Radio frequency puncture guide wire and radio frequency puncture device

Abstract

The application discloses a radio frequency puncture guide wire and a radio frequency puncture device, relates to the technical field of medical equipment, and comprises a hard guide wire section 6, one end of which is connected with a flexible guide wire section 5; the flexible guide wire section 5 is connected with a memory bending section 4; the memory bending section 4 is made of a flexible memory material; a radio frequency electrode section 1, the head end of which is in an arc shape, is used for being close to an atrial septum in an operation, and is connected to the memory bending section 4 through an electrically insulating wrapping section 2; the whole radio frequency puncture guide wire is linear after the connection of the sections, and the flexible guide wire section 5 and the memory bending section 4 can be bent after being controlled. The embodiment of the application can efficiently complete puncture through a single head end plastic guide wire device and a controllable radio frequency energy generator, and has the function of remotely assisting in completing puncture through a surgical robot.

Description

Technical Field

[0001] This application relates to the field of medical device technology, and in particular to a radiofrequency puncture guidewire and radiofrequency puncture device. Background Technology

[0002] The human heart chambers include the right ventricle, right atrium, left ventricle, and left atrium. The right atrium is connected to the superior vena cava and inferior vena cava. The tricuspid valve separates the right atrium and right ventricle, while the mitral valve separates the left atrium and left ventricle. The right atrium is separated from the left atrium by the interatrial septum. The left atrium is the most difficult to access during surgery. The most common method for accessing the left atrium is through puncture of the fossa ovalis in the interatrial septum. Under normal circumstances, the percutaneous catheter cannot directly reach the left atrium via the antegrade route. Although it can be retrogradely passed through the two bends of the aortic and mitral valves to enter the left atrium, the catheter operation is very complicated. Atrial septal puncture allows the catheter to pass through the right atrium and directly reach the left atrium via the interatrial septum. In the early years, atrial septal puncture was mainly used for left heart catheterization in patients with mitral or aortic stenosis. In the past 20 years, with the development of interventional treatment for cardiovascular diseases, especially percutaneous mitral valve repair and radiofrequency ablation, and especially the rapid development of radiofrequency ablation for atrial fibrillation, atrial septal puncture has begun to be increasingly valued by electrophysiologists and has become one of the essential skills that electrophysiologists must master.

[0003] Traditional atrial septal puncture has drawbacks such as cumbersome procedures, high operational difficulty, and a high risk of various serious complications. In response, Chinese patent CN 116602753 A discloses an energy-based atrial septal puncture system. The puncture system includes: a main unit that generates and regulates radiofrequency energy for atrial septal puncture; a guidewire that can enter the human blood vessel for guidance and can be connected to the main unit for atrial septal puncture; and a negative electrode plate that is connected to the human body and forms a circuit with the guidewire. The guidewire can enter the human heart, and the main unit transmits radiofrequency energy to the guidewire in a constant power manner. The atrial septal puncture system described in this application uses a guidewire to guide the sheath during atrial septal puncture, delivering the sheath into the heart. Then, during the puncture of the atrial septum, the main unit delivers radiofrequency energy to the guidewire. A circuit is then formed between the guidewire, the atrial septal tissue, and the negative electrode plate. Localized high temperatures are generated at the foramen ovale of the atrial septum in contact with the guidewire, allowing the guidewire to pass through the atrial septum through the area damaged by the high temperature. The sheath and dilator then pass through the atrial septum along the guidewire. During the atrial septal puncture, there is no need to withdraw the guidewire from the sheath and insert a puncture needle; the guidewire can simultaneously serve as a guide and puncture needle, significantly reducing the number of puncture steps, lowering the possibility of cardiac damage during atrial septal puncture, and thus reducing the risk of surgical complications.

[0004] Currently, atrial septal puncture is performed in clinical practice using an electrosurgical unit connected to a standard interventional guidewire. However, standard interventional guidewires are not designed for atrial septal puncture and are prone to various complications, such as guidewire breakage and detachment of the guidewire insulation coating. Different operators also face challenges in selecting radiofrequency energy parameters. To complete the puncture, operators typically need to use high power levels of 20W or more, and improper operation can easily cause electrical and thermal damage to cardiac tissue.

