Endoscope structures and techniques for navigating to a target in branched structure
First Claim
1. A method for steering a catheter through a branched structure to a target location, the method comprising:
- (a) providing a flexible, steerable catheter with a position sensor element located near a distal tip of the catheter, the position sensor element being part of a position measuring system measuring a position and a pointing direction of the tip of the catheter relative to a three-dimensional frame of reference;
(b) designating the target location relative to the three-dimensional frame of reference;
(c) advancing the catheter into the branched structure; and
(d) displaying a representation of at least one parameter defined by a geometrical relation between the pointing direction of the tip of the catheter and a direction from the tip of the catheter towards the target location.
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Accused Products
Abstract
Systems and methods employing a small guage steerable catheter (30) including a locatable guide (32) with a sheath (40), particularly as an enhancement to a bronchoscope (14). A typical procedure is as follows. The location of a target in a reference coordinate system is detected or imported. The catheter (30) is navigated to the target which tracking the distal tip (34) of the guide (32) in the reference coordinate system. Insertion of the catheter is typically via a working channel of a convention bronchoscope. Once the tip of the catheter is positioned at the target, the guide (32) is withdrawn, leaving the sheath (40) secured in place. The sheath (40) is then used as a guide channel to direct a medical tool to target.
331 Citations
76 Claims
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1. A method for steering a catheter through a branched structure to a target location, the method comprising:
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(a) providing a flexible, steerable catheter with a position sensor element located near a distal tip of the catheter, the position sensor element being part of a position measuring system measuring a position and a pointing direction of the tip of the catheter relative to a three-dimensional frame of reference;
(b) designating the target location relative to the three-dimensional frame of reference;
(c) advancing the catheter into the branched structure; and
(d) displaying a representation of at least one parameter defined by a geometrical relation between the pointing direction of the tip of the catheter and a direction from the tip of the catheter towards the target location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method for achieving registration between computerized tomography data and a three dimensional frame of reference of a position measuring system, the method comprising:
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(a) providing a catheter with;
(i) a position sensor element which operates as part of the position measuring system to allow measurement of a position and a pointing direction of the tip of the catheter relative to the three-dimensional frame of reference, and (ii) an image sensor;
(b) generating from the computerized tomography data at least three simulated views of distinctive features within the branched structure;
(c) generating at least three camera views of the distinctive features, each camera view and a corresponding one of the simulated views constituting a pair of similar views;
(d) allowing an operator to designate a reference point viewed within each of the camera views and a corresponding reference point viewed within each corresponding simulated view; and
(e) deriving from the designated reference points a best fit registration between the computerized tomography image and the three-dimensional frame of reference.
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38. A method for achieving registration between computerized tomography data and a three dimensional frame of reference of a position measuring system, the method comprising:
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(a) providing a catheter with;
(i) a position sensor element which operates as part of the position measuring system to allow measurement of a position and a pointing direction of the tip of the catheter relative to the three-dimensional frame of reference, and (ii) an image sensor;
(b) moving the tip of the catheter along a first branch portion of a branched structure and deriving a plurality of images from the camera, each image being associated with corresponding position data of the position sensor in said three dimensional frame of reference;
(c) processing said images and corresponding position data to derive a best-fit of a predefined geometrical model to said first branch portion in said three dimensional frame of reference;
(d) repeating steps (b) and (c) for a second branch portion of the branched structure; and
(e) correlating said geometrical models of said first and second branch portions with the computerized tomography data to derive a best fit registration between the computerized tomography data and the three dimensional frame of reference. - View Dependent Claims (33, 34, 35, 36, 37, 39, 40, 41, 42, 43)
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44. An endoscope for guiding a medical tool to a target location, the endoscope comprising:
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(a) a sheath having a lumen extending from a proximal insertion opening to a distal opening;
(b) a guide element configured for insertion through said proximal opening of said sheath to an inserted position extending along said lumen to said distal opening, said guide element including at least part of an imaging system deployed for taking optical images of a region beyond said distal opening; and
(c) at least one steering mechanism for co-deflecting said sheath and said guide element, wherein said guide element is retractable from said lumen to leave said lumen available for insertion of a medical tool. - View Dependent Claims (45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56)
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57. A method of guiding a medical tool through a branched structure to a target location, the method comprising:
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(a) providing a catheter assembly including a handle having a working channel, a sheath deployed within the working channel and having an internal lumen, and a guide element deployed within the lumen;
(b) locking the guide element within the sheath so as to prevent movement of the guide element relative to the sheath;
(c) guiding the sheath and the guide element to the target location;
(d) locking the sheath within the working channel to prevent relative movement of the sheath relative to the handle; and
(e) unlocking and withdrawing the guide element from the sheath so as to leave the lumen of the sheath in place as a guide for inserting a tool to the target location. - View Dependent Claims (58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70)
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71. A steering mechanism for selectively deflecting a distal portion of a steerable catheter in any one of at least two independent directions, the mechanism comprising:
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(a) at least three elongated tensioning elements extending along the catheter and configured such that tension applied to any one of said tensioning elements causes deflection of a tip of the catheter in a corresponding predefined direction;
(b) an actuator displaceable from a first position to a second position; and
(c) a selector mechanism configured for selectively mechanically interconnecting a selected at least one of said elongated tensioning elements and said actuator such that displacement of said actuator from said first position to said second position applies tension to said selected at least one of said elongated tensioning elements. - View Dependent Claims (72, 73, 74, 75, 76)
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Specification