Aspects of the present disclosure generally relate to medical devices and procedures. In particular, aspects relate to articulating devices and methods.
Medical devices are commonly used to access remote regions of the body for diagnostic, surgical, or therapeutic purposes. In some examples, endoscopes may be inserted through a body lumen to access the colon, esophagus, stomach, urethra, bladder, ureter, kidneys, lungs, bronchi, uterus, and/or or other organs. In other examples, catheters may be inserted through the circulatory system to access treatment sites near the heart, or through the urinary system to access sites near the kidney.
Body lumens come in various shapes and sizes. Some medical devices may be introduced into the body through a large body lumen (such as the urethra) and passed through a narrower body lumen (such as a ureter) to reach a treatment site (such as the interior of a kidney). Some body lumens are naturally formed to curve, loop around, or even wind back, while other body lumens are surgically formed by tunneling tools and, thus, irregularly shaped. A device with a steerable shaft is advantageous when negotiating any of these body lumens. Such a device should be flexible enough to permit steering, yet rigid enough to prevent buckling.
Wires may be used to steer the device through a body lumen. In some devices, the wires are routed through the interior of the device, potentially increasing its outer diameter. Because the device may be pushed through the body lumen, even small increases in the outside diameter of the device may complicate access to some treatments sites by preventing passage of the device through a preferred body lumen. In other devices, the wires may be routed through a structure inside of the device, such as a sleeve, which may further increase the outer diameter of the device. These structures also may decrease the usable interior space of the device. Given that most body lumens are narrow, even small decreases in the usable interior space of the device may limit its usefulness by, for example, reducing the size of one or more working lumens extending through the device, and/or the type of tool usable therewith.
The articulating devices and methods described herein may rectify some of the deficiencies described above, and address other aspects of the prior art.
Aspects of the present disclosure relate to articulating devices and methods. Numerous aspects of the present disclosure are now described.
One aspect of this disclosure is an articulating device. The device may comprise an interior core with a reinforcing element extending along a central axis, an exterior layer bonded to an exterior surface of the interior core by an interface, a lumen extending through the exterior layer, exterior of the reinforcing element, and parallel to the central axis, and a steering wire moveable in the lumen to articulate a distal end of the device relative to the central axis in response to a force applied to the wire.
According to this aspect, the interface may comprise a chemical bond or a physical bond formed between the exterior layer and the interior core. A plurality of articulation slots may be defined by an exterior surface of the exterior layer. The interior core may be encased in a first material. The exterior layer may include a second material, and the interface may comprise a fused portion of the first and second materials. An exterior portion of the exterior layer may be made of a third material, an interior portion of the exterior layer may be made of the second material, and an exterior portion of the interior core may be made of the first material. The third material may have a melting point greater than that of the first and second materials. Each of the first, second, and third materials may be a polymeric material, such as a thermoplastic.
The reinforcing element may comprise one or more wires spiraled about the central axis. The one or more wires may be interwoven to form a braided wire tube. The one or more wires may have an exterior surface configured to maximize surface area contact with the first material. The reinforcing material of the interior core may be a first reinforcing element, the exterior layer may comprise a second reinforcing element encased in the second material, and the lumen may be contained between an exterior surface of the core and an interior surface of the second reinforcing material. The lumen may have a cross-sectional shape with a minimum dimension in a direction perpendicular to the central axis. The second reinforcing element may comprise a wire spiraled about the central axis to surround the interior core and the lumen. A portion of second reinforcing element may be interwoven with a portion of the first reinforcing element.
The lumen may comprise a plurality of lumens, the steering wire may comprise a plurality of steering wires, and each of the plurality steering wires may be received in one of the plurality lumens. A cap may be attached to a distal end of each of the plurality of steering wires. A distal end of the interior core and/or a distal end of the exterior layer may be attached to a proximal end of the cap to seal each of the plurality of lumens. A proximal end of each of the plurality of steering wires may be attached to a steering device configured to apply the force.
Another aspect of this disclosure is an articulating device. The device may comprise an interior core extending along a central axis, the core including a reinforcing element encased therein; an exterior layer bonded to an exterior surface of the interior core by an interface, the exterior layer defining a plurality of articulation slots; a plurality of lumens extending through the exterior layer, exterior of the reinforcing element, and parallel to the central axis; and a plurality of steering wires, each steering wire being moveable in one of the plurality of lumens to articulate a distal end of the device relative to the central axis in response to a force applied to one or more of the wires.
