EP4267032A1

EP4267032A1 - Catheter robot comprising at least two modules for moving an elongate flexible medical instrument in translation

Info

Publication number: EP4267032A1
Application number: EP21843736.6A
Authority: EP
Inventors: Laurent DE CROUY-CHANEL
Original assignee: Robocath
Current assignee: Robocath
Priority date: 2020-12-28
Filing date: 2021-12-22
Publication date: 2023-11-01
Also published as: FR3118406A1; WO2022144266A1; KR20230124932A; CN116867458A; US20240058082A1; FR3118406B1; JP2024500540A

Abstract

The invention relates to a catheter robot having a longitudinal axis and comprising: a catheter robot holder (14), a distal module comprising an internal mechanism for moving an external elongate flexible medical instrument in longitudinal translation and rotation, a proximal module comprising an internal mechanism for moving an internal elongate flexible medical instrument in longitudinal translation and rotation, the distal module being intended to be disposed between the patient and the proximal module, the external elongate flexible medical instrument surrounding the internal elongate flexible medical instrument along at least a part of the longitudinal axis, characterized in that: the proximal module is movable in longitudinal translation with respect to the holder (14) and/or with respect to the distal module, the proximal module also comprises an internal mechanism for rotating the external elongate flexible medical instrument, which is feedback-controlled according to the rotation of the internal mechanism for moving the external elongate flexible medical instrument in longitudinal translation and rotation of the distal module .

Description

DESCRIPTION

TITLE ; CATHETER ROBOT COMPRISING AT LEAST TWO EXTENDED FLEXIBLE MEDICAL DEVICE TRANSLATION MODULES

FIELD OF THE INVENTION

The invention relates to a catheter robot that automates the translation and rotation of an elongated flexible medical instrument located between two modules each comprising an internal mechanism for the longitudinal translation and rotation of an elongated flexible medical instrument.

TECHNOLOGICAL BACKGROUND OF THE INVENTION

According to a prior art, the catheter robot has a longitudinal axis. The catheter robot comprises a catheter robot support, a distal module, comprising an internal mechanism for longitudinal translation and rotation of an external elongated flexible medical instrument, a proximal module, comprising an internal mechanism for longitudinal translation and rotation of a internal elongated flexible medical instrument. The distal module is placed between the patient and said proximal module. The outer elongated flexible medical instrument surrounds, on at least a portion of the longitudinal axis, the inner elongated flexible medical instrument.

The internal elongated flexible medical instrument will have to ensure two types of movement, in particular in translation. On the one hand, a generic movement in translation, simply to be able to follow the movement in translation of the external elongated flexible medical instrument. On the other hand, a specific displacement in translation, to be able to respond to the command of the user wishing a specific relative movement between the external elongated flexible medical instrument and the internal elongated flexible medical instrument. The translational movement of the internal elongated flexible medical instrument will be the combination of the generic translational movement and the specific translational movement.

The management of this movement in translation of the internal elongated flexible medical instrument on the one hand will be quite complex and on the other hand may require great lengths of internal elongated flexible medical instrument, especially if the catheter robot no longer comprises only two , but three coaxial elongated flexible medical instruments, which will often be the case in practice. INVENTION

The object of the present invention is to provide a catheter robot which at least partially overcomes the aforementioned drawbacks.

More particularly, the invention aims to provide a catheter robot:

> which firstly simplifies the complexity of the translation movement of an elongated flexible medical instrument located between two modules each comprising an internal mechanism for the longitudinal translation and rotation of an elongated flexible medical instrument, by creating a variable distance between the two mods,

> and which then solves a problem of torsion of an elongated flexible medical instrument located between two modules each comprising an internal mechanism for the longitudinal translation and rotation of an elongated flexible medical instrument, made important by the creation of this variable distance between the two mods.

More precisely, the invention proposes first of all to be able to manage part of this movement in translation of the internal elongated flexible medical instrument by an overall displacement of the whole of the proximal module and of the internal elongated flexible medical instrument which move together relative to the support of the catheter robot in order to be able to vary the distance between the distal module and the proximal module.

This variable distance between the distal module carrying the external elongated flexible medical instrument and the proximal module carrying the internal elongated flexible medical instrument, will generate a first problem of risk of buckling of the external elongated flexible medical instrument. But this variable distance between the distal module carrying the external elongated flexible medical instrument and the proximal module carrying the internal elongated flexible medical instrument will above all render preponderant a second problem of torsion of the external elongated flexible medical instrument between the distal module and the proximal module.

It could be envisaged to solve this second torsion problem by using an external elongated flexible medical instrument guide between the distal module and the proximal module. But then, not only on the one hand would this guide be a relatively expensive element and would have a relatively complex structure to solve this second problem of torsion, then having to be able to deform in torsion, while sparing this deformation in torsion to the medical instrument external elongated flexible, but also on the other hand, for reasons of sanitary hygiene, because of its close proximity to the external elongated flexible medical instrument, this guide should be a consumable element discarded each time for each new patient. The invention then proposes, to manage this second problem of torsion of the external elongated flexible medical instrument, made preponderant by this variable distance between the distal module carrying the external elongated flexible medical instrument and the proximal module carrying the medical instrument internal elongated flexible medical instrument, to integrate in the proximal module an internal mechanism for rotation of the external elongated flexible medical instrument, which would be slaved to the rotation of the internal mechanism for longitudinal translation and rotation of the already existing external elongated flexible medical instrument in the distal module.

