CN115192181B - Sheath tube and catheter state control mechanical arm and linkage control system thereof - Google Patents
Sheath tube and catheter state control mechanical arm and linkage control system thereof Download PDFInfo
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- CN115192181B CN115192181B CN202210645737.3A CN202210645737A CN115192181B CN 115192181 B CN115192181 B CN 115192181B CN 202210645737 A CN202210645737 A CN 202210645737A CN 115192181 B CN115192181 B CN 115192181B
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- 238000013507 mapping Methods 0.000 claims abstract description 110
- 238000005452 bending Methods 0.000 claims abstract description 29
- 238000011282 treatment Methods 0.000 claims abstract description 27
- 238000002679 ablation Methods 0.000 claims description 95
- 238000003745 diagnosis Methods 0.000 claims description 17
- 238000000034 method Methods 0.000 claims description 16
- 210000005242 cardiac chamber Anatomy 0.000 claims description 8
- 230000004913 activation Effects 0.000 claims description 3
- 238000004891 communication Methods 0.000 claims description 3
- 230000001225 therapeutic effect Effects 0.000 claims description 3
- 230000002792 vascular Effects 0.000 claims description 2
- 230000002093 peripheral effect Effects 0.000 claims 1
- 238000007674 radiofrequency ablation Methods 0.000 abstract description 25
- 230000005855 radiation Effects 0.000 abstract description 10
- 230000000694 effects Effects 0.000 abstract description 7
- 230000005540 biological transmission Effects 0.000 description 82
- 238000012545 processing Methods 0.000 description 14
- 230000005284 excitation Effects 0.000 description 10
- 230000006793 arrhythmia Effects 0.000 description 9
- 206010003119 arrhythmia Diseases 0.000 description 9
- 210000001519 tissue Anatomy 0.000 description 8
- 238000001356 surgical procedure Methods 0.000 description 7
- 238000005516 engineering process Methods 0.000 description 5
- 210000005259 peripheral blood Anatomy 0.000 description 5
- 239000011886 peripheral blood Substances 0.000 description 5
- 230000002457 bidirectional effect Effects 0.000 description 4
- 206010028851 Necrosis Diseases 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 238000012549 training Methods 0.000 description 2
- 238000011298 ablation treatment Methods 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 238000013153 catheter ablation Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000002001 electrophysiology Methods 0.000 description 1
- 230000007831 electrophysiology Effects 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 210000003516 pericardium Anatomy 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 238000005086 pumping Methods 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/35—Surgical robots for telesurgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/303—Surgical robots specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
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Abstract
The invention provides a sheath tube and catheter state control mechanical arm and a linkage control system thereof, wherein the mechanical arm comprises: the first control component is connected with the sheath tube, and the axial movement, circumferential rotation and bending state of the sheath tube are controlled by controlling the movable state of the first control component; the second control assembly is connected with the catheter, and controls the axial movement, circumferential rotation and bending state of the catheter by controlling the activity state of the second control assembly. According to the invention, the two-way bending, rotation, front and back pushing and back withdrawing of the sheath tube and the catheter can be controlled through the mechanical arm, an operator can remotely control the two mechanical arms outside the treatment room through the remote control system, and the high-density mapping catheter, the radio frequency ablation catheter and the respective sheath tube are controlled in parallel, so that the electrophysiological operation is remotely performed, the X-ray radiation of the operator is greatly reduced, the operator can quickly grasp the catheter, and the doctor culture period is shortened.
Description
Technical Field
The invention relates to the technical field of medical devices, in particular to a sheath tube and catheter state control mechanical arm and a linkage control system thereof.
Background
Catheter radio frequency ablation is currently the most commonly used minimally invasive interventional technique for treating arrhythmias, the basic principle of which is: firstly, an operator sends a three-dimensional mapping catheter into a target heart cavity through a peripheral blood vessel, draws a three-dimensional model of a heart cavity through a three-dimensional mapping system, and marks the excitation origin and focus positions at the same time; then the radiofrequency ablation catheter is sent to a target heart chamber through peripheral blood vessels by guide sheaths with different lengths, under the guidance of a three-dimensional mapping technology, the origin focus of arrhythmia is precisely positioned, a columnar ablation electrode at the head end of the catheter is contacted with focus tissues by effective contact force, and then radiofrequency current is emitted by a loop electrode attached to the skin of the body surface of a patient.
The radio frequency current flows through the focal tissue below the electrode, heat is generated in the tissue, when the temperature reaches the extent of coagulation necrosis, the tissue permanently loses electrophysiological activity, arrhythmia is cured, therefore, the ability to control the exact position and direction of the catheter tip is crucial, and the practicability of the catheter is determined to a great extent.
When an operator clinically performs an ablation operation, firstly, a catheter access is established through percutaneous vascular puncture by utilizing a puncture needle and an introducer sheath, a mapping catheter is firstly conveyed into a target heart cavity under the guidance of perspective or three-dimensional images, then, under the guidance of electrophysiology and three-dimensional imaging technologies, the operator manually controls the mapping catheter outside a patient, performs position three-dimensional mapping on the position of an arrhythmia focus in the heart cavity, then establishes another catheter access in the same blood vessel by utilizing a second introducer sheath, the ablation catheter enters the target heart cavity through a catheter channel, and the operator manually controls the ablation catheter under the guidance of the three-dimensional images, so that an ablation electrode at the head end of the ablation catheter is attached to the target ablation position at an effective angle, and positioning and ablation of the arrhythmia focus are completed.
