Among minimally invasive techniques in medicine angiography and angioplasty are continuously gaining momentum in lieu of the traditional surgery, which can require extracorporeal circulation and which are less well tolerated by the patient.
However, even these minimally invasive procedures carry a significant risk linked to exposure to ionizing radiation (which can induce cancer) not so much for the patient, who is exposed once in a while and gains an advantage, but the doctor who operates on the patient’s side, even wearing the specific protections anti-radiation, is forced to receive an important daily dose of rays to conduct the procedure.
For this reason Corindus created a robot that enables to guide the catheters during coronary procedures allowing both the catheter progress and the rotation by moving mouse and joystick. However, the method of handling joystick requires additional specific training to a doctor who instead has been trained to perform tasks manually. Moreover the system needs a major disposable component, and is not flexible.
The idea of this system is instead to develop a new system whose basic mechanism is able to function both as a measurement of penetration and rotation of the catheter, in the control section, Master with an interface for the surgeon that reproduces a traditional operatory field, and as an actuator of the same movements in the section of implementation, giving also the possibility of independent movement of guide and catheter, and introducing a small disposable component, while all the rest of the apparatus can also be used thousands of times.
In other words ROSA allows the separation of the doctor from the patient, with an innovative robot that uses the same basic mechanism to measure the movements of the doctor, and to actuate them, introducing guides and catheters into the vascular system of the patient, operating in the traditional way. However the system also allows PC control via keyboard, mouse, touch screen, and even with a new ad-hoc interface.
In addition, the system will be able to use multiple Slaves as well as to guide the first catheter by coupling two slaves into a series, and also to allow control of two guide-catheter pairs by placing two in parallel and possibly one In series for the first catheter. Finally, the system will also be able to allow doctors’ training to traditional manual use, while allowing them to practice on previously recorded cases through an ambient in VR representing various scenarios and relative decision making options.
In practice, the system allows all the usual and unusual operations, being virtually configurable as decided by the doctor for the particular case, all using small disposables not too expensive, of course one for Slave. Obviously all the advancements are independently controllable, and measured, so the system, for example, knows how much a catheter has penetrated, so it even knows, when retreating the catheter, how much it needs to call in order to be always controlled by the system. It should also be noted that the separation operation between the guide and the catheter is in this case particularly simple. Of course remote controls both for the injection of contrast medium, and for the inflation of the angioplasty balloon are also provided.