CN112842533B - Flexible surgical tool and vascular intervention surgical robot system - Google Patents
Flexible surgical tool and vascular intervention surgical robot system Download PDFInfo
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- 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
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- 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
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- 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
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
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- 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
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
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- 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
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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- 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
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- 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
- A61B2034/303—Surgical robots specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
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Abstract
The application discloses a flexible surgical tool, which comprises a flexible continuum structure, wherein the flexible continuum structure comprises a passive flexible section at a proximal end and an active flexible section at a distal end; the active flexible segment is driven to move, and the passive flexible segment is passively bent along with the bending shape of the blood vessel. The active flexible section and the passive flexible section of the flexible continuum structure in the flexible surgical tool can more accurately control the bending movement of the surgical tool under the guidance of angiography, including the bending direction and the bending radian, reduce the force on the blood vessel of an operator, improve the surgical precision and reduce the surgical risk.
Description
The scheme is a divisional application of an application patent application with a patent application number of 201811175035.3, which is named as a vascular intervention operation robot combined system and a using method thereof and is filed on the basis of the date of 2018, the date of 10 and the date of 9.
Technical Field
The application belongs to the field of medical instruments, and relates to a flexible surgical tool and a vascular intervention surgical robot system.
Background
The vascular intervention operation is a minimally invasive image guided diagnosis and treatment method. The skin is penetrated by a puncture needle in a non-open manner to reach viscera or other tissues for treating cardiovascular diseases and tumors, etc. Typically, in vascular interventions, a medical device is introduced into a patient's blood vessel by needle punching. Vascular interventions have the benefit of ease of introducing the device into the patient without the use of large incisions, significantly reducing patient pain and the potential for bleeding or infection. The vascular intervention incision is smaller, so that the vascular intervention incision is easier to seal, and the postoperative healing is rapid.
The surgical tools of the existing vascular interventional robots are all composed of single super-elastic alloy wires or catheters, a small-sized bend is arranged at the distal end of the surgical tool, and the vascular interventional surgical tools can be moved to focus positions along a given path through bifurcated vessels, bent vessels and the like by controlling the feeding and rotation of the surgical tools. Existing vascular interventional robot assistance systems all assist the operator with US (B-ultrasound), CT or MRI (magnetic resonance imaging) images to spatially position and orient the end effector and instrument.
The existing surgical tool can only control the forward and backward feeding and rotating freedom of movement in the blood vessel, and has limited accurate positioning and accurate movement capability under the guidance of contrast for complex vascular environments. Although the use of pre-bent catheters or superelastic alloy wires may be introduced into the bent vessel and vessel bifurcation by pre-bending, the risk of surgery increases because the pre-bending curvature does not conform to the vessel curvature and may create a certain contact force with the vessel.
Accordingly, there is a need to develop a vascular interventional surgical robotic system to further increase the flexibility of surgical tools to increase surgical accuracy and reduce surgical risk.
Disclosure of Invention
In order to solve the problems, the application applies the continuum operation arm to the treatment of vascular intervention, and can improve the flexibility of operation tools compared with the traditional vascular intervention operation robot. The flexible continuum structure of the application can more accurately control the bending movement of the operation tool, including the bending direction and the bending radian, under the visual guidance of angiography, so as to reduce the force on the blood vessel of a patient, improve the operation precision and reduce the operation risk.
The present application provides a flexible surgical tool comprising:
a flexible continuum structure comprising a passive flexible segment at a proximal end and an active flexible segment at a distal end;
the active flexible segment is driven to move, and the passive flexible segment is passively bent along with the bending shape of the blood vessel.
Drawings
FIG. 1 is a schematic diagram of the composition and arrangement of one embodiment of the system of the present application.
Fig. 2 is a schematic side view of the master trolley of fig. 1.
Fig. 3 is a schematic front view of an equipment trolley in the system of fig. 1.
Fig. 4 is a schematic side view of an equipment trolley in the system of fig. 1.
Fig. 5 is a schematic structural view of an operation cart in the system of fig. 1.
Fig. 6 is a detailed structural schematic of the flexible surgical tool of fig. 5.
