System for rotationally and translationally driving an elongate flexible medical instrument

Abstract

The invention relates to a system for driving a flexible and elongate medical instrument along a main elongation axis, said drive system comprising a first roller (6) and a second roller (7) intended to cooperate in order to drive the medical instrument translationally along its main elongation axis and to drive the medical instrument rotationally about its main elongation axis. The first roller (6) is coupled to a first shaft (61) and the second roller (7) is coupled to a second shaft (71).

Description

[0001] DESCRIPTION

[0002] TITLE: SYSTEM FOR DRIVING ROTATION AND TRANSLATION OF AN ELONGATED FLEXIBLE MEDICAL INSTRUMENT

[0003] FIELD OF THE INVENTION

[0004] The present invention relates to systems and methods for driving elongated flexible medical instruments, and associated robotic systems.

[0005] More particularly, the invention relates to a system for driving an elongated flexible instrument in rotation and translation, and to the robot comprising such a drive system.

[0006] TECHNOLOGICAL BACKGROUND OF THE INVENTION

[0007] Inserting an elongated flexible medical instrument, such as a catheter or guidewire, into a patient is a relatively common medical procedure. Such a procedure is used, for example, in the treatment of vascular diseases.

[0008] However, since this procedure is monitored under X-rays, the doctor and paramedics in charge of this procedure are subjected to significant irradiation when they carry out such an operation repeatedly.

[0009] In order to reduce the risks for medical personnel, it is known to robotize such insertion.

[0010] For example, document EPI 442720 is known, which describes a catheter handling robot. This document describes a drive system comprising a pair of rollers which drives a medical instrument in translation along the main axis of elongation of said medical instrument as well as in rotation around said main axis of elongation of said medical instrument (see figures 5 and 6). The translational movement of the medical instrument is ensured by the rotation of the rollers, while the rotational movement of the medical instrument is ensured by a translation of the rollers in the opposite direction.

[0011] Document CN104644270 is also known, which also describes a catheter handling robot with a pair of rollers and in which the translational movement of the medical instrument is ensured by the rotation of the rollers, while the rotational movement of the medical instrument is ensured by a translation of the rollers in the opposite direction. However, in the solution described in this document, the medical instrument is driven in translation by a driving force only by one of the rollers, the roller which is equipped with a direct current motor (DC 8 motor illustrated in Figure 1 of document CN 104644270).

[0012] Document WO202111533 is also known, which also describes a catheter handling robot with a pair of rollers and in which the translational movement of the medical instrument is provided by the rotation of the rollers, while the rotational movement of the medical instrument is provided by a translation of the rollers in the opposite direction (see Figures 22A-22X). Document WO202111533 describes two embodiments for driving the rollers in rotation. According to the first embodiment, the medical instrument is driven in translation by a driving force only by one of the rollers. In the second embodiment, the two rollers are in contact so that the roller connected to the motor drives the other roller by friction.However, such a frictional transmission has the risk of slippage occurring between the rollers, particularly when the force required to drive the medical instrument increases, for example when the medical instrument has to pass through a lesion.

[0013] However, none of the proposed solutions is satisfactory in terms of the efficiency of the medical instrument drive, as well as the simplicity and compactness of the drive system.

[0014] OBJECTS OF THE INVENTION

[0015] The aim of the present invention is to provide a catheter robot which at least partially overcomes the aforementioned drawbacks.

[0016] More particularly, the invention aims to provide a drive system for a flexible and elongated medical instrument whose transmission of movement provided by its motors is as efficient as possible.

[0017] The invention also aims to provide a drive system whose structure is as simple and compact as possible.

[0018] According to a first object, the invention proposes a system for driving a flexible and elongated medical instrument along a main axis of elongation, said drive system comprising a first roller and a second roller intended to cooperate to drive the medical instrument in translation along its main axis of elongation, and to drive the medical instrument in rotation about its main axis of elongation, the first roller being coupled to a first shaft and the second roller being coupled to a second shaft, characterized in that: - the drive system comprises a first motor which is coupled to the first shaft, said first motor being configured to drive the first shaft and the first roller in rotation about a first axis collinear with the first shaft,the first shaft being coupled to the second shaft to transmit the movement of the first motor to said second shaft and thus drive the second shaft and the second roller in rotation about a second axis collinear with the second shaft, the medical instrument being driven in translation by a driving force transmitted both by the rotation of the first roller and by the rotation of the second roller; and,

[0019] • the drive system comprises a second motor which is coupled to the first shaft, said second motor being configured to drive the first shaft and the first roller in translation along the first axis, the first shaft being coupled to the second shaft to transmit the movement of the second motor to said second shaft and thus drive the second shaft and the second roller in translation along the second axis in the opposite direction relative to the first roller, the medical instrument being driven in rotation by a driving force transmitted both by the translation of the first roller and by the translation of the second roller; or

[0020] • the drive system comprises a second motor which is coupled to the second shaft, said second motor being configured to drive the second shaft and the second roller in translation along the second axis, the second shaft being coupled to the first shaft to transmit the movement of the second motor to said first shaft and thus drive the first shaft and the first roller in translation along the first axis in the opposite direction relative to the second roller, the medical instrument being driven in rotation by a driving force transmitted both by the translation of the first roller and by the translation of the second roller, in which the first shaft comprises a first gear which is meshed on the one hand with an output gear of the first motor, and on the other hand with a second gear of the second shaft.

[0021] The fact that the driving force for rotation and the driving force for translation of the medical instrument are transmitted to the medical instrument by both rollers at the same time makes it possible to improve the efficiency of transmission of the movement of the first motor and the second motor. In addition, such a feature makes it possible to reduce the risk of slippage between the rollers and the medical instrument.

