US20170249867A1 - Apparatus for simulating insertion of an elongated instrument into a structure including a pulley and a pulley position sensing arrangement - Google Patents
Apparatus for simulating insertion of an elongated instrument into a structure including a pulley and a pulley position sensing arrangement Download PDFInfo
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- US20170249867A1 US20170249867A1 US15/054,501 US201615054501A US2017249867A1 US 20170249867 A1 US20170249867 A1 US 20170249867A1 US 201615054501 A US201615054501 A US 201615054501A US 2017249867 A1 US2017249867 A1 US 2017249867A1
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- elongated instrument
- pulley
- carriage
- tether
- outer elongated
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B9/00—Simulators for teaching or training purposes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
Definitions
- the present invention generally relates to apparatuses for simulating insertion of an elongated instrument into a structure and medical insertion simulators for healthcare training.
- Minimally invasive surgical procedures through the use of endoscopic instruments are more and more used for replacing conventional surgery. Indeed, technological progresses have provided miniaturized tools and implements that can be inserted through an endoscopic instrument in the body of a human for performing various tasks. These tools are generally combined with a video system to view from the inside the procedure being performed.
- Virtual simulation systems have been developed for training medical professionals to perform these types of procedures. These simulation systems aim to produce realistic real-time simulated operating conditions for providing interactive training through the combination of real-time visual representation and interactive tactile force feedback returned to the medical professional under training.
- an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument comprises a casing having an aperture for receiving a distal end of the outer elongated instrument therethrough and a longitudinal guide fixedly mounted in the casing.
- the apparatus is provided with a carriage comprising a mounting plate for mounting the distal end of the outer elongated instrument, the carriage being slidably mounted onto the longitudinal guide for translation thereon according to a translation of the outer elongated instrument through the aperture of the casing.
- the apparatus also has a carriage position sensing element for sensing a longitudinal position of the carriage along the longitudinal guide.
- the apparatus further comprises a pulley having an outer tether receiving groove on a peripheral portion thereof and an anchoring element therein for anchoring a distal end of a tether extending through the outer elongated instrument, the pulley being rotatably mounted on the carriage for rotating according to a longitudinal translation of the tether into the outer elongated instrument.
- the apparatus is also provided with a pulley position sensing arrangement for sensing an angular position of the pulley representative of a relative longitudinal position of the inner elongated instrument attached to the tether.
- the apparatus also has a feedback force actuator mounted on the carriage and operatively connected to the casing for applying an adjustable resistive force to a translation of the carriage on the longitudinal guide according to the sensed longitudinal position of the carriage and resistance characteristics of the structure, the feedback force actuator being further connected to an axle of the pulley for applying an adjustable resistive force to a rotation of the pulley according to the sensed angular position of the pulley and the resistance characteristics of the structure.
- a medical insertion simulator comprising an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument.
- the medical insertion simulator is provided with an outer elongated instrument for attachment in the apparatus and a control unit for controlling the feedback force actuator.
- the medical insertion simulator further has a processing unit for receiving the sensed longitudinal position of the carriage, the sensed angular position of the pulley and a model of a patient's internal structure and associated resistance characteristics of the structure.
- the processing unit further determines the adjustable resistive force to apply to the translation of the carriage and the adjustable resistive force to apply to the rotation of the pulley according to previously received information for operating the control unit.
- the processing unit then further produces a visual display image of the patient's internal structure and movement of the inner and outer elongated instruments therein.
- the medical insertion simulator is further provided with a display unit for displaying the produced visual display image.
- FIG. 1 is a partially exploded perspective view of an example of an apparatus for simulating insertion of an elongated instrument
- FIG. 2 is a further partially exploded perspective view of a portion of the apparatus of FIG. 1 ;
- FIG. 3 is a further partially exploded perspective view of another portion of the apparatus of FIG. 1 ;
- FIG. 4 is an exploded perspective view of a mounting plate and a mounting shaft arrangement
- FIG. 5 is a partially exploded perspective view of the mounting plate of FIG. 4 with a sensing element
- FIG. 6 is an exploded view of a pulley and a feedback force actuator of the apparatus of FIG. 1 ;
- FIG. 7 is a top view of another example of an apparatus for simulating insertion of an elongated instrument
- FIG. 8 is an exploded partial side view of the apparatus shown in FIG. 7 ;
- FIG. 9 is an enlarged view of the right portion of FIG. 8 ;
- FIG. 10 is a perspective partial view showing the mounting of a tether with a pulley
- FIG. 11 is a top view of a portion of the apparatus of FIG. 7 , with an elongated instrument mounted therein;
- FIG. 12 is a schematic view of an example of a medical insertion simulator.
- FIG. 13 is a perspective view of an example of an elongated instrument.
- Various aspects of the present disclosure generally address one or more of the problems of simulating medical interventions relying on insertion of a medical instrument into an anatomical structure of a patient such as veins, arteries and other tubular anatomical structures.
- these aspects will be described in the specific application of simulating the implantation of a micro-pacemaker small enough to be delivered with minimally invasive techniques through a catheter, and implanted directly into the heart.
- the micro-pacemaker is provided with flexible tines attachable to the interior of the right ventricle. The tines can be engaged and disengaged during the implantation process without causing trauma to the cardiac tissue, thereby allowing the device to be repositioned during implantation or retrieved if needed.
- Transcatheter pacemaker implantations are generally performed through an opening realized in the femoral artery in the groin region although other entry points may be used.
- Training of such a procedure may be done as a sequence of procedures, for example an initial catheter insertion up to the heart, fine manipulation of the implant inside the heart before final attachment, or as complete procedure encompassing all the manipulations required for a complete implantation process.
- the present apparatus thus allows training medical professionals on a sequence of procedures of the complete procedure with improved realistic feedback feeling.
- the apparatus may be used with a conventional portable PC and is compact enough to provide a complete portable simulator fitting in a conventional carry-on luggage, as detailed below.
- FIG. 1 there is shown a partially exploded view of an example of an apparatus 100 for simulating insertion of an elongated instrument (not shown), a medical catheter for example, into a structure such as an artery.
- the apparatus 100 has a casing 102 provided with bottom, top, front and back panels 104 , 106 , 108 , 110 mounted together.
- the top panel 106 can be slidably mounted to the bottom panel 104 through slides 112 , 114 mounted on the longitudinal sides of the panels 106 , 104 for easing access to the interior of the casing 102 and enabling a quick installation of the elongated instrument in the apparatus 100 .
- the front panel 108 is provided with an aperture 116 for receiving a distal end of the elongated instrument therethrough, as it will become more apparent below with reference to FIGS. 8 to 12 .
- Various additional apertures are provided, for example in the front and back panels, for power and electronics communication.
- the apparatus 100 is also provided with a longitudinal guide 118 fixedly mounted in the casing 102 , for example through a guide rail 120 secured to a bottom mounting plate 122 secured to the bottom panel 104 .
- the longitudinal guide 118 could consist of a rail, a pair of rails, a channel, a tunnel, or any other type of structure, which can act as a longitudinal guide.
- the apparatus 100 also has a carriage 124 slidably mounted onto the longitudinal guide 118 for translation therealong.
- the carriage 124 has a base plate 126 freely sliding onto the guide 118 between two abutting positions defined with abutting elements 128 , 130 mounted on each end on the guide 118 to restrain the travel of the carriage 124 onto a longitudinal operating range. Limits switches (not shown) can be provided for control purposes.
- the carriage 124 further has a mounting bracket 132 secured to the base plate 126 and a mounting plate 400 secured to the carriage 124 through the mounting bracket 132 .
- the mounting plate 400 which is better shown in exploded views thereof in FIG. 4 and FIG. 5 , is used for mounting the distal end of the elongated instrument to the carriage 124 .
- a translation of the elongated instrument operated by a user through the aperture 116 of the casing 102 for simulating insertion and/or removal of the elongated instrument will generate a corresponding translation of the carriage 124 along the longitudinal guide 118 inside the casing 102 .
- the mounting plate 400 has a receiving portion 402 for receiving a corresponding attaching portion (not shown) mounted at the distal end of the instrument.
- a shaft 404 is rotatably mounted through the mounting plate 400 and secured in place with snap ring 406 to thereby provide a axial rotating connection of the elongated instrument to the carriage 124 .