This internal mechanism of rotation of the external elongated flexible medical instrument, integrated in the proximal module, solves the second preponderant problem of torsion of the external elongated flexible medical instrument, but it does not address the first problem of risk of buckling of the external elongated flexible medical instrument generated by the creation of a variable distance between the distal module bearing the external elongated flexible medical instrument and the proximal module bearing the internal elongated flexible medical instrument.

To this end, the present invention proposes a catheter robot having a longitudinal axis, and comprising: a catheter robot support, a distal module, comprising an internal mechanism for longitudinal translation and rotation of an external elongated flexible medical instrument, a module proximal, comprising an internal mechanism for longitudinal translation and rotation of an internal elongated flexible medical instrument, said distal module being intended to be placed between the patient and said proximal module, said external elongated flexible medical instrument surrounding, on at least a portion of the longitudinal axis, said internal elongated flexible medical instrument, characterized in that: said proximal module is movable in longitudinal translation relative to the support and/or relative to said distal module, said proximal module also comprises an internal mechanism for rotation of said external elongated flexible medical instrument, slaved to the rotation of said internal translation mechanism n longitudinal and rotation of said external elongated flexible medical instrument of said distal module.

Preferably, said distal module is fixed relative to the support, said external elongated flexible medical instrument is a guide catheter, said internal elongated flexible medical instrument is a catheter. Thus, the torsion problem of the guide catheter is solved.

Preferably, said distal module is movable in longitudinal translation relative to the support, said proximal module is movable in longitudinal translation relative to the support, said external elongated flexible medical instrument is a catheter, said internal elongated flexible medical instrument is a catheter guide . Thus, the torsion problem of the catheter is solved. To this end, the present invention also proposes a catheter robot having a longitudinal axis, and comprising: a catheter robot support, a first module, comprising an internal mechanism for longitudinal translation and rotation of a guide catheter, fixed relative to the support, a second module, comprising an internal mechanism for the longitudinal translation and rotation of a catheter, a third module, comprising an internal mechanism for the longitudinal translation and rotation of a catheter guide, characterized in that: the said second module is movable in longitudinal translation relative to the support, said third module is movable in longitudinal translation relative to the support and relative to the second module, said second module also comprises an internal mechanism for rotating said guide catheter, slaved to the rotation of said internal mechanism longitudinal translation and rotation of said guide catheter of said first module, said third modu the, also comprises an internal mechanism for rotation of said catheter, slaved to the rotation of said internal mechanism for longitudinal translation and rotation of said catheter of said second module.

According to embodiments of the invention, in order to be able to use catheters of the OTW ("Over The Wire" in English) type, the drive members which control the movements of the guide catheter, of the catheter, and of the catheter guide , will see their parts being spaced from each other in order to allow a relative translational movement between these different parts of drive members. Then, due to the spacing between the different parts of drive members, the guide catheter and the catheter will encounter an increased risk of deforming at this spacing.

To solve this type of deformation problem, a guide could be placed between the different drive member parts in order to guide the movement of the medical instruments in the spacing between said drive member parts. However, when the parts of drive members are movable in translation in order to allow relative movement between them, the guide located between them will then have to accept the movements of said parts of drive members, which will then require the use of a guide with a complex structure (for example telescopic or concertina). However, for hygiene reasons, this guide is a single-use item that is replaced each time the robot is used for each new patient.

But, in fact, the most troublesome and most complex deformation to manage is the twisting of the medical instrument around its own axis. The deformable guide system following the movements of the parts of drive members, in addition to being complex and expensive because of single use, may also not be sufficient to prevent twisting of the catheter or of the guide catheter. According to preferred embodiments, the invention comprises one or more of the following characteristics which can be used separately or in partial combination with each other or in total combination with each other, with one or other of the aforementioned objects of the invention .

Preferably, said catheter robot comprises a control unit configured to control the longitudinal translation of the proximal module by slaving it to the longitudinal translation of the external elongated flexible medical instrument, and to control the longitudinal translation of the flexible medical instrument internal elongated by compensating the longitudinal translation of the proximal module so as to maintain the flexible internal elongated medical instrument stationary with respect to the support.

Thus, when a first elongated flexible medical instrument is moved in translation by a first translational module, and when a second translational module of a second elongated flexible medical instrument is slaved to this translational movement, and when simultaneously this second elongated flexible medical instrument does not need to be moved in translation, then this second elongated flexible medical instrument can still be maintained at the same place, by transmitting to it two mutually opposed translational movements which compensate for each other exactly mutually, the movement in translation of the second module in translation in a first direction, and the movement in translation of the second flexible medical instrument elongated relatively with respect to the second module in translation in a second direction, parallel and opposite to the first direction , the two translational movements being of equal force. The translational movement of the second module relative to the first medical instrument can be controlled so as to permanently maintain a certain distance with the first module in translation, so as to avoid a collision between the two modules in translation.

