Left atrial appendage measurement and angiography robotic arm and medical equipment

Abstract

The present application discloses a left atrial appendage measurement and angiography mechanical arm and medical equipment, comprising: a frame (5); a first actuator (1), arranged on the frame (5), and provided with: a pushing block (63) for pushing a syringe (6); a syringe (6), the output end of which is connected to a pigtail catheter (4) and a delivery sheath (3), and is used to inject a contrast agent into the pigtail catheter (4) and the delivery sheath (3) under the push of the pushing block (63); a first clamper (31), having two opposite ends, a first end of which leads out the delivery sheath (3), and a second end for clamping the delivery sheath (3), and introducing the pigtail catheter (4) into the delivery sheath (3) through the second end; and a second actuator (2), arranged on the frame (5), and provided with: a second clamper (32), arranged opposite to the first clamper (31), and a third end of which is used to clamp the pigtail catheter (4). The solution of the present application avoids damage to the operator's body caused by fluoroscopy or X-rays, and improves the operator's control accuracy over the delivery sheath and pigtail catheter.

Description

Technical Field

[0001] The present application relates to the technical field of medical equipment, and in particular to a left atrial appendage measurement and angiography robotic arm and medical equipment. Background Art

[0002] Left atrial appendage occlusion (LAAC), also known as interventional left atrial appendage occlusion, involves inserting a disc or plug occluder into the left atrial appendage (LAA) through the femoral vein. This occluder effectively prevents blood clots from being carried out of the LAA by the bloodstream and potentially blocking small blood vessels, thereby reducing the risk of embolic events. Different LAA sizes vary from patient to patient, and occluders of varying sizes are used for each patient. Prior to the procedure, the patient's LAA size must be determined and the appropriate occluder will be selected based on the patient's LAA size.

[0003] Currently, when doctors measure a patient's left atrial appendage, they need to manually manipulate the delivery sheath and pigtail catheter from the inferior femoral vein through the atrial septum into the left atrial appendage of the left atrium under X-rays, and inject contrast agent into the left atrial appendage through the pigtail catheter to visualize the left atrial appendage. During this process, the diameter of the delivery sheath is used as a size reference to estimate the size of the left atrial appendage, and the corresponding occluder is adapted during the left atrial appendage occlusion surgery.

[0004] Left atrial appendage occlusion (LAA) is an interventional procedure that uses an occluder to block the LAA. This procedure effectively prevents the formation of LAA thrombi during atrial fibrillation (AF). This thrombus can then escape and block small cerebral blood vessels, potentially leading to ischemic stroke and long-term disability or death. LAA occlusion also eliminates patients' dependence on long-term oral anticoagulation therapy, providing a new treatment option for patients who cannot or do not want long-term anticoagulation therapy or who are at high risk of bleeding.

[0005] A key step before performing left atrial appendage occlusion surgery is to measure the size of the left atrial appendage. It is crucial to match the appropriate size of the occluder for the operation. If the occluder is too small, it will lead to incomplete occlusion of the left atrial appendage. After partial occlusion of the left atrial appendage, the blood in the left atrial appendage will also have lower fluidity, making it more likely to produce thrombosis than before occlusion. Since the occlusion is not complete, the thrombus in the left atrial appendage can still leave the left atrial appendage and block small blood vessels, leading to surgical complications such as stroke. Compared with before occlusion, the possibility of stroke is increased. Therefore, it is crucial to choose the right type of occluder. Accurate measurement of the left atrial appendage size is required before surgery.

[0006] However, currently, when the surgeon measures the patient's left atrial appendage during surgery, the surgeon needs to manually manipulate the delivery sheath and pigtail catheter to puncture the femoral vein into the right atrium, then enter the left atrium through the atrial septal channel established by the atrial septal puncture surgery, and finally enter the left atrial appendage in the left atrium. The above processes need to be performed under the guidance of X-rays and fluoroscopy. The radiation during the process causes great damage to the surgeon's body, and the surgeon needs to wear a lead coat and perform the operation next to the operating table, which will limit the surgeon's control of the sheath and pigtail catheter, affecting the measurement of the left atrial appendage size.