- the tip 408 of the shaft 404 projecting outward the casing 102 has a threaded portion 410 for receiving a corresponding threaded portion of the distal end of the instrument to firmly secure the two elements together.
- An optional rotation stopper 412 may be installed with the shaft 404 to limit the axial rotational course of the shaft 404 to thereby limit the axial rotational course of the elongated instrument through the aperture 116 of the casing 102 .
- an angular position sensing element 500 can be used for sensing a relative axial rotation of the shaft 404 and thereby of the elongated instrument.
- the angular position sensing element 500 can be for example an optical encoder 502 having a circular disk 504 fixedly mounting around the shaft 404 and an associated optical reader 506 secured to the mounting plate 400 .
- An angular feedback force actuator (not shown) mounted with the mounting plate 400 may be used for applying an adjustable resistive force to a rotation of the shaft 404 according to the sensed relative axial rotation, as further detailed below.
- the apparatus 100 is provided with a feedback force actuator 600 mounted on the carriage 124 and operatively connected to the casing 102 for applying an adjustable resistive force to a translation of the carriage 124 on the longitudinal guide 118 .
- the feedback force actuator 600 has an electric motor 602 (for example a stepper motor) whose frame 604 is secured to the carriage 124 though a supporting plate 606 secured to the mounting plate 400 .
- the feedback force actuator 600 may optionally further comprise a transmission element 200 mounted between the motor 602 and the guide 118 for applying a resistive force to the carriage 124 .
- the transmission element 200 could consist of a belt cooperating with the rotating shaft 608 of the motor 602 although various other arrangements for applying a resistive force to the carriage 124 may alternatively be envisaged.
- a carriage position sensing element 300 a linear encoder strip 302 mounted along the guide 118 and a corresponding optical reader 304 as shown in FIG. 3 for example, is used for sensing a longitudinal position of the carriage 124 along the longitudinal guide 118 .
- the apparatus 100 is provided with an embedded control unit 220 mounted on the bottom plate 122 for controlling the feedback force actuator 600 according to the sensed position of the carriage 124 and eventually the sensed relative axial rotation of the elongated instrument, and further according to resistance characteristics of the structure.
- the resistance characteristics of the structure are representative of a patient's internal structure into which a medical catheter is to be inserted. These resistance characteristics may be provided by a specific 3D model of a structure of a specific patient and may embed natural movements of a human body like heart beating and breathing.
- the medical insertion simulator 10 is provided with an apparatus 100 for simulating insertion of an elongated instrument into a structure as described above and shown in FIG. 1 and a corresponding elongated instrument 50 for attachment in the apparatus 100 .
- the medical insertion simulator 10 also has a control unit 20 embedded in the casing 102 of the apparatus 100 for controlling the feedback force actuator 600 .
- the medical insertion simulator 10 is further provided with a processing unit 30 connected to the apparatus 100 for receiving the sensed longitudinal position of the carriage 124 and eventually the sensed relative axial rotation of the elongated instrument 50 .
- a processing unit 30 connected to the apparatus 100 for receiving the sensed longitudinal position of the carriage 124 and eventually the sensed relative axial rotation of the elongated instrument 50 .
- At least one model of a patient's internal structure and associated resistance characteristics of the structure is provided to the processing unit 30 for further determination of the adjustable resistive force to apply to the translation of the carriage 124 and eventually the adjustable resistive force to apply to the relative axial rotation of the elongated instrument 50 according to previously received position information.
- the processing unit 30 further operates the control unit 20 to simulate a realistic insertion in the specific structure in providing forces (i.e. haptic feedback) to the movements of the user operating the elongated instrument 50 .
- the processing unit 30 further produces a visual display image of the patient's internal structure and movement of the elongated instrument 50 therein and displays the produced visual display image in real time on a display unit 40 .
- the processing unit 30 can be for example a portable computer provided with suitable control cards and software.
- FIG. 13 showing an example of a training handle 60 usable with the apparatus 100 and to FIG. 11 .
- the training handle 60 has a gripping portion 62 connected to a rigid elongated instrument 50 connectable to the mounting plate 400 .
- the distal end 52 of the rigid elongated instrument 50 is provided with a threaded tip 54 for mounting with the threaded portion 410 of the tip 408 of the shaft 404 .
- an introducer 56 may be coaxially secured with the rigid elongated instrument 50 in the aperture 116 of the casing 102 to provide a sliding longitudinal relationship of the training handle 60 in and out of the casing 102 .
- the training handle 60 is further provided with a tether 64 extending through the rigid elongated instrument 50 and the gripping portion 62 and therealong.
- the distal end of the tether 64 (which corresponds to the distal end 52 of the rigid elongated instrument 50 ) is used to simulate the position of a medical implantable device to which the tether 64 is attached.
- the tether 64 is driven inside and out of the rigid elongated instrument 50 through controls 66 provided on the gripping portion 62 .
- the controls 66 further allow controlling the distal end 52 of the rigid elongated instrument 50 . Additional controls for simulating further spatial movements of the medical implantable device attached to the tether 64 may also be provided for further realistic simulation of a complete implantation procedure, as it will become apparent below.
- the apparatus 100 may also be used for simulating insertion of an elongated instrument, for example a medical implantable device, attached to a tether into a structure, for example a patient's internal structure into which the medical implantable device is to be implanted.
- an elongated instrument for example a medical implantable device
- a tether into which the medical implantable device is to be implanted.
- this arrangement may enable to simulate installation of the medical implantable device into the structure once this implantable device has already been brought proximate the structure into which the implantation has to be performed.
- the aperture 116 of the casing 102 receives a distal end of the tether therethrough for attachment therein, as better described below with reference to FIG. 10 .
- the apparatus 100 is provided with a pulley 620 having an outer tether receiving groove 622 on a peripheral portion 624 thereof and an anchoring element 626 therein for anchoring the distal end of the tether extending through the aperture 116 of the casing 102 .
- the pulley 620 is rotatably mounted in the casing 102 for rotating according to a longitudinal translation of the tether relatively to the casing 102 .
- the apparatus 100 also has a feedback force actuator 600 connected to an axle 628 of the pulley 620 for applying an adjustable resistive force to a rotation of the pulley 620 .
- the feedback force actuator 600 is for example an electric motor 602 , such as for example a stepper motor, operatively connected to the axle 628 of the pulley 620 .
- the stepper motor 602 is operatively connected to the casing 102 through a mounting plate 630 attached to the frame 604 of the motor 602 .
- the shaft 640 of the motor 602 is mounted on the axle 628 of the pulley 620 and is secured in place through a set screw 642 extending radially to the axle 628 through the pulley 620 .
- the pulley 620 has the shape of a partial disk or a disk in which a radial portion has been removed to provide opposed radial surfaces 644 , 646 .
- the set screw 642 is mounted with the axle through one of the radial surfaces.
- a retaining plate 648 associated with a torsion spring 650 and a pin spring 652 is arranged between the two radial surfaces 644 , 646 to retain the retaining plate 648 against a corresponding radial surface.
- This arrangement defines an anchoring point 654 for anchoring the distal end of the tether to the pulley 620 while a portion of the tether extends in the outer tether receiving groove 622 on the peripheral portion 624 of the pulley 620 . With this arrangement, the tether can be easily installed and removed from the apparatus 100 .
- the pulley 620 may be provided with an abutting pin 656 extending radially on the side 658 of the pulley 620 and cooperating with an associated abutting device attached to the casing 102 for restraining a pivotal movement of the pulley 620 .
- the mounting plate 630 used for mounting the motor 602 may be shaped to provide an abutting shaped surface limiting the rational course of the pulley 620 .
- the mounting plate 630 has a circular portion around which the abutting pin 656 may freely moves and two abutting elements 660 , 662 projecting radially for defining two abutting positions.
- Various alternative arrangements may be envisaged for restraining movement of the pulley 620 .
- the apparatus 100 is also provided with a sensing arrangement 664 for sensing an angular position of the pulley 620 .
- the sensing arrangement 664 has a sensor mounted to the mounting plate 630 for sensing a relative position of the abutting pin 656 .
- the relative position of the tether tip could be determined through the controls provided on a training handle.
- FIG. 8 to FIG. 10 are partial views of the apparatus 100 showing the anchoring of the distal end of the tether to the pulley 620 .
- a training handle 800 similar to the one illustrated in FIG. 13 and provided with a tether 802 is used.
