Device for moving a medical object and method for providing a signal

Abstract

The invention relates to a device for moving a medical object, the device comprising a moving device and a sensor unit, wherein the moving device is designed to hold and / or move a medical object at least partially arranged in the moving device by transmitting a force, wherein the sensor unit is designed to detect a reaction force exerted by the medical object on the moving device and directed opposite to the force, wherein the medical object is at least partially arranged in an object to be examined, wherein the device is designed to provide a signal as a function of the reaction force, wherein the moving device is designed to move the medical object as a function of the signal. The invention also relates to a system, a method for providing a signal, a method for controlling a trimming unit and a computer program product.

Description

Technical Field

[0001] The invention relates to a device, a system, a method for providing a signal, a method for controlling a trimming unit and a computer program product for moving a medical object. Background Art

[0002] Interventional medical procedures in and / or on a hollow organ of the subject usually require that a medical object be introduced into the hollow organ, in particular percutaneously. In this case, the medical object can be designed, for example, as an especially elongated surgical instrument and / or diagnostic instrument. Furthermore, the hollow organ can be, for example, a blood vessel segment, in particular a vein and / or an artery, and / or the heart and / or lungs of the subject.

[0003] Furthermore, for successful diagnosis and / or treatment, it is usually necessary to move at least a part of the medical object towards the target area to be treated in the hollow organ, in particular in the blood vessel segment. When moving and / or positioning the medical object, it may happen that the medical object, in particular the distal area of ​​the medical object, hits an obstacle in the hollow organ. As a result, there may usually be a resistance, in particular a reaction force acting on the medical object, which is directed in the opposite direction to the force applied to the medical object by the user, for example. However, it is usually difficult for the user to recognize the reaction force and respond to it accordingly. If the reaction force is not noticed and / or is not taken into account in the further movement of the medical object, it may disadvantageously lead to penetration, in particular perforation, of the structure of the examination object and thus to damage.

[0004] Furthermore, friction between the medical object and the hollow organ may also cause reaction forces.Medical objects usually have hydrophilic and / or hydrophobic surfaces, depending on the application area, which can be adversely affected by external mechanical and / or chemical and / or electromagnetic effects.

[0005] From the literature of AJMMelcop "Vergleichende Untersuchung der Steifigkeit von minimally invasive Kathetersysteme-Experimentelle in-vitro-Studie an 21 -", a doctoral thesis from the University of Munich in 2018, found that the coefficient of friction of medical objects can be reduced by a factor of 2 due to a hydrophobic coating and by a factor of 3 due to a hydrophilic coating. In addition, the literature discloses that especially hydrophilic coatings can be slightly damaged.

[0006] This can disadvantageously result in increased friction between the medical object and the hollow organ, which generally requires increased forces for moving the medical object. As a result, the risk of injury to the object being examined is generally increased. Summary of the invention

[0007] The object of the present invention is therefore to enable a reliable and at the same time precise movement of a medical object.

[0008] This object is achieved according to the invention by a device for moving a medical object, a system, a method for providing a signal, a method for controlling a grooming unit and a computer program product.

[0009] In a first aspect, the present invention relates to a device for moving a medical object. The device comprises a moving device and a sensor unit. The moving device is designed to hold and / or move a medical object at least partially arranged in the moving device by transmitting a force, and the sensor unit is designed to detect a reaction force exerted by the medical object on the moving device and directed opposite to the force, wherein the medical object is at least partially arranged in an object to be examined. The device is designed to provide a signal according to the reaction force. The moving device is designed to move the medical object according to the signal.

[0010] Here, the medical object can be designed, for example, as an especially elongated surgical instrument and / or diagnostic instrument. The medical object can be especially flexible and / or rigid at least in sections. The medical object can be designed, for example, as a catheter and / or an endoscope and / or a guide wire.

[0011] Furthermore, the device can have a processing unit which is designed to control the device and / or its components, in particular a mobile device.

[0012] The mobile device can advantageously be a robot device designed for remote manipulation of a medical object, such as a catheter robot. Advantageously, the mobile device is arranged outside the object of examination. In addition, the mobile device can have a fixed element that is particularly movable and / or operable. In addition, the mobile device can have a cassette element designed to accommodate at least a portion of the medical object. In addition, the mobile device has a mobile element, which is fixed on a fixed element, such as a tripod and / or a robot arm. In addition, the fixed element can be designed to fix the mobile element on a patient support device. In addition, the mobile element can advantageously have at least one actuator element, such as a motor, wherein the processing unit is designed to control the actuator element. The cassette element can advantageously be coupled to the mobile element, in particular at least one actuator element, in particular mechanically and / or electromagnetically and / or pneumatically. Here, the cassette element can also have at least one transmission element, which can be moved by coupling between the cassette element and the mobile element, in particular at least one actuator element. The at least one transmission element can be particularly movably coupled to at least one actuator element. Advantageously, the transmission element is designed to transmit the movement of the actuator element, in particular the force, to the medical object in such a way that the medical object moves along the longitudinal extension direction of the medical object and / or rotates the medical object around its longitudinal extension direction. The at least one transmission element can, for example, have rollers and / or a screen and / or a shear plate. In addition, the transmission element can be designed to hold the medical object in a particularly stable manner by the transmission of force. Holding the medical object can in particular include positioning the medical object in a fixed position relative to the movement device.

[0013] Advantageously, the moving element can have a plurality of actuator elements, in particular independently controllable. In addition, the cassette element can have a plurality of transmission elements, in particular at least one transmission element coupled to movement for each actuator element. This can enable, in particular, independent and / or simultaneous movement of the medical object along different degrees of freedom of movement.

[0014] The medical object can advantageously be at least partially introduced into the examination object by means of an introduction sheath such that the distal region of the medical object, for example the tip, is arranged within the examination object. The examination object can be, for example, a human patient and / or an animal patient and / or a vascular model. Furthermore, the examination object can have hollow organs, for example, vascular segments, in particular veins and / or arteries, and / or a heart and / or a lung, in which the distal region of the medical object can be arranged.

[0015] The sensor unit can advantageously have a force receiver, which is designed to collect (erfassen) the reaction force applied to the force receiver by the medical object. The sensor unit can, for example, have an electromagnetic, especially capacitive and / or resistive and / or piezoelectric and / or electrodynamic, and / or mechanical and / or optical force receiver. In addition, the force receiver can be integrated at least partially in the actuator element and / or the transmission element, for example as a torque sensor. The reaction force can be directed in the opposite direction to the force used to hold and / or move the medical object, especially for the translation and / or rotation of the medical object. The sensor unit, especially the force receiver, can be designed to provide a sensor signal according to the collected reaction force. Here, the sensor signal can advantageously have information about the direction and / or value of the reaction force. In addition, the sensor signal can be time-resolved. The sensor signal can additionally have operating parameters of the mobile device and / or operating parameters of the medical object and / or physiological parameters of the examination object, especially as metadata.

[0016] The device, in particular the processing unit, can be designed to provide a signal based on the reaction force, in particular based on the sensor signal. The device can be designed in particular to provide the sensor signal as the signal. The signal can advantageously have information about the direction and / or value of the reaction force.

[0017] The mobile device can advantageously be designed to move the medical object according to the signal in such a way that the reaction force is reduced. To this end, the processing unit can be designed to compare the signal with a preset threshold value, wherein the mobile device can be designed to adapt or adjust the in particular current movement of the medical object according to the signal when the signal exceeds the threshold value. The mobile device can in particular be designed to slow down, in particular stop, the in particular current movement of the medical object when the reaction force is detected by means of the sensor unit. As an alternative or in addition, the mobile device can be designed to adjust the in particular current movement of the medical object according to the signal when the reaction force is detected by means of the sensor unit. For example, the mobile device can be designed to adjust, in particular reverse, the movement direction of the movement of the medical object according to the signal. In addition, the mobile device can be designed to adjust, in particular reduce, the movement speed of the movement of the medical object according to the signal.

[0018] The medical object can be designed to be deformable at least in sections, for example by means of a Bowden cable. The distal region of the medical object can be particularly deformable. In addition, the movement device can be designed to control at least a section-wise deformation of the medical object, in particular the distal region, according to the signal. This makes it possible to advantageously adapt the movement direction of the medical object to the distal region.

[0019] The proposed embodiment enables a particularly safe, in particular robotic, movement of a medical object by means of a movement device, wherein the movement of the medical object can be controlled and / or stopped when a reaction force is detected. This advantageously reduces the detected reaction force, thereby advantageously reducing the risk of injury to the subject under examination. Furthermore, the proposed device enables reliable detection of reaction forces, in particular relative to manual movement and / or holding of the medical object.

[0020] In another advantageous embodiment of the proposed device, the device may further comprise a processing unit and a reference unit. In addition, the medical object, in particular the distal region, may be arranged in a hollow organ of the object under examination. Here, the reference unit may be designed to acquire at least one friction coefficient of the medical object on the mobile device and / or the introduction sheath, which is used to introduce the medical object into the object under examination. In addition, the processing unit may be designed to simulate a virtual friction force between the medical object and the hollow organ according to the at least one friction coefficient. In addition, the processing unit may be designed to identify the friction force between the hollow organ and the medical object as the origin of the reaction force or to exclude the possibility of the friction force between the hollow organ and the medical object as the origin of the reaction force by comparing the reaction force with the virtual friction force. In addition, the processing unit may be designed to provide a signal according to the origin of the reaction force.

