SHAFT ACTUATING HANDLE

• US 20180280660A1
• Filed: 03/27/2018
• Published: 10/04/2018
• Est. Priority Date: 03/28/2017
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Auris Health, Inc. (Johnson & Johnson)
• Inventors: Landey, Casey Teal, Connolly, Ryan Jeffrey, Snyder, Brett Andrew
• Granted Patent: US 10,792,466 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 1/00147 Holding or positioning arrangements
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 2010/045 Needles pointed biopsy devices with vacuum aspiration A61B10/0283
• CPC Class Codes: A61B 2017/003 Steerable
• 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 34/30 Surgical robots
• CPC Class Codes: A61M 25/0113 Mechanical advancing means, e.g. catheter dispensers
• CPC Class Codes: A61M 25/0136 Handles therefor

Abstract

Certain aspects relate to a handle mechanism that permits control of linear motion of a shaft secured within the handle via two different interfaces for actuating the linear motion. In some aspects, a rotational interface can allow for fine control linear positioning of the shaft, for example by allowing a user to rotate the rotational interface to extend or retract the shaft. In some aspects, a plunging interface can enable a faster linear motion, for example by implementing a biasing mechanism that releases to drive rapid linear motion.

Claims

1. A handle configured to drive movement of a bronchoscopy instrument, the handle extending along a longitudinal axis between a proximal end and a distal end of the handle and comprising:

a casing having an inner surface defining an internal volume including a biasing element housing portion;

a proximal handle member positioned at least partly within a proximal portion of the internal volume of the casing and including a first helical cam interface, the proximal handle member configured to couple to a proximal end of an elongate channel extending beyond the distal end of the handle with a distal end of the elongate channel coupled to the bronchoscopy instrument;

an actuation sleeve positioned at least partly within a distal portion of the internal volume of the casing and including;

a proximal portion having a second helical cam interface engaging the first helical cam interface,

a rotation grip extending distally from the proximal portion of the actuation sleeve, and

a plunger grip formed by a distal surface of the actuation sleeve; and

a biasing element having a first end secured within the biasing element housing portion of the casing and a second end engaging the proximal portion of the actuation sleeve.

2. The handle of claim 1, wherein the biasing element comprises a spring positioned to compress and expand along the longitudinal axis during movement of the actuation sleeve via the plunger.

3. The handle of claim 1, wherein the second helical cam interface engaging the first helical cam interface is configured to translate rotation of the rotation grip into linear motion of the proximal handle member along the longitudinal axis of the device, and wherein the linear motion of the proximal handle member is configured to drive the movement of the instrument via the elongate channel.

4. The handle of claim 1, wherein:

the second helical cam interface engaging the first helical cam interface translates proximal retraction of the plunger grip into proximal motion of the proximal handle member along the longitudinal axis of the device, and wherein the linear motion of the proximal handle member is configured to drive proximal retraction of the instrument via the elongate channel; and

the biasing element is positioned to compress as the plunger grip is retracted proximally such that, upon release of the plunger grip, a bias of the biasing element drives distal linear motion of the proximal handle member along the longitudinal axis of the device, and wherein the linear motion of the proximal handle member is configured to drive distal extension of the instrument.

5. The handle of claim 1, further comprising:

a distal handle member positioned within the casing; and

an internal receiving portion at a distal portion of the proximal handle member, wherein a proximal portion of the distal handle member is positioned within the internal receiving portion.

6. The handle of claim 5, further comprising a lumen extending through the device along the longitudinal axis, wherein a distal portion of the lumen extends through the distal handle member and a proximal portion of the lumen extends through the proximal handle member.

7. The handle of claim 6, further comprising a distal aperture formed in a distal end of the distal handle member, wherein the lumen is sized to accommodate positioning of the elongate channel within the lumen, and wherein the distal aperture is sized to accommodate passage of the elongate channel through the distal aperture.

8. The handle of claim 5, further comprising:

a peg extending inwardly within the internal volume of the casing;

an aperture in the distal handle member sized and positioned to receive the peg, wherein the distal handle member is fixed relative to the casing via the received peg; and

an elongate slot formed in a wall of the proximal handle member, wherein the elongate slot is sized and positioned to slide around the peg with the wall of the proximal handle member positioned between the casing and the distal handle member.

9. The handle of claim 1, further comprising a fluid fitting at a proximal end of the proximal handle member, the fluid fitting configured to couple to an aspiration device or a respiration device.

10. The handle of claim 9, further comprising a flexible shaft portion of the proximal handle member positioned between the second helical cam interface and the fluid fitting, wherein the fluid fitting is fixed relative to the casing.

11. The handle of claim 10, wherein the flexible shaft portion comprises a length of coiled conduit.

12. The handle of claim 9, further comprising a rigid shaft portion of proximal handle member extending between the second helical cam interface and the fluid fitting, wherein a proximal portion of rigid shaft portion is coupled to the fluid fitting, and wherein the rigid shaft portion is slidably engaged with a proximal aperture of the casing.

