WO2023093155A1 - 一种同步型介入手术机器人 - Google Patents

一种同步型介入手术机器人 Download PDF

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Publication number
WO2023093155A1
WO2023093155A1 PCT/CN2022/114736 CN2022114736W WO2023093155A1 WO 2023093155 A1 WO2023093155 A1 WO 2023093155A1 CN 2022114736 W CN2022114736 W CN 2022114736W WO 2023093155 A1 WO2023093155 A1 WO 2023093155A1
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WO
WIPO (PCT)
Prior art keywords
driving mechanism
synchronous
drive mechanism
elongated medical
robot according
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PCT/CN2022/114736
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English (en)
French (fr)
Inventor
任文永
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深圳市爱博医疗机器人有限公司
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Publication of WO2023093155A1 publication Critical patent/WO2023093155A1/zh

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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
    • A61B34/35—Surgical robots for telesurgery
    • 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
    • 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

Definitions

  • the present application relates to the field of medical robots, and is applied to a master-slave vascular interventional surgery robot, in particular to a synchronous interventional surgery robot.
  • Minimally invasive vascular interventional surgery refers to that the operator, under the guidance of the digital subtraction angiography (DSA) system, manipulates the catheter guide wire to move in the human blood vessel, treats the lesion, and achieves embolization of malformed blood vessels, dissolution of thrombus, and dilation of stenosis. blood vessels, etc.
  • DSA digital subtraction angiography
  • interventional surgery has played an important role in the diagnosis and treatment of hundreds of diseases such as tumors, peripheral blood vessels, large blood vessels, digestive tract diseases, nervous system, and non-vascular diseases.
  • the scope of interventional surgery can be said to cover the human body “from head to toe". "The treatment of all diseases, and has become the first choice for the treatment of some diseases.
  • Interventional surgery does not need to cut human tissue, and its incision (puncture point) is only the size of a grain of rice. It can treat many diseases that could not be treated or had poor curative effect in the past. It has the characteristics of no surgery, small trauma, fast recovery, and good curative effect. Medical circles at home and abroad attach great importance to it.
  • the inventor realizes that at present, minimally invasive vascular interventional surgery assisting robots are developing rapidly due to the involvement of high-end medical equipment and robot technology. We also invest in research and development.
  • the technical problem to be solved in this application is to provide a synchronous interventional surgery robot that assists an operator in interventional surgery.
  • the synchronous interventional surgery robot provided by this application includes:
  • the first driving mechanism and the second driving mechanism are used for clamping the first elongated medical device and synchronously moving the first elongated medical device on the main body.
  • the first driving mechanism is used to rotate the first elongated medical device to move.
  • the first drive mechanism is used to move and rotate the first elongated medical device simultaneously or not.
  • the second driving mechanism is used to rotate the first elongated medical device synchronously with the first driving mechanism.
  • first driving mechanism and the second driving mechanism are used to move and rotate the first elongated medical device simultaneously or not at the same time.
  • the synchronous interventional surgery robot also includes a third driving mechanism and a fourth driving mechanism installed on the main body, and the third driving mechanism and the fourth driving mechanism are used to clamp the second elongated medical device.
  • the device and the second elongated medical device move synchronously on the body.
  • the third driving mechanism and the fourth driving mechanism are used to synchronously rotate the movement of the second elongated medical device.
  • the third driving mechanism and the fourth driving mechanism are used to make the second elongated medical device move and rotate simultaneously or not at the same time.
  • the third driving mechanism and the fourth driving mechanism are used to push and rotate the second elongated medical device at the same time or at different times
  • the first driving mechanism and the second driving mechanism are used to make the first elongated medical device move and rotate simultaneously or not at the same time.
  • the fourth drive mechanism is located between the first drive mechanism and the third drive mechanism, and the first drive mechanism is located between the second drive mechanism and the fourth drive mechanism.
  • the second driving mechanism is used to rotate the first elongated medical device, and the second driving mechanism makes the rotation speed of the first elongated medical device different from that of the first driving mechanism to make the first elongated medical device rotate. Rotational speed of long medical instruments.
  • the rotation speed of the first elongated medical device by the second driving mechanism is lower than the rotation speed of the first elongated medical device by the first driving mechanism.
  • the second driving mechanism makes the rotation speed of the first elongated medical device zero.
  • This application allows the operator to remotely control the first driving mechanism and the second driving mechanism to move synchronously on the main body, thereby driving the slender medical device to move precisely, not only avoiding X-ray radiation, but also controlling more precisely, which can avoid Operation errors prevent slender medical devices from twisting.
  • Fig. 1 is a schematic diagram of an embodiment of a synchronous interventional surgical robot of the present application
  • Fig. 2 is another schematic diagram of Fig. 1;
  • Fig. 3 is the schematic diagram when adding two driving mechanisms in Fig. 1;
  • Fig. 4 is a schematic diagram when only two driving mechanisms are left in Fig. 1 .
  • connection should be understood in a broad sense, for example, it can be a fixed connection or a detachable connection, Or into one, or even a connection that can move relative to each other; it can be a mechanical connection or an electrical connection; it can be directly connected or indirectly connected through an intermediary, and it can be the internal communication of two components or the mutual connection of two components role relationship.
  • connection can be a fixed connection or a detachable connection, Or into one, or even a connection that can move relative to each other; it can be a mechanical connection or an electrical connection; it can be directly connected or indirectly connected through an intermediary, and it can be the internal communication of two components or the mutual connection of two components role relationship.
  • the direction “distal” is a direction toward the patient
  • the direction “proximal” is a direction away from the patient.
  • the terms “upper” and “upper” refer to an Yin direction away from the direction of gravity
  • the terms “bottom”, “lower” and “lower” refer to an Yin direction of gravity.
  • the term “front” refers to the side of the interventional surgical robot facing the user from the end device, and “advance” refers to the direction in which the guidewire or catheter is displaced into the surgical patient's body.
  • the term “posterior” refers to the side of the interventional surgical robot that faces away from the user from the end device, and “backward” refers to the direction in which the guidewire or catheter is displaced out of the surgical patient's body.
  • the term “inwardly” refers to the interior portion of a feature.
  • the term “outwardly” refers to the outer portion of a feature.
  • the term “rotation” includes “forward rotation” and “reverse rotation”, where “forward rotation” refers to the direction that the guidewire or catheter is rotated into the body of the surgical patient, and “reverse rotation” refers to the direction that the guidewire or catheter is rotated Exit the orientation of the surgical patient's body.
  • first”, “second”, etc. are used for descriptive purposes only, and should not be understood as indicating or implying relative importance or implicitly specifying the quantity of the indicated technical features.
  • a feature defined as “first”, “second”, etc. may expressly or implicitly include one or more of that feature.
  • “many” or “plurality” means two or more.
  • the guide wires here include but not limited to guide wires, micro guide wires and stents to guide and support interventional medical devices
  • catheters include but not limited to guide catheters, micro catheters, contrast catheters, multifunctional tubes (also known as intermediate catheters) , thrombolytic catheters, balloon dilatation catheters and ball expansion stent catheters and other therapeutic interventional medical devices.
