DIRECT DRIVE ENDOSCOPY SYSTEMS AND METHODS

• US 20080188868A1
• Filed: 11/28/2007
• Published: 08/07/2008
• 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, Shaw, William J., Suon, Naroun, Golden, John B., Smith, Paul J., Intoccia, Brian J.
• Granted Patent: US 9,345,462 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• 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 facilitating control of a tool or tools. The systems can allow a user to control multiple degrees of freedom. One such system allows a user to control multiple degrees of freedom of two tools simultaneously. Another such system allows a user to control multiple degrees of freedom with a single hand. Frames and rails for supporting and/or constraining movement of a tool or tools are also described herein.

Claims

1. A drive system for simultaneously controlling multiple degrees of freedom, the system comprising:

at least one tool, the tool comprising

an elongate body extending between a proximal and distal end,

a controller for receiving user input and mechanically transmitting those user inputs to a distal manipulation segment, and

a distal end,

wherein the controller can direct at least one degree of freedom of the distal end; and

a frame configured to mate with the tool and wherein the controller of the at least one tool is movably connected with the frame, such that the controller can move relative to the frame to allow a user to control at least two degrees of freedom of the tool with respect to the frame and while allowing simultaneously control of the at least one degrees of freedom of the distal end via the controller.

2. The system of claim 1, wherein the controller can direct at least two degrees of freedom of the distal end via the manipulation segment and can control an additional degree of freedom of the distal end by actuation of a distal end effector.

3. The system of claim 1, wherein a user'"'"'s input to the controller can simultaneously control movement of the manipulation segment and movement of the tool relative to the frame.

4. The system of claim 1, wherein the controller includes a handle, wherein movement of the handle relative to a body of the controller controls the at least one degree of freedom.

5. The system of claim 4, wherein the at least one degree of freedom is movement of the manipulation segment.

6. The system of claim 1, wherein the frame is adapted to mate with a patient.

7. The system of claim 1, wherein frame is fixed with respect to a patient.

8. The system of claim 1, further comprising an optical device.

9. The system of claim 1, wherein the tool can translate and rotate relative to the frame.

10. The system of claim 9, wherein tool translation is movement along a longitudinal axis parallel to an axis defined by the elongate body of the tool.

11. The system of claim 9, wherein the tool is constrained to movement parallel to an axis and rotation around the axis.

12. The system of claim 1, further comprising a rail that movably mates the tool and the frame.

13. The system of claim 12, wherein the rail constrains movement of the controller with respect to the frame to movement along axes parallel to an axis defined by the rail.

14. The system of claim 13, wherein the rail is parallel to an axis defined by the elongate body of the tool.

15. The system of claim 12, wherein the rail includes proximal and distal stops to limit longitudinal movement of the controller.

16. The system of claim 12, further comprising an electrically conductive pathway extending between the rail and the controller.

17. The system of claim 12, further comprising indicia on the rail, frame, and/or controller for indicating the relative position and/or orientation of the distal end.

18. The system of claim 12, wherein the rail has a non-linear shape.

19. The system of claim 1, further comprising a guide tube having at least one lumen sized and shaped for the passage of the elongate body.

20. The system of claim 19, wherein the guide tube comprises a rail and the tool is movably mated with the rail.

21. The system of claim 1, further comprising a lock for inhibiting movement of the manipulation section of the tool when engaged.

22. A drive system for simultaneously controlling multiple degrees of freedom, the system comprising:

a first tool including a first distal end effector connected with a first controller, wherein the first controller includes a handle that allows a user to simultaneously control at least three degrees of freedom of the first tool with a single hand;

a second tool including a second distal end effector connected with a second controller, wherein the second controller includes a handle that allows a user to simultaneously control at least three degrees of freedom of the second tool with a single hand; and

a frame, wherein the first and second tools are movably mated with the frame.

23. The system of claim 22, wherein the frame comprises first and second rails mated with the first and second tools, respectively.

