System and method for a control station for robotic intervention procedures using a plurality of elongated medical devices

Abstract

A system for controlling a robotic drive configured to operate one or more elongated medical devices, the system including a housing including a first surface and a second surface not coplanar with the first surface, a first controller provided on the first surface and operable by a first finger of a first hand of a user to select one of the one or more elongated medical devices, and a second controller provided on the second surface and operable by a second finger of the first hand of a user to direct the robotic drive to operate the selected elongated medical device in a first degree of freedom, the first controller and the second controller being simultaneously operable by the first finger and the second finger.

Description

Technical Field

[0001] Broadly speaking, the embodiments relate to the field of robotic medical treatment systems, and more specifically, to systems, devices, and methods for robotically controlling the movement of one or more elongate medical devices in robotic intervention medical treatment.

Background Art

[0002] As used herein, "elongate medical device (EMD)" refers to, but is not limited to, catheters (such as guide catheters, microcatheters, balloon / stent catheters, etc.), wire-based devices (such as guide wires, embolization coils, stent retrievers, etc.), and devices having combinations thereof. Wire-based devices include, but are not limited to, guide wires, micro wires, proximal pushers for embolization coils, stent retrievers, self-expanding stents, and flow diverters. Typically, an elongate wire-based medical device (EMD) has a hub or handle at its proximal end Absent .

[0003] Catheters and other elongate medical devices (EMDs) are used in minimally invasive medical procedures for the diagnosis and treatment of various vascular diseases, including neurovascular intervention (NVI), also known as neurointerventional surgery, percutaneous coronary intervention (PCI), and peripheral vascular intervention (PVI). These procedures typically involve navigating a guide wire through the vasculature and using the guide wire to advance a catheter for treatment.

[0004] Catheter-based procedures begin by accessing a suitable blood vessel, such as an artery or vein, using a standard percutaneous technique and an introducer sheath. Through the introducer sheath, a diagnostic guide wire is then used to advance a sheath or guide catheter to a primary location, such as the internal carotid artery in the case of NVI, the coronary ostium in the case of PCI, or the superficial femoral artery in the case of PVI. A guide wire suitable for the vasculature is then navigated through the sheath or guide catheter to the target location within the vasculature. In situations such as tortuous anatomical structures, a support catheter or microcatheter is inserted over the guide wire to assist with the navigation of the guide wire.

[0005] An operator, such as a physician, can use an imaging system (e.g., a fluoroscope) to obtain cine by injecting a contrast agent and select a stationary frame to be used as a roadmap for navigating a guide wire or catheter to a target location, such as a lesion. Fluoroscopic images can also be obtained while the operator advances the guide wire or catheter, allowing the operator to confirm that the device is moving along the correct path towards the target location. The operator manipulates the proximal end of the guide wire or catheter while observing the anatomical structures using fluoroscopy, inserts the distal tip into a suitable blood vessel, and directs it towards the target anatomical location (such as a lesion), avoiding entry into collateral branches.

[0006] For example, robotic catheter-based treatment systems have been developed to assist physicians performing catheter-based procedures such as NVI, PCI, and PVI. Examples of NVI procedures include coil embolization of aneurysms, liquid embolization of arteriovenous malformations, and mechanical thrombectomy for large vessel occlusions in the setting of acute ischemic stroke. In an NVI procedure, the physician uses a robotic system to gain access to the target lesion by controlling the manipulation of a neurovascular guidewire and a microcatheter, and performs a treatment to restore normal blood flow. Access to the target is enabled by a sheath or a guiding catheter, but an intermediate catheter may be required for more distal regions or to provide appropriate support for the microcatheter and guidewire. The distal tip of the guidewire is navigated within the lesion or past the lesion depending on the type of lesion and treatment. When treating an aneurysm, the microcatheter is advanced into the lesion, the guidewire is removed, and several embolization coils are placed within the aneurysm through the microcatheter and used to block blood flow into the aneurysm. When treating an arteriovenous malformation, a liquid embolization is injected into the malformation through the microcatheter. Mechanical thrombus removal for treating vascular occlusions is achieved by either or both of the use of aspiration and a stent retriever. Depending on the location of the thrombus, aspiration is performed either through an aspiration catheter or, in the case of a small artery, through a microcatheter. Once the aspiration catheter is in the lesion, negative pressure is applied to remove the thrombus through the catheter. Alternatively, the thrombus can also be removed by placing a stent retriever through the microcatheter. After snaring the thrombus with the stent retriever, the thrombus is retrieved by pulling the stent retriever and the microcatheter (or intermediate catheter) into the guiding catheter.

[0007] In the case of PCI, the physician uses a robotic system to access the lesion by manipulating the coronary guidewire, perform treatment, and restore normal blood flow. Access is made possible by seating the guiding catheter at the coronary artery entry site. The distal tip of the guidewire is navigated to the tip of the lesion, and due to the complex anatomical structure, a microcatheter can be used to appropriately support the guidewire. Blood flow is restored by delivering and deploying a stent or balloon to the lesion. The lesion may require pretreatment before stent implantation, and a balloon may be delivered for pre-dilation of the lesion, or, for example, atherectomy is performed using a laser or a rotational atherectomy catheter and a balloon using a guidewire. Imaging diagnosis and physiological measurements can be performed to determine the appropriate treatment method by using an imaging catheter or a fractional flow reserve (FFR) measurement.

[0008] In the case of PVI, the physician performs treatment using a robotic system and restores blood flow using a technique similar to NVI. The distal tip of the guidewire is navigated to the tip of the lesion, and a microcatheter is used to appropriately support the guidewire for complex anatomical structures. Blood flow is restored by delivering and deploying a stent or balloon to the lesion. Similar to the case of PCI, pretreatment of the lesion and imaging diagnosis are also used in the same manner.

[0009] If support at the distal end of the catheter or guidewire is required, for example, for navigation of tortuous or calcified vasculature, to reach a distal anatomical location, or to cross a stenotic lesion, an over-the-wire (OTW) catheter or a coaxial system is used. The OTW catheter has a lumen for the guidewire, and this lumen extends along the entire length of the catheter. As a result, the guidewire is supported throughout its length, making it a relatively stable system. However, this system has some weaknesses such as high friction and a long overall length when compared to the rapid exchange catheter (described later).

[0010] Typically, in order to remove or replace an OTW catheter while maintaining the position of the guidewire, the exposed length of the guidewire (exiting the patient) must be longer than the OTW catheter. A guidewire with a length of 300 cm is generally considered sufficient for this purpose and is often referred to as an exchange-length guidewire. Due to the length of this guidewire, two operators are required to remove or replace the OTW catheter. This becomes even more difficult when using a triple coaxial system known in the art as a triaxial system (it is also known that a quadruple coaxial catheter is used). However, due to its stability, the OTW system is often used in NVI and PVI procedures. On the other hand, in the case of PCI procedures, a rapid exchange (or monorail) catheter is often used. The guidewire lumen of a rapid exchange catheter only passes through the distal portion of the catheter, which is called the monorail or rapid exchange (RX) section. Operators using the RX system operate the intervention devices parallel to each other (in contrast to operating the devices in a tandem configuration with the OTW system), and the exposed length of the guidewire only needs to be slightly longer than the RX section of the catheter. Rapid exchange guidewires typically have a length of 180 - 200 cm. Considering the short lengths of the guidewire and the monorail, the RX catheter can be exchanged by a single operator. However, the RX catheter is often inappropriate when more distal support is required.

[0011] When performing a vascular intervention procedure, an operator generally uses a set of controllers provided at a control station to control a robotic system to operate each catheter or wire. Each of the controllers is typically configured to control a specific device or to operate a catheter or wire in a specific manner. Therefore, an operator may sometimes need to switch between different controllers or operate multiple controllers simultaneously. A system for improving operator controllability of multiple EMDs during a robotic vascular intervention procedure is desired. SUMMARY OF THE INVENTION

[0012] In one aspect, a system is included for controlling a robotic drive device configured to operate one or more elongate medical devices. The system includes a housing having a first surface and a second surface that is not in the same plane as the first surface, a first controller integrated on the first surface and operable by a first finger of a user's first hand to select one of the one or more elongate medical devices, and a second controller integrated on the second surface and operable by a second finger of the user's first hand to instruct the robotic drive device to operate the selected elongate medical device in a first degree of freedom. The first controller and the second controller are simultaneously operable by the first finger and the second finger.

[0013] In one aspect, a system for controlling a robotic drive device configured to operate one or more elongate medical devices includes a housing having a first surface and a second surface that is not in the same plane as the first surface. A first controller is integrated on the first surface and is operable by the thumb of the user's first hand, and a second controller is integrated on the second surface and is operable by a second finger of the user's first hand to instruct the robotic drive device to control the linear velocity of one of the one or more elongate medical devices. A third controller is integrated on the second surface and is operable by a second finger of the user's first hand to instruct the robotic drive device to control the linear position of one of the one or more elongate medical devices.

[0014] In one aspect, a system is included for controlling a robotic drive configured to operate one or more elongate medical devices. The system includes a housing including a first surface and a second surface not coplanar with the first surface, a first controller integrated on the first surface and operable by a first finger of a first hand of a user to instruct the robotic drive to operate one of the one or more elongate medical devices in a first degree of freedom, and a second controller integrated on the second surface and operable by a second finger of the first hand of the user to instruct the robotic drive to operate one of the one or more elongate medical devices in a second degree of freedom.

Brief Description of the Drawings

[0015] The embodiments will be understood more deeply from the following detailed description which refers to the following drawings, in which reference numerals are assigned to similar parts.

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[0016] The following description is provided to enable any person skilled in the art to make and use the disclosed embodiments. However, various modifications can be readily envisioned by anyone skilled in the art.

[0017] FIG. 1 according to an embodiment is a perspective view showing an example of a catheter-based treatment system 10. The catheter-based treatment system 10 is used to perform catheter-based medical treatments, such as percutaneous intervention treatments such as percutaneous coronary intervention (PCI) (for example, to treat STEMI), neurovascular intervention treatments (NVI) (for example, to treat emergency large vessel occlusion (ELVO)), peripheral vascular intervention treatments (PVI) (for example, for severe limb ischemia (CLI)), etc. Catheter-based medical treatments include diagnostic catheterization procedures that use one or more catheters and other elongated medical devices (EMDs) to assist in diagnosing a patient's disease. For example, in one embodiment of a catheter-based diagnostic procedure, a contrast agent is injected into one or more arteries through a catheter, and an image of the patient's vasculature where the contrast agent is present is obtained.