FIG. 7 is a schematic view of the puncture site and puncture cannula position in example 1.
FIG. 8 is a schematic view of the puncture site and puncture cannula position in example 2.
Fig. 9 is a schematic diagram of the arrangement of the system of the present application in embodiment 2.
Detailed Description
Preferred embodiments of the present application will be described below with reference to the accompanying drawings, and it will be understood by those skilled in the art that the embodiments or examples described below with reference to the drawings are only illustrative of the best mode for carrying out the present application, and do not limit the scope of the present application to these embodiments. The present application is capable of numerous modifications and variations in light of the embodiments described below. Such modifications and variations are intended to be included within the scope of the present application. Like reference numerals designate like parts among the various embodiments of the application shown in the accompanying drawings.
Definition:
distal or distal: in this specification, when referring to "distal or distal end", the term refers to the end that is relatively closer to the surgical site of the subject being operated on or relatively farther from the surgical trolley.
Proximal or proximal: in this specification, when referring to "proximal or proximal end", the term refers to the side relatively far from the surgical site of the operated subject, relatively close to one end of the surgical trolley.
Front and rear: in this specification, as previously mentioned, when referring to both "anterior" and "posterior" refer to relative directions, wherein the side relatively closer to the subject surgical site is defined as anterior and the side relatively farther from the subject surgical site is defined as posterior.
The vascular intervention operation robot combination system comprises:
the system of the application comprises a main control trolley, an equipment trolley, an operation trolley, a contrast imaging equipment, a puncture cannula and a flexible operation tool, wherein
The main control trolley comprises control equipment, a first display and an industrial personal computer, wherein a receiving module and a signal conversion module are arranged in the industrial personal computer;
the equipment trolley comprises a cabinet, a second display, a cable, an optical tracker and a hub, wherein the hub is installed in the cabinet, and the display is fixed on the cabinet; the optical tracker is fixed on the cabinet through a lockable fixing bracket; the cable comprises an operation trolley cable and a master-slave connection cable; the main control trolley is connected with the equipment trolley through the master-slave connection cable, and the operation trolley is connected with the equipment trolley through the operation trolley cable;
the operation trolley comprises a trolley chassis, a positioning mechanical arm, a linear module, a driving module, a flexible operation tool, an optical positioning mark, a sleeve isolating device and a tool isolating device; the linear module is mounted on the positioning mechanical arm, and the driving module is arranged on the linear module and can move back and forth along the longitudinal axis of the linear module; the flexible surgical tool comprises a driving transmission unit and a flexible continuous body structure, wherein the vascular interventional surgical tool is carried at the distal end of the flexible continuous body structure; the flexible continuum structure comprises a proximal passive flexible segment and a distal active flexible segment, wherein the action of the active flexible segment is controlled by a manipulation device of the master trolley; the distal end of the driving module is connected with a driving transmission unit of the flexible surgical tool and controls the action of the flexible continuum structure;
the cannula isolation device is mounted at a distal end of the linear module, and the cannula isolation device is provided with a through hole such that the flexible surgical tool can pass through the through hole; the tool isolation device is arranged on the driving module; the optical positioning mark is arranged on the sleeve isolating device;
the penetration cannula having a lumen for receiving the flexible surgical tool therethrough and the penetration cannula being configured to connect with the cannula isolation device;
the contrast imaging device is configured to contrast image a vascular interventional procedure region and transmit and display contrast image signals to and on the first and the second display, respectively; and
the control equipment is configured to receive a control signal of an operator and send the control signal to a receiving module of the industrial personal computer, the receiving module sends the control signal to the signal conversion module, the signal conversion module converts the control signal into driving quantity parameter information, sends the driving quantity parameter information to a hub on the equipment trolley, and then sends the driving quantity parameter information to a driving module on the operation trolley through the hub; the driving module pushes and controls the flexible continuum structure to move according to the driving quantity parameter information so as to drive the vascular interventional operation tool to move.
