SYSTEMS AND METHODS FOR MEDICAL DEVICE ADVANCEMENT AND ROTATION

• US 20100305502A1
• Filed: 12/21/2009
• Published: 12/02/2010
• Est. Priority Date: 05/06/2001
• Status: Active Grant

• Current Assignee: Stereotaxis, Inc.
• Original Assignee: Stereotaxis, Inc.
• Inventors: Klimek, Scott G., Pikus, Michael J., Hall, Andrew F., Ferry, Steven J., Habeger, Cam, Houge, Reed A., Finney, Jennifer R., Hackenmueller, Vincent
• Granted Patent: US 8,114,032 B2
• Time in Patent Office: Days
• US Class Current: 604/95.01
• CPC Class Codes: A61B 1/00133 Drive units for endoscopic tools inserted through or with the endoscope
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 2017/22075 with motorized advancing or retracting means
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 2090/571 for clamping a support arm to a bed or other supports
• 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

Abstract

A system for moving an elongate medical device has at least one drive element for engaging and moving an elongate medical device. Various embodiments provide for moving the separate inner and outer elements of a telescoping medical device. Some systems also provide for the rotation of a rotatable distal element on a rotatable medical device or the rotation of extension element in a telescoping medical device.

Claims

1-21. -21. (canceled)

22. A device motion control mechanism for moving at least one elongate medical device, the mechanism comprising:

a drive base having a plurality of slots, each slot having an open top and opposed sides therein;

a first plurality of pairs of opposed wheels, each pair on opposite sides of a corresponding slot;

a drive mechanism configured for connection to a plurality of motors, each motor configured to turn at least one wheel of a corresponding pair of opposed wheels;

a rotary sleeve into which the device may pass for engagement with the sleeve, which sleeve together with device may be axially rotated by means of engagement with a second plurality of opposed wheels, and

for each first pair of wheels, a cover movably mounted on the drive base for movement between a loading position in which the top of a slot is open to allow a portion of at least one elongate device to be inserted into the open slot between the corresponding pair of wheels, and a drive position in which the cover at least partially blocks the top of a slot to retain at least one elongate device therein.

23. The device motion control mechanism of claim 22 further comprising a guide base extending distally from the drive base and in which at least two of the slots converge to form a common slot.

24. The device motion control mechanism of claim 22 further comprising:

a hemostasis valve adapter attached to the guide base and aligned with the common slot for passage therethrough of at least one elongate device.

25. A device motion control system for moving at least one elongate medical device within a body, the system comprising:

an advancer and axial rotation mechanism having a drive base with a plurality of slots, each slot having an open top and a pair of opposed wheels on opposed sides of the slot, each wheel pair, when in a drive position, configured to engage at least one elongate device placed lengthwise in the slot;

a plurality of motors connected to the advancer and axial rotation mechanism, each motor configured to turn at least one wheel of a corresponding wheel pair; and

a user-operable control system configured to control the motors.

26. The advancer system of claim 25 further comprising a flexible arm having a proximal end anchorable to an anchoring location, and a distal end connectable to the advancer, the arm configured to allow the advancer to be adjustably positioned relative to a patient, the arm further configured to be locked in a desired position.

27. The advancer system of claim 25 further comprising a flexible coaxial drive cable having a plurality of coaxial drive members connecting the motors to the advancer, each drive member operable to drive a corresponding wheel pair.

28. The advancer system of claim 25 wherein the control system is operable by a user remote from a site in which the body is positioned.

29. The advancer system of claim 25 wherein the control system is operable by a user to drive a plurality of elongate devices independently of one another.

30. The device motion control system of claim 25, where said control system controls the device motion so as to produce a doddering motion of the device comprising rapid alternation of small advancements and retractions.

31. The device motion control system of claim 25, wherein the user-operable control system comprises:

a low-level electronic control system configured to control the motors; and

a computer that controls the low-level electronic control system, said computer being capable of translating user-defined high-level commands into low-level controls of actual device motion.

32-38. -38. (canceled)

39. A method of moving a plurality of elongate medical devices having proximal and distal ends, the method comprising:

inserting a portion of a first elongate device lengthwise into a slot in a base of a first advancer and between a first opposed pair of wheels;

inserting a portion of a second elongate device lengthwise into a slot in a base of a second advancer and between a second opposed pair of wheels, where a portion of at least one of the first or second elongate device are inserted through and engage a rotatable sleeve;

engaging the first device between the first wheel pair and the second device between the second wheel pair; and

selectively turning at least one wheel of at least one of the wheel pairs to cause elongate movement of at least one of the devices.

41. The method of claim 39 where at least one medical device is selectively axially rotated by rotating the engaging rotatable sleeve.

42. The method of claim 41, where at least one axial rotation or elongate movement is computer-controlled.

43. The method of claim 41, where at least one of the advancement or axial rotation engagements may be disengaged.

44. The method of claim 43 where the motion of the device is computer-controlled through control of the remaining engagements.

40. (canceled)

45-49. -49. (canceled)

50. A telescoping medical device and driver combination, the telescoping medical device comprising an outer sheath and an inner core slidably disposed in the outer sheath and telescopable from the distal end thereof, and the driver comprising a first drive that compressibly engages the outer sheath sufficiently to cause the outer sheath to frictionally engage the inner core therein to drive the inner core and outer sheath together, and a second drive that engages the inner core sufficiently to drive the inner core to overcome the inner and outer core without overcoming the compressible engagement between the first drive and the outer sheath, where at least one of outer sheath or inner core may be axially rotated by an axial rotation mechanism.

53. The combination of claim 50, where the axial rotation is computer-controlled.

54. The combination of claim 50, where the axial rotation is computer-controlled.

51-52. -52. (canceled)

55-58. -58. (canceled)

59. An drive unit for remotely controlling the motion of a catheter and associated sheath, the drive unit comprising:

a base;

a shuttle slideably mounted on the base;

a catheter mover for engaging a catheter, mounted on the shuttle;

a sheath mover having a sheath bracket for engaging a sheath that surrounds the catheter, slideably mounted on the shuttle, the sheath mover being movable relative to the shuttle to advance and retract the sheath relative to the catheter; and

the bracket being rotatable;

the shuttle being movable relative to the base for coordinated advancement and retraction of the catheter and sheath;

the sheath mover being movable relative to the shuttle for advancement and retraction of the sheath relative to the catheter, and the bracket being rotatable for rotation of the sheath.

60. The drive unit according to claim 59 further comprising a catheter bracket on the catheter mover, the catheter bracket being rotatable to rotate the catheter.