- the distal end 804 of the tether 802 which can be provided with a tip 806 having a larger diameter than the outer tether receiving groove 622 of the pulley 620 , is first inserted through the aperture 116 of the casing 102 .
- To attach the distal end 804 of the tether 802 to the pulley 620 one has first to rotate the retaining plate 648 (see FIG. 10 ), insert the tip 806 of the distal end 804 in the outer tether receiving groove 622 on the peripheral portion 624 and trap this end 804 with the pulley 620 in releasing the spring biased retaining plate 648 .
- the pulley 620 rotates accordingly while the tether 802 freely winds in the receiving groove portion 622 .
- the sensed angular position of the pulley 620 is representative of a relative longitudinal position of the tip 806 of the tether 802 in the casing 102 .
- the apparatus 100 is provided with an embedded control unit 220 mounted on the bottom plate 122 for controlling the feedback force actuator 600 according to the sensed angular position of the pulley 620 , and further according to resistance characteristics of the structure.
- the resistance characteristics of the structure are representative of a patient's internal structure into which an elongated instrument like a medical implantable device is to be inserted. These resistance characteristics may be generated using a 3D model of a structure of a specific patient, embedding natural movements of a human body like heart beating and breathing.
- the resistance characteristics may comprise a combination of predetermined resistance characteristics (i.e. static) and modeled resistance characteristics (i.e. dynamic).
- the assembly of the pulley 620 and the actuator 600 may be fixedly mounted in the casing 102 .
- the pulley 620 may be mounted on the carriage 124 slidable along the longitudinal guide 118 . This latter arrangement may provide a more realistic simulation of an installation of a medical implantable device into a structure embedding natural movements of a human body.
- the medical insertion simulator 10 is provided with an apparatus 100 for simulating insertion of an elongated instrument, such as a medical implantable device, attached to a tether, into a structure, the apparatus 100 having a pulley and feedback force actuator assembly 620 , 600 just previously described and shown in FIG. 6 .
- the medical insertion simulator 10 is also provided with a tether 64 embedded in a training handle 60 .
- the tether 64 has a distal end for anchoring to the anchoring element of the pulley 620 .
- the medical insertion simulator 10 also has a control unit 20 embedded in the casing of the apparatus 100 for controlling the feedback force actuator 600 of the pulley 620 .
- the insertion simulator 10 is further provided with a processing unit 30 connected to the apparatus 100 for receiving the sensed angular position of the pulley 620 .
- a processing unit 30 connected to the apparatus 100 for receiving the sensed angular position of the pulley 620 .
- At least one model of a patient's internal structure and associated resistance characteristics of the structure is provided to the processing unit 30 for further determination of the adjustable resistive force to apply to the rotation of the pulley 620 according to previously received position information.
- the processing unit 30 further operates the control unit 20 to simulate a realistic implantation in the specific structure in providing forces to the movements of the user operating the tether 64 .
- the processing unit 30 further produces a visual display image of the patient's internal structure and movement of the implantable device therein and displays the produced visual display image in real time on a display unit 40 .
- the apparatus for simulating insertion and associated simulators previously described enable a realistic medical training of the initial catheter insertion up to the heart only, or the fine manipulation only of the implantable device inside the heart structure before final attachment thereto.
- FIG. 1 and FIG. 2 and also to FIG. 12 another example of an apparatus 100 and associated simulator 10 enabling to simulate the whole implantation procedure including initial catheter insertion up to the heart and subsequent fine manipulation of the implantable device outside the catheter for final attachment will now be described.
- This apparatus 10 controls whole or partial simulation.
- the catheter used to bring the implantable device up to the structure is alternatively called the outer elongated instrument while the implantable device initially extending inside the catheter and attached to a tether is called the inner elongated instrument.
- the apparatus 10 has a casing 102 having an aperture 116 for receiving a distal end of the outer elongated instrument therethrough and a longitudinal guide 118 fixedly mounted in the casing 102 .
- the apparatus 100 also has a carriage 124 provided with a mounting plate 400 for mounting the distal end of the outer elongated instrument.
- the carriage 124 is slidably mounted onto the longitudinal guide 118 for translation thereon according to a translation of the outer elongated instrument through the aperture 116 of the casing 102 , as previously detailed.
- a carriage position sensing element 300 is provided for sensing a longitudinal position of the carriage 124 along the longitudinal guide 118 .
- the apparatus 100 is also provided with a pulley 620 having an outer tether receiving groove 622 on a peripheral portion 624 thereof and an anchoring element 626 therein for anchoring a distal end of a tether extending through the outer elongated instrument.
- the pulley 620 is rotatably mounted on the carriage 124 for rotating according to a longitudinal translation of the tether into the outer elongated instrument, as previously detailed.
- a pulley position sensing arrangement 664 is also provided for sensing an angular position of the pulley 620 representative of a relative longitudinal position of the inner elongated instrument attached to the tether.
- the apparatus 100 is also provided with a feedback force actuator 600 mounted on the carriage 124 and operatively connected to the casing 102 for applying an adjustable resistive force to a translation of the carriage 124 on the longitudinal guide 118 according to the sensed longitudinal position of the carriage 124 and resistance characteristics of the structure as previously detailed.
- the feedback force actuator 600 is further connected to an axle 628 of the pulley 620 for applying an adjustable resistive force to a rotation of the pulley according to the sensed angular position of the pulley 620 and the resistance characteristics of the structure.
- an axial rotation of the outer elongated instrument through the aperture 116 of the casing 102 may be sensed with an angular position sensing element 500 mounted on the mounting plate 400 of the carriage 124 , while an angular feedback force actuator (not shown) is provided for applying an adjustable resistive force to such sensed axial rotation, according to the resistance characteristics of the structure.
- the apparatus 100 is provided with an embedded control unit 220 for controlling the feedback force actuators according to the various sensed positions.
- the apparatus 100 previously described may be used in a medical insertion simulator as illustrated in FIG. 12 .
- a single stepper motor 602 is controlled according to various modes of simulation for providing corresponding resistive forces to the pulley 620 and the carriage 124 .
- This arrangement is of great advantage to provide a compact apparatus.
- Others arrangements for actuating the carriage 124 and the pulley 620 may also be envisaged, for example two distinct actuators suitably mounted and controlled.
- FIG. 7 shows another embodiment of an apparatus 700 for simulation insertion wherein the arrangement used for applying the resistive force to the carriage 124 is slightly different.
- the carriage 124 is also mounted on two parallel longitudinal guides 118 , 118 ′.
- a controlled latch mechanism 710 mounted to the casing 102 and having a movable member 712 cooperating with the carriage 124 is provided for latching the carriage 124 in resting position, for transport purposes and/or according to a specific simulation application for example.
- the apparatus may be operated through a portable computer and associated control cards and software to provide a portable realistic simulator easy to mount and use.
- the apparatus may have a casing of a total weight of 10 lb with total dimensions small enough to fit with a portable computer and associated accessories in a carry-on whose dimensions are less than 25′′ ⁇ 20′′ ⁇ 14.5′′, which is of great advantage for transport purposes.
- the apparatus is designed small enough to fit in a carry-on while still providing an operating range long enough to enable a realistic simulation of an implantation of a medical implantable device in the heart through the femoral artery.
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Abstract
The present disclosure relates to an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument. The apparatus has a carriage for mounting the outer elongated instrument, for translation according to a translation of the outer elongated instrument. The apparatus has a pulley for anchoring a tether and rotating according to a longitudinal translation of the tether into the outer elongated instrument. The apparatus has a feedback force actuator for applying an adjustable resistive force to a translation of the carriage according to the sensed longitudinal position of the carriage and resistance characteristics of the structure, and for further applying an adjustable resistive force to a rotation of the pulley according to the sensed angular position of the pulley and the resistance characteristics. The present disclosure also relates to a medical insertion simulator comprising such an apparatus.
Description
- The present invention generally relates to apparatuses for simulating insertion of an elongated instrument into a structure and medical insertion simulators for healthcare training.
- Minimally invasive surgical procedures through the use of endoscopic instruments are more and more used for replacing conventional surgery. Indeed, technological progresses have provided miniaturized tools and implements that can be inserted through an endoscopic instrument in the body of a human for performing various tasks. These tools are generally combined with a video system to view from the inside the procedure being performed.
- Virtual simulation systems have been developed for training medical professionals to perform these types of procedures. These simulation systems aim to produce realistic real-time simulated operating conditions for providing interactive training through the combination of real-time visual representation and interactive tactile force feedback returned to the medical professional under training.