[0022] Furthermore, the fact that the motors are coupled to a shaft that transmits the motor's motion to the other shaft simplifies the structure of the drive system and improves the transmission. Furthermore, the fact that the first shaft includes a first gear that is meshed on the one hand with an output gear of the first motor, and on the other hand with a second gear of the second shaft allows for a compact, simple, and high-efficiency coupling. The high efficiency comes in particular from the fact that the gears ensure an identical speed for both rollers.

[0023] According to an advantageous characteristic, the first gear of the first shaft is integral in rotation with the first shaft while being movable in translation along said first shaft, and the second gear of the second shaft is integral in rotation with the second shaft while being movable in translation along said second shaft.

[0024] Such a feature makes it possible to decouple the transmission of the rotational movement from the first motor to the first and second shafts from the translational movements of said first and second shafts, so as not to make the first motor follow the translational movements or to make the second motor follow the rotational movements.

[0025] According to an advantageous characteristic, the first shaft comprises a third gear which is meshed on the one hand with an output gear of the second motor, and on the other hand with a fourth gear of the second shaft, the third gear of the first shaft comprising a tapping which cooperates with a thread formed on the first shaft in order to form a helical connection, and the fourth gear of the second shaft comprising a tapping which cooperates with a thread formed on the second shaft in order to form a helical connection.

[0026] Such a feature allows for compact, simple, and high-efficiency coupling.

[0027] According to an advantageous characteristic, the second shaft comprises a fourth gear which is meshed on the one hand with an output gear of the second motor, and on the other hand with a third gear of the first shaft, the third gear of the first shaft comprising a tapping which cooperates with a thread formed on the first shaft in order to form a helical connection, and the fourth gear of the second shaft comprising a tapping which cooperates with a thread formed on the second shaft in order to form a helical connection.

[0028] Such a feature allows for compact, simple, and high-efficiency coupling.

[0029] According to an advantageous characteristic, at least one of the first roller and the second roller is movable between a close position in which the first roller and the second roller are spaced apart by a first spacing, and a spaced apart position in which the first roller and the second roller are spaced apart by a second spacing, the first spacing being less than the second spacing, and a roller spacing device controls the position of the at least one of the first roller and the second roller between its close position and its spaced apart position.

[0030] Such a feature makes it easier to install and remove the medical instrument between the rollers.

[0031] According to an advantageous characteristic, the first gear of the first shaft remains engaged with the second gear of the second shaft when at least one of the first roller and the second roller is in the spaced position.

[0032] Such a feature allows to simplify the structure of the drive system and make it more compact, because it allows to do without a device that manages the synchronization of the gears when they have to re-enter in the event that the gears move apart.

[0033] According to an advantageous characteristic, the roller spacing device comprises a third motor which rotates an eccentric ring fixed to the first shaft and / or to the second shaft, the center of said eccentric ring being offset relative to the first shaft or to the second shaft.

[0034] Such a feature is a simple, compact, and high-performance solution for controlling roller spacing.

[0035] According to an advantageous characteristic, a first toothed eccentric ring is fixed on the first shaft and forms a fifth gear which is meshed on the one hand with an output gear of the third motor, and on the other hand with a sixth gear of the second shaft formed by a second toothed eccentric ring; or a second toothed eccentric ring is fixed on the second shaft and forms a sixth gear which is meshed on the one hand with an output gear of the third motor, and on the other hand with a fifth gear of the first shaft formed by a first toothed eccentric ring.

[0036] Such a feature makes it possible to simplify the structure of the roller spacing device and to improve the transmission. According to another object, the invention provides a catheter robot comprising a system for driving a flexible and elongated medical instrument along a main axis of elongation according to any one of the preceding features.

[0037] According to an advantageous characteristic, the catheter robot comprises:

[0038] - a support comprising a longitudinal axis;

[0039] - a first module comprising a first system for driving a first flexible medical instrument elongated along the longitudinal axis according to any one of the preceding characteristics;

[0040] - a second module comprising a second system for driving a second flexible medical instrument elongated along the longitudinal axis according to any one of the preceding characteristics; the first module being intended to be arranged between the patient and the second module, the second module being movable in longitudinal translation relative to the first module, the second module also comprising a system for rotating the first medical instrument which is controlled by the rotation of said first medical instrument by the first drive system.

[0041] Such a feature makes it possible to obtain a robot that is capable of manipulating two coaxial medical instruments by controlling both their rotational movements and their translational movements. In addition, the rotation system of the first medical instrument installed on the second module makes it possible to limit the torsion of said first medical instrument, this torsion being able in particular to be created by braking forces applied by a hemostatic valve installed at the proximal end of the first medical instrument.

[0042] According to an advantageous characteristic, the second module does not include any other system capable of driving the first medical instrument into motion.

[0043] This feature allows to simplify the structure of the robot and limit its size.

[0044] According to an advantageous characteristic, a third module which comprises a third system for driving a third flexible medical instrument elongated along the longitudinal axis according to any one of the preceding characteristics, the second module being arranged between the first module and the third module, the third module being movable in translation relative to the second module, the third module also comprising a system for rotating the second medical instrument which is controlled by the rotation of said second medical instrument by the second drive system.

[0045] Such a feature makes it possible to manipulate three coaxial medical instruments by controlling both their rotational movements and their translational movements. In addition, the rotation system of the second medical instrument installed on the third module makes it possible to limit the torsion of said second medical instrument, this torsion being able in particular to be created by braking forces applied by a hemostatic valve installed at the proximal end of the second medical instrument.

