WO2021065311A1 - Actionneur et système de cathéter robotisé - Google Patents

Actionneur et système de cathéter robotisé Download PDF

Info

Publication number
WO2021065311A1
WO2021065311A1 PCT/JP2020/033292 JP2020033292W WO2021065311A1 WO 2021065311 A1 WO2021065311 A1 WO 2021065311A1 JP 2020033292 W JP2020033292 W JP 2020033292W WO 2021065311 A1 WO2021065311 A1 WO 2021065311A1
Authority
WO
WIPO (PCT)
Prior art keywords
gripping
unit
sheath
arm
robot
Prior art date
Application number
PCT/JP2020/033292
Other languages
English (en)
Japanese (ja)
Inventor
弘通 谷岡
一樹 仲宗根
Original Assignee
テルモ株式会社
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 テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2021065311A1 publication Critical patent/WO2021065311A1/fr

Links

Images

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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • 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
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms

Definitions

  • the present invention relates to an actuator and a robot catheter system.
  • a robot hand when treating and diagnosing a patient with a cardiovascular disease, a robot hand may be used to operate a catheter or the like.
  • the robot hand By providing a plurality of joints, the robot hand is configured so that it can rotate not only in a straight line but also in the joints with multiple degrees of freedom.
  • a cassette to which a diagnostic catheter can be attached is provided at the tip of the robot hand.
  • the cassette is equipped with a drive mechanism that can move the guide wire in the longitudinal direction and a drive mechanism that can move the diagnostic catheter and the like.
  • the diagnostic catheter is sandwiched by wheels and rollers so as to be movable in the longitudinal direction (see Patent Document 1).
  • the diagnostic catheter When the diagnostic catheter is sandwiched between a roller and a wheel and the diagnostic catheter is moved forward and backward in the longitudinal direction as in Patent Document 1, the diagnostic catheter receives the sandwiching force between the roller and the wheel. In this way, when the diagnostic catheter receives a force that contracts inward in the radial direction in the cross section intersecting the longitudinal direction, a fluid such as a contrast medium is circulated inside the catheter, or a medium such as light for diagnostic imaging is used. The function of transmitting may be impaired. For medical long bodies such as catheters, it is common to perform the procedure by moving various members into the internal space of the tubular member, and the above-mentioned problems use medical long bodies. If so, it can be applied to medical devices other than diagnostic imaging catheters.
  • the present invention has been made in view of the above problems, and an object of the present invention is to provide a novel structure capable of adjusting the gripping force for gripping a medical long body in a robot catheter system.
  • One aspect of the present invention is provided in a robot catheter system that moves a medical elongated body forward and backward in the longitudinal direction, and in a pair of gripping members that feed the medical elongated body in the longitudinal direction, a pair of the gripping members is provided. It is an actuator that adjusts the distance between the first gripping member and the second gripping member to move at least one of the first gripping member and the second gripping member with respect to the other.
  • one aspect of the present invention is a robot catheter system equipped with the above actuator.
  • FIG. 12 It is a schematic perspective view which shows the structure which adjusts the gripping force by a pair of rollers in a robot catheter system, and shows the state which partially cut a cassette.
  • the robotic catheter system according to the present embodiment is used in a percutaneous coronary intervention (PCI) used in treating a patient having a cardiovascular disease.
  • PCI percutaneous coronary intervention
  • FIG. 1 is a schematic perspective view showing the overall configuration of the robot catheter system 1 according to the present embodiment
  • FIG. 2 is a diagram showing a cassette 400, a medical device P, and the like constituting the robot catheter system 1.
  • the robot catheter system 1 is used when moving the sheath 110 forward and backward in the longitudinal direction.
  • the robot catheter system 1 includes a medical device P including a sheath 110 (corresponding to a long medical body), a bed 200, and a robot arm 300.
  • the robot catheter system 1 includes a cassette 400, a computer 600, an irradiation device 700, and an operation unit 800.
  • FIG. 3 is a diagram showing an overall configuration of an image diagnostic catheter (hereinafter referred to as an image catheter or a catheter device) as an example of a medical device attached to the robot catheter system 1.
  • FIG. 4 is a view showing the tip of the diagnostic imaging catheter 100
  • FIG. 5 is a cross-sectional view showing the proximal end side of the diagnostic imaging catheter.
  • the medical device is a dual type diagnostic imaging catheter 100 having both functions of endovascular ultrasonic diagnosis (IVUS) and optical coherence tomography (OCT).
  • IVUS endovascular ultrasonic diagnosis
  • OCT optical coherence tomography
  • the medical device that can be connected to the external device 500 is not limited to the above, and is, for example, an IVUS catheter, an OCT catheter, or a catheter used for purposes other than obtaining a diagnostic image (for example, a therapeutic catheter). You may.
  • the diagnostic imaging catheter 100 will be described with reference to FIGS. 3 to 5.
  • the diagnostic imaging catheter 100 is driven by being connected to an external device 500.
  • the diagnostic imaging catheter 100 generally includes a long sheath 110 inserted into the body cavity of a living body and an outer tube 120 provided on the proximal end side of the sheath 110.
  • the diagnostic imaging catheter 100 includes an inner shaft 130 that is inserted into the outer tube 120 so as to be movable back and forth, and a drive shaft 140 that has a signal transmission / reception unit 145 at the tip and is rotatably provided in the sheath 110.
  • the diagnostic imaging catheter 100 has a unit connector 150 provided on the proximal end side of the outer tube 120 and configured to receive the inner shaft 130, and a hub 160 provided on the proximal end side of the inner shaft 130. ing.
  • the side inserted into the body cavity of the diagnostic imaging catheter 100 is referred to as the distal end side
