CATHETER ROBOT

Disclosed is a catheter robot including: a base supporting at least three catheter translation modules, each module including a pair of movable pads: the pads of a pair at least partly facing each other, the pair clamping therebetween a flexible elongated medical element to then translate longitudinally the such element, the catheter translation modules being successively longitudinally disposed so that: first module has its pairs of pads performing a longitudinal translation of a first flexible elongated medical element which is a catheter guide, second catheter translation module: can translate longitudinally with respect to the first module, its pairs of pads performing a longitudinal translation of a second flexible elongated medical element, third catheter translation module: can translate longitudinally with respect to the first catheter translation module, its pair of pads performing a longitudinal translation of the second flexible elongated medical element or a third flexible elongated medical element.

FIELD OF THE INVENTION

The invention relates to the technical field of catheter robots, and especially to the technical field of catheter robots including several flexible elongated medical elements.

BACKGROUND OF THE INVENTION

A catheter robot has to perform translations of several flexible elongated medical elements. Those flexible elongated medical elements can include a catheter guide partially surrounding a catheter itself partially surrounding a guide of a catheter. Those translations have to be independent from one another, since those flexible elongated medical elements have to move independently from one another, at least sometimes. However, at some other times, at least some of those flexible elongated medical elements may have to move synchronously with one another.

According to a prior art, each flexible elongated medical element is translated by a translation device, most often one or more pairs of rollers, sometimes a pair of pads facing each other and clamping this flexible elongated medical element in between.

Therefore, when those flexible elongated medical elements have to move independently from one another, each translation device performs translation motion of its associated flexible elongated medical element independently from one another translation device.

However, when those flexible elongated medical elements have to move synchronously from one another, which means not necessarily the same translation moves, but at least different translation moves which have to be synchronized together, each translation device performs translation motion of its associated flexible elongated medical element while trying and synchronizing this translation motion with the other translation motions performed by the other translation devices for the other flexible elongated medical elements.

This prior art presents an inconvenient of needing to synchronize two or three, or even more, translation motions respectively of two or three, or even more, translation devices, what can become rather complex, especially when some of these translation motions are triggered by specific variable inputs of user, including variations of speed and directions.

SUMMARY OF THE INVENTION

The object of the present invention is to alleviate at least partly the above-mentioned drawbacks.

More particularly, the invention aims at providing for a global translation system which can have a good compromise between simplicity and efficiency, not only in situations when one or more flexible elongated medical elements have to translate independently from each other or from one another, but also when one or more flexible elongated medical elements have to translate in synchronization with each other or with one another.

According to the invention, this problem, in case of those flexible elongated medical elements needing to move synchronously with one another, is solved by splitting the translation motion into two parts:a first part of “synchronized” translation motion where one or more translation devices translate themselves, as complete devices, i.e. as sliding supports, to match the synchronization with another translation motion of another flexible elongated medical device with which synchronization is to be done,while a second part of translation motion, matches the specific user inputs, by performing corresponding relative translation(s) of one or more flexible elongated medical elements with respect to their own one or more translation devices, so as to take into account, besides the needed synchronization between translation devices, the specific additional user inputs, still different, at least possibly, for each flexible elongated medical element.

According to the invention, in some cases, the translation motion, of at least some of the flexible elongated medical elements, can be performed by two different manners:either by translating the translation device itself, with no relative translation between this translation device and its associated flexible elongated medical element,this first translation motion corresponding to the need of synchronization with the translation motion of another associated flexible elongated medical element of another translation device,and/or by translating this associated flexible elongated medical element relatively to its associated translation device,this second translation motion corresponding to the specific variable user input corresponding to the specific translation wanted by the user.

According to the invention, these separate and independent translation devices, being able to translate relatively to each other, at least for some of them, will be therefore called translation modules, for all of them. These separate and independent translation devices also have each an internal translation mechanism able to translate their respectively associated flexible elongated medical elements, without translating themselves, while remaining themselves stationary with respect to the base, i.e. to the body of the catheter robot.

