Endoluminal tool deployment system

• US 20040138525A1
• Filed: 01/15/2003
• Published: 07/15/2004
• Est. Priority Date: 01/15/2003
• Status: Active Grant

• Current Assignee: USGI Medical, Inc., USGI Medical Incorporated
• Original Assignee: USGI Medical Incorporated
• Inventors: Saadat, Vahid, Miller, David, Chen, Eugene, Ewers, Richard C.
• Granted Patent: US 7,637,905 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 1/0057 Constructional details of force transmission elements, e.g. control wires
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/2906 Multiple forceps
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/508 with releasable brake mechanisms
• CPC Class Codes: A61M 2025/0096 being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 25/0043 characterised by structural features
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

Claims

1. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and an arm guide lumen extending over or through at least a distal section of the elongated main body; and

at least one tool arm being adapted to extend through the arm guide lumen of the elongated main body and having a laterally stabilized, steerable distal end.

2. A system as in claim 1, wherein the laterally stabilized, steerable distal end of the tool arm is deflectable in only a single plane.

3. A system as in claim 2, wherein the laterally stabilized, steerable distal end of the tool arm is deflectable to a deflected position in the single plane and is lockable in the deflected position.

4. A system as in claim 2, wherein the steerable distal end comprises a plurality of adjacent links.

5. A system as in claim 4, wherein the adjacent links are pivotally connected by hinge structures.

6. A system as in claim 5, wherein the hinge structures comprise pivot pins, and wherein said pivot pins are arranged in parallel to limit deflection to the single plane.

7. A system as in claim 1, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

8. A system as in claim 7, wherein the arm guide lumen terminates at a distal tip of the elongated main body so that said tool arm advances through said distal tip.

9. A system as in claim 1, wherein the arm guide lumen extends through the distal section and terminates at a distal tip thereof.

10. A system as in claim 9, wherein the distal section of the elongated main body has a generally cylindrical exterior, and wherein the arm guide lumen does not extend out of the cylindrical exterior.

11. A system as in claim 1, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

12. A system a in claim 11, wherein the elongated main body has a second arm guide lumen, and wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

13. A system as in claim 1, wherein at least a portion of the elongated main body is steerable.

14. A system as in claim 13, wherein the elongated main body comprises a first section and a second section disposed proximally of the first section, and wherein the first and second sections are independently lockable.

15. A system as in claim 14, wherein the first section is lockable while the second section remains steerable.

16. A system as in claim 14, further comprising a means for selectively deflecting the second section within at least a single plane.

17. A system as in claim 16, wherein the second section is deflectable in retroflexion wherein the distal end of the main body is directed toward the proximal end.

18. A system as in claim 13, wherein the steerable portion of the elongated main body comprises a plurality of adjacent links.

19. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and an arm guide lumen extending over or through at least a distal section of the elongated main body; and

at least one tool arm being adapted to extend through the arm guide lumen of the elongated main body, and comprising a steerable distal end comprising a plurality of adjacent links.

20. A system as in claim 19, wherein the steerable distal end of the tool arm is deflectable in only a single plane.

21. A system as in claim 20, wherein the steerable distal end includes a base which is deflectable laterally outward in the single plane and a tip section which is deflectable laterally inward in the single plane.

22. A system as in claim 21, wherein the tip section is deflectable to face the distal end of the main body.

23. A system as in claim 20, wherein the adjacent links are pivotally connected by hinge structures.

24. A system as in claim 23, wherein the hinge structures comprise pivot pins, and wherein said pivot pins are arranged in parallel to limit deflection to the single plane.

25. A system as in claim 19, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

26. A system as in claim 25, wherein the arm guide lumen terminates at a distal tip of the elongated main body so that said tool arm advances through said distal tip.

27. A system as in claim 19, wherein the adjacent links are shaped so that the steerable distal end is deflectable to form a predetermined curvature wherein the arm is then restricted from further deflection.

28. A system as in claim 19, wherein the at least one tool arm further comprises pullwires which steer the distal end.

29. A system as in claim 19, wherein the tool arm includes a tool deployment lumen, and further comprising a tool adapted to extend through the tool deployment lumen.

30. A system as in claim 29, wherein the tool arm further comprises a steering cuff arranged for extension of the tool therethrough so that manipulation of the tool within the steering cuff steers the distal end of the tool arm.

31. A system as in claim 19, wherein the arm guide lumen extends through the distal section and terminates at a distal tip thereof.