[0007] After the pigtail catheter enters the left atrial appendage, the surgeon injects contrast agent into the left atrial appendage through the pigtail catheter to visualize the outline of the left atrial appendage. By comparing the size of the sheath, the various dimensions of the left atrial appendage can be obtained. Since occluders are divided into disc-type and plug-type occluders, the disc-type occluder seals the left atrial appendage by blocking the left atrial appendage opening, so the size of the left atrial appendage opening needs to be measured very accurately. The plug-type occluder blocks the left atrial appendage by filling the occluder with the left atrial appendage, so the size of the deep part of the left atrial appendage and the longitudinal depth of the left atrial appendage need to be accurately measured. After the pigtail catheter injects the contrast agent, due to the rapid blood flow rate in the heart, the contrast agent is washed away before it diffuses to the deep part of the left atrial appendage or the opening of the left atrial appendage, and the visualization is not obvious. It is impossible to accurately measure the depth and opening of the left atrial appendage, resulting in large errors, which affects the selection of the occluder in the later stage and thus affects the effect of the left atrial appendage occlusion surgery.

[0008] After the LAA measurement is complete, the surgeon removes the pigtail catheter from the delivery sheath and then installs the LAA occluder and delivery cable. During the procedure change, additional personnel are required to secure the delivery sheath and complete the loading process, a complex and tedious process. Unstable instrument manipulation during the procedure can prolong the procedure and cause unnecessary complications. Summary of the Invention

[0009] An embodiment of the present application provides a left atrial appendage measurement and angiography robotic arm and medical equipment, which is used to control a delivery sheath, a pigtail catheter and a contrast agent injection mechanism through the robotic arm. The operator can remotely control the robotic arm to control the delivery sheath and the pigtail catheter to enter the left atrial appendage under the guidance of fluoroscopy, and then control the robotic arm to control the contrast agent injection mechanism to inject contrast agent into the left atrial appendage.

[0010] The present application provides a left atrial appendage measurement and angiography robotic arm, comprising:

[0011] Rack 5;

[0012] The first actuator 1 is provided on the frame 5 and is provided with:

[0013] A pushing block 63 for pushing the syringe 6;

[0014] an injector 6, the output end of which is in communication with the pigtail catheter 4 and the delivery sheath 3, for injecting contrast agent into the pigtail catheter 4 and the delivery sheath 3 under the push of the push block 63;

[0015] A first clamper 31 has two opposite ends, a first end of which leads out the delivery sheath 3, and a second end is used to clamp the delivery sheath 3, and the pigtail catheter 4 is introduced into the delivery sheath 3 through the second end;

[0016] The second actuator 2 is provided on the frame 5 and is provided with:

[0017] The second clamper 32 is disposed opposite to the first clamper 31 , and a third end thereof is used to clamp the pigtail catheter 4 .

[0018] Optionally, the first actuator 1 is further provided with a first gear 11 , and the first clamper 31 is further provided with a third gear 12 , and the third gear 12 is engaged with the first gear 11 to control the circumferential rotation of the delivery sheath 3 under the drive of the first gear 11 .

[0019] Optionally, the second actuator 2 is further provided with a second gear 21 , and the second clamper 32 is further provided with a fourth gear 22 . The second gear 21 is engaged with the fourth gear 22 to control the circumferential rotation of the pigtail catheter 4 under the drive of the second gear 21 .

[0020] Optionally, the pushing block 63 is slidably connected to the first actuator 1 and is provided with a rack;

[0021] The first actuator 1 is further provided with a fifth gear 62 , which is engaged with the rack.

[0022] Optionally, a driving assembly is further included to provide driving force for the first gear 11, the second gear 21 and the fifth gear 62 to control the circumferential rotation of the delivery sheath 3 and the pigtail catheter 4, and to control the injection of contrast agent by the syringe 6.

[0023] Optionally, the first actuator 1 is further provided with:

[0024] The first support 7 includes a first support base 71 and a first flip cover 72 . The first support base 71 is provided with a first clamper adapting structure 73 to adapt to the first clamper 31 and the delivery sheath 3 .