[0021] The reference unit can have, for example, a friction sensor and / or a surface sensor. Here, the friction sensor can have, for example, a friction wheel and / or a friction roller and / or a friction plate, which mechanically contacts the surface of the medical object on the introduction sheath and / or the moving device. The friction sensor can be designed to determine at least one friction coefficient by means of the friction resistance of the friction wheel and / or the friction roller and / or the friction plate relative to the surface of the medical object.

[0022] In a first variant, the friction sensor can be designed to transmit a reference force directed opposite to the force to the medical object by means of a friction wheel and / or a friction roller and / or a friction plate, wherein the sensor unit can also be designed to detect a deviation from the reference force. The reference unit can advantageously be designed to determine at least one friction coefficient of the surface of the medical object based on the detected deviation.

[0023] In a second variant, the friction sensor can be designed to detect a slip on the surface of the medical object. To this end, the friction sensor can be designed to transmit a reference force to the medical object along the force or opposite to the force by means of a friction wheel and / or a friction roller and / or a friction plate. In addition, the friction sensor can be designed to detect the slip of the friction wheel and / or the friction roller and / or the friction plate, in particular quantitatively. The reference unit can be designed to determine at least one friction coefficient of the surface of the medical object based on the detected slip. The friction sensor can be integrated at least partially in the transmission element in particular. Here, the transmission element can additionally serve as a friction wheel and / or a friction roller and / or a friction plate.

[0024] The surface sensor can, for example, have an electromagnetic and / or optical and / or mechanical and / or ultrasound-based sensor, which can be designed to collect surface properties of the medical object on the introduction sheath and / or the mobile device. The surface sensor can be advantageously designed to collect material properties of the surface of the medical object, in particular quantitatively. The medical object can have a coating and / or surface structure that is particularly hydrophobic or hydrophilic, so as to reduce the friction between the medical object and the examination object, in particular a hollow organ. The surface sensor can be advantageously designed to collect changes in the surface, in particular the coating and / or the surface structure of the medical object relative to a reference value. The reference value can characterize the state of the surface of the medical object before the examination object is introduced. The surface sensor can be particularly designed to collect a reduction in the layer thickness of the coating of the medical object. The reference unit can advantageously be designed to determine at least one friction coefficient of the medical object based on the surface properties and / or surface changes of the medical object collected by means of the surface sensor.

[0025] The processing unit can advantageously be designed to simulate a virtual friction force between the hollow organ and a medical object at least partially arranged in the hollow organ based on the at least one friction coefficient. In addition, the processing unit can be designed to simulate the virtual friction force additionally based on parameters of the medical object, such as operating parameters and / or material parameters, and / or operating parameters of the mobile device and / or physiological parameters of the examination object.

[0026] The processing unit may also be designed to compare the reaction force with the virtual friction force. Here, the processing unit may be designed to identify the friction force between the hollow organ and the medical object as the origin of the reaction force, in particular the only origin of the reaction force, when the reaction force substantially coincides with the virtual friction force. The processing unit may be designed in particular to determine a deviation between the reaction force and the virtual friction force. Furthermore, the processing unit may be designed to identify the friction force between the hollow organ and the medical object as the origin of the reaction force, in particular the only origin of the reaction force, when the deviation is below a preset threshold value.

[0027] Furthermore, the processing unit can be designed to exclude the possibility that the friction force is the origin of the reaction force, in particular the only origin of the reaction force, when the deviation between the reaction force and the virtual friction force exceeds a preset threshold value. The threshold value can advantageously be preset as a function of parameters of the medical object and / or operating parameters of the mobile device and / or physiological parameters of the object under examination. Alternatively or additionally, the threshold value can be preset by a user with respect to the deviation between the reaction force and the virtual friction force via an input of the input unit.

[0028] Furthermore, the processing unit can be designed to provide a signal with information about the origin of the reaction force. The provision of the signal can include, for example, storage on a computer-readable storage medium and / or display on a display unit and / or transmission to a mobile device.

[0029] The proposed embodiment advantageously allows the identification of friction as the in particular sole origin of the reaction force or the possibility of excluding friction as the in particular sole origin of the reaction force. This allows a particularly precise adjustment of the movement of the medical object by means of the displacement device depending on the origin of the reaction force.

[0030] In a further advantageous embodiment of the proposed device, the device can also be designed to receive a data set, wherein the data set has an image of the examination object. Furthermore, the device can be designed to determine the spatial position of the distal region of the medical object with respect to the data set. Furthermore, the device can be designed to identify the origin of the reaction force based on the reaction force, the spatial position of the distal region and the data set. Furthermore, the device can be designed to provide a signal based on the origin of the reaction force.

[0031] The receiving of the data set may in particular comprise the acquisition and / or reading of a computer-readable data memory and / or the receiving from a data storage unit, for example a database. Furthermore, the data set may be provided by a providing unit of a medical imaging device for recording and / or for providing the data set. The medical imaging device may, for example, comprise a magnetic resonance device (MRT) and / or a computed tomography device (CT) and / or a medical X-ray device, in particular a medical C-arm X-ray device, and / or an ultrasound device and / or a positron emission tomography device (PET).

[0032] The data set can advantageously include a two-dimensional and / or three-dimensional image of the examination object, in particular a hollow organ. In this case, the data set can preferably map the examination object in a time-resolved manner and / or preoperatively, in particular before the introduction of the medical object. Furthermore, the data set can advantageously be registered with a coordinate system of the examination object. Furthermore, the data set can include an image of the development of the examination object, in particular a hollow organ, wherein the flow of contrast medium in the examination object, in particular a hollow organ, is imaged in the data set in a time-resolved manner. This makes it possible, for example, to achieve an exact identification of structures in the examination object that do not change over time based on the time intensity curve of the image points of the data set.

[0033] Furthermore, the data set can have an in particular two-dimensional and / or three-dimensional model of the examination object, in particular a hollow organ, for example a centerline model and / or a volume mesh model.

[0034] In addition, the processing unit can be designed to determine the spatial positioning of the distal region of the medical object with respect to the data set, in particular the position and / or orientation of the space. The processing unit can be designed in particular to determine the length of the medical object between the distal region of the medical object and the introduction sheath and / or the mobile device based on the operating parameters of the mobile device. The operating parameters of the mobile device can advantageously have information about the movement, in particular translation and / or rotation, of the medical object by means of the mobile device so far. Here, the processing unit can also be designed to determine the spatial orientation of the medical object in the examination object, in particular the hollow organ, based on the data set and the length of the medical object between the distal region of the medical object and the introduction sheath and / or the mobile device.

[0035] As an alternative or in addition, the device can have a positioning unit. The positioning unit can, for example, include an electromagnetic and / or ultrasound-based sensor, which is designed to detect the spatial position of the distal region, especially in the coordinate system of the examination object. The positioning unit can, for example, be arranged on the patient support device and / or on the movement device and / or on the introduction sheath and / or on the medical object.

[0036] Furthermore, the processing unit can be designed to determine a change in the spatial positioning of the distal region relative to the data set. Furthermore, the processing unit can be designed to compare the spatial positioning of the distal region, in particular the change in the spatial positioning of the distal region, with control specifications of a movement device for moving and / or holding the medical object, in particular for positioning the distal region in the examination object.

[0037] The processing unit can be designed to identify the origin of the reaction force based on the reaction force, in particular the direction and / or value of the reaction force, the spatial position of the distal region relative to the data set and the data set. The identification of the origin of the reaction force can include identifying the friction force between the medical object and the examination object, in particular the hollow organ, as the origin of the reaction force, in particular the only origin of the reaction force, or excluding the possibility of the friction force as the origin of the reaction force, in particular the only origin of the reaction force.

[0038] If a change in the spatial positioning of the distal region of the medical object is measured or determined in the presence of a reaction force, which change deviates from the control presetting of the movement device, the processing unit can be designed to identify the friction force between the medical object and the hollow organ as the origin of the reaction force, in particular the only origin of the reaction force. If no change in the spatial positioning of the distal region of the medical object is measured in the presence of a reaction force, wherein the control presetting of the movement device specifies the force for moving the medical object, the processing unit can be designed to additionally identify the origin of the reaction force based on the data set. In addition, the processing unit can be designed to identify a wrong positioning, in particular a wrong orientation, of the distal region of the medical object in the hollow organ as the origin of the reaction force based on the spatial positioning, in particular the current spatial positioning, with respect to the data set.

[0039] Furthermore, the processing unit can be designed to simulate the virtual friction force additionally based on the spatial orientation of the distal region. This can advantageously improve the accuracy of the simulation.

[0040] The proposed specific embodiment advantageously makes it possible to identify the origin of the reaction force taking into account, in particular, the current spatial position of the distal region of the medical object, the data set and the detected reaction forces.

