WO2005072445A2 - Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities - Google Patents
Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities Download PDFInfo
- Publication number
- WO2005072445A2 WO2005072445A2 PCT/US2005/003140 US2005003140W WO2005072445A2 WO 2005072445 A2 WO2005072445 A2 WO 2005072445A2 US 2005003140 W US2005003140 W US 2005003140W WO 2005072445 A2 WO2005072445 A2 WO 2005072445A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- endoscope
- energy
- treatment
- steerable
- ablation
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0052—Constructional details of control elements, e.g. handles
- A61B1/0053—Constructional details of control elements, e.g. handles using distributed actuators, e.g. artificial muscles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0058—Flexible endoscopes using shape-memory elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/0125—Endoscope within endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2407—Optical details
- G02B23/2461—Illumination
- G02B23/2469—Illumination using optical fibres
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2476—Non-optical details, e.g. housings, mountings, supports
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2476—Non-optical details, e.g. housings, mountings, supports
- G02B23/2484—Arrangements in relation to a camera or imaging device
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0052—Constructional details of control elements, e.g. handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00434—Neural system
- A61B2018/00446—Brain
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
Definitions
- the present invention relates generally to endoscopes and endoscopic medical procedures. More particularly, it relates to methods and apparatus for accessing and treating regions within the body which are difficult to reach through conventional surgical devices and procedures. BACKGROUND OF THE INVENTION Many surgical procedures typically require large incisions be made to provide access to regions within the body.
- thoracotomy typically involves creating an incision in the intercostal space between adjacent ribs while a sternotomy involves the "chest spreader" approach, which is generally the most invasive.
- chest spreader is generally the most invasive.
- such an invasive procedure produces significant morbidity, increased mortality rates, and significantly increases recovery time for the patient.
- Minimally invasive surgery is an alternative surgical procedure in which small incisions are made in the patient's body to provide access for various surgical devices for viewing and operating inside the patient.
- Laparoscopes are typically used for accessing and performing operations within the body through these small incisions using specially designed surgical instruments. These instruments generally have handles which are manipulatable from outside of the patient's body by the surgeon to control the operation of the instrument typically through an elongated tubular section which fits through a tube, introducer, or trocar device entering the patient's body.
- conventional laparoscopic procedures are limited in applicability in part because of a "straight-line" requirement in utilizing laparoscopic tools. This requirement makes accessing certain areas within the body extremely difficult, if not impracticable.
- Flexible endoscopic devices are also available for use in minimally invasive surgical procedures in providing access to regions within the body.
- Flexible endoscopes are typically used for a variety of different diagnostic and interventional procedures, including colonoscopy, bronchoscopy, thoracoscopy, laparoscopy and video endoscopy.
- a flexible endoscope may typically include a fiberoptic imaging bundle or a miniature camera located at the instrument's tip, illumination fibers, one or two instrument channels that may also be used for insufflation or irrigation, air and water channels, and vacuum channels.
- the scope forms loops within the patient.
- excess force may be exerted, damaging delicate tissue in the patient's body.
- the physician may proceed with the attempted insertion of the endoscope without realizing there is a problem.
- a visual imaging device the user can observe images transmitted from the distal end of the endoscope. From these images and from knowledge of the path the endoscope has followed, the user can ordinarily determine the position of the endoscope.
- Such endoscopes may include a steerable distal portion and an automatically controlled proximal portion which may be controlled by a physician or surgeon to facilitate steering the device while the proximal portion may be automatically controlled by, e.g., a controller or computer.
- the steerable endoscope may be advanced within the body of a patient, e.g., via any one of the natural orifices into the body such as through the anus.
- the device may be introduced percutaneously through a small incision into the body. Once the endoscopic device has been introduced into the body, it may be advanced and maneuvered to avoid obstructing anatomical features such as organs, bones, etc., without impinging upon the anatomy of the patient.
- one method of treating an obstructed region of tissue within a body may generally comprise advancing an elongate device into the body through an opening, the elongate device having a proximal portion and a selectively steerable distal portion and the elongate device having a plurality of segments, selectively steering the distal portion to assume a selected curve along a desired path within the body which avoids contact with tissue (or does not require displacement of adjacent tissue along the desired path or avoids applying excess force to the adjacent tissue), and further advancing the elongate device through the body and towards the region of tissue to be treated while controlling the proximal portion of the device to assume the selected curve of the distal portion.