  • an embodiment of a synchronous interventional surgical robot of the present application includes a main body 10 , drive mechanisms 20 , 30 , 40 , 50 , 60 movably mounted on the main body 10 , and a gripper 70 and rapid exchange mechanism 80 .
  • the main body 10 is narrow and long, and has a straight channel 102 .
  • These driving mechanisms 20, 30, 40, 50, 60 are successively placed in the channel 102 and can move along the channel.
  • these driving mechanisms 20, 30, 40, 50, 60 can slide directly on the main body 10, such as fixing a linear guide rail on the main body 10, these driving mechanisms 20, 30, 40, 50, 60 can be Slide along the rails.
  • these driving mechanisms 20, 30, 40, 50, 60 can also slide along different guide rails.
  • Each drive mechanism is used to clamp, push (including forward and backward) and rotate (including forward rotation and reverse rotation) catheter or guide wire (collectively referred to as "slender medical devices", the same below), and can also be used to simultaneously clamp Hold, advance (including forward and backward) and rotate (including forward rotation and reverse rotation) catheters and guide wires to realize the coordinated movement of multiple catheters and one guide wire or the coordinated movement of multiple catheters and multiple guide wires.
  • Each drive mechanism includes a clamping assembly for clamping the catheter or guide wire, a rotating assembly for rotating the catheter or guide wire, and the rotating assembly can be either actively driven or passively followed, or all actively driven type, or part of it is active driving type, and the other is passive following type. The clamping of the catheter by the driving mechanism 20, 40 does not affect the rotation of the catheter.
  • the clamping assembly and the rotating assembly of the drive mechanism 20, 30, 40, 50, 60 can be an interventional surgery robot guide wire catheter rubbing device as described in Chinese patent application 202111010071.6, the entire content of which is incorporated into this application.
  • the specific structures of the driving mechanisms 20 , 30 , 40 , 50 , 60 are not limited to being the same, and may also be different, as long as they can realize the clamping, pushing and/or rotating of the catheter and guide wire. It is also possible that only the clamping components are the same and the rotating components are different, or the clamping components are different and the rotating components are the same, or multiple clamping components and rotating components are the same, and other clamping components and rotating components are different.
  • the driving mechanisms 20 and 30 are spaced at a certain distance back and forth, and are used to clamp, push and/or rotate the same guide catheter 90 (ie, the first catheter) so as not to bend.
  • drive mechanisms 20 and 30 preferably move and/or rotate guide catheter 90 synchronously so that it straightens and does not bend.
  • the driving mechanisms 40 and 50 cooperate with a certain distance back and forth, and are used to cooperatively clamp, preferably synchronously push and/or rotate the same multifunctional tube 91 (ie, the second conduit, also known as the intermediate conduit).
  • the drive mechanism 60 is used to clamp, push and/or rotate the guide wire 92 .
  • the gripper 70 is used to grip and move the guide wire 92 synchronously with the drive mechanism 60 .
  • the quick exchange mechanism 80 is detachably fixed together with the driving mechanism 50, and is used for clamping and pushing the quick exchange catheter.
  • preoperative preparation select appropriate (such as length, diameter) guide catheter 90, multifunctional tube 91 and guide wire 92, and flush and exhaust the guide catheter 90 and multifunctional tube 91 with physiological saline.
  • main-end console such as the main-end operating handle of the interventional surgery robot described in Chinese patent application 202111009835.X and the main-end control module of the interventional surgery robot described in 202111009832.6, the entire contents of which are incorporated into this application
  • the driving mechanisms 20 and 30 clamp the guide tube 90 together and move along the channel 102 to drive the guide tube 90 forward, and at the same time or not at the same time, the rotating components of the drive mechanisms 20 and 30 allow the guide tube 90 to rotate.
  • the driving mechanism 30 clamps the guiding catheter 90 and does not move.
  • the clamping assembly of the driving mechanism 20 clamps the guiding catheter 90 again, so that the driving mechanisms 20 and 30 together drive the guiding catheter 90 forward, simultaneously or not at the same time.
  • the rotating assembly of 20 and 30 allows the guide tube 90 to rotate, and so on, until it advances into place.
  • the driving mechanisms 40 and 50 clamp the multifunctional tube 91 and move along the channel 102 to drive the multifunctional tube 91 forward, and at the same time or at different times, the rotating components of the driving mechanisms 40 and 50 allow the multifunctional tube 91 to move forward.
  • the driving mechanism 40 moves to the limit position (for example, the distance from the driving mechanism 30 is close to the threshold) to reset and release the multifunctional tube 91, the driving mechanism 50 clamps the multifunctional tube 91 and does not move.
  • the clamping assembly of the driving mechanism 40 clamps the multifunctional tube 91 again, so that the driving mechanism 40 and 50 together drive the multifunctional tube 91 forward, simultaneously or not at the same time.
  • the rotating assembly of 40 and 50 allows the multi-functional tube 91 to rotate, so reciprocating, until advancing in place.
  • the driving mechanism 60 and the clamper 70 clamp the guide wire 92 and move along the channel 102 to drive the guide wire 92 to advance, and at the same time or not at the same time, the rotating assembly of the drive mechanism 60 makes the guide wire 92 move. 92 turns.
  • the driving mechanism 60 moves to a limit position (for example, the distance from the driving mechanism 50 is close to the threshold) to be reset and the guide wire 92 is released, the guide wire 92 is clamped by the clamper 70 and does not move.
  • the clamping assembly of the drive mechanism 60 clamps the guide wire 92 again, so that the drive mechanism 60 and the clamper 70 drive the guide wire 92 to advance together, or simultaneously or not at the same time.
  • Guide wire 92 rotates, and so reciprocates, until advanced in place.
  • How to remotely control the movement of the drive mechanism 20, 30, 40, 50, 60, the gripper 70 and the quick exchange mechanism 80 by the main console can be the same as the main control module of the interventional surgery robot described in Chinese patent application 202111009832.6. It includes two operating levers, one of which is used to control the driving mechanism 20, 30, 40, 50 and the quick exchange mechanism 80, and the operating lever can control the driving mechanism 20, 30, and the driving mechanism 40, 50 in time through the switching device and quick exchange mechanism 80 , another lever is used to manipulate drive mechanism 60 and gripper 70 . It may also be that the main console includes more than two operating levers, such as four operating levers, which are used to remotely control the driving mechanism 20, 30, the driving mechanism 40, 50, the driving mechanism 60 and the gripper 70, the fast switching mechanism 80 .
  • the driving mechanisms 30 and 50 respectively clamp the guiding catheter 90 and the multifunctional tube 91 through the Y valve. That is, the guide tube 90 and the multifunctional tube 91 are respectively connected to the Y valve, and the Y valve is fixed to the driving mechanism 30, 50, and the clamping assembly of the driving mechanism 30, 50 clamps the Y valve, and the rotating assembly rotates the Y valve Luer connector. Drive guide tube 90, multifunctional tube 91 to rotate.
