CN118267103A - Slave end driving control device - Google Patents
Slave end driving control device Download PDFInfo
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- CN118267103A CN118267103A CN202310710257.5A CN202310710257A CN118267103A CN 118267103 A CN118267103 A CN 118267103A CN 202310710257 A CN202310710257 A CN 202310710257A CN 118267103 A CN118267103 A CN 118267103A
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Abstract
The application discloses a slave end driving control device which is used for driving a sheath tube and a catheter movably arranged in the sheath tube, wherein the slave end driving control device comprises a first driving mechanism connected with the proximal end of the sheath tube and a second driving mechanism connected with the proximal end of the catheter, the first driving mechanism comprises a first linear module and a first rotating module, the first linear module is configured to drive the sheath tube to move back and forth along a first axis, and the first rotating module is configured to drive the sheath tube to rotate around the first axis; the second driving mechanism comprises a second linear module and a second rotating module, the second linear module is configured to drive the catheter to move back and forth along a second axis, the second rotating module is configured to drive the catheter to rotate around the second axis, and the secondary end driving control device can adjust the position, the posture and the like of the sheath tube and the catheter, thereby assisting a doctor in completing vascular interventional operation and improving stability and safety of the operation.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to a slave-end driving control device.
Background
The vascular intervention technology is a treatment technology which is gradually developed in recent years, has the advantages of small wound, simple and convenient operation, accurate intervention part and the like, and can effectively treat some patients which cannot tolerate major surgery and drug resistance. The vascular intervention operation robot is medical equipment for assisting a doctor in completing an operation by adopting a robot technology, can greatly improve the stability of the operation, reduce the working strength of the operation process and effectively reduce the radiation injury to the doctor. Meanwhile, the standardized operation flow reduces the influence of clinical experience of doctors on the operation effect, improves the operation safety and reduces the culture period and the culture cost of the doctors.
The vascular intervention operation robot has research at home and abroad, and the vascular intervention operation robot product also has clinical application in the market. However, as the interventional operation process is complex, no product is available at present to realize the auxiliary operation of the whole operation process, only a certain part of operation can be completed in an auxiliary way, and the rest operation still needs to be completed independently by doctors. The operation process only reduces the partial dependence on doctors, and the clinical experience of the doctors still has larger influence on the operation effect. These products do not currently effectively address the problems associated with vascular interventional procedures mentioned above.
Disclosure of Invention
Therefore, the slave-end driving control device is used for assisting a doctor in vascular intervention operation in a whole process, realizing remote operation of the doctor, reducing radiation injury, reducing operation intensity and improving operation stability and safety.
A slave drive control device for driving a sheath and a catheter movably disposed in the sheath, the slave drive control device comprising a first drive mechanism coupled to a proximal end of the sheath and a second drive mechanism coupled to the proximal end of the catheter, the first drive mechanism comprising a first linear module configured to drive the sheath to move back and forth along a first axis and a first rotational module configured to drive the sheath to rotate about the first axis; the second drive mechanism includes a second linear module configured to drive the catheter to move back and forth along a second axis and a second rotational module configured to drive the catheter to rotate about the second axis.
Compared with the prior art, the slave end driving control device enables the sheath tube and the catheter to have multiple degrees of freedom through the arrangement of the first driving mechanism and the second driving mechanism, accurately adjusts and controls the positions and the postures of the sheath tube and the catheter, assists a doctor to complete vascular intervention operation, can reduce dependence of an operation process on clinical experience of the doctor, improves stability and safety of the operation, can realize remote operation of the doctor, reduces harm of radiation to the doctor, and ensures health and safety of the doctor. The slave end driving control device provided by the application is convenient for aseptic isolation, namely, the aseptic isolation bag is used for sleeving, so that the operation is kept in an aseptic environment, and medical instruments can be conveniently disassembled and assembled in the operation process, and the medical instruments can be replaced or the operation control rights can be exchanged without damaging the aseptic environment. Meanwhile, the whole slave-end driving control device realizes decoupling of various operations for various medical instruments, can realize independent control or joint control of the various medical instruments, has wider application range, can assist doctors to complete vascular intervention operation in a whole flow, is more visual in operation and more convenient in control, and reduces learning and culturing costs.
Drawings
Fig. 1 is a schematic diagram of an embodiment of a slave-end driving control device according to the present application.
Fig. 2 is a schematic view of a first driving mechanism of the slave-end driving control device shown in fig. 1.
Fig. 2a is another angular view of the first drive mechanism of fig. 2.
Fig. 3 is a side view of the first drive mechanism shown in fig. 2.
Fig. 4 is a schematic view of a first linear module of the first driving mechanism shown in fig. 2.
Fig. 5 is a schematic view of a first rotary module of the first driving mechanism shown in fig. 2.
Fig. 6 is a schematic diagram of a first bending module of the first driving mechanism shown in fig. 2.
Fig. 6a is an assembled cross-sectional view of the first bending module and the handle shown in fig. 6.
Fig. 7 is a schematic diagram of another embodiment of the first bending module.
Fig. 8 is an exploded view of the sheath mount of the primary drive mechanism.
Fig. 8a is a schematic view of another embodiment of a sheath holder.
Fig. 9 is a schematic diagram of a second drive mechanism of the slave-end drive control apparatus shown in fig. 1.
Fig. 9a is another angular view of the second drive mechanism of fig. 9.
Fig. 9b is a side view of the second drive mechanism of fig. 9.
Fig. 10 is a schematic view of a sheath-core drive module of the secondary drive mechanism of fig. 9.
Fig. 10a is a side view of the sheath-core drive module of fig. 10.
Fig. 11 is a schematic diagram of another embodiment of a sheath-core drive module.
Fig. 12 is a schematic diagram of a slave drive control device with a guidewire drive module.
Fig. 13 is a schematic view of the guidewire drive module of fig. 12.
Fig. 14 is a schematic view of a mounting block of the guidewire drive module of fig. 13.
Fig. 15 is a schematic view of another embodiment of a guidewire drive module.
Detailed Description
In order that the application may be readily understood, a more complete description of the application will be rendered by reference to the appended drawings. One or more embodiments of the present application are illustrated in the accompanying drawings to provide a more accurate and thorough understanding of the disclosed subject matter. It should be understood, however, that the application may be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein.
