Robotic systems, devices, and methods for vascular access
An apparatus includes a cart having a vertical adjustment element configured to adjust a distance between the platform and a ground supporting the cart, the cart defining a surface for supporting an arm of the patient. The apparatus includes a manipulation device including a plurality of motors each configured to operably couple to a different one of a needle, a catheter, and a guidewire to selectively advance one or more of the needle, the catheter, and the guidewire, and a robotic arm having a first end mounted to the cart 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 in the arm.
1 . A method, comprising:
advancing, using a plurality of linear actuators of a robotic system, at least two of a tip of a needle, a tip of a guidewire, and a tip of a catheter toward a target vessel, subsequently advancing the tip of the needle, using a first linear actuator, such that the tip of the needle is disposed in the target vessel, the needle being coaxially disposed with a catheter and the guidewire;
after the tip of the needle is disposed in the target vessel, advancing, using a second linear actuator of the plurality of linear actuators, the tip of the guidewire distal to the tip of the needle such that a portion of the guidewire is disposed outside of the needle and in the target vessel;
after advancing the tip of the guidewire distal to the tip of the needle, advancing, using a third linear actuator of the robotic system, the tip of the catheter over the portion of the guidewire such that the tip of the catheter is disposed within the target vessel at a location distal to the tip of the needle, the catheter including a catheter hub that is releasably coupled to the third linear actuator; and
after advancing the tip of the catheter over the portion of the guidewire, retracting, using the first linear actuator and the second linear actuator, the needle and the guidewire from the target vessel.
2 . The method of claim 1 , further comprising decoupling, after advancing the tip of the catheter, the catheter hub from the third linear actuator so that the catheter is decoupled from the robotic system.
3 . The method of claim 1 , wherein the needle, the guidewire, and the catheter are disposed in a cartridge that is releasably coupled to a robotic arm of the robotic system, and the method further comprises rotating at least one joint of the robotic arm to position the cartridge at a predetermined acute angle relative to a longitudinal axis of a target vessel.
4 . The method of claim 3 , further comprising coupling the cartridge to the robotic arm prior to rotating at least one joint of the robotic arm to position the cartridge at the predetermined acute angle.
5 . The method of claim 3 , further comprising:
decoupling, after advancing the tip of the catheter over the portion of the guidewire, the catheter from the robotic system by decoupling the catheter hub from the third linear actuator; and
decoupling the cartridge from the robotic arm after retracting the needle and the guidewire and after the catheter hub has been decoupled from the third linear actuator.
6 . The method of claim 3 , wherein the predetermined acute angle is between about 20 degrees and about 60 degrees.
7 . The method of claim 1 , further comprising aligning the tip of the needle with the tip of the catheter prior to advancing the tip of the needle and the tip of the guidewire toward the target vessel.
8 . The method of claim 1 , further comprising advancing, using the robotic system, a tip of a dilator coaxially disposed with the needle, the guidewire, and the catheter, prior to advancing the catheter.
9 . The method of claim 1 , wherein the target vessel is at least one of a femoral artery, a jugular vein, or a peripheral artery.
10 . The method of claim 1 , further comprising capturing, using an imaging system of the robotic system, at least two views of the target vessel as the needle, the guidewire, and the catheter are being advanced into the target vessel, the at least two views of the target vessel showing one or more portions of the needle, the guidewire, or the catheter after being advanced into the target vessel.
11 . The method of claim 10 , wherein the at least two views include a transverse view of the target vessel and a longitudinal view of the target vessel.
12 . The method of claim 11 , wherein the imaging system is configured to change the transverse view as the 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.
13 . A method, comprising:
simultaneously advancing, using at least one linear actuator of a plurality of linear actuators of a robotic system, a tip of a needle, a tip of a guidewire, and a tip of a catheter into a target vessel, the needle, the guidewire, and the catheter being coaxially disposed;
after simultaneously advancing the tip of the needle, the tip of the guidewire, and the tip of the catheter into the target vessel, advancing, using a first linear actuator of the plurality of linear actuators, a tip of the guidewire distal to the tip of the needle such that a portion of the guidewire is disposed outside of the needle and in the target vessel;
after advancing the tip of the guidewire distal to the tip of the needle, advancing, using a second linear actuator of the plurality of linear actuators, a tip of the catheter over the portion of the guidewire such that the tip of the catheter is disposed within the target vessel at a location distal to the tip of the needle; and
after advancing the tip of the catheter distal to the tip of the needle, retracting, using the first linear actuator, the needle from the target vessel.
14 . The method of claim 13 , further comprising decoupling, after advancing the tip of the catheter distal to the tip of the needle, a catheter hub from the second linear actuator so that the catheter is decoupled from the robotic system.
15 . The method of claim 13 , wherein the needle, the guidewire, and the catheter are disposed in a cartridge that is releasably coupled to a robotic arm of the robotic system, and the method further comprises rotating at least one joint of the robotic arm to position the cartridge at a predetermined acute angle relative to a longitudinal axis of a target vessel.
16 . The method of claim 13 , further comprising capturing, using an imaging system of the robotic system, at least two views of the target vessel as the needle, the guidewire, and the catheter are being advanced into the target vessel, the at least two views of the target vessel showing one or more portions of the needle, the guidewire, or the catheter after being advanced into the target vessel.
17 . A method, comprising:
simultaneously advancing, using at least one linear actuator of a plurality of linear actuators of a robotic system, a tip of a needle and a tip of a catheter into a target vessel, the needle and the catheter being coaxially disposed;
after simultaneous advancing the tip of the needle and the tip of the catheter into the target vessel, advancing, using a first linear actuator of the plurality of linear actuators, a tip of a guidewire through the needle and into the target vessel such that a portion of the guidewire is disposed outside of the needle and in the target vessel;
after advancing the tip of the guidewire, advancing, using a second linear actuator of the plurality of linear actuators, a tip of the catheter over the portion of the guidewire such that the tip of the catheter is disposed within the target vessel at a location distal to the tip of the needle; and
after advancing the tip of the catheter distal to the tip of the needle, retracting, using the first linear actuator, the needle and the guidewire from the target vessel.
18 . The method of claim 17 , further comprising decoupling, after advancing the tip of the catheter distal to the tip of the needle, a catheter hub from the second linear actuator so that the catheter is decoupled from the robotic system.
19 . The method of claim 17 , wherein the needle, the guidewire, and the catheter are disposed in a cartridge that is releasably coupled to a robotic arm of the robotic system, and the method further comprises rotating at least one joint of the robotic arm to position the cartridge at a predetermined acute angle relative to a longitudinal axis of a target vessel.
20 . The method of claim 17 , further comprising capturing, using an imaging system of the robotic system, at least two views of the target vessel as the needle, the guidewire, and the catheter are being advanced into the target vessel, the at least two views of the target vessel showing one or more portions of the needle, the guidewire, or the catheter after being advanced into the target vessel.