  • the hub 160 side provided in the diagnostic imaging catheter 100 is referred to as the proximal end side
  • the extending direction of the sheath 110 is referred to as the extending direction. It is called the axial direction.
  • the drive shaft 140 passes through the sheath 110, the outer tube 120 connected to the base end of the sheath 110, and the inner shaft 130 inserted into the outer tube 120, and extends to the inside of the hub 160. ing.
  • the hub 160, the inner shaft 130, the drive shaft 140, and the signal transmission / reception unit 145 are connected to each other so as to move forward and backward in the axial direction. Therefore, for example, when the hub 160 is pushed toward the tip end side, the inner shaft 130 connected to the hub 160 is pushed into the outer pipe 120 and the unit connector 150. Then, the drive shaft 140 and the signal transmission / reception unit 145 move inside the sheath 110 toward the tip side. For example, when the hub 160 is pulled toward the proximal end side, the inner shaft 130 is pulled out from the outer tube 120 and the unit connector 150 as shown by the arrow a1 in FIG. Further, when the hub 160 is pulled toward the proximal end side, the drive shaft 140 and the signal transmitting / receiving unit 145 move inside the sheath 110 toward the proximal end side as shown by the arrow a2 in FIG.
  • the relay connector 170 is a connector that connects the sheath 110 and the outer tube 120.
  • the drive shaft 140 includes a flexible tube body 141, and an electric signal cable 142 and an optical fiber 143 connected to a signal transmission / reception unit 145 are arranged inside the drive shaft 140.
  • the tube body 141 can be composed of, for example, a multi-layer coil having different winding directions around the axis. Examples of the constituent material of the coil include stainless steel, Ni—Ti (nickel / titanium) alloy, platinum, and iridium alloy.
  • the electric signal cable 142 is connected to an electrode terminal provided in the connector portion 165, which will be described later, as shown in FIG.
  • the electric signal cable 142 is configured to include two signal lines 142a and 142b for transmitting and receiving high frequency voltage.
  • the signal transmission / reception unit 145 has an ultrasonic wave transmission / reception unit 145a for transmitting / receiving ultrasonic waves and an optical transmission / reception unit 145b for transmitting / receiving light.
  • the ultrasonic transmission / reception unit 145a is provided with an oscillator, and has a function of transmitting ultrasonic waves based on a pulse signal into the body cavity and receiving ultrasonic waves reflected from living tissues in the body cavity.
  • the ultrasonic transmission / reception unit 145a is electrically connected to an electrode terminal (not shown) on the proximal end side of the diagnostic imaging catheter 100 via an electric signal cable 142.
  • a piezoelectric material such as ceramics or quartz can be used.
  • the light transmission / reception unit 145b continuously transmits the transmitted measurement light into the body cavity and continuously receives the reflected light from the living tissue in the body cavity.
  • the light transmission / reception unit 145b has a ball lens (optical element) provided at the tip of the optical fiber 143 and having a lens function for collecting light and a reflection function for reflecting light.
  • the signal transmission / reception unit 145 is housed inside the housing 146 as shown in FIG.
  • the base end side of the housing 146 is connected to the drive shaft 140.
  • the housing 146 is provided with an opening on the cylindrical surface of a cylindrical metal pipe so as not to obstruct the progress of ultrasonic waves transmitted and received by the ultrasonic wave transmitting and receiving unit 145a and light transmitted and received by the optical transmitting and receiving unit 145b. It has a good shape.
  • the sheath 110 includes a lumen 110a into which the drive shaft 140 is inserted so as to be movable back and forth.
  • a guide wire insertion member 114 is attached to the tip of the sheath 110 so as to be juxtaposed with the lumen 110a provided on the sheath 110 and provided with a guide wire lumen 114a through which the guide wire G can be inserted.
  • the sheath 110 and the guide wire insertion member 114 can be integrally formed by heat fusion or the like.
  • the guide wire insertion member 114 is provided with a marker 115 having X-ray contrast property.
  • the marker 115 is composed of a metal coil having high X-ray impermeable properties such as Pt and Au.
  • a communication hole 116 that communicates the inside and the outside of the lumen 110a is formed at the tip of the sheath 110.
  • a reinforcing member 117 for firmly joining and supporting the guide wire insertion member 114 is provided at the tip of the sheath 110.
  • the reinforcing member 117 is formed with a communication passage 117a that communicates the inside of the lumen 110a arranged on the proximal end side of the reinforcing member 117 with the communication hole 116.
  • the reinforcing member 117 may not be provided at the tip of the sheath 110.
  • the communication hole 116 is a priming liquid discharge hole for discharging the priming liquid.
  • a priming process is performed in which the sheath 110 is filled with a priming solution in order to reduce the attenuation of ultrasonic waves due to air in the sheath 110 and efficiently transmit and receive ultrasonic waves.
  • the priming liquid can be discharged from the communication hole 116 into the living lumen, and a gas such as air can be discharged from the inside of the sheath 110 together with the priming liquid.
  • the sheath 110, the guide wire insertion member 114, and the reinforcing member 117 are made of a flexible material, and the material is not particularly limited, and examples thereof include styrene-based, polyolefin-based, polyurethane-based, polyester-based, and polyamide-based. Examples thereof include various thermoplastic elastomers such as polyimide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, and chlorinated polyethylene-based, and one or a combination of two or more of these (polymer alloy, polymer blend). , Laminates, etc.) can also be used.
  • a hydrophilic lubricating coating layer that exhibits lubricity when wet can be arranged on the outer surface of the sheath 110.
  • the hub 160 includes a hub body 161 having a hollow shape, a connector case 165c connected to the base end side of the hub body 161 and a port 162 communicating with the inside of the hub body 161. ..
  • the hub 160 includes protrusions 163a and 163b for determining the position (direction) of the hub 160 when connecting to the external device 500, and a connection pipe 164b for holding the drive shaft 140.
