatic front view of an actuating member; embodiment of the actuating system; FIG. 14b is a detail view of FIG. 14a; FIG. 15 is a kinematic diagram of an exemplary translation drive according to an exemplary embodiment; FIG. a plane view in the plane XZ of an example of an actuator; FIGS. 16b and 16c are two sections in distinct planes transverse to the plane XZ of the example of the actuator of FIG. 16a; FIG. a plan view of an actuation system in two dimensions, - Figures 18a to 18m have simplified diagrams illustrating a portion of a "crank" drive cycle of the elongated flexible medical device according to one embodiment. In the different figures, the same references designate identical or similar elements. [0003] Figure 1a schematically illustrates an arteriography facility 1. The arteriography facility 1 is divided into two distinct locations, an operating room 2 and a control room 3. The control room 3 may be close to the room 10 2, separated from it by a single wall 4, X-ray opaque, or remote. The equipment of the operating room 2 and the control room 3 are interconnected functionally, wired, wireless or network, .... [0004] The operating room 2 comprises an operating table 5 receiving a patient 6. The operating room 2 may also comprise a medical imager 7, in particular an X-ray imager, comprising a source 8 and a detector 9 arranged with both sides of the patient, possibly moving relative to the patient. The arteriography facility 1 comprises a robot 10 disposed in the operating room 2. The arteriography facility 1 comprises a control station 11 arranged in the control room 3. The control station 11 is adapted to remotely control the robot 10. The arteriography facility 1 may also include, arranged in the control room 3, one or more remote controls 12 of the imager 7, communicating with the imager 7 to control it at 30 distance. The arteriography facility 1 may also comprise, arranged in the control room 3, a screen 13, communicating with the imager 7, to visualize in real time in the control room 3 the images acquired by the imager 7. [0005] The robot 10 may comprise a container 14 adapted to contain an elongated flexible medical organ 15 to be introduced into the body of a patient. As an elongated flexible medical device 15, it may for example be an organ to be introduced into a patient's canal, and to move in this channel, in particular an artery or a vein of a patient, through a gap leaving access opening in the patient. The elongated flexible medical organ may in particular be a catheter. Alternatively, the elongated flexible medical organ may be a catheter guide. A guide is generally of smaller transverse diameter than that of the catheter, which is generally hollow on a portion close to the patient, or even over its entire length, so that the guide can move inside it, especially within the body of the patient. The guide may also include a curved end, as will be described in more detail below. The robot 10 may comprise a drive module 16 of the elongate flexible medical device 15. The drive module 16 is controllable from the control station 11 to drive the elongate flexible medical device relative to the patient according to less a degree of freedom, as will be described in detail later. The training module may comprise a communication box 17 for interfacing with the control station 11. If necessary, the robot 10 may comprise a control box 18 locally, for controlling the robot from the control room. 2 operations if necessary. It should be noted that all the commands and returns available in the control room 3 may also be available in the operation room 2 for local operation, such as an imager control 19, for example. and a screen 20 for displaying the images acquired by the imager 7. The hollow elongate flexible medical organ can be connected to a connector 56 for injecting a contrast medium facilitating imaging at the same time. interior of the elongated flexible medical organ. The arteriography facility may comprise a contrast agent injector 57 connected to the control-controllable connector 56 located in the control room 3. A control 59 of the contrast agent injector may also be present in the control chamber. 2. As shown in Figure 2, purely illustrative, there is shown in more detail the container 14 receiving a catheter 15 '. The container 14 keeps the catheter 15 'in a medium suitable for its preservation. The drive module 16 is adapted for driving the catheter 15 '. In the example, it is provided that the container 14 also receives a guide 15. The container 14 keeps the guide 15 "in a medium suitable for its preservation. The drive module 16 'is adapted for driving the guide 15. Depending on the applications, the drive modules 16, 16' may be identical or different and may be according to one of the embodiments of the invention. In the example shown, the guide 15 "can be introduced into the catheter 15 'at the rear end 15'b thereof, and protrude from the front end 15a. of the catheter as shown. In what follows, the reference 15 will be used alternately to designate the guide 15 ", the catheter 15 ', or generally an elongated flexible medical organ to be introduced into the body of a patient. Such an interventional catheter may be of smaller diameter than the catheter, so as to be guided inside the catheter, coaxially inside the patient, and be hollow so as to be guided over the catheter. guide inside the patient. [0006] Figure 3a shows the various degrees of freedom possible with the present system. The guide 15 "is shown with its front end 15" slightly curved with respect to the main longitudinal axis of the guide, and opening through the front end 15'a of the catheter 5 '. The catheter 15 'can be subjected to two distinct movements: - A translation along its longitudinal axis, - A rotation about its longitudinal axis. These movements can be generated in one direction or the other. Where appropriate, the catheter 15 'may be subjected to a combined movement of the two simple movements described above. If desired, the catheter 15 'may be subjected to two combined movements of the two simple movements described above, in different combinations. What has been described above regarding the catheter also applies to the guide. In some cases, the catheter itself is provided with a curved end, either to allow navigation on the same principle as a guide, or to facilitate positioning in an anatomical area having a particular curvature. In Figure 3b, there is shown an artery 21 of a patient 25 comprising a main trunk 22 and two branches 23a, 23b opening on the main trunk. Figure 3b illustrates the movement of an elongated flexible medical organ 15 (here a guide 15 ") in translation between a retracted position shown in dotted lines and an advanced position shown in solid lines, in Figure 3c in the same artery. there is shown a rotation of the elongated flexible medical organ 15 between a first position, shown in dashed lines, where the elongated flexible medical organ is ready to be translated in the direction of the branch 23a, and a second 3036972 13, shown in solid lines, where the elongated flexible medical organ is ready to be translated in the direction of the branch 23b The elongated flexible medical organ can be driven according to the movement or movements described above by The drive members may be arranged in pairs, and according to one embodiment, a given drive member may be actuated. by an actuator. [0007] Referring to Fig. 4, there is disclosed a drive member 24 actuated in a single direction Z. The drive member 24 includes an actuating surface 25 normal to the Z axis. The actuator 26 comprises an actuating rod 27 including an end 27a for biasing the actuating surface 25 in the Z direction. The driving member 24 is freely movable in the Y direction without loss of contact with the actuating rod 27 The end 27a of the actuating rod 27 slides with respect to the actuating surface 25 in the direction Y. For example, it is provided that the actuating rod 27 is integral with a carriage 28 slidably mounted according to the invention. Y direction on rails 29 secured to the drive member 24. [0008] Under these conditions, if the actuating surface 25 of the drive member 24 is moved in direction Y, no movement of the carriage 28, and therefore of the actuator 26, is generated. With the actuator end 27a in the Z direction downward (in FIG. 4), a movement of the drive member 24 in the Z direction downwards is generated. The range of movement of the carriage 28 relative to the drive member 24 in the Y direction is preferably limited so that at each