BASKET APPARATUS

• US 20180221039A1
• Filed: 04/09/2018
• Published: 08/09/2018
• Est. Priority Date: 10/30/2015
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Auris Health, Inc. (Johnson & Johnson)
• Inventors: Shah, Paren
• Granted Patent: US 11,571,229 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00358 Snares for grasping
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00303 active, e.g. with a motor creating vibrations
• CPC Class Codes: A61B 2018/00517 : Urinary bladder or urethra
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• 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 2034/302 : specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms

Abstract

A basket apparatus is described that assists in removing objects from within a patient. The apparatus includes a number of pull wires, each pull wire physically coupled to a different capstan that individually actuates one of the pull wires. The apparatus also includes an outer support shaft itself including a number of channels through which the pull wires traverse. The portions of the pull wires extending out of the outer support shaft form a basket of adjustable size, shape, and position. The pull wires are attached together at a tip located at a distal end of the basket apparatus. By controlling the actuation of the various pull wires, the basket'"'"'s shape, position size can be manipulated to reposition the basket around an object located within a patient, independent of or in conjunction with motion of the remainder of the apparatus or an associated endoscope.

Claims

1. A basket apparatus for removing an object from within a patient, the apparatus comprising:

a plurality of pull wires, each pull wire physically coupled to a different capstan configured to individually actuate one of the pull wires;

an outer shaft comprising a plurality of channels through which the pull wires traverse; and

a basket formed from the pull wires, the basket located on an opposite side of the outer support shaft from the capstans, the pull wires attached together at a tip located at a distal end of the basket apparatus.

2. The basket apparatus of claim 1 wherein the plurality of pull wires comprises four pull wires coupled to form two loops.

3. The basket apparatus of claim 2 wherein the pull wires forming each loop are threaded through channels located on opposite sides of the outer shaft.

4. The basket apparatus of claim 1 wherein the plurality of pull wires cross each other at at least one point forming a distal tip of the basket.

5. The basket apparatus of claim 1 wherein actuation of the capstans controls a size of the basket.

6. The basket apparatus of claim 1 wherein selective retraction and release of different pull wires steers the basket towards a direction in which the pull wires that are relatively more retracted.

7. The basket apparatus of claim 1 wherein the outer shaft comprises a working channel.

8. The basket apparatus of claim 7 wherein the working channel is sufficiently wide to receive a guide wire, therapeutic device, or an imaging device.

9. The basket apparatus of claim 1 wherein the outer shaft comprises a plurality of lateral slots on its outer surface.

10. The basket apparatus of claim 9 wherein the lateral slots provide sufficient space to allow for fluid irrigation or aspiration between the outer shaft and an inner wall of a surrounding lumen.

11. The basket apparatus of claim 1 wherein the outer shaft comprises a plurality of peripheral channels.

12. The basket apparatus of claim 11 wherein each of the peripheral channels comprise rounded vertices on an outer surface of the outer support shaft.

13. The basket apparatus of claim 1 wherein the basket comprises a shape, based on a shape of the pull wires, that is at least one of an ellipse shape, a spherical shape, and a shape where the pull wires form an indentation having a jaw shape.

14. The basket apparatus of claim 1 wherein the outer support shaft comprises a working channel, the basket apparatus further comprising:

an optical fiber or a laser capable of performing lithotripsy, the optical fiber or laser passing through the working channel.

15. The basket apparatus of claim 1 wherein the outer support shaft comprises a working channel, the basket apparatus further comprising:

a mechanical drill capable of drilling into the object, the mechanical drill passing through the working channel.

16. The basket apparatus of claim 1 wherein the outer support shaft comprises a working channel, the basket apparatus further comprising:

a chisel capable of breaking apart the object, the chisel passing through the working channel.

17. The basket apparatus of claim 1 wherein the outer support shaft comprises a working channel, the basket apparatus further comprising:

a fluid source capable of sending a high pressure jet of fluid through the working channel towards the central working channel towards the object.

18. The basket apparatus of claim 1 wherein the basket apparatus is sized so as to fit within and pass through an endoscope working channel of an endoscope.

19. The basket apparatus of claim 18 wherein the endoscope comprises a leader and a sheath, and where the endoscope working channel is located within the leader.

20. The basket apparatus of claim 19

wherein the capstans are coupled to a first robotic arm;

wherein the leader is controlled by a plurality of leader pull wires coupled to a second robotic arm;

wherein the sheath is controlled by a plurality of sheath pull wires coupled to a third robotic arm.

21. The basket apparatus of claim 19 wherein the leader is at least one of:

telescopically disposed within a sheath working channel located within the sheath; and

concentrically aligned within a sheath working channel located within the sheath.

30. The method of claim 1,

wherein the object is at least one from the group consisting of:

a kidney stone or a bladder stone, a stone formed from at least one of calcium, magnesium, ammonia, uric acid, and cysteine;

wherein the cavity is a kidney of a patient or a calyx within the kidney of the patient.

31. The basket apparatus of claim 18, wherein movement of the endoscope is controlled by a plurality of pull wires coupled to a robotic arm.

32. The basket apparatus of claim 31, wherein the plurality of pull wires have a helix section.

33. The basket apparatus of claim 18, wherein movement of the endoscope is controlled by at least four pull wires coupled to a robotic arm and movement of the endoscope can be controlled in at least eight degrees of freedom.

34. The basket apparatus of claim 18, wherein movement of the endoscope is controlled by at least three pull wires coupled to a robotic arm and movement of the endoscope can be controlled in at least six degrees of freedom.

35. The basket apparatus of claim 1, wherein the capstans can be coupled to output shafts of a drive unit.

22. A method for capturing an object in a cavity comprising:

advancing an endoscope into the cavity comprising the object;

advancing a basket apparatus through a working channel of the endoscope;

opening a basket of the basket apparatus within the cavity, the basket controlled by a plurality of pull wires;

selectively retracting or releasing the pull wires to position the basket to surround the object;

collapsing the basket around the object; and

retracting the basket holding the object out of the cavity.

23. The method of claim 22

wherein pairs of the pull wires are attached together, and

wherein selectively retracting or releasing the pull wires comprises:

retracting a first one of the pull wires of a first of the pairs and releasing a second of the pull wires of the first pair to reposition the basket so that a distal tip of the basket is directed away from the object.

24. The method of claim 23 wherein selectively retracting or releasing the pull wires further comprises:

retracting a third one of the pull wires of a second of the pairs and releasing a fourth of the pull wires of the second pair to reposition the basket so that a distal tip of the basket is directed away from the object.

25. The method of claim 23 further comprising:

moving at least one of the basket, the basket apparatus, and the endoscope so that the object is located between either end of the basket.

26. The method of claim 25 further comprises:

retracting the second pull wire of the first pair and releasing the first pull wire of the first pair to reposition the basket so that the object is located within the basket.

27. The method of claim 26 wherein selectively retracting or releasing the pull wires comprises:

actuating a tool base coupled to a first robotic arm controlling the pull wires.

28. The method of claim 27 wherein moving the endoscope comprises:

actuating an instrument base coupled to a second robotic arm at least partially controlling motion of the endoscope.

29. The method of claim 22 further comprising at least one:

passing an optical fiber or a laser through a working channel of the basket apparatus and activating the optical fiber or laser perform lithotripsy on the object to break it apart;

passing a mechanical drill through a working channel of the basket apparatus, and activating the drill in contact with the object to break it apart;

passing a chisel through a working channel of the basket apparatus, and activating the chisel in contact with the object to break it apart; and

passing fluid through a working channel of the basket apparatus towards the object to break it apart.