  • the multifunctional tube 91 and the guide wire 92 In the process of cooperating the guide catheter 90, the multifunctional tube 91 and the guide wire 92, preferably, it is necessary to keep the multifunctional tube 91 protruding from the guide catheter 90 for a certain distance, and the guide wire 92 to extend out of the multifunctional tube. 91 a certain distance.
  • the guide catheter 90, the multifunctional tube 91 and the guide wire 92 reach certain parts of the blood vessel, it may be necessary to remotely control the driving mechanism 20, 30, 40, 50, 60 and the holder 70 through the console at the main end, so that the guide The guide tube 90, the multifunctional tube 91 and the guide wire 92 are forwarded, retreated, forward rotated and reversed for many times.
  • the guiding catheter 90 After the guiding catheter 90 is advanced to the right position, the guiding catheter 90 is fixed and does not move, and the driving mechanism 40, 50, 60 and the holder 70 are remotely controlled through the console at the main end, so that the multifunctional tube 91 and the guiding wire 92 are moved back and forth.
  • the process is similar to the above-mentioned forward process, and will not be repeated here.
  • the heads of the multifunctional tube 91 and the guide wire 92 retreated to the puncture sheath the multifunctional tube 91 and the guide wire 92 were manually taken out from the clamping assembly of the driving mechanism 40, 50, 60 and the holder 70 and Soak in heparin water.
  • microguide wire 96 is manually threaded into the microcatheter 94 and together into the guide catheter 90 with the microguidewire 96 protruding out of the microcatheter 94 for a certain distance.
  • the driving mechanism 40, 50, 60 and the holder 70 are in a reasonable position, and the microcatheter 94 and the microguiding wire 96 are respectively clamped in the clamping position of the driving mechanism 40, 50.
  • Components and the clamping component of the driving mechanism 60 and the clamper 70 so as to realize the clamping and fixing of the microcatheter 94 and the microguide wire 96.
  • the micro-catheter 94 is connected to the Y-valve, and the Y-valve is fixed to the driving mechanism 50 and clamped by its clamping assembly, and the rotating assembly rotates the Luer connector of the Y-valve to rotate the micro-catheter 94 .
  • the movement of the driving mechanisms 40 , 50 , 60 and the holder 70 is remotely controlled by the console at the main end.
  • the specific process is the same as the above-mentioned moving and/or rotating process of the multifunctional tube 91 and the guide wire 92, and will not be repeated here.
  • the microcatheter 94 and the microguidewire 96 advance to the head of the guide catheter 90, the microcatheter 94 and the microguidewire 96 are further pushed to the lesion of the surgical patient (also called the stenosis of the target vessel).
  • Angiography confirms the position of the micro-guide wire 96, and if it reaches the designated position (generally, the micro-guide wire 96 will pass through the lesion of the surgical patient, except for the possible treatment of aneurysm embolism), the driving mechanism 40, 50, 60 and the holder 70 will respectively The fixed microcatheter 94 and the microguide wire 96 do not move. If the specified position is not reached, the remote control drive mechanism 40 , 50 , 60 and the gripper 70 are repeatedly moved until the micro guide wire 96 reaches the specified position.
  • the driving mechanism 40, 50 is controlled remotely through the console at the main end to make the micro-catheter 94 retreat while keeping the micro-guide wire 96 from moving.
  • the device 70 clamps the micro guide wire 96 and does not move.
  • the operator manually takes the microcatheter 94 out of the driving mechanism 40, 50 and soaks it in heparin water.
  • the micro guide wire 96 can be clamped by the driving mechanism 60, and the driving mechanisms 20, 30 and the driving mechanism 60 can be fixed to fix the guide catheter 90 and the micro guide wire 96 respectively so that they do not move.
  • the operator manually allows the tail of the micro-guide wire 96 to pass through the quick-exchange balloon dilation catheter 98, and the quick-exchange balloon dilation catheter 98 advances along the micro-guide wire 96. Dilation catheter 98 .
  • the operator uses the main-end console to remotely control the rapid exchange mechanism 80, so that the rapid exchange balloon dilation catheter 98 is advanced to the patient's lesion (not beyond the head of the micro guide wire 96). During this process, pay attention to the position and angle of the micro-guide wire 96 at all times, and adjust it in time through forward rotation, reverse rotation, forward and backward rotation if necessary.
  • the rapid exchange balloon dilation catheter 98 arrives at the lesion of the surgical patient, the rapid exchange balloon dilation catheter 98 is filled with a contrast agent in the catheter room for pre-dilation, and angiography is performed to confirm the vasodilation effect. If the vasodilation effect is achieved, the contrast medium is extracted from the rapid exchange balloon dilation catheter 98 .
  • the operator uses the console at the main end to remotely control the rapid exchange mechanism 80 to retreat to the puncture sheath.
  • the position of the microguide wire 96 is kept unchanged.
  • multiple blood vessel dilations may be required, so the above-mentioned rapid exchange balloon dilation catheter 98 advances and retreats multiple times.
  • the operator manually removes the rapid exchange balloon dilation catheter 98 from the rapid exchange mechanism 80, and then manually passes the rapid exchange balloon expansion catheter through the micro guide wire 96 and clamps it to the rapid exchange mechanism 80.
  • the specific process The progress and/or process of the rapid exchange balloon dilation catheter 98 described above will not be repeated.
  • the operator remotely controls the quick-exchange mechanism 80 using the console at the main end, so as to push the quick-exchange ball expansion stent catheter along the micro-guide wire 96 to the patient's lesion (extended blood vessel).
  • the operator remotely controls the quick-exchange mechanism 80 using the console at the main end, so as to push the quick-exchange ball expansion stent catheter along the micro-guide wire 96 to the patient's lesion (extended blood vessel).
  • the rapid exchange ball expansion stent catheter reaches the patient's lesion (extended blood vessel)
  • the position of the rapid exchange ball expansion stent catheter is fine-tuned, and after confirmation, the rapid exchange ball expansion stent catheter is filled with contrast medium in the catheterization room to allow the stent to form.
  • the contrast agent can be drawn out and the rapid exchange mechanism 80 is controlled to drive the rapid exchange ball expansion stent catheter back to the puncture sheath, while the ball expansion stent remains at the lesion of the surgical patient.
  • the operator manually removes the rapid-exchange balloon dilator catheter from the rapid-exchange mechanism 80 and places it in heparinized water. So far the treatment process is over.
  • the operator remotely controls the movement of the driving mechanisms 20 , 30 , 40 , 50 , 60 and the holder 70 using the console at the main end, so that the guide catheter 90 and the micro guide wire 96 are retracted to the puncture sheath.
  • the operator manually removes the guide catheter 90 and the micro guide wire 96 from the clamping assembly of the driving mechanism 20, 30, 60 and the clamper 70, withdraws them from the puncture sheath and puts them into heparin water, and then pulls out the puncture sheath Out and post-operative treatment to complete the operation.