- the endoscopic device may be utilized for neurological surgical applications. Because the endoscopic device is unconstrained by "straight-line" requirements for accessing regions of the brain which are conventionally difficult to reach and/or because the device avoids forming loops when advanced, the endoscope may be accurately advanced and positioned within the cranium by steering the device around the brain with minimal or no trauma to healthy brain tissue. The endoscope may also be advanced through the tissue as necessary to access treatment areas embedded deep within the tissue through pathways which may minimize any damage to healthy adjacent tissue.
- the endoscopic device may allow access to sensitive regions over or within the brain, minimally invasive surgery may be performed where conventional surgery would normally require removal of portions of the skull, for instance, in craniotomy procedures or treatment of intracranial hematomas, etc. In addition, access through the nasal passages or other natural cranial orifices may be facilitated.
- Another area of treatment in which the endoscopic device may be utilized may include use for coronary procedures, e.g., treatment of the mitral valve, tissue ablation for the treatment of atrial fibrillation, placement, removal, or adjustment of pacing leads, etc.
- the endoscopic device may be introduced within the heart via the superior vena cava and advanced through the right atrium.
- the distal portion may be steered through the atrial septum and into the left atrium where the distal portion of the device may be positioned adjacent to the tissue to be treated, in this example, the mural valve.
- various tools or devices e.g., scalpels, graspers, etc.
- various thoracoscopy procedures may be accomplished in a minimally invasive procedure, e.g., percutaneously.
- the endoscope may be advanced into the patient via an introducer or port, which may also be configured as a datum for establishing a fixed point of reference for the endoscope during the procedure.
- the port or datum may be in electrical communication with a computer or processor used for determining and/or maintaining the position of the device within the patient.
- the endoscope may be advanced into the body of the patient through an incision made, e.g., in the intercostal space between the ribs.
- the endoscope may then be advanced into the thoracic cavity and maneuvered to regions within the body such as the posterior region of the heart which are normally inaccessible for conventional laparoscopic procedures due to a lack of straight- line access.
- One embodiment of the present invention provides a method for facilitating a treatment within a body including inserting an endoscope having a steerable distal end and a controllable proximate end, the controllable proximate end being controlled to follow the steerable distal end.
- the endoscope is maneuvered into a position within the body to facilitate a treatment of a body portion.
- a treatment is performed on the body portion.
- the body portion could be, for example, in the thoracic cavity, the skull, or the peritoneal cavity.
- Another embodiment of the present invention provides a system for performing a treatment of a condition related to a physiological indication within a body. There is a system for detecting and localizing a physiological indication within the body.
- a system for providing imaging of a portion of the body related to the physiological indication within the body A steerable endoscope having a steerable distal end and a controllable proximate end under the control of a computer controller that receives information from the system for detecting and the system for providing.
- Another embodiment of the present invention provides a system for facilitating a treatment of the heart having a system for indicating the location of an errant condition of the heart.
- a controller system utilizing information generated by the system for indicating to assist in the articulation of a steerable endoscope having a steerable distal end and a controllable proximate end to follow the steerable distal end into a position to facilitate a treatment of the errant condition of the heart.
- a treatment device provided by the steerable endoscope to perform a treatment of the errant condition of the heart.
- an apparatus for performing a cardiac ablation therapy having a steerable endoscope having a steerable distal end and a controllable proximate end configured to automatically follow the configuration of the steerable distal end.
- An ablation therapy device adapted to be deployed by the steerable endoscope.
- a fastener that fixes the position of the ablation therapy device.
- Another embodiment of the present invention provides a method of performing a treatment within the body by advancing a steerable distal end of an endoscope along a pathway into a treatment position to facilitate a treatment within a body.
- the proximate end of the endoscope is controlled to follow the pathway of the steerable distal end of the endoscope.
- a treatment element is provided to the treatment position.
- Another embodiment of the present invention utilizes a pair of steerable endoscopes to deliver a therapy within the body.
- the pair of endoscopes may be arranged such that one endoscope is within the other endoscope or, alternatively, where one endoscope is adjacent the other endoscope.
- one steerable endoscope may be maneuvered into a desired position within the body to facilitate treatment and then fixed into that position. Thereafter, the second endoscope may be maneuvered to perform the therapy or facilitate a treatment utilizing the fixed position within the body provided by the first endoscope.
- This procedure may be useful in conditions of movement, such as beating heart treatments where the first endoscope may be used as a fixed treatment point for utilizing the second endoscope.
- the endoscope device may also be utilized for procedures within the peritoneal cavity. Potential applications may include minimally invasive surgery for urologic, bariatric, and liver surgery. Moreover, minimally invasive access may be achieved for treatments in spinal or orthopedic surgery as well.
