Remote nasal jejunum tube implantation device and guide wire steering method thereof

Abstract

The invention relates to a remote nasal jejunum tube implantation device and a guide wire steering method thereof, and a clamping and delivering module is arranged on a mechanical arm, so that a rotatable guide wire and a nutrient canal can complete placement operation. The steering angle, direction and bending position of the guide wire are controlled through the lengths of the first control line, the second control line and the third control line. According to data of an optical fiber sensor and an ultrasonic distance measuring sensor at the front end of the guide wire, a guide wire steering optimization strategy is obtained based on a depth Q network, and control over advancing and steering of the guide wire is carried out in cooperation with a handle, so that remote operation is achieved. Through the reference degree of the historical data, the attention of the action at the current moment and the comprehensive consideration of the resistance and the distance, the strategy has high real-time performance and accuracy. Compared with the prior art, the method has the advantages of high safety, high accuracy, high practicability and the like.

Description

Technical Field

[0001] The present invention relates to the field of medical devices, and in particular to a remote nasojejunal tube insertion device and a guide wire steering method thereof. Background Art

[0002] With the advancement of medical technology, especially in the field of precision medicine and intelligence, the application of remote operation technology in clinical treatment is increasing. As a common clinical operation, nasojejunal tube insertion inserts the nutrition tube from the nasal cavity into the digestive tract through a guide wire, which is of great significance for some patients who need long-term enteral nutrition support. During the operation, due to the long and curved guide wire path, the accuracy of the insertion position cannot be ensured by simply relying on the physician's blind insertion. Therefore, in order to correctly position the guide wire and smoothly reach the target position, X-ray images are needed to provide reference for the physician. However, most surgeons must stand to complete the operation during the operation, and when fluoroscopic guidance is required, the doctor is exposed to radiation. At the same time, due to the repeated use of X-rays, the physician needs to repeatedly enter and exit the X-ray room, and the operation time is long and the operation efficiency is low. Therefore, how to improve the nasojejunal tube insertion device and the guide wire entry method so that the physician can remotely operate the operation, simplify the operation and improve efficiency is a technical problem that needs to be solved. Summary of the invention

[0003] The purpose of the present invention is to overcome the defects of the above-mentioned prior art and to provide a remote nasojejunal tube insertion device and a guidewire steering method thereof. The guidewire is clamped and transported by a robotic arm, and the position and obstruction of the guidewire head are collected by ultrasonic sensors and optical fiber sensors integrated on the main head and three sub-heads of the guidewire. After processing, the most suitable steering direction of the guidewire is obtained, and the guidewire is guided to steer and smoothly reach the target position.

[0004] The purpose of the present invention can be achieved by the following technical solutions:

[0005] According to one aspect of the present invention, there is provided a remote nasojejunal tube insertion device, characterized in that it comprises a clamping module, a delivery module, a rotatable guide wire, a remote control module, and a nasojejunal tube;

[0006] The clamping module clamps and positions the rotatable guide wire at the proximal end through the first clamping plate; the delivery module clamps the rotatable guide wire at the distal end through the second clamping plate, and delivers the rotatable guide wire by sliding back and forth on the guide rail;

[0007] The outside of the rotatable guide wire is composed of a first spring group and a second spring group, the diameter of the first spring group is larger than the diameter of the second spring group, and the first spring group and the second spring group are arranged in the form of concentric circles; the inside of the rotatable guide wire is provided with a first control line, a second control line and a third control line, the first control line and the third control line are fixed to the inner wall of the head of the first spring group, the head of the second control line is spherical, and the diameter is consistent with the inner diameter of the second spring group; when controlling the rotation of the head of the rotatable guide wire, the spherical head of the second control line is the starting point of the bending, and the first control line and the third control line control the bending curvature;

[0008] A guide wire main head and three guide wire sub-heads are arranged at the front end of the rotatable guide wire, and the three guide wire sub-heads are arranged around the guide wire main head at 120° intervals, and the length of the guide wire sub-head is shorter than the guide wire main head; the guide wire main head is integrated with an optical fiber sensor, and the guide wire sub-head is integrated with an ultrasonic distance measuring sensor;