In the application, the function realized by the main control trolley is to provide a platform for an operator to remotely operate a flexible surgical tool and observe an intraoperative surgical field image. The operation trolley is used for controlling the movement of the flexible operation tool in the operated object body and simultaneously plays a role in supporting and positioning the flexible operation tool. The equipment trolley is used for equipment such as a hub, an optical tracker, auxiliary equipment (e.g. an electrotome generator and a safety management module) and the like, receives driving quantity parameter information sent by the main control trolley through the hub, and sends the driving quantity parameter information to a driving module on the operation trolley so as to push and control the movement of the flexible continuous body.
In the system of the application, the positioning mechanical arm is mounted on the trolley chassis of the operation trolley, the linear module is mounted on the positioning mechanical arm, and the driving module can move back and forth along the linear module. The trolley chassis has the functions of moving and locking the operation trolley in an operating room, and the positioning mechanical arm is used for adjusting the posture after the trolley chassis is locked so as to control the position and the direction of the flexible operation tool. After the positioning mechanical arm is locked, the back-and-forth movement of the flexible surgical tool can be adjusted through the linear module, and the driving module is used for driving the bending and the multi-degree-of-freedom movement of the flexible continuous body structure.
Specifically, the flexible continuum structure includes a passive flexible segment proximal to the flexible continuum structure and an active flexible segment distal to the flexible continuum structure. The passive flexible segment is preferably free to bend passively following the shape of the vessel curve, while the active flexible segment is preferably free to bend in space 4 degrees of freedom (including two bending directions, one rotational direction and one feeding direction) under the control of the master controller to better follow the curve and branch of the vessel. Thus, in a preferred embodiment, the active flexible segment of the flexible continuum structure may be configured to perform bending of 4 degrees of freedom in space under control of the handling device of the master trolley, the 4 degrees of freedom comprising two bending directions, one rotation direction and one feeding direction.
In the present application, the flexible surgical tool may be retrofitted with a commercially available surgical robot, so long as the flexible continuum structure adopts the design of the flexible continuum structure of the present application and is capable of adapting to the system of the present application.
In the present application, the vascular intervention tool carried on the flexible surgical tool may include various surgical tools that may be used in vascular interventions, such as stent placement tools, vasodilation tools, electrosurgical tools, and the like.
In the application, the design of the cannula isolation device and the tool isolation device is mainly based on the requirement of aseptic operation of the operation, and the function of the cannula isolation device and the tool isolation device is used as a barrier for isolating mechanical structures or equipment such as a sterilized operation tool or endoscope, a drive module and a linear module which cannot be sterilized, and the like, thereby ensuring the sterility of an operation area. Those skilled in the art will appreciate that cannula and tool isolation devices may be implemented in a number of ways, for example, a device that may be attached or mounted with a sterile plastic garment or drape (e.g., the sterile barrier disclosed in the inventor's another patent application publication number CN106377315a, the entire contents of which are incorporated herein by reference) that may cover and isolate all non-sterile portions of a surgical trolley, as long as it may achieve the objective of isolating sterile and non-sterile portions, the implementation of which is not limited in the present application.
In the present application, the puncture cannula may be an instrument such as a puncture trocar, a puncture cannula device, etc. commonly used in vascular interventional procedures, as long as it can puncture a blood vessel and can receive the flexible surgical tool in the system of the present application into the operation area. The connection of the puncture cannula to the cannula isolation device may be any suitable mechanical connection, including but not limited to mechanical snap, nested locking, etc.
In the present application, the master-slave connection cable may be a composite cable or a plurality of cables, the form of which is not limited, and the types thereof include, but are not limited to: video transmission cable, optical fiber, equipment common ground wire, control signal transmission cable. The surgical trolley cable may also be a composite cable or cables including, but not limited to, a 24V power cable, a device common ground, a CAN communication cable, a scram switch cable, and the like. In addition, the system of the present application requires some other commonly used cables, such as ac cables, for connecting the master and equipment carts to the hospital power supply. The cable between master control trolley, equipment trolley and operation trolley is spread on the ground of the operating room. The contrast imaging device, the main control trolley and the device trolley can be connected with video signals, and the connection mode and the interface depend on the selected contrast imaging device.