- the endoscope may be introduced into the patient through an incision via a port, which may also function as a datum.
- the distal portion may be steered to avoid various organs while being advanced to a tissue region to be treated, e.g., the liver.
- Fig. 1 shows one variation of a steerable endoscope which may be utilized for accessing various regions within the body without impinging upon the anatomy of the patient.
- Fig. 2A shows a wire frame model of a section of the elongate body of the endoscope in a neutral or straight position.
- FIG. 2B shows an illustration of the endoscope body maneuvered through a curve with the selectively steerable distal portion and automatically controlled proximal portion.
- Fig. 3 shows a cross-sectional side view of a patient's head with a variation of the endoscope being advanced therethrough.
- Fig. 4 shows the interaction of several components to provide a method of positioning a steerable endoscope system to facilitate treatment.
- Fig. 5 shows a cross-sectional anterior view of a heart with the endoscopic device introduced via the superior vena cava and advanced to the right atrium.
- Fig. 6 shows an example of a thoracoscopy procedure which may be performed percutaneously with the endoscopic device.
- FIG. 7 A to 7D show an example of the endoscopic device advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia.
- Figs. 8 A to 8D show an example of the endoscopic device advanced about the posterior region of a heart and retracted to deploy a device to facilitate treatment of a supraventricular tachycardia.
- Fig. 9 shows an embodiment of a treatment device having a plurality of fasteners to facilitate contact between the treatment device and the surrounding tissue.
- Figs. 10A and 10B show additional examples of the endoscopic device advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia (Fig. 10A) and a combination of supraventricular and ventricular tachycardia (Fig. 10B).
- Fig. 10A supraventricular tachycardia
- Fig. 10B a combination of supraventricular and ventricular tachycardia
- FIG. 11 shows yet another example of a treatment for atrial fibrillation using the endoscopic device.
- Figs. 12 A and 12D show additional examples of the endoscopic device advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia and/or combinations of supraventricular and ventricular tachycardia.
- Fig. 13 shows an embodiment of a dual, steerable endoscope of the present invention utilized to facilitate treatment of the heart.
- Figs. 14A to 14C shows side and end views, respectively, of various electrode configurations on the endoscope for tissue ablation treatment.
- Figs. 15 A and 15B show an embodiment of a needle array in a retracted (Fig. 15 A) and a deployed (Fig. 15B) configuration.
- Fig. 15A a needle array in a retracted
- Fig. 15B deployed
- FIG. 16 shows an embodiment of a needle array having a continuous spacing.
- Fig. 17 shows an embodiment of a needle array having a variety of spacing configurations.
- Fig. 18A and 18B show a side and isometric view of an embodiment of a treatment device of the present invention.
- Figures 18C and 18C show a plurality of the treatment devices in optimized positions for facilitating a therapy.
- Fig. 19 shows a graph illustrating a technique to optimize placement of a device to facilitate therapy.
- Fig. 20 shows an example of a procedure within the peritoneal cavity which may be performed with the endoscopic device.
- Endoscopic devices which are particularly useful may include various endoscopes having a steerable distal portion and an automatically controlled proximal portion.
- the steerable distal portion may be controlled by a physician or surgeon to facilitate steering the device while the proximal portion may be automatically controlled by, e.g., a controller or computer.
- the steerable endoscope may be advanced within the body of the patient through a number of different methods. For instance, the endoscope may be introduced via any one of the natural orifices into the body such as through the anus. Alternatively, the device may be introduced percutaneously through a small incision into the body.
- Fig. 1 illustrates one variation of a steerable endoscope 100 which may be utilized for accessing various regions within the body without impinging upon the anatomy of the patient.
- the endoscope 100 generally has an elongate body 102 with a manually or selectively steerable distal portion 104 and an automatically controlled proximal portion 106.
- the selectively steerable distal portion 104 may be selectively steered or bent up to a full 180° bend in any direction, as shown by the dashed lines.
- a fiberoptic imaging bundle 112 and one or more illumination fibers 114 may optionally be extended through the body 102 from the proximal end 110 to the distal end 108.
- the endoscope 100 may be configured as a video endoscope with a miniaturized video camera, such as a CCD or CMOS camera, positioned at the distal end 108 of the endoscope body 102. The images from the video camera may be transmitted to a video monitor by a transmission cable or by wireless transmission.
- the body 102 of the endoscope 100 may also include at least one or two instrument channels 116, 118 that may be used to provide access through the endoscope for any number of tools.
- Channels 116, 118 may also be used for various other purposes, e.g., insufflation or irrigation.
