Systems and methods for positioning an elongate member inside a body

• US 10,130,427 B2
• Filed: 01/23/2015
• Issued: 11/20/2018
• Est. Priority Date: 09/17/2010
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Auris Health, Inc. (Johnson & Johnson)
• Inventors: Tanner, Neal A., Miller, Teresa, Sewell, Christopher M., Walker, Sean P.
• Primary Examiner(s): Johnson, Nicole F
• Application Number:
  US14/603,836
• Publication Number:
  US 20150142013A1
• Time in Patent Office: 1,397 Days
• Field of Search: 606 1, 606130
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2034/715 Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/35 for telesurgery
• CPC Class Codes: A61B 34/37 Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/74 Manipulators with manual electric input means
• CPC Class Codes: A61B 46/10 specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4423 related to hygiene or sterilisation
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4218 characterised by articulated arms
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: G06T 19/00 : Manipulating 3D models or images for computer graphics
• CPC Class Codes: G06T 2210/41 : Medical

Abstract

Systems and methods for introducing and driving flexible members in a patient'"'"'s body are described herein. In one embodiment, a robotic method includes positioning a flexible elongated member that has a preformed configuration, wherein at least a part of the flexible elongated member has a first member disposed around it, and wherein the first member includes a first wire for bending the first member or for maintaining the first member in a bent configuration, releasing at least some tension in the first wire to relax the first member, and advancing the first member distally relative to the flexible elongated member while the first member is in a relaxed configuration.

Claims

1. A method for robotically navigating first and second coaxial elongate members into a target anatomy of a patient, the method comprising:

advancing the first elongate member toward the target anatomy;

advancing the second elongate member over a distal tip of the first elongate member;

applying tension to one or more pullwires to articulate a distal tip of the second elongate member to direct the distal tip of the first elongate member toward the target anatomy;

advancing the distal tip of the first elongate member into the target anatomy;

after advancing the distal tip of the first elongated member into the target anatomy advancing the second elongate member over the first elongate member and into the target anatomy; and

releasing the tension on the one or more pullwires of the second elongate member while advancing the second elongate member into the target anatomy.

2. The method of claim 1, wherein the first elongate member is a guidewire.

3. The method of claim 1, wherein the second elongate member is a steerable robotic catheter.

4. The method of claim 1, wherein the step of advancing the distal tip of the first elongate member into the target anatomy further comprises maintaining a fixed tension on the pullwires of the second elongate member.

5. The method of claim 1, wherein the step of advancing the distal tip of the first elongate member into the target anatomy further comprises maintaining a fixed articulation angle of the distal tip of the second elongate member.

6. The method of claim 1, further comprising adjusting an angle of the distal tip of the second elongate member to maintain the distal tip of the second elongate member in a center of the target anatomy as the first elongate member is advanced into the target anatomy.

7. The method of claim 1, further comprising:

advancing a third elongate member over the distal tips of the first and second elongate members towards the target anatomy, wherein the first, second, and third elongate members are coaxial;

articulating a distal tip of the third elongate member towards the target anatomy;

extending the distal tip of the second elongate member beyond the distal tip of the third elongate member into the target anatomy;

releasing the tension on the one or more pullwires of the second elongate member as the second elongate member advances;

advancing the third elongate member over the second elongate member toward the target anatomy; and

releasing a tension on one or more pullwires of the third elongate member as the third elongate member advances over the second elongate member.

8. The method of claim 7, wherein the third elongate member is a sheath instrument.

9. The method of claim 7, further comprising controlling the first, second, and third elongate members with an instrument driver.

10. The method of claim 7, further comprising maintaining a curved shape of the distal tip of the third elongate member by tensioning the one or more pullwires of the third elongate member as the second elongate member is advanced through a lumen of the third elongate member.

11. The method of claim 7, wherein the second elongate member is flexible, such that the distal tip of the third elongate member maintains a curved shape as the second elongate member is advanced through a lumen of the third elongate member.

12. The method of claim 7, further comprising automatically releasing the tension in the one or more pullwires of the second or third elongate member.

13. The method of claim 7, wherein the third elongate member follows a path of the second elongate member automatically.

14. The method of claim 7, further comprising maintaining a position of the distal tip of the first elongate member as the second elongate member is advanced over the first elongate member.

15. The method of claim 7, further comprising maintaining a position of the distal tip of the first elongate member as the third elongate member is advanced over the first elongate member.

16. The method of claim 7, further comprising maintaining a position of the distal tip of the second elongate member as the third elongate member is advanced over the second elongate member.

17. The method of claim 7, further comprising maintaining a position of the distal tip of the first elongate member and a position of the distal tip of the second elongate member as the third elongate member is advanced over the first and second elongate members.

18. The method of claim 7, further comprising advancing the first and second elongate members simultaneously.

19. The method of claim 7, further comprising advancing the second and third elongate members simultaneously.

20. The method of claim 7, further comprising tensioning the one or more pullwires of the second elongate member to facilitate advancement of the third elongate member over the second elongate member.