Endoscope with adjacently positioned guiding apparatus

• US 6,984,203 B2
• Filed: 11/27/2002
• Issued: 01/10/2006
• 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: Tartaglia, Joseph M., Keller, Wade A., Belson, Amir, Ratchford, Arthur R.
• Primary Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US10/306,580
• Publication Number:
  US 20030171650A1
• Time in Patent Office: 1,140 Days
• Field of Search: 600/114, 600/115, 600/121, 600144-146, 600/139
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00073 with externally grooved shaft
• CPC Class Codes: A61B 1/0014 Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
• CPC Class Codes: A61B 1/00147 Holding or positioning arrangements
• 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 1/008 Articulations
• 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 2017/00323 Cables or rods
• 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 2034/741 Glove like input devices, e.g. "data gloves"
• CPC Class Codes: A61B 2034/742 Joysticks
• 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 provided. The endoscope has an elongate body with a steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable guiding apparatus. The guiding apparatus may be positioned within the endoscope or may be positioned adjacent to the endoscope. An interlocking device is provided to slidably interlock the guiding apparatus and 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 rigidized, the endoscope can be advanced along the 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 using a guiding apparatus adjacently positioned to the instrument, comprising:

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

advancing an elongate guide adjacent to 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 adjacent to 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 further comprising advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion prior to advancing the elongate guide adjacent to the instrument, 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 adjacent to the instrument.

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

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

8. The method of claim 7 further comprising advancing at least one additional elongate guide adjacent to the instrument such that the additional elongate guide conforms to and assumes the second shape.

9. The method of claim 8 further comprising rigidizing the additional elongate guide such that the second shape is maintained by the additional guide.

10. 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.

11. The method of claim 10 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.

12. The method of claim 10 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.

13. The method of claim 1 wherein prior to advancing the elongate guide, the elongate guide is first advanced into an interlocking device where it becomes slidably interlocked with the instrument.

14. The method of claim 13 wherein the interlocking devices compresses the elongate guide into a channel positioned on the outer surface of the instrument.

15. The method of claim 13 wherein the interlocking device compresses the instrument into a channel positioned on the outer surface of the elongate guide.

16. The method of claim 13 wherein the interlocking device facilitates magnetic attachment of the elongate guide within a channel on the outer surface of the instrument.

17. The method of claim 13 wherein the interlocking device facilitates magnetic attachment of the instrument within a channel on the outer surface of the elongate guide.

18. The method of any of claims 14, 15, 16, or 17 wherein the channel is partially open.

19. The method of either claim 14, 15, 16, or 17 wherein the channel is non-continuous.

20. 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 adjacent to and along the length of the elongate body 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.

21. The apparatus of claim 20 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.

22. The apparatus of claim 20 wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.

23. The apparatus of claim 20 wherein the proximal portion comprises a flexible tubular member.

24. The apparatus of claim 21 wherein the controllable portion comprises a plurality of pivotally connected segments.

25. The apparatus of claim 24 wherein each of the segments comprises an actuator for propagating the selected shape along the controllable portion.

26. The apparatus of claim 25 wherein the actuator comprises a type of motor selected from the group consisting of pneumatic, hydraulic, electromechanical motors, and drive shafts.

27. The apparatus of claim 24 wherein the controllable portion comprises at least two pivotally connected segments.

28. The apparatus of claim 20 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.

29. The apparatus of claim 28 wherein the elongate guide is configured to selectively rigidize along the external length of the guide to maintain the selected shape in the rigidized state.

30. The apparatus of claim 28 wherein the proximal section of the elongate guide is in communication with a guide controller for selectively rigidizing the guide along its length.

31. The apparatus of claim 28 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.

32. The apparatus of claim 31 further comprising a tensioning member disposed within the common channel such that applying a force to the tensioning member compresses the adjacent segments together.

33. The apparatus of claim 31 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.

34. The apparatus of claim 20 further comprising an obstruction located within the lumen distally of the guide for preventing contamination of the guide.

35. The apparatus of claim 34 wherein the obstruction is selectively removable from a passageway of the lumen.

36. The apparatus of claim 35 wherein the obstruction comprises a trap or an expandable balloon.

37. The apparatus of claim 20 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 adjacent to the elongate body and being configured to conform to and selectively maintain an additional selected curve assumed by the steerable distal portion.

38. The apparatus of claim 20 further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.

39. The apparatus of claim 20 further comprising an interlocking device for receiving and slidably interlocking the elongate body and elongate guide.

40. The apparatus of claim 39 wherein the elongate guide has a channel positioned on at least a portion of its outer surface.

41. The apparatus of claim 40 wherein the channel has at least one magnetic portion on at least a portion of its inner surface.

42. The apparatus of claim 40 wherein the elongate body has at least one magnetic surface positioned on at least a portion of its outer surface.

43. The apparatus of claim 39 wherein the elongate body has a channel positioned on at least a portion of its outer surface.

44. The apparatus of claim 43 wherein the channel has at least one magnetic portion on at least a portion of its inner surface.

45. The apparatus of claim 43 wherein the elongate guide has at least one magnetic surface positioned on at least a portion of its outer surface.

46. The apparatus of either claim 40 or 43 wherein the channel is closed, the closed channel having an entry slit disposed along its length.

47. The apparatus of either claim 40 or 43 wherein the channel is at least partially open.

48. A device for slidably interlocking an elongate body and an elongate guide adjacent to one another comprising:

a proximal end, a distal end, and a lumen therethrough, the lumen configured to receive an elongate body and an elongate guide therein; and

a mechanism configured to provide pressure sufficient to slidably interlock the elongate guide and elongate body to one another while advancing the elongate guide and elongate body through the lumen.

49. The device of claim 48 further comprising a segregating member disposed within the lumen for defining separate compartments in which the elongate body and elongate guide are to be received.

50. The device of claim 48 wherein the mechanism configured to provide pressure comprises a lumen diameter that is less than the combined diameter of the elongate guide and elongate body when not interlocked.

51. The device of claim 48 wherein the mechanism to provide pressure further comprises a processor for controllably applying pressure to the outer surface of the device.

52. A method for slidably interlocking an elongate body and an elongate guide adjacent to one another comprising the steps of:

providing an interlocking device having a proximal end, a distal end, and a lumen therethrough;

advancing an elongate body into the lumen of the interlocking device; and

advancing an elongate guide into the lumen of the interlocking device.

53. The method of claim 52 further comprising the step of applying pressure to the outer surface of the interlocking device.

54. The method of claim 52 wherein the elongate body has a channel positioned on at least a portion of its outer surface.

55. The method of claim 52 wherein the elongate guide has a channel positioned on at least a portion of its outer surface.

56. The method of either claim 54 or 55 wherein the channel is slidable.

57. The method of either claim 54 or 55 wherein the channel is permanently affixed to the outer surface.

58. The method of claim 52 wherein the elongate guide is advanced into the lumen of the interlocking device at its proximal end.

59. The method of claim 52 wherein the elongate body is advanced into the lumen of the interlocking device at its proximal end.