The same or similar reference numbers in the drawings correspond to the same or similar components; in the description of the present application, it should be understood that, if any, terms such as "upper", "lower", "left", "right", "front", "rear", "top", "bottom", etc. are used for convenience in describing the present application and simplifying the description based on the orientation or positional relationship shown in the drawings, but do not indicate or imply that the devices or elements to be referred must have a specific orientation, be constructed and operated in the specific orientation, and thus the terms describing the positional relationship in the drawings are merely used for exemplary illustration and are not to be construed as limiting the present application, and the specific meaning of the terms described above may be understood by those of ordinary skill in the art according to specific circumstances.
In the description of the present application, it is noted in advance that the terms "proximal" and "distal" refer to the relative orientation, relative position, orientation of elements or actions with respect to one another from the perspective of the operator using the medical device, although "proximal" and "distal" are not intended to be limiting, and "proximal" generally refers to the end of the medical device that is proximate to the operator during normal operation, and "distal" generally refers to the end that first enters the patient. The direction of the rotation center axis of the column, the tube body and the like is defined as the axial direction, and the direction perpendicular to the axial direction is defined as the radial direction. Circumferential refers to "circumferential direction", i.e., about the cylinder, the tube, and the like (perpendicular to the axis, and also perpendicular to the radius of the cross section). The "circumferential", "axial" and "radial" collectively form three orthogonal directions of the cylindrical coordinates. The definitions are provided for convenience of description and are not to be construed as limiting the application.
The application provides a slave-end driving control device which is used for assisting a doctor in vascular interventional operation. Fig. 1 shows an embodiment of a slave drive control apparatus according to the present application, which includes a first drive mechanism 100 and a second drive mechanism 200. The first driving mechanism 100 and the second driving mechanism 200 are mounted on the support module 30, wherein the first driving mechanism 100 is used for driving the sheath 10 to move, is connected with the proximal end of the sheath 10 and enables the sheath 10 to have multiple degrees of freedom; the second driving mechanism 200 is used for driving the catheter 20 movably disposed in the sheath 10 to move, is connected to the proximal end of the catheter 20, and allows the catheter 20a plurality of degrees of freedom. In this way, the sheath 10 and the catheter 20 can be adjusted in position and posture in a plurality of directions as required after entering the operation subject through the blood vessel, so that the distal end of the catheter 20 can accurately reach the predetermined position and complete the corresponding operation.
As shown in fig. 2, 2a and 3, the first driving mechanism 100 includes a first linear module 130 and a first rotating module 140, and the first linear module 130 is configured to drive the sheath 10 to move back and forth along the first axis X1, so as to realize feeding and retracting of the sheath 10; the first rotation module 140 is configured to drive rotation of the sheath 10 about the first axis X1, effecting rotation of the sheath 10.
Referring to fig. 4, the first linear module 130 includes a first driving motor 131 and a first screw assembly 132 drivingly connected to an output shaft of the first driving motor 131, and converts rotation of the first driving motor 131 into linear motion through the first screw assembly 132. Specifically, the first screw assembly 132 includes a first screw 133 and a first moving member, such as a first nut 134, threadedly coupled to the first screw 133. The first screw rod 133 is connected to an output shaft of the first driving motor 131 through a coupling 135, so that the first screw rod 133 moves along an axial direction of the first screw rod 133 when the first screw rod 133 is rotated by the driving of the first driving motor 131.
In an embodiment, the first linear module 130 further includes a first linear guide 136 and a first slider 137, where the first slider 137 is slidably connected to the linear guide 136, and the first nut 134 is fixedly connected to the first slider 137, so that the first nut 134 cannot rotate, and the first linear guide 136 only enables the first nut 134 to move along the first lead screw 133, when the first driving motor 131 is started, the first lead screw 133 will reciprocate along the output shaft of the first driving motor 131, the first nut 134 will reciprocate linearly along the first lead screw 133, the first slider 137 also reciprocates linearly along the first linear guide 136 along with the first nut 134, and the first lead screw assembly 132 pushes the first nut 134 to reciprocate linearly, and the first linear guide 136 supports the gravity of the component above the first nut 134, so that the stability and the stress balance of the first linear module 130 can be improved.
The first nut 134 may advance or retreat along the first screw rod 133 according to different rotational directions of the first driving motor 131. For example, when the first driving motor 131 rotates clockwise, the first nut 134 moves forward to drive the sheath 10 to feed; conversely, when the first driving motor 131 rotates in the counterclockwise direction, the first nut 134 moves backward to drive the sheath 10 to retreat. Of course, the first driving motor 131 may drive the sheath 10 to retract when rotating clockwise and drive the sheath 10 to feed when rotating counterclockwise.
Referring to fig. 5, the first rotating module 140 includes a second driving motor 141 and a first swing arm 142 drivingly connected to an output shaft of the second driving motor 141. In the illustrated embodiment, the second driving motor 141 is fixedly connected to the first nut 134 and the first slider 137 of the first screw assembly 132 through the first motor support 143, and the first rotating module 140 may move back and forth along the first screw 133 along with the first nut 134 as a whole. The second driving motor 141 and the first driving motor 131 are disposed in the same direction or in opposite directions, and the axial directions of the two are parallel to each other. When the first swing arm 142 swings under the action of the second driving motor 141, the extending direction of the central shaft of the swing is parallel to the extending direction of the first screw rod 133, so that the control of the rotational degree of freedom and the control of the advancing and retreating degree of freedom of the sheath 10 can be mutually noninterfered, and the independence and stability of the motion control can be maintained.
The radial outer end of the first swing arm 142 is connected with a first supporting seat 150, the first supporting seat 150 is vertically connected with the first swing arm 142, and the first supporting seat 150 and the first swing arm 142 can be of an integral structure or can be connected together after being respectively molded. Under the action of the second driving motor 141, the first supporting base 150 rotates in synchronization with the first swing arm 142. The sheath handle 12 is provided at the proximal end of the sheath, the first support block 150 serves as a support member for the sheath 10, and a sheath holder 160 is provided for holding the sheath handle 12. As shown in fig. 8, the sheath holder 160 includes a first support 161 and a first clamping member 162 separable from the first support 161, the first support 161 is fixedly connected to the first support 150, the sheath handle 12 is clamped between the first support 161 and the first clamping member 162, so that the sheath handle 12 can be conveniently detached and installed in the operation process, and the surgical instrument can be replaced without damaging the sterile isolation environment, or in the case of an emergency operation, such as a special requirement or a machine failure of a patient in the operation, the control right of the sheath 10 can be exchanged, and instead, the control right can be manually operated by a doctor, the original sheath consumable does not need to be discarded, the new consumable is replaced, the economic burden of the patient is reduced, and the material waste is reduced.