[0018] Catheter-based medical treatments also include catheter-based treatment procedures (such as angioplasty, stent placement, treatment of peripheral vascular diseases, thrombus removal, treatment of arteriovenous malformations, treatment of aneurysms, etc.) that use a catheter (or other EMD) to treat a disease. The treatment procedure can be enhanced, for example, by including an auxiliary device 54 (shown in FIG. 2) such as intravascular ultrasound (IVUS), optical coherence tomography (OCT), fractional flow reserve (FFR), etc. However, it is natural for those with ordinary knowledge in the art to recognize that a specific percutaneous intervention device or component (such as the type of guidewire, the type of catheter, etc.) can be selected based on the type of procedure to be performed. The catheter-based treatment system 10 can accommodate dedicated percutaneous intervention devices used in the treatment with minor adjustments and can perform any catheter-based medical treatment.

[0019] The catheter treatment system 10 includes, among other elements, a bedside unit 20 and a control station 26. The bedside unit 20 includes a robotic drive 24 and a positioning system 22 located beside the patient 12. The patient 12 is lying on the patient table 18. The positioning system 22 is used to position and support the robotic drive 24. The positioning system 22 can be, for example, a robotic arm, an articulated arm, a holder, etc. The positioning system 22 can be attached at one end, for example, to a rail, a base, or a cart of the patient table 18. The robotic drive 24 is attached to the other end of the positioning system 22. The positioning system 22 (along with the robotic drive 24) can be retracted to place the patient 12 on the patient table 18. After placing the patient 12 on the patient table 18, the positioning system 22 is used to position (fix) the robotic drive 24 relative to the patient 12 for treatment. In one embodiment, the patient table 18 is supported and operated by a pedestal 17 installed on the floor and / or the ground. The patient table 18 can be operated relative to the pedestal 17 with multiple degrees of freedom, for example, roll, pitch, yaw. The bedside unit 20 may also include control equipment and a display 46 (shown in FIG. 2). For example, the control equipment and the display can be arranged on the housing of the robotic drive 24.

[0020] "Front (front side, near side)" refers to the side of the robotic drive 24 facing the patient 12 and opposite to the positioning system 22, while "Rear (rear side, far side)" refers to the side of the robotic drive 24 closest to the positioning system 22. "Up, upper end, upper part, above" refers to the general direction opposite to the direction of gravity, and "down, lower end, lower part, below" refers to the general direction of the direction of gravity.

[0021] Generally, the robot drive device 24 is provided with a suitable percutaneous intervention device and accessory equipment 48 (shown in FIG. 2) (for example, various catheters including guide wires, balloon catheters, stent delivery systems, stent retrievers, embolization coils, liquid plugs, suction pumps, delivery devices for contrast agents and drugs, hemostatic valve adapters, syringes, stopcocks, inflation devices, etc.), and enables an operator (user) 11 to perform a catheter-based medical treatment using the robot system by operating various control devices such as the control device and input device arranged at the control station 26. The bedside unit 20, particularly the robot drive device 24, may include any component and / or combination thereof for imparting the functions described herein to the bedside unit 20. The operator 11 of the control station 26 is referred to as the control station operator (user), and herein refers to the operator (user). The operator (user) of the bedside unit 20 is referred to as the bedside unit operator (user).

[0022] The robot drive device 24 includes a plurality of device modules 32a-d attached to a rail or linear member 60 (shown in FIG. 3). The rail or linear member 60 guides and supports the device modules. Each of the device modules 32a-d can be used to drive an EMD such as a catheter or a guide wire. For example, the robot drive device 24 can be used to automatically feed a guide wire into a diagnostic catheter and into a guide catheter in the artery of the patient 12. One or more devices, such as an EMD, enter the body (e.g., blood vessel) of the patient 12 from the insertion point 16, for example, through an introducer sheath.

[0023] The bedside unit 20 communicates with the control station 26, and the control station 26 is capable of wirelessly or wiredly transmitting a signal generated by a user input of the control station 26 to the bedside unit 20 to control various functions of the bedside unit 20. As will be described later, the control station 26 includes a control computing system 34 (shown in FIG. 2) or is connected to the bedside unit 20 via the control computing system 34. The bedside unit 20 can also provide a feedback signal (e.g., loading, speed, operating conditions, warning signal, error code, etc.) to the control station 26 or the control computing system 34, or both. The communication between the control computing system 34 and each component of the catheter treatment system 10 is provided via a communication link that can be a wireless connection, a wired connection, or any other means that enables communication between components. The control station 26 or other similar control systems are located at either a local site (e.g., the local control station 38 in FIG. 2) or a remote site (e.g., the remote control station and computing system 42 in FIG. 2).

[0024] "Local" is used to refer to the location of the patient 12 and the bedside unit 20. The catheter treatment system 10 can be operated by the control station at the local site or the control station at the remote site, or simultaneously by both the local control station and the remote control station. At the local site, the operator 11 and the control station 26 are located in the same room or the adjacent room as the patient 12 and the bedside unit 20. The local site as used herein is the location of the bedside unit 20 and the patient 12 or the subject (e.g., an animal or a cadaver), and the remote site is the location of the control station 26 and the operator 11 used to remotely control the bedside unit 20. "Remote" is used to refer to a location that does not provide physical access to the bedside unit 20 and / or the patient 12 at the local site.

[0025] The control station 26 (and control computing system) of the remote site and the bedside unit 20 and / or control computing system of the local site communicate via a communication system and service 36 (shown in FIG. 2), for example, via the Internet. In one embodiment, the remote site and the local (patient) site are separated from each other. For example, they are in separate rooms within the same building, separate buildings within the same city, separate cities, or other separate locations where the remote site does not have physical access to the bedside unit 20 and / or patient 12 of the local site.

[0026] The control station 26 typically includes one or more input systems 28 including a controller configured to receive user operations for controlling each component or system of the robot drive device 24 and / or the catheter treatment system 10. In the case of the embodiment shown here, the control station 26 enables the operator 11 to control the bedside unit 20 to perform a catheter medical treatment. For example, the input system 28 is configured to cause the bedside unit 20 to perform various tasks using a percutaneous intervention device (e.g., EMD) associated with the robot drive device 24 (e.g., advancing, retracting, or rotating a guide wire, advancing, retracting, or rotating a catheter, inflating or deflating a balloon placed with the catheter, placing and / or deploying a stent, placing and / or deploying a stent retriever, placing and / or deploying a coil, injecting a contrast agent into the catheter, injecting a liquid plug into the catheter, injecting a drug or saline into the catheter, aspirating with the catheter, or performing other functions that can be implemented as part of a catheter medical treatment). The robot drive device 24 includes various drive mechanisms for operating (e.g., axial and rotational movements) the components of the bedside unit 20 including the percutaneous intervention device in response to user operations of the controller of the one or more input systems 28.

[0027] As described below, the input system 28 includes one or more touchscreens, joysticks, scroll wheels, and / or buttons. In addition to the input system 28, the control station 26 can use additional user control devices 44 (shown in FIG. 2), such as foot switches and microphones for voice commands. The input system 28 is configured to direct various components and various percutaneous intervention devices, such as guidewires and one or more catheters or microcatheters, to move forward, backward, or rotate. The controller of the input system can include, for example, an emergency stop button, magnification buttons, device selection buttons, and an auto-operation button. When the emergency stop button is pressed, the power (e.g., electricity) of the bedside unit 20 is cut off or removed. In the speed control mode, the magnification buttons act to increase or decrease the speed at which the associated components move in response to the operation of the input controller. In the position control mode, the magnification buttons change the mapping between the input distance and the output command distance.

[0028] The input system 28 includes device selection buttons that allow the operator 11 to select which of the percutaneous intervention devices loaded in the robotic drive 24 to control with user operations of the input controller. The auto-operation button is used to execute operations according to an algorithm that the catheter treatment system 10 can perform with the percutaneous intervention device without receiving direct commands from the operator 11. In one embodiment, the input system 28 includes one or more controllers or icons (not shown) displayed on a touchscreen (which may or may not be part of the display 30), and when activated, these operate the components of the catheter treatment system 10.

[0029] The input system 28 can also include a balloon or stent controller configured to issue instructions to inflate or deflate the balloon and / or deploy the stent. The input system 28 can include one or more buttons, scroll wheels, joysticks, touchscreens, etc., which can be used to issue instructions to exclusively control one or more specific components. Further, one or more touchscreens display one or more icons (not shown) associated with each part of the input system 28 or each component of the catheter treatment system 10.

[0030] The control station 26 includes a display 30. In one embodiment, the control station 26 can also include two or more displays 30. The display 30 is configured to display information or patient-specific data to the operator 11 located at the control station 26. For example, the display 30 can be configured to display image data (e.g., X-ray images, MRI images, CT images, ultrasound images, etc.), hemodynamic data (e.g., blood pressure, heart rate, etc.), patient chart information (e.g., medical history, age, weight, etc.), lesion or treatment evaluation data (e.g., IVUS, OCT, FFR, etc.). Further, the display 30 is also configured to display treatment-specific information (e.g., treatment checklist, recommendations, treatment duration, position of the catheter or guidewire, amount of drug or contrast agent delivered, etc.). Also, the display 30 may be configured to display information for providing functions related to the control computing system 34 (shown in FIG. 2). The display 30 may have a touchscreen function to provide a part of the user input function of the system.

[0031] The catheter-based treatment system 10 also includes an imaging system 14. The imaging system 14 can be any medical imaging system (e.g., non-digital X-ray, digital X-ray, CT, MRI, ultrasound, etc.) that can be used in conjunction with catheter-based medical treatments. In one embodiment, the imaging system 14 is a digital X-ray imaging device that communicates with a control station 26. In one embodiment, the imaging system 14 includes a C-arm (shown in FIG. 1) that allows the imaging system 14 to rotate partially or completely around the patient 12 in order to obtain images of the patient 12 at various angular positions (e.g., sagittal images, coronal images, anteroposterior images, etc.). In one embodiment, the imaging system 14 is a fluoroscopy system that includes a C-arm having an X-ray source 13 and a detector 15, also known as an image intensifier.