Preferably, in a similar way, said catheter robot comprises a control unit configured to control the longitudinal translation of the second module by slaving it to the longitudinal translation of the guide catheter, and to control the longitudinal translation of the catheter by compensating for the longitudinal translation of the second module so as to keep the catheter stationary with respect to the support.

Preferably, in a similar manner, said catheter robot comprises a control unit configured to control the longitudinal translation of the third module by slaving it to the longitudinal translation of the catheter, and to control the longitudinal translation of the catheter guide by compensating for the translation longitudinal of the third module so as to maintain the catheter guide stationary with respect to the support. Preferably, said second module does not include any other internal mechanism capable of ensuring a movement of said guide catheter other than the rotation of said guide catheter.

Thus, while remaining very effective, the second module is much simplified.

Alternatively, said internal rotation mechanism of said guide catheter of said second module is also capable of ensuring the longitudinal translation of said guide catheter.

Preferably, said first module also comprises a device for clamping only said guide catheter, said second module also comprises a device for clamping only said catheter.

Thus, while remaining very effective, the second module is much simplified.

Preferably, said third module also comprises a device for clamping only said catheter guide.

Thus, while remaining very effective, the second module is much simplified.

Preferably, said first module also comprises an additional internal mechanism for longitudinal translation and rotation of said guide catheter which can operate alternately with said internal mechanism for longitudinal translation and rotation of said guide catheter of said first module, said second module also comprises an additional internal mechanism longitudinal translation and rotation of said catheter operable alternately with said internal mechanism for longitudinal translation and rotation of said catheter of said second module, said third module also comprises an additional internal mechanism for longitudinal translation and rotation of said catheter guide operable alternately with said internal mechanism for longitudinal translation and rotation of said catheter guide of said third module.

Thus, the translational movement of the various elongated flexible medical instruments will be able to be made more fluid and faster, at the cost, however, of a certain complexity of the entire catheter robot. But this improvement in fluidity and speed, making it more natural for the practitioner to move the various elongated flexible medical instruments in translation, will thus be able to be carried out in a more controlled manner by the practitioner, and therefore ultimately , in an overall more secure way, while being more efficient.

Alternatively, said second module also comprises an additional internal mechanism for longitudinal translation and rotation of said guide catheter that can operate alternately with said internal mechanism for rotation of said guide catheter of said second module, said internal mechanism for rotation of said guide catheter of said second module also able to ensure the longitudinal translation of said guide catheter, said third module also comprises an additional internal mechanism for longitudinal translation and rotation of said catheter able to operate alternately with said internal mechanism for rotating said catheter of said third module, said internal mechanism for rotating said catheter of said third module which can also ensure the longitudinal translation of said catheter.

Preferably, said catheter robot comprises: a first Y connector located between said internal mechanism for rotation of said guide catheter of said second module and said internal mechanism for longitudinal translation and rotation of said catheter of said second module, a second Y connector located between said internal mechanism rotation of said catheter of said third module and said internal mechanism for longitudinal translation and rotation of said catheter guide of said third module.

Thus, other elongated flexible medical instruments or other products can be added laterally to the longitudinal axis of the catheter robot, therefore from the side, so as to then be moved in translation parallel to the elongated flexible medical instruments already in line along the longitudinal axis of the catheter robot.

Preferably, said first Y connector is fixed to said internal mechanism for rotation of said guide catheter of said second module and to said internal mechanism for longitudinal translation and rotation of said catheter of said second module, said second Y connector is fixed to said internal mechanism for rotation of said catheter of said third module and to said internal mechanism for longitudinal translation and rotation of said catheter guide of said third module.

Thus, the first Y connector and the second Y connector further improve the management of the torsion problem, respectively of the guide catheter and of the catheter.

Advantageously, said first Y connector is fixed to said internal rotation mechanism of said guide catheter of said second module via a first rotary joint. Advantageously, said second Y connector is fixed to said internal rotation mechanism of said catheter of said third module via a second rotary joint.

Preferably, on at least part of said longitudinal axis: said guide catheter surrounds said catheter which itself surrounds said catheter guide.

Thus, the catheter robot can be used in a coaxial configuration where the elongated flexible medical instruments are all coaxial with one another, over at least part of their length. Preferably, said second module and said third module are structurally identical to each other.

Thus, the overall structure of the catheter robot is simplified, without sacrificing its overall efficiency.

Preferably, one, several or all of the internal longitudinal translation and rotation mechanisms of an elongated flexible medical instrument which can be a guide catheter, a catheter or a catheter guide, comprises: two keys which can approach and move away to respectively clamping or releasing said elongated flexible medical instrument, said two keys being able to perform a synchronous longitudinal translation to translate said elongated flexible medical instrument, said two keys being able to perform opposite transverse translations to cause said elongated flexible medical instrument to rotate around the longitudinal axis .