As described above, the driving module moves back and forth on the linear module, and the flexible surgical tool moves under the control of the driving module, so that the position of the vascular interventional surgical tool and the flexible continuum structure relative to the linear module can be directly obtained by the sensor, but the relative position of the linear module in space cannot be directly obtained. Thus, to obtain the spatial relative position of the linear module and thus the three-dimensional spatial positioning of the flexible surgical tool, the system of the present application may further comprise an optical tracker and one or more optical positioning markers, wherein the optical tracker may be fixed to the cabinet of the equipment trolley by a lockable fixing bracket; the optical locating identifier may be mounted on a cannula isolation device on the surgical trolley.
In the present application, the optical tracker and optical locating marks may be implemented using a variety of optical tracking devices and locating means known in the art. For example, the optical tracker comprises an infrared emitting device, one or more cameras and an image analysis device, while the optical positioning identifier consists of a plurality of reflective spheres made of a specific material. In the operation process, the infrared emission device emits infrared light, the camera receives the infrared light reflected by the optical positioning mark, and the image analysis device can analyze the optical information reflected by the optical positioning mark through an image algorithm, so that positioning information of three coordinates and a spatial direction in space is obtained. Because the optical positioning identifier is mounted on the cannula isolation device, the positioning information of the optical positioning identifier reflects the spatial position information of the flexible surgical tool. By three-dimensional positioning of the optical positioning mark, the spatial relative position parameters of the flexible surgical tool can be obtained, and the spatial relative position parameters can be further used in a remote control operation algorithm of the flexible surgical tool to realize accurate control of the flexible surgical tool.
In one embodiment, the system of the present application further comprises an operating table. In this context, any surgical table known in the art may be used as long as it is capable of carrying the object to be operated and is capable of being used with the system of the present application.
In a preferred embodiment, the first and the second display are preferably 3D displays. In one embodiment, the first display is a 3D display and the second display is a 2D display for providing surgical field images, operational reminders, and input instructions to the attendant during the surgical procedure.
In the present application, the contrast imaging apparatus functions to visualize the blood vessel into which the contrast agent is injected, and thus, apparatuses capable of achieving both visualization and imaging of the blood vessel into which the contrast agent is injected can be used in the present application, including but not limited to a B-mode ultrasound apparatus, a CT apparatus (computed tomography apparatus), an MRI apparatus (magnetic resonance imaging apparatus), and a digital subtraction angiography apparatus (DSA).
In the present application, the industrial personal computer may be realized by selecting a commercially available corresponding device according to the corresponding functions mentioned in the present specification, or by accompanying software or hardware of a commercially available robotic surgical system, or may be modified or developed by itself on the basis thereof, as long as it can realize the corresponding functions mentioned in the present application.
FIG. 1 is a schematic diagram of the composition and arrangement of one embodiment of the system of the present application. In the embodiment of fig. 1, the system of the present application is composed of a main control dolly 001, an apparatus dolly 002, an operation dolly 003 arranged beside an operation table 004, and a contrast imaging apparatus 005. Fig. 2 is a schematic side view of the master trolley. As shown in fig. 1 and 2, the console 001 includes a manipulation device 103 and a first display 102, and the operator 101 views the surgical live vessel image displayed in the first display 102, and manipulates the manipulation device 103 to generate control signals (note: for simplicity, parts, such as an industrial personal computer, which are not partially hidden are not labeled in fig. 1, and the functions of these parts are described above). As can also be seen from fig. 1, an optical tracker 205 is mounted on the equipment trolley 002. The auxiliary personnel 104 stand beside the operating table 004, which observes the surgical field images 204 of the surgical procedure displayed on the second display 201 on the equipment trolley, and provides the relevant auxiliary work in time. Fig. 2 also shows a master slave connection cable 401 and an ac cable 403 of the master trolley 001.
Fig. 3 is a schematic front view of the equipment trolley in the system of fig. 1, and fig. 4 is a schematic side view of the equipment trolley in the system of fig. 1. As shown in fig. 3, the equipment trolley 002 includes a cabinet 208, a hub 202, a second display 201, a master-slave connection cable 401, an operation trolley cable 402, and an ac cable 403, where the hub 202 is installed in the cabinet 208, and the cabinet 208 may further include other auxiliary equipment 203, for example, an electric knife, where the electric knife is connected to the industrial personal computer; the safety management module is used for monitoring the state of the whole system, and can cut off the power supply of the driving module when an abnormality occurs; the power module is used for supplying power to all the devices; the video processor is for processing the video signal. As shown in fig. 3, the display 201 is fixed on the cabinet 208, and the display 201 can display a 2D image 204 of the surgical field during the operation. Fig. 4 shows the optical tracker 205 connected to the equipment trolley 002 via a lockable support 207.
