WO2014127353A1 - Effecteur terminal pour système chirurgical et procédé d'utilisation correspondant - Google Patents

Effecteur terminal pour système chirurgical et procédé d'utilisation correspondant Download PDF

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Publication number
WO2014127353A1
WO2014127353A1 PCT/US2014/016889 US2014016889W WO2014127353A1 WO 2014127353 A1 WO2014127353 A1 WO 2014127353A1 US 2014016889 W US2014016889 W US 2014016889W WO 2014127353 A1 WO2014127353 A1 WO 2014127353A1
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WO
WIPO (PCT)
Prior art keywords
wire
pinch mechanism
pinch
servo
robotic system
Prior art date
Application number
PCT/US2014/016889
Other languages
English (en)
Inventor
Thenkurussi Kesavadas
Aditya Reddy ASHAMMAGARI
Original Assignee
The Research Foundation For The State University Of New York
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Research Foundation For The State University Of New York filed Critical The Research Foundation For The State University Of New York
Publication of WO2014127353A1 publication Critical patent/WO2014127353A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

  • This invention relates to robotic systems and, more particularly, to a robotic system for translating a flexible device.
  • Stroke is the third most common cause of death in North America with approximately 600,000 new cases of stroke reported annually, of which 150,000 are fatal.
  • interventional treatment falls into three categories: i) medicinal (i.e., blood-thinning drugs) to improve the blood flow to impacted parts of the brain; ii) highly invasive surgery; or iii) minimally invasive endo vascular techniques.
  • Endovascular intervention is a minimally invasive surgery used to access regions of vasculature deep inside the skull and surrounding the brain using a process called catheterization.
  • a new type of robot which can share the surgical space with the human user, such as a doctor or surgeon, is needed.
  • Such a robot may need to be able to understand the physical phenomenon behind the device placement, understand the strategy the surgeon is proposing, and reduce tedium. It should also be able to perform the procedure with greater accuracy or precision, overcoming physical limitations of a human user.
  • Complex vessel geometry increases the tedium of navigation and decision making for a surgeon. This happens because the navigation of a catheter, both in fluoroscope-based and current tele-robotic systems, require dexterous manual input from the surgeon. This takes away valuable time that could be otherwise spent in treatment planning and other cognitive tasks.
  • Previous robot-assisted wire insertion devices suffer from multiple drawbacks.
  • a robotic system has a first pinch mechanism coupled to a first servo and a second pinch mechanism coupled to a second servo.
  • An end effector is connected to the first servo and a frame is connected to the second servo.
  • Each of the first and second pinch mechanisms can pinch a wire and lock this wire in a fixed position relative to the respective first or second pinch mechanism.
  • the wire that is pinched by the first or second pinch mechanism may be, for example, a stent, a needle, a guidewire, or a catheter.
  • Each of the first pinch mechanism and second pinch mechanism may have a wire holder and a cam.
  • the wire holder may be a hollow tube that the wire is configured to pass through.
  • the robotic system also may include a force and torque sensor on the first servo.
  • a robotic arm may be connected to the end effector. This robotic arm may have at least two degrees of freedom. In one example, the robotic arm may have six degrees of freedom.
  • the end effector may be connected to the frame using this robotic arm.
  • a cap on a flexible beam may be located on the end effector. This cap may define an aperture that the wire projects through.
  • a haptic device may be connected to, for example, the first servo, the second servo, and a force and torque sensor.
  • a method of operating a robotic system is disclosed.
  • a wire is released by a second pinch mechanism while being pinched with a first pinch mechanism to lock the wire in a fixed position relative to the first pinch mechanism.
  • the wire is translated into a patient by moving the first pinch mechanism toward the second pinch mechanism while the wire is pinched by the first pinch mechanism and released by the second pinch mechanism. After translating the wire into the patient, the wire is released by the first pinch mechanism while being pinched by the second pinch mechanism to lock the wire in a fixed position relative to the second pinch mechanism.
  • the first pinch mechanism is moved away from the second pinch mechanism while the wire is released by the first pinch mechanism and pinched by the second pinch mechanism.
  • the wire translated into the patient may be, for example, a stent, a needle, a guidewire, or a catheter. Translating the wire may advance the wire through the second pinch mechanism.
  • Pinching with the first pinch mechanism may use a first servo and may press the wire against a first wire holder with a first cam.
  • Pinching with the second pinch mechanism may use a second servo and may press the wire against a second wire holder with a second cam. Both the first cam and second cam may be configured to rotate.
