Methods and apparatus for off-axis visualization

• US 8,992,420 B2
• Filed: 08/28/2012
• Issued: 03/31/2015
• Est. Priority Date: 04/14/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Maahs, Tracy D., Ewers, Richard C., Chang, Arvin T., Rothe, Chris, Chen, Eugene C., Elmer, Marvin C., Madrid, Gilbert, Gambhir, Kabir
• Primary Examiner(s): Leubecker, John P
• Assistant Examiner(s): Torres Diaz, Arnaldo
• Application Number:
  US13/597,072
• Publication Number:
  US 20130041214A1
• Time in Patent Office: 945 Days
• Field of Search: 600/104, 600/103, 600106-107, 600/137, 600/139, 600/160, 600/170, 600/172, 600/173, 600/129, 600/114
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/00098 Deflecting means for inserted tools
• CPC Class Codes: A61B 1/00179 for off-axis viewing
• CPC Class Codes: A61B 1/00183 for variable viewing angles
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/0627 for variable illumination angles

Abstract

Methods and apparatus for off-axis visualization are described herein. An endoluminal tissue manipulation assembly is disclosed which provides for a stable endoluminal platform and which also provides for effective triangulation of tools. Such an apparatus may comprise an optionally shape-lockable elongate body defining a longitudinal axis and adapted for endoluminal advancement in a patient body, at least one articulatable visualization lumen disposed near or at a distal region of the elongate body, the at least one articulating visualization lumen being adapted to articulate off-axis relative to a longitudinal axis of the elongate body, and at least one articulatable tool arm member disposed near or at the distal region of the elongate body, the at least one articulatable tool arm member being adapted to articulate off-axis and manipulate a tissue region of interest.

Claims

1. A surgical method, comprising:

advancing an imager at a distal end of an endoscope through an elongate body until the imager moves out of the elongate body through a front end opening at a distal end of the elongate body;

positioning the imager at a first position to obtain a first field of view of a surgical site;

partially withdrawing the endoscope proximally until the imager is adjacent to or proximal of a skive opening through an outermost sidewall of the elongate body;

re-advancing the endoscope to move the imager through the skive opening and into a second position outside of the elongate body without moving the imager through the distal end of the elongate body, to obtain a second field of view of the surgical site, with the second field of view different from the first field of view.

2. The method of claim 1 further including the imager viewing surrounding environment through the skive opening.

3. The method of claim 1 wherein the imager is entirely outside of the elongate body after moving through the skive opening.

4. The method of claim 1 wherein the imager is distal of the distal end of the elongate body when the imager is in the first position.

5. The method of claim 1 wherein the imager is proximal of the distal end of the elongate body when the imager is in the second position.

6. The method of claim 1 wherein the first field of view is aligned on a first view axis that forms an acute angle with a central axis of the elongate body.

7. The method of claim 1 wherein the second field of view is aligned on a second view axis that forms an acute angle with a central axis of the elongate body.

8. The method of claim 1 wherein the first position is closer to the surgical site than the second position.

9. The method of claim 1 wherein the distal end of the endoscope is free to move in left/right and up/down directions after moving through the skive opening.

10. An endoluminal surgical method, comprising:

advancing an imager on a front end of an endoscope through an elongate body;

moving the imager out of a front end of the elongate body and into a first viewing position to provide a first field of view of a surgical site;

pulling the endoscope back from the front end of the elongate body;

steering the front end of the endoscope in an at least partially radially outward direction from a central axis of the elongate body;

advancing the front end of the endoscope through a skive opening in an outermost sidewall of the elongate body, and

steering the endoscope to move the imager to a second viewing position to provide a second field of view of the surgical site, with the second field of view different from the first field of view.

11. The endoluminal surgical method of claim 10 with first viewing position at a first distance from the surgical site, and the second viewing position at a second distance from the surgical site different from the first distance.

12. The endoluminal surgical method of claim 10 with the first field of view aligned on a first view axis converging with the central axis of the elongate body.

13. The endoluminal surgical method of claim 10 with the second field of view aligned on a second view axis converging with the central axis of the elongate body.

14. The endoluminal surgical method of claim 10 with the first viewing position closer to the central axis of the elongate body than the second viewing position.

15. The endoluminal surgical method of claim 10 with the first viewing position forward of the front end of the elongate body.

16. The endoluminal surgical method of claim 10 with the second viewing position behind the front end of the elongate body.

17. The method of claim 10 wherein the distal end of the endoscope is free to move in left/right and up/down directions after moving through the skive opening.

18. A surgical method comprising:

advancing an imager at a distal end of an endoscope through an elongate body until the imager moves out of the elongate body through a front end opening at a distal end of the elongate body;

positioning the imager at a first position to obtain a first field of view of a surgical site;

partially withdrawing the endoscope proximally until the imager is adjacent to or proximal of a skive opening through an outermost sidewall of the elongate body;

re-advancing the endoscope to move the imager through the skive opening and into a second position outside of the elongate body without moving the imager through the distal end of the elongate body, to obtain a second field of view of the surgical site, with the second field of view different from the first field of view;

with the imager, while positioned inside of the elongate body, able to view an environment around the elongate body through the skive opening; and

wherein the imager is entirely outside of the elongate body after moving through the skive opening, and the distal end of the endoscope is free to move in left/right and up/down directions after moving through the skive opening.