Transcavital needle insertion device

• US 20050203413A1
• Filed: 08/06/2004
• Published: 09/15/2005
• Est. Priority Date: 08/07/2003
• Status: Abandoned Application

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Okamura, Allison M., Schneider, Chad M., Fichtinger, Gabor
• Application Number:
  US10/912,545
• Publication Number:
  US 20050203413A1
• Time in Patent Office: Days
• US Class Current: 600/461
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/2253 using a coupling gel or liquid
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Disclosed is a transcavital needle insertion device that incorporates a transrectal ultrasound (TRUS) probe; a support sheath incorporated with, but mechanically decoupled from the TRUS probe to substantially stabilize the target tissue being imaged; and a needle guide sheath that moves relative to the TRUS probe. The device substantially enables a practitioner to more accurately and precisely insert a therapeutic needle into a target tissue, such as a prostate, in a decoupled three degree of freedom coordinate space that is registered to the imagery generated from the TRUS probe. The support sheath may enable the practitioner to move the TRUS probe, and independently position and insert the needle, without problems brought about by variable deformation of the target tissue, which would otherwise result from motion of the TRUS probe and the needle.

Claims

1. A transcavital needle insertion device comprising:

a support sheath;

an ultrasound probe; and

a guide sheath having at least one needle guide.

2. The device of claim 1, wherein the support sheath includes a plurality of holes.

3. The device of claim 1, wherein the ultrasound probe comprises a TRUS probe.

4. The device of claim 1, further comprising a stepper connected to the ultrasound probe.

5. The device of claim 1, wherein the guide sheath includes a partial cylindrical shape and wherein the guide sheath includes a longitudinal axis that is substantially collinear with an ultrasound probe longitudinal axis.

6. The device of claim 5, further comprising:

a first positioner means for controlling and measuring a first orientation of the guide sheath according to an angle around the longitudinal axis;

a second positioner means for controlling and measuring a second orientation of the guide sheath according to a distance along the longitudinal axis.

7. The device of claim 5, wherein the at least one needle guide includes an exit aperture having an exit axis central to the exit aperture, the exit axis having an exit angle relative to the longitudinal axis.

8. The device of claim 7, wherein the exit aperture includes a rounded shape.

9. The device of claim 7, wherein the exit aperture includes a cover.

10. The device of claim 7, further comprising a needle depth positioning means for controlling and measuring a length from a tip of a needle to the exit aperture.

11. The device of claim 7, wherein the needle depth positioning means includes a means for rotating the needle.

12. The device of claim 1, wherein the needle guide includes a curvature.

13. The device of claim 1, wherein the guide sheath comprises PTFE.

14. The device of claim 1, wherein the needle guide comprises stainless steel.

15. A method for inserting a needle into a cavity wall using a transcavital needle insertion device having a support sheath, an ultrasound probe, and a guide sheath having a needle guide, the method comprising the steps of:

inserting the transcavital needle device into a cavity;

obtaining an ultrasound image;

determining a target location inside the cavity wall;

computing a guide sheath position corresponding to the target location;

computing a needle depth corresponding to the target location and the guide sheath position;

positioning the guide sheath according to the guide sheath position; and

inserting the needle according to the needle depth.

16. The method of claim 15, wherein the step of inserting the transcavital needle device comprises the step of commanding a stepper to move the transcavital needle device a first distance into the cavity.

17. The method of claim 15, wherein the step of computing a guide sheath position comprises the steps of:

computing a translational position corresponding to a position along a longitudinal axis; and

computing an angular position corresponding to a rotation around the longitudinal axis.

18. The method of claim 17, wherein the step of positioning the guide sheath comprises the steps of:

sending a first command to a first positioner corresponding to the translational position; and

sending a second command to a second positioner corresponding to the angular position.

19. The method of claim 15, wherein the step of inserting the needle according to a needle depth includes the step of sending a needle depth command to the a needle depth positioner, the needle depth command corresponding to the needle depth.

20. The method of claim 19, wherein the step of inserting the needle further comprises sending a needle rotation command to the needle depth positioner.

21. The method of claim 20, wherein the needle rotation command corresponds to an elasticity of the needle.

22. A computer readable medium encoded with a program for controlling a transcavital needle insertion device, the device having a guide sheath, a guide sheath positioner, and a needle depth positioner, the program comprising the steps of:

acquiring a desired needle tip position;

converting the desired needle tip position to a desired translational position for the guide sheath, a desired rotational position for the guide sheath, and a desired needle depth;

sending a command to the guide sheath positioner corresponding to the desired translation position;

sending a command to the guide sheath positioner corresponding to the desired rotational position; and

sending a command to the needle depth positioner corresponding to the desired needle depth.

23. The computer readable medium of claim 22, wherein the step of acquiring a desired needle position comprises the step of:

prompting a practitioner for a desired needle position; and

reading a desired needle position data corresponding to the desired needle position, wherein the desired needle position data is input by the practitioner.

24. The computer readable medium of claim 23, wherein the step of acquiring a desired needle position further comprises the steps of:

acquiring an ultrasound image; and

displaying the ultrasound image, the displaying step containing an instruction to be executed before the step of prompting a practitioner.

25. The computer readable medium of step 22, wherein the step of sending a command to the needle depth positioner comprises the step of displaying information to a practitioner informing the practitioner to insert a needle to the desired needle depth.