Drive systems and methods of use

• US 20080287862A1
• Filed: 01/11/2008
• Published: 11/20/2008
• Est. Priority Date: 05/18/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Weitzner, Barry, Smith, Paul, Barenboym, Michael, Golden, John, Kappel, Gary
• Granted Patent: US 9,533,122 B2
• Time in Patent Office: Days
• US Class Current: 604/28
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00446 for use only by lefthanded or only by righthanded persons
• 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 2034/715 Cable tensioning mechanisms for removing slack
• 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: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

Drive systems and methods of use are disclosed herein for performing medical procedures on a patient. The drive systems include various handle types and triggers for controlling catheters and end effectors. The various handle types include a flexible handle and ambidextrous handles that can alter the handedness of the handle for particularized use. The handles drive articulation sections of the catheter and end effectors with various degrees of freedom, and include locks for holding the catheter and/or end effector in place. The catheter systems include structures for allowing degrees of freedom, such as notches, mechanical interlocks, and articulation joints. In addition, the catheters articulate via cables or fluids.

Claims

1. A drive system, comprising:

a control handle including a flexible body extending between a first and second end, wherein at least two control wires extend along at least a portion of the flexible body proximate to opposing side surfaces of the flexible body, wherein bending the flexible body increases the length of one of the opposing side surfaces and causes a force to be applied to at least one of the control wires; and

a flexible shaft having an articulation section, wherein applying a force on at least one of the wires drives the articulation section.

2. The system of claim 1, wherein the flexible body includes an elastomic material.

3. The system of claim 2, wherein the control wires lays against an outer side surface of the elastomic material.

4. The system of claim 2, wherein the control wires are embedded within the elastomic material.

5. The system of claim 1, wherein the body includes a spring.

6. The system of claim 5, wherein the control wires lay against an outer side surface of the spring.

7. The system of claim 1, wherein the at least two control wires extend between the handle and the flexible shaft.

8. A drive system, comprising:

a control handle;

a pivoting member having a first set of teeth positioned on a curved surface; and

a second set of teeth positioned on a gear, wherein the gear is mated with a control wire for driving an articulating catheter,

wherein moving the control handle in a first plane drives the gear, and wherein moving the control handle in a second plane causes the first set of teeth to move relative to the second set of teeth without driving the gear.

9. The system of claim 8, further comprising a shaft mated with a second control wire.

10. The system of claim 9, wherein the member drives the shaft when moved in the second plane and does not drive the shaft when moved in the first plane.

11. The system of claim 8, wherein the member comprises a third set of teeth.

12. The system of claim 11, wherein a fourth set of teeth is meshed with the third set of teeth, the fourth set of teeth positioned on a gear mated with a second control wire.

13. The system of claim 8, further comprising a locking mechanism that allows for locking at least one set of teeth to eliminate a degree of freedom.

14. A method for controlling a catheter, comprising:

providing a control mechanism for articulating a catheter comprising;

a handle,

a first member having a curved surface with first teeth positioned thereon,

a second member with second teeth meshed with the first set of teeth,

a first control wire for controlling a first degree of freedom, and

a second control wire for controlling a second degree of freedom;

moving the handle in a first direction and driving the second member and second control wire; and

moving the handle is a second, different direction and driving the first member and first control wire without driving the second member,

wherein moving the handle in the first direction controls a first degree of freedom of a catheter articulation section and wherein moving the handle in the second direction controls a second degree of freedom of the catheter articulation section.

15. The method of claim 14, wherein moving the handle upward articulates the catheter upward.

16. The method of claim 14, wherein moving the handle in the first direction controls the first degree of freedom without driving the second degree of freedom.

17. A drive system, comprising:

a control handle that has at least three degrees of freedom;

a control mechanism coupled to the control handle;

a catheter including an articulation section; and

a cable including a proximal end and a distal end, wherein the proximal end is coupled to the control mechanism and the distal end is coupled to the articulation section,

wherein the cable articulates the articulation section by transferring force applied by the control handle.

18. The drive system of claim 17, wherein the control mechanism rotates around a first axis to transfer the force applied by the control handle.

19. A drive system, comprising:

a first tool adapted for use by a left hand; and

a second tool adapted for use by a right hand, the second tool comprising;

a control handle;

a housing containing a pivoting control mechanism being driven by the control handle;

a catheter having an articulation section; and

a first control wire including a proximal end and a distal end, the proximal end mating with the control mechanism and the distal end mating with the articulation section,

wherein the first control wire articulates the articulation section by transferring force applied by the control handle.

