Removal of kidney stones and other calculi within body cavities may be accomplished with an endoscope. The endoscope is inserted into the patient through a body passageway, such as the ureter. The endoscope includes an integral optical system, a working channel, and a controller to maneuver the endoscope so that the surgeon can accomplish a therapeutic or diagnostic procedure. The surgeon positions the endoscope so that the surgeon can observe the desired body part of the patient using the optical system, with irrigation if necessary. The surgeon then uses at least one instrument, such as a laser or a grasper, to break up and remove objects in the body passageway. The endoscope may also be used for diagnostic purposes, such as for observing the desired portion of the patient and then taking a biopsy sample.
Obstructions or blockages may be found during observations of a patient's kidney. It is generally beneficial to remove these obstructions or blockages during the observation with minimal device change-outs. While visualization capabilities are important; it is also important to have the ability to deflect or steer the catheter to aid in navigation, and manipulate and/or actively diminish and remove the obstruction or blockage. Catheters designed to perform all these functions are typically bulky and expensive.
Effective diagnostic visualization, particularly, in small passages or spaces, before and/or during endoscopic surgery including an increased ability to navigate through tortuous body passageways and cavities while allowing for important access functions continues to be a priority.
In one example embodiment, an imaging scope for a multiple catheter system includes an elongated body having a first length. The elongated body includes a passage extending along the first length. A flexible distal tip portion is coupled to the elongated body. An imaging device including a wiring harness at least partially disposed in the passage and an imaging sensor is disposed at the flexible distal tip portion. The imaging sensor is operatively coupled to the wiring harness. A proximal portion is coupled to the elongated body opposite the flexible distal tip portion. The proximal portion has an outer surface. The proximal portion includes a proximal termination of the wiring harness, e.g., a printed circuit board (PCB), operatively coupled to the imaging sensor. An annular slip ring is electrically coupled to the proximal termination.
In another example embodiment, a multiple catheter system includes an imaging scope having an elongated body having a first length and a first outer diameter. The elongated body includes a first passage extending along the first length. A flexible distal tip portion is coupled to the elongated body. The flexible distal tip portion includes an imaging sensor and a light source. A proximal connector is coupled to the elongated body opposite the flexible distal tip portion. The proximal connector is operatively coupled to the imaging sensor and the light source. The proximal connector has a second outer diameter not greater than the first outer diameter. A first catheter, e.g., a steering catheter, includes a flexible distal tip portion and a first lateral extension disposed at the flexible distal tip portion. The first lateral extension forms a second passage having an inner diameter greater than the first outer diameter and the second outer diameter, wherein the imaging scope is movably positionable within the second passage.
In another example embodiment, a method for introducing an imaging scope into a lumen of a human includes slidably positioning a first catheter about a proximal portion of an imaging scope. The first catheter is advanced along a length of the imaging scope. A flexible distal tip portion of the first catheter is positioned proximal to a distal portion of the imaging scope. The first catheter and the imaging scope can be advanced through the lumen to a target site.
The detailed description is set forth with reference to the accompanying figures. The use of the same reference numbers in different figures indicates similar or identical items or features.
Example embodiments of the present invention are disclosed herein. It is understood, however, that the disclosed embodiments are merely exemplary and may be embodied in various and alternative forms. The figures are not necessarily to scale; some figures may be configured to show the details of a particular component. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting but merely as a representative basis for the claims and/or teaching one skilled in the art to practice the embodiments.
Example embodiments seek to overcome some of the concerns associated with visualization of body pathways and cavities, which may be tortuous, during endoscopic and laparoscopic surgery. Example embodiments of a multiple catheter system are described that utilize “rapid-exchange” features to enable two or more devices to couple together, or to be selectively withdrawn while minimizing a profile of the multiple catheter system. For example, components may be replaced without discarding components that are still viable. Different size components may be mixed-and-matched. Further, a steerable component may be rotated independently of an imaging component so that visualization does not suffer during navigation. Because the components are not coaxial or fully nested or enveloped, the profile can be minimized.
