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

• US 8,696,685 B2
• Filed: 03/12/2010
• 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): CHAO, ELMER M
• Application Number:
  US12/723,577
• Publication Number:
  US 20100160733A1
• Time in Patent Office: 1,495 Days
• Field of Search: 600/117, 600/407, 600424-427, 600/429, 600/410, 600/411, 606/130
• US Class Current: 606/130
• 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 Once the tip of the catheter is positioned at the target, the guide (32) is withdrawn, leaving the sheath (40) secured in place.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 for navigating a medical tool through a branched structure comprising the steps of:

determining a geometric shape of an interior space of a section of said branched structure by;

moving a locatable probe through said interior space;

recording said real-time location data received from a sensor near a distal end of the locatable probe; and

,

processing said recorded real-time location data to create said geometric shape;

conducting a best fit correlation between said geometric shape and corresponding features within a data set representative of said branched structure;

providing an indication of a real-time location of said sensor within said branched structure positioned within said three-dimensional frame of reference based on said correlating; and

advancing said sensor through said branched structure based on said indications of said real-time location of said sensor.

2. The method of claim 1 wherein the step of determining a geometric shape of an interior space of a section of said branched structure comprises determining a geometric shape of an interior space of a section of airways in a lung.

3. The method of claim 1 wherein the step of determining a geometric shape of an interior space of a section of said branched structure by moving a locatable probe through said section while recording said real-time location data received from a sensor near a distal end of a locatable probe comprises moving said sensor past a bifurcation within said branched structure.

4. The method of claim 1 wherein the step of determining a geometric shape of an interior space of a section of said branched structure by moving a locatable probe through said interior space while recording said real-time location data received from a sensor near a distal end of a locatable probe comprises moving said sensor through connected branches of said branched structure.

5. The method of claim 1 wherein the step of providing an indication of a real-time location of a sensor within said branched structure positioned within said three-dimensional frame of reference based on said correlating comprises providing a computer tomography display showing said real-time location of said sensor.

6. The method of claim 1 wherein the step of providing an indication of a real-time location of a sensor within said branched structure positioned within said three-dimensional frame of reference based on said correlating comprises providing a virtual display showing said real-time location of said sensor.

7. The method of claim 1 further comprising the step of using said data set representative of said branched structure for importing a pre-planned route map to a target within said branched structure positioned within said three-dimensional frame of reference.

8. A method for navigating a medical tool through a branched structure comprising the steps of:

(a) acquiring a plurality of images of anatomical features in a branched structure;

(b) compiling a data set from said plurality of images of said anatomical features in said branched structure;

(c) defining a three-dimensional frame of reference including at least a portion of said branched structure;

(d) advancing a locatable probe into a branch of said branched structure;

(e) recording location data relative to said three-dimensional frame of reference received from said locatable probe within said branch to develop a geometric model of a section of said branched structure containing said locatable probe;

(f) processing said recorded real-time location to create a geometric shape;

(g) correlating said geometric shape to corresponding data in said data set from said plurality of images by comparing said geometric model to said data set;

(h) aligning said three-dimensional frame of reference with said data set from said plurality of images based on said correlating; and

(i) repeating steps (d) through (h).

9. The method of claim 8 further comprising the step of providing an indication of a real-time location of said locatable probe within said three-dimensional frame of reference based on said step of aligning.

10. The method of claim 9 wherein the step of providing an indication of a real-time location of said locatable probe within said three-dimensional frame of reference based on said step of aligning comprises providing a computer tomography display corresponding to said real-time location of said locatable probe.

11. The method of claim 9 wherein the step of providing an indication of a real-time location of said locatable probe within said three-dimensional frame of reference based on said step of aligning comprises providing a virtual display corresponding to said real-time location of said locatable probe.

12. The method of claim 9 wherein said step of providing an indication of a real-time location of said locatable probe within said three-dimensional frame of reference based on said step of aligning occurs between steps (h) and (i).

13. The method of claim 9 wherein said step of providing an indication of a real-time location of said locatable probe within said three-dimensional frame of reference based on said step of aligning occurs after step (i).

14. The method of claim 8 wherein step (i) comprises repeating steps (d) through (h) with a different branch of said branched structure.

15. The method of claim 8 further comprising the step of using said data set for importing a pre-planned route map to a target into said three-dimensional frame of reference.

16. The method of claim 8 further comprising the step of advancing said locatable probe to a target in said three-dimensional frame of reference based on said aligning said three-dimensional frame of reference with said data set from said plurality of images.

17. A method for navigating a medical tool through a branched structure comprising the steps of:

(a) providing a probe with a position sensor element which operates as part of a position measuring system to allow measurement of a position and a pointing direction of a tip of a probe relative to a three-dimensional frame of reference;

(b) moving the tip of the probe along a first branch portion of a branched structure and deriving and recording position data of the position sensor in said three dimensional frame of reference, and processing said position data to develop a geometric model of a section of said branched portion;

(c) repeating step (b) for a second branch portion of the branched structure;

(d) correlating said position data of said first and second branch portions with three-dimensional anatomical imaging data, by calculating a best fit match between said geometric model and said imaging data, to derive a registration between the three-dimensional imaging data and the three dimensional frame of reference; and

(e) advancing said sensor through said branched structure to a target based on said registration between the three-dimensional anatomical imaging data and the three dimensional frame of reference.

18. The method of claim 17 further comprising the step of using said registration between the three-dimensional anatomical imaging data and the three dimensional frame of reference to provide a indication of a real-time location of said position sensor within said three-dimensional frame of reference.