Module for driving a robotic catheterisation system

The invention relates to a module for driving a robotic catheterization system, comprising a base and mobile equipment that rotates in relation to the base about a rotational axis, and comprising a support receiving a flexible medical body; a device for driving in translation, suitable for generating a translation of said body in the main direction; a regulating device comprising a push element which is mobile in relation to the receiving space in a lateral adjustment direction perpendicular to the main direction; and a system for transferring motive energy comprising a control part carried by the base and a transmission part carried by the mobile equipment, the motive energy transfer system being suitable for moving the push element irrespective of the relative orientation of the mobile unit and the base.

CROSS-REFERENCE TO RELATED APPLICATION

This Application is a 35 USC §371 US National Stage filing of International Application No. PCT/FR2014/050515 filed on Mar. 6, 2014, and claims priority under the Paris Convention to French Patent Application No. 13 52058 filed on Mar. 7, 2013.

FIELD OF THE DISCLOSURE

The present invention relates to modules for driving a robotic catheterization systems.

BACKGROUND OF THE DISCLOSURE

A catheter is a typical example of an elongate flexible medical member to be introduced into the body of a patient. Such a catheter is introduced into a tubular anatomical opening of a patient, and therefore must be relatively flexible. The catheter tip must also reach a patient's internal organ, so therefore must be relatively elongated.

Manual insertion of a catheter, or more generally a flexible elongate medical member, into the body of a patient, for example into a tubular anatomical opening, is a relatively standard medical procedure. However, as this procedure is generally monitored by X-rays, the practitioner is exposed to a certain amount of radiation when performing such insertions repeatedly.

To reduce the risks to the practitioner related to repeated irradiation by X-rays, efforts have been made to automate such insertion so that this procedure can be carried out by a robot controlled by the practitioner remotely, still under X-ray guidance but from a room not exposed to the radiation. Such automation is complex, as retaining a grip on the catheter is problematic because it is bathed in preservative liquid such as normal saline solution and must remain sterile. In addition, it must be possible to alternate between rotational and translational movements of the catheter in a completely reliable manner, to enable the practitioner to conduct an examination.

Finally, it is also desirable for such a drive module to work with catheters of different diameters or with other elongate flexible medical members, such as a guide, of smaller diameter than a catheter and generally placed inside the catheter to serve as a guide for the catheter to slide on, or an interventional catheter, also arranged inside the catheter, having a tip providing some medical function such as a surgical tool (clamp, balloon, etc.).

There is therefore a need to develop drive modules that can reliably grip a catheter or other flexible elongate medical members and reliably drive their translational and rotational movements, and that are able to adapt to the varying dimensions of such members.

Recently, a drive system for managing both the translation and rotation of the catheter was proposed in document U.S. Pat. No. 7,917,310. In the system according to this document, the catheter is carried and retained on a plate rotatably mounted on a base to impart rotational motion to the catheter. The plate itself is provided with a mechanism to impart linear motion to the catheter, as well as a biasing wheel associated with an adjustment knob for adapting the drive mechanism to different catheter diameters. The drive system according to this document makes use of external motors, permanently fixed to the frame and associated with systems for transferring linear and rotational motion to the catheter.

However, in the system according to this document, adjustment of the biasing wheel must necessarily be done manually by the practitioner, in an area that may be difficult to access, and located in a room subject to X-ray irradiation, which is not satisfactory in view of the resulting problems outlined above.

Therefore, a need exists to develop catheter drive modules in which adaptation to the procedures concerned can be performed remotely by the practitioner when he or she is located in a room not exposed to X-rays.

The present invention is intended to overcome some or all of these disadvantages.

SUMMARY OF THE DISCLOSURE

For this purpose, the invention provides a module for driving a robotic catheterization system, comprising a base and a mobile unit mounted so as to rotate relative to the base about an axis of rotation extending along a main direction, the mobile unit comprising:a mounting in which is defined a receiving space extending along the main direction and adapted to receive an elongate flexible medical member;a translation driving means, carried by the mounting and comprising a drive element having a driving surface adapted to engage with the flexible medical member so as to generate a translational movement of said medical device along the main direction;

said drive module further comprising an adjustment device comprising:a push element that is part of the mobile unit, movable relative to the receiving space along a lateral adjustment direction perpendicular to the main direction and having a push surface engaging with the drive element so as to move the driving surface along the adjustment direction;a motive power transfer system comprising a control part carried by the base, adapted to receive motive power from a motive power source integral with the base, and capable of selectively adopting an active adjustment configuration and an inactive configuration, and a transmission part carried by the mobile unit, engaging with the control part in the active adjustment configuration and adapted to convert the motive power into driving force and to transfer said driving force to the push element in order to move said push element along the adjustment direction,

and wherein the motive power transfer system is adapted to transfer the driving force to the push element regardless of the relative orientation of the mobile unit and the base about the axis of rotation, when the control part is in the active adjustment configuration.

With these arrangements, the drive module of the invention can overcome the problems related to the transfer of motive power between a motive power source, integral to a fixed part of the module, and a part receiving this motive power, associated with the mobile unit in a rotatable manner relative to the fixed part.

One of the underlying concepts of the invention is to power the movement of an adjustment device, in particular to adapt the drive module to the various members to be driven and to be able to drive them reliably in translation and in rotation, the motor or motors for this adjustment being remotely controlled by the practitioner while he or she is located in a room not exposed to X-rays.

Such a drive module has applications in the following alternatives:a first alternative lies the use of one or more external motors integral to a fixed part of the module, particularly the base, capable of generating motive power such as torque and associated with motion transfer devices which allow converting this motive power and transferring a driving force to an adjustment mechanism carried by a mobile unit that is rotatable relative to the fixed part of the module;a second alternative consists of employing one or more motors embedded in a mobile unit that is rotatable relative to a fixed part of the module, in particular the base, and transferring a motive power, this time in the form of electric power, by means of motive power transfer devices, between a power source integral to the fixed part and the motor or motors embedded in the mobile unit.

In preferred embodiments of the invention, one or more of the following arrangements may possibly also be used:the control part is adapted to be selectively coupled to and uncoupled from the motive power source in order to switch from the active adjustment configuration to the inactive configuration;the control part is movable relative to the transmission part, between a first position corresponding to the active adjustment configuration, in which the control part engages with the transmission part, and a second position corresponding to the inactive configuration, in which the control part does not engage with the transmission part;the mobile unit is mounted so as to rotate relative to the base about a first axis of rotation, and the receiving space comprises a defined portion at the mounting along a second axis, parallel to the first axis and offset relative thereto, and the adjustment device is adapted to adjust the offset of the first and second axis;the transmission part comprises a circular element centered on the axis of rotation of the mobile unit relative to the base and having a radially outer side which engages with the control part in the active adjustment configuration, and a radially inner side, the transmission part further comprising a transmission mechanism engaging with the inner side of the circular element;the mounting of the mobile unit extends between first and second ends along the main direction and has an access opening extending between the first and second ends along the main direction, opening on the one hand to the receiving space defined in the mounting and on the other hand to outside the mobile unit in the radial direction, and the circular element of the transmission part has an opening extending for the entire length of the circular element along the main direction, at least a portion of the opening of the circular element being radially aligned with the access opening of the mounting regardless of the position of the push element in the adjustment direction, allowing access to the receiving space of the mounting from outside the mobile unit;the control part comprises a plurality of control members of which at least one engages in the active adjustment configuration with the outer side of the circular element that is part of the transmission part, regardless of the relative orientation of the mobile unit and the base about the axis of rotation.

According to a first variant embodiment of the invention, the control part of the motive power transfer system is adapted to receive motive power in mechanical form from a mechanical motive power source, such as a motor.

