Device for Supporting an Elongated Body and for the Controlled Translational Movement of the Same

• US 20080167663A1
• Filed: 02/28/2006
• Published: 07/10/2008
• Est. Priority Date: 02/28/2005
• Status: Active Grant

• Current Assignee: Centre National De La Recherche Scientifique, Universite De Strasbourg (Financière Meeschaert SA), Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD), L'Institut National Des Sciences Appliques (Insa)
• Original Assignee: Centre National De La Recherche Scientifique, Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD), L'Institut National Des Sciences Appliques (Insa), Université Louis Pasteur
• Inventors: Maurin, Benjamin, Piccin, Olivier, Bayle, Bernard, Gangloff, Jacques, De Mathelin, Michel
• Granted Patent: US 8,840,627 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis

Abstract

A device for supporting and controlling the translational movement of an elongated body, the body extending along the longitudinal axis thereof in the form of a rod, such as a needle intended for a percutaneous medical procedure. The device is designed to be mounted to a support that can be controlled in terms of position and orientation, and includes: (i) a first member for gripping the body, whose movement can be controlled in the translation direction with a pre-determined maximum stroke; and (ii) a second fixed member which can guide the elongated body when the body is moved by the first mobile gripping member and which can maintain the body in position when the body is not engaged with the first member.

Claims

1. Device for holding and for controlled translational movement, in its longitudinal direction, of a rod-shaped elongated body, in particular of a needle, and in particular a needle for a percutaneous medical procedure, a device that is designed to be mounted on an adjustable support in a manner that is controlled in position and in orientation, such as, for example, a platform or an arm of a robotic device for positioning and orientation, whereby this device (1) essentially comprises, on the one hand, a first part (5) for gripping the elongated body (2), movable relative to the support (3) in a manner that is commanded and/or controlled in the translational direction (Z) with a predetermined maximum travel, and, on the other hand, a second part (6) that is stationary relative to the support (3) and able to guide the elongated body (2) when the latter is moved by the first movable gripping part (5) and, if necessary, to keep said elongated body (2) in position when the latter is not engaged with said first part (5), whereby the two parts (5 and 6) are aligned in the translational direction (Z) and whereby the first part (5) can be moved alternatively between a proximal position of the second part (6) and a distant position of the latter device (1), characterized in that the movable gripping part (5) comprises clamping means (7), whereby the elongated body (2) is locked and consists of a mandrel through which the elongated body (2) passes, whereby said mandrel (5) can be moved in rotation with the elongated body (2) around the translational axis (Z).

2. Device according to claim 1, wherein the tightening and loosening movements of the mandrel (5) are controlled by a rotary maneuvering part (9), preferably in the form of a maneuvering ring gear or toothed maneuvering ring, integrated in said mandrel (5), and wherein the jaw-shaped tightening means (7) are mounted, with the capability of guided sliding, in a body (10) with a tubular passage (10″

) that is designed to hold the elongated body (2) in such a way that the body surrounds said passage and said passage extends through the body, whereby the movement of said jaws (7) is generated by a rotational movement of said maneuvering ring (9) that surrounds the body (10).

3. Device according to claim 1, wherein the mandrel (5) that forms the moving gripping part is mounted on or in a cart (8) that can be moved by motorized driving in the two opposite directions from the translational direction (Z) of said elongated body (2) by being guided in an elongated support structure (15) that is able to be assembled rigidly with the platform or the arm (3) of a robotic device (4) for positioning and orientation, whereby said support structure (15) is advantageously shaped so as to allow lateral access to the body (2) that is engaged in said support structure (15) and optionally an installation and an extraction at a lateral or radial slant from the body (2), if necessary with the mandrel (5).

4. Device according to claim 1, wherein the mandrel (5) that forms the moving gripping part is accommodated directly in a support body (15) that is elongated with the capability of guided sliding in the translational direction (Z) of the elongated body (2) and with the capability of rotation around said axis (2), whereby said support body (15) forms a slide for said moving mandrel (5), whose travel preferably results directly from the manual action of an operator, whereby said support structure (15) is advantageously shaped so as to allow lateral access to the body (2) that is engaged in said support structure (15) and optionally an installation and an extraction at a lateral or radial slant from the body (2).

5. Device according to claim 3, wherein the second stationary part (6) is located at the end of the support body (15) with an elongated structure, which is distal relative to the platform or to the arm (3) that holds said device (1), by being a body (10′

) that is connected to this support body (15) or formed by a portion of the latter.