  • the hub 160 includes a bearing 164c that rotatably supports the connecting pipe 164b, and a sealing member 164a that prevents the priming liquid from leaking from between the connecting pipe 164b and the bearing 164c toward the proximal end side.
  • the hub 160 includes an electrode terminal 165a connected to the external device 500 and a connector portion 165 in which the optical connector 165b is arranged inside.
  • the inner shaft 130 is connected to the tip of the hub body 161.
  • the drive shaft 140 is pulled out from the inner shaft 130 inside the hub body 161.
  • An injection device S (see FIG. 3) for injecting the priming liquid is connected to the port 162 when performing the priming process.
  • the injection device S includes a connector S1 connected to the port 162, a tube S2 connected to the connector S1, and a three-way stopcock S3 connected to the tube S2.
  • the injection device S includes a first syringe S4 and a second syringe S5 that are connected to the three-way stopcock S3 and capable of injecting the priming liquid into the port 162.
  • the second syringe S5 is a syringe that has a larger capacity than the first syringe S4 and is used as an auxiliary when the amount of the priming liquid to be injected by the first syringe S4 is insufficient.
  • connection pipe 164b holds the drive shaft 140 in order to transmit the rotation of the electrode terminal 165a and the optical connector 165b, which are rotationally driven by the external device 500, to the drive shaft 140.
  • An electric signal cable 142 and an optical fiber 143 are inserted inside the connecting pipe 164b.
  • the connector portion 165 includes an electrode terminal 165a that is electrically connected to the electric signal cable 142 and an optical connector 165b that is connected to an optical fiber.
  • the received signal in the ultrasonic transmission / reception unit 145a is transmitted to the external device 500 via the electrode terminal 165a, subjected to predetermined processing, and displayed as an image.
  • the received signal in the optical transmission / reception unit 145b is transmitted to the external device 500 via the optical connector 165b, subjected to predetermined processing, and displayed as an image.
  • the diagnostic imaging catheter 100 is connected to and driven by an external device 500.
  • the external device 500 is connected to the connector portion 165 (see FIG. 5) provided on the base end side of the hub 160.
  • the external device 500 includes a motor 500a which is a power source for rotating the drive shaft 140 and a motor 500b which is a power source for moving the drive shaft 140 in the axial direction.
  • a motor 500a which is a power source for rotating the drive shaft 140
  • a motor 500b which is a power source for moving the drive shaft 140 in the axial direction.
  • the rotational motion of the motor 500b is converted into axial motion by the ball screw 500c connected to the motor 500b.
  • the operation of the external device 500 is controlled by the control device 501 electrically connected to the external device 500.
  • the control device 501 includes a CPU (Central Processing Unit) 501a and a memory as a main configuration.
  • the control device 501 is electrically connected to the monitor 502.
  • the control device 501 can be electrically connected to a server (not shown).
  • the bed 200 is arranged in a direction perpendicular to the ground from a pedestal placed on the ground, extends approximately along the ground, and is configured to have a flat surface capable of supporting patient Pa from children to adults. ing.
  • the bed 200 is configured such that the medical device P is attached to a cassette 400 attached to the tip of the robot arm 300 so that the medical device P can be arranged above the bed 200 when the robot arm 300 is operated.
  • the bed 200 has a table size configured according to the physique of an adult, but is equipped with a slide mechanism so that the table size can be changed in a plurality of stages according to the physique of the patient Pa. You may.
  • the robot arm 300 is configured to hold the cassette 400.
  • the robot arm 300 is a vertical articulated robot including a first axis 310, a second axis 320, a third axis 330, and a mounting portion 340 provided at the tip of the third axis 330. It is configured.
  • the first shaft 310 and the second shaft 320 are rotatably connected, and the second shaft 320 and the third shaft 330 are rotatably connected.
  • the first shaft 310, the second shaft 320, and the third shaft 330 are configured to be rotationally driven by a servomotor or the like.
  • the robot arm 300 is configured as described above so that the cassette 400 attached to the tip can be translated and rotated with 6 degrees of freedom.
  • the degree of freedom of the robot hand is not limited to 6 degrees of freedom as long as the medical device P attached to the cassette 400 can be reached by translating and rotating to a desired position.
  • the mounting portion 340 will be described in the description of the cassette 400.
  • the cassette 400 can be configured for single use and is replaceably installed at the attachment portion 340 provided at the tip of the third axis 330 of the robot arm 300 to move the guide wire G and the medical device P used for the procedure for the patient Pa. It is configured to be possible. As shown in FIG. 2, the cassette 400 includes a first drive unit 410, a second drive unit 430, and an installation unit 450.
  • the cassette 400 is configured so that the guide wire G can be moved forward and backward by the first drive unit 410 in the left-right direction shown in FIG.
  • the first drive unit 410 includes rollers 411 to 422.
  • the rollers 411 to 422 have rollers represented by odd-numbered symbols arranged on one side of the guide wire G, that is, on the upper side of the guide wire G in FIG.
  • the rollers 411 to 422 are arranged on the other side with respect to the guide wire G, that is, on the lower side with respect to the guide wire G in FIG. 2, the rollers indicated by even numbers.
  • the rollers 411 to 420 are configured such that the rollers indicated by odd-numbered or even-numbered symbols are driven rollers by a motor or the like, and the other is a driven roller.
  • the drive roller in the first drive unit 410 is configured to be rotatable by an actuator (not shown) such as a motor.
  • the second drive unit 430 is configured so that the medical device P such as the above-mentioned diagnostic imaging catheter can be moved forward and backward in the longitudinal direction.