  • a haptic device may be used during the translation of the wire into the patient.
  • Translating the haptic device a distance may correspond to a distance that the wire is translated into the patient.
  • the wire may be pinched by the first pinch mechanism to lock the wire in a fixed position relative to the first pinch mechanism while the wire is released by the second pinch mechanism.
  • the wire may be translated out of the patient by moving the first pinch mechanism away from the second pinch mechanism while the wire is released by the second pinch mechanism and the wire is pinched by the first pinch mechanism. After translating the wire out of the patient, the wire is released by the first pinch mechanism and the wire is pinched by the second pinch mechanism to lock the wire in a fixed position relative to the second pinch mechanism.
  • the first pinch mechanism moves toward the second pinch mechanism while the wire is released by first pinch mechanism and the wire is pinched by the second pinch mechanism.
  • the wire may be rotated with an end effector while first pinch mechanism pinches the wire.
  • the wire also may be jiggled with an end effector while the first pinch mechanism pinches the wire.
  • Haptic feedback may be used to generate resistance corresponding to the resistance of the wire as this wire translates into the patient.
  • FIG. 1 is a side elevation view of an end effector for a robotic system
  • FIG. 2 is a perspective view of part of the end effector illustrated in FIG. 1 ;
  • FIG. 3 is a perspective view of a pinch mechanism for the end effector illustrated in FIG. 1 ;
  • FIG. 4 is a perspective view of a flexible beam and cap used with the end effector illustrated in FIG. 1;
  • FIG. 5 is a side elevation view of a robotic system using the end effector of FIG. 1 ;
  • FIG. 6 is an example of a visual interface used with the end effector of FIG. 1 ;
  • FIGs. 7 and 8 are flowcharts illustrating translating a wire into and out of a patient.
  • FIG. 1 is a side elevation view of an end effector for a robotic system.
  • the wire 101 extends through the end effector 100.
  • the end effector 100 advances, withdraws, positions, torques, or jiggles the wire 101.
  • This wire 101 may be, for example, a stent, a needle, a guidewire, a catheter, a balloon, a coil, or another device that is inserted into a patient.
  • the wire 101 is a 0.35" guidewire.
  • the wire 101 passes through an aperture of the first pinch mechanism 107, the second pinch mechanism 111 , and the cap 109 in the x-direction.
  • the first pinch mechanism 107 and second pinch mechanism 1 11 prevent slip of the wire 101 when activated.
  • first pinch mechanism 107 and second pinch mechanism 111 can grip the wire 101 or lock the wire 101 in a fixed position relative to either the first pinch mechanism 107 or second pinch mechanism 111.
  • approximately 0.1 N to 4.5 N of force is used to pinch the wire 101 with either the first pinch mechanism 107 or second pinch mechanism 1 11.
  • a robotic arm 103 is connected to an end effector base 102.
  • the end effector base 102 is connected to a holding frame 104.
  • the holding frame is connected to a force and torque sensor 105.
  • the force and torque sensor 105 is connected to a first servo 106, which is connected or coupled to the first pinch mechanism 107.
  • the force and torque sensor 105 is an ATI force/torque sensor, though other sensors may be used.
  • the force and torque sensor 105 may be able to measure between approximately 0.1 N and at least 10 N of force.
  • a second servo 110 is connected to a frame 109. This second servo 110 is also connected or coupled to the second pinch mechanism 111.
  • the robotic arm 103 also may be connected to the frame 109 (illustrated in FIG. 5).
  • the cap 108 is connected to the flexible beam 112, which is connected to the robotic arm 103, end effector base 102, or another part of the end effector 100.
  • the flexible beam 112 may be bendable or may flex in the x-direction, y-direction, or z-direction.
  • the second pinch mechanism 111 may be positioned relative to the cap 108 in a manner that the apertures of each are aligned. This may prevent stress or torque from being unintentionally induced in the wire 101.
  • the apertures of the second pinch mechanism 111 and cap 109 may still be aligned even if the end effector 100 is angled in or relative to, for example, the y- direction or z-direction.
  • the cap 108 may need to move relative to the second pinch mechanism 111 such that these apertures are not always aligned.
  • FIG. 2 is a perspective view of part of the end effector illustrated in FIG. 1.
  • the wire 101 passes through the first wire holder 201 that is disposed on the first servo 106.
  • a first cam 200 connected to and activated by the first servo 106, is used to pinch the wire 101.