6. Device according to claim 1, wherein the second stationary part (6) consists of an adjusted guide bearing of the elongated body (2), whereby the friction between the latter and said bearing is at least enough to ensure that said elongated body (2) is held against gravity.

7. Device according to claim 1, wherein the second stationary part (6) consists of an opening or a guide channel with play of the elongated body (2), designed to limit the radial jarring or the angular slope of the elongated body (2) relative to the translational direction (Z) and to hold said elongated body (2) essentially in a coaxial arrangement with said direction (Z), in cooperation with the mandrel (5) that forms a moving gripping and driving part.

8. Device according to claim 2, wherein the second stationary part (6) performs a controlled gripping function of the elongated body (2) and consists of a mandrel through which the elongated body (2) extends, whereby this second mandrel (6) has a structure, a mode of operation and constituent elements that are identical to those of the first mandrel (5), namely in particular a maneuvering ring (9′

), jaws (7′

), and a body (10′

) with a tubular passage (10″

).

9. Device according to claim 2, wherein the mandrel (5, 6) or each mandrel (5, 6) essentially consists of a body (10, 10′

) with a tubular through passage (10″

), open laterally for allowing the passage of at least two, preferably three, jaws (7, 7′

) and equipped with guide means (11, 11′

) of said jaws (7, 7′

) in a radial direction relative to the tubular passage of the body (10, 10′

) in question, wherein said jaws (7, 7′

) are distributed uniformly around said passage (10″

) and can be moved between a so-called tightening position in which they extend partially into the corresponding passage (10″

) and a position in which they totally release said passage (10″

), and wherein said jaws (7, 7′

) comprise rib/groove segments (12) that can be engaged and that can circulate in a groove/rib (13) in a spiral portion that is made in a lateral face of a toothed maneuvering ring gear (9, 9′

) that is mounted with the capability of rotation on a portion with a tubular external shape (10′

″

) of the body (10, 10′

) of the mandrel in question (5, 6), whereby a rotation of said ring (9 or 9′

) entrains a simultaneous or identical radial slide of the jaws (7 or 7′

).

10. Device according to claim 9, wherein the mandrel (5, 6) or each mandrel (5, 6) is mounted with the capability of rotation around the longitudinal axis (Z′

) of the elongated body (2) that passes through it, if necessary, together with the latter, and wherein with each mandrel (5, 6), there is associated a pawl mechanism (14, 14′

) that locks the body (10, 10′

) of said mandrel (5, 6) in question against rotation in the direction of loosening and that allows a gradual rotation of said mandrel (5, 6), in the direction of tightening, when the latter is thoroughly tightened around the elongated body (2), and wherein an additional tightening torque, having an intensity that is greater than a determined value defined by the pawl mechanism (14, 14′

) in question is applied at the corresponding toothed maneuvering ring (9, 9′

).

11. Device according to claim 1, wherein the first moving part (5) and the second stationary part (6) are mounted, preferably in a removable manner, on a support structure (15) that can be assembled rigidly with the platform or the arm (3) of a robotic device (4) for positioning and orientation, whereby the support structure (15) in the form of a chassis has a given extension in the translational movement direction (Z) of the elongated body (2), comprising a mounting site (16) for the second stationary part (6), positioned at the extreme end in the direction corresponding to a positive movement or embedding of said elongated body (2) in the translational direction (Z), and being equipped with means (17, 18) for guiding and for controlled movement of the first moving part (5) that is mounted, at a suitable corresponding mounting site (19), on or in a cart (8) that works with these means (17, 18).

12. Device according to claim 11, wherein the means for guiding and controlled movement of the first moving part (6) comprise, on the one hand, a threaded shaft (17) that forms a mother screw, and, on the other hand, at least one guide rail or rod (18), and wherein the cart (8) integrates a threaded perforation (8′

) that forms a wire nut and at least one bearing or guide shoe (8″

) that may or may not pass through and that works, in a sliding manner, with the guide rail or rod (18) or each guide rail or rod (18).

13. Device according to claim 11, wherein the first and second parts (5 and 6) that come in the form of mandrels are accommodated in a removable manner and with the capability of rotation in their respective essentially U-shaped mounting sites (16 and 19), wherein the bodies (10, 10′

) of the mandrels (5, 6) that are generally circular-cylindrical in shape have an outside circumferential groove (20, 20′

), and the mounting sites (16 and 19) each have a rib (21, 21′

) that can work with the groove (20, 20′

) of the corresponding body (10, 10′

) of mandrel (5, 6), over a portion of their circumferential extension, for the purpose of the retention of said body (10, 10′

), and wherein said mounting sites (16, 19) are open laterally to allow the installation and removal of said mandrels (5, 6), whereby the latter are locked in the mounted state in their respective sites (16, 19) by moving locking pieces (22, 22′

), preferably stressed elastically in the locking position of said mandrels (5, 6), whereby these locking pieces (22, 22′

) become engaged in the outside grooves (20, 20′

) of the body (10, 10′

) of the mandrels (5, 6) respectively in question in the continuity of the ribs (21, 21′

) and by closing the lateral openings (23, 23′

) of the respective mounting sites (16, 19).

