CN117653372A - Telescopic supporting device and operation system - Google Patents

Abstract

The invention provides a telescopic support device for axially supporting a medical instrument, comprising: a telescoping member axially deformable having first and second ends axially, the telescoping member including a coupling portion between the first and second ends and a first passageway therethrough axially for passage of a medical instrument therethrough; one end of the flexible traction rope is fixed relative to the second end of the telescopic piece, and the other end of the flexible traction rope movably penetrates through the coupling part; and the tensioning mechanism is connected with the first end of the telescopic piece and coupled with the other end of the traction rope, and is configured to maintain the tensioning state of the traction rope in the axial deformation process of the telescopic piece. The supporting device provided by the invention can radially limit the part of the medical instrument positioned outside the human body in the operation process, avoid the arching of the medical instrument, and is favorable for ensuring the accuracy of operation navigation.

Description

Telescopic supporting device and operation system

Technical Field

The invention relates to the technical field of medical instruments, in particular to a telescopic supporting device and a surgical system.

Background

Minimally invasive surgery refers to a surgical mode for performing surgery in a human cavity by using modern medical instruments such as laparoscopes, thoracoscopes and related devices. Compared with the traditional operation mode, the minimally invasive operation has the advantages of small wound, light pain, quick recovery and the like.

With the development of minimally invasive surgery and artificial intelligence, robot-assisted minimally invasive surgery is one of the development trends of minimally invasive surgery. Minimally invasive surgery may be performed through a natural orifice in the patient's body surface or through one or more surgical incisions. Through these natural orifices or incisions, a physician may insert minimally invasive medical instruments, such as surgical, diagnostic, therapeutic or biopsy instruments, etc., into a patient's body to a target location.

In order to accurately guide the corresponding minimally invasive medical instruments to a target location, minimally invasive surgery may be provided with an endoscope that allows the instruments to provide a field of view to a physician displaying tissues, organs and/or instruments during insertion, extraction or performing a medical procedure. For example, during an examination using a bronchoscope, an elongate flexible tool in which the scope is positioned may be inserted into a patient's mouth, sequentially into the trachea, pulmonary airways, lungs, past the patient's throat, to allow a physician to examine the internal condition of the patient's pulmonary airways, such as bronchi and bronchioles, for diagnostic and/or medical procedures.

Surgical tools such as endoscopes are typically deployed at the distal ends of various elongate flexible tools that are driven from outside the patient's body to deform as needed within a body, such as a small lumen. However, the portion of the elongate flexible tool located outside the body is generally long, and when the distal end of the elongate flexible tool cannot advance continuously or advance slowly due to the damping action of the lumen, the portion of the elongate flexible tool located outside the body inevitably arches, which results in that the system cannot accurately acquire the position of the distal end of the elongate flexible tool inside the body, and the navigation accuracy of the operation is affected.

Disclosure of Invention

In view of the defects in the prior art, the invention provides the telescopic supporting device and the surgical system, which can avoid the camber of the slender flexible tool in vitro and are beneficial to ensuring the precision of surgical navigation.

In order to achieve the above purpose, the present invention adopts the following technical scheme:

a telescopic support device for axially supporting a medical instrument, comprising:

a telescoping member axially deformable having first and second ends axially, the telescoping member including a coupling portion between the first and second ends and a first passageway therethrough axially for passage of a medical instrument therethrough;

one end of the flexible traction rope is fixed relative to the second end of the telescopic piece, and the other end of the flexible traction rope movably penetrates through the coupling part;

and the tensioning mechanism is connected with the first end of the telescopic piece and coupled with the other end of the traction rope, and is configured to maintain the tensioning state of the traction rope in the axial deformation process of the telescopic piece.

As one embodiment, the telescopic member is provided with a plurality of coupling portions spaced apart in the axial direction, and the traction rope passes through the plurality of coupling portions at the same time.

As one embodiment, the supporting device comprises at least two traction ropes, and the telescopic piece comprises at least two groups of coupling parts which are arranged at intervals in the radial direction; each group of the coupling parts comprises a plurality of coupling parts which are arranged at intervals along the axial direction of the telescopic piece, and each traction rope movably passes through one group of the coupling parts respectively.

As one embodiment, the coupling portion is disposed at the periphery of the first channel, and includes a through hole penetrating through the outer wall of the telescopic member.

As one embodiment, the expansion element comprises a bellows or a spring.

As one embodiment, the tensioning mechanism comprises a retainer and a winding assembly, wherein the winding assembly is rotatably arranged on the retainer through a first rotating shaft; the retainer is connected to the first end of the telescoping member and includes a second passage through which a medical instrument passes, and the other end of the haulage rope is wound on and tensioned by the winding assembly.

