Methods and apparatus for steering medical devices in body lumens

• US 20060074297A1
• Filed: 08/23/2005
• Published: 04/06/2006
• Est. Priority Date: 08/24/2004
• Status: Active Grant

• Current Assignee: Stereotaxis, Inc.
• Original Assignee: Stereotaxis, Inc.
• Inventors: Viswanathan, Raju R.
• Granted Patent: US 7,627,361 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/73 Manipulators for magnetic surgery

Abstract

A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a network of body lumens in an operating region in a subject that includes identifying a path through the network of body lumens in the operating region; displaying a two-dimensional image of the operating region including the path through the body lumens; determining at least one location on the path; and operating the navigation system to orient the distal end of the medical device in a direction substantially aligned with the path at the at least one location and advancing the distal end of the medical device.

Claims

1. A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a portion of a body lumen in an operating region in a subject, the method comprising:

identifying a path through a portion of the body lumen in the operating region;

selecting a location on the identified path; and

operating the navigation system to orient the distal end of the medical device in a direction along the path and advancing the distal end of the medical device.

2. The method according to claim 1 wherein the path is identified by identifying points on the path on at least two images of the operating region.

3. The method according to claim 1 wherein the path is identified by identifying lines on the path on at least two images of the operating region.

4. The method according to claim 1 where the path is determined from an idealized anatomical model.

5. The method according to claim 1 where the path is determined from a three dimensional dataset.

6. The method of claim 1 where the selection of the location on the path is done by determining the current location of the distal end of the medical device.

7. The method according to claim 6 wherein the current location of the distal end of the medical device is determined from image processing.

8. The method according to claim 6 wherein the current location of the distal end of the medical device is determined with a localization system.

9. The method according to claim 6 wherein the current location of the distal end of the medical device is determined with a length tracking system.

10. The method according to claim 1 wherein the distal end of the medical device is advanced by manually advancing the proximal end of the medical device.

11. The method according to claim 1 wherein the distal end of the medical device is advanced with a machine that advances the proximal end of the medical device.

12. The method according to claim 11 wherein the steps of operating the navigation system to orient the distal end of the medical device in a direction along the path and advancing the distal end of the medical device comprises:

repeatedly determining the location of the distal end of the medical device and orienting the medical device at the determined location to follow the determined path; and

advancing the medical device.

13. The method according to claim 12 wherein the location of the distal end of the medical device is determined continuously.

14. The method according to claim 12 wherein the location of the distal end of the medical device is determined at predetermined time intervals.

15. The method according to claim 14 wherein the predetermined time intervals are dynamically adjusted depending upon the curvature of the path.

16. The method according to claim 14 wherein the speed of the advancement is controlled based upon the curvature of the path.

17. The method according to claim 12 wherein the location of the distal end of the medical device is determined at predetermined distance intervals, as determined from the advancement of the distal end of the medical device.

18. The method according to claim 17 wherein the predetermined distance intervals are dynamically adjusted depending upon the curvature of the path.

21. The method according to claim 16 wherein the predetermined angle changes.

19. A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a portion of a body lumen in an operating region in a subject, the method comprising:

identifying a path through an idealized model of the body lumen;

selecting a location on the path for device tip alignment with the path; and

operating the navigation system to orient the distal end of the medical device in a direction along the idealized path at the determined location and advancing the distal end of the medical device.

20. A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a portion of a body lumen in an operating region in a subject, the method comprising:

identifying a path through a portion of the body lumen in the operating region;

displaying a two-dimensional image of the operating region including the path through the body lumen;

determining the current location of the distal end of the medical device; and

operating the navigation system to orient the distal end of the medical device in a direction at a predetermined angle with respect to the path and advancing the distal end of the medical device.

22. A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a portion of a body lumen in an operating region in a subject, the method comprising:

identifying a path through a portion of the body lumen in the operating region;

displaying a two-dimensional image of the operating region including the path through the body lumen;

selecting a location on the path for device tip alignment with the path; and

operating the navigation system to orient the distal end of the medical device in a direction substantially aligned with the path direction at the selected location.

23. A method of operating a navigation system that can orient the distal end of a medical device in a selected direction to navigate the medical device through a portion of a body lumen in an operating region in a subject, the method comprising:

determining a three dimensional configuration of the portion of the body lumen in the operating region;

displaying a two-dimensional image of the operating region including the portion of the body lumen;

accepting a selection from the two-dimensional display of a point on the portion of the body lumen in the operating region;

determining the corresponding three dimensional location of the point selected on the two dimensional display;

determining the current location of the distal end of the medical device;

determining a path through the body lumen from the current location of the distal end of the medical device to the three dimensional location corresponding to the point selected on the two dimensional display; and

operating the navigation system to orient the distal end of the medical device in a direction along the path and advancing the distal end of the medical device.

24. The method according to claim 23 wherein the distal end of the medical device is advanced by manually advancing the proximal end of the medical device.

25. The method according to claim 23 wherein the distal end of the medical device is advanced with a machine that advances the proximal end of the medical device.

26. The method according to claim 23 wherein the steps of operating the navigation system to orient the distal end of the medical device in a direction along the path and advancing the distal end of the medical device comprises:

repeatedly determining the location of the distal end of the medical device and determining the orientation of the medical device in the determined location to follow the determined path; and

advancing the medical device.

27. The method according to claim 23 wherein the location of the distal end of the medical device is determined continuously.

28. The method according to claim 23 wherein the location of the distal end of the medical device is determined at predetermined time intervals.

29. The method according to claim 23 wherein the location of the distal end of the medical device is determined at predetermined distance intervals, as determined from the advancement of the distal end of the medical device.