In preferred embodiments of the first variant of the invention, one or more of the following arrangements may possibly be used:the control part comprises a rotary control member which, in the active adjustment configuration, is in a driving relation with the outer side of the circular element;the circular element consists of a ring or a belt mounted so as to rotate on the mobile unit about the axis of rotation;the circular element consists of a flexible endless belt following a generally C-shaped path centered on the axis of rotation and stationary relative to the mobile unit about said axis of rotation, the opening of the C defining an opening for unobstructed access to the access opening of the mobile unit, and having a radially outer side which engages with the control part in the active adjustment configuration and a radially inner side which engages with the transmission mechanism;

According to a second variant embodiment of the invention, the control part of the motive power transfer system is adapted to receive motive power in electrical form from an electrical motive power source.

Preferably, in this second variant embodiment, the transmission mechanism of the transmission part comprises a motor embedded in the mobile unit, and the motive power transfer system comprises a slip ring comprising a first portion that is part of the control part carried by the base and connected to an electrical power source, and a second portion that is part of the transmission part and connected to the motor, the first portion and second portion being maintained in sliding contact regardless of the relative orientation of the mobile unit and the base about the axis of rotation, when the control part is in the active adjustment configuration.

Furthermore, in preferred embodiments of the invention, one or more of the following arrangements may possibly be employed:the translation driving means comprises a first drive element and a facing second drive element, the receiving space extending between said drive elements, each drive element having a driving surface adapted to engage with the flexible medical member,

and the adjustment device comprises a first push element and a second push element, each part of the mobile unit and each movable relative to the receiving space along the adjustment direction, each push element having a push surface engaging with an associated drive element so as to move the driving surface of said drive element along the adjustment direction;the adjustment device comprises a first motive power transfer system and a second motive power transfer system which are associated with each of the push elements;when the control part of the first motive power transfer system is in the active adjustment configuration, the transmission part of the first motive power transfer system is adapted to move the first push element towards the second push element so as to adjust the spacing between the driving surfaces of each of the drive elements along the adjustment direction,

and, when the control part of the second motive power transfer system is in the active adjustment configuration, the transmission part of the second motive power transfer system is adapted to move the first and second push elements jointly along the adjustment direction in a manner that adjusts the offset of the first axis and second axis;the adjustment device comprises a single motive power transfer system for the two push elements, and, when the control part of said motive power transfer system is in the active adjustment configuration, the transmission part of said motive power transfer system is adapted to, during a first portion of the actuating stroke, move the first push element towards the second push element so as to adjust the spacing between the driving surfaces of each of the drive elements along the adjustment direction, and, during a second portion of the actuating stroke which follows the first portion, to move the first and second push elements jointly along the adjustment direction in a manner that adjusts the offset of the first axis and second axis;the translation driving means comprises, on each side of the receiving space:at least first and second pulleys comprising a driving surface and carried by the mounting,an elongate band constituting the drive element and comprising a first side and an opposite second side, the first side engaging with the driving surface of the pulleys, the second side constituting the driving surface adapted to engage with the flexible medical member, the band being tensioned between the pulleys with an elongate portion extending along the receiving space in the main direction,

and the push surface of the push element is positioned between the first and second pulleys and engages with the first side of the band.

According to another aspect of the invention, a module is provided for driving a robotic catheterization system, comprising a base and a mobile unit mounted so as to rotate relative to the base about an axis of rotation extending in a main direction, the mobile unit comprising:a mounting in which is defined a receiving space extending along the main direction and adapted to receive an elongate flexible medical member;a translation driving means, carried by the mounting and comprising a drive element having a driving surface adapted to engage with the flexible medical member so as to generate a translational movement of said medical device along the main direction,an embedded motor adapted to drive the driving element;

said drive module further comprising a motive power transfer system comprising a slip ring having a first portion carried by the base and adapted to receive electrical power from an electrical power source integral to the base, and capable of selectively assuming an active adjustment configuration and an inactive configuration, and a second portion carried by the mobile unit and connected to the embedded motor, said first portion and said second mobile being maintained in sliding contact regardless of the relative orientation of the mobile unit and the base about the axis of rotation, when said first portion is in the active adjustment configuration.

According to an advantageous feature of the invention, all of the parts of the drive module are consumable and/or sterilizable items.

The consumable items can be discarded after use and replaced with identical items for future use, and the various non-consumable items are parts that can be disassembled and sterilized for future use.

Other features and advantages of the invention will be apparent from the following description of one of its embodiments, given by way of non-limiting example with reference to the accompanying drawings.

DETAILED DESCRIPTION OF THE DISCLOSURE

In the various figures, the same references designate identical or similar elements.

FIG. 1illustrates an example of a medical system. A patient1is lying on an examination table, and there is medical personnel2, such as a surgeon, performing an automated catheterization (this can also be referred to as robotic catheterization). The catheterization is automated via a computerized unit3comprising a central processing unit4(processor, logical or otherwise) remotely controlling a robot5positioned near the patient1. The robot5is also sometimes referred to as a “winder/unwinder”.

The robot5is adapted for moving an elongate flexible medical member6inside the patient's body1, under the control of the computerized unit3. “Elongate flexible medical member” denotes a flexible member that is longitudinally elongated and that can be inserted into a tubular passage of a patient, particularly an artery or vein of a patient, such as a catheter in the conventional sense of the term, a guide wire for guiding such a catheter, or an interventional catheter comprising medical equipment such as a balloon, a gripping or surgical tool, etc.

The robot can be automatically controlled by the computerized unit according to a predefined program, or by medical personnel2via a user interface7such as a mouse, keyboard, joystick, or similar device.

Such catheterization is monitored by imaging, in particular X-ray imaging. As can be seen in thisFIG. 1, there is therefore an X-ray source8,9emitting an X-ray beam toward the patient1, as well as an X-ray detector10arranged beyond the patient in the direction of the X-ray beam emission, able to detect transmission of the X-ray beam through the patient. The imaging system can be connected to the computerized unit3so that the image obtained by the imaging system is visible on a screen11that is part of the computerized unit3. Alternatively, the radiographic image is displayed on a dedicated screen.

The medical personnel2can thus control the catheterization while viewing on the screen11the position of the elongate flexible medical member within the patient's body1in relation to the various organs of the patient, which allows controlling various movements of the elongate flexible medical member, by means of the robot5, such as the two main movements which are the translation (linear motion) of the elongate flexible medical member in either direction longitudinally (advancing or withdrawing) and/or the rotation of the elongate flexible medical member about its longitudinal direction, in one direction of rotation or the other.

The robot5will be described in more detail below. It mainly comprises a receptacle12within which the elongate flexible medical member can be contained in a sterile manner. For example, the receptacle12is a tube open at one end, which holds the elongated flexible medical body immersed in a sterile liquid such as normal saline solution. The elongate flexible medical member exits through an end of the receptacle12, and engages with a drive module carried by the robot5and described in more detail below. The drive module13can receive various commands from the computerized unit3, which include a command to move the elongate flexible medical member translationally along the longitudinal direction, and a command to rotate about this direction. Note that, where appropriate, the robot may receive a command comprising a combination of a translation command and a rotation command in different proportions, and if appropriate, a judicious combination of two commands allows ordering a purely translational movement or purely rotational movement of the elongate flexible medical member by simple resolution of mathematical equations.

Note that the robot5can be more complex if such is appropriate.

In particular, the robot5can be used for controlling two medical devices such as an elongate flexible medical member (as described above) and a guide threaded inside the flexible elongate medical member. Thus the robot5comprises, in addition to the first system14described above which comprises both the receptacle12and the drive module13, a second system15comprising a receptacle16and a drive module17for the medical device contained in the receptacle16. Similarly, the second system15cooperates with the first14, with the end of the second system15connected to the receptacle12of the first system14, and more particularly to the back end of the elongate flexible medical member6. Thus, the guide18can be moved within the elongate flexible medical member6. Drive module17is similar to drive module13, apart from the adaptation to the diameter of the member to be driven, and will not be specifically described. The robot5is controlled by the computerized unit3so that drive module17controls the translation of the guide18in its longitudinal direction, and the rotation about this direction. Receptacle16is, for example, a basin holding a preservative liquid for storing the guide18. If necessary, a third system of a similar design (not shown) can be used, nested within the second.

