Device for guiding a medical instrument inserted into a natural duct or an artificial duct of a patient
| Title: | Device for guiding a medical instrument inserted into a natural duct or an artificial duct of a patient |
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| Patent Number: | 9,895,197 |
| Publication Date: | February 20, 2018 |
| Appl. No: | 14/348323 |
| Application Filed: | September 28, 2012 |
| Abstract: | A device for guiding a medical instrument (2) inserted into a natural duct (101) or an artificial duct of a patient in order to bring at least a distal end (1) of the instrument in proximity to an internal organ (100). The device includes an articulated arm (3) with a plurality of degrees of freedom, for moving a proximal end (4) of the instrument, and a controlled blocking mechanism (7) for blocking the degrees of freedom of the articulated arm. The blocking mechanism is designed in such a way that, for at least one of the degrees of freedom, a blockage imposed on the degree of freedom can be released when an outer stress exerted on the instrument (2) exceeds a predetermined threshold. |
| Inventors: | Poquet, Cecile (Ivry-sur-seine, FR); Mozer, Pierre (Vincennes, FR); Baumann, Michael (Grenoble, FR); Vitrani, Marie-Aude (Paris, FR); Morel, Guillaume (Paris, FR); Leroy, Antoine (Meylan, FR); Henri, Patrick (Bois-Colombes, FR) |
| Assignees: | UNIVERSITE PIERRE ET MARIE CURIE (PARIS 6) (Paris, FR), CENTRE NATIONAL DE LA RECHERCHE SCIENTIFIQUE (Paris, FR), KIELIS (Grenoble, FR) |
| Claim: | 1. A device for guiding a medical instrument (2 ; 21) inserted into a natural duct (101 ; 201) or an artificial duct of a patient in order to bring at least a distal end (1) of the instrument in proximity to an internal organ (100 ; 200), the device comprising: an articulated arm (3 ; 27) with a plurality of degrees of freedom for moving a proximal end (4) of the instrument, controlled locking means (7 ; 30) for restricting the degrees of freedom of the articulated arm, the locking means being designed so that, for at least one of the degrees of freedom, imposed restriction of said degree of freedom can be released when an external effort exerted on the instrument (2 ; 21) exceeds a predetermined threshold, and a computing module (6 ; 29) for controlling the locking means, the guiding device comprises image acquisition means (10 ; 25), carried by the instrument, for acquiring images of the organ, the computing module being based on at least said images in order to control the locking means; and wherein the computing module comprises means for estimating the displacement of the organ relative to the instrument and/or any deformation of the organ, on the basis of images supplied by the image acquisition means, the computing module further comprising monitoring means communicating with the estimating means so as to determine on the basis of the estimated displacement and/or deformation whether locking should be released. |
| Claim: | 2. The guiding device as claimed in claim 1 , wherein the computing module (6 ; 29) comprises means for storing a position to be reached by the instrument (2 ; 21) relative to the organ (100 ; 200), the computing module controlling the locking means, on the basis of the images taken by the image acquisition means (10 ; 25), so as to impose restriction on at least one of the degrees of freedom of the articulated arm when the instrument is substantially close to said position. |
| Claim: | 3. The guiding device as claimed in claim 1 , wherein the locking means comprise at least one motor (7) arranged on an articulation of the articulated arm (3), the computing module (6) controlling the locking means by modulating an electric current passing through the motor. |
| Claim: | 4. The guiding device as claimed in claim 1 , wherein the locking means comprise at least one brake (30) arranged on an articulation of the articulated arm (27). |
| Claim: | 5. The guiding device as claimed in claim 1 , wherein the locking means are designed so that the predetermined threshold is determined according to external efforts already exerted on the instrument (2 ; 21) when the locking means (7 ; 30) impose restriction on the degrees of freedom of the articulated arm (3 ; 27). |
| Claim: | 6. The guiding device as claimed in claim 1 , comprising communication means (11 ; 26) for warning that imposed locking has been released. |
| Claim: | 7. The guiding device as claimed in claim 5 , wherein the communication means comprise a display screen (11 ; 26). |
| Claim: | 8. The guiding device as claimed in claim 1 , comprising means (32) for selecting a first operating mode wherein the locking means are deactivated so that no degree of freedom of the articulated arm (3 ; 27) is restricted or a second operating mode wherein the locking means are activated so that the degrees of freedom of the articulated arm (3 ; 27) are restricted. |
| Claim: | 9. The guiding device as claimed in claim 1 , wherein the articulated arm (27) is linked to the proximal end of the instrument (21) by a ball-joint type link (28). |
| Claim: | 10. The guiding device as claimed in claim 1 , comprising weight balancers (9) to balance the articulated arm (3) so that the proximal end (4) of the instrument is held substantially in the center of the duct into which the distal end (1) of the instrument (2) is inserted. |
| Claim: | 11. A method for controlling the locking means in the device of claim 1 , comprising the successive steps of: acquiring at least one reference image (I r) of the organ (100 ; 200), using the image acquisition means (10 ; 25) to acquire at least a first image (I s) of the organ, using the computing module (6 ; 29) to compute a similarity parameter (S) between the reference image and the first image, using the computing module to compare the similarity parameter with a predetermined similarity threshold (S min) representative of the predetermined effort threshold, using the computing module to control the locking means to release imposed locking if the similarity parameter is below the predetermined similarity threshold. |