location in this range of movement, the end 27a of the drive rod 3036972 14 remains in engagement with the actuating surface 25 of the drive member 24. For a downward movement in FIG. 4, it suffices for the actuator 26 to extend with respect to its fixed reference. For an upward movement, it is enough that it is shortened. As can be seen in FIG. 5, the mechanism which has just been described can be duplicated so as to allow free movement of the drive member 24 throughout the XY plane, and actuation in the only Z direction. FIG. 4 then corresponds to the first stage of a mechanism described in FIG. 5, the second stage of which makes it possible to drive the drive member in the direction Z but not in the direction X. To do this, one may use a carriage 28 'movable along rails 29' along the axis X relative to the drive member 24 and carrying a connecting rod 27 'cooperating with an intermediate surface connected to the rails 29. [0009] Under these conditions: - A shortening of the actuator 26 in the direction Z causes a displacement of the drive member 24 in the direction Z upwards, - an elongation of the actuator 26 in the direction Z allows a displacement of the drive member 24 in the Z direction downwards, - A displacement of the drive member 24 in the X direction causes no further movement, - A displacement of the drive member 24 30 in direction Y causes the carriage 28 'to move in the direction Y relative to the carriage 28. The actuating system 55 described in FIG. 5 allows actuating of the drive member 24 in a single Z direction until the carriages 28, 28 'do not come out of the associated rails. [0010] The actuating system 55 is for example based on electromagnetic or piezoelectric actuators, for example. A similar actuation system 55 'can be provided for actuating the driving member 24 in a single direction X. To do this, it suffices to rotate the system shown in FIG. Y axis, the rails 29 'of this system then being secured to an actuating surface 31 of the drive member 24 which is normal to the axis X. A similar actuating system can be provided for actuating the drive member 24 in a single direction Y. It suffices to rotate the system shown in Figure 5 by 90 ° around the axis X, the rails 29 'of this system being then integral with an actuating surface 32 of the drive member 24 which is normal to the Y axis. In another embodiment, the double carriage principle is replaced by a set 200 (see FIG. 16 ) composed of an interface piece 201, for example of cylindrical shape, sandwiched between plates 202a and 202b, themselves held together with each other, for example by means of two pieces 203a and 203b, the distance between the two inner surfaces 204a and 204b of the plates 202a and 202b being substantially equal to the thickness of the interface piece 201. In order to allow the axis 27 of the actuator 26 to pass, an opening, for example of substantially rectangular or square shape 205, is formed in the plate 202a. An action of the actuator 26 along the axis Z then causes the corresponding displacement of the actuating surface 25 of the drive member 24, integral with the plate 202b along the axis Z. Simultaneously, the assembly 200 can move freely along the X and Y axes, the actuator 26 35 remaining stationary along these two axes. To allow this relative sliding movement between the interface piece 201, on the one hand, and the assembly 200, on the other hand, the interface piece 201 must be able to slide with the least amount of friction possible on the surfaces 204a and 204b. For this purpose, materials with a very low coefficient of friction can be used. For example - but this is not limiting - the interface piece 201 may be made of aluminum, and the parts 202a and 202b in a plastic material containing polytetrafluoroethylene (PTFE). In order to drive the drive member 24 along one or two axes, X and Z, two actuators 26x and 26z are used simultaneously (see FIG. 17), placed in the directions: Z for the actuator 26z and 15 X for the 26x actuator. The drive shaft of the actuator 26z is connected, via a rod 27a, to an interface piece 201. The drive shaft of the actuator 26x is connected, via from a rod 27a 'to an interface piece 201'. The axes 27b and 27b 'of the actuators are fixed relative to the base of the system. The interface piece 201 is held by the assembly 200. The interface piece 201 'is held by the assembly 200'. A plate 204 secures the assemblies 200 and 200 'to each other. The drive member 24 is fixed on the plate 204 on the face opposite to the contact face between the assembly 200 and the plate 204. In this case, a movement of the actuator 26z, along its axis of Z work, causes a corresponding movement of the driving surface along the same axis Z. At the same time, this causes a sliding of the assembly 200 'relative to the interface part 201', this piece of interface 201 'remaining stationary. Reciprocally, a movement of the actuator 26x along its axis X will cause a corresponding displacement of the drive member 24 along the X axis, the interface piece 201 3036972 17 remaining stationary. Finally, a simultaneous movement of the actuators 26z and 26x will cause a combined movement of the drive member along the X and Z directions. The principle of a two-axis displacement 5 described above can be extrapolated to the three dimensions of the space by replacing the plate 204 by a cube 204 'and placing three actuators 26x, 26y and 26z held by three sets, these three sets being fixed on three adjacent faces of a cube 204, and the drive member 10 24 being placed on any one of the other three faces. The three actuators being integrally connected to the base of the system by respective axes, a movement of their respective axis 27 in each associated direction is transmitted to the driving surface 24, which will reproduce these movements, successive or concurrent. Thus, the drive member can occupy any position (X, Y, Z) defined by the three windows in space and follow any path, but its surface maintains a constant orientation. Its range of motion is defined both by the maximum stroke of 26x, 26y and 26z actuators, the size of the apertures, as well as the dimension of the interface pieces. Whatever the position of the elongated flexible medical organ, an emergency withdrawal thereof away from the robotic module is therefore always possible. A practical implementation will be described later in connection with FIGS. 14a and 14b. It has thus been presented a system for actuating a driving finger in 3 directions independent of the space. In Figure 6, there is shown a drive module 131 according to a first embodiment. This drive module 131 is adapted to drive an elongated flexible medical member 15 extending in a longitudinal direction X. It will be appreciated that the longitudinal direction X at the drive module 131 is not necessarily the same. than that of the elongated flexible medical member 15 at its end but that a translation and / or a rotation of the elongated flexible medical organ 15 along / about the longitudinal direction X at the level of the drive module 131 will cause a translation and / or rotation of the elongated flexible medical member 15, respectively, according to / around its longitudinal direction at its end. [0011] The drive module 131 comprises a base 132 and at least one drive member 24 mounted to move relative to the base 132. The drive member 24 is, for example, mounted to move relative to the base 132 as explained herein. above in relation to FIG. [0012] In the example shown, the drive module 131 further comprises a second drive member 24 '. The drive member 24, also hereinafter referred to as the first drive member, and the second drive member 24 'together form a pair of drive members 33. A pair of drive members 33 comprises two driving members which cooperate together to generate a movement of the elongate flexible medical member relative to the base 132. In the example shown, the second drive member 24 'is movably mounted relative to the base 132. The second drive member 24 'is for example movably mounted relative to the base 132 as explained above in connection with Figure 5. The first drive member 24 and the second drive member 24 are paired for simultaneous movements. For example, the first and second drive members 24, 24 'can be controlled individually independently of one another, but according to respective synchronized commands. Alternatively, a common control may be provided which will be distributed to both first and second drive members 24, 24 'by a mechanical or electronic connection between their control systems. Each