  • the second drive unit 430 includes rollers 431 to 434, a first arm 435, a second arm 436, a rotating shaft 437, 438, 439, and an elastic member 441.
  • the mounting portion 340 of the robot arm 300 includes gears 341 and 342, gears 343 and 344, and motors 345 and 346.
  • the rollers 433 and 434 correspond to a pair of gripping members.
  • the roller 434 corresponds to the first gripping member
  • the roller 433 corresponds to the second gripping member.
  • the motor 345 corresponds to the first drive unit
  • the motor 346 corresponds to the second drive unit
  • the first arm 435 corresponds to the first installation member
  • the second arm 436 corresponds to the second installation member.
  • the elastic member 441 corresponds to an urging member.
  • the motor 345, the gears 341, 342 and the first arm 435 adjust the distance between the rollers 433 and 434 in the rollers 433 and 434 that send the medical device P including the sheath 110 in the longitudinal direction in the robot catheter system 1.
  • the motor 345, gears 341, 342 and the first arm 435 correspond to actuators.
  • rollers 431 to 434 similarly to the rollers 411 to 422, the rollers indicated by odd-numbered symbols are arranged on one side with respect to the medical device P, and on the upper side of the medical device P in FIG.
  • the rollers 431 to 434 are configured so that the rollers represented by the even-numbered reference numerals are arranged on the other side with respect to the medical device P, that is, on the lower side with respect to the medical device P in FIG.
  • the rollers 431 to 434 are configured such that the rollers indicated by odd numbers are driven rollers by a motor or the like, and the other is a driven roller.
  • the medical device P is configured to be movable back and forth in the longitudinal direction while being sandwiched by the second drive unit 430 in a direction intersecting the longitudinal direction.
  • the first arm 435 adjusts the distance between the rollers 433 and 434 and moves the roller 434 with respect to the roller 433.
  • the first arm 435 is rotatably configured by a motor 345, and a roller 434 is rotatably attached to a rotating shaft 437.
  • the first arm 435 is rotatably supported by a rotating shaft 438 in the cassette 400. With this configuration, the roller 434 can be approached and separated from the roller 433, and the relative distance between the roller 433 and the roller 434 is adjusted. That is, when the first arm 435 rotates clockwise in FIG. 6 about the rotation shaft 438, the roller 433 and the roller 434 come close to each other.
  • the first arm 435 rotates counterclockwise about the rotation shaft 438, the roller 434 is separated from the roller 433.
  • the first arm 435 is provided with a mounting portion 435a to which the elastic member 441 can be mounted.
  • the mounting portion 435a is formed in a hollow cylindrical shape so that the elastic member 441 described later can be mounted.
  • the second arm 436 can be rotated by the motor 345 and is supported by the rotating shaft 438.
  • the second arm 436 includes a mounting portion 436a to which the elastic member 441 can be mounted, similarly to the first arm 435.
  • the mounting portion 436a is configured to be insertable into the internal space of the mounting portion 435a.
  • the first arm 435 and the second arm 436 are configured to be close to each other in the rotation direction around the rotation shaft 438.
  • the operation of the first arm 435 and the second arm 436 by the motor 345, that is, the setting of the rotation angle is performed by the operation unit 800 described later.
  • the rotation shaft 439 is provided on the cassette 400 to rotatably support the roller 434, which is the drive roller in the rollers 433 and 434.
  • the elastic member 441 is provided so as to be attachable to the attachment portion 435a of the first arm 435 and the attachment portion 436a of the second arm 436.
  • the elastic member 441 is configured to use a compression spring or the like capable of urging the second arm 436 with respect to the first arm 435 in the rotation direction of the first arm 435 and the second arm 436.
  • the rollers 433 and 434 impart a constant holding force to the medical device P to prevent or suppress the slip of the medical device P.
  • the elastic member 441 acts when the rollers 433 and 434 reach the portion of the sheath 110 where the diameter changes, and only a slight stress change is required.
  • the sheath 110 is configured so that an excessive holding force is not applied.
  • the gear 341 is provided on the mounting portion 340 of the robot arm 300 in order to rotate the rotating shaft 438 on the driven side.
  • the gear 341 is derived from the motor 345 as shown in FIG. 8 and is rotatably attached to a shaft intersecting the rotation shaft 438.
  • the gear 342 is rotatably provided on the rotating shaft 438 of the cassette 400. By meshing the gear 341 and the gear 342, the rotation from the motor 345 can be converted into the rotation of the rotation shaft 438.
  • the gears 341 and 342 are configured as so-called bevel gears in the present embodiment.
  • the gear 343 is provided on the mounting portion 340 of the robot arm 300 in order to rotate the roller 433 on the drive side.
  • the gear 343 is derived from the motor 346 and is rotatably attached to a shaft that intersects the rotating shaft 439.
  • the gear 344 is rotatably provided on the rotating shaft 439 of the roller 434 in the cassette 400. By engaging the gear 343 and the gear 344, the rotation from the motor 346 can be converted into the rotation of the roller 433.
  • the gears 343 and 344 can be configured by bevel gears as described above.
  • the motor 345 applies a driving force that causes the first arm 435 to approach or separate from the second arm 436.
  • the motor 346 is provided to rotate the roller 433 around the rotation shaft 439.
  • the motor 345 and the motor 346 can be configured by a known motor.
  • the installation unit 450 is configured to install a medical device through which the first drive unit 410, the second drive unit 430, the guide wire G, and the medical device P are inserted. As shown in FIG. 2, the installation unit 450 includes a first installation unit 451, a second installation unit 452, a third installation unit 453, and a fourth installation unit 454.
  • the first installation portion 451 is configured so that the entire outer circumference shown in FIG. 2 is formed of a resin such as hard plastic.
  • the first installation portion 451 can be provided with a cover for accommodating the guide wire G and the medical device P by a hinge or the like in a state where the guide wire G and the medical device P can be inserted.