[0009] The remote control module includes a guidewire rotation control unit, a clamping and delivery control unit, a data processing unit and a display unit. The guidewire rotation control unit includes a handle, a first control knob and a motor. The handle is used to control the bending degree of the rotatable guidewire, the first control knob is used to control the bending length of the rotatable guidewire, and the motor is used to control the steering of the rotatable guidewire with a control power less than that of the handle; the clamping and delivery control unit includes a first control button and a second control button. The first control button controls the opening and closing of the clamping module, and the second control button controls the start and stop of the delivery module.

[0010] The clamping module, the delivery module and the guide rail are fixed on the robotic arm so that the rotatable guide wire is parallel to the bed.

[0011] The first spring group and the second spring group are arranged at an interval.

[0012] The first control line and the third control line are connected to the handle, and the length of the first control line and the third control line in the rotatable guide wire is adjusted by rotating the handle, so as to control the bending degree and bending direction of the front end of the rotatable guide wire. The shortened control line side is the concave side of the bending, and the extended control line side is the convex side of the bending.

[0013] The first control knob is connected to the second control wire, and changes the length of the second control wire, thereby changing the position where the rotatable guide wire starts to bend, that is, the length of the bend.

[0014] According to another aspect of the present invention, a guidewire steering method for a remote nasojejunal tube insertion device is provided, the method comprising the following steps:

[0015] S1, obtain resistance and displacement signals through the optical fiber sensor of the main head of the guide wire, collect the distance signal between the nasojejunal tube and the obstacle through the ultrasonic distance measuring sensor of the secondary head of the guide wire, and transmit the collected signal to the data processing unit through wireless communication;

[0016] S2, the data processing unit pre-processes the collected signals, processes the collected signals based on the deep Q network, and obtains the real-time strategy of the moving direction of the rotatable guide wire through dynamic time weighting;

[0017] S3, the data processing unit provides adaptive force feedback based on the strategy, displays the resistance and distance measurement results in the X-ray image through the display module, and controls the motor to work based on the strategy;

[0018] S4. Control the steering and movement of the rotatable guide wire according to the preset control power ratio of the handle and the motor.

[0019] In S1, the optical fiber sensor obtains a displacement signal of the rotatable guide wire through bending or stretching of the optical fiber, and obtains a resistance signal through changes in light intensity.

[0020] The loss function of the deep Q network in S2 is:

[0021]

[0022] Among them, R(s, a) is the immediate reward obtained after taking action a in the current state s; γ is the discount factor that balances the impact of immediate rewards and future rewards; s' is the next state; θ - is the target network parameter; θ is the current network parameter; ω t Weighting for real-time rewards; ω h Weighting historical rewards; ω r Weighting of resistance signals;

[0023] The real-time reward weighted ω t The expression is:

[0024]

[0025] Where D(t) is the minimum distance to the obstacle; D min is the minimum distance allowed;

[0026] The historical reward weight ω h The expression is:

[0027] ω h =e -αΔR(s,a) ,

[0028] Among them, α is the historical reward attenuation factor; ΔR(s,a) is the increment of the reward at the previous moment;

[0029] The resistance signal is weighted ω r The expression is:

[0030]

[0031] Among them, β is the resistance adjustment coefficient; r(t) is the current resistance signal.

[0032] The adaptive force feedback in S3 is that when the handle is operated so that the advancing direction of the rotatable guide wire is different from the direction obtained by the strategy, the greater the difference in direction, the greater the resistance of the handle.

[0033] In S4, during the operation, the control right of the handle is greater than the control right of the motor, and the lengths of the first control line and the third control line are controlled according to a preset control right ratio, further controlling the bending degree and bending direction of the front portion of the rotatable guide wire, thereby controlling the forward direction of the rotatable guide wire.

