Complex shape steerable tissue visualization and manipulation catheter

• US 9,155,452 B2
• Filed: 04/24/2008
• Issued: 10/13/2015
• Est. Priority Date: 04/27/2007
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Rothe, Chris A., Miller, David, Saadat, Vahid, Peh, Ruey-Feng, Tam, Edmund
• Primary Examiner(s): HENDERSON, RYAN N
• Application Number:
  US12/108,812
• Publication Number:
  US 20080275300A1
• Time in Patent Office: 2,728 Days
• Field of Search: 600/104, 600/106, 600114-116, 600/127, 600/129, 600139-142, 600/146, 600374-375, 600/381, 600/407, 600/424, 600433-435, 600/466, 600/467, 600/471, 600/478, 600/508, 600/509, 600/585, 604/104, 604/264, 604507-510, 604/528, 606/15, 606/41
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00006 of control signals
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/00096 Optical elements
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• 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 1/008 Articulations
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• 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 2018/00577 Ablation
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61M 2025/0161 wherein the distal tips have two or more deflection regions
• CPC Class Codes: A61M 25/0138 : having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires

Abstract

Complex shape steerable tissue visualization and manipulation catheters and their methods of use of disclosed herein. The deployment catheter may be articulated utilizing various steering mechanisms to adjust a position of a visualization hood or membrane through which underlying tissue may be visualized.

Claims

1. A method of accessing difficult-to-reach target tissue in a region of a body having continuous interfering blood flow, the method comprising:

advancing a deployment catheter shaft having an articulatable assembly near or at a distal portion of the catheter shaft into the region of the body, the articulatable assembly having a proximal steerable section and a distal steerable section fixedly connected, wherein the distal steerable section is positioned distal to the proximal steerable section;

bending the proximal steerable section such that a hood attached to a distal end of the distal steerable section is articulated in a first plane relative to a longitudinal axis of the catheter shaft, wherein the hood projects distally from the distal end of the distal steerable section and defines an open area therein in fluid communication with an environment distal of a distal opening defined by the hood and further has at least one membrane extending over the distal opening such that the at least one membrane partially covers the open area;

bending the distal steerable section in one or more additional planes relative to a longitudinal axis of the proximal steerable section such that the hood is positioned in proximity to the target tissue;

bending the hood with respect to the distal steerable section through use of steerable members integrated with the hood;

infusing a fluid through the catheter shaft and into the open area such that the infused fluid displaces blood from within the open area to an environment external to the hood through at least one aperture defined along the hood; and

visualizing the target tissue within the open area through the infused fluid.

2. The method of claim 1 wherein advancing comprises advancing the deployment catheter into a heart of a patient.

3. The method of claim 1 wherein bending the proximal section comprises constraining the proximal section to curve within the first plane.

4. The method of claim 1 wherein bending the distal section comprises bending the distal section in a plurality of planes relative to the longitudinal axis of the catheter.

5. The method of claim 1 further comprising positioning the open area of the hood against or adjacent to the target tissue.

6. The method of claim 1 wherein infusing a fluid comprises infusing a transparent fluid into the open area defined by the hood.

7. The method of claim 1 further comprising visualizing the target tissue within the open area through the transparent fluid via an imager integrated with the deployment catheter shaft.

8. The method of claim 1 further comprising ablating at least a portion of the target tissue within the open area.

9. The method of claim 8 further comprising ablating tissue circumferentially surrounding an ostium of a pulmonary vein.

10. The method of claim 1 further comprising repositioning the hood relative to the target tissue by re-articulating the distal section.

11. A method of accessing a target tissue in a chamber of a heart, the method comprising:

advancing a deployment catheter shaft having an articulatable assembly near or at a distal portion of the catheter shaft into a region of the body, the articulatable assembly having a proximal steerable section and a distal steerable section fixedly connected, the distal steerable section being positioned distal to the proximal steerable section and further having a hood projecting distally from the distal steerable section, wherein the hood defines an open area therein in fluid communication with an environment distal of a distal opening defined by the hood and further has at least one membrane extending over the distal opening such that the at least one membrane partially covers the open area;

positioning the distal steerable section within range of the target tissue by bending the proximal steerable section such that a distal end of the distal steerable section bends in a first plane relative to a longitudinal axis of the catheter shaft;

bending the distal steerable section in two planes relative to a longitudinal axis of the proximal steerable section such that the hood is positioned in proximity to the target tissue;

bending the hood with respect to the distal steerable section through use of steerable members integrated with the hood;

infusing a fluid through the catheter shaft and into the open area such that the infused fluid displaces blood from within the open area to an environment external to the hood through at least one aperture defined along the membrane; and

visualizing the target tissue through the fluid retained temporarily within the open area.