This object is achieved with a catheter robot comprising: a base, at least 3 catheter translation modules supported by said base, each catheter translation module comprising at least one pair of movable pads: said pads of a same pair at least partly facing each other, said pair clamping between its pads a flexible elongated medical element so as to then translate longitudinally said flexible elongated medical element, said catheter translation modules being successively longitudinally disposed so that: first catheter translation module has its pair of pads performing a longitudinal translation of a first flexible elongated medical element which is a catheter guide, second catheter translation module: can translate longitudinally with respect to said first catheter translation module, its pair of pads performing a longitudinal translation of a second flexible elongated medical element which could be a catheter, preferably a catheter balloon or a catheter stent or a microcatheter, third catheter translation module: can translate longitudinally with respect to said first catheter translation module, its pair of pads performing a longitudinal translation of the second flexible elongated medical element or a third flexible elongated medical element which could be a guide of catheter.

This object may also be achieved with a catheter robot comprising: a base, at least 3 catheter translation modules supported by said base, each catheter translation module comprising an internal translation mechanism structured and disposed so as to translate longitudinally a flexible elongated medical element, said catheter translation modules being successively longitudinally disposed so that: first catheter translation module has its internal translation mechanism performing a longitudinal translation of a first flexible elongated medical element which is a catheter guide, second catheter translation module: can translate longitudinally with respect to said first catheter translation module, its internal translation mechanism performing a longitudinal translation of a second flexible elongated medical element which could be a catheter, preferably a catheter balloon or a catheter stent or a microcatheter, third catheter translation module: can translate longitudinally with respect to said first catheter translation module, its internal translation mechanism performing a longitudinal translation of the second flexible elongated medical element or a third flexible elongated medical element which could be a guide of catheter.

Preferably, not only translation motion can be freely and independently imparted to all flexible elongated medical elements, but also rotation motion, all the more than the specific internal translation structure of the translation modules, can also allow for imparting rotation move too of its associated flexible elongated medical element.

Preferred embodiments comprise one or more of the following features, which can be taken separately or together, either in partial combination or in full combination.

Preferably, the catheter robot comprises a control unit configured for commanding the translation of the second catheter translation module by following the translation of the first flexible elongated medical element, and for controlling the translation of the second flexible elongated medical element by compensating the translation of the second catheter translation module so as to maintain the second flexible elongated medical element stationary with respect to said base.

Hence, when a flexible elongated medical element is translated by a translation module, and when the translation module of another flexible elongated medical element follows this translation, so as to always keep a certain distance with this former translation module, and so as to avoid collision between translation modules, and when at the same time, this another flexible elongated medical element does not need to be translated, then this another flexible elongated medical element can be still kept at the same location, by imparting to him two opposite translation motions which compensate exactly for each other, the translation motion of its associated translation module in a first direction and the relative translation motion of this another flexible elongated medical element with respect to its associated translation module in a second direction, parallel and opposite to the first direction, both translation motions having equal intensities.

Preferably, said catheter translation modules are all structurally identical.

Hence, not only can translation motion of all flexible elongated medical elements be performed independently, but also this independence can be obtained with a rather simple and cheap system, by making this system fully modular.

Preferably, said catheter translation modules are successively longitudinally spaced apart from one another.

Hence, this leads to an improved supplementary degree of liberty between flexible elongated medical elements, because thereby these flexible elongated medical elements can perform more easily independent translations moves in both opposite directions of translation line, and with extended translation travels, even in an over the wire configuration.

Preferably, said third catheter translation module can translate longitudinally with respect both to said first catheter translation module and to said second catheter translation module.

Hence, this leads to a supplementary degree of liberty between second and third flexible elongated medical elements, because thereby these flexible elongated medical elements can perform independent translations moves, even in an over the wire configuration.

Preferably, a first Y connector is located between said first and second catheter translation modules, one of Y branches and output of Y being disposed longitudinally, a second Y connector is located between said second and third catheter translation modules, one of Y branches and output of Y being disposed longitudinally.

Hence, other flexible elongated medical elements or materials can be added sideways so as to afterwards translate in parallel to the other flexible elongated medical elements already in line.