32. A system as in claim 31, wherein the distal section of the elongated main body has a generally cylindrical exterior, and wherein the arm guide lumen does not extend out of the cylindrical exterior.

33. A system as in claim 19, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

34. A system as in claim 33, wherein the elongated main body has a second arm guide lumen, and wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

35. A system as in claim 19, wherein at least the distal section of the elongated main body is steerable.

36. A system as in claim 35, wherein the elongated main body comprises a first section and a second section disposed proximally of the first section, and wherein the first and second sections are independently lockable.

37. A system as in claim 36, wherein the first section is lockable while the second section remains steerable.

38. A system as in claim 36, further comprising a means for selectively deflecting the second section within at least a single plane.

39. A system as in claim 38, wherein the second section is deflectable in retroflexion wherein the distal end of the main body is directed toward the proximal end.

40. A system as in claim 35, wherein the distal section of the elongated main body comprises a plurality of adjacent links.

41. A system as in claim 40, further comprising a means for selectively deflecting the distal section within at least a single plane.

42. A system as in claim 19, wherein the steerable distal end of the tool arm is deflectable to a deflected position and lockable in the deflected position.

43. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and an arm guide lumen extending through at least a distal section of the elongated main body; and

at least one tool arm adapted to extend through the arm guide lumen of the elongated main body.

44. A system as in claim 43, wherein at least the distal section of the elongated main body has a generally cylindrical exterior, and wherein the arm guide lumen does not extend out of the cylindrical exterior.

45. A system as in claim 44, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

46. A system as in claim 45, wherein the arm guide lumen terminates at a distal tip of the elongated main body so that said tool arm advances through said distal tip.

47. A system as in claim 43, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

48. A system as in claim 47, wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

49. A system as in claim 43, wherein at least the distal section of the elongated main body is steerable.

50. A system as in claim 49, wherein the distal section of the elongated main body comprises a plurality of adjacent links.

51. A system as in claim 50, further comprising a means for selectively deflecting the distal section within at least a single plane.

52. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and at least two arm guide lumens extending over or through at least a distal section of the elongated main body, wherein said arm guide lumens extend fully to a distal tip of the main body; and

at least two tool arms adapted to extend through the arm guide lumens of the elongated main body, said tool arms emerging from the distal tip of the main body.

53. A system as in claim 52, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

54. A system as in claim 53, wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

55. A system as in claim 52, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

56. A system as in claim 52, wherein at least one of the tool arms has a steerable distal end which comprises a flexible tube having at least one pullwire attached thereto so that manipulation of the at least one pullwire deflects the steerable distal end.

57. A system as in claim 56, wherein at least one of the tool arms has a steerable distal end which comprises a flexible tube having shape memory material so that emergence of the steerable distal end from the distal tip of the main body allows deflection of the steerable distal end to a shape memory position.

58. A system as in claim 52, further comprising a deployment frame extending from the distal tip of the main body, the frame comprising at least two supports each attached to one of the at least two tool arms so that manipulation of the deployment frame deflects the attached tool arms.

59. A system as in claim 52, wherein the arm guide lumen extends through the distal section and terminates at a distal tip thereof.

60. A system as in claim 59, wherein the distal section of the elongated main body has a generally cylindrical exterior and wherein the arm guide lumen does not extend out of the cylindrical exterior.

61. A system as in claim 52, wherein at least the distal section of the elongated main body is steerable.

62. A system as in claim 61, wherein the distal section of the elongated main body comprises a plurality of adjacent links.

63. A system as in claim 62, further comprising a means for selectively deflecting the distal section within at least a single plane.

64. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and an arm guide lumen extending through at least a distal section of the elongated main body, wherein the arm guide lumen terminates distally on a rounded distal tip of the elongated main body; and

at least one tool arm adapted to extend through the arm guide lumen of the elongated main body, said tool arm emerging from the rounded distal tip of the main body.

65. A system as in claim 64, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

66. A system as in claim 65, wherein the distal section of the elongated main body, has a generally cylindrical exterior, and wherein the arm guide lumen does not extend out of the cylindrical exterior.

67. A system as in claim 64, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

68. A system a in claim 67, wherein the elongated main body has a second arm guide lumen, and wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

69. A system as in claim 64, wherein at least the distal section of the elongated main body is steerable.

70. A system as in claim 69, wherein the distal section of the elongated main body comprises a plurality of adjacent links.

71. A system as in claim 70, further comprising a means for selectively deflecting the distal section within at least a single plane.