A first example of a drive module13will now be described with reference toFIG. 2. A distinctive feature of the drive module13is that is has no embedded motors. The motors are fixed and the motions to impart to the elongate flexible medical member are transferred by a transfer system. Two motors19and20are thus provided, independently controllable by the computerized unit3. Motor19is intended to control rotation of the elongate flexible medical member6. Motor20is intended to control translation of the elongate flexible medical member6.

Another distinctive feature of the drive module13is that a single module controls both the rotational and translational movements of the elongate flexible medical member. This is achieved in practice by providing a fixed base21for the drive module, integral to the motors19and20. The fixed base21supports a mobile unit22adapted to rotate on the base21about an axis23extending in the main direction X. In this example, axis23coincides with the longitudinal direction of the elongate flexible medical member6to be driven. As will be explained in more detail below in various embodiments, the mobile unit supports a system120for gripping the elongate flexible medical member6which, when not driven, allows rotation of the mobile unit22relative to the base21to result in rotational movement of the elongate flexible medical member6about the main direction X, or when driven, results in translational movement of the elongate flexible medical member6in the main direction X.

The drive module13comprises a housing24which receives the base21and the mobile unit22, and provides basic protection from external contaminants. The housing24comprises a lower receptacle25and an associated cover26. The receptacle25and the cover26can be associated (by fitting one inside the other or by some other means) to surround a substantially closed space containing the base21and the mobile unit22. The receptacle25comprises two passages27and28which can respectively be traversed by a rotation control shaft33and a translation control shaft71, respectively connected to the rotation motor19and the translation motor20.

The base21contains part of a rotational movement control system29. In particular, the rotational movement control system29imparts, to the mobile unit22, a rotational movement about axis23. This system29is particularly visible inFIG. 7. In particular, according to this embodiment, the system29comprises an endless belt30movable along a path comprising a driving portion forming an arc of a circle, the center of the circle coinciding with the axis23. A guide system31guides the belt30along this path. A mechanical transfer system32is provided for driving the belt30along its path. In particular, it may be arranged for example that the end of the rotation control shaft33comprises a gear34meshing with a gear35driving the belt30. In particular, a mechanical transfer system32comprising a right-angle drive transfer may be provided.

The mobile unit22comprises a housing39extending along the main direction between two end faces36aand36b. The housing39comprises an outer peripheral surface37defining an almost fully closed right circular cylinder about axis23. The outer peripheral surface37comprises, for example, a right circular cylindrical driving surface38about axis23, and engaging with the belt30. For this engaging, it may be arranged for example that the belt30has a toothed face and that the driving surface38has a complementary toothed surface, the driving relation of the two toothed surfaces being such that movement of the belt30causes the housing39to rotate about axis23.

Referring again toFIG. 2, the housing39is not fully closed, and comprises an access opening40extending substantially between the two end surfaces36aand36b. In particular, the access opening40extends continuously along the main direction X. In particular, the access opening40also extends along the driving surface38. The access opening40is wide enough to allow insertion or removal of an elongate flexible medical member6into or from the housing39. In addition, two lips51of elastomer may be provided that block the access opening40when the cover26is attached to the receptacle25around the base21and the mobile unit22, preventing contaminants from entering said access opening but deformable to allow insertion or removal of an elongate flexible medical member6.

Referring now toFIGS. 5 and 6, a translation driving means120for the elongate flexible medical member6according to an exemplary embodiment will now be described. The translation driving system120comprises a frame43fixed to the housing39(not shown in theseFIGS. 5 and 6). This frame43defines a receiving space E centered on the axis of rotation23and adapted to receive the flexible medical member6. The frame43further comprises a set of arms or other structural elements acting as bearings for the various shafts rotatably supported by the frame. The frame43accommodates a rotation driving system on one side and part of a translation driving system on the other. These two sides are separate along axis23. The frame43also accommodates, between the rotation driving system and part of the translation driving system along the axis of rotation, a transmission part (not shown in theseFIGS. 5 and 6) that is part of an adjustment device which will be described in more detail below.

The frame43supports a drive shaft44via an end bearing45and a second end bearing46at the opposite end. The drive shaft44extends along the main direction X substantially parallel to axis23but offset relative thereto in a transverse direction Z. It extends between a first end that rotates within end bearing45, and a second end protruding beyond bearing46. In addition, the shaft44comprises at least one gear47concentric with the axis of the shaft44, for rotating a translation driving member48for the elongate flexible medical member6placed within the receiving space E. In this example, the translation driving member48for the elongate flexible medical member6comprises a pulley integral with a shaft mounted on the frame43so as to be rotatable about an axis normal to the main direction X, meaning the transverse direction Z. The translation driving member48is operatively coupled to a driving surface49bthat is part of a drive element and is placed in contact with the elongate flexible medical member6, such that the rotation of the translation driving member about the transverse direction Z moves the elongate flexible medical member6translationally along axis23. In the example shown, there are in particular driving surfaces49b,49b′ which are carried by elongate bands, here belts50and51arranged one on either side of the elongate flexible medical member6and forming drive elements for the flexible medical member6. The belts50and51are endless belts driven by the rotation of a respective translation driving member48,52. For example, a translation driving member48as described above is used to drive belt50, and a similar member52is used to drive belt51. Member52is arranged diagonally to member48in a rectangle whose other two vertices contain driven pulleys53and54. Thus, on one side translation driving member48and driven pulley53receive belt50. On the other side, driving member52and driven pulley54receive belt51. Translation driving member52also cooperates with the shaft44, via a transfer gear154supported by the shaft44.

Thus, in the illustrated embodiment, the translation driving member120for the elongate medical member6comprises, on each side of the receiving space E defined in the frame43, a first driving pulley48,52and a second driven pulley53,54, the first and second pulley48,52having a driving surface and being carried by the frame43, and an elongate band in the form of a belt50,51constituting the translation driving member for the elongate flexible medical member6and having a first face49a,49a′ engaging with the driving surface of the pulleys48,52,53,54, and an opposite second face49b,49b′ constituting the driving surface adapted to engage with the flexible medical member6, the elongate band in the form of a belt50,51being taut between the pulleys48,52,53,54with an elongate portion extending along the receiving space E of said medical member6.

Alternatively, a system of belts is not necessarily used; instead there is direct use of member48and/or member52, and a (some) associated counter-member(s), arranged one on either side of the elongate flexible medical member6in order to drive translationally member48and/or member52which then directly form the drive element providing the driving surface intended to engage with the flexible medical member6.

The main direction X was described above as being that of the translational axis when driving the elongate flexible medical member6. The transverse direction Z was defined as the direction of the axis between the level of the shaft44and the level of the elongate flexible medical member6. A third direction Y can be defined, the lateral direction, forming a trihedron with the two other directions, and considered below as the adjustment direction.

In the drive module according to the invention, an adjustment device55is provided that is adapted for adjusting the position of the driving surfaces49b,49b′ of the belts50,51in the adjustment direction Y, firstly in order to adjust the spacing between the driving surfaces49b,49b′ of the translation driving members formed by the belts50,51so as to accommodate the different sizes of flexible medical member6to be driven when placed in the receiving space E, and secondly in order to adjust an offset of the axis X2along which the elongate flexible medical member6extends between the driving surfaces49b,49b′ relative to the axis of rotation23, while keeping these axes23and X2parallel, within a defined portion of the receiving space E at the mounting, so as to improve the rotation about said axis of rotation23, as will be described in more detail below.

The adjustment device55thus comprises a first push element56, movable along the adjustment direction Y and comprising a push surface57, placed between the first and the second pulley48,53supporting the belt50with which it is associated, and engaging with the inner face49aof said associated belt50. Movement of the push element59along the adjustment direction Y will move driving surface49bof belt50laterally relative to driving surface49b′ of the facing belt51. One can thus clasp an elongate flexible medical member6placed in the receiving space E, between the two belts50and51. By continuing this movement of the push element56towards the facing belt51along the adjustment direction Y, one can adjust the offset of axis X2along which the elongate flexible medical member6extends between the driving surfaces49b,49b′ of belts50and51relative to the axis of rotation23, in order to improve the rotation.