The catheter can not be accurately controlled through manual operation of an operator, so that the stability and the accuracy of the catheter are poor, the difficulty of the operator in the operation process and the manual operation of the catheter are very high, the electrophysiological operation is independently performed at present, 300-500 cases of operation training are conventionally required, the doctor has long culture period and long learning curve, the operation workload is high, the operation safety is easily affected due to fatigue of the doctor and unstable factors of personnel operation in the manual operation of the catheter, particularly, the pericardium is stuffed due to heart perforation in the operation process, and the manual operation of the catheter has a plurality of inconveniences and unsafe.
Disclosure of Invention
The invention provides a mechanical arm for controlling the state of a sheath pipe and a catheter and a linkage control system thereof, which aim to solve the technical problem of safely and reliably controlling the state of the sheath pipe and the catheter.
According to an embodiment of the invention, a sheath and catheter state control mechanical arm comprises:
a base;
The first control component is movably arranged on the base, is connected with the sheath pipe and controls the axial movement, circumferential rotation and bending state of the sheath pipe by controlling the moving state of the first control component;
The second control assembly is movably arranged on the base and connected with the catheter, and the axial movement, circumferential rotation and bending states of the catheter are controlled by controlling the moving state of the second control assembly.
According to the sheath and catheter state control mechanical arm disclosed by the embodiment of the invention, the states of the sheath and the catheter can be accurately and reliably controlled through the mechanical arm, and the operation is convenient. Moreover, the state of the sheath and catheter can be remotely controlled by the mechanical arm, thereby reducing X-ray radiation of the operator in the treatment room.
According to some embodiments of the invention, the first control assembly comprises:
The first driving assembly comprises a first motor and a first transmission shaft which is connected with the first motor in a matched mode, and the first transmission shaft is connected with a first mounting block on the base in a threaded mode;
When the first motor drives the first transmission shaft to rotate, the first transmission shaft is in threaded fit with the first mounting block, so that the first control assembly moves axially relative to the base, and the sheath tube is driven to move axially.
In some embodiments of the invention, the second control assembly comprises:
A second drive assembly, the second drive assembly comprising: the sheath tube is connected with the first motor through a first knob, and the sheath tube is connected with the second motor through a second knob;
when the second motor drives the second transmission shaft to rotate, the second transmission shaft drives the first knob to rotate, so that the sheath tube is driven to circumferentially rotate.
According to some embodiments of the invention, the first control assembly comprises:
A third drive assembly, the third drive assembly comprising: the sheath tube is connected with the first motor through a first knob, and the sheath tube is connected with the second motor through a second knob;
when the third motor drives the third transmission shaft to rotate, the third transmission shaft drives the second knob to rotate, so that the sheath tube is driven to bend.
In some embodiments of the invention, the second control assembly comprises:
The fourth driving assembly comprises a fourth motor and a fourth transmission shaft which is connected with the fourth motor in a matched mode, and the fourth transmission shaft is connected with a second installation block on the base in a threaded mode;
When the fourth motor drives the fourth transmission shaft to rotate, the fourth transmission shaft is in threaded fit with the second mounting block, so that the second control assembly moves axially relative to the base, and the guide pipe is driven to move axially.
According to some embodiments of the invention, the second control assembly comprises:
a fifth drive assembly, the fifth drive assembly comprising: the device comprises a fifth motor and a fifth transmission shaft which is matched and connected with the fifth motor, wherein one end of the fifth transmission shaft far away from the fifth motor is in threaded connection with a third knob which controls the catheter to circumferentially rotate;
When the fifth motor drives the fifth transmission shaft to rotate, the fifth transmission shaft drives the third knob to rotate, so that the catheter is driven to circumferentially rotate.
In some embodiments of the invention, the second control assembly comprises:
A sixth drive assembly, the sixth drive assembly comprising: the device comprises a sixth motor and a sixth transmission shaft which is matched and connected with the sixth motor, wherein one end of the sixth transmission shaft far away from the sixth motor is in threaded connection with a fourth knob for controlling the bending of the catheter;
when the sixth motor drives the sixth transmission shaft to rotate, the sixth transmission shaft drives the fourth knob to rotate, so that the guide pipe is driven to bend.
A remote mapping and ablation coordinated control system according to an embodiment of the invention comprises:
The first mechanical arm adopts the sheath tube and catheter state control mechanical arm, and a first control component of the first mechanical arm is connected with the mapping sheath tube so as to control the state of the mapping sheath tube; the second control component of the first mechanical arm is connected with a mapping catheter to control the state of the mapping catheter;
the second mechanical arm adopts the sheath tube and catheter state control mechanical arm, and the first control component of the second mechanical arm is connected with the ablation sheath tube so as to control the state of the ablation sheath tube; the second control component of the second mechanical arm is connected with an ablation catheter to control the state of the ablation catheter;
The control system is in communication connection with the first mechanical arm and the second mechanical arm, and controls the states of the mapping sheath and the mapping catheter through the first mechanical arm or controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction.