[0025] The first support seat 71 is further provided with a first support seat through hole 74 for receiving the first gear 11;

[0026] The first flip cover 72 is used to buckle the first support seat 71 and limit the radial and axial displacement of the delivery sheath 3 relative to the first actuator 1 after buckling;

[0027] The second actuator 2 is also provided with:

[0028] The second support 8 includes a second support base 81 and a second flip cover 82. The second support base 81 is provided with a second clamper adapting structure 83 to adapt to the second clamper 32 and the pigtail catheter 4;

[0029] The second support base 81 is further provided with a second support base through hole 84 for receiving the second gear 21;

[0030] The second flip cover 82 is used to buckle the second support seat 81 and limit the radial and axial displacement of the pigtail catheter 4 relative to the second actuator 2 after buckling.

[0031] Optionally, the first holder 31 is further provided with a delivery sheath contrast agent input port 33 for connecting to the syringe 6 based on the first branch tube;

[0032] The second holder 32 is also provided with a pigtail catheter contrast agent input port 34 for connecting to the syringe 6 via a second branch tube.

[0033] Optionally, the syringe 6, the first clamp 31 and the second clamp 32 are arranged on the same side of the frame 5, so that the consumables connected to the syringe 6, the first clamp 31 and the second clamp 32 are distributed on the same side.

[0034] An embodiment of the present application also proposes a medical device, including the aforementioned left atrial appendage measurement and angiography robotic arm.

[0035] In this embodiment, a robotic arm controls the delivery sheath, pigtail catheter, and contrast agent injection mechanism. The operator can remotely manipulate the robotic arm to direct the delivery sheath and pigtail catheter into the left atrial appendage under fluoroscopic guidance. The operator then manipulates the robotic arm to control the contrast agent injection mechanism to inject contrast agent into the left atrial appendage. This remote operation avoids damage to the operator's body caused by fluoroscopy or X-rays and improves the operator's control precision over the delivery sheath and pigtail catheter.

[0036] The above description is only an overview of the technical solution of the present application. In order to more clearly understand the technical means of the present application, it can be implemented in accordance with the contents of the specification. In order to make the above and other purposes, features and advantages of the present application more obvious and easy to understand, the specific implementation methods of the present application are listed below. BRIEF DESCRIPTION OF THE DRAWINGS

[0037] Various other advantages and benefits will become apparent to those skilled in the art upon reading the detailed description of the preferred embodiment below. The accompanying drawings are for illustration purposes only and are not to be considered as limiting the present application. The same reference symbols are used throughout the drawings to represent the same components. In the drawings:

[0038] Figure 1 This is a schematic diagram of the overall structure of the robotic arm according to an embodiment of the present application;

[0039] Figure 2 This is a schematic diagram of the structure of the robotic arm injector portion of an embodiment of the present application;

[0040] Figure 3 This is a schematic structural diagram of the first actuator and the second actuator of the robotic arm in an embodiment of the present application;

[0041] Figure 4 A cross-sectional view of a gripper and a handle of a robotic arm according to an embodiment of the present application;

[0042] Figure 5 This is a schematic diagram of the support structure of the robotic arm according to an embodiment of the present application;

[0043] Figure 6 This is a schematic diagram of the signal control flow of the robotic arm according to an embodiment of the present application;

[0044] Figure 7 This is an example of the UI control interface of the robotic arm in an embodiment of the present application. DETAILED DESCRIPTION

[0045] Exemplary embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. Although exemplary embodiments of the present disclosure are shown in the accompanying drawings, it should be understood that the present disclosure can be implemented in various forms and should not be limited by the embodiments set forth herein. Rather, these embodiments are provided to enable a more thorough understanding of the present disclosure and to fully convey the scope of the present disclosure to those skilled in the art.

[0046] The left atrial appendage measurement methods currently used in clinical practice have the following disadvantages:

[0047] 1. During the measurement process, the surgeon needs to manually control the delivery sheath and pigtail catheter, which results in low surgical accuracy. The surgeon can only estimate and control based on personal experience. Surgeon fatigue and unstable operation can easily affect surgical safety.

[0048] 2. During the operation, the surgeon needs to perform the operation under X-ray at the operating table. Repeated X-ray operations over time will have an adverse effect on the surgeon's health.