[0005] Traditional interventional septal puncture using a guidewire and external electrosurgical unit currently has the following problems:

[0006] 1) Traditional interventional guidewires are inserted via electrosurgical puncture using an external electrosurgical unit. Because the tip is too soft and lacks the basic rigidity required for puncture, they are difficult to control, have high operational difficulty, and are prone to multiple puncture failures.

[0007] 2) The guidewire body and tip are made of conductive metal spring coils. When heated by radio frequency, the heat is not easily concentrated, requiring a high power output for puncture. This can easily lead to the formation of air bubbles and tissue crusts in the blood pool, resulting in serious complications.

[0008] 3) The entire guide wire tip forms a large heat-generating area due to high power, which can easily damage the plastic tip of the expansion tube;

[0009] 4) High-power radiofrequency puncture can easily cause the insulating coating of traditional interventional guidewires to fall off, leading to surgical complications. Summary of the Invention

[0010] This application provides a radiofrequency puncture guidewire and radiofrequency puncture device, which efficiently completes puncture through a single-tip shaping guidewire device and a controllable radiofrequency energy generator, and also has the function of remotely completing puncture with the assistance of a surgical robot.

[0011] This application provides a radiofrequency puncture guidewire, comprising,

[0012] A rigid guidewire segment 6, one end of which leads out a flexible guidewire segment 5;

[0013] Flexible guide wire segment 5, which is connected to memory bend segment 4;

[0014] The memory-shaped curved segment 4 is made of flexible memory material;

[0015] The radiofrequency electrode segment 1 has an arc-shaped tip, which is used to be close to the interatrial septum tissue during the operation. It is connected to the memory curved segment 4 through an electrically insulating wrapping segment 2. A rigid mandrel segment 3 is provided inside the electrically insulating wrapping segment 2, which is used to provide rigid support for puncture.

[0016] The radiofrequency puncture guidewire is linear as a whole after the segments are connected, and the flexible guidewire segment 5 to the memory bending segment 4 can be bent under control.

[0017] This application provides a radiofrequency puncture device, including the radiofrequency puncture guidewire as described above;

[0018] Clamp 13 is used to fix the radiofrequency puncture guidewire;

[0019] A power transmission structure is provided, wherein a transmission gear 95 is provided on the power transmission structure for meshing with the robot actuator, so as to control the overall rotation of the transmission structure through the transmission gear 95.

[0020] This application embodiment uses a single-tip shaping guidewire device and a controllable radiofrequency energy generator to efficiently complete puncture, and also has the function of remotely completing puncture with the assistance of a surgical robot.

[0021] The above description is only an overview of the technical solution of this application. In order to better understand the technical means of this application and to implement it in accordance with the contents of the specification, and to make the above and other objects, features and advantages of this application more obvious and understandable, specific embodiments of this application are given below. Attached Figure Description

[0022] Various other advantages and benefits will become apparent to those skilled in the art upon reading the following detailed description of preferred embodiments. The accompanying drawings are for illustrative purposes only and are not intended to limit the scope of this application. Furthermore, the same reference numerals denote the same parts throughout the drawings. In the drawings:

[0023] Figure 1 This is a schematic diagram of the overall structure of the radiofrequency puncture guidewire according to an embodiment of this application;

[0024] Figure 2 This is a schematic diagram of the radiofrequency puncture guidewire tip structure according to an embodiment of this application;

[0025] Figure 3 This is a schematic diagram of a partial structure of the front end of the radiofrequency puncture guidewire in an embodiment of this application;

[0026] Figure 4 This is a schematic diagram of the handle fixing structure of the rigid section of the radio frequency guide wire and the expansion tube in an embodiment of this application;

[0027] Figure 5 This is a schematic diagram of a partial structure of the front end of the radiofrequency puncture guidewire in an embodiment of this application;

[0028] Figure 6 This is a schematic diagram of a power transmission structure according to an embodiment of this application;

[0029] Figure 7 This is a schematic diagram of another power transmission structure according to an embodiment of this application;

[0030] Figure 8 This is a schematic diagram of the radiofrequency puncture system according to an embodiment of this application. Detailed Implementation

[0031] Exemplary embodiments of the present disclosure will now be described in more detail with reference to the accompanying drawings. While exemplary embodiments of the present disclosure are shown in the drawings, it should be understood that the present disclosure may be implemented in various forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art.