Preferably, said guide of catheter translates within said catheter itself translating within said catheter guide, for at least part of their respective lengths.

Hence, this translation modular system can also work with an over the wire configuration.

Preferably, the catheter robot comprises a control unit configured for commanding the translation of the third catheter translation module by following the translation of the second flexible elongated medical element, and for controlling the translation of the third flexible elongated medical element by compensating the translation of the third catheter translation module so as to maintain the third flexible elongated medical element stationary with respect to said base.

Hence, when a flexible elongated medical element is translated by a translation module, and when the translation module of another flexible elongated medical element follows this translation, so as to always keep a certain distance with this former translation module, and so as to avoid collision between translation modules, and when at the same time, this another flexible elongated medical element does not need to be translated, then this another flexible elongated medical element can be still kept at the same location, by imparting to him two opposite translation motions which compensate exactly for each other, the translation motion of its associated translation module in a first direction and the relative translation motion of this another flexible elongated medical element with respect to its associated translation module in a second direction, parallel and opposite to the first direction, both translation motions having equal intensities.

Preferably, said second and third catheter translation modules are fastened together so as to be able to translate longitudinally with respect to said first catheter translation module only jointly.

Hence, the global translation system is made simpler, since two translation modules are linked together so as to translate as if they were a single translation module.

Preferably, said pair of pads of said third catheter translation module are transversely shifted from said pair of pads of said second catheter translation module.

Hence, this translation modular system can also work with a rapid exchange configuration.

Preferably, said pair of pads of said third catheter translation module are transversely shifted from said pair of pads of said second catheter translation module, so that: said guide of catheter and said catheter can translate: parallel to each other over the length extending along said 3 catheter translation modules, along each other for most of the length of said catheter, both within said catheter guide for at least part of their respective lengths, said guide of catheter translating within said catheter for only distal portions of their respective lengths.

Hence, this shift is a simple and efficient way to allow for a rapid exchange configuration, with a simpler structure of the global translation system, since two translation modules are linked together so as to translate as if they were a single translation module.

Preferably, said first catheter translation module is fixed with respect to said base.

Hence, this first catheter translation module can be considered as a “master” translation module, other translation modules being “slave” translation modules when they translate themselves so as to keep synchronization with the translation move of the first flexible elongated medical element associated to this first translation module. Thereby, not only can independence of all flexible elongated medical elements be maintained, but the global translation system is made simpler, since this first translation module can be kept fixed and immobile with respect to the base of the whole catheter robot.

Preferably, said base is an end of an articulated robotic arm.

Hence, this group of three translation modules can be set at any desired position with respect to the patient.

Preferably, said catheter translation modules are successively longitudinally disposed from one another, in an order which is: first then second and then third catheter translation module.

Hence, this is more practical to move independently all flexible elongated medical elements, while keeping the biggest of them with the shorter length.

Preferably, the catheter robot comprises at least 4 catheter translation modules supported by said base, which are successively longitudinally disposed.

Hence, the number and the type of configurations which can be used with the catheter robot of the invention, is richer and broader.

An example of such a catheter robot is a catheter robot where:said first translation module translates a catheter guide,said second translation module translates a catheter,said third translation module translates a micro-catheter,said fourth translation module translates a guide of catheter.

Preferably, the catheter robot comprises at least 5 catheter translation modules supported by said base, which are successively longitudinally disposed, and preferably only 5 catheter translation modules.

Hence, the number and the type of configurations which can be used with the catheter robot of the invention, is richer and broader.

Another example of such a catheter robot is a catheter robot where:said first translation module translates a catheter guide,said second translation module translates a first balloon or stent,said third translation module translates a first guide of catheter,said fourth translation module translates a second balloon or stent,said fifth translation module translates a second guide of catheter.

Preferably, second and third catheter translation modules are configured as rapid exchange catheter translation modules, fourth and fifth catheter translation modules are configured as over the wire catheter translation modules.

Hence, the number and the type of configurations which can be used with the catheter robot of the invention, is richer and broader.

An application for this type of catheter robot could be CTO (Chronical Total Occlusion), where both types of catheters, rapid exchange type and over the wire type, are mixed within a same and single catheter robot.

