Robotic system for inserting a medical instrument into a patient's body and MRI add-on system

Abstract

A Robotic system for inserting a medical instrument into a patient's body, comprising at least one slave part (2) and control means (5, 6) for remote control of the at least one slave part (2), the slave part (2) or at least one of the slave parts (2) comprising a holding element (9) adapted to hold the medical instrument (11) and a bearing unit (10) for bearing the holding element (9), is characterized in that the holding element (9) has a drive surface having at least in partial areas a substantially spherical curved basic shape, wherein at least one actuating element engages the drive surface (15), wherein the at least one actuating element is controlled by the control means (5, 6) in order to move the holding element (9) in a rotational manner with at least two rotational degrees of freedom. Furthermore, an MRI add-on system comprising an MRI insert device (4) for an MRI host apparatus (1) is claimed having a robotic system as mentioned above.

Description

[0001] P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0002] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0003] 1

[0004] ROBOTIC SYSTEM FOR INSERTING A MEDICAL INSTRUMENT INTO A PATIENT’S BODY AND MRI ADD-ON SYSTEM

[0005] Description

[0006] The invention relates to a robotic system for inserting a medical instrument into a patient’s body according to the preamble of claim 1 and an MRI add-on system according to the preamble of claim 11.

[0007] Robotic systems for inserting a medical instrument into a patient’s body are useful especially in surroundings or situations in which for an operator the treatment is harmful or the access to the patient is difficult, e.g. for reasons of space. In particular medical interventions or treatments under MRI conditions are difficult to achieve.

[0008] MRI add-on systems are intended to use with existing conventional MRI host apparatuses to cope with special situations and requirements in connection with the examination or treatment of patients. There is a well-known desire to be able to carry out interventional MRI applications in which medical instruments can be introduced into patients under MRI conditions and observed in real time during the examination or treatment.

[0009] A robotic system according to the preamble of claim 1 , allowing interventional treatment under MRI conditions is known from “Results of the NeuroBlate System first-in-humans Phase I clinical trial for recurrent glioblastoma" (Andrew E. Sloan et al. in J Neurosurg 118:1202-1219, 2013; ©AANS, 2013). This robotic system serves for laser interstitial thermal therapy and comprises a mounting device and a ball-stem is provided for frameless, trajectory-based laser ablation surgery of a patient’s brain. The ablation treatment can be performed under MRI conditions.

[0010] The known device comprises a frame to be fixed to a patient's skull, a shaft for guiding the probe and a partial sphere that can be moved rotationally within the frame and can be fixed in a suitable position. A shaft connected with the fixed partial sphere serves to drive the probe. It is possible to operate the probe remotely. ToP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0011] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0012] 2

[0013] protect the brain as much as possible against damage caused by the procedure the probe is to be moved in a translational direction and can be rotated only around its longitudinal axis being oriented parallel to said translational direction. The opening of the skull and the alignment of the sample holder must be carried out before the patient is fully inserted into the MRI scanner.

[0014] EP 2194906 B1 also discloses an MRI-guided interventional tool, e.g. for DBS (Deep Brain Stimulation), including a frame with a cooperating targeting cannula. The frame is configured to be secured to the body of a patient, and is configured to translate and rotate such that the targeting cannula can be positioned to a desired intrabody trajectory. The frame includes an arc-like guide for the cannula movement. The frame may further include one or more MRI-visible fiducial markers that allow frame location / orientation to be determined within an MRI image.

[0015] US 5783943 A discloses an MRI add-on system mentioned above comprising an MRI insert device with an insert gradient coil assembly and a trolley cage for selectively positioning an insert gradient coil along a patient beam of a host magnetic resonance imaging apparatus. Insert gradient coils are coils which can temporarily reside inside a gradient coil of the host MRI apparatus and are intended to be installed or removed as patient imaging needs dictate. Insert gradient coils can have a smaller diameter enabling a higher slew rate for the gradient magnetic fields. It is possible to have a plurality of interchangeable insert gradient coils which would fit within the trolley cage of the insert gradient coil assembly. The trolly cage has a number of wheels for permitting the trolley cage to roll along a patient beam extending through an examination region of the magnetic resonance imaging apparatus. The trolley cage also includes a number of pneumatic latching mechanisms for locking the trolley cage to the patient beam when the insert gradient coil is positioned at isocenter. Moreover, a patient couch is disclosed slidably secured to a patient couch guide beam and having a horizontal drive motor. Patient couch and patient beam are part of the host MRI apparatus.