drive member 24, 24 'has a drive surface 34, 34' respectively. The elongate flexible medical organ 15 is disposed between the drive surfaces 34, 34 'of the drive members 24, 24' of the same pair. For the sake of clarity, the drive surfaces 34, 34 'are spaced from each other in the Y direction. The pair of drive members 24, 24' can be placed in a free configuration, shown in Fig. 6, in which the driving surface 34, 34 'of the driving members 24, 24' of the pair of driving members 33 is not engaged with the elongated flexible medical member 15 The pair of drive members 33 is locatable in a driving configuration in which the driving surfaces 34, 34 'of the driving members 20 of the pair of driving members are engaged with the drive member. elongated flexible medical organ 15 to be trained. The force applied by a drive member on the elongated flexible medical device in this configuration is for example of the order of a few Newtons (5-30 N for example). The return means, described above, are for example arranged to return the pair of drive members in free configuration, which provides a safe function, for example in case of power failure. [0013] To place the pair of drive members 33 alternately in the free and drive configurations, relative movement of the two drive members 24, 24 'relative to each other can be controlled. This displacement may for example be the displacement of one drive member 24 relative to the base, the other 3036972 remaining fixed. Alternatively, the two drive members 24, 24 'can both move towards each other with respect to the base. In the example, a displacement in the direction Y is provided. In the embodiment shown, the two drive members 24, 24 'are movable relative to the base according to a degree of freedom. This degree of freedom differs from that allowing the alternative placement of the drive members between the free and drive positions. In particular, it is provided that the drive members 24, 24 'are movable relative to the base according to a degree of freedom in their drive configuration. Thus, the displacement of the drive members according to a degree of freedom in their drive configuration generates a displacement of the elongated flexible medical organ with respect to the base 132. An example will be described in more detail below in connection with with Figures 7a to 7e. This example describes the generation of a translational movement of the elongate flexible medical organ along its longitudinal direction X. The starting position, shown in FIG. 7a, corresponds to that of FIG. 6 described above. In a first step, the free configuration shown in FIG. 7a is changed to the drive configuration (FIG. 7b). According to the example, this passage is made by a movement in opposite directions of the two drive members in the Y direction. The amplitude of this movement may depend on the elongated flexible medical member 30 to be driven. A guide, smaller in diameter than the catheter, may require movement of greater amplitude than the catheter from the same starting position. In the drive configuration, a simultaneous movement in the same direction of the drive members 30 in longitudinal direction X is generated in a first direction, which generates an identical movement of the elongate flexible medical device 15 (FIG. ). We move from the drive configuration 5 shown in Figure 7c to the free configuration (Figure 7d). According to the example, this passage is made by a movement in opposite directions of the two drive members in the direction Y, in the direction opposite to the direction for moving the drive members from the drive configuration to the configuration. free. In free configuration, a simultaneous displacement (or not) in the same direction of the drive members in the longitudinal direction X is generated in a second direction opposite to the first direction, which does not generate any movement of the flexible medical device. elongated 15 (Figure 7e). We then returned to the initial configuration. The above steps can be repeated in a cyclically controlled manner to generate a translation of the elongated flexible medical organ along a long stroke (for example of the order of several meters) in the longitudinal direction X in the first direction. The displacement of the elongate flexible medical organ along a long stroke in the longitudinal direction X in the second direction can be done by a series of operations opposite to that just described. The frequency of the cycle can be adjustable and controllable. In particular, it is possible to provide a low frequency for the introduction of the elongated flexible medical organ into the patient, or even several low frequency levels, in particular to allow slow navigation in difficult environments. A fast frequency can be provided, for example for a withdrawal or an emergency withdrawal. The displacement amplitudes for each cycle may also be adjustable. [0014] For the translation, speeds of between 0.1 and 200 millimeters per second are possible. An example will be described in more detail below in connection with FIGS. 8a to 8e. This example describes the generation of a rotational movement of the elongate flexible medical organ about its longitudinal direction X. The starting position, shown in FIG. 8a, corresponds to that of FIG. 6 described above. In a first step, the free configuration 10 shown in FIG. 8a is changed to the driving configuration (FIG. 8b). According to the example, this passage is by a movement in opposite directions of the two drive members in the direction Y. This passage is the same as already described in relation to Figures 7a, 7b above. In the drive configuration, a simultaneous displacement in opposite direction of the drive members is generated in a direction Z transverse to the longitudinal direction X, different from the direction Y, which generates a rotational movement of the flexible medical device In particular, the elongated flexible medical member rolls, preferably without sliding, on the driving surfaces 34, 34 'of the driving members 24, 24'. Alternatively, one could move one of the two drive members, the other remaining fixed. We move from the drive configuration shown in Figure 8c to the free configuration (Figure 8d). According to the example, this passage is made by a movement 30 in opposite directions of the two drive members in the direction Y, in the direction opposite to the direction to move the drive members from the drive configuration to the configuration free. In free configuration, a simultaneous movement (or not) of the Z-direction drive members 35 opposite to the displacement described above in relation to FIG. 8c is generated, which does not generate any movement of the elongated flexible medical organ 15 (FIG. 8e). We then returned to the initial configuration. [0015] The above steps can be repeated in a cyclically controlled manner to generate a rotation of the elongated flexible medical organ along a long stroke (for example several times 360 °) around the longitudinal direction X in a first direction of rotation. [0016] The displacement of the elongate flexible medical organ along a long stroke about the longitudinal direction X in the second direction of rotation opposite to the first one can be done by a series of operations opposite to that which has just been described. [0017] In the above description, the degree of rotation of the free end of the flexible medical organ within the patient's body can be monitored by imaging. However, one can alternatively or additionally seek to control upstream the amplitude of the rotation applied to the flexible medical organ at the drive module. This requires knowledge of the diameter of the flexible medical organ elongated at the drive members 24, 24 '. Indeed, the angle of rotation of the elongated flexible medical member for a given displacement of the actuating members depends on the ratio between the diameter of the elongate flexible medical organ and the stroke of the driving members. This diameter can be predefined and stored in the control station 11. It is sufficient to first inform the control station 11 of the type of catheter used, the type in question comprising the diameter. Alternatively, the diameter of the elongate flexible medical organ can be detected in situ. If the free configuration of each drive member constitutes a reference position, it is possible to know the position of the drive member in training configuration for example by using a coding system on the actuator associated with the drive. each drive member and for moving the drive member from its free