The first push element56also comprises a tensioning surface58intended for tensioning the belt50. The first push element56comprises for example, in the lateral direction, a front face providing the push surface57and a rear face opposite the front face. The rear face provides the tensioning surface58, which cooperates with the belt on the return side. Thus, regardless of the lateral offset imposed by the first push element56on the corresponding span, the belt50remains tensioned.

On the side opposite the first push element56relative to the elongate flexible medical member6, the adjustment device55comprises a second push element59which cooperates with inner face49a′ of belt51. Push element59may be movable in the lateral direction Y. This second push element59comprises a push surface60opposite push surface57, arranged between the first and second pulleys52,54supporting belt51with which it is associated, and engaging with the inner face49a′ of said associated belt51. The elongate flexible medical member6is clasped by belts50and51between these two push surfaces57and60. The lateral offset of the axis of the elongate flexible medical member6may be imposed by the first push element56and cause lateral displacement of the second push element59in direction Y by means of the elongate flexible medical member6, against an opposing biasing means (not shown).

Alternatively, and as will be described below, the adjustment device55may be adapted to allow moving the first push element56towards the second push element59in the adjustment direction Y in order to adapt the spacing between the driving surfaces49b,49b′ of belts50and51to the elongate flexible medical member6to be driven, and to allow moving the first and second push elements56and59jointly in the adjustment direction Y in order to adjust the offset of axis X2along which the elongate flexible medical member6extends between the driving surfaces49b,49b′ of belts50and51, relative to the axis of rotation23, in order to improve the rotation.

On this same opposite side, a tensioner61is provided which, together with push surface60, keeps belt51taut, an elastic member such as a spring (not shown) extending between the second push element59and the tensioner61in the lateral adjustment direction Y.

Thus, as can be understood from the above description, installing the elongate flexible medical member6in the mobile unit comprises placing the elongate flexible medical member6in the receiving space E between the two belts50and51. The clamping of the elongate flexible medical member6, and the lateral offset of the axis of the elongate flexible medical member relative to axis23, are obtained by operating the adjustment device, meaning by adjusting the lateral position of the first and second push elements56and59by means of the adjustment device55.

Once the elongate flexible medical member6is in position and clamped and/or offset as expected, movement of the elongate flexible medical member6along axis23is controlled by simple rotation of the drive shaft44. Rotation of the drive shaft44relative to the frame43about its axis, parallel to axis23, causes rotation of at least the rotation driving member48about its own axis (transverse axis) due to meshing. In practice, in the present case, rotation of the drive shaft44relative to the frame43about its axis, parallel to axis23, also causes rotation of the rotation driving member52about its own axis (transverse axis) due to meshing with the transfer gear154. Rotation driving member48drives belt50, the driving surface49bthereof then being subjected, at the interaction with the elongate flexible medical member6, to a translational movement parallel to axis23. Rotation driving member52drives belt51, the driving surface49bthereof then being subjected, at the interaction with the elongate flexible medical member6, to a translational movement parallel to axis23. These two movements are generated in the same translational direction for the driving surfaces49band49b′ (in other words, in opposite directions of rotation of the two belts). The movement of belts50and51drives the translation of the elongate flexible medical member6along axis23.

To generate a translational movement of the elongate flexible medical member6, it is therefore sufficient to rotate the shaft44.

However, as the shaft44rotates about axis23due to rotation of the mobile unit22relative to the base21about this axis, while the translation motor20remains fixed relative to the base21, a transfer system63needs to be provided which is always connecting the shaft44to the motor20, regardless of the position of the mobile unit22relative to this direction. The transfer system63comprises a fixed part64supported by the base21, and a mobile part65supported by the mobile unit22. An exemplary embodiment will be provided with reference toFIGS. 2 and 3.

According to this first embodiment, the fixed part64comprises a belt66which is guided along a closed continuous path. A guide67is provided for the belt.

The belt66comprises a portion68forming an arc of a circle centered on axis23. This arc portion68has a minimum central angle, which will be explained in more detail below, and a maximum central angle which is strictly less than 360°. In particular, the belt66defines an access opening69large enough to allow passage of the elongate flexible medical member6. In the particular example represented, the arc portion68of the belt66has a central angle of about 180°. The belt66also comprises a drive portion70. The drive portion70receives the drive command from the translation motor20. For example, as represented inFIG. 2, the fixed part64comprises shaft71connected to motor20, traversing passage28, and rotating a gear72about the vertical axis. The bevel teeth of said gear engage with a gear73having an axis parallel to axis23. That gear73engages with the drive portion70of the belt as shown inFIG. 4.

The fixed part64comprises a set of pulleys adapted to guide the belt66so that it moves along a path74comprising both the drive portion70and the arc portion68. For example, pulleys75a,75b,75care provided having parallel axes and arranged to form a rectangle with the gear73. The path74includes three sides of the rectangle, and the arc portion68is provided in place of the fourth side. Note that the inner face76of the belt66is designed to engage with the gear73to transfer motion by means of matching shapes, meshing, or other.

The mobile part65comprises a support disc77integral to the frame43. The support disc77, the frame43, and any other integral part, in particular the housing39, of the mobile unit22forming a frame assembly are denoted as a whole by the term “mounting”121. The support disc77supports a plurality of gears78a,78b,78c, and78d. These gears78a-dare each mounted so as to be rotatable relative to the support disc77about an axis parallel to the main direction X. In addition, these gears78a-78dare arranged in a circle centered on axis23(therefore concentric with the arc portion68of the belt66). The radius of this circle is smaller than the radius of the arc portion68of the belt66. Each gear78a-dhas its own radius, such that the sum of the radius of the circle and of the radius of the gear78a-dcorresponds to the radius of the arc portion68of the belt66.

Furthermore, each gear78a-dis in a meshing relation with the shaft44passing through the support disc77. For example, a direct meshing relation may be provided, as is the case for the two gears78aand78dwhich are in direct contact with the head79of the shaft44. There may also be an indirect meshing relation, as is the case for the two gears78band78cwhich are in contact with the head79of the shaft44via the two gears78aand78d.

A system may also be provided for transferring motion between the “indirect” gears78band78cand the “direct” gears78aand78d, so that they all rotate in the same direction. An intermediate gear80acan thus be provided between gears78aand78b, and an intermediate gear80bbetween gears78cand78d.

Thus, the support disc77carries a mechanized system78a-78d,80a-80b, which has an access opening81aligned with an access opening82of the support disc77. In the present case, the mechanized system has gears arranged in a general U shape, the open side of the U defining the access opening81. A first arm of the U comprises aligned gears78a,80a, and78b. A second arm of the U comprises aligned gears78d,80b, and78c. Gears78aand78dare arranged one on either side of the head76of the shaft44to form the base of the U.

In the position represented inFIG. 4, the gears78aand78dare engaged with the belt66in the arc portion of the belt. In this position, to drive the elongate flexible medical member6translationally along axis23, gear73drives belt66. Belt66rotates gears78aand78dabout their own axis relative to the support disc77(assuming for clarity that the support disc77is unmoving during this operation). Gears78aand78drotate the shaft via the head79. Rotation of the shaft44causes translation of the elongate flexible medical member by the mechanism described above.

As can be seen inFIG. 3, in actual practice the various mechanisms are hidden and guided by respective covers83and84for the fixed part and mobile part. The covers have the same access openings as described above, and define bearings for the shafts of the various gears.

As the inner face76of the belt is designed to mesh with gear73, and the opposite outer face88is designed to mesh with gears78a-d, each is shaped for such meshing, for example by being provided with teeth that fit with the teeth of the various gears.

FIG. 8ashows an initial position of the drive module. During a preparatory phase, the single access opening89, formed by the various aligned access openings81,82,40, allows insertion of the elongate flexible medical member into the module, in particular between belts50and51.

To generate a pure translational movement, the rotation driving motor19is locked. The translation driving motor20is controlled to generate translational movement of the belt66along its path. The arc portion68causes gears78aand78dto rotate about their axis, which moves the elongate flexible medical member translationally along axis23. The elongate flexible medical member6can be withdrawn at any time via the access openings.