  • the quick-exchange catheter is selected above, so the quick-exchange mechanism 80 needs to be used to clamp, push and/or rotate. If it is a coaxial exchange catheter, after the tail of the micro guide wire 96 is inserted into the coaxial exchange catheter, the coaxial exchange mechanism clamps, pushes and/or rotates the coaxial exchange catheter, so that the coaxial exchange catheter runs along the micro guide wire 96 advance to a suitable position or retreat to the puncture sheath place. Whether it is the quick exchange mechanism 80 or the coaxial exchange mechanism, the roller driving method can be used to realize the clamping, shifting and/or rotation of the quick exchange catheter and the coaxial exchange catheter.
  • the above is to illustrate the motion and control process of the present application by taking the "ball expansion stent forming operation" as an example.
  • the application can also be used in various surgical procedures such as radiography, embolization, and thrombectomy.
  • the driving mechanism 20, 30, 40, 50, 60, the holder 70 and the quick exchange mechanism 80 can be freely deployed by the operator according to the actual needs of the operation, that is, the driving mechanism 20, 30, 40, 50, 60, the holder Both 70 and the quick exchange mechanism 80 can be easily disassembled.
  • more driving mechanisms, holders and quick exchange mechanisms can be added.
  • multiple catheters can correspond to one guide wire or multiple catheters.
  • two drive mechanisms which can be drive mechanisms 20, 30, or drive mechanisms 40, 50
  • two drive mechanisms are added to clamp, synchronously push and/or rotate more Catheter, for details, please refer to the above-mentioned "ball expansion stent forming operation"; corresponding to each driving mechanism (such as the driving mechanism 30, 50) that always clamps the catheter, a quick exchange mechanism is provided, and the quick exchange mechanism is detachably installed on the driving mechanism or connected to the driving mechanism.
  • the driving mechanism is made into an integrated mechanism. However, when implementing simple inspection operations such as angiography, only parts of the drive mechanisms 20, 30, 40, 50, and 60 are needed, such as drive mechanisms 20, 30, and 60 (or drive mechanisms 40, 50, and 60).
  • the other driving mechanisms, the holder 70 and the quick exchange mechanism 80 are removed from the main body 10 .
  • the following describes the cooperative movement and control process of a catheter and a guide wire when only the driving mechanisms 20 (or 40), 30 (or 50) and 60 are used in this application:
  • the movement of the driving mechanism 20 (or 40), 30 (or 50), and 60 is remotely operated by the console at the main end.
  • the guiding catheter and the guiding wire are respectively advanced to the target blood vessel in coordination. Refer to the aforementioned "ball expansion stent forming operation" for the process. Keep the head of the guiding catheter and guiding wire within the imaging field of view. At this time, let the driving mechanism 20 (or 40), 30 (or 50) clamp the guide catheter and not move, and remotely operate the driving mechanism 60 to retreat, so that the guide wire is withdrawn to the puncture sheath.
  • the guide wire is manually taken out from the clamping assembly of the driving mechanism 60 and soaked in heparin water.
  • the contrast agent is injected into the guiding catheter, and radiographic imaging is performed to obtain complete image information at different angles of the target blood vessel.
  • another guide wire is selected to be inserted into the guide catheter and advanced to the puncture sheath, and the guide wire is clamped to the clamping assembly of the driving mechanism 60 .
  • the operator then uses the console at the main end to remotely operate the driving mechanisms 20 (or 40), 30 (or 50), and 60 to advance the guiding catheter and the guiding wire to another target blood vessel in coordination.
  • the driving mechanism Mechanisms 20 (or 40), 30 (or 50) clamp the guide catheter without moving, back the guide wire to the puncture sheath and take it out, inject contrast agent into the guide catheter again, perform radiographic contrast, and obtain the image of another target vessel.
  • the guiding catheter can also be withdrawn first, and another guiding catheter is used to cooperate with the other guiding wire to advance to another target blood vessel.
  • the guiding catheter is driven to withdraw to the puncture sheath.
  • only the driving mechanism 60 can clamp the guide wire 92 and drive the guide wire 92 to advance and/or rotate, while the clamper 70 does not clamp.
  • the driving mechanism 60 moves to a certain position and needs to be reset, the guide wire 92 is clamped by the clamper 70 instead, and the driving mechanism 60 releases the guide wire 92 .
  • the clamper 70 releases the guide wire 92 , so that the driving mechanism 60 and the clamper 70 clamp the guide wire 92 alternately.
  • the holder 70 is fixedly installed at the distal end of the main body 10 and does not slide along with the driving mechanism 60 .
  • the rapid exchange mechanism 80 can also rotate the rapid exchange catheter or rotate the rapid exchange catheter while pushing the rapid exchange catheter.
  • the driving mechanisms 20, 40 move the guide tubes 90, 91 faster than the corresponding driving mechanisms 30, 50 respectively. Respectively move the speed of the guiding catheters 90, 91, so that the guiding catheters 90, 91 can be straightened without bending. 2.
  • the driving mechanisms 20, 40 allow the rotational speeds of the guiding catheters 90, 91 to be different from (eg, less than or greater than) the rotational speeds of the driving mechanisms 30, 50 allowing the guiding catheters 90, 91 to rotate, although it will cause the guiding catheters 90, 91 91, but as long as the maximum permissible distortion of the guide tubes 90, 91 is met; it is even possible to have only the drive mechanism 30, 50 clamp the guide tubes 90, 91 and allow the guide tubes 90, 91 to rotate and drive
  • the mechanism 20, 40 only clamps the guiding catheter 90, 91 and does not allow the guiding catheter 90, 91 to rotate.
  • the console at the main end and the console for placing the console at the main end are located outside the catheterization chamber. In fact, they can also be placed in a separate space in the catheterization room, as long as the X-ray radiation can be isolated and the operator can be exempted from X-ray radiation.
  • this application allows the operator to remotely control the driving mechanism, the gripper and the quick exchange mechanism, thereby driving the catheter guide wire to move cooperatively, not only avoiding X-ray radiation from affecting health, but also controlling the catheter guide wire with the help of interventional surgery robots
  • the movement is more precise, the work intensity is reduced, and operation errors can also be avoided.

