Articulating guide with integral position sensor

Patent metadata

Field	Value
Publication number	US-11998284-B2
Application number	US-201916670190-A
Country	US
Kind code	B2
Filing date	Oct 31, 2019
Priority date	Dec 7, 2018
Publication date	Jun 4, 2024
Grant date	Jun 4, 2024

Abstract

A guide sheath includes ports at a handle portion through which flexible endoscopic tools may be advanced until they emerge from corresponding ports at a distal tip of the guide sheath. The guide sheath includes a position sensor at its distal tip that is compatible with an image guided surgery (IGS) system, such that a virtual view of the distal tip's position relative to a surgical site may be presented by the IGS system. The virtual view may assist a surgeon in precisely positioning the distal tip at the surgical site, and then one or more flexible endoscopic tools may be advanced the length of the guide sheath for use at the surgical site. The guide sheath may also include an articulating portion at the distal tip that may be deflected in one or more directions in order to provide additional control over placement within the surgical site.

First claim

We claim:

1. A guide sheath comprising:
(a) an origin port comprising a plurality of proximal channel openings;
(b) a destination port comprising a plurality of distal channel openings, the destination port being distal to the origin port;
(c) a shaft between the origin port and the destination port, the shaft comprising:
(i) a plurality of channels, each channel of the plurality of channels connecting one proximal channel opening of the plurality of proximal channel openings to one distal channel opening of the plurality of distal channel openings, the plurality of channels comprising:
(A) a tool channel, the tool channel being sized and configured to receive a tool,
(B) an endoscope channel, the endoscope channel being sized and configured to receive an endoscope,
(C) an illumination channel, the illumination channel being sized and configured to receive an illumination source, and
(D) a tool tracking sensor, the tool tracking sensor being configured to generate a signal indicating a distance to which a tool is advanced in the tool channel, and

(ii) an articulating portion at a distal end of the shaft, the articulating portion being configured to articulate, the destination port being distal to the articulating portion, and
(iii) a straight portion at a proximal end of the shaft, the straight portion being configured to remain straight during articulation of the articulating portion, the origin port being proximal to the straight portion;

(d) a first position sensor located at the destination port, the first position sensor being configured to cooperate with an image guided surgery (IGS) navigation system to determine a current position of the first position sensor;
(e) a second position sensor located proximal to the articulating portion and at the straight portion, the second position sensor being configured to operate with the IGS navigation system to determine a current position of the second position sensor;
(f) an integrated endoscope positioned within the endoscope channel, the endoscope channel being adapted to receive the integrated endoscope at the proximal channel opening of the endoscope channel and guide the integrated endoscope to the distal channel opening of the endoscope channel as the integrated endoscope is advanced into the endoscope channel;
(g) an integrated irrigation and suction tool positioned within the tool channel, the tool channel being adapted to receive the integrated irrigation and suction tool at the proximal channel opening of the tool channel and guide the integrated irrigation and suction tool to the distal channel opening of the tool channel as the integrated irrigation and suction tool is advanced into the tool channel; and
(h) an illumination source positioned within the illumination channel, the illumination channel being adapted to receive the integrated illumination source positioned at the proximal channel opening of the illumination channel and guide the integrated illumination source positioned to the distal channel opening of the illumination channel as the integrated illumination source positioned is advanced into the illumination channel;
at least one channel of the plurality of channels being configured to transfer fluid between the origin port and the destination port.

2. The guide sheath of claim 1 , the first position sensor being configured to generate an electrical signal in response to a magnetic field, the electrical signal generated by the first position sensor being configured to indicate the position of the first position sensor within the magnetic field.

3. The guide sheath of claim 1 , the origin port comprising a handle from which the shaft extends, the handle being adapted to be held in a hand during use.

4. The guide sheath of claim 1 , further comprising a control wire with a first end fixed at the distal end of the guide sheath and a second end proximal to the first end, such that the second end may be retracted to cause the articulating portion to flex in a first direction.

5. The guide sheath of claim 4 , a distance of displacement of the control wire within the guide sheath determining a degree to which the articulating portion flexes in the first direction.

6. The guide sheath of claim 4 , the control wire being coupled at the first end to an articulation control, the articulation control being configured to retract the second end of the control wire and thereby cause the flex.

7. The guide sheath of claim 1 , further comprising the IGS navigation system, the IGS navigation system being configured to display the current position of the destination port on a pre-operative image of a surgical site based on a signal from the first position sensor.

8. The guide sheath of claim 7 , the IGS navigation system being further configured to determine a current flex of the articulating portion by comparing a current position of the first position sensor to a current position of the second position sensor and display the articulating portion on the pre-operative image based on the current position and the current flex.

9. The guide sheath of claim 8 , the IGS navigation system being further configured to determine a position of a distal end of a deployed tool within a channel of the plurality of channels and display the position of the distal end of the deployed tool on the pre-operative image.

10. The guide sheath of claim 1 , the first position sensor being configured to be integrated along an exterior surface of the destination port.

11. The guide sheath of claim 1 , the first position sensor being configured to be integrated within an interior portion of the destination port.

12. The guide sheath of claim 1 , the first position sensor comprising a circumferential sensor positioned around a circumference of the destination port.

13. The guide sheath of claim 1 , the articulating portion of the shaft including a plurality of sections configured to articulate the articulating portion.

14. The guide sheath of claim 1 , further comprising a third position sensor, the first and third position sensors being offset from one another around a circumference of the destination port.

15. The guide sheath of claim 1 , the tool tracking sensor including a motion sensor.

16. The guide sheath of claim 1 , the tool tracking sensor including a proximity sensor.

17. The guide sheath of claim 1 , the tool tracking sensor including an optical sensor.

18. The guide sheath of claim 1 , the tool tracking sensor being positioned at the origin port.

19. The guide sheath of claim 1 , the tool tracking sensor being positioned at the destination port.

20. An image guided surgery (IGS) navigation system comprising:
(a) a magnetic field generator operable to provide a magnetic field;
(b) a guide sheath comprising:
(i) a shaft defining a central longitudinal axis and a plurality of channels, the shaft including a straight portion at a proximal end of the shaft, the shaft further including an origin port, the origin port being proximal to the straight portion, the plurality of channels including:
(A) at least one working channel configured to slidably receive an instrument, the at least one working channel being open at a distal end of the shaft,
(B) an endoscope channel configured to receive an endoscope, the endoscope channel being laterally offset from the central longitudinal axis and from the at least one working channel, and
(C) an illumination channel configured to transmit light or receive a light source, the illumination channel being laterally offset from the c

Assignees

• Acclarent Inc

Inventors

• Palushi Jetmir
• Syby Jonathan A
• Fang Itzhak
• Higley Michelle

Classifications

• A61B34/20 Primary

  Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis · CPC title

• A61B1/00154

  using guiding arrangements for insertion · CPC title

• A61B1/015

  Control of fluid supply or evacuation · CPC title

• A61B1/07

  using light-conductive means, e.g. optical fibres · CPC title

• A61B5/062

  using magnetic field · CPC title