Preferably, all second to fifth catheter translation modules are configured as over the wire catheter translation modules.

Hence, the number and the type of configurations which can be used with the catheter robot of the invention, is richer and broader.

Preferably, each catheter translation module is also a catheter rotation module: alternatively, each pair clamping between its facing pads a flexible elongated medical element so as to then rotate around longitudinal axis said flexible elongated medical element, by making said flexible elongated medical element rolling between its facing pads.

Hence, not only translation motion can be freely and independently imparted to all flexible elongated medical elements, but also rotation motion, all the more than the specific structure of the translation modules, with a pair of pads facing each other and clamping its associated flexible elongated medical element, allows for imparting rotation move too of its associated flexible elongated medical element.

Further features and advantages of the invention will appear from the following description of embodiments of the invention, given as non-limiting examples, with reference to the accompanying drawings listed hereunder.

According to an embodiment of the invention, the catheter robot comprises: a base, at least 3 catheter translation modules supported by said base, each catheter translation module comprising two pairs of movable pads: said pads of a same pair at least partly facing each other, alternatively, each of said two pairs clamping between its pads a flexible elongated medical element so as to then translate longitudinally said flexible elongated medical element, said catheter translation modules being successively longitudinally disposed so that: first catheter translation module has its pairs of pads performing a longitudinal translation of a first flexible elongated medical element which is a catheter guide, second catheter translation module: can translate longitudinally with respect to said first catheter translation module, its pairs of pads performing a longitudinal translation of a second flexible elongated medical element which is a catheter, preferably a catheter balloon or a catheter stent, third catheter translation module: can translate longitudinally with respect to said first catheter translation module, its pairs of pads performing a longitudinal translation of a third flexible elongated medical element which is a guide of said catheter.

DETAILED DESCRIPTION OF THE INVENTION

In the vascular field, there are mainly two types of catheter configurations, which are first the over the wire (OTW) catheter configuration and second the rapid exchange (REX) catheter configuration.

FIG.1shows schematically an over the wire configuration of flexible elongated medical elements, with a manual control.

A first hand51of practitioner is manipulating a catheter12, and especially translating the catheter12along its own axis. A second hand52of practitioner is manipulating a guide13of catheter, and especially translating the guide13of catheter along its own axis. The catheter12surrounds the guide13of catheter on part of its length, the catheter12being shorter than the guide13of catheter. The guide13of catheter can slide within the catheter12. Guide13of catheter and catheter12are coaxial. First hand51can translate catheter12forward and backward. Second hand52can translate guide13of catheter forward and backward. First hand51can translate catheter12independently from second hand52translating guide13of catheter. Catheter12and guide13of catheter are both inserted within patient, and more precisely within a vein50or an artery50of patient.

The main difference lies in the handling. In the case of an OTW assembly, if the practitioner wishes to move the catheter12back, then the second hand52which handles the guidewire13has also to move back, because the grip area available on the guidewire13has been reduced by the retraction length of the catheter12. If the practitioner wants to remove the catheter12without changing the position of the guidewire13in the vein50or artery50of the patient, what is indeed a rather frequent case in intervention, it is needed to have a guidewire13at least twice as long as the catheter12, so that at any time a guidewire13portion is accessible to the practitioner's hand, upstream or downstream of the catheter12, in order to hold the guidewire13and prevent it from moving in the vein50or artery50of the patient.

FIG.2shows schematically a rapid exchange configuration of flexible elongated medical elements, with a manual control. Rapid exchange configuration distinguishes mainly from over the wire configuration by the fact that the coaxial part16of the catheter14and of the guide15of the catheter is very short, and in practice is often limited to a few centimeters at distal end of catheter14. Throughout the rest of its length, the guidewire15, which is the guide15of catheter14, is therefore outside, parallel to the catheter14.