To generate a rotational movement, the rotation driving motor19rotates belt30which causes the mobile unit22to rotate about axis23. During this movement, gears78aand78droll on belt66, until one of the gears, here gear78d, exits the arc portion68. In addition, it may be desirable to prevent translational movement of the elongate flexible medical member when ordering the rotation. In this case, action is taken so that the relative orientations of the shaft44and the elongate flexible medical member6within the mobile unit remain unchanged (meaning that the shaft44is not rotated relative to the frame43). This can be achieved by controlling the translation motor so that the belt66travels a corresponding distance to prevent any rotation of gears78a-drelative to the support disc77.

This is particularly visible when one comparesFIGS. 8aand 8b, where arrows have been added to the various moving components to illustrate their relative orientations in the different positions.

Thus, if the operator wants to obtain a pure rotational movement of the elongate flexible medical member6, the two motors19and20are controlled at predetermined ratios.

During rotation of the mobile unit22, the elongate flexible medical member6remains captured between belts50and51from which it receives the rotational motion imparted to the mobile unit22.

Of course, simultaneous translation and rotation of the elongate flexible medical member6could be ordered, in which case only the rotation motor19may be controlled, or the two motors19and20may be controlled according to a ratio other than the predetermined ratio in order to achieve rotation only.

As can be seen inFIG. 8b, in this position it is not possible to withdraw the elongate flexible medical member6via the access opening89, because the opening is obstructed by the belt66of the fixed part. However, there is only one access opening89. To remove the elongate flexible medical member6from the module when in this position, the rotation motor19is controlled to achieve rotational movement in the appropriate direction, for example towards the position ofFIG. 8a. If it is desired to withdraw the elongate flexible medical member6from the module with no translational movement of the member within the patient1, the translation motor20is also controlled according to the predetermined ratio in order to generate pure rotational movement.

If, in the position ofFIG. 8b, translation of the elongate flexible medical member6is desired, the rotation driving motor19is locked and the translation driving motor is controlled as explained above. In the position represented, the arc portion68of the belt66causes rotation of gear78aand gear78b, but no longer that of gear78das above. Regardless of the relative orientation of the mobile unit22and the base21, at least one gear78a-dis in a driving relation with the arc portion68of the belt66. This property defines the minimum central angle of the arc portion68of the belt66, based on the number and arrangement of gears78a-78d. In the square configuration shown, the minimum central angle of the arc portion68of the belt66is at least 90°. In the example presented, 180° is used for clarity.

The structure and operation of the adjustment device according to various embodiments of the invention will now be described in greater detail, with reference toFIG. 9and subsequent figures.

As shown above, the mobile unit22of the drive module13is equipped in the embodiment illustrated inFIGS. 2 to 6with an adjustment device comprising two push elements56and59that are movable relative to the receiving area E in the lateral adjustment direction Y and each having a push surface57,60engaging with the associated belt50,51so as to move the driving surface49b,49b′ thereof along the adjustment direction Y.

One object of the invention is for a practitioner2positioned in a room not exposed to x-ray irradiation to be able to control remotely the movement of these push elements56and59in the lateral adjustment direction Y, regardless of the relative orientation of the mobile unit22and of the base21relative to the axis of rotation23. The problem to be solved here is that the push elements56and59are carried by the mobile unit22, which is mounted so as to rotate relative to the base21about axis23, and that their movement must be initiated from a control part carried by the base21and adapted to receive the motive power required for such movements.

To this end, the invention proposes that the adjustment device55comprise a motive power transfer system comprising a control part carried by the base21, adapted to receive motive power from a motive power source integral to the base21, and capable of selectively assuming an active adjustment configuration and an inactive configuration, and a transmission part carried by the mobile unit22, engaging with the control part in the active adjustment configuration, and adapted to convert the motive power into a driving force and to transfer this driving force to the associated push element in order to move it in the lateral adjustment direction Y, the transfer system being adapted to transfer the driving force to the associated push element regardless of the relative orientation of the mobile unit22and the base21about the axis of rotation23, when the control part is in the active adjustment configuration.

FIGS. 9, 10aand10billustrate a first embodiment of motive power transfer systems equipping an adjustment device55that is part of the drive module.

For clarity, the transfer system63described above is not represented in thisFIG. 9.

In this embodiment, a first external servomotor85and a second external servomotor86are utilized, external meaning they are not embedded in the mobile unit22, and fixed relative to the base21, similarly to the rotation19and translation20motors described above in connection withFIG. 2.

These servomotors85and86are independently controllable by the computerized unit3and allow generating motive power in mechanical form, for example torque, which must be converted into a driving force to be transferred to the push elements56,59so that they are moved along the adjustment direction Y.

The receptacle25described in connection with figure also comprises two passages (not shown) which can respectively be traversed by a first adjustment shaft87and second adjustment shaft88, respectively connected to the first servomotor85and the second servomotor86.

In this first embodiment illustrated inFIGS. 9, 10a, and10b, the adjustment device55comprises two push elements56and59movable along the adjustment direction Y and cooperating with an associated belt50,51to move the driving surfaces49b,49b′ thereof in said adjustment direction Y.

The adjustment device according toFIG. 9comprises two motive power transfer systems, each of the motive power transfer systems being associated with a respective push element56,59.

As the two transfer systems are similar, the following description which references the first transfer system also applies to the second transfer system, similar elements being designated by the same references but accompanied by a ′ symbol.

The first transfer system, associated with the first push element56, comprises a first control part carried by the base21, adapted to receive motive power from the first servomotor85integral to the base21. The second transfer system, associated with the second push element59, comprises a second control part carried by the base21and adapted to receive motive power from the second servomotor integral to the base21. The first control part and second control part can selectively adopt an active adjustment configuration and an inactive configuration as will be detailed below.

In particular, according to this first embodiment, the first control part comprises first and second rotary control members91and92such as pinions/gears or drive rollers, mounted on the base21so as to rotate about a respective axis91aand92aextending in the main direction X.

A mechanical transfer system (not represented) is provided for operatively connecting the rotary control members91and92to the first servomotor85such that the rotary members91and92rotate in the same direction about their respective axes91a,92awhen driven by the first servomotor85. This transfer system may, for example, make use of a set of bevel gear teeth such as those connecting the rotation19and translation20motors to the rotation control system29and to the translation control system, or a belt system similar to that implemented in the rotation control system29for controlling rotation of the mobile unit22relative to the base21described above and allowing the transfer of rotational movement received by one of the rotary control members91, adapted to be connected to the shaft87of the first servomotor85, to the other of the rotary control members.

Alternatively, it may be provided that each rotary control member91,92is associated with a dedicated servomotor, the servomotors associated with each of the rotary control members being controlled in a synchronized manner.

In addition, it is arranged that the rotary control members91,92, which are in the form of drive rollers or pinions in the embodiment ofFIG. 9, can be selectively coupled and uncoupled from the first servomotor85to allow transition from an active adjustment configuration in which they are coupled to the first servomotor to drive their rotation, to an inactive configuration in which they are uncoupled from the first servomotor and turn freely on their axis of rotation91a,92a. A reversible coupling system known to those skilled in the art may thus be provided between the shaft87of the first servomotor85and the driving pinions91and92.

Additionally or alternatively, the servomotor85can be placed in a freewheeling state, meaning in a state where the motor does not drive the rotary control members91,92and does not oppose or offers very low resistance to the free rotation of these rotary control members91,92. In this embodiment, the rotary control members91,92are therefore permanently coupled to the servomotor85, and the transition of the rotary control members91,92from the active adjustment configuration to the inactive configuration is caused by the change of the servomotor from an active driving state to a freewheeling state.

