Flexible instrument

• US 20020087166A1
• Filed: 11/16/2001
• Published: 07/04/2002
• Est. Priority Date: 02/24/1998
• Status: Active Grant

• Current Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Rogers, Gary, Brock, David L., Weitzner, Barry, Lee, Woojin, Ailinger, Robert E.
• Granted Patent: US 7,090,683 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• 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 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/715 Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 : Joysticks
• CPC Class Codes: A61B 2034/744 : Mouse
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/506 : using a parallelogram linkage, e.g. panthograph
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• 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 34/30 : 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 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/4893 : Nerves
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: B25J 3/04 : involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: B25J 9/104 : with cables, chains or ribbons

Abstract

A remote control flexible instrument system, employing a shaft which supports a tool, is described in which the has proximal and distal ends with at least a portion thereof extending through a lumen of the human body so as to locate the shaft at an internal target site. A master station including an input device provides control of the instrument situated at a slave station. The master station can control at least one degree-of-freedom of the flexible instrument. A controller intercouples the master and slave stations and is operated in accordance with a computer algorithm that receives a command from the input device for controlling at least one degree-of-freedom of the catheter so as to respond in accordance with action at the input device. The flexible instrument further comprises a controlled flexible segment along the shaft, for controlled bending at the flexible segment to guide the shaft and to dispose the tool at an operative site.

Claims

1. A robotic medical system comprising:

a flexible instrument having proximal and distal ends with at least one flexible segment extending through a lumen of the human body, the at least one flexible segment being controllably bendable so as to locate a distal end of the shaft at an internal target site;

a tool carried at the distal end of the shaft for performing a procedure;

a master station including an input device;

a slave station including a receiver for the catheter for controlling through the receiver at least one degree-of-freedom of the catheter; and

a controller coupled between the master station and the slave station operated in accordance with a computer algorithm that receives a command from said input device and for controlling the at least one degree-of-freedom of the catheter so as to respond in accordance with action at the input device.

2. The system of claim 1, further comprising a mechanically drivable mechanism intercoupled with the tool via the flexible instrument.

3. The system of claim 1, further comprising a mechanical cable extending along the flexible instrument between the proximal and distal ends.

4. The system of claim 1, wherein the controller activates the mechanical cable to effect flexure of the flexible instrument at the at least one flexible segment.

5. The system of claim 1, wherein the flexible instrument comprises an outer shaft and an inner shaft.

6. The system of claim 5, wherein the outer shaft coaxially receives the inner shaft.

7. The system of claim 6, wherein said outer shaft comprises a flexible section.

8. The system of claim 1, further comprising a cable terminating at a point more distal than a first flexible segment, the cable capable of being pulled to bend the first flexible segment.

9. The system of claim 2, wherein the mechanically drivable mechanism comprises a first control element for controlling the bending of the at least one flexible segment.

10. The system of claim 9, wherein the flexible instrument comprises an outer shaft and an inner shaft and further including a second control element that controls the rotation of the outer shaft.

11. The system of claim 10, further including a third control element that controls the rotation of the inner shaft.

12. The system of claim 1, further comprising a drive unit coupled to and intermediate the controller and the mechanically drivable mechanism.

14. The method of claim 13, wherein the step of inserting the shaft comprises providing a percutaneous access.

15. The method of claim 13, wherein said step of inserting the shaft comprises providing access through a natural body orifice.

17. The system of claim 16, wherein the flexible shaft is controllable to a greater number of degrees-of-freedom than the degrees-of-freedom of the receiver.

18. The system of claim 17, wherein the receiver is controllable to one degree-of-freedom.

19. The system of claim 18, wherein the shaft is controllable to at least two degrees-of-freedom.

20. The system of claim 16, wherein the tool, the shaft and the mechanically drivable mechanism are disposable as a single unit.

21. The system of claim 16, further comprising a drive unit intercoupled between the computation system and the shaft, for converting electrical control signals into mechanical actuations.

22. The system of claim 21, wherein the drive unit is drivably intercoupled with the shaft, the drive unit being disposed at a first location which is remote from a second location at which the shaft is disposed.

23. The system of claim 21, wherein the drive unit couples to and controls both the shaft the receiver.

24. The system of claim 21, wherein the receiver is readily drivably engageable with and disengageable from the mechanically drivable mechanism.

25. The system of claim 16, wherein the shaft is controllably bendable at the at least one flexible segment.

26. The system of claim 16, wherein the shaft is an inner shaft, the system further comprising a flexible guide shaft for receiving and guiding the inner shaft.

28. The system of claim 27, wherein the system is remotely controlled through a user input device controllable by a user, and a computation system for receiving user input from the input device.