A first hand51of practitioner is manipulating a catheter14, and especially translating the catheter14along its own axis. A second hand52of practitioner is manipulating a guide15of catheter, and especially translating the guide15of catheter along its own axis. The catheter14surrounds the guide15of catheter on a very short part16of its length, this very short part16being located at distal end of catheter14. On most of their respective lengths, catheter14and guide15of catheter are outside from each other, and parallel to each other. The guide15of catheter can slide within very short part16of catheter14. Guide15of catheter and catheter14are coaxial only within very short part16. First hand51can translate catheter14forward and backward. Second hand52can translate guide15of catheter forward and backward. First hand51can translate catheter14independently from second hand52translating guide15of catheter. Catheter14and guide15of catheter are both inserted within patient, and more precisely within a vein50or an artery50of patient.

In contrast, the rapid exchange configuration (also called quick exchange configuration) allows for the guidewire15and for the catheter14to be manipulated without interference between each other, and the hands51and52can stay in the same place, assuming that translation is performed using small repeated steps. For example, push the flexible elongated medical element, either guidewire15or catheter14, by a small distance, for example by 1 cm, from proximal position to distal position, i.e. from right to left taking the disposition ofFIG.2into account, release it, replace the fingers of the hands51and52at their original position, grip the flexible elongated medical element, either guidewire15or catheter14, again and repeat the same steps of this cycle several times. In this way, if those 1 cm back and forth movements are neglected, the average positions of the hands51and52remain rather unchanged. This manipulating principle has been used in a robotic module a described in the patent application FR3022147 (hereby incorporated by reference), with the same assignee as present patent application.

FIG.3shows schematically a specific problem happening in an over the wire configuration of flexible elongated medical elements, with a manual control.

Even if the second hand52manipulating the guidewire13could be placed farther from the proximal end (convention: proximal=close to the physician/distal=close to the patient) of the catheter12, pushing the guidewire13from that distance would cause the guidewire13to bend rather than to translate inside the catheter12. This can be seen onFIG.3, with the bending130of the guidewire13.

Because of their respective strengths and weaknesses, these two solutions are rather dedicated respectively to specific applications. In interventional cardiology, the catheters14used are mainly REX. In interventional radiology, for instance lower and upper limbs, neurology, etc., OTW catheters12are, on the contrary, generally preferred.

To be able to build a robot that handle both OTW and REX catheters, following features are interesting:the considered translation module, which can translate and/or rotate a flexible elongated medical element (a guidewire, a balloon, a stent, etc.), should be able to reproduce the function of a hand51or52as shown on bothFIGS.1and2.the considered translation module should be duplicated according to the number of flexible elongated medical elements manipulated. For example, to robotize the manipulation performed on eitherFIG.1or onFIG.2, two such translation modules would be needed.The considered translation module should be located at the most possible distal position in order to avoid the negative effect shown onFIG.3.

For two rapid exchange flexible elongated medical elements, the two corresponding translation modules should be fixed, relatively to the patient and relatively to the base of the catheter robot.

For two over the wire flexible elongated medical elements, the catheter translation module should be fixed relatively to the patient and relatively to the base of the catheter robot, whereas the guidewire translation module should move back and forth in order to follow the translation motion of the catheter.

Therefore, designing a catheter robot for the manipulation of REX flexible elongated medical elements should not seem, at first sight, to lead to the same architecture as a robot for OTW flexible elongated medical elements.

One purpose of embodiments of the invention is to try and provide for, if not a unique architecture, or at least very close and quite similar architectures, which can accommodate either OTW or REX flexible elongated medical elements. Two embodiments families can exist, within which either the same robot can manipulate both types of flexible elongated medical elements, or the same technology is implemented in two slightly different catheter robots.

FIG.4shows schematically an example of a first embodiment of a catheter robot according to the invention, with an application to an over the wire configuration of flexible elongated medical elements.

Over part of their respective lengths, catheter guide11surrounds catheter12which itself surrounds guide13of catheter. Guide of catheter13can slide within catheter12which itself can slide within catheter guide11.

Three translation modules1,2and3are successively disposed space apart from one another.