14. Device according to claim 13, wherein the first and second parts (5 and 6) are mounted in their mounting sites (19 and 16) respectively against an elastic stressing, whereby the latter ejects said parts (5 and 6) beyond said sites (19 and 16) when the locking pieces (22, 22′

), preferably controlled simultaneously, release the corresponding lateral openings (23 and 23′

).

15. Device according to claim 3, provided that the latter depend on claim 3, wherein the cart (8) that holds the gripping part (5) is connected in a removable manner to said device (1) by being able to be moved in particular into an end sliding position at the level of which it disengages from said device (1).

16. Device according to claim 11, wherein the driving of the maneuvering ring (9, 9′

) of each part in the form of a mandrel (5, 6) is carried out via a gear (24, 25) that engages with said ring (9, 9′

) and is integral in rotation with a rod or a shaft (24′

, 25′

) that is driven in rotation by a corresponding, optionally common, respective actuator (24″

, 25″

), wherein the gear (25) that engages with the ring (9′

) of the stationary mandrel (6) is made integral rigidly at the end of a corresponding drive shaft (25′

) and wherein the gear (24) that engages with the ring (9) of the moving mandrel (5) is integral in rotation and free in translation relative to a corresponding drive shaft (24′

).

17. Device according to claim 13, wherein it comprises a pivoting or sliding control rod or pole (26) that is connected in driving with the locking rods (22, 22′

) for the purpose of their travel beyond their locking position against elastic stressing forces, for example provided by compression springs (27, 27′

), whereby this control rod (26) is integral in driving an actuating mechanism (26′

), in particular a safety mechanism that causes unlocking by default.

18. Device according to claim 16, wherein the shafts (24′

and 25′

) as well as the control rod (26) have free ends, on the side of the actuators (24″

, 25″

), respectively of the mechanism (26′

), tapered or pointed, in particular able to pierce the wall of a sterile package.

19. Device according to claim 16, provided that they depend on claim 11, wherein the chassis that forms a support structure (15) comprises a lower plate (15′

) that contains the mounting site at the extreme end (16) for the second part (6) and an upper plate (15″

) for attachment to the platform (3) of a robotic device (4) for operation and orientation, whereby said upper plate (15″

) is equipped with quick assembly means (28), such as, for example, latches, able to become engaged with said platform (3) or with a piece that is integral with the latter in the mounted state of said chassis (15), and wherein the means (17, 18) for guiding and controlled movement, as well as, if necessary, the drive shafts (24′

, 25′

) and the control rod (26), extend and are mounted between these two plates (15′ and

15″

), whose mutual spacing essentially determines the travel of the first moving part (5).

20. Device according to claim 19, wherein it comprises force sensors (29) that measure the intensity of the thrust exerted on the elongated body (2) in the translational direction (Z), and, if necessary, the torque or certain components at least of the torque that is exerted on this elongated body (2).

21. Device according to claim 20, wherein the force sensors (29) are arranged between the upper plate (15″

) of the support structure (15) and the platform (3) of the robotic device (4) by preferably being mounted on a separator (30) that is sandwiched between said upper plate (15″

) and said platform (3).

22. Device according to claim 20, wherein the force sensors (29) consist of unidirectional sensors that are oriented in the translational direction (Z), are three in number and are arranged in a plane that is orthogonal to said direction (2) and positioned symmetrically on a circle with radius (r) that is centered on the longitudinal axis (Z′

) of the elongated body (2), whereby this arrangement of three sensors (29) thus allows the determination of two components of the reaction torque that is exerted on the elongated body (2).

23. Device according to claim 16, wherein the actuators (24″

, 25″

) that drive the shafts (24′

, 25′

) are grouped on a support plate (31) that is connected to the platform (3) of the robotic device (4) opposite the support structure (15) that holds the first and second parts (5 and 6), whereby this support plate (31) also holds, if necessary, the actuating mechanism (26′

) of the control rod (26) that can move the locking pieces (22, 22′

) out of their locked position.

