In-vivo visualization systems

• US 9,055,906 B2
• Filed: 05/12/2010
• Issued: 06/16/2015
• Est. Priority Date: 06/14/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Saadat, Vahid, Malchano, Zachary J., Watson, Jason P., Fields, Antony J., Rothe, Chris A., Swaminathan, Veerappan, Wylie, Bryan
• Primary Examiner(s): Roy, Baisakhi
• Application Number:
  US12/778,878
• Publication Number:
  US 20100292558A1
• Time in Patent Office: 1,861 Days
• Field of Search: 600/471, 600/476, 600/478, 606/1, 606/130, 606/41
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

In vivo visualization systems are described which facilitate tissue treatment by a user in utilizing real time visualized tissue images with generated three-dimensional models of the tissue region of interest, such as the left atrial chamber of a subject'"'"'s heart. Directional indicators on the visualized tissue as well as the imaging systems may be utilized while other variations may utilize image rotation or manipulation of visualized tissue regions to facilitate catheter control. Moreover, visualized tissue regions may be combined with imaged tissue regions as well as navigational information to further facilitate tissue treatments.

Claims

1. A method for assessing a tissue region of interest within a blood-filled environment, comprising:

advancing a deployment catheter within a body towards the tissue region of interest, the deployment catheter having a reconfigurable barrier or membrane attached to a distal end of the catheter, wherein the barrier or membrane is reconfigurable from a low-profile delivery configuration to an expanded deployment configuration which defines an open area;

introducing a purging fluid through the catheter and into the open area when the barrier or membrane is positioned in proximity to the tissue region of interest, where the open area is in fluid communication with an environment external to the barrier or membrane;

visualizing the tissue region of interest through the purging fluid restrained temporarily within the open area;

projecting a computer generated model representative of the barrier or membrane onto a model representative of the tissue region of interest where the model of the barrier or membrane includes at least one directional indicator;

flashing the at least one directional indicator in response to at least one sensor being contacted on a handle assembly attached to a proximal end of the catheter where the at least one sensor is coordinated with the at least one directional indicator.

2. The method of claim 1 wherein visualizing the tissue region of interest comprises viewing an image of the tissue region upon a first monitor.

3. The method of claim 2 wherein projecting a computer generated model comprises viewing the model upon a second monitor.

4. The method of claim 1 wherein the model of the barrier or membrane includes at least four directional indicators.

5. The method of claim 4 wherein flashing comprises contacting at least one of four sensors on the handle assembly corresponding to the at least four directional indicators.

6. A method for navigating relative to a tissue region of interest within a blood-filled environment, comprising:

advancing a deployment catheter within a body towards the tissue region of interest, the deployment catheter having a reconfigurable barrier or membrane attached to a distal end of the catheter, wherein the barrier or membrane is reconfigurable from a low-profile delivery configuration to an expanded deployment configuration which defines an open area;

introducing a purging fluid through the catheter and into the open area when the barrier or membrane is positioned in proximity to the tissue region of interest, where the open area is in fluid communication with an environment external to the barrier or membrane;

visualizing the tissue region of interest through the purging fluid restrained temporarily within the open area; and

,

rotating an image of the tissue region of interest upon a monitor such that a direction of articulation of a control on a handle assembly attached to a proximal end of the catheter is maintained whereby articulation of the control in a first direction articulates the image of the tissue region in a corresponding first direction regardless of an orientation of the handle assembly.

7. The method of claim 6 wherein visualizing the tissue region of interest comprises viewing an image of the tissue region upon a first monitor.

8. The method of claim 6 further comprising projecting a computer generated model representative of the barrier or membrane onto a model representative of the tissue region of interest.

9. The method of claim 6 wherein rotating further comprises calibrating an initial position of the handle assembly relative to a first position.

10. A method for assessing a tissue region of interest within a blood-filled environment, comprising:

advancing a deployment catheter within a body towards the tissue region of interest, the deployment catheter having a reconfigurable barrier or membrane attached to a distal end of the catheter, wherein the barrier or membrane is reconfigurable from a low-profile delivery configuration to an expanded deployment configuration which defines an open area;

introducing a purging fluid through the catheter and into the open area when the barrier or membrane is positioned in proximity to the tissue region of interest, where the open area is in fluid communication with an environment external to the barrier or membrane;

visualizing the tissue region of interest through the purging fluid restrained temporarily within the open area;

projecting a computer generated model representative of the barrier or membrane onto a model representative of the tissue region of interest; and

,

imposing an image of the tissue region visualized through the purging fluid upon the model representative of the tissue region of interest in proximity to the model representative of the barrier or membrane.

11. The method of claim 10 wherein visualizing the tissue region of interest comprises viewing an image of the tissue region upon a first monitor.

12. The method of claim 11 wherein projecting a computer generated model comprises viewing the model upon a second monitor.

13. The method of claim 10 further comprising imposing a plurality of adjacent images of the tissue region visualized through the purging fluid.

14. A method for navigating relative to a tissue region of interest within a blood-filled environment, comprising:

advancing a deployment catheter within a body towards the tissue region of interest, the deployment catheter having a reconfigurable barrier or membrane attached to a distal end of the catheter, wherein the barrier or membrane is reconfigurable from a low-profile delivery configuration to an expanded deployment configuration which defines an open area;

introducing a purging fluid through the catheter and into the open area when the barrier or membrane is positioned in proximity to the tissue region of interest, where the open area is in fluid communication with an environment external to the barrier or membrane;

visualizing the tissue region of interest through the purging fluid restrained temporarily within the open area; and

,

projecting a computer generated model representative of the barrier or membrane onto a model representative of the tissue region of interest; and

,

selecting one or more regions for treatment upon the model representative of the tissue region of interest; and

indicating directional information upon an image of the visualized tissue region of interest corresponding to the one or more regions selected for treatment.

15. The method of claim 14 wherein visualizing the tissue region of interest comprises viewing an image of the tissue region upon a first monitor.

16. The method of claim 15 wherein projecting a computer generated model comprises viewing the model upon a second monitor.

17. The method of claim 14 wherein selecting comprise selecting one or more regions to be ablated about a pulmonary vein ostium.

18. The method of claim 14 wherein indicating comprises indicating a region of tissue to be ablated upon the image.

19. The method of claim 18 further comprising indicating a distance to an adjacent region of tissue to be ablated upon the image.

20. The method of claim 14 further comprising indicating one or more anatomical landmarks in proximity to the tissue region of interest.