According to another embodiment, the rotary control members91,92that are parts of the control part may be movable, relative to the transmission part of the motive power transfer system, between a first position corresponding to the active configuration of the control part, where said rotary control members91and92engage with the transmission part, and a second position corresponding to the inactive configuration of the control part, where said rotary control members91and92do not engage with the transmission part and are spaced apart from it. In particular, to change from the active adjustment configuration to the inactive configuration, these rotary control members91and92can be moved in the main direction X and/or in the lateral direction Y and/or in the transverse direction Z by means of a dedicated movement device (not shown), until they are distanced from the transmission part and no longer engage with it.

This prevents the rotary control members91,92, when in the inactive configuration, from causing unintentional movement of the associated push element56during rotation of the mobile unit22relative to the base21about the axis23, which would have a detrimental effect on the clamping and/or movement of the flexible medical member6.

As shown inFIG. 9, the transmission part of each of the motive power transfer systems comprises a circular element101,101′ carried by the mobile unit22and centered on the axis of rotation23.

As can be seen more clearly inFIGS. 10aand 10b, the circular element101,101′ has a radially outer side101a,101a′ which cooperates with the rotary control members91,91′,92,92′ that are parts of the associated control part, and a radially inner side101b,101b′ which engages with a transmission mechanism that is part of the associated transmission part and is described in greater detail below.

Furthermore, in this embodiment illustrated inFIG. 9, the housing39has an access opening40which provides access on the one hand to the receiving space E of the elongate flexible medical member6and on the other hand to outside the mobile unit22in the radial direction. This access opening40should be always be radially accessible to allow easy removal of an elongate flexible medical member6from the receiving space E inside the drive module regardless of the relative orientation of the mobile unit22and the base21about axis23, as was described above in connection withFIGS. 2, 7, and 8ato8c.

To allow such easy removal of the elongate flexible medical member6from the drive module, the adjustment device55for the push elements56,59should not radially block the access opening40of the housing39, regardless of the adjustment position of each of the push elements56,59along the adjustment direction Y.

Also, in the first embodiment of the invention visible inFIGS. 9, 10a, and10b, the circular element101,101′ that is part of the transmission part of each of the motive power transfer systems has an opening102,102′ extending along the entire length of the circular element101,101′ in the main direction X and radially aligned with the access opening40of the housing39regardless of the adjustment position of each of the push elements56,59along the adjustment direction Y.

More specifically, in the first embodiment of the invention shown inFIGS. 9, 10a, and10b, the circular element that is part of the transmission part of each of the transfer systems consists of a continuous flexible belt101,101′ following a generally C-shaped path. The path of each belt is centered on the axis of rotation23of the mobile unit22relative to the base21; this path, in other words the route followed by each belt, is stationary, fixed relative to the mobile unit about the axis of rotation23.

The circumferential dimension of the opening102,102′ of the C defined by the path of each belt101,101′ is at least equal to that of the access opening40. This ensures that the access opening40is not obstructed, or rendered radially inaccessible, by an element of the adjustment device55.

The presence of this opening102,102′ in the path of each belt101,101′ requires providing a plurality of control members91,92, here two such members for each belt, spaced sufficiently apart from each other along the circumference to ensure that at least one of these control members91,92, when they are in the active adjustment configuration, engages with the outer face of the belt regardless of the relative orientation of the mobile unit22and the base21about the axis of rotation23. As the belts101,101′ are supported in a stationary path by the mobile unit22, when this mobile unit22rotates relative to the base21about the axis23, the belts101,101′ are rotated along with it. During this rotation, when the opening102,102′ of each belt101,101′ reaches a first control member91,91′, the first control member91,91′ is no longer in contact with the outer surface of the associated belt101,101′ and can no longer advance this belt along its path. This is why a second control member92,92′ is provided: to take over for the first control member91,91′ in driving the belt101,101′ along its path when the first control member91,91′ is opposite the opening102,102′ of the belt101,101′, and vice versa.

In other words, the spacing between the two control members91,91′ and92,92′ along the periphery is chosen so as to be greater than the circumferential dimension of the opening102,102′ of the associated belt101,101′ such that at least one of said control members91,91′ and92,92′ is in contact with the associated belt regardless of the orientation of the mobile unit22relative to the base21about the axis of rotation23, when the control members91,91′ and92,92′ are in the active adjustment configuration.

As is particularly visible inFIGS. 9, 10a, and10b, each flexible belt101,101′ is received in a respective annular channel391,392provided on the outer face of the housing39, between the first and second ends36a,36bof the housing39along the main direction X. Each belt101,101′ is guided in its movement along its path by the bottom and sides of the associated annular channel391,392, and by two idler guide rollers104,105,104′,105′ removably mounted on the housing39(for assembling the belt101,101′ on the housing39) near the access opening40.

Each flexible belt101,101′ has a radially outer side101a,101a′ forming the “outer face” of the circular element, engaging with the associated rotary control members91,92,91′,92′ when they are in the active adjustment configuration, and a radially inner side101b,101b′ forming the “inner face” of the circular element, cooperating with an associated transmission mechanism.

We will now describe a first transmission mechanism that is part of the first transmission part associated with the first push element56, with reference toFIG. 10a.

As can be seen inFIG. 10a, the frame43that is part of the mounting integral with the mobile unit22supports a first rotary transfer member106mounted in the frame43so as to rotate freely about an axis extending in the main direction X. The housing39is provided with a window393to the space inside the housing39, at the first rotary transfer member106mounted on the frame43, said window also opening onto the channel391that receives the belt101. The first rotary transfer member106can thus engage with the radially inner side101bof the belt101so that movement of the belt101along its path causes rotation of the rotary transfer member106.

The transmission mechanism that is part of the first transmission part associated with the first push element56further comprises a worm gear107rotatably supported on the frame43and extending in the lateral direction Y. This worm gear107engages with the rotary transfer member106such that rotation of said rotary transfer member106about its axis of rotation causes rotation of the worm gear107about its axis of rotation. The push element56associated with this first transmission mechanism also has a threaded portion561engaging with the worm gear107so that rotation of the worm gear107about its axis causes linear movement of the push element56along this same axis extending in the lateral adjustment direction Y. The position of the first push element56is thus adjusted in the lateral adjustment direction Y.

InFIG. 10b, a second transmission mechanism that is part of the second transmission part associated with the second push element59is represented.

As can be seen in thisFIG. 10b, the second transmission mechanism has a structure that is substantially symmetrical to that of the first transmission mechanism. Thus, the frame43supports a second rotary transfer member106′ mounted so as to rotate freely in the frame43about an axis extending in the main direction X, the housing39is provided with a window393′ to the space inside the housing39, at the second rotary transfer member106′ mounted on the frame43, said window also opening onto the channel392that receives the belt101′. The second rotary transfer member106′ can thus engage with the radially inner side101b′ of the belt101′ so that movement of the belt101′ along its path causes rotation of the rotary transfer member106′.

The transmission mechanism that is part of the second transmission part associated with the second push element59further comprises a worm gear107′ rotatably supported on the frame43and extending in the lateral direction Y. This worm gear107′ engages with the rotary transfer member106′ such that rotation of said rotary transfer member106′ about its axis of rotation causes rotation of the worm gear107′ about its axis of rotation. The push element59associated with this second transmission mechanism also has a threaded portion561′ engaging with the worm gear107′ so that rotation of the worm gear107′ about its axis causes linear movement of the push element59along this same axis extending in the lateral adjustment direction Y. The position of the second push element59is thus adjusted in the lateral adjustment direction Y.

In this embodiment, one can see that the first and second push elements56and59can be moved independently along the lateral adjustment direction Y, which allows adjusting the spacing between the driving surfaces49b,49b′ of the belts50,51to adapt to different diameters of flexible medical member6to be driven, and adjusting the offset between the axis of rotation23and the axis along which the elongate flexible medical member6extends between the driving surfaces49b,49b′ of the belts50,51, to facilitate driving the rotation of said member6about axis23(lever arm effect).

We will now describe a second embodiment of motive power transfer systems equipping an adjustment device55that is part of the drive module, with reference toFIGS. 11, 12ato12d, and13.

In this second embodiment, only the transmission parts associated with each of the motive power transfer systems differ from the first embodiment described above, and these will therefore be described in detail below; the other elements remain similar or identical.

