Methods and Devices for Facilitating Visualization In a Surgical Environment

• US 20090240112A1
• Filed: 06/05/2009
• Published: 09/24/2009
• Est. Priority Date: 09/15/2006
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Facteau, William M., Goldfarb, Eric, Chang, John Y., Morriss, John
• Granted Patent: US 9,603,506 B2
• Time in Patent Office: Days
• US Class Current: 600/249
• CPC Class Codes: A61B 1/00126 optical, e.g. for light supply cables
• CPC Class Codes: A61B 1/063 for monochromatic or narrow-band illumination
• CPC Class Codes: A61B 1/0684 using light emitting diodes [LED]
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 17/24 for use in the oral cavity, larynx, bronchial passages or nose for medical inspection of cavities or tubes in the body A61B1/00; Tongue scrapers
• CPC Class Codes: A61B 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 2018/2222 Fibre material or composition
• CPC Class Codes: A61B 2018/2244 Features of optical fibre cables, e.g. claddings
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2562/228 Sensors with optical connectors
• 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 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/6851 Guide wires
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 2025/09008 : having a balloon
• CPC Class Codes: A61M 2025/09083 : having a coil around a core
• CPC Class Codes: A61M 2025/09125 : Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 2025/09166 : having radio-opaque features
• CPC Class Codes: A61M 2025/09175 : having specific characteristics at the distal tip
• CPC Class Codes: A61M 2029/025 : characterised by the guiding element
• 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 25/09 : Guide wires
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104
• CPC Class Codes: G02B 23/2469 : using optical fibres
• CPC Class Codes: G02B 6/0006 : Coupling light into the fibre in general G02B6/4298
• CPC Class Codes: G02B 6/0008 : the light being emitted at the end of the fibre
• CPC Class Codes: G02B 6/04 : formed by bundles of fibres G02B6/24 takes precedence
• CPC Class Codes: G02B 6/1228 : Tapered waveguides, e.g. integrated spot-size transformers for coupling with fibres G02B6/305
• CPC Class Codes: G02B 6/125 : Bends, branchings or intersections
• CPC Class Codes: G02B 6/241 : Light guide terminations
• CPC Class Codes: G02B 6/262 : Optical details of coupling light into, or out of, or between fibre ends, e.g. special fibre end shapes or associated optical elements
• CPC Class Codes: G02B 6/4292 : the light guide being disconnectable from the opto-electronic element, e.g. mutually self aligning arrangements

Abstract

Devices and methods for visually confirming the positioning of a distal end portion of an illuminating device placed within a patient include inserting a distal end portion of an illuminating device internally into a patient, emitting light from the distal end portion of the illuminating device, observing transillumination resulting from the light emitted from the distal end portion of the illuminating device that occurs on an external surface of the patient, and correlating the location of the observed transillumination on the external surface of the patient with an internal location of the patient that underlies the location of observed transillumination, to confirm positioning of the distal end portion of the illuminating device.

Claims

1. A sinusitis treatment system comprising:

an illuminating guidewire device having sufficient length to extend from a proximal end located outside a patient'"'"'s head to a distal end located within a paranasal sinus, the illuminating guidewire comprising;

a flexible distal end portion;

at least one light emitting element in the distal end portion; and

at least one structure extending from a proximal end of the device through the proximal end portion and at least part of the distal end portion to connect the at least one light emitting element with a power source;

a guide device having a lumen for passage of the illuminating guidewire into the paranasal sinus; and

a balloon catheter having a lumen for passage over the illuminating guidewire to position a balloon of the catheter within an opening into the paranasal sinus.

2. A system as in claim 1, wherein the at least one light emitting element comprises a distal end of at least one illumination fiber, and wherein the at least one structure comprises the at least one illumination fiber running proximally of the distal end to the proximal end of the device.

3. A system as in claim 2, wherein the distal end of the at least one illumination fiber is configured to emit light from a distal tip of the distal end portion.

4. A system as in claim 2, wherein the distal end of the at least one illumination fiber is positioned proximally of a distal tip of the distal end portion.

5. A system as in claim 4, wherein a flexible distal portion of the distal end portion extends distally of the distal end of the at least one illumination fiber.

6. A system as in claim 1, wherein the power source is a light source.

7. A system as in claim 1, wherein the at least one light emitting element comprises a distal end of at least one laser fiber, and wherein the at least one structure comprises the at least one laser fiber running proximally of the distal end to the proximal end of the device.

8. A system as in claim 7, wherein the power source is a laser light source.

9. A system as in claim 1, wherein the at least one light emitting element comprises a light emitting diode, and wherein the at least one structure comprises at least one electrical wire electrically connected to the light emitting diode and extending proximally of the light emitting diode to the proximal end of the device.

10. A system as in claim 9, wherein the power source is an electrical power source.

11. A system as in claim 1, wherein the distal end portion of the illuminating guidewire has an outside diameter configured and dimensioned to pass through an ostium of a sinus.

12. A system as in claim 11, wherein the distal end portion has an outside diameter less than about 0.038 inches.

13. A system as in claim 1, wherein the distal end portion of the illuminating guidewire comprises a flexible coil and a core support extending internally of, and fixed to, the coil.

14. A system as in claim 1, wherein the distal end portion of the illuminating guidewire includes a bend, such that a proximal part of the distal end portion is substantially aligned with a longitudinal axis of the device, and a distal part of the distal end portion is angled with respect to the longitudinal axis.

15. A system as in claim 1, wherein the guide comprises:

a first lumen for passage of the illuminating guidewire and the balloon catheter; and

a second lumen disposed beside the first lumen for passage of an endoscope.

16. A system as in claim 1, further comprising a quick release connector mounted over at least part of the proximal end portion, the quick release connector adapted to be connected to the power source and to quickly connect to and release from the proximal end portion.

17. A system as in claim 16, wherein a proximal end portion of the quick release connector is adapted to connect with a light source.

18. A system as in claim 17, wherein the proximal end portion of the quick release connector comprises an ACMI light post.

19. A system as in claim 16, wherein the connector is rotatable with respect to a light cable extending from the light source, when the connector is connected to the light cable.

20. A system as in claim 16, wherein a distal end portion of the connector comprises:

an opening configured to slidably receive the proximal end portion of the guidewire device; and

a quick release locking mechanism configured to fix the proximal end portion received in the connector.