- the elongate body 102 of the endoscope 100 is highly flexible so that it is able to bend around small diameter curves without buckling or kinking.
- the elongate body 102 of the endoscope 100 may range in length typically from, e.g., 135 to 185 cm, and 12 to 13 mm in diameter. However, if the endoscope 100 were utilized in regions within the body which are smaller than the space within, e.g., the gastrointestinal tract, the device may be modified in size to be smaller in diameter.
- the endoscope 100 may also be modified in length to be longer or shorter, depending upon the desired application.
- a handle 120 is attachable to the proximal end 110 of the elongate body 102.
- the handle 120 may include an ocular 124 connected to the fiberoptic imaging bundle 112 for direct viewing and/or for connection to a video camera 126.
- the handle 120 may also be connected to an illumination source 128 via an illumination cable 134 that may connected to or continuous with the illumination fibers 114.
- An optional first luer lock fitting 130 and an optional second luer lock fitting 132 which may be in communication with instrument channels 116, 118, respectively, may also be located on or near the handle 120.
- the handle 120 may be connected to an electronic motion controller 140 by way of a controller cable 136.
- a steering control 122 may be connected to the electronic motion controller 140 by way of a second cable 138.
- the steering control 122 may be configured to allow the physician or surgeon to selectively steer or bend the selectively steerable distal portion 104 of the elongate body 102 in the desired direction.
- the steering control 122 may be a joystick controller as shown, or other known steering control mechanism.
- the steering may be effected manually, e.g. by the use of cables, hydraulics, or pneumatics, or any other known mechanical apparatus for controlling the distal portion of the elongate body.
- the electronic motion controller 140 may be used to control the motion of the automatically controlled proximal portion 106 of the elongate body 102 and may be implemented using a motion control program running on a microcomputer or through an application-specific motion controller. Alternatively, the electronic motion controller 140 may be implemented using a neural network controller.
- An axial motion transducer 150 may be provided to measure the axial motion of the elongate body 102 as it is advanced and withdrawn.
- the axial motion transducer 150 can be made in many configurations, some of which are described below.
- the axial motion transducer 150 is configured as a ring 152, for illustrative purposes only, that surrounds the elongate body 102 of the endoscope 100.
- the axial motion transducer 150 may be attached to a fixed point of reference, such as the surgical table or the insertion point for the endoscope 100 on the patient's body, as described below.
- the axial motion transducer 150 may use optical, electronic, magnetic, mechanical, etc., methods to determine the axial position of the endoscope body 102.
- the motion transducer may be configured to simultaneously measure and communicate rotational motion of the endoscope, so that this additional data may be used in the control of the instrument's motion.
- FIG. 2 A shows a wire frame model of a section of the body 102 of the endoscope 100 in a neutral or straight position. Most of the internal structure of the endoscope body 102 has been eliminated in this drawing for the sake of clarity.
- the endoscope body 102 is divided up into sections 1, 2, 3 . . . 10, etc.
- the geometry of each section is defined by four length measurements along the a, b, c and d axes.
- the geometry of section 1 may be defined by the four length measurements 1 ⁇ a , 1 ib, 1 lc, 1 id
- the geometry of section 2 may be defined by the four length measurements l 2a , h b , e, l 2d , etc.
- the geometry of each section may be altered using the linear actuators to change the four length measurements along the a, b, c and d axes.
- the measurements l ⁇ a , a, a • • ••lioa can be shortened and the measurements lib, hb, l 3 b liob can be lengthened an equal amount.
- the a, b, c and d axis measurements of each section may be automatically controlled by the electronic motion controller 140.
- the endoscope body 102 has been maneuvered through the curve C with the benefit of the selectively steerable distal portion 104 and now the automatically controlled proximal portion 106 resides in the curve C.
- the axial motion transducer 150 produces a signal indicative of the axial position of the endoscope body 102 with respect to a fixed point of reference and sends the signal to the electronic motion controller 140. Under control of the electronic motion controller 140, each time the endoscope body 102 advances one unit, each section in the automatically controlled proximal portion 106 is signaled to assume the shape of the section that previously occupied the space that it is now in.
- the S-shaped curve propagates proximally along the length of the automatically controlled proximal portion 106 of the endoscope body 102.
- the S-shaped curve appears to be fixed in space, as the endoscope body 102 advances distally.
- each section in the automatically controlled proximal portion 106 is signaled to assume the shape of the section that previously occupied the space that it is now in.
