Robotically guided catheter

• US 8,214,019 B2
• Filed: 09/01/2011
• Issued: 07/03/2012
• Est. Priority Date: 02/23/2004
• Status: Active Grant

• Current Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Original Assignee: Biosense Webster Incorporated (Johnson & Johnson)
• Inventors: Govari, Assaf, Altmann, Andres Claudio, Ephrath, Yaron
• Primary Examiner(s): Cwern, Jonathan
• Application Number:
  US13/223,804
• Publication Number:
  US 20110313352A1
• Time in Patent Office: 306 Days
• Field of Search: 600/424
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 34/20 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 34/71 Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61M 2025/0058 having an electroactive polymer material, e.g. for steering purposes, for control of flexibility, for locking, for opening or closing
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0158 with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials

Abstract

Apparatus is provided for use with a steerable catheter that includes a thumb control adapted to control a deflection of a distal tip of the catheter. The apparatus includes a robot, including an end-effector, adapted to be coupled to the thumb control, and a controller, adapted to drive the end-effector to deflect the distal tip by manipulating the thumb control.

Claims

1. Apparatus comprising:

a human-controllable steerable catheter comprising a thumb control configured to manually control a deflection of a distal tip of the catheter and a position sensor configured to generate a position signal indicative of six dimensions of location and orientation information, the position sensor fixed in a vicinity of the distal tip of the catheter, and a robot comprising;

an end-effector coupled to the thumb control; and

a controller configured to drive the end-effector to manipulate in an automated fashion the thumb control in response to the position signal to position the distal tip of the catheter at a desired position based on the six dimensions of location and orientation information, the controller comprising an algorithm that uses an iterative process to direct the distal tip of the catheter to the desired position, responsive to the six dimensions of location and orientation information.

2. The apparatus according to claim 1, wherein the controller is configured to drive the end-effector to deflect the distal tip by moving the thumb control longitudinally with respect to a longitudinal axis of the catheter.

3. The apparatus according to claim 1, wherein the catheter includes a handle configured to control a roll of the distal tip, wherein the robot comprises a handle end-effector coupled to the handle, and wherein the controller manipulates the handle end-effector to drive the handle to roll the distal tip.

4. The apparatus according to claim 1, wherein the catheter includes a handle configured to advance and withdraw the catheter, wherein the robot comprises a handle end-effector coupled to the handle, and wherein the controller drives the handle end-effector to perform, by manipulating the handle, at least one action selected from the list consisting of:

advancing the catheter and withdrawing the catheter.

5. The apparatus according to claim 1, comprising a computer pointing device receiving an indication of a desired position of the distal tip of the catheter.

6. An apparatus comprising:

a human-controllable steerable catheter that includes controls configured to control a deflection of a distal tip of the catheter and a position sensor configured to generate a position signal indicative of six dimensions of location and orientation information, the position sensor being fixed in a vicinity of the distal tip of the catheter, and the controls being generally optimized for manipulation by a human hand; and

a robot comprising;

at least one end-effector coupled to at least a portion of the controls; and

a controller configured to drive the at least one end-effector to deflect the distal tip in response to the position signal by inducing motion of the portion of the controls that generally mimics motion of the portion of the controls induced when a human hand manipulates the controls, the controller comprising an algorithm that uses an iterative process to direct the distal tip of the catheter to the desired position, responsive to the six dimensions of location and orientation information.

7. The apparatus according to claim 6, wherein the controller is configured to drive the end-effector to deflect the distal tip by moving the portion of the controls longitudinally with respect to a longitudinal axis of the catheter.

8. The apparatus according to claim 6, wherein the controls are configured to control a roll of the distal tip, wherein the robot comprises a roll end-effector coupled to the controls, and wherein the controller is configured to drive the roll end-effector to roll the distal tip by inducing motion of the controls that generally mimics motion of the controls induced when a human hand manipulates the controls.

9. The apparatus according to claim 6, wherein the controls are configured to advance and withdraw the catheter, wherein the robot comprises a longitudinal motion end-effector coupled to the controls, and wherein the controller is configured to drive the longitudinal motion end-effector to perform, by inducing motion of the controls that generally mimics motion of the controls induced when a human hand manipulates the controls, at least one action selected from the list consisting of:

advancing the catheter and withdrawing the catheter.

10. The apparatus according to claim 6, comprising a computer pointing device configured to receive an indication of a desired position of the distal tip of the catheter.

11. Apparatus comprising:

a human-controllable steerable catheter comprising controls configured to manually control a deflection of a distal tip of the catheter and a position sensor configured to generate a position signal indicative of six dimensions of location and orientation information, the position sensor being fixed in a vicinity of the distal tip of the catheter, and the controls being generally optimized for manipulation by a human hand; and

a robot, comprising;

at least one end-effector coupled to at least a portion of the controls; and

a controller configured to drive the end-effector to position the distal tip of the catheter at a desired position based on the six dimensions of location and orientation information by inducing motion of the portion of the controls that generally mimics motion of the portion of the controls induced when a human hand manipulates the controls, the controller comprising an algorithm that uses an iterative process to direct the distal tip of the catheter to the desired position, responsive to the six dimensions of location and orientation information.

