Guide tube systems and methods

• US 9,084,621 B2
• Filed: 11/28/2007
• Issued: 07/21/2015
• Est. Priority Date: 12/01/2006
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Weitzner, Barry, Smith, Paul J., Golden, John B., Intoccia, Brian J., Suon, Naroun, Krueger, Katie, Tinkham, Brian, Weisman, Michal, Krueger, Brett A.
• Primary Examiner(s): Price, Nathan R
• Application Number:
  US11/946,812
• Publication Number:
  US 20080243176A1
• Time in Patent Office: 2,792 Days
• Field of Search: 604/95.01, 604/95.04, 604/164.13, 604523-528
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00042 for mechanical operation
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/0014 Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
• CPC Class Codes: A61B 1/00147 Holding or positioning arrangements
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/00183 for variable viewing angles
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/0057 Constructional details of force transmission elements, e.g. control wires
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 2017/00212 using remote controls
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/003 : Steerable
• CPC Class Codes: A61B 2017/00314 : Separate linked members
• CPC Class Codes: A61B 2017/00323 : Cables or rods
• CPC Class Codes: A61B 2017/00331 : with preformed bends
• CPC Class Codes: A61B 2017/0034 : adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00353 : one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00362 : Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/00371 : Multiple actuation, e.g. pushing of two buttons, or two working tips becoming operational
• CPC Class Codes: A61B 2017/00398 : using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00469 : for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/00876 : magnetic
• CPC Class Codes: A61B 2017/00973 : pedal-operated
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2906 : Multiple forceps
• CPC Class Codes: A61B 2017/2931 : with releasable head
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Disclosed herein are various systems and methods for guiding, supporting, and/or housing instruments. One exemplary system includes a guide tube having a manipulation section and mated with rails carrying instrument control members. Moving the rails with respect to the guide tube, or another point of reference, can control movement of the manipulation section.

Claims

1. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a longitudinal axis, a handle, and a distal end;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the elongate body, wherein the elongate body is moveably mated with the rail to permit movement of the instrument along or about the longitudinal axis of the rail; and

an elongate guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the distal end of the guide tube including an articulation section having at least one degree of freedom and the proximal end of the guide tube mated with the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section.

2. The system of claim 1, further comprising two rails mated with the guide tube and two instruments, wherein each instrument is mated with only one of the two rails.

3. The system of claim 1, wherein movement of the rail drives an elongate control member extending between the articulation section of the guide tube and the rail.

4. The system of claim 1, wherein the articulation section has at least two degrees of freedom and the movement of the rail controls the at least two degrees of freedom.

5. The system of claim 1, wherein the guide tube further comprises a proximal housing having a first pivot point around which the rail rotates generally perpendicular to the longitudinal axis of the rail to permit movement of the rail relative to the guide tube.

6. The system of claim 1, wherein the distal end of the instrument is configured to move relative to the distal end of the guide tube by corresponding movement of the instrument relative to the rail.

7. The system of claim 1, wherein the elongate body slideably engages the rail to permit movement of the instrument relative to the rail.

8. The system of claim 1, wherein the rail includes a lumen configured to receive at least part of the instrument.

9. The system of claim 8, wherein the lumen is configured to receive at least part of the elongate body of the instrument.

10. The system of claim 9, wherein the elongate body includes a rigid section configured to engage the lumen.

11. The system of claim 1, wherein the handle includes a trigger configured to actuate an end effector located at the distal end of the instrument.

12. The system of claim 11, wherein the trigger is biased.

13. The system of claim 1, wherein the guide tube includes a catheter.

14. The system of claim 3, wherein the elongate control member includes a control cable.

15. The system of claim 14, wherein the control cable includes a first section that is detachable from a second section.

16. The system of claim 15, wherein an end of the first section includes a pin configured to engage an end of the second section.

17. The system of claim 16, wherein the pin is biased.

18. The system of claim 5, wherein rotation about the first pivot point moves the articulation section in a first direction.

19. The system of claim 18, wherein the proximal housing has a second pivot point around which the rail rotates to permit movement of the rail relative to the guide tube to move the articulation section in a second direction different to the first direction.

20. The system of claim 19, wherein the first pivot point has a first axis of rotation and the second pivot point has a second axis of rotation that is generally perpendicular to the first axis of rotation.