As one embodiment, the winding assembly comprises a wire spool and a coil spring, the traction rope is wound on the outer circumferential surface of the wire spool, and two ends of the coil spring are respectively connected with the wire spool and the first rotating shaft and provide tension force for the traction rope.

As one embodiment, the tensioning mechanism further comprises a guide wheel, and the retainer further comprises a side hole penetrating through the inner wall of the second channel;

the guide wheel is rotatably arranged on the retainer through a second rotating shaft, at least part of the guide wheel is positioned in the side hole and/or the second channel, and the traction rope on the winding assembly enters the second channel through the side hole after being guided by the guide wheel.

As one embodiment, the tensioning mechanism includes a plurality of the wire winding assemblies, each of which is arranged at intervals in the circumferential direction of the holder.

As one of the embodiments, the free ends of the tensioning mechanism and the telescopic piece are respectively provided with a docking mechanism for allowing an instrument to pass through and fix the supporting device.

It is a further object of the present invention to provide a surgical system comprising at least one support device as described above and a medical instrument passing at least partially through the first channel of the at least one support device and being radially restrained by the support device.

As one embodiment, the surgical system further comprises:

a first mechanical arm;

a second mechanical arm;

the medical device includes a first device including a first driver and a first elongate device, and a second device including a second driver and a second elongate device having a hollow device channel through which the first elongate device can pass;

one of the support devices is configured to be relatively fixed to the first driver and the second driver at both ends thereof after the first elongated instrument enters the instrument channel through the first channel thereof, so as to be telescopic with the distance between the first mechanical arm and the second mechanical arm after the first driver and the second driver are respectively mounted to the first mechanical arm and the second mechanical arm.

As one embodiment, the other one of the support devices is configured to have one end fixed relative to the second driver and the other end fixed relative to the operating table, and the second elongated instrument is disposed through the first channel of the other one of the support devices, and the other one of the support devices stretches and contracts with the distance between the second mechanical arm and the operating table.

As one embodiment, a first interface on the first driver for engaging the first mechanical arm and a second interface on the second driver for engaging the second mechanical arm are identical, and the second mechanical arm is selectively engageable with the first interface and the second interface to transmit torque.

As one embodiment, the rotation axes of the joints of the first mechanical arm are parallel to each other, the rotation axes of the joints of the second mechanical arm are parallel to each other, and the rotation axes of the first mechanical arm and the second mechanical arm are parallel to each other.

As one embodiment, the surgical system further comprises a second robotic arm;

the medical instrument includes a first instrument including a first driver and a first elongate instrument;

one of the support devices is configured to have one end fixed relative to the first driver and the other end fixed relative to the operating table so as to be telescopic with the change of the distance between the second mechanical arm and the operating table after the first driver is mounted to the second mechanical arm.

The supporting device provided by the invention can radially limit the part of the medical instrument positioned outside the human body in the operation process, avoid the arching of the medical instrument, and is favorable for ensuring the accuracy of operation navigation.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are needed in the embodiments will be briefly described below, it being understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and other related drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.

FIG. 1 is a schematic view showing a shortened configuration of a supporting device according to an embodiment of the present invention;

FIG. 2 is a schematic view showing an elongated structure of a supporting device according to an embodiment of the present invention;

FIG. 3 is an exploded view of a support device according to an embodiment of the present invention;

FIG. 4A is a cross-sectional view of a support device according to an embodiment of the present invention;

FIG. 4B is another cross-sectional view of a support device according to an embodiment of the present invention;

FIG. 5 is a top view of a support device according to an embodiment of the present invention;

FIG. 6 is a schematic view illustrating a use state of a supporting device according to an embodiment of the present invention;

FIG. 7 is a schematic view of a surgical system according to an embodiment of the present invention;

FIG. 8 is a schematic view of an application of the supporting device according to the embodiment of the present invention;

FIG. 9 is a schematic view of another application of the supporting device according to the embodiment of the present invention;

FIG. 10 is a schematic view of another application of the supporting device according to the embodiment of the present invention;

reference numerals illustrate:

10-supporting means; 10A-a first support means; 10B-a second support means; 11-telescoping pieces; 12-pulling ropes; 13-a tensioning mechanism; 14-a docking mechanism; 31-a first mechanical arm; 32-a second mechanical arm; 40-medical device; 41-a first instrument; 42-a second instrument; 50-a trolley; 60-operating bed; 70-a guide mechanism; 80-fixing a bracket; 110-a coupling; 130-a cage; 131-winding assembly; 131 a-wire spool; 131 b-a coil spring; 132-guide wheels; 141-a claw; 142-tube interface; 410-a first driver; 411-a first elongate instrument; 420-a second driver; 421-a second elongate instrument; 422-instrument channel; a C-drive interface; h1-first channel; h2-second channel; h3-side holes; s1, a first installation interface; s2-a second installation interface; x1-a first rotating shaft; x2-second rotating shaft.