[0049] 3. Contrast agent is injected into the left atrial appendage only through a pigtail catheter. Due to the rapid blood flow in the heart, the contrast agent is easily dispersed. The area close to the contrast agent outlet of the pigtail catheter is clearly visualized, while the area farther away from the pigtail catheter has a lower contrast agent concentration and is blurred. It is impossible to measure the size of the deep part of the left atrial appendage and the opening of the left atrial appendage at the same time, or the measurement accuracy is low.

[0050] 4. Left atrial appendage occlusion surgery includes left atrial appendage measurement and occluder implantation. The switching of surgical instruments in the middle requires collaborative control by multiple people. At the same time, unstable instrument operation often prolongs the operation time and causes complications.

[0051] Based on this, the embodiment of the present application provides a left atrial appendage measurement and angiography robot arm, such as Figure 1 、 Figure 2 As shown, including:

[0052] Rack 5;

[0053] The first actuator 1 is provided on the frame 5 and is provided with:

[0054] A pushing block 63 for pushing the syringe 6;

[0055] The syringe 6 has an output end in communication with the pigtail catheter 4 and the delivery sheath 3, and is used to inject contrast agent into the pigtail catheter 4 and the delivery sheath 3 under the push of the push block 63. The syringe 6 includes a syringe push rod 64, and the push block 63 can be used to push the syringe push rod 64 to inject the contrast agent into the pigtail catheter 4 and the delivery sheath 3.

[0056] The first clamp 31 has two opposite ends, a first end of which leads out the delivery sheath 3, and a second end for clamping the delivery sheath 3, through which the pigtail catheter 4 is introduced into the delivery sheath 3. Specifically, the first clamp 31 can clamp the delivery sheath handle 35, thereby leading the delivery sheath 3 out from the first end of the first clamp 31.

[0057] The second actuator 2 is provided on the frame 5 and is provided with:

[0058] The second clamp 32 is disposed opposite to the first clamp 31 , and its third end is used to clamp the pigtail catheter 4 . Specifically, the second clamp 32 can clamp the pigtail catheter handle 36 , so that the pigtail catheter 4 is led out from the third end of the second clamp 32 .

[0059] In this embodiment, a robotic arm controls the delivery sheath, pigtail catheter, and contrast agent injection mechanism. The operator can remotely manipulate the robotic arm to direct the delivery sheath and pigtail catheter into the left atrial appendage under fluoroscopic guidance. The operator then manipulates the robotic arm to control the contrast agent injection mechanism to inject contrast agent into the left atrial appendage. This remote operation avoids damage to the operator's body caused by fluoroscopy or X-rays and improves the operator's control precision over the delivery sheath and pigtail catheter.

[0060] In some embodiments, as Figure 3 As shown, the first actuator 1 is further provided with a first gear 11, and the first clamper 31 is further provided with a third gear 12. The third gear 12 is engaged with the first gear 11 to control the circumferential rotation of the delivery sheath 3 under the drive of the first gear 11.

[0061] In some embodiments, as Figure 3 As shown, the second actuator 2 is further provided with a second gear 21 , and the second clamper 32 is further provided with a fourth gear 22 . The second gear 21 is engaged with the fourth gear 22 to control the circumferential rotation of the pigtail catheter 4 under the drive of the second gear 21 .

[0062] In some specific applications, the axial rotation of the pigtail catheter 4 is performed synchronously, that is, the first gear 11 and the second gear 21 can be controlled to operate synchronously to achieve circumferential rotation of the pigtail catheter 4 .

[0063] In some embodiments, the pushing block 63 is slidably connected to the first actuator 1 , on which a rack is provided; the first actuator 1 is also provided with a fifth gear 62 , which is engaged with the rack.

[0064] In some embodiments, a driving assembly is also included to provide driving force for the first gear 11, the second gear 21 and the fifth gear 62 to control the circumferential rotation of the delivery sheath 3 and the pigtail catheter 4, and to control the injection of contrast agent by the syringe 6.