According to some embodiments of the invention, the control system has a switch for switching between a diagnostic mode and a therapeutic mode;
When the change-over switch is switched to a diagnosis mode, the control system controls the states of the mapping sheath and the mapping catheter through the first mechanical arm according to the received operation instruction;
When the change-over switch is switched to a treatment mode, the control system controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction.
In some embodiments of the invention, the control system is provided in a control room, and the first and second robotic arms are provided in a treatment room.
According to the embodiment of the invention, the remote mapping and ablation linkage control system comprises two mechanical arms which are respectively used for controlling the high-density mapping catheter, the radio frequency ablation catheter and the sheaths thereof, wherein the mechanical arms can control the two-way bending, rotation, front-back pushing and back withdrawing of the sheaths and the catheters, an operator can remotely control the two mechanical arms outside a treatment room through the remote control system, and the high-density mapping catheter, the radio frequency ablation catheter and the sheaths thereof are controlled in parallel, so that an electrophysiological operation is performed remotely, X-ray radiation of the operator is greatly reduced, the control precision of the catheter is improved, a stable catheter in place in the operation is provided, the operation complications caused by unstable operation in the traditional operation are reduced, the operator can quickly master the electrophysiological operation treatment technology, and the doctor culture period is shortened.
Drawings
FIG. 1 is a schematic view of a sheath and catheter state control mechanical arm according to an embodiment of the present invention at a first view angle;
FIG. 2 is a schematic view of a sheath and catheter state control mechanical arm according to an embodiment of the present invention at a second view angle;
FIG. 3 is a signal control flow diagram of a remote mapping and ablation coordinated control system according to an embodiment of the invention;
fig. 4 is a schematic diagram illustrating the operation of a remote mapping and ablation coordinated control system according to an embodiment of the invention.
Reference numerals:
The mechanical arm 100 is configured to move,
A base 1, a first frame 11, a second frame 12,
A first motor 21, a second motor 22, a third motor 23, a fourth motor 24, a fifth motor 25, a sixth motor 26,
A first motor output shaft 27, a fourth motor output shaft 28, a second motor output shaft 221, a third motor output shaft 231, a fifth motor output shaft 251, a sixth motor output shaft 261,
The first mounting block 31, the second mounting block 32,
A first drive shaft 41, a second drive shaft 42, a third drive shaft 43, a fourth drive shaft 44,
Sheath handle 5, first knob 51, second knob 52;
a catheter handle 6, a third knob 61, a fourth knob 62;
The catheter comprises a catheter support 3, a mechanical arm support 101, a main control data processing system 71, a three-dimensional mapping system navigation interface 72, a doctor control end 8, a change-over switch 81 and a radio frequency ablation instrument 9.
Detailed Description
In order to further describe the technical means and effects adopted by the present invention for achieving the intended purpose, the following detailed description of the present invention is given with reference to the accompanying drawings and preferred embodiments.
The steps of the method flow described in the specification and the flow chart shown in the drawings of the specification are not necessarily strictly executed according to step numbers, and the execution order of the steps of the method may be changed. Moreover, some steps may be omitted, multiple steps may be combined into one step to be performed, and/or one step may be decomposed into multiple steps to be performed.
Electrode catheters have been commonly used in electrophysiological surgical medical practice for many years for stimulating and mapping electrical activity in the heart and ablating sites of abnormal electrical activity, in use, the electrode catheter is navigated into the heart chamber of the heart via a primary venous or arterial puncture. Thus, the ability to control the exact position and orientation of the catheter tip is critical and largely determines the practicality of the catheter.
Catheter radio frequency ablation is currently the most commonly used minimally invasive interventional technique for treating arrhythmias, the basic principle of which is: firstly, an operator sends a three-dimensional mapping catheter into a target heart cavity through a peripheral blood vessel, draws a three-dimensional model of a heart cavity through a three-dimensional mapping system, and marks the excitation origin and focus positions at the same time; then the radio frequency ablation catheter is sent to a target heart chamber through a guiding sheath tube, under the guidance of a three-dimensional mapping model, the arrhythmia origin focus is precisely mapped and precisely positioned, an operator manually controls the catheter outside a patient, a columnar ablation electrode at the head end of the catheter is contacted with focus tissues with effective contact force, and then radio frequency current is emitted through a loop electrode attached to the skin of the body surface of the patient. The radio frequency current flows through the focus tissue below the electrode, heat is generated in the tissue, and when the temperature reaches the degree of coagulation necrosis, the tissue permanently loses the electrophysiological activity, and the arrhythmia is cured.
This manual operation technique has the following disadvantages:
1. The operator must hold the catheter all the time, keep the current posture of catheter, work intensity is big. 2. The operator must be positioned at the operating table to manipulate the catheter until the operation is completed, and the exposure time of the X-ray radiation during the operation is long, which affects the physical health of the operator. 3. The operator needs to complete three-dimensional mapping and ablation operation of the heart cavity successively, and the operation time period is long. 4. The hand feeling and experience of the operator obviously influence the safety, efficiency and quality of the operation. 5. The difficulty of manual operation of the catheter is very high, a doctor can grasp the catheter through a large amount of exercises, and the cultivation period of the doctor is long.
In order to solve the above-mentioned problems, the present invention provides a sheath and catheter state control mechanical arm 100 and a linkage control system thereof.