  • the second installation unit 452 includes a wall surface in which the rollers 411 to 418 constituting the first drive unit 410 are operably installed in the first installation unit 451.
  • the second installation portion 452 can be configured to be rotatable with respect to the first installation portion 451 by a motor or gear pair (not shown) with the longitudinal direction of the guide wire G (the left-right direction in FIG. 2) as the rotation axis.
  • the third installation unit 453 includes a wall surface on which rollers 419 to 422 constituting the first drive unit 410 and rollers 431 to 434 constituting the second drive unit 430 are operably installed.
  • the fourth installation unit 454 is configured as a portion to which the guide wire G to be attached to the cassette 400 and the connector C through which the medical device P is inserted can be attached.
  • the connector C installed in the fourth installation unit 454 is configured as a Y-shaped connector in the present embodiment.
  • the third installation portion is configured by a concave-convex shape or a concave-convex groove to which the connector can be attached in the present embodiment.
  • the computer 600 includes a server 650 and a client 610 as shown in FIG.
  • the client 610 includes a storage unit 620 and a control unit 630.
  • the storage unit 620 is electrically connected to the operation unit 800 and is configured to store data on the gripping force gripped by the rollers 433 and 434 with respect to the sheath 110.
  • the storage unit 620 can be configured by a ROM or the like.
  • the control unit 630 selects one of the data stored in the storage unit 620 according to the selection of the user Pb in the operation unit 800, and issues a command to operate the rollers 433 and 434.
  • the control unit 630 can be configured by a processor such as a CPU, a RAM, or the like.
  • the data stored in the storage unit 620 is configured to be updatable by communication with the server 650.
  • the server 650 is configured to be able to communicate with the control unit 630 or the storage unit 620 by a network card or the like provided on the client.
  • the irradiation device 700 is used to grasp the position of the tip of the guide wire G that has entered the living body by a marker or the like provided on the guide wire G.
  • the irradiation device 700 is provided so as to be movable in the vicinity of the bed 200, and includes a portion for irradiating radiation such as X-rays and a portion for forming an captured image by receiving the irradiated X-rays.
  • the operation unit 800 can be operated by the user Pb, and the gripping force of the medical device P by the rollers 433 and 434 can be adjusted. As shown in FIG. 10, the operation unit 800 includes a screen 810, a grip portion 820.830.840, and a pressing portion 850.
  • the operation unit 800 is configured to be able to operate each part of the robot catheter system 1.
  • the operation unit 800 is electrically connected to the robot arm 300, the cassette 400, and the irradiation device 700, and is configured to be able to operate the operation of each unit.
  • the screen 810 is configured so that the user Pb can visually recognize various operations performed by the operation unit 800.
  • the screen 810 can also be configured as a touch screen in which various operations are performed by touching the screen with a finger.
  • the user Pb selects the manufacturer name, product name, etc. of the medical device P to be used on the screen, it can be configured to display information such as the material and outer diameter of the sheath 110.
  • the grip portions 820 and 830 are configured to be operable by the fingers of the user Pb.
  • the grip portion 820 is gripped by the fingers of the left hand of the user Pb, and the grip portion 830 is configured to be grippable by the fingers of the right hand of the user Pb.
  • the grip portions 820 and 830 can be configured as sticks that can be tilted to any angle position in the circumferential direction by the pressing force from the hand of the user Pb.
  • the grip portion 840 can be configured in the same manner as the grip portions 820 and 830.
  • the guiding catheter set in the cassette 400 can be moved forward and backward by operating the grip portion 840.
  • the pressing portion 850 is configured as a button capable of urgently stopping the operation of the medical device P and / or the guide wire G in the unlikely event that the operations of the grip portions 820, 830, 840 and the like do not work.
  • the operator connects the device for injecting the priming liquid to the port 162 with the hub 160 pulled to the most proximal side, and injects the priming liquid into the lumen 110a of the sheath 110.
  • the priming liquid When the priming liquid is injected into the lumen 110a, the priming liquid is discharged to the outside of the sheath 110 through the communication passage 117a and the communication hole 116. As a result, a gas such as air can be discharged from the inside of the sheath 110 to the outside together with the priming liquid.
  • the operator connects the external device 500 to the connector portion 165 of the diagnostic imaging catheter 100 as shown in FIG. Then, the operator pushes the hub 160 until it comes into contact with the base end of the unit connector 150, and moves the signal transmission / reception unit 145 to the tip end side.
  • the operator inserts a guide wire (not shown) to the vicinity of the entrance of the coronary artery (coronary artery) of the heart of the living body. Then, the guiding catheter is inserted into the target site along the guide wire. Next, the operator pulls out the guide wire and opens the cover of the first installation portion 451 in the cassette 400. Then, the guiding catheter is attached to the Y-shaped connector C installed in the fourth installation portion 454. Next, a guide wire G different from the above is inserted through the guide wire insertion member 114 of the medical device P, and the connector C is attached to the fourth installation portion 454 of the cassette 400.
  • the guide wire G is sandwiched between the rollers 411 to 422 of the first drive unit 410.
  • the medical device P is sandwiched between the rollers 431 to 434 of the second drive unit 430. After setting the guide wire G and the medical device P, close the cover of the first installation portion 451.
  • the operator operates the operation unit 800 and inserts the guide wire G attached to the cassette 400 by the first drive unit 410 to the lesion portion.
  • the operator operates the operation unit 800 and inserts the diagnostic imaging catheter 100 to the lesion portion by the second drive unit 430 along the guide wire G.