[0032] This application provides a radiofrequency puncture guidewire, such as Figure 1 , 2 As shown, including,

[0033] A rigid guide wire segment 6 has a flexible guide wire segment 5 leading out from one end. In some embodiments, the other end of the rigid guide wire segment 6 leads out to an RF tail wire connection segment 7. The outer layer of the RF tail wire connection segment 7 is directly conductive and connected to the tail wire of the RF energy generator to transmit RF energy.

[0034] Flexible guide wire segment 5, which is connected to memory bend segment 4.

[0035] The memory-shaped curved segment 4 is made of flexible memory material;

[0036] The radiofrequency electrode segment 1 has an arc-shaped tip, which is used to approach the interatrial septum tissue during the procedure. It is connected to the memory-curved segment 4 through an electrically insulating wrapping segment 2. A rigid mandrel segment 3 is provided inside the electrically insulating wrapping segment 2. The rigid mandrel segment 3 is used to provide rigid support for puncture. In a specific example, the radiofrequency electrode segment 1 is located at the tip of the radiofrequency puncture guidewire and is made of platinum-iridium alloy.

[0037] During the procedure, when a radiofrequency current of a certain frequency is input, the arc-shaped tip of the radiofrequency electrode segment 1 generates high temperature, which enables the tip of the radiofrequency guidewire to pass through the interatrial septum from the tissue damaged by the high temperature and complete the puncture. At the same time, the arc-shaped tip is not like the sharp tip of a traditional mechanical puncture needle, so it will not damage the heart tissue. Moreover, compared with the direct conduction of the guidewire, the radiofrequency energy output through the radiofrequency platinum-iridium electrode is more concentrated, and only a low-power radiofrequency current is needed to complete the puncture, avoiding additional electrical and thermal damage to the heart tissue.

[0038] The radiofrequency puncture guidewire is linear as a whole after the segments are connected, and the flexible guidewire segment 5 to the memory bending segment 4 can be bent under control.

[0039] This application embodiment uses a single-tip shaping guidewire device and a controllable radiofrequency energy generator to efficiently complete puncture, and also has the function of remotely completing puncture with the assistance of a surgical robot.

[0040] In some embodiments, such as Figure 3 As shown, the flexible guidewire segment 5 and the memory-shaped bend segment 4 have a core made of a soft metal material, with a spring coil 41 wrapped around it, and an insulating layer between the core and the spring coil 41. Taking a J-shaped guidewire as an example, the memory-shaped bend segment 4 is made of flexible memory material. After puncture, as the guidewire continues to be pushed into the left atrium, the tip of the guidewire recovers its J-shape under the action of the memory material, allowing it to wrap around the heart chamber and avoid excessive advancement that could cause mechanical damage to the heart tissue.

[0041] The flexible guide wire section 5 is coated with an insulating layer, such as... Figure 3 As shown, the outer layer is wrapped by a spring coil 41, which is also coated with an insulating layer. The mandrel and the spring coil are not electrically conductive. The flexible guidewire segment can be inserted into the left atrium entirely through the interatrial septal puncture site. Before the puncture is completed, because the flexible guidewire segment is located within the sheath and dilator, it can transmit axial pushing force to the guidewire tip. After the puncture is completed, the flexible guidewire segment extends out of the sheath and dilator and is pushed into the left atrium. Inside the left atrium, the flexible guidewire segment becomes flexible after leaving the support of the sheath and dilator. During continued forward pushing, the flexible guidewire will not cause mechanical damage to the left atrial myocardial tissue.

[0042] In some embodiments, the rigid guidewire segment 6 is made of rigid metal with an insulating outer coating. The main body of the rigid guidewire segment 6 is inside the sheath dilator and does not protrude from the sheath or dilator lumen throughout the puncture process, providing the necessary rigidity for advancement within the interventional device. The rigid guidewire segment 6 is provided with a dilator fixing mark 61 for mounting a robotic arm adapter handle and securing the guidewire. The rigid guidewire segment 6 can freely enter and exit within the dilator, and a hemostatic valve is located at the end of the dilator to prevent blood backflow.

[0043] In some embodiments, the head end of the radio frequency electrode segment 1 is connected to the radio frequency electrode rod 31 in the rigid mandrel segment 3 via the head end 11 of the radio frequency electrode rod. The length of the head end is 0.5mm-0.8mm, and the total length of the radio frequency electrode rod 11 is 7-10mm.

[0044] Adjacent to the radio frequency electrode segment 1 are the electrically insulated wrapping segment 2 and the rigid mandrel segment 3. In a specific example, the radio frequency electrode rod 11 is provided inside the electrically insulated wrapping segment 2 and the rigid mandrel segment 3 and is connected to the arc-shaped front end of the radio frequency electrode segment. In some examples, the length of the arc-shaped front end can be 0.7mm. Under a certain frequency radio frequency current, with an input power of only 5W or more, the arc-shaped head end can generate heat of more than 30 degrees Celsius to complete the puncture.

[0045] The RF electrode rod 11 has a diameter of 0.015” and a total length of approximately 7-10 mm. The electrode rod is wrapped with an outer electrical insulator, such as... Figure 3 As shown, the electrical insulator is used to isolate the radio frequency energy from the guide wire body, while the smaller diameter radio frequency electrode rod 11 is conducive to the transmission of current, so as to achieve the same energy at the tip with a lower current, that is, to achieve efficient current conduction under low power output, and avoid electrical damage to heart tissue.

[0046] The radiofrequency microelectrode segment in this application is located at the tip of the guidewire, featuring a rounded end design. Under a specific frequency of radiofrequency current, it adheres closely to the tissue, generating high temperatures to complete the puncture. This design simultaneously eliminates the risk of mechanical damage from the sharp tip of traditional mechanical puncture needles, preventing puncture complications in cardiac tissue. The radiofrequency electrode is designed in a mushroom shape, with the tip (approximately 0.7mm) featuring a rounded top. This independent radiofrequency microelectrode connects to the flexible guidewire mandrel and, when working in conjunction with a dedicated radiofrequency generator at the tail end, achieves efficient current conduction at low power output, generating sufficient heat to complete the puncture, thus balancing safety and therapeutic efficacy.

[0047] This application also proposes a radiofrequency puncture device, comprising:

[0048] As described in the previous embodiment, the radiofrequency puncture guidewire is fixed by a dedicated handle, which is also compatible with a surgical robot, allowing for precise puncture assistance from the robot. The handle fixing structure for the rigid segment of the radiofrequency guidewire and the dilator is as follows: Figure 4 , Figure 5 As shown in the figure, the markings include a fixed curved sheath tube 81, an expansion tube 82, a hemostatic valve 83, a Luer interface fixing tube 91, and a clamping locking button 92.

[0049] A clamp 13 is used to fix the radiofrequency puncture guidewire. The clamp 13 includes a clamping locking button 92 and a Luer interface fixing tube 91. The clamping locking button 92 and the Luer interface fixing tube 91 are detachably connected. The clamping locking button 92 is used to fix the puncture guidewire, and a hemostatic valve 83 is provided at the outlet of the clamping locking button 92. The tail end of the Luer interface fixing tube 91 is connected to an expansion tube 82 and a fixing curved sheath tube 81.

[0050] The Luer interface fixing tube 91 and the clamping locking button 92 are the structures that control the transmission of the sheath and guidewire, respectively. Before fixing the puncture guidewire with the handle, the relative position of the handle to the guidewire is determined according to the fixing marks on the radiofrequency puncture guidewire. After the clamp 13 completes the fixing of the radiofrequency puncture guidewire, the operator can operate the clamp 13 to control the extension distance of the radiofrequency puncture guidewire tip at the dilator tip, while the front end of the dilator tube 82 extends out of the sheath.

[0051] A power transmission structure is provided, wherein a transmission gear 95 is provided on the power transmission structure for meshing with the robot actuator, so as to control the overall rotation of the transmission structure through the transmission gear 95.

[0052] In some embodiments, as an example, such as Figure 6 As shown, the power transmission structure includes two parts: an upper cover 93 and a lower cover 94. The upper cover 93 and the lower cover 94 are provided with an adapter structure for the clamp 13. The upper cover 93 and the lower cover 94 are provided with a Luer interface locking window 911 and a clamping locking window 922 at the splicing position.

[0053] The Luer interface locking window 911 and clamping locking window 922 are used to unlock the connection between the Luer interface fixing tube 91 and the clamping locking button 92 without opening the upper and lower covers of the transmission structure, so as to unlock the lock between the puncture guide wire and the expansion tube and finely adjust the relative position of the radiofrequency puncture guide wire.