configuration to its drive configuration. By knowing the position of the two drive members in drive configuration, and knowing the gap between the drive surfaces 34, 34 'of the two drive members in their free configuration, the difference can be determined. between the two driving surfaces in drive configuration and thereby the diameter of the elongate flexible medical member. This knowledge can also be used to detect the end of a withdrawal movement of the elongated flexible medical member. Indeed, if the control station 11 detects a sudden change in the diameter detected over time during withdrawal control of the elongated flexible medical organ, it presumably means that the elongated flexible medical organ has been fully withdrawn. the patient, and even the module. The diameter then detected may be either zero or for example the diameter of the guide if it then extends between the two drive members. It is also possible to control the tightening of the elongated flexible medical member into a driving configuration. Indeed, in drive configuration, the current applied to the actuators is proportional to the clamping force applied to the elongated flexible medical device. Knowledge of this current therefore makes it possible to determine the clamp applied to the catheter. In practice, it will be possible to provide at the control station 11 different current setpoints for the actuators, arranged in an acceptable clamping range outside of which there is a risk of either sliding the elongated flexible medical member 35 out of engagement, or to damage the flexible medical organ elongated by excessive mechanical stress by the drive members. Control of the tightening of the elongated flexible medical organ can be done for any movement applied to the catheter, not just for the rotational movement described above. The determination of the diameter of the elongated flexible medical organ could be made for other catheter displacement implementations than the cyclic repeat commands described herein. Thus, independently of the cyclic repeat commands described herein, it would appear that another invention relates to an elongated flexible medical organ driver module comprising: a base 132, a pair of drive members 24, 24 'each having a driving surface 34, 34', the pair 33 of driving members 24, 24 'being displaceable by at least one actuator 26 in a driving configuration in which the surfaces of drive 34, 34 'drive members 24, 24' of the pair 33 of drive members 24, 24 'are engaged with the elongated flexible medical member to be driven and arranged on both sides of the here, the pair 33 of drive members 24, 24 'being movably mounted relative to the base 132 according to a degree of freedom between a first and a second position, - a control member 18, 11 adapted to control from a representative signal relating to the actuation 26 (for example repeatedly cyclic) a displacement relative to the base 132 of the drive members 24, 24 'of the pair 33 of drive members 24, 24' in drive configuration of the first to the second position, thereby causing the flexible medical organ elongated with respect to the base 132. [0018] In particular, the representative signal relating to the actuator makes it possible to determine a spacing between the driving surfaces 34, 34 ', the control member 18, 11 controlling a displacement determined from the relative spacing. at the base 132 of the drive members 24, 24 'of the pair 33 of drive members 24, 24' thus causing a controlled amplitude rotation of the flexible medical organ elongated with respect to the base 132. [0019] In particular, the representative signal relating to the actuator makes it possible to control a clamping force applied to the elongate flexible medical device within a permissible range of clamping forces. In both of the above embodiments, there is described a sequenced movement during which it is expected to complete the movement of a driver in one direction to initiate another movement. However, since the actuations of the driving members according to various degrees of freedom can be made independent by independently using the three actuating systems 55, 55 ', 55 "described above, it would be possible to implement At the same time, the displacement of a drive member with two degrees of freedom, for example, the displacement of the drive members from the position of FIG. 8c to that of FIG. 8e could include an intermediate phase between a first phase. pure spacing and a second phase of pure return to the initial position, where these two movements are combined. [0020] A similar intermediate phase can also be envisaged between the position of FIG. 8d and the position of FIG. 8b between the pure return to the initial position phase and a pure approach phase. By pulling the line, one could have no more phases of pure return to the initial position, pure spacing and pure approximation, insofar as there is no risk of generating parasitic movements of the elongated flexible medical organ. . On the other hand, while a pure translational movement of the elongated flexible medical organ has been shown independently in FIGS. 7a-7e, and in FIGS. 8a-8e a pure rotational movement, these two movements could alternatively be combined. . It would be sufficient, in the engaged configuration, to combine the adapted movements of the drive members to simultaneously generate translation and rotation. The previous example comprises a single pair of drive members. Alternatively, one could provide several pairs of drive members. For example, for descriptive purpose, one could provide two pairs of drive members. The drive members 24 ", 24" 'of the second pair 33' may be similar to those of the first pair, and in particular have drive surfaces 34 ", 34" ', and be actuated from the station remote control 11 or even the local control unit 18 according to implementations similar to those of the first pair. The first pair 33 and the second pair 33 'of driving members may be offset relative to each other along the longitudinal axis X of the elongated flexible medial member. According to a first example, the two pairs 33, 33 'may be provided coplanar in their free configuration. That is, they can be provided for a base 132 common to both pairs. [0021] Alternatively, the bases 132, 132 'of each pair could be independent or even non-coplanar. The operations of the two pairs can be synchronized. For example, the actuation of the two pairs can generate identical simultaneous movements of the two pairs. [0022] In a variant, the two pairs can be actuated synchronously to generate phase-shifted motions. That is, a first pair 33 may be in drive configuration while another pair is in free configuration, and vice versa. For example, there is always at least one pair in training configuration. At any given moment, it can be the first, the second, or both at the same time. Such a configuration makes it possible to improve the maintenance of the elongated flexible medical organ. In particular, when the elongated flexible medical device is moved while rubbing against an anatomical zone of the patient, it must be possible to maintain it sufficiently to overcome local resistance to movement. This is made all the more difficult when the elongated flexible medical member is slippery, for example because of its retention in a solution. An example is given for illustration in Figures 9a to 9f for a drive mode in translation. [0023] In these figures, a fixed reference over time is designated by the sign "+". The movement of the first pair, shown in Figures 9a to 9e has already been described above in relation to Figures 7a to 7e. Figure 9f shows the same position as Figure 9b, the displacement being cyclical. Figures 9b to 9f show the displacements of the second pair 33 'during a cycle. These displacements are out of phase with those of the first pair, the position illustrated in Figure 9d for the second pair corresponding to that of Figure 9b for the first pair, and so on. The two pairs are spaced so as to avoid any collision, particularly as shown in FIG. 9e, where the second pair is moved in the direction of advance of the elongated flexible medical organ 3036972 29 and where the first pair is moved in the opposite direction. By way of illustration, FIG. 9a may represent an initial state in which the two pairs are located away from the elongated flexible medical organ. When starting up the system, the first pair will be controlled and then, out of phase, the second pair. This implementation applies for other movements than translation. This implementation applies for more than