Endoscope with guiding apparatus

• US 6,800,056 B2
• Filed: 03/01/2002
• Issued: 10/05/2004
• Est. Priority Date: 04/03/2000
• Status: Expired due to Term

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Neoguide Systems, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Ohline, Robert Matthew, Belson, Amir, Tartaglia, Joseph M.
• Primary Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US10/087,100
• Publication Number:
  US 20020120178A1
• Time in Patent Office: 949 Days
• Field of Search: 600/114, 600/144, 600/145, 600/146, 600/115, 600/139
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00078 with stiffening means
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/0053 using distributed actuators, e.g. artificial muscles
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• 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 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe

Abstract

An endoscope with guiding apparatus is described herein. A steerable endoscope is described having an elongate body with a manually or selectively steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable tracking rod or guide. The tracking rod or guide is positioned within a guide channel within the endoscope and slides relative to the endoscope. When the guide is in a flexible state, it can conform to a curve or path defined by the steerable distal portion and the automatically controlled portion. The guide can then be selectively rigidized to assume that curve or path. Once set, the endoscope can be advanced over the rigidized guide in a monorail or “piggy-back” fashion so that the flexible proximal portion follows the curve held by the guide until the endoscope reaches a next point of curvature within a body lumen.

Claims

1. A method of advancing an instrument along an arbitrary path, comprising:

selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path;

advancing an elongate guide along the instrument such that a portion of the guide conforms to and assumes the selected shape; and

maintaining a position of the guide while advancing the instrument along the guide such that a proximal portion of the instrument assumes the selected shape defined by the guide, wherein the elongate guide is freely slidable along the length of the instrument such that advancing of the instrument along the guide is unconstrained.

2. The method of claim 1 wherein prior to advancing the elongate guide along the instrument, further comprising advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion, wherein the controllable portion is proximal of the distal portion.

3. The method of claim 1 further comprising measuring a depth change of the instrument while advancing the instrument distally.

4. The method of claim 3 further comprising incrementing a current depth by the depth change.

5. The method of claim 1 further comprising releasing the position of the guide and further advancing the guide along the instrument.

6. The method of claim 1 further comprising withdrawing the guide from the instrument.

7. The method of claim 1 wherein the elongate guide is advanced along the instrument through a lumen defined within the instrument.

8. The method of claim 1 wherein the distal portion of the instrument selectively assumes a second shape when the instrument is advanced along the guide.

9. The method of claim 8 further comprising advancing at least one additional elongate guide along the instrument such that the additional elongate guide conforms to and assumes the second shape.

10. The method of claim 9 further comprising rigidizing the additional elongate guide such that the second shape is maintained by the additional guide.

11. The method of claim 1 wherein maintaining the position of the guide comprises rigidizing the guide such that the guide rigidly assumes a position of the selected shape.

12. The method of claim 11 wherein rigidizing the guide comprises applying tension to a tensioning member disposed within the guide such that a plurality of adjacent segments comprising the guide are compressed.

13. The method of claim 11 wherein rigidizing the guide comprises applying a vacuum force within a lumen defined within the guide such that a plurality of adjacent segments comprising the guide are compressed.

14. An apparatus for insertion into a body cavity, comprising:

an elongate body having a proximal portion and a selectively steerable distal portion and defining a lumen therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;

an elongate guide having a proximal section, a distal section, and a length therebetween, the guide being slidably disposed without constraint within the lumen along the length for selectively supporting the body, wherein the guide is configured to conform to and selectively maintain the selected shape assumed by the steerable distal portion, and

wherein the proximal portion of the elongate body when advanced distally is configured to conform to the selected curve maintained by the guide.

15. The apparatus of claim 14 further comprising a controllable portion located proximally of the distal portion, wherein the controllable portion is configured to propagate the selected shape along the controllable portion.

16. The apparatus of claim 14 wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.

17. The apparatus of claim 14 wherein the proximal portion comprises a flexible tubular member.

18. The apparatus of claim 15 wherein the controllable portion comprises a plurality of pivotally connected segments.

19. The apparatus of claim 18 wherein each of the segments comprises an actuator for propagating the selected shape along the controllable portion.

20. The apparatus of claim 19 wherein the actuator comprises a type of motor selected from the group consisting of pneumatic, hydraulic, electromechanical motors, and drive shafts.

21. The apparatus of claim 18 wherein the controllable portion comprises at least two pivotally connected segments.

22. The apparatus of claim 14 wherein the elongate guide is configured to assume the selected shape when the guide is in a flexible state and wherein the guide is further configured to maintain the selected shape when the guide is in a rigidized state.

23. The apparatus of claim 22 wherein the elongate guide is configured to selectively rigidize along the length of the guide to maintain the selected shape in the rigidized state.

24. The apparatus of claim 22 wherein the proximal section of the elongate guide is in communication with a guide controller for selectively rigidizing the guide along its length.

25. The apparatus of claim 22 wherein the elongate guide comprises a plurality of adjacent segments each defining a channel therethrough such that a common channel is defined through the length of the guide.

26. The apparatus of claim 25 further comprising a tensioning member disposed within the common channel such that applying a force to the tensioning member compresses the adjacent segments together.

27. The apparatus of claim 25 wherein the elongate guide is configured to maintain a position of adjacent segments relative to each other upon applying a vacuum force within the common channel.

28. The apparatus of claim 14 further comprising an obstruction located within the lumen distally of the guide for preventing contamination of the guide.

29. The apparatus of claim 28 wherein the obstruction is selectively removable from a passageway of the lumen.

30. The apparatus of claim 29 wherein the obstruction comprises a trap or an expandable balloon.

31. The apparatus of claim 14 further comprising at least one additional elongate guide having a proximal section, a distal section, and a length therebetween, the additional guide also being slidably disposed within the elongate body and being configured to conform to and selectively maintain an additional selected curve assumed by the steerable distal portion.

32. The apparatus of claim 14 further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.