29. The system of claim 27, wherein the tool, the shaft and the mechanically drivable mechanism of the medical implement are all disposable as a single unit.

13. A method of remotely controlling a catheter, comprising:

providing a flexible shaft having a distal end supporting a tool, the shaft further including at least one controlled flexible segment about the distal end capable of controlled bending for positioning the tool to an operative site;

inserting the shaft into an anatomic lumen, the flexible shaft adapted to conform to the configuration of the anatomic lumen;

mechanically driving, via a drive unit, a cabling system extending through the shaft and the at least one flexible segment; and

activating the at least one controlled flexible segment by operating the drive unit from a location remote from the shaft, so as to effect bending of the at least one flexible segment and thereby effect positioning of the tool to a target site.

16. A flexible instrument system comprising:

a flexible shaft having a proximal end and a distal end, the distal end supporting a tool, the shaft being insertable into a subject so as to dispose the tool at an operative site;

a mechanically drivable mechanism disposed at the proximal end of the shaft, the mechanically drivable mechanism capable of operating said tool via at least one flexible segment positioned along the shaft;

a receiver supported in a fixed position over the subject, for receiving and supporting the shaft via the mechanically drivable mechanism in a position to maintain the tool at the operative site;

a computation system for receiving electrical control signals received from a user input device for controlling the shaft.

27. A flexible instrument system, comprising:

a medical implement having sufficient flexibility along a length thereof so as to readily flex and conform to a pathway in an anatomic vessel or cavity as the implement is inserted therein, the medical implement comprising;

a tool for performing a medical procedure;

a flexible shaft having proximal and distal ends and supporting the tool at its distal end, the shaft being insertable into a subject so as to dispose the tool at an operative site via controlled bending of at least one flexible segment positioned along the shaft; and

a mechanically drivable mechanism disposed at the proximal end of the shaft; and

a drive unit intercoupled with the medical implement and including;

at least a first cable intercoupled with the tool; and

at least a second cable intercoupled with the shaft for controlling a bend at the at least one flexible segment.

30. A flexible instrument system comprising:

a drive unit, for controlling operation of a medical implement;

a mechanical actuation system extending from the drive unit; and

the medical implement having sufficient flexibility to conform to a pathway in an anatomic vessel or cavity as the implement is inserted therein, the medical implement comprising;

a flexible shaft having proximal and distal ends, the flexible shaft being insertable into a subject so as to dispose the distal end at an operative site, the shaft further comprising at least one controlled flexible segment for actuating a controlled bend; and

a mechanically drivable mechanism disposed at a proximal end of the flexible shaft.

31. The system of claim 30, wherein the mechanical actuation system comprises a cable extending between the mechanically drivable mechanism and the at least one flexible segment, the cable being axially movable under control of the drive unit to provide the bending at the at least one flexible segment.

32. The system of claim 30, wherein the medical implement further comprises a tool for performing a medical procedure and disposed at the distal end of the flexible shaft.

33. The system of claim 32, wherein the mechanical actuation system is a first mechanical actuation system, the system further comprising a second mechanical actuation system extending between the drive unit and the tool for controlling operation of the tool.

34. The system of claim 33, wherein the second mechanical actuation system comprises a cable extending between the mechanically drivable mechanism and the tool, the cable being axially movable to control operation of the tool.

35. The system of claim 30, wherein the system is remotely controlled and further comprising an electrical controller intercoupled with the drive unit for establishing electrical control signals convertible to mechanical actuations for controlling the medical implement, and a user input device coupled to the controller.

36. The system of claim 30, wherein the flexible shaft and mechanically drivable mechanism of the medical implement are all disposable as a single unit.

37. The system of claim 30, wherein the drive unit is drivably coupled with the medical implement, the drive unit being disposed at a first location which is remote from a second location at which the medical implement is disposed.

38. The system of claim 30, further comprising a receiver for engaging the mechanically drivable mechanism, the receiver and mechanically drivable mechanism having respective laterally facing engagement surfaces that interlock to couple drive therebetween.

39. The system of claim 38, wherein the laterally facing engagement surfaces are each substantially flat.

40. The system of claim 38, wherein the receiver and the mechanically drivable mechanism have respective rotatable members are adapted to mate with each other to transfer drive therebetween.

41. The system of claim 40, wherein one of the rotatable members includes a blade which interlocks with a receiving slot of a mating rotatable member.

42. The system of claim 40, further comprising at least one cable associated with each rotatable member and a cam associated with each rotatable member for tensioning the at least one cable.

43. The system of claim 40, wherein the receiver and the mechanically drivable mechanism carry respective gears adapted to rotate the flexible shaft.

44. The system of claim 40, including a carriage supporting the receiver and the mechanically drivable mechanism for transition in a direction axial of the flexible shaft.