| Claim: | 12. The method for controlling the locking means in the device of claim 1 , comprising the successive steps of: acquiring at least one reference image (I r) of the organ (100 ; 200), using the image acquisition means (10 ; 25) to acquire at least a first image (I s) of the organ, using the computing module (6 ; 29) to compute a Euclidean distance parameter (D e) and an angular distance parameter (D a) between the reference image and the first image, using the computing module to compare the Euclidean distance parameter with a predetermined Euclidean distance threshold (De min) and comparing the angular distance parameter with a predetermined angular distance threshold (Da min), each of the thresholds being representative of the predetermined effort threshold, using the computing module to control the locking means to release imposed locking if the Euclidean distance parameter exceeds the predetermined Euclidean distance threshold or if the angular distance parameter exceeds the predetermined angular distance threshold. |
| Claim: | 13. The method for controlling the locking means in the device of in claim 1 , comprising the successive steps of: acquiring at least one reference image (I r) of the organ (100 ; 200), using the image acquisition means (10 ; 25) to acquire at least a first image (I 1) of the organ as soon as the articulated arm is locked, using the computing module (6 ; 29) to determine a first position (T 1) of the first image relative to the reference image, using the acquisition means to acquire at least a second image (I 2) of the organ, using the computing module to determine a second position (T 2) of the second image relative to the reference image, computing a Euclidean distance parameter (D e) and an angular distance parameter (D a) between the first position and the second position, using the computing module to compare the Euclidean distance parameter with a predetermined Euclidean distance threshold (De min) and comparing the angular distance parameter with a predetermined angular distance threshold (Da min), each of the thresholds being representative of the predetermined effort threshold, using the computing module to control the locking means to release imposed locking if the Euclidean distance parameter is below the predetermined Euclidean distance threshold or if the angular distance parameter is below the predetermined angular distance threshold. |
| Claim: | 14. A device for guiding a medical instrument inserted into a natural duct or an artificial duct of a patient in order to bring at least a distal end of the instrument in proximity to an internal organ, the device comprising: an articulated arm with a plurality of degrees of freedom for moving a proximal end of the instrument; controlled locking means for restricting the degrees of freedom of the articulated arm, the locking means being designed so that, for at least one of the degrees of freedom, imposed restriction of said degree of freedom can be released when an external effort exerted on the instrument exceeds a predetermined threshold; a computing module for controlling the locking means; and image acquisition means, carried by the instrument, for acquiring images of the organ, the computing module being based on at least said images in order to control the locking means and the computing module comprises means for estimating the displacement of the organ relative to the instrument and/or any deformation of the organ on the basis of images supplied by the image acquisition means. |
| Claim: | 15. The guiding device as claimed in claim 14 , wherein the computing module comprises means for storing a position to be reached by the instrument relative to the organ, the computing module controlling the locking means, on the basis of the images taken by the image acquisition means, so as to impose restriction on at least one of the degrees of freedom of the articulated arm when the instrument is substantially close to said position. |
| Claim: | 16. The guiding device as claimed in claim 14 , wherein the locking means comprise at least one motor arranged on an articulation of the articulated arm, the computing module controlling the locking means by modulating an electric current passing through the motor. |
| Claim: | 17. The guiding device as claimed in claim 14 , wherein the locking means comprise at least one brake arranged on an articulation of the articulated arm. |
| Claim: | 18. The guiding device as claimed in claim 14 , wherein the locking means are designed so that the predetermined threshold is determined according to external efforts already exerted on the instrument when the locking means impose restriction on the degrees of freedom of the articulated arm. |
| Claim: | 19. The guiding device as claimed in claim 14 , comprising communication means for warning that imposed locking has been released. |
| Claim: | 20. The guiding device as claimed in claim 19 , wherein the communication means comprise a display screen. |
| Claim: | 21. The guiding device as claimed in claim 14 , comprising means for selecting a first operating mode wherein the locking means are deactivated so that no degree of freedom of the articulated arm is restricted or a second operating mode wherein the locking means are activated so that the degrees of freedom of the articulated arm are restricted. |
| Claim: | 22. The guiding device as claimed in claim 14 , wherein the articulated arm is linked to the proximal end of the instrument by a ball-joint type link. |
| Claim: | 23. The guiding device as claimed in claim 14 , comprising weight balancers to balance the articulated arm so that the proximal end of the instrument is held substantially in the center of the duct into which the distal end of the instrument is inserted. |
| Patent References Cited: | 5078140 January 1992 Kwoh 2002/0177857 November 2002 Otsuka et al. 2004/0092810 May 2004 Daum et al. 2008/0065109 March 2008 Larkin 2009/0000627 January 2009 Quaid et al. 2012/0283747 November 2012 Popovic 10 2006 007 858 August 2007 1 520 548 April 2005 2011/058530 May 2011 |
| Primary Examiner: | McEvoy, Thomas |
| Attorney, Agent or Firm: | Sughrue Mion, PLLC |
| Accession Number: | edspgr.09895197 |
| Database: | USPTO Patent Grants |
| Language: | English |
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