24. Device according to claim 23, wherein the actuators (24″

, 25″

) of the shafts (24′

, 25′

) come in the form of a double actuator that integrates a single motor (35) with high torque and with a low rotation speed, for example of the piezoelectric type, and an arrangement (36) for transmission gears that transform the rotational movement of the outlet of said motor into two synchronous rotational movements in opposite directions, provided with two shafts (24′ and

25′

).

25. Device according to claim 23, wherein the support plate (31) also holds an actuator (17′

) for the threaded shaft (17), moving the cart (8), this, for example, in the form of a piezoelectric motor combined with a gear mechanism.

26. Device according to claim 2, wherein the jaws (7) that form the means for tightening the mandrel (5) are mounted guided in the tubular through passage (10″

) of the body (10), whereby said jaws (7) are equipped with drive means (39) that are stressed, directly or indirectly, by the surrounding maneuvering ring (9), so as to be moved in translation along (Z or Z′

) during the rotation of this ring (9) by generating a simultaneous movement of mutual coming-together or moving-apart of said jaws (7) around the median axis of said passage (10″

) or an elongated body (2) that is mounted in said mandrel (5).

27. Device according to claim 26, wherein the tightening means (7) consist of two opposite and opposing jaws with mutually offset jaws (7″

) so as to interlock during their coming-together movement for the purpose of tightening, wherein the tubular passage (10″

) then has two planar opposite faces (37) that form planar guide surfaces for said jaws (7), whereby the latter are also equipped with portions of lateral guide surfaces (38) that are suitable for sliding supported on said faces (37) and wherein each of said jaws (7) is guided in an additional manner during their mutual coming-together and moving-apart movements to carry out travel in the direction (Z or Z′

) simultaneously.

28. Device according to claim 27, wherein each of said jaws (7) is equipped with at least two drive and guide rods (39″

) that project laterally relative to its guide surface portions (38) and wherein each form a pair of opposite lugs or pins (39), whereby the latter are, on the one hand, mounted to slide in portions of grooves (40) that are made in the wall portions of the body (10) defining the planar opposite faces (37), coinciding two by two in the case of the two planar opposite faces (37) being superposed and located by coincident pairs in planes or sloped non-planar surfaces relative to the longitudinal direction (Z′

) of an elongated body (2) that is mounted in a tightened manner in the mandrel (5), and, on the other hand, at least for one pair of opposing pins or lugs (39) of each jaw (7), in direct or indirect drive connection with the maneuvering ring (9) at their ends (39′

) that go through portions of grooves (40) through which they pass, in view of their movement in the longitudinal direction (Z′

) during a rotational movement of said maneuvering ring (9).

29. Device according to claim 27, wherein the ratio between the maximum inside opening of the mandrel (5), for a maximum separation from the jaw (7), and the outside diameter of the ring (9) is more than 0.2, preferably at least 0.3.

30. Device according to claim 28, wherein the body (10) has a circular-cylindrical outside shape, adjusted in diameter to the inside diameter of the maneuvering ring (9), the ends (39′

) of the pins or lugs (39) that exceed groove portions (40) at the outside face of the body (10) that is guided to slide into the grooves (41) that are made at the inside face of the maneuvering ring (9) and formed by portions of curves each produced by the intersection between a regulated surface and the inside cylindrical surface of said ring (9), whereby the body (10) is locked in translation and is free in rotation in this surrounding ring (9).

31. Device according to claim 28, wherein the body (10) has a square or rectangular outside shape and is mounted in the maneuvering ring (9) with insertion of an intermediate piece (42) that has a circular-cylindrical outside shape, adjusted in diameter to the inside diameter of the ring (9), and that has an inside shape that is complementary to the outside shape of the body (10), whereby this intermediate piece (42) is equipped, on the one hand, with grooves (43) coinciding by pairs, arranged by pairs in planes that are perpendicular to the median axis of the tubular passage (10″

) and that accommodate, with a guided sliding engagement, the ends (39′

) of the pins or lugs (39) that exceed portions of grooves (40) at the outside face of the body (10) and, on the other hand, at least two lugs (44) that project at its outside face and are guided to slide into grooves (41) that are essentially in the form of coil portions and are made at the inside face of the maneuvering ring (9), whereby the body (10) is locked in translation and free in rotation in this surrounding ring (9).