- the S-shaped curve propagates distally along the length of the automatically controlled proximal portion 106 of the endoscope body 102, and the S-shaped curve appears to be fixed in space, as the endoscope body 102 withdraws proximally.
- the axial motion transducer 150 may be used to detect the change in position and the electronic motion controller 140 may be used to propagate the selected curves proximally or distally along the automatically controlled proximal portion 106 of the endoscope body 102 to maintain the curves in a spatially fixed position.
- a rotational motion transducer (separate from or integrated within transducer 150) may be used to detect the change in position and the electronic motion controller may be similarly used to adjust the shape of the endoscope body 102 to maintain the curves in a spatially fixed position. This allows the endoscope body 102 to move through tortuous curves without putting unnecessary force on the wall of the curve C. Examples of other endoscopic devices which may be utilized in the present invention are described in further detail in the following patents and co-pending applications, U.S. Pat. No. 6,468,203; U.S. Pat. No. 6,610,007; U.S. Pat. App., No. 10/087,100 filed March 1, 2002; U.S.
- the endoscope may be advanced and positioned within the cranium by steering the device around the brain with minimal or no trauma to healthy brain tissue.
- the endoscope may also be advanced through the tissue as necessary to access treatment areas embedded deep within the tissue through pathways which may minimize any damage to healthy adjacent tissue.
- minimally invasive surgery may be performed where conventional surgery would normally require removal of portions of the skull, for instance, in craniotomy procedures or treatment of intracranial hematomas, etc.
- Fig. 3 shows a cross-sectional side view of head 202 of patient 200.
- the brain 206 may be seen within the cranial cavity 210 of cranium 204.
- the endoscopic device 212 is an embodiment of a steerable endoscope of the present invention that has been sized, shaped and configured for accessing the interior of the cranial cavity and external and internal regions of the brain.
- the movement, position, tracking and control of the endoscopic device 212 is performed by a user alone or in cooperation with any or all of imaging systems, position and location systems, and surgical planning methods and techniques.
- the endoscopic device 212 may be introduced into the cranial cavity 210 from an easily accessible insertion site 222, e.g., a perforation within the skull.
- the endoscope 212 may be then advanced through the insertion site 222 by controlling the steerable distal portion 214 to avoid brain tissue. As the endoscope 212 is further advanced into the cranial cavity 210, the automatically controlled proximal portion 216 may attain the shape defined by the steerable distal portion 214 to avoid contact with brain tissue 206. The endoscope 212 may be further advanced through the cranial cavity 210 and within the cerebrospinal fluid so that the device is advanced above or within the layers of the meninges, e.g., within the subarachnoid space. In either case, the endoscope 212 may be steered along a path which avoids or minimizes contact or pressure against the brain tissue 206.
- the proximal portion 216 As the controlled proximal portion 216 is advanced distally and attains the shape defined by the distal portion 214, the proximal portion 216 likewise may be controlled to automatically avoid or minimize contact or pressure against the brain tissue 206.
- various tools 220 may be introduced through the instrument channel 218 to enable treatment of the region 208. Any number of treatments or procedures may accordingly be effected, e.g., tumor biopsy and/or removal, shunt placement, lead placement, device placement, drainage of excess cerebrospinal fluid or blood, etc.
- Fig. 4 shows the interaction of several components to provide a method of positioning a steerable endoscope system to facilitate treatment.
- the system schematic 4000 illustrates one embodiment of an integrated detection, mapping and control system for positioning and controlling a steerable, controllable endoscope of the present invention.
- a suitable device, element or system is used to detect and localize a physiological indication (4010).
- a physiological indication could be any perceptible indicia of a condition for which treatment may be facilitated.
- physiological indicators include electrophysiology data or electrical signals from the heart. This system would be capable of identifying or performing analysis of monitored data to identify or determine the location of errant activity.
- An image/mapping system includes any imaging modality that may provide position, location, tissue type, disease state, or any other information that facilitates correlating the physiological activity to a identifiable and/or localizable position within the anatomy or within a frame of reference.
- imaging technologies such as x-ray, fluoroscopy, computed tomography (CT), three dimensional CAT scan, magnetic resonance imaging (MRI), and magnetic field locating systems.
- Examples of image/mapping systems specifically suited for the treatment of cardiovascular disorders include electrocardiogram detection systems, cardiac electrophysiology mapping systems, endocardial mapping systems, or other systems and methods that provide the ability acquire, visualize, interpret and act on cardiac electrophysiological data.
