A catheter winder/unwinder comprising at least a first system and a second system is disclosed wherein, the first system comprises a first receptacle that receives a catheter and a first drive mechanism that applies movement to the catheter, the second system comprising a second receptacle that receives a guide and including an outlet, said second receptacle being rotatable relative to the first receptacle, and a second drive mechanism that applies movement to the guide. The outlet includes a fastener device for fastening to the catheter.
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19. A catheter winder/unwinder comprising a base adapted to receive a tubular an elongate member for inserting into a duct of a patient and extending between a first end and a second end along a longitudinal direction of the member, and a drive mechanism adapted to apply to said tubular elongate member at least movement along said longitudinal direction, said drive mechanism comprising:
a rotation ring gear mounted on the base;
a translation ring gear mounted on the base;
a plate having a top face adapted to carry the elongate member and an opposed bottom face, wherein the plate is mounted to rotate relative to the base about said longitudinal direction under actuation through the rotation ring gear;
an application portion mounted to move on the plate, in contact with the elongate member, wherein the application portion comprises at least one drive wheel disposed on the top face of the plate, and at least one corresponding gear wheel disposed on the bottom face of the plate;
a wormscrew movement transfer system mounted on the plate, driven by the translation ring gear, and adapted to drive said application portion at least one drive wheels through said corresponding at least one gear wheel so that said application portion at least one drive wheels moves on the plate so as to apply said movement to the tubular elongate member along the longitudinal direction; and
an electric motoring device adapted to drive the wormscrew movement transfer system through the translation ring gear.
1. A catheter winder/unwinder comprising at least a first system and a second system,
the first system comprising:
a first receptacle adapted to receive a first elongate tubular hollow member for inserting into a duct of a patient and extending between a first end and a second end along a longitudinal direction of the first member;
said first receptacle including an opening formed to allow said first member to pass towards the outside of the first system;
a first drive mechanism adapted to apply movement to the first member through said opening relative to said first receptacle;
the second system comprising:
a second receptacle adapted to receive a second elongate tubular member for inserting into the duct and extending between a first end and a second end along a longitudinal direction of the second member;
said second receptacle having an outlet formed to allow the second member to pass to the outside of the second system and towards the inside of the first system;
said second receptacle being mounted to rotate relative to the first receptacle drive mechanism about an axis of rotation;
a second drive mechanism adapted to apply to the second member at least movement along said longitudinal direction of the second member relative to said second receptacle;
said outlet including a fastener device for fastening to the first member and adapted to enable the first member and the second receptacle to move together along the longitudinal direction of the first member.
15. A system including an exchangeable elongate tubular member, and a catheter winder/unwinder comprising a receptacle adapted to receive an said elongate tubular member for insertion into a duct of a patient and extending between a first end and a second end along a longitudinal direction;
the receptacle having an opening formed to allow said elongate tubular member to pass to the outside;
the winder/unwinder further comprising a drive mechanism adapted to apply to the elongate tubular member movement through said opening relative to said receptacle, said drive mechanism comprising:
an equipment mounted to move relative to the receptacle in a first degree of freedom, the equipment carrying the elongate tubular member; and
an electric motoring device adapted to generate movement when powered electrically;
said electric motoring device being adapted to generate relative movement between the equipment and the receptacle in the first degree of freedom so as to generate relative movement of the elongate tubular member and of the receptacle in said first degree of freedom;
the elongate tubular member being mounted to move relative to the equipment in a second degree of freedom distinct from the first degree of freedom;
said electric motoring device being adapted to generate relative movement of the equipment and of the elongate tubular member in the second degree of freedom in order to generate relative movement of the elongate tubular member and of the receptacle in said second degree of freedom;
said electric motoring device comprising at least an electric motor, said electric motoring device comprising at least one movement transfer element connected to one of said electric motors to transmit said relative movement of the elongate tubular member and the equipment in the second degree of freedom from said electric motor;
the installation system comprising a permanent portion comprising said electric motors, and a utilized replaceable portion, distinct from said elongate tubular member, mounted removably relative to the permanent portion, the permanent portion and the replaceable portion in an assembled state together forming said winder/unwinder, the installation system having a plurality of replaceable replacement portions that are identical to the utilized replacement portion.