Thus, this catheter robot presents a very good compromise between efficiency and simplicity.

Preferably, said catheter robot does not include any deformable guide located around one or the other of the elongated flexible medical instruments.

Thus, the structure of the catheter robot is simpler while its use is made less expensive.

In one embodiment, one or more or all of the modules include a movable platform sliding longitudinally in at least one rail.

In another embodiment, one or more or all of the modules comprise a longitudinally rolling carriage.

According to another object, the invention relates to a catheter robot having a longitudinal axis, and comprising:

> a catheter robot support,

> a distal module, comprising an internal mechanism for the longitudinal translation and rotation of an external elongated flexible medical instrument,

> a proximal module, comprising an internal mechanism for the longitudinal translation and rotation of an internal elongated flexible medical instrument,

> said distal module being intended to be placed between the patient and said proximal module,

> said external elongated flexible medical instrument surrounding, on at least part of the longitudinal axis, said internal elongated flexible medical instrument, characterized in that:

> said proximal module is movable in longitudinal translation relative to the support and/or relative to said distal module, > at least one of the internal longitudinal translation and rotation mechanism of the internal elongated flexible medical instrument and the internal longitudinal translation and rotation mechanism of the external elongated flexible medical instrument consists of a part of a pair of keys able to approach and move away to respectively grip or release the elongated flexible medical instrument, said pair of keys being able to perform a synchronous longitudinal translation to translate said elongated flexible medical instrument, said pair of keys being able to perform opposite transverse translations to rotating said elongated flexible medical instrument around its longitudinal axis, and on the other hand a clamping device alone of the elongated flexible medical instrument.

Such a catheter robot makes it possible to limit the size, while allowing to control in translation and in rotation two elongated flexible medical instruments.

Other characteristics and advantages of the invention will appear on reading the following description of a preferred embodiment of the invention, given by way of example and with reference to the appended drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[Fig.1] Figure 1 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a first possible embodiment variant according to the invention.

[Fig.2] Figure 2 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a second possible embodiment variant according to the invention.

[Fig.3] Figure 3 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a third possible embodiment variant according to the invention.

[Fig-4] Figure 4 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a fourth possible embodiment variant according to the invention.

DETAILED DESCRIPTION OF THE EMBODIMENTS OF THE INVENTION

Throughout the remainder of the text of the description, and for all the figures, reference will be made indiscriminately to catheter robot, medical robot or medical catheter robot. The longitudinal axis of the catheter robot 1 is the axis common to the three flexible medical instruments coaxial elongates, guide catheter 2, catheter 3, and guide catheter 4. According to a possible variant, it is possible to use more than three flexible medical instruments. It is thus possible, for example, to use two catheters, the two catheters thus being parallel to the longitudinal axis of the catheter robot 1 and are introduced inside the guide catheter 2.

FIG. 1 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a first possible embodiment variant according to the invention.

According to a first alternative embodiment of the invention, at least one elongated flexible medical instrument drive element is placed at the proximal end of the guide catheter 2 and at the proximal end of the catheter 3, this element of the drive being configured to perform the same rotational movement at the proximal end of the elongated flexible medical instrument as the rotational movement imparted to the distal end of this elongated flexible medical instrument, thereby preventing twisting of the medical instrument flexible elongated.

In the first variant illustrated in Figure 1, a medical robot 1 for driving elongated flexible medical instruments comprises a first drive member 5 which controls the movements of a guide catheter 2, a second drive member 6 which controls the movements of a catheter 3, and a third drive member 7 which controls the movements of a guide 4 of the catheter.

The catheter guide 4 is placed inside the catheter 3, on which a stent or a balloon can for example be mounted, said catheter 3 itself being placed inside the guide catheter 2.

The first drive member 5 drives the guide catheter 2 according to a translational movement along the main axis of elongation, also called the longitudinal axis, of said guide catheter 2, and according to a rotational movement around the main axis elongation of said guide catheter 2. Similarly, the second drive member 6 drives the catheter 3 according to a translational movement along the main axis of elongation of said catheter 3, and according to a rotational movement around the main axis of elongation of said catheter 3. Similarly, the third drive member 7 drives the guide 4 of the catheter according to a translational movement along the main axis of elongation of the said guide 4 of the catheter, and according to a rotational movement around the main axis of elongation of said catheter guide 4. Guide catheter 2 partially surrounds catheter 3 which itself partially surrounds guide catheter 4. The guide catheter 2, the catheter 3, and the catheter guide 4 are coaxial with each other, over part of their length. In order to control the movements of the guide catheter 2, the first drive member 5 comprises four identical elements 51 which are each configured to grip the guide catheter 2 and give it a translational movement and/or a rotational movement. Each element 51 is formed by a pair of manipulator fingers, the two fingers being located opposite each other, as described for example in the document FR3044541 (see in particular FIGS. 4a-4e and 5a-5e) , incorporated by reference. The four elements 51 are divided into two pairs spaced apart from each other along the main axis of elongation of the guide catheter 2. A first pair 5a of elements 51 is located at the proximal end of the guide catheter 2 and is fixed to the Y connector 21 of the guide catheter 2, and more precisely to the pivot 22 of the Y connector 21. The second pair 5b of elements 51 is located at the distal end of the medical robot 1. This pair 5b of elements 51 is carried by a base 12 which is fixed relative to the support 14 (and to the housing, whether the latter is closed or partially open or completely open) of the medical robot 1. The movements of the first pair 5a and of the second pair 5b d elements 51 are synchronized so that the movement performed by the first pair 5a is identical to the movement performed by the second pair 5b. The fact that the same movement is imparted by the two pairs of elements 51 makes it possible to prevent the guide catheter 2 from deforming at the level of the spacing between said two pairs 5a and 5b of elements 51, in particular by preventing the twisting of the guide catheter 2 around its own axis.