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Abstract

本申请涉及医疗机器人及数字医疗领域，提供一种同步型介入手术机器人，包括主体及安装于主体上的第一驱动机构和第二驱动机构，所述第一驱动机构和第二驱动机构用于夹持第一细长型医疗器械并在所述主体上同步地推移第一细长型医疗器械运动。可让操作者远程操控机器人，免受X射线辐射，同步运动也可以防止细长型医疗器械迂曲，控制更精准。

Description

一种同步型介入手术机器人
本申请要求于2021年11月23日提交中国专利局、申请号为202111398408.5，发明名称为“一种同步型介入手术机器人”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请涉及医疗机器人领域，应用于主从式血管介入手术机器人，尤其涉及一种同步型介入手术机器人。
 背景技术
微创血管介入手术是指操作者在数字减影血管造影成像（DSA）系统的导引下，操控导管导丝在人体血管内运动，对病灶进行治疗，达到栓塞畸形血管、溶解血栓、扩张狭窄血管等目的。目前介入手术治疗已经在肿瘤、外周血管、大血管、消化道疾病、神经系统、非血管等数百种疾病的诊疗中发挥着重要作用，介入手术治疗范围可以说是囊括了人体“从头到脚”的所有疾病治疗，并且已经成为部分疾病治疗的首选方案。介入手术不用切开人体组织，其切口（穿刺点）仅有米粒大小，就可治疗许多过去无法治疗或疗效欠佳的疾病，具有不开刀、创伤小、恢复快、疗效好的特点，受到了国内外医学界高度重视。
发明人意识到当前，微创血管介入手术辅助机器人，由于涉及高端医疗设备和机器人技术，发展迅猛。我们也投入了研发。
 技术问题
本申请要解决的技术问题是提供一种辅助操作者进行介入手术的同步型介入手术机器人。
 技术解决方案
为了解决上述问题，本申请提供的同步型介入手术机器人包括：
主体及安装于主体上的第一驱动机构和第二驱动机构；
所述第一驱动机构和第二驱动机构用于夹持第一细长型医疗器械并在所述主体上同步地推移第一细长型医疗器械运动。
进一步地，所述第一驱动机构用于转动第一细长型医疗器械运动。
进一步地，所述第一驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
进一步地，所述第二驱动机构用于与所述第一驱动机构同步地转动第一细长型医疗器械运动。
进一步地，所述第一驱动机构和第二驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
进一步地，所述同步型介入手术机器人还包括安装于所述主体上的第三驱动机构和第四驱动机构，所述第三驱动机构和第四驱动机构用于夹持第二细长型医疗器械并在所述主体上同步地推移第二细长型医疗器械运动。
进一步地，所述第三驱动机构和第四驱动机构用于同步地转动第二细长型医疗器械运动。
进一步地，所述第三驱动机构和第四驱动机构用于让第二细长型医疗器械同时或者不同时推移和转动。
进一步地，当第二细长型医疗器械穿入第一细长型医疗器械时，所述第三驱动机构和第四驱动机构用于让第二细长型医疗器械同时或者不同时推移和转动的同时，所述第一驱动机构和第二驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
进一步地，所述第四驱动机构位于所述第一驱动机构和第三驱动机构之间，所述第一驱动机构位于所述第二驱动机构和第四驱动机构之间。
进一步地，所述第二驱动机构用于转动第一细长型医疗器械运动，所述第二驱动机构让第一细长型医疗器械的转动速度不同于所述第一驱动机构让第一细长型医疗器械的转动速度。
进一步地，所述第二驱动机构让第一细长型医疗器械的转动速度小于所述第一驱动机构让第一细长型医疗器械的转动速度。
进一步地，所述第二驱动机构让第一细长型医疗器械的转动速度为零。
 有益效果
本申请可让操作者通过远程操控第一驱动机构、第二驱动机构在所述主体上同步运动，从而带动细长型医疗器械精准运动，不仅免受X射线辐射，而且控制更精准，可避免操作失误，防止细长型医疗器械迂曲。
 附图说明
图1是本申请一种同步型介入手术机器人的实施例示意图；
图2是图1的另一示意图；
图3是图1中增加两个驱动机构时的示意图；
图4是图1中拆除只剩两个驱动机构时的示意图。
 本发明的最佳实施方式
为了使本申请所要解决的技术问题、技术方案及有益效果更加清楚明白，以下结合附图及实施例，对本申请进行进一步详细说明。应当理解，此处所描述的具体实施例仅仅用以解释本申请，并不用于限定本申请。
在本申请中，除非另有明确的规定和限定，术语“安装”、“相连”、“连接”、“固定”等应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或成一体，甚至是可相对运动的连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通或两个元件的相互作用关系。对于本领域的普通技术人员而言，可以根据具体情况理解上述术语在本申请中的具体含义。
在本申请的描述中，术语“长度”、“直径”、“上”、“下”、“前”、“后”、“左”、“右”、“竖直”、“水平”、“顶”、“底”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本申请和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本申请的限制。
本申请所使用的方向“远”为朝向患者的方向，方向“近”是远离患者的方向。术语“上”和“上部”指的是背离重力的方向的一殷方向，术语“底部”、“下”和“下部”指的是重力的一殷方向。术语“前”指的是介入手术机器人从端装置面向使用者的一侧、“前进”指的是让导丝或导管位移进入手术病人身体的方向。术语“后”指的是介入手术机器人从端装置背向使用者的一侧、“后退”指的是让导丝或导管位移退出手术病人身体的方向。术语“向内地”指的是特征的内部部分。术语“向外地”指的是特征的外面的部分。术语“转动”包括“正转”和“反转”，其中，“正转”指的是让导丝或导管旋转进入手术病人身体的方向、“反转”指的是让导丝或导管旋转退出手术病人身体的方向。
此外，术语“第一”、“第二”等仅用于描述目的，而不能理解为指示或暗示相对重要性或者隐含指明所指示的技术特征的数量。由此，限定有“第一”、“第二”等的特征可以明示或者隐含地包括一个或者更多个该特征。在本申请的描述中，“多”或“多个”的含义是两个或两个以上。
最后需要说明的是，如果不冲突，本申请实施例以及实施例中的各个特征可以相互结合，均在本申请的保护范围之内。另外，上述方法中的全部或部分步骤可以在诸如一组计算机可执行指令的计算机系统中执行，并且，虽然所述步骤按照1、2、3…顺序列出，但是在某些情况下，可以以不同于此处的顺序执行所示出或描述的步骤。
这里的导丝包括但不限于导引导丝、微导丝和支架等引导、支撑类介入医疗器械、导管包括但不限于导引导管、微导管、造影导管、多功能管（亦称中间导管）、溶栓导管、球囊扩张导管和球扩支架导管等治疗类介入医疗器械。