- An example of such a system is described in US Patent 5,848,972 entitled, “Method for Endocardial Activation Mapping Using a Multi- Electrode Catheter” the entirety of which is incorporated herein by reference. Additional examples are described in US Patent 5,487,385; US Patent 5,848,972; and US Patent 5,645,064, the entirety of each of these patents is incorporated by reference.
- Integrated mapping, detection and or ablation probes and devices may also be delivered using the steerable endoscope of the present invention.
- Additional other systems may provide mapping, display or position information of a local isochronal activation map of the heart along with the relative position of the endoscope and direction information or movement commands to position the endoscope (or components, elements or systems onboard the endoscope) to provide treatment to the source of the arrhythmia.
- information provided, compiled and/or analyzed in the prior steps or other additional information provided by a user or other system used by the user is input into or utilized by the endoscope controller (4030).
- This step indicates the ability of the endoscope controller to respond to the indication, position, image, mapping and other data and utilize that data for altering the scope configuration, position, orientation or other relational information indicative of the scope controller responding to the information provided.
- the endoscope is configured to provide of facilitate providing components, elements or systems to facilitate a treatment of the physiological indication being monitored.
- the controller utilizes the data provided to position the steerable, controllable endoscope into a position related to the location or site that exhibits the errant activity. The proximity of the endoscope to the location or site of the errant activity will vary depending upon, for example, the treatment being implemented, the element, component or system being used to facilitate treatment.
- the system 4000 may include an overall mapping system that provides medically significant data that facilitates a treatment.
- This overall mapping or imaging system may include mapping or imaging an area of monitored activity.
- the area of monitored activity includes not only the portion of the body important to the treatment but also imaging information of those other parts of the body not impacted by the treatment but are instead the likely pathway(s) of the steerable, controllable endoscope to reach the area where the treatment will be facilitated.
- some embodiments of the system may include the ability to detect, localize or otherwise indicate the position of the treatment area or area of errant activity or conditions subject to treatment. These indications may then be utilized to augment the guidance of the steerable, controllable endoscope into the desired position to facilitate treatment.
- other medical imaging and tracking systems may be utilized to provide tracking, guidance and position feedback information to the control of the steerable endoscope.
- An exemplary system is described by Dumoulin et al. in US Patent 5,377,678 which is incorporated herein by reference in its entirety. The above steps are only representative of one embodiment of how physiological indications, and position information may be utilized to improve the guidance system and controls used by steerable endoscopes to ensure the placement of the endoscope to facilitate treatment.
- image and mapping systems may also be employed and may also be selected depending upon the treatment being facilitated through the use of a steerable controllable endoscope of the present invention.
- the system may also control the movement of the endoscope automatically based on inputs from the user, pre-surgical planning data, or other indications of desired pathways or pathways to avoid.
- a user may input additional guidance or control information into the system for furthering the guidance or desired placement of the endoscope.
- Another area of treatment in which the endoscopic device may be utilized may include use for coronary procedures, e.g., treatment of the mitral valve, performing or facilitating treatment of supraventricular tachycardia, including, for example, tissue ablation for the treatment of atrial fibrillation, treatment of ventricular tachycardia alone or in combination with treatment of supraventricular tachycardia, treatments for the placement, repositioning or removal of device leads, etc.
- Atrial fibrillation is typically sustained by the presence of multiple electrical reentrant wavelets propagating simultaneously in the atria of the heart.
- Surgical and catheter-based techniques typically place segmented or continuous lesions near and around the pulmonary veins as one way to re-synchronize the atria.
- Embodiments of the present invention may be utilized to facilitate ablation therapies, ablation elements and devices that employ one or a combination of energy modalities, such as, for example, cryogenic energy, hydraulic energy, laser energy, magnetic energy, mechanical energy, microwave energy, radiation energy, radio-frequency energy, thermal energy, and ultrasonic energy.
- energy modalities such as, for example, cryogenic energy, hydraulic energy, laser energy, magnetic energy, mechanical energy, microwave energy, radiation energy, radio-frequency energy, thermal energy, and ultrasonic energy.
- Microwave ablation systems may include, for example, those based on AFx microwave surgical ablation systems such as the AFx Flex 4 or the like. AFx is currently owned by Guidant Corp.
- Cryogenic ablation systems may include, for example, systems available from Cryocath Technologies such as the "SurgiFrost,” “Frostbyte” or “Artie Circler” systems and the like. Ultrsound based surgical probes may be, for example, based upon the ultrasound ablation systems produced by EpiCor Medical or the like. A large number of commercially available ablation systems are available to illustrate the wide variety of ablation systems , techniques and modalities that may be delivered or utilized by embodiments of the steerable endoscopic systems of the present invention. As shown in Fig. 5, a cross-sectional anterior view of heart 302 may be seen in coronary procedure 300 for treatment of the mitral valve MV located between the left atrium LA and the left ventricle LV.