- The systems of the prior art are however complex, cumbersome and expensive. The haptic sensation returned to the trained medical professional is oftentimes not realistic enough. Moreover, such simulation systems often have to be used at a training center, as they are not designed to be easily transportable.
- It would therefore be desirable to provide an improved simulation apparatus that would reduce at least one of the above-mentioned drawbacks of known simulation system.
- It is an object of the present invention to obviate or mitigate at least one disadvantage of previous simulation apparatus for simulating insertion of an elongated instrument into a structure.
- It is another object to provide a portable simulation apparatus for simulating insertion of an elongated instrument into a structure that is transported in a conventional carry-on luggage.
- It is another object of the invention to provide a simulation apparatus particularly adapted for simulation of transcatheter pacemaker implantation procedure.
- Accordingly, there is provided an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument. The apparatus comprises a casing having an aperture for receiving a distal end of the outer elongated instrument therethrough and a longitudinal guide fixedly mounted in the casing. The apparatus is provided with a carriage comprising a mounting plate for mounting the distal end of the outer elongated instrument, the carriage being slidably mounted onto the longitudinal guide for translation thereon according to a translation of the outer elongated instrument through the aperture of the casing. The apparatus also has a carriage position sensing element for sensing a longitudinal position of the carriage along the longitudinal guide. The apparatus further comprises a pulley having an outer tether receiving groove on a peripheral portion thereof and an anchoring element therein for anchoring a distal end of a tether extending through the outer elongated instrument, the pulley being rotatably mounted on the carriage for rotating according to a longitudinal translation of the tether into the outer elongated instrument. The apparatus is also provided with a pulley position sensing arrangement for sensing an angular position of the pulley representative of a relative longitudinal position of the inner elongated instrument attached to the tether. The apparatus also has a feedback force actuator mounted on the carriage and operatively connected to the casing for applying an adjustable resistive force to a translation of the carriage on the longitudinal guide according to the sensed longitudinal position of the carriage and resistance characteristics of the structure, the feedback force actuator being further connected to an axle of the pulley for applying an adjustable resistive force to a rotation of the pulley according to the sensed angular position of the pulley and the resistance characteristics of the structure.
- According to another aspect, there is also provided a medical insertion simulator comprising an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument. The medical insertion simulator is provided with an outer elongated instrument for attachment in the apparatus and a control unit for controlling the feedback force actuator. The medical insertion simulator further has a processing unit for receiving the sensed longitudinal position of the carriage, the sensed angular position of the pulley and a model of a patient's internal structure and associated resistance characteristics of the structure. The processing unit further determines the adjustable resistive force to apply to the translation of the carriage and the adjustable resistive force to apply to the rotation of the pulley according to previously received information for operating the control unit. The processing unit then further produces a visual display image of the patient's internal structure and movement of the inner and outer elongated instruments therein. The medical insertion simulator is further provided with a display unit for displaying the produced visual display image.
- Embodiments of the disclosure will be described by way of example only with reference to the accompanying drawings, in which:
-
FIG. 1 is a partially exploded perspective view of an example of an apparatus for simulating insertion of an elongated instrument; -
FIG. 2 is a further partially exploded perspective view of a portion of the apparatus ofFIG. 1 ; -
FIG. 3 is a further partially exploded perspective view of another portion of the apparatus ofFIG. 1 ; -
FIG. 4 is an exploded perspective view of a mounting plate and a mounting shaft arrangement; -
FIG. 5 is a partially exploded perspective view of the mounting plate ofFIG. 4 with a sensing element; -
FIG. 6 is an exploded view of a pulley and a feedback force actuator of the apparatus ofFIG. 1 ; -
FIG. 7 is a top view of another example of an apparatus for simulating insertion of an elongated instrument; -
FIG. 8 is an exploded partial side view of the apparatus shown inFIG. 7 ; -
FIG. 9 is an enlarged view of the right portion ofFIG. 8 ; -
FIG. 10 is a perspective partial view showing the mounting of a tether with a pulley; -
FIG. 11 is a top view of a portion of the apparatus ofFIG. 7 , with an elongated instrument mounted therein; -
FIG. 12 is a schematic view of an example of a medical insertion simulator; and -
FIG. 13 is a perspective view of an example of an elongated instrument. - The foregoing and other features will become more apparent upon reading of the following non-restrictive description of illustrative embodiments thereof, given by way of example only with reference to the accompanying drawings. Like numerals represent like features on the various drawings.
- Various aspects of the present disclosure generally address one or more of the problems of simulating medical interventions relying on insertion of a medical instrument into an anatomical structure of a patient such as veins, arteries and other tubular anatomical structures. In the present description, these aspects will be described in the specific application of simulating the implantation of a micro-pacemaker small enough to be delivered with minimally invasive techniques through a catheter, and implanted directly into the heart. In one example, the micro-pacemaker is provided with flexible tines attachable to the interior of the right ventricle. The tines can be engaged and disengaged during the implantation process without causing trauma to the cardiac tissue, thereby allowing the device to be repositioned during implantation or retrieved if needed.
- The various aspects of the present disclosure described therein are particularly well suited for training medical professionals to perform such transcatheter pacemaker implantation process although the skilled person in the art will appreciate that various other applications not limited to the medical field may also be envisaged.
- Transcatheter pacemaker implantations are generally performed through an opening realized in the femoral artery in the groin region although other entry points may be used.
- Training of such a procedure may be done as a sequence of procedures, for example an initial catheter insertion up to the heart, fine manipulation of the implant inside the heart before final attachment, or as complete procedure encompassing all the manipulations required for a complete implantation process.
- The present apparatus thus allows training medical professionals on a sequence of procedures of the complete procedure with improved realistic feedback feeling.
- The apparatus may be used with a conventional portable PC and is compact enough to provide a complete portable simulator fitting in a conventional carry-on luggage, as detailed below.