[0046] According to an advantageous characteristic, the third module does not include any other system capable of driving the second medical instrument into motion.

[0047] This feature allows to simplify the structure of the robot and limit its size.

[0048] According to an advantageous characteristic, the first module comprises a first device for holding the first medical instrument in position and / or the second module comprises a second device for holding the second medical instrument in position.

[0049] Such a feature ensures that the first medical instrument and / or the second medical instrument remains stationary, in particular when the rollers of the drive systems move apart.

[0050] According to an advantageous characteristic, the third module comprises a third device for holding the third medical instrument in position.

[0051] Such a feature ensures that the third medical instrument remains stationary, especially when the rollers of the third drive system move apart.

[0052] According to an advantageous characteristic, the first device for holding the first medical instrument in position is located at a distance less than or equal to 5 cm from the rollers of the first drive system, and / or the second device for holding the second medical instrument in position is located at a distance less than or equal to 5 cm from the rollers of the second drive system. Such a characteristic makes it possible to limit the elastic return of the first medical instrument and / or the second medical instrument when the rollers of the drive systems move apart.

[0053] According to an advantageous characteristic, the third device for holding the third medical instrument in position is located at a distance less than or equal to 5 cm from the rollers of the third drive system.

[0054] Such a feature makes it possible to limit the elastic return of the third medical instrument when the rollers of the third drive system move apart.

[0055] According to an advantageous characteristic, the rotation system of the first medical instrument of the second module comprises a pair of keys, the rotation system being configured to rotate the first medical instrument by gripping the first medical instrument with the pair of keys, and by translating the keys in opposite directions in a direction perpendicular to the first medical instrument.

[0056] Such a feature allows to ensure the handling of the first medical instrument for all existing references.

[0057] According to an advantageous characteristic, the rotation system of the second medical instrument of the third module comprises a pair of keys, the rotation system being configured to rotate the second medical instrument by gripping the second medical instrument with the pair of keys, and by translating the keys in opposite directions in a direction perpendicular to the second medical instrument.

[0058] Such a feature allows to ensure the handling of the second medical instrument for all existing references.

[0059] According to an advantageous characteristic, the rotation system of the first medical instrument of the second module comprises an output gear which is configured to mesh with a gear located on the first medical instrument.

[0060] Such a feature makes it possible to simplify the rotation system of the first instrument. According to an advantageous feature, the rotation system of the second medical instrument of the third module comprises an output gear which is configured to mesh with a gear located on the second medical instrument.

[0061] Such a feature allows to simplify the rotation system of the second instrument.

[0062] Other characteristics and advantages of the invention will appear on reading the following description of a preferred embodiment of the invention, given by way of example and with reference to the appended drawings.

[0063] BRIEF DESCRIPTION OF THE DRAWINGS

[0064] [Fig.1] Figure 1 schematically represents an example of a catheter robot for driving elongated flexible medical instruments according to one possible embodiment.

[0065] [Fig.2] Figure 2 schematically represents a drive system for a flexible and elongated medical instrument according to a possible embodiment.

[0066] [Fig.3] Figure 3 schematically represents a sectional view of the drive system of Figure 2 in which the rollers are in a close position.

[0067] [Fig.4] Figure 4 schematically represents a sectional view of the drive system of Figure 2 in which the rollers are in the spaced position.

[0068] [Fig.5] Figure 5 schematically represents a system solely for rotating an elongated flexible medical instrument according to a first possible variant.

[0069] [Fig.6] Figure 6 schematically represents a system solely for rotating an elongated flexible medical instrument according to a second possible variant.

[0070] [Fig.7] Figure 7 schematically represents a variant of a catheter robot for driving four elongated flexible medical instruments.

[0071] [Fig.8] Figure 8 schematically represents a sectional view of the drive system according to another embodiment in which the rollers are in a close position.

[0072] [Fig.9] Figure 9 schematically represents a sectional view of the drive system of Figure 8 in which the rollers are in the spaced position. DETAILED DESCRIPTION OF THE EMBODIMENTS OF THE INVENTION

[0073] Throughout the remainder of the text of the description, and for all the figures, we will speak indifferently of catheter robot, medical robot or medical catheter robot. The longitudinal axis of the catheter robot 1 is the axis common to the elongated flexible medical instruments manipulated by the catheter robot 1 and which corresponds to their main axis of elongation. Furthermore, for the purposes of simplification, we will speak of rotation of the medical instrument to refer to the rotation of said medical instrument around its main axis of elongation, and we will speak of translation of the medical instrument to refer to the translation of said medical instrument along its main axis of elongation.

[0074] Figure 1 schematically represents an example of a catheter robot 1 for driving elongated flexible medical instruments according to one possible embodiment.

[0075] The catheter robot 1 comprises a support 10 on which three modules are installed for handling three elongated flexible medical instruments. Thus, the catheter robot 1 comprises:

[0076] - a first module 20 which comprises a first drive system 21 for a first flexible medical instrument 2 elongated along the longitudinal axis of the catheter robot 1, the first drive system 21 being configured to drive the first medical instrument 2 in rotation around the main axis and in translation along said main axis;

[0077] - a second module 30 which comprises a second drive system 31 for a second flexible medical instrument 3 elongated along the longitudinal axis of the catheter robot 1, the second drive system 31 being configured to drive the second medical instrument 3 in rotation around the main axis and in translation along said main axis;

[0078] - a third module 40 which comprises a third drive system 41 for a third flexible medical instrument 4 elongated along the longitudinal axis of the catheter robot 1, the third drive system 41 being configured to drive the third medical instrument 4 in rotation around the main axis and in translation along said main axis.