13. The handle of claim 1, further comprising a proximal flange of actuation sleeve and an internal flange positioned at a distal end of the biasing element housing portion, wherein the biasing element biases the proximal flange against the internal flange in its extended state.

14. The handle of claim 1, further comprising a support annulus of the proximal handle member sized to slidably engage a proximal portion of the internal volume of the casing.

15. A handle configured to drive movement of an instrument, the handle extending along a longitudinal axis between a proximal end and a distal end of the handle and comprising:

a casing having an inner surface defining an internal volume;

a proximal handle member configured to couple to a channel extending beyond the distal end of the handle to the instrument;

an actuation sleeve;

a rotational motion transmitting interface coupling the proximal handle member to the actuation sleeve and configured to translate rotational motion of the actuation sleeve into linear motion of the proximal handle member along the longitudinal axis of the handle; and

a plunging mechanism configured to drive distal movement of the proximal handle member along the longitudinal axis, the plunging mechanism comprising a biasing element positioned to compress and expand along the longitudinal axis during movement of the actuation sleeve.

16. The handle of claim 15, wherein expansion of the biasing element drives the distal movement of the proximal handle member along the longitudinal axis.

17. The handle of claim 16, wherein the plunging mechanism comprises a grip of the actuation sleeve positioned such that pressure applied to the grip drives proximal movement of the actuation sleeve along the longitudinal axis and drives compression of the biasing element.

18. The handle of claim 17, wherein the rotational motion transmitting interface coupling the proximal handle member to the actuation sleeve is configured to transmit the proximal and distal movement of the actuation sleeve to the proximal handle member.

19. The handle of claim 15, wherein the biasing element comprises one of a spring, opposing magnets, hydraulic fluid, and a shape memory alloy.

20. An apparatus configured to drive movement of an instrument, the apparatus extending along a longitudinal axis between a proximal end and a distal end of the apparatus and comprising:

a casing having an inner surface defining an internal volume;

an actuation sleeve configured to impart linear motion along the longitudinal axis to the instrument and including a grip extending beyond a distal end of the casing; and

a biasing element within the internal volume, the biasing element positioned to compress and expand along the longitudinal axis during movement of the actuation sleeve wherein expansion of the biasing element drives linear movement of the actuation sleeve in a proximal direction along the longitudinal axis.

21. The apparatus of claim 20, wherein the grip is positioned such that pressure applied to the grip drives the linear movement of the actuation sleeve along the longitudinal axis and drives compression of the biasing element.

22. The apparatus of claim 20, further comprising:

a proximal handle member; and

a rotational motion transmitting interface coupling the proximal handle member to the actuation sleeve and configured to translate rotational motion of the actuation sleeve into linear motion of the proximal handle member along the longitudinal axis of the handle,

wherein the rotational motion transmitting interface coupling the proximal handle member to the actuation sleeve is further configured to transmit the linear movement of the actuation sleeve to the proximal handle member.

23. The apparatus of claim 22, further comprising a distal handle member positioned at least partly within the actuation sleeve and comprising a rounded protrusion, wherein the actuation sleeve comprises at least one detent positioned to engage the rounded protrusion during rotation of the actuation sleeve.

24. The apparatus of claim 22, further comprising a lock to fix relative positioning of the actuation sleeve and the proximal handle member prior to actuating linear movement of the actuation sleeve.

25. A method of accessing a target tissue site of a patient with an instrument, the method comprising:

actuating a first motion transmitting interface of a delivery handle coupled to the instrument, wherein actuating the first motion transmitting interface causes a distal end of the instrument to advance through a working channel of a bronchoscope inserted at least partly into the patient;

determining that the distal end of the instrument is positioned within the target tissue site; and

actuating a second motion transmitting interface of the delivery handle, wherein actuating the second motion transmitting interface causes extension and retraction of the distal end of the instrument, by at least;

applying a pressure to a portion of the delivery handle to;

compress a biasing element of the second motion transmitting interface, and

drive retracting motion of the instrument to withdraw the distal end of the instrument from the tissue site, and

releasing at least some of the pressure from the portion of the delivery handle to allow expansion of the second motion transmitting interface, wherein the expansion of the biasing element drives the distal end of the instrument into the tissue site.

26. The method of claim 25, wherein actuating the first motion transmitting mechanism and actuating the second motion transmitting mechanism are performed by a single hand of a user of the delivery handle.

27. The method of claim 25, wherein releasing the expansion of the biasing element drives the distal end of the instrument up to approximately 2 cm.

28. The method of claim 25, wherein releasing the expansion of the biasing element drives the distal end of the instrument up to an extension length of the distal end.

29. The method of claim 25, further comprising configuring the delivery handle to provide a structural limit on a distance the biasing element drives the distal end of the instrument prior to actuating the second motion transmitting interface.

30. The method of claim 25, wherein actuating the first motion transmitting interface and actuating the second motion transmitting interface are performed by a robotic control system.