As shown in fig. 1 and 2, a sheath and catheter state control robot 100 according to an embodiment of the present invention includes: a base 1, a first control assembly and a second control assembly.
The first control component is movably arranged on the base 1, is connected with the sheath pipe and controls the axial movement, circumferential rotation and bending state of the sheath pipe by controlling the movable state of the first control component;
the second control assembly is movably arranged on the base 1 and connected with the catheter, and the axial movement, circumferential rotation and bending states of the catheter are controlled by controlling the moving state of the second control assembly.
According to the sheath and catheter state control mechanical arm 100, the states of the sheath and the catheter can be accurately and reliably controlled through the mechanical arm 100, and the operation is convenient. Moreover, the status of the sheath and catheter can be controlled remotely by the robotic arm 100, thereby reducing the X-ray radiation of the operator in the treatment room.
According to some embodiments of the invention, the first control assembly comprises: a first drive assembly.
As shown in fig. 1 and 2, the first driving assembly includes a first motor 21 and a first transmission shaft 41 cooperatively connected with the first motor 21, and the first transmission shaft 41 is screwed with a first mounting block 31 on the base 1. When the first motor 21 drives the first transmission shaft 41 to rotate, the first transmission shaft 41 is in threaded fit with the first mounting block 31, so that the first control assembly moves axially relative to the base 1, and the sheath tube is driven to move axially. Thereby, the axial forward and backward movement of the sheath tube can be controlled easily and reliably by the first drive assembly.
In some embodiments of the invention, the second control assembly comprises: and a second drive assembly.
As shown in fig. 1 and 2, the second driving assembly includes: the second motor 22 and the second transmission shaft 42 which is connected with the second motor 22 in a matching way, and one end of the second transmission shaft 42 far away from the second motor 22 is in threaded connection with a first knob 51 which controls the circumferential rotation of the sheath. When the second motor 22 drives the second transmission shaft 42 to rotate, the second transmission shaft 42 drives the first knob 51 to rotate, so as to drive the sheath to rotate circumferentially. Thereby, the sheath can be conveniently and reliably controlled to rotate circumferentially by the second drive assembly.
According to some embodiments of the invention, the first control assembly comprises: and a third drive assembly.
As shown in fig. 1 and 2, the third driving assembly includes: the third motor 23 and the third transmission shaft 43 which is connected with the third motor 23 in a matching way, and one end of the third transmission shaft 43 far away from the third motor 23 is connected with the second knob 52 which controls the bending of the sheath tube in a threaded way. When the third motor 23 drives the third transmission shaft 43 to rotate, the third transmission shaft 43 drives the second knob 52 to rotate, so as to drive the sheath tube to bend. Thereby, the sheath bending can be controlled conveniently and reliably by the third drive assembly.
In some embodiments of the invention, the second control assembly comprises: and a fourth drive assembly.
As shown in fig. 1 and 2, the fourth driving assembly includes a fourth motor 24 and a fourth transmission shaft 44 cooperatively connected with the fourth motor 24, and the fourth transmission shaft 44 is screwed with the second mounting block 32 on the base 1. When the fourth motor 24 drives the fourth drive shaft 44 to rotate, the fourth drive shaft 44 is threadedly engaged with the second mounting block 32 to axially move the second control assembly relative to the base 1, thereby axially moving the catheter. Thereby, the axial forward and backward movement of the catheter can be controlled easily and reliably by the fourth drive assembly.
According to some embodiments of the invention, the second control assembly comprises: and a fifth drive assembly.
As shown in fig. 1 and 2, the fifth driving assembly includes: the fifth motor 25 and the fifth transmission shaft which is connected with the fifth motor 25 in a matching way, and one end of the fifth transmission shaft far away from the fifth motor 25 is in threaded connection with a third knob 61 which controls the circumferential rotation of the catheter. When the fifth motor 25 drives the fifth transmission shaft to rotate, the fifth transmission shaft drives the third knob 61 to rotate, thereby driving the catheter to rotate circumferentially. Thereby, the circumferential rotation of the catheter can be controlled conveniently and reliably by the fifth drive assembly.
In some embodiments of the invention, the second control assembly comprises: and a sixth drive assembly.
As shown in fig. 1 and 2, the sixth driving assembly includes: the sixth motor 26 and the sixth transmission shaft that is connected with the sixth motor 26 in a matching way, one end of the sixth transmission shaft far away from the sixth motor 26 is connected with a fourth knob 62 for controlling the bending of the catheter in a threaded way. When the sixth motor 26 drives the sixth drive shaft to rotate, the sixth drive shaft drives the fourth knob 62 to rotate, thereby driving the catheter to bend. Thereby, the catheter bending can be controlled conveniently and reliably by the sixth drive assembly.
As shown in fig. 3 and 4, a remote mapping and ablation coordinated control system according to an embodiment of the invention comprises: the system comprises a first mechanical arm, a second mechanical arm and a control system.
The first mechanical arm adopts the sheath tube and catheter state control mechanical arm 100, and a first control component of the first mechanical arm is connected with the mapping sheath tube so as to control the state of the mapping sheath tube; the second control component of the first mechanical arm is connected with the mapping catheter to control the state of the mapping catheter;
The second mechanical arm adopts the sheath tube and catheter state control mechanical arm 100, and the first control component of the second mechanical arm is connected with the ablation sheath tube so as to control the state of the ablation sheath tube; the second control component of the second mechanical arm is connected with the ablation catheter to control the state of the ablation catheter;
The control system is in communication connection with the first mechanical arm and the second mechanical arm, and controls the states of the mapping sheath and the mapping catheter through the first mechanical arm or controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction.
According to the embodiment of the invention, the remote mapping and ablation linkage control system comprises two mechanical arms 100 respectively used for controlling the high-density mapping catheter, the radio frequency ablation catheter and the sheaths thereof, wherein the mechanical arms 100 can control the two-way bending, rotation, front-back pushing and back withdrawing of the sheaths and the catheters, an operator can remotely control the two mechanical arms 100 outside a treatment room through the remote control system, and the high-density mapping catheter, the radio frequency ablation catheter and the sheaths thereof are controlled in parallel, so that the electrophysiological operation is performed remotely, X-ray radiation of the operator is greatly reduced, the control precision of the catheter is improved, a stable catheter in place in the operation is provided, the operation complications caused by the instability of the operation in the traditional operation are reduced, the operator can quickly grasp the electrophysiological operation treatment technology, and the doctor culture period is shortened.
According to some embodiments of the invention, as shown in fig. 4, the control system has a switch 81 for switching between a diagnostic mode and a therapeutic mode;
When the change-over switch 81 is switched to the diagnosis mode, the control system controls the states of the mapping sheath and the mapping catheter through the first mechanical arm according to the received operation instruction;
When the switch 81 is switched to the treatment mode, the control system controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction.
Therefore, the high-density mapping catheter and the radio frequency ablation catheter can be controlled simultaneously, and the three-dimensional mapping of the heart cavity and the electro-physiological excitation mapping and the ablation operation can be completed in parallel.
In some embodiments of the invention, as shown in fig. 4, the control system is provided in a control room, and the first and second robotic arms are provided in a treatment room. Therefore, an operator can remotely control two mechanical arms outside a treatment room through a remote control system, and control the high-density mapping catheter, the radio frequency ablation catheter and the sheath pipes thereof in parallel, so as to remotely perform electrophysiological operation, and greatly reduce X-ray radiation of the operator.
The sheath and catheter state control robot 100 and its coordinated control system according to the present invention will be described in detail with reference to the accompanying drawings in one specific embodiment. It is to be understood that the following description is exemplary only and is not to be taken as limiting the invention in any way.
In the catheter radio frequency ablation procedure, two key steps are included:
Firstly, a three-dimensional mapping catheter is sent to a target heart cavity through a peripheral blood vessel to complete three-dimensional modeling and excitation mapping;
and secondly, accurately conveying an ablation electrode at the head end of the radio frequency ablation catheter to a target ablation position in the heart cavity.
At present, the catheter and the sheath are manually operated by an operator to perform the catheter radio frequency ablation operation, and the catheter radio frequency ablation operation has the following defects:
1. By manually holding the front and back pumping, rotating and bending of the catheter, the operator can not accurately control the pushing amount, the rotating amount and the bending amount of the catheter and can only operate by feeling estimation, the operation quality can not be ensured, and the operation efficiency is low.
2. There is no way to remotely perform catheter ablation procedures by the operator manually handling the catheter, requiring the operator to operate the catheter by prolonged exposure to X-ray radiation, which can adversely affect the health of the healthcare worker.
3. By holding the catheter by the operator for a long period of time, stable catheter operation cannot be maintained from end to end, and repeated catheter position adjustments affect the efficiency of the procedure.
4. The operation is performed by manually manipulating the catheter by the operator, the operation difficulty is very high, the doctor culture period is long, the learning curve of the operation skills is long, and the operation workload is high.
5. The catheter is manually operated by an operator, the mapping of the target heart cavity can be performed firstly, then electrophysiological excitation mapping is performed, ablation can be performed afterwards, the operation can not be switched or synchronously performed at any time, and the operation efficiency is low.
Aiming at the problems existing in the traditional operation method, the invention mainly solves the following problems:
1. The invention comprises two mechanical arms 100 arranged beside an operation table, an operator can respectively control the two mechanical arms 100 to control a high-density mapping catheter and a radio frequency ablation catheter, the mechanical arms 100 can be switched at any time according to the needs through a diagnosis and treatment switch 81 of a doctor control end 8 to control the mapping catheter or the ablation catheter, and three-dimensional modeling, electrophysiological excitation mapping and ablation of a heart chamber are completed in parallel, so that the operation efficiency is greatly improved.
2. The problem that the operation quality cannot be guaranteed is solved, the front and back pushing, bending and rotation of the catheter and the sheath tube are controlled through the mechanical arm 100 controlled by the operation robot system, the accurate and stable control of the catheter and the sheath tube is realized, the operation efficiency and the operation quality are improved, meanwhile, the operation difficulty is reduced, the pushing quantity, the bending quantity and the rotation quantity of the catheter and the sheath tube are not required to be estimated by means of the hand feeling and experience of an operator, and the training period of doctors is shortened.
3. The doctor needs to operate under the X-ray irradiation beside the operation bed, which affects the health of the operator. The operator uses the surgical robot system to remotely control the high-density mapping system and the ablation surgical system to perform surgical actions outside the catheter, so that the operator can be prevented from being influenced by X-ray radiation to the health.
