Tissue visualization device and method variations

• US 8,221,310 B2
• Filed: 08/30/2007
• Issued: 07/17/2012
• Est. Priority Date: 10/25/2005
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Voyage Medical, Inc.
• Inventors: Saadat, Vahid, Rothe, Chris A., Tam, Edmund, Peh, Ruey-Feng
• Primary Examiner(s): KASZTEJNA, MATTHEW JOHN
• Application Number:
  US11/848,202
• Publication Number:
  US 20080058591A1
• Time in Patent Office: 1,783 Days
• Field of Search: 600/127, 600/129, 600153-159, 604104-109, 604/278
• US Class Current: 600/129
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• 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 1/00091 Nozzles
• CPC Class Codes: A61B 1/00177 for 90 degrees side-viewing
• CPC Class Codes: A61B 1/005 Flexible endoscopes
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• 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 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 5/02007 : Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/6882 : Anchoring means
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

Tissue visualization devices and variations thereof are described herein where such devices may utilize a variety of methods for facilitating clearing of the device of opaque bodily fluids and sealing between the device and the underlying tissue surface. Additionally, methods and devices for enhancing navigation of the device through a patient body are also described.

Claims

1. A method of treating a tissue region within a body lumen, comprising:

positioning an open area of a barrier or membrane projecting distally from a deployment catheter against or adjacent to the tissue region to be treated, wherein the barrier or membrane self-expands into an expanded deployed configuration, and where the barrier or membrane comprises a non-inflatable membrane which defines the open area therein which is in fluid communication with a lumen defined through the catheter and also with an environment external to the barrier or membrane through an opening defined by the barrier or membrane;

displacing an opaque fluid with a transparent fluid from the open area defined by the barrier or membrane and the tissue region by infusing one or more streams of the transparent fluid into the open area in a spiral manner such that the opaque fluid is displaced from within the open area and through the opening into the environment external to the barrier or membrane; and

visualizing the tissue region within the open area through the transparent fluid.

2. The method of claim 1 wherein positioning comprises advancing the barrier or membrane into an atrial chamber of a heart.

3. The method of claim 1 wherein positioning further comprises placing the barrier or membrane circumferentially upon the tissue region via a contact portion extending from the barrier or membrane.

4. The method of claim 3 wherein placing the barrier or membrane comprises temporarily adhering the contact portion to the tissue region via at least one biasing suspension element prior to visualizing the tissue region.

5. The method of claim 1 wherein visualizing comprises viewing the tissue region via an imaging element disposed within or adjacent to the open area.

6. The method of claim 5 wherein the imaging element is positioned along or upon the interior surface of the barrier or membrane.

7. The method of claim 5 wherein the imaging element comprises a CMOS, CCD, or optical fiber.

8. The method of claim 1 wherein displacing an opaque fluid comprises systematically flushing blood from a proximal end of the open area progressively out towards the opening.

9. The method of claim 1 wherein displacing an opaque fluid further comprises providing additional structural support to the barrier or membrane by imparting a centrifugal force from a spiral flow of the transparent fluid.

10. The method of claim 1 further comprising advancing an instrument through the open area such that the spirally infused transparent fluid is minimally impacted.

11. The method of claim 1 further comprising ablating the tissue region within the open area while visualizing.