[0016] US 5485087 A discloses an insertable gradient coil for a magnetic resonance imaging apparatus. Gradient magnetic field inducing windings are disposed adjacentP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0017] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0018] 3

[0019] a common physical and magnetic isocenter of the coil. Return windings extend symmetrically to opposite ends of the coil. At the patient receiving end of the coil, sections are cut out to receive otherwise interfering body portions. The return windings are configured to conform to the cutout portions. The form of the insertable gradient coil of a disclosed embodiment is optimized for the head and neck region of a human patient. One of the stated purposes of this invention is to provide a small insert gradient coil in order to increase the slew rate of the magnetic field gradients so that fast imaging methods can be used. A method of inserting the coil into the host MRI apparatus is not disclosed.

[0020] US 2023 / 293253 A1 discloses a fluid driven robotic needle positioner e.g. for biopsy, drainage, drug administration and further applications. The needle positioner is patient mounted and can be used when the patient is positioned in an MRI-apparatus. The system provides semi-automated needle positioning. A passive holder comprising a needle guide is manually operated by the surgeon for coarse orientation adjustment within a large range of ±30°. The passive holder is nested between an outer and inner cover which works with a constraint ring to both constrain its axial motion and act as a friction-lock for the coarse adjustment. Within the passive holder the needle orientation is then adjusted automatically in a small motion range by a so-called soft actuator, which is fluid-driven and realized by three pushing elements filled with fluid and fed via hydraulic lines. The pushing elements acting essentially vertically on the needle guide. Subsequently, the finely adjusted needle orientation is rigidly fixed by means of granular jamming which is realized by a small pack of granules sealed in an elastic cover enclosing the needle guide, allowing stiffening of the pack by applying a vacuum.

[0021] US 2014 / 350572 A1 discloses a positioning apparatus for a medical instrument, e.g. an endoscope. The positioning apparatus is patient mounted and has two openings spaced apart from each other for the medical instrument, wherein a motor driven actuation mechanism is used to set the relative positions of the openings. Thus, the orientation of the medical instrument passing through both openings can be adjusted. The openings may be arranged in parallel plates that are shifted in the plate plane to align the openings. In the alternative it is disclosed that two plates with said openingsP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0022] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0023] 4

[0024] are coupled to each other by a plurality of actuators, e.g. linear actuators, which can be manually, hydraulicly, pneumatically or electromechanically actuated. The actuators allow translational or rotational relative movements of the plates.

[0025] US 5585724 A discloses an MRI apparatus with a retractable patient support, the patient support having two gradient coils separated from each other by an interstitial gap for the shoulder part of the patient. Both gradient coils have upper and lower portions separable from each other. The gradient coils are configured to fit snugly around the patient's torso below the shoulders and around the patient's head, but are too small in diameter to pass around the patient's shoulders. Within the interstitial gap a radio frequency coil is arranged having a lower portion disposed below the patient's shoulders and an upper portion removably positionable above the patient's shoulders. An invasive medical instrument, e.g. a biopsy gun, is mounted to the patient support adjacent the interstitial gap for performing invasive medical procedures on a portion of the patient’s body. A window in the vacuum dewar of the MRI apparatus enables a physician to position the medical instrument manually. As an alternative it is disclosed to position the medical instrument remotely using servomotors or the like. Furthermore, it is disclosed to correlate the position of the medical instrument with the patient support are by e.g. sonic, optical, radio frequency, or other emitters arranged on the medical instrument and selectively emitting signals that are received by receivers mounted to the patient support. In order to detect the position of the patient support within the MRI apparatus it is disclosed to embedded magnetic resonance detectable elements, such as spheres of copper sulfate, in the patient support.