Referring toFIG. 11, in this second embodiment the housing39has two channels391,392on its outer peripheral surface37, each designed to accommodate a circular element in the form of a ring201,201′ that is part of an associated transmission part. These rings may be slightly flexible so that they can be slightly deformed for threading onto the outer surface37of the housing39at one of its ends36a,36balong the main direction X, and sliding on this outer surface37along the main direction X until they reach their intended channels391,392where they fit into place within these grooves by elastic recovery.

In this second embodiment, the rings201,201′ are rotatable relative to the housing39of the mobile unit22, about the axis of rotation23. As can be seen inFIG. 11, the rotation of each ring201,201′ relative to the housing39about the axis of rotation23is induced by the engaging of each ring201,201′ with two rotary control members91,92,91′,92′ which, in the active adjustment configuration, engage with the radially outer faces201a,201a′ of the rings201,201′.

In the manner described with reference to the first embodiment illustrated inFIGS. 9, 10a, and10b, the rotary control members91,92,91′,92′ associated with each of the rings201,201′ can transition from the active adjustment configuration to the inactive configuration either by being uncoupled from their respective servomotor85,86, or by being moved away from the associated ring201,201′ until they are distanced from it.

In this second embodiment, the rings201,201′ that are part of the associated transmission parts have an opening202,202′ whose circumferential dimension is chosen so that the access opening40of the mobile unit22is always radially unobstructed/accessible, regardless of the relative position of the rings201,201′ with respect to the housing39of the mobile unit22about the axis of rotation23, their relative positions being directly dependent on the positions of the push elements56and59along the adjustment direction as will be discussed below.

The relative rotation of the rings with respect to the mobile unit22is limited to an angular range chosen to comply with this principle, while allowing adjustment of both the spacing and the offset of the push elements56and59to the various settings desired. This limitation on the angular range of the relative rotation between the rings201,201′ and the housing39of the mobile unit22may, for example, be achieved by means of stops provided for example in the channels391and392, or directly by the push elements56and59coming into contact with each other via the belts50and51.

However, as withdrawing the medical member6from the mobile unit22through the access opening40may require at least slightly relaxing the grip on the member6, the ring controlling the gap between push elements could slightly protrude into the access opening40when the member6is tightly clamped, and completely unblock the opening when the grip on the member6is slightly relaxed.

We will now describe a sequence for adjusting the position of the push elements56and59in the lateral adjustment direction Y by means of motive power transfer systems implemented according to the second embodiment of the invention, with reference toFIGS. 12ato12c.

TheseFIGS. 12ato 12care schematic views showing a frame43schematically represented as a block, a first push element56, a second push element59, a tensioner61, a first belt50associated with the first push element56, a second belt51associated with the second push element59and with the tensioner61, a first ring201and first rotary transfer member206that are part of a first transmission mechanism, a second ring201′ and second rotary transfer member206′ that are part of a second transmission mechanism, and an elongate flexible medical member lying within the receiving space E defined in the mobile unit22between the belts50and51.

In addition, illustrated with dotted lines in these figures is the portion of the housing39of the mobile unit22which defines the access opening40. Lastly, although not shown directly in these figures, the housing39of the mobile unit22is provided with windows similar to the window393of the first embodiment and allowing each of the first and second rotary transfer members206,206′ to engage with the radially inner surface201b,201b′ of the associated ring201,201′.

Thus,FIG. 12ashows an initial position of the push elements56and59before adjusting in the adjustment direction Y. In this position, the first and second push elements56and59are fully apart in the adjustment direction Y. An elongate flexible medical member6has been placed in the receiving area E of the mobile unit by insertion for example radially through the access opening40of the housing39and the openings202,202′ of the rings201,201′.

In this second embodiment, and as will be described in more detail with reference toFIG. 13, the first transmission part associated with the first push element56comprises a first transmission mechanism adapted to move the first push element56toward the second push element59along the adjustment direction Y, so as to adjust the spacing between the belts50and51to the diameter of the elongate flexible medical member6to be driven. In addition, the second transmission part associated with the second push element59comprises a second transmission mechanism adapted to move the first push element56and second push element59jointly along the adjustment direction Y, so as to adjust the offset in the adjustment direction Y between the axis of rotation23and the axis X2along which the elongate flexible medical member6extends at the belts50and51.

Thus, starting from the configuration illustrated inFIG. 12a, a practitioner can cause the first ring201to rotate by placing the associated rotary control members91, in the active adjustment configuration. In the manner described with reference to the first embodiment, these rotary control members91,92are spaced sufficiently apart from one another along the circumference to ensure that at least one of them remains in contact with the outer face201aof the ring201regardless of the relative orientation of the mobile unit22and the base21about the axis of rotation23. In other words, the central angle of the arc between these rotary control members91,92along the circumference is at least equal to the central angle of the circumferential opening202of the ring201.

Rotation of the first ring201, for example counterclockwise inFIGS. 12a-12cas indicated by arrow F1inFIG. 12a, causes the rotation of the first rotary transfer member206about its axis extending in the main direction X, and the translational movement in the adjustment direction Y, by means of the first transmission mechanism, of the first push element56towards the second push element59which is held stationary. As can be seen inFIG. 12b, this phase brings the driving surface49bof the first belt50closer to the driving surface49b′ of the second belt51until the elongate flexible medical member6is gripped between the belts50and51, for example with a predetermined force adjusted by means of an elastic member (not shown) such as a spring, arranged in a suitable manner between the first push element56and a push element support561relative to which the push element56is movable in the adjustment direction Y against the force exerted by said elastic element, as shown inFIG. 13.

If the practitioner2wishes to adjust an offset in the adjustment direction Y between the axis of rotation23and the axis X2along which the elongate flexible medical member6extends at the belts50and51, the practitioner can cause rotation of the second ring201′ by placing the associated rotary control members91′,92′ in the active adjustment configuration. In the manner described with reference to the first embodiment, these rotary control members91′,92′ are spaced sufficiently apart from one another along the circumference to ensure that at least one of them remains in contact with the outer face201a′ of the ring201′ regardless of the relative orientation of the mobile unit22and the base21about the axis of rotation23.

Rotation of the second ring201′, for example clockwise inFIGS. 12ato 12cas indicated by arrow F2inFIG. 12b, causes the rotation of the second rotary transfer member206′ about its axis extending in the main direction X and the joint translational movement in the adjustment direction Y, by means of the second transmission mechanism, of the first push element56and the second push element59. This phase allows adjusting the offset in the adjustment direction Y between the axis of rotation23and the axis X2along which the elongate flexible medical member6extends at the belts50and51.

We will now describe the first and second transmission mechanisms according to the second embodiment of the invention, with reference toFIG. 13.

ThisFIG. 13shows a bottom view of the first push element56, the second push element59, the tensioner61, the first belt50and second belt51which can be moved along the adjustment direction Y relative to the mounting43, as well as the first transmission mechanism and second transmission mechanism.

As can be seen in thisFIG. 13which illustrates non-limiting embodiments of the first and second transmission mechanisms, the first transmission mechanism comprises the first rotary transfer member206. The first transmission mechanism further comprises a first gear207, with which the first rotary transfer member206is in driving engagement, the first gear207being integral with a shaft208of non-circular cross-section, for example square, mounted so as to rotate freely about its axis extending in the adjustment direction Y on the mounting43. The shaft208is threaded through an opening of complementary cross-section provided inside a first worm gear209extending as an extension of the shaft208. The first worm gear209comprises a grooved ring211that fits into a complementary opening provided on the second push element59. The width of the opening provided on the second push element59is adapted to receive the groove of the ring211, the lateral edges defining the opening being received between the side walls of the groove. This first worm gear209can thus rotate freely about its axis relative to the second push element59while being guided in rotation on the second push element59by the cooperation of the ring211and the opening provided on the second push element59. In addition, the first worm gear209is fixed translationally along the adjustment direction Y of the second push element59, by means of the groove provided on the ring211.