[0065] In a specific application scenario, the drive assembly (not shown) may include corresponding drive motors. For example, a drive motor may be provided for each of the first gear 11, the second gear 21, and the fifth gear 62. Instructions are sent to the drive motors through the backend, thereby controlling the drive motors to provide driving force to achieve the driving effect. Similarly, the overall movement of the first actuator 1 and / or the second actuator 2 on the frame 5 may also be driven by a drive motor, rack, or track, without specific limitation herein.

[0066] The solution of the present application uses a robotic arm to drive the delivery sheath and pigtail catheter, allowing the surgeon to control the delivery sheath and pigtail catheter more simply and accurately, reducing the doctor training cycle, improving surgical accuracy, and preventing uncertain factors such as surgeon fatigue from affecting surgical safety.

[0067] In some embodiments, the first holder 31 is further provided with a delivery sheath contrast agent input port 33 for connecting to the syringe 6 based on the first branch tube;

[0068] The second holder 32 is also provided with a pigtail catheter contrast agent input port 34 for connecting to the syringe 6 via a second branch tube.

[0069] Specifically, such as Figure 1 、 Figure 2 、 Figure 4 As shown, the output end of the syringe 6 is designed with two branches, which are connected to the contrast agent input port 33 of the delivery sheath and the contrast agent input port 34 of the pigtail catheter through the first branch and the second branch respectively, so that the output port of the syringe 6 is connected to the liquid channels in the delivery sheath and the pigtail catheter respectively, and the pushing device includes a fifth gear arranged on the first actuator and a pushing block slidably connected to the first actuator. The robotic arm can drive the fifth gear to rotate, thereby driving the pushing block engaged with the fifth gear to move axially, and the pushing block pushes the syringe push rod 64, and presses the contrast agent in the syringe 6 into the liquid channels of the delivery sheath and the pigtail catheter respectively through the infusion tube, and finally injects it into the target position from the head end of the delivery sheath 3 and the pigtail catheter 4 respectively.

[0070] In a specific example, the head end of the delivery sheath 3 is arranged at the opening of the left atrial appendage, and the contrast agent injected from the head end of the delivery sheath 3 has the highest concentration and the clearest imaging at the opening of the left atrial appendage, while the head end of the pigtail catheter 4 is arranged at the bottom of the left atrial appendage, so the contrast agent injected from the head end of the pigtail catheter 4 into the left atrial appendage has the highest concentration and the clearest imaging at the bottom of the left atrial appendage. By injecting the contrast agent from slow to fast at the opening of the left atrial appendage and the bottom of the left atrial appendage at the same time, the opening of the left atrial appendage, the bottom of the left atrial appendage and the depth of the left atrial appendage are made clearer. Compared with the traditional left atrial appendage measurement method, the scheme of the present application injects less contrast agent. In order to make the opening and bottom of the left atrial appendage have clear imaging, the traditional single-head injection method can only improve the imaging clarity by increasing the injection amount of contrast agent, and excessive injection of contrast agent has certain harm to the patient's body. The scheme of the present application can overcome the above technical problems.

[0071] In some embodiments, the first actuator 1 is further provided with:

[0072] The first support 7 includes a first support base 71 and a first flip cover 72 . The first support base 71 is provided with a first clamper adapting structure 73 to adapt to the first clamper 31 and the delivery sheath 3 .

[0073] The first support seat 71 is further provided with a first support seat through hole 74 for receiving the first gear 11;

[0074] The first flip cover 72 is used to buckle the first support seat 71 and limit the radial and axial displacement of the delivery sheath 3 relative to the first actuator 1 after buckling.

[0075] Specifically, such as Figure 5 As shown, the first actuator and the second actuator are respectively provided with a first support 7 and a second support 8, wherein the first support 7 is used to rotatably mount the delivery sheath 3 and the first clamp 31 on the first actuator 1. The first support 7 includes a first support seat 71 and a first flip cover 72. The first support 7 is provided with an adapting structure for the first clamp 31. After the delivery sheath 3 and the first clamp 31 are mounted on the first support seat 71, the first gear on the first actuator 1 and the third gear on the first clamp 31 are automatically engaged. The first support seat 71 is also provided with a first support seat through hole 74, through which the first gear and the third gear are engaged. The first flip cover 72 is used to buckle on the first support seat 71 after the delivery sheath 3 is mounted on the first support seat 71 to limit the radial and axial displacement of the delivery sheath 3 relative to the first actuator.