two pairs. In this case, the pairs are, if appropriate, all out of phase with each other, or some pairs may be in phase with each other. Figure 15 depicts a concrete example of synchronization of the two pairs 33, 33 '. The cycle below is described with reference to the first pair 33, knowing that the pair 33 'is in phase opposition with respect thereto. Step 0: acceleration to reach the target speed; step 1: the speed being reached, it is maintained at a constant level and the clamping order is started, with the objective of attaining the effective tightening before the end of step 1; during this time, the second pair 33 'is still at full speed, with clamping enabled - Step 2: remaining in clamping and constant speed; at this time, the second pair 33 'receives the loosening command, which will be effective after a certain delay (related to the mechanical and electronic response time of the whole system); in total, we can consider that we have had a period of simultaneous training by the two pairs starting between the beginning of step 1 and the beginning of step 2, and ending between the beginning of the step 2 and the beginning of step 3. Step 3: remaining in clamping and constant speed; during this time, the second pair 33 'returns to its original position - Step 4: it remains in clamping and constant speed; during this time, the second pair 33 'waits, still, at its original position; this waiting time is variable as a function of the reference speed of translation and rotation, and also of the total cycle time. Step 5: it remains in clamping and constant speed; the second pair 33 'arrives at the beginning of its cycle, that is to say the equivalent of step 0 for the first pair 33. - Step 6: it remains in constant tightening and speed; the second pair 33 'ends its acceleration and arrives at the beginning of the step at a constant speed (equivalent of step 1 for the first pair 33) - Step 7: the release command is sent, while keeping the speed constant; indeed, the order of loosening will necessarily take a certain time to be effective, and it is therefore necessary to continue at a constant speed during this time - Step 8: it is considered that the loosening is now effective, and it sends the order of return to the initial position, in view of the next cycle - Step 9: the return being effective, the initial position is expected until the beginning of the next cycle. In the case where the diameter of the elongate flexible medical organ is detected with at least two pairs of drive members, it is possible to detect that the end of a step of withdrawing the elongated flexible medical organ is reached. if two pairs of drive members can determine different diameters. This will occur when an upstream pair still detects the presence of the flexible medical organ 30 elongated between its drive members and a downstream pair no longer detects it (no longer detects either a guide or nothing). Such detection makes it possible to stop controlling the downstream drive members if it is not intended that these drive the guide. Furthermore, independently, such a detection makes it possible to stop, if necessary, a complete withdrawal of the elongated flexible medical organ, which makes it possible, if necessary, to re-insert the elongated flexible medical organ into the patient. without manual intervention to re-engage the flexible medical organ elongated in the training module. In the embodiments described above, the drive members are symmetrically disposed with respect to a median general plane of the elongated flexible medical organ. However, alternatively, the drive members may be movably mounted relative to the base 132 to laterally offset the locally elongated flexible medical organ 20 relative to its neutral longitudinal axis X '. The neutral longitudinal axis X 'is defined by the longitudinal axis naturally occupied by the elongate flexible medical organ without any biasing by drive members 24. Such a lateral shift is possible by generating a simultaneous movement of the organs of FIG. drive 24, 24 'in a configuration engaged in the same direction in a transverse direction (Y or Z axis, or a combination along these two axes) with respect to the configuration engaged at the level of the neutral longitudinal axis. [0024] If necessary, if more than one pair of drive members are used, they can be arranged in an engaged configuration with different lateral offsets with respect to the neutral longitudinal axis. It is then possible to implement a "crank" type actuation. [0025] Fig. 18a is a front view corresponding to the configuration of Fig. 10 taken in the plane of the first pair of drive members 24, 24 'shown in Fig. 10. The elongated flexible medical member in this plane is shown in solid lines. The position of the flexible medical organ elongate in the plane of the second pair of drive members is shown in dashed lines. The same code solid lines / dotted lines is applied to the second pair of drive members 10 is in training configuration for the following description (Figures 18a to 18m). Figures 18a to 18m describe an implementation for this mode. As in Fig. 10, the two pairs of drive members are shown one behind the other. The pair (24 ", 24" ') behind is shown in dotted lines. The elongate flexible medical organ is shown twice, in the form of two sections, one 304 at the first pair (in the foreground), solid line, and the other at the second pair 20 drive units (in the background), in dotted lines: - 18a: initial position. - 18b: right shift of the first pair - 18c: the barycentre of the first pair (24, 24 ') describes an arc around the axis defined by the flexible medical organ elongated in Figure 18a. Simultaneously, the two pairs have a translation movement along Z, each drive member having a direction opposite to the other drive member of the same pair. For each element of the first pair (24, 24 '), we see that the trajectory is the vector sum of a rectilinear trajectory and a circular trajectory. As a result, two rising curves are obtained, with however a smaller radius of curvature 35 for the curve 300 of the drive member 24 than the curve 301 of the drive member 24 '. This is because the trajectory of the drive member 24 is the sum of an arc of a circle identical to the trajectory 302 of the elongated flexible medical organ, directed approximately upwards, and a trajectory rectilinear downwards, identical to the trajectory 303 of the actuator 24 ", and directed downwards, - 18d: return of the first pair to the original position, so that the elongated flexible medical member is 10 again guided in a straight line, - 18e: loosening of the first pair, the second pair remaining tight, - 18f: following movement Z of the two drive members of the first pair, in opposite directions, in order to obtain a Z end position symmetrical of the initial position with respect to the elongated flexible medical organ, - 18g: tightening of the first pair, - 18h: loosening of the second pair, the first pair remaining tight, - 18i: movement of the first pair, second pair following Z identical to 18f for the first pair, - 18j: tightening the second pair, - 18k: return of the first pair of actuator 25 to the final position of 18c, - 181: similar movement 18c but on a different arc [to note that it would be possible to always use the same arc of circle, rather than using a succession of arcs of circles which will form a complete circle, as presented here]. - 18m: return of the first pair to the position, as in 18d, - Etc ... The implementation which has just been described 3036972 34 schematically represents a non-limiting example of combined implementation of displacements of two organs d training of the same pair according to two degrees of freedom combined, successive implementation of 5 displacements of two drive members of the same pair according to two different degrees of freedom, combination of the implementation of two pairs independent of training organs. An example of practical implementation of such a system is presented below in connection with Figures 14a and 14b. This exemplary embodiment is provided illustratively only of a concrete embodiment of an actuating system. Figure 14a includes a fixed base 132 common to four actuating systems. Each actuating system controls the displacement of a respective driving member, not shown, but integral with a respective cube 60, 60 ', 60 ", 60"'. The cubes 60, 60 ', 60 ", 60"' respectively correspond to the drive members 24, 24 ', 24 ", 24"' in Fig. 9a, substantially in the same orientation. Subsequently, only the operation of a