[0026] US 2024 / 293186 A1 discloses a system comprising an MRI scanner and a surgical robot, wherein the MRI scanner’s permanent magnet array defines a dome to surround a region of interest, e.g. the head of the patient. It is disclosed that the MRI scanner includes an opening for accessing the head of the patient via the surgical robot mounted to the MRI scanner, wherein the surgical passes through the opening to perform a surgical procedure on the patient.P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0027] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0028] 5

[0029] The technical problem underlying the invention is to provide a robotic system and an MRI add-on system as mentioned at the beginning with a different kind of feeding and / or controlling the special orientation of the medical instrument with the slave part needing less space in the operating area.

[0030] With respect to the robotic system the technical problem is solved by the characterizing features of claim 1. Advantageous further embodiments of the invention are defined in the dependent claims.

[0031] Therewith a robotic system for inserting a medical instrument into a patient’s body is provided, comprising at least one slave part and control means for remote control of the at least one slave part, the slave part or at least one of the slave parts comprising a holding element adapted to hold the medical instrument and a bearing unit for bearing the holding element. The holding element has a drive surface having at least in partial areas a substantially spherical curved basic shape, wherein at least one actuating element engages the drive surface, wherein the at least one actuating element is controlled by the control means in order to move the holding element (9) in a rotational manner with at least two rotational degrees of freedom.

[0032] Preferably, the holding element has a maximum diameter of 25 cm, more preferably a maximum diameter of 20 cm, more preferably a maximum diameter of 15 cm and more preferably a maximum diameter of 10 cm. This means that only a small amount of space is required for the holding element.

[0033] With the slave part configured in this way, the alignment of the instrument can be controlled in a space-saving way by means of pure rotational movements. Extensive movements along curved paths can thus be avoided. This brings new possibilities for interventional MRI applications. With two degrees of rotational freedom, it is possible to generate swivel movements of a rod-shaped medical instrument in such a way that the medical instrument can point in all directions within a conical area.

[0034] A substantially spherical curved basic shape of the drive surface means that the drive surface of the holding element can be smooth or essentially smooth or might have aP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0035] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0036] 6

[0037] structure, for example. The structure might comprise protruding elements and / or recesses on the substantially spherically curved drive surface, for example, depending on the kind of engagement of the at least one actuating element. The holding element might have a ball-like basic shape, preferably with the medical instrument guided through its center point.

[0038] According to a further embodiment of the robotic system the at least one actuating element is controlled by the control means in order to move the holding element in a rotational manner with three rotational degrees of freedom. Three rotational degrees of freedom of the holding elements give more possibilities for the adjustment of the medical instrument or to rotate the medical instrument around its longitudinal axis.

[0039] According to a further embodiment of the robotic system the at least one actuating element actuates the drive surface in a force-fit manner. This means that the at least one actuating element drives the drive surface with frictional forces, e.g. in case of an essentially smooth drive surface.

[0040] It is possible that only one actuating element provides for a movement of the holding element with two or three rotational degrees of freedom, e.g. in case the actuating element is set up to accordingly change the drive direction.

[0041] According to a further embodiment of the robotic system the at least one of three actuating elements engaging the drive surface comprises a multidirectional drive element. At least one of the multidirectional drive elements might comprise an omnidirectional wheel or a M ecan urn -type wheel. Omnidirectional wheels and / or Mecanum-type wheels might be arranged such that the holding element might be rotated in any circumferential direction within the bearing unit. In case of a spherically curved drive surface and omnidirectional wheels and / or Mecanum-type wheels engaging in a friction-locked or force-fit manner in the drive surface the movement of the holding element is realized in a similar way as the ball of a ball-balancing robot, also known as a ballbot. A ball-balancing robot and drive assembly therefor is disclosed in US 2018 / 022197 A1.P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0042] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0043] 7

[0044] Preferably, the multidirectional drive element, in particular in case of omnidirectional wheels or Mecanum-type wheels, has a maximum diameter of 8 cm, more preferably a maximum diameter of 6 cm, more preferably a maximum diameter of 4 cm, more preferably a maximum diameter of 2 cm and more preferably a maximum diameter of 1 cm. This means that only a small amount of space is required for the drive element. Moreover, advantageous transmission ratios can be achieved.