Detailed Description

In order to make the technical problems, technical schemes and beneficial effects to be solved more clear, the invention is further described in detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the invention.

It will be understood that when an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like are used herein for illustrative purposes only and are not meant to be the only embodiment. The terms "distal," "proximal," and "proximal" are used herein as directional terms that are conventional in the art of interventional medical devices, wherein "distal" refers to the end of the procedure that is distal to the operator and "proximal" refers to the end of the procedure that is proximal to the operator.

It is to be understood that the terms "length," "width," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are merely for convenience in describing and simplifying the description based on the orientation or positional relationship shown in the drawings, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus are not to be construed as limiting the invention.

Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include one or more such feature. In the description of the present invention, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.

The following detailed description will be given with reference to the accompanying drawings.

Referring to fig. 1 and 2, the present embodiment provides a telescopic supporting device 10 for supporting a medical device in an axial direction, so as to reduce the possibility of arching of the medical device during insertion into a human body, the supporting device 10 includes a telescopic member 11, a traction rope 12 and a tensioning mechanism 13, the telescopic member 11 is deformable in the axial direction, and has a first end (e.g., an upper end in fig. 2) and a second end (e.g., a lower end in fig. 2) in the axial direction, and the telescopic member 11 includes a coupling portion 110 between the first end and the second end and a first channel H1 extending through the axial direction thereof for the medical device to pass through. The traction rope 12 is flexible, for example, a metal wire is adopted, one end of the traction rope is fixed relative to the second end of the telescopic piece 11, and the other end of the traction rope movably passes through the coupling part 110 and then is connected with the tensioning mechanism 13. The tensioning mechanism 13 is connected to the first end of the telescopic member 11 and coupled to the other end of the traction rope 12, and is configured to maintain the tension state of the traction rope 12 during the axial deformation of the telescopic member 11, so that the first end, the second end, and the coupling portion 110 of the telescopic member 11 are substantially aligned without buckling.

When the second end of the telescopic member 11 and the tensioning mechanism 13 are respectively fixed at two ends of the surgical system, the medical instrument passes through the first channel H1 from the first end, the telescopic member 11 can be compressed in the process of inserting and feeding the medical instrument, and can be elongated in the process of pulling out the medical instrument from the human body, and the tensioning mechanism 13 can always tension the traction rope 12 in the process of pulling out and inserting the medical instrument, so that the basically straight state of the telescopic member 11 is maintained, and therefore, the medical instrument in the telescopic member 11 is also in the basically straight state. Illustratively, the first passageway H1 is 5-7 mm in diameter and allows the medical device to pass freely therethrough without allowing significant doming of the medical device. It will be appreciated that the mounting positions of the two ends of the support device 10 may be interchanged, i.e. the medical instrument may be inserted from the end of the tensioning means 13, protruding from the end of the telescopic member 11, or may be inserted from the end of the telescopic member 11, protruding from the end of the tensioning means 13.

As an example, fig. 2 of the present embodiment shows a case where a plurality of coupling portions 110 are provided on the telescopic member 11 at intervals in the axial direction, and a single traction rope 12 is simultaneously passed through the plurality of coupling portions 110, for example, the coupling portions 110 are provided at the periphery of the first passage H1, including through holes penetrating the outer wall of the telescopic member 11.

Illustratively, the support device 10 includes at least two traction ropes 12, the telescopic member 11 includes at least two sets of coupling portions 110 disposed at intervals in a radial direction, each set of coupling portions 110 includes a plurality of coupling portions 110 disposed at intervals in an axial direction of the telescopic member 11, and each traction rope 12 movably passes through one set of coupling portions 110, respectively. For example, the coupling portions 110 of each set of coupling portions 110 are arranged in a line, so that the connecting line of the coupling portions 110 for threading the same traction rope 12 is parallel to the axis of the telescopic member 11, the traction rope 12 is straightened after being tensioned by the tensioning mechanism 13, the coupling portions 110 on the telescopic member 11 are restrained by the traction rope 12 and are adaptively arranged in a line on the traction rope 12 to limit the buckling of the telescopic member 11, and the traction rope 12 increases the strength of the telescopic member 11 at the coupling portions 110 against the buckling to a certain extent. For another example, the plurality of traction ropes 12 are uniformly arranged at intervals in the circumferential direction of the expansion element 11, and uniformity of tension on each side of the expansion element 11 can be achieved. It will be appreciated that in other embodiments, the number of pull cords 12 may be adjusted as desired.

In one embodiment, the telescoping member 11 is a continuous body and may be comprised primarily of bellows or springs. When the telescopic member 11 mainly comprises a spring, in a stretched state, the telescopic member 11 is provided with an axial elastic restoring force, and under the double actions of the tension of the traction rope 12 and the elastic restoring force of the telescopic member 11, the telescopic member 11 can have stronger bending strength, so that the internal medical instrument can be better prevented from arching.

