Catheter locator apparatus and method of use

• US 8,606,347 B2
• Filed: 08/09/2012
• Issued: 12/10/2013
• Est. Priority Date: 08/23/2000
• Status: Expired due to Term

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: CORPAK MedSystems, Inc. (Avanos Medical, Inc.)
• Inventors: Besz, William John, Chorley, Donald Philip, Brasted, Stuart, Walker, Robert Anthony
• Primary Examiner(s): KISH, JAMES M
• Application Number:
  US13/570,999
• Publication Number:
  US 20130035589A1
• Time in Patent Office: 488 Days
• Field of Search: 600/407, 600/424
• US Class Current: 600/424
• 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 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/6851 Guide wires
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61J 15/0007 inserted by using a guide-wire guide wires A61M25/09
• CPC Class Codes: A61J 15/0069 Tubes feeding directly to the intestines, e.g. to the jejunum
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• 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 25/09 Guide wires

Abstract

In one embodiment, a catheter locator apparatus is configured to determine the location of the tip of a catheter as it is inserted used in a human body. In one example embodiment, where a radiating coil is used in conjunction with a catheter, a coil locating device can be used to determine the distance the coil is from the device and hence its depth in the body of a patient.

Claims

1. A method of controlling a display device for confirming placement of a catheter inserted into a subject after the catheter is inserted through a nasal or oral cavity of the subject, wherein the catheter has a tip positioned in a jejunum of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject, wherein the vertical line and horizontal line intersect at a point representative of a xiphoid process of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil; and

(d) displaying on the display device, in three-dimensions, the graphical representation of an insertion path of the catheter,

wherein confirmation of placement of the catheter in the subject is enabled based on the graphical representation of the insertion path, and

wherein the graphical representation of the insertion path defines a shape including;

(i) an esophageal segment extending substantially parallel to said vertical line, the esophageal segment extending from a position above the horizontal line to the horizontal line and having a first depth relative to the anterior surface of the subject, the esophageal segment indicating absence of placement in an airway of the subject,

(ii) a stomach segment extending from said vertical line abaxially away from the vertical line, returning axially to the vertical line and having a second depth relative to the anterior surface of the subject,

(iii) a pylorus segment intersecting the vertical line at a third depth relative to the anterior surface of the subject,

(iv) a duodenum segment extending abaxially away from the vertical line in a direction substantially opposite from the stomach segment, returning axially to the vertical line and having a fourth depth relative to the anterior surface of the subject, and

(v) a jejunum segment extending abaxially away from said vertical line in a direction substantially opposite the duodenum segment, the jejunum segment terminating in a location representing the jejunum of the subject.

2. The method of claim 1, wherein the second depth is shallower than the first depth.

3. The method of claim 1, wherein the third depth is shallower than both the second depth and the first depth.

4. The method of claim 1, wherein the fourth depth is deeper than the third depth.

5. The method of claim 1, wherein the fourth depth is deeper than the third depth and the third depth is shallower than the first depth.

6. The method of claim 1, wherein the esophageal segment has a range of depths relative to the anterior surface of the subject, and wherein the first depth represents a maximum depth of said esophageal segment in said range.

7. The method of claim 1, wherein the stomach segment has a range of different depths relative to the anterior surface of the subject, and wherein the second depth represents a maximum depth of said stomach segment in said range.

8. The method of claim 1, wherein the pylorus segment has a range of different depths relative to the anterior surface of the subject, and wherein the third depth represents a minimum depth of said pylorus segment in said range.

9. The method of claim 1, wherein the duodenum segment has a range of different depths relative to the anterior surface of the subject, and wherein the fourth depth represents a maximum depth of said duodenum segment in said range.

10. A method of controlling a display device for confirming placement of a catheter inserted into a subject, after the catheter is inserted through a nasal or oral cavity of the subject, wherein the catheter has a tip positioned in a stomach of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil; and

(d) displaying on the display device, in three-dimensions, the graphical representation of an insertion path of the catheter,

wherein confirmation of placement of the catheter in the subject is enabled based on the graphical representation of the insertion path, and

wherein the graphical representation of the insertion path defines a shape including;

(i) an esophageal segment extending substantially parallel to said vertical line, the esophageal segment extending from a position above the horizontal line to the horizontal line and having a first depth relative to the anterior surface of the subject, the esophageal segment indicating absence of placement in an airway of the subject, and

(ii) a stomach segment extending from said vertical line abaxially away from the vertical line, returning axially to the vertical line and having a second depth relative to the anterior surface of the subject, the stomach segment terminating in a location representing the stomach of the subject.

11. The method of claim 10, which includes displaying the stomach segment terminating in the stomach of the subject at a second depth relative to the surface of the subject, wherein the second depth is shallower than the first depth.