In the embodiment shown in fig. 8, the first clamping member 162 is a cover plate detachably connected to the first support 161, the first support 161 is provided with a fastening hole 163, and the cover plate is provided with a fastening hook 164 corresponding to the fastening hole 163. The first support 161 and the cover plate are hooked and connected by the clasp 164 and the clasp hole 163, and the cover plate can be conveniently detached when the sheath handle 12 needs to be replaced. In some embodiments, a clasp 164 may also be provided on the first support 161 and a corresponding clasp hole 163 provided on the cover. The shell of the sheath tube handle 12 is provided with a plurality of clamping grooves 15 which are matched with a plurality of rib positions 165 arranged on the first support 161, so that the handle 12 of the sheath tube 10 is convenient to install and fix on the first support 161.
In the embodiment shown in fig. 8a, the first clamping members 162 are elastic members, such as springs, respectively disposed on two opposite sides of the first support 161, and the sheath handle 12 is sandwiched between the two elastic members. The width of the sheath handle 12 is larger than the interval width between two elastic pieces (in a natural stretching state), when the sheath handle 12 is placed, a certain acting force can be applied to pull the elastic pieces apart, and at the moment, the elastic pieces deform to a certain extent; after the sheath handle 12 is placed, the elastic member is released to clamp the sheath handle 12. The elastic piece can stretch and deform, so that the width of the clamped sheath handle 12 can be automatically adapted, the device can be suitable for sheath handles 12 of different specifications, the universality is better, and the disassembly and the assembly are convenient.
In the illustrated embodiment, the sheath handle 12 is carried on the first support 150 of the first swing arm 142 of the first rotation module 140, and swings synchronously with the first swing arm 142 under the action of the second driving motor 141, so that the sheath 10 rotates around the first axis X1; the first rotating module 140 is connected to the first nut 134 of the first linear module 130, and slides synchronously with the first nut 134 under the action of the first driving motor 131, so that the sheath 10 moves back and forth along the first axis X1, and the sheath 10 has at least two degrees of freedom of movement and rotation. The sheath interface of the sheath handle 12 may be coaxially disposed with the second driving motor 141 such that the first axis X1 involved in the movement and rotation of the sheath 10 is on the same line as the central axis of the swing of the first swing arm 142.
In the above embodiment, the first linear module 130 drives the first rotating module 140 to move, and the first rotating module 140 directly drives the sheath handle 12 to rotate, so that the sheath 10 can move and rotate finally. In other embodiments, the order of the first linear module 130 and the first rotating module 140 may be reversed, and it may be that the first rotating module 140 directly drives the first linear module 130 to integrally rotate, and the first linear module 130 directly drives the sheath handle 12 to move. The first linear module 130 may also adopt other structures, such as a rack and pinion, a synchronous belt, etc., to realize conversion between rotation and linear motion, so as to drive the sheath 10 to move back and forth; a transmission element may also be disposed between the second driving motor 141 and the first swing arm 142 of the first rotation module 140, so as to implement remote transmission.
The sheath 10 may be an introducer sheath, a fixed curve sheath, an adjustable curve sheath, etc., to provide support and guidance for the catheter 20. In some embodiments, the sheath 10 is a flexible sheath, as shown in fig. 6, the first drive mechanism 100 may further include a first bending module 170, the first bending module 170 configured to drive the distal end of the sheath 10 to bend laterally relative to its axis, to better accommodate the interventional path of the subject.
Referring to fig. 6a, the first bending module 170 is connected to the first support 150 of the first swing arm 142 of the first rotating module 140, and can swing synchronously with the first swing arm 142 and/or move with the first nut 134. A sheath bending adjustment assembly, such as a traction wire, is arranged in the shell of the sheath handle 12, and is connected with the distal end of the sheath 10, and the bending deflection and the straightening of the distal end of the sheath 10 in one side, two sides or multiple directions are realized through the mechanical operations of traction, winding, releasing and the like of the sheath bending adjustment assembly. The sheath bending assembly further comprises a first bending knob 14 positioned on the shell of the sheath handle 12, and the first bending module 170 is in transmission connection with the sheath bending assembly through the first bending knob 14, controls the operation of the sheath bending assembly, and releases or tightens the traction wire, so that the distal end of the sheath 10 is bent at a certain angle relative to the axial side direction of the sheath. Because the first bending knob 14 is positioned above the housing of the handle 12, a greater bending angle can be achieved through the drive connection of the sheath bending assembly and the bending thread can be calculated conveniently. Compared with the structure that the bending adjusting knob is positioned on two sides of the handle shell, the control stroke of the bending adjusting operation in the embodiment is longer, the bending adjusting operation of the sheath tube can be conveniently and mechanically controlled through the transmission connection of the bending adjusting assembly matched with the bending adjusting knob while the convenience of the manual bending adjusting operation is not affected, and a larger bending adjusting angle can be realized.
The first bending adjustment module 170 includes a third driving motor 171, a first rotary actuator 172, and a first transmission assembly 173 disposed between the third driving motor 171 and the first rotary actuator 172. The first rotary actuating member 172 is cooperatively connected with the first bending adjusting knob 14, and when the third driving motor 171 drives the first rotary actuating member 172 to rotate, the first bending adjusting knob 14 is driven to rotate synchronously, so that the traction wire is released or tightened, and lateral bending of the distal end of the sheath tube 10 is realized, so that the sheath tube 10 has at least 3 degrees of freedom. In an embodiment, the first rotary actuating member 172 is disposed coaxially with the first bending knob 14, and the rotation axes of the first rotary actuating member 172 and the first bending knob are both disposed at an angle with the rotation axis of the third driving motor 171, so that the third driving motor 171 can be disposed on one side of the first rotary actuating member 172, and space is effectively utilized, so that the overall structure is more compact.