As shown in fig. 3 and 4, the master cart 001 and the equipment cart 002 are connected by a master-slave connection cable 401. The operation cart 003 and the equipment cart 002 are connected by an operation cart cable 402. The main control trolley 001 and the equipment trolley 002 are each connected to a hospital power supply through a 220V ac cable 403. The cables among the main control trolley 001, the equipment trolley 002 and the operation trolley 003 are paved on the ground of an operating room.
Fig. 5 is a schematic structural view of an operation cart in the system of fig. 1. Fig. 6 is a detailed structural schematic of the flexible surgical tool of fig. 5. As shown in fig. 5 and 6, the surgical trolley 003 includes a trolley chassis 306, a positioning robot 305, a linear module 303, a drive module 302, a flexible surgical tool 300, a cannula spacer 3031, and a tool spacer 3021, wherein the positioning robot 305 is mounted on the trolley chassis 306, the positioning robot 305 is mounted with the linear module 303, and the drive module 302 can move back and forth along a longitudinal axis of the linear module 303. The flexible surgical tool 300 includes a flexible continuum structure 301 and a vascular interventional surgical tool 310 carried on a distal end of the flexible continuum structure 301. The flexible surgical tool 300 is connected to a tool isolation device 3021 mounted on the drive module 302. The trolley chassis 306 can realize the movement and locking of the operation trolley 003 in an operating room, the positioning mechanical arm 305 can adjust the posture to control the position and the pointing direction of the vascular intervention operation tool after the trolley chassis 306 is locked, the linear module 303 can adjust the front-back movement of the vascular intervention operation tool 310 after the positioning mechanical arm 305 is locked, and the driving module 302 can drive the flexible operation tool 301 to bend to complete the spatial multi-degree-of-freedom movement (preferably three-degree-of-freedom movement) of the vascular intervention operation tool 310.
As shown in fig. 6, a tool isolation device 3021 and a cannula isolation device 3031 are provided on the operation cart 003 for isolating an unsterile portion of the operation cart from an object to be operated, wherein the cannula isolation device 3031 is installed at a distal end of the linear module 303, and a through hole (not shown in the drawing) is provided at a center of the cannula isolation device 3031 so that the flexible operation tool 300 can pass through the through hole; the tool isolation device 3021 is mounted on the drive module 302 and the flexible surgical tool 300 is mounted on the tool isolation device 3021. In addition, an optical positioning identifier 206 is disposed on the cannula isolation device 3031 and is responsible for positioning the operation trolley 003. In addition, fig. 5 and 6 also show that the optical positioning identifier 206 is mounted on the sleeve spacer 3031.
As shown in fig. 6, the flexible continuum structure 301 includes a passive flexible segment 3011 and an active flexible segment 3012, the passive flexible segment 3011 being proximal to the flexible continuum structure 301 and the active flexible segment 3012 being distal to the flexible continuum structure 301. The passive flexible segment 3011 can bend freely passively following the shape of the vessel curve, while the active flexible segment 3012 is controlled by the master controller to bend in space 4 degrees of freedom (including two bending directions, one rotation direction and one feeding direction).
The assembly method of the endoscope operation robot combination system comprises the following steps:
the assembling method of the vascular intervention operation robot combination system of the application can comprise the following steps:
(1) Mounting the sleeve isolation device at a distal end of the linear module and mounting the tool isolation device on the drive module;
(2) Locking a trolley chassis of an operation trolley, adjusting the posture of a positioning mechanical arm of the operation trolley to enable a through hole of a sleeve isolating device to be axially aligned with a cavity of a puncture sleeve, and connecting the puncture sleeve with the sleeve isolating device;
(3) Mounting a flexible continuum structure on a tool isolation device of the surgical trolley and advancing the flexible surgical tool through the cannula isolation device toward a distal end of the penetration cannula; and
(4) An optical locating identifier is mounted on the cannula isolation device, and the lockable support is adjusted so that the optical tracker can observe the optical locating identifier of the surgical trolley.