The invention accurately controls the bidirectional bending, forward and backward pushing and axial rotation of the mapping catheter and the ablation catheter through the robot mechanical arm 100 by developing a remote mapping and ablation linkage operation robot device, thereby completing the diagnosis mapping and ablation treatment required by arrhythmia ablation operation in a full period. The precise control and stable operation of the catheter head end can be realized under the guidance of the three-dimensional mapping system, the difficulty of ablation surgery is reduced, and the surgery quality and efficiency are improved.
As shown in fig. 1-2, the mechanical arm 100 includes a base 1, a first frame 11 is connected to the base 1, a first transmission shaft 41 is disposed on the first frame 11, and the first transmission shaft 41 passes through and is screwed with a first mounting block 31 disposed at one end of the base 1. The first transmission shaft 41 can rotate relative to the first frame 11, and a limiting part for limiting the first transmission shaft 41 to axially move relative to the first frame 11 is arranged on the first frame 11, so that the first transmission shaft 41 can axially move to drive the first frame 11 to axially move.
One end of the first transmission shaft 41 is provided with a gear, the gear is meshed with the first motor output shaft 27 of the first motor 21 arranged on the first frame 11, and the output shaft of the first motor 21 rotates to drive the first transmission shaft 41 to rotate, so that the first transmission shaft 41 is in threaded connection with the first mounting block 31 on the base 1. Therefore, the first transmission shaft 41 rotates to move axially relative to the base 1, and the first frame 11 is provided with an axial limiting portion. Therefore, the first transmission shaft 41 moves axially to drive the first frame 11 to move axially. The first motor 21 controls the axial pushing and withdrawing of the first frame 11 relative to the base 1 in a transmission manner, so as to control the pushing and withdrawing of the sheath tube arranged on the first frame 11.
The first frame 11 is provided with a second motor 22 and a third motor 23, a second motor output shaft 221 of the second motor 22 is meshed with a gear at the lower end of a vertically arranged second transmission shaft 42, and a third motor output shaft 231 of the third motor 23 is meshed with a gear at the lower end of a third transmission shaft 43.
The upper ends of the second transmission shaft 42 and the third transmission shaft 43 are respectively provided with a second bevel gear and a third bevel gear, the second bevel gear and the third bevel gear are respectively meshed with a first knob 51 used for controlling the rotation of the sheath tube and a second knob 52 used for controlling the bidirectional bending of the sheath tube on the sheath tube handle 5, the second transmission shaft 42 and the third transmission shaft 43 are respectively connected to the first frame 11 in a rotating way, and the output shafts of the second motor 22 and the third motor 23 can drive the second transmission shaft 42 and the third transmission shaft 43 to rotate, so that the first knob 51 and the second knob 52 meshed with the upper end gears of the second transmission shaft 42 and the third transmission shaft 43 are driven to rotate, and the rotation and the bidirectional bending of the sheath tube are controlled.
The sheath tube is driven to push back and forth and bend and rotate in both directions by the two parts.
The base 1 is connected with a second frame 12, the second frame 12 is provided with a fourth transmission shaft 44, the fourth transmission shaft 44 passes through a second mounting block 32 arranged at the other end of the base 1 and is in threaded connection with the second mounting block, the fourth transmission shaft 44 can axially rotate relative to the second frame 12, the second frame 12 is provided with a limiting part for limiting the fourth transmission shaft 44 to axially move relative to the second frame 12, and the fourth transmission shaft 44 can drive the second frame 12 to axially move.
One end of the fourth transmission shaft 44 is provided with a gear, the gear is meshed with the fourth motor output shaft 28 of the fourth motor 24 arranged on the second frame 12, and the output shaft of the fourth motor 24 rotates to drive the fourth transmission shaft 44 to rotate, so that the fourth transmission shaft 44 is in threaded connection with the second mounting block 32 on the base 1. Therefore, the fourth transmission shaft 44 rotates to move axially relative to the base 1, and the second frame 12 is provided with the fourth transmission shaft 44 axial limiting portion, so that the fourth transmission shaft 44 moves axially to drive the second frame 12 to move axially. The fourth motor 24 controls the axial pushing and withdrawing of the first frame 11 relative to the base 1 in a driving manner.
The second frame 12 is provided with a fifth motor 25 and a sixth motor 26, a fifth motor output shaft 251 of the fifth motor 25 is meshed with a gear vertically arranged at the lower end of a fifth transmission shaft on the second frame 12, and a sixth motor output shaft 261 of the sixth motor 26 is meshed with a gear at the lower end of the sixth transmission shaft. The upper ends of the fifth transmission shaft and the sixth transmission shaft are respectively provided with a fifth conical gear and a sixth conical gear, and the fifth conical gear and the sixth conical gear are respectively meshed with a third knob 61 used for controlling the rotation of the catheter and a fourth knob 62 used for controlling the bidirectional bending of the catheter on the catheter handle 6.
The fifth transmission shaft and the sixth transmission shaft are respectively and rotatably connected to the second frame 12, and the output shafts of the fifth motor 25 and the sixth motor 26 rotate to drive the fifth transmission shaft and the sixth transmission shaft to rotate, so as to drive a third knob 61 and a fourth knob 62 which are respectively meshed with the gears at the upper ends of the fifth transmission shaft and the sixth transmission shaft to rotate, thereby controlling the rotation of the catheter and bidirectionally bending.