In the illustrated embodiment, the third driving motor 171 is disposed below the first support base 150, and the first rotary actuator 172 is connected to the first bending knob 14 above the first support base 150 through the first support base 150. The first transmission assembly 173 includes first and second transmission elements that intermesh, at least one of which is a bevel gear. In one embodiment, the first and second drive members are intermeshing first and second bevel gears 174 and 175, respectively. The first bevel gear 174 is coaxially disposed and fixedly coupled to the output shaft of the third driving motor 171, and the second bevel gear 175 is coaxially disposed and fixedly coupled to the first rotary actuator 172. The torque is transmitted through the first transmission assembly 173 while also making a 90 degree transition in the rotational direction such that the rotational axis of the first rotary actuator 172 is perpendicular to the rotational axis of the third driving motor 171.
As shown in fig. 6a, the first rotary actuator 172 is integrally formed as a shaft, a first plug 172a is formed at a bottom end thereof and connected to the second bevel gear 175 of the first transmission assembly 173, and a second plug 172b is formed at a top end thereof and connected to the first bending knob 14. A first insertion hole is formed in the center of the second bevel gear 175, and the first insertion head 172a is fixedly inserted into the first insertion hole; the center of the first bending knob 14 is formed with a second insertion hole, and the second insertion head 172b is fixedly inserted into the second insertion hole.
In an embodiment, a key slot is further formed in a recess in a hole wall of the first inserting hole of the second bevel gear 175, a key is formed on an outer wall surface of the first inserting head 172a in a protruding manner, and the key is clamped with the key slot, so that a limit can be formed in a circumferential direction after the first rotary actuating member 172 and the second bevel gear 175 are inserted and connected, and the second bevel gear 175 can drive the first rotary actuating member 172 to rotate synchronously. It should be understood that, a key groove may be formed in a recessed manner on the outer wall surface of the first plug 172a, and a key may be formed on the wall surface of the first plug hole correspondingly in a protruding manner to engage with the key groove, so as to limit the first rotary actuator 172 and the second bevel gear 175 in the circumferential direction.
In another embodiment, the cross section of the second plugging hole of the first bending knob 14 is non-circular, optionally, is regular polygon such as square, regular hexagon, etc., the cross section shape and size of the second plugging head 172b are matched with those of the second plugging hole, and the two plugging connection is followed by realizing the limit in the circumferential direction through the matching of the shapes, so that the first rotary actuating member 172 can drive the first bending knob 14 to rotate synchronously, and the power transmission and the accurate control from the third driving motor 171 to the first bending knob 14 are completed. It should be understood that the first rotary actuator 172 may form a second socket, and the first bending knob 14 may form a second socket, where the two sockets are connected to achieve the circumferential limit.
Because the first bending adjusting module 170 is connected with the first bending adjusting knob 14 through the transmission, the mechanical fine calculation bending adjusting thread and the accurate control bending adjusting angle are facilitated, the accurate positioning of the sheath tube position is realized, the surgical efficiency is higher compared with the traditional interventional operation, and the occurrence of complications can be reduced. The rotation angle of the third driving motor 171 is converted and calculated to the rotation angle of the first bending knob 14, and then converted and calculated to the passing angle or arc length of the end point of the traction wire, i.e. the winding or releasing length, and further converted and calculated to the bending angle of the end of the sheath.
In another embodiment of the present application, as shown in fig. 7, one of the first transmission element and the second transmission element may be a bevel gear, and the other may be a worm, for example, a worm 177 is connected to and coaxially disposed with an output shaft of the third driving motor 171, and a bevel gear 176 is connected to and coaxially disposed with the first rotary actuator 172. The arrangement of the bevel gear 176, the worm 177 may also enable power transmission between the third drive motor 171 and the first rotary actuator 172 and change the direction of rotation such that the axis of rotation of the first rotary actuator 172 and the axis of rotation of the third drive motor 171 are disposed at angles, including but not limited to perpendicular to each other. It should be appreciated that in some embodiments, the third drive motor 171 may also directly drive the first rotary actuator 172, omitting the first transmission assembly 173.
As shown in fig. 9, 9a and 9b, the second driving mechanism 200 includes a second linear module 230 and a second rotary module 240, and the second linear module 230 is configured to drive the catheter 20 to move back and forth along the second axis X2, so as to realize feeding and retracting of the catheter 20; the second rotation module 240 is configured to drive the rotation of the catheter 20 about the second axis X2, effecting rotation of the catheter 20.
The second linear module 230 has a similar structure to the first linear module 130, and includes a fourth driving motor 231 and a second screw assembly 232. The second screw assembly 232 includes a second screw 233 and a second moving element, such as a second nut 234, the second screw 233 being coupled to an output shaft of the fourth driving motor 231 through a coupling 235, the second nut 234 being coupled to the second screw 233 and being screwed to the second screw 233. In one embodiment, the second linear module 230 further includes a second linear guide 236 and a second slider 237, where the second slider 237 is slidably connected to the second linear guide 236, and the second nut 234 is fixedly connected to the second slider 237, such that the second nut 234 cannot rotate, and thus the second nut 234 can only move along the second screw 233.
When the fourth driving motor 231 is started, the second screw rod 233 will reciprocate along with the output shaft of the fourth driving motor 231, the second nut 234 will reciprocate linearly along with the second screw rod 233, the second slider 237 will also reciprocate linearly along with the second nut 234 along with the second linear guide rail 236, the second screw rod assembly 232 pushes the second nut 234 to reciprocate linearly, and the second linear guide rail 236 supports the gravity of the component above the second nut 234, so that the stability and the stress balance of the second linear module 230 can be improved.
The second rotating module 240 is similar in structure to the first rotating module 140, and includes a fifth driving motor 241 and a second swing arm 242 drivingly connected to an output shaft of the fifth driving motor 241. In the illustrated embodiment, the fifth driving motor 241 is fixedly connected to the second nut 234 and the second slider 237 of the second screw assembly 232 through the second motor support 243, and the second rotating module 240 can move back and forth along the axial direction of the second screw 233 along with the second nut 234 as a whole. The fifth driving motor 241 and the fourth driving motor 231 are arranged in the same direction or in opposite directions, and when the second swing arm 242 swings under the action of the fifth driving motor 241, the extending direction of the central shaft of the swing is parallel to the extending direction of the second screw 233.
