Automated alignment

• US 8,657,781 B2
• Filed: 11/15/2012
• Issued: 02/25/2014
• Est. Priority Date: 11/20/2008
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Sewell, Christopher M., Tanner, Neal A., Miller, Teresa
• Primary Examiner(s): Cattungal, Sanjay
• Application Number:
  US13/678,280
• Publication Number:
  US 20130072944A1
• Time in Patent Office: 467 Days
• Field of Search: 600/101, 600/109, 600/114, 600/117, 600/118, 600/139, 600/146, 600/424, 606/130, 604/95.04, 604/164.12, 604/164.09
• US Class Current: 604/95.04
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 2090/0818 Redundant systems, e.g. using two independent measuring systems and comparing the signals
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• 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 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Systems and method are disclosed whereby elongate medical instruments may be registered to adjacent tissue structures and other structures, and may be navigated and operated in a coordinated fashion to maximize ranges of motion, ease of use, and other factors. A method for registering an instrument relative to nearby structures may comprise moving a portion of the instrument between two in situ positions, tracking movement during this movement with both a kinematic model and also a localization sensor based configuration, determining the orientation of the tracked portion relative to both the instrument coordinate system used in the kinematic modeling and also a localization coordinate reference frame, and adjusting the orientation of the instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors. Methods and configurations for navigating coupled and registered instrument sets are also disclosed.

Claims

1. A method for registering an elongate medical instrument relative to nearby anatomical structures, comprising:

moving a distal portion of a robotically controlled elongate medical instrument between a first position in situ and a second position in situ relative to an instrument coordinate reference frame;

tracking movement of the distal portion of the medical instrument relative to the instrument coordinate reference frame using a kinematic model;

tracking movement of the distal portion of the medical instrument relative to a localization coordinate reference frame using one or more localization sensors coupled to the distal portion of the medical instrument;

determining an orientation of the instrument distal end portion relative to both the instrument coordinate reference frame and the localization coordinate reference frame; and

adjusting an orientation of the instrument coordinate reference frame to minimize a difference between the determined orientations using the kinematic model and localization sensors.

2. The method of claim 1, wherein the first position in situ is a substantially straight position for the distal portion of the medical instrument.

3. The method of claim 2, wherein in the first position in situ, the distal portion of the medical instrument is substantially coincident with a coordinate axis representing a substantially unloaded, substantially straight, longitudinal axis of the distal portion of the medical instrument.

4. The method of claim 1, wherein the medical instrument comprises a flexible catheter at least partially positioned in a lumen of a flexible sheath, and wherein the distal portion of the catheter has been retracted toward the sheath lumen while the sheath instrument is maintained in a substantially straight position in the first position in situ.

5. The method of claim 1, wherein tracking movement of the distal portion of the medical instrument relative to the instrument coordinate reference frame using a kinematic model comprises determining an estimated position of the distal portion of the medical instrument based at least in part upon an insertion position of the distal portion of the medical instrument and positions of one or more steering positioners comprising the medical instrument.

6. The method of claim 5, wherein the medical instrument is a steerable, flexible catheter, and wherein the one or more steering positioners comprise steering pull wires embedded in the catheter.

7. The method of claim 2, wherein the second position in situ is a curved position for the distal portion of the medical instrument.

8. The method of claim 7, wherein the curved position has a minimum radius of curvature, and wherein a user interface is configured to assist an operator in positioning the distal portion of the medical instrument into a curved position having a radius of curvature greater than or equal to the minimum radius of curvature.

9. The method of claim 8, wherein the user interface presents the operator with a cylindrical shaped guiding envelope past which the medical instrument distal portion should be driven to place the portion into a curved position having a radius of curvature greater than or equal to the minimum radius of curvature.

10. The method of claim 1, wherein determining the orientation of the medical instrument distal portion relative to the localization coordinate reference frame comprises selecting a subset of available localization data collected for movement of the medical instrument distal portion between the first position in situ and the second position in situ, fitting a line through the subset, and determining orientation relative to the localization coordinate reference frame based upon the position of the line.

11. The method of claim 10, further comprising sequentially

a) adding additional data from the available localization data collected to form an updated subset of data;

b) fitting a line through the updated subset of data;

c) determining the quality of fit of the line through the updated subset of data; and

d) determining, based upon the quality of fit of the line through the updated subset of data, an optimized subset of data for determining the orientation of the medical instrument distal portion relative to the localization coordinate reference frame.

12. The method of claim 1, wherein moving a distal portion of the medical instrument between a first position in situ and a second position in situ is conducted as an overlay to other concurrent navigation of the medical instrument.

13. The method of claim 1, further comprising stopping other navigation of the medical instrument before moving the distal a portion of the medical instrument between the first position in situ and the second position in situ.

14. The method of claim 1, wherein tracking movement of the distal portion of the medical device takes into account image data acquired by the IVUS imaging assembly coupled to the medical device.

15. The method of claim 1, further comprising allowing for an operator adjustment of the orientation of the instrument coordinate reference frame, and synchronizing adjustment of an associated master input device coordinate reference frame to retain instinctiveness of the master input device relative to observed operation of the medical device.

16. A method for registering an elongate flexible catheter instrument relative to nearby anatomical structures, comprising:

moving a distal portion of a robotically controlled elongate flexible catheter instrument between a first position in situ and a second position in situ relative to an instrument coordinate reference frame, wherein the catheter is at least partially disposed in a lumen of an elongate flexible sheath instrument;

tracking movement of the distal portion of the medical instrument relative to the instrument coordinate reference frame using a kinematic model;

tracking movement of the distal portion of the medical instrument relative to a localization coordinate reference frame using one or more localization sensors coupled to the distal portion of the medical instrument;

determining an orientation of the instrument distal end portion relative to both the instrument coordinate reference frame and the localization coordinate reference frame; and

adjusting an orientation of the instrument coordinate reference frame to minimize a difference between the determined orientations using the kinematic model and localization sensors,

wherein in the first position in situ, the distal portion of the catheter instrument is substantially coincident with a coordinate axis representing a substantially unloaded, substantially straight, longitudinal axis of the distal portion of the catheter instrument, and the second position in situ is a curved position for the distal portion of the catheter instrument.

17. The method of claim 16, wherein moving a distal portion of the catheter instrument between a first position in situ and a second position in situ is conducted as an overlay to other concurrent navigation of the catheter instrument.

18. The method of claim 16, further comprising stopping other navigation of the catheter instrument before moving the distal a portion of the catheter instrument between the first position in situ and the second position in situ.