According to this aspect, a cap may be attached to a distal end of each of the plurality of steering wires. A distal end of the interior core and/or a distal end of the exterior layer may be attached to a proximal end of the cap to seal each of the plurality of lumens. A proximal end of each of the plurality of steering wires may be attached to a steering device configured to apply the force.
Another aspect of the present disclosure is a method of manufacturing an articulating device. The method may comprise forming an interior core, forming an exterior layer, interfacing the interior core to the exterior layer so as to define a central axis within the interior core and at least one lumen extending parallel to the axis between the interior core and the exterior layer, inserting a steering wire into each at least one lumen, and attaching a distal end of each wire to a cap.
According to this aspect, forming the interior core may comprise extruding a first material through a mold together with a first reinforcing element. Forming the exterior layer may comprise extruding a second material through a mold. The interfacing may further comprises sliding the interior core into the exterior layer, and applying a heat to the interior core and the exterior layer so as to fuse at least a portion of the first material to a portion of the second material. The interfacing may further comprise placing a elongated mold adjacent an exterior surface of the interior core so that each of the plurality of lumens are formed into an interior portion of the exterior layer by the heat.
It may be understood that both the foregoing summary and the following detailed descriptions are exemplary and explanatory only, neither being restrictive of the inventions claimed below.
The accompanying drawings are incorporated in and constitute a part of this specification. These drawings illustrate exemplary aspects of this disclosure that, together with the written descriptions, serve to explain the principles described herein.
Aspects of the present disclosure are now described with reference to exemplary articulating devices and methods. Some aspects are described with reference to a medical procedure, wherein a distal end of an articulating device is steered towards a body cavity, such as the interior of a kidney. During this procedure, said distal end may be steered toward a material in the body, such as a kidney stone formed in the interior of a kidney. Any reference to a particular type of procedure, such as medical; material, such as a kidney stone or portion thereof; or body cavity, such as the interior of a kidney, is provided as an example and not intended to limit the present disclosure unless claimed. Accordingly, the concepts described herein may be utilized for any analogous device, method, or system—medical or otherwise.
The directional terms “proximal” and “distal,” and their respective initials “P” and “D,” are used to describe relative components and features of the present disclosure. Proximal refers to a position closer to the exterior of the body or a user, whereas distal refers to a position closer to the interior of the body or further away from the user. Appending the initials P or D to an element number signifies its proximal or distal location. Unless claimed, these directional terms and initials are provided for convenience and not intended to limit the present disclosure to a particular direction or orientation. As used herein, the terms “comprises,” “comprising,” “including,” or the like, are intended to cover a non-exclusive inclusion, such that a device or method that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or inherent thereto. Unless stated otherwise, the term “exemplary” is used in the sense of “example” rather than “ideal.”
One aspect of this disclosure is an articulating device 10 that extends along a central axis A-A between a distal end 10D and a proximal end 10P. Examples of device 10 are provided in
Interior core 20 of
First material 24 may be formulated to achieve a chemical or physical bond with reinforcing element 22 to maximize force transfer therebetween. For example, the geometric configuration and/or exterior surfaces of element 22 may be configured (e.g., roughened) to maximize surface area contact with material 24. Core 20 may be further optimized for strength. For example, although depicted as a spiral, a portion of reinforcing element 22 may be parallel with central axis A-A to provide core 20 with additional column strength and/or transverse to axis A-A to provide additional shear strength. In other examples, element 22 may comprise plurality of particles (e.g., a polymeric aggregate) suspended in material 24 to provide core 20 with additional compressive strength. Various discrete portions of element 22 also may be interconnected for additional torsional strength and/or kink resistance.
