前言導(dǎo)讀

西門子醫(yī)療表示：“我們始終相信介入手術(shù)機(jī)器人技術(shù)將在未來(lái)血管治療中發(fā)揮重要作用。然而， 機(jī)器人在心臟介入領(lǐng)域的應(yīng)用落后于我們最初的預(yù)期。經(jīng)過過去幾個(gè)季度的分析決策后，西門子醫(yī)療決定停止CorPath GRX途靈（Corindus）介入手術(shù)機(jī)器人在心臟冠脈領(lǐng)域的業(yè)務(wù)。”

該公司還稱：“西門子醫(yī)療仍將繼續(xù)進(jìn)行神經(jīng)介入手術(shù)機(jī)器人的研發(fā)，已經(jīng)開始著手開發(fā)新一代的機(jī)器人平臺(tái)，希望得以在關(guān)鍵的卒中發(fā)病早期，為患者帶來(lái)有效的治療。”

保留一顆敬畏產(chǎn)品和技術(shù)的心

對(duì)于血管介入手術(shù)機(jī)器人，筆者也在前幾日發(fā)表的文章（可點(diǎn)擊查看）中提到了自己的思考。

血管介入手術(shù)機(jī)器人是否會(huì)成為下一個(gè)內(nèi)卷主戰(zhàn)場(chǎng)？對(duì)于血管介入機(jī)器人，醫(yī)療器械行業(yè)人士是存在不同認(rèn)識(shí)的，有的專業(yè)人士認(rèn)為血管介入機(jī)器人是“脫衣戰(zhàn)士”，能夠降低手術(shù)操作醫(yī)生的射線暴露，提高手術(shù)效率，不過又有專業(yè)人士發(fā)出不同的聲音，認(rèn)為目前血管介入手術(shù)機(jī)器人實(shí)際上并不適合我國(guó)實(shí)情，醫(yī)生群體對(duì)于血管介入機(jī)器人的需求并不像宣傳里所提及的那么大，而且血管介入類的耗材器械種類繁多，血管介入機(jī)器人只能對(duì)數(shù)量較少的器械進(jìn)行輸送，運(yùn)用范圍有限。但是不管怎么樣，不論是切實(shí)解放醫(yī)生群體的好產(chǎn)品也好，還是能夠撬動(dòng)資本講故事的好產(chǎn)品也罷，血管介入手術(shù)機(jī)器人就是這樣來(lái)了。

筆者認(rèn)為，對(duì)于西門子Corindus途靈血管介入手術(shù)機(jī)器人，我們應(yīng)當(dāng)心存感謝。

是西門子這樣的大廠率先挖掘了血管介入手術(shù)機(jī)器人的市場(chǎng)潛力，在醫(yī)療器械領(lǐng)域公認(rèn)的“帶頭大哥”的引領(lǐng)下，我們自信的聚焦于從事于血管介入手術(shù)機(jī)器人，大部分研發(fā)初始的產(chǎn)品競(jìng)標(biāo)和對(duì)照就是西門子Corindus途靈手術(shù)機(jī)器人，在國(guó)內(nèi)激烈的內(nèi)卷行情的洗禮下，各大血管介入手術(shù)機(jī)器人八仙過海，各顯神通，不斷的產(chǎn)品迭代，挖掘臨床痛點(diǎn)，已有產(chǎn)品實(shí)現(xiàn)了“青出于藍(lán)而勝于藍(lán)”，在我們血管介入機(jī)器的人技術(shù)發(fā)展路徑上，我們真的應(yīng)當(dāng)對(duì)西門子Corindus途靈手術(shù)機(jī)器人道一聲感謝。

現(xiàn)在，西門子Corindus途靈手術(shù)機(jī)器人主動(dòng)退出市場(chǎng)競(jìng)爭(zhēng)，一石激起千層浪，把當(dāng)下血管介入手術(shù)機(jī)器人的現(xiàn)狀照進(jìn)現(xiàn)實(shí)，撕開了當(dāng)下血管介入機(jī)器人臨床痛點(diǎn)解決不利的面紗。不管輿論再怎么看再怎么說(shuō)，筆者認(rèn)為國(guó)內(nèi)當(dāng)下血管介入手術(shù)機(jī)器人各大廠家一定還會(huì)繼續(xù)將血管介入機(jī)器人做下去，雖有微調(diào)但目標(biāo)一定不會(huì)變，保持這份定力和決心的一定是自信于自家產(chǎn)品和技術(shù)的先進(jìn)性，這種先進(jìn)性的實(shí)現(xiàn)一定會(huì)加快，這正是臨床痛點(diǎn)被放大之后的反饋。與其遮遮掩掩，不如痛痛快快的去面對(duì)，去克服這個(gè)挑戰(zhàn)，從這一點(diǎn)上我們也應(yīng)當(dāng)對(duì)西門子Corindus途靈手術(shù)機(jī)器人說(shuō)一聲謝謝。

而且，西門子家大業(yè)大，放棄某一管線實(shí)際上對(duì)其影響是可控的甚至是不大的，但是對(duì)于我們的血管介入機(jī)器人廠家來(lái)講是做不到的，既然當(dāng)下的大環(huán)境不允許我們廠家去任性，那么在血管介入手術(shù)機(jī)器人帶頭大哥的退出之下，是不是少了一個(gè)大競(jìng)爭(zhēng)對(duì)手，有了更好的逐鹿中原的機(jī)會(huì)，筆者認(rèn)為切實(shí)做好產(chǎn)品和技術(shù)的先進(jìn)性機(jī)會(huì)還是很大的。

