Endoscope structures and techniques for navigating to a target in branched structure

• US 8,696,548 B2
• Filed: 06/09/2011
• Issued: 04/15/2014
• Est. Priority Date: 04/17/2002
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Gilboa, Pinhas
• Primary Examiner(s): Leubecker, John P
• Application Number:
  US13/157,283
• Publication Number:
  US 20110237897A1
• Time in Patent Office: 1,041 Days
• Field of Search: 600/104, 600/106, 600/107, 600/113, 600/114, 600/102, 600/424, 600/117, 606/1
• US Class Current: 600/117
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• 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 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 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 5/065 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: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

Systems and methods employing a small gauge steerable catheter (30) including a locatable guide (32) with a sheath (40), particularly as an enhancement to a bronchoscope (14). A typical procedure is as follows. The location of a target in a reference coordinate system is detected or imported. The catheter (30) is navigated to the target which tracking the distal tip (34) of the guide (32) in the reference coordinate system. Insertion of the catheter is typically via a working channel of a convention bronchoscope. Once the tip of the catheter is positioned at the target, the guide (32) is withdrawn, leaving the sheath (40) secured in place. The sheath (40) is then used as a guide channel to direct a medical tool to target.

Claims

1. A method of guiding a medical tool through a branched structure to a target location, the method comprising:

(a) inserting a locatable guide surrounded by a sheath through a working channel of a bronchoscope;

(b) navigating the locatable guide and the sheath to a target location, the locatable guide selectively locked relative to the sheath by a locking mechanism;

(c) locking the sheath relative to the target location;

(d) unlocking the locatable guide relative to the sheath;

(e) removing the locatable guide from the sheath, leaving an open lumen through the sheath; and

(f) inserting a tool through the lumen to the target location.

2. The method of claim 1, wherein navigating the locatable guide to the target location comprises:

monitoring data received from a position sensor element disposed in the locatable guide.

3. The method of claim 2 wherein monitoring data received from a position sensor element disposed in the locatable guide comprises monitoring position and orientation data received from said position sensor element.

4. The method of claim 1 wherein locking the sheath relative to the target location comprises locking the sheath relative to a handle through which the sheath is fed during navigation to the target location.

5. The method of claim 1, wherein navigating the locatable guide to the target location comprises viewing an image generated by an image sensor deployed for generating an image in the pointing direction of the catheter.

6. The method of claim 5 wherein navigating the locatable guide to the target location further comprises illuminating a field of view of the image sensor by using at least a distal portion of the sheath as an optical waveguide.

7. The method of claim 6, wherein illuminating a field of view of the image sensor by using at least a distal portion of the sheath as an optical waveguide comprises supplying light to the optical waveguide from at least one light source mounted within the locatable guide.

8. The method of claim 1 wherein inserting a tool through the lumen to the target location comprises:

(a) inserting the tool into a calibration tube, the calibration tube having a length corresponding to a length of the lumen; and

(b) marking an extent of insertion on the tool.

9. The method of claim 1, wherein locking the sheath relative to the target location includes locking the sheath relative to the bronchoscope.

10. A method of guiding a medical tool through a branched structure to a target location, the method comprising:

(a) navigating to a target location a locatable guide surrounded by, and temporarily fixed relative to, a sheath;

(b) fixing the sheath relative to the target location;

(c) removing the locatable guide from the sheath, thereby leaving an open lumen;

(d) inserting a tool through the lumen to the target location, wherein inserting the tool through the lumen to the target comprises;

(a) inserting the tool into a calibration tube, the calibration tube having a length corresponding to a length of the lumen; and

(b) marking an extent of insertion on the tool.