Patent Application
20060281990
This invention relates to the navigation of medical devices through body lumens and cavities, and in particular to an interface for controlling remote navigation systems for navigating medical devices through body lumens and cavities.
Remote navigation systems have been developed which allow a user to remotely orient the distal end of a medical device and thereby navigate the device through a subject's body lumen or cavity, and particularly the subject's vasculature. In particular, magnetic navigation systems have been developed by Stereotaxis, Inc., that apply a strong magnetic field in a selected direction to orient the distal end of a medical device provided with a magnetically responsive element. These magnetic navigation systems provide fast and accurate remote control over the distal end of the medical device. Other attempts have been made to provide remotely navigable medical devices, including devices employing conventional pull wires and push wires, and other mechanical means for remotely orienting the distal end of a medical device. Thus, while the technology is available to remotely navigate medical devices, the in certain circumstance it can be difficult for the physician or other health care worker to visualize the procedure site, and more specifically to indicate to the remote navigation system the desired direction of orientation of the distal end of the medial device.
Embodiments of the present invention provide an interface to facilitate the control of medical devices and in particular the control of remotely controlled medical devices. Generally, the interface of the present invention comprises a display of a view from inside the body lumen or cavity (an “endoluminal view”) in the vicinity of the distal end of the medical device. This view may be an actual image from inside the body lumen or cavity, but in the preferred embodiment, it is a reconstructed view from preoperative or intraoperative imaging. This view preferably includes an image of the distal end portion of the medical device. The image of the distal end portion of the medical device may be an actual image of the distal end portion obtained with or separately from the image of the body lumen or cavity. The image of the distal end portion of the medical device is preferably a generated image of the device based upon a model of the device and the current state of the remote navigation system. This combined view of the body lumen and cavity allows the physician or other user more easily understand the current position and orientation of the medical device, and to determine the desired new direction of orientation.
In a first preferred embodiment, a plurality of control buttons are associated with the displayed image. These control buttons can be physical buttons, they can be “virtual” buttons on which the physician or other user can point with a cursor or other indicator and “click”, or they can be defined locations on a touch screen display which the user can operate by touching either with a finger or a stylus. In the preferred embodiment these buttons are arranged around the periphery of the image, and their positions indicate the direction they control. They may also be shaped to visually reinforce the direction associated with the particular button. If the user desires to re-orient the tip of the device in a particular direction, the user simply operates the corresponding button. The displayed image of the medical device updates as the remote navigation system changes the orientation of the distal end portion of the medical device. The buttons could operate in a discrete mode where each operation or “click” changes the orientation in the selected direction by a predetermined amount, or the buttons could operate in a continuous mode where the direction changes as long as the button is held down.
In a second preferred embodiment, the surface of the displayed endoluminal image is active, and when the physician or user identifies a particular point on the image, the remote navigation system orients the distal tip of the device to point toward the selected point. The active surface can be one in which the user points and clicks a cursor, or alternatively it can be touch screen on which the user indicates the desired direction with a finger or a stylus.
In a third preferred embodiment, both the buttons of the first preferred embodiment and the active image of the second preferred embodiment are provided to provide dual modes of control of the remote navigation system.
Thus, the interface and control methods of the various embodiments of the present invention allows the user to visualize and to control the orientation of a distal end of the medical device as it is being navigated in a body lumen or cavity. The interfaces and controls allows the user to more quickly and easily indicate to a remove navigation system the desired orientation of the medical device to facilitate the navigation of a medical device through the body lumen or cavity.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
A computer screen illustrating a possible implementation of the interface and methods of the present invention is shown in
The display 100 also includes an image 102 of the distal end portion of the medical device. The image of the distal end portion of the medical device may be an actual image of the distal end portion obtained with or separately from the image of the body lumen or cavity. The image of the distal end portion of the medical device is preferably a generated image of the device based upon a model of the device and the current state of the remote navigation system. The modeling and display is disclosed in U.S. patent application Ser. No. 10/448,273, filed May 29, 2003, incorporated herein by reference. Alternatively, the orientation and or position can be determined by various localization methods, including rf localization, electrostatic localization, optical localization, ultrasound localization, or the like. In the case of navigation through a constrained lumen, such as a blood vessel, the position and orientation may be know simply from the extended length of the medical device, which is many cases is a good indicator of the position and thus the orientation of the distal end of the medical device.