cube will be described. For example, reference is made to the cube 60. The cube 60 is associated with three actuators 26x, 26y, 26z (the latter not visible, similar in all respects to the actuators 26x and 26y, and located under the base 132. Actuator 26y is used to move the cube 60 "in the Y direction, while allowing a displacement of the cube 60" both in the X and Z directions with respect to the actuator 26y within a certain range of movement. in Figure 14b, the actuator 26y has an end secured to a disc 61 of large diameter.This disc 61 is placed in a slot 62 formed between the cube 60 "and a plate 63 integral therewith. [0026] In particular, the thickness of slot 62 and disc 61 correspond to one another so that a surface 61a of the disc is in contact with the cube 60 "and an opposite surface 61b is in contact with the plate 63. The arm 64 passes through a window 65 formed in the plate 63. The window 65 is shaped such that the disk 61 can not leave the slot 62 through the window 65. The window 65 defines the range allowed displacement of the cube relative to the actuator 26y in directions Y and Z. [0027] The other actuators have a similar configuration according to their respective orientations. Therefore, when extending the actuator 26y, the disk 61 pushes on the cube 60 "in the Y direction, and generates a displacement thereof in this direction. the disk 61 pulls on the plate 63 in the direction Y, and generates a displacement of the cube 60 "integral therewith along this direction. These displacements are allowed in the range of movement allowed by the windows of the plates associated with actuators 26x and 26z. When another actuator, for example the actuator 26x, generates a displacement of the cube 60 "in the X direction in the same way, this displacement is possible within the limit allowed by the dimension of the window 65 in the direction X ( and ditto for the plate associated with the actuator 26z in this example.) Figures 11a and 11b show a robotic drive module 16 comprising a housing 35 housing the actuating members 24, 24 '. openings permitting the passage of the actuating rods 27. Alternatively, it will be noted that the rod, shown in FIG. 11b with the reference 27, is not necessarily an actuating rod, but may simply be a rod for transferring movement, secured to one end of the actuating member 24. [0028] In this case, it is the other end of this motion transfer rod which is subjected to actuation by the actuating systems 55, 55 ', 55 "as described above. an upstream face 35a and a downstream face 35b each comprising a lumen 36 allowing passage of the elongate flexible medical organ The lumen 36 may be in the form of a slot to allow the emergency removal of the organ flexible medical elongated. [0029] If, according to the example shown, several pairs of actuating members which are offset with respect to one another along the longitudinal axis X are used, two pairs of successive actuating members can be separated by one intermediate wall 37 of the housing. The intermediate wall 37 may also include a lumen for passage of the elongate flexible medical organ, which lumen is delimited by an edge capable of forming a support zone of the elongated flexible medical organ. The housing 35 comprises a fastening system 38 for fixing the housing 35 to a support, for example fixed to the container 14. Any type of attachment is possible, removable or not, for example by clipping or electromechanical locking. The housing 35 also includes a sterile barrier 39 which will be described in more detail hereinafter. The sterile barrier 39 may be integral with the housing 55. The sterile barrier 39 separates the space into two subspaces, a sterile subspace 40 including the elongated flexible medical organ 15, and a subspace that is not necessarily sterile. 41. In the example presented, the actuating members 24, 24 'are arranged in the not necessarily sterile subspace 41. That is to say that the actuating members 24, 24' cooperate with the flexible medical organ elongated through the sterile barrier 39. [0030] For example, the sterile barrier 39 comprises a continuous film 42 comprising an attachment portion 43 for each drive member 24, 24 ', and flexible portions 44 between two adjacent attachment portions. Each driver 24, 24 'is attached to an attachment portion 43 of the continuous film 42, the drive surfaces 34, 34' being engaged with the elongated flexible medical member 15 via the film 42 continuous. As can be seen in FIG. 13, provision is made, for example, for the flexible portions 44 to be secured to a hooking peg 45. The flexible portions 44 are, for example, overmolded onto the hooking pegs 45. hooking 45 is assembled by any appropriate means to the drive member 24, such as for example by clipping in the subspace not necessarily sterile 41. [0031] The driving surface 46 of the latching pin 45, in contact with the elongated flexible medical member 15, may be specially adapted for this contact. For example, it is formed, striated, fleece and / or has a coating adapted to this contact. [0032] The flexible portions 44 are sufficiently long and flexible to allow the relative movements described above for the drive members 24, 24 'without impediment or deterioration of the sterile barrier 39. [0033] The catching pegs 45 may include frangible areas 53 such as arms connecting the drive surface 46 to the clipping portion 54. After an intervention, when the sterile barrier is removed, the frangible areas 53 are broken. This mechanism provides security to prevent, if necessary, reinstalling a used sterile barrier for later intervention. The housing 35 may include a receptacle 47 and a cover 48 movable relative to the receptacle 47 between a closed configuration where operator access to the elongated flexible medical member 15 within the housing 3036972 38 is prohibited, and a open configuration where an access by an operator to the flexible medical organ elongated within the housing is possible. Figure 12 shows a possible intermediate position between these 5 configurations. The lumen 36 can be opened to allow this placement in two distinct configurations, the elongated flexible medical organ. For example, the lumen 36 has an L shape, a first leg 49 having an opening 50 for disengaging the elongated flexible medical member 15 from the lid 48, and a second leg 51 having a support surface 52 for the organ flexible medical elongated 15 in closed configuration. The housing 35, possibly including the actuators, may be constructed as a disposable consumable. The configuration described above facilitates the emergency removal of the elongate flexible medical organ 15 from the robotic module, since it can, at any stage of the movement, be easily removed from the module for manipulation at the same time. hand. The implementation of a sterile barrier between the elongate flexible medical device and the drive members is particularly well suited to the above embodiment which provides for low amplitude movements of the drive members, thereby allowing to attach the sterile barrier and absorb the movements by deformation of the soft portions. Alternatively, however, other embodiments may be provided wherein the sterile barrier is disposed directly between the elongated flexible medical organ and the actuators, thereby minimizing sterilization operations and / or consumables to be changed between two operations. Alternatively, for this invention, the sterile barrier could therefore not be attached to the drive members, but only adapted, and the drive members could be subjected to large amplitude movements. Thus, independently of the above invention, it would appear that another invention relates to an elongated flexible medical robot drive module comprising: - a base, - a pair of drive members having Each a driving surface, the pair of driving members being locatable in a driving configuration in which the driving surfaces of the driving members of the pair of driving members are engaged with the driving member. elongate flexible medical organ 15 to be driven and arranged on either side thereof, the pair of drive members being movably mounted relative to the base according to a degree of freedom between a first and a second position, A control member adapted to control a displacement relative to the base of the driving members of the pair of drive members in a driving configuration, thereby causing the flexible medical organ elongated by providing a continuous film to the base, the drive surfaces being engaged with the elongated flexible medical member through the continuous film.