- the endoscopic device 212 is shown in this treatment variation as being introduced within the heart 302 via the superior vena cava SVC and advanced through the right atrium RA. Also shown is the right ventricle RV below the tricuspid valve TV and inferior vena cava IVC.
- the endoscope 212 may be sized accordingly to be delivered intravascularly. Once the endoscopic device 212 is within the right atrium RA, the distal portion 214 may be steered towards the atrial septum AS which separates the left atrium LA and right atrium RA. Once at the atrial septum AS, a cutting tool deliverable through the device 212 may be used to perforate the atrial septum AS to allow passage of the endoscopic device 212 into the left atrium LA.
- the distal portion 214 may then be steered and positioned adjacent the mitral valve MV while the proximal portion 216 is automatically controlled to minimize any pressure which may be exerted by the device 212 against the tissue of the heart 302.
- various tools or devices may be delivered through the channel 218 to effect the treatment.
- the endoscope 212 may simply be withdrawn proximally in the same manner while minimizing any contact pressure against the tissue.
- various thoracoscopy procedures may be accomplished in a minimally invasive procedure. Fig.
- FIG. 6 shows an example of a thoracoscopy procedure 400 which may be performed percutaneously.
- the endoscope 212 may be advanced into the patient 402 via an introducer or port 412, which may also be configured as a datum for establishing a fixed point of reference for the endoscope 212 during the procedure.
- the port or datum 412 may be in electrical communication via electrical lines 418 with a computer or processor 416 which may be used for determining and/or maintaining the position of the device 212 within the patient 402.
- the endoscope 212 may be advanced into the body of the patient 402 through an incision 414 made, e.g., in the intercostal space between the ribs 404.
- the endoscope 212 may then be advanced into the thoracic cavity and maneuvered to regions within the body such as the posterior region of the heart 408 which are normally inaccessible for conventional laparoscopic procedures due to a lack of straight-line access.
- the endoscopic device 212 is shown having been inserted through port or datum 412 and advanced posteriorly of heart 408 behind sternum 406.
- the lungs are not shown for the sake of clarity; however, the endoscope 212 may be steered and advanced around the lungs in a manner described above so as to avoid contact or to minimize contact with the lung tissue or any other organs or structures which may be obstructing a straight-line path.
- the endoscopic device 212 is capable of reaching regions within the body, without damaging surrounding tissue, which is normally inaccessible via conventional laparoscopic procedures.
- Figs. 7A to 7D show an example of the endoscopic device advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia.
- a supraventricular tachycardia is atrial fibrillation.
- Another procedure 500 is shown in Figs. 7A to 7D, which illustrate how the endoscopic device may be utilized for the treatment of atrial fibrillation.
- the figures show a posterior view of the heart with the aorta AA and pulmonary trunk PT as anatomical landmarks.
- Atrial fibrillation is typically sustained by the presence of multiple electrical reentrant wavelets propagating simultaneously in the atria of the heart.
- Surgical and catheter-based techniques typically place segmented or continuous lesions near and around the pulmonary veins as one way to re- synchronize the atria.
- the endoscopic device 212 may be utilized by advancing the device 212 into the thoracic cavity, as described above or through various other channels, and steered towards the posterior region of the heart.
- the steerable distal portion 214 may be advanced as shown in Fig. 7A such that the endoscope 212 approaches above the left pulmonary veins LPV.
- Fig. 7A such that the endoscope 212 approaches above the left pulmonary veins LPV.
- the distal portion 214 may be steered around the right pulmonary veins RPV while the endoscope 212 is advanced distally.
- the automatically controllable proximal portion 216 may thus assume the shape defined by the distal portion 214 in traversing around the pulmonary vessels.
- the distal portion 214 is steered around the left pulmonary vessels LPV while the proximal portion has assumed the curved path traversed by the device around the right pulmonary vessels RPV.
- the device 212 may be fully advanced entirely around the pulmonary vessels such that the distal portion 214 and proximal portion 216 are in intimate contact against the heart tissue while maintaining its configuration.
- the tissue which is in contact against the device 212 may then be ablated by one or several electrodes located along the length of the distal and/or proximal portions 214, 216, as described in further detail below.
- an ablation device such as a catheter or other energy source, may be delivered through one or more working channels in or on the endoscope, and left in place as desired. This ablation device may then be used to deliver ablative energy in various forms, e.g., RF, microwave, cryogenic cooling, etc as described herein or known to those of ordinary skill in the art.