- Referring to
FIG. 1 , there is shown a partially exploded view of an example of anapparatus 100 for simulating insertion of an elongated instrument (not shown), a medical catheter for example, into a structure such as an artery. - In the illustrated embodiment, the
apparatus 100 has acasing 102 provided with bottom, top, front andback panels top panel 106 can be slidably mounted to thebottom panel 104 throughslides panels casing 102 and enabling a quick installation of the elongated instrument in theapparatus 100. - The
front panel 108 is provided with anaperture 116 for receiving a distal end of the elongated instrument therethrough, as it will become more apparent below with reference toFIGS. 8 to 12 . Various additional apertures are provided, for example in the front and back panels, for power and electronics communication. - Still referring to
FIG. 1 and also toFIG. 2 andFIG. 3 which are further exploded view of portions of theapparatus 100, theapparatus 100 is also provided with alongitudinal guide 118 fixedly mounted in thecasing 102, for example through aguide rail 120 secured to abottom mounting plate 122 secured to thebottom panel 104. Thelongitudinal guide 118 could consist of a rail, a pair of rails, a channel, a tunnel, or any other type of structure, which can act as a longitudinal guide. Theapparatus 100 also has acarriage 124 slidably mounted onto thelongitudinal guide 118 for translation therealong. In the illustrated embodiment, thecarriage 124 has abase plate 126 freely sliding onto theguide 118 between two abutting positions defined withabutting elements guide 118 to restrain the travel of thecarriage 124 onto a longitudinal operating range. Limits switches (not shown) can be provided for control purposes. Thecarriage 124 further has a mountingbracket 132 secured to thebase plate 126 and a mountingplate 400 secured to thecarriage 124 through the mountingbracket 132. - The mounting
plate 400, which is better shown in exploded views thereof inFIG. 4 andFIG. 5 , is used for mounting the distal end of the elongated instrument to thecarriage 124. With this arrangement, a translation of the elongated instrument operated by a user through theaperture 116 of thecasing 102 for simulating insertion and/or removal of the elongated instrument will generate a corresponding translation of thecarriage 124 along thelongitudinal guide 118 inside thecasing 102. - The mounting
plate 400 has a receivingportion 402 for receiving a corresponding attaching portion (not shown) mounted at the distal end of the instrument. In the illustrated example, ashaft 404 is rotatably mounted through the mountingplate 400 and secured in place withsnap ring 406 to thereby provide a axial rotating connection of the elongated instrument to thecarriage 124. Thetip 408 of theshaft 404 projecting outward thecasing 102 has a threadedportion 410 for receiving a corresponding threaded portion of the distal end of the instrument to firmly secure the two elements together. Anoptional rotation stopper 412 may be installed with theshaft 404 to limit the axial rotational course of theshaft 404 to thereby limit the axial rotational course of the elongated instrument through theaperture 116 of thecasing 102. - To provide a more realistic feedback to a user of the
apparatus 100, a feedback system sensitive to the axial rotation of the instrument is provided. As illustrated, an angularposition sensing element 500 can be used for sensing a relative axial rotation of theshaft 404 and thereby of the elongated instrument. The angularposition sensing element 500 can be for example anoptical encoder 502 having acircular disk 504 fixedly mounting around theshaft 404 and an associatedoptical reader 506 secured to the mountingplate 400. An angular feedback force actuator (not shown) mounted with the mountingplate 400 may be used for applying an adjustable resistive force to a rotation of theshaft 404 according to the sensed relative axial rotation, as further detailed below. - Referring again to
FIG. 2 , theapparatus 100 is provided with afeedback force actuator 600 mounted on thecarriage 124 and operatively connected to thecasing 102 for applying an adjustable resistive force to a translation of thecarriage 124 on thelongitudinal guide 118. In the illustrated embodiment, thefeedback force actuator 600 has an electric motor 602 (for example a stepper motor) whoseframe 604 is secured to thecarriage 124 though a supporting plate 606 secured to the mountingplate 400. Thefeedback force actuator 600 may optionally further comprise atransmission element 200 mounted between themotor 602 and theguide 118 for applying a resistive force to thecarriage 124. Thetransmission element 200 could consist of a belt cooperating with therotating shaft 608 of themotor 602 although various other arrangements for applying a resistive force to thecarriage 124 may alternatively be envisaged. - A carriage
position sensing element 300, alinear encoder strip 302 mounted along theguide 118 and a correspondingoptical reader 304 as shown inFIG. 3 for example, is used for sensing a longitudinal position of thecarriage 124 along thelongitudinal guide 118. - The
apparatus 100 is provided with an embeddedcontrol unit 220 mounted on thebottom plate 122 for controlling thefeedback force actuator 600 according to the sensed position of thecarriage 124 and eventually the sensed relative axial rotation of the elongated instrument, and further according to resistance characteristics of the structure. The resistance characteristics of the structure are representative of a patient's internal structure into which a medical catheter is to be inserted. These resistance characteristics may be provided by a specific 3D model of a structure of a specific patient and may embed natural movements of a human body like heart beating and breathing. - With reference to
FIG. 12 , amedical insertion simulator 10 will now be described. Themedical insertion simulator 10 is provided with anapparatus 100 for simulating insertion of an elongated instrument into a structure as described above and shown inFIG. 1 and a correspondingelongated instrument 50 for attachment in theapparatus 100. Themedical insertion simulator 10 also has acontrol unit 20 embedded in thecasing 102 of theapparatus 100 for controlling thefeedback force actuator 600. - The
medical insertion simulator 10 is further provided with aprocessing unit 30 connected to theapparatus 100 for receiving the sensed longitudinal position of thecarriage 124 and eventually the sensed relative axial rotation of theelongated instrument 50. At least one model of a patient's internal structure and associated resistance characteristics of the structure is provided to theprocessing unit 30 for further determination of the adjustable resistive force to apply to the translation of thecarriage 124 and eventually the adjustable resistive force to apply to the relative axial rotation of theelongated instrument 50 according to previously received position information. Theprocessing unit 30 further operates thecontrol unit 20 to simulate a realistic insertion in the specific structure in providing forces (i.e. haptic feedback) to the movements of the user operating theelongated instrument 50. Theprocessing unit 30 further produces a visual display image of the patient's internal structure and movement of theelongated instrument 50 therein and displays the produced visual display image in real time on adisplay unit 40. Theprocessing unit 30 can be for example a portable computer provided with suitable control cards and software. - Reference is now made to
FIG. 13 showing an example of atraining handle 60 usable with theapparatus 100 and toFIG. 11 . The training handle 60 has a grippingportion 62 connected to a rigidelongated instrument 50 connectable to the mountingplate 400. Thedistal end 52 of the rigidelongated instrument 50 is provided with a threadedtip 54 for mounting with the threadedportion 410 of thetip 408 of theshaft 404. Optionally, anintroducer 56 may be coaxially secured with the rigidelongated instrument 50 in theaperture 116 of thecasing 102 to provide a sliding longitudinal relationship of the training handle 60 in and out of thecasing 102. - In the illustrated example, the training handle 60 is further provided with a
tether 64 extending through the rigidelongated instrument 50 and the grippingportion 62 and therealong. The distal end of the tether 64 (which corresponds to thedistal end 52 of the rigid elongated instrument 50) is used to simulate the position of a medical implantable device to which thetether 64 is attached. Thetether 64 is driven inside and out of the rigidelongated instrument 50 throughcontrols 66 provided on the grippingportion 62. Thecontrols 66 further allow controlling thedistal end 52 of the rigidelongated instrument 50. Additional controls for simulating further spatial movements of the medical implantable device attached to thetether 64 may also be provided for further realistic simulation of a complete implantation procedure, as it will become apparent below. - Referring again to
FIG. 1 andFIG. 2 and also toFIG. 6 which is an exploded view of a portion of the apparatus shown inFIG. 1 , theapparatus 100 may also be used for simulating insertion of an elongated instrument, for example a medical implantable device, attached to a tether into a structure, for example a patient's internal structure into which the medical implantable device is to be implanted. In other words, this arrangement may enable to simulate installation of the medical implantable device into the structure once this implantable device has already been brought proximate the structure into which the implantation has to be performed. - The
aperture 116 of thecasing 102 receives a distal end of the tether therethrough for attachment therein, as better described below with reference toFIG. 10 . Theapparatus 100 is provided with apulley 620 having an outertether receiving groove 622 on aperipheral portion 624 thereof and ananchoring element 626 therein for anchoring the distal end of the tether extending through theaperture 116 of thecasing 102. Thepulley 620 is rotatably mounted in thecasing 102 for rotating according to a longitudinal translation of the tether relatively to thecasing 102. - The
apparatus 100 also has afeedback force actuator 600 connected to anaxle 628 of thepulley 620 for applying an adjustable resistive force to a rotation of thepulley 620. As better shown inFIG. 6 , thefeedback force actuator 600 is for example anelectric motor 602, such as for example a stepper motor, operatively connected to theaxle 628 of thepulley 620. In the illustrated example, thestepper motor 602 is operatively connected to thecasing 102 through a mountingplate 630 attached to theframe 604 of themotor 602. Theshaft 640 of themotor 602 is mounted on theaxle 628 of thepulley 620 and is secured in place through aset screw 642 extending radially to theaxle 628 through thepulley 620. In the illustrated example, thepulley 620 has the shape of a partial disk or a disk in which a radial portion has been removed to provide opposedradial surfaces set screw 642 is mounted with the axle through one of the radial surfaces. A retainingplate 648 associated with atorsion spring 650 and apin spring 652 is arranged between the tworadial surfaces plate 648 against a corresponding radial surface. This arrangement defines ananchoring point 654 for anchoring the distal end of the tether to thepulley 620 while a portion of the tether extends in the outertether receiving groove 622 on theperipheral portion 624 of thepulley 620. With this arrangement, the tether can be easily installed and removed from theapparatus 100. - Still referring to