The first pair 5a is mobile in translation relative to the second pair 5b of elements 51 along the main axis of elongation of the guide catheter 2. To do this, the first pair 5a is mounted on a first mobile platform 10 which can for example be arranged on rails, and the second pair 5b of elements 51 is kept fixed on the robot 1. The guide catheter 2 can thus be inserted or withdrawn by moving the first mobile platform 10 forwards or backwards.

In order to control the movements of the catheter 3, the second drive member 6 comprises four identical elements 61 which are each configured to clamp the catheter 3 and give it a translational movement and/or a rotational movement. Each element 61 is formed by a pair of manipulator fingers, the two fingers being located opposite each other, as described for example in the document FR3044541 (see in particular FIGS. 4a-4e and 5a-5e) , incorporated by reference. The four elements 61 are divided into two pairs spaced apart from each other along the main axis of elongation of the catheter 3. A first pair 6a of elements 61 is located at the proximal end of the catheter 3 and is fixed to the Y connector 31 of the catheter 3, and more precisely to the pivot 32 of the Y connector 31. The second pair 6b of elements 61 is located at the distal end of the medical robot 1. The movements of the first pair 6a and of the second pair 6b of elements 61 are synchronized so that the movement performed by the first pair 6a is identical to the movement performed by the second pair 6b. The fact that the same movement is imparted by the two pairs of elements 61 makes it possible to prevent the catheter 3 from deforming at the level of the spacing between said two pairs of elements 61, in particular by preventing twisting of the catheter 3 around its own axis.

The first pair 6a is movable in translation with respect to the second pair 6b of elements 61 along the main axis of elongation of the catheter 3. The second pair 6b being fixed to the Y connector 21 of the guide catheter 2, the second pair 6b of elements 61 is installed on the first mobile platform 10 in order to follow the translation movements of the guide catheter 2. In addition, in order to allow the catheter 3 to be pushed in or taken out, the first pair 6a of elements 61, which is fixed to the Y connector 31, is installed on a second mobile platform 11 which can for example be arranged on rails.

In order to control the movements of the catheter guide 4, the third drive member 7 comprises two identical elements 71 which are each configured to clamp the catheter guide 4 and give it a translational movement and/or a rotational movement. Each element 71 is formed by a pair of manipulator fingers, the two fingers being located opposite each other, as described for example in the document FR3044541 (see in particular FIGS. 4a-4e and 5a-5e) . The two elements 71 are arranged in a pair which is fixed to the Y connector 31. The third drive member 7 does not require a second pair of elements 71 because the proximal end of the catheter guide 4 being free, the guide 4 catheter is not subject to twisting or buckling. The elements 71 are arranged on the second mobile platform 11 in order to follow the translational movements of the catheter 3.

In this first variant illustrated in Figure 1, the elements 51, 61 and 71 are structurally identical to each other.

The first module comprises the pair 5b of elements 51, as well as the base 12. The second module comprises the first mobile platform 10, the pair 5a of elements 51, and the pair 6b of elements 61, as well as the Y connector 21. The third module comprises the second mobile platform 11, the pair 6a of elements 61, and the pair 7 of elements 71, as well as the Y connector 31.

Structural modules can be connected to functional drive units. The first module comprises a part of the first drive member 5 which is located on the base 12, as well as the base 12. The second module comprises the other part of the first drive member 5 which is located on the first mobile platform 10, and the part of second drive member 6 which is located on the first mobile platform 10, as well as the Y connector 21 and as well as the first mobile platform 10. The third module comprises the other part of the second drive member 6 located on the second mobile platform 11, and the third drive member 7 located on the second mobile platform 11, as well as the Y connector 31 and as well as the second mobile platform 11.

FIG. 2 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a second possible embodiment variant according to the invention.

According to a second preferred variant embodiment of the invention, in order to limit the size of the catheter robot, only a single elongated flexible medical instrument drive element is installed at the proximal end of the guide catheter 2 and of the catheter 3.

In the second variant illustrated in Figure 2, the first pair 5a of elements 51 and the first pair 6a of elements 61 of the first variant illustrated in Figure 1 are respectively each replaced by a single element 52 or 62 which is configured to transmit only a rotational movement to the elongated flexible medical instrument.