[0045] According to a further embodiment of the robotic system the drive surface comprises at least in partial areas a structure allowing form-fitting actuation by the at least one actuating element. Such a structure of the drive surface might comprise protrusions, e.g. teeth like protrusions, and / or recesses. At least one of the actuating elements may have a compatible structure on the parts that engage with the drive surface. A spherical type holding element with a structured drive surface is known from JP 2023038119 A, the complete disclosure of which is incorporated here. This document discloses a holding element with a substantially spherical shape having a first tooth structure with a plurality of teeth aligned in a first direction and a second tooth structure with a plurality of teeth aligned in a second direction crossing the first direction and as actuating elements two spherical gears. The first actuating element provides for the engagement with the first tooth structure and the second actuating element provides for the engagement with the first tooth structure. The actuating elements might have more than one rotational degree of freedom, so that with only one actuating element rotation of the holding element around more than one rotation axis can be realized.

[0046] According to a further embodiment of the robotic system the holding element is adapted for holding a rod-shaped medical instrument, preferably an aspiration needle or a delivery needle or a biopsy needle or a catheter or a guidewire or an instrument for radiofrequency ablation or an instrument for ultrasonic treatment. These are medical instruments with small diameters to be introduced into a patient's body. The kind of holding the medical instrument might be such that it allows movement of the medical instrument relative to the holding element.P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0047] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0048] 8

[0049] According to a further embodiment of the robotic system medical instrument driving means for moving the medical instrument relative to the holding element are provided. A rotational movement of the holding element allows to change the spacial orientation of the medical instrument and to align the medical instrument to an entry point in a patient’s body. The driving means for moving the medical instrument relative to the holding element additionally allows to penetrate the patient’s skin with the medical instrument at the entry point, e.g. by a translational movement of the medical instrument in direction of its longitudinal extension. Driving means for moving the medical instrument relative to the holding element can be motor driven and might be realized by rotating elements, e.g. rollers, preferably fictionally engaging the surface of the medical instrument and enabling a preferably controllable translational and / or rotational movement relative to the holding element.

[0050] According to a further embodiment of the robotic system, it provides a slave part carrying element adapted to carry the slave part or at least one of the slave parts. The slave part carrying element might be adapted to controllably move the slave part or at least one of the slave parts. This movement gives at least one further degree of freedom for the movement of the holding element. Therewith it is possible to move the slave part or at least one of the slave parts in relation to a patient’s body to find a suitable starting position of the slave part for applying it on the patient's body.

[0051] According to a further embodiment of the robotic system at least one MRI detectable marker is positioned on or within the slave part or on or within at least one of the slave parts. Furthermore, it is possible that the slave part or at least one of the slave parts carries the medical instrument, wherein the medical instrument or at least one of the medical instruments comprises at least one MRI detectable marker. With at least one MRI detectable marker on or in the slave part or the least one of the slave parts and / or on or in the medical instrument, e.g. in the tip area of the medical instrument, it is possible to check and / or control the position and / or orientation of the according slave part and / or the medical instrument within an MRI apparatus. MRI detectable markers are widely known in the state of the art, e.g. from

[0052] EP 3020442 B1 , and might be realized by at least one MRI detectable particleP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0053] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0054] 9

[0055] embedded in a matrix material of the slave part or medical instrument or by a liquid or gel-like marking agent within a lumen, for example.

[0056] Controlling the movement of the slave part or of one of the slave parts can be done via the control means of a remote control station (master part) and / or via a closed loop control.

[0057] With respect to the MRI add-on system the technical problem is solved by the characterizing features of claim 11. Advantageous further embodiments of the invention are defined in the dependent claims 12 to 17.