[0032] The imaging system 14 is configured to capture X-ray images of the appropriate region of the patient 12 during the treatment. For example, the imaging system 14 can be configured to capture one or more X-ray images of the head to diagnose neurovascular conditions. The imaging system 14 can also be configured to capture one or more X-ray images (e.g., real-time images) during catheter-based medical treatment to assist the operator 11 at the control station 26 in properly positioning a guide wire, guide catheter, microcatheter, stent retriever, coil, stent, balloon, etc. during the treatment. One or more images are displayed on the display 30. For example, the images are displayed on the display 30 to allow the operator 11 to accurately move the guide catheter or guide wire to the appropriate position.

[0033] For clarity of direction, a Cartesian coordinate system is presented with X, Y, and Z axes. The positive X-axis is oriented in the distal direction of the longitudinal (axial) direction, i.e., the direction from the proximal end to the distal end, or in other words, the proximal-to-distal direction. The Y-axis and Z-axis are in the cross-section with respect to the X-axis, the positive Z-axis is upward, i.e., in the opposite direction of gravity, and the Y-axis is automatically determined by the right-hand rule.

[0034] FIG. 2 according to one embodiment is a block diagram of a catheter treatment system 10. The catheter treatment system 10 includes a control computing system 34. The control computing system 34 can physically be a part of, for example, the control station 26 (shown in FIG. 1). The control computing system 34 is typically an electronic control unit suitable for providing the catheter treatment system 10 with each function described herein. For example, the control computing system 34 can be an embedded system, a dedicated circuit, a general-purpose system programmed with the functions described herein, etc. The control computing system 34 communicates with a bedside unit 20, a communication system and service 36 (such as the Internet, a firewall, a cloud service, a session manager, a hospital network, etc.), a local control station 38, an additional communication system 40 (such as a telepresence system), a remote control station and computing system 42, and a patient sensor 56 (such as an electrocardiogram (ECG) device, an electroencephalogram (EEG) device, a blood pressure monitor, a temperature monitor, a heart rate monitor, a respiration monitor, etc.). The control computing system also communicates with an imaging system 14, a patient table 18, an additional medical system 50, a contrast agent injection system 52, and an auxiliary device 54 (such as IVUS, OCT, FFR, etc.). The bedside unit 20 includes a robot drive 24 and a positioning system 22, and can also include additional control devices and a display 46. As described above, the additional control devices and the display can be arranged in the housing of the robot drive 24. An intervention device and accessory 48 (such as a guide wire, a catheter, etc.) are connected to the bedside system 20. In one embodiment, the intervention device and accessory 48 include dedicated devices (such as an IVUS catheter, an OCT catheter, an FFR wire, a diagnostic catheter for angiography, etc.) for connecting to their respective auxiliary devices 54, that is, an IVUS system, an OCT system, an FFR system, etc.

[0035] In one embodiment, the control computing system 34 is configured to receive and generate control signals based on user operations of controllers of one or more input systems 28 (such as the control station 26 shown in FIG. 1, for example, the local control station 38 or the remote control station 42) and / or based on information accessible to control the control computing system 34 to perform a medical treatment using the catheter treatment system 10. The local control station 38 includes one or more displays 30, one or more input systems 28, and additional user control devices 44.

[0036] The remote control station and computing system 42 may include components similar to those of the local control station 38. The remote control station 42 and the local control station 38 can be made different according to the functions required for each. The additional user control devices 44 include, for example, one or more foot input controllers. The foot input controller can be configured to enable an operator to select functions of the imaging system 14, such as turning X-rays on / off and scrolling through a plurality of stored images. In one embodiment, the foot input device can be configured to enable an operator to select a device mapped to a scroll wheel included in the input module 28. An additional communication system 40 (such as voice conversation, video conversation, telepresence, etc.) can be employed to assist an operator in communicating with a patient, medical staff (such as angio suite staff), and / or devices near the bedside.

[0037] The catheter-based treatment system 10 can be connected or configured to include any other system and / or device not explicitly shown. For example, the catheter-based treatment system 10 can include an image processing engine, a data storage and archival system, an automated balloon and / or stent inflation system, a drug infusion system, a drug tracking and / or logging system, a user log, an encryption system, a system that restricts access to or use of the catheter-based treatment system 10, and the like.

[0038] As described above, the control computing system 34 communicates with the bedside unit 20 that includes the robotic drive 24 and the positioning system 22 and may include additional control equipment and a display 46. The control computing system 34 receives signals from the remote control station 42 based on user operations of the controller of the input system of the remote control station 42 and provides corresponding control signals to the bedside unit 20. Thereby, the operation of the motors and drive mechanisms used to drive the corresponding proximal portions of percutaneous intervention devices (e.g., guidewires, catheters, etc.) is controlled with various degrees of freedom including (but not limited to) straight-line and rotational (i.e., about a linear axis) motion. Various drive mechanisms can be provided as part of the robotic drive 24.

[0039] FIG. 3 according to the embodiment is a perspective view of the robot drive device 24 of the catheter treatment system 10. The embodiment is not limited to the robot drive device 24 of FIG. 3. In FIG. 3, the robot drive device 24 includes a plurality of device modules 32a-d connected to a linear member 60. Each of the device modules 32a-d is connected to the linear member 60 via a stage 62a-d movably attached to the linear member 60. Each individual device module 32a-d is connected to the stage 62a-d using a connector such as an offset bracket 78a-d. In one embodiment, the device modules 32a-d are directly attached to the stage 62a-d. Each stage 62a-d can be independently operated to move linearly along the linear member 60. Thus, each stage 62a-d (and the corresponding device module 32a-d connected to the stage 62a-d) can be individually operated relative to each other and relative to the linear member 60. A drive mechanism is used to operate each stage 62a-d. In the embodiment shown in FIG. 3, the drive mechanism has individual stage translation motors 64a-d connected to each stage 62a-d and a stage drive mechanism 76, or the stage translation motors 64a-d themselves can be linear motors. The stage drive mechanism 76 is, for example, a lead screw via a rotating nut, a rack via a pinion, a belt via a pinion or a pulley, or a chain via a sprocket. In one embodiment, the stage drive mechanism 76 is a combination of these mechanisms. For example, at each of the stages 62a-d, different types of stage drive mechanisms can be employed. In the case of an embodiment where the stage drive mechanism is a lead screw and a rotating nut, the lead screw is rotated and each stage 62a-d is engaged and disengaged with respect to the lead screw to operate, for example, to move forward or backward. In the embodiment illustrated in FIG. 3, the stages 62a-d and the device modules 32a-d have a column drive structure.

[0040] Each device module 32a-d includes drive modules 68a-d and cassettes 66a-d mounted on and connected to the drive modules 68a-d. In the illustrated embodiment of FIG. 3, each of the cassettes 66a-d is mounted to the drive modules 68a-d in a vertical orientation. In another embodiment, each of the cassettes 66a-d may be mounted to the device modules 68a-d in a different orientation. Each of the cassettes 66a-d is configured to connect to and support a proximal portion of an EMD (not shown). Further, each of the cassettes 66a-d can include elements that provide one or more degrees of freedom in addition to the linear motion provided by the actuation of corresponding stages 62a-d that move linearly along the linear member 60. For example, the cassettes 66a-d can include elements that can be used to rotate the EMD when the cassette is connected to the device module 68a-d. Each of the device modules 68a-d includes at least one coupler to provide a drive interface to the mechanisms within each cassette 66a-d to provide additional degrees of freedom. Each of the cassettes 66a-d includes a channel in which a device support 79a-d is disposed, and each device support 79a-d is used to prevent buckling of the EMD. Support arms 77a, 77b, 77c are respectively attached to each of the device modules 32a, 32b, 32c, providing fixed points for supporting the proximal ends of the device supports 79b, 79c, 79d, respectively. The robot drive 24 also includes a device support connection 72 connected to the device support 79, the distal support arm 70, and the support arm 77 0 The support arm 77 0 is used to provide a fixed point for supporting the proximal end of the most distal device support 79a housed in the most distal device module 32a. Further, an introducer interface support (redirector) 74 can be connected to the device support connection 72 and the EMD (e.g., an introducer sheath). This configuration of the robot drive 24 has the advantage of reducing the volume and weight of the robot drive 24 by using an actuator with one linear member.

[0041] To prevent pathogen infection of the patient, healthcare staff use aseptic techniques in the room where the bedside unit 20 and the patient 12 or subject (shown in FIG. 1) are housed. The room housing the bedside unit 20 and the patient 12 is, for example, a catheter lab or an angiography suite. Aseptic techniques consist of using sterile barriers, sterile instruments, appropriate patient preparation, environmental management, and contact guidelines. That is, all EMDs and intervention accessories are sterilized, and contact is permitted only with either a sterile barrier or a sterile instrument. In one embodiment, a sterile drape (not shown) is placed over the non-sterile robotic drive unit 24. Each cassette 66a-d is sterilized and functions as a sterile interface between the draped robotic drive unit 24 and at least one EMD. Each cassette 66a-d is designed to be sterilizable for single use or to be fully or partially resterilizable so that the cassette 66a-d or its components can be used in multiple procedures.

[0042] As used herein, "cassette" broadly refers to a component of a robotic drive system that includes components for supporting and operating (e.g., rotating and / or translating) at least one EMD. "Device module" broadly refers to a component of a robotic drive system that includes one or more motors with drive couplers that interface with the EMD-actuating elements of the cassette. The cassette can provide a sterile interface between at least one EMD and the device module, either directly or via a device adapter. "Drive module" refers to the combination of the device module and the cassette.

[0043] In one embodiment, the EMD is a catheter having a hub at the proximal end of the catheter and a flexible shaft extending from the hub to the distal end of the catheter, with the shaft being more flexible than the hub. In one embodiment, the catheter includes an intermediate portion that transitions between the hub and the shaft, the intermediate portion having an intermediate flexibility that is softer than the hub and harder than the shaft. In one embodiment, the intermediate portion is a strain relief.