The first push element56is carried by a first push element support561, with the option of translational motion along the adjustment direction Y against the force exerted by an elastic member (not shown) of the first push element relative to the first push element support561. The first push element support561drives the first push element56along the adjustment direction when the first worm gear209is rotated by the shaft208and first gear207; for this purpose, the first push element support561has a threaded portion562engaging with the first worm gear209.

Thus, when a practitioner2causes movement of the first ring201by placing the associated rotary control members91,92in the active adjustment configuration, the first ring201rotates the first rotary transfer member206, causing the shaft208to rotate by means of the first gear207. The shaft208then rotates the first worm gear209, causing linear movement along the adjustment direction Y of the first push element support561and of the first push element56towards the second push element59. The spacing between push elements56and59is thus adjusted, which adjusts the spacing between the driving surfaces49band49b′ of the belts50and50in the adjustment direction Y.

Still in relation to thisFIG. 13, the second transmission mechanism comprises the second rotary transfer member206′. The second transmission mechanism further comprises a second gear207′, with which the second rotary transfer member206′ is in driving engagement, the second gear207′ being integral with a second worm gear209′ extending parallel to the first worm gear209, meaning along the adjustment direction Y. The second push element59has a threaded portion591engaging with the second worm gear209′ such that rotation of the second worm gear209′ causes translational movement of the second push element59along the adjustment direction.

Thus, when a practitioner2causes movement of the second ring201′ by placing the associated rotary control members91′,92′ in the active adjustment configuration, the second ring201′ rotates the second rotary transfer member206′, causing the second worm gear209′ to rotate by means of the second gear207′, resulting in translational movement along the adjustment direction Y of the second push element jointly with the first push element support561, the latter being translationally integral, along the adjustment direction, with the second push element59due to the threaded portion562engaging with the first worm gear209and grooved ring211, guided by the shaft of non-circular cross-section208. Adjustment of the offset along the adjustment direction Y between the axis of rotation23and the axis X2along which the elongate flexible medical member extends at the belts50and51is thus achieved, by jointly moving the first and second push elements56and59along the adjustment direction.

We will now describe a third embodiment of a motive power transfer system according to the invention, with reference toFIGS. 14 and 15.

In this embodiment, the adjustment device comprises two push elements56and59and a single motive power transfer system for both push elements56and59.

As can be seen inFIG. 15, in this third embodiment the mobile unit22has an embedded motor M that is part of the transmission mechanism of the transmission part, for example carried by the mounting43. The problem here lies in bringing the motive power, in the form of electricity, from a power source S integral to the base21to the motor M embedded in a mobile unit22that is rotatable relative to the base21about the axis of rotation23, and achieving this regardless of the relative orientation of the mobile unit22and the base21about the axis23.

According to this third embodiment of the invention, this is done by utilizing a slip ring comprising a first portion302that is part of the control part carried by the base21and connected to an electrical power source S integral with the base21, and a second portion301that is part of the transmission part and connected to the motor M embedded in the mounting43of the mobile unit22.

The first slip ring portion302is movable on the base21relative to the transmission part, between a first position corresponding to the active adjustment configuration in which the first slip ring portion302engages with the second slip ring portion301that is part of the transmission part and connected to the motor M embedded in the mounting43of the mobile unit22, for example via one or more connecting wires311, and a second position corresponding to the inactive configuration in which the first slip ring portion302does not engage with, is apart from, the second slip ring portion301, as shown inFIG. 14.

Additionally or alternatively, it could be arranged that the transition from the active adjustment configuration to the inactive configuration is achieved by opening a switch arranged between the first slip ring portion301and the electrical power source S.

In this third embodiment of the invention, the transmission part of the motive power transfer system comprises a second slip ring portion in the form of a ring301fixedly received in a channel394provided on the peripheral surface37of the housing39. This ring may be slightly flexible so that it can be slightly deformed for threading onto the outer surface37of the housing39at one of its ends36a,36balong the main direction X, and sliding on this outer surface37along the main direction X until it reaches the intended channel394where it fits into place within the groove by elastic recovery.

As can be seen inFIGS. 14 and 15, the ring301has an opening303whose circumferential dimension is at least equal to that of the opening40of the housing39.

The control part of the motive power transfer mechanism according to this third embodiment comprises the first slip ring portion302which, when in the active adjustment configuration, is maintained in sliding contact with the outer surface301bof the second slip ring portion301integral with the mobile unit22. For this purpose, and similarly to what has been described for the rotary control members of the first and second embodiments, the first slip ring portion302has two control members302a,302bspaced apart along the circumference by a distance at least equal to the size of the opening303of the ring301, to ensure that when the first slip ring portion302is in the active adjustment configuration, at least one of the members302a,302bremains in contact with the outer surface301bof the slip ring301regardless of the relative orientation of the mobile unit22and the base21about the axis of rotation23.

In addition, the housing39has a window395which allows connecting the embedded motor M to the inner surface301aof the ring301via one or more connecting wires311.

Thus, in this third embodiment of the invention, starting from the configuration shown inFIG. 14, when a practitioner2wishes to clamp the flexible medical member between the belts50,51by moving the push elements56,59, he or she first causes the first slip ring portion302to transition to the active configuration. In the current case, the practitioner causes the first slip ring portion302to move so that its control members302a,302bcome in contact with the slip ring301. Once this contact is established, the motive power in the form of electrical power coming from the electrical power source S, and possibly other control signals, are transmitted to the embedded motor M via the connecting wires311in continuous contact with the slip ring301regardless of the relative orientation of the mobile unit22and the base21.

Referring toFIG. 15, in this third embodiment of the invention, the transmission part of the motive power transfer system when in the active adjustment configuration as illustrated inFIG. 15, is adapted to move, during a first portion of the actuating stroke, the first push element56towards the second push element59in order to adjust the spacing between the driving surfaces49b,49b′ of each of the belts50and51along the adjustment direction Y, and to move jointly, during a second portion of the actuating stroke which follows the first portion, the first and second push elements56,59along the adjustment direction Y in order to adjust the offset between the axis of rotation23of the mobile unit22relative to the base21and the axis along which the elongate flexible medical member6extends between the belts50and51.

Thus, and as can be seen schematically inFIG. 15, the transmission part of the motive power transfer system according to the third embodiment of the invention comprises, in addition to the embedded motor M, wires311, and slip ring301, a rotary transfer member312provided at the output shaft of the embedded motor M and engaging with a gear313integral with a worm gear314extending in the adjustment direction Y. The first push element56is provided with a threaded portion562engaging with the worm gear314such that rotation of the worm gear about its axis extending in the adjustment direction Y causes translational movement of the first push element56along this adjustment direction Y.

Thus, when the embedded motor M is supplied with power, it rotates the rotary transfer member312which causes the worm gear314to rotate about its axis. In this first actuating stroke, the first push element56is moved toward the second push element59by the engagement of the threaded portion562with the worm gear314, until the elongate flexible medical6is gripped between the belts50,51. The spacing between the belts50,51is thus adjusted to the diameter of the elongate flexible medical member6to be driven, thus clamping this member6, for example with a predetermined force calibrated by means of an elastic member such as a spring (not shown) extending in the adjustment direction Y between the second push element59and the tensioner61.

Then, while continuing the rotation of the embedded motor in the same direction of rotation, in a second portion of the actuating stroke which follows the first, the first push element56is driven translationally along the adjustment direction Y, in the same direction as during the first actuating stroke, and pushes against the second push element59through the belts50,51and the elongate flexible medical member6gripped between these belts50,51, which causes the joint movement of the second push element59along the adjustment direction Y so as to adjust the offset between the axis of rotation23of the mobile unit22relative to the base21and the axis along which the elongate flexible member medical6extends between the belts50and51.

Throughout the above description of the invention, the driving engagement of rotary members having respective perpendicular axes of rotation may be achieved by means of drive transfer elements known to the skilled person, in particular right-angle elements, such as bevel gears, tapered friction rollers, or other such elements.

Furthermore, the engaging contact surfaces driving these various rotary members may be provided with corresponding teeth and/or coatings suitable for facilitating the driving engagement of these rotary elements.