Exterior layer 30 of
Each lumen 50 is formed in exterior layer 30 to receive a steering wire 60 therein. Device 10 may be articulated by applying force F to one or more of pull wires 60 in a direction parallel to central axis A-A until a portion of device 10 (e.g., a side) is deflected away from central axis A-A. Device 10 of
Because of interface 40, each lumen 50 may be disposed external of interior core 20 and reinforcing element 22, thereby maximizing the inner diameter of interior lumen 12 of device 10. Each lumen 50 may have a cross-sectional shape with a minimum dimension in a direction perpendicular to central axis A-A. Exemplary cross-sectional shapes may include a rectangle, a rounded rectangle, a curved rectangle, an oval, or the like, any of which may be configured (e.g., elongated or flattened) to maximize the inner diameter of lumen 12 by residing within layer 30. Each wire 60 also may be configured to maximize the inner diameter of lumen 12. For example, as shown in
Distal end 10D of device 10 may have a cap 70, illustrated in
Additional aspects of articulation device 10 are illustrated in
As shown in
Other aspects of this disclosure are shown in
Still other aspects of this disclosure are shown with respect to device 300 of
In still other aspects of device 300, a plurality of interior lumens may be formed in lumen 312. For example, second thermoplastic 324B may be formed to define a plurality of lumens extending through device 10 through interior lumen 12. Each of these exemplary lumens may be sized to house one or more elongated objects (e.g., object 2 of
Another aspect of the present disclosure is a method 400 of manufacturing device 10. With slight modifications, as described below, method 400 may be used to make devices 10, 100, 200, and 300. An exemplary method 400 is depicted in
Forming an interior core (402) may comprise co-extruding interior core 20. For example, a flow of first material 24 may be pushed through a mold together with a length of reinforcing element 22 so that element 22 is encased in core 20. This The length of interior core 20 may be varied, as needed, in method 400. Device 300 may also be formed by co-extrusion. For example, the method 400 (e.g., at 402) may be further modified to form core 320 by pushing materials 324A and 324B through a heated mold at a temperature equal to melting point temperatures T324B, thereby bonding materials 324A and 324B to each other and/or reinforcing element 322.
The method 400 (e.g., at 412) may comprise extruding exterior layer 30. For example, a flow of polymeric material may be pushed through a mold to form a tube of any length. Slots 32 may be formed by applying laser energy to the exterior surface of an articulating section 80 of the tube (e.g.,
Interface 40 may be formed by creation of a chemical or physical bond between the core 20 and layer 30. For example, the method 400 (e.g., at 422) may comprise applying an adhesive agent to the exterior surface of core 20 and/or the interior surface of layer 30, sliding core 20 into layer 30 along central axis A-A, and allowing the adhesive agent to cure, thereby fusing core 20 with layer 30. In other examples, core 20 may be slid into layer 30, and heat applied to core 20 and layer 30 to fuse the exterior surface of core 20 with the interior surface of layer 30. These aspects of method 400 may also be combined. For example, the adhesive agent may serve as both a lubricant that allows core 20 to be slid into layer 30, and a catalyst that, when heated, promotes fusion of core 20 with layer 30.
The plurality of lumens 50 may be formed in method 400 (e.g., at 422) by, for example, placing a plurality of elongated forms along the outside of core 20, and then sliding core 20 and the elongated forms into layer 30. Each form may be similar in shape to wire 60 and have a melting point temperature greater than T334B and/or T324A. For example, each form may be made of metal. According to this aspect, heat may be applied to core 20 and layer 30 until a first interior portion of layer 30 is fused to an exterior portion of core 20, and a second interior portion of layer 30 is conformed around each elongated form to define each lumen 50. After removing the heat, each elongated form may then be removed. With devices 100 and 200, the method 400 may further comprise attaching the elongated forms to interior cores 120 or 220. For example, reinforcing bands 190 may be a staple with two forks that are pushed through the interior surface of core 120, in between spaces in reinforcing element 122, and out the exterior surface of layer 130. Each fork may then be folded over the elongated form, securing it to core 120. As further example, reinforcing element 290 of device 210 may be wrapped around core 220 and interwoven with reinforcing element 222 in order to secure the forms to core 220.