[0058] The MRI add-on system comprises an MRI insert device for an MRI host apparatus. The MRI insert device has an inner receiving area for receiving at least one body part of a patient.

[0059] With the MRI insert device improved conditions in an MRI machine, adapted to a patient's specific needs, for examination and / or treatment of the patient can be provided. The MRI insert device can be adapted to a specific part of the patient’s body, to the whole body or to a specific application. The MRI insert device can be designed to fit into different MRI host systems.

[0060] According to the invention the MRI insert device has a robotic system as claimed in claim 1 or related dependent claims, wherein the at least one slave part or at least one of the slave parts of the robotic system is arranged on the MRI insert device.

[0061] The slave part or at least one of the slave parts can be arranged on a carrier permanently or detachably fixed to the MRT insert device, preferably spanning the patient's lying area, e.g., in width. More than one carrier can be provided for different parts of the patient’s body. The carrier or at least one of the carriers might be arched. Preferably, the slave part or at least one of the slave parts might be movably arranged on the carrier. Preferably, the slave part or at least one of the slave parts might be motor-driven for position change.P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0062] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0063] 10

[0064] According to an alternative embodiment of the MRI add-on system an enclosure unit laterally surrounding the inner receiving area is provided, wherein the MRI insert device comprises at least one gradient coil on the enclosure unit. Therewith the gradient field can be influenced and adapted to different needs. The at least one gradient coil of the MRI insert device can be used instead of or additionally to the gradient coil(s) of the host MRI apparatus.

[0065] According to a further embodiment of the MRI add-on system for the slave part or for each slave part the enclosure unit of the MRI insert device has a respective through opening for the arrangement of the slave part. Therewith the MRI insert device provides a slave part carrying element, e.g. a docking station for the slave part or for at least one of the slave parts, and allows access to a patient's body from outside the MRI insert device via the medical instrument.

[0066] According to a further embodiment of the MRI add-on system the MRI insert device comprises at least one RF-coil and / or at least one shim coil.

[0067] According to a further embodiment of the MRI add-on system the MRI insert device is arranged on a movable trolley. Therewith it is easily possible to move the robotic system from and to an MRI host apparatus.

[0068] According to a further embodiment of the MRI add-on system a patient couch is arranged on the trolley and being movable with respect to the MRI insert device. The patient can lie on the couch so that an MRI interventional treatment can be prepared outside the MRI host apparatus, especially if the carrying element is an MRI insert device. Moreover, the movable patient couch enables to move the patient relative to the carrying element and therewith relative to the medical instrument to find a suitable position to apply the instrument on the patient. The couch can be manually moved or also be motor driven, preferably controlled by the control means for remote control of the at least one slave part.

[0069] According to a further embodiment of the MRI add-on system the MRI insert device comprises coupling means to couple the MRI insert device to the MRI hostP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0070] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0071] 11

[0072] apparatus, the coupling means arranged for mechanically fixing the MRI insert device to the MRI host apparatus and / or for transmitting electrical current, control signals and / or measurement signals.

[0073] Exemplary embodiments of the system according to the invention are illustrated below by means of drawings.

[0074] The drawings show schematically in

[0075] Fig. 1 a robotic system integrated in an MRI host apparatus with a slave part attached to an MRI insert device,

[0076] Fig. 2 an enlarged detail of the robotic system of Fig. 1 depicting the slave part in the MRI insert device,

[0077] Fig. 3 a further enlarged detail of the slave part of Fig. 2,

[0078] Fig. 4 a cross section of the slave part,

[0079] Fig. 5 a side view of the MRI host apparatus with an indication of a swivel range of the medical instrument,

[0080] Fig. 6 a robotic system integrated in an MRI host apparatus with a slave part movably attached to an arched carrier and

[0081] Fig. 7 an enlarged detail of Fig. 6 with the arched carrier.

[0082] Fig. 1 shows a robotic system according to an embodiment of the invention integrated in an MRI host apparatus 1 of which a part is cut out to allow a view of the interior. Within the magnet of the MRI host apparatus 1 a slave part 2 of the robotic system is arranged within a through hole 3 through an enclosure unit 30 laterally surrounding an inner receiving area 31 of an MRI insert device 4. The MRI insert device 4 comprises a gradient coil for example. The MRI insert device 4 canP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0083] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0084] 12

[0085] alternatively or additionally comprise at least a radio frequency coil (abbreviated as RF coil) and / or a shim coil.

[0086] The slave part 2 is connected and controlled via control wire 5 with a remote control station 6. The remote control station 6 can alternatively be placed in a different room. A wireless connection between the remote control station 6 and the slave part 2 is also possible.

[0087] The MRI insert device 4 is arranged on a couch trolley 7 carrying a patient couch 8. Therewith components of the MRI add-on system that are intended for use in the MRI host device 1 , namely the slave part 2 and the MRI insert device 4, can be prepared together with a patient on the trolley 7 outside the MRI host apparatus and inserted into the MRI host apparatus 1 for medical treatment or examination.

[0088] Fig. 2 shows an enlarged detail of slave part 2 in the through opening 3 of the MRI insert device 4, whereas Fig. 3 shows a perspective view of an enlarged detail of slave part 2 without the MRI insert device 4. Fig. 4 shows a cross-section of the enlarged detail of slave part 2 fixed to enclosure unit 30 of MRI insert device 4 from which only a minor part is shown. The slave part 4 has a holding element 9 mounted in a bearing unit 10. Holding element 9 holds a medical instrument 11 being, for example, a guide wire or a catheter or a different rod-shaped medical instrument. The medical instrument 11 can be fixed in place or translationally moved along its longitudinal extension relative to the holding element 9. A mechanism for the translational movement of the medical instrument 11 relative to the holding element 9 is not shown. Manual movement against a frictional holding force between holding element 9 and medical instrument 11 is conceivable, as well as a motor driven movement, e.g. via driven rollers frictionally engaging the medical instrument 11.

[0089] Attached to the bearing unit 10 are three omnidirectional wheels 12, 13 and 14 each engaging a drive surface 15 of holding element 9. Holding element 9 is at least partially of ball-like shape, wherein parts, e.g. pole regions 16 and 17 of the sphere, where the medical instrument enters or exits, may deviate from the spherical shapeP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0090] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0091] 13

[0092] as shown in the drawings. Alternative shapes of the pole regions 16 and 17 are also possible.

[0093] Fig. 2 shows an optional deflecting entry element 18 for guiding a medical instrument to enter the holding element 9. The deflecting entry element 18 is advantageous for saving space. To enable a movement of medical instrument 11 relative to holding element 9, medical instrument 11 can be held by friction. The deflecting entry element 18 is preferably used in connection with a bendable or flexible medical instrument 11 , like a guidewire or a catheter, for example.

[0094] The omnidirectional wheels 12, 13 and 14 each a part of a respective actuating element, are driven by motors 19, 20 and 21 respectively, preferably by servo motors, being fixed to bearing unit 10. The omnidirectional wheels 12, 13 and 14 are preferably arranged at equal distances of 120° circumferential angle of the holding element 9 when looking in the direction of the polar axis of the holding element 9, which is essentially collinear with the path of the medical instrument 11 through the holding element 9. It is also conceivable to provide fewer active actuating elements with omnidirectional wheels, e.g. two actuating elements in case two degrees of rotational freedom are sufficient.

[0095] Each omnidirectional wheel 12, 13 or 14 is aligned relative to the holding element 9 so that the axis of rotation of the wheel 12, 13 or 14 is perpendicular to imaginary lines of latitude of the holding element 9. The lines of latitude revolve concentrically around the polar axis of the holding element 9. Different orientations of the axes of rotation of the wheels 12, 13 and 14 are also possible to obtain three rotational degrees of freedom for rotating the holding element 11.