32. Device according to claim 26, wherein on its peripheral outside face, the maneuvering ring (9) has an inclined set of teeth (45) that is suitable for a functional engagement with an endless screw (46) for the purpose of its driving in rotation, a driving of said ring (9) beyond one degree of tightening determined from the elongated body (2) by the jaws (7), causing a rotation of the mandrel (5) and of the tightened body (2).

33. Device according to claim 3, wherein the mandrel (5) is secured, in a removable manner and with the capability of rotation, in a cart (8) that is mounted to slide in the translational direction (Z) in the elongated support structure (15) that is equipped with at least one suitable slide (47), whereby said structure (15) is equipped with an upper plate (15″

) for its attachment to the platform (3) of the robotic device (4) and a lower plate (15′

) that comprises a guide opening or guide channel with play and with centering forming the second stationary part (6), and wherein a motorized assembly (48) for controlled movement of the cart (8) and a motorized assembly (49) for actuation of the maneuvering ring (9) are combined with the cart (8)/support body (15) assembly by being mounted either on the platform (3) or on said support body (15).

34. Device according to claim 33, wherein the motorized assembly (48) consists of a mother screw (51) that is driven in rotation by a motor unit (52) that optionally is combined with a position coder and that drives in translation a wire nut (53), whereby said wire nut (53) is connected rigidly to a cart or a pair of intermediate guide carts (54) that slide on a rail (55) that is parallel to the translational direction (Z) and to the slide (47), wherein said cart or carts (54) is (are) also connected rigidly to a site (56′

) for removable coupling of a connecting bar (56) that is integral with the cart (8), wherein the points of attachment and connection of said wire nut (53) and of said coupling site (56′

) with the cart (54) or one of the carts (54) are connected to one another with insertion of a force sensor (54′

) that can measure the intensity of the mechanical actions in the direction (Z), and wherein said device comprises opposite ends-of-travel (57) that are mutually offset in the translational direction (Z) and that delimit the maximum travel of said intermediate cart or carts (54) and therefore of cart (8), whereby said motorized assembly (48), with the exception of the ends-of-travel (57), is optionally mounted in a housing (60), formed by a single support with the platform (3) or accommodated, in an indexed way and with locking into position, in a receiving site (61) that is integral with the platform (3), by thus forming a removable autonomous module.

35. Device according to claim 33, wherein the motorized assembly (49) consists of a motor unit (58) that drives, via a flexible drive shaft (59), an endless screw (46) that is integrated in the cart (8) and is engaged in driving with the peripheral maneuvering ring (9) of the mandrel (5) that is mounted in said cart (8), whereby said motor unit (58) is mounted in a housing that is formed by a single support with the platform (3) or accommodated in an indexed manner and with locking in position in a site for accommodating said platform (3).

36. Device according to claim 1, wherein the elongated body (2) consists of a needle for implementing percutaneous medical procedures.

37. Device according to claim 13, wherein the platform (3) of the robotic device (4) has an open cutaway (3′

), as well as optionally the upper plate (15″

) of the support structure (15), the separator (30) that holds the force sensors (29) and the support plate (31) of the actuators (17′

, 24′

, 25′

), whereby the opening of this cutaway or these cutaways is oriented in the same direction as the openings (23, 23′

) of the mounting sites (16 and 19) of the first and second parts (5 and 6), and/or as a lateral release of the structure (15), so as to allow an installation and/or a lateral removal of said needle (2).

38. System to assist in percutaneous medical procedures that are guided by medical imagery, comprising a robotic device for positioning and orienting a platform, a device for controlled insertion and retraction of the needle, and a device for piloting said devices based on preprogrammed parameters and results of instantaneous measurements, such as measurements extracted from preoperative medical images, measurements of stresses in the axial direction of the needle and/or torque stresses at said needle, or else indications or measurements of position that are provided by the above-mentioned robotic device and/or insertion device, system characterized in that the device for inserting and retracting the needle consists of a device (1) according to claim 1.

39. System according to claim 38, wherein the device (1) for inserting and extracting the needle (2) has a staged modular structure, with a first module (32) that contains the first and second parts (5 and 6) and the mechanical control means of the latter, whereby a second module (33) contains sensor means, and a third module (34) contains the means for actuating the above-mentioned mechanical control means, whereby the second and third modules (33 and 34) are packed in a sterile package, together with a portion that is adjacent to at least the robotic device (4) for positioning and orientation, and whereby the first module (32) is produced, partially or totally, as a module of the expendable or single-use type.

40. System according to claim 38, wherein the support body (15), if necessary with the cart (8) and optionally the hose (59), form(s) a module of the expendable or single-use type, whereby the additional portion of the system is packed in a sterile package.