Referring to fig. 3 and 4A, the tensioning mechanism 13 may include a holder 130 and a winding assembly 131, the winding assembly 131 being rotatably disposed on the holder 130 through a first rotation axis X1, the holder 130 being coupled to the first end of the telescopic member 11 including a second passage H2 through which a medical instrument passes, and the other end of the traction rope 12 being wound on the winding assembly 131 and being tensioned by the winding assembly 131.

In one embodiment, the winding assembly 131 includes a winding reel 131a and a coil spring 131b, the pull wire 12 is wound around the outer circumferential surface of the winding reel 131a, the inner end of the coil spring 131b is wound around and fixed on the first rotation axis X1, and the outer end of the coil spring 131b is connected to the winding reel 131a. When the external force is not applied, the telescopic piece 11 is tensioned by the coil spring 131b to be in the maximum compression state, the coil spring 131b is in the initial tightening state, and when the telescopic piece 11 stretches to pull the traction rope 12, the deformation of the coil spring 131b is increased to provide reverse tensioning force for the traction rope 12, so that the traction rope 12 is automatically kept in the tightening state without applying active tensioning force; when the extension of the telescopic member 11 is reduced, the traction rope 12 is wound on the wire spool 131a under the deformation action of the coil spring 131b, so that automatic storage is realized and the tension state is still maintained. The winding direction of the coil spring 131b may be opposite to the winding direction of the traction rope 12 or the same as the winding direction of the traction rope 12.

In other embodiments, the tensioning mechanism 13 may be a mechanism that is driven by electricity, gas, or the like to perform tensioning, for example, by controlling the tensioning operation of the traction rope 12 with a motor.

In one embodiment, as shown in fig. 4A, the tensioning mechanism 13 may further include a guide wheel 132, the holder 130 further has a side hole H3 extending through an inner wall of the second channel H2 from a side, the guide wheel 132 is rotatably disposed on the holder 130 through the second rotation shaft X2, and at least part of the guide wheel 132 is located in the side hole H3 and/or the second channel H2, that is, at least part of the guide wheel 132 is located in the side hole H3, or at least part of the guide wheel 132 is located in both the side hole H3 and the second channel H2, or the guide wheel 132 is smaller, the whole guide wheel 132 is located completely in the second channel H2, and the traction rope 12 on the winding assembly 131 is guided by the guide wheel 132 back into the second channel H2 through the side hole H3, so as to be led out to be connected with the second end of the telescopic member 11. Because of the guide wheel 132, the traction rope 12 is not in direct friction contact with the retainer 130, but is guided by rolling contact with the guide wheel 132, so that the service life of the traction rope 12 is prolonged. Illustratively, the first and second rotation axes X1 and X2 are parallel or substantially parallel, and the side hole H3 may have a tapered shape with a large outside and a small inside.

As shown in fig. 4B, the spool 131a includes a wheel body 1301 and a first rotation shaft X1 integrally provided, the coil spring 131B is provided between the wheel body 1301 and the holder 130, an inner ring thereof is fixed to the first rotation shaft X1, an outer ring thereof is fixed to the holder 130, and the first rotation shaft X1 is rotatably connected to the holder 130. When the traction rope 12 is pulled out to drive the wheel body 1301 to rotate, the deformation amount of the coil spring 131b is increased, and as the length of the traction rope 12 pulled out is increased, the deformation amount of the coil spring 131b is larger and larger, so that the tension force of the traction rope 12 is larger when the extension length of the traction rope 12 is larger, and the resistance variable effect of the traction rope is better.

Illustratively, the cage 130 includes an endcap 1302 with an end of the wheel body 1301 facing the coil spring 131b open, and a first rotational axis X1 movably passes through the endcap 1302, the endcap 1302 and the wheel body 1301 enclosing a cavity 1300 in which the coil spring 131b is received. End cap 1302 and wheel 1301 each have a portion of the receiving cavity that combine to form the entire cavity 1300.

Illustratively, the holder 130 has a number of mounting brackets 1310 corresponding to the number of the traction ropes 12, each mounting bracket 1310 has a pair of mounting arms, each mounting bracket 1310 is disposed at intervals in the circumferential direction of the holder 130, one guide wheel 132 and one winding assembly 131 are rotatably provided on each pair of mounting arms, the winding assembly 131 is located radially outward of the holder 130 with respect to the guide wheel 132, and both ends of the first rotation axis X1 and the second rotation axis X2 are mounted between the mounting arms of the mounting brackets 1310. The two ends of the first rotation axis X1 are rotatably connected with the mounting arms of the mounting frame 1310 through bearings M.

