Robotic catheter system

• US 20050222554A1
• Filed: 03/04/2005
• Published: 10/06/2005
• Est. Priority Date: 03/05/2004
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Stahler, Gregory J., Niemeyer, Gunter D., Wallace, Daniel T., Martin, Kenneth M., Moll, Frederic H., Moore, David F., Adams, Daniel T., Zinn, Michael R., Younge, Robert G.
• Granted Patent: US 7,972,298 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 2034/715 Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2090/035 preventing further rotation
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 46/10 : specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 5/066 : Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/283 : Invasive
• CPC Class Codes: A61B 5/6852 : Catheters
• CPC Class Codes: A61B 5/6885 : Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/7285 : for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 5/746 : Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 6/4423 : related to hygiene or sterilisation
• CPC Class Codes: A61B 6/503 : for diagnosis of the heart
• CPC Class Codes: A61B 6/504 : for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/541 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• 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 8/4254 : using sensors mounted on the probe
• CPC Class Codes: A61B 8/4461 : Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
• CPC Class Codes: A61B 8/4466 : involving deflection of the probe
• CPC Class Codes: A61B 8/543 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 25/0113 : Mechanical advancing means, e.g. catheter dispensers
• CPC Class Codes: A61M 25/09041 : Mechanisms for insertion of guide wires

Abstract

A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Claims

1. A robotic catheter system, comprising:

a controller including a master input device;

an instrument driver in communication with the controller, the instrument driver having a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device; and

an elongate guide instrument having a base, distal end, and a working lumen, the guide instrument base operatively coupled to the guide instrument interface, the guide instrument comprising a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument, the guide instrument control elements axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by movement of the master input device.

2. The robotic catheter system of claim 1, further comprising an elongate sheath instrument having a base, distal end, and a lumen through which the guide instrument is coaxially disposed, the instrument driver further comprising a sheath instrument interface operatively coupled to the sheath instrument base.

3. The robotic catheter system of claim 2, wherein the instrument driver is configured such that the guide instrument interface is moveable relative to the sheath instrument interface, whereby the guide instrument is moveable axially relative to the sheath instrument.

4. The robotic catheter system of claim 2, the sheath instrument interface including a sheath instrument drive element responsive to control signals generated, at least in part, by the master input device, the sheath instrument comprising a sheath instrument control element operatively coupled to the sheath instrument drive element and secured to the distal end of the sheath instrument, the sheath instrument control element axially moveable relative to the sheath instrument such that movement of the sheath instrument distal end may be controlled by movement of the master input device.

5. The robotic catheter system of claim 2, wherein an outer surface of the guide instrument and a surface defining the sheath instrument lumen are jointly configured to limit rotational movement of the guide instrument relative to the sheath instrument.

6. The robotic catheter system of claim 1, wherein the controller and instrument driver are configured to independently control the guide instrument drive elements and corresponding guide instrument control elements in order to achieve a desired bending of the guide instrument distal end.

7. The robotic catheter system of claim 6, wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on a kinematic relationship between the desired bending and a linear movement of the guide instrument control element relative to the guide instrument.

8. The robotic catheter system of claim 1, further comprising a working instrument disposed in the working lumen of, and axially movable relative to, the guide instrument.

9. The robotic catheter system of claim 8, wherein the working instrument is an ablation catheter.

10. The robotic catheter system of claim 8, wherein the working instrument is a guidewire.

11. The robotic catheter system of claim 8, wherein the working instrument comprises one or both of a dilator and a needle.

12. The robotic catheter system of claim 6, further comprising an imaging system and a display, each operatively coupled to the controller.

13. The robotic catheter system of claim 12, the imaging system comprising an elongate imaging instrument including an operative imaging element on a distal portion thereof, the imaging instrument configured for placement in a body passage or cavity, the operative imaging element configured for acquiring images of the body passage or cavity, the imaging system configured for presenting the acquired images on the display.

14. The robotic catheter system of claim 12, wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on data from the acquired images.

15. The robotic catheter system of claim 12, wherein the imaging system selected from the group comprising an ultrasound imaging system, an optical imaging system, a fluoroscopic imaging system, a computer tomography imaging system, and an MR imaging system.

16. The robotic catheter system of claim 6, further comprising a localization system operatively coupled to the controller, the localization system configured to obtain position information of the guide instrument.

17. The robotic catheter system of claim 16, wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on position data from the localization system.

18. The robotic catheter system of claim 16, wherein the localization system is an ultrasound localization system or an electromagnetic localization system.

19. The robotic catheter system of claim 18, further comprising an operative contact sensing element carried on the distal end of the guide instrument.

20. A robotic catheter system, comprising:

a controller including a master input device;

an instrument driver in communication with the controller, the instrument driver having a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device;

an elongate guide instrument having a base, distal end, and a working lumen, the guide instrument base operatively coupled to the guide instrument interface, the guide instrument comprising a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument, the guide instrument control elements axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by movement of the master input device, the controller and instrument driver being configured to independently control the guide instrument drive elements and corresponding guide instrument control elements in order to achieve a desired bending of the guide instrument distal end; and

an elongate sheath instrument having a base, distal end, and a lumen through which the guide instrument is coaxially disposed.