72. An endoluminal tool deployment system comprising:

an elongated main body having a distal end, a proximal end, and an arm guide lumen extending through at least a distal section of the elongated main body, wherein at least the distal section comprises a plurality of adjacent links;

a means for selectively deflecting the distal section within at least a single plane; and

at least one tool arm adapted to extend through the arm guide lumen of the elongated main body.

73. A system as in claim 72, wherein the elongated main body comprises a first section and a second section disposed proximally of the first section, and wherein the first and second sections are independently lockable.

74. A system as in claim 73, wherein the first section is lockable while the second section remains deflectable.

75. A system as in claim 72, wherein the deflection of the distal section within the at least a single plane includes retroflexion wherein the distal end of the main body is directed toward the proximal end.

76. A system as in claim 72, wherein the tool arm is axially and rotationally translatable within the arm guide lumen.

77. A system as in claim 76, wherein the arm guide lumen terminates at a distal tip of the elongated main body so that said tool arm advances through said distal tip.

78. A system as in claim 72, wherein the distal section of the elongated main body has a generally cylindrical exterior, and wherein the arm guide lumen does not extend out of the cylindrical exterior.

79. A system as in claim 72, wherein the elongated main body has a viewing scope lumen extending therethrough and terminating in the distal tip.

80. A system as in claim 79, wherein the elongated main body has a second arm guide lumen, and wherein the distal terminations of the two arm guide lumens and the one viewing scope lumen are arranged in a generally triangular pattern on the distal tip of the main body.

87. A tool arm as in claim 80, wherein the means for selectively deflecting the distal section further comprises at least one additional pullwire or pushwire.

88. A tool as in claim 80, wherein the means for selectively deflecting the distal section further comprises at least one spring which is configured to straighten the distal section in opposition to the pullwire or pushwire.

81. A laterally stabilized, steerable tool arm comprising:

a shaft having a proximal end and a distal end, wherein a distal section of the arm comprises a plurality of adjacent links pivotally attached by hinge structures which limit deflection of the distal section to within a single plane; and

means for selectively deflecting the distal section within the single plane.

82. A tool arm as in claim 81, wherein the hinge structures each include a pin, wherein the pins are disposed in parallel to limit the deflection of the distal section to within the single plane.

83. A tool arm as in claim 82, wherein the hinge structures comprise male and female bearing surfaces which define axes, wherein the axes are disposed in parallel to limit deflection of the distal section to within the single plane.

84. A tool arm as in claim 81, wherein the distal end includes at least two steerable sections, wherein a distal-most steerable section includes a tip section which curves in a first direction and wherein an intermediate steerable section includes a base which curves in the opposite direction, where both curves are in the single plane.

85. A tool arm as in claim 84, wherein the tip section curve has a radius which is greater than that of the base curve.

86. A tool arm as in claim 81, wherein the means for selectively deflecting the distal section comprises at least one pullwire or one pushwire.

89. A tool as in claim 81, wherein the adjacent links are shaped so that the steerable distal end is deflectable to form a predetermined curvature wherein the arm is then restricted from further deflection.

90. A tool as in claim 81, wherein a tool deployment lumen extends through the shaft for passage of a tool therethrough.

91. A tool as in claim 90, wherein the tool arm further comprises a steering cuff arranged for passage of the tool therethrough so that manipulation of the tool within the steering cuff steers the distal end of the tool arm.

92. A tool as in claim 81, further comprising an end effector disposed on or near the distal end of the shaft.

93. A method for deploying one or more tools in an anatomical space, said method comprising:

introducing a distal end of a main body to said anatomical space;

advancing a tool arm from a tool deployment lumen in said main body into said anatomical space;

deflecting and positioning the tool arm to locate a distal tip thereof adjacent to a target location within the anatomical space, wherein a distal section of the arm is curved and laterally stabilized in a single plane; and

advancing a tool through a lumen of the tool arm to the target location.

94. A method as in claim 93, wherein deflecting and position comprises tensioning a plurality of adjacent hinged links within the distal section of the tool arm.

95. A method as in claim 94, wherein said adjacent hinged links are joined by hinge pins which are disposed perpendicularly to the single plane such that the pins stabilize the distal section and inhibit deflection outside of the single plane.

96. A method as in claim 93, further comprising viewing the target location through a viewing scope disposed in the main body, wherein the tool arm extends axially from a distal tip of the main body from a location adjacent to the viewing scope.