As shown in fig. 5, the holder 130 further includes a handle portion 1311 for an operator to hold, and one handle portion 1311 is connected between each two adjacent mounting frames 1310. The handle portion 1311 may be formed in a concentric arc shape, and the handle portion 1311 may serve as a reinforcing structure between the mounting frames 1310, to improve the overall strength of the cage 130 to some extent.

As shown in conjunction with fig. 4A, 4B and 5, the tensioning mechanism 13 may have a plurality of winding assemblies 131, each winding assembly 131 being arranged at intervals in the circumferential direction of the holder 130, for example, each winding assembly 131 being uniformly distributed in the circumferential direction of the holder 130.

Illustratively, the tensioning mechanism 13, the free end of the telescoping member 11 may each be provided with a docking mechanism 14 for passing an instrument therethrough and securing the support device 10. The docking mechanism 14 includes one or more of a jaw 141, a tube interface 142, and the like.

As shown in conjunction with fig. 6 and 7, the surgical system of the present embodiment includes a first mechanical arm 31 and a second mechanical arm 32, both of which are mounted on a carriage 50, a medical instrument 40 including a first instrument 41 and a second instrument 42, the first instrument 41 including a first driver 410 and a first elongated instrument 411, the second instrument 42 including a second driver 420 and a second elongated instrument 421, the second elongated instrument 421 having a hollow instrument channel 422 through which the first elongated instrument 411 can pass.

The free ends of the first and second mechanical arms 31, 32 are each provided with a drive interface C for outputting torque, the first driver 410 of the first instrument 41 is mounted on the drive interface C of the first mechanical arm 31, the second driver 420 of the second instrument 42 is mounted on the drive interface C of the second mechanical arm 32, and the output torque of the mechanical arm ends can be transferred to the corresponding drivers through the respective drive interfaces C, so that the corresponding elongated instruments are driven to bend in the corresponding directions, and the first instrument 41 can extend out of the second instrument 42 through the instrument channel 422. When the first mechanical arm 31 and the second mechanical arm 32 perform relative movement, the length of the first instrument 41 extending out of the second instrument 42 is changed, and the first mechanical arm 31 and the second mechanical arm 32 can also synchronously advance or retreat.

In other embodiments, the number of mechanical arms may be greater, or the mechanical arms may all be mounted on the operating table 60, or at least one mechanical arm may be mounted on each of the trolley 50 and the operating table 60.

Fig. 7 shows a low-cost surgical system with simple control algorithm and high reliability, wherein the first mechanical arm 31 and the second mechanical arm 32 respectively have 3 arms and 3 joints J1, J2 and J3, the first mechanical arm 31 and the second mechanical arm 32 are respectively rotatably connected on the same carriage 51 through the joint J1 closest to the trolley 50, the carriage 51 is arranged on the trolley 50 in a lifting manner, the rotating shafts of the joints of the first mechanical arm 31 are parallel, the rotating shafts of the joints of the second mechanical arm 32 are parallel, and the rotating shafts of the first mechanical arm and the second mechanical arm are parallel. In this way, the first and second robot arms 31 and 32 can change their heights in synchronization with each other in the vertical direction and can also be rotated arbitrarily in the horizontal direction. The height of the first mechanical arm 31 and the second mechanical arm 32 can be adjusted to adapt to the natural cavity channel of the human body, such as the oral cavity, or the height of the wound, so that the instrument can be inserted into the human body, and after the instrument enters the human body through the natural cavity channel or the wound, the feeding amount of the instrument can be adjusted by driving the rotation of each arm of the first mechanical arm 31 and the second mechanical arm 32. By varying the drive commands to the respective drivers 410/420 on the instruments 41/42, the bending conditions (e.g., bending direction, curvature, etc.) of each elongated instrument 411/421 can be varied to accommodate the shape of the human body lumen tract.

It is to be understood that the number of arms and the number of joints on the first and second robot arms 31, 32 are not limited thereto, and may be more. Compared with the traditional seven-axis mechanical arm, the mechanical arm is more suitable for the feeding type surgical system, and because a complex control algorithm is not needed, the mechanical arm is simpler in structure and control mode, lower in cost and higher in reliability.

Referring to fig. 8, a surgical system is shown in which instruments may be inserted into the upper lung lobes a.

Because the lumen diameters of the bronchi at different levels are not the same, the deeper level lumens are narrower, so the diameter of the elongate instrument needs to be as small as possible if the instrument is required to enter the deeper level. However, in the anterior segment of the bronchial tree (not before reaching the upper lobe of the lung), such an elongate instrument may have a large gap with the lumen and may be severely shaky. If the target lesion is located at the anterior segment of the bronchial tree, the catheter can have large sloshing in the lumen, causing the problem of inaccurate navigation accuracy. Thus, during surgery of the anterior segment of the bronchial tree, the surgical system introduces the second elongated instrument 421, which may correct the accuracy of the movement of the first elongated instrument 411 within the anterior segment of the bronchial tree. During the operation, the operation of the device on the anterior segment of the bronchial tree can be completed by the second elongated device 421 matching with the first elongated device 411, i.e. the second elongated device 421 is sleeved outside the first elongated device 411, and the two devices advance synchronously.