The radial outer end of the second swing arm 242 is connected with a second supporting seat 250, and the second supporting seat 250 is vertically connected with the second swing arm 242. The proximal end of the catheter 20 is connected to a catheter handle 22, and the catheter handle 22 is detachably mounted on the second support base 250 through a catheter mount 260. As shown in fig. 10, the catheter mount 260 includes a second mount 261 and a second clip 262 that is separable relative to the second mount 261. The second support 261 is connected to the second support 250, and the handle 22 of the catheter 20 is clamped between the second support 261 and the second clamping member 262, so that on one hand, the catheter handle can be conveniently detached and installed in the operation process, and the surgical instrument can be replaced without damaging the sterile isolation environment, and on the other hand, under the emergency of the operation, if special requirements or machine faults and other conditions occur to a patient in the operation, the control right of the catheter 20 is exchanged, and the control right is changed into the control right by a doctor to be manually operated, so that the original catheter does not need to be discarded, new instruments are replaced, the economic burden of the patient is reduced, and the material waste is also reduced. The second clamping member 262 may be a cover plate in snap connection with the second support 261, or may be elastic members, such as springs, respectively disposed on two opposite sides of the second support 261, so as to facilitate replacement of the catheter handle 22.
In the illustrated embodiment, the catheter handle 22 is carried on the second support 250 of the second swing arm 242 of the second rotating module 240, and is synchronously swung with the second swing arm 242 under the action of the fifth driving motor 241, so that the catheter 20 rotates around the second axis X2; the second rotating module 240 is connected to the second nut 234 of the second driving module, and slides synchronously with the second nut 234 under the action of the fourth driving motor 231, so that the catheter 20 moves along the second axis X2, and the catheter 20 has at least two degrees of freedom of movement and rotation.
The catheter interface of the catheter handle 22 may be coaxially disposed with the fifth drive motor 241 such that the second axis X2 involved in the movement and rotation of the catheter 20 is collinear with the central axis of oscillation of the second swing arm 242. In one embodiment, as shown in FIG. 1, the second axis X2 is parallel to the first axis X1 and is not collinear with the first axis X1, and has a height differential therebetween such that the proximal end of the catheter 20 may avoid the various components of the first drive mechanism 100, facilitating sterile isolation, i.e., nesting with a sterile isolation pouch, to maintain the surgical procedure in a sterile environment.
In other embodiments, the order of the second linear module 230 and the second rotary module 240 may be reversed, or the second rotary module 240 directly drives the second linear module 230 to rotate integrally, and the second linear module 230 directly drives the catheter handle 22 to move. The second linear module 230 may also adopt other structures, such as a rack and pinion, a synchronous belt, etc., to convert rotation and linear motion, so as to drive the catheter 20 to move back and forth; a transmission element may also be disposed between the fifth driving motor 241 and the second swing arm 242 of the second rotation module 240, so as to implement remote transmission.
Catheter 20 may be a mapping catheter, ultrasound catheter, laser catheter, ablation catheter, balloon catheter, contrast catheter, guide catheter, pigtail catheter, atrial septum needle, etc. to provide mapping, imaging, energy release, angioplasty, stent release, imaging, atrial septum puncture, etc. In some embodiments, the catheter 20 is a flexible catheter, enabling one-way, two-way, or multi-way bending of the catheter tip, and the second drive mechanism 200 may further include a second bending module 270, the second bending module 270 configured to drive the distal end of the catheter 20 to bend laterally relative to the axial direction thereof, which may better accommodate the interventional path of the subject.
In the illustrated embodiment, the second bending module 270 is connected to the second support 250 of the second swing arm 242 of the second rotating module 240, and can swing synchronously with the second swing arm 242 and/or move with the second nut 234 as a whole. A catheter bending assembly, such as a traction wire, is disposed in the housing of the catheter handle 22 and is connected to the distal end of the catheter 20, whereby bending deflection of the distal end of the catheter 20 in one, two or more directions is achieved by mechanical manipulation of the catheter bending assembly, such as pulling, winding, etc. The catheter bending component comprises a second bending knob 24 arranged on the shell of the handle 22, and a second bending module 270 is connected with the catheter bending component through the second bending knob 24 and controls the operation of the catheter bending component to release or tighten the traction wire, so that the distal end of the catheter 20 bends a certain angle relative to the axial side direction of the distal end.
The second bending module 270 is similar to the first bending module 170 and includes a sixth drive motor 271, a second rotary actuator 272, and a second transmission assembly 273. The second rotary actuating member 272 is cooperatively connected with the second bending adjusting knob 24, and when the sixth driving motor 271 drives the second rotary actuating member 272 to rotate, the second bending adjusting knob 24 is driven to rotate, so that the traction wire is released or tightened, and lateral bending of the distal end of the catheter 20 is realized, so that the catheter 20 has at least 3 degrees of freedom. In one embodiment, the second rotary actuating member 272 is disposed coaxially with the second bending knob 24, and the rotation axes of both are disposed at an angle to the rotation axis of the sixth driving motor 271. In the illustrated embodiment, the sixth driving motor 271 is disposed below the second supporting seat 250, and the second rotary actuator 272 is connected to the second bending knob 24 above the second supporting seat 250 through the second supporting seat 250.
In another embodiment, the second transmission assembly 273 includes a third transmission member and a fourth transmission member intermeshed, at least one of the third transmission member and the fourth transmission member being a bevel gear. In one embodiment, the third transmission element and the fourth transmission element are a third bevel gear 274 and a fourth bevel gear 275 meshed with each other, respectively, the third bevel gear 274 is coaxially disposed and fixedly connected with the output shaft of the sixth driving motor 271, and the fourth bevel gear 275 is coaxially disposed and fixedly connected with the second rotary actuator 272. In the illustrated embodiment, the second rotary actuator 272 has a shaft-like structure as a whole, the top end of which has a non-circular cross section, the bottom end of which forms a third socket to be connected with the fourth bevel gear 275 of the second transmission assembly 273, and the top end of which forms a fourth socket to be connected with the non-circular hole of the second bending knob 24. In some embodiments, one of the third transmission element and the fourth transmission element can be a bevel gear, and the other one can be a worm, so that the direction of rotation can be changed while the power is transmitted.