[0079] The second module 30 and the third module 40 are both movable in translation along the main axis relative to the support 10 of the catheter robot 1 as well as relative to the first module 20 which is fixed to it relative to said support 10. In addition, the third module 40 is movable in translation relative to the second module 30, thus allowing the second module 30 and the third module 40 to have decoupled translational movements. The translational mobility of the second module 30 and the third module 40 makes it possible to adapt the position of the second module 30 and the third module 40 according to the insertion of the first medical instrument 20 and the third medical instrument 30 into the patient's body. Thus, the position of the second module 30 along the support 10 is controlled by the translation of the first medical instrument 2 by the first drive system 21 of the first module 20.Likewise, the position of the third module 40 along the support 10 is controlled by the translation of the second medical instrument 3 by the second drive system 31 of the second module 30.

[0080] The translation of the second module 30 and the third module 40 along the support 10 can for example be carried out with a system of rails forming slides along which the second module 30 and the third module 40 move.

[0081] According to a possible variant of use of the catheter robot 1, the first medical instrument 2 is a guide catheter which penetrates the body of a patient via an introducer I or desilet. The second medical instrument 3 is a catheter or a micro-catheter. The third medical instrument 4 is a guide.

[0082] V hemostatic valves are installed at the following locations:

[0083] - at the proximal end of the introducer I (i.e. the end directed towards the practitioner, opposite the patient);

[0084] - at the proximal end of the first medical instrument 2;

[0085] - at the proximal end of the second medical instrument 3.

[0086] As illustrated in Figure 1, the second module 30 comprises a rotation system 32 of the first medical instrument 2 around its main axis of elongation. The rotation system 32 of the first medical instrument 2 is controlled by the rotation of said first medical instrument 2 by the first drive system 21 of the first module 20. The rotation system 32 of the first medical instrument 2 installed on the second module 30 thus ensures that the proximal end of the first medical instrument 2 follows the same rotation as the part driven by the first drive system 21, thus limiting the risk of twisting of said first medical instrument 2. Indeed, the hemostatic valve V installed at the proximal end of the first medical instrument 2 generates friction which opposes the rotation of said first medical instrument 2.

[0087] Similarly, the third module 400 comprises a rotation system 42 of the second medical instrument 3 around its main axis of elongation. The rotation system 42 of the second medical instrument 3 is controlled by the rotation of said second medical instrument 3 by the second drive system 31 of the second module 30. The rotation system 42 of the second medical instrument 3 installed on the third module 40 thus ensures that the proximal end of the second medical instrument 3 follows the same rotation as the part driven by the second drive system 31, thus limiting the risk of twisting of said second medical instrument 3. Indeed, the hemostatic valve V installed at the proximal end of the second medical instrument 3 generates friction which opposes the rotation of said second medical instrument 3.

[0088] The first module 20 also comprises a first device 23 for holding the first medical instrument 2 in position. The first device 23 for holding the first medical instrument 2 in position is movable between, on the one hand, a locking position in which said first device 23 for holding the first medical instrument 2 in position and prevents it from moving, and on the other hand, an open position in which said first device 23 for holding the first medical instrument 2 free. The first device 23 for holding the first medical instrument in position may, for example, be formed by a clamp.

[0089] Similarly, the second module 30 also comprises a second device 33 for holding the second medical instrument 3 in position. The second device 33 for holding the second medical instrument 3 in position is movable between, on the one hand, a locking position in which said second device 33 for holding the second medical instrument 3 in position and prevents it from moving, and on the other hand, an open position in which said second device 33 for holding the second medical instrument 3 free. The second device 3 for holding the second medical instrument in position may, for example, be formed by a clamp.

[0090] Similarly, the third module 40 also comprises a third device 43 for holding the third medical instrument 4 in position. The third device 43 for holding the third medical instrument 4 in position is movable between, on the one hand, a locking position in which said third device 43 for holding the third medical instrument 4 in position and prevents it from moving, and on the other hand, an open position in which said third device 43 for holding the third medical instrument 4 in position leaves the third medical instrument 4 free. The third device 4 for holding the third medical instrument in position may, for example, be formed by a clamp.

[0091] According to an advantageous characteristic, the first position-holding device 23, the second position-holding device 33, and the third position-holding device 43 are located at a distance D less than or equal to 5 cm respectively from the rollers of the first drive system 21, the second drive system 31, and the third drive system 41. Such a distance D makes it possible to limit the elastic return effect of the medical instrument when the drive system releases said medical instrument. In order to simplify the structure of the catheter robot 1, the first drive system 21 of the first module 20, the second drive system 31 of the second module 30 and the third drive system 41 of the third module 40 are identical.In Figures 2, 3 and 4 reference is made to the first drive system 21, however Figures 2-4 also clearly illustrate the second drive system 31 as well as the third drive system 41.

[0092] As illustrated in Figures 2 to 4, the first drive system 21 comprises:

[0093] - a first roller 6 coupled to a first shaft 61 which is perpendicular to the main axis of the catheter robot 1, and

[0094] - a second roller 7 coupled to a second shaft 71 which is perpendicular to the main axis of the catheter robot 1 and which is parallel to the first shaft 61.

[0095] The first roller 6 is rotatable about a first axis a which is collinear with the first shaft 61, while the second roller 7 is rotatable about a second axis P which is collinear with the second shaft 71. Furthermore, the first roller 6 is movable in translation along the first axis a and the second roller 7 is movable in translation along the second axis p.