[0034] Compared with the prior art, the present invention has the following beneficial effects:

[0035] (1) Protecting operators: The twisting and delivery operation of the guidewire head is remotely controlled, so that the physician does not need to operate in the X-ray room. The guidewire's forward direction is adjusted by the handle and the strategy obtained by the deep Q network. The guidewire and the feeding tube are delivered and positioned by the robotic arm. The physician can achieve the effect of direct operation through the device and steering method, thereby reducing exposure and increasing safety.

[0036] (2) High real-time and accuracy: The deep Q network is used to optimize the guidewire steering strategy. The strategy has high real-time and accuracy through the reference to historical data, the focus on the current action, and the comprehensive consideration of resistance and distance. At the same time, in order to further improve the accuracy, a guidewire sub-head is set at the front of the guidewire to collect the distance signals of obstacles from multiple directions to improve the accuracy of the data.

[0037] (3) High practicality and adaptability to different operating habits: By mainly operating with the handle and supplemented by strategy planning, and by presetting the weight of the operating weight, the device of the present invention can adapt to a variety of different operating habits; in addition, by feeding back the strategy to the handle in the form of force, the resistance and distance signals obtained by the sensor are intuitively fed back, which is highly practical and easier to operate. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Figure 1 It is a schematic diagram of the overall structure of the remote nasojejunal tube insertion device;

[0039] Figure 2 This is the structural diagram of the module on the robot arm;

[0040] Figure 3 The figure is the overall structure diagram of the rotatable guide wire;

[0041] Figure 4 It is a schematic diagram of the bending structure of the rotatable guide wire;

[0042] Figure 5 This is a structural diagram of the front end of the rotatable guide wire;

[0043] Figure 6 Flow chart of the guidewire steering method for remote nasojejunal tube placement.

[0044] Explanation of the numbers in the figure: 1. Clamping module; 11. First splint; 2. Delivery module; 21. Second splint; 3. Rotatable guide wire; 31. First spring group; 32. Second spring group; 33. First control line; 34. Second control line; 35. Third control line; 36. Guide wire main head; 37. Guide wire sub-head; 4. Nasojejunal tube; 5. Guide rail; 6. Robotic arm. DETAILED DESCRIPTION

[0045] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work should fall within the scope of protection of the present invention.

[0046] like Figure 1 As shown, a remote nasojejunal tube insertion device includes a clamping module 1, a delivery module 2, a rotatable guide wire 3, a remote control module, and a nasojejunal tube 4.

[0047] The clamping module 1 clamps and positions the rotatable guide wire 3 at the proximal end through the first clamping plate 11; the delivery module 2 clamps the rotatable guide wire 3 at the distal end through the second clamping plate 21, and delivers the rotatable guide wire 3 by sliding forward and backward on the guide rail 5; the clamping module 1, the delivery module 2 and the guide rail 5 are fixed on the robot arm 6, so that the rotatable guide wire 3 is parallel to the bed, which is convenient for the delivery of the rotatable guide wire 3 and the nasojejunal tube 4. The structure of the module on the robot arm 6 is as follows Figure 2 shown.

[0048] like Figure 3The figure shows a rotatable guide wire 3. The outside of the rotatable guide wire 3 is composed of a first spring group 31 and a second spring group 32. The diameter of the first spring group 31 is larger than the diameter of the second spring group 32. The first spring group 31 and the second spring group 32 are arranged in the form of concentric circles, and the surface is flat and easier to clean. The inside of the rotatable guide wire 3 is provided with a first control line 33, a second control line 34 and a third control line 35. The first control line 33 and the third control line 35 are fixed to the inner wall of the head of the first spring group 31. The head of the second control line 34 is spherical, and the diameter is consistent with the inner diameter of the second spring group 32. When controlling the rotation of the head of the rotatable guide wire 3, the spherical head of the second control line 34 is the starting point of the bending, and the first control line 33 and the third control line 35 control the bending curvature. The schematic diagram of the bending structure is shown in Figure 4 As shown. The first spring group 31 and the second spring group 32 are arranged at intervals. The first control line 33 and the third control line 35 are connected to the handle, and the length of the first control line 33 and the third control line 35 in the rotatable guide wire 3 is adjusted by rotating the handle, so as to control the degree and direction of the bending of the front end of the rotatable guide wire 3. The shortened control line side is the concave side of the bending, and the extended control line side is the convex side of the bending.