12. Apparatus comprising:

a human-controllable steerable catheter, comprising;

a distal tip configured to be controllably deflectable in no more than two directions for any given rotation of the distal tip, such that a set of all points to which the tip can be deflected at the given rotation forms a deflection curve for the given rotation; and

a position sensor configured to generate a position signal indicative of six dimensions of location and orientation information, the position sensor being fixed in a vicinity of the distal tip; and

a robot configured to manipulate a proximal end of the catheter; and

a control unit configured to;

receive the position signal, and position the distal tip of the catheter at a target by manipulating the robot in response to the position signal to;

position the distal tip of the catheter in a vicinity of the target, responsive to the position signal based on the six dimensions of location and orientation information using an iterative process to direct the distal tip of the catheter to the target, rotate the proximal end of the catheter in order to cause the distal tip of the catheter to roll to a rotation the deflection curve of which includes the target, the rotation determined responsive to the position signal, and deflect the distal tip of the catheter along the deflection curve to the target.

13. The apparatus according to claim 12, wherein the distal tip is configured to be controllably deflected in no more than one direction for the given rotation of the distal tip.

14. The apparatus according to claim 12, wherein the control unit is configured to position the distal tip in the vicinity of the target by positioning the distal tip so that the deflection curve of at least one rotation of the distal tip includes the target.

15. The apparatus according to claim 12, comprising a computer pointing device configured to receive an indication of a position of the target, wherein the control unit is configured to drive the robot to position the distal tip at the position of the target, responsive to the position signal.

16. Apparatus comprising:

a human-controllable steerable catheter having a distal tip, the catheter comprising a position sensor configured to generate a position signal indicative of six dimensions of location and orientation information, the position sensor being fixed in a vicinity of the distal tip;

a robot configured to be coupled to a proximal end of the catheter; and

a control unit comprising an algorithm that uses an iterative process to direct the distal tip of the catheter to a desired position, wherein the control unit is configured to;

drive the robot to apply rotation to the proximal end of the catheter, receive the position signal, responsive to the six dimensions of location and orientation information of the position signal, determine a roll of the distal tip of the catheter, and responsive to a determination that the roll lags the rotation, drive the robot to move a portion of the proximal end of the catheter.

17. The apparatus according to claim 16, wherein the control unit is configured to drive the robot to move the portion of the proximal end of the catheter to perform at least one action selected from the list consisting of:

straightening the distal tip and deflecting the distal tip.

18. The apparatus according to claim 16, wherein the control unit is configured to drive the robot to move the portion of the proximal end of the catheter to effect translational back and forth motion of the distal tip.

19. The apparatus according to claim 16, wherein the control unit is configured to drive the robot to move the portion of the proximal end of the catheter to perform at least one action selected from the list consisting of:

advancing the distal tip and withdrawing the distal tip.

20. The apparatus according to claim 16, wherein the control unit is configured to move the portion of the proximal end of the catheter to jiggle the distal tip.

21. The apparatus according to claim 20, wherein the control unit is configured to jiggle the distal tip by rotating the proximal end of the catheter.

22. A method for use with a human-controllable steerable catheter having a distal tip configured to be controllably deflectable in no more than two directions for any given rotation of the distal tip, such that a set of all points to which the tip can be deflected at the given rotation forms a deflection curve for the given rotation, the method comprising:

receiving a position signal indicative of six dimensions of location and orientation information from a vicinity of the distal tip of the human-controllable steerable catheter; and

robotically positioning, using a robot, the distal tip of the catheter at a target by;

robotically positioning the distal tip of the catheter in a vicinity of the target, responsive to the six dimensions of location and orientation information of the position signal using an iterative process to direct the distal tip of the catheter to the target, robotically rotating a handle control at the proximal end of the catheter in order to cause the distal tip of the catheter to roll to a rotation the deflection curve of which includes the target, the rotation determined responsive to the six dimensions of location and orientation information of the position signal, and robotically deflecting the distal tip of the catheter along the deflection curve to the target.

23. The method according to claim 22, wherein robotically positioning the distal tip in the vicinity of the target comprises robotically positioning the distal tip so that the deflection curve of at least one rotation of the distal tip includes the target.

24. The method according to claim 22, comprising receiving an indication of a position of the target, wherein robotically deflecting the distal tip comprises robotically deflecting the distal tip to the position of the target, responsive to the position signal.

25. A method for use with a human-controllable steerable catheter having a distal tip and a proximal end, the method comprising:

robotically rotating a handle control at the proximal end of the human-controllable steerable catheter;

receiving a position signal indicative of six dimensions of location and orientation information from a vicinity of the distal tip of the catheter;

responsive to the position signal, determining a roll of the distal tip; and

responsive to a determination that the roll lags the rotation, robotically moving, using a robot, a portion of the proximal end of the catheter, wherein the steps of robotically rotating and robotically moving are performed in an automated fashion using an iterative process to direct the distal tip of the catheter to the desired position.

26. The method according to claim 25, wherein robotically moving the portion of the proximal end of the catheter comprises robotically performing at least one action selected from the list consisting of:

straightening the distal tip and deflecting the distal tip.

27. The method according to claim 25, wherein robotically moving the portion of the proximal end of the catheter comprises robotically translating the distal tip back and forth.

28. The method according to claim 25, wherein robotically moving the portion of the proximal end of the catheter comprises robotically performing at least one action selected from the list consisting of:

advancing the distal tip and withdrawing the distal tip.

29. The method according to claim 25, wherein robotically moving the portion of the proximal end of the catheter comprises robotically jiggling the distal tip.

30. The method according to claim 29, wherein robotically jiggling the distal tip comprises robotically rotating the proximal end of the catheter.