[0096] The first roller 6 and the second roller 7 are configured to cooperate by gripping the first medical instrument 2 between them and thus drive said first medical instrument 2 in translation and rotation.

[0097] The translational movement of the first medical instrument 2 is obtained on the one hand by rotation of the first roller 6 around the first axis a in a first direction, and on the other hand by rotation of the second roller 7 around the second axis P in a second direction which is opposite to the first direction.

[0098] The rotational movement of the first medical instrument 2 is obtained on the one hand by translation of the first roller 6 along the first axis a in a first direction, and on the other hand by translation of the second roller 7 along the second axis P in a second direction which is opposite to the first direction.

[0099] The first roller 6 and the second roller 7 are capable of simultaneously performing a rotational movement and a translational movement in order to drive the first medical instrument 2 in a combined rotational and translational movement.

[0100] The first roller 6 and the second roller 7 can for example each be formed by a cylinder of revolution made of elastomer.

[0101] The first drive system 21 also includes:

[0102] - a first motor 211 which is intended to drive the first roller 6 and the second roller 7 in rotation; - second motor 212 which is intended to drive the first roller 6 and the second roller 7 in translation;

[0103] - a third motor 213 which is intended to move the first roller 6 and the second roller 7 apart or closer together.

[0104] In order to transmit the rotational movement to the first roller 6 and to the second roller 7, the first motor 211 is coupled to the first shaft 61, the first shaft 61 itself being coupled to the second shaft 71 so as to transmit to it the rotational movement coming from the first motor 211. Thus, the first medical instrument 2 is driven in translation by a driving force coming from both the first roller 6 and the second roller 7.

[0105] Preferably, the coupling between the first motor 211, the first shaft 61 and the second shaft 71 is carried out with gears. Thus, the first motor 211 comprises an output gear 2110 which is meshed with a first gear 611 located on the first shaft 61, said first gear 611 also being meshed with a second gear 711 located on the second shaft 71.

[0106] In order to allow the coupling between the first motor 211, the first gear 611 and the second gear 711 while allowing the translation of the first shaft 61 and the second shaft 71, the first gear 611 is mounted on said first shaft 61 so as to be free in translation along said first shaft 61 but secured to said first shaft 61 for all other movements, and the second gear 711 is mounted on said second shaft 71 so as to be free in translation along said second shaft 71 but secured to said second shaft 71 for all other movements. A stop may be installed on the first shaft 61 and on the second shaft 71 in order to limit the amplitude of the translational movement of the first gear 611 and the second gear 711 along the first shaft 61 and the second shaft 71 respectively.

[0107] In order to transmit the translational movement to the first roller 6 and to the second roller 7, the second motor 212 is coupled to the second shaft 71, the second shaft 71 itself being coupled to the first shaft 61 so as to transmit to it the movement coming from the second motor 212. Thus, the first medical instrument 2 is driven in rotation by a driving force coming from both the first roller 6 and the second roller 7.

[0108] According to another possible variant, the second motor 212 is coupled to the first shaft 61, the first shaft 61 itself being coupled to the second shaft 71 in order to transmit to it the driving force coming from the second motor 212.

[0109] Preferably, the coupling between the second motor 212, the first shaft 61 and the second shaft 71 is carried out with gears. Thus, as illustrated in the variant of Figures 2-4, the second motor 212 comprises an output gear 2120 which is meshed with a fourth gear 712 located on the second shaft 71, said fourth gear 712 also being meshed with a third gear 612 located on the first shaft 61. According to another variant not shown in the figures, the output gear 2120 of the second motor 212 is meshed with the third gear 612 of the first shaft 61, said third gear 612 also being meshed with the fourth gear 712 of the second shaft 71.

[0110] In order to transform the rotational movement from the second motor 212 into a translational movement of the first shaft 61, the third gear 612 comprises a thread which cooperates with a thread formed on the first shaft 61 and thus forms a helical connection. Similarly, in order to transform the rotational movement from the second motor 212 into a translational movement of the second shaft 71, the fourth gear 712 comprises a thread which cooperates with a thread formed on the second shaft 71 and thus forms a helical connection.

[0111] If the user wishes to drive only the first medical instrument 2 in translation, the catheter robot 1 activates both the first motor 211 and the second motor 212 so that the first roller 6 and the second roller 7 rotate in opposite directions without translating. Activation of the first motor 211 causes the first shaft 61 and the second shaft 71 to rotate. The fact that the first shaft 61 and the second shaft 71 rotate tends to cause their translation by screwing them respectively into the tapping of the third gear 612 and the fourth gear 712. To counter this phenomenon and maintain only the rotational movement of the first shaft 61 and the second shaft 71, activation of the second motor 212 makes it possible to rotate the third gear 612 and the fourth gear 712 at the same speed and in the same direction as the first shaft 61 and the second shaft 71 respectively, thus preventing the first shaft 61 and the second shaft 71 from screwing together.

[0112] If the user wishes to drive only the first medical instrument 2 in rotation, the catheter robot 1 activates only the second motor 212 so that the first roller 6 and the second roller 7 translate in opposite directions without rotating. Activation of the second motor 212 causes the third gear 612 and the fourth gear 712 to rotate. Rotation of the third gear 612 and the fourth gear 712 makes it possible to screw the first shaft 61 and the second shaft 71 respectively into the thread of the third gear 612 and the fourth gear 712, thus driving the first shaft 61 and the second shaft 71 in translation.