21. The system of claim 1, further including

a joint coupling the rail to the guide tube to permit movement of the rail relative to the guide tube to control movement of the articulation section.

22. The system of claim 21, wherein the rail includes a sleeve configured to receive at least part of the instrument.

23. The system of claim 21, wherein the rail includes a lumen configured to receive at least part of the elongate body.

24. The system of claim 23, wherein the elongate body includes a rigid linear section configured to engage the lumen.

25. The system of claim 21, further including at least one elongate control member configured to transmit a mechanical force to the articulation section.

26. The system of claim 25, wherein the at least one elongate control member is coupled to at least one of the joint and the rail.

27. The system of claim 26, wherein the at least one elongate control member includes a first section that is detachable from a second section.

28. The system of claim 21, wherein the joint is lockable to limit the movement of the rail relative to the guide tube.

29. The system of claim 21, wherein the joint includes a first axis of rotation to permit rotational movement of the rail relative to the guide tube to move the articulation section in a left/right direction.

30. The system of claim 29, wherein the joint includes a second axis of rotation generally orthogonal to the first axis of rotation to permit rotational movement of the rail relative to the guide tube to move the articulation section in an up/down direction.

31. The system of claim 21, wherein the instrument includes a rotational control knob configured to rotate the distal end of the instrument relative to the distal end of the guide tube.

32. The system of claim 21, wherein the handle includes a trigger configured to actuate an end effector located at the distal end of the instrument.

33. The system of claim 21, wherein the guide tube includes a catheter.

34. The system of claim 21, wherein the joint is coupled to a proximal end of the guide tube and a distal end of the rail.

35. The system of claim 1, wherein the articulation section is fixedly attached to the guide tube.

36. The system of claim 1, wherein the guide tube is flexible.

37. The system of claim 1, wherein the handle is configured to control a distally-located end effector and a distally-located bending section.

38. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a proximal region with a longitudinal axis, and a handle;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the elongate body is moveably mated with the rail to permit movement of the instrument about the longitudinal axis of the rail; and

an elongate guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the distal end of the guide tube including an articulation section having at least one degree of freedom and the proximal end of the guide tube mated with the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section.

39. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a flexible distal region, a rigid proximal region with a longitudinal axis, and a handle;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the proximal region is moveably mated with the rail to permit movement of the instrument along or about the longitudinal axis of the rail; and

an elongate guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the distal end of the guide tube including an articulation section having at least one degree of freedom and the proximal end of the guide tube mated with the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section.

40. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a flexible distal region, a rigid proximal region with a longitudinal axis, and a handle configured to control a distally-located articulation section coupled to the elongate body;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the proximal region is moveably mated with the rail to permit movement of the instrument along or about the longitudinal axis of the rail; and

an elongate guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the guide tube including a distally-located articulation section having at least one degree of freedom and a proximal region coupled to the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section of the guide tube.

41. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a flexible distal region, a rigid proximal region with a longitudinal axis, and a handle configured to control a distally-located end effector coupled to the flexible distal region;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the proximal region is moveably mated with the rail to permit movement of the instrument along or about the longitudinal axis of the rail; and

an elongate guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the guide tube including a distally-located articulation section having at least one degree of freedom and a proximal region coupled to the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section of the guide tube.

42. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a flexible distal region, a rigid proximal region with a longitudinal axis, and a handle;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the proximal region is moveably mated with the rail to permit movement of the instrument along or about the longitudinal axis of the rail; and

a flexible guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the guide tube including a distally-located articulation section having at least one degree of freedom and a proximal region coupled to the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section of the guide tube.

43. A system for controlling movement of a guide tube, comprising:

an instrument including a flexible elongate body having a proximal region with a longitudinal axis, and a handle;

a rail having a longitudinal axis aligned substantially parallel to the longitudinal axis of the proximal region, wherein the elongate body is moveably mated with the rail to permit movement of the instrument about the longitudinal axis of the rail; and

a flexible guide tube extending between a proximal end and a distal end and including at least one channel for the passage of the instrument, the guide tube including a distally-located articulation section having at least one degree of freedom and a proximal region coupled to the rail, wherein movement of the rail relative to the guide tube controls movement of the articulation section.