Precision control systems for tissue visualization and manipulation assemblies

• US 10,070,772 B2
• Filed: 05/12/2009
• Issued: 09/11/2018
• Est. Priority Date: 09/01/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Peh, Ruey-Feng, Saadat, Vahid, Tam, Edmund
• Primary Examiner(s): Chen, Tse
• Assistant Examiner(s): IP, JASON M
• Application Number:
  US12/464,800
• Publication Number:
  US 20090221871A1
• Time in Patent Office: 3,409 Days
• Field of Search: 600407, 600424, 600433-435, 600466-468, 600470, 600471, 606130
• 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 1/005 Flexible endoscopes
• 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 1/04 combined with photographic or television appliances
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• 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 5/02007 : Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for

Abstract

Precision control systems for tissue visualization and manipulation assemblies are described herein where such devices may utilize a variety of apparatus and methods for facilitating advancement, articulation, control, navigation, etc. of systems which may be used to visualize and/or treat tissue regions. Additionally, methods and devices for enhancing navigation of the device through a patient body are also described.

Claims

1. A computer-assisted treatment system comprising:

a delivery catheter defining at least one lumen therethrough;

a computer-controlled guidance assembly including one or more actuation members;

a processor coupled to and in electrical communication with the computer-controlled guidance assembly;

a deployment catheter which is positionable through the at least one lumen of the delivery catheter and through which the one or more actuation members extend;

a self-expanding fluid impermeable barrier coupled to a distal end of the deployment catheter by a pivot assembly attached to the one or more actuation members, wherein the self-expanding fluid impermeable barrier is constrained to movement by the one or more actuation members about at least one axis of the pivot assembly;

a section of the deployment catheter positioned proximal of the self-expanding fluid impermeable barrier, the section having multiple cut-outs;

an imager carried by the deployment catheter for generating an image of a tissue surface through an open area defined by the self-expanding fluid impermeable barrier in an expanded state, the imager positioned within the open area such that movement of the self-expanding fluid impermeable barrier about the pivot assembly causes a corresponding movement of the imager about the pivot assembly; and

a display couplable to the imaging assembly so as to display the tissue surface image.

2. The system of claim 1 further comprising a tracking system transmitting position feedback signals to the processor, wherein the processor transmits drive signals for the computer-controlled guidance assembly using the position feedback signals.

3. The system of claim 1 wherein actuation of the one or more actuation members moves the self-expanding fluid impermeable barrier within a first plane about the pivot assembly and within a second plane transverse to the first plane in response to signals from the computer-controlled guidance assembly.

4. The system of claim 1 wherein the computer-controlled guidance assembly comprises one or more drive assemblies coupled to the one or more actuation members.

5. The system of claim 1 further comprising a drive assembly configured to retract the delivery catheter from the fluid impermeable barrier.

13. The system of claim 1 wherein the pivot assembly includes first and second hinge joints.

14. The system of claim 1 wherein at least one of the one or more actuation members is coupled to the fluid barrier.

15. The system of claim 1 wherein the one or more actuation members includes one or more pullwires.

16. The system of claim 1 wherein the at least one axis of the pivot assembly is defined by a pin.

6. A computer-assisted method of treating a patient tissue region comprising:

actuating a distal end of a deployment catheter with one or more actuation members extending through the deployment catheter, the distal end of the deployment catheter coupled to a self-expanding fluid impermeable barrier by a pivot assembly attached to the one or more actuation members, the catheter having a section having multiple cut-outs proximal of the pivot assembly;

actuating, with the one or more actuation members, the self-expanding fluid impermeable barrier, the self-expanding fluid barrier being constrained to movement about at least one axis of the pivot assembly;

locally displacing patient fluid from an open area defined by the barrier in an expanded state, the open area disposed adjacent the tissue region; and

visualizing, on a display, through use of an imager positioned within the open area such that movement of the self-expanding fluid impermeable barrier about the pivot assembly causes corresponding movement of the imager about the pivot assembly, the tissue region within the open area.

7. The method of claim 6 wherein actuating the distal end comprises rotating one or more drive assemblies coupled to the one or more actuation members.

8. The method of claim 7 wherein rotating one or more drive assemblies in a first rotational direction urges the distal end of the deployment catheter to deflect in a first direction and rotating one or more drive assemblies in a second rotational direction opposite to the first rotational direction urges the distal end of the deployment catheter to deflect in a second direction opposite to the first direction.

9. The method of claim 6 further comprising deploying the barrier from a delivery configuration within a delivery catheter into an expanded deployed configuration external of a distal portion of the delivery catheter.

10. The method of claim 6 further comprising positioning the deployment catheter so that an open area defined by the self-expanding fluid impermeable barrier is against or adjacent to the tissue region.

11. The method of claim 6 further comprising advancing the distal end of the deployment catheter toward the patient tissue region.

12. The method of claim 6 further comprising actuating the one or more actuation members to move the self-expanding fluid impermeable barrier in at least two transverse planes about the pivot assembly.