[0113] If the user wishes to drive the first medical instrument 2 both in rotation and in translation, the catheter robot 1 activates both the first motor 211 and the second motor 212 so that the first roller 6 and the second roller 7 translate in opposite directions while also rotating in opposite directions. As previously indicated, the activation of the first motor 211 causes the rotation of the first shaft 61 and the second shaft 71. Furthermore, the activation of the second motor 212 makes it possible to control the screwing of the first shaft 61 and the second shaft 71 respectively into the thread of the third gear 612 and the fourth gear 712, thus controlling the translation of the first shaft 61 and the second shaft 71.

[0114] In order to ensure the movement of the first roller 6 and the second roller 7 apart or towards each other, the third motor 213 is coupled to the first shaft 61, the first shaft 61 itself being coupled to the second shaft 71 in order to transmit to it the driving force coming from the third motor 213.

[0115] Preferably, the coupling between the third motor 213, the first shaft 61 and the second shaft 71 is carried out with gears. Thus, the third motor 213 comprises an output gear 2130 which is meshed with a fifth gear 613 located on the first shaft 61, said fifth gear 613 also being meshed with a sixth gear 713 located on the second shaft 71. According to another possible variant, the output gear 2130 is meshed with the sixth gear 713 located on the second shaft 71, said sixth gear 713 also being meshed with the fifth gear 613 located on the first shaft 61.

[0116] In the variant illustrated in Figures 2-4, the first roller 6 and the second roller 7 are both movable between a close position in which the first roller 6 and the second roller 7 are spaced apart by a first spacing E1, and a spaced apart position in which the first roller 6 and the second roller 7 are spaced apart by a second spacing E2, the first spacing E1 being less than the second spacing E2.

[0117] The close position is illustrated in Figure 3 and corresponds to a working position in which the first roller 6 and the second roller grip the first medical instrument 2 in order to manipulate it.

[0118] The spread position is illustrated in Figure 4 and corresponds to a release position in which the first medical instrument 2 is no longer in contact with at least one of the first roller 6 and the second roller 7, thus allowing the installation or removal of said first medical instrument 2.

[0119] According to a possible variant, only the first roller 6 is movable between the spaced apart position and the close position, the second roller 7 remaining stationary. According to another possible variant, only the second roller 7 is movable between the spaced apart position and the close position, the first roller 6 remaining stationary. In the embodiment illustrated in Figures 2 to 4, the movement of the first roller 6 and the second roller 7 apart or towards each other is obtained because the fifth gear 613 and the sixth gear 713 are eccentric gears. The center of the fifth gear 613 is offset relative to the first shaft 61, and the center of the sixth gear 713 is offset relative to the second shaft 71.

[0120] The fifth gear 613 having as its only degree of freedom the rotation around the first shaft 61, the rotation of the fifth gear 613 causes the rotation of the first shaft 61 around the center of the fifth gear 613, and therefore the radial offset of said first shaft 61 and of the first roller 6 relative to the second shaft 71 and to the second roller 7.

[0121] Similarly, the sixth gear 713 having as its only degree of freedom the rotation around the second shaft 71, the rotation of the sixth gear 713 causes the rotation of the second shaft 71 around the center of the sixth gear 713, and therefore the radial offset of the second shaft 71 and the second roller 7 relative to the first shaft 61 and the first roller 6.

[0122] According to a preferred variant making it possible to simplify the structure of the catheter robot 1 and to limit its size, the rotation system 32 of the second module 30 and the rotation system 42 of the third module 40 are capable of driving only in rotation respectively the first medical instrument 2 and the second medical instrument 3. The rotation system 32 of the second module 30 and the rotation system 42 of the third module 40 are thus not capable of driving in translation respectively the first medical instrument 2 and the second medical instrument 3.

[0123] Furthermore, preferably, the second module 30 does not comprise any other system for driving the first medical instrument 2 in movement other than the rotation system 32. Similarly, the third module 40 also does not comprise any other system for driving the second medical instrument 3 in movement other than the rotation system 42.

[0124] In order to simplify the structure of the catheter robot 1, the rotation system 32 of the second module 30 and the rotation system 42 of the third module 40 are identical. In Figures 5 and 6 reference is made to the rotation system 32 of the second module 30, however Figures 5 and 6 also clearly illustrate the rotation system 42 of the third module 40. Furthermore, in the case where the catheter robot 1 comprises a fourth module 50 with a rotation system 52, this rotation system 52 of the fourth module 50 is also identical to the rotation system 32 of the second module 30.

[0125] According to a first variant illustrated in Figure 5, the rotation system 32 comprises a first key 321 and a second key 322 located opposite said first key 321 so as to be on either side of the first medical instrument 2. The rotation system 32 is configured to rotate the first medical instrument 2 on the one hand by enclosing said first medical instrument 2 between the first key 321 and the second key 322, and on the other hand by translating the first key 321 and the second key 322 in a direction perpendicular to the first medical instrument 2 and each in a direction opposite to the other.

[0126] The translational movement of the first key 321 and the second key 322 is obtained by a rotary motor 323 whose rotational movement is transformed into a translational movement by an assembly of connecting rods 324 connected to each other by pivots 325.

[0127] In order to enable the first key 321 and the second key 322 to clamp or release the first medical instrument 2, a linear motor 326 is installed so as to move the first key 321 closer to or further away from the second key 322. In this variant only the first key 321 is movable for clamping and loosening, the second key

[0128] 322 remaining fixed. According to another possible variant, both the first key 321 and the second key 322 are movable for tightening and loosening. Loosening the pair of keys allows on the one hand the keys to make the return movement when rotating the first medical instrument 2, and on the other hand to install or remove the first medical instrument 2.