2. A catheter winder/unwinder according to
wherein the second receptacle presents a bottom adapted to receive said elongate guide, and at least a second guide surface co-operating with said first guide surface of the first receptacle to guide the relative movement of the first and second receptacles about said axis of rotation.
3. A catheter winder/unwinder according to
movement in translation along said longitudinal direction of the first member; and
movement in rotation about said longitudinal direction of the first member.
4. A catheter winder/unwinder according to
movement in translation along said longitudinal direction of the second member; and/or
movement in rotation about said longitudinal direction of the second member.
5. A catheter winder/unwinder according to
6. A catheter winder/unwinder according to
7. A catheter winder/unwinder according to
the first end of the guide passing through said outlet to the inside of the catheter.
8. A catheter winder/unwinder according to
9. A catheter winder/unwinder according to
10. A catheter winder/unwinder according to
11. A catheter winder/unwinder according to
a third receptacle adapted to receive a third elongate tubular member for inserting in the duct and extending between a first end and a second end along a longitudinal direction of the third member;
said third receptacle including an outlet formed to allow the third member to pass therethrough;
said third receptacle being mounted to rotate relative to the second receptacle about said axis of rotation;
a third drive mechanism adapted to apply to the third member at least movement through said outlet of the third receptacle along said longitudinal direction of the third member relative to said third receptacle;
the outlet of the third receptacle including a fastener device for fastening to the second member and adapted for the second member and the third receptacle to move together along the longitudinal direction of the second member.
12. A catheter winder/unwinder according to
a third receptacle adapted to receive a third elongate tubular member for inserting in the duct and extending between a first end and a second end along a longitudinal direction of the third member;
said third receptacle including an outlet formed to allow the third member to pass therethrough;
said third receptacle being mounted to rotate relative to the first receptacle about said axis of rotation;
a third drive mechanism adapted to apply to the third member at least movement through said outlet of the third receptacle along said longitudinal direction of the third member relative to said third receptacle;
the outlet of the third receptacle including a fastener device for fastening to the first member and adapted to enable the first member and the third receptacle to move together along the longitudinal direction of the first member.
13. A catheter winder/unwinder according to
14. A catheter winder/unwinder according to
16. A system according to
17. A system according to
18. A system according to
0. 20. A system according to claim 15, wherein the winder/unwinder comprises a plate having a bottom portion comprising drive shafts, and being part of the permanent portion, and having a top portion, part of the replaceable portion, and having wheels applying movement to the elongate tubular member and engaged by respective drive shafts.
0. 21. A catheter winder/unwinder according to claim 19, wherein the movement transfer system comprises a wormscrew.
0. 22. A catheter winder/unwinder according to claim 21, wherein the wormscrew is mounted to rotate on the plate in two bearings.
0. 23. A catheter winder/unwinder according to claim 19, wherein the movement transfer system receives drive via an intermediate gear intermediate between the movement transfer system and the translation ring gear.
0. 24. A catheter winder/unwinder according to claim 19, wherein the application portion comprises at least two drive wheels disposed on the top face of the plate, and at least two corresponding gear wheels disposed on the bottom face of the plate.
0. 25. A catheter winder/unwinder according to claim 19, wherein the application portion comprises a non-motor driven wheel disposed on the top face, in contact with the elongate member.
0. 26. A catheter winder/unwinder according to claim 25, further comprising an adjustment mechanism to adapt to catheters of different diameters.
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The present invention relates to catheter winders/unwinders and to arteriography systems provided with such winders/unwinders.
Manual introduction of catheters or guides into the inside of the body of a patient, performed by a practitioner, e g in order to perform an arteriography, is unsatisfactory since it is generally carried out under X-rays in order to allow the practitioner to view the displacement of the end of the catheter inside the patient's body while it is being inserted This results in the practitioner being irradiated, and although not more harmful per se than the patient being irradiated, this constitutes a difficulty since the practitioner is liable to repeat the operation on numerous patients, thus leading to exposure to considerable doses of X-rays.