[0076] The second actuator 2 is also provided with:

[0077] The second support 8 includes a second support base 81 and a second flip cover 82. The second support base 81 is provided with a second clamper adapting structure 83 to adapt to the second clamper 32 and the pigtail catheter 4;

[0078] The second support base 81 is further provided with a second support base through hole 84 for receiving the second gear 21;

[0079] The second flip cover 82 is used to buckle the second support seat 81 and limit the radial and axial displacement of the pigtail catheter 4 relative to the second actuator 2 after buckling.

[0080] Specifically, such as Figure 5As shown, the second support 8 is used to rotatably mount the pigtail catheter 4 and the second clamp 32 on the second actuator 2. The second support 8 includes a second support seat 81 and a second flip cover 82. The second support 8 is provided with an adaptor mechanism for the second clamp 32. After the pigtail catheter 4 and the second clamp 32 are mounted on the second support seat, the second gear on the second actuator 2 automatically engages with the fourth gear on the pigtail catheter handle. The second support seat 81 is also provided with a second support seat through-hole 84, through which the second gear and the fourth gear engage. The second flip cover 82 is used to buckle on the second support seat after the pigtail catheter 4 is mounted on the second support seat 81 to limit the axial and radial displacement of the pigtail catheter relative to the rear-end actuator.

[0081] Through the cooperation of the above two supports and two clamps, the robotic arm can control the delivery sheath and pigtail catheter more accurately and stably.

[0082] In some embodiments, the syringe 6, the first clamp 31 and the second clamp 32 are arranged on the same side of the frame 5, so that the consumables connected to the syringe 6, the first clamp 31 and the second clamp 32 are distributed on the same side. Figure 1 、 Figure 2 As shown, the syringe 6, the first clamp 31 and the second clamp 32 are arranged on the same side of the frame 5, so that the consumables connected thereto are also on the same side. On the one hand, the efficiency of replacing consumables is improved, and on the other hand, the angle of feeding consumables during surgery is reduced, and the degree of bending of consumables during use is reduced, which facilitates the surgeon to complete the surgery efficiently.

[0083] In this application, a pigtail catheter is inserted into the bottom of the left atrial appendage, a delivery sheath is set at the opening of the left atrial appendage, and contrast agent is injected from slow to fast through the pigtail catheter and the delivery sheath. This not only improves the dimensional measurement accuracy of the left atrial appendage opening and the bottom of the left atrial appendage, but also allows measurements of these two parts to be made at the same time, thereby improving surgical efficiency and allowing patients to adapt to more types of occluders. This method of contrast agent injection can also improve the utilization efficiency of the contrast agent and prevent excessive injection of contrast agent.

[0084] An embodiment of the present application also proposes a medical device, including the aforementioned left atrial appendage measurement and angiography robotic arm.

[0085] Specifically, the medical equipment of this embodiment also includes a doctor control terminal and a main control system. The surgeon can send control instructions to the main control system through the doctor control terminal in the doctor control room, and the main control system remotely controls the robotic arm in the operating room to perform corresponding surgical operations. The surgeon can perform surgery outside the operating room, avoiding the harm to the doctor's health caused by exposure to radiation during surgery.

[0086] The signal control and flow chart of this application are as follows Figure 6 As shown, the surgeon controls the doctor control terminal to send control instructions to the main control system, and the main control system sends surgical instructions to the remote robotic arm in the operating room. The remote robotic arm executes the corresponding surgical instructions, including controlling the two degrees of freedom of the pigtail catheter and the delivery sheath (rotation and forward and backward pushing), and controlling the contrast agent injection mechanism to inject the contrast agent from slow to fast. The contrast agent diffuses at the left atrial appendage orifice and the left atrial appendage bottom through the inner cavity of the delivery sheath and the pigtail catheter, respectively, and the outline of the left atrial appendage is developed under DSA fluoroscopy.