24. The system of claim 22, wherein the first and second tools can translate and/or rotate with respect to a patient via movement of the first and second rails with respect to the frame.

25. The system of claim 22, wherein the first and second tools can be operated by a user simultaneously.

26. The system of claim 22, wherein the system is adapted to allow a user to drive at least eight degrees of freedom of the first and second tools via the first and second controllers.

27. The system of claim 26, wherein a single user can direct the at least eight degrees of freedom.

28. The system of claim 22, further comprising a guide tube.

29. The system of claim 28, wherein the guide tube provides at least one additional degree of freedom to the system.

30. The system of claim 22, wherein at least one of the three degrees of freedom of the first tool is rotation of the first distal end effector relative to the first controller.

31. A drive system for simultaneously controlling multiple degrees of freedom, the system comprising:

a first tool including a first distal end connected with a first controller, wherein the first controller includes a handle that allows a user to simultaneously control at least three degrees of freedom of the first tool with a single hand;

a second tool including a second distal end connected with a second controller, wherein the second controller includes a handle that allows a user to simultaneously control at least three degrees of freedom of the second tool with a single hand; and

a first and a second frame, wherein the first and second tools are movably mated with the first and second frames, respectively.

32. A direct drive system, comprising:

an elongate guide tube extending between a proximal and distal end, the guide tube comprising at least one working channel for at least one tool, the guide tube having at least one distal opening and at least one proximal opening;

a first tool including an elongate body extending between and proximal and distal end, a distal end effector, and a controller, the elongate body sized such that the distal end effector can be positioned proximate to the distal opening of the guide tube while the controller extends from the at least one proximal opening of the guide tube, the first tool including a connection between the controller and distal end effector for transmitting force to the end effector, wherein the connection can direct at least two degrees of freedom of the distal end effector; and

a frame configured to support the first tool, wherein the controller of the first tool mates with the frame and allows a user to move the controller relative to the guide tube while manipulating the at least two degrees of freedom of the first tool via the controller.

33. The system of claim 32, wherein the frame include a first rail.

34. The system of claim 33, wherein the controller is detachably mated with the first rail.

35. The system of claim 33, further comprising an optical device mated with the frame.

36. The system of claim 33, further comprising a second rail configured to support a second tool.

37. The system of claim 33, wherein the controller can translate and rotate with respect to the frame.

38. The system of claim 33, wherein a the connection between the controller and the rail allows simultaneous longitudinal and rotational movement.

39. A method of simultaneously controlling multiple degrees of freedom of a tool, the method comprising:

providing a tool comprising a distal end, an elongate body, and a controller for controlling at least one degree of freedom of the distal end;

moving the tool relative to a frame to control at least two degrees of freedom of the tool; and

manipulating, simultaneously, the controller to control the at least one degree of freedom of the distal end.

40. The method of claim 39, wherein the controller mates with the frame via a rail.

41. The method of claim 39, wherein the step of moving includes applying forces on the controller to move the tool with respect to the frame

42. A method of simultaneously controlling multiple degrees of freedom of a drive system, the method comprising:

providing a drive system comprising;

a tool having a distal end effector, an elongate body, and a controller for controlling at least one degree of freedom of the distal end effector;

a frame movably mated with the controller; and

a guide tube;

moving the tool relative to the guide tube to control at least two degrees of freedom of the tool; and

manipulating, simultaneously, the controller to control the at least one degree of freedom of the distal end effector.

43. A method of simultaneously controlling multiple degrees of freedom of a drive system, the method comprising:

providing first and second tools movably mated with a frame, the first tool including a first distal end effector, a first elongate body, and a first controller and the second tool including a second distal end effector, a second elongate body, and a second controller;

manipulating the first controller to simultaneously control at least three degrees of freedom of the system; and

manipulating the second controller to simultaneously control at least three additional degrees of freedom of the system.

44. The method of claim 43, wherein manipulating the first controller includes moving the first tool with respect to a frame and controlling movement of the first distal end effector.