[0096] As known form the ballbot as mentioned above it is possible to rotate the holding element 9 in each direction by controlled driving of one, two or all three omnidirectional wheels 12, 13 or 14. Rollers 22, only some of which are marked with reference numbers in Fig. 3, can each freely rotate around a corresponding roller axis perpendicular to the axis of rotation of the according omnidirectional wheel 12, 13 or 14 and therewith allowing low-friction rolling of the omnidirectional wheel 12, 13P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0097] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0098] 14

[0099] or 14 on the drive surface 15 in the circumferential direction of the rollers 22 when contacting the drive surface 15.

[0100] Fig. 5 is a side view of the MRI host apparatus 1 along the z-direction (direction of the main magnetic field) showing MRI insert device 4, remote control station 6 and control wire 5 connecting the remote control station 6 with slave part 2, wherein the slave part 2 cannot be seen entirely in Fig. 5. Medical instrument 11 extends into the inner receiving area 31 of the MRI insert device 4. A swivel range 23 of the medical instrument 11 perpendicular to the viewing direction is indicated and results from the freedom of rotation of the holding element 9 around one of its rotation axes. Thus, the medical instrument 9 can be directed to specific areas of a patient's body by targeted rotation of the holding element 11. For example, the tip of the medical instrument 11 can be directed to an entry point for a puncture. Moreover, the patient couch 8 can be part of the robotic system if arranged such that it can be moved by motor controlled by the remote control station 6. A controlled movement of the patient’s couch 8 is possible by controlled movement of the trolley 7 and / or of the couch 8 relative to the trolley 7. An according couch motor and a connection between couch motor and remote control station 6 is not shown here.

[0101] Fig. 6 shows an overview and Fig. 7 an enlarged detail of an alternative robotic system integrated in an MRI host apparatus 1 which largely corresponds to the solution according to Figures 1 to 5. However, no MRI insert device 4 with a gradient coil and / or other coils is provided in the MRI host apparatus 1 , but rather an arched carrier 24 on which one or more slave parts 2 can be moved by a motor not shown here.

[0102] The slave part 2 is held between and guided along two frame elements 25 and 26 of the arched carrier 23. The design of the holding element 9 and the omnidirectional wheels can be similar to those of the embodiment according to Fig. 1 to 5. Due to the components corresponding to the first embodiment, reference is therefore made to the description of Figs. 1 to 5.P 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0103] Applicant: Nano4lmaging GmbH, 40225 DusseldorfP 2748 EP Representative: NAEVEN, Ralf, 52072 Aachen

[0104] Applicant: Nano4lmaging GmbH, 40225 Dusseldorf

[0105] 16 Reference Number List

[0106] 1 MRI host apparatus

[0107] 2 Slave part

[0108] 3 Through opening

[0109] 4 MRI insert device

[0110] 5 Control wire

[0111] 6 Remote control station

[0112] 7 Trolley

[0113] 8 Patient couch

[0114] 9 Holding element

[0115] 10 Bearing unit

[0116] 11 Medical instrument

[0117] 12 Omnidirectional wheel

[0118] 13 Omnidirectional wheel

[0119] 14 Omnidirectional wheel

[0120] 15 Drive surface

[0121] 16 Pole region

[0122] 17 Pole region

[0123] 18 Entry element

[0124] 19 Motor

[0125] 20 Motor

[0126] 21 Motor

[0127] 22 Roller

[0128] 23 Swivel range

[0129] 24 Arched carrier

[0130] 25 Frame element

[0131] 26 Frame element

[0132] 30 Enclosure unit

[0133] 31 Inner receiving area

Claims

P 2748 WO / 2025019031 Representative: NAEVEN, Ralf, 52072 AachenApplicant: Nano4lmaging GmbH, 40225 DusseldorfROBOTIC SYSTEM FOR INSERTING A MEDICAL INSTRUMENT INTO A PATIENT’S BODY AND MRI ADD-ON SYSTEMClaims1. Robotic system for inserting a medical instrument into a patient’s body, comprising at least one slave part (2) and control means (5, 6) for remote control of the at least one slave part (2), the slave part (2) or at least one of the slave parts (2) comprising- a holding element (9) adapted to hold the medical instrument (11 ) and- a bearing unit (10) for bearing the holding element (9),characterized in that the holding element (9) has a drive surface having at least in partial areas a substantially spherical curved basic shape, whereinat least one actuating element engages the drive surface (15), wherein the at least one actuating element is controlled by the control means (5, 6) in order to move the holding element (9) in a rotational manner with at least two rotational degrees of freedom.