First translation module1can translate catheter guide11forward and backward, along its own axis, by two pairs of two movable pads20respectively facing each other and alternatively clamping catheter guide11in order to translate it. The cooperation of these two pairs of two movable pads20respectively facing each other and alternatively clamping catheter guide11in order to translate it, and which can also rotate this catheter guide11, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application. First translation module is fixed and immobile with respect to base40of catheter robot.

Second translation module2can translate catheter12forward and backward, along its own axis, by two pairs of two movable pads22respectively facing each other and alternatively clamping catheter12in order to translate it. The cooperation of these two pairs of two movable pads22respectively facing each other and alternatively clamping catheter12in order to translate it, and which can also rotate this catheter12, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application.

Second translation module2can also translate catheter12forward and backward, along its own axis, by translating itself, i.e. the whole second translation module2, on a sliding device42, which is for example a carrier on wheels or a slider in a rail, in order to follow translation of catheter guide11. In that case, the two pairs of two movable pads22can either add another translation of catheter12with respect to first translation module1, or compensate for translation of catheter12coming from the translation of the whole second translation module2on its sliding device42in order to maintain catheter12stationary with respect to first translation module1and base40of catheter robot.

Third translation module3can translate guide of catheter13forward and backward, along its own axis, by two pairs of two movable pads23respectively facing each other and alternatively clamping guide of catheter13in order to translate it. The cooperation of these two pairs of two movable pads23respectively facing each other and alternatively clamping guide of catheter13in order to translate it, and which can also rotate this guide of catheter13, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application.

Third translation module3can also translate guide of catheter13forward and backward, along its own axis, by translating itself, i.e. the whole third translation module3, on a sliding device43, which is for example a carrier on wheels or a slider in a rail, in order to follow translation of catheter12. In that case, the two pairs of two movable pads23can either add another translation of guide of catheter13with respect to second translation module2and to base40, or compensate for translation of guide of catheter13coming from the translation of the whole third translation module3on its sliding device43in order to maintain guide of catheter13stationary with respect to second translation module2and to base40of catheter robot.

The two pairs of two movable pads20are aligned with the two pairs of two movable pads22which in turn are aligned with the two pairs of two movable pads23.

A first Y connector or valve31is inserted between first translation module1and second translation module2. The first Y connector31is fixed to the proximal end of the catheter guide11and is fixed to the distal end of the second translation module2. Catheter12surrounding guide13of catheter is inserted within first input312of first Y connector31and comes out of output311of first Y connector31. Output311and first input312of first Y connector31are aligned with common axis of catheter12and guide13of catheter. A second input313of first Y connector31, disposed at an angle of this common axis of catheter12and guide13of catheter, for example at 30° or at 45°.

A second Y connector or valve32is inserted between second translation module2and third translation module3. The second Y connector32is fixed to the proximal end of the catheter12and is fixed to the distal end of the third translation module3. Guide13of catheter is inserted within first input322of second Y connector32and comes out of output321of second Y connector32. Output321and first input322of second Y connector32are aligned with axis of guide13of catheter. A second input323of second Y connector32, disposed at an angle of this axis of guide13of catheter, for example at 30° or at 45°.

In a working embodiment, when the pads20of the first translation module1move in order to translate the catheter guide11, the second translation module2and the third translation module3have to be translated by the same amount along the common axis of the catheter12and of the guide13of catheter. When the pads22of the second translation module2move in order to translate the catheter12, the third translation module3has to be translated by the same amount along the common axis of the catheter12and of the guide13of catheter. This ensures that all movable translation modules, i.e. second translation module2and third translation module3, will be always located at their respective most possible distal positions, and thus will allow to avoid the negative bending effect of guide13of catheter shown onFIG.3.

Another solution, to avoid this negative bending effect of guide13of catheter or (here) guidewire13, could be thought of. It would consist in allowing for the considered translation module not to be at the most possible distal position and providing for a guiding channel between this translation module and the closest more distal device (for example, the closest more distal device to the guidewire13is the Y valve32and then the catheter12). Such devices can be used in other catheter robots, including for example a flexible track, as described in detail for example in the patent application US2018193603. In this case, a guidewire13is pushed from its proximal end by a catheter robot, and this flexible track avoids any bending of this guidewire13in its portion located between the catheter robot and the introducer (which is, in this case, the closest more distal device). This flexible track plays the role of a king of “guiding tunnel” with a variable length. This variable length is then needed to accommodate for the variable distance between the manipulation location of a manipulated flexible elongated medical element, i.e. the location of the translation modules that manipulate it, and the position where the manipulated flexible elongated medical element is coaxially inserted into another flexible elongated medical element.

