Apparatus for insertion of a medical device within a body during a medical imaging process

• US 8,521,257 B2
• Filed: 03/14/2007
• Issued: 08/27/2013
• Est. Priority Date: 03/14/2006
• Status: Active Grant

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Whitcomb, Louis L., Krieger, Axel, Susil, Robert Charles, Fichtinger, Gabor, Atalar, Ergin, Iordachita, Iulian I.
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US12/225,198
• Publication Number:
  US 20100056900A1
• Time in Patent Office: 2,358 Days
• Field of Search: 600407-472, 600/104, 600/112, 600/153, 600/160, 601/1, 601 41- 46, 604/510, 604/164.13, 604/264
• US Class Current: 600/411
• CPC Class Codes: A61B 10/0241 for prostate
• CPC Class Codes: A61B 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A device, system, and method for entering a medical device such as a needle into the body inside a medical imager such as a MRI scanner, CT, X-ray fluoroscopy, and ultrasound imaging, from within a body cavity (such as the rectum, vagina, or laparoscopically accessed cavity). A three degree-of-freedom mechanical device translates and rotates inside the cavity and enters a needle into the body, and steers the needle to a target point selected by the user. The device is guided by real-time images from the medical imager. Networked computers process the medical images and enable the clinician to control the motion of the mechanical device that is operated within the imager, outside of the imager or remotely from outside the imager.

Claims

1. An interventional device for use while a subject including a mammalian body is within an imaging field of a medical imaging apparatus, said interventional device comprising:

an end member, a portion configured to be inserted into one of a natural cavity or an artificially formed cavity of the subject while the subject is within the imaging field of a medical imaging apparatus; and

wherein said end member includes;

a medical device;

a sheath member being configured and arranged to be received with said one of natural or artificial body cavity,

a carrier member being one of translatably or rotatably disposed within the sheath member,

wherein the carrier member is configured and arranged to selectively deploy the medical device therefrom between a stored position and a deployed position, where in the deployed position a portion of the medical device is disposed in target tissues about said one of the natural or artificial body cavity, and

wherein the carrier member includes a plurality of continuously linear guide channels that are each angulated at different angles toward a common axis and that are spaced apart from each other at an outlet end and intersect at the common axis to form a single inlet, where the medical device is deployed from an exit port of one of the plurality of guide channels and each guide channel includes an exit port in the carrier member that is displaced from other exit ports of each other guide channel of the plurality of guide channels, each exit port deploying the medical device at a different angle through an opening in the sheath member.

2. The interventional device of claim 1, wherein the sheath member and the carrier member are configured and arranged so rotation or translation of the carrier member is not imparted to the sheath member.

3. The interventional device of claim 1, wherein the sheath member is configured so as to include a through aperture that communicates with a sheath member interior compartment and which extends partially circumferentially and partially longitudinally so as to form a window in an exterior surface of the sheath member.

4. The interventional device of claim 1, wherein said end member further includes an imaging device that is configured and arranged so as to allow a volume of tissues including the target tissues to be imaged.

5. The interventional device of claim 1, further comprising:

a positioning mechanism operably coupled to the carrier member; and

wherein said positioning mechanism is configured and arranged to cause the carrier member to translate or rotate within the sheath member interior compartment.

6. The interventional device of claim 1, wherein said end member further includes a plurality of tracking devices, each of said plurality of tracking devices being configured and arranged so a position of each tracking device is determined by the medical imaging apparatus.

7. An interventional device for use while a subject including a mammalian body is within an imaging field of a medical imaging apparatus, said interventional device comprising:

an end member, a portion configured to be inserted into one of a natural cavity or an artificially formed cavity of the subject while the subject is within the imaging field of a medical imaging apparatus; and

wherein said end member includes;

a medical device;

a sheath member being configured and arranged to be received with said one of natural or artificial body cavity,

a carrier member being one of translatably or rotatably disposed within the sheath member wherein the carrier member includes a plurality of continuously linear guide channels that are each angulated at different angles toward a common axis and that are spaced apart from each other at an outlet end and intersect at the common axis to form a single inlet, where the medical device is deployed from an exit port of one of the plurality of guide channels, wherein each guide channel includes an exit port in the carrier member that is displaced from other exit ports of each other guide channel of the plurality of guide channels, each exit port deploying the medical device at a different angle through an opening in the sheath member,

wherein the carrier member is configured and arranged to selectively deploy the medical device therefrom between a stored position and a deployed position, where in the deployed position a portion of the medical device is disposed in target tissues about said one of the natural or artificial body cavity, and

wherein the sheath member includes a drive mechanism for rotating the sheath member about a long axis thereof.

8. The interventional device of claim 7, further comprising a mechanism operably coupled to the medical device, said mechanism being configured so as to rotate the medical device.

9. An interventional device for use while a subject including a mammalian body is within an imaging field of a medical imaging apparatus, said interventional device comprising:

an end member, a portion configured to be inserted into one of a natural cavity or an artificially formed cavity of the subject while the subject is within the imaging field of a medical imaging apparatus; and

wherein said end member includes;

a medical device;

a sheath member being configured and arranged to be received with said one of natural or artificial body cavity,

a carrier member being one of translatably or rotatably disposed within the sheath member wherein the carrier member includes a plurality of continuously linear guide channels that are each angulated at different angles toward a common axis and that are spaced apart from each other at an outlet end and intersect at the common axis to form a single inlet, where the medical device is deployed from an exit port of one of the plurality of the guide channels, wherein each guide channel includes an exit port in the carrier member that is displaced from other exit ports of each other guide channel of the plurality of guide channels, each exit port deploying the medical device at a different angle through an opening in the sheath member,

wherein the carrier member is configured and arranged to selectively deploy a medical device therefrom between a stored position and a deployed position, where in the deployed position a portion of the medical device is disposed in target tissues about said one of the natural or artificial body cavity, and

wherein the sheath member further includes a stabilizing mechanism for stabilizing tissue being targeted while the end member portion is inserted into the one of a natural cavity or the artificially formed cavity of the subject.

10. An interventional device for use while a subject including a mammalian body is within an imaging field of a medical imaging apparatus, said interventional device comprising:

an end member, a portion configured to be inserted into one of a natural cavity or an artificially formed cavity of the subject while the subject is within the imaging field of the medical imaging apparatus; and

wherein said end member includes;

a medical device;

a sheath member being configured and arranged to be received with said one of natural or artificial body cavity,

an inner member being one of translatably or rotatably disposed within the sheath member,

a medical device pathway though which the medical device passes between a stored position and a deployed position, where in the deployed position a portion of the medical device is configured to be disposed in target tissues about said one of the natural or artificial body cavity, and

wherein the medical device pathway includes a flexible portion that is operably coupled to the inner member so that the flexible portion is steered in at least one direction responsive to the movement of the inner member within the sheath, and

wherein the medical device pathway includes a plurality of continuously linear guide channels that are each angulated at different angles toward a common axis and that are spaced apart from each other at an outlet end and intersect at the common axis to form a single inlet, to deploy the medical device from an exit port of one of the guide channels at different angles, wherein each guide channel includes an exit port in the medical device pathway that is displaced from other exit ports of each other guide channel of the plurality of guide channels, each exit port deploying the medical device at a different angle through an opening in the sheath member.