20. The drive system of claim 19, wherein the control handle includes a trigger, and the catheter includes an end effector that is driven by the control handle.

21. The drive system of claim 19, further comprising a locking mechanism that inhibits movement of the control handle in at least one direction.

22. The drive system of claim 21, wherein movement is prevented at the cable.

23. The drive system of claim 21, wherein movement is prevented at the control mechanism.

24. The drive system of claim 19, wherein the control mechanism includes a trunnion having at least one pulley.

25. A drive system, comprising:

a handle;

a control mechanism including a first pulley and a second pulley, the control mechanism being driven by the handle;

a catheter having an articulation section; and

a first control wire corresponding to the first pulley and a second control wire corresponding to the second pulley, the first and second control wires coupled to the articulation section,

wherein a first handle movement causes the first pulley to turn relatively more than the second pulley, and a second handle movement causes the second pulley to turn relatively more than the first pulley.

26. The drive system of claim 25, wherein the first handle movement causes substantially no turn in the second pulley.

27. The drive system of claim 25, wherein the handle drives the control mechanism by coupling to the control mechanism with a stem.

28. A drive system, comprising:

a control handle;

a control mechanism driven by the control handle;

a catheter; and

a first and second cable coupled between the control mechanism and the catheter,

wherein the cables are driven by opposing movements by the control handle, and the control mechanism pulls one cable without pushing the other cable.

29. The drive system of claim 28, wherein the control mechanism includes a trunnion with a first pulley that pulls the first cable and a second pulley that pulls the second cable.

30. A drive system, comprising:

a control handle having at least two sides including a first mating feature on the first side and a second mating feature;

a control mechanism for detachably mating with the control handle at either mating feature; and

a catheter including an articulation section, wherein applying a force on the control handle articulates the articulation section.

31. The drive system of claim 30, wherein the control mechanism is coupled to a control stem, and the control stem detachably mates with at least one of the mating structures.

32. The drive system of claim 30, wherein mating the control handle with the first mating feature orients the control handle for left-handed use and mating the control handle with the second mating feature orients the control handle for right-handed use.

33. The drive system of claim 30, wherein mating the control handle with the first mating feature orients the control handle in a joystick configuration.

34. The drive system of claim 30, wherein the control handle comprises a third mating feature.

35. The drive system of claim 34, wherein mating the control handle with the third mating feature orients the control handle in a joystick configuration.

36. The drive system of claim 30, wherein the second mating features is located on the second side, opposite from the first mating feature.

37. The drive system of claim 30, further comprising a switch that detaches the control mechanism from the mating structure.

38. The drive'"'"'system of claim 30, wherein at least one of the mating structures includes an opening.

39. The drive system of claim 30, wherein at least one of the mating structures includes a protrusion.

40. The drive system of claim 30, further comprising an end effector and a first cable for articulating the end effector;

and

wherein the ambidextrous control handle includes a trigger that applies force across the first cable when manipulated.

41. The drive system of claim 30, further comprising a locking mechanism that inhibits movement of the handle in at least one direction.

42. The drive system of claim 30, further comprising a second cable with a proximal end and a distal end, the proximal end coupled to the ambidextrous control handle and the distal end coupled to the articulation section.

43. A drive system, comprising:

an ambidextrous control handle including a first portion and a second portion, the two portions being rotatably coupled via a first rotatable connection, the first portion also being rotatably coupled with a control mechanism via a second rotatable connection, wherein rotating the first portion at the second rotatable connection and rotating second portion relative to the first portion changes the handedness; and

a catheter including an articulation section, wherein applying a force on the control handle articulates the articulation section.

44. The drive system of claim 43, further comprising:

a trigger; and

an end effector controlled by the trigger.

45. The drive system of claim 44, further comprising a trigger control cable that passes through the first rotatable connection, the trigger control cable having a first end coupled to the trigger and a second end coupled to the end effector.

46. The drive system of claim 43, further comprising:

a first lock for inhibiting movement at the first rotatable connection; and

a second lock for inhibiting movement at the second rotatable connection.