如图1和图2所示，本申请一种同步型介入手术机器人的实施例包括主体10、可运动地安装于主体10上的驱动机构20、30、40、50、60、夹持器70和快速交换机构80。
所述主体10呈狭长型，设有直线型通道102。这些驱动机构20、30、40、50、60先后渐次地置于通道102内并可沿通道移动。在本实施例中，这些驱动机构20、30、40、50、60可直接在主体10上滑动，如在主体10上固定一线性导轨，这些驱动机构20、30、40、50、60均可沿导轨滑动。在其它实施例中，这些驱动机构20、30、40、50、60也可以沿不同的导轨滑动。
每一驱动机构用于夹持、推移（包括前进和后退）和转动（包括正转与反转）导管或导丝（统称“细长型医疗器械”，下同），也可以用于同时夹持、推移（包括前进和后退）和转动（包括正转与反转）导管、导丝，实现多个导管、一个导丝协同运动或者多个导管、多个导丝协同运动。每一驱动机构包括用于夹持导管或导丝的夹持组件、让导管或导丝转动的转动组件，所述转动组件既可以为主动驱动型也可以为被动跟随型、或者全部为主动驱动型、亦或部分为主动驱动型、另外的为被动跟随型，驱动机构20、40对导管的夹持不影响导管的转动。
驱动机构20、30、40、50、60的夹持组件和转动组件可为如中国专利申请202111010071.6描述的一种介入手术机器人从端导丝导管搓动装置，其全部内容引入本申请。
在其它实施例中，驱动机构20、30、40、50、60的具体结构不限于相同，也可以不同，只要能实现导管、导丝的夹持、推移和/或转动。也可以只是夹持组件相同、转动组件不相同，或者夹持组件不相同、转动组件相同，亦或多个夹持组件、转动组件相同、另外的夹持组件、转动组件不相同。
在本实施例中，驱动机构20和30前后间隔一定距离、用于配合夹持、推移和/或转动同一导引导管90（即第一导管），让其不致弯曲。事实上，驱动机构20和30最好同步地推移和/或转动导引导管90，以便使其拉直不弯曲。同样地，驱动机构40和50前后间隔一定距离配合、用于配合夹持、最好同步地推移和/或转动同一多功能管91（即第二导管，亦称中间导管）。驱动机构60用于夹持、推移和/或转动导引导丝92。夹持器70用于夹持和与驱动机构60同步地推移导引导丝92。快速交换机构80与驱动机构50可拆卸地固定在一起，用于夹持和推移快速交换导管。
在进行术前准备时，选用合适（比如长度、直径）的导引导管90、多功能管91和导引导丝92，对导引导管90、多功能管91进行生理盐水冲水排气。手动将多功能管91穿入导引导管90并伸出导引导管90一定距离、将导引导丝92穿入多功能管91并伸出多功能管91一定距离，如导引导丝92头部超出多功能管91约10cm左右。使驱动机构20、30、40、50、60处于合理位置，将导引导管90、多功能管91和导引导丝92一起置入穿入手术病人的穿刺鞘（如穿入股动脉、桡动脉或者其他）内，让驱动机构20和30的夹持组件同时夹持导引导管90、驱动机构40和50的夹持组件同时夹持多功能管91、驱动机构60的夹持组件和夹持器70同时夹持导引导丝92，从而实现导引导管90、多功能管91和导引导丝92的装夹固定。
开始手术时，利用主端操控台（如中国专利申请202111009835.X描述的介入手术机器人主端操作手柄和202111009832.6描述的介入手术机器人主端控制模组，其全部内容引入本申请）远程操作驱动机构20、30、40、50、60、夹持器70和快速交换机构80运动。具体地，驱动机构20和30一起夹持导引导管90沿通道102移动而带动导引导管90前进、同时或者不同时驱动机构20和30的转动组件让导引导管90转动，当驱动机构20移动到极限位置（比如驱动机构20运动至通道102的远端）要复位而松开导引导管90时，驱动机构30夹持导引导管90不运动。待驱动机构20复位到更靠近驱动机构30的位置时，驱动机构20的夹持组件再次夹持导引导管90，让驱动机构20和30一起带动导引导管90前进、同时或者不同时驱动机构20和30的转动组件让导引导管90转动，如此往复，直到前进到位。
在此过程中，同时或者不同时驱动机构40和50一起夹持多功能管91沿通道102移动而带动多功能管91前进、同时或者不同时驱动机构40和50的转动组件让多功能管91转动，当驱动机构40移动到极限位置（比如与驱动机构30的距离接近阈值）要复位而松开多功能管91时，驱动机构50夹持多功能管91不运动。待驱动机构40复位到更靠近驱动机构50的位置时，驱动机构40的夹持组件再次夹持多功能管91，让驱动机构40和50一起带动多功能管91前进、同时或者不同时驱动机构40和50的转动组件让多功能管91转动，如此往复，直到前进到位。
在上述过程中，同时或者不同时驱动机构60和夹持器70一起夹持导引导丝92沿通道102移动而带动导引导丝92前进、同时或者不同时驱动机构60的转动组件让导引导丝92转动。当驱动机构60移动到极限位置（比如与驱动机构50的距离接近阈值）要复位而松开导引导丝92时，由夹持器70夹持导引导丝92不运动。待驱动机构60复位后，驱动机构60的夹持组件再次夹持导引导丝92，让驱动机构60和夹持器70一起带动导引导丝92前进、同时或者不同时驱动机构60的转动组件让导引导丝92转动，如此往复，直到前进到位。
对于主端操控台如何远程操控驱动机构20、30、40、50、60、夹持器70和快速交换机构80运动，可如中国专利申请202111009832.6描述的介入手术机器人主端控制模组一样，其包括两个操作杆，其中一操作杆用于操控驱动机构20、30、40、50和快速交换机构80，且该操作杆可通过切换装置分时操控驱动机构20、30、驱动机构40、50和快速交换机构80，另一操作杆用于操控驱动机构60和夹持器70。也可以为，所述主端操控台包括两个以上操作杆，如四个操作杆，分别用于远程操控驱动机构20、30、驱动机构40、50、驱动机构60和夹持器70、快速交换机构80。
在其它的实施例中，驱动机构30、50通过Y阀来分别夹持导引导管90、多功能管91。即导引导管90、多功能管91分别连接于Y阀，Y阀固定于驱动机构30、50，驱动机构30、50的夹持组件夹持Y阀、转动组件转动Y阀鲁尔连接器而带动导引导管90、多功能管91转动。
在上述将导引导管90、多功能管91和导引导丝92协同推移过程中，优选地，需要始终保持多功能管91伸出导引导管90一定距离、导引导丝92伸出多功能管91一定距离。当导引导管90、多功能管91和导引导丝92到达血管某些部位时，可能需要通过主端操控台远程操控驱动机构20、30、40、50、60和夹持器70，让导引导管90、多功能管91和导引导丝92多次进行前进、后退、正转、反转调换。
当导引导管90前进到位后，固定导引导管90不运动，通过主端操控台远程操控驱动机构40、50、60和夹持器70，让多功能管91、导引导丝92后退，后退过程跟上述前进过程类似，在此不再赘述。当多功能管91、导引导丝92的头部后退到穿刺鞘时，手动将多功能管91和导引导丝92从驱动机构40、50、60的夹持组件和夹持器70上取出并浸泡于肝素水中。