The method of assembling the endoscopic surgical robotic combination system of the present application prior to performing a procedure is described below with the aid of the embodiments illustrated in fig. 1-6:
1. the sleeve insulator 3031 is installed at the distal end of the linear module 303 and the tool insulator 3021 is installed on the drive module 302;
2. locking a trolley chassis 306 of the operation trolley 003, adjusting the posture of the positioning mechanical arm 305 to axially align the through hole of the cannula isolation device 3031 with the cavity of the puncture cannula 308, and connecting the puncture cannula 308 with the cannula isolation device 3031;
3. the flexible surgical tool 300 is mounted on the tool isolation device 3021, which is already in place, and the flexible surgical tool 300 is advanced through the cannula isolation device 3031 and the lumen of the side-passing cannula 308 toward the distal end of the penetration cannula 308.
4. The lockable support 207 is adjusted so that the optical tracker 205 can observe the optical localization identification 206 of the surgical trolley 003.
The use method of the system comprises the following steps:
the method of using the system of the present application may comprise the steps of:
(1) Mounting the sleeve isolation device at a distal end of the linear module and mounting the tool isolation device on the drive module;
(2) Locking a trolley chassis of an operation trolley, adjusting the posture of a positioning mechanical arm of the operation trolley to enable a through hole of a sleeve isolating device to be axially aligned with a cavity of a puncture sleeve, and connecting the puncture sleeve with the sleeve isolating device;
(3) Mounting a flexible continuum structure on a tool isolation device of the surgical trolley and advancing the flexible surgical tool through the cannula isolation device toward a distal end of the penetration cannula; and
(4) Installing an optical positioning identifier on the cannula isolation device, and adjusting the lockable support so that the optical tracker can observe the optical positioning identifier of the operation trolley;
(5) Starting the contrast imaging equipment to irradiate a target position and obtaining a contrast image of the target position;
(6) Displaying the contrast images obtained in the step (2) on the first display and the second display, and operating the control equipment by an operator according to the guidance of the contrast images so as to generate control signals and sending the control signals to a receiving module of an industrial personal computer; and
(7) The receiving module sends a control signal to the signal conversion module, the signal conversion module converts the control signal into driving quantity parameter information, the driving quantity parameter information is sent to a hub on the equipment trolley, and the hub is then sent to a driving module on the operation trolley; and the driving module is used for pushing and controlling the bending and the direction of the active flexible section of the flexible continuous body structure according to the driving quantity parameter information.
Vascular intervention surgery method:
vascular interventional procedures may be performed using the system of the present application, which may include the steps of:
(1) And adjusting the operated object to a proper pose, and calibrating the puncture position.
(2) Penetrating a puncture cannula into a blood vessel of the puncture site of the operated object marked in the step (1).
(3) Local anesthesia is applied to the puncture site.
(4) And moving the operation trolley according to the position of the puncture cannula, and executing the assembly method.
(5) Advancing the flexible continuum structure of the flexible surgical tool in the direction of the body of the operated object until the vascular interventional surgical tool enters the blood vessel of the puncture site.
(6) And starting the contrast imaging equipment to irradiate the vascular intervention puncture site and obtain a contrast image of the vascular intervention puncture site.
(7) Displaying the contrast images obtained in step (2) on the first display and the second display, an operator operating the manipulation device under guidance of the contrast images to control bending and orientation of the active flexible segment of the flexible continuum structure, feeding the vascular interventional tool to the surgical field.
In a preferred embodiment, the contrast imaging device may be selected by the operator as appropriate depending on factors such as the site of the procedure, the type of disease, the nature of the lesion, and the like, and the devices that may be selected include, but are not limited to, a B-ultrasound device, a CT device, an MRI device, and a digital subtraction angiography device.
In a preferred embodiment, the active flexible segment of the flexible continuum structure may be configured to bend in space with 4 degrees of freedom under control of the handling device of the master trolley, said 4 degrees of freedom may comprise two bending directions, one rotation direction and one feeding direction.