Thus, in a manner similar to the first variant, the first drive member 5 comprises a pair of elements 51 which are located at the distal end of the robot 1. The first drive member 5 also comprises an element 52 of rotation which is fixed to the Y connector 21 of the guide catheter 2. The element 52 is an element which comprises a pair of manipulator fingers, the two fingers being located one in front of the other, as is for example described in document FR3044541. However, the element 52 is a simplified element for which the displacement of the manipulator fingers along the main axis of elongation of the guide catheter 2 is suppressed, the manipulator fingers being only capable of clamping the guide catheter 2 and of transmitting to it a rotational movement around its axis. The element 52 is thus more compact than an element 51 which can make translational and rotational movements. The rotational movement given by the element 52 is synchronized with the rotational movement given by the pair of elements 51, thus preventing the torsion of the guide catheter 2 around its axis. During pure translational movements of the guide catheter 2, the fingers of the element 52 are tight around the guide catheter 2 and the first mobile platform 10 moves the element 52 in translation. During the combined translational and rotational movements of guide catheter 2, element 52 drives the proximal end of guide catheter 2 in rotation and said element 52 is moved in translation by first mobile platform 10. Similarly to the first variant, the second drive member 6 comprises a pair of elements 61 which is fixed to the Y connector 21 of the guide catheter 2 and which is installed on the first mobile platform 10. The second drive member 6 also comprises a rotation element 62 which is attached to the Y connector 31 of the catheter 3. The element 62 is an element which comprises a pair of manipulator fingers, the two fingers being located one in front of the other, as is for example described in the document FR3044541. However, the element 62 is a simplified element for which the displacement of the manipulator fingers along the main axis of elongation of the catheter 3 is suppressed, the manipulator fingers being only capable of clamping the catheter 3 and of transmitting a movement to it. of rotation around its axis. The element 62 is thus more compact than an element 61 which can make translational and rotational movements. The rotational movement given by the element 62 is synchronized with the rotational movement given by the pair of elements 61, thus preventing the torsion of the catheter 3 around its axis. During pure translational movements of the catheter 3, the fingers of the element 62 are tight around the catheter 3 and the second mobile platform 11 moves the element 62 in translation. During the combined translational and rotational movements of the catheter 3, the element 62 drives the proximal end of the catheter 3 in rotation and said element 62 is moved in translation by the second mobile platform 11.

The third drive member 7 of the second variant is identical to that of the first variant.

The first module comprises the pair of elements 51, as well as the base 12. The second module comprises the first mobile platform 10, the element 52, and the pair 6b of elements 61, as well as the Y connector 21. The third module comprises the second mobile platform 11, the element 62, and the pair 7 of elements 71, as well as the Y connector 31.

Structural modules can be connected to functional drive units. The first module comprises a part of the first drive member 5 which is located on the base 12, as well as the base 12. The second module comprises the other part of the first drive member 5 which is located on the first mobile platform 10, and the part of the second drive member 6 which is located on the first mobile platform 10, as well as the Y connector 21 and as well as the first mobile platform 10. The third module comprises the other part of the second drive member drive 6 located on the second mobile platform 11, and the third drive member 7 located on the second mobile platform 11, as well as the Y connector 31 and as well as the second mobile platform 11. FIG. 3 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a third possible embodiment variant according to the invention.

According to a third interesting alternative embodiment of the invention, in order to simplify the catheter robot, the elongated flexible medical instrument driving element, or else the pair of elongated flexible medical instrument driving elements , can only perform rotational training of the elongated flexible medical instrument. Thus, one of the three kinematic blocks of the element can be removed, in fact the kinematic block which causes the fingers to move the catheter 3 can be removed.

The third variant illustrated in FIG. 3 is a variant in which the structure of the robot 1 is simplified, and in which the guide catheter 2 and the catheter 3 are no longer driven in translation and in rotation with a continuous movement.

The first drive member 5 of the third variant (FIG. 3) corresponds to the first drive member of the second variant (FIG. 2) in which one of the elements 51 is replaced by a clamping device 53 which can only clamp or release the guide catheter 2 in order to keep it in position or to leave it free. The clamping device 53 can for example be formed by a pair of manipulator fingers which clamp or release the guide catheter 2. The clamping device 53 has the function of holding the guide catheter 2 in position while the manipulator fingers of the element 51 are not in engagement around guide catheter 2 during back and forth movements of said manipulator fingers of element 51.

The second drive member 6 of the third variant (Figure 3) corresponds to the second drive member 6 of the second variant (Figure 2) in which one of the elements 61 is replaced by a clamping device 63 which can only clamp or release the catheter 3 in order to keep it in position or to leave it free. The clamping device 63 can for example be formed by a pair of manipulator fingers which clamp or release the catheter 3. The clamping device 63 has the function of holding the catheter 3 in position while the manipulating fingers of the element 61 are not in engagement around the catheter 3 during the back and forth movements of said manipulator fingers of the element 61.