  • the medical device P is selected by the operation unit 800 and moves back and forth at intervals of rollers 433 and 434 defined by the first arm 435 and the second arm 436.
  • the diagnostic imaging catheter 100 is moved back and forth to protrude from the tip opening of the guiding catheter. Then, while inserting the guide wire G through the guide wire lumen, the diagnostic imaging catheter 100 is further pushed along the guide wire G to be inserted into the target position in the blood vessel.
  • a known guiding catheter having a port (not shown) to which a syringe (not shown) can be connected can be used at the proximal end.
  • the blood in the blood vessel is temporarily replaced with a flash solution such as a contrast medium, and the blood in the blood vessel is temporarily replaced with the flash solution.
  • a flash solution such as a contrast medium
  • the syringe containing the flush solution is connected to the port of the guiding catheter, and the pusher of the syringe is pushed to inject the flush solution into the lumen of the guiding catheter.
  • the flush fluid passes through the lumen of the guiding catheter and is introduced into the blood vessel through its tip opening.
  • the introduced flush liquid flushes the blood around the tip of the sheath 110, and the flash liquid is filled around the tip of the sheath 110.
  • the step of replacing with the flash liquid described above can be omitted.
  • the signal transmission / reception unit 145 moves to the proximal end side while rotating together with the drive shaft 140 (pullback operation).
  • the ultrasonic transmission / reception unit 145a transmits the ultrasonic waves toward the blood vessel wall and receives the ultrasonic waves reflected by the blood vessel wall.
  • the light transmission / reception unit 145b also transmits the measurement light toward the blood vessel wall and receives the reflected light reflected by the blood vessel wall.
  • the ultrasonic wave transmitted from the ultrasonic transmission / reception unit 145a and the measurement light transmitted from the light transmission / reception unit 145b intersect, the region inspected by the ultrasonic wave in the living body and the light are inspected. Areas can be overlapped.
  • the rotation and movement operations of the drive shaft 140 are controlled by the control device 501.
  • the connector portion 165 provided in the hub 160 is rotated while being connected to the external device 500, and the drive shaft 140 is rotated in conjunction with this.
  • the signal transmission / reception unit 145 transmits ultrasonic waves and light into the body.
  • the signal corresponding to the reflected wave and the reflected light received by the signal transmitting / receiving unit 145 is sent to the control device 501 via the drive shaft 140 and the external device 500.
  • the control device 501 generates a tomographic image of the biological lumen based on the signal sent from the signal transmission / reception unit 145, and displays the generated image on the monitor 502.
  • the robot catheter system 1 for moving the sheath 110 forward and backward in the longitudinal direction includes an actuator.
  • the actuator adjusts the spacing between the rollers 433 and 434 in a pair of rollers 433 and 434 that feed the sheath 110 in the longitudinal direction, and moves the roller 434 with respect to the roller 433.
  • the actuator includes a motor 345 and a first arm 435.
  • the motor 345 generates a driving force that causes the roller 434 to approach or separate relative to the roller 433.
  • the first arm is configured to be rotatable by a motor 345, and a roller 434 can be attached to the first arm. By configuring the actuator as described above, the roller 434 can be moved closer to or further from the roller 433 to adjust the gripping force of the sheath 110 by the rollers 433 and 434.
  • the first arm 435 adjusts the relative spacing of the roller 434 to the roller 433 by rotating around the rotation shaft 438.
  • the actuator includes a second arm 436 and an elastic member 441.
  • the second arm 436 is rotatably installed on the rotating shaft 438.
  • the elastic member 441 is provided on the first arm 435 and the second arm 436, and is configured to urge the second arm 436 with respect to the first arm 435 in the rotation direction of the first arm 435 and the second arm 436. ing.
  • the present embodiment includes a robot catheter system 1 in which a motor 345 in the actuator can be installed, a robot arm 300 having a plurality of joints and capable of moving and rotating with multiple degrees of freedom, and a cassette 400. ..
  • the cassette 400 is replaceably installed in the mounting portion 340 provided at the tip of the robot arm 300, and the rollers 433, 434 and the first arm 435 are rotatably provided. With this configuration, the holding force of the sheath 110 by the rollers 433 and 434 can be adjusted so that the medical device P can be operated satisfactorily.
  • the robot catheter system 1 includes an operation unit 800, a storage unit 620 and a control unit 630 provided in the computer 600.
  • the operation unit 800 can be operated by the user Pb, and the gripping force of the rollers 433 and 434 can be adjusted.
  • the storage unit 620 is electrically connected to the operation unit 800 and stores data regarding the gripping force gripped by the rollers 433 and 434 with respect to the sheath 110.
  • the control unit 630 is configured to operate the rollers 433 and 434 by selecting any of the data stored in the storage unit 620 according to the selection of the user Pb in the operation unit 800.
  • the medical worker such as a doctor can perform the operation on the patient Pa after adjusting the holding force on the medical device P by the robot catheter system 1 without using the medical device P.
  • the computer 600 is configured to include a server 650 capable of communicating with at least one of the storage unit 620 and the control unit 630 in the present embodiment.
  • the data stored in the storage unit 620 is configured to be updatable by communication with the server 650. Therefore, the holding force of the rollers 433 and 434 can be adjusted more appropriately according to the specifications of the medical device P to be used, or the holding force can be adjusted according to the specifications of the new medical device P that has been put on the market (sold) over time. Can be adjusted.
  • FIG. 11 is a perspective view showing a modified example of FIG.
  • the present invention is not limited to this, and as shown in FIG. 11, a change in torque for moving the sheath 110 forward and backward when moving the sheath 110 forward and backward in addition to the gears 343 and 344 is detected between the rotating shaft 439 and the motor 346.