47. The drive system of claim 46, further comprising a switch for engaging at least one of the first and second locks.

48. The drive system of claim 43, further comprising a locking mechanism for inhibiting movement of the handle in at least one direction.

49. A drive system, comprising:

a control handle including a first portion and a second portion, wherein rotating the first portion around a first axis and the second portion around a second axis changes the handedness of the control handle;

a control body coupled to the control handle; and

a catheter including an articulation section, wherein applying a force on the control handle articulates the articulation section.

50. A drive system, comprising:

a control handle;

a trigger for manipulation by at least one of a user'"'"'s right hand digits while in a first orientation, the trigger coupled to the control handle;

a control body coupled to the control handle;

a moveable connection between the handle and control body that permits moving the trigger into a second orientation for manipulation of at least one of a user'"'"'s left hand digits; and

a catheter including an articulation section, wherein user inputs on the control drive at least two degrees of freedom of the articulation section.

51. The drive system of claim 50, wherein the at least one right hand digit is a right thumb, and the at least one left hand digits comprises a left thumb.

52. The drive system of claim 50, wherein the at least one right hand digit comprises a right index finger, and the at least one left hand digits comprises a left index finger.

53. A method for switching the handedness of a control handle on a surgical tool, comprising the steps of:

providing a tool that includes a control handle, a control body coupled to the control handle, and a catheter including an articulation section;

with a first hand, moving the handle relative to the control body to drive the articulation section of the catheter;

moving the control handle relative to the control body to change the handedness of the control handle; and

with a second hand, moving the handle relative to the control body to drive the articulation section of the catheter.

54. The method of claim 53, wherein moving the control handle relative to the control body to change the handedness of the control handle includes:

detaching the control handle from the control body; and

reattaching control handle to the control body at a second location on the control handle.

55. The method of claim 53, wherein moving the control handle relative to the control body to change the handedness of the control handle includes rotating the control handle around at least one axis.

56. A drive system, comprising:

a catheter body comprising;

multiple first segments mated with multiple second segments via first ball sockets that permit pivoting in a first direction, the mated multiple first and second segments comprising multiple first units,

wherein the multiple first units are mated within one another via second ball sockets that permit pivoting in a second direction,

wherein the first and second directions differ,

wherein the first and second ball sockets include rounded members inside sockets, each socket having an opening with a width less than a diameter of the corresponding curved member; and

at least one channel extended through the first and second segments for driving a surgical tool.

57. The drive system of claim 56, wherein the sockets wrap around the rounded members by at least 180 degrees in at least one plane.

58. The drive system of claim 56, further comprising stops that prevent the first segments from detaching from the second segments in a lateral direction.

59. The drive system of claim 58, wherein the stops are part of the sockets.

60. The drive system of claim 56, wherein the rounded members snap into the sockets.

61. A drive system, comprising:

a catheter body including an articulation section, the articulation section including a solid segment with multiple hinges, wherein the body bends at the multiple hinges in response to a tension; and

at least one channel extending through the catheter body for driving a surgical tool.

62. The drive system of claim 61, wherein the solid segment is comprised of at least two pieces that intersect, the two pieces permanently joined together at the intersection, the first and second pieces each having pluralities of the multiple hinges.

63. The drive system of claim 62, wherein the pluralities of hinges for each piece are offset from one another.

64. The drive system of claim 61, wherein the first piece includes first and second eyelets at different peripheries for receiving first and second cables, the cables providing the tension to the body.

65. The drive system of claim 61, wherein the articulation section extends less than the length of the catheter body.

66. A hydraulically driven catheter system comprising:

at least one fluid actuator; and

a catheter body comprising at least two fluid channels positioned on generally opposite lateral sides of the catheter body and adapted to receive fluid from the fluid actuator, wherein the fluid channels expand when liquid from the at least one fluid actuator is forced into the fluid channels,

wherein forcing fluid into one of the two fluid channels and removing fluid from the other of the two fluid channels causes the catheter body to bend.

67. The hydraulically driven catheter system of claim 66, wherein the one of the two fluid channels, when filled with fluid, causes the catheter body to conform to a predetermined shape.

68. The hydraulically driven catheter system of claim 67, wherein the catheter body maintains a most recent shape when fluid is not being forced into one of the two fluid channels.

69. The hydraulically driven catheter system of claim 68, wherein the catheter body substantially maintains the most recent shape even when rotated.