[0054] In some embodiments, as another example, such as Figure 7 As shown, the power transmission structure includes a first transmission handle 11 and a second transmission handle 12.

[0055] The first transmission handle 11 has an adapter structure for the sheath handle end 14 and the expansion tube handle end 15. The sheath handle end 14 and the expansion tube handle end 15 are integrally installed in the first transmission handle 11 as a transmission handle for controlling the movement of the sheath and the expansion tube. A guide wire guide tube 16 is provided at the central axis position of the first transmission handle 11. One end of the guide wire guide tube 16 is attached to the guide wire inlet at the tail end of the expansion tube, and the other end is provided at the tail end of the first transmission handle 11 for inserting a guide wire 17 at the tail end and guiding the guide wire 17 into the expansion tube. It provides support force during the axial movement of the guide wire and enhances the axial force transmission function of the guide wire.

[0056] The second transmission handle 12 is provided with an adapter structure for the clamp 13, and the guide wire 17 is installed in the second transmission handle 12 through the clamp 13.

[0057] In some embodiments, such as Figure 7 As shown, rotating gears are provided on the outside of the first transmission handle 11 and the second transmission handle 12 for meshing with the robot actuator gears. The rotation and axial pushing of the sheath and dilation tube are controlled by the transmission of the first transmission handle, while the axial movement of the guidewire is controlled by the transmission of the second transmission handle and the gripper. This example, by adding a second transmission handle, allows for independent control of the guidewire's axial movement. During puncture, the sheath and dilation tube can be kept stationary, and the axial position of the guidewire can be finely adjusted to change the contact force between the guidewire tip and the target puncture site. This avoids damage to other myocardial tissues during the synchronous movement of the sheath and dilation tube, thus preventing complications.

[0058] like Figure 8 As shown, the end of the radiofrequency puncture guidewire is provided with a radiofrequency guidewire connection section. Except for the radiofrequency guidewire connection section, all other parts of the guidewire tube are provided with an insulating coating. The radiofrequency guidewire connection section is used to conduct radiofrequency energy to the radiofrequency energy conduction structure in the tail wire of the radiofrequency puncture instrument. After the puncture guidewire and the tail wire are connected, the radiofrequency energy conduction structure in the tail wire is connected to the guidewire tail wire connection section. The radiofrequency energy is transmitted from the radiofrequency puncture instrument to the puncture guidewire tip through the tail wire, and the radiofrequency energy is output by the radiofrequency electrode segment to the target atrial septum tissue, realizing atrial septal radiofrequency puncture based on the puncture guidewire.

[0059] The radiofrequency puncture guidewire of this application has a localized insulation treatment at its arc-shaped tip. Through the isolation of the insulator, no additional heat is generated on the guidewire surface, no high-temperature damage is caused to the front end of the dilation tube, and no electric sparks or microbubbles are generated in the blood pool. It can be connected to a surgical robot handle to complete remote assisted atrial septal puncture.

[0060] It should be noted that, in the embodiments of this application, the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such a process, method, article, or apparatus. Without further limitations, an element defined by the phrase "comprising one..." does not exclude the presence of other identical elements in the process, method, article, or apparatus that includes that element.

[0061] The sequence numbers of the embodiments in this application are for descriptive purposes only and do not represent the superiority or inferiority of the embodiments.

[0062] The embodiments of this application have been described above with reference to the accompanying drawings. However, this application is not limited to the specific embodiments described above. The specific embodiments described above are merely illustrative and not restrictive. Those skilled in the art can make many other forms under the guidance of this application without departing from the spirit and scope of the claims. All of these forms are within the protection scope of this application.

Claims

1. A radio frequency puncture guide wire, characterized by, Comprising, a hard guide wire segment (6) leading out of a flexible guide wire segment (5); a flexible guide wire segment (5) connecting a memory curved segment (4); a memory curved segment (4) made of flexible memory material; a radio frequency electrode segment (1) with a head end in the shape of a circular arc, the head end being used to approach the atrial septum tissue during surgery, the radio frequency electrode segment (1) being connected to the memory curved segment (4) through an electrically insulated wrapping segment (2), a hard rigid core shaft segment (3) being arranged in the electrically insulated wrapping segment (2), the hard rigid core shaft segment (3) being used to provide rigid support for puncture; the segments of the radio frequency puncture guide wire are connected to form a linear whole, wherein the flexible guide wire segment (5) to the memory curved segment (4) can be bent under control.