2. Robotic system according to claim 1 , characterized in that the at least one actuating element is controlled by the control means (5, 6) in order to move the holding element (9) in a rotational manner with three rotational degrees of freedom surface is.

3. Robotic system according to claim 1 or 2, characterized in that the at least one actuating element actuates the drive surface in a force-fit manner.

4. Robotic system according to one of the preceding claims, characterized in that at least one of the actuating elements engaging the drive surface (15) comprises a multidirectional drive element.

5. Robotic system according to claim 4, characterized in that at least one of the multidirectional drive elements comprises an omnidirectional wheel (12, 13, 14) ora Mecanum-type wheel.P 2748 WO / 2025019031 Representative: NAEVEN, Ralf, 52072 AachenApplicant: Nano4lmaging GmbH, 40225 Dusseldorf6. Robotic system according to claim 4, characterized in that at least in partial areas the drive surface comprises a structure allowing form-fitting actuation by the at least one actuating element.

7. Robotic system according to one of the preceding claims, characterized in that the holding element (9) is adapted for holding a rod-shaped medical instrument, preferably an aspiration needle or a delivery needle or a biopsy needle or a catheter or a guidewire or an instrument for radiofrequency ablation or an instrument for ultrasonic treatment.

8. Robotic system according to one of the preceding claims, characterized by medical instrument driving means for moving the medical instrument relative to the holding element (9).

8. Robotic system according to one of the preceding claims, characterized by a slave part (2) carrying element adapted to carry the slave part (2) or at least one of the slave parts (2) and adapted to controllably move the slave part (2) or at least one of the slave parts (2).

9. Robotic system according to one of the preceding claims, characterized in that at least one MRI detectable marker is positioned on or within the slave part (2) or on or within at least one of the slave parts (2).

10. Robotic system according to one of the preceding claims, characterized in that the slave part (2) or at least one of the slave parts (2) carries the medical instrument (11 ), wherein the medical instrument (11 ) or at least one of the medical instruments (11) comprises at least one MRI detectable marker.P 2748 WO / 2025019031 Representative: NAEVEN, Ralf, 52072 AachenApplicant: Nano4lmaging GmbH, 40225 Dusseldorf11. MRI add-on system comprising an MRI insert device (4) for an MRI host apparatus (1), the MRI insert device (4) having an inner receiving area (31) for receiving at least one body part of a patient,characterized bya robotic system according to one of the preceding claims, wherein the at least one slave part (2) or at least one of the slave parts (2) of the robotic system is arranged on the MRI insert device (4).

12. MRI add on system according to claim 11 , characterized by an enclosure unit (30) laterally surrounding the inner receiving area (31), wherein the MRI insert device (4) comprises at least one gradient coil on the enclosure unit (30).

13. MRI add-on system according to claim 12, characterized in that the enclosure unit (30) has a respective through opening (3) for the arrangement of the slave part (2) or for at least one of the slave parts (2).

14. MRI add-on system according to claim 12 or 13, characterized in that the MRI insert device (4) comprises at least one RF-coil and / or at least one shim coil.

15. MRI add-on system according to one of the claims 11 to 14, characterized in that the MRI insert device (4) is arranged on a movable trolley (7).

16. MRI add-on System according to claim 15, characterized by a patient couch (8) arranged on the trolley (7) and being movable with respect to the MRI insert device (4).

17. MRI add-on system according to one of the claims 11 to 16, characterized in that the MRI insert device (4) comprises coupling means to couple the MRI insert device (4) to the MRI host apparatus (1), the coupling means arranged for mechanically fixing the MRI insert device (4) to the MRI host apparatus (1) and / or for transmitting electrical current, control signals and / or measurement signals.

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