[0087] This application quantifies the relative positions of the delivery sheath and pigtail catheter through the main control system workstation, such as Figure 7 The following is an example of the workstation UI interface. Based on the quantified relative positions, the axial position and circumferential relative angle of the delivery sheath and pigtail catheter are simulated, for example: Figure 7 As shown in the figure, the delivery sheath is advanced 30mm, and the pigtail catheter is advanced 50mm. The relative positions of the sheath and pigtail are simulated, with the pigtail catheter extending 20mm beyond the sheath. The workstation interface also displays the rotational status of the delivery sheath and pigtail catheter, as well as a simulated representation of their relative positions. This interface allows the surgeon to monitor the relative positions of the delivery sheath and pigtail catheter in real time, facilitating accurate control of the pigtail and delivery sheath.

[0088] The present application also provides an example of a left atrial appendage occlusion surgical procedure using the robotic arm of the present application:

[0089] After the atrial septal puncture procedure is completed, the guide wire is withdrawn, and a 2.6-meter-long 0.035-inch stiffened steel wire (usually a J-head stiffened steel wire with a 7-cm soft end) is inserted along the sheath to the distal end of the left superior pulmonary vein. The steel wire is then fixed and the atrial septal puncture sheath is withdrawn.

[0090] Carefully deliver the left atrial appendage occlusion delivery sheath along the hardened steel wire to the orifice of the left superior pulmonary vein.

[0091] Keep the delivery sheath stationary, withdraw the stylet, and insert a J-bend pigtail catheter (5Fr or 6Fr) to the orifice of the left superior pulmonary vein.

[0092] Disposable supports are installed on the front and rear actuators of the robotic arm respectively, the delivery sheath is installed into the support of the front actuator, the J-shaped pigtail catheter is installed into the support of the rear actuator, and the three-way connection of the delivery sheath is connected to the syringe for exhaust.

[0093] Under X-ray fluoroscopy, the robotic arm is manipulated to adjust the angle of the delivery sheath and pigtail catheter at a small angle, usually to the right anterior oblique position of 30° + the foot position of 20° (or adjusted to the optimal expansion position of the left atrial appendage).

[0094] The rear end actuator of the manipulator arm is controlled to move the tip of the pigtail catheter toward the deepest part of the left atrial appendage, and the front end actuator of the manipulator arm is controlled to deliver the tip of the delivery sheath to the opening of the left atrial appendage.

[0095] The contrast agent injection mechanism is controlled by the front-end actuator of the robotic arm, and the contrast agent is injected into the delivery sheath and pigtail catheter from slow to fast speed to fully visualize the left atrial appendage orifice and each lobule of the left atrial appendage bottom.

[0096] Under DSA fluoroscopy, contrast agents are used to clearly show the morphology, opening, and lobes of the left atrial appendage. DSA then measures the maximum diameter and maximum available depth of the left atrial appendage opening (anchoring zone depth).

[0097] Under DSA fluoroscopy, the left atrial appendage outline is drawn on the surgical screen with a whiteboard pen (locking the DSA position) to determine the left atrial appendage closure route, anchoring area and working axis (there are significant differences in the closure line, anchoring area and working axis of the left atrial appendage between the internal plug occluder and the external cover occluder).

[0098] According to the left atrial appendage opening diameter and maximum available depth measured by DSA, the appropriate size of the occluder is selected (usually the occluder size is 4-6 mm larger than the measured value of the left atrial appendage opening).

[0099] Finally, the occluder was prepared in vitro, the pigtail catheter was withdrawn, and the left atrial appendage measurement was completed.

[0100] This application uses a remotely controlled robotic arm to perform surgery, allowing the surgeon to perform the surgery outside the operating room, avoiding radiation exposure and improving surgical safety. This application simulates the movement of the delivery sheath and pigtail catheter starting from their initial position by quantifying the rotation and axial movement of the delivery sheath and pigtail catheter. Through the simulation interface, the surgeon can clearly understand the relative positions of the delivery sheath and pigtail catheter, enabling more accurate control.

[0101] It should be noted that, in this document, the terms "comprises," "includes," or any other variations thereof are intended to encompass non-exclusive inclusion, such that a process, method, article, or apparatus comprising a series of elements includes not only those elements but also other elements not explicitly listed, or elements inherent to such process, method, article, or apparatus. In the absence of further limitations, an element defined by the phrase "comprising a ..." does not exclude the presence of other identical elements in the process, method, article, or apparatus comprising the element.