[0044] The longitudinal axis (longitudinal axis, vertical axis) of a member (e.g., an EMD or other element in a catheter-based treatment system) is a line or axis in the length direction of the member that passes through the center of the cross-section of the member in the direction from the proximal portion of the member to the distal portion of the member. For example, the longitudinal axis of a guide wire is the center line in the direction from the proximal portion of the guide wire to the distal portion of the guide wire, even if the guide wire is not straight in the relevant portion.

[0045] Axial movement of a member means translation (parallel movement) of the member along the longitudinal axis of the member. For example, when the distal end of an EMD is axially moved distally into or further into the patient along its longitudinal axis, the EMD is advancing. When the distal end of an EMD is axially moved proximally out of or further out of the patient along its longitudinal axis, the EMD is being withdrawn.

[0046] In this regard, axial insertion means inserting a first member into a second member along the longitudinal axis of the second member. For example, an EMD axially loaded into a collet is axially inserted into the collet. An example of axial insertion can be said to be rear-loading a catheter onto the proximal end of a guide wire. Lateral insertion means inserting a first member into a second member along a direction in a plane orthogonal to the longitudinal axis of the second member. Lateral insertion can also be called radial loading or side loading.

[0047] The rotational movement of a member refers to a change in the angular direction of the member around the local longitudinal axis of the member. For example, the rotational movement of an EMD corresponds to clockwise or counterclockwise rotation of the EMD around its longitudinal axis by an applied torque. Continuous operation refers to an operation without interruption that does not require reset, and discontinuous operation refers to an operation with interruption that requires reset.

[0048] "Distal" and "proximal" define the relative positions of two different parts. In terms of a robotic drive device, "distal" and "proximal" are defined by the position of the robotic drive device relative to the patient in the intended use.

[0049] When used to define relative positions, the distal portion is the part of the robotic drive device that is closer to the patient than the proximal portion when the robotic drive device is in its intended position of use. Among the patient's vasculature landmarks, those that are further along the path from the access point are considered distal to those closer to the access point. Note that the access point is the point where the EMD enters the patient. Similarly, the proximal portion is the part of the robotic drive device that is further from the patient than the distal portion when the robotic drive device is in its intended position of use.

[0050] When used to define directions, the distal direction refers to the path of the robotic drive device when something is moving, or is intended to move something, or is aimed or oriented from the proximal portion towards the distal portion and / or towards the patient. The proximal direction is the opposite of the distal direction. For example, referring to Figure 1, the robotic device is shown from the perspective of an operator facing the patient. In this configuration, the distal direction is in the direction of the positive X-axis, and the proximal direction is in the direction of the negative X-axis.

[0051] Regarding the operation of the module, referring to Figure 3, the EMD moves distally along the path towards the patient through the introducer interface support 74 that defines the distal end of the robotic drive device 24. The proximal end of the robotic drive device 24 is the furthest from the distal end in the direction of the negative X-axis.

[0052] Regarding the positions of the individual modules, also referring to Figure 3, the most distal device module is the device module 32a closest to the distal end of the robotic drive device 24. The most proximal device module is the device module 32d located furthest from the distal end of the robotic drive device 24 in the direction of the negative X-axis. The relative positions of the device modules can be determined by their relative positions with respect to the distal end of the robotic drive device. For example, device module 32b is distal to device module 32c.

[0053] With respect to the distal / proximal portions, parts, or ends of the EMD or the robotic drive device, the parts of the cassette 66a and the device module 68a are defined by their relative positions with respect to the distal end of the robotic drive device. For example, when the cassette is in the use position of the device module 68a, the distal end of the cassette 66a is the part of the cassette closest to the distal end of the robotic drive device, and the proximal end of the cassette 66a is the part of the cassette farthest from the distal end of the robotic drive device in the direction of the negative X-axis. In other words, the distal end of the cassette 66a is the part of the cassette closest to the patient in the path by which the EMD reaches the patient when in the use position.

[0054] As described above, the control station 26 according to one embodiment can include various input systems for controlling the bedside unit 20. The input system can include various input controllers (e.g., buttons, scroll wheels, joysticks, etc.) that can be operated by a user to control (or direct) the operation of the robotic drive device 24. These input controllers can be arranged in various layouts or patterns in the input system to facilitate the functions and their cooperative permutations required to perform a predetermined task that requires the independent (and sometimes simultaneous) operation of multiple EMDs.

[0055] Furthermore, the input system according to one embodiment can be configured to operate in various control modes. The functions assigned to one or more controllers of the input system in the first control mode may be different from the functions assigned to one or more controllers in the second control mode, and the control mode can be selected based on the procedure being performed, one or more devices being controlled, the user's preferences, or any other factor. The input system can be configured to switch between multiple control modes in response to input from the user or the control computing system 34.

[0056] The input system described herein can be fixed, integrated, or simply placed on the surface of the control station 26. As described herein, the input system can comprise a single integrated housing or multiple individual movable housings.

[0057] FIG. 4A according to one embodiment is a perspective view of an input system 400 for controlling a robotic drive of a catheter treatment system. As described below, the input system 400 can easily perform the selection of one or more sets of EMDs and the linear operation of the selected set of EMDs using the first and second fingers of the user's right hand, and can easily perform either the rotation of the selected set of EMDs or the selection and linear operation of a second set of one or more EMDs using the user's left hand. In the latter case, there are no EMDs belonging to both the first (initial) set and the second set.

[0058] The input system 400 includes a main housing 410 that includes a right controller housing 420 and a left controller housing 430. These housings 410, 420, 430 are made of any suitable material including (but not limited to) thermoplastic materials. The housings 410, 420, 430 house mechanical and electrical components for performing the functions attributed to each controller of the input system 400.

[0059] As shown in FIG. 4B, in one embodiment, the individual horizontal and rotational positions of the right controller housing 420 and the left controller housing 430 can be changed by the operator. The position can be changed to increase the user's comfort level (i.e., to adapt the position to the operator's body size). In the example shown, the horizontal position of the housing 420 is shifted to the left and the horizontal position of the housing 430 is also shifted to the left compared to their respective positions shown in FIG. 4A. In addition, the housing 420 is rotated slightly clockwise and the housing 430 is rotated slightly counterclockwise. The direction and amount of the horizontal or rotational movement of each of the housings 420, 430 need not be the same.

[0060] In one embodiment, an element (not shown) of the housing 410 releases each of the housings 420, 430 from its current position, adjusts the horizontal position and / or the rotational position as desired, and fixes the horizontal position and the rotational position of each of the housings 420, 430 after adjustment so that its position does not inadvertently change during operation as described below. The element of the housing 410 may fix the horizontal distance between the right controller housing 420 and the left controller housing 430 so that both housings 420, 430 can move equidistantly in the same direction, or alternatively, the horizontal distance may be adjustable. The adjustment of rotation may be limited to a specific degree in either rotational direction.

[0061] FIGS. 5A and 5B are perspective views of the left and right sides of the input system 400 and are provided to facilitate understanding of the following description of the controller of the input system 400.

[0062] The right controller housing 420 includes a surface 421 and a surface 425. As most clearly shown in FIG. 5B, the surface 421 and the surface 425 are not coplanar with each other. The surface 425 can be commonly referred to as the "upper" surface and the surface 421 can be commonly referred to as the "side" surface.

[0063] Either of the two surfaces 421, 425 is bent or shaped in a suitable manner. By bending or shaping either of the two surfaces 421, 425, comfortable positioning of the fingers of the user who operates the controller integrated thereon becomes possible. The positioning of the user's hand during operation on the surfaces 421, 425 will be described later.

[0064] In one embodiment, the controllers 422, 423, 424 are integrated on the first surface 421. In this embodiment, such integration is achieved from the provision of an opening in the surface 421 facing each controller 422, 423, 424. In one embodiment, one or more controllers are integrated on the surface 421 through the equipment to the surface 421. In one embodiment, the surface 421 defines one opening facing the controllers 422, 423, 424.

[0065] The parts of the surface 421 where the controllers 422, 423, 424 are arranged do not have to be on the same plane. According to one embodiment, one or more of the controllers 422, 423, 424 are arranged on a part of the surface 421 that is curved with respect to the part of the surface 421 where another one or more of the controllers 422, 423, 424 are arranged. As shown in the figure, the surface 421 can be regarded as consisting of two non - coplanar surfaces, with the controllers 422, 423 integrated on one of them and the controller 424 integrated on the other.

[0066] According to this embodiment, the controller 424 consists of a scroll wheel, and the controllers 422, 423 consist of binary buttons. When the user operates (i.e., presses) the controller 422 or the controller 423, a signal indicating that the controller 422 or the controller 423 has been pressed is generated. For example, a signal is generated when the controller 422 or the controller 423 is held in the pressed state and / or when the controller 422 or the controller 423 is switched between the pressed state and the unpressed state. According to one embodiment, one or both of the controllers 422, 423 consist of analog input controllers that generate a control signal that varies between a minimum value and a maximum value based on the degree of depression.

[0067] The scroll wheel 424 is partially housed within the right controller housing 420, with a portion of the scroll wheel 424 protruding outward from the surface 421 and being operable by the user. On the other hand, the opposite portion of the scroll wheel 424 is located within the right controller housing 420. The axis of rotation of the scroll wheel 424 is substantially parallel to the surface 421. As a result, when rotated by the user, a portion of the exposed part of the scroll wheel 424 moves into the housing 420, and a portion of the hidden part of the scroll wheel 424 moves out of the housing 420 and into the user's field of view.

[0068] Rotation of the scroll wheel 424 generates a signal indicating how far, in which direction (and, in one embodiment, how fast) the scroll wheel 424 has rotated. In one embodiment, the scroll wheel 424 includes a plurality of detents (claws) configured to provide the individual rotational positions of the scroll wheel 424. As the scroll wheel 424 rotates between these positions, the detents provide tactile feedback to the user. For example, the detents can provide an initial resistance to the rotation of the scroll wheel 424, but then, when the scroll wheel 424 has rotated far enough, push the wheel, resulting in the scroll wheel "skipping" or "snapping" to the next rotational position. The scroll wheel 424 is configured to generate a signal each time it moves between the rotational positions defined by the detents, providing a first signal when the scroll wheel 424 is rotated in a first direction and a second signal when rotated in a second direction opposite the first direction.