FIG.6toFIG.8illustrates embodiments wherein the catheter translation modules1,2,3comprises one pair of movable pads20. First translation module1comprises only one pair of pads20for translating and rotating catheter guide11. First translation module1could also comprises a clamp29for clamping catheter guide11, for example when the catheter guide11is released by the pair of pads20. Second translation module2comprises one pair of pads20for translating and rotating a second elongated medical element, and a clamp29for clamping said second elongated medical element. Third translation module3comprises one pair of pads20for translating and rotating a second elongated medical element or a third elongated medical element, and a clamp29for clamping said second or third elongated medical element. Pair of pads20is similar to the pair of pads described in previous embodiments. By using only one pair of pads20the catheter robot is more compact.

FIG.6illustrates an embodiment wherein the catheter robot is in “over the wire” (or coaxial) configuration. In this configuration, the first translation module1drives a catheter guide11, the second translation module2drives a microcatheter121that is coaxial to catheter guide11, and the third translation module3drives a guidewire13that is coaxial to microcatheter121and catheter guide11. In configuration ofFIG.6, second translation module2and third translation module3are separated and mobile relative to each other.

FIG.7illustrates an embodiment wherein the catheter robot is in “rapid exchange” configuration. In this configuration, the first translation module1drives a catheter guide11, the second translation module2drives a catheter12inserted inside catheter guide11, which can be a balloon catheter or a stent catheter, and the third translation module3drives a guidewire13that is inserted inside catheter12. In configuration ofFIG.7, second translation module2and third translation module3are connected and move relatively to first translation module1together.

FIG.8illustrates an embodiment wherein the second translation module2and the third translation module3drive the same elongated medical element, for example a guidewire13. Such embodiment is advantageous when a smooth and fast drive is needed. In configuration ofFIG.8, second translation module2and third translation module3are connected and move relatively to first translation module1together.

The catheter robot could switch from the configuration ofFIGS.6to8by connecting or separating second translation module2and third translation module3. Besides the pair of pads20and clamp29of the second translation module and/or third translation module3can move in order to be coaxial to pair of pads20of first translation module1or to be axially shifted from said pair of pads20of first translation module1.

The benefit of some embodiments of the invention is, among others, to avoid this flexible track, or any other equivalent burdensome solution, because this flexible track is necessarily part of the consumable, and as such, it adds complexity to the consumable. This can lead to, for instance, reduced usability, including risk of manipulation errors, risk of reduced reliability, higher cost . . . .

Embodiments of the invention described here solve this problem, because the push movement, i.e. translation from a proximal to a distal position, is done at a place where the flexible elongated medical element enters another flexible elongated medical element (as explained above), the said other flexible elongated medical element acting as a guiding channel, and thus suppressing the need for this burdensome flexible track or any other added equivalent burdensome mechanism. This has been made possible, because the translation is obtained using the internal mechanism of the translation module (using for instance small repeated steps as described in patent application FR3022147, hereby incorporated by reference). This is different from the principle used in patent application US2018193603, where the proximal end of a flexible elongated medical element (in this case a guidewire for example) is attached to a translation module, and then the whole translation motion performed by the translation module is used to generate the same translation of the flexible elongated medical element.

Indeed, embodiments of the invention can avoid using a burdensome flexible track (or any equivalent burdensome guiding principle), thanks to the combination of both:First, placing the translation module at the most distal position possible, so that the flexible elongated medical element going out of the translation module from its distal end directly enters coaxially in another flexible elongated medical element (a catheter with a higher diameter, a Y valve, an introducer, etc.), this another flexible elongated medical element acting as a guiding channel,and second, ensuring the motion of the flexible elongated medical element using the internal mechanisms of the translation module, where the flexible elongated medical element moves relatively to the translation module rather than performing a global motion of the translation module where the flexible elongated medical element and the translation module would be linked together and thus would be compelled to move together at exactly the same speed.

The architecture shown inFIG.4includes a total of 3 translation modules1,2and3, robotically translating3flexible elongated medical elements,11,12and13. However, in some cases, it may be desirable to use even more flexible elongated medical elements. The architecture disclosed onFIG.4can be extrapolated to a four translation modules architecture or even more. The most distal module is fixed relatively to the patient, or more precisely to the patient bed, whereas all other modules can be translated along the axis of the flexible elongated medical elements.

FIG.5shows schematically an example of a second embodiment of a catheter robot according to the invention, with an application to a rapid exchange configuration of flexible elongated medical elements.

Over a very short part16of catheter14length, catheter guide11surrounds catheter14which itself surrounds guide15of catheter. Guide of catheter15can slide within catheter14which itself can slide within catheter guide11, over this very short part16of catheter14.

Three translation modules1,2and3are successively disposed space apart from one another.

First translation module1can translate catheter guide11forward and backward, along its own axis, by two pairs of two movable pads20respectively facing each other and alternatively clamping catheter guide11in order to translate it. The cooperation of these two pairs of two movable pads20respectively facing each other and alternatively clamping catheter guide11in order to translate it, and which can also rotate this catheter guide11, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application. First translation module is fixed and immobile with respect to base40of catheter robot.

Second translation module2can translate catheter14forward and backward, along its own axis, by two pairs of two movable pads24respectively facing each other and alternatively clamping catheter14in order to translate it. The cooperation of these two pairs of two movable pads24respectively facing each other and alternatively clamping catheter14in order to translate it, and which can also rotate this catheter14, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application.

Third translation module3can translate guide of catheter15forward and backward, along its own axis, by two pairs of two movable pads25respectively facing each other and alternatively clamping guide of catheter15in order to translate it. The cooperation of these two pairs of two movable pads25respectively facing each other and alternatively clamping guide of catheter15in order to translate it, and which can also rotate this guide of catheter15, is described in more detail in patent application EP 15733825 (hereby incorporated by reference) belonging to the same assignee as present patent application. Except on very short part16, where catheter14and guide15of catheter are coaxial with each other, catheter14and guide15of catheter are outside from each other and parallel to each other. Therefore, the two pairs of two movable pads24are transversely shifted from the two pairs of two movable pads25.

Second translation module2and third translation module3are solidarized with each other and can only translate themselves together with complete synchronization to each other. Indeed, both second translation module2and third translation module3can translate themselves together on a common sliding device44, which is for example a carrier on wheels or a slider in a rail, in order to follow translation of catheter guide11. Second translation module2and third translation module3can also translate respectively catheter14and guide15of catheter forward and backward, along their own respective axis, by translating themselves together.

In that case, the two pairs of two movable pads24can either add another translation of catheter14with respect to first translation module1, or compensate for translation of catheter14coming from the translation of both second translation module2and third translation module on their common sliding device44, in order to maintain catheter14stationary with respect to first translation module1and base40of catheter robot.

In that case, the two pairs of two movable pads25can either add another translation of guide15of catheter with respect to first translation module1, or compensate for translation of guide15of catheter coming from the translation of the both second translation module2and third translation module3on their common sliding device44in order to maintain guide15of catheter stationary with respect to first translation module1and base40of catheter robot.

A first Y connector or valve31is inserted between first translation module1and second translation module2linked to third translation module3. First Y connector31is fixed to the proximal end of the catheter guide11and is fixed to the distal end of the second translation module2. Catheter14and guide13of catheter parallel to each other, are inserted within first input312of first Y connector31and comes out of output311of first Y connector31. Output311and first input312of first Y connector31are aligned with common axis of catheter14and guide15of catheter. A second input313of first Y connector31, disposed at an angle of the two parallel axes respectively of catheter14and guide15of catheter, for example at 30° or at 45°.

The invention has been described with reference to preferred embodiments. However, many variations are possible within the scope of the invention.