[0129] According to a second variant illustrated in Figure 6, the rotation system 32 comprises a rotary motor 321' which rotates an output gear 322'. The output gear 322' is meshed with a gear 2' located on the proximal end of the first medical instrument 2. The gear 2' may be an insert which is fixed on the proximal end of the first medical instrument 2, or the proximal end of the first medical instrument 2 may be manufactured so as to have teeth and thus form the gear 2'.

[0130] The embodiment illustrated in Figures 8 and 9 is similar to that illustrated in Figures 3 and 4 and varies only in that the first gear 611 remains meshed with the second gear 711, and the third gear 612 remains meshed with the fourth gear 712, when the rollers 6 and 7 are in the separated position. The fact that the gears remain meshed makes it possible to avoid problems of synchronizing the gears when they have been separated and must re-mesh, and thus makes it possible not to install a device which ensures the rotation of the gears at the same speed during re-mesh.

[0131] In the embodiment of Figures 8 and 9, the movement of the first roller 6 and the second roller 7 apart or towards each other is also achieved because the fifth gear 613 and the sixth gear 713 are eccentric gears. The center of the fifth gear 613 is offset from the first shaft 61, and the center of the sixth gear 713 is offset from the second shaft 71.

[0132] In the embodiment of Figures 8 and 9, the first gear 611 remains meshed with the second gear 711, and the third gear 612 remains meshed with the fourth gear 712 in all positions of the rollers 6 and 7.

[0133] Of course, the present invention is not limited to the examples and embodiments described and shown, but it is susceptible to numerous variants accessible to those skilled in the art. For example, the catheter robot 1 may comprise only two modules for handling two elongated flexible medical instruments, or the catheter robot 1 may comprise more than three modules in order to handle more than three elongated flexible medical instruments.

Claims

CLAIMS A drive system (21, 31, 41, 51) for a flexible and elongated medical instrument (2, 3, 4, 5) along a principal axis of elongation, said drive system (21, 31, 41, 51) comprising a first roller (6) and a second roller (7) intended to cooperate to drive the medical instrument (2, 3, 4, 5) in translation along its principal axis of elongation, and to drive the medical instrument (2, 3, 4, 5) in rotation about its principal axis of elongation, the first roller (6) being coupled to a first shaft (61) and the second roller (7) being coupled to a second shaft (71), characterized in that: - the drive system (21, 31, 41, 51) comprises a first motor (211) which is coupled to the first shaft (61), said first motor (211) being configured to drive the first shaft (61) and the first roller (6) in rotation about a first axis (a) collinear with the first shaft (61), the first shaft (61) being coupled to the second shaft (71) to transmit the motion of the first motor (211) to said second shaft (71) and thus drive the second shaft (71) and the second roller (7) in rotation about a second axis (P) collinear with the second shaft (71), the medical instrument (2, 3, 4, 5) being driven in translation by a driving force transmitted both by the rotation of the first roller (6) and by the rotation of the second roller (7); and • the drive system (21, 31, 41, 51) comprises a second motor (212) which is coupled to the first shaft (61), said second motor (212) being configured to drive the first shaft (61) and the first roller (6) in translation along the first axis (a), the first shaft (61) being coupled to the second shaft (71) to transmit the motion of the second motor (212) to said second shaft (71) and thus drive the second shaft (71) and the second roller (7) in translation along the second axis (P) in the opposite direction to the first roller (6), the medical instrument (2, 3, 4, 5) being driven in rotation by a driving force transmitted both by the translation of the first roller (6) and by the translation of the second roller (7); or • The drive system (21, 31, 41, 51) includes a second motor (212) coupled to the second shaft (71). This second motor (212) is configured to drive the second shaft (71) and the second roller (7) in translation along the second axis (P). The second shaft (71) is coupled to the first shaft (61) to transmit the motion of the second motor (212) to the first shaft (61), thereby driving the first shaft (61) and the first roller (6) in translation along the first axis (a) in the opposite direction to the second roller (7). The medical instrument (2, 3, 4, 5) is driven in rotation. by a driving force transmitted both by the translation of the first roller (6) and by the translation of the second roller (7), wherein the first shaft (61) comprises a first gear (611) which is meshed on one side with an output gear (2110) of the first motor (211), and on the other side with a second gear (711) of the second shaft (71). Drive system (21, 31, 41, 51) according to claim 1, wherein: - the first gear (611) of the first shaft (61) is rotationally fixed with the first shaft (61) while being translationally mobile along said first shaft (61); - the second gear (711) of the second shaft (71) is rotationally fixed to the second shaft (71) while being free to move translationally along said second shaft (71). Drive system (21, 31, 41, 51) according to any one of claims 1 or 2, wherein the first shaft (61) comprises a third gear (612) which is meshed on one side with an output gear (2120) of the second motor (212), and on the other side with a fourth gear (712) of the second shaft (71), and wherein: - the third gear (612) of the first shaft (61) includes a tapping which cooperates with a thread formed on the first shaft (61) in order to form a helical connection; - The fourth gear (712) of the second shaft (71) includes a tapped hole that cooperates with a thread formed on the second shaft (71) to form a helical connection. A drive system (21, 31, 41, 51) according to any one of claims 1 or 2, wherein the second shaft (71) includes a fourth gear (712) that meshes on one side with an output gear (2120) of the second motor (212), and on the other side with a third gear (612) of the first shaft (61), and wherein: - the third gear (612) of the first shaft (61) includes a tapping which cooperates with a thread formed on the first shaft (61) in order to form a helical connection; - The fourth gear (712) of the second shaft (71) includes a tapped hole that cooperates with a thread formed on the second shaft (71) to form a helical connection. A drive system (21, 31, 41, 51) according to any one of claims 1 to 4, wherein: - at least one of the first roller (6) and the second roller (7) is movable between a close position in which the first roller (6) and the second roller (7) are separated by a first distance (E1), and a wide position in which the first roller (6) and the second roller (7) are separated by a second distance (E2), the first distance (El) being less than the second gap (E2); - a roller spacing device controls the position of at least one of the first roller (6) and the second roller (7) between its close position and its spread position.