  • the first cam 200 and first wire holder 201 are part of the first pinch mechanism 107.
  • FIG. 3 is a perspective view of a pinch mechanism for the end effector illustrated in FIG. 1.
  • the wire 101 passes through an aperture 300 extending along the length of the first wire holder 201.
  • the first wire holder 201 may be a hollow tube having a diameter large enough to accommodate the wire 101.
  • the first wire holder 201 also defines an aperture 301 on the surface of the hollow tube, such that the wire 101 is exposed through the aperture 301. This aperture 301 may be larger than the portion of the first cam 200 that contacts the wire 101.
  • the first cam 200 positioned on an axis 303, rotates in the direction illustrated by arrow 302.
  • the first cam 200 can press or otherwise lock the wire 101 against the wall of the first wire holder 201 through the aperture 301. This movement of the first cam 200 can result in the wire 101 being held in place without slippage.
  • the wire 101 can pass through the first wire holder 201 because the wire 101 is not pinched by the first cam 200.
  • first cam 200 is illustrated as having four arms, more or fewer arms may be used. Thus, the first cam 200 is not limited solely to four arms.
  • the second pinch mechanism 111 may contain a second cam similar to the first cam 200 and a second wire holder similar to the first wire holder 201. This second cam may be connected to and activated by the second servo 110. Thus, the second pinch mechanism 111 may operate similar to the first pinch mechanism 107.
  • FIG. 4 is a perspective view of a flexible beam and cap used with the end effector illustrated in FIG. 1.
  • the flexible beam 112 is connected to the cap 108 and the end effector 100.
  • This cap 108 which may be fabricated of plastic, may be conical, pyramidal, or other shapes and defines an aperture 400 along its length that the wire 101 passes through. In one example, this aperture 400 is through the center of the cone in cap 108
  • the flexible beam 112 in one instance is fabricated of metal, such as aluminum, and may act as a leaf spring.
  • the cap 108 protects the robotic system and the first pinch mechanism 107 when used with the flexible beam 112.
  • the cap 108 also may ensure the wire 101 is inserted properly when used with the flexible beam 112.
  • the cap 108 also carries the wire 101 to the second pinch mechanism 111 and, with the flexible beam 112, can act as a safety mechanism if the end effector 100 applies more than a desired amount of pressure to the wire 101.
  • the flexible beam 112 protects the first pinch mechanism 107 from shock due to any failure. For example, if the robotic system fails and is not held in a desired position or the robotic system moves suddenly beyond the limit, this flexible beam 112 absorbs the shock and limits the movement to protect the end effector 100 of the robotic system or the wire 101.
  • the cap 108 and flexible beam 112 can act as a compliant mechanism and deflect to absorb the excess force or failure of the end effector 100 or robotic arm 103, thereby protecting the robotic system.
  • the flexible beam 112 also protects the first pinch mechanism 107 if the wire 101 does not move or translate as expected because the flexible beam 112 can compress in the x-direction (as seen in FIG. 1).
  • the flexible beam 112 and cap 108 also may prevent coiling of the wire 101 during insertion because the shape of the cap 108 may hold the wire 101 in place during the feed or correct any misalignment of the wire 101 during insertion.
  • FIG. 5 is a side elevation view of a robotic system using the end effector of FIG.
  • the wire 101 is translated into, out of, or inside of the patient 500.
  • the robotic arm 103 connects the end effector 100 to the frame 109.
  • the number of segments, joints, or the degrees of freedom of the robotic arm 103 can vary. In one example, the robotic arm 103 has two degrees of freedom. In another example, the robotic arm 103 has six degrees of freedom. This robotic arm 103 may facilitate stroke lengths or simulate movement similar to a surgeon's hand, wrist, or arm.
  • the robotic arm 103 is based on the Robai Cyton Veta, which has 350 g of payload and 480 mm of reach.
  • the robotic arm 103 is a KUKA youBot, which has brushless DC motors with a planetary gear box.
  • other robotic arms 105 are possible and the design may vary from that illustrated in FIG. 5.
  • the robotic arm 103 does not connect to the frame 109.
  • the robotic arm 103 connects to a stand or some other unit.
  • the robotic arm 103 may be connected to a pedestal.
  • the frame 109 with the second pinch mechanism 111 also may be connected to this pedestal in one particular example.
  • the end effector 100 is connected to a haptic device 501.
