Robotic systems, devices, and methods for vascular access

Abstract

An apparatus for vascular access is described herein. The apparatus can comprise a cart movable from a first location to a second location near a patient, a manipulating device configured to releasably couple a cartridge including a needle, a catheter, and a guidewire that are coaxially disposed with respect to each other, and a robotic arm having a first end mounted to the cart and a second end coupled to the manipulating device. The manipulation device can include a plurality of actuation mechanisms configured to selectively advance the needle, the catheter, and the guidewire when the manipulating device is coupled to the cartridge. The robotic arm can include a plurality of joints that are configured to rotate about a plurality of axes to position the cartridge relative to the arm of the patient such that the needle, the catheter, and the guidewire can be inserted into a target vessel of the patient.

1 . An apparatus, comprising:
 a cart movable from a first location to a second location near a patient, the cart having a platform and a vertical adjustment element configured to adjust a distance between the platform and a ground supporting the cart;   a cartridge including a needle, a catheter, and a guidewire, each of the needle, the catheter, and the guidewire being disposed linearly within a housing and coaxially relative to one another;   a manipulation device configured to releasably couple to the cartridge;   a plurality of actuators each configured to couple to a different one of the needle, the catheter, and the guidewire to selectively advance the needle, the catheter, and the guidewire, when the manipulation device is coupled to the cartridge; and   a robotic arm having a first end mounted to the platform and a second end coupled to the manipulation device, the robotic arm having a plurality of segments joined together via a plurality of joints such that the robotic arm can be moved to position the needle, the catheter, and the guidewire for insertion into a target vessel.   
     
     
         2 . The apparatus of  claim 1 , further comprising an imaging system coupled to a distal end portion of the manipulation device, the imaging system configured to capture a transverse view and a longitudinal view each including the target vessel. 
     
     
         3 . The apparatus of  claim 2 , wherein the imaging system is configured to change the transverse view as a tip of the needle is advanced into the target vessel to show the transverse view that corresponds to a transverse plane of the tip of the needle. 
     
     
         4 . The apparatus of  claim 2 , wherein the imaging system includes an ultrasound array. 
     
     
         5 . The apparatus of  claim 1 , wherein the manipulation device includes a coupling mechanism coupled to one of the plurality of actuators, the coupling mechanism configured to releasably couple to a coupling element in the cartridge that is coupled to at least one of the needle, the catheter, or the guidewire, such that, upon the coupling mechanism being coupled to the coupling element, movement of the actuator causes a respective movement of the at least one of the needle, the catheter, and the guidewire. 
     
     
         6 . The apparatus of  claim 5 , wherein the coupling mechanism includes at least one magnet, and the coupling element includes at least one magnetic element, the at least one magnet being configured to magnetically couple to the at least one magnetic element. 
     
     
         7 . The apparatus of  claim 5 , wherein the manipulation device includes at least one sensor to detect the coupling between the coupling mechanism of the manipulation device and the coupling element in the cartridge. 
     
     
         8 . The apparatus of  claim 7 , wherein the at least one sensor includes a Hall Effect sensor, and the manipulation device further includes a permanent magnet that is configured to displace in response to the coupling between the coupling mechanism and the coupling element, the Hall Effect sensor configured to measure a change in a magnetic field intensity caused by the movement of the permanent magnet. 
     
     
         9 . The apparatus of  claim 1 , wherein the manipulation device is pivotably supported by a joint of the plurality of joints with respect to a distalmost segment of the robotic arm such that an angle of insertion of the needle, the catheter, and the guidewire into the target vessel can be adjusted via the joint. 
     
     
         10 . The apparatus of  claim 9 , wherein a center of mass of the manipulation device is disposed near the joint to reduce torque due to gravity on the joint. 
     
     
         11 . The apparatus of  claim 1 , wherein each joint of the plurality of joints of the robotic arm includes a failsafe brake configured to lock movement about the joint until electrically released. 
     
     
         12 . The apparatus of  claim 1 , further comprising:
 an imaging system configured to capture a view including at least a part of the manipulating device and a portion of the patient including the target vessel; and   a communication interface configured to send image data of the view to a remote compute device such that a position of the cartridge relative to the portion of the patient can be confirmed by a user at the remote compute device.   
     
     
         13 .- 30 . (canceled) 
     
     
         31 . The apparatus of  claim 1 , wherein each of the guidewire, the needle, and the catheter is coupled to a guide of a plurality of guides,
 each of the plurality of actuators configured to couple to a different guide of the plurality of guides.   
     
     
         32 . The apparatus of  claim 31 , wherein the manipulation device includes a plurality of recessed portions, each recessed portion of the plurality of recessed portions being configured to receive a respective guide member of the plurality of guides. 
     
     
         33 . The apparatus of  claim 1 , wherein the plurality of actuators include:
 a first linear actuator configured to linearly advance and retract the guidewire;   a second linear actuator configured to linearly advance and retract the needle; and   a third linear actuator configured to linearly advance and retract the catheter.   
     
     
         34 . The apparatus of  claim 33 , wherein at least two of the first, second, and third linear actuators are disposed parallel to one another. 
     
     
         35 . The apparatus of  claim 33 , wherein each of the first, second, and third linear actuators includes: a screw shaft, and ball screw nut configured to linearly advance along the screw shaft in response to a rotation of the screw shaft. 
     
     
         36 . The apparatus of  claim 1 , wherein each actuator of the plurality of actuators includes a magnet configured to magnetically couple that actuator with a respective one of the needle, the catheter, and the guidewire. 
     
     
         37 . The apparatus of  claim 1 , wherein at least one actuator of the plurality of actuators includes a sensor configured to detect a coupling between that actuator and a respective one of the needle, the catheter, and the guidewire. 
     
     
         38 . (canceled) 
     
     
         39 . The apparatus of  claim 1 , wherein the cartridge is configured to house the at least the portion of the guidewire in a linear state. 
     
     
         40 . The apparatus of  claim 1 , wherein the cartridge further includes:
 a first guide coupled to the guidewire and configured to couple to a first actuator of the plurality of actuators;   a second guide coupled to the needle and configured to couple to a second actuator of the plurality of actuators; and   a third guide releasably coupled to the catheter and configured to couple to a third actuator of the plurality of actuators.   
     
     
         41 . The apparatus of  claim 1 , wherein the manipulation device includes a plurality of motors coupled to the plurality of actuators, the plurality of motors configured to rotate to drive the plurality of actuators. 
     
     
         42 . The apparatus of  claim 1 , wherein the manipulation assembly includes a housing that houses the plurality of actuators. 
     
     
         43 . The apparatus of  claim 1 , wherein the platform includes a surface for mounting the robotic arm and for supporting an arm of the patient. 
     
     
         44 . The apparatus of  claim 2 , wherein the imaging device and the manipulator device are fixedly coupled.