选用更细的微导管94和微导丝96（如0.014 in）。手动将微导丝96穿入微导管94并一起穿入导引导管90，且微导丝96伸出微导管94一定距离。根据微导管94和微导丝96的需要，让驱动机构40、50、60和夹持器70处于合理位置，让微导管94、微导丝96分别夹持于驱动机构40、50的夹持组件以及驱动机构60的夹持组件和夹持器70，从而实现微导管94、微导丝96的装夹固定。优选地，微导管94连接于Y阀，Y阀固定于驱动机构50并由其夹持组件夹持Y阀、转动组件转动Y阀鲁尔连接器而让微导管94转动。
进一步地，利用主端操控台远程操控驱动机构40、50、60和夹持器70运动。具体过程同上述多功能管91和导引导丝92的推移和/或转动过程，在此不再赘述。微导管94、微导丝96前进到导引导管90头部时，进一步将微导管94、微导丝96推移至手术病人病灶处（也称靶血管狭窄处）。造影确认微导丝96位置，若到达指定位置（一般而言微导丝96要穿过手术病人病灶处，可能治疗动脉瘤栓塞除外）则由驱动机构40、50、60和夹持器70分别固定微导管94、微导丝96不运动。若没有到达指定位置，则重复远程操控驱动机构40、50、60和夹持器70运动，直到微导丝96到达指定位置。
在微导丝96到达指定位置后，通过主端操控台远程操控驱动机构40、50，让微导管94后退，同时保持微导丝96不运动，比如驱动机构60随着后退时换由夹持器70夹持微导丝96不运动。当微导管94头部后退到穿刺鞘时，操作者手动将微导管94从驱动机构40、50上取出并浸泡于肝素水中。这时，可换由驱动机构60夹持微导丝96，并保持驱动机构20、30和驱动机构60分别固定导引导管90、微导丝96不运动。
进一步地，操作者手动让微导丝96尾部穿入快速交换球囊扩张导管98，快速交换球囊扩张导管98顺着微导丝96前进，这时由快速交换机构80夹持快速交换球囊扩张导管98。
进一步地，操作者利用主端操控台远程操控快速交换机构80，从而让快速交换球囊扩张导管98前进至手术病人病灶处（不超出微导丝96头部）。在此过程中，时刻注意微导丝96的位置和角度，有需要及时通过正转、反转、前进、后退来调整。当快速交换球囊扩张导管98到达手术病人病灶处时，在导管室内给快速交换球囊扩张导管98充填造影剂做预扩张，造影确认血管扩张效果。若达到血管扩张效果，则从快速交换球囊扩张导管98内抽出造影剂。操作者利用主端操控台远程操控快速交换机构80后退至穿刺鞘处。此快速交换球囊扩张导管98后退过程中，保持微导丝96位置不变。对于某些手术，可能需要多次血管扩张，因此上述快速交换球囊扩张导管98前进和后退会进行多次。
进一步地，操作者手动将快速交换球囊扩张导管98从快速交换机构80取下，再手动将快速交换球扩支架导管穿设于微导丝96并夹持到快速交换机构80上，具体过程同上述快速交换球囊扩张导管98推移和/或过程，不再赘述。
进一步地，操作者利用主端操控台远程操控快速交换机构80，从而顺着微导丝96将快速交换球扩支架导管推移至手术病人病灶处（已经扩展的血管处）。在此过程中，时刻注意微导丝96的位置和角度，有需要及时通过正转、反转、前进、后退来调整。当快速交换球扩支架导管到达手术病人病灶处（已经扩展的血管处）时，微调快速交换球扩支架导管位置，确定后在导管室内给快速交换球扩支架导管充填造影剂，让支架成形。造影确认球扩支架放置无误，即可抽出造影剂并操控快速交换机构80带动快速交换球扩支架导管后退至穿刺鞘处，而球扩支架留在手术病人病灶处。操作者手动将快速交换球扩支架导管从快速交换机构80上取出并放入肝素水中。至此治疗过程结束。
进一步地，操作者利用主端操控台远程操控驱动机构20、30、40、50、60和夹持器70运动，让导引导管90、微导丝96后退至穿刺鞘处。操作者手动将导引导管90、微导丝96从驱动机构20、30、60的夹持组件和夹持器70上取出，并从穿刺鞘中撤出放入肝素水中，然后进行穿刺鞘拔出及手术后处理，完成手术。
以上选用的是快速交换导管，因此需要用快速交换机构80来夹持、推移和/或转动。若是同轴交换导管，则让微导丝96尾部穿入同轴交换导管后，由同轴交换机构来夹持、推移和/或转动同轴交换导管，让同轴交换导管顺着微导丝96前进至合适位置或后退至穿刺鞘处。不管是快速交换机构80，还是同轴交换机构，都可以采用滚轮驱动方式来实现快速交换导管和同轴交换导管的夹持、推移和/或转动。
以上是以“球扩支架成形手术”为例说明本申请的运动和控制过程。事实上，本申请也可以用于造影、栓塞、取栓等等多种手术术式。驱动机构20、30、40、50、60、夹持器70和快速交换机构80可以根据手术实际需要，由操作者自由调配，也即驱动机构20、30、40、50、60、夹持器70和快速交换机构80均可方便地拆装。如实施更复杂的手术时，可以增设更多的驱动机构、夹持器和快速交换机构，如增设更多的驱动机构、夹持器后，可以实现多个导管对应一个导丝或者多个导管对应多个导丝的协同运动，如图3中增加两个驱动机构（可以为驱动机构20、30、也可以为驱动机构40、50）来夹持、同步地推移和/或转动更多的导管，具体可参上述“球扩支架成形手术”；对应始终夹持导管的每一驱动机构（如驱动机构30、50）均设置快速交换机构，快速交换机构可拆卸地安装于驱动机构或者与驱动机构制成一体化机构。而在实施简单的检查手术比如血管造影手术时，只需要驱动机构20、30、40、50、60中的部分，如驱动机构20、30和60（或者驱动机构40、50和60），参图4，则把其他驱动机构、夹持器70和快速交换机构80从主体10拆除。以下以血管造影手术为例，描述本申请只有驱动机构20（或者40）、30（或者50）和60时的一个导管、一个导丝协同运动和控制过程：
准备手术时，根据血管病灶位置选用合适直径和长度的导引导管、导引导丝、造影导管，对导引导管、造影导管进行生理盐水冲水排气。启动介入手术机器人，完成初始化。对手术病人进行穿刺鞘置入。手动将导引导丝穿入导引导管并伸出导引导管一定距离，如导引导丝头部超出导引导管10cm左右，并将它们一起置入穿刺鞘内。让驱动机构20（或者40）、30（或者50）与60的夹持组件分别夹持导引导管、导引导丝，从而实现导引导管、导引导丝的装夹固定。
开始手术时，利用主端操控台远程操作驱动机构20（或者40）、30（或者50）、60运动。分别让导引导管、导引导丝协同前进到靶血管处。过程参前述“球扩支架成形手术”。保持导引导管、导引导丝的头部在影像视野范围内。这时，让驱动机构20（或者40）、30（或者50）夹持导引导管不移动，远程操作驱动机构60后退，让导引导丝撤出至穿刺鞘处。
进一步地，通过手动将导引导丝从驱动机构60的夹持组件上取出并浸泡在肝素水中。向导引导管内输入造影剂，进行放射线造影，取得靶血管处的不同角度的完整影像信息。