The two parts drive the front and back pushing and the two-way bending and the rotation of the catheter. The two-way bending, rotation, and advancement and retraction of the catheter and sheath may be controlled by the robotic arm 100.
As shown in fig. 3 and 4, the present invention comprises two mechanical arms 100, a catheter support 3, a mechanical arm support 101, a catheter and a sheath tube, wherein the two mechanical arms 100 are arranged beside a patient end operation table in a catheter room, the catheter support 3 is used for receiving an operation instruction sent by a doctor end and controlling the mechanical arms 100 to perform corresponding operation according to the instruction, the support is used for respectively installing the catheter and the sheath tube on a first frame 11 and a second frame 12 of the mechanical arms 100, and respectively enabling respective knobs to be meshed with corresponding bevel gears on the mechanical arms 100, wherein one mechanical arm 100 is used for controlling a high-density mapping catheter and a sheath tube thereof, the other mechanical arm 100 is used for controlling a radio-frequency ablation catheter and a sheath tube thereof, and three-dimensional mapping of a heart cavity, electro-physiological excitation mapping and ablation operation are completed in parallel.
As shown in fig. 3-4, the invention further comprises a main control data processing system 71 and a navigation interface 72 of the three-dimensional mapping system, wherein the main control data processing system 71 is internally provided with the three-dimensional mapping system, and the signal acquisition is completed through the cooperation of the adjustable high-density mapping catheter and the adjustable curved sheath, the rapid modeling is performed in the three-dimensional mapping system, and meanwhile, the electrophysiological signals are acquired, so that the electrophysiological activation sequence mapping is completed.
The invention is also internally provided with a radio frequency ablation instrument 9, the radio frequency ablation instrument is navigated by a three-dimensional mapping system, a doctor sends a control instruction to a control system by using a doctor end, the control system controls the mechanical arm 100 to operate the adjustable bending sheath tube and the adjustable bending radio frequency ablation catheter according to the received instruction, after the large-head electrode at the head end of the ablation catheter reaches a target ablation position, the doctor end sends an ablation instruction to a main control data processing system 71, and the main control data processing system 71 controls the radio frequency ablation instrument 9 to send radio frequency energy to the large-head electrode at the head end of the ablation catheter so as to ablate the target ablation position.
As shown in fig. 4, the doctor control end 8 is provided with a diagnosis and treatment mode switch 81, and can switch two mechanical arms 100 at any time to respectively control the mapping catheter or the ablation catheter, when the switch 81 is switched to the diagnosis mode, the doctor control end 8 can control the mechanical arm 100 where the mapping catheter and the sheath thereof are located, so as to control the mapping catheter and the sheath thereof to perform corresponding three-dimensional mapping operation, and when the switch 81 is switched to the treatment mode, the doctor control end 8 can control the mechanical arm 100 where the ablation catheter and the sheath thereof are located, so as to control the ablation catheter and the sheath thereof to perform corresponding ablation operation. The operation and the back-and-forth switching between the two mechanical arms 100 are simple and convenient, so that the two mechanical arms 100 can be operated alternately, the three-dimensional mapping of the heart cavity and the electro-physiological excitation mapping can be completed in parallel, and the operation efficiency can be effectively improved.
Referring to fig. 3 and 4, firstly, the operator switches the diagnosis and treatment switch 81 to a diagnosis mode, the operator sends a control instruction to the main control data processing system 71 through the doctor control end 8, the main control data processing system 71 controls the mechanical arm 100 where the high-density mapping catheter and the sheath tube are located after receiving the instruction of the doctor control end 8, so that the mapping catheter and the sheath tube perform corresponding operation to perform signal acquisition, the high-density mapping catheter feeds back the acquired signals to the three-dimensional mapping system in the main control data processing system 71, the three-dimensional mapping system is rapidly modeled, the three-dimensional navigation interface is used for displaying, and the operator performs the next operation according to the information displayed by the three-dimensional navigation interface.
Then, the operator can switch the switch to a treatment mode, the operator sends a control instruction to the main control data processing system 71 through the doctor control end 8, the main control data processing system 71 controls the mechanical arm 100 where the ablation catheter and the sheath tube are positioned after receiving the instruction of the doctor control end 8, so that the ablation catheter and the sheath tube perform corresponding operation actions, after the large-head electrode at the head end of the ablation catheter is attached to the target ablation part, the operator can send an instruction to the main control data processing system 71 through the doctor control end 8, and the main control data processing system 71 controls the radio frequency ablation instrument 9 to send radio frequency energy to the large-head electrode at the head end of the ablation catheter, so as to ablate the target ablation position. In the operation process, the doctor control end 8 can be freely switched between a diagnosis mode and a treatment mode, and three-dimensional mapping of the heart cavity, electrophysiological excitation mapping and ablation operation are completed in parallel, so that the operation efficiency and the operation effect are greatly improved.
The working process of the invention is as follows:
the peripheral blood vessel punctures, the vein is put the guiding sheath tube that high density mapping catheter used and the guiding sheath tube that ablation catheter used respectively.
The high density mapping catheter is placed through the sheath to the target heart chamber.
The ablation catheter is placed through its corresponding sheath to the target heart chamber.
The robotic arm 100 is first moved to the proper surgical position by the robotic arm 100 support.