[0102] The serial numbers of the above embodiments of the present application are for description only and do not represent the advantages or disadvantages of the embodiments.

[0103] The embodiments of the present application are described above in conjunction with the accompanying drawings, but the present application is not limited to the above-mentioned specific implementation methods. The above-mentioned specific implementation methods are merely illustrative and not restrictive. Under the guidance of this application, ordinary technicians in this field can also make many forms without departing from the purpose of this application and the scope of protection of the claims, all of which are protected by this application.

Claims

1. A left atrial appendage measurement and angiography robotic arm, characterized in that: include: Rack (5); The first actuator (1) is arranged on the frame (5) and is provided with: A push block (63) for pushing the syringe (6); an injector (6), the output end of which is in communication with the pigtail catheter (4) and the delivery sheath (3), and is used for injecting contrast agent into the pigtail catheter (4) and the delivery sheath (3) under the push of the push block (63); a first clamp (31) having two opposite ends, wherein the first end thereof leads out of the delivery sheath (3), and the second end is used to clamp the delivery sheath (3), and the pigtail catheter (4) is introduced into the delivery sheath (3) through the second end; The second actuator (2) is arranged on the frame (5) and is provided with: a second clamp (32), disposed opposite to the first clamp (31), with a third end for clamping the pigtail catheter (4); A first actuator (1) is further provided with a first gear (11), and the first clamper (31) is further provided with a third gear (12), wherein the third gear (12) is engaged with the first gear (11) to control the circumferential rotation of the delivery sheath tube (3) under the drive of the first gear (11); The second actuator (2) is further provided with a second gear (21), and the second clamper (32) is further provided with a fourth gear (22), the second gear (21) being meshed with the fourth gear (22) to control the circumferential rotation of the pigtail catheter (4) under the drive of the second gear (21); The pushing block (63) is slidably connected to the first actuator (1) and is provided with a rack; The first actuator (1) is further provided with a fifth gear (62), and the fifth gear (62) is meshed with the rack; It also includes a driving assembly for providing driving force to the first gear (11), the second gear (21) and the fifth gear (62), so as to control the circumferential rotation of the delivery sheath (3) and the pigtail catheter (4); and to control the injection of contrast agent by the syringe (6); The syringe (6), the first clamp (31) and the second clamp (32) are arranged on the same side of the frame (5), so that the consumables connected to the syringe (6), the first clamp (31) and the second clamp (32) are distributed on the same side.

2. The left atrial appendage measurement and angiography robotic arm according to claim 1, characterized in that: The first actuator (1) is further provided with: A first support (7) comprises a first support seat (71) and a first flip cover (72); a first clamper adapting structure (73) is provided on the first support seat (71) to adapt to the first clamper (31) and the delivery sheath (3); The first support seat (71) is also provided with a first support seat through hole (74) for receiving the first gear (11); The first flip cover (72) is used to buckle the first support seat (71) and limit the radial and axial displacement of the delivery sheath (3) relative to the first actuator (1) after buckling; The second actuator (2) is also provided with: A second support (8), comprising a second support base (81) and a second flip cover (82), wherein the second support base (81) is provided with a second clamper adapting structure (83) for adapting the second clamper (32) and the pigtail catheter (4); The second support seat (81) is also provided with a second support seat through hole (84) for receiving the second gear (21); The second flip cover (82) is used to buckle the second support seat (81) and, after buckling, limit the radial and axial displacement of the pigtail catheter (4) relative to the second actuator (2).

3. The left atrial appendage measurement and angiography robotic arm according to claim 1, characterized in that: The first holder (31) is also provided with a delivery sheath contrast agent input port (33) for connecting to the syringe (6) based on the first branch tube; The second holder (32) is also provided with a pigtail catheter contrast agent input port (34) for connecting to the syringe (6) based on the second branch tube.

4. A medical device, characterized in that: It includes the left atrial appendage measurement and angiography robotic arm as described in any one of claims 1-3.

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