Consequently, it would be desirable to have means for automating and remotely controlling such arteriography via a controller; thereby enabling the practitioner to guide the insertion of the catheter into the patient's body remotely.
Document WO 2005/000105 describes numerous examples of such controllers Nevertheless, a problem remains with all of those embodiments. During insertion, the portions of the various catheters or guides that have not yet been inserted need to be kept in a suitable liquid medium to prevent them from becoming contaminated by external elements, and that is not made possible by any of the embodiments described in that document
To this end, the invention provides a catheter winder/unwinder comprising at least a first system and a second system,
the first system comprising:
said first receptacle including an opening formed to allow said first member to pass towards the outside of the first system;
the second system comprising:
said second receptacle having an outlet formed to allow the second member to pass to the outside of the second system and towards the inside of the first system;
said outlet including a fastener device for fastening to the first member and adapted to enable the first member and the second receptacle to move together along the longitudinal direction of the first member.
By means of these dispositions, a catheter winder/unwinder is obtained that is in the form of receptacles capable of containing both the preservation liquid and the catheters in question Furthermore, the assembly is made in a manner that is compact and that can be provided in the form of consumables. Construction around a single axis of rotation also makes a modular arrangement possible, thus making it easy to use two or more catheters during an operation, as is often required in practice, without it being necessary to make provision for numerous manipulations of the mechanism during the insertion operation.
In preferred embodiments of the invention, recourse may optionally be had to one or more of the following dispositions:
the second receptacle presents a bottom adapted to receive said elongate guide, and at least one second guide surface co-operating with said first guide surface of the first receptacle to guide relative movement of the first and second receptacles about said axis of rotation;
said first end of the guide passing through said outlet to the inside of the catheter;
said third receptacle including an outlet formed to allow the third member to pass therethrough,
said third receptacle being mounted to rotate relative to the second receptacle about said axis of rotation,
the outlet of the third receptacle including a fastener device for fastening to the second member and adapted for the second member and the third receptacle to move together along the longitudinal direction of the second member;
said third receptacle including an outlet formed to allow the third member to pass therethrough,
said third receptacle being mounted to rotate relative to the second receptacle about said axis of rotation,
the outlet of the third receptacle including a fastener device for fastening to the first member and adapted to enable the first member and the third receptacle to move together along the longitudinal direction of the first member;
said element to be moved is mounted to move on said equipment in a second degree of freedom distinct from the first degree of freedom,
said electric motoring device is adapted to generate relative movement of the equipment and the receptacle in the first degree of freedom in order to generate degree of freedom,
said electric motoring device being adapted to generate relative movement of the equipment and the element to be moved in the second degree of freedom so as to generate relative movement of the element to be moved and the receptacle in said second degree of freedom;
In another aspect, the invention provides an arteriography system including such a catheter winder/unwinder
In an embodiment, the arteriography system further includes a central unit adapted to control the drive mechanisms
In another aspect, the invention provides an installation including a catheter winder/unwinder comprising a receptacle adapted to receive an elongate tubular member for insertion into a duct of a patient and extending between a first end and a second end along a longitudinal direction;
the receptacle having an opening formed to allow said member to pass to the outside;
the winder/unwinder further comprising a drive mechanism adapted to apply to the member movement through said opening relative to said receptacle, said drive mechanism comprising:
said electric motoring device being adapted to generate relative movement between the equipment and the receptacle in the first degree of freedom so as to generate relative movement of the member and of the receptacle in said first degree of freedom;
the member being mounted to move relative to the equipment in a second degree of freedom distinct from the first degree of freedom;
said electric motoring device being adapted to generate relative movement of the equipment and of the member in the second degree of freedom in order to generate relative movement of the member and of the receptacle in said second degree of freedom;
said electric motoring device comprising at least an electric motor, said electric motoring device comprising at least one movement transfer element connected to one of said electric motors to transmit said relative movement of the member and the equipment in the second degree of freedom from said electric motor;
the installation comprising a permanent portion comprising said electric motors, and a utilized replaceable portion, distinct from said member, mounted removably relative to the permanent portion, the permanent portion and the replaceable portion in an assembled state together forming said winder/unwinder, the installation having a plurality of replaceable replacement portions that are identical to the utilized replacement portion.