权利要求:
Claims (22) [0001] REVENDICATIONS1. An elongated flexible medical robot training module comprising: - a base (132), - a pair (33) of driving members (24, 24 ') each having a driving surface (34, 34') ), the pair (33) of driving members (24, 24 ') being locatable in a driving configuration in which the driving surfaces (34, 34') of the driving members (24, 24 ') of the driver pair (33) are engaged with the elongated flexible medical member to be driven and disposed on either side thereof, the pair (33) of wherein the drive (24, 24 ') is movably mounted relative to the base (132) in a degree of freedom between first and second positions, - a control member (18, 11) adapted to control a displacement relative to the base (132) of the drive members (24, 24 ') of the drive train pair (33), thereby driving the medical device or elongated with respect to the base (132), a continuous film (42), the drive surfaces (34, 34 ') being engaged with the elongated flexible medical organ through the continuous film. [0002] Robotic module according to claim 1, wherein the displacement from the base (132) of the driving members (24, 24 ') from the first position to the second position comprises a combination of: - a translation of the members driving (24, 24 ') with respect to the base (132) in a direction parallel to the longitudinal direction (X) local of the elongated flexible medical member, - a translation of the drive members (24, 24 ') relative to the base (132) in a direction (Z) transverse to the longitudinal longitudinal direction (X) of the elongated flexible medical organ and in opposite directions, - a translation of the drive members (24); , 24 ') with respect to the base (132) in a direction (Z) transverse to the longitudinal direction (X) local of the elongate flexible medical organ and in the same direction, - a translation of the drive members (24) , 24 ') with respect to the base (132) in a transverse direction (Y) at the d Local longitudinal irection (X) of the elongated flexible medical organ in a same direction. [0003] 3. Robotic module according to claim 2, wherein one, two or three members of the combination are null. [0004] Robotic module according to claim 1, wherein the pair (33) of drive members (24, 24 ') is alternately locatable in the drive configuration and in a free configuration in which the drive surface (34, 34 ') of the drive members (24, 24') of the pair (33) of drive members (24, 24 ') are not engaged with the elongated flexible medical member, said control member (18, 11) being adapted to repeatedly cyclically control said movement relative to the base (132) of the driving members (24, 24 ') of the pair (33) of driving members (24, 24 ') in the drive configuration from the first to the second position, and a displacement relative to the base (132) of the drive members (24, 24') of the pair (33) of driving members (24, 24 ') in free configuration from the second to the first position without causing the flexible medical organ elongated with respect to the b ase. 3036972 42 [0005] The robotic module according to claim 4, wherein the degree of freedom between the first and second positions is a first degree of freedom, wherein the pair (33) of driving members (24, 24 ') is also movably mounted relative to the base (132) according to a second degree of freedom differing from the first degree of freedom between the first and third positions, the control member (18, 11) being adapted to repeatedly control a displacement cyclically in relation to the base (132) of the driving members (24, 24 ') in the driving configuration from the first to the third position, thereby causing the elongate flexible medical member relative to the base (132), and moving relative to the base (132) of the drive members (24, 24 ') in a free configuration from the third to the first position without driving the flexible medical organ relative to the base (132). [0006] Robotic module according to claim 5, wherein the displacement relative to the base (132) of the drive members (24, 24 ') from the first position to the second position and the displacement relative to the base (132). ) drive members (24, 24 ') from the first to the third position comprise two distinct combinations of: - a translation of the drive members (24, 24') with respect to the base (132) in one direction parallel to the longitudinal longitudinal direction (X) of the elongate flexible medical organ; - a translation of the drive members (24, 24 ') relative to the base (132) in a direction transverse (Z) to the direction local longitudinal (X) of the elongated flexible medical organ and in opposite directions, - a translation of the drive members (24, 24 ') relative to the base (132) in a direction (Z) 3036972 43 transverse to the longitudinal (X) local direction of the elongated flexible medical organ and in a same direction, a translation of the drive members (24, 24 ') relative to the base (132) in a transverse direction (Y) to the longitudinal direction (X) local of the flexible medical organ lengthened and in one direction. [0007] Robotic drive module according to claim 4, 5 or 6, wherein the translation of the drive members (24, 24 ') with respect to the base (132) in a direction (Z) transverse to the direction. longitudinal axis (X) of the elongate and opposite flexible medical organ is adapted to allow rolling of the elongate flexible medical member on the driving surfaces (34, 34 ') about the longitudinal direction (X local) of the elongated flexible medical organ. [0008] A robotic drive module according to one of claims 4 to 7, wherein the pair (33) of drive members (24, 24 ') is locatable from its free configuration to its drive configuration by relative movement of the drive members (24, 24 ') relative to the base (132). [0009] Robotic drive module according to claim 8, wherein the first and second positions define a first degree of freedom, wherein the pair of drive members is also movably mounted relative to the base in a third degree. of freedom from its free configuration to its training configuration. [0010] A robotic drive module according to any one of claims 4 to 9, wherein the base (132) is a first base, the pair (33) of drive members (24, 24 ') is a first pair of drive members, the robotic module further comprising a second baSe (132 '), a second pair (33') of drive members (24 ", 24" ') each having a driving surface (34 ", 34" '), the second pair (33') of driving members (24 ", 24" ') being alternately locatable in a driving configuration in which the surfaces of drive (34 ", 34 '") of the drive members (24 ", 24"') of the second pair (33 ') of drive members (24 ", 24"') are engaged with the elongate flexible medical organ to be driven and arranged on either side thereof, and in a free configuration in which the driving surface (34 ", 34" ') of the drive members (24 ", 24 "') of the second pa (33 ') of drive members (24 ", 24" ") is not engaged with the elongate flexible medical member, the second pair (33') of drive members (24") , 24 "') being movably mounted with respect to the second base (132') according to a degree of freedom between a first and a second position, - the control member (18, [0011] 11) being further adapted to cyclically repeat a movement relative to the base (132 ') of the drive members (24 ", 24"') of the second pair (33 ') of drive (24 ", 24") in drive configuration from the first to the second position, thereby causing the flexible medical organ elongate with respect to the second base (132 '), and a displacement relative to the second base (132 ') of the drive members (24 ", 24"') of the second pair (33 ') of drive members (24 ", 24"') in free configuration from the second to the first position without driving the medical device flexible relative to the second base (32 ') - 3036972 45 11.The robotic training module according to claim 10, wherein the first base (132) and the second base (132' ) are solidary or common. [0012] Robotic drive module according to claim 10 or 11, wherein the control member (18, 11) is adapted to control the movements of the drive members of the first pair and the second pair in a synchronized manner. . [0013] The robotic drive module according to claim 12, wherein the controller (18, 11) is adapted to place the drive members of the first pair and the second pair simultaneously in drive configuration. [0014] 14. robotic drive module according to claim 12 or 13, wherein the control member (18, 11) is adapted for place r the drive members of the first pair and the second pair simultaneously in configuration free. [0015] Robotic drive module according to claim 12 or 13, wherein the control member (18, 11) is adapted to simultaneously place the drive members of the first pair and the second pair for each. training configuration and for others in free configuration. 25 [0016] Robot drive module according to one of Claims 10 to 15, in which the second pair (33 ') of drive members (24 ", 24"') has the characteristics of the pair (33). driving members (24, 24 ') described in any one of claims 4 to 9. [0017] A robotic drive module according to any one of claims 1 to 16, wherein the continuous film (42) is a disposable consumable comprising an attachment portion (45) for each drive member (45). 24, 24 '), and flexible portions (44) between two adjacent attachment portions (45), each drive member (24, 24') being attached to an attachment portion (45) of the film (42). ) continued. 5 [0018] A robotic drive module according to any one of claims 1 to 17, comprising a closed housing (35) including the base (132) and the drive members (24, 24 '), and including a light (36). and a downstream lumen (36) through which the elongate flexible medical organ extends. [0019] The robotic drive module of claim 18, wherein the housing (35) further comprises a link member (27) of any drive member (24, 24 ') to a motor external to the housing. 15 [0020] Robotic drive module according to claim 18 or 19, wherein the housing (35) has a receptacle (47) and a cover (48) movable relative to the receptacle (47) between a closed configuration where access by a Operator to the flexible medical organ 20 elongated within the housing (35) is prohibited, and an open configuration where access by an operator to the flexible medical organ elongated within the housing (35) is possible. [0021] 21. A robotic training module according to one of claims 18 to 20, wherein the housing (35) is a disposable consumable. [0022] 22.An arteriography robot comprising a container (14), an elongated flexible medical member (15, 15 ', 15 ") at least partially contained in the container (14), a robotic drive module (16) according to the present invention. one of claims 1 to 21 attached to the container (14), and adapted for driving the elongated flexible medical member (15, 15 ', 15 ") out of the container (14).