Because the second bending adjusting module 270 is connected with the second bending adjusting knob 24 through the transmission, the mechanical fine calculation bending adjusting thread and the accurate control bending adjusting angle are facilitated, the accurate positioning of the catheter position is realized, the operation efficiency is higher compared with the traditional interventional operation, and the occurrence of complications can be reduced. The rotation angle of the sixth driving motor 271 is converted into the rotation angle of the second bending knob 24, and then converted into the passing angle or arc length of the end point of the traction wire, i.e., the winding or releasing length, and further converted into the bending angle of the end of the catheter.
In some embodiments, the distal end of the catheter 20 may be deformed, the shape of the distal end of the catheter 20 prior to deformation may be a bundle, the shape of the distal end of the catheter 20 after deformation may be annular, basket, ball, octopus, mesh, etc., to conform to tissue for diagnostic or therapeutic functions. As shown in fig. 9a and 10, a sheath core 26 which can move relative to the tube body of the catheter 20 is arranged in the tube body of the catheter 20, and is used for driving the distal end of the catheter 20 to deform, the sheath core 26 is connected with the distal end of the catheter 20, and the distal end supporting framework of the catheter 20 can be radially expanded or contracted by pulling the proximal end of the sheath core 26 to move relative to the tube body along the axial direction, so that the distal end of the catheter 20 is driven to deform, and the specific diagnosis or treatment operation is completed by fitting tissues.
Accordingly, the secondary drive mechanism 200 further includes a sheath-core drive module 280, the sheath-core drive module 280 configured to drive the sheath-core 26 to move telescopically relative to the catheter 20 such that the catheter 20 has at least 4 degrees of freedom. For example, where catheter 20 is an ablation catheter, the distal end thereof is provided with an ablation electrode, and deformation of the distal end of catheter 20 includes a change in shape of the backbone of the ablation electrode. For example, before reaching the ablation site of the operation subject, the skeleton of the ablation electrode is compressed to be a bundle-like structure as a whole; after reaching the ablation site, the sheath-core drive module 280 drives the sheath core 26 back, expanding the backbone of the ablation electrode in a radial direction, generally in a cage-like structure, to better abut the ablation site.
The sheath-core driving module 280 is disposed on the second supporting seat 250, and includes a seventh driving motor 281 and a moving member 282 driven by the seventh driving motor 281. The seventh drive motor 281 provides linear reciprocation of the moving member 282, the moving member 282 being coupled to the proximal end of the sheath core 26 via the sheath-core interface 27. In one embodiment, the proximal end of the sheath core 26 is provided with a handle 26a, the sheath core interface 27 is provided with a clamping groove 27a matching the shape of the handle 26a, the handle 26a is detachably clamped in the clamping groove 27a, and the sheath core 26 and the sheath core interface 27 are connected together, so that the sheath core is convenient to detach and install, and surgical control rights can be exchanged under special conditions. The movement member 282 moves back and forth along the first direction relative to the second support base 250 under the action of the seventh driving motor 281, so as to drive the sheath-core interface 27 to move back and forth along the second direction relative to the second support base 250, and the first direction and the second direction are parallel. Because the seventh driving motor 281 and the proximal end of the catheter 20 are fixed relative to the second supporting seat 250, the handle 26a can move back and forth relative to the catheter body of the catheter 20 through clamping the handle 26a by the sheath core interface 27, so that the distal end of the sheath core 27 can move telescopically relative to the catheter body of the catheter 20.
In the embodiment shown in fig. 9a-10, the moving member 282 is a telescopic push rod, the fixed end of which is in driving connection with the seventh driving motor 281, and the movable end of which is fixedly connected with the sheath-core interface 27. Under the action of the seventh driving motor 281, the movable end of the telescopic push rod moves telescopically along the first direction, so as to drive the sheath-core interface 27 to move back and forth along the second direction, and further enable the sheath core 26 to feed or retract relative to the catheter 20. In other embodiments, the seventh driving motor 281 may be a linear motor, and the moving member 282 may be a push rod, where one end of the push rod is in driving connection with the linear motor, and the other end of the push rod is fixedly connected with the sheath-core interface 27.
In the embodiment shown in fig. 11, the moving member 282 is a gear. The second support 250 is provided with a rack 253 matched with the gear, and the rack 253 extends along the first direction; the seventh driving motor 281 is fixedly connected to the sheath-core interface 27, and the gear is connected to the output shaft of the seventh driving motor 281 and rotates therewith. Under the action of the seventh driving motor 281, the gear rotates and moves along the rack 253 along the first direction, so as to drive the sheath-core interface 27 to move back and forth along the second direction, and further enable the sheath core 26 to feed or retract relative to the catheter 20.
In other embodiments, the sheath-core interface 27 may be connected to a rack; the seventh driving motor 281 is fixedly disposed on the second supporting seat 250, an output shaft thereof is connected with a gear, and a rack is engaged with the gear. Under the action of the seventh driving motor 281, the gear rotates and drives the rack to reciprocate along a straight line, so as to drive the sheath-core interface 27 to move back and forth along the second direction, and further enable the sheath core 26 to feed or retract relative to the catheter 20.
In another embodiment, the second support 250 is provided with a sliding rail 251 and a third sliding block 252 matched with the sliding rail 251, and the sliding rail 251 extends along the second direction. The sheath core interface 27 is fixedly connected with the third sliding block 252, and moves back and forth along the sliding rail 251, so that the stability of movement of the sheath core 27 and the stress balance are improved.
The seventh driving motor 281 may be a linear motor providing a linear reciprocating motion to the moving member 282. In other embodiments, the seventh driving motor 281 may be replaced with a cylinder or an oil cylinder to directly provide the linear reciprocating motion.