6. Drive system (21, 31, 41, 51) according to claim 5, wherein the first gear (611) of the first shaft (61) remains meshed with the second gear (711) of the second shaft (71) when at least one of the first roller (6) and the second roller (7) is in its spread position.

7. Drive system (21, 31, 41, 51) according to claim 6 or claim 6, wherein the roller spacing device comprises a third motor (213) which drives in rotation an eccentric ring fixed on the first shaft (61) and / or on the second shaft (71), the center of said eccentric ring being offset from the first shaft (61) or the second shaft (71).

8. Drive system (21, 31, 41, 51) according to claim 7, wherein: - a first toothed eccentric ring is fixed to the first shaft (61) and forms a fifth gear (613) which meshes on one side with an output gear (2130) of the third motor (213), and on the other side with a sixth gear (713) of the second shaft (71) formed by a second toothed eccentric ring; or - a second toothed eccentric ring is fixed on the second shaft (71) and forms a sixth gear (713) which is meshed on one side with an output gear (2130) of the third motor (213), and on the other side with a fifth gear (613) of the first shaft (61) formed by a first toothed eccentric ring.

9. Catheter robot (1) comprising a drive system for a flexible and elongated medical instrument (21, 31, 41, 51) along a principal axis of elongation according to any one of claims 1 to 8.

10. Catheter robot (1) according to claim 9, comprising: - a support (10) comprising a longitudinal axis; - a first module (20) comprising a first drive system (21) of a first medical instrument (2) flexible and elongated along the longitudinal axis according to any one of claims 1 to 8; - a second module (30) comprising a second drive system (31) for a second medical instrument (3) flexible and elongated along the longitudinal axis according to one any of claims 1 to 8; the first module (20) being intended to be disposed between the patient and the second module (30), the second module (30) being movable in longitudinal translation relative to the first module (20), the second module (30) also comprising a rotation system (32) of the first medical instrument (2) which is controlled to the rotation of said first medical instrument (2) by the first drive system (21).

11. Catheter robot (1) according to claim 10, wherein the second module (30) does not include any other system capable of driving the first medical instrument (2) into motion.

12. Catheter robot (1) according to claim 10 or 11, comprising a third module (40) which includes a third drive system (41) of a third medical instrument (4) flexible and elongated along the longitudinal axis according to any one of claims 1 to 8, the second module (30) being disposed between the first module (20) and the third module (40), the third module (40) being movable in translation relative to the second module (30), the third module (40) also comprising a rotation system (42) of the second medical instrument (3) which is servo-controlled to the rotation of said second medical instrument (3) by the second drive system (31).

13. Catheter robot (1) according to claim 12, wherein the third module (40) does not include any other system capable of driving the second medical instrument (3) into motion.

14. Catheter robot (1) according to any one of claims 10 to 13, wherein the first module (20) comprises a first positioning device (23) for the first medical instrument (2) and / or, the second module (30) comprises a second positioning device (33) for the second medical instrument (3).

15. Catheter robot (1) according to claim 14, in combination with claim 12 or 13, wherein the third module (40) comprises a third positioning device (43) for the third medical instrument (4).

16. Catheter robot (1) according to claim 14 or 15, wherein the first positioning device (23) of the first medical instrument (2) is located at a distance (D) less than or equal to 5 cm from the rollers of the first drive system (21), and / or the second holding device (33) in position of the second medical instrument (3) is located at a distance (D) less than or equal to 5cm from the rollers of the second drive system (31).

17. Catheter robot (1) according to claim 16, in combination with claim 15, wherein the third positioning device (43) of the third medical instrument (4) is located at a distance (D) less than or equal to 5cm from the rollers of the third drive system (41).

18. Catheter robot (1) according to any one of claims 10 to 17, wherein the rotation system (32) of the first medical instrument (2) of the second module (30) comprises a pair of keys (321, 322), the rotation system (32) being configured to drive the rotation of the first medical instrument (2) by clamping the first medical instrument (2) with the pair of keys (321, 322), and by translating the keys (321, 322) in opposite directions in a direction perpendicular to the first medical instrument (2).

19. Catheter robot (1) according to claim 12, or any one of claims 13 to 18 in combination with claim 12, wherein the rotation system (42) of the second medical instrument (3) of the third module (40) comprises a pair of keys, the rotation system (42) being configured to drive the second medical instrument (3) into rotation by clamping the second medical instrument (3) with the pair of keys, and by translating the keys in the opposite direction in a direction perpendicular to the second medical instrument (3).

20. Catheter robot (1) according to any one of claims 10 to 17, wherein the rotation system (32) of the first medical instrument (2) of the second module (30) includes an output gear (322') which is configured to mesh with a gear (2') located on the first medical instrument (2).

21. Catheter robot (1) according to claim 12, or any one of claims 13 to 18 in combination with claim 12, wherein the rotation system (42) of the second medical instrument (3) of the third module (40) includes an output gear which is configured to mesh with a gear located on the second medical instrument (3).

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