21. The robotic catheter system of claim 20, the instrument driver further comprising a sheath instrument interface operatively coupled to the sheath instrument base, wherein the instrument driver is configured such that the guide instrument interface is moveable relative to the sheath instrument interface, whereby the guide instrument is moveable axially relative to the sheath instrument.

22. The robotic catheter system of claim 21, the sheath instrument interface including a sheath instrument drive element responsive to control signals generated, at least in part, by the master input device, the sheath instrument comprising a sheath instrument control element operatively coupled to the sheath instrument drive element and secured to the distal end of the sheath instrument, the sheath instrument control element axially moveable relative to the sheath instrument such that movement of the sheath instrument distal end may be controlled by movement of the master input device.

23. The,robotic catheter system of claim 20, wherein an outer surface of the guide instrument and a surface defining the sheath instrument lumen are jointly configured to limit rotational movement of the guide instrument relative to the sheath instrument.

24. The robotic catheter system of claim 20, wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on a kinematic relationship between the desired bending and a linear movement of the guide instrument control element relative to the guide instrument.

25. The robotic catheter system of claim 20, further comprising a working instrument disposed in the working lumen of, and axially movable relative to, the guide instrument.

26. A robotic catheter system, comprising:

a controller including a master input device;

an instrument driver in communication with the controller, the instrument driver having a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device;

an elongate guide instrument having a base, distal end, and a working lumen, the guide instrument base operatively coupled to the guide instrument interface, the guide instrument comprising a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument, the guide instrument control elements axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by movement of the master input device, the controller and instrument driver being configured to independently control the guide instrument drive elements and corresponding guide instrument control elements in order to achieve a desired bending of the guide instrument distal end; and

a working instrument disposed in the working lumen of, and axially movable relative to, the guide instrument.

27. The robotic catheter system of claim 26, wherein the working instrument is an ablation catheter.

28. The robotic catheter system of claim 26, wherein the working instrument is a guidewire.

29. The robotic catheter system of claim 26, wherein the working instrument comprises one or both of a dilator and a needle.

30. The robotic catheter system of claim 26, wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on a kinematic relationship between the desired bending and a linear movement of the guide instrument control element relative to the guide instrument.

31. A robotic catheter system, comprising:

a controller including a master input device;

an instrument driver in communication with the controller, the instrument driver having a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device;

an elongate guide instrument having a base, distal end, and a working lumen, the guide instrument base operatively coupled to the guide instrument interface, the guide instrument comprising a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument, the guide instrument control elements axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by movement of the master input device; and

an imaging system and a display, each operatively coupled to the controller.

32. The robotic catheter system of claim 31, the imaging system comprising an elongate imaging instrument including an operative imaging element on a distal portion thereof, the imaging instrument configured for placement in a body passage or cavity, the operative imaging element configured for acquiring images of the body passage or cavity, the imaging system configured for presenting the acquired images on the display.

33. The robotic catheter system of claim 32, wherein the controller and instrument driver are configured to independently control the guide instrument drive elements and corresponding guide instrument control elements in order to achieve a desired bending of the guide instrument distal end, and wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on data from the acquired images.

34. The robotic catheter system of claim 31, wherein the imaging system selected from the group comprising an ultrasound imaging system, an optical imaging system, a fluoroscopic imaging system, a computer tomography imaging system, and an MR imaging system.

35. A robotic catheter system, comprising:

a controller including a master input device;

an instrument driver in communication with the controller, the instrument driver having a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device;

an elongate guide instrument having a base, distal end, and a working lumen, the guide instrument base operatively coupled to the guide instrument interface, the guide instrument comprising a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument, the guide instrument control elements axially moveable relative to the guide instrument such that movement of the guide instrument-distal end may be controlled by movement of the master input device; and

a localization system operatively coupled to the controller, the localization system configured to obtain position information of the guide instrument.

36. The robotic catheter system of claim 35, wherein the controller and instrument driver are configured to independently control the guide instrument drive elements and corresponding guide instrument control elements in order to achieve a desired bending of the guide instrument distal end, and wherein the controller determines a tensioning to be applied to a respective guide instrument control element based on position data from the localization system.

37. The robotic catheter system of claim 35, wherein the localization system is an ultrasound localization system or an-electromagnetic localization system.

38. The robotic catheter system of claim 35, further comprising an operative contact sensing element carried on the distal end of the guide instrument.

39. The robotic catheter system of claim 35, further comprising an elongate sheath instrument having a base, distal end, and a lumen through which the guide instrument is coaxially disposed, the instrument driver further comprising a sheath instrument interface operatively coupled to the sheath instrument base.

40. The robotic catheter system of claim 35, wherein the instrument driver is configured such that the guide instrument interface is moveable relative to the sheath instrument interface, whereby the guide instrument is moveable axially relative to the sheath instrument.

41. The robotic catheter system of claim 35, the sheath instrument interface including a sheath instrument drive element responsive to control signals generated, at least in part, by the master input device, the sheath instrument comprising a sheath instrument control element operatively coupled to the sheath instrument drive element and secured to the distal end of the sheath instrument, the sheath instrument control element axially moveable relative to the sheath instrument such that movement of the sheath instrument distal end may be controlled by movement of the master input device.

42. The robotic catheter system of claim 35, wherein an outer surface of the guide instrument and a surface defining the sheath instrument lumen are jointly configured to limit rotational movement of the guide instrument relative to the sheath instrument.