Once the lumens 50 have been defined, at least one wire 60 may be inserted into each lumen 50. The cross-sectional area of each lumen 50 is greater than the cross-sectional area of each wire 60, allowing each wire 60 to move inside of a lumen 50 in a direction parallel to central axis A-A. The method 400 (e.g. at 432) may additionally include applying a lubricant (e.g., a silicone-based coating) to, for example, the interior surfaces of each lumen 50 to ensure smooth operation of device 10. The distal end 60D of each wire 60 may be attached (e.g., welded) to the interior surface of cap 70, as shown in
In some aspects, the method 400 may be used to attach the proximal end 60P of each wire 60 to steering device 4. The proximal ends 20P and 30P of core 20 and layer 30 may also be attached to steering device 4 so as to seal each lumen 50 and any lubricants contained therein. For device 100, some aspects of method 400 may further comprise placing each reinforcing band 190 around one of the lumens 150. Each band 190 may, for example, be a staple with two forks that are pushed through the interior surface of core 120, out the exterior surface of layer 130, and folded into one of the slots 132. Alternatively, each band 190 may be a spiraled metal wire that is screwed into portions of core 120 and layer 130 to both surround a lumen 150 and interweave with reinforcing element 122, as shown in
While principles of the present disclosure are described herein with reference to illustrative aspects for particular applications, the disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize additional modifications, applications, aspects, and substitution of equivalents all fall in the scope of the aspects described herein. Accordingly, the present disclosure is not to be considered as limited by the foregoing description.
This patent application claims the benefit of priority under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 62/341,982, filed May 26, 2016, which is herein incorporated by reference in its entirety.
Number | Name | Date | Kind |
---|---|---|---|
3924632 | Cook | Dec 1975 | A |
4425919 | Alston, Jr. et al. | Jan 1984 | A |
4911148 | Sosnowski et al. | Mar 1990 | A |
5005558 | Aomori | Apr 1991 | A |
5025778 | Silverstein et al. | Jun 1991 | A |
5037404 | Gold et al. | Aug 1991 | A |
5271382 | Chikama | Dec 1993 | A |
5313967 | Lieber et al. | May 1994 | A |
5381782 | DeLaRama et al. | Jan 1995 | A |
5477856 | Lundquist | Dec 1995 | A |
5480382 | Hammerslag et al. | Jan 1996 | A |
5562619 | Mirarchi et al. | Oct 1996 | A |
5662119 | Brennen et al. | Sep 1997 | A |
5738742 | Stevens | Apr 1998 | A |
5795341 | Samson | Aug 1998 | A |
5865800 | Mirarchi et al. | Feb 1999 | A |
5873817 | Kokish et al. | Feb 1999 | A |
5916147 | Boury | Jun 1999 | A |
5964971 | Lunn | Oct 1999 | A |
6012494 | Balazs | Jan 2000 | A |
6068622 | Sater et al. | May 2000 | A |
6123699 | Webster, Jr. | Sep 2000 | A |
6171235 | Konstorum et al. | Jan 2001 | B1 |
6450948 | Matsuura et al. | Sep 2002 | B1 |
6589227 | Sonderskov | Jul 2003 | B2 |
6749560 | Konstorum et al. | Jun 2004 | B1 |
6780151 | Grabover et al. | Aug 2004 | B2 |
6945956 | Waldhauser et al. | Sep 2005 | B2 |
6991616 | Bencini et al. | Jan 2006 | B2 |
7011655 | Thompson et al. | Mar 2006 | B2 |
7824392 | Zhou | Nov 2010 | B2 |
7833218 | Lunn et al. | Nov 2010 | B2 |
7922650 | McWeeney et al. | Apr 2011 | B2 |
8376991 | Kauphusman | Feb 2013 | B2 |
8579802 | Robertson | Nov 2013 | B2 |
9039676 | Klima | May 2015 | B2 |
20040102719 | Keith | May 2004 | A1 |
20050015072 | Engel et al. | Jan 2005 | A1 |
20050272975 | McWeeney et al. | Dec 2005 | A1 |
20060111649 | Zhou | May 2006 | A1 |
20070016130 | Leeflang et al. | Jan 2007 | A1 |
20080091169 | Heideman et al. | Apr 2008 | A1 |
20090192495 | Ostrovsky | Jul 2009 | A1 |
20120123327 | Miller | May 2012 | A1 |
20120277671 | Fuentes | Nov 2012 | A1 |
20130072905 | Jansen | Mar 2013 | A1 |
20150174363 | Sutermeister | Jun 2015 | A1 |
Number | Date | Country |
---|---|---|
2 937 110 | Oct 2015 | EP |
WO 2014203343 | Dec 2014 | WO |
Number | Date | Country | |
---|---|---|---|
20170340862 A1 | Nov 2017 | US |
Number | Date | Country | |
---|---|---|---|
62341982 | May 2016 | US |