Such an installation makes it possible to use a replaceable portion as a consumable, thus making it possible to guarantee the hygiene conditions required for such an installation while minimizing costs, since only the consumable portion is replaced between two utilizations.
In preferred embodiments of this installation, recourse may also be had to one or more of the following dispositions:
The electric motors positioned on the receptacle but not on the moving equipment make it possible to provide the moving equipment as a consumable, without it being necessary to replace the electric motors after each operation, given that the motors are amongst the most expensive elements of the system
In another aspect, the invention provides a catheter winder/unwinder comprising a base adapted to receive a tubular member for inserting into a duct of a patient and extending between a first end and a second end along a longitudinal direction of the member, and a drive mechanism adapted to apply to said tubular member at least movement along said longitudinal direction, said drive mechanism comprising:
A winder/unwinder of such a construction is relatively simple and inexpensive to make, while also being robust and very easy to use
Other characteristics and advantages of the invention appear from the following description of five embodiments, given by way of non-limiting example, and with reference to the accompanying drawings.
In the drawings:
In the various figures, the same references are used to designate elements that are identical or similar
In
The displacement of a catheter 6 within the body of the patient 1 is remotely controlled by the qualified personnel 2 using control means 7, such as a mouse, for example, connected to the programmable machine 4
The installation further comprises an X-ray source 8 emitting X-rays 9 towards the patient 1, and an X-ray detector 10 suitable for detecting the radiation passing through the patient 1. The detector 10 may be connected to the computer 4 in order to display a detected image on the computer screen 11.
As shown in
The first system 12 comprises a first receptacle 14 in the form of a hollow tank or trough having an outer wall 42a and an inner wall 42b that are substantially vertical defining between them a bottom wall on which there is placed, prior to use, a tubular catheter that is to be inserted into an artery of the patient 1. The catheter extends from a first end to a second end along a catheter longitudinal direction The trough 14 is also filled with a preservation liquid in which the catheter is immersed. The first receptacle 14 has an opening 15 through which the catheter can reach the outside 12, and in particular the inside of the body of the patient 1. The first system 12 also includes a drive mechanism 16 that is described in greater detail below with reference to
The second system 13 comprises a second receptacle 17 capable of turning about the axis Z relative to the first receptacle 14. In this respect, provision can be made for the second receptacle 17 to present a central opening 45b that co-operates with the inner wall 42b of the first receptacle. The second receptacle 17 also has an outlet 18 via which a guide 37 contained in the second receptacle 17 can access the outside of the second receptacle, and in particular the inside of the first receptacle 14.
The second receptacle 17 comprises a trough or tank having a cylindrical outer wall 45a, and it receives a tubular guide extending between first and second ends along a guide longitudinal direction, and immersed in a liquid suitable for preserving it. Furthermore, the second receptacle 17 also includes a drive mechanism 19 similar to the first drive mechanism 16 of the first system 12, located outside the trough and described in greater detail below with reference to
The first drive mechanism 16 includes a rotation electric motor 24 (not visible in
The drive mechanism 16 also includes a translation electric motor 26 which serves, when powered electrically under the control of the computer 4, to rotate a translation gear 27 that co-operates with a translation ring gear 22 mounted to rotate freely on the cylindrical shaft 49 secured to the rotation ring gear 23 and through which the catheter 6 passes.
In a variant, provision could be made to use a single motor coupled either to one or to the other of the rotation gear 25 and the translation gear 27 By way of example, these motors may be stepper motors.
As shown in
The catheter 6 is kept in contact with the edge of each of the drive wheels 31 by a non-motor-driven bias wheel 33 whose position relative to the plate is defined by an adjustment mechanism 34 serving to adapt the presently-described drive mechanism 16 to catheters of different diameters With the catheter being held in engagement with the drive wheels 31a and 31b by the bias wheel 33, rotation of the drive wheels entrains displacement of the catheter along its longitudinal axis X These drive wheels 31a, 31b thus for an application portion, applying movement to the catheter.
