Systems and methods for performing minimally invasive procedures

• US 8,409,172 B2
• Filed: 08/03/2007
• Issued: 04/02/2013
• Est. Priority Date: 08/03/2006
• 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., Carlson, Christopher R., Barbagli, Federico
• Primary Examiner(s): Johnson, III, Henry M
• Application Number:
  US11/833,969
• Publication Number:
  US 20080058836A1
• Time in Patent Office: 2,069 Days
• Field of Search: 606 1- 25, 606/10, 606 13- 16, 606/34, 606/130, 600433-435, 600/466, 600/585, 600/101, 604/96.1, 604/523, 604/544, 607/1, 607 88- 89, 969 1- 25, 969/10, 969 13- 16, 969/34, 969/130
• US Class Current: 606/1
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22059 transparent
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22072 : with an instrument channel, e.g. for replacing one instrument by the other
• CPC Class Codes: A61B 2017/2212 : having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 : having an open distal end
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00547 : Prostate
• 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 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/32 : operating autonomously
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61M 2025/1072 : having balloons with two or more compartments
• CPC Class Codes: A61M 2025/1086 : having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
• CPC Class Codes: A61M 25/0127 : Magnetic means; Magnetic markers
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence

Abstract

A robotic surgical system includes an instrument driver and an instrument assembly operatively coupled to the instrument driver such that mechanisms of the instrument driver operate or control movement, operation, or both, of components of the instrument assembly. The instrument assembly components include an elongate flexible guide instrument, an optical light source, a camera and a working tool, wherein the light source, camera, and working tool are carried in one or more lumens of the guide instrument. An operator control station is operatively coupled to the instrument driver via a remote communication link. The instrument assembly further includes an inflatable visualization balloon carried on a distal end portion of the guide instrument, the light source and camera having distal ends located within an interior of the balloon, the balloon comprising a lumen extending from the guide instrument to a distal facing wall of the balloon, such that the working instrument may extend from a respective lumen of the guide instrument through the balloon lumen to contact body tissue when the distal end of the guide instrument is positioned in an interior body region.

Claims

1. A method for performing a medical procedure on an abnormality of a prostate of a patient using a robotically steerable catheter having a distal catheter portion and a surgical tool carried by the distal catheter portion, comprising:

inserting a steerable sheath into the urethra using a robotically controlled system, wherein the distal catheter portion is advanced within the steerable sheath along the urethra until the surgical tool is adjacent the prostate;

manipulating the catheter using the robotically controlled system;

imaging an area of the prostate using an imaging device to obtain an image of the area of the prostate;

locating an anatomical landmark using the image of the area of the prostate, and storing a position and orientation of the robotically steerable catheter to arrive at the anatomical landmark;

creating a restricted zone, based on the image of the area of the prostate, into which the surgical tool is restricted from entering by a navigation logic of the robotically controlled system;

operating the surgical tool using the robotically controlled system to treat abnormality of the prostate; and

wherein the operation of the surgical tool is at least partially automatically controlled based on the image obtained by the imaging device.

2. The method of claim 1, wherein advancing the steerable sheath and distal catheter portion along the urethra and operating the surgical tool comprises inputting user commands into an operator control station and transmitting corresponding signals to at least one drive unit coupled to the steerable sheath and catheter.

3. The method of claim 2, wherein the corresponding signals are remotely transmitted from the operator control station to the at least one drive unit.

4. The method of claim 1, wherein the abnormality is benign prostatic hyperplasia that narrows the urethra.

5. The method of claim 1, wherein the abnormality is treated by destroying tissue of the prostate.

6. The method of claim 1, wherein the tool is a laser, and the abnormality is treated by conveying laser energy from the laser to destroy tissue of the prostate.

7. The method of claim 1, wherein the tool is a resectoscope, and the abnormality is treated by scraping tissue away from the prostate with the resectoscope.

8. The method of claim 7, wherein the instrument is a tissue grasper that is operated to remove tissue samples from the prostate.

9. The method of claim 1, wherein the tool is a wire loop tool, and the abnormality is treated by conveying electrical energy from the wire loop tool.

10. The method of claim 1, wherein the catheter has an instrument carried by the distal catheter end, the method further comprising operating the instrument using the robotically controlled system.

11. The method of claim 10, wherein the instrument is an imaging device that is operated to image the prostate.

12. The method of claim 11, wherein the imaging device is an optical imaging fiber.

13. The method of claim 10, wherein the instrument is a flush port that is operated to irrigate and flush the prostate.

14. The method of claim 13, wherein treatment of the prostate comprises removing tissue from the prostate, and the flushing of the prostate carries the removed tissue away from the prostate down the urethra.