[0049] like Figure 5 As shown, a guide wire main head 36 and three guide wire sub-heads 37 are arranged at the front end of the rotatable guide wire 3. The three guide wire sub-heads 37 are arranged around the guide wire main head 36 at an equal interval of 120°. The length of the guide wire sub-heads 37 is smaller than the guide wire main head 36. The guide wire main head 36 is integrated with an optical fiber sensor, and the guide wire sub-heads 37 are integrated with an ultrasonic distance sensor. Therefore, the rotatable guide wire 3 can collect the distance from the obstacle in multiple directions and obtain the resistance received.

[0050] The remote control module includes a guide wire rotation control unit, a clamping and delivery control unit, a data processing unit and a display unit. The guide wire rotation control unit includes a handle, a first control knob and a motor. The handle is used to control the bending degree of the rotatable guide wire 3, the first control knob is used to control the bending length of the rotatable guide wire 3, and the motor is used to control the steering of the rotatable guide wire 3 with a control power less than that of the handle; the clamping and delivery control unit includes a first control button and a second control button. The first control button controls the opening and closing of the clamping module 1, and the second control button controls the start and stop of the delivery module 2. The first control knob is connected to the second control line 34, and the length of the second control line 34 is changed, thereby changing the position where the rotatable guide wire 3 starts to bend, that is, the length of the bend.

[0051] like Figure 6 As shown, a guidewire steering method for a remote nasojejunal tube insertion device comprises the following steps:

[0052] S1, obtain resistance and displacement signals through the optical fiber sensor of the main guide wire head 36, collect the distance signal between the nasojejunal tube 4 and the obstacle through the ultrasonic distance measuring sensor of the secondary guide wire head 37, and transmit the collected signal to the data processing unit through wireless communication;

[0053] S2, the data processing unit pre-processes the collected signals, processes the collected signals based on the deep Q network, and obtains the real-time strategy of the moving direction of the rotatable guide wire 3 through dynamic time weighting;

[0054] S3, the data processing unit provides adaptive force feedback based on the strategy, and displays the resistance and distance measurement results in the X-ray image through the display module, and controls the motor operation based on the strategy;

[0055] S4. Control the turning and moving of the rotatable guide wire 3 according to the preset control power ratio of the handle and the motor.

[0056] In S1, the optical fiber sensor obtains a displacement signal of the rotatable guide wire 3 through the bending or stretching of the optical fiber, and obtains a resistance signal through the change of light intensity.

[0057] The state space of the deep Q network in S2 is s t =[r t , d t ,θ t ],r t is the resistance signal measured by the optical fiber sensor, d t is the distance to the obstacle measured by the ultrasonic sensor, θ t is the current direction of the guidewire, that is, the angle compared to the preset reference. The action space of the deep Q network is the guidewire bending direction, guidewire bending degree and guidewire bending position.

[0058] The reward function of the deep Q network is:

[0059]

[0060] Among them, R(s,a) is the immediate reward obtained after taking action a in the current state s; D(t) is the minimum distance to the obstacle; D min is the minimum distance allowed; r(t) is the current resistance signal; μ, ρ, Adjust the weights for the reward function.

[0061] The loss function of the deep Q network is:

[0062]

[0063] Among them, R(s, a) is the immediate reward obtained after taking action a in the current state s; γ is the discount factor that balances the impact of immediate rewards and future rewards; s' is the next state; θ- is the target network parameter; θ is the current network parameter; ω t Weighting for real-time rewards; ω h Weighting historical rewards; ω r Weighting of resistance signals.