The first module comprises the element 51 and the element 53, as well as the base 12. The second module comprises the first mobile platform 10, the element 52, and the elements 61 and 63, as well as the Y connector 21. The third module comprises the second mobile platform 11, the element 62, and the pair 7 of elements 71, as well as the Y connector 31. Structural modules can be connected to functional drive units. The first module comprises a part of the first drive member 5 which is located on the base 12, as well as the base 12. The second module comprises the other part of the first drive member 5 which is located on the first mobile platform 10, and the part of the second drive member 6 which is located on the first mobile platform 10, as well as the Y connector 21 and as well as the first mobile platform 10. The third module comprises the other part of the second drive member drive 6 located on the second mobile platform 11, and the third drive member 7 located on the second mobile platform 11, as well as the Y connector 31 and as well as the second mobile platform 11.

FIG. 4 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to a fourth possible embodiment variant according to the invention.

According to a fourth possible variant embodiment of the invention, which makes it possible to simplify the catheter robot even more, but however to the detriment of no longer having a completely continuous movement of translation of the elongated flexible medical instrument, only a an elongated flexible medical instrument drive element in rotation and in translation is installed at the distal end of the elongated flexible medical instrument, this single elongated flexible medical instrument drive element being coupled to a clamping device which can block any movement of the elongated flexible medical instrument by pinching it.

The fourth variant illustrated in FIG. 4 corresponds to the third variant (FIG. 3) in which the third drive member 7 also comprises an element 71 which is replaced by a clamping device 73. Such a third drive member 7 is more compact than those comprising a pair of elements 71, but the movement of the catheter guide 4 given by the third drive member 7 is not continuous, which causes it to lose fluidity.

The first module comprises the element 51 and the element 53, as well as the base 12. The second module comprises the first mobile platform 10, the element 52, and the elements 61 and 63, as well as the Y connector 21. The third module comprises the second mobile platform 11, the element 62, and the elements 71 and 73, as well as the Y connector 31.

Of course, the present invention is not limited to the examples and to the embodiment described and represented, but it is capable of numerous variants accessible to those skilled in the art.

Claims

1. Catheter robot having a longitudinal axis, and comprising:

> a catheter robot support (14),

> said proximal module is movable in longitudinal translation relative to the support (14) and/or relative to said distal module,

> said proximal module also comprises an internal mechanism for rotating said external elongated flexible medical instrument, slaved to the rotation of said internal mechanism for longitudinal translation and rotation of said external elongated flexible medical instrument of said distal module.

2. Catheter robot according to claim 1, characterized in that:

> said distal module (12) is fixed relative to the support (14),

> said external elongated flexible medical instrument is a guide catheter (2),

> said internal elongated flexible medical instrument is a catheter (3).

3. Catheter robot according to claim 1, characterized in that:

> said distal module (10) is movable in longitudinal translation relative to the support (14),

> said proximal module (11) is movable in longitudinal translation relative to the support (14),

> said external elongated flexible medical instrument is a catheter (3),

> said internal elongated flexible medical instrument is a catheter guide (4).

4. Catheter robot according to any one of the preceding claims, characterized in that said catheter robot comprises a control unit configured to control the longitudinal translation of the proximal module by slaving it to the translation longitudinal translation of the outer elongated flexible medical instrument, and for controlling the longitudinal translation of the inner elongated flexible medical instrument by compensating the longitudinal translation of the proximal module so as to maintain the inner elongated flexible medical instrument stationary with respect to the support. Catheter robot having a longitudinal axis, and comprising:

> a catheter robot support (14),

> a first module (12), comprising an internal mechanism for longitudinal translation and rotation of a guide catheter (2), fixed relative to the support,

> a second module (10), comprising an internal mechanism for the longitudinal translation and rotation of a catheter (3),

> a third module (11), comprising an internal mechanism for the longitudinal translation and rotation of a catheter guide (4), characterized in that:

> said second module (10) is movable in longitudinal translation relative to the support (14),

> said third module (11) is movable in longitudinal translation relative to the support (14) and relative to the second module (10),

> said second module (10) also comprises an internal mechanism for rotation of said guide catheter (2), slaved to the rotation of said internal mechanism for longitudinal translation and rotation of said guide catheter (2) of said first module (12),

> said third module (11) also comprises an internal mechanism for rotation of said catheter (3), slaved to the rotation of said internal mechanism for longitudinal translation and rotation of said catheter (3) of said second module (11). Catheter robot according to Claim 5, characterized in that the said second module (10) does not comprise any other internal mechanism capable of providing a movement of the said guide catheter (2) other than the rotation of the said guide catheter (2). Catheter robot according to claim 5, characterized in that said internal mechanism for rotation of said guide catheter (2) of said second module (10) is also capable of ensuring the longitudinal translation of said guide catheter (2). Catheter robot according to any one of Claims 5 to 7, characterized in that:

> said first module (12) also comprises a clamping device (53) alone of said guide catheter (2), > said second module (10) also comprises a clamping device (63) alone of said catheter (3).

9. Catheter robot according to claim 8, characterized in that said third module (11) also comprises a clamping device (73) alone of said catheter guide (4).

