A rapid clamping and control device for a ureteral flexible endoscope
By designing quick clamping and control devices for clamping, rotation and feeding components of ureteroscopes, the complex problem of ureteroscope clamping is solved, improving surgical efficiency and safety, and reducing patient pain and infection risk.
Patent Information
- Application Number
- CN202411125557.8
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- Filing Date
- 2024-08-16
- Publication Date
- 2025-07-18
- Estimated Expiration
- 2044-08-16
AI Technical Summary
In the prior art, the clamping and control process of ureteroscopes is complicated, resulting in low surgical efficiency, high cost, long time, and great pain in patients.
A quick clamping and control device including a clamping assembly, a rotating assembly and a feed assembly are designed to achieve rapid clamping of the ureteroscope through the clamping member, the rotating member adjusts the angle, and the feed member automatically delivers the laser guide wire to simplify the operation process.
It improves the accuracy of equipment positioning and operation efficiency, reduces the surgical time, reduces the risk of complications in patients, reduces the probability of cross-infection, and simplifies the surgical steps of doctors.
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Figure CN118766399B_ABST
Abstract
Description
Technical Field
[0001] The invention relates to the technical field of medical instruments, and in particular to a quick clamping and control device for a ureteroscope. Background Art
[0002] Urethra ureteroscope is a medical device used for the diagnosis and treatment of urinary system diseases. Combined with holmium laser lithotripsy, it can effectively treat upper urinary tract diseases such as urinary tract stones and urothelial tumors. Due to its low trauma and definite effect, ureterhra ureteroscope is increasingly widely used in my country and has become an important treatment method in the field of urology.
[0003] Currently, during the operation, multiple steps must be performed to place the soft endoscope to the predetermined position in the body, including adjustment of the laser guide wire, angle adjustment and fixed installation of the ureteroscope surgical robot, etc., which requires repeated confirmation and assurance by the doctor, resulting in low work efficiency, high surgical costs, long operation time, and physical and mental pain for the patient.
[0004] Therefore, providing an auxiliary device to help doctors quickly clamp and control the ureteroscope has become a technical problem that needs to be solved urgently by those skilled in the art. Summary of the invention
[0005] The object of the present invention is to provide a quick clamping and controlling device for a ureteroscope to solve the problems existing in the above-mentioned prior art.
[0006] To achieve the above object, the present invention provides the following solution: The present invention provides a quick clamping and control device for a ureteroscope, comprising:
[0007] The clamping assembly comprises a fixing frame and a clamping member, wherein the fixing frame is mounted on the surgical robot platform, and the clamping member is arranged on one side of the fixing frame and is used to control the fixing frame to clamp the ureteroscope;
[0008] A rotating assembly, comprising a fixed connecting plate and a rotating member, wherein the fixed connecting plate is fixedly connected to a side of the fixing frame away from the clamping member, and the rotating member is arranged on the fixed connecting plate and is used to adjust the angle of the ureteroscope;
[0009] The feeding assembly includes a fixed column and a conveying member, wherein the fixed column is fixedly connected to a side of the fixed frame away from the clamping member, and the conveying member is arranged on the fixed column for conveying a laser guide wire, and the laser guide wire is connected to the ureteroscope.
[0010] Preferably, the fixing bracket includes a left clamping plate and a right clamping plate. The clamping member includes one end of a hinge stud fixedly connected to the right clamping plate. The left clamping plate is slidably connected to the hinge stud. The other end of the hinge stud passes through the left clamping plate and is rotatably connected to a clamping handle. A clamping pressure block is sleeved on the hinge stud and is configured to push the clamping pressure block against the left clamping plate when the clamping handle rotates, so that the ureteral soft tube endoscope is clamped between the left clamping plate and the right clamping plate.
[0011] Preferably, the rotating member includes a synchronous belt device provided on the fixed connection plate. An angle adjustment motor is provided at the bottom of the fixed connection plate. The synchronous belt device is in transmission connection with the angle adjustment motor. A rotating handle connecting member is provided at the top of the fixed connection plate. The rotating handle connecting member is in transmission connection with the synchronous belt device. A rotating handle is fixedly connected to the rotating handle connecting member. The ureteral soft tube endoscope is in contact with the rotating handle.
[0012] Preferably, the conveying member includes a motor fixing plate fixedly connected to the fixed column. A worm and gear motor is fixedly connected to the motor fixing plate. The output end of the worm and gear motor is connected to a guide wire conveying driving wheel. A guide wire conveying driven wheel is installed on the worm and gear motor through a driven wheel fixing bracket. The laser guide wire is located between the guide wire conveying driving wheel and the guide wire conveying driven wheel.
[0013] Preferably, the synchronous belt device includes a driven wheel and a driving wheel rotatably connected to the fixed connection plate. The driven wheel and the driving wheel are in transmission connection through a synchronous belt. The driven wheel is connected to the rotating handle connecting member. The driving wheel is connected to the output shaft of the angle adjustment motor.
[0014] Preferably, the left clamping plate and the right clamping plate are spliced by a stepped structure.
[0015] Preferably, one end of the clamping handle close to the hinge stud is an eccentric wheel structure.
[0016] Preferably, a driven wheel fixing shell is fixedly connected to the driven wheel fixing bracket. The driven wheel fixing shell covers the guide wire conveying driven wheel.
[0017] Preferably, the laser guide wire is connected to the ureteral soft tube endoscope through a three-way joint.
[0018] Preferably, arc-shaped grooves are formed on the guide wire conveying driving wheel and the guide wire conveying driven wheel. The arc-shaped grooves are adapted to the laser guide wire.
[0019] Compared with the prior art, the present invention has the following advantages and technical effects:
[0020] A rapid clamping and control device for an ureteral flexible endoscope provided by the present invention realizes the rapid clamping of the ureteral flexible endoscope through the provided clamping member. The fixing structure is stable and reliable, the installation is convenient and rapid, which greatly improves the positioning accuracy and operation efficiency of the equipment, reduces the operation duration, and reduces the risk of patient complications. The angle of the ureteral flexible endoscope can be flexibly adjusted through the provided rotating member to adapt to the physical conditions of various patients. The automatic replenishment and feeding of the laser guide wire can be realized through the provided conveying member, eliminating the operation of the doctor on the laser guide wire during the operation and reducing the operation time. The structure of the present invention is simple, the operation is convenient, the operation steps of the doctor are reduced, the operation time is reduced, thereby reducing the degree of damage to the patient's body and the probability of cross-infection. BRIEF DESCRIPTION OF THE DRAWINGS
[0021] In order to more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the following will briefly introduce the drawings required for use in the embodiments. Obviously, the following described drawings are only some embodiments of the present invention. For those of ordinary skill in the art, without creative efforts, other drawings can be obtained based on these drawings:
[0022] Figure 1 Schematic diagram of the rapid clamping mechanism part of the present invention;
[0023] Figure 2 Schematic diagram of the flexible endoscope rotating mechanism part of the present invention;
[0024] Figure 3 Schematic diagram of the guide wire feeding mechanism part of the present invention;
[0025] Figure 4 Front view of the rapid clamping and control mechanism of the present invention;
[0026] Figure 5 Left view of the rapid clamping and control mechanism of the present invention;
[0027] Figure 6 Right view of the rapid clamping and control mechanism of the present invention;
[0028] Figure 7 Top view of the rapid clamping and control mechanism of the present invention;
[0029] Figure 8 Schematic diagram of the working state of the present invention;
[0030] Among them, 1. Clamping handle; 2. Hinge stud; 3. Clamping block; 4. Fixing bracket; 41. Left clamping plate; 42. Right clamping plate; 5. Rotating handle connecting piece; 6. Rotating handle; 7. Angle adjustment motor; 8. Bearing end cover; 9. Fixed connecting plate; 10. Synchronous belt device; 101. Driven pulley; 102. Synchronous belt; 103. Driving pulley; 11. Guide wire conveying driving pulley; 12. Guide wire conveying driven pulley; 13. Motor fixing plate; 14. Worm and worm gear motor; 15. Driven pulley fixing bracket; 16. Driven pulley fixing shell; 17. Fixed column; 18. Laser guide wire; 19. Three-way joint; 20. Ureteral flexible endoscope. Detailed implementation manners
[0031] Next, the technical solutions in the embodiments of the present invention will be clearly and completely described in conjunction with the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. All other embodiments obtained by those of ordinary skill in the art based on the embodiments of the present invention without creative efforts shall fall within the protection scope of the present invention.
[0032] To make the above objects, features and advantages of the present invention more obvious and understandable, the present invention will be further described in detail below in conjunction with the accompanying drawings and specific implementation manners.
[0033] Referring to Figures 1-8 , the present invention provides a quick clamping and control device for a ureteral flexible endoscope, including:
[0034] A clamping assembly, including a fixing bracket 4 and a clamping member. The fixing bracket 4 is installed on the surgical robot platform, and the clamping member is arranged on one side of the fixing bracket 4 for controlling the fixing bracket 4 to clamp the ureteral flexible endoscope 20;
[0035] A rotating assembly, including a fixed connecting plate 9 and a rotating member. The fixed connecting plate 9 is fixedly connected to the side of the fixing bracket 4 away from the clamping member, and the rotating member is arranged on the fixed connecting plate 9 for adjusting the angle of the ureteral flexible endoscope 20;
[0036] A feeding assembly, including a fixed column 17 and a conveying member. The fixed column 17 is fixedly connected to the side of the fixing bracket 4 away from the clamping member, and the conveying member is arranged on the fixed column 17 for conveying the laser guide wire 18, and the laser guide wire 18 is connected to the ureteral flexible endoscope 20.
[0037] For a further optimized solution, the fixing bracket 4 includes a left clamping plate 41 and a right clamping plate 42. The clamping member includes one end of the hinge stud 2 fixedly connected to the right clamping plate 42. The left clamping plate 41 is slidably connected to the hinge stud 2. The other end of the hinge stud 2 passes through the left clamping plate 41 and is rotatably connected to a clamping handle 1. A clamping pressure block 3 is sleeved on the hinge stud 2 and is configured to push the clamping pressure block 3 against the left clamping plate 41 when the clamping handle 1 rotates, so that the ureteral flexible endoscope 20 is clamped between the left clamping plate 41 and the right clamping plate 42.
[0038] In an embodiment of the present invention, the hinge stud 2 is an M6 hinge stud with a length of 50 mm, wherein the threaded length is 25 mm. There is a through hole in the middle of the clamping pressure block 3. Through the hinge stud 2, the part cooperating with the clamping handle 1 adopts an arc structure. The fixing bracket 4 is composed of a left clamping plate 41 and a right clamping plate 42. There is an installation hole for the hinge stud 2 on the left clamping plate 41. In addition to the installation hole for the hinge stud 2, the right clamping plate 42 correspondingly has installation holes for the fixed column 17 and the fixed connection plate 9.
[0039] Specifically, the installation hole for the hinge stud 2 on the left clamping plate 41 is a through hole, and its diameter is slightly larger than the diameter of the hinge stud 2, ensuring that the left clamping plate 41 can adjust the distance between the left clamping plate 41 and the right clamping plate 42 through axial movement, facilitating the installation of the ureteral flexible endoscope 20.
[0040] Specifically, the installation hole for the hinge stud 2 on the right clamping plate 42 is a threaded hole for threaded connection with the hinge stud 2. During operation, the right clamping plate 42 and the hinge stud 2 are fixed.
[0041] For a further optimized solution, the rotating member includes a synchronous belt device 10 arranged on the fixed connection plate 9. An angle adjustment motor 7 is arranged at the bottom of the fixed connection plate 9. The synchronous belt device 10 is in transmission connection with the angle adjustment motor 7. A handle connecting member 5 is arranged at the top of the fixed connection plate 9. The handle connecting member 5 is in transmission connection with the synchronous belt device 10. A handle 6 is fixedly connected to the handle connecting member 5. The ureteral flexible endoscope 20 is in contact with the handle 6.
[0042] In an embodiment of the present invention, the angle adjustment motor 7 is a stepper motor, which is simple to control and has high precision; for the synchronous belt device 10, the synchronous belt device 10 is composed of a driven wheel 101, a synchronous belt 102, and a driving wheel 103. The center distance between the driven wheel 101 and the driving wheel 103 is 45 mm. There is a hole in the middle of the handle connecting member 5, which is concentrically matched with the output shaft of the driven wheel 101. At the same time, it is locked with the shaft by the pre-tightening force applied by bolts on both sides. The handle 6 is fixedly connected to the handle connecting member 5 by bolts and rotates together with the handle connecting member 5.
[0043] Specifically, the fixed connecting plate 9 has four working holes, of which the two through holes on the left are used for fixed connection with the mounting holes on the right rear side of the fixing frame 4; the central stepped hole in the upper right corner is used for installing and placing the rolling bearing, and one side of the bearing is positioned by the shoulder of the stepped hole, while increasing the stiffness of the output shaft of the handle connector 5 and the driven wheel 101, and the small holes around it are used to fix the bearing end cover 8 and to position the bearing on the other side, and the lower right central through hole is used for adjusting the output shaft of the motor 7 by angle, and the small holes around it are used to fix the angle adjustment motor 7, and the fixed connecting plate 9 adopts a hollow structure in the middle to facilitate wiring.
[0044] A further optimized solution is that the conveying member includes a motor fixing plate 13 fixedly connected to a fixing column 17, a worm gear motor 14 is fixedly connected to the motor fixing plate 13, an output end of the worm gear motor 14 is connected to a guide wire conveying active wheel 11, a guide wire conveying driven wheel 12 is installed on the worm gear motor 14 through a driven wheel fixing frame 15, and the laser guide wire 18 is located between the guide wire conveying active wheel 11 and the guide wire conveying driven wheel 12.
[0045] In one embodiment of the present invention, there are three through holes on the fixing column 17, which is arranged on the right front side of the fixing frame 4. The worm gear motor 14 is fixed to the fixing column 17 through the motor fixing plate 13. The guide wire conveying active wheel 11 is directly interference fit with the output shaft of the worm gear motor 14. The driven wheel fixing frame 15 is fixed on the output side of the worm gear motor 14, and a boss is designed for installing the guide wire conveying driven wheel 12. The boss has a 45° inclined surface, and there are two locating pin holes and two threaded holes diagonally on the inclined surface, and an arc groove is provided in the middle of the inclined surface; the driven wheel fixing frame 15 is fixed by threaded connection after being positioned by the locating pin, and a circular arc groove identical to that of the driven wheel fixing frame 15 is provided in the middle of the mating surface. At the same time, two small holes are opened on the side of the driven wheel fixing shell 16 for fixing with the guide wire conveying driven wheel 12 through a fixing pin. The guide wire conveying driving wheel 11 and the guide wire conveying driven wheel 12 are used for feeding and replenishment. The guide wire conveying driving wheel 11 is driven to rotate by the worm gear motor 14. Due to the effect of friction, the guide wire conveying driven wheel 12 will also rotate. At this time, the laser guide wire 18 sandwiched between the two rollers starts to feed forward, thereby realizing stable feeding of the laser guide wire 18.
[0046] A further optimized solution is that the synchronous belt device 10 includes a driven wheel 101 and a driving wheel 103 rotatably connected to the fixed connecting plate 9, the driven wheel 101 and the driving wheel 103 are connected through a synchronous belt 102, the driven wheel 101 is connected to the handle connecting piece 5, and the driving wheel 103 is connected to the output shaft of the angle adjustment motor 7.
[0047] In one embodiment of the present invention, the angle adjustment motor 7 drives the driving wheel 103 to rotate. When the driving wheel 103 rotates, it drives the driven wheel 101 to rotate through the provided synchronous belt 102, and further drives the rotating handle 6 to rotate through the provided angle adjustment motor 7.
[0048] In a further optimized solution, the left clamping plate 41 and the right clamping plate 42 are spliced using a stepped structure.
[0049] In one embodiment of the present invention, through the provided stepped structure splicing, relative rotation caused by the clearance fit between the left clamping plate 41 and the right clamping plate 42 is prevented.
[0050] In a further optimized solution, one end of the clamping handle 1 close to the hinge stud 2 has an eccentric wheel structure.
[0051] In one embodiment of the present invention, the clamping handle 1 is divided into a handle part and a rotating part. The rotating part has an eccentric wheel structure. The end farther from the rotation center is called the distal end, which contacts the clamping block 3 during clamping. The end closer to the rotation center is called the proximal end, which leaves a certain gap from the clamping block 3 when loosening, for the axial adjustment of the left clamping plate 41.
[0052] In a further optimized solution, a driven wheel fixing shell 16 is fixedly connected to the driven wheel fixing frame 15, and the driven wheel fixing shell 16 covers the wire guiding driven wheel 12.
[0053] In one embodiment of the present invention, the driven wheel fixing shell 16 is used to cover the wire guiding driven wheel 12.
[0054] In a further optimized solution, the laser wire 18 is connected to the disposable ureteral flexible endoscope 20 through a three-way joint 19.
[0055] In one embodiment of the present invention, the laser wire 18 starts to feed forward, enters the disposable ureteral flexible endoscope 20 through the three-way joint 19 channel, and realizes the stable feeding of the laser wire 18.
[0056] In a further optimized solution, arc-shaped grooves are provided on the wire guiding driving wheel 11 and the wire guiding driven wheel 12, and the arc-shaped grooves are adapted to the laser wire 18.
[0057] In one embodiment of the present invention, the provided arc-shaped grooves are used to guide the laser wire 18 to pass smoothly.
[0058] The present invention provides a quick clamping and control device for a ureteral flexible endoscope. When in use:
[0059] Ureteral guide sheath installation:
[0060] Adjust the height of the surgical robot according to the patient's physical condition, and position the distal end of the ureteral guiding sheath into the patient's urethra and ureter to facilitate the smooth insertion of the ureteral flexible endoscope.
[0061] Installation of the flexible endoscope:
[0062] In the initial state, the rotating part of the clamping handle 1 does not contact the clamping block 3, and there is a certain gap between the proximal end and the clamping block 3 for the axial adjustment of the left splint 41. The left splint 41 has a clearance fit with the hinge stud 2, and the left splint 41 can move axially along the hinge stud 2, so that the distance between the left splint 41 and the right splint 42 can be adjusted to facilitate the insertion of the ureteral flexible endoscope 20. After inserting the ureteral flexible endoscope 20, rotate the clamping handle 1 clockwise. When the eccentric rotating part rotates to a certain angle, its distal end gradually contacts the clamping block 3, generating a clamping force. Continue to rotate the clamping handle 1, and the clamping force will gradually increase until the distal part is completely pressed into the clamping block 3 to reach the maximum clamping force, clamping the ureteral flexible endoscope 20. After the fixation is completed, introduce the flexible endoscope tube into the ureteral guiding sheath.
[0063] Adjustment of the flexible endoscope angle:
[0064] Start the angle adjustment motor 7. The angle adjustment motor 7 drives the driving wheel 103, the driven wheel 101, and the handle connecting piece 5 to rotate in sequence, and then the handle 6 and the ureteral flexible endoscope 20 rotate to adjust the angle of the flexible endoscope. When the position of the flexible endoscope is determined, the ureteral flexible endoscope lithotripsy surgery can be normally performed.
[0065] Feeding of the laser guide wire:
[0066] Install the guide wire conveying driving wheel 11 and the guide wire conveying driven wheel 12 in their corresponding positions. Before the surgery starts, place the laser guide wire 18 in the groove formed by the guide wire conveying driving wheel 11 and the guide wire conveying driven wheel 12 to ensure the correct positioning of the laser guide wire 18 and prepare it for feeding. Start the worm and gear motor 14 to drive the guide wire conveying driving wheel 11 to rotate. Due to the action of friction, the guide wire conveying driven wheel 12 will also rotate. At this time, the laser guide wire 18 clamped between the two rollers starts to feed forward and enters the disposable ureteral flexible endoscope 20 through the channel of the three-way joint 19, realizing the stable feeding of the laser guide wire 18.
[0067] In the description of the present invention, it should be understood that the orientation or positional relationship indicated by the terms "longitudinal", "transverse", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present invention, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be construed as a limitation to the present invention.
[0068] The embodiments described above are only descriptions of the preferred embodiments of the present invention, and do not limit the scope of the present invention. Without departing from the design spirit of the present invention, various deformations and improvements made by those of ordinary skill in the art to the technical solutions of the present invention shall fall within the protection scope determined by the claims of the present invention.
Claims
1. A quick clamping and control device for a ureteral flexible endoscope, characterized in that, Comprising: A clamping assembly, including a fixing bracket (4) and a clamping member. The fixing bracket (4) is installed on the surgical robot platform, and the clamping member is arranged on one side of the fixing bracket (4) for controlling the fixing bracket (4) to clamp the ureteral flexible endoscope (20); A rotating assembly, including a fixed connecting plate (9) and a rotating member. The fixed connecting plate (9) is fixedly connected to the side of the fixing bracket (4) away from the clamping member, and the rotating member is arranged on the fixed connecting plate (9) for adjusting the angle of the ureteral flexible endoscope (20); A feeding assembly, including a fixed column (17) and a conveying member. The fixed column (17) is fixedly connected to the side of the fixing bracket (4) away from the clamping member, and the conveying member is arranged on the fixed column (17) for conveying the laser guide wire (18), and the laser guide wire (18) is connected to the ureteral flexible endoscope (20); The rotating member includes a synchronous belt device (10) arranged on the fixed connecting plate (9). An angle adjustment motor (7) is arranged at the bottom of the fixed connecting plate (9). The synchronous belt device (10) is in transmission connection with the angle adjustment motor (7). A handle connecting member (5) is arranged at the top of the fixed connecting plate (9). The handle connecting member (5) is in transmission connection with the synchronous belt device (10). A handle (6) is fixedly connected to the handle connecting member (5), and the ureteral flexible endoscope (20) is in contact with the handle (6); The synchronous belt device (10) includes a driven pulley (101) and a driving pulley (103) rotatably connected to the fixed connecting plate (9). The driven pulley (101) and the driving pulley (103) are in transmission connection through a synchronous belt (102). The driven pulley (101) is connected to the handle connecting member (5), and the driving pulley (103) is connected to the output shaft of the angle adjustment motor (7); The conveying member includes a motor fixing plate (13) fixedly connected to the fixed column (17). A worm and gear motor (14) is fixedly connected to the motor fixing plate (13). The output end of the worm and gear motor (14) is connected to a guide wire conveying driving pulley (11). A guide wire conveying driven pulley (12) is installed on the worm and gear motor (14) through a driven pulley fixing bracket (15). The laser guide wire (18) is located between the guide wire conveying driving pulley (11) and the guide wire conveying driven pulley (12); A driven pulley fixing shell (16) is fixedly connected to the driven pulley fixing bracket (15), and the driven pulley fixing shell (16) covers the guide wire conveying driven pulley (12).
2. The quick clamping and control device for a ureteral flexible endoscope according to claim 1, characterized in that: The fixing bracket (4) includes a left clamping plate (41) and a right clamping plate (42). The clamping member includes one end of a hinge stud (2) fixedly connected to the right clamping plate (42). The left clamping plate (41) is slidably connected to the hinge stud (2). The other end of the hinge stud (2) passes through the left clamping plate (41) and is rotatably connected to a clamping handle (1). A clamping pressure block (3) is sleeved on the hinge stud (2) and is configured to push the clamping pressure block (3) against the left clamping plate (41) when the clamping handle (1) rotates, so that the ureteral flexible endoscope (20) is clamped between the left clamping plate (41) and the right clamping plate (42).
3. The quick clamping and control device for a ureteral flexible endoscope according to claim 2, characterized in that: The left clamping plate (41) and the right clamping plate (42) are spliced by a stepped structure.
4. A quick clamping and control device for a ureteral flexible endoscope according to claim 2, characterized in that: One end of the clamping handle (1) close to the hinge stud (2) is an eccentric wheel structure.
5. The quick clamping and control device for a ureteral flexible endoscope according to claim 1, characterized in that: The laser guide wire (18) is connected to the ureteral flexible endoscope (20) through a three-way joint (19).
6. The quick clamping and control device for a ureteral flexible endoscope according to claim 1, characterized in that: Arc-shaped grooves are formed on the wire conveying driving wheel (11) and the wire conveying driven wheel (12), and the arc-shaped grooves are adapted to the laser guide wire (18).
Citation Information
Patent Citations
Flexible ureteroscope surgical robot with multiple instruments cooperatively operated
CN118304000A