[0069] The selection controller 426 includes controllers 427a, 427b, 427c, and 427d. The selection controller 426 is integrated on the surface 425 in one embodiment. In the illustrated example, the surface 425 defines an opening facing each of the controllers 427a, 427b, 427c, and 427d that are in the controller 426. Each of the controllers 427a, 427b, 427c, and 427d can be integrated on the surface 425 in other suitable ways such that the controller 426 can be considered to be substantially on and / or in the surface 425. One or more of the controllers 427a, 427b, 427c, and 427d can be disposed at a portion of the surface 425 that is curved relative to a portion of the surface 425 where the other one or more of the controllers 427a, 427b, 427c, and 427d are disposed.

[0070] The controllers 427a, 427b, 427c, and 427d consist of buttons that generate a signal when pressed. The generated signal enables determination of which of the controllers 427a, 427b, 427c, and 427d has been depressed when the user presses one or more of the controllers 427a, 427b, 427c, and 427d simultaneously.

[0071] Typically, each of the controllers 427a, 427b, 427c, and 427d is operable by a finger of the user's hand to select an EMD, while each of the controllers 422, 423, and 424 is operable by a different finger of the user's hand to instruct the robotic drive 24 to move the selected EMD in a first degree of freedom (e.g., linearly). For example, the controller 422 consists of a linear forward speed controller, and the controller 423 consists of a linear reverse speed controller. The controller 424 can be a straight-ahead position controller.

[0072] In one embodiment, the user presses one or more of controllers 427a, 427b, 427c, 427d to select one or more corresponding EMDs, and then selectively operates controllers 422, 423, 424 to instruct the robot drive 24 to linearly operate the selected one or more EMDs as planned. Pressing and releasing one or more of controllers 427a, 427b, 427c, 427d results in the selection of the corresponding one or more EMDs until another one or more EMDs are selected. Alternatively, the selection of the EMD occurs only while the corresponding controller 427a, 427b, 427c, 427d is being pressed. In the latter case, the robot drive is instructed to move the EMD only when any of the corresponding controllers 427a, 427b, 427c, 427d is pressed and one of the controllers 422, 423, 424 is simultaneously being operated.

[0073] In one embodiment, controller 427d is larger than any of controllers 427a, 427b, 427c and corresponds to the guide wire. In this embodiment, each of controllers 427a, 427b, 427c corresponds to a respective catheter. The embodiments are not limited to examples where there are four controllers 426 or EMDs and the number of controllers 426 is the same. Also, the embodiments are not limited to examples where the correspondence between controllers 427a, 427b, 427c, 427d and their respective EMDs is fixed. The correspondence can be changed according to the operating mode and / or the specific devices loaded in each cassette of the robot drive 24.

[0074] Knob 442 and function button 444 are integrated on the surface 440 of the main housing 410. The surface 440 is not in the same plane as either surface 421 or surface 425. Knob 442 is mounted on the surface 440, protrudes from the surface 440, or is physically connected to the surface 440 in some other way. Knob 442 is a rotational position controller and can be operated with the user's left hand to instruct the robot drive 24 to correspondingly rotate one or more EMDs selected using the controller 426.

[0075] Rotation of the knob 442 generates a signal indicating how long, in which direction (and, in one embodiment, how fast) the knob 442 has rotated. In one embodiment, the knob 442 includes a plurality of detents configured to provide individual rotational positions. The detents provide an initial resistance to rotation of the knob 442, but can also bias the knob 442 to the next rotational position. The knob 442 can be configured to generate a signal each time it moves between rotational positions defined by the detents, providing a first signal when the knob 442 rotates clockwise and a second signal when it rotates counterclockwise.

[0076] The function button 444 can be configured (but is not limited thereto) to control system modes or settings, such as changing the speed at which the EMD moves in response to the operation of other controllers of the input system 400. Pressing and holding the function button 444 activates the "turbo" mode, increasing the movement speed of the currently selected EMD (including the EMD selected by the controller 436 described below), or activates the "precision" mode, decreasing the movement speed. As other modes, algorithmic operation profiles are included. For example, when this profile is activated, the EMD spins a predetermined amount each time it moves backward after moving forward. One or more function buttons 444 can also operate as a toggle that alternately activates and deactivates the corresponding mode in response to each press by the user, rather than requiring the user to continue pressing to maintain the mode.

[0077] The left controller housing 430 includes a surface 431 and a surface 435. FIG. 5A shows that the surfaces 421 and 425 are not in the same plane. Similar to the surfaces 421 and 425 of the right controller housing 420, the surface 435 can be commonly referred to as the "upper" surface and the surface 431 as the "side" surface. Either of the two surfaces 431, 435 may be curved or shaped in some manner to support a portion of the user's left hand in a manner that facilitates operation of the controllers 432, 433, 434 with the fingers of the user's left hand, for example.

[0078] In one embodiment, the controllers 432, 433, 434 are integrated on the first surface 431. The integration is achieved through one or more openings defined in the surface 431, and each of the controllers 432, 433, 434 faces one of these openings. In one embodiment, one or more controllers are integrated on the surface 431 via attachment to the surface 431. In one embodiment, one or more of the controllers 432, 433, 434 are disposed at a portion of the surface 431 that is curved relative to a portion of the surface 431 where the other one or more of the controllers 432, 433, 434 are located. The surface 431 can be regarded as consisting of two non - coplanar surfaces, with the controllers 432, 433 integrated on one of them and the controller 434 integrated on the other one.

[0079] The controller 434 consists of a scroll wheel, and the controllers 432, 433 consist of binary buttons. As described with respect to the controllers 422, 423, a signal is generated when the controller 432 or the controller 433 is pushed by the user. A signal is generated when the controller 432 or the controller 433 is held in the pressed state and / or when the controller 432 or the controller 433 is released after being pushed. According to one embodiment, one or both of the controllers 432 and 433 consist of an analog input controller that generates a control signal that varies between a minimum value and a maximum value based on the degree to which the controller is depressed.

[0080] The scroll wheel 434 is partially housed in the left - hand controller housing 430, as described with respect to the scroll wheel 424. Rotation of the scroll wheel 434 generates a signal indicating the range and direction of the rotation angle. In one embodiment, the scroll wheel 434 includes a plurality of detents configured to provide individual rotational positions to the scroll wheel 424. The detents can provide haptic feedback to the user, as described above.

[0081] The selection controller 436 includes controllers 437a, 437b, and 437c. The selection controller 436 is integrated on the surface 435 in one embodiment. For example, the surface 435 defines an opening facing each of the controllers 437a, 437b, and 437c. As described with respect to the controller 426, the controllers 437a, 437b, and 437c can be buttons that generate a signal when pressed. The generated signal enables determination of which of the controllers 437a, 437b, and 437c is being pressed when the user presses one or more of the controllers 437a, 437b, and 437c simultaneously.

[0082] Each of the controllers 437a, 437b, and 437c can be operated by a finger (e.g., the thumb) of the user's left hand to select an EMD. In the illustrated example, the controllers 437a, 437b, and 437c correspond to three catheters loaded into the robot drive device 24, and none of the controllers 437a, 437b, and 437c correspond to a guide wire. The embodiment is not limited to an example where the correspondence between the controllers 437a, 437b, and 437c and each EMD is fixed. The correspondence can also be changed according to the operating mode and / or the specific device loaded in each cassette of the robot drive device 24.

[0083] By pressing and releasing one or more of the controllers 437a, 437b, and 437c, the corresponding one or more EMDs are selected until another one or more EMDs are selected, or the selection of the EMD is made only while the corresponding controllers 437a, 437b, and 437c are being pressed.

[0084] Each of the controllers 432, 433, and 434 can be operated by another finger (e.g., the index finger) of the user's left hand and instructs the robot drive device 24 to move the currently selected EMD in the first degree of freedom (e.g., linearly). For example, the controller 432 is a linear forward speed controller, the controller 433 is a linear reverse speed controller, and the controller 434 is a straight-ahead position controller.

[0085] 6A and 6B, which relate to one embodiment, are perspective views of the input system 400 during operation. Generally speaking, FIG. 6A shows the operation of controllers 422, 423, 424 for controlling the operation of the selected EMD in a first degree of freedom (e.g., linear translation) using controller 426, and the operation of knob 442 for controlling the operation of the selected EMD in a second degree of freedom (e.g., rotation).

[0086] As shown in FIG. 6A, the user's right hand 610 is in a state where the thumb 612 is placed on controller 426 on surface 425, and the index finger 614 is placed on / around controllers 422, 423, 424 on surface 421. This hand placement is facilitated by the relative positions of surfaces 421 and 425 that are not on the same plane.

[0087] As described above, the user can operate one or more controllers 427a, 427b, 427c, 427d with the thumb 612 to select the corresponding one or more EMDs (i.e., press). Also, the user can selectively and individually operate controllers 422, 423, 424 to direct the robot drive 24 to operate the selected one or more EMDs as desired in a first degree of freedom (e.g., linear translation) using the thumb 612. The selection of one or more EMDs can be implemented by pressing and releasing the corresponding one or more controllers 427a, 427b, 427c, 427d, in which case the selection is maintained until one or more other EMDs are selected. Alternatively, the selection can be implemented by pressing and holding any of the corresponding controllers 427a, 427b, 427c, 427d.

[0088] While one or more EMDs are selected using controller 426, FIG. 6A also shows that the user's left hand 620 is placed on surface 440. The left thumb 622 and the left index finger 624 of the left hand grasp knob 442 and rotate knob 442 to instruct robot drive 24 to rotate one or more EMDs selected by controller 426. The other fingers of left hand 620 are available to select a desired one of function buttons 444 without the need for prominent movement of left hand 620 and, in one embodiment, without the need to release left thumb 622 and left index finger 624 from knob 442.

[0089] There may be situations where it is not desirable to rotate one or more EMDs disposed in robot drive 24. For example, rotating a stent retriever, balloon catheter, or embolization coil may not be desirable in certain situations. Thus, when selecting such an EMD using the input system described herein, the user is asked via display 30 whether to permit rotation of the EMD. If rotation of the EMD is not permitted, rotation is disabled either by not transmitting the corresponding signal to robot drive 24 if the user operates a controller associated with the EMD, such as knob 442, or by configuring robot drive 24 to ignore the signal.