FIG. 6 , thepulley 620 may be provided with anabutting pin 656 extending radially on theside 658 of thepulley 620 and cooperating with an associated abutting device attached to thecasing 102 for restraining a pivotal movement of thepulley 620. As illustrated, the mountingplate 630 used for mounting themotor 602 may be shaped to provide an abutting shaped surface limiting the rational course of thepulley 620. As an example, the mountingplate 630 has a circular portion around which theabutting pin 656 may freely moves and two abuttingelements pulley 620. - The
apparatus 100 is also provided with asensing arrangement 664 for sensing an angular position of thepulley 620. Thesensing arrangement 664 has a sensor mounted to the mountingplate 630 for sensing a relative position of theabutting pin 656. Alternatively, as it should become apparent below, the relative position of the tether tip could be determined through the controls provided on a training handle. - In addition to
FIG. 6 , reference is now made toFIG. 8 toFIG. 10 which are partial views of theapparatus 100 showing the anchoring of the distal end of the tether to thepulley 620. In the illustrated example, atraining handle 800 similar to the one illustrated inFIG. 13 and provided with atether 802 is used. Thedistal end 804 of thetether 802, which can be provided with atip 806 having a larger diameter than the outertether receiving groove 622 of thepulley 620, is first inserted through theaperture 116 of thecasing 102. To attach thedistal end 804 of thetether 802 to thepulley 620, one has first to rotate the retaining plate 648 (seeFIG. 10 ), insert thetip 806 of thedistal end 804 in the outertether receiving groove 622 on theperipheral portion 624 and trap thisend 804 with thepulley 620 in releasing the spring biased retainingplate 648. - As it should become apparent, upon longitudinal translation of the
tether 802 inside thecasing 102, thepulley 620 rotates accordingly while thetether 802 freely winds in the receivinggroove portion 622. The sensed angular position of thepulley 620 is representative of a relative longitudinal position of thetip 806 of thetether 802 in thecasing 102. - The
apparatus 100 is provided with an embeddedcontrol unit 220 mounted on thebottom plate 122 for controlling thefeedback force actuator 600 according to the sensed angular position of thepulley 620, and further according to resistance characteristics of the structure. The resistance characteristics of the structure are representative of a patient's internal structure into which an elongated instrument like a medical implantable device is to be inserted. These resistance characteristics may be generated using a 3D model of a structure of a specific patient, embedding natural movements of a human body like heart beating and breathing. The resistance characteristics may comprise a combination of predetermined resistance characteristics (i.e. static) and modeled resistance characteristics (i.e. dynamic). - The assembly of the
pulley 620 and theactuator 600 may be fixedly mounted in thecasing 102. Alternatively and as illustrated inFIG. 1 toFIG. 3 , thepulley 620 may be mounted on thecarriage 124 slidable along thelongitudinal guide 118. This latter arrangement may provide a more realistic simulation of an installation of a medical implantable device into a structure embedding natural movements of a human body. - Referring again to
FIG. 12 , another example of amedical insertion simulator 10 for simulating an installation of a medical implantable device into a structure will now be described. Themedical insertion simulator 10 is provided with anapparatus 100 for simulating insertion of an elongated instrument, such as a medical implantable device, attached to a tether, into a structure, theapparatus 100 having a pulley and feedbackforce actuator assembly FIG. 6 . Themedical insertion simulator 10 is also provided with atether 64 embedded in atraining handle 60. Thetether 64 has a distal end for anchoring to the anchoring element of thepulley 620. Themedical insertion simulator 10 also has acontrol unit 20 embedded in the casing of theapparatus 100 for controlling thefeedback force actuator 600 of thepulley 620. - The
insertion simulator 10 is further provided with aprocessing unit 30 connected to theapparatus 100 for receiving the sensed angular position of thepulley 620. At least one model of a patient's internal structure and associated resistance characteristics of the structure is provided to theprocessing unit 30 for further determination of the adjustable resistive force to apply to the rotation of thepulley 620 according to previously received position information. Theprocessing unit 30 further operates thecontrol unit 20 to simulate a realistic implantation in the specific structure in providing forces to the movements of the user operating thetether 64. Theprocessing unit 30 further produces a visual display image of the patient's internal structure and movement of the implantable device therein and displays the produced visual display image in real time on adisplay unit 40. - As it should be apparent, the apparatus for simulating insertion and associated simulators previously described enable a realistic medical training of the initial catheter insertion up to the heart only, or the fine manipulation only of the implantable device inside the heart structure before final attachment thereto.
- Referring again to
FIG. 1 andFIG. 2 and also toFIG. 12 , another example of anapparatus 100 and associatedsimulator 10 enabling to simulate the whole implantation procedure including initial catheter insertion up to the heart and subsequent fine manipulation of the implantable device outside the catheter for final attachment will now be described. Thisapparatus 10 controls whole or partial simulation. In the following description and for ease of understanding, in which the catheter used to bring the implantable device up to the structure is alternatively called the outer elongated instrument while the implantable device initially extending inside the catheter and attached to a tether is called the inner elongated instrument. - The
apparatus 10 has acasing 102 having anaperture 116 for receiving a distal end of the outer elongated instrument therethrough and alongitudinal guide 118 fixedly mounted in thecasing 102. Theapparatus 100 also has acarriage 124 provided with a mountingplate 400 for mounting the distal end of the outer elongated instrument. Thecarriage 124 is slidably mounted onto thelongitudinal guide 118 for translation thereon according to a translation of the outer elongated instrument through theaperture 116 of thecasing 102, as previously detailed. A carriageposition sensing element 300 is provided for sensing a longitudinal position of thecarriage 124 along thelongitudinal guide 118. Theapparatus 100 is also provided with apulley 620 having an outertether receiving groove 622 on aperipheral portion 624 thereof and ananchoring element 626 therein for anchoring a distal end of a tether extending through the outer elongated instrument. Thepulley 620 is rotatably mounted on thecarriage 124 for rotating according to a longitudinal translation of the tether into the outer elongated instrument, as previously detailed. A pulleyposition sensing arrangement 664 is also provided for sensing an angular position of thepulley 620 representative of a relative longitudinal position of the inner elongated instrument attached to the tether. Theapparatus 100 is also provided with afeedback force actuator 600 mounted on thecarriage 124 and operatively connected to thecasing 102 for applying an adjustable resistive force to a translation of thecarriage 124 on thelongitudinal guide 118 according to the sensed longitudinal position of thecarriage 124 and resistance characteristics of the structure as previously detailed. Thefeedback force actuator 600 is further connected to anaxle 628 of thepulley 620 for applying an adjustable resistive force to a rotation of the pulley according to the sensed angular position of thepulley 620 and the resistance characteristics of the structure. To provide a more realistic simulation, an axial rotation of the outer elongated instrument through theaperture 116 of thecasing 102 may be sensed with an angularposition sensing element 500 mounted on the mountingplate 400 of thecarriage 124, while an angular feedback force actuator (not shown) is provided for applying an adjustable resistive force to such sensed axial rotation, according to the resistance characteristics of the structure. Theapparatus 100 is provided with an embeddedcontrol unit 220 for controlling the feedback force actuators according to the various sensed positions. - The
apparatus 100 previously described may be used in a medical insertion simulator as illustrated inFIG. 12 . - In the illustrated examples, a
single stepper motor 602 is controlled according to various modes of simulation for providing corresponding resistive forces to thepulley 620 and thecarriage 124. This arrangement is of great advantage to provide a compact apparatus. Others arrangements for actuating thecarriage 124 and thepulley 620 may also be envisaged, for example two distinct actuators suitably mounted and controlled. -
FIG. 7 shows another embodiment of anapparatus 700 for simulation insertion wherein the arrangement used for applying the resistive force to thecarriage 124 is slightly different. Thecarriage 124 is also mounted on two parallellongitudinal guides latch mechanism 710 mounted to thecasing 102 and having amovable member 712 cooperating with thecarriage 124 is provided for latching thecarriage 124 in resting position, for transport purposes and/or according to a specific simulation application for example. - With its embedded control unit and its compact design, the apparatus may be operated through a portable computer and associated control cards and software to provide a portable realistic simulator easy to mount and use. The apparatus may have a casing of a total weight of 10 lb with total dimensions small enough to fit with a portable computer and associated accessories in a carry-on whose dimensions are less than 25″×20″×14.5″, which is of great advantage for transport purposes. In fact, the apparatus is designed small enough to fit in a carry-on while still providing an operating range long enough to enable a realistic simulation of an implantation of a medical implantable device in the heart through the femoral artery.
- Although the present disclosure has been described hereinabove by way of non-restrictive, illustrative embodiments thereof, these embodiments may be modified at will within the scope of the appended claims without departing from the present claims.