  • the haptic device is an Omni- Phantom device, though other haptic tools or mechanisms may be used.
  • the haptic device 501 may be connected to the force and torque sensor 105, the first servo 106, or second servo 109.
  • the haptic device 501 may be connected elsewhere in the end effector 100 or robotic arm 103.
  • Force may be scaled and transmitted from the force and torque sensor 105 to the haptic device 501 and a visual interface (not illustrated) can show the motion, linear force, and torque in real-time.
  • the force in the haptic device 501 may represent a curve in the patient's vessels, plaque in the patient's vessels, or a patient's vessels that are bunched or labyrinthine.
  • a pedal (not illustrated) may be used activate and clutch at least one of the first pinch mechanism 107 or second pinch mechanism 111.
  • a suitable size of wire 101 and, optionally, a matching holder are chosen.
  • the wire 101 is placed in the end effector 100.
  • the first servo 106 is activated by a button actuated by a user, such as on the haptic device 501.
  • a first button on the haptic device 501 When a first button on the haptic device 501 is pressed by the user, it activates the first servo 106 to pinch the wire 101 using the first pinch mechanism 107 and the second servo 110 to release the wire 101 with the second pinch mechanism 111.
  • the first button When the first button is not pressed, the first servo 106 releases the wire 101 with the first pinch mechanism 107 and the second servo 110 pinches the wire 101 with the second pinch mechanism 111.
  • the wire 101 can be urged into the patient because the wire 101 is pinched by the first pinch mechanism 107 while the end effector 101 is moved forward (such as in the x-direction).
  • Releasing the first button on the haptic device 501 results in holding the inserted wire 101 in place with the second pinch mechanism 111 and allows the robotic arm 103 and end effector 100 to move back (such as in the x-direction) to get hold of more wire 101 for insertion without the wire 101 slipping or being withdrawn from the patient 500.
  • This process of inserting parts of wire 101 may be performed until the required amount of wire 101 is inserted into a patient. Similarly, extraction of the wire 101 is done by opposite actions.
  • the second pinch mechanism 111 may be actuated to keep the wire 101 , which has already been inserted, in-place.
  • the second pinch mechanism 1 11 may protect the built up force and torque of the wire 101 that has been inserted.
  • the second servo 110 is used when the robotic arm 103 attempts to get hold of the next segment of the wire 101 to be inserted or withdrawn.
  • the force and torque sensor 105 also provides continuous force feedback to the user in real-time. Every action of the robotic system, including the proximal and distal forces, may be communicated to the haptic device 501 as graduated or resultant forces. The reaction to the force may be the supervisory layer on the system to execute the planned feed of the mechanism.
  • the device will work normally. However if the nominal position is negative, the haptic device 501 will slow down and vice versa. Thus, a positive position will increase the speed of the feed mechanism of the robotic system. This may not be tele-control because the actual rotation and translation and the path plan to reach the goal is being shared by robot and not by the implicit command from a user. In the same way, if the system applies negative force (pull back) the user must counter it to allow the robotic system to withdraw the wire 101.
  • the wire 101 is moving at an expected rate into or in the patient, then no resistance may be felt by the user through the haptic device 501.
  • the user may feel resistance through the haptic device 501 if the wire 101 is moving slower than expected in the patient.
  • the user may feel the haptic device 501 pulling if the wire 101 is moving faster than expected in a patient.
  • the robotic system may have a predictive range of resistance or range of expected speeds for certain regions of the patient, certain wires 101 or devices on the wire 101 , or certain procedures to determine whether the user should feel no resistance, a degree of resistance, or pulling.
  • velocity of the wire 101 during insertion may average around 84 mm/s with a peak at approximately 562 mm/s.
  • the average stroke may be around 54 mm with a peak at approximately 235 mm.
  • the maximum axial force may be 4.5 N and the maximum torque may be 8 N mm.
  • the range for patient safety during a procedure may be set with a permissible force between approximately 0.1 N and 4.5 N and permissible torque between approximately 0.5 N mm to 8 N mm.
  • these are based on three distinct procedures and these numbers may vary considerably depending on the patient, procedure, or type of wire 101 (i.e., a stent versus a needle). Thus, the exact range set for patient safety or predicted based on a patient may deviate from these numbers.
  • the wire 101 may be torqued or twisted.
  • the first servo 106 may be activated to pinch the wire 101 with the first pinch mechanism 107.
  • the end effector 100 may then rotate (such as around the x-direction).