[0090] In one embodiment, system 10 recognizes the type of EMD loaded at each position of robot drive 24. If a particular type of EMD is loaded at the selected position, rotation can also be automatically disabled as described above without the need for user intervention. In this embodiment, it may also be possible for the user to override such disabling so that rotation control as described herein is performed for the EMD loaded at the selected position.

[0091] FIG. 6B shows an operation of the input system 400 in which the user's left hand 620 has moved to the left controller housing 430. FIG. 6B shows the operations of the controllers 422, 423, 424 for controlling the operation of the selected EMD in the first degree of freedom (e.g., straight-ahead movement), and the operations of the controllers 432, 433, 434 for controlling the operation of the other selected EMD in the first degree of freedom (e.g., straight-ahead movement).

[0092] The left hand 620 is positioned such that the thumb 622 is placed on the controller 436 of the surface 435 and the index finger 624 is placed on / around the controllers 432, 433, 434 of the surface 431. As described above with respect to the right controller housing 420, such a left hand positioning is facilitated by the relative positions of the surfaces 431 and 435 that are not in the same plane.

[0093] The user can operate (i.e., press) one or more of the controllers 437a, 437b, 437c with the thumb 622 to select one or more corresponding EMDs. In one embodiment, any EMD currently selected using the controller 426 of the right controller housing 420 cannot be selected using the controllers 437a, 437b, 437c. The user can selectively and individually operate the controllers 432, 433, 434 to direct the robot drive 24 to move one or more EMDs selected with the thumb 632 as desired in the first degree of freedom (e.g., straight-ahead movement). Selection of one or more EMDs can be done by pressing and releasing or holding down the corresponding one of the controllers 437a, 437b, 437c.

[0094] FIG. 7 according to one embodiment is a detailed view of the controller 426. The controller 426 of FIG. 7 enables one or more EMDs to be selected using one finger, e.g., the thumb. The controller 426 allows for toggle selection (i.e., press and release for selection) or "continuous operation" (EMD is selected only while the corresponding controller is depressed). The embodiments are not limited to the controller 426 of FIG. 7.

[0095] In one embodiment, the controllers 427a, 427b, 427c are arranged in a first arcuate shape so as to approximately correspond to an arc that will be drawn by the user's thumb crossing the surface 425 when searching for the controllers 427a, 427b, 427c. As a result, the thumb can be appropriately placed on each of the controllers 427a, 427b, 427c without repositioning the hand (without changing the position). For the same reason, the controller 427d can also be formed in an arcuate shape.

[0096] In one embodiment, each of the controllers 427a, 427b, 427c is assigned to a catheter loaded at its respective drive positions 1, 2, 3. The controller 427d always corresponds to the guide wire. In one embodiment, when the guide wire is loaded at position 2, the controllers 427a, 427b, 427c assigned to position 2 become invalid (i.e., cannot be used to select the guide wire loaded at position 2).

[0097] The controller 426 is also arranged so that a plurality of combinations of controllers can be selected. When the position 710 is pressed with the thumb, the EMD corresponding to the controller 427a (for example, the catheter loaded at position 1) will be selected. On the other hand, when the position 720 is pressed with the thumb, the EMDs corresponding to the controller 427b (for example, the catheter loaded at position 2) and the controller 427c (for example, the catheter loaded at position 3) are selected. Further, when the position 730 is pressed with the thumb, the EMDs corresponding to the controller 427a (for example, the catheter loaded at position 1), the controller 427b (for example, the catheter loaded at position 2), and the controller 427d (for example, the guide wire) are selected.

[0098] In one embodiment, each of the controllers 426 is wide compared to the narrow gaps in between to allow for simultaneous pressing of multiple controllers. In one embodiment, any static structures arranged between each of the controllers 426 are omitted. The edges of each of the controllers 426 may be shaped to provide a tactile distinction between the push buttons 1, 2, 3.

[0099] In one embodiment, each of the controllers 426 may have a low actuation force, provide a tactile sensation when passing through the actuation point, and allow for overtravel past the actuation point. The overtravel facilitates pushing the controller past the actuation point while operating other controllers (e.g., controllers 422, 423, 424) with the same hand. In one embodiment, the heights of the controllers 427a, 427b, 427c on the surface 425 are different from the height of the controller 427d on the surface 425 to enhance the ability to distinguish them by touch alone. Each of the controllers 426 can include design characteristics that ensure a relatively linear travel and a relatively flat profile even when pushed at the edge.

[0100] Some procedures indicate the need to select the aforementioned combinations of EMDs. Here, the drive positions where the EMDs are placed are numbered, and assuming "W" represents the guide wire: 1 + 2; 2 + 3; 1 + W; 2 + W; 3 + W; 1 + 2 + W; and 2 + 3 + W. These arrangements enable the corresponding positions of the controller 426 to be pushed with one thumb to select each of these clinically appropriate combinations of EMDs. Referring to FIG. 7, when pushing the position 710 with the thumb, the controller 427a is pushed down and one EMD is selected (e.g., 1), when pushing the position 720 with the thumb, the controllers 427b and 427c are pushed down and two EMDs are selected (e.g., 2 + 3), and when pushing the position 730 with the thumb, the controllers 427a, 427b, and 427d are pushed down and three EMDs are selected (1 + 2 + W). It should be noted that the three selection methods illustrated in FIG. 7 do not account for the following combinations: 1 + 2 + 3; 1 + 3 + W; and 1 + 2 + 3 + W. These may not be particularly beneficial in many situations. However, these latter combinations are not excluded from the controller 426 in FIG. 7.

[0101] FIG. 8 according to one embodiment is a perspective view of a right controller housing 820 and a left controller housing 830 of an input system 800 for a catheter-based treatment system. The controllers of the input system 800, although physically separate, are identical to and operate in the same manner as the controllers of the input system 400 described above. Thus, the controllers and components labeled with 4×× reference numerals in the figures of the input system 400 are labeled with 8×× reference numerals in the figures of the input system 800, and like descriptions apply.

[0102] The right controller housing 820 and the left controller housing 830 are not integrated into one main housing. Thus, the user can move the right controller housing 820 and / or the left controller housing 830 away from or closer to each other and individually as desired. The knob 842 on the surface 840 is disposed here to the left of the left controller housing 830. Also, the function buttons 844 are disposed to the right of the right controller housing 820.

[0103] In one embodiment regarding operation, the user's right hand 610 is positioned such that the thumb is placed on the controller 826 on the surface 825 of the right controller housing 820 and the index finger is placed on the controllers 822, 823, 824 on the surface 821. The right hand thumb operates the controller 826 to select one or more EMDs, and the right hand index finger simultaneously operates the controllers 822, 823, 824 to instruct the robotic drive 24 to control the movement of the selected EMD in a first degree of freedom (e.g., straight ahead). At the same time, the user's left hand operates the knob 842 to control the movement of the selected EMD in a second degree of freedom (e.g., rotation).

[0104] The user's left hand can also be moved to the left controller housing 830 such that the left thumb is placed on the controller 836 on the surface 835 and the left index finger is placed on / around the controllers 832, 833, 834 on the surface 831. The user can operate the controller 836 with the left thumb to select one or more corresponding EMDs, and operate the controllers 832, 833, 834 with the left index finger to instruct the robot drive 24 to control the operation of the EMD selected using the controller 836 in a first degree of freedom (e.g., linear translation).

[0105] FIG. 9A according to one embodiment is a perspective view of an input system 900 for controlling a robot drive of a catheter treatment system. FIGS. 10A and 10B show left and right perspective views of the input system 900.

[0106] The input system 900 facilitates the control of the linear motion of the EMDs using the first finger of the user's right hand and the rotational motion of the EMDs using the second finger of the user's right hand, and the linear motion of the selected EMDs using the first finger of the user's left hand and the selection of the EMDs using the second finger of the user's left hand and the control of the rotational motion of the selected EMDs. Such an operation arrangement is shown in FIG. 9B.

[0107] The input system 900 includes a main housing 910 including a right controller housing 920 and a left controller housing 930. The right controller housing 920 includes a "side" surface 921 and a "top" surface 925 that are not in the same plane as each other. Either of the two surfaces 921, 925 is curved or shaped to comfortably support the part of the user's hand that is to be brought into contact with the respective surface.

[0108] In one embodiment, the controllers 922, 923, 924 are integrated on the first surface 921. In this embodiment, the controller 924 consists of a scroll wheel as described above, and the controllers 922, 923 consist of binary buttons. The controller 922 can be a linear forward speed controller, the controller 923 can be a linear reverse speed controller, and the controller 924 can be a straight-ahead position controller. Each of the controllers 922, 923, 924 is arranged for operation by a finger of the user's right hand (e.g., the index finger).

[0109] The controller 926 is integrated on the surface 925 and consists of a scroll wheel. The controller 926 can be a rotational position controller. The axis of rotation of the controller 926 is determined so that it can rotate in response to dragging the user's right thumb across the surface of the controller 926 from left to right and from right to left. This operation of the controller 926 by the user's right thumb can occur simultaneously with the operation of the controllers 922, 923, 924 by another finger of the user's right hand.

[0110] The right controller housing 920 of the input system 900 does not include an EMD selection controller. Thus, the controllers of the right controller housing 920 can be dedicated to controlling the straight-ahead and rotational movements of one EMD, such as a guide wire, during operation. This dedicated EMD can be selected by the control computing system 34 or other control elements of the robot drive 24.

[0111] The controller 927 can instantaneously activate functions such as the turbo mode described above. Since it is difficult to accurately operate the controller 926 while activating the controller 927 with the user's right thumb, such a turbo mode is only applied to the straight-ahead movement controlled using the controllers 922, 923, and / or 924. Further, the turbo mode is considered to be most suitable for scenarios where rotation is not required, such as when linearly moving a guide wire among other catheters.

[0112] The left controller housing 930 includes a side surface 931 and a top surface 935. The surfaces 931 and 935 are curved or shaped to support the parts of the user's left hand as shown in FIG. 9B.

