SYSTEMS AND METHODS FOR DIRECTING INSTRUMENTS TO VARYING POSITIONS AT THE DISTAL END OF A GUIDE TUBE

• US 20100160729A1
• Filed: 12/17/2009
• Published: 06/24/2010
• Est. Priority Date: 12/19/2008
• Status: Active Grant

• Current Assignee: Andy Campbell, Barry Weitzner, Katie Krueger, Paul J. Smith
• Original Assignee: Andy Campbell, Barry Weitzner, Katie Krueger, Paul J. Smith
• Inventors: Smith, Paul J., Campbell, Andy, Krueger, Katie, Weitzner, Barry
• Granted Patent: US 8,425,406 B2
• Time in Patent Office: Days
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00098 Deflecting means for inserted tools
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61M 2025/0035 characterized by a variable lumen cross-section by means of a resilient flexible septum or outer wall
• CPC Class Codes: A61M 25/0023 by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/003 characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067

Abstract

Described herein are various systems and methods for directing endoscopy instruments to varying positions at a target site. In one aspect, at least one instrument channel has multiple exit points at the distal end of the guide tube, and the position of an instrument delivered through the channel may be switched between the different exit points. In another aspect, an instrument channel splits into multiple branches at the distal end of the guide tube, and the position of an instrument at the target site may be changed by selectively directing the instrument into a different channel branch. In yet another aspect, the guide tube, or a portion thereof, may be rotated to reposition an instrument at the target site. The capability of changing the instrument positions during a procedure would enable a physician to examine or treat multiple target sites within an operative field, without necessitating the full retraction of the instruments or the guide tube from the operative field.

Claims

1. A system for delivering instruments to a target site, the system comprising:

an elongate guide tube extending between a proximal end and a distal end and including two or more channels for the passage of the instruments, wherein at least one of the channels comprise;

an elongate distal opening defining a first and a second instrument position; and

a lateral displacement element for moving an instrument delivered through the channel from the first instrument position to the second instrument position.

2. The system of claim 1, wherein the lateral displacement element locks the instrument delivered through the channel in the first or the second instrument position.

3. A system for delivering instruments to a target site, the system comprising:

an elongate guide tube extending between a proximal end and a distal end and including two or more channels for the passage of the instruments, wherein at least one of the channels comprise;

an elongate distal opening defining a first and a second instrument positions; and

a narrow passage between the first and the second instrument positions.

4. The system of claim 3, wherein the passage is at the distal end of the channel.

5. The system of claim 3, wherein the passage extends between the proximal and distal ends of the channel.

6. The system of claim 3, wherein the width of the passage is smaller than the cross-sectional diameter of an instrument delivered through the channel.

7. The system of claim 6, wherein the passage locks the instrument delivered through the channel in the first or the second instrument position.

8. The system of claim 3, wherein the sidewalls of the passage are flexible, deformable, elastic and/or compressible.

9. The system of the claim 3, wherein the area of the guide tube surrounding the passage is flexible, deformable, elastic and/or compressible.

10. The system of the claim 3, wherein the area of the guide tube surrounding the passage is void.

11. The system of claim 3, wherein the passage defines at least one additional channel.

12. The system of claim 11, wherein an instrument delivered through the at least one additional channel prevents the passage of a first instrument from the first instrument position to the second instrument position.

13. The system of claim 3, further comprising a second and a third channel positioned on either side of the elongate distal opening;

and

wherein movement of an instrument from the first instrument position to the second instrument position passes between the second and the third channels.

14. A system for delivering instruments to a target site, the system comprising:

an elongate guide tube extending between a proximal end and a distal end and including two or more channels for the passage of the instruments, wherein at least one of the channels comprise;

an elongate distal opening defining a first and a second instrument positions; and

deformable sidewalls at the distal opening of the channel.

15. The system of claim 14, wherein the insertion of an instrument into the first or the second instrument position causes deformation of the sidewalls and changes the shape of the channel.