Claims (11)
1. An apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument, the apparatus comprising:
a casing having an aperture for receiving the outer elongated instrument therethrough;
a longitudinal guide fixedly mounted in the casing;
a carriage comprising a mounting plate and a shaft rotationally mounted through the mounting plate, the shaft receiving a distal end of the outer elongated instrument, the carriage being slidably mounted onto the longitudinal guide for translation thereon according to a translation of the outer elongated instrument through the aperture of the casing;
a carriage position sensing element for sensing a longitudinal position of the carriage along the longitudinal guide;
a pulley having an outer tether receiving groove on a peripheral portion thereof and an anchoring element therein for anchoring a distal end of a tether extending through the outer elongated instrument, the pulley being rotatably mounted on the carriage for rotating in response to a pulling movement of the tether by a user of the outer elongated instrument in the outer elongated instrument;
a pulley position sensing arrangement for sensing an angular position of the pulley representative of a relative longitudinal position of the inner elongated instrument attached to the tether; and
a feedback force actuator mounted on the carriage for applying resistive force to a translation of the carriage on the longitudinal guide according to the sensed longitudinal position of the carriage, the feedback force actuator being further connected to an axle of the pulley for applying resistive force to a rotation of the pulley according to the sensed angular position of the pulley.
2. (canceled)
3. The apparatus of claim 1 , further comprising an angular position sensing element mounted on the mounting plate of the carriage for sensing a relative axial rotation of the outer elongated instrument through the aperture of the casing.
4. The apparatus of claim 3 , further comprising an angular feedback force actuator for applying resistive force to a rotation of the outer elongated instrument through the aperture of the casing according to the sensed relative axial rotation.
5. The apparatus of claim 1 , further comprising a control unit for controlling the feedback force actuator and applying the corresponding resistive forces to the translation of the carriage and the rotation of the pulley.
6. The apparatus of claim 1 , wherein the feedback force actuator comprises a stepper motor mounted on the carriage and connected to the axle of the pulley, the feedback force actuator further comprising a transmission element mounted between the motor and the guide for applying the resistive force to the carriage.
7. (canceled)
8. (canceled)
9. The apparatus of claim 1 , wherein the outer elongated instrument comprises a medical catheter and the inner elongated instrument attached to the tether is a medical implantable device, and further wherein the resistance characteristics of the structure are representative of a patient's internal structure into which the outer elongated instrument is to be inserted before the medical implantable device is to be implanted.
10. A medical insertion simulator comprising:
an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument of claim 1 ;
an outer elongated instrument for attachment in the apparatus;
a control unit for controlling the feedback force actuator;
a processing unit for receiving the sensed longitudinal position of the carriage, the sensed angular position of the pulley and a model of a patient's internal structure and associated resistance characteristics, the processing unit further determining the resistive force to apply to the translation of the carriage and the resistive force to apply to the rotation of the pulley according to previously received information for operating the control unit, the processing unit further producing a visual display image of the patient's internal structure and movement of the inner and outer elongated instruments therein; and
a display unit for displaying the produced visual display image.
11. A medical insertion simulator comprising:
an apparatus for simulating insertion of an inner elongated instrument attached to a tether into a structure through an outer elongated instrument of claim 4 ;
an outer elongated instrument for attachment in the apparatus;
a control unit for controlling the feedback force actuator;
a processing unit for receiving the sensed longitudinal position of the carriage, the sensed angular position of the pulley, the sensed relative axial rotation and a model of a patient's internal structure and associated resistance characteristics, the processing unit further determining the resistive force to apply to the translation of the carriage, the resistive force to apply to the rotation of the pulley and the force to apply to the relative axial rotation according to previously received information for operating the control unit, the processing unit further producing a visual display image of the patient's internal structure and movement of the inner and outer elongated instruments therein; and
a display unit for displaying the produced visual display image.
Priority Applications (1)
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PCT/CA2017/050236 WO2017143448A1 (en) | 2016-02-26 | 2017-02-23 | Apparatus for simulating insertion of an elongated instrument into a structure including a pulley and a pulley position sensing arrangement |
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CA2921852 | 2016-02-26 | ||
CA2921852A CA2921852C (en) | 2016-02-26 | 2016-02-26 | Apparatus for simulating insertion of an elongated instrument into a structure and medical insertion simulator |
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Citations (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5431645A (en) * | 1990-05-10 | 1995-07-11 | Symbiosis Corporation | Remotely activated endoscopic tools such as endoscopic biopsy forceps |
US5623582A (en) * | 1994-07-14 | 1997-04-22 | Immersion Human Interface Corporation | Computer interface or control input device for laparoscopic surgical instrument and other elongated mechanical objects |
US5769640A (en) * | 1992-12-02 | 1998-06-23 | Cybernet Systems Corporation | Method and system for simulating medical procedures including virtual reality and control method and system for use therein |
US5800179A (en) * | 1996-07-23 | 1998-09-01 | Medical Simulation Corporation | System for training persons to perform minimally invasive surgical procedures |
US5821920A (en) * | 1994-07-14 | 1998-10-13 | Immersion Human Interface Corporation | Control input device for interfacing an elongated flexible object with a computer system |
US6074213A (en) * | 1998-08-17 | 2000-06-13 | Hon; David C. | Fractional process simulator with remote apparatus for multi-locational training of medical teams |
US6096004A (en) * | 1998-07-10 | 2000-08-01 | Mitsubishi Electric Information Technology Center America, Inc. (Ita) | Master/slave system for the manipulation of tubular medical tools |
US6106301A (en) * | 1996-09-04 | 2000-08-22 | Ht Medical Systems, Inc. | Interventional radiology interface apparatus and method |
US20010055748A1 (en) * | 2000-05-15 | 2001-12-27 | Bailey Bradford E. | System for training persons to perform minimally invasive surgical procedures |
US6375471B1 (en) * | 1998-07-10 | 2002-04-23 | Mitsubishi Electric Research Laboratories, Inc. | Actuator for independent axial and rotational actuation of a catheter or similar elongated object |
US20020111635A1 (en) * | 1995-06-07 | 2002-08-15 | Sri International | Surgical manipulator for a telerobotic system |
US20040048230A1 (en) * | 1996-09-04 | 2004-03-11 | Ht Medical Systems, Inc. | Interface device and method for interfacing instruments to medical procedure simulation systems |
US20040076940A1 (en) * | 1998-01-28 | 2004-04-22 | Immersion Medical, Inc. | Interface device and method for interfacing instruments to medical procedure simulation systems |
US20060127864A1 (en) * | 2002-12-03 | 2006-06-15 | Fredrik Ohlsson | Interventional simulation device |
US20060234195A1 (en) * | 2002-12-03 | 2006-10-19 | Jan Grund-Pedersen | Interventional simulator control system |
US20070063971A1 (en) * | 2004-03-12 | 2007-03-22 | Xitact S.A. | Actuator for an elongated object for a force feedback generating device |
US20070103437A1 (en) * | 2005-10-26 | 2007-05-10 | Outland Research, Llc | Haptic metering for minimally invasive medical procedures |
US20080126041A1 (en) * | 2006-11-16 | 2008-05-29 | Peter Maspoli | Systems and Methods for Medical Tool Auto-Capture |
US7455523B2 (en) * | 2004-06-14 | 2008-11-25 | Medical Simulation Corporation | Medical simulation system and method |
US20090130643A1 (en) * | 2005-07-20 | 2009-05-21 | Corrado Cusano | Method for simulating a manual interventional operation by a user in a medical procedure |