[0113] In one embodiment, the controllers 932, 933, 934 are integrated on the first surface 931. The controller 934 is a scroll wheel as a straight - ahead position controller as described above, and the controllers 932, 933 are binary buttons as straight - ahead speed controllers as described above. Each of the controllers 932, 933, 934 is arranged for operation by a finger (e.g., index finger) of the user's left hand.

[0114] The controller 936 is integrated on the surface 935 and consists of a scroll wheel as a rotational position controller. The controller 936 is arranged in a position to be operated by the user's left thumb as shown in FIG. 9B. That is, the left - hand controllers 932, 933, 934, 936 are similar to the right - hand controllers 922, 923, 924, 926. Different from the right - hand controllers 922, 923, 924, 926, the EMD whose operation is controlled by the left - hand controllers 932, 933, 934, 936 can be selected by the user using the selection controller 937.

[0115] Specifically, each of the three controllers 937 is selected by the user's left thumb, and the corresponding EMD is selected to be controlled. Since it is not easy to operate the controller 936 while depressing one or more of the controllers 937, each of the controllers 937 only needs to be depressed once to select the corresponding EMD to be controlled. For example, to select two catheters, the user presses one of the controllers 937 with the left thumb, releases the selected controller 937, and then presses and releases one of the controllers 937 with the left thumb again. Then, the thumb is moved to the controller 936 to control the rotational movement of the two selected EMDs.

[0116] The controller 938 functions as a "selection cancellation" controller. The user presses and releases the controller 938 with the left thumb to cancel the selection of all the EMDs currently selected by the controller 937. Such an arrangement helps the user understand the state of the control system within a predetermined time.

[0117] FIG. 11 according to one embodiment is a perspective view of a right controller housing 1120 and a left controller housing 1130 of an input system 1100 for a catheter-based treatment system. The controllers of the input system 1100 are the same as those of the input system 900 described above, although their physical arrangements are different. The controllers and components labeled with 9×× in the drawings of the input system 900 are represented by 11×× in the drawings of the input system 1100, and the same explanations apply.

[0118] The right controller housing 1120 and the left controller housing 1130 are not integrated into one main housing. Therefore, for ease of use, comfort, or other reasons, the user can move the right controller housing 1120 and / or the left controller housing 1130 away from or closer to each other, or move them as desired. The operations of the controllers of the right controller housing 1120 and the left controller housing 130 can proceed in the same manner as the operations described with respect to the input system 900.

[0119] The input system 1200 shown in FIGS. 12A, 13A, and 13B includes a right controller housing 1220 similar to the right controller housing 920 of the input system 900 and a left controller housing 1230 similar to the left controller housing 430 of the input system 400. Therefore, it may be assumed that the elements of the right controller housing 1220 function in the same manner as the similarly labeled elements of the right controller housing 920.

[0120] However, as previously described, the EMDs controlled by the controllers 922, 923, 924, 926 of the input system 900 are not user-selectable using the input system 900. In contrast, the controller 1244 can be operated to select one or more EMDs that can control the straight-ahead movement via user operation of the controllers 1222, 1223, 1224 of the surface 1221, and the rotational movement of the EMDs can be controlled via user operation of the control 1226.

[0121] FIG. 12B shows the operation of the input system 1200 according to the above method. Specifically, the left hand 1260 is placed over / around the controller 1244, and the thumb and the first three fingers are placed approximately corresponding to the controllers 1245d, 1245a, 1245b, 1245c, respectively. In one embodiment, the controller 1245d corresponds to the guide wire, and the controllers 1245a, 1245b, 1245c correspond to the EMDs loaded at positions 1, 2, 3, respectively. To select any combination of the four EMDs, use the left hand 1260 to press and hold the corresponding ones of the controllers 1245d, 1245c, 1245b, 1245a. Then, operate the controller 1226 with the thumb of the right hand 1250 and operate one of the controllers 1222, 1223, 1224 with another finger of the right hand 1250 so that the rotational movement and the straight-ahead movement of the selected EMDs can be controlled as described above.

[0122] FIG. 12C shows the movement of the left hand 1260 towards the left controller housing 1230, while the right hand 1250 maintains its position at the right controller housing 1220. The left hand 1260 can operate the controller of the left controller housing 120 as described above with respect to the left controller housing 430 of the input system 400. Specifically, the left thumb depresses one of the controllers 1237a, 1237b, 1237c to select the corresponding (non-guide wire) EMD, and the left index finger operates the controllers 1232, 1233, 1234 to instruct the robot drive device 24 to control the straight movement of the selected EMD. On the right controller housing 1220, the right thumb presses and holds the controller 1227 to activate the guide wire, and at that time, the right index finger operates the controllers 1222, 1223, 1224 to instruct the robot drive device 24 to control the straight movement of the guide wire.

[0123] As described above, the input system 1200 is useful for arbitrarily controlling, for example, two degrees of freedom of an EMD (i.e., FIG. 12B) or one degree of freedom of each of two separate EMDs (i.e., FIG. 12C). From the ability to select a set of one or more EMDs corresponding to the control of one hand, the operation of FIG. 12B controls two degrees of freedom of each of the sets of one or more EMDs, and the operation of FIG. 12C shows the control of one degree of freedom of each of two separate sets of one or more EMDs.

[0124] FIG. 14 according to an embodiment is a perspective view of the right controller housing 1420 and the left controller housing 1430 of the input system 1400 for a catheter treatment system. The controllers of the input system 1400 are the same as those of the input system 1200 described above, although the physical arrangements are different, and can operate in the same manner. Therefore, the controllers and components labeled with the reference numerals 12×× in the drawings of the input system 1200 are shown labeled with the reference numerals 14×× in the drawings of the input system 1400, and similar descriptions apply.

[0125] The right controller housing 1420 and the left controller housing 1430 are physically separated. Thus, the user can move the right controller housing 1420 and / or the left controller housing 1430 separately. The selection controller 1444 is shown disposed to the left of the left controller housing 1430, which is in contrast to the position of the selection controller 1244 relative to the left controller housing 1230.

[0126] In one example of operation, the user places the left hand on top of the left controller housing 1430 and presses and holds the selected one of the selection controllers 1444. The user's right hand is positioned such that the thumb is placed on the scroll wheel 1426 of the surface 1425 of the right controller housing 1420 and the index finger is placed on top of the controllers 1422, 1423, 1424 of the surface 1421. The right thumb operates the controller 1426 to rotate one or more EMDs corresponding to the selected selection controller 1444, and the right index finger can operate any of the controllers 1422, 1423, 1424 to instruct the robot drive 24 to control the linear movement of the selected EMD.

[0127] Also, the user's left hand can move to the left controller housing 1430 such that the left thumb selects any of the controllers 1437a, 1437b, 1437c. The left index finger is placed on or around the controllers 1432, 1433, 1434 of the surface 1431 and operates the controllers 1432, 1433, 434 with the left fingers to instruct the robot drive 24 to control the linear movement of the selected EMD. While the left thumb is selecting an EMD, the right thumb presses and holds the controller 1427 to activate the guide wire, and while holding the controller 1427, the right index finger can operate the controllers 1422, 1423, 1424 to instruct the robot drive 24 to control the linear movement of the guide wire.

[0128] When any of the above input controllers is used in the position control mode, when the input controller is operated, the robot drive device 24 can be instructed to operate the EMD by a specified increment. When controlling the axial movement in the position control mode, the input controller can instruct at least one device module 32 to move an individual distance in the distal or proximal direction. When controlling the rotational movement of the EMD in the position control mode, the input control can instruct the device module 32 to rotate the EMD by an individual angle in the counterclockwise or clockwise direction. When a position movement command is issued in a closed-loop system, the control computing system 34 can compare the commanded increment or position with the measured increment or position. If the commanded value is different from the measured value, the control computing system 34 can close the loop by giving an additional movement command to correct the difference.

[0129] When used in the speed control mode, any of the above input controllers can instruct the robot drive device 24 to continuously operate the EMD at a specified speed when the input control is operated by the user. When controlling the axial movement, the input controller in the speed control mode can instruct at least one device module 32 to continuously move in the distal or proximal direction at a specified speed until the user stops operating the input controller (or until the limit of the robot drive device 24 is reached). Similarly, the input controller in the speed control mode can instruct at least one device module 32 to continuously rotate at a specified speed throughout the time the input controller is being operated. When a speed movement command is issued in a closed-loop system, the control computing system 34 compares the commanded speed with the measured speed and, if a difference is detected, adjusts the moving speed to close the loop.

[0130] In some operating modes, the relationship between the binary, analog, and scroll input controllers and the increments of the EMD - commanded axial or rotational movement may be fixed. When operating in such a mode, the respective defined increment values and defined speed values for the position controller and the speed controller may be fixed for each input controller. However, in other operating modes, the relationship between the binary, analog, and scroll input controllers and the amount of the EMD - commanded axial or rotational movement can be set by the user or the control computing system 34.

[0131] In one embodiment, a scaling input controller is provided, which, when actuated by the user, increases or decreases the defined speed value and the defined increment value of the input controller by a predetermined value. Additionally, or alternatively, each time the corresponding scaling input is pressed, the defined increment or speed of the input controller can be increased or decreased based on a scaling factor.

[0132] In one embodiment, the input system can be configured to have a selection verification function, which requests the user to approve that the required EMD and / or device module 32 has been selected before the operation command is sent to the robot drive 24.

[0133] In one embodiment, the robot system is configured such that an input controller that instructs the movement of the guide wire is mapped to a device module that holds the guide wire. The identification of the device module that holds the guide wire can be detected by a sensor that responds to loading the guide wire into the device module. The detection can use a contact sensor or a non - contact sensor such as a mechanical sensor, an electrical sensor, or a vision sensor, or can be based on user input required by the system.

[0134] In one embodiment, the GUI can also use an input map (not shown) to provide a graphical display of input system 28 and the input controllers of the input system (e.g., buttons, scroll wheels, knobs, joysticks, or any other input controller). When an input controller is operated by the user, the button map can indicate which input controller is activated. This allows the user to visually recognize which input controller is being operated without looking at input system 28, which is useful. For example, the button map includes an array of icons corresponding to each input controller or all input controllers, arranged on the screen in a pattern similar to the physical layout of the input controllers in input system 28. Each icon can be set to light up and / or display an animation when operated by the user. In the case of a binary input controller, the icon corresponding to the button indicates whether the input controller is in an active state (pressed state) or an inactive state (not pressed state). The icon corresponding to an analog input controller indicates the degree of operation.