10. Catheter robot according to claim 5, characterized in that:

> said first module (12) also comprises an additional internal mechanism for longitudinal translation and rotation of said guide catheter (2) which can operate alternately with said internal mechanism for longitudinal translation and rotation of said guide catheter (2) of said first module (12) ,

> said second module (10) also comprises an additional internal mechanism for longitudinal translation and rotation of said catheter (3) which can operate alternately with said internal mechanism for longitudinal translation and rotation of said catheter (3) of said second module (10),

> said third module (11) also comprises an additional internal mechanism for longitudinal translation and rotation of said catheter guide (4) which can operate alternately with said internal mechanism for longitudinal translation and rotation of said catheter guide (4) of said third module ( 11).

11. Catheter robot according to claim 10, characterized in that:

> said second module (10) also comprises an additional internal mechanism for longitudinal translation and rotation of said guide catheter (2) able to operate alternately with said internal mechanism for rotation of said guide catheter (2) of said second module (10), said internal mechanism rotation of said guide catheter (2) of said second module (10) which can also ensure the longitudinal translation of said guide catheter (2),

> said third module (11) also comprises an additional internal mechanism for longitudinal translation and rotation of said catheter (3) able to operate alternately with said internal mechanism for rotation of said catheter (3) of said third module (11), said internal mechanism for rotation said catheter (3) of said third module (11) also being able to ensure the longitudinal translation of said catheter (3).

12. Catheter robot according to any one of claims 5 to 11, characterized in that:

> said catheter robot comprises: o a first Y connector (21) located between said internal mechanism for rotation of said guide catheter (2) of said second module (10) and said internal mechanism for longitudinal translation and rotation of said catheter (3) of said second module (10), o a second Y connector (31) located between said internal mechanism for rotation of said catheter (3) of said third module (11) and said internal mechanism for longitudinal translation and rotation of said catheter guide (4) of said third module (11).

13. Catheter robot according to claim 12, characterized in that:

> said first Y connector (21) is fixed to said internal mechanism for rotation of said guide catheter (2) of said second module (10) and to said internal mechanism for longitudinal translation and rotation of said catheter (3) of said second module (10),

> said second Y connector (31) is fixed to said internal mechanism for rotation of said catheter (3) of said third module (11) and to said internal mechanism for longitudinal translation and rotation of said catheter guide (4) of said third module (11).

14. Catheter robot according to any one of claims 5 to 13, characterized in that, on at least part of said longitudinal axis, said guide catheter (2) surrounds said catheter (3) which itself surrounds said guide (4) of catheter.

15. Catheter robot according to any one of claims 5 to 14, characterized in that said second module (10) and said third module (11) are structurally identical to each other.

16. Catheter robot according to any one of claims 5 to 15, characterized in that said catheter robot comprises a control unit configured to control the longitudinal translation of the second module (10) by slaving it to the longitudinal translation of the catheter guide (2), and to control the longitudinal translation of the catheter (3) by compensating the longitudinal translation of the second module (10) so as to keep the catheter stationary with respect to the support (14).

17. Catheter robot according to any one of claims 5 to 16, characterized in that said catheter robot comprises a control unit configured to control the longitudinal translation of the third module (11) by slaving it to the longitudinal translation of the catheter (3), and to control the longitudinal translation of the guide (4) from catheter by compensating for the longitudinal translation of the third module (11) so as to keep the catheter guide (4) stationary with respect to the support (14). . Catheter robot according to any one of the preceding claims, characterized in that:

> one, several or all of the internal longitudinal translation and rotation mechanisms of an elongated flexible medical instrument which may be a guide catheter (2), a catheter (3) or a catheter guide (4), comprising: o two keys able to approach and move away to respectively grip or release said elongated flexible medical instrument, o said two keys being able to perform a synchronous longitudinal translation to translate said elongated flexible medical instrument, o said two keys being able to perform opposite transverse translations to rotate said flexible medical instrument lying around the longitudinal axis. . Catheter robot according to any one of the preceding claims, characterized in that the said catheter robot does not comprise any deformable guide located around one or the other of the elongated flexible medical instruments. . Catheter robot according to any one of Claims 1 to 19, characterized in that one or more or all of the modules comprise a mobile platform sliding longitudinally in at least one rail. . Catheter robot according to any one of claims 1 to 19, characterized in that one or more or all of the modules comprise a longitudinally rolling carriage. Catheter robot having a longitudinal axis, and comprising:

> a catheter robot support (14),

> at least one of the internal longitudinal translation and rotation mechanism of the internal elongated flexible medical instrument and the internal longitudinal translation and rotation mechanism of the external elongated flexible medical instrument consists of a part of a pair of keys able to approach and move away to respectively grip or release the elongated flexible medical instrument, said pair of keys being able to perform a synchronous longitudinal translation to translate said elongated flexible medical instrument, said pair of keys being able to perform opposite transverse translations to rotating said elongated flexible medical instrument around its longitudinal axis, and on the other hand a clamping device alone of the elongated flexible medical instrument.