In a preferred embodiment, the first and the second display may each be a 3D display.
In a preferred embodiment, the vascular intervention may be selected from cardiovascular disease interventions, cerebrovascular disease interventions and oncological disease interventions.
A method of performing a vascular intervention using the vascular intervention robot combination system of the present application is described below with the aid of examples 1 and 2.
Example 1:
in this embodiment, a method of performing cardiovascular disease intervention using the system of the present application is illustrated.
The configuration illustrated in fig. 1 and its arrangement are adopted in the present embodiment.
As shown in fig. 7, in the supine position by the operator 105, the puncture cannula 308 is inserted into the blood vessel via the femoral artery or vein of the operator. The procedure was performed as follows:
calibrating the puncture site 106;
a cable connecting the main control carriage 001, the equipment carriage 002 and the operation carriage 003;
starting up the main control trolley 001 and the equipment trolley 002, and performing self-inspection on the surgical robot;
mounting the cannula isolation device 3031 and the tool isolation device 3021 on the surgical trolley 003 and mounting the optical locating identification 206 on the cannula isolation tool 3031;
the attendant 104 pierces the puncture cannula 308 through the puncture site 106 into the blood vessel;
the auxiliary personnel 104 performs local anesthesia on the puncture part of the operator, pushes the operation trolley 003 beside the operation bed 004, locks the trolley chassis 306, adjusts the positioning mechanical arm 305 to enable the flexible operation tool 300 and the puncture sleeve 308 to have the same pointing direction, and connects the puncture sleeve 308 with the sleeve isolation device 3031 after aligning the positions;
connecting and locking the flexible surgical tool 300 with the driving module 303, and then feeding the flexible continuous body structure 301 to the direction of the inside of the body of the operator until the tail end of the flexible continuous body structure enters the blood vessel;
the attendant 104 adjusts the lockable support 207 so that the position of the optical tracker 205 can be observed to the optical locating marking 206 on the surgical trolley 003;
the auxiliary person 104 turns on the CT machine 005 to start irradiating the puncture site 106;
the operator 101 feeds the flexible continuous body structure 301 along a predetermined path to the lesion area under the guidance of the contrast image displayed by the CT machine 005. In the process, the operator 101 operates the control device 103 on the main control trolley 001 to control the bending and the direction of the active flexible section 3012 so that the active flexible section 3012 can follow the bending of the blood vessel to enter the bifurcated blood vessel, and the passive flexible section 3011 can follow the bending and the passive bending of the blood vessel;
after the operation is finished, the operator 101 manipulates the flexible continuum structure 301 to the extravascular position;
the attendant 104 completely withdraws the flexible surgical tool 300 from the body of the operator, disconnects the penetration cannula 308 from the cannula isolation device 3031, and removes the surgical trolley 003;
the flexible surgical tool 300 is uncoupled from the drive module 302 and removed;
hemostatic to the puncture site 106.
Example 2:
in this embodiment, a method of performing a cerebral vascular embolic interventional procedure using the system of the present application is illustrated.
The present embodiment adopts the configuration and arrangement illustrated in fig. 9. Fig. 8 is a schematic view of the position of the person being treated and the location of the puncture site 106 and the puncture cannula 308.
As shown in fig. 8, with the operator 105 in the supine position, the puncture cannula 308 is inserted into the blood vessel via the carotid artery of the operator.
The specific procedure is basically the same as in embodiment 1, except that the CT machine 005 is placed on the head side of the operator 105 so that the blood vessel from the neck to the brain of the operator 105 can be irradiated.
The application has the beneficial effects that:
the system of the application utilizes a continuum surgical arm, which has flexibility of replacement compared with the traditional vascular interventional surgical robot.
The active flexible section and the passive flexible section of the flexible continuum structure adopted by the system can more accurately control the bending movement of the operation tool under the guidance of angiography, including the bending direction and the bending radian, reduce the force on the blood vessel of the operated object, improve the operation precision and reduce the operation risk.
The various devices in the system can be flexibly placed in an operating room according to different surgical procedures, and the system has stronger environmental adaptability.