  • the detection unit 347 may be provided.
  • the frictional resistance of the medical device P with the rollers 433 and 434 can be simply considered to be uniform.
  • the surface on the tip end side of the sheath 110 is coated with a hydrophilic coating in consideration of lubricity and the like, the surface on the hand side may not be coated with a hydrophilic coating.
  • the load torque detected by the detection unit 347 becomes small when the surface of the sheath 110 shifts from non-hydrophilic to hydrophilic.
  • the rotation positions of the first arm 435 and the second arm 436 are adjusted to bring the roller 434 closer to the roller 433.
  • the frictional resistance between the rollers 433 and 434 and the sheath 110 changes, and it is effective that the long medical body such as the sheath 110 to be moved back and forth slips. Can be suppressed or prevented.
  • the medical long body constituting the medical device P attached to the cassette 400 of the robot catheter system 1 is the sheath 110 of the diagnostic imaging catheter 100 .
  • the medical long body constituting the medical device P is suitable for the object of the present invention such as a balloon catheter or a catheter for stent delivery in addition to the above. It can be applied to various catheters.
  • FIGS. 12 and 13 are diagrams showing a cassette 400a according to another embodiment of the present invention.
  • FIGS. 12 and 13 are diagrams showing a cassette 400a according to another embodiment of the present invention.
  • FIG. 12 and 13 are diagrams showing a cassette 400a according to another embodiment of the present invention.
  • FIG. 12 and 13 are diagrams showing a cassette 400a according to another embodiment of the present invention.
  • FIG. 12 and 13 are diagrams showing a cassette 400a according to another embodiment of the present invention.
  • other preferred embodiments of the present invention are shown below. That is, in the form shown below, when a hydrophilic coating is formed on the surface of the sheath 110, the sheath is formed by forming a portion in contact with the sheath having a relatively large contact area with the sheath 110 other than the roller. Slip is more strongly suppressed or prevented. Since the first drive unit 410 and the installation unit 450 constituting the cassette 400a are the same as the respective configurations indicated by the same reference numerals of the cassette 400,
  • the second drive unit 430a includes a drive belt 431a, a passive belt 431b, a drive pulley 432a, a passive pulley 433a, 433b, 433c, a support member 435b, an elastic member 436b, and a pinion gear 437a.
  • the drive belt 431a and the passive belt 431b are rotatably fixed to the cassette 400a.
  • the drive belt 431a is rotatably supported by a drive pulley 432a and a passive pulley 433a, which are drive shafts.
  • the passive belt 431b is rotatably supported by passive pulleys 433b and 433c.
  • the passive belt 431b is configured to be rotatably connected to the support member 435b. That is, the passive belt 431b is formed with a gangway through which the support member 435b is inserted near the center in the width direction of the belt.
  • the passive belt 431b is pressed against the drive belt 431a by the elastic member 436b and the movable portion 435d of the support member 435b with a constant stress that does not deform the sheath 110.
  • the support member 435b is formed in a long shape, and the movable portion 435d is provided at the end portion of the support member 435b in the longitudinal direction.
  • the elastic member 436b can be composed of a string-wound spring or the like that is inserted into the movable portion 435d of the support member 435b. With this configuration, elastic force (urging force) is applied to the passive belt 431b by the elastic member 436b.
  • the pinion gear 437a that constitutes the actuator is operated by a drive motor (not shown).
  • a bevel gear or the like as the main mechanism as described above, it is possible to transmit the rotation of the motor to the pinion gear 437a in the cassette 400a.
  • the rack 435c is provided on the support member 435b and is configured to be meshable with the teeth of the pinion gear 437a.
  • the rotation of the pinion gear 437a is converted by the rack 435c into a substantially linear approach / separation movement of the support member 435b with respect to the direction intersecting the belt surface of the passive belt 431b. That is, in the embodiment of FIGS. 12 and 13, the motor and gear similar to the motor 345 and gears 341 and 342 of FIG. 8, the pinion gear 347a, the support member 345b provided with the rack 345c, and the elastic member 346b constitute an actuator. To do.
  • the stress on the sheath 110 can be adjusted by the operation of the rack 435c and the pinion gear 437a of the support member 435b constituting the actuator.
  • the pinion gear 437a is rotated and the rack 435c of the support member 435b is displaced toward the sheath 110 side, the pressing load by the elastic member 436b increases.
  • the rack 435c of the support member 435b is displaced to the side opposite to the sheath 110, the pressing load by the elastic member 436b becomes small, so that the deformation of the sheath 110 can be suppressed.
  • the distance between the drive belt 431a and the passive belt 431b can be increased by the action of the actuator described above, and an operator such as a medical worker can easily attach / detach a long medical body such as a sheath 110. It becomes possible to do.
  • the drive pulley 432a of the drive belt 431a can operate to take a relatively large contact area with the sheath 110, and the sheath 110 can be moved back and forth in the longitudinal direction to prevent the sheath 110 from slipping. It can be strongly prevented or suppressed.
  • Robot catheter system 110 sheath (long medical body), 300 robot arm (arm), 341, 342 gears (actuators), 345 motor (first drive unit, actuator), 346 motor (second drive unit), 347 detector, 400 cassettes, 433 rollers (a pair of gripping members, a second gripping member), 434 Roller (a pair of gripping members, first gripping member), 435 1st arm (1st installation member, actuator), 436 Second arm (second installation member, actuator), 438 axis of rotation, 441 Elastic members (urging members, actuators), 600 computers, 620 Memory, 630 control unit, 650 server, 800 operation unit.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Robotics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Endoscopes (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