US7815436B2 (en) * | 1996-09-04 | 2010-10-19 | Immersion Corporation | Surgical simulation interface device and method |
US7819799B2 (en) * | 2000-03-16 | 2010-10-26 | Immersion Medical, Inc. | System and method for controlling force applied to and manipulation of medical instruments |
US20110015483A1 (en) * | 2009-07-16 | 2011-01-20 | Federico Barbagli | Endoscopic robotic catheter system |
US20110178508A1 (en) * | 2010-01-15 | 2011-07-21 | Ullrich Christopher J | Systems and Methods for Minimally Invasive Surgical Tools with Haptic Feedback |
US20120178062A1 (en) * | 2009-09-04 | 2012-07-12 | Ecole Polytechnique Federale De Lausanne | Haptic Interface for Simulator, Such as a Colonoscopy Simulator |
US8485829B2 (en) * | 2005-07-20 | 2013-07-16 | DIES S.r.l. | System and a method for simulating a manual interventional operation by a user in a medical procedure |
US20150289946A1 (en) * | 2012-11-30 | 2015-10-15 | Surgical Science Sweden Ab | User interface device for surgical simulation system |
US20150325147A1 (en) * | 2013-01-24 | 2015-11-12 | Surgical Science Sweden Ab | Haptic user interface device for surgical simulation system |
US20160117956A1 (en) * | 2013-06-07 | 2016-04-28 | Surgical Science Sweden Ab | A user interface for a surgical simulation system |
US20160166347A1 (en) * | 2013-08-26 | 2016-06-16 | Olympus Corporation | Medical manipulator |
Family Cites Families (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1051698B1 (en) | 1998-01-28 | 2018-01-17 | Immersion Medical, Inc. | Interface device and method for interfacing instruments to vascular access simulation systems |
US6538634B1 (en) | 1998-12-18 | 2003-03-25 | Kent Ridge Digital Labs | Apparatus for the simulation of image-guided surgery |
US6377011B1 (en) | 2000-01-26 | 2002-04-23 | Massachusetts Institute Of Technology | Force feedback user interface for minimally invasive surgical simulator and teleoperator and other similar apparatus |
WO2003021553A1 (en) | 2001-09-03 | 2003-03-13 | Xitact S.A. | Device for simulating a rod-shaped surgical instrument for generating a feedback signal |
US6773263B2 (en) | 2001-10-09 | 2004-08-10 | Robert J. Nicholls | Medical simulator |
GB0129593D0 (en) | 2001-12-11 | 2002-01-30 | Keymed Medicals & Ind Equip | An apparatus for use in training an operator in the use of an endoscope system |
GB2392000B (en) | 2002-08-13 | 2004-11-03 | Keymed | A dummy medical instrument for use in a simulator |
CN101653356B (en) | 2009-10-10 | 2011-01-05 | 上海交通大学 | Virtual surgery haptic information acquiring device |
CN102855799B (en) | 2012-09-06 | 2015-02-18 | 佛山市金天皓科技有限公司 | Neuro-endoscope simulation training device and system comprising same |
KR101372880B1 (en) | 2012-12-13 | 2014-03-10 | 한국과학기술원 | Rotational motion simulating device for haptic apparatus of simulator for training endoscope operation, haptic apparatus of simulator for training endoscope operation having the same and simulator for training endoscope operation having the same |
CN103280145B (en) | 2013-05-03 | 2016-01-13 | 上海交通大学 | Cardiovascular intervention virtual operation force feedback system |
CN203373002U (en) | 2013-07-09 | 2014-01-01 | 广州市海同机电设备有限公司 | Electric rail pulley |
CN203900980U (en) | 2014-05-21 | 2014-10-29 | 浙江金博金属科技有限公司 | Servo motor type screw drive device |
WO2016005959A1 (en) | 2014-07-11 | 2016-01-14 | Indian Institute Of Science | A device for simulating endoscopy and a system thereof |
CN204965812U (en) | 2015-08-31 | 2016-01-13 | 徐挺 | Two -dimentional emulation of medical treatment training operation device |
-
2016
- 2016-02-26 CA CA2921852A patent/CA2921852C/en active Active
- 2016-02-26 US US15/054,501 patent/US9754513B1/en active Active
-
2017
- 2017-02-23 WO PCT/CA2017/050236 patent/WO2017143448A1/en active Application Filing
Patent Citations (33)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5431645A (en) * | 1990-05-10 | 1995-07-11 | Symbiosis Corporation | Remotely activated endoscopic tools such as endoscopic biopsy forceps |
US5769640A (en) * | 1992-12-02 | 1998-06-23 | Cybernet Systems Corporation | Method and system for simulating medical procedures including virtual reality and control method and system for use therein |
US5623582A (en) * | 1994-07-14 | 1997-04-22 | Immersion Human Interface Corporation | Computer interface or control input device for laparoscopic surgical instrument and other elongated mechanical objects |
US5821920A (en) * | 1994-07-14 | 1998-10-13 | Immersion Human Interface Corporation | Control input device for interfacing an elongated flexible object with a computer system |
US20020111635A1 (en) * | 1995-06-07 | 2002-08-15 | Sri International | Surgical manipulator for a telerobotic system |
US5800179A (en) * | 1996-07-23 | 1998-09-01 | Medical Simulation Corporation | System for training persons to perform minimally invasive surgical procedures |
US7815436B2 (en) * | 1996-09-04 | 2010-10-19 | Immersion Corporation | Surgical simulation interface device and method |
US8480406B2 (en) * | 1996-09-04 | 2013-07-09 | Immersion Medical, Inc. | Interface device and method for interfacing instruments to medical procedure simulation systems |
US6106301A (en) * | 1996-09-04 | 2000-08-22 | Ht Medical Systems, Inc. | Interventional radiology interface apparatus and method |
US20040048230A1 (en) * | 1996-09-04 | 2004-03-11 | Ht Medical Systems, Inc. | Interface device and method for interfacing instruments to medical procedure simulation systems |
US20040076940A1 (en) * | 1998-01-28 | 2004-04-22 | Immersion Medical, Inc. | Interface device and method for interfacing instruments to medical procedure simulation systems |
US7806696B2 (en) * | 1998-01-28 | 2010-10-05 | Immersion Corporation | Interface device and method for interfacing instruments to medical procedure simulation systems |
US6096004A (en) * | 1998-07-10 | 2000-08-01 | Mitsubishi Electric Information Technology Center America, Inc. (Ita) | Master/slave system for the manipulation of tubular medical tools |
US6375471B1 (en) * | 1998-07-10 | 2002-04-23 | Mitsubishi Electric Research Laboratories, Inc. | Actuator for independent axial and rotational actuation of a catheter or similar elongated object |
US6074213A (en) * | 1998-08-17 | 2000-06-13 | Hon; David C. | Fractional process simulator with remote apparatus for multi-locational training of medical teams |
US7819799B2 (en) * | 2000-03-16 | 2010-10-26 | Immersion Medical, Inc. | System and method for controlling force applied to and manipulation of medical instruments |
US20010055748A1 (en) * | 2000-05-15 | 2001-12-27 | Bailey Bradford E. | System for training persons to perform minimally invasive surgical procedures |
US20060127864A1 (en) * | 2002-12-03 | 2006-06-15 | Fredrik Ohlsson | Interventional simulation device |
US20060234195A1 (en) * | 2002-12-03 | 2006-10-19 | Jan Grund-Pedersen | Interventional simulator control system |
US7520749B2 (en) * | 2002-12-03 | 2009-04-21 | Mentice Ab | Interventional simulation device |
US20070063971A1 (en) * | 2004-03-12 | 2007-03-22 | Xitact S.A. | Actuator for an elongated object for a force feedback generating device |
US7455523B2 (en) * | 2004-06-14 | 2008-11-25 | Medical Simulation Corporation | Medical simulation system and method |
US8485829B2 (en) * | 2005-07-20 | 2013-07-16 | DIES S.r.l. | System and a method for simulating a manual interventional operation by a user in a medical procedure |
US20090130643A1 (en) * | 2005-07-20 | 2009-05-21 | Corrado Cusano | Method for simulating a manual interventional operation by a user in a medical procedure |
US20070103437A1 (en) * | 2005-10-26 | 2007-05-10 | Outland Research, Llc | Haptic metering for minimally invasive medical procedures |
US20080126041A1 (en) * | 2006-11-16 | 2008-05-29 | Peter Maspoli | Systems and Methods for Medical Tool Auto-Capture |
US20110015483A1 (en) * | 2009-07-16 | 2011-01-20 | Federico Barbagli | Endoscopic robotic catheter system |
US20120178062A1 (en) * | 2009-09-04 | 2012-07-12 | Ecole Polytechnique Federale De Lausanne | Haptic Interface for Simulator, Such as a Colonoscopy Simulator |
US20110178508A1 (en) * | 2010-01-15 | 2011-07-21 | Ullrich Christopher J | Systems and Methods for Minimally Invasive Surgical Tools with Haptic Feedback |
US20150289946A1 (en) * | 2012-11-30 | 2015-10-15 | Surgical Science Sweden Ab | User interface device for surgical simulation system |
US20150325147A1 (en) * | 2013-01-24 | 2015-11-12 | Surgical Science Sweden Ab | Haptic user interface device for surgical simulation system |
US20160117956A1 (en) * | 2013-06-07 | 2016-04-28 | Surgical Science Sweden Ab | A user interface for a surgical simulation system |
US20160166347A1 (en) * | 2013-08-26 | 2016-06-16 | Olympus Corporation | Medical manipulator |
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US9754513B1 (en) | 2017-09-05 |
WO2017143448A1 (en) | 2017-08-31 |
CA2921852C (en) | 2016-11-29 |
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