[0064] Real-time reward weighting ω t The expression is:

[0065]

[0066] Where D(t) is the minimum distance to the obstacle; D min is the minimum distance allowed. When the guide wire approaches an obstacle, ω t Increase, encourage action to avoid collision.

[0067] Historical reward weighted ω h The expression is:

[0068] ω h =e -αΔR(s,a) ,

[0069] Among them, α is the historical reward attenuation factor; ΔR(s,a) is the increment of the reward at the previous moment. The change of historical rewards affects the stability of current decisions. If the historical rewards increase suddenly, reduce the historical impact and avoid over-reliance on historical data.

[0070] Resistance signal weighted ω r The expression is:

[0071]

[0072] Where β is the resistance adjustment coefficient and r(t) is the current resistance signal. If the guidewire encounters a large resistance r(t) during its progress, this term will reduce the update of the current Q value and encourage the system to change its direction of travel.

[0073] The adaptive force feedback in S3 is that when the handle is operated so that the advancing direction of the rotatable guide wire 3 is different from the direction obtained by the strategy, the greater the difference in direction, the greater the resistance of the handle.

[0074] In S4, during the operation, the control right of the handle is greater than the control right of the motor, and the lengths of the first control line 33 and the third control line 35 are controlled according to a preset control right ratio, further controlling the bending degree and bending direction of the front part of the rotatable guide wire 3, thereby controlling the forward direction of the rotatable guide wire 3.

[0075] The above is only a specific embodiment of the present invention, but the protection scope of the present invention is not limited thereto. Any technician familiar with the technical field can easily think of various equivalent modifications or replacements within the technical scope disclosed by the present invention, and these modifications or replacements should be included in the protection scope of the present invention. Therefore, the protection scope of the present invention shall be based on the protection scope of the claims.

Claims

1. A remote nasojejunal tube insertion device, characterized in that: It comprises a clamping module (1), a delivery module (2), a rotatable guide wire (3), a remote control module, and a nasojejunal tube (4); The clamping module (1) clamps and positions the rotatable guide wire (3) at the proximal end through a first clamping plate (11); the delivery module (2) clamps the rotatable guide wire (3) at the distal end through a second clamping plate (21), and delivers the rotatable guide wire (3) by sliding forward and backward on the guide rail (5); The outside of the rotatable guide wire (3) is composed of a first spring group (31) and a second spring group (32), the diameter of the first spring group (31) is larger than the diameter of the second spring group (32), and the first spring group (31) and the second spring group (32) are arranged in the form of concentric circles; the inside of the rotatable guide wire (3) is provided with a first control line (33), a second control line (34) and a third control line (35), the first control line (33) and the third control line (35) are fixed to the inner wall of the head of the first spring group (31), the head of the second control line (34) is spherical, and the diameter is consistent with the inner diameter of the second spring group (32); when the rotation of the head of the rotatable guide wire (3) is controlled, the spherical head of the second control line (34) is the starting point of bending, and the first control line (33) and the third control line (35) control the bending curvature; A guide wire main head (36) and three guide wire sub-heads (37) are arranged at the front end of the rotatable guide wire (3), the three guide wire sub-heads (37) are arranged around the guide wire main head (36) at equidistant intervals of 120°, and the length of the guide wire sub-heads (37) is shorter than that of the guide wire main head (36); the guide wire main head (36) is integrated with an optical fiber sensor, and the guide wire sub-heads (37) are integrated with an ultrasonic distance measuring sensor; The remote control module comprises a guide wire rotation control unit, a clamping delivery control unit, a data processing unit and a display unit, wherein the guide wire rotation control unit comprises a handle, a first control knob and a motor, wherein the handle is used to control the bending degree of the rotatable guide wire (3), the first control knob is used to control the bending length of the rotatable guide wire (3), and the motor is used to control the steering of the rotatable guide wire (3) with a control power less than that of the handle; The clamping and delivery control unit comprises a first control button and a second control button, the first control button controls the opening and closing of the clamping module (1), and the second control button controls the start and stop of the delivery module (2).