其實(shí)，西門子并未放棄Corindus途靈手術(shù)機(jī)器人，而是退出了PCI領(lǐng)域，人家也明確說(shuō)了，會(huì)繼續(xù)做研發(fā)，聚焦于神經(jīng)外科介入手術(shù)機(jī)器人，做產(chǎn)品的顛覆，可見人家還是保留了重回賽道的基礎(chǔ)的，這個(gè)基礎(chǔ)就是產(chǎn)品和技術(shù)的先進(jìn)性，說(shuō)不定哪一天來(lái)個(gè)王者歸來(lái)都不好說(shuō)。而且筆者可以肯定的說(shuō)，西門子Corindus途靈手術(shù)機(jī)器人的專利布局一定不會(huì)停止，在這個(gè)賽道上國(guó)內(nèi)各大血管介入手術(shù)機(jī)器人廠家依然會(huì)感受到“帶頭大哥”的威懾力，國(guó)內(nèi)各大血管介入機(jī)器人廠家不能被帶亂了節(jié)奏，要時(shí)刻保持警惕，保持一顆敬畏產(chǎn)品和技術(shù)的心。

西門子Corindus?技術(shù)探究

產(chǎn)品簡(jiǎn)介

CorPath?GRX產(chǎn)品實(shí)物示意

技術(shù)脈絡(luò)

CorPath系統(tǒng)是第一個(gè)獲得 FDA 批準(zhǔn)并獲得CE標(biāo)志的機(jī)器人平臺(tái)，專為介入醫(yī)生設(shè)計(jì)。在 CorPath 機(jī)器人輔助干預(yù)期間，該產(chǎn)品是由硬件設(shè)備及耗材組合使用的系統(tǒng)，通過醫(yī)生坐在遠(yuǎn)程工作區(qū)使用操作桿或控制臺(tái)上的觸摸屏，實(shí)現(xiàn)介入設(shè)備的遠(yuǎn)程傳輸和操作。

Corindus途靈血管介入機(jī)器人整體系統(tǒng)圖如下所示：

Corindus途靈血管介入機(jī)器人整體系統(tǒng)圖

機(jī)器人裝置是Corindus途靈手術(shù)機(jī)器人的核心部件之一，其主要包括及其支撐臂及其一次性Cassette。如下附圖所示：

Corindus途靈血管介入機(jī)器人支撐臂系統(tǒng)圖

Corindus途靈血管介入機(jī)器人一次性Cassette系統(tǒng)圖

專利概覽

公開/公告號(hào)	US6726675B1	申請(qǐng)日	2000-12-12
發(fā)明名稱	Remote control catheterization
解決的技術(shù)問題	Catheterization procedures are very commonly performed for diagnosis and treatment of diseases of the heart and vascular system. The catheterization procedure is generally initiated by inserting a guide wire into a blood vessel in the patient's body. The guide wire is then guided to the desired location, most commonly in one of the heart vessels or elsewhere in the vascular system. At this point the catheter is slid over the guide wire into the blood vessel and/or heart. Once the catheter is in the desired position, the guide wire can then be removed, leaving the catheter in location. Alternatively, in some procedures, the catheter is inserted without using a guide wire. The catheter may be used to pass ancillary devices into the body, such as an angioplasty balloon, or to perform other diagnostic or therapeutic procedures.
技術(shù)方案	A remote control catheterization system (20) includes a propelling device (28), which controllably inserts a flexible, elongate probe (26) into the body of a patient (22). A control console (34), in communication with the propelling device, includes user controls (38, 40) which are operated by a user of the system remote from the patient to control insertion of the probe into the body by the propelling device.
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02

公開/公告號(hào)	US7615042B2	申請(qǐng)日	2006-10-12
發(fā)明名稱	Transmission for a remote catheterization system
解決的技術(shù)問題	To insert a catheter manually, the physician applies torque and axial push force on the proximal end of a guide wire to effect tip direction and axial advancement at the distal end. However, it is difficult to control the distal tip of the catheter from the proximal end. Although these navigation techniques are effective, they are tedious, require extraordinary skill, and result in long medical procedures that fatigue the user.
技術(shù)方案	An apparatus for imparting motion from at least one of a plurality of motion sources into linear, rotary, or combined linear and rotary motion of an elongated device, the apparatus comprising a transmission for translating the motion to linear or rotary motion of the elongated device.
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03

公開/公告號(hào)	US8828021B2	申請(qǐng)日	2009-11-25
發(fā)明名稱	Catheter system
解決的技術(shù)問題	Before performing an interventional procedure with the disclosed invention, a diagnostic procedure is typically performed. An exemplary diagnostic procedure performed before performing a PCI may include a number of steps. Starting in the femoral artery, a 0.038 guide wire is run over the top of the aortic arch. A diagnostic catheter is advanced over the 0.038 guide wire after which the 0.038 guide wire is removed allowing the diagnostic catheter (DC) to return to its preformed shape enabling the DC to access either the left or the right ostium of the aorta. A contrast media is injected through the DC and the heart is x-rayed to identify the existence and location of any lesion. A y-connector may be secured to the end of the DC outside of the patient. The y-connector provides a means for introducing the contrast media or medication. The y-connector employs a one way valve both at the y-connector leg and the free open end. The 0.038 guide is then reinserted into the DC advanced over the top of the aortic arch, and the diagnostic catheter is removed. When the diagnostic is completed the 0.038 guide wire may be left in place for use in a PCI procedure.
技術(shù)方案	A robotic catheter system is provided. The catheter system includes a housing, and the housing has a sidewall and a longitudinal axis. The catheter system includes a recess formed in the sidewall of the housing and a drive mechanism supported by the housing. The drive mechanism is configured to impart movement to a catheter device. The catheter system includes a first channel configured to receive a catheter device, and the first channel has a opening located within the recess.
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