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同族专利:
公开号 | 公开日 EP3154466A2|2017-04-19| CN106488752B|2020-11-17| EP3154465A1|2017-04-19| CN106488752A|2017-03-08| CN106535808A|2017-03-22| WO2015189529A1|2015-12-17| JP6785665B2|2020-11-18| MX2016016401A|2017-10-16| BR112016028950A2|2017-08-22| US20170151024A1|2017-06-01| KR102352122B1|2022-01-18| FR3022147A1|2015-12-18| WO2015189531A2|2015-12-17| JP2017526397A|2017-09-14| JP2017518818A|2017-07-13| KR20170035887A|2017-03-31| CN106535808B|2020-06-19| KR20170032291A|2017-03-22| FR3036972B1|2021-08-20| WO2015189531A3|2016-05-19| FR3022147B1|2016-07-22| JP6783148B2|2020-11-11| US20220061933A1|2022-03-03| BR112016029077A2|2017-08-22| KR102329945B1|2021-11-23|
引用文献:
公开号 | 申请日 | 公开日 | 申请人 | 专利标题 US20090082722A1|2007-08-21|2009-03-26|Munger Gareth T|Remote navigation advancer devices and methods of use| US20120179167A1|2010-09-17|2012-07-12|Corindus Inc.|Robotic catheter system| EP2567670A1|2011-09-07|2013-03-13|Robocath|Module and method for driving elongate flexible medical instruments and associated robotic system| US20130172713A1|2011-12-29|2013-07-04|Mark B. Kirschenman|Drive assembly for use in a robotic control and guidance system| WO2014005689A2|2012-07-03|2014-01-09|Kuka Laboratories Gmbh|Surgical instrument arrangement and drive train arrangement for a surgical instrument, in particular a robot-guided surgical instrument, and surgical instrument| JP3174074B2|1991-01-08|2001-06-11|オリンパス光学工業株式会社|Surgical equipment| US8755864B2|2004-05-28|2014-06-17|St. Jude Medical, Atrial Fibrillation Division, Inc.|Robotic surgical system and method for diagnostic data mapping| JP2008541797A|2005-05-03|2008-11-27|ハンセンメディカル，インク．|Robotic guide catheter system| FR2893851B1|2005-11-30|2008-02-08|Philippe Bencteux|CATHETER ROLLER / DEROULER AND ARTERIOGRAPHY SYSTEM EQUIPPED WITH SUCH ROLLER / DEROULEUR| WO2008014425A2|2006-07-26|2008-01-31|Hansen Medical, Inc.|Systems for performing minimally invasive surgical operations| EP2124711A4|2007-03-16|2011-03-30|Univ Nanyang Tech|Method and apparatus for anorectal examination| EP3858416A1|2008-05-06|2021-08-04|Corindus, Inc|Catheter system| US8720448B2|2008-11-07|2014-05-13|Hansen Medical, Inc.|Sterile interface apparatus| WO2011028627A2|2009-08-26|2011-03-10|The Research Foundation Of State University Of New York|System and method for endovascular telerobotic access| US8460236B2|2010-06-24|2013-06-11|Hansen Medical, Inc.|Fiber optic instrument sensing system| CN101933837B|2010-07-08|2011-10-12|中国科学院自动化研究所|Minimally invasive vascular interventional surgical robot tube feeding device| CN103239793A|2013-05-17|2013-08-14|徐州医学院|Vessel intervention robot guide wire driving box|WO2018176458A1|2017-04-01|2018-10-04|中国科学院深圳先进技术研究院|Catheter advancing controlling method and catheter advancing device for vessel interventional surgery robot| CN107106244B|2017-04-01|2020-06-12|中国科学院深圳先进技术研究院|Catheter twisting device of vascular intervention surgical robot| FR3065164B1|2017-04-14|2019-05-10|Robocath|MODULE FOR TRAINING OF LONG-LASTING MEDICAL ORGANS| FR3066381B1|2017-05-16|2019-06-28|Robocath|PROTECTIVE ENVELOPE FOR A ROBOTIC MODULE FOR DRIVING AN ELONGATED MEDICAL DEVICE WITH A GUIDE TRACK| EP3417901A1|2017-06-20|2018-12-26|Siemens Healthcare GmbH|Autonomous catheterization assembly| KR102184889B1|2018-04-19|2020-12-01|엘엔로보틱스|Roller module for medical robot, driving apparatus for medical robot and medical robot| CN110236679B|2019-07-10|2020-07-21|北京唯迈医疗设备有限公司|Disinfection box of interventional operation robot|
法律状态:
2016-06-08| PLFP| Fee payment|Year of fee payment: 3 | 2017-02-24| PLSC| Publication of the preliminary search report|Effective date: 20170224 | 2017-05-30| PLFP| Fee payment|Year of fee payment: 4 | 2018-05-30| PLFP| Fee payment|Year of fee payment: 5 | 2019-05-28| PLFP| Fee payment|Year of fee payment: 6 | 2020-04-28| PLFP| Fee payment|Year of fee payment: 7 | 2021-04-22| PLFP| Fee payment|Year of fee payment: 8 |
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申请号 | 申请日 | 专利标题 FR1455330A|FR3022147B1|2014-06-12|2014-06-12|ROBOTISE MODULE OF SOFT MEDICAL MEDICAL TRAINING| FR1655248A|FR3036972B1|2014-06-12|2016-06-08|EXTENDED FLEXIBLE MEDICAL ORGAN TRAINING ROBOTISE MODULE|FR1655248A| FR3036972B1|2014-06-12|2016-06-08|EXTENDED FLEXIBLE MEDICAL ORGAN TRAINING ROBOTISE MODULE| 相关专利
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