When the lesion is located on the upper lobe a of the lung, the first elongate instrument 411 needs to be bent at a larger angle with a smaller bending radius to access the next bronchi. However, the thinner first elongate instrument 411 lacks support in the steeper bronchial lumen and is less efficient in transmitting axial motion and more difficult to further enter the next lumen, thus limiting coverage of the upper lobe a region of the lung by the catheter. Thus, the feeding of the device on the upper lobe a of the lung still requires the introduction of the second elongated device 421, which can perform a rigid supporting and guiding function on the first elongated device 411 in a steep and large-angle cavity, ensuring the accuracy of the axial motion transmission of the first elongated device 411 at this angle and greatly expanding the coverage of the upper lobe a area of the lung by the first elongated device 411. Specifically, as the instruments enter the upper lobe a of the lung from the anterior segment of the bronchial tree, the first elongated instrument 411 begins to move synchronously through the second elongated instrument 421, and when the bronchi with smaller or steeper lumen diameter enter the patient and cannot go on, the second elongated instrument 421 stops advancing, the distal end of the second elongated instrument 421 can be kept at a specific orientation by controlling the tension of the driving wire in the second elongated instrument 421 by controlling the second driver 420, and then the first elongated instrument 411 is continuously controlled to advance, during which time, the orientation of the distal end of the first elongated instrument 411 can be adjusted as required by controlling the tension of the driving wire applied to the first elongated instrument 411 by the first driver 410, so that the distal end of the first elongated instrument 411 reaches the focus.

During the above-mentioned operation, especially during the insertion of the instrument into the upper lobe a of the lung, the first elongated instrument 411 is inevitably arched due to the resistance of the bronchial lumen, causing buckling of the extracorporeal portion, which results in an inaccurate implementation of the control command. Thus, the surgical system may further include the support device 10 through which the instrument passes, where the support device 10 may radially limit the instrument, and where the support device 10 may be configured by more than one, for example, the first support device 10A as one of the support devices 10, where the first support device 10A is configured such that after the first elongated instrument 411 passes through the first channel H1 of the first support device 10A and enters the instrument channel 422, both ends of the first support device 10A are respectively fixed relative to the first driver 410 and the second driver 420, so that after the first driver 410 and the second driver 420 are respectively mounted to the first mechanical arm 31 and the second mechanical arm 32, the first channel H1 of the first support device 10A is always radially limited and tensioned as a function of preventing buckling of the first elongated instrument 411, regardless of whether the first elongated instrument is fed or pulled out. The diameter of the first channel H1 of the first support means 10A is slightly larger than the diameter of the first elongated instrument 411, for example 5-6 mm.

During surgery, when the lesion is located at a deeper level of the bronchi, the lumen diameter of the lesion is smaller, and the second elongated instrument 421 cannot be accessed, so that the first elongated instrument 411 is decoupled from the second elongated instrument 421 in advance and moves independently, and is controlled to enter the deeper level.

As shown in fig. 9, a surgical system is shown in which instruments can be inserted into the subpulmonary leaflet B. Based on the embodiment shown in fig. 8, the surgical system of this embodiment may further include a second supporting device 10B that is axially retractable, wherein the second supporting device 10B is used as another supporting device 10 different from the first supporting device 10A, the second supporting device 10B is configured such that one end is relatively fixed to the second driver 420, the other end is relatively fixed to the operating table 60, and the second elongated instrument 421 is disposed through the first channel H1 of the second supporting device 10B, and the second supporting device 10B is retractable according to the distance between the second mechanical arm 32 and the operating table. That is, in addition to radially restraining and tensioning the first elongated instrument 411 exposed between the two robotic arms 31, 32, the surgical system of the present embodiment also restrains and tensions the second elongated instrument 421 outside the human body, preventing buckling of the second elongated instrument 421 through which the first elongated instrument 411 is threaded. The diameter of the first channel H1 of the second support means 10B is slightly larger than the diameter of the second elongated instrument 421, which may be for example 6-7 mm. In some embodiments, the first channel H1 of the first support device 10A and the first channel H1 of the second support device 10B are of the same or similar specifications, and each has a diameter of 5-7 mm, and can be used to support the first elongated instrument 411 or the second elongated instrument 421, thereby improving the versatility of the consumable.