12. The method of claim 11, wherein the esophageal segment has a range of depths relative to the anterior surface of the subject, and wherein the first depth represents a maximum depth of said esophageal segment in said range.

13. The method of claim 11, wherein the stomach segment has a range of different depths relative to the anterior surface of the subject, and wherein the second depth represents a maximum depth of said stomach segment in said range.

14. A method of controlling a display device for confirming placement of a catheter inserted into a subject, after the catheter is inserted through a nasal or oral cavity of a subject, wherein the catheter has a tip positioned in a duodenum of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil; and

(d) displaying on the display device, in three-dimensions, the graphical representation of an insertion path of the catheter,

wherein confirmation of placement of the catheter in the subject based on the graphical representation of the insertion path, and

wherein the graphical representation of the insertion path defines a shape including;

(i) an esophageal segment extending substantially parallel to said vertical line, the esophageal segment extending from a position above the horizontal line to the horizontal line and having a first depth relative to the anterior surface of the subject, the esophageal segment indicating absence of placement in an airway of the subject,

(ii) a stomach segment extending from said vertical line abaxially away from the vertical line, returning axially to the vertical line and having a second depth relative to the anterior surface of the subject,

(iii) a pylorus segment intersecting the vertical line at a third depth relative to the anterior surface of the subject, and

(iv) a duodenum segment extending abaxially away from the vertical line in a direction substantially opposite from the stomach segment, returning axially to the vertical line and having a fourth depth relative to the anterior surface of the subject.

15. The method of claim 14, wherein the second depth is shallower than the first depth.

16. The method of claim 14, wherein the third depth is shallower than both the second depth and the first depth.

17. The method of claim 14, wherein the fourth depth is deeper than the third depth.

18. The method of claim 14, wherein the fourth depth is deeper than the third depth and the third depth is shallower than the first depth.

19. The method of claim 14, wherein the esophageal segment has a range of depths relative to the anterior surface of the subject, and wherein the first depth represents a maximum depth of said esophageal segment in said range.

20. The method of claim 14, wherein the stomach segment has a range of different depths relative to the anterior surface of the subject, and wherein the second depth represents a maximum depth of said stomach segment in said range.

21. The method of claim 14, wherein the pylorus segment has a range of different depths relative to the anterior surface of the subject, and wherein the third depth represents a minimum depth of said pylorus segment in said range.

22. The method of claim 14, wherein the duodenum segment has a range of different depths relative to the anterior surface of the subject, and wherein the fourth depth represents a maximum depth of said duodenum segment in said range.

23. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter is inserted through a nasal or oral cavity of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) at a first time, detecting a distal end of the catheter at a first location in the subject;

(e) in response to the distal end of the catheter being at the first location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a first position of the displayed reference image, the first position of the displayed reference image located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(f) at a second time, detecting the distal end of the catheter at a second location in the subject, the second location representing a stomach of the subject;

(g) in response to the distal end of the catheter being at the second location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a second position of the displayed reference image, the second position having a second depth relative to the anterior surface of the subject;

(h) at a third time, detecting the distal end of the catheter at a third location in the subject;

(i) in response to the distal end of the catheter being at the third location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a third position of the displayed reference image, the third position of the displayed reference image located along the vertical line of the displayed reference image and having a third depth relative to the anterior surface of the subject;

(j) at a fourth time, detecting the distal end of the catheter at a fourth location representing a duodenum of the subject;

(k) in response to the distal end of the catheter being at the fourth location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a fourth position of the displayed reference image, the fourth position having a fourth depth relative to the anterior surface of the subject;

(l) at a fifth time, detecting the distal end of the catheter at a fifth location in the subject, the fifth location representing a jejunum of the subject; and

(m) in response to the distal end of the catheter being at the fifth location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a fifth position of the displayed reference image,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of the distal end of the catheter at each of the first, second, third, fourth, and fifth positions of the reference image.

24. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter is inserted through a nasal or oral cavity of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) at a first time, detecting a distal end of the catheter at a first location in the subject;

(e) in response to the distal end of the catheter being at the first location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a first position of the displayed reference image, the first position of the displayed reference image located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(f) at a second time, detecting the distal end of the catheter at a second location in the subject, the second location representing a stomach of the subject;

(g) in response to the distal end of the catheter being at the second location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a second position of the displayed reference image, the second position having a second depth relative to the anterior surface of the subject;

(h) at a third time, detecting the distal end of the catheter at a third location in the subject;

(i) in response to the distal end of the catheter being at the third location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a third position of the displayed reference image, the third position of the displayed reference image located along the vertical line of the displayed reference image and having a third depth relative to the anterior surface of the subject;

(j) at a fourth time, detecting, the fourth location representing a duodenum of the subject; and

(k) in response to the distal end of the catheter being at the fourth location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a fourth position of the displayed reference image, the fourth position having a fourth depth relative to the anterior surface of the subject,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of the distal end of the catheter at each of the first, second, third, and fourth, positions of the reference image.

25. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter is inserted through a nasal or oral cavity of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) at a first time, detecting a distal end of the catheter at a first location in the subject;

(e) in response to the distal end of the catheter being at the first location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a first position of the displayed reference image, the first position of the displayed reference image located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(f) at a second time, detecting the distal end of the catheter at a second location in the subject, the second location representing a stomach of the subject; and

(g) in response to the distal end of the catheter being at the second location in the subject, displaying, in three-dimensions, a graphical representation of the distal end of the catheter at a second position of the displayed reference image, the second position having a second depth relative to the anterior surface of the subject,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of the distal end of the catheter at each of the first and second positions of the reference image.

26. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter extends through a nasal or oral cavity of the subject and terminates at a jejunum of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) displaying on the display device, in three-dimensions, a graphical representation of a first portion of the catheter at a first position of the displayed reference image, the first position being located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(e) displaying on the display device, in three-dimensions, a graphical representation of a second portion of the catheter at a second position of the displayed reference image, the second position representing a stomach of the subject and having a second depth relative to the anterior surface of the subject;

(f) displaying on the display device, in three-dimensions, a graphical representation of a third portion of the catheter at a third position of the displayed reference image, the third position being located along the vertical line of the displayed reference image and having a third depth relative to the anterior surface of the subject;

(g) displaying on the display device, in three-dimensions, a graphical representation of a fourth portion of the catheter at a fourth position of the displayed reference image, the fourth position representing a duodenum of the subject and having a fourth depth relative to the anterior surface of the subject; and

(h) displaying on the display device, in three-dimensions, a graphical representation of a fifth portion of the catheter at a fifth position of the displayed reference image, the fifth position representing the jejunum of the subject,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of an insertion path of the catheter including;

(i) the graphical representation of the first portion of the catheter at the first position of the reference image,

(ii) the graphical representation of the second portion of the catheter at the second position of the reference image,

(iii) the graphical representation of the third portion of the catheter at the third position of the reference image,

(iv) the graphical representation of the fourth portion of the catheter at the fourth position of the reference image, and

(v) the graphical representation of the fifth portion of the catheter at the fifth position of the reference image.

27. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter extends through a nasal or oral cavity of the subject and terminates at a jejunum of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) displaying on the display device, in three-dimensions, a graphical representation of a first portion of the catheter at a first position of the displayed reference image, the first position being located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(e) displaying on the display device, in three-dimensions, a graphical representation of a second portion of the catheter at a second position of the displayed reference image, the second position representing a stomach of the subject and having a second depth relative to the anterior surface of the subject;

(f) displaying on the display device, in three-dimensions, a graphical representation of a third portion of the catheter at a third position of the displayed reference image, the third position being located along the vertical line of the displayed reference image and having a third depth relative to the anterior surface of the subject; and

(g) displaying on the display device, in three-dimensions, a graphical representation of a fourth portion of the catheter at a fourth position of the displayed reference image, the fourth position representing a duodenum of the subject and having a fourth depth relative to the anterior surface of the subject,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of an insertion path of the catheter including;

(i) the graphical representation of the first portion of the catheter at the first position of the reference image,

(ii) the graphical representation of the second portion of the catheter at the second position of the reference image,

(iii) the graphical representation of the third portion of the catheter at the third position of the reference image, and

(iv) the graphical representation of the fourth portion of the catheter at the fourth position of the reference image.

28. A method of controlling a display device for confirming intubation of a catheter in a human subject, wherein the catheter extends through a nasal or oral cavity of the subject and terminates at a jejunum of the subject, the method comprising:

(a) storing data representative of a reference image in a data storage device;

(b) displaying on the display device the reference image, the reference image including;

(i) a vertical line representing a mid-sagittal line of the subject, and

(ii) a horizontal line representing a vertical cross-section of a diaphragm of the subject;

(c) storing instructions which, when executed by a processor, cause the processor to generate a graphical representation of an insertion path of the catheter, which includes a coil inserted into the catheter that is detected by a detector positioned over a predetermined location of an anterior surface of the subject for detecting a position of the coil;

(d) displaying on the display device, in three-dimensions, a graphical representation of a first portion of the catheter at a first position of the displayed reference image, the first position being located along the vertical line of the displayed reference image and having a first depth relative to the anterior surface of the subject;

(e) displaying on the display device, in three-dimensions, a graphical representation of a second portion of the catheter at a second position of the displayed reference image, the second position representing a stomach of the subject and having a second depth relative to the anterior surface of the subject,

wherein confirmation of an insertion path of the catheter, in three-dimensions, is enabled based on the graphical representation of an insertion path of the catheter including;

(i) the graphical representation of the first portion of the catheter at the first position of the reference image, and

(ii) the graphical representation of the second portion of the catheter at the second position of the reference image.