The system of the present application can be applied to various vascular intervention procedures, for example, cardiovascular disease intervention procedures, cerebrovascular disease intervention procedures, oncological disease intervention procedures, and the like.
While particular embodiments of the present application have been illustrated and described, it would be obvious to those skilled in the art that various other changes and modifications can be made without departing from the spirit and scope of the application. Accordingly, it is intended to cover in the appended claims all such changes and modifications that are within the scope of this application.
Claims (9)
1. A vascular interventional procedure robotic system, comprising:
a linear module;
the linear module is positioned at the far end of the positioning mechanical arm;
the driving module is arranged on the linear module in a sliding way;
a flexible surgical tool, the proximal end of the flexible surgical tool being connected to the drive module; the flexible surgical tool includes: a flexible continuum structure comprising a passive flexible segment at a proximal end and an active flexible segment at a distal end; the active flexible section is driven to move, and the passive flexible section is passively bent along with the bending shape of the blood vessel;
a cannula isolation device disposed at a distal end of the linear module, the cannula isolation device being provided with a through hole for passing through the flexible surgical tool;
an optical positioning identifier mounted on the cannula isolation device such that positioning information of the optical positioning identifier reflects spatial location information of the flexible surgical tool; the spatial position information of the flexible surgical tool is used in a remote operation algorithm of the flexible surgical tool;
the main control trolley is used for converting control signals of the flexible surgical tool into driving quantity parameter information; the driving module drives the active flexible section to move according to the driving quantity parameter information; the master control trolley is also used for: controlling the bending and direction of the active flexible segment based on the control signal so that it can follow the bending of the blood vessel into a bifurcated blood vessel; and
a contrast imaging device for imaging a target angiography; the target angiographic imaging is used to guide and control the bending and direction of the active flexible segment to feed the flexible surgical tool to the surgical field.
2. The vascular interventional procedure robotic system of claim 1, the flexible surgical tool further comprising:
a vascular interventional surgical tool located distally of the flexible surgical tool.
3. The vascular interventional procedure robotic system of claim 2, the vascular interventional procedure tool comprising: any one of a stent placement tool, a vasodilation tool and an electrosurgical tool.
4. The vascular interventional procedure robotic system of any one of claims 1-3, the flexible surgical tool further comprising:
a drive transmission unit; the driving transmission unit is used for driving the active flexible section.
5. The vascular interventional procedure robot system of claim 1, the master trolley comprising:
and the control device is used for generating the control signal according to the control action.
6. The vascular interventional procedure robot system of claim 1, the surgical style executable by the vascular interventional procedure robot system comprising:
any one of cardiovascular disease intervention, cerebrovascular disease intervention and neoplastic disease intervention.
7. The vascular interventional procedure robot system of claim 1, further comprising:
and the puncture cannula is used for being detachably connected with the cannula isolating device.
8. The vascular interventional procedure robot system of claim 1, further comprising:
a puncture cannula;
the puncture cannula is used for being detachably connected with the cannula isolating device;
the positioning robotic arm is configured to maintain the cannula isolation device in a predetermined orientation suitable for connection of the cannula isolation device with the cannula.
9. The vascular interventional procedure robot system of claim 1, the linear module being configured to adjust the feeding of the flexible surgical tool in the locked position of the positioning robotic armThe driving module is used for driving the bending motion of the flexible continuum structure 。
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| Application Number | Priority Date | Filing Date | Title |
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| CN202011538232.4A CN112842533B (en) | 2018-10-09 | 2018-10-09 | Flexible surgical tool and vascular intervention surgical robot system |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811175035.3A CN109431606B (en) | 2018-10-09 | 2018-10-09 | Vascular intervention operation robot combination system and use method thereof |
| CN202011538232.4A CN112842533B (en) | 2018-10-09 | 2018-10-09 | Flexible surgical tool and vascular intervention surgical robot system |
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| CN114504388A (en) * | 2022-03-15 | 2022-05-17 | 山东大学齐鲁医院 | Flexible surgical robot system and control method thereof |
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| CN112842533A (en) | 2021-05-28 |
| CN109431606A (en) | 2019-03-08 |
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