In one embodiment, the surgical system further comprises a guide mechanism 70, the guide mechanism 70 being hollow and tubular and configured to be secured to the patient's side, such as by a securing bracket 80 to the surgical bed 60, for the first 411 and second 421 elongate instruments to pass through, the other end of the second support device 10B being securable to the guide mechanism 70.

Referring to fig. 4A and 6, to mount the support device 10, the distal end of the first driver 410 has a first mounting interface S1, where the first mounting interface S1 is tubular and is sleeved on the outer surface of the first elongated instrument 411, and for example, the first mounting interface S1 is detachably fixed to the first driver 410. When the support apparatus 10 is mounted to the first driver 410, one of the docking mechanisms 14 of the support apparatus 10 (e.g., the docking mechanism 14 proximate to the tensioning mechanism 13) is aligned with and engaged with the first mounting interface S1, e.g., the first mounting interface S1 is at least partially inserted into the docking mechanism 14, and the docking mechanism 14 is interference fit or snapped into engagement with the first mounting interface S1. Similarly, the distal end of the second driver 420 may also have a second mounting interface S2 for mounting the support device 10. The proximal end of the second driver 420 may be aligned with and engaged with another docking mechanism 14 of the support apparatus 10, e.g., the docking mechanism 14 is at least partially inserted into the proximal end of the second driver 420, with an interference fit with the inlet of the second driver 420 for insertion of the first elongate instrument 411.

As shown in fig. 10, in yet another usage method of the surgical system of the present embodiment, a first interface 412 on the first driver 410 for engaging the first mechanical arm 31 and a second interface 423 on the second driver 420 for engaging the second mechanical arm 32 are the same, that is, the driving interfaces C on the two mechanical arms 31, 32 are the same, and the second mechanical arm 32 can selectively engage the first interface 412 and the second interface 423 to transmit torque. In such a case, the surgical system may include only the second robot arm 32, or although it includes both the first robot arm 31 and the second robot arm 32, only the second robot arm 32 may be applied, the first instrument 41 that was originally mounted to the first robot arm 31 may be mounted to the second robot arm 32, the second instrument 42 may not be mounted, and only the first instrument 41 may be applied to perform the surgery. This method of use is suitable when the lesion is located in a smooth area of a deeper level of the bronchi, such as the lower lobes of the lung, and since there is no complex curved lumen, it is sufficient to insert only the first elongate instrument 411 into the body. By fixing one end of the second supporting device 10B to the first driver 410 and the other end to the operating table 60, after the first driver 410 is mounted to the second mechanical arm 32, the second supporting device 10B can be stretched and contracted along with the distance between the second mechanical arm 32 and the operating table 60, and can tighten the first elongated instrument 411 outside the body to limit the first elongated instrument in the radial direction. The surgical costs can be made lower because the second instrument 42 is not needed.

It will be appreciated that when only the first instrument 41 is inserted into the human body for surgery, the first mechanical arm 31 may be controlled to rotate to deviate from the feeding direction before surgery, and only the second mechanical arm 32 is controlled to perform feeding of the first instrument 41, thereby avoiding the influence of the first mechanical arm 31 on the surgical procedure. In other embodiments, it is also possible that the surgical system has only one mechanical arm, which by cooperation with the first instrument 41 effects a feeding of the first instrument 41 within a smoother lumen. In addition, the surgical system can be applied to not only the pulmonary lumen, but also the cardiac and vascular lumen surgery.

In the description of the present specification, a description referring to terms "one embodiment," "some embodiments," "examples," "specific examples," or "some examples," etc., means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present invention. In this specification, schematic representations of the above terms are not necessarily directed to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, the different embodiments or examples described in this specification and the features of the different embodiments or examples may be combined and combined by those skilled in the art without contradiction.

While embodiments of the present invention have been shown and described above, it will be understood that the above embodiments are illustrative and not to be construed as limiting the invention, and that variations, modifications, alternatives and variations may be made to the above embodiments by one of ordinary skill in the art within the scope of the invention.

Claims (16)

1. A telescopic support device for axially supporting a medical instrument, comprising:

-a telescopic member (11) deformable in an axial direction, having a first end and a second end in an axial direction, said telescopic member (11) comprising a coupling portion (110) between said first end and said second end and a first channel (H1) extending through its axial direction for the passage of a medical instrument;

a flexible traction rope (12) having one end fixed relatively to the second end of the expansion element (11) and the other end movably passing through the coupling portion (110);

and the tensioning mechanism (13) is connected to the first end of the telescopic piece (11) and coupled with the other end of the traction rope (12) and is configured to maintain the tensioning state of the traction rope (12) during the axial deformation of the telescopic piece (11).

2. Telescopic support device according to claim 1, wherein the telescopic member (11) is provided with a plurality of coupling portions (110) spaced apart in the axial direction, the traction ropes (12) passing through the plurality of coupling portions (110) simultaneously.