As shown in fig. 10a, a force sensing module 254 is further disposed in the driving direction of the feeding and retracting of the catheter 20 of the second support base 250, and is configured to detect the force applied to the distal end of the catheter 20, monitor the pushing force and the retracting pulling force of the feeding of the catheter 20 in real time, and output the detected contact force data, for example, feedback to the doctor by communication or the like, so as to avoid the catheter 20 from injuring the operation object and damaging the tissue or organ of the operation object. Specifically, the second support 250 is provided with a first fixing frame 255 and a second fixing frame 256 at intervals, and the catheter fixing frame 260 is slidably connected with the first and second fixing frames 255 and 256, so that the catheter 20 and the catheter fixing frame 260 can move integrally relative to the first and second fixing frames 255 and 256 on the second support 250. Correspondingly, two ends of the second support 261 of the catheter holder 260 are respectively provided with a first connecting portion 268 and a second connecting portion 269, the force sensing module 254 is arranged along the axial direction of the catheter handle 22, one end of the force sensing module, which is close to the operation object, is in sliding connection with the catheter holder 260 through the first connecting portion 268, and one end, which is far away from the operation object, is fixedly connected with the second support 250 through the first holder 255, and the second holder 256 is in sliding connection with the second connecting portion 269.
In one embodiment, one of the second fixing frame 256 and the second connecting portion 269 is provided with a shaft 258, and the other one of the second fixing frame 256 and the second connecting portion 269 is provided with a bearing 259 to cooperate with the shaft 258, and an axial direction of the shaft 258 is parallel to the first direction and the second direction. When the distal end of the catheter 20 is in contact with tissue, the contact force is transmitted to the catheter handle 22 and the catheter holder 260 for fixing the catheter handle 22 through the catheter body of the catheter 20, and then transmitted to the force sensing module 254 through the first connecting portion 268 of the catheter holder 260, in which process the force sensing module 254 can detect and feed back the contact force received to monitor the abnormality of the interventional instrument in real time.
As shown in fig. 12 and 13, a guide wire 29 can be movably arranged in the catheter body of the catheter 20 to provide guiding and supporting functions for the intervention of other instruments. The slave drive control device accordingly also includes a guidewire drive module 290. A guidewire drive module 290 is coupled to the proximal end of the guidewire 29 and is configured to drive the distal end of the guidewire 29 to extend or retract the catheter 20. The guide wire driving module 290 includes an eighth driving motor 291, a mounting base 292, and a pair of friction wheels, i.e., a driving friction wheel 293 and a driven friction wheel 294, disposed in the mounting base 292. The driving friction wheel 293 is in driving connection with the eighth driving motor 291, the driven friction wheel 294 is slidably disposed in the mounting base 292, and the guide wire 29 is clamped between the driving friction wheel 293 and the driven friction wheel 294.
In one embodiment, an elastic member is disposed between the driven friction wheel 294 and the mounting base 292, and the elastic member includes a coil spring or the like, and forms a pre-tightening force on the driven friction wheel 294 to move toward the driving friction wheel 293, so as to clamp the guide wire 29. Preferably, a sliding block 296 is disposed in the mounting seat 292, the sliding block 296 is sleeved on one side of the driven friction wheel 294 opposite to the driving friction wheel 293, a guide rod 297 is connected between the mounting seat 292 and the sliding block 296, and an elastic member is sleeved on the guide rod 297. In the embodiment shown in fig. 14, two guide bars 297 are symmetrically arranged to make the stress of the sliding block 296 more uniform; in the embodiment shown in fig. 15, the guide bar 297 is single and is disposed opposite the center of the slider 296. The sliding block 296 is pushed away from the guide wire, so that the guide wire 29 can be conveniently installed and removed, and the instrument can be conveniently replaced in the operation process.
The slave end driving control device provided by the application can be applied to mechanical control operation of various instruments in interventional operation treatment, can realize independent control and joint control of various instruments such as a sheath tube, a catheter or a guide wire, can operate various operation modes, and has a wider application range. It will be appreciated that the interventional procedure may be an endovascular procedure, or may be a natural luminal intervention of various human or animal subjects, such as an digestive tract intervention, etc. In some embodiments, the slave-end driving control device provided by the application can complete atrial septum penetration and ablation operations to perform atrial fibrillation treatment, and the specific operation process comprises the following steps: the guide wire driving module 290 axially advances the guide wire 29 to a proper position, the first driving mechanism 100 axially advances the sheath 10 and the dilator along the guide wire 29 to the superior vena cava, the guide wire 29 is removed, the second driving mechanism 200 is advanced into the atrial septum puncture needle along the sheath 10, the position of the distal end of the fixed sheath 10 is adjusted through advancing and retreating and rotating two degrees of freedom, or the adjustable bending sheath 10 is adjusted by the first bending module 170, mechanical or energy atrial septum puncture is performed after the oval fossa and the puncture point are positioned, the first driving mechanism 100 continues to axially advance the sheath 10 and the dilator, the puncture needle is axially withdrawn by the second driving mechanism 200, the ablation catheter 20 is replaced on the second driving mechanism 200 to axially advance and position the pulmonary vein in cooperation with the adjustment bending of the sheath 10, ablation is performed, and for the distal end deformable ablation catheter 20, the skeleton shape of the distal end of the catheter 20 can be adjusted by controlling the axial advance and retreat of the sheath core 26, so as to realize a better therapeutic function by fitting tissues. The slave-end driving control device provided by the application can complete operation through machine control, and has wider applicability.
The application provides a slave end driving control device, which is provided with a first driving mechanism 100 and a second driving mechanism 200 corresponding to a sheath tube 10 and a catheter 20 respectively, so that the sheath tube 10 and the catheter 20 can have a plurality of degrees of freedom, can respectively realize operations such as movement, rotation, bending adjustment and the like, can conveniently adjust the position and the posture of the distal end of the catheter 20 in the use process, and mutually coordinates the movement of the catheter 20 and the sheath tube 10, so that the distal end of the catheter 20 can efficiently and accurately reach the preset position in an operation object body, thereby implementing corresponding operation. Meanwhile, the whole slave-end driving control device realizes decoupling of various operations of various medical instruments, the operation is more visual, the control is more convenient, and the learning and culturing cost is reduced.
It should be noted that the present application is not limited to the above embodiments, and those skilled in the art can make other changes according to the inventive spirit of the present application, and these changes according to the inventive spirit of the present application should be included in the scope of the present application as claimed.