2. A remote nasojejunal tube insertion device according to claim 1, characterized in that: The clamping module (1), the delivery module (2) and the guide rail (5) are fixed on the mechanical arm (6) so that the rotatable guide wire (3) is parallel to the bed.

3. A remote nasojejunal tube insertion device according to claim 1, characterized in that: The first spring group (31) and the second spring group (32) are arranged at intervals.

4. A remote nasojejunal tube insertion device according to claim 1, characterized in that: The first control line (33) and the third control line (35) are connected to a handle, and the length of the first control line (33) and the third control line (35) in the rotatable guide wire (3) is adjusted by rotating the handle, thereby controlling the degree and direction of bending of the front end of the rotatable guide wire (3), the shortened control line side being the concave side of the bending, and the lengthened control line side being the convex side of the bending.

5. A remote nasojejunal tube insertion device according to claim 1, characterized in that: The first control knob is connected to the second control wire (34) to change the length of the second control wire (34), thereby changing the position where the rotatable guide wire (3) starts to bend, that is, the length of the bend.

6. A guidewire steering method for a remote nasojejunal tube insertion device, suitable for the device as claimed in any one of claims 1 to 5, characterized in that: The method comprises the following steps: S1, obtaining resistance and displacement signals through the optical fiber sensor of the main guide wire head (36), collecting the distance signal between the nasojejunal tube (4) and the obstacle through the ultrasonic distance measuring sensor of the secondary guide wire head (37), and transmitting the collected signal to the data processing unit through wireless communication; S2, the data processing unit pre-processes the collected signals, and processes the collected signals based on the deep Q network, and obtains the real-time strategy of the moving direction of the rotatable guide wire (3) through dynamic time weighting; S3, the data processing unit provides adaptive force feedback based on the strategy, displays the resistance and distance measurement results in the X-ray image through the display module, and controls the motor to work based on the strategy; S4. According to the preset control power ratio of the handle and the motor, the turning and moving of the rotatable guide wire (3) are controlled.

7. A guidewire steering method for a remote nasojejunal tube insertion device according to claim 6, characterized in that: In S1, the optical fiber sensor obtains a displacement signal of the rotatable guide wire (3) through the bending or stretching of the optical fiber, and obtains a resistance signal through the change of light intensity.

8. A guidewire steering method for a remote nasojejunal tube insertion device according to claim 6, characterized in that: The loss function of the deep Q network in S2 is: Among them, R(s, a) is the immediate reward obtained after taking action a in the current state s; γ is the discount factor that balances the impact of immediate rewards and future rewards; s' is the next state; θ - is the target network parameter; θ is the current network parameter; ω t Weighting for real-time rewards; ω h Weighting historical rewards; ω r Weighting of resistance signals; The real-time reward weighted ω t The expression is: Where D(t) is the minimum distance to the obstacle; D min is the minimum distance allowed; The historical reward weight ω h The expression is: oh h =e -αΔR(s,a) , Among them, α is the historical reward attenuation factor; ΔR(s,a) is the increment of the reward at the previous moment; The resistance signal is weighted ω r The expression is: Among them, β is the resistance adjustment coefficient; r(t) is the current resistance signal.

9. A guidewire steering method for a remote nasojejunal tube insertion device according to claim 6, characterized in that: The adaptive force feedback in S3 is that when the handle is operated so that the advancing direction of the rotatable guide wire (3) is different from the direction obtained by the strategy, the greater the difference in direction, the greater the resistance of the handle.

10. A guidewire steering method for a remote nasojejunal tube insertion device according to claim 6, characterized in that: In S4, during the operation, the control right of the handle is greater than the control right of the motor, and the lengths of the first control line (33) and the third control line (35) are controlled according to a preset control right ratio, thereby further controlling the bending degree and bending direction of the front part of the rotatable guide wire (3), thereby controlling the forward direction of the rotatable guide wire (3).

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