45. An adjustable frame for supporting a surgical instrument comprising:

a surgical instrument comprising an elongate catheter body, a distal end, and a controller for controlling at least one degree of freedom of the distal end via user inputs to the controller;

a frame for supporting the surgical instrument, the frame including a first and a second body member, the controller movably connected with the first body member and having at least two degrees of freedom with respect to the first body member, wherein the movable connection between the first body member and the controller constrains movement of the controller within a given volume, the second body member being fixedly connected to a point of reference; and

an adjustable connection between the first and second body members, wherein movement of the first body member with respect to the second body member allows a user to change the location of the volume in which the controller is constrained.

46. The frame of claim 45, wherein the first body member is a rail.

47. The frame of claim 45, wherein the first body member constrains movement of the controller to movement along parallel axes.

48. The frame of claim 47, wherein the adjustable connection allow a user to change the orientation of the axes.

49. The frame of claim 45, wherein the second body member includes mating features for mating to a structure in an operating theater.

50. The frame of claim 45, wherein the second body member includes mating features for mating with a patient or operating room furniture.

51. The frame of claim 45, wherein the second body member mates with a movable base.

52. A frame for supporting a guide tube comprising:

a surgical instrument comprising an elongate catheter body, a distal end, and a controller for controlling at least one degree of freedom of the distal end;

an elongate guide tube having at least one channel for the passage of the catheter body; and

a frame, the controller movably and detachably connected with the frame and having at least two degrees of freedom of movement with respect to the frame and the guide tube detachably connected with the frame.

53. The frame of claim 52, wherein the frame includes a rail and the controller is movably mated with the rail.

54. The frame of claim 53, wherein the controller is detachably mated with the rail.

55. The frame of claim 53, wherein the rail is detachable mated with the frame.

56. The frame of claim 52, wherein the connection between the guide tube and frame is a quick disconnect.

57. The frame of claim 52, wherein the connection between the controller and frame is a quick disconnect.

58. The frame of claim 52, wherein the frame constrains movement of the controller to movement along axes parallel to one another.

59. The frame of claim 52, wherein the frame is adjustable to allow movement of the guide tube and/or controller with respect to a point of reference while the guide tube and/or controller is connected to the frame.

60. A guide tube for supporting an instrument comprising:

a surgical instrument comprising an elongate catheter body, a distal end effector, and a controller for controlling at least one degree of freedom of the distal end effector; and

an elongate guide tube having at least one channel for the passage of the catheter body, the guide tube including proximal controls and a distal articulating section, the controller movably connected with the guide tube and having at least two degrees of freedom with respect to the guide tube,

wherein the guide tube supports the controller and the movable connection constrains movement of the controller with respect to the guide tube.

61. The guide tube of claim 60, wherein the movable connection comprises a rail mounted on the guide tube.

62. The guide tube of claim 60, wherein the movable connection comprises a rail defined by a portion of the guide tube

63. The guide tube of claim 61, wherein the rail is positioned adjacent to the proximal controls of the guide tube.

64. The guide tube of claim 60, wherein a single user can manipulate the controller of the surgical instrument and the proximal controls of the guide tube at the same time.

65. The guide tube of claim 60, wherein the guide tube is detachably mated with a frame.

66. An adjustable system for supporting a surgical instrument comprising:

a surgical instrument comprising an elongate catheter body, a distal end effector, and a controller for controlling at least one degree of freedom of the distal end effector via user inputs to the controller;

an elongate guide tube having at least one channel for the passage of the catheter body, wherein manipulating the controller moves the distal end effector within a working volume adjacent to the distal end of the guide tube;

a frame for supporting the surgical instrument, the guide tube adjustably connected with frame, wherein moving the guide tube relative to the frame via the adjustable connection allows a user to change the location of the working volume.

67. The system of claim 66, wherein the guide tube further comprises an articulation section.

68. The system of claim 67, wherein articulating the guide tube moves the location of the working volume.

69. The system of claim 66, wherein the guide tube is detachably mated with the frame.