INTRADURAL ENDOSCOPE

• US 20120296166A1
• Filed: 11/12/2010
• Published: 11/22/2012
• Est. Priority Date: 11/13/2009
• Status: Active Grant

• Current Assignee: Daniel H. Kim
• Original Assignee: Daniel H. Kim
• Inventors: Kim, Daniel H.
• Granted Patent: US 9,504,372 B2
• Time in Patent Office: Days
• US Class Current: 600/109
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00

Abstract

A method for treating a patient includes inserting an endoscope into an intradural space of the patient via an interspace of a vertebral column of the patient; steering the endoscope along the intradural space to a location; and performing a medical procedure at the location using a working lumen of the endoscope.

Claims

1. A method for treating a patient, comprising:

inserting an endoscope into an intradural space of the patient via an interspace of a vertebral column of the patient;

steering the endoscope along the intradural space to a location; and

performing a medical procedure at the location using a working lumen of the endoscope.

2. The method of claim 1, wherein the intradural space is a spinal subarachnoid space.

6. The method of claim 1, wherein:

the endoscope is inserted through a cannula or sheath, and

the method further comprises operating a dural closer while removing the cannula or sheath.

7. The method of claim 1, wherein:

the endoscope is inserted through a cannula or sheath, and

the method further comprises operating a dural puncture element while positioning the cannula or sheath.

14. The method of claim 1, wherein the medical procedure is implantation of electrodes.

15. The method of claim 1, wherein the medical procedure is injection of a drug or stem cells.

19. The method of claim 1, wherein the medical procedure is diagnostic or therapeutic neuromodulation.

20. The method of claim 1, wherein:

the endoscope carries a guidewire, and

the method further comprises removing the endoscope from the intradural space and leaving the guidewire in place.

21. The method of claim 1, wherein the medical procedure comprises heating or cooling cerebrospinal fluid by circulating the CSF through working lumens of the endoscope and a pump and heat exchanger in communication with the working lumens.

22. The method of claim 1, further comprising deploying an auxiliary endoscope through the working lumen.

3-5. -5. (canceled)

8-13. -13. (canceled)

16-18. -18. (canceled)

23. A steerable endoscope system for treatment of a patient, comprising:

an endoscope, comprising;

a tube having a guide portion, an optical lumen, a working lumen, and a maximum outer diameter less than or equal to 3.5 mm; and

a head having a port for access to the working lumen;

a steering actuator operable to move the guide portion between a straight position and a curved position;

a steering system in communication with the steering actuator and operable to steer the guide portion; and

a video interface for receiving an object image from the optical lumen.

24. The system of claim 23, wherein the steering actuator is connected to the guide portion.

25. The system of claim 24, wherein the steering actuator comprises a steering wire.

26. The system of claim 24, wherein the steering actuator comprises an electroactive polymer actuator.

27. The system of claim 26, wherein:

the tube further has a steering lumen, and

the system further comprises a cable extending along the steering lumen and in communication with the steering system and the actuator.

28. The system of claim 23, wherein the steering system comprises:

a robot operable to articulate the tube;

a controller operable by the surgeon to control the robot and the steering actuator.

29. The system of claim 23, wherein:

the guide portion has a tracking device in communication with the steering system, and

the steering system is operable to display a position of the guide portion.

30. The system of claim 23, wherein:

the guide portion has one or more biosensors in communication with the steering system, and

the steering system is operable to display data from the biosensors.

31. The system of claim 23, wherein:

the guide portion has a strain gage in communication with the steering system, and

the steering system is operable to display an orientation of the guide portion.

32. The system of claim 23, wherein:

the tube further has a guide lumen, and

the system further comprises a guidewire extending through the guide lumen and releasably coupled to the guide portion.

33-45. -45. (canceled)