  • torqueing of the wire 101 is done by pressing the first button on the haptic device 501 to pinch the wire 101 with the first pinch mechanism 107 and rotating the haptic pen or joystick in a direction to torque the wire 101 in that direction.
  • the wrist of the robotic arm 103 may enable twisting or torqueing motion.
  • the wire 101 also can be vibrated or jiggled. This may release wire 101 bunching or tension when the force encountered by the wire 101 is deemed as too high. This jiggling or vibrating also may free a wire 101 that is stuck.
  • the wire 101 is harmonically jiggled.
  • the wire 101 may be jiggled harmonically with a frequency of 10 to 60 Hz and with an amplitude ranging from 1 mm to 10 mm.
  • the first pinch mechanism 107 may be activated to pinch the wire 101 while the second pinch mechanism 111 is not pinching the wire 101.
  • the end effector 100 may then move in a manner to vibrate or jiggle the wire 101 (such as in the x-direction, y-direction, and/or z-direction).
  • the angle of entry of the wire 101 may be adjusted prior to or during insertion into a patient.
  • the robotic arm 103 and end effector 100 may adjust the angle, such as in the y- direction or z-direction relative to the x-direction, based on user input or patient information. This may be used, for example, if the wire 101 is or contains a needle. Thus, the wire 101 can approach the patient's body at any angle.
  • Both the first pinch mechanism 107 and second pinch mechanism 111 can be commanded to release the wire 101 if, for example, both a first and second button are pressed on the haptic device 501.
  • This allows for manual action on the wire 101 by the user.
  • Manual action by a user may be used to thread a catheter over the wire or for inserting another device.
  • Manual action by a user also may be used to take control for safety of the patient or for other reasons during the procedure.
  • a first button and a second button on the haptic device 501 are disclosed, other control mechanisms known to those skilled in the art may be used.
  • the first and second button may be located elsewhere besides the haptic device 501.
  • a pedal, voice command, or other control mechanism may be used instead of or supplementary to the disclosed first button and second button.
  • a visual interface may be included with the haptic device.
  • FIG. 6 is an example of a visual interface used with the end effector of FIG. 1.
  • Key locations and orientations may be displayed.
  • Information about the patient and properties of the robotic system may be displayed to enable a user to make treatment planning decisions. Predicted intersections and potential obstacles that may need to be avoided to reduce the risk of vessel dissection or perforation may be marked or highlighted on the display. This may be helpful as treatment proceeds to more distal regions of the vascular tree. Changes in color and quantitative data may be presented at intersections.
  • the location of the wire 101 in the patient also may be displayed.
  • the robotic arm 103 may be attached to a computer (not illustrated).
  • a patient end computer may be connected through the internet to a user end computer.
  • the haptic device 501 may be connected to the user end computer.
  • the haptic device 501 and the robotic arm 103 may be mapped to move using a master/slave map.
  • the communication between the devices is done using a TCP/IP protocol.
  • One embodiment reduces data losses, given that the procedure is already learned by the robotic system. If any data losses occur in this embodiment, the robotic arm 103, while tele-controlled, does not make any unapproved actuations. It may use a predictive model to guess what it should do in case of data loss in between a communication sequence.
  • TCP/IP includes performing a procedure several times offline by connecting the robotic system to the user control, such as the haptic device 501.
  • Force profiles of the wire 101 can be captured for all procedures performed offline.
  • a force versus wire position model can be generated from the data collected.
  • the model is programmed as a reference instruction to the robotic system at the patient's end.
  • the robotic system refers to the instructions and predicts its approach to overcome that data loss.
  • the robotic system can take a motion path from a 3D reconstruction of the patient's vessels and predict forces as the wire 101 moves through the vessels. This allows the robotic system to react if the actual forces are higher than predicted forces.
  • FIGs. 7 and 8 are flowcharts illustrating translating a wire into and out of a patient.
  • the wire 101 is pinched with the first pinch mechanism 107 and released by the second pinch mechanism 1 11.
  • the wire 101 is translated into the patient by moving the first pinch mechanism 107 toward the second pinch mechanism 111 while the wire 101 is pinched by first pinch mechanism 107 and released by second pinch mechanism 111.
  • the wire 101 is released by the first pinch mechanism 107 while the wire 101 is pinched with the second pinch mechanism 111.
  • the first pinch mechanism 107 is moved away from the second pinch mechanism 111 while the wire 101 is released by the first pinch mechanism 107 and pinched by the second pinch mechanism 111. This process may be repeated as needed until a desired length of the wire 101 is translated into the patient, as seen in 704.