As shown in
In a variant, the flap could be replaced by an opening fitted on the wall.
It should be observed that the embodiment shown in
It is also possible to provide a third system 43 that is insertable in the second system and that is concentric therewith about the axis Z, to enable an intervention catheter to be inserted into the patient in addition to the guide and the catheter as shown in
Furthermore, each system can itself be made in modular manner, i.e. the electric motors may be removed from the remainder of the system so as to be installed on a winder/unwinder having no electric motor, and that is itself put on the market as a consumable This greatly reduces costs associated with reusing the system, since the more expensive elements can be retained from one use to another (possibly being sterilized or decontaminated before subsequent reuse).
An example of using the device shown in
In order to enable the end of the catheter to reach the location of interest inside the body of the patient 1, the surgeon 2 controls the following functions from the computer 4:
In certain embodiments, provision can also be made to enable both the guide and the catheter to be controlled to move together in translation by controlling the two corresponding motors simultaneously.
Movement both in translation and in rotation can naturally be controlled in one direction or in the other for the purpose of moving the guide and the catheter to the site, or for the purpose of returning them.
The second receptacle can be caused to turn quickly relative to the first receptacle by driving the central opening 45b of the second receptacle in rotation by means of a specially-dedicated electric motor (not shown) connected under the bottom of the tank to the corresponding end 50 of said opening This dedicated motor can be used in particular for rewinding the guide after use.
As an alternative, the dedicated motor could be replaced for the rewinding function by a dedicated spring that is loaded by the movement of the receptacle under drive during deployment of the catheter which is connected to its opening.
As shown in
The first tray 80 has placed thereon a second tray 90 similar to the first tray, and adapted to turn about the axis Z relative to the hub 85. The second tray 90 has spokes 91 extending to a peripheral edge 52 and carries a second pipe 93 receiving the guide 37 internally. This pipe has an opening 94 through which the guide exits going towards the second drive mechanism 19 (not shown again) The outlet 35 is made in the manner described above The guide 37 penetrates into the first pipe 83 via an elongate slot 53 therein, e.g. extending all the way round it (shown in part only). In operation, turning of the second tray 90 relative to the hub causes the second pipe 93 that is carried thereby to turn likewise.
In addition, in an embodiment that also includes inserting an intervention catheter, e.g. for the purpose of delivering a certain function to the site, the above-described operations and variants can also be implemented for the third system.
For this purpose, the end 51 of the third receptacle can also be driven by a dedicated electric motor (not shown) for rewinding the guide in a three-system winder/unwinder.
In a variant, the second and third systems can be used in parallel for parallel, non-coaxial, insertion of both a guide and an intervention catheter, which are disposed respectively in the second and third receptacles. At the rear end of the catheter contained in the first receptacle, a T-shaped ring (not shown) can then be provided that includes a first inlet for connecting to the second receptacle with freedom to rotate, and a second inlet for connecting to the third receptacle, likewise with freedom to rotate.
As also shown in
The use of pipes is not limited to the embodiment of
In a fifth embodiment, shown in
This embodiment corresponds substantially to that of
As shown in
In the embodiment of
In an assembled state, the replaceable portion formed by the top portion of the plate has its wheels 31a, 31b engaged on respective drive shafts 64a, 64b connected to the gear wheels.
After the winder/unwinder has been used for a first operation, the replaceable portion 61 used for this first operation can be removed from the permanent portion and can be replaced by a replacement portion 65 that is identical to the replaceable portion, in order to perform a subsequent operation.
In the embodiment of
As shown in
After the winder/unwinder has been used for a first operation, the replaceable portion 61 can be removed from the permanent portion, and can be replaced by a replacement portion 65 that is identical to the replaceable portion, in order to perform a subsequent operation. By way of example, the entire receptacle, possibly containing the member, can be replaced for each new operation.
Bencteux, Philippe, Cordette, Steevy
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