Claims (20)
1. A slave drive control device for driving a sheath and a catheter movably disposed in the sheath, the slave drive control device comprising a first drive mechanism coupled to a proximal end of the sheath and a second drive mechanism coupled to the proximal end of the catheter, the first drive mechanism comprising a first linear module configured to drive the sheath to move back and forth along a first axis and a first rotational module configured to drive the sheath to rotate about the first axis; the second drive mechanism includes a second linear module configured to drive the catheter to move back and forth along a second axis and a second rotational module configured to drive the catheter to rotate about the second axis.
2. The slave drive control apparatus of claim 1, wherein the first axis and the second axis are not collinear.
3. The slave-end drive control apparatus of claim 1, wherein the first linear module includes a first drive motor and a first screw assembly coupled to an output shaft of the first drive motor, the first screw assembly including a first screw and a first moving element threadedly coupled to the first screw, a direction of movement of the first moving element being parallel to the first axis.
4. A slave end drive control device according to claim 3, wherein the sheath proximal end is provided with a sheath handle, the first rotary module comprises a second drive motor, a first motor support and a first swing arm connected to an output shaft of the second drive motor, the first motor support is fixedly connected to the first moving element, the first swing arm is connected to a first support base, and the sheath handle is detachably connected to the first support base.
5. The slave-end drive control device of claim 4, wherein a first bend knob is disposed above the sheath handle housing, the first drive mechanism further comprising a first bend module configured to drive the sheath distal end to bend laterally relative to an axial direction thereof; the first bending adjustment module comprises a third driving motor, a first rotary actuating piece and a first transmission assembly, wherein the third driving motor is fixedly connected to the first supporting seat, the first transmission assembly is arranged between the third driving motor and the first rotary actuating piece, and the first rotary actuating piece is connected with the first bending adjustment knob in a matched mode.
6. The slave drive control apparatus of claim 5, wherein the first transmission assembly comprises a first transmission element and a second transmission element intermeshed, the first transmission element being coupled to the output shaft of the third drive motor, the second transmission element being disposed coaxially with the first rotary actuator, at least one of the first transmission element and the second transmission element being a bevel gear.
7. The slave end drive control device of claim 5, wherein the first rotary actuator is a shaft-like structure having a non-circular cross-section, the first turn knob has a non-circular aperture, and the first rotary actuator and the first turn knob are circumferentially limited by a form fit.
8. The slave-end drive control apparatus according to claim 1, wherein the second linear module includes a fourth drive motor and a second screw assembly connected to an output shaft of the fourth drive motor, the second screw assembly including a second screw and a second moving element screwed to the second screw, a moving direction of the second moving element being parallel to the second axis.
9. The slave-end drive control device of claim 8, wherein the catheter proximal end is provided with a catheter handle, the second rotation module comprises a fifth drive motor, a second motor support and a second swing arm connected with an output shaft of the fifth drive motor, the second motor support is fixedly connected with the second moving element, the second swing arm is connected with a second support seat, and the catheter handle is detachably connected to the second support seat through a catheter fixing frame.
10. The slave drive control device of claim 9, wherein the second drive mechanism further comprises a force sensing module disposed in a direction parallel to the second axis, the force sensing module configured to capture a contact force of the distal end of the catheter.
11. The slave drive control device of claim 10, wherein the second support base is provided with a first fixing frame and a second fixing frame at intervals, the catheter fixing frame is provided with a first connecting portion and a second connecting portion along the axial extension, one end of the force sensing module is fixedly connected with the second support base through the first fixing frame, the other end of the force sensing module is slidably connected with the catheter fixing frame through the first connecting portion, and the second fixing frame is slidably connected with the second connecting portion.
12. The slave drive control apparatus according to claim 11, wherein one of the second mount and the second connection portion is provided with a shaft, the other of which is provided with a bearing fitted to the shaft, and an axis direction of the shaft is parallel to the second axis direction.
13. The slave end drive control device of claim 9, wherein a second bend knob is disposed above the catheter handle housing, the second drive mechanism further comprising a second bend module configured to drive the catheter distal end to bend laterally relative to its axis; the second bending adjustment module comprises a sixth driving motor, a second rotary actuating piece and a second transmission assembly, wherein the sixth driving motor is fixedly connected to the second supporting seat, the second transmission assembly is arranged between the sixth driving motor and the second rotary actuating piece, and the second rotary actuating piece is connected with the second bending adjustment knob in a matched mode.
14. The slave drive control apparatus of claim 13, wherein the second transmission assembly includes a third transmission element and a fourth transmission element intermeshed, the third transmission element being coupled to the output shaft of the sixth drive motor, the fourth transmission element being disposed coaxially with the second rotary actuator, at least one of the third transmission element and the fourth transmission element being a bevel gear.
15. The slave end drive control device of claim 13, wherein the second rotary actuator is a shaft-like structure having a non-circular cross-section, the second turn knob has a non-circular aperture, and the second rotary actuator and the second turn knob are circumferentially limited by a form fit.
16. The slave drive control device of claim 9, wherein a sheath core is disposed within the tube of the catheter and is movable relative to the tube of the catheter, the second drive mechanism further comprising a sheath core drive module configured to drive the sheath core to move to change the shape of the distal end of the catheter.
17. The slave-end drive control device of claim 16, wherein the sheath-core drive module comprises a seventh drive motor and a displacement member driven by the seventh drive motor, the displacement member being coupled to the sheath-core proximal end via a sheath-core interface.
18. The slave drive control device of claim 1, wherein a guidewire is movably disposed through the catheter, the slave drive control device further comprising a guidewire drive module coupled to a proximal end of the guidewire, the guidewire drive module configured to drive the guidewire to advance and retract.
19. The slave-end drive control device of claim 18, wherein the guidewire drive module comprises an eighth drive motor, a pair of friction wheels drivingly connected to the eighth drive motor, and a mount to which the pair of friction wheels are mounted, the pair of friction wheels comprising a driving friction wheel drivingly connected to the eighth drive motor and a driven friction wheel slidingly disposed within the mount, and an elastic member is disposed between the driven friction wheel and the mount.
20. The slave drive control device of claim 19, wherein a slider is disposed in the mounting base, the slider is sleeved on a side of the driven friction wheel facing away from the driving friction wheel, and a guide rod is connected between the mounting base and the slider.
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