Flexible instrument

• US 7,713,190 B2
• Filed: 06/14/2007
• Issued: 05/11/2010
• Est. Priority Date: 02/24/1998
• Status: Expired due to Fees

• Current Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Rogers, Gary, Brock, David L., Weitzner, Barry, Lee, Woojin
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US11/762,774
• Publication Number:
  US 20070239120A1
• Time in Patent Office: 1,062 Days
• Field of Search: 600/114, 600/101, 600/103, 600/106, 600/117, 600/137, 600/139, 604/95.01, 604/156, 604/500, 604/510, 604/523, 604/528, 604/164.12, 604/165.02, 604/272, 606/1, 606/130, 606/146, 606/319
• US Class Current: 600/114
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• 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 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/715 Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2034/744 Mouse
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/506 : using a parallelogram linkage, e.g. panthograph
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/4893 : Nerves
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: B25J 3/04 : involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: B25J 9/104 : with cables, chains or ribbons

Abstract

A method of performing a medical procedure on a patient comprises conveying control signals from a remote controller to a drive unit, intravenously introducing the catheter into a heart of the patient (e.g., via the vena cava into the right atrium), and creating a puncture within a wall between two chambers (e.g., the left and right atria) of the heart. The method further comprises creating a puncture within a wall between two chambers of the heart, and operating the drive unit in accordance with the control signals to advance a working catheter within the guide catheter through the puncture.

Claims

1. A method of performing a medical procedure on a patient, comprising:

conveying control signals from a remote controller to a drive unit to thereby manipulate, including bending, a distal end portion of a catheter coupled to the drive unit;

operating the drive unit in accordance with the control signals to intravenously position the catheter distal end portion within a first heart chamber of the patient; and

conveying control signals from the remote controller to the drive unit to thereby manipulate the catheter distal end portion to create a puncture in a wall between the first chamber and a second chamber of the heart.

2. The method of claim 1, wherein the first and second heart chambers are the respective right and left atria of the heart.

3. The method of claim 1, wherein the catheter is introduced through the inferior vena cava into the right atrium of the heart.

4. The method of claim 1, further comprising operating the drive unit in accordance with the control signals received from the remote controller to advance the catheter distal end portion from the first chamber into the second chamber through the puncture.

5. The method of claim 4, wherein the catheter distal end portion has an expandable device, the method further comprising actuating the expandable device to anchor the catheter against the wall.

6. The method of claim 1, wherein the catheter is a guide catheter, and the method further comprises operating the drive unit in accordance with the control signals received from the remote controller to advance a working catheter within the guide catheter through the puncture.

7. The method of claim 6, wherein the working catheter has an end effector, and the method further comprises operating the drive unit in accordance with the control signals received from the remote controller to actuate the end effector within the heart.

8. The method of claim 7, wherein the end effector is actuated to repair a valve within the heart.

9. A method of performing a medical procedure on a patient, comprising:

conveying control signals from a remote controller to a drive unit to thereby manipulate, including bending, a distal end portion of a guide catheter coupled to the drive unit;

operating the drive unit in accordance with the control signals to position the guide catheter in a first heart chamber of the patient;

operating the drive unit in accordance with the control signals to manipulate guide catheter distal end portion for creating a puncture in a wall between the first chamber and a second chamber of the heart; and

operating the drive unit in accordance with the control signals to advance a working catheter carried by the guide catheter through the puncture.

10. The method of claim 9, wherein the first and second heart chambers are the respective right and left atria.

11. The method of claim 9, wherein the guide catheter is introduced through the inferior vena cava into the right atrium of the heart.

12. The method of claim 9, further comprising operating the drive unit in accordance with the control signals received from the remote controller to intravenously introduce the guide catheter into the heart.

13. The method of claim 9, further comprising operating the drive unit in accordance with the control signals received from the remote controller to advance the guide catheter through the puncture.

14. The method of claim 13, wherein the guide catheter distal end portion has an expandable device, the method further comprising actuating the expandable device to anchor the guide catheter against the wall.

15. The method of claim 9, wherein the working catheter has an end effector, and the method further comprises operating the drive unit in accordance with the control signals received from the remote controller to actuate the end effector within the heart.

16. The method of claim 15, wherein the end effector is actuated to repair a valve within the heart.

17. The method of claim 9, further comprising operating the drive unit in accordance with the control signals received from the remote controller to deflect a distal end of the working catheter.