[0041] Furthermore, the processing unit can be designed to provide a signal with information about the origin of the reaction force. The provision of the signal can include, for example, storage on a computer-readable storage medium and / or display on a display unit and / or transmission to a mobile device.

[0042] In a further advantageous embodiment of the proposed device, the reference unit can be designed to detect a plurality of friction coefficients along the longitudinal extension of the medical object. The medical object can be movable relative to the reference unit by means of a displacement device. Furthermore, the processing unit is designed to simulate a virtual friction force as a function of the spatial positioning of the distal region of the medical object in the examination object, in particular as a function of the data set and the plurality of friction coefficients.

[0043] The reference unit can advantageously be designed to acquire a plurality of friction coefficients along the longitudinal extension of the medical object during movement of the medical object relative to the reference unit by means of the mobile device. The medical object can have different friction coefficients along its longitudinal extension. The reference unit can preferably be designed to acquire and / or map a plurality of friction coefficients as a function of the length of the medical object between the distal region and the introduction sheath and / or the mobile device.

[0044] Furthermore, the processing unit can be designed to simulate the virtual friction force as a function of the spatial positioning of the distal region of the medical object in the examination object, the length of the medical object between the distal region and the introduction sheath and / or the moving device, and a plurality of friction coefficients. The processing unit can be designed in particular to repeatedly simulate the virtual friction force when the spatial positioning of the distal region changes, for example, due to a movement of the medical object by means of the moving device.

[0045] The proposed embodiment enables a particularly accurate simulation of the virtual friction force between the hollow organ and the medical object. As a result, the friction force between the hollow organ and the medical object can be reliably identified as the origin of the reaction force, in particular the only origin of the reaction force, or the possibility of the friction force being the origin of the reaction force, in particular the only origin of the reaction force, can be excluded.

[0046] In a further advantageous embodiment of the proposed device, the medical object, in particular the distal region, can be arranged in a hollow organ of the examination object. Furthermore, the processing unit can be designed to, in the presence of a reaction force, identify an obstacle in the hollow organ at the distal region as the origin of the reaction force from the data set or to identify friction between the hollow organ and the medical object as the origin of the reaction force by excluding obstacles in the hollow organ from the data set.

[0047] The processing unit can be designed to determine the spatial position of the distal region of the medical object with respect to the data set. In addition, the processing unit can be designed to identify obstacles at the distal region of the medical object in the data set, in particular in the presence of reaction forces. The processing unit can be designed in particular to identify walls of hollow organs, such as blood vessel walls, and / or occlusions, such as thrombi, and / or stenosis as obstacles in the data set. In this case, the processing unit can be designed to identify obstacles in the data set based on image values ​​and / or development values. If the data set has a development image of the examination object, in particular a hollow organ, the processing unit can be designed to identify obstacles at the distal region of the medical object as structures that do not change over time in the hollow organ, for example based on the time intensity curve of the image points of the data set.

[0048] The processing unit can advantageously be designed to identify obstacles based on operating parameters of the medical object and / or the mobile device, in particular the direction of movement of the medical object. This can advantageously ensure that only structures in the hollow organ that do not change over time are identified as obstacles, which adjoin the distal region of the medical object along the direction of movement. In addition, the processing unit can be designed to identify structures in the hollow organ that impede and / or limit the movement of the medical object as obstacles. In this case, the processing unit can be designed to identify obstacles in the hollow organ at the distal region of the medical object as the origin of the reaction force based on the data set.

[0049] The processing unit can also be designed to exclude obstacles at the distal region of the medical object based on the data set, in particular along the direction of movement of the medical object. Here, the processing unit can be designed to identify the friction between the medical object and the hollow organ as the origin of the reaction force, in particular the only origin of the reaction force, by excluding obstacles at the distal region of the medical object in the hollow organ based on the data set.

[0050] The moving device can advantageously be designed to adjust the moving direction and / or moving speed of the medical object based on the signal, in particular the origin of the identified reaction force, so that the reaction force is reduced. In addition, the moving device can be designed to move the medical object so that the distal region of the medical object avoids the identified obstacle in the hollow organ.

[0051] The proposed embodiment enables precise identification of the origin of the reaction force, in particular without additional intraoperative imaging and / or radiation exposure of the examination subject. Furthermore, the risk of injury to the examination subject can be advantageously reduced thereby.

[0052] In another advantageous embodiment of the proposed device, the data set can have an image and / or a model of the examination object and of a medical object at least partially arranged in the examination object. The processing unit can also be designed to determine the spatial location of a distal region of the medical object in the data set.

[0053] The data set can advantageously include two-dimensional and / or three-dimensional images of an examination object, in particular a hollow organ, and a medical object at least partially arranged in the examination object, in particular a hollow organ. In this case, the data set can preferably image the examination object and the medical object in a time-resolved manner and / or intraoperatively, in particular after the introduction of the medical object. In addition, the data set can include masked and / or segmented images of the hollow organ and / or the medical object. For example, the data set can be recorded according to digital subtraction angiography (DSA), wherein, in particular during the filling phase of the DSA, the contrast medium flow in the hollow organ and / or the movement of the medical object in the hollow organ is imaged (or mapped) as a change over time.

[0054] In addition, the data set can have a model of the examination object, in particular a hollow organ and / or a medical object, in particular a two-dimensional and / or three-dimensional model. The data set can, for example, have a model of the medical object, in particular a linear model and / or a volume mesh model, which is generated and / or received according to parameters of the medical object, in particular material parameters and / or operating parameters, and / or is selected from a selection of multiple models of different medical objects. As an alternative or in addition, the processing unit can be designed to generate a model of the examination object, in particular a hollow organ, and / or a model of the medical object based on imaging, for example by segmentation. The medical object can also have a marking structure, in particular at the distal region, which enables the identification and / or positioning of the medical object in the hollow organ in the data set.

[0055] Advantageously, the processing unit can be designed to determine the spatial position of the distal region of the medical object in a data set, in particular during surgery. This can be achieved in particular by registering the data set with a coordinate system of the object under examination. Furthermore, the processing unit can be designed to determine in the data set the spatial orientation of the medical object, in particular between the introduction sheath and the distal region.

[0056] The movement device can be designed in particular to continue to move the medical object in the presence of a reaction force when obstacles at the distal region have been eliminated based on the data set, in particular during surgery. This can advantageously reduce the risk of injury to structures, in particular hollow organs, caused by the movement of the medical object.

[0057] The proposed embodiment enables a particularly precise determination of the spatial positioning of the distal region of the medical object in the examination object. In addition, the simulation of virtual friction forces and / or the identification of the origin of the reaction forces can be advantageously improved thereby. This is achieved in particular by determining the spatial course of the medical object in the examination object, in particular a hollow organ, based on the data set.

[0058] In a further advantageous embodiment of the proposed device, the medical object, in particular the distal region, can be arranged in a hollow organ of the examination object. Furthermore, the processing unit can be designed to detect a winding and / or spiraling of the medical object in the hollow organ from the data set in the presence of a reaction force. Furthermore, the movement device is also designed to additionally move the medical object based on the detected winding and / or spiraling of the medical object in the hollow organ.

[0059] The processing unit can advantageously be designed to detect a winding and / or spiraling of a medical object in a hollow organ based on a data set, in particular based on a spatial course of the medical object imaged in the data set. The winding of a medical object here particularly describes a curled course of the medical object, wherein the curled course changes with a bend, in particular a curve, of the hollow organ, which is mostly on the curved outer side of the hollow organ. In addition, the medical object can spiral due to a rotation of the medical object by means of a displacement device. In this case, the spatial course of the medical object in the hollow organ can have an at least partially spiral, in particular a spatially curled course. The processing unit can be designed to detect a winding and / or spiraling of a medical object based on a two-dimensional and / or three-dimensional imaging of the spatial course of the medical object in the data set.

[0060] As an alternative or in addition, the processing unit can be designed to detect a detour and / or a spiral formation of the medical object by determining a deviation in the data set between a preset and actual spatial positioning of the distal region of the medical object. A detour and / or a spiral formation of the medical object in a hollow organ can in particular lead to a shortening of the effective length of the medical object between the distal region and the introduction sheath and / or the moving device.

[0061] Here, the winding and / or spiraling can be caused by obstacles along the movement direction of the medical object and / or by friction between the hollow organ and the medical object. The winding and / or spiraling of the medical object in the hollow organ can especially lead to an increase in the contact surface between the medical object and the hollow organ. This can lead to an increase in friction between the medical object and the hollow organ and thus to an increase in the reaction force.

[0062] The processing unit can advantageously be designed to simulate virtual friction forces additionally based on the identified winding and / or spiraling of the medical object in the hollow organ. In addition, the movement device can advantageously be designed to adjust the movement, in particular the movement direction and / or the movement speed of the medical object additionally based on the identified winding and / or spiraling of the medical object in the hollow organ so that the reaction force is reduced.

[0063] The proposed embodiment advantageously enables an improved simulation of virtual frictional forces. In addition, by identifying the winding and / or spiral formation of the medical object in the hollow organ, an improved adjustment of the movement of the medical object by means of the movement device can be achieved. This can advantageously reduce the risk of injury to structures, in particular hollow organs, caused by the movement of the medical object.

[0064] In another advantageous embodiment of the proposed device, the device can also include a conditioning unit, which can be designed to condition the surface of the medical object at least in sections as a function of the signal in such a way that the coefficient of friction of the surface is reduced.

[0065] The trimming unit can be designed, for example, to hydrophilize and / or hydrophobize the surface of the medical object. For example, the trimming unit can be used to hydrophilize the surface of the medical object by applying plasma, in particular locally. As an alternative or in addition, the trimming unit can be designed to achieve hydrophilization and / or hydrophobization by applying a substance, in particular a coating, to the surface of the medical object. Here, depending on the scope of application of the medical object in the examination object, it can be advantageous to hydrophilize or hydrophobize the surface of the medical object.

[0066] In this case, the conditioning unit can be designed to apply the substance, for example, in powder form, in particular by providing an electrostatic field between the surface of the medical object and the conditioning unit, and / or in gaseous and / or liquid form. Furthermore, the conditioning unit can be designed to fix the substance on the surface of the medical object, for example by applying a further substance and / or by applying electromagnetic radiation, in particular light, and / or by the action of heat.

[0067] As an alternative or in addition, the trimming unit can be designed to trim the surface of the medical object by removing a predefined layer of the surface of the medical object. The medical object can have, for example, a plurality of, in particular overlapping, hydrophilic and / or hydrophobic layers on its surface, which can be removed mechanically and / or chemically and / or electromagnetically.

[0068] The trimming unit can also advantageously be designed to trim the surface of the medical object in such a way that the coefficient of friction of the trimmed surface is reduced. The trimming unit can be designed in particular to trim the surface of the medical object at least in sections, in particular at the distal region and / or between the distal region and the introduction sheath and / or between the distal region and the mobile device.

[0069] The proposed embodiment advantageously achieves a reduction in the friction between the medical object and the hollow organ, whereby the reaction force can be reduced. Furthermore, the forces for moving the medical object, which the moving device transmits to the medical object, can be reduced thereby. The risk of injury to the structure of the medical object due to the movement of the medical object can thereby be advantageously reduced. Furthermore, the tendency of the medical object to meander and / or spiral in the hollow organ can advantageously be reduced by reducing the friction coefficient by means of the trimming unit.

[0070] In another advantageous embodiment of the proposed device, the trimming unit can be arranged on a moving device and / or on an introduction sheath for introducing the medical object into the examination object. In addition, the moving device can be designed to at least partially remove the medical object from the examination object in response to a signal. In this case, the trimming unit can be designed to trim the surface of the removed section of the medical object.

[0071] The trimming unit can be integrated at least partially in the introduction sheath and / or the mobile device, in particular the cassette element. It can thus be advantageously achieved that the medical object moves relative to the trimming unit during movement, in particular translation and / or rotation, of the mobile device. The trimming unit can be arranged, for example, annularly and / or at least sectionally around the medical object.

[0072] In addition, the trimming unit can be designed to trim the surface of the medical object, especially along the longitudinal extension direction of the medical object. As an alternative or in addition, the trimming unit can be arranged to be particularly translatably and / or rotationally movable relative to the medical object and / or the mobile unit and / or the introduction sheath. Thus, it can be achieved that the surface of the medical object is trimmed as extensively as possible with the trimming unit.

[0073] The displacement device can advantageously be designed to remove the medical object at least partially, in particular completely, from the examination object based on the signal, in particular when a reaction force is present and / or when a friction force between the medical object and the hollow organ is identified as the in particular sole origin of the reaction force. In this case, the removed section can be moved relative to the trimming unit, in particular during the removal by means of the displacement device. In this case, the trimming unit can be designed to trim the surface of the removed section of the medical object. After the trimming of the surface of the removed section of the medical object has been completed by means of the trimming unit, the displacement device can be designed to reposition the medical object, in particular the distal region, in the examination object, in particular the hollow organ, at its original position before the removal.

[0074] The proposed embodiment enables a particularly flexible design of the trimming unit, wherein the trimming unit can be designed for trimming different medical objects. In addition, by removing and trimming the surface of the medical object and subsequently repositioning at least a part of the medical object, the aforementioned winding and / or spiraling of the medical object in the hollow organ can be advantageously reduced. By trimming the surface of the medical object with the aid of the trimming unit, the coefficient of friction of the surface of the medical object can be reduced, thereby advantageously reducing the tendency of the medical object to meander and / or spiral in the hollow organ.

[0075] In another advantageous embodiment of the proposed device, the trimming unit can be at least partially integrated in the medical object. Here, the trimming unit can be designed to trim the surface of the medical object at least in sections while the section to be trimmed is arranged in the examination object.

[0076] In this case, the trimming unit can be arranged so as to be particularly translatably and / or rotationally movable relative to a section of the medical object, in particular the distal region, to be trimmed. The trimming unit can be arranged, for example, annularly and / or at least sectionally around the section to be trimmed. In this case, the trimming unit can be designed to trim the surface of the section to be trimmed, in particular the distal region, of the medical object, by moving the trimming unit, for example, by means of a Bowden cable, along the section to be trimmed.

[0077] As an alternative or in addition, at least one section of the medical object, in particular of the distal region, can be movable, in particular translationally and / or rotationally, relative to the trimming unit, wherein the trimming unit can be arranged on the medical object in a fixed position. For example, the at least one section, in particular of the distal region, can be moved into the trimming unit. In this case, the trimming unit can be designed to trim the surface of the moved-in section of the medical object, in particular of the distal region.

[0078] The proposed embodiment advantageously enables the trimming of the surface of a section of a medical object to be trimmed, in particular while the section to be trimmed is arranged in a hollow organ. This advantageously enables a particularly time-efficient surface trimming and thus a reduction in the coefficient of friction, wherein a repositioning of the distal region by means of the movement device for trimming the surface of the distal region by means of the trimming unit can advantageously be minimized.

[0079] In a second aspect, the present invention relates to a system comprising the proposed device for moving a medical object and a medical imaging device. In this case, the medical imaging device is designed to record data sets of the examination object and to provide them to a processing unit.

[0080] The advantages of the proposed system correspond substantially to the advantages of the proposed device for moving medical objects. The features, advantages and alternative embodiments mentioned here can also be transferred to the other claimed technical solutions and vice versa.

[0081] In particular, the data set and / or the examination object and / or the proposed device can have all the properties and features described with reference to the device for moving a medical object and vice versa.

[0082] The medical imaging device can be designed, for example, as a magnetic resonance device (MRT) and / or a computed tomography device (CT) and / or an ultrasound device and / or a medical X-ray device, in particular a medical C-arm X-ray device. The medical imaging device can advantageously be designed to record a data set of the examination object, in particular before and / or during the operation. The medical imaging device can be designed in particular to record a data set with an image of the examination object, in particular a hollow organ, and / or an image of a medical object, in particular a distal region.

[0083] Furthermore, the medical imaging device can be designed to provide the data set to the device. In this case, the provision can include, for example, storage on a computer-readable storage medium and / or display on a display unit and / or transmission to a processing unit.

[0084] The proposed system advantageously allows a particularly precise movement of the medical object, in particular a reduced risk of injury to the examination subject when the medical object is moved by means of the movement device.

[0085] The present invention relates to a method for providing a signal in a third aspect. Here, before the method starts, a medical object is moved and / or held by means of a mobile device. In addition, the mobile device is designed to hold and / or move a medical object at least partially arranged in the mobile device by the transmission of force. In addition, the medical object is at least partially arranged in the examination object. In the first step a) of the method, a sensor signal of a sensor unit is received. Here, the sensor unit is designed to collect a reaction force exerted by the medical object on the mobile device and directed opposite to the force. In addition, the sensor signal has information about the reaction force. In the second step b), a data set is received, wherein the data set has an imaging of the examination object. In the third step c), the spatial positioning of the distal region of the medical object with respect to the data set is determined. In addition, in the fourth step d), the origin of the reaction force is identified based on the sensor signal, the spatial positioning of the distal region and the data set. In the fifth step e), a signal is provided based on the origin of the reaction force.

[0086] The advantages of the proposed method for providing a signal correspond substantially to the advantages of the proposed device for moving a medical object. The features, advantages and alternative embodiments mentioned here can also be transferred to the other claimed technical solutions and vice versa.

[0087] In particular, the movement device and / or the medical object and / or the object under examination and / or the sensor unit can have all the properties and features described with reference to the device for moving a medical object and vice versa.

[0088] The receiving of sensor signals and / or data sets may in particular include the acquisition and / or reading of a computer-readable data memory and / or the receiving from a data storage unit, such as a database. In addition, the sensor signals may be provided by a sensor unit. In addition, the data sets may be provided by a medical imaging device for recording the data sets.

[0089] The reaction force can be directed in the opposite direction to the force for holding and / or moving, in particular for translating and / or rotating the medical object. The sensor unit can advantageously have a force receiver for collecting the reaction force. In addition, the sensor unit can be designed to provide a sensor signal according to the collected reaction force. The sensor signal can advantageously have information about the direction and / or value of the reaction force. In addition, the sensor signal can be time-resolved. The sensor signal can additionally have operating parameters of the mobile device and / or operating parameters of the medical object and / or physiological parameters of the object under examination, in particular as metadata. The sensor signal can advantageously map out the time period during which the medical object is moved by means of the mobile device before the proposed method begins.

[0090] In particular, the data set can have all the properties and features described with reference to the device for moving a medical object and vice versa.

[0091] Advantageously, in step c), the spatial positioning of the distal region of the medical object with respect to the data set, in particular the spatial position and / or orientation, can be determined. For this purpose, the length of the medical object between the distal region of the medical object and the introduction sheath and / or the mobile device used to introduce the medical object, in particular along the longitudinal extension direction of the medical object, can be determined based on the operating parameters of the mobile device. The operating parameters of the mobile device can advantageously have information about the movement, in particular the translation and / or rotation, of the medical object performed by the mobile device before the method begins. In addition, in step c), the spatial orientation of the medical object in the examination object, in particular the hollow organ, can be determined based on the data set and the length of the medical object between the distal region of the medical object and the introduction sheath and / or the mobile device.

[0092] Furthermore, in step c), a change in the spatial positioning of the distal region with respect to the data set can be determined. Furthermore, the spatial positioning of the distal region, in particular the determined change in the spatial positioning of the distal region, can be compared with a control specification of the movement device, wherein the control specification has information, in particular instructions for moving the medical object, in particular for positioning the distal region in the examination object, before the start of the method.

[0093] Advantageously, in step d), the origin of the reaction force can be identified based on the reaction force, in particular its direction and / or value, the spatial position of the distal region relative to the data set and the data set. The identification of the origin of the reaction force can include identifying the friction force between the medical object and the examination object, in particular the hollow organ, as the origin of the reaction force, in particular the only origin of the reaction force, or excluding the possibility that the friction force is the origin of the reaction force, in particular the only origin of the reaction force.

[0094] If a change in the spatial positioning of the distal region of the medical object is detected in the presence of a reaction force, which change deviates from a control presetting of the displacement device, then in step d), the friction force between the medical object and the hollow organ can be identified as the origin of the reaction force, in particular the sole origin of the reaction force. If, however, no change in the spatial positioning of the distal region of the medical object is detected in the presence of a reaction force, wherein the control presetting of the displacement device specifies a force for moving the medical object, then the origin of the reaction force can additionally be identified based on the data set. Furthermore, in step d), based on the in particular current spatial positioning of the distal region of the medical object in the hollow organ, in particular a wrong orientation, can be identified as the origin of the reaction force.

[0095] The provision of the signal can include, for example, storage on a computer-readable storage medium and / or display on a display unit and / or transmission to a processing unit. In particular, the signal can be provided to a mobile device in step e). As an alternative or in addition, the signal with information about the reaction force and / or the origin of the reaction force can be displayed to the user by means of a display unit.

[0096] The proposed specific embodiment advantageously makes it possible to identify the origin of the reaction force taking into account, in particular, the current spatial position of the distal region of the medical object, the data set and the detected reaction forces.

[0097] In a further advantageous embodiment of the proposed method, the medical object, in particular the distal region, is arranged in a hollow organ of the examination object. In this case, step c) can also include step c.1), in which an obstacle in the hollow organ at the distal region of the medical object is identified as the origin of the reaction force based on the data set. Alternatively, friction forces between the hollow organ and the medical object can be identified as the origin of the reaction force by excluding obstacles in the hollow organ based on the data set.

[0098] In a further advantageous embodiment of the proposed method, the data set can have an image and / or a model of the examination object and of a medical object at least partially arranged in the examination object. Furthermore, in step c), the spatial position of a distal region of the medical object in the data set can be determined.

[0099] In a further advantageous embodiment of the proposed method, the medical object, in particular the distal region, can be arranged in a hollow organ of the examination object. In this case, step c) can also include step c.2), wherein in step c.2) a winding and / or spiraling of the medical object in the hollow organ is detected based on the data set. Furthermore, in step e), a signal can additionally be provided based on the detected winding and / or spiraling of the medical object in the hollow organ.

[0100] The identification of the winding and / or spiraling of the medical object in the hollow organ can advantageously be carried out based on the spatial course of the medical object imaged in the data set. In particular, the winding and / or spiraling of the medical object can be identified based on the data set based on the two-dimensional and / or three-dimensional imaging of the spatial course of the medical object in the hollow organ.

[0101] As an alternative or in addition, a detour and / or spiral formation of the medical object can be identified by determining a deviation in the data set between a preset and actual spatial positioning of the distal region of the medical object. A detour and / or spiral formation of the medical object in a hollow organ can in particular result in a shortening of the effective length of the medical object between the distal region and the introduction sheath.

[0102] The detours and / or spiral formation of the medical object in the hollow organ can lead to an increase in the contact surface between the medical object and the hollow organ. This can lead to an increase in the friction between the medical object and the hollow organ and thus to an increase in the reaction force. Advantageously, in step e), a signal with information about the identified detours of the medical object in the hollow organ and / or about the identified spiral formation of the medical object in the hollow organ can be provided. This makes it possible to achieve a particularly precise identification of the origin of the reaction force, in particular taking into account the spatial course of the medical object in the hollow organ.

[0103] In another advantageous embodiment of the proposed method, the medical object, in particular the distal region, can be arranged in a hollow organ of the object under examination. Here, step a) can also include steps a.1) and a.2), wherein, in step a.1), a reference signal of a reference unit is received. Here, the reference unit can be designed to acquire at least one friction coefficient of the medical object on a moving device and / or an introduction sheath, which is used to introduce the medical object into the object under examination. In another step a.2), a virtual friction force between the medical object and the hollow organ can be simulated based on the at least one friction coefficient. Step c) can also include another step c.3), wherein, in step c.3), the friction force between the hollow organ and the medical object can be identified as the origin of the reaction force by comparing the sensor signal with the virtual friction force, or the possibility of the friction force between the hollow organ and the medical object being the origin of the reaction force can be excluded.

[0104] In a further advantageous embodiment of the proposed method, the reference unit can be designed to detect a plurality of friction coefficients along the longitudinal extension of the medical object, and a movement of the medical object relative to the reference unit can be performed by means of a movement device before the method is started. In this case, in step a.2), a virtual friction force can be simulated based on the data set and the plurality of friction coefficients as a function of the spatial positioning of the distal region of the medical object in the examination object.

[0105] Furthermore, virtual friction forces can additionally be simulated based on detected winding and / or spiral formations of the medical object in the hollow organ.

[0106] In a fourth aspect, the present invention relates to a method for controlling a trimming unit. Here, a signal is received by applying the proposed method for providing a signal. Furthermore, the trimming unit is controlled according to the signal to trim the surface of a medical object in order to reduce the coefficient of friction of the surface.

[0107] The conditioning unit can in particular have all the properties and features described with reference to the device for moving a medical object and vice versa. The advantages of the proposed method for controlling a conditioning unit correspond essentially to the advantages of the proposed device for moving a medical object and / or the proposed method for providing a signal. The features, advantages and alternative embodiments mentioned here can also be transferred to other claimed technical solutions and vice versa.

[0108] In a fifth aspect, the invention relates to a computer program product with a computer program, which can be directly loaded into a memory of a processing unit and has program segments so that when the program segments are executed by the processing unit, all steps of the proposed method for providing a signal and / or the proposed method for controlling a trimming unit are implemented. The computer program product can here comprise software with source code, which still needs to be compiled and combined or only needs to be interpreted, or executable software code, which only needs to be loaded into the processing unit for execution. By means of the computer program product, the method for providing a signal and / or the method for controlling a trimming unit can be implemented quickly, identically, repeatedly and robustly by means of the processing unit. The computer program product is configured in such a way that the computer program product can implement the method steps according to the invention by means of the processing unit.

[0109] The computer program product is stored, for example, on a computer-readable storage medium or on a network or server, from which the computer program product can be loaded into a processor of a processing unit, which can be directly connected to the processing unit or designed as a part of the processing unit. In addition, the control information of the computer program product can be stored on an electronically readable data carrier. The control information of the electronically readable data carrier can be designed so that when the data carrier is used in the processing unit, the information implements the method according to the present invention. An example of the electronically readable data carrier is a DVD, a magnetic tape or a USB disk storing electronically readable control information, especially software. When these control information are read by the data carrier and stored in the processing unit, all embodiments of the above-mentioned method according to the present invention can be implemented.

[0110] Furthermore, the present invention can be based on a computer-readable storage medium and / or an electronically readable data carrier on which program segments are stored that can be read and executed by a processing unit so that when the program segments are executed by the processing unit, all steps of the method for providing a signal and / or for controlling a trimming unit are implemented.

[0111] The implementation in software to a large extent has the advantage that previously used processing units can also be easily retrofitted by software updates to operate in the manner according to the invention. In addition to the computer program, such a computer program product may include additional components, such as documentation and / or additional components, as well as hardware components for using the software, such as hardware dongles (dongles, etc.). BRIEF DESCRIPTION OF THE DRAWINGS

[0112] Embodiments of the present invention are shown in the drawings and described in detail below. The same reference numerals are used for the same features in different drawings. In the drawings:

[0113] Figure 1 A schematic diagram showing the proposed apparatus for moving a medical object;

[0114] Figure 2 A schematic diagram showing a mobile device;

[0115] Figure 3 A schematic diagram showing the proposed system;

[0116] Figure 4 and Figure 5 Schematic diagrams showing different embodiments of the proposed method for providing a signal;

[0117] Figure 6 A schematic diagram showing the proposed method for controlling a trimming unit. DETAILED DESCRIPTION

[0118] Figure 1 1 shows a schematic diagram of a proposed device for moving a medical object. The device may include a moving device CR which is designed to hold and / or move a medical object MO arranged at least partially in the moving device CR by transmitting force.

[0119] The mobile device CR can be designed, for example, as a catheter robot, in particular for remote manipulation of a medical object MO. The medical object MO can be designed, in particular, as an elongated surgical and / or diagnostic instrument. The medical object MO can be deformed, in particular, rigidly and / or flexibly and / or mechanically, at least in sections. The medical object MO can be designed, for example, as a catheter and / or an endoscope and / or a guidewire. Advantageously, the medical object MO can be introduced at the entry point into an object to be examined 31 arranged on a patient support device 32, in particular into a hollow organ of the object to be examined 31, via an introduction sheath IP. In this case, the patient support device 32 can be at least partially movable. For this purpose, the patient support device 32 can advantageously have a motion device BV, which can be controlled by means of a motion signal 28 of the processing unit 22.

[0120] Furthermore, the medical object MO can have a distal region DP. In this case, the distal region DP can, for example, describe a tip and / or a segment with a marking structure located on the medical object MO. The distal region DP of the medical object MO can advantageously be arranged at least partially in the examination object 31, in particular in a hollow organ. In this case, the hollow organ can, for example, be a vessel segment in which the distal region DP is at least partially arranged.

[0121] In addition, the mobile device CR can be fixed to the patient support device 32 in a particularly movably manner by means of a fixing element 71, such as a tripod and / or a robot arm. The mobile device CR can advantageously be designed to translate the medical object MO, which is at least partially arranged in the mobile device, at least along the longitudinal extension direction of the medical object MO. In addition, the mobile device CR can be designed to rotate the medical object MO around its longitudinal extension direction. As an alternative or in addition, the mobile device CR can be designed to control the movement of at least a part of the medical object MO, such as the distal region DP of the medical object MO, in particular the tip. In addition, the mobile device CR can be designed to deform the distal region DP of the medical object MO in a defined manner, for example by a Bowden cable inside the medical object MO. In addition, the mobile device CR can be controlled by means of a signal SIG of the processing unit 22.

[0122] The device may also include a sensor unit SEN, wherein the sensor unit SEN is designed to collect a reaction force applied by the medical object MO to the mobile device CR and directed in the opposite direction to the force. The sensor unit SEN may advantageously have a force receiver, which is designed to collect the reaction force applied by the medical object MO to the force receiver. The sensor unit SEN may, for example, have an electromagnetic, especially capacitive and / or resistive and / or piezoelectric and / or electrodynamic, and / or mechanical and / or optical force receiver. The reaction force may be directed in the opposite direction to the force used to hold and / or move the medical object MO, especially for the translation and / or rotation of the medical object MO. The sensor unit SEN, especially the force receiver, may be designed to provide a sensor signal S according to the collected reaction force. Here, the sensor signal S may advantageously have information about the direction and / or value of the reaction force. In addition, the sensor signal may be time-resolved. The sensor signal S may additionally have operating parameters of the mobile device CR and / or operating parameters of the medical object MO and / or physiological parameters of the object 31 under examination, especially as metadata.

[0123] The sensor unit SEN can advantageously be arranged at least partially integrated in the mobile device CR. Furthermore, the sensor unit SEN can be designed to provide a sensor signal S to the processing unit 22. The device, in particular the processing unit 22, can also be designed to provide a signal SIG as a function of the reaction force, in particular as a function of the sensor signal S. The device can in particular be designed to provide the sensor signal S as a signal SIG. The signal SIG can advantageously have information about the direction and / or the magnitude of the reaction force.

[0124] The moving device CR can advantageously be designed to move the medical object MO according to the signal SIG. For this purpose, the processing unit 22 can be designed to compare the signal SIG with a preset threshold value, wherein the moving device CR can be designed to adjust, in particular the current movement of the medical object MO according to the signal SIG when the signal SIG exceeds the threshold value. The moving device CR can be designed in particular to stop, in particular the current movement of the medical object MO, when a reaction force is detected by means of the sensor unit SEN. As an alternative or in addition, the moving device CR can be designed to adjust, in particular the current movement of the medical object MO according to the signal SIG, when a reaction force is detected by means of the sensor unit SEN. The moving device CR can be designed in particular to move the medical object MO according to the signal SIG in such a way that the reaction force is reduced. The moving device CR can be designed, for example, to adjust the movement direction and / or the movement speed of the movement of the medical object MO according to the signal SIG. In addition, the moving device CR can be designed to control, in accordance with the signal SIG, at least a section-wise deformation of the medical object MO, in particular the distal region DP.

[0125] Furthermore, the device can have an input unit 42, which is designed to capture user inputs. The input unit 42 can include, for example, a keyboard and / or a pointing device, in particular a computer mouse. In this case, the device, in particular the mobile device CR and / or the proposed system and / or the patient support device 32, can be controlled, in particular supplementarily, by user inputs on the input unit 42. For this purpose, the input element 42 sends, for example, an input signal 26 to the processing unit 22.

[0126] Furthermore, the device can have a display unit 41, for example a monitor and / or a display screen. In this case, the input unit 42 can preferably be at least partially integrated in the display unit 41, for example in a capacitive and / or resistive input display screen. Furthermore, the display unit 41 can be designed to display information and / or a graphical representation of information of the device, in particular the mobile device CR and / or the system. For this purpose, the processing unit 22 can, for example, send a display signal 25 to the display unit 41. The display unit 41 can be designed in particular to display a graphical representation of the signal SIG and / or information about the detected reaction force.

[0127] Furthermore, the processing unit 22 can be designed to receive a data set, in particular a preoperative recording. In this case, the data set can include an image, in particular a preoperative image, of the examination object 31. Furthermore, the processing unit 22 can be designed to determine the spatial position of the distal region DP of the medical object MO with respect to the data set. Furthermore, the processing unit 22 can be designed to identify the origin of the reaction force based on the reaction force, in particular the value and / or direction of the reaction force, the spatial position of the distal region DP and the data set. Furthermore, the processing unit 22 can be designed to provide a signal SIG based on the origin of the reaction force.

[0128] Furthermore, the processing unit 22 can advantageously be designed to identify, in the presence of a reaction force, an obstacle in the hollow organ in the distal region DP as the origin of the reaction force based on the data set, or to identify, by excluding the obstacle in the hollow organ based on the data set, a friction force between the hollow organ and the medical object MO as the origin of the reaction force.

[0129] Figure 2 A schematic diagram of a mobile device CR for robotically moving a medical object MO is shown. The mobile device CR can advantageously have a fixing element 71 that is particularly movable and / or operable. In addition, the mobile device CR can have a cassette element 74 that is designed to accommodate at least a portion of the medical object MO. In addition, the mobile device CR can have a mobile element 72 that is fixed to a fixing element 71, such as a tripod and / or a robot arm. In addition, the fixing element 71 can be designed to fix the mobile element 72, particularly movably, on a patient support device 32. Here, the mobile element 72 can advantageously have at least one, for example three, actuator elements 73, such as electric motors, wherein the processing unit 22 is designed to control the at least one actuator element 73, particularly by means of a signal SIG. The cassette element 74 can advantageously be coupled to the mobile element 72, particularly at least one actuator element 73, particularly mechanically and / or electromagnetically and / or pneumatically. Here, the cassette element 74 may also have at least one transmission element 75, which can be moved by coupling between the cassette element 74 and the moving element 72, in particular, at least one actuator element 73. The at least one transmission element 75 may be particularly movably coupled to the at least one actuator element 73. In addition, the transmission element 75 may be designed to transmit the movement of the actuator element 73 to the medical object MO in such a way that the medical object MO moves along the longitudinal extension direction of the medical object MO and / or rotates the medical object MO around the longitudinal extension direction. The at least one transmission element 75 may, for example, have rollers and / or rollers and / or masks and / or shear plates.

[0130] Advantageously, the movement element 72 can have a plurality of, in particular independently controllable, actuator elements 73. In addition, the cassette element 74 can have a plurality of transmission elements 75, in particular at least one movement-coupled transmission element 75 for each actuator element 73. This makes it possible to achieve, in particular, independent and / or simultaneous movement of the medical object MO along different degrees of freedom of movement.

[0131] Furthermore, the movement device CR, in particular at least one actuator element 73, can be controlled by the processing unit 22 by means of the signal SIG. As a result, the movement of the medical object MO can be controlled, in particular indirectly, by the processing unit 22. Furthermore, by moving the fixing element 71, the orientation and / or position of the movement device CR relative to the examination object 31 can be adjusted.

[0132] Furthermore, the mobile device CR can advantageously have a movement acquisition unit 77, which is designed to acquire a relative movement of the medical object MO relative to the mobile device CR. In this case, the movement acquisition unit 77 can in particular have an encoder, such as a wheel encoder and / or a roller encoder, and / or an optical sensor, such as a barcode scanner and / or a laser scanner and / or a camera, and / or an electromagnetic sensor. The movement acquisition unit 77 can preferably be designed to acquire a relative movement of the medical object MO, in particular by acquiring the medical object MO relative to the mobile device CR. As an alternative or in addition, the movement acquisition unit 77 can be designed to acquire a movement and / or a position change of a component of the mobile device CR, which is coupled to the medical object MO in a movement manner, such as at least one actuator element 73 and / or at least one transmission element 74. The movement acquisition unit 77 can advantageously be designed to provide a capture signal C to the processing unit 22 as a function of the acquired relative movement of the medical object MO.

[0133] The sensor unit SEN and / or the movement detection unit 77 can advantageously be arranged at least partially integrated in at least one actuator element 73 and / or in the transmission element 75 .

[0134] In addition, the device may include a reference unit RU, wherein the reference unit RU is designed to acquire at least one friction coefficient of the medical object MO on the mobile device CR and / or the introduction sheath IP, the introduction sheath being used to introduce the medical object MO into the examination object 31. The reference unit RU can be arranged in particular at least partially integrated in the mobile device CR. The reference unit RU can advantageously be designed to provide at least one friction coefficient of the medical object MO to the processing unit 22 by means of a reference signal REF. In addition, the processing unit 22 can be designed to simulate a virtual friction force between the medical object MO and the hollow organ according to the at least one friction coefficient, in particular the reference signal REF. In addition, the processing unit 22 can be designed to identify the friction force between the hollow organ and the medical object MO as the origin of the reaction force or to exclude the possibility that the friction force between the hollow organ and the medical object MO is the origin of the reaction force by comparing the reaction force with the virtual friction force. In addition, the processing unit 22 can be designed to provide a signal SIG according to the origin of the reaction force.

[0135] Furthermore, the reference unit RU can be designed to acquire a plurality of friction coefficients along the longitudinal extension direction of the medical object MO. Here, the medical object MO can be moved relative to the reference unit RU by means of a moving device CR. Furthermore, the processing unit 22 can also be designed to simulate a virtual friction force based on the spatial positioning of the distal region DP of the medical object MO in the examination object 31 and the plurality of friction coefficients.

[0136] Furthermore, the device can have a trimming unit REN, wherein the trimming unit REN is designed to trim the surface of the medical object MO according to the signal SIG at least in such a way that the coefficient of friction of the surface is reduced. To this end, the processing unit can send a correction signal 53 to the trimming unit REN according to the signal SIG. Figure 2 In the embodiment shown, the trimming unit REN can be arranged at least partially integrated on the mobile device CR. Here, the mobile device CR can also be designed to at least partially remove the medical object MO from the examination object 31 according to the signal SIG. In addition, the trimming unit REN can be designed to trim the surface of the removed section of the medical object MO.

[0137] As an alternative or in addition, the trimming unit REN may be at least partially integrated in the medical object MO (not shown). In this case, the trimming unit REN may be designed to trim the surface of the medical object MO at least in sections while the section to be trimmed is arranged in the examination object 31 .

[0138] Figure 3A schematic diagram of the proposed system is shown, wherein the proposed system comprises the proposed device for moving a medical object MO and a medical C-arm X-ray device 37 as an example of a medical imaging device. The medical C-arm X-ray device 37 can be designed to record data sets of the examination object 31, in particular preoperatively and / or intraoperatively.

[0139] The medical C-arm X-ray device 37 can have a detector 34, in particular an X-ray detector, and an X-ray source 33. For recording data sets, an arm 38 of the medical C-arm X-ray device 37 can be mounted movably about one or more axes. In addition, the medical C-arm X-ray device 37 can include a movement device 39, which enables the movement of the medical C-arm X-ray device 37 in space. The detector 34 and the X-ray source 33 can be movably fixed on the common C-arm 38 in a defined arrangement.

[0140] Furthermore, the processing unit 22 can be designed to control the positioning of the medical C-arm X-ray device 37 relative to the examination object 31 in such a way that the distal region DP of the medical object MO is imaged in the data set recorded with the aid of the medical C-arm X-ray device 37. The positioning of the medical C-arm X-ray device 37 relative to the examination object 31 can, for example, include a defined arrangement of the X-ray source 33 and the detector 34, in particular the positioning of the C-arm 38 around one or more spatial axes. Furthermore, the medical C-arm X-ray device 37 can include a movement device 39, such as a wheel system and / or a rail system and / or a robot arm, which enables the movement of the medical C-arm X-ray device 37 in space.

[0141] In order to record a data set of the examination object 31, the processing unit 22 can send a signal 24 to an X-ray source 33. The X-ray source 33 can then emit an X-ray beam, in particular a cone beam and / or a fan beam and / or a parallel beam. After the X-ray beam interacts with the examination area to be imaged of the examination object 31, when the X-ray beam reaches the surface of the detector 34, the detector 34 can send a signal 21 to the processing unit 22. The processing unit 22 can, for example, receive and / or reconstruct the data set based on the signal 21. In addition, the display unit 41 can be designed to display a graphical view of the data set.

[0142] Advantageously, the data set can include an image and / or a model of the examination object 31, in particular of a hollow organ and a medical object MO at least partially arranged in the examination object 31. In this case, the processing unit 22 can be designed to determine the spatial position of the distal region DP in the data set.

[0143] Furthermore, the processing unit 22 can be designed to identify the winding and / or spiral formation of the medical object MO in the hollow organ based on the data set in the presence of the reaction force. Furthermore, the movement device CR can be designed to additionally move the medical object MO based on the identified winding and / or spiral formation of the medical object MO in the hollow organ.

[0144] Figure 4 A schematic diagram of an advantageous embodiment of the proposed method for providing a PROV-SIG signal SIG is shown. Here, the movement and / or retention of the medical object MO can be performed by means of a mobile device CR before the method starts. In a first step a), a sensor signal S of a REC-S sensor unit SEN can be received. In a second step b), a REC-D, in particular a preoperative and / or intraoperative data set D can be received. In a third step c), the spatial position POS of the distal region DP of the DET-POS medical object MO with respect to the data set D can be determined. For this purpose, in particular, REC-C can be additionally received by a mobile acquisition unit 77 and the acquisition signal C can be used. If the data set D has an image and / or a model of the medical object MO of the examination object 31 and at least partially arranged in the examination object 31, the spatial position POS of the DET-POS distal region DP in the data set D can be determined. In a fourth step d), the origin of the ID-ORIG reaction force can be identified based on the sensor signal S, the spatial position POS of the distal region DP and the data set D. As a result, the PROV-SIG signal SIG can be provided based on the origin of the reaction force.

[0145] In addition, step c) may also include step c.1), wherein, in step c.1), an obstacle in the hollow organ at the distal area DP is identified as the origin of the reaction force based on the data group D, or the friction force between the hollow organ and the medical object MO is identified ID-ORIG as the origin of the reaction force by excluding the obstacle in the hollow organ.

[0146] Furthermore, in a further step c.2), a winding and / or spiraling of the medical object MO in the hollow organ can be identified based on the data set D. In this case, a PROV-SIG signal SIG can additionally be provided based on the identified winding and / or spiraling of the medical object MO in the hollow organ.

[0147] exist Figure 5A further advantageous embodiment of the proposed method for providing the PROV-SIG signal SIG is schematically shown in . Here, step a) may also include steps a.1) and a.2). In step a.1), the reference signal REF of the REC-REF reference unit RU is received. Furthermore, in step a.2), a virtual friction force vFRIC between the SIMU-FRIC medical object MO and the hollow organ may be simulated based on the at least one friction coefficient, in particular based on the reference signal REF. Furthermore, step c) may include a further step c.3), wherein the friction force between the ID-ORIG medical object MO and the hollow organ may be identified or excluded by a comparison COMP between the sensor signal S and the virtual friction force vFRIC.

[0148] If the reference unit RU is designed to acquire multiple friction coefficients along the longitudinal extension direction of the medical object MO, and a movement of the medical object MO relative to the reference unit RU is performed with the aid of a movement device CR before the method starts, the SIMU-FRIC virtual friction force vFRIC can be simulated based on the data set D and the multiple friction coefficients based on the spatial positioning POS of the distal area DP of the medical object MO in the examination object 31.

[0149] Figure 6 A schematic diagram of the proposed method for controlling a trimming unit REN is shown. Here, a signal SIG can be received by applying the proposed method for providing a signal PROV-SIG. Furthermore, the trimming unit REN can be controlled according to the signal SIG to trim the surface of the REN-MO medical object MO in order to reduce the coefficient of friction of the surface.

