PRECISION CONTROL SYSTEMS FOR TISSUE VISUALIZATION AND MANIPULATION ASSEMBLIES

• US 20090221871A1
• Filed: 05/12/2009
• Published: 09/03/2009
• Est. Priority Date: 09/01/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Voyage Medical, Inc.
• Inventors: TAM, Edmund A., SAADAT, Vahid, PEH, Ruey-Feng
• Granted Patent: US 10,070,772 B2
• Time in Patent Office: Days
• US Class Current: 600/118
• 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 1/00097 Sensors
• 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 visual 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 heart treatment system for treating a tissue of a heart, wherein blood is disposed within a chamber of the heart, comprising:

an articulatable catheter defining at least one lumen therethrough;

a computer-controlled guidance assembly coupled to the catheter;

a processor coupled to the computer-controlled guidance assembly so that the articulation of the catheter effects repositioning of a distal portion of the catheter;

an imaging assembly positionable through the at least one lumen and configured to obtain, while blood is disposed in the chamber, an image of a tissue surface within the chamber, wherein repositioning of the distal portion effects a corresponding repositioning of the imaging assembly; and

a display coupleable 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 2 wherein the imaging assembly comprises an imaging element and a barrier extending from a deployment catheter positioned through the at least one lumen.

4. The system of claim 3 wherein the deployment catheter defines at least one fluid lumen therethrough which is in communication with an open area defined in part by the barrier such that the open area is in communication with an environment external to the barrier.

5. The system of claim 1 wherein the distal portion of the catheter is movable within a first plane in response to signals from the computer-controlled guidance assembly, and wherein the distal portion is further movable within a second plane transverse to the first plane in response to signals from the computer-controlled guidance assembly.

6. The system of claim 1 wherein the computer-controlled guidance assembly comprises one or more drive assemblies coupled to the distal end of the catheter via a respective pullwire.

7. The system of claim 1 further comprising an instrument guidance assembly configured to retract an outer sheath relative to the articulatable catheter.

8. A computer assisted method of treating a tissue surface region within a chamber of a heart, comprising:

positioning a distal portion of a catheter within the chamber, the catheter coupled to a computer-controlled guidance assembly;

articulating the catheter with the computer-controlled guidance assembly so that movement of the catheter within the chamber is registered;

positioning a deployment catheter having a barrier projecting from its distal end within a lumen defined through the catheter within the chamber;

locally displacing blood with a transparent fluid from an open area defined by the barrier which is disposed within a portion of the chamber, the open area disposed adjacent the tissue region; and

visualizing, on a display, the tissue region within the open area as imaged through the transparent fluid.

9. The method of claim 8 wherein positioning a distal portion comprises advancing the distal portion of the catheter into a left atrial chamber of a heart.

10. The method of claim 8 wherein positioning a distal portion comprises rotating one or more drive assemblies coupled to the distal portion of the catheter via a respective pullwire.

11. The method of claim 10 wherein rotating one or more drive assemblies in a first rotational direction urges the 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 catheter to deflect in a second direction opposite to the first direction.

12. The method of claim 8 wherein positioning a deployment catheter comprises deploying the barrier from a low-profile delivery configuration within the lumen into an expanded deployed configuration external of the distal portion of the catheter.

13. The method of claim 8 wherein positioning a deployment catheter further comprises placing the open area of the barrier against or adjacent to the tissue region.

14. The method of claim 8 wherein locally displacing blood comprises infusing the transparent fluid into the open area through a fluid delivery lumen defined through the catheter within the chamber.

15. The method of claim 8 further comprising repositioning the barrier relative to the tissue region by repositioning the distal portion of the catheter within the chamber.