16. The system of claim 15, wherein the insertion of the instrument into the first instrument position reduces the cross-sectional area of the second instrument position.

17. The system of claim 15, wherein the insertion of the instrument into the first or the second instrument position changes the shape of the other channels in the guide tube.

18. The system of claim 17, wherein the removal of the instrument from the first or the second instrument position restores the shape of the channels in the guide tube.

19. A system for delivering instruments to a target site, the system comprising:

an elongate guide tube extending between a proximal end and a distal end and comprising multiple instrument exit points at the distal end, wherein at least two of the exit points are connected by a common lumen.

20. The system of claim 19, wherein an instrument delivered through the common lumen can be inserted into any of the multiple instrument exit points connected to it.

21. A system for delivering instruments to a target site, the system comprising:

an elongate guide tube extending between a proximal end and a distal end and comprising multiple instrument exit points at the distal end, wherein the guide tube is rotatable about a longitudinal axis of the guide tube.

22. The system of claim 21, wherein only a portion of the guide tube rotates around the longitudinal axis.

23. The system of claim 21, wherein the guide tube is segmented and only one of the segments is rotatable around the longitudinal axis.

24. A method for delivering instruments to a target site, the method comprising the steps of:

providing an elongate guide tube extending between a proximal end and a distal end and including two or more channels for the passage of the instruments, wherein at least one of the channels comprise an elongate distal opening defining a first and a second instrument position and a lateral displacement element;

delivering an instrument to the first instrument position at the distal end of the guide tube;

moving the instrument from the first instrument position to the second instrument position using the lateral displacement element.

25. A method for delivering instruments to a target site, the method comprising the steps of:

providing an elongate guide tube extending between a proximal end and a distal end and including two or more channels for the passage of the instruments, wherein at least one of the channels comprise an elongate distal opening defining a first and a second instrument positions and a narrow passage between the first and the second instrument positions;

delivering an instrument to the first instrument position at the distal end of the guide tube;

applying a lateral force to the instrument by an user to move the instrument from the first instrument position to the second instrument position through the narrow passage.

26. The method of claim 25, wherein the application of the lateral force to the instrument causes the narrow passage to expand.

27. The method of claim 25, further comprising the step of providing a second and a third channel positioned on either side of the elongate distal opening;

and

wherein movement of the instrument from the first instrument position to the second instrument position passes between the second and the third channels.

28. A method for delivering instruments to a target site, the method comprising the steps of:

providing an elongate guide tube extending between a proximal end and a distal end and including multiple exit points for the instruments at the distal end, wherein at least two of the exit points are connected by a common lumen;

delivering an instrument though the common lumen;

positioning the instrument at a first exit point;

withdrawing the instrument into the common lumen; and

redirecting the instrument to a second exit point.

29. A method for delivering instruments to a target site, the method comprising the steps of:

providing an elongate guide tube extending between a proximal end and a distal end and having multiple instrument exit points at the distal end, wherein the guide tube is rotatable about a longitudinal axis of the guide tube;

delivering an instrument to the target site through a first exit point; and

rotating the guide tube around the longitudinal axis to shift the position of the instrument at the target site.

30. The method of claim 29, wherein only a portion of the guide tube is rotatable.

31. The method of claim 30, further comprising the steps of retracting the instrument from a first exit point into the rotatable portion of the guide tube prior to rotation of that portion;

and

reinsertion of the instrument into a second exit point.

32. The method of claim 31, wherein the first and the second exit points are positioned symmetrically opposite to each other in the guide tube.

33. The method of claim 30, wherein the guide tube is segmented into a proximal segment and a distal segment and the step of rotating the guide tube comprises rotation of only the distal segment around the longitudinal axis.

34. The method of claim 33, further comprising the steps of retracting the instrument from the first exit point into the proximal segment prior to rotation of the distal segment;

and

reinsertion of the instrument into the first exit point.

35. The method of claim 33, wherein the proximal segment comprises a control element to rotate the distal segment.