  • the wire 101 is pinched with the first pinch mechanism 107 and released by the second pinch mechanism 111.
  • the wire 101 is translated out of the patient by moving the first pinch mechanism 107 away from the second pinch mechanism 111 while the wire 101 is pinched by first pinch mechanism 107 and released by second pinch mechanism 1 11.
  • the wire 101 is released by the first pinch mechanism 107 while the wire 101 is pinched with second pinch mechanism 111.
  • the first pinch mechanism 107 is moved toward the second pinch mechanism 111 while the wire 101 is released by the first pinch mechanism 107 and pinched by the second pinch mechanism 111. This process may be repeated as needed until a desired length of the wire 101 is translated out of the patient, as seen in 804.
  • Both the embodiments of FIGs. 7 and 8 may use the haptic device 501 to translate the wire 101 into our out of the patient.
  • the haptic device 501 may move a distance that corresponds to a particular distance that the wire 101 is translated into or out of the patient. These distances may or may not be exactly one-to-one.
  • the haptic device 501 may move a distance more than or less than the distance that the wire 101 is correspondingly translated into or out of the patient.
  • the robotic system can adjust the speed of the wire 101 to prevent harm to the patient. For example, if a user attempts to insert the wire 101 at a speed above a safety threshold, the robotic system may automatically reduce the speed of insertion of the wire 101 or not perform the requested action.
  • Automatic shutdown may lock the wire 101 with the first pinching mechanism
  • Tele-control may be used. There may be instances where a user is not satisfied with the path the wire is taking or a complication occurs. In this case, the user's actions will be directly mapped to motions of the robotic system and the robotic system will navigate under full user control.
  • two robotic systems are used in conjunction to feed multiple wires or devices inside one another.
  • two end effectors 100 may be used together.
  • the robotic systems herein may be used for placement of , for example, catheters, stents, or needles in a patient.
  • this robotic system may be used for any cardiac or neuro- endovascular procedure where catheterization may be required for placement.
  • Other minimally- invasive surgeries or endovascular surgeries also may use this robotic system.
  • This robotic system also may be used for placement of needles for various procedures such as biopsies or brachytherapy.
  • the robotic system disclosed herein may imitate a human wrist and hand, which enables it to overcome many of the previous drawbacks in robotic systems.
  • the dual pinch mechanism may enable quick changes to the wires 101.
  • wires 101 , catheters, or other devices of different sizes can be easily changed.
  • the pinching applied by the first pinch mechanism 107 and second pinch mechanism 111 prevents slippage of the wire 101.
  • a force and torque sensor 105 enable automatic shutdown, which improves patient safety. Force feedback is provided to the user through the haptic device 501 , which improves patient safety and may enable a user to perform more complex procedures.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Robotics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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Abstract

L'invention concerne un système robotique pouvant être utilisé avec un fil, par exemple, une endoprothèse, une aiguille, un guide-fil, un cathéter, ou tout autre dispositif. Le système robotique présente un premier mécanisme de pincement couplé à un premier servomécanisme et un second mécanisme de pincement couplé à un second servomécanisme. Un effecteur terminal est connecté au premier servomécanisme et un cadre est connecté au second servomécanisme. Chacun des premier et second mécanismes de pincement peut pincer et bloquer le fil dans une position fixe par rapport au premier ou au second mécanisme de pincement. Le fil peut être transféré à l'intérieur ou à l'extérieur d'un patient au moyen du premier mécanisme de pincement et du second mécanisme de pincement.
PCT/US2014/016889 2013-02-18 2014-02-18 Effecteur terminal pour système chirurgical et procédé d'utilisation correspondant WO2014127353A1 (fr)

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US201361766027P 2013-02-18 2013-02-18
US61/766,027 2013-02-18

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Cited By (4)

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Publication number Priority date Publication date Assignee Title
US11266424B2 (en) 2017-06-20 2022-03-08 Siemens Healthcare Gmbh Autonomous catheterization assembly
US11696808B2 (en) 2009-10-12 2023-07-11 Corindus, Inc. System and method for navigating a guide wire
US11918314B2 (en) 2009-10-12 2024-03-05 Corindus, Inc. System and method for navigating a guide wire
EP4157112A4 (fr) * 2020-06-01 2024-07-03 Auris Health Inc Gestion d'instrument collé

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