The high-density mapping catheter and its sheath, the ablation catheter and its sheath are mounted in the mechanical arm 100 support, respectively, and the control knobs of the catheter and sheath are engaged with the corresponding drive gears, respectively.
And closing the support hinge, and respectively fixing the high-density mapping catheter and the sheath tube thereof, the ablation catheter and the sheath tube thereof in the respective supports.
The operator firstly switches the diagnosis and treatment switch on the doctor control end 8 to a diagnosis mode, controls the mechanical arm 100 where the high-density mapping catheter is positioned to control the high-density mapping catheter to perform three-dimensional mapping and acquisition of electrophysiological signals on the target heart cavity by the sheath tube, and simultaneously completes the sequential drawing of the electrophysiological activation of the heart.
The operator switches the diagnosis and treatment switch 81 on the doctor control end 8 to a treatment mode, controls the mechanical arm 100 where the ablation catheter is positioned to control the ablation catheter and the sheath thereof, sends the large-head electrode at the head end of the ablation catheter to a target ablation position under the guidance of the three-dimensional mapping system, and clings to the target ablation position at an optimal clinging angle.
In the two processes, the operator can freely switch between the diagnosis mode and the treatment mode in parallel.
The operator controls the doctor control end 8 to send an instruction to the main control data processing system 71, and the main control data processing system 71 controls the radio frequency ablation instrument 9 to send radio frequency energy to the large-head electrode at the head end of the ablation catheter so as to ablate the target ablation part.
In summary, the invention can remotely control the surgical robot to perform surgery, can simultaneously control the high-density mapping catheter and the radio frequency ablation catheter, and can complete three-dimensional mapping of heart chambers, electro-physiological excitation mapping and ablation in parallel, and the surgical efficiency is high, safe and stable. The remote control surgical robot performs surgery, can greatly reduce X-ray radiation of operators, improve the control accuracy of the catheter, provide stable catheter in place in surgery, reduce surgical complications caused by unstable operation in traditional surgery, and quickly master electrophysiological surgical treatment technology. The doctor control end 8 is provided with a diagnosis and treatment mode switching switch 81, and can freely switch any mechanical arm 100 to control the mapping catheter or the ablation catheter to perform corresponding operation, so that the operation is simple and easy to operate, the operation difficulty is reduced, and the culture period of the electrophysiologist is greatly shortened.
While the invention has been described in connection with specific embodiments thereof, it is to be understood that these drawings are included in the spirit and scope of the invention, it is not to be limited thereto.
Claims (2)
1. A remote mapping and ablation coordinated control system, comprising:
The first mechanical arm adopts a sheath tube and a catheter state control mechanical arm, and a first control component of the first mechanical arm is connected with a mapping sheath tube so as to control the state of the mapping sheath tube; the second control component of the first mechanical arm is connected with a mapping catheter to control the state of the mapping catheter;
the first control component of the second mechanical arm is connected with the ablation sheath so as to control the state of the ablation sheath; the second control component of the second mechanical arm is connected with an ablation catheter to control the state of the ablation catheter;
The control system is in communication connection with the first mechanical arm and the second mechanical arm, and controls the states of the mapping sheath and the mapping catheter through the first mechanical arm or controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction;
the sheath and catheter state control robotic arm includes:
a base;
The first control component is movably arranged on the base, is connected with the sheath pipe and controls the axial movement, circumferential rotation and bending state of the sheath pipe by controlling the moving state of the first control component;
The second control assembly is movably arranged on the base, is connected with the catheter and controls the axial movement, circumferential rotation and bending states of the catheter by controlling the movable state of the second control assembly;
the control system has a switch for switching between a diagnostic mode and a therapeutic mode;
When the change-over switch is switched to a diagnosis mode, the control system controls the states of the mapping sheath and the mapping catheter through the first mechanical arm according to the received operation instruction;
When the change-over switch is switched to a treatment mode, the control system controls the states of the ablation sheath and the ablation catheter through the second mechanical arm according to the received operation instruction;
The operation process of the remote mapping and ablation linkage control system is as follows:
Peripheral vascular puncture, venous access, respectively placing a mapping sheath and an ablation sheath;
The mapping catheter is placed into the target heart cavity through the mapping sheath;
The ablation catheter is placed into the target heart cavity through the ablation sheath;
Respectively fixing the mapping catheter, the mapping sheath, the ablation catheter and the ablation sheath in the respective supporters;
Switching the change-over switch to a diagnosis mode, controlling a first mechanical arm where the mapping catheter is located to control the mapping catheter and the mapping sheath to perform three-dimensional mapping and electrophysiological signal acquisition on the target heart chamber, and simultaneously completing the sequential drawing of the electrophysiological activation of the heart;
Switching the change-over switch to a treatment mode, controlling a second mechanical arm where the ablation catheter is positioned to control the ablation catheter and the ablation sheath, and conveying a large-head electrode at the head end of the ablation catheter to a target ablation position under the guidance of the three-dimensional mapping system, and abutting against the target ablation position at an optimal abutting angle;
In the two processes, the free switching between the diagnosis mode and the treatment mode is completed in parallel.
2. The remote mapping and ablation coordinated control system of claim 1, wherein the control system is provided in a control room and the first and second robotic arms are provided in a treatment room.
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