Endoscope with single step guiding apparatus

• US 20030032859A1
• Filed: 08/27/2002
• Published: 02/13/2003
• Est. Priority Date: 04/03/2000
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Neoguide Systems, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Belson, Amir
• Granted Patent: US 6,974,411 B2
• Time in Patent Office: Days
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00078 with stiffening means
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0053 using distributed actuators, e.g. artificial muscles
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 1/008 Articulations
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• 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 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61M 2025/0063 having means, e.g. stylets, mandrils, rods or wires to reinforce or adjust temporarily the stiffness, column strength or pushability of catheters which are already inserted into the human body

Abstract

An endoscope with guiding apparatus is described herein. A steerable endoscope is described having an elongate body with a manually or selectively steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable tracking rod or guide. The tracking rod or guide is positioned within a guide channel within the endoscope and slides relative to the endoscope. When the guide is in a flexible state, it can conform to a curve or path defined by the steerable distal portion and the automatically controlled portion. The guide can then be selectively rigidized to assume that curve or path. Once set, the endoscope can be advanced over the rigidized guide in a monorail or “piggy-back” fashion so that the flexible proximal portion follows the curve held by the guide until the endoscope reaches a next point of curvature within a body lumen.

Claims

1. A method of advancing an instrument along an arbitrary path, comprising:

selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path such that a portion of an elongate guide conforms to and assumes the selected shape; and

maintaining a position of said guide while advancing said instrument along said guide such that a proximal portion of said instrument assumes the selected shape defined by said guide, wherein said instrument is freely slidable along said guide such that advancing said instrument along said guide is unconstrained.

2. The method of claim 1 wherein prior to maintaining a position of said guide, further comprising advancing said instrument distally while configuring a controllable portion of said instrument to assume the selected shape of said distal portion, wherein said controllable portion is proximal to said distal portion.

3. The method of claim 1 wherein maintaining the position of said guide comprises rigidizing said guide such that said guide rigidly assumes a position of the selected shape.

4. The method of claim 3 wherein rigidizing said guide comprises applying tension to a tensioning member disposed within said guide such that a plurality of adjacent segments comprising said guide are compressed.

5. The method of claim 3 wherein rigidizing said guide comprises applying a vacuum force within a lumen defined within said guide such that a plurality of adjacent segments comprising said guide are compressed.

6. The method of claim 1 further comprising withdrawing said guide from said instrument.

7. The method of claim 1 wherein said guide is slidably located within said instrument through a lumen defined within the instrument.

8. The method of claim 7 wherein prior to steering said distal portion of said instrument, the distal end of said guide is disposed within the distal end of said lumen.

9. A method of advancing an instrument along an arbitrary path, comprising:

providing an instrument having a proximal end, a controllable proximal portion, and a selectively steerable distal portion, and further providing an elongate guide having a distal portion positioned substantially adjacent to said distal portion of said instrument;

selectively steering said distal portion of said instrument to assume a selected shape along a desired path;

advancing said instrument distally along said desired path while controlling said controllable proximal portion to assume the selected shape of said distal portion such that said guide also assumes substantially the selected shape; and

maintaining a position of said guide while advancing said instrument along said guide such that a proximal portion of said instrument assumes the selected shape defined by said guide, wherein said instrument is freely slidable along said guide such that advancing said instrument along the guide is unconstrained.

10. The method of claim 9 wherein maintaining the position of said guide comprises rigidizing said guide such that said guide rigidly assumes a position of the selected shape.

11. The method of claim 10 wherein rigidizing said guide comprises applying tension to a tensioning member disposed within said guide such that a plurality of adjacent segments comprising said guide are compressed.

12. The method of claim 10 wherein rigidizing said guide comprises applying a vacuum force within a lumen defined within said guide such that a plurality of adjacent segments comprising said guide are compressed.

13. The method of claim 9 further comprising withdrawing said guide from the instrument.

14. An apparatus for insertion into a body cavity, comprising:

an elongate body having a selectively steerable distal portion adapted to assume a selected shape along an arbitrary path, a controllable proximal portion located proximal to said steerable distal portion, adapted to propagate the selected shape, and a flexible proximal portion proximal to said controllable proximal portion; and

an elongate guide having an axial length that is less than an axial length of said elongate body, wherein said guide is configured to conform to and selectively maintain the selected shape assumed by said steerable distal portion;

wherein said flexible proximal portion of said elongate body is adapted to conform to a selected shape maintained by said guide.

15. The apparatus of claim 14 wherein said axial length of said guide is approximately equal to a combined length of said controllable proximal portion and said steerable distal portion.

16. The apparatus of claim 14 wherein said elongate body defines a lumen therethrough.

17. The apparatus of claim 16 wherein said guide is slidably disposed within said lumen.

18. The apparatus of claim 14 wherein said selectively steerable distal portion is controllable via a control located externally of the body cavity.

19. The apparatus of claim 14 wherein said a length of said proximal controllable portion is approximately equal to half the length of said elongate body.

20. The apparatus of claim 14 wherein said proximal controllable portion comprises a plurality of pivotally connected segments.

21. The apparatus of claim 20 wherein each of said segments comprises an actuator for propagating the selected shape along said proximal controllable portion.

22. The apparatus of claim 21 wherein said actuator comprises a type of motor selected from the group consisting of pneumatic, hydraulic, electromechanical motors and drive shafts.

23. The apparatus of claim 21 wherein said actuator comprises a tendon.

24. The apparatus of claim 14 wherein said guide is configured to assume the selected shape when the guide is in a flexible state and wherein said guide is further configured to maintain the selected shape when the guide is in a rigidized state.

25. The apparatus of claim 24 wherein said guide is configured to selectively rigidize along the length of said guide to maintain the selected shape in the rigidized state.

26. The apparatus of claim 24 wherein the proximal section of said guide is in communication with a guide controller for selectively rigidizing the guide along its length.

27. The apparatus of claim 24 wherein said guide comprises a plurality of adjacent segments each defining a channel therethrough such that a common channel is defined through the length of the guide.

28. The apparatus of claim 27 further comprising a tensioning member disposed within said common channel such that applying a force to said tensioning member compresses said adjacent segments together.

29. The apparatus of claim 27 wherein said guide is configured to maintain a position of said adjacent segments relative to each other upon applying a vacuum force within said common channel.

30. The apparatus of claim 14 further comprising a suction device for withdrawing a gas from the body cavity through the elongate body.

31. The apparatus of claim 30 wherein the suction device is in fluid communication with a suction port defined on an outer surface of said elongate body.

32. The apparatus of claim 30 wherein said suction device is controllable via a controller located externally of the body cavity

33. The apparatus of claim 30 wherein said suction device is configured to operate continuously.

34. An apparatus for inserting into a body cavity comprising:

an elongate body having a proximal portion and a selectively steerable distal portion and defining a lumen therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;

a suction device for withdrawing a gas from the body cavity and through the elongate body, wherein the suction device is in fluid communication with a suction port defined on an outer surface of said elongate body;

an elongate guide having a proximal section, a distal section, and a length therebetween, said guide being slidably disposed without constraint within said lumen for selectively supporting said body, wherein said guide is configured to conform to and selectively maintain the selected shape assumed by said steerable distal portion, and

wherein said proximal portion of said elongate body when advanced distally is configured to conform to the selected curve maintained by said guide.