3. Telescopic support device according to claim 1, comprising at least two of said traction ropes (12), said telescopic element (11) comprising at least two sets of said coupling portions (110) arranged radially at intervals; each group of the coupling parts (110) comprises a plurality of coupling parts (110) which are arranged at intervals along the axial direction of the telescopic piece (11), and each traction rope (12) respectively and movably passes through one group of the coupling parts (110).

4. Telescopic support device according to claim 1, wherein the coupling portion (110) is provided at the periphery of the first channel (H1), comprising a through hole penetrating the outer wall of the telescopic member (11).

5. Telescopic support device according to claim 1, wherein the telescopic member (11) comprises a bellows or a spring.

6. The telescopic support device according to claim 1, wherein the tensioning mechanism (13) comprises a holder (130) and a winding assembly (131), the winding assembly (131) being rotatably arranged on the holder (130) by means of a first rotation axis (X1); the retainer (130) is connected to the first end of the telescopic member (11) and comprises a second channel (H2) for a medical instrument to pass through, and the other end of the traction rope (12) is wound on the winding assembly (131) and is tensioned by the winding assembly (131).

7. The telescopic support device according to claim 6, wherein the winding assembly (131) comprises a wire spool (131 a) and a coil spring (131 b), the traction rope (12) is wound around an outer circumferential surface of the wire spool (131 a), and both ends of the coil spring (131 b) are respectively connected to the wire spool (131 a) and the first rotary shaft (X1) and provide a tensioning force to the traction rope (12).

8. The telescopic support device according to claim 6, wherein the tensioning mechanism (13) further comprises a guide wheel (132), the cage (130) further comprising a side hole (H3) through the inner wall of the second channel (H2);

the guide wheel (132) is rotatably arranged on the retainer (130) through a second rotating shaft (X2), at least part of the guide wheel (132) is positioned in the side hole (H3) and/or the second channel (H2), and the traction rope (12) on the winding assembly (131) enters the second channel (H2) through the side hole (H3) after being guided by the guide wheel (132).

9. The telescopic support device according to claim 6, wherein the tensioning mechanism (13) comprises a plurality of the wire winding assemblies (131), each wire winding assembly (131) being arranged at intervals in the circumferential direction of the holder (130).

10. Telescopic support device according to any of claims 1-9, wherein the tensioning means (13) and the free end of the telescopic member (11) are each provided with a docking means (14) for passing an instrument and securing the support device.

11. A surgical system comprising at least one support device according to any one of claims 1 to 10 and a medical instrument which passes at least partially through the first channel (H1) of the at least one support device and is radially restrained by the support device.

12. The surgical system of claim 11, further comprising:

a first mechanical arm (31);

a second robot arm (32);

the medical instrument comprises a first instrument (41) and a second instrument (42), the first instrument (41) comprising a first driver (410) and a first elongated instrument (411), the second instrument (42) comprising a second driver (420) and a second elongated instrument (421), the second elongated instrument (421) having a hollow instrument channel (422) through which the first elongated instrument (411) can pass;

one of the support devices is configured to be relatively fixed to the first driver (410) and the second driver (420) at both ends after the first elongated instrument (411) passes through the first channel (H1) thereof and enters the instrument channel (422), so as to be telescopic with the distance between the first mechanical arm (31) and the second mechanical arm (32) after the first driver (410) and the second driver (420) are respectively mounted to the first mechanical arm (31) and the second mechanical arm (32).

13. The surgical system according to claim 12, wherein the other of the support devices is configured to be fixed at one end relative to the second driver (420) and at the other end relative to a surgical bed (60), and the second elongated instrument (421) is disposed through the first channel (H1) of the other of the support devices, the other of the support devices telescoping as a function of the distance between the second robotic arm (32) and the surgical bed.

14. The surgical system of claim 12, wherein a first interface (412) on the first driver (410) for engaging the first robotic arm (31) and a second interface (423) on the second driver (420) for engaging the second robotic arm (32), the second robotic arm (32) being selectively engageable with the first interface (412), the second interface (423) to transfer torque.

15. The surgical system according to any one of claims 12 to 14, wherein the rotational axes at the respective joints of the first robot arm (31) are parallel to each other, the rotational axes at the respective joints of the second robot arm (32) are parallel to each other, and the rotational axes of the first and second robot arms are parallel to each other.

16. The surgical system of claim 11, further comprising a second robotic arm (32);

the medical instrument comprises a first instrument (41), the first instrument (41) comprising a first driver (410) and a first elongated instrument (411);

one of the support devices is configured to be relatively fixed to the first driver (410) at one end and to be relatively fixed to an operating table at the other end so as to be telescopic with a change in distance between the second mechanical arm (32) and the operating table after the first driver (410) is mounted to the second mechanical arm (32).