[0135] In addition to visual feedback, control station 26 may be configured to provide physical feedback to the user. For example, the feedback is provided in at least one of the ways of vibration, cogging (pulsation), and resistance or reaction force. In one embodiment, vibration feedback can be used to provide various alarms. The vibration can be provided at a preset, constant intensity, or an intensity that varies based on each level of the alert. For example, the intensity of the vibration increases as the measured load approaches the maximum load limit. As another method, different intensities or vibration patterns are also possible so that different alarms can be distinguished. Cogging feedback can be described as a gradual hitting or clicking sensation that conveys to the user the feeling of the travel of the control mechanism. In one embodiment, cogging is similar to the tactile feedback provided by a scroll input controller that rotates between positions created by detents. However, depending on the system, at least one different sensation can be used for cogging feedback. The type and intensity of the cogging sensation can be fixed or adjustable by the user or the system.

[0136] Physical feedback may be due to physical interactions between components that occur when the user operates the input system 28, or may be simulated using an electromechanical device. For example, a motor can be controlled to provide a tapping sensation as cogging feedback. When physical feedback is provided via the input system 28, the feedback can also be felt throughout the input system and is provided in the vicinity of (or appears to originate from) a region proximate to a particular input controller. For example, vibration feedback can be provided by a motor (or any other device) near the corresponding input controller to alert in relation to the input controller.

[0137] Computer-executable program code for controlling a catheter treatment system according to a method of using any of the above components can be stored on a non-transitory computer-readable medium. The computer-readable medium includes volatile and non-volatile, removable, and non-removable media implemented in any method or technology for storing information such as computer-readable instructions, data structures, program modules, or other data. The computer-readable medium includes, but is not particularly limited to, random access memory (RAM), read-only memory (ROM), electrically erasable programmable ROM, flash memory, or other memory technologies, compact disc ROM (CDROM), digital versatile disc (DVD), or other optical storage, magnetic cassette, magnetic tape, magnetic disk storage, or other magnetic storage devices, or any other medium that can be used to store instructions and can be accessed by the system 10 (shown in FIG. 1), including Internet or other computer network access forms.

[0138] Embodiments may also include other examples that would occur to those skilled in the art. Such other examples are suggested to be included within the scope of the claims if they have structural elements that do not differ from those recited in the claims, or if they include structural elements that are substantially different from but equivalent to those recited in the claims. Any of the steps of a process or method may be changed or rearranged in order and sequence in alternative embodiments.

[0139] Many other changes and modifications can be applied to the embodiments described herein. The scope of these and other changes will become apparent from the claims.

Claims

1. A system for controlling a robotic drive device configured to operate one or more elongated medical devices, including a first housing and a second housing arranged left and right as viewed by a user, wherein the first housing and the second housing are each capable of changing a horizontal position and a rotational position, and the rotational position can be changed by rotation about a rotation axis extending in the vertical direction, the first housing including a first surface corresponding to a first finger of a first hand of the user and a second surface extending from and bending away from the first surface and corresponding to a second finger of the first hand other than the first finger of the first hand, the second housing including a third surface corresponding to a first finger of a second hand of the user and a fourth surface extending from and bending away from the third surface and corresponding to a second finger of the second hand other than the first finger of the second hand, a first controller integrated on the first surface and operable by the first finger of the first hand to select a first device among the one or more elongated medical devices, a second controller integrated on the second surface and operable by the second finger of the first hand to direct the robotic drive device to operate the selected first device in a first degree of freedom, such that the robotic drive device operates the selected first device in accordance with the direction, the system including the second controller, wherein the first controller and the second controller are simultaneously operable by the first finger and the second finger of the first hand.

2. The second controller is operable by the second finger of the first hand to direct the robotic drive device to control the speed of the selected first device in the first degree of freedom, such that the robotic drive device moves the selected first device at a speed in accordance with the direction, and the system according to claim 1, further including a third controller integrated on the second surface and operable by the second finger of the first hand to direct the robotic drive device to control the current position of the selected first device in the first degree of freedom, such that the robotic drive device changes the current stopped position of the selected first device in accordance with the direction.

3. The system according to claim 2, further comprising, in the system, a fourth controller integrated on the first surface and operable by a first finger of the first hand to select a second device among one or more elongated medical devices.

4. The system further comprises, in the system, a fifth controller integrated on the first surface and operable by a first finger of the first hand to select a third device among one or more elongated medical devices, wherein the third device is a guide wire, and the fifth controller is larger than the first controller and the fourth controller, the system according to claim 3.

5. wherein the first finger of the first hand is a thumb, and the second controller and the third controller are configured to issue an instruction to the robot drive device only when at least one of the first controller, the fourth controller, and the fifth controller is being operated by the user, the system according to claim 4.

6. At least two of the first controller, the fourth controller, and the fifth controller are simultaneously operable by a first finger of the first hand to select at least two of the first device, the second device, and the guide wire, the system according to claim 4.

7. wherein the first housing and the second housing are disposed on an upper surface of the main housing, wherein the first degree of freedom is linear translation, The system according to claim 1, further comprising, in the system, a third controller integrated on the main housing and operable by the second hand of the user to issue an instruction to the robot drive device to rotate the selected first device, and the robot drive device rotates the selected first device according to the instruction.

8. The second controller is operable by a second finger of the first hand to issue an instruction to the robot drive device to control a linear translation speed of the selected first device, and the robot drive device linearly translates the selected first device at a speed according to the instruction, A fourth controller operable by a second finger of the first hand is further included in the system according to claim 7, which is integrated on the second surface and issues an instruction to the robot drive device to control the current position of the selected first device, and the robot drive device moves the selected first device forward and backward according to the instruction to change the current position.

9. A fifth controller integrated on the first surface and operable by a first finger of the first hand to select a second device among one or more elongated medical devices, A sixth controller integrated on the first surface and operable by a first finger of the first hand to select a third device among one or more elongated medical devices, are further included in the system, wherein the third device is a guide wire, and the sixth controller is larger than the first controller and the fifth controller. The system according to claim 8.

10. A seventh controller integrated on the third surface and operable by a first finger of the second hand to select a device among one or more elongated medical devices, An eighth controller integrated on the fourth surface and operable by a second finger of the second hand to issue an instruction to the robot drive device to operate the device selected by the seventh controller in the first degree of freedom, and the robot drive device operates the device selected by the seventh controller according to the instruction, are further included in the system, wherein the seventh controller and the eighth controller are simultaneously operable by the first finger and the second finger of the second hand. The system according to claim 9.

11. The eighth controller is operable by a second finger of the second hand to issue an instruction to the robot drive device to control the straight - ahead speed of the device selected by the seventh controller, and the robot drive device moves the device selected by the seventh controller straight ahead at the speed according to the instruction. Integrated on the fourth surface, to control the current position of the device selected by the seventh controller, an instruction is issued to the robot drive device, and the robot drive device moves the device selected by the seventh controller forward and backward according to the instruction to change the current position. The system further includes a ninth controller that can be operated by the second finger of the second hand, as described in claim 10 of the system.

12. A tenth controller integrated on the third surface and operable by the first finger of the second hand to select a device among one or more elongated medical devices different from the device selected by the seventh controller, and An eleventh controller integrated on the third surface and operable by the first finger of the second hand to select a guide wire among one or more elongated medical devices. The system further includes the eleventh controller, as described in claim 11 of the system. The eleventh controller is larger than the seventh controller and the tenth controller, as described in claim 11 of the system.

13. The first finger of the second hand is the thumb, The eighth controller and the ninth controller are configured to issue an instruction to the robot drive device only when at least one of the seventh controller, the tenth controller, and the eleventh controller is being operated by the user, as described in claim 12 of the system.

14. At least two of the seventh controller, the tenth controller, and the eleventh controller are simultaneously operable by the first finger of the second hand to select at least two of the elongated medical devices and the guide wire, as described in claim 12 of the system.

15. A third controller integrated on the first surface and operable by the first finger of the first hand to select a second device among one or more elongated medical devices, and A fourth controller integrated on the first surface and operable by the first finger of the first hand to select a third device among one or more elongated medical devices. The system further includes the fourth controller, as described in claim 1 of the system. The third device is a guide wire, The fourth controller is larger than the first controller and the third controller, as described in claim 1 of the system.

16. The first finger of the first hand is the thumb, The system according to claim 15, wherein the second controller is configured to issue an instruction to the robot drive device only when at least one of the first controller, the third controller, and the fourth controller is being operated by a user.

17. The system according to claim 15, wherein at least two of the first controller, the third controller, and the fourth controller are simultaneously operable by a first finger of the first hand to select at least two of the first device, the second device, and the guide wire.

18. A third controller integrated on the third surface and operable by a first finger of the second hand to select a second device among one or more elongated medical devices; A fourth controller integrated on the fourth surface and operable by a second finger of the second hand to issue an instruction to the robot drive device to operate the selected second device in the first degree of freedom, and the robot drive device operates the selected second device according to the instruction, and the system further includes; The system according to claim 1, wherein the third controller and the fourth controller are simultaneously operable by the first finger of the second hand and the second finger of the second hand.

19. A fifth controller integrated on the third surface and operable by a first finger of the second hand to select a third device among one or more elongated medical devices; The system further includes a sixth controller integrated on the third surface and operable by a first finger of the second hand to select a guide wire among one or more elongated medical devices; The system according to claim 18, wherein the sixth controller is larger than the third controller and the fifth controller.

20. The first finger of the second hand is the thumb, The system according to claim 19, wherein the fourth controller is configured to issue an instruction to the robot drive device only when at least one of the third controller, the fifth controller, and the sixth controller is being operated by a user.

21. The system according to claim 19, wherein at least two of the third controller, the fifth controller, and the sixth controller are simultaneously operable by the first finger of the second hand to select at least two of the elongated medical device and the guide wire.

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