2. The radiofrequency puncture guide wire as claimed in claim 1, wherein The flexible guide wire segment (5) and the memory curved segment (4) are made of soft metal material, and the outer layer is wrapped with a spring ring (41), and an insulating layer is arranged between the core shaft and the spring ring (41).

3. The radiofrequency puncture guide wire as claimed in claim 1, wherein The hard guide wire segment (6) is made of hard metal material, and the outer layer is an insulating coating, and the other end of the hard guide wire segment (6) leads out a radio frequency tail wire connecting segment (7); The outer layer of the radio frequency tail wire connecting segment (7) is directly conductive, and is connected to the tail wire of the radio frequency energy generator to transmit radio frequency energy.

4. The radiofrequency puncture guide wire as claimed in claim 1, wherein The head end of the radio frequency electrode segment (1) is connected to the radio frequency electrode rod (31) in the hard rigid core shaft segment (3) through the radio frequency electrode rod head end (11), and the length of the head end is 0.5-0.8mm, and the total length of the radio frequency electrode rod (11) is 7-10mm.

5. A radio frequency piercing device characterized by, The radio frequency puncture guide wire comprises the radio frequency puncture guide wire according to any one of claims 1-4; The holder (13) comprises a clamping locking knob (92) and a luer interface fixing tube (91), and the clamping locking knob (92) and the luer interface fixing tube (91) are detachably connected, the clamping locking knob (92) is used for fixing the puncture guide wire, and the holder (13) can control the extension distance of the head end of the radio frequency puncture guide wire at the head end of the expansion tube after the radio frequency puncture guide wire is fixed. The power transmission structure is provided with a transmission gear (95) for engaging with the robot manipulator to control the overall rotating action of the transmission structure through the transmission gear (95).

6. The radio frequency piercing tool of claim 5, wherein the piercing tip is formed of a material having a hardness of about 50 to about 60 on the Rockwell C scale. The power transmission structure comprises an upper cover (93) and a lower cover (94), and the upper cover (93) and the lower cover (94) are provided with an adaptive structure of the holder (13) inside, and the upper cover (93) and the lower cover (94) are provided with a luer interface locking window (911) and a clamping locking window (922) at the splicing position. The luer interface locking window (911) and the clamping locking window (922) are used to unlock the connection between the luer interface fixing tube (91) and the clamping locking knob (92) without opening the upper and lower covers of the transmission structure, to unlock the locking between the puncture guide wire and the expansion tube, and to fine-tune the relative position of the radio frequency puncture guide wire.

7. The radio frequency piercing tool of claim 5, wherein the piercing tip is formed of a material having a hardness of about 50 to about 60 on the Rockwell C scale. The power transmission structure comprises a first transmission handle (11) and a second transmission handle (12). The first transmission handle (11) is internally provided with the matching structure of the sheath handle end (14) and the dilating tube handle end (15), the sheath handle end (14) and the dilating tube handle end (15) are integrally installed into the first transmission handle (11) as the transmission handle for controlling the movement of the sheath and the dilating tube, the guide wire guide tube (16) is arranged at the central axis position of the first transmission handle (11), one end of the guide wire guide tube (16) abuts against the guide wire access port of the tail end of the dilating tube, and the other end is arranged at the tail of the first transmission handle (11) and is used for passing the guide wire (17) into the tail end and guiding the guide wire (17) into the dilating tube. The second transmission handle (12) is internally provided with the matching structure of the holder (13), and the guide wire (17) is installed into the second transmission handle (12) through the holder (13).

8. The radio frequency piercing tool of claim 7, wherein the piercing tip is formed of a material having a hardness of at least 50 Rockwell C scale. The first transmission handle (11) and the second transmission handle (12) are externally provided with the rotary gear for engaging with the gear of the robot executor, the overall rotation and the axial pushing of the sheath and the dilating tube are controlled through the transmission of the first transmission handle, and the overall axial movement of the guide wire is controlled through the transmission of the second transmission handle and the holder.

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