Intradural endoscope

• US 9,504,372 B2
• Filed: 11/12/2010
• Issued: 11/29/2016
• Est. Priority Date: 11/13/2009
• Status: Active Grant

• Current Assignee: Daniel H. Kim
• Original Assignee: Daniel H. Kim
• Inventors: Kim, Daniel H.
• Primary Examiner(s): HENDERSON, RYAN N
• Application Number:
  US13/509,571
• Publication Number:
  US 20120296166A1
• Time in Patent Office: 2,209 Days
• Field of Search: 600/104, 600/106, 600/107, 600114-116, 600239-152, 604/506, 604 9501- 9505, 604/528, 606/1
• US Class Current: 1/1
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00

Abstract

A method for treating a patient includes inserting an endoscope into an intradural space of the patient via an interspace of a vertebral column of the patient; steering the endoscope along the intradural space to a location; and performing a medical procedure at the location using a working lumen of the endoscope.

Claims

1. A method for treating a patient, comprising:

inserting an endoscope tube into an intradural space of the patient via an interspace of a vertebral column of the patient, wherein the endoscope tube has an electroactive tip, a guide portion containing one or more actuators, and a maximum outer diameter of less than 2.5 mm;

steering the endoscope tube along the intradural space to a location by causing the electroactive tip to bend via an electrical signal directly supplied to the electroactive tip and along an electrical cable extending along a steering lumen of the endoscope tube and a steering system in communication with the electrical cable while visually monitoring the steering using an optical lumen of the endoscope tube and a video monitor in communication with the optical lumen, wherein the steering system comprises;

a computer having a microprocessor, a memory, a monitor, a first controller and a second controller, wherein the microprocessor translates movements from the first controller into commands and sends the commands to a tip controller to operate the one or more actuators, and wherein the microprocessor translates movements from the second controller into commands to advance or retract the endoscope tube;

once the endoscope tube has been steered to the location, inserting a medical device through a working lumen of the endoscope tube; and

performing a medical procedure at the location using the medical device while visually monitoring the medical procedure using the optical lumen and the video monitor.

2. The method of claim 1, wherein the intradural space is a spinal subarachnoid space.

3. The method of claim 1, wherein:

the endoscope tube is inserted through a cannula or sheath, and

the method further comprises operating a dural closer while removing the cannula or sheath.

4. The method of claim 1, wherein:

the endoscope tube is inserted through a cannula or sheath, and

the method further comprises operating a dural puncture element while positioning the cannula or sheath.

5. The method of claim 1, wherein the medical procedure is implantation of electrodes.

6. The method of claim 1, wherein the medical procedure is diagnostic or therapeutic neuromodulation.

7. The method of claim 1, wherein:

the endoscope tube carries a guidewire in a guide lumen thereof, and

the method further comprises removing the endoscope tube from the intradural space and leaving the guidewire in place.

8. The method of claim 1, further comprising deploying an auxiliary endoscope through the working lumen before insertion of the medical device or after removal of the medical device from the working lumen.

9. The method of claim 1, wherein the interspace is a cervical interspace.

10. The method of claim 2, wherein the endoscope tube is steered along the spinal subarachnoid space into an intracranial subarachnoid space.

11. The method of claim 1, wherein the maximum outer diameter of the tube is less than or equal to 1 mm.

12. The method of claim 1, wherein the steering system comprises

a robot operable to articulate the tube.

13. The method of claim 1, wherein:

the electroactive tip has a tracking device in communication with the steering system, and

the steering system displays a position of the electroactive tip.

14. The method of claim 1, wherein:

the electroactive tip has one or more biosensors in communication with the steering system, and

the steering system displays data from the biosensors.

15. The method of claim 1, wherein:

the electroactive tip has a strain gage in communication with the steering system, and

the steering system displays an orientation of the electroactive tip.