[0150] The schematic diagrams contained in the described drawings do not reflect scale or size relationships.

[0151] Finally, it is pointed out again that the method described in detail above and the device shown are only embodiments, and those skilled in the art can change the embodiments in different ways without departing from the scope of the invention. In addition, the use of the indefinite article "a" does not exclude that the relevant features can also exist multiple times. Similarly, the terms "unit" and "element" do not exclude that the relevant components are composed of multiple cooperating subcomponents, which can also be distributed in space if necessary.

Claims

1. A device for moving a medical object (MO), the device comprising a mobile device (CR) and a sensor unit (SEN), in, The movement device (CR) is designed to hold and / or move a medical object (MO) at least partially arranged in the movement device (CR) by means of force transmission, The sensor unit (SEN) is designed to detect a reaction force exerted by the medical object (MO) on the mobile device (CR) and directed opposite to the force, wherein the medical object (MO) is at least partially arranged in the examination object (31), The device further comprises a processing unit (22) and a reference unit (RU), wherein the distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), The reference unit (RU) is designed to detect at least one friction coefficient of the medical object (MO) on the moving device (CR) and / or the introduction sheath (IP), which is used to introduce the medical object (MO) into the examination object (31), Wherein, the processing unit (22) is designed to: - simulating (SIMU-FRIC) a virtual friction force (vFRIC) between the medical object (MO) and the hollow organ according to the at least one friction coefficient, - identifying friction forces between the hollow organ and the medical object (MO) as the origin of the reaction forces by comparison (COMP) between the reaction forces and virtual friction forces (vFRIC) or excluding the possibility of friction forces between the hollow organ and the medical object (MO) as the origin of the reaction forces, wherein the device is designed to provide a (PROV-SIG) signal (SIG) as a function of the reaction force, Therein, the movement device (CR) is designed to move the medical object (MO) according to the signal (SIG).

2. The device according to claim 1, wherein: The device further comprises a processing unit (22) configured to: - receiving (REC-D) a data set (D), wherein the data set (D) comprises an image of the object under examination (31), - determining (DET-POS) a spatial position (POS) of a distal region (DP) of a medical object (MO) with respect to a data set (D), - identification (ID-ORIG) of the origin of the reaction force based on the spatial location (POS) of the reaction force, the distal zone (DP) and the data set (D), - providing a (PROV-SIG) signal (SIG) depending on the origin of said reaction force.

3. The device according to claim 2, characterized in that The reference unit (RU) is designed to acquire a plurality of friction coefficients along a longitudinal extension direction of the medical object (MO), The medical object (MO) can be moved relative to a reference unit (RU) by means of a movement device (CR), Therein, the processing unit (22) is further designed to simulate (SIMU-FRIC) a virtual friction force (vFRIC) based on the spatial positioning (POS) of the distal region (DP) of the medical object (MO) in the examination object (31) and the plurality of friction coefficients.

4. The device according to claim 2 or 3, characterized in that The distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), The processing unit (22) is also designed to, in the presence of a reaction force, Identification (ID-ORIG) of obstacles in the hollow organ at the distal region (DP) as the origin of the reaction force based on the data set (D) or By eliminating obstacles in the hollow organ based on the data set (D), the friction forces between the hollow organ and the medical object (MO) are identified (ID-ORIG) as the origin of the reaction forces.

5. The device according to claim 2, characterized in that The data set (D) comprises an image and / or a model of an examination subject (31) and of a medical object (MO) at least partially arranged in the examination subject (31). The processing unit (22) is also designed to determine (DET-POS) a spatial position (POS) of a distal region (DP) of the medical object (MO) in the data set (D).

6. The device according to claim 5, characterized in that The distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), The processing unit (22) is further designed to detect a winding and / or spiral formation of the medical object (MO) in the hollow organ in the presence of a reaction force based on the data set (D), Therein, the movement device (CR) is also designed to additionally move the medical object (MO) as a function of a detected winding and / or spiral formation of the medical object (MO) in the hollow organ.

7. The device according to claim 1, further comprising a conditioning unit (REN), in, The conditioning unit (REN) is designed to condition the surface of the medical object (MO) at least in sections as a function of the signal (SIG) in such a way that the coefficient of friction of the surface is reduced.

8. The device according to claim 7, characterized in that The trimming unit (REN) is arranged on a movement device (CR) and / or on an introduction sheath (IP) for introducing a medical object (MO) into an examination object (31), The movement device (CR) is designed to move the medical object (MO) at least partially out of the examination object (31) in response to a signal (SIG). Therein, the conditioning unit (REN) is designed to condition the surface of the removed section of the medical object (MO).

9. The device according to claim 7 or 8, characterized in that The conditioning unit (REN) is at least partially integrated in the medical object (MO), The trimming unit (REN) is designed to trim the surface of the medical object (MO) at least in sections while the section to be trimmed is arranged in the examination object (31).

10. A system comprising an apparatus according to one of the preceding claims and a medical imaging device, wherein: The medical imaging device is designed to record a data set (D) of an examination subject (31) and to provide it to the apparatus.

11. A method for providing a signal (PROV-SIG), wherein: Before the method is started, a movement and / or holding of the medical object (MO) is carried out by means of the movement device (CR), wherein the movement device (CR) is designed to hold and / or move a medical object (MO) at least partially arranged in the movement device (CR) by means of force transmission, wherein the medical object (MO) is at least partially arranged in the examination object (31), The method comprises: a) receiving (REC-S) a sensor signal (S) from a sensor unit (SEN), The sensor unit (SEN) is designed to detect a reaction force exerted by the medical object (MO) on the mobile device (CR) and directed opposite to the force, Among them, the sensor signal (S) has information about the reaction force, b) receiving (REC-D) data group (D), The data set (D) comprises an image of the object under examination (31), c) determining (DET-POS) a spatial position (POS) of a distal region (DP) of a medical object (MO) with respect to the data set (D), d) identifying (ID-ORIG) the origin of the reaction force based on the sensor signal (S), the spatial location (POS) of the distal region (DP) and the data set (D), e) providing a (PROV-SIG) signal (SIG) according to the origin of the reaction force, wherein the distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), Wherein, step a) further comprises: a.1) Receive (REC-REF) the reference signal (REF) of the reference unit (RU), The reference unit (RU) is designed to detect at least one friction coefficient of the medical object (MO) on the moving device (CR) and / or the introduction sheath (IP), which is used to introduce the medical object (MO) into the examination object (31), a.2) simulating (SIMU-FRIC) a virtual friction force (vFRIC) between the medical object (MO) and the hollow organ based on the at least one friction coefficient, Wherein, step c) further comprises: c.3) Identifying the friction between the hollow organ and the medical object (MO) as the origin of the reaction force or excluding the possibility of the friction between the hollow organ and the medical object (MO) as the origin of the reaction force by comparing (COMP) the sensor signal (S) with the virtual friction force (vFRIC).

12. The method according to claim 11, wherein: The distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), Wherein, step c) further comprises: c.1) Identification of obstacles in the hollow organ at the distal region (DP) as the origin of the reaction force from the data set (D) or By eliminating obstacles in the hollow organ based on the data set (D), the friction forces between the hollow organ and the medical object (MO) are identified as the origin of the reaction forces.

13. The method according to claim 11 or 12, characterized in that The data set (D) comprises an image and / or a model of an examination subject (31) and of a medical object (MO) at least partially arranged in the examination subject (31). In this case, in step c), the spatial position (POS) of the distal region (DP) of the medical object (MO) in the data set (D) is determined (DET-POS).

14. The method according to claim 13, characterized in that The distal region (DP) of the medical object (MO) is arranged in a hollow organ of the object under examination (31), Wherein, step c) further comprises: c.2) identifying the winding and / or spiral formation of the medical object (MO) in the hollow organ based on the data set (D), In this case, in step e), a (PROV-SIG) signal (SIG) is additionally provided as a function of the detected meandering and / or spiraling of the medical object (MO) in the hollow organ.

15. The method according to claim 11, in, The reference unit (RU) is designed to acquire a plurality of friction coefficients along a longitudinal extension direction of the medical object (MO), wherein before the method is started, a movement of the medical object (MO) relative to the reference unit (RU) is carried out by means of a movement device (CR), Therein, in step a.2), a virtual friction force (vFRIC) is simulated (SIMU-FRIC) based on the spatial positioning (POS) of the distal region (DP) of the medical object (MO) in the examination object (31) based on the data set (D) and multiple friction coefficients.

16. A method for controlling a trimming unit (REN), wherein: Receiving a signal (SIG) by applying a method according to one of claims 11 to 15, Therein, the trimming unit (REN) is controlled according to a signal (SIG) to trim the surface of the medical object (MO) in order to reduce the coefficient of friction of the surface.

17. A computer program product comprising a program and being directly loadable into a memory of a programmable arithmetic unit of a processing unit (22), having program instructions for carrying out a method according to one of claims 11 to 16 when the program is executed in the arithmetic unit of the processing unit (22).

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