若需要取得多处靶血管的影像信息，则再选用另一导引导丝穿入导引导管内并前进至穿刺鞘处，将该导引导丝夹持于驱动机构60的夹持组件。操作者再利用主端操控台远程操作驱动机构20（或者40）、30（或者50）、60运动，分别将导引导管、导引导丝协同前进到另一靶血管处，这时，让驱动机构20（或者40）、30（或者50）夹持导引导管不移动，后退导引导丝至穿刺鞘处并取出，再次向导引导管内输入造影剂，进行放射线造影，取得另一靶血管处的不同角度的完整影像信息。如此多次，直至取得所有靶血管的完整影像信息为止。上述过程，也可以通过先撤出导引导管，使用另一导引导管配合该另一导引导丝而前进到另一靶血管处。
通过远程操控驱动机构20（或者40）、30（或者50）后退，带动导引导管撤出至穿刺鞘处。再手动将导引导管和最后一次所用导引导丝分别从驱动机构20（或者40）、30（或者50）、60的夹持组件上取出，并从穿刺鞘中撤出。
其它实施例中，开始时，可只由驱动机构60夹持导引导丝92并带动导引导丝92前进和/或转动，而夹持器70不夹持。待驱动机构60移动到一定位置要复位时，换由夹持器70夹持导引导丝92，驱动机构60松开导引导丝92。当驱动机构60复位后而再次夹持导引导丝92时，夹持器70松开导引导丝92，如此，驱动机构60和夹持器70交替夹持导引导丝92。这时，优先地，夹持器70固定地安装于主体10的远端，不随驱动机构60一起滑动。
其它实施例中，快速交换机构80也可以让快速交换导管转动或者在推移快速交换导管的同时让快速交换导管转动。
如上所述，虽然同步地推移和/或转动是最好的选择，但也不排除：比如，1、驱动机构20、40分别推移导引导管90、91的速度快于相应驱动机构30、50分别推移导引导管90、91的速度，这样也可以让导引导管90、91拉直不弯曲。2、驱动机构20、40分别让导引导管90、91的转动速度不同于（如小于或者大于）驱动机构30、50让导引导管90、91的转动速度，虽然会造成导引导管90、91的扭曲，但只要满足导引导管90、91可以容许的最大扭曲变形即可；甚至也可以只有驱动机构30、50夹持导引导管90、91并让导引导管90、91转动、驱动机构20、40仅是夹持导引导管90、91而不会让导引导管90、91转动。
上面的描述中，主端操控台和放置主端操控台的操作台位于导管室外。其实，它们也可以放置于导管室内一个独立的空间，只要能够隔离X射线辐射，让操作者免除X射线辐射即可。
以上仅是描述了一些情况下导管导丝的拆换方式。实际上，导管导丝的拆换完全可由操作者根据手术实际需要以及个人操作习惯而定。并不仅以以上导管导丝的拆换方式而限。
由此可见，本申请可让操作者远程操控驱动机构、夹持器和快速交换机构，从而带动导管导丝协同运动，不仅免受X射线辐射而影响健康，而且借助介入手术机器人控制导管导丝运动更精准，减轻工作强度，也可避免操作失误。
本领域普通技术人员可以理解上述方法中的全部或部分步骤可通过程序来指令相关硬件完成，所述程序可以存储于计算机可读存储介质中，如只读存储器、磁盘或光盘等。可选地，上述实施例的全部或部分步骤也可以使用一个或多个集成电路来实现。相应地，上述实施例中的各模块/单元可以采用硬件的形式实现，也可以采用软件功能模块的形式实现。本申请不限制于任何特定形式的硬件和软件的结合。
当然，本申请还可有其他多种实施例，在不背离本申请精神及其实质的情况下，熟悉本领域的技术人员当可根据本申请作出各种相应的改变和变形，但这些相应的改变和变形都应属于本申请的权利要求的保护范围。

Claims (18)

  1. 一种同步型介入手术机器人，其中，包括主体及安装于主体上的第一驱动机构和第二驱动机构；
    所述第一驱动机构和第二驱动机构用于夹持第一细长型医疗器械并在所述主体上同步地推移第一细长型医疗器械运动。
  2. 如权利要求1所述的同步型介入手术机器人，其中，所述第一驱动机构和第二驱动机构间隔有让第一细长型医疗器械保持拉直的距离。
  3. 如权利要求1所述的同步型介入手术机器人，其中，所述第一驱动机构用于转动第一细长型医疗器械运动。
  4. 如权利要求3所述的同步型介入手术机器人，其中，所述第一驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
  5. 如权利要求3所述的同步型介入手术机器人，其中，所述第二驱动机构用于与所述第一驱动机构同步地转动第一细长型医疗器械运动。
  6. 如权利要求5所述的同步型介入手术机器人，其中，所述第一驱动机构和第二驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
  7. 如权利要求6所述的同步型介入手术机器人，其中，所述同步型介入手术机器人还包括安装于所述主体上的第三驱动机构和第四驱动机构，所述第三驱动机构和第四驱动机构用于夹持第二细长型医疗器械并在所述主体上同步地推移第二细长型医疗器械运动。
  8. 如权利要求7所述的同步型介入手术机器人，其中，所述第三驱动机构和第四驱动机构间隔有让第二细长型医疗器械保持拉直的距离。
  9. 如权利要求7所述的同步型介入手术机器人，其中，所述第三驱动机构和第四驱动机构用于同步地转动第二细长型医疗器械运动。
  10. 如权利要求9所述的同步型介入手术机器人，其中，所述第三驱动机构和第四驱动机构用于让第二细长型医疗器械同时或者不同时推移和转动。
  11. 如权利要求10所述的同步型介入手术机器人，其中，当第二细长型医疗器械穿入第一细长型医疗器械时，所述第三驱动机构和第四驱动机构用于让第二细长型医疗器械同时或者不同时推移和转动的同时，所述第一驱动机构和第二驱动机构用于让第一细长型医疗器械同时或者不同时推移和转动。
  12. 如权利要求7所述的同步型介入手术机器人，其中，所述第四驱动机构位于所述第一驱动机构和第三驱动机构之间，所述第一驱动机构位于所述第二驱动机构和第四驱动机构之间。
  13. 如权利要求7所述的同步型介入手术机器人，其中，所述主体呈狭长型，设有直线型的通道，第一驱动机构、第二驱动机构、第三驱动机构和第四驱动机构先后渐次地置于所述通道内并可沿所述通道移动。
  14. 如权利要求7所述的同步型介入手术机器人，其中，第一驱动机构、第二驱动机构、第三驱动机构和第四驱动机构直接在所述主体上滑动。
  15. 如权利要求7所述的同步型介入手术机器人，其中，所述主体上固定一线性导轨，第一驱动机构、第二驱动机构、第三驱动机构和第四驱动机构沿所述线性导轨在所述主体上滑动。
  16. 如权利要求3所述的同步型介入手术机器人，其中，所述第二驱动机构用于转动第一细长型医疗器械运动，所述第二驱动机构让第一细长型医疗器械的转动速度不同于所述第一驱动机构让第一细长型医疗器械的转动速度。
  17. 如权利要求16所述的同步型介入手术机器人，其中，所述第二驱动机构让第一细长型医疗器械的转动速度小于所述第一驱动机构让第一细长型医疗器械的转动速度。
  18. 如权利要求17所述的同步型介入手术机器人，其中，所述第二驱动机构让第一细长型医疗器械的转动速度为零。
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