The combined view of the body lumen and cavity allows the physician or other user more easily understand the current position and orientation of the medical device, and to determine the desired new direction of orientation.
In this first preferred embodiment, a plurality of control buttons 104 are associated with the displayed image. These control buttons 104 can be physical buttons. Alternatively, these control buttons 104 can be “virtual” buttons on which the physician or other user can point with a cursor or other indicator and “click”. Alternatively, these control buttons 104 can be defined locations on a touch screen display which the user can operate by touching either with a finger or a stylus. In the preferred embodiments these buttons are arranged around the periphery of the image, and the positions of the button indicate the direction they control. They may also be shaped to visually reinforce the direction associated with the particular button. As shown in
If the user desires to re-orient the tip of the device in a particular direction, the user simply operates the button 104 in the direction corresponding to the desired direction of movement. The displayed image 102 of the medical device updates as the remote navigation system changes the orientation of the distal end portion of the medical device. The buttons 104 can operate in a discrete mode where each operation or “click” of the button changes the orientation in the selected direction by a predetermined amount. Alternatively, or in addition, the buttons 104 could operate in a continuous mode where the direction changes as long as the button is held down.
Thus, as shown in
In the second preferred embodiment shown in
In the third preferred embodiment, shown in
To facilitate the navigation of a medical device through body lumens and cavities, it is desirable to clearly indicate to the physician or other user where the distal end of the device is presently located. Thus in accordance with one embodiment of the present invention, an external image 200 of a body lumen or cavity is displayed. The position of the medical device is determined by any conventional means of localization, including using rf signals, electrostatic localization, optical localization, image processing localization, etc. In the case of navigating through a relatively constricted lumen, such as a blood vessel, the position in the vessel can be determined by measuring the extended length of the device, as advancement of a given length will substantially correspond to the same advancement along the centerline of the vessel. The advancement of the medical device can be measured in a number of ways. If the device is advanced by machine, for example opposed rollers as disclosed in U.S. patent application Ser. No. 10/138,710, filed May 3, 2002, and U.S. patent application Ser. No. 10/858,485, filed Jun. 1, 2004, (the disclosures of which are incorporated by reference), then the rotation of the rollers can be used to measure the advancement of device. Alternatively, marks can be provided on the device which can be physically, electrically, optically, or otherwise sensed to measure the advancement of the medical device.
As shown in
Operation
In operation as a medical device is being navigated through a body lumen or cavity such as a blood vessel, an endoluminal view 100 of the blood vessel is displayed. The user can view the relative position of the image 102 of the medical device in the endoluminal view 100. If there is a blockage or partial blockage, the user can use the buttons 104 to adjust or suitably bias the orientation of the distal end of the device to navigate past the blockage. Alternatively, the user can click on the image 100 to adjust the orientation of the distal end of the device to navigate past the blockage. When the user reaches a branch in the blood vessel the user can navigate to and through a branch either by adjusting the orientation of the distal end of the device using buttons 104 or by adjusting the orientation of the device by pointing to the branch on the image 100 and clicking. The user interface causes the remote navigation system to change the oritentation of the distal end of the device so that it can be advanced through the vessel or other lumen or cavity, following the centerline of the path and easily steering around vascular obstructions past branches and bifurcations. To facilitate the user's operation of the interface, the interface preferably only displays and manipulate device direction.
This application claims the benefit of U.S. Provisional Patent Application Ser. No. 60/678,321, filed May 6, 2005, the entire disclosure of which is incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 60678321 | May 2005 | US |