An example embodiment of a multiple catheter system includes a first component, e.g., an imaging scope having a fiber optic or digital endoscope with a light source. The imaging scope has a proximal connector having a diameter equal to or less than a diameter of an elongated body of the imaging scope, such that other devices, e.g., a second component and/or a third component, can be moved over the proximal connecter and be maintained over the elongated body of the imaging scope with the imaging device acting as a wireguide. The second component, e.g., a steerable or deflectable first catheter, includes a control unit having a deflection actuator configured to allow the surgeon to control deflection of at least a distal portion of the first catheter. The distal portion of the first catheter includes a rapid-exchange feature, e.g., a first lateral extension, such as a tab, a collar, a projection, a protuberance, an appendage, or other suitable structure, made of a suitable material such as an extruded polymer, including a passage sized to accommodate the elongated body of the imaging device. The first catheter may also include a lumen or channel extending at least a portion of a length of the first catheter that can be used to introduce instruments or devices for suction, aspiration, and/or flushing, for example. A third component, e.g., a second catheter having a basket or snare at its distal portion, includes a rapid-exchange feature near its distal portion. In certain embodiments, the rapid-exchange feature of the second catheter is positioned proximal to the rapid-exchange feature of the first catheter with the first catheter and the second catheter coupled to the imaging device. In certain embodiments, these rapid-exchange features are similar, e.g., having the same or similar characteristics. The basket or snare disposed at the distal portion of the second catheter is movably positioned in a channel of the second catheter and extendible from the channel. The basket or snare is controlled by a controller disposed at a proximal portion of the second catheter. The second catheter may also include an additional lumen or channel extending at least a portion of a length of the second catheter that can be used to introduce instruments or devices for suction, aspiration, and/or flushing, for example. In a particular embodiment, the second catheter includes a laser, a lithotripsy device, or another suitable device for breaking and diminishing stones.
Referring now to the figures,
Referring further to
In example embodiments, elongated body 20 has a first length of 25.00 inches (63.50 centimeters (cm)) to 50.00 inches (127.00 cm), and, more particularly, a first length of 28.00 inches (71.12 cm) to 45.00 inches (114.30 cm), and, even more particularly, a first length of 29.537 inches (75.0 cm) to 39.370 inches (100.0 cm), suitable to allow the user to reach the multiple poles of the patient's kidney by transurethral introduction, for example. In alternative embodiments, elongated body 20 may have any suitable length less than 25.0 inches or greater than 50.00 inches. Elongated body 20 has an outer diameter of 0.010 inch (0.03 cm) to 0.118 inch (0.3 cm), and, more particularly, an outer diameter of 0.014 inch (0.0356 cm) to 0.063 inch (0.1400 cm). In a particular embodiment, elongated body 20 is tapered along at least a portion of the first length.
In example embodiments, an imaging device 40 extends through passage 26. Imaging device 40 includes an imaging sensor 42 disposed at distal portion 22 of elongated body 20 and a wiring harness 44 including one or more signal transmission connections 45 coupled to imaging sensor 42. As shown in
In example embodiments, imaging device 40 includes a suitable imaging device sized and configured to navigate the tortuous passages and multiple poles of the patient's kidney by transurethral introduction. Imaging device 40 may include, for example, a solid state imaging device (SSID), such as a charged coupled device (CCD) camera, having a gradient refractive index (GRIN) lens. The term “solid state imaging device” generally refers to a camera or imaging device having a size approximately equal to or less than the diameter of a bundle of optical fibers. Suitable SSIDs include, for example, charge-injection devices (CID), charge-coupled devices (CCD), complementary metal oxide semiconductor (CMOS) devices, and other miniature-sized imaging devices, including those made from compound semiconductors such as InGaAs, capable of imaging reflected illumination of visible and/or non-visible light. In certain embodiments, the SSID is configured to transmit recorded images to imaging control unit 46 or another external processing system via signal transmission connection 45, disposed within passage 26. In alternative embodiments, the image information is sent via a wireless connection to imaging control unit 46 or the external processing system.
A light source 50 extends through passage 26 and is configured to emit light at distal portion 22 of elongated body 20. In example embodiments, passage 26 is configured to accommodate at least a portion of imaging device 40, e.g., signal transmission connection 45, and at least a portion of light source 50, e.g., a flexible optical conductor 52 operatively coupling, e.g., electrically coupling or optically coupling, light source 50 to imaging control device 46. In a particular embodiment, as mentioned above, elongated body 20 includes a first passage, e.g., first passage 26, configured to accommodate at least a portion of imaging device 40, e.g., signal transmission connection 45, and a second passage (not shown) configured to accommodate at least a portion of light source 50, e.g., flexible optical conductor 52. As shown in
In example embodiments, light source 50 includes any light source configured to emit a suitable amount of light at the target site. For example, light source 50 may include a light emitting diode (LED) light source, a fiber optic light source, a laser or another suitable light source. With elongated body 20 inserted into a patient's lumen, light source 50 emits one or more beams of optical energy, e.g., light, that propagates through a flexible optical conductor 52 of light source 50 extending through elongated body 20. Imaging device 40, e.g., imaging sensor 42, can image the illumination reflected by an object during navigation of imaging device 40 through the lumen or at the target site, e.g., interior walls of the lumen or kidney, in response to the beam of optical energy.
In example embodiments, image information captured and recorded by imaging device 40 is filtered and processed by imaging control unit 46 or another external processing system, having imaging software 54 for processing and displaying images on a display screen 56 positioned on imaging control unit 46 or an external display operatively coupled to imaging control unit 46 or the external processing system. In example embodiments, imaging control unit 46 or the external processing system controls light source 50 via optical conductor 52.
Referring further to
In example embodiments, flexible distal tip portion 60 is configured to deflect in a plurality of directions including, for example, a first direction and a second direction different from the first direction. In certain embodiments, flexible distal tip portion 60 is configured to deflect at least 180°. Flexible distal tip portion 60 is configured to navigate through tight spaces and prevent perforation of the lumen or vessel in which imaging scope 12 is positioned. In example embodiments, flexible distal tip portion 60 has a length of 0.125 inch (0.318 cm) to 1.969 inch (5.00 cm) and, more particularly, a length of 0.787 inch (2.0 cm) to 1.0 inch (2.541 cm). Flexible distal tip portion 60 includes a suitable material and/or configuration to facilitate controllable steerability or deflection of flexible distal tip portion 60.
As shown in
Referring now to
Referring to
Referring now to
With imaging control unit 46 electrically coupled to proximal connector 62, imaging control unit 46 is in operational control communication with imaging device 40 to control operation of imaging device 40. Additionally, or alternatively, light source 50 extends through passage 26 to electrically couple to imaging control unit 46. With imaging control unit 46 electrically coupled to light source 50, imaging control unit 46 is in operational control communication with light source 50 to control operation of light source 50. In example embodiments, imaging control unit 46 includes a USB port 92 to electrically couple imaging control unit 46 to a remote processing system and an electrical connection 94 to electrically connect imaging control unit 46 to a standard electrical outlet.
Referring again to
As shown in
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In example embodiments, second catheter 16 includes a third length that extends between flexible distal tip portion 150 and proximal portion 152. Second catheter 16 includes at least one channel, such as channel 170 shown in
Referring again to
In example embodiments, the imaging scope, coupled to first catheter 14 or independently, is placed transurethral, inserted through the patient's urethra and into the patient's bladder, for example. The imaging scope is navigated through the UVJ and into the ureter. As the imaging scope navigates up the ureter, the imaging scope visualizes the inner wall of the ureter and can be used diagnostically to identify strictures, stones, etc. Visualization, as well as the deflection properties of the flexible distal tip portion and the rigid core of the elongated body allows the imaging scope to navigate past the stricture, for example, and move up into the patient's kidney. If, for example, a stone in the ureter or the kidney needs to be removed, a rapid exchange second catheter is placed about the proximal portion of the imaging scope and inserted into the body lumen and up to the source of the stone burden. Devices or instruments for removing the stone are then introduced through the channel of the second catheter and visualized via the imaging scope.
When an occlusion or blockage is encountered and/or identified, the imaging control unit is removed 212 from the proximal connector at the proximal portion of the imaging device to allow a second catheter, e.g., a basket or snare catheter, to be slidably positioned 214 about the proximal portion of the imaging scope. The imaging control unit is then reconnected 216 to the proximal connector to electrical couple the imaging control unit to an imaging sensor and a light source disposed at a distal portion of the imaging scope. The second catheter is advanced 218 along the elongated body of the imaging scope such that a flexible distal tip portion of the second catheter is positioned immediately proximal to the flexible distal tip portion of the first catheter. The second catheter can then be utilized to remove the obstruction or blockage.
Imaging control unit 46 may be implemented as any of a number of different types of electronic devices. Some examples of imaging control unit 46 may include tablet computing devices, mobile devices, laptop and netbook computing devices or any other device capable of connecting with image device 40 and/or light source 50 and including a processor and memory for controlling image device 40 and/or light source 50 according to the techniques described herein.
In a very basic configuration, imaging control unit 46 includes, or accesses, components such as at least one control logic circuit, central processing unit, or processor, and one or more computer-readable media. Each processor may itself comprise one or more processors or processing cores. For example, each processor can be implemented as one or more microprocessors, microcomputers, microcontrollers, digital signal processors, central processing units, state machines, logic circuitries, fog computing, and/or any devices that manipulate signals based on operational instructions. In some cases, the processor may be one or more hardware processors and/or logic circuits of any suitable type specifically programmed or configured to execute the algorithms and processes described herein. The processor can be configured to fetch and execute computer-readable instructions stored in a computer-readable media or other computer-readable media.
Depending on the configuration of imaging control unit 46, computer-readable media may be an example of tangible non-transitory computer storage media and may include volatile and nonvolatile memory and/or removable and non-removable media implemented in any type of technology for storage of information such as computer-readable instructions, data structures, program modules or other data. The computer-readable media may include, but is not limited to, RAM, ROM, EEPROM, flash memory or other computer readable media technology, CD-ROM, digital versatile disks (DVD) or other optical storage, magnetic cassettes, magnetic tape, solid-state storage and/or magnetic disk storage. Further, in some cases, imaging control unit 46 may access external storage, such as RAID storage systems, storage arrays, network attached storage, storage area networks, cloud storage, or any other medium that can be used to store information and that can be accessed by the processor directly or through another computing device or network. Accordingly, computer-readable media may be computer storage media able to store instructions, modules or components that may be executed by the processor.
Computer-readable media may be used to store and maintain any number of functional components that are executable by the processor. In some implementations, these functional components comprise instructions or programs that are executable by the processor and that, when executed, implement operational logic for performing the actions attributed above to imaging control unit 46. Functional components of imaging control unit 46 stored in the computer-readable media may include the operating system and a user interface module for controlling and managing various functions of imaging device 40 and/or light source 50, and for generating one or more user interfaces on imaging control unit 46.
Imaging control unit 46 may further include one or more communication interfaces, which may support both wired and wireless connection to various networks, such as cellular networks, radio, Wi-Fi networks, close-range wireless connections, near-field connections, infrared signals, local area networks, wide area networks, the Internet, and so forth. The communication interfaces may further allow a user to access storage on or through another device, such as a remote computing device, a network attached storage device, cloud storage, or the like.
Imaging control unit 46 may further be equipped with one or more various input/output (I/O) components. Such I/O components may include a touchscreen and various user controls (e.g., buttons, a joystick, a keyboard, a keypad, etc.), a haptic or tactile output device, connection ports, physical condition sensors, edge devices, and so forth. For example, the operating system of imaging control unit 46 may include suitable drivers configured to accept input from a keypad, keyboard, or other user controls and devices included as I/O components. Additionally, imaging control unit 46 may include various other components that are not shown, examples of which include removable storage, a power source, such as a battery and power control unit, a PC Card component, and so forth.
Various instructions, methods and techniques described herein may be considered in the general context of computer-executable instructions, such as program modules stored on computer storage media and executed by the processors herein. Generally, program modules include routines, programs, objects, components, data structures, etc., for performing particular tasks or implementing particular abstract data types. These program modules, and the like, may be executed as native code or may be downloaded and executed, such as in a virtual machine or other just-in-time compilation execution environment. Typically, the functionality of the program modules may be combined or distributed as desired in various implementations. An implementation of these modules and techniques may be stored on computer storage media or transmitted across some form of communication.
Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described. Rather, the specific features and acts are disclosed as illustrative forms of implementing the claims.
One skilled in the art will realize that a virtually unlimited number of variations to the above descriptions are possible, and that the examples and the accompanying figures are merely to illustrate one or more examples of implementations.
It will be understood by those skilled in the art that various other modifications can be made, and equivalents can be substituted, without departing from claimed subject matter. Additionally, many modifications can be made to adapt a particular situation to the teachings of claimed subject matter without departing from the central concept described herein. Therefore, it is intended that claimed subject matter not be limited to the particular embodiments disclosed, but that such claimed subject matter can also include all embodiments falling within the scope of the appended claims, and equivalents thereof.
In the detailed description above, numerous specific details are set forth to provide a thorough understanding of claimed subject matter. However, it will be understood by those skilled in the art that claimed subject matter can be practiced without these specific details. In other instances, methods, devices, or systems that would be known by one of ordinary skill have not been described in detail so as not to obscure claimed subject matter.
Reference throughout this specification to “one embodiment” or “an embodiment” can mean that a particular feature, structure, or characteristic described in connection with a particular embodiment can be included in at least one embodiment of claimed subject matter. Thus, appearances of the phrase “in one embodiment” or “an embodiment” in various places throughout this specification are not necessarily intended to refer to the same embodiment or to any one particular embodiment described. Furthermore, it is to be understood that particular features, structures, or characteristics described can be combined in various ways in one or more embodiments. In general, of course, these and other issues can vary with the particular context of usage. Therefore, the particular context of the description or the usage of these terms can provide helpful guidance regarding inferences to be drawn for that context.
This invention claims the benefit of priority of U.S. Provisional Application No. 62/466,543, entitled “Rapid Exchange Multiple Catheter System,” filed Mar. 03, 2017, which is hereby incorporated by reference in its entirety.
Number | Date | Country | |
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62466543 | Mar 2017 | US |