Method for controlling position of medical instruments

• US 20030176767A1
• Filed: 03/15/2002
• Published: 09/18/2003
• Est. Priority Date: 03/15/2002
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Long, Gary L., Stefanchik, David
• Granted Patent: US 7,060,025 B2
• Time in Patent Office: Days
• US Class Current: 600/106
• CPC Class Codes: A61B 1/0014 Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure

Abstract

A method for guiding an instrument associated with a medical device, such as an endoscope, is provided. The method is useful for positioning a flexible medical instrument extending from an instrument channel of an endoscope, such as for the treatment of tissue. The method is also useful for providing cooperative motion between first and second instruments extending from instrument channels within a patient'"'"'s body lumen. In one embodiment, the step of guiding the instrument comprises bending the instrument as the instrument extends from the instrument channel.

Claims

1. A method of treating tissue within a patient, said method comprising the steps of:

providing at least one instrument having a distal end;

providing at least one channel for accessing a treatment site;

extending at least a portion of the instrument from a distal end of the channel to access the treatment site; and

guiding motion of the distal end of instrument at the treatment site.

2. The method of claim 1 wherein the step of guiding motion of the distal end of the instrument comprises restricting twisting of the instrument about the longitudinal axis of the instrument.

3. The method of claim 1 wherein the step of guiding motion of the end of the instrument comprises bending the instrument.

4. The method of claim 3 wherein the step of bending the instrument comprises bending the instrument through an angle of at least about 90 degrees.

5. The method of claim 1 wherein the step of guiding motion of the end of the instrument comprises constraining motion of the distal end of the instrument along a predetermined path, wherein the path is not parallel to a longitudinal axis of the channel.

6. The method of claim 1 wherein the step of guiding motion of the end of the instrument comprises constraining motion of the end of the instrument along an arc.

7. The method of claim 1 wherein the step of providing at least one channel comprises providing a channel having a proximal channel opening outside the patient and a distal channel opening within the patient.

8. The method of claim 1 wherein the step of guiding motion of the end of the instrument comprises bending the instrument to position the end of the instrument adjacent a lumen wall.

9. The method of claim 1 further comprising the step of cutting a tissue sample.

10. The method of claim 9 further comprising the step of removing the tissue sample through the channel without removing the instrument from the channel.

11. The method of claim 1 further comprising the step of ablating tissue.

12. The method of claim 1 further comprising the step of treating the tissue with argon plasma.

13. The method of claim 1 wherein the first instrument comprises a hollow member, and wherein the method further comprises communicating a source of vacuum with the hollow member.

14. A method of treating tissue within a patient, said method comprising the steps of:

providing a first instrument having a distal end;

providing a second instrument having a distal end;

providing a first channel for accessing a treatment site;

providing a second channel for accessing a treatment site;

advancing the first instrument from a distal end of the first channel to a treatment site within the patient;

advancing the second instrument from a distal end of the second channel to the treatment site; and

cooperating motion of the distal ends of the first and second instruments.

15. The method of claim 14 wherein the step of cooperating motion of the distal ends of the first and second instruments comprises engaging the distal ends of the first and second instruments, one with the other.

16. The method of claim 14 wherein the step of cooperating motion of the distal ends of the first and second instruments comprises bending at least one of the first and second instruments.

17. The method of claim 14 wherein the step of cooperating motion of the distal ends of the first and second instruments comprises preventing twisting of at least one of the first and second instruments.

18. The method of claim 14 wherein the step of cooperating motion of the distal ends of the first and second instruments comprises bending at least one of the first and second instrument through an angle of at least about 90 degrees.

19. The method of claim 18 wherein the step of cooperating motion of the distal ends of the first and second instruments comprises bending at least one of the first and second instruments through an angle of at least about 180 degrees.

20. A method of treating tissue within a patient, said method comprising the steps of:

providing an endoscope having at least one instrument channel;

disposing the endoscope in a body lumen;

advancing a flexible instrument from the distal end of the instrument channel to access a treatment site in the body lumen; and

guiding motion of the distal end of the flexible instrument as the instrument is advanced from the distal end of the instrument channel.

21. The method of claim 20 wherein the step of guiding motion of the end of the flexible instrument comprises bending the instrument as the instrument is advanced from the instrument channel.

22. The method of claim 20 wherein the step of bending the instrument comprises bending the instrument through an angle of at least about 90 degrees.

23. The method of claim 22 wherein the step of bending the instrument comprises bending the instrument through an angle of at least about 180 degrees.

24. The method of claim 20 wherein the step of guiding motion of the end of the instrument comprises constraining motion of the distal end of the instrument along a desired path.

25. The method of claim 20 wherein the step of guiding motion of the end of the instrument comprises constraining motion of the end of the instrument along an arc.

26. The method of claim 20 wherein the step of guiding motion of the end of the instrument comprises positioning the distal end of the instrument adjacent a lumen wall.

27. The method of claim 20 wherein the step of guiding motion of the end of the instrument comprises positioning the distal end of the instrument to treat tissue located adjacent the perimeter of the distal end of endoscope.

28. The method of claim 20 wherein the step of guiding motion of the end of the instrument comprises providing a device disposed at the distal end of the endoscope for constraining motion of the distal end of the instrument a long a desired path.

30. The method of claim 20 further comprising the step of suturing tissue.

29. A method of treating tissue within a patient, said method comprising:

attaching a mechanism for guiding motion of a medical instrument to the distal end of an endoscope;

inserting a first instrument having a distal end through an instrument channel of said endoscope;

connecting the distal end of the medical instrument to the mechansim;

inserting said endoscope with the mechanism and the medical instrument into the patient.