- Figs. 8 A to 8D show an example of a procedure 600 wherein a steerable endoscopic device is advanced about the posterior region of a heart and then retracted to deploy a device to facilitate treatment of a supraventricular tachycardia.
- the steerable endoscopic device 800 is capable of reaching regions within the body as described above and as an improvement over laparoscopic procedures.
- the figures show a posterior view of the heart with the aorta AA and pulmonary trunk PT as anatomical landmarks. Fig.
- FIG. 8A illustrates an endoscopic device 800 having a steerable, controllable distal end 805 and a controllable proximal end 810.
- the endoscopic device 800 has been maneuvered into position to initiate deployment of an ablation device 815.
- the steerable endoscopic device 800 has been maneuvered to the initial deployment point by tracing out a desired deployment or treatment pathway about the pulmonary veins. While illustrated with regard to the pulmonary veins for purposes of the discussion of procedure 600, the utilization of the steerable endoscope is not so limited and may be used to trace out desired treatment pathways about organs, tissues and body portions as desired.
- Fig. 8 A illustrates an endoscopic device 800 having a steerable, controllable distal end 805 and a controllable proximal end 810.
- FIG. 8 A also illustrates the ablation device 815 distal end is attached to the heart using any of the attachment methods described in this application or known to those of ordinary skill in the art.
- the steerable endoscope 800 is withdrawn proximally along the pathway leaving behind the ablation device 815.
- the ablation device 815 is completely deployed about the pulmonary veins in the desired deployment pathway created by the steerable endoscope 800.
- the endoscope 800 may be withdrawn during the treatment that utilizes the ablation device 815.
- the endoscope 800 may be utilized to visually inspect the position and orientation of each ablation element distributed along the ablation device 815 in those embodiments where the ablation device 815 comprises a plurality of ablation elements.
- the ablation device 815 has been illustrated as a single ablation element for ease of illustration.
- the endoscope may also be utilized to ensure the ablation device 815 has been properly deployed into the desired position to facilitate treatment.
- the endoscope may be utilized to visually inspect any fasteners or other adhesives or affixing means used to maintain the position of the ablation device 815 relative to the pulmonary veins.
- Fig. 9 shows an embodiment of a treatment device having a plurality of fasteners to facilitate contact between the treatment device and the surrounding tissue.
- An endoscopic device 900 has a controllable, steerable end 905 positioned to deploy or facilitate the deployment of an ablation device 915.
- the ablation device 915 has a plurality of ablation elements 920.
- the ablation device 915 also has a plurality of fasteners 925 to increase the contact between the ablation device 915 and the surrounding tissue, organ or body portion to facilitate ablation therapy. Note the position of the fasteners 925 relative to the ablation elements 920 to provide maximum contact between and to ensure the location of the ablation elements 920 relative to the surrounding tissue.
- the fasteners 925 may be in other positions and may also be of other configurations and type described elsewhere in this application and/or as known to those of ordinary skill in the art.
- the fasteners 925 could be configured such that as the steerable tip 905 is withdrawn proximally, the fastener 925 engages the surrounding tissue to secure the position of the ablation device 915. Once the ablation device 915 is positioned, the ablation treatment proceeds as desired. When the ablation treatment is complete, the steerable endoscope 900 is advances proximally from the distal end of the ablation device 915. As the steerable endoscope tip 905 advances distally past a fastener 925, the fastener 925 along with the ablation device 915 are withdrawn into the steerable endoscope 900. It is to be appreciated that any of a wide variety of fasteners may be utilized to engage with the surrounding tissue.
- the fasteners 925 could be formed from superelastic or shape memory alloy material.
- the properties of the shape memory alloy material could be selected such that the thermal energy of the body temperature is used to engage the fastener with the surrounding tissue.
- the shape memory alloy fasteners could be selectively actuated to release the shape memory effect to engage with the surrounding tissue.
- Engagement with the tissue includes fasteners that do not break the surface of the tissue as well as fasteners that do break the surface of the tissue. While some fasteners may disengage from the surrounding tissue through the movement of the steerable endoscope, it is to be appreciated that a tool or element may be present on or in the distal end of the endoscope 900 to facilitate the disengagement of the fastener from the surrounding tissue. Figs.
- FIG. 10A and 10B show additional examples of the endoscopic device advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia (Fig. 10A) and a combination of supraventricular and ventricular tachycardia (Fig. 10B).
- Fig. 10A shows another variation 600 of treating atrial fibