Robotic catheter system and methods

• US 8,257,303 B2
• Filed: 09/02/2011
• Issued: 09/04/2012
• Est. Priority Date: 07/01/2005
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Moll, Frederic H., Wallace, Daniel T., Stahler, Gregory J., Moore, David F., Adams, Daniel T., Martin, Kenneth M., Younge, Robert G., Zinn, Michael R., Niemeyer, Gunter D., Lundmark, David C.
• Primary Examiner(s): Cattungal, Sanjay
• Application Number:
  US13/225,324
• Publication Number:
  US 20120065467A1
• Time in Patent Office: 368 Days
• Field of Search: 600407-411, 600/424, 600/473, 600/476, 600/427, 600/101, 600/109, 600/114, 600/146, 600/139, 600/117, 600/118, 606/130, 604/95.04, 604/164.12, 604/164.09
• US Class Current: 604/95.04
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 1/273 for the upper alimentary canal, e.g. oesophagoscopes, gastroscopes
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 2017/00238 Type of minimally invasive operation A61B2017/00805 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00743 Type of operation; Specification of treatment sites A61B2017/00238 takes precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• 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 2034/303 : specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2034/715 : Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2090/035 : preventing further rotation
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/364 : Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3784 : both receiver and transmitter being in the instrument or receiver being also transmitter
• 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 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 46/10 : specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 5/0006 : ECG or EEG signals
• CPC Class Codes: A61B 5/053 : Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/7285 : for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/541 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/0808 : for diagnosis of the brain
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 2025/0004 : having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 25/0105 : Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/0113 : Mechanical advancing means, e.g. catheter dispensers
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Claims

1. A robotic endoscopic instrument system, comprising:

a parent endoscopic instrument defining a working lumen and having a base removably coupled to an parent instrument interface of an instrument driver, the instrument driver comprising at least one motor operably coupled through the parent instrument interface to a control element extending thorough the parent endoscopic instrument, whereby movement of a distal bending portion of the parent endoscopic instrument may be controlled by selected operation of the motor; and

a guide-sheath instrument pair at least partially positioned in the working lumen of the parent endoscopic instrument, the guide-sheath instrument pair including

a sheath instrument defining a working lumen and having a base removably coupled to a sheath instrument interface located on a same or different instrument driver as the parent instrument interface, and

a guide instrument positioned in the sheath instrument lumen and comprising a base removably coupled to a guide instrument interface located on a same or different instrument driver as the respective parent instrument interface and sheath instrument interface,

wherein the parent endoscopic instrument, sheath instrument and guide instrument are independently controllable by the respective same or different instrument drivers.

2. The system of claim 1, wherein the parent endoscopic instrument further comprises one or more image capture devices.

3. The system of claim 1, wherein the parent endoscopic instrument further comprises one or more imaging radiation sources.

4. The system of claim 1, wherein the parent endoscopic instrument further comprises an irrigation port.

5. The system of claim 1, further comprising a tool positioned in a working lumen of the guide instrument, wherein the tool may be actuated by an actuator operatively coupled to the guide instrument base.

6. The apparatus of claim 5, wherein the tool is selected from the group comprising an electrode, a grasper, a scissor, a needle, a collapsible basket, a cauterizing tool, a scalpel, an expandable balloon, a staple applier, a laser emitting element, an ultrasound transducer, and a cryogenic cooling element.

7. The apparatus of claim 5, wherein the tool can be actuated to mechanically manipulate internal body tissue at an interventional procedure site.

8. The apparatus of claim 1, further comprising a respective localization sensor coupled to one or more of the parent endoscopic instrument, sheath instrument and guide instrument.

9. The apparatus of claim 1, wherein the guide instrument interface is movable relative to the sheath instrument interface, such that the guide instrument is axially movable relative to the sheath instrument, whereby a distal end portion of the guide instrument may be extended out of, and retracted back into, a distal opening of the sheath instrument in communication with the sheath working lumen.

10. A robotic endoscopic instrument system, comprising:

a parent endoscopic instrument defining a plurality of working lumens and having a base removably coupled to an instrument interface of a parent instrument driver, the parent instrument driver comprising at least one motor operably coupled through the instrument interface to a control element extending thorough the parent endoscopic instrument, whereby movement of a distal bending portion of the parent endoscopic instrument may be controlled by selected operation of the motor;

a first guide-sheath instrument pair at least partially positioned in a first working lumen of the parent endoscopic instrument, the first guide-sheath instrument pair including

a first sheath instrument defining a working lumen and having a base removably coupled to a sheath instrument interface of a first guide-sheath instrument driver, and

a first guide instrument positioned in the first sheath instrument working lumen and comprising a base removably coupled to a guide instrument interface of the first guide-sheath instrument driver,

wherein the first sheath instrument and first guide instrument are independently controllable by the first guide-sheath instrument driver; and

a second guide-sheath instrument pair at least partially positioned in a second working lumen of the parent endoscopic instrument, the second guide-sheath instrument pair including

a second sheath instrument defining a working lumen and having a base removably coupled to a sheath instrument interface of a second guide-sheath instrument driver, and

a second guide instrument positioned in the second sheath instrument working lumen and comprising a base removably coupled to a guide instrument interface of the second guide-sheath instrument driver,

wherein the second sheath instrument and second guide instrument are independently controllable by the first guide-sheath instrument driver.

11. The system of claim 10, wherein the parent endoscopic instrument further comprises one or more image capture devices.

12. The system of claim 10, wherein the parent endoscopic instrument further comprises one or more imaging radiation sources.

13. The system of claim 10, wherein the parent endoscopic instrument further comprises an irrigation port.

14. The system of claim 10, further comprising a respective tool positioned in one or both of a working lumen of the first guide instrument and a working lumen of the second guide instrument, wherein the respective tools may be actuated by actuators operatively coupled to the respective first and second guide instrument bases.

15. The system of claim 14, wherein the respective tool or tools are selected from the group comprising an electrode, a grasper, a cauterizing tool, a scalpel, a scissor, a needle, a collapsible basket, an expandable balloon, a staple applier, a laser emitting element, an ultrasound transducer, and a cryogenic cooling element.

16. The system of claim 14, wherein the respective tool or tools can be actuated to mechanically manipulate internal body tissue at an interventional procedure site.

17. The system of claim 10, further comprising a respective localization sensor coupled to one or more of the parent endoscopic instrument, first sheath instrument, first guide instrument, second sheath instrument and second guide instrument.

18. The system of claim 10, wherein

the guide instrument interface of the first guide-sheath instrument driver is movable relative to the sheath instrument interface of the first guide-sheath instrument driver, such that the first guide instrument is axially movable relative to the first sheath instrument, whereby a distal end portion of the first guide instrument may be extended out of, and retracted back into, a distal opening of the first sheath instrument in communication with the first sheath working lumen, and

the guide instrument interface of the second guide-sheath instrument driver is movable relative to the sheath instrument interface of the second guide-sheath instrument driver, such that the second guide instrument is axially movable relative to the second sheath instrument, whereby a distal end portion of the second guide instrument may be extended out of, and retracted back into, a distal opening of the second sheath instrument in communication with the second sheath working lumen.

19. A robotic endoscopic instrument system, comprising:

a parent endoscopic instrument defining a plurality of working lumens and having a base removably coupled to an instrument interface of a parent instrument driver, the parent instrument driver comprising at least one motor operably coupled through the instrument interface to a control element extending thorough the parent endoscopic instrument, whereby movement of a distal bending portion of the parent endoscopic instrument may be controlled by selected operation of the motor;

a first guide-sheath-tool assembly at least partially positioned in a first working lumen of the parent endoscopic instrument, the first guide-sheath-tool assembly including

a first sheath instrument defining a working lumen and having a base removably coupled to a sheath instrument interface of a first guide-sheath-tool instrument driver,

a first guide instrument positioned in the first sheath instrument working lumen, the first guide instrument defining a working lumen and comprising a base removably coupled to a guide instrument interface of the first guide-sheath-tool instrument driver, and

a first tool positioned in the working lumen of the first guide instrument, wherein the tool may be actuated by an actuator operatively coupled to the guide instrument base,

wherein the first sheath instrument, first guide instrument and first tool are independently controllable by the first guide-sheath-tool instrument driver; and

a second guide-sheath instrument pair at least partially positioned in a second working lumen of the parent endoscopic instrument, the second guide-sheath instrument pair including

a second sheath instrument defining a working lumen and having a base removably coupled to a sheath instrument interface of a second guide-sheath-tool instrument driver, and

a second guide instrument positioned in the second sheath instrument working lumen, the second guide instrument defining a working lumen and comprising a base removably coupled to a guide instrument interface of the second guide-sheath-tool instrument driver, and

a second tool positioned in the working lumen of the second guide instrument, wherein the tool may be actuated by an actuator operatively coupled to the guide instrument base,

wherein the second sheath instrument, second guide instrument and second tool are independently controllable by the second guide-sheath-tool instrument driver.

20. The system of claim 19, wherein the first tool and second tool are each selected from the group comprising an electrode, a grasper, a cauterizing tool, a scalpel, a scissor, a needle, a collapsible basket, an expandable balloon, a staple applier, a laser emitting element, an ultrasound transducer, and a cryogenic cooling element.

21. The system of claim 19, wherein one or both of the first and second tools can be actuated to mechanically manipulate internal body tissue at an interventional procedure site.

22. The system of claim 19, wherein

the guide instrument interface of the first guide-sheath-tool instrument driver is movable relative to the sheath instrument interface of the first guide-sheath-tool instrument driver, such that the first guide instrument is axially movable relative to the first sheath instrument, whereby a distal end portion of the first tool extending out of the first guide instrument may be extended out of, and retracted back into, a distal opening of the first sheath instrument in communication with the first sheath working lumen, and

the guide instrument interface of the second guide-sheath instrument driver is movable relative to the sheath instrument interface of the second guide-sheath instrument driver, such that the second guide instrument is axially movable relative to the second sheath instrument, whereby a distal end portion of the second tool extending out of the second guide instrument may be extended out of, and retracted back into, a distal opening of the second sheath instrument in communication with the second sheath working lumen.