Le problème décrit par la présente invention est de fournir une nouvelle structure pour un système de cathéter robotisé, la nouvelle structure pouvant ajuster la force de retenue pour retenir un corps allongé à usage médical. La solution selon l'invention porte sur un actionneur, qui est disposé dans un système de cathéter robotisé (1) pour déplacer une gaine (110) vers l'arrière et vers l'avant dans la direction longitudinale, règle l'espace entre un rouleau (433) et un rouleau (434) qui envoient la gaine dans la direction longitudinale, et déplace l'un des rouleaux )433, 434) vers l'autre.
PCT/JP2020/033292 2019-09-30 2020-09-02 Actionneur et système de cathéter robotisé WO2021065311A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2019179014A JP2022169814A (ja) 2019-09-30 2019-09-30 アクチュエータ及びロボットカテーテルシステム
JP2019-179014 2019-09-30

Publications (1)

Publication Number Publication Date
WO2021065311A1 true WO2021065311A1 (fr) 2021-04-08

Family

ID=75337900

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2020/033292 WO2021065311A1 (fr) 2019-09-30 2020-09-02 Actionneur et système de cathéter robotisé

Country Status (2)

Country Link
JP (1) JP2022169814A (fr)
WO (1) WO2021065311A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022224234A1 (fr) * 2021-04-19 2022-10-27 Microbot Medical Ltd. Dispositif robotisé compact et ensembles pour la manipulation d'outils chirurgicaux allongés
CN115644771A (zh) * 2022-11-11 2023-01-31 深圳先进技术研究院 一种内镜控制装置和内镜机器人
WO2023171097A1 (fr) * 2022-03-11 2023-09-14 テルモ株式会社 Corps de maintien, dispositif de maintien et unité de maintien de cathéter

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006177090A (ja) * 2004-12-24 2006-07-06 Hitachi Constr Mach Co Ltd 把持力制御装置および作業機械
JP2015037572A (ja) * 2008-05-06 2015-02-26 コリンダス インコーポレイテッド カテーテルシステム
US20150297864A1 (en) * 2014-04-21 2015-10-22 Hansen Medical, Inc. Devices, systems, and methods for controlling active drive systems
JP2019010724A (ja) * 2017-06-30 2019-01-24 大成建設株式会社 物品配置システム及び食品盛り付けシステム
JP2019503778A (ja) * 2016-01-07 2019-02-14 ロボカト 細長い可撓性のある医療用部材を駆動するためのロボット化可能なモジュール、そうしたモジュールを含む医療用ロボットおよびシステム

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006177090A (ja) * 2004-12-24 2006-07-06 Hitachi Constr Mach Co Ltd 把持力制御装置および作業機械
JP2015037572A (ja) * 2008-05-06 2015-02-26 コリンダス インコーポレイテッド カテーテルシステム
US20150297864A1 (en) * 2014-04-21 2015-10-22 Hansen Medical, Inc. Devices, systems, and methods for controlling active drive systems
JP2019503778A (ja) * 2016-01-07 2019-02-14 ロボカト 細長い可撓性のある医療用部材を駆動するためのロボット化可能なモジュール、そうしたモジュールを含む医療用ロボットおよびシステム
JP2019010724A (ja) * 2017-06-30 2019-01-24 大成建設株式会社 物品配置システム及び食品盛り付けシステム

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022224234A1 (fr) * 2021-04-19 2022-10-27 Microbot Medical Ltd. Dispositif robotisé compact et ensembles pour la manipulation d'outils chirurgicaux allongés
WO2023171097A1 (fr) * 2022-03-11 2023-09-14 テルモ株式会社 Corps de maintien, dispositif de maintien et unité de maintien de cathéter
CN115644771A (zh) * 2022-11-11 2023-01-31 深圳先进技术研究院 一种内镜控制装置和内镜机器人
CN115644771B (zh) * 2022-11-11 2023-08-15 深圳先进技术研究院 一种内镜控制装置和内镜机器人

Also Published As

Publication number Publication date
JP2022169814A (ja) 2022-11-10

Similar Documents

Publication Publication Date Title
WO2021065311A1 (fr) Actionneur et système de cathéter robotisé
EP2934652B1 (fr) Dispositifs intravasculaires orientables
US5846204A (en) Rotatable ultrasound imaging catheter
US20130060145A1 (en) Ultrasound Catheter With Rotatable Transducer
JP7414939B2 (ja) 画像診断用カテーテル
US11596310B2 (en) Image diagnosis catheter
WO2021065312A1 (fr) Jeu d'instruments médicaux et élément tubulaire
JP2017093506A (ja) 画像診断用カテーテル
JP6805009B2 (ja) 画像診断用カテーテル
JP2021145860A (ja) 医療器具
EP3545825B1 (fr) Cathéter de diagnostic d'images
JP2000189517A (ja) 超音波カテ―テル
JP6823043B2 (ja) 医療用デバイス
JP6779799B2 (ja) 医療デバイス
JP6826847B2 (ja) 医療用デバイス
WO2019189755A1 (fr) Système médical
JP4280112B2 (ja) 超音波カテーテル
WO2021140839A1 (fr) Ensemble cathéter et procédé de reliure
JP7245704B2 (ja) カテーテル及びカテーテルを分解する方法
JP7179943B2 (ja) 画像診断用カテーテル
JP3597066B2 (ja) 超音波カテーテル
WO2022071156A1 (fr) Arbre d'entraînement et cathéter d'imagerie diagnostique
JP6949579B2 (ja) 画像診断用カテーテル
WO2022071157A1 (fr) Arbre d'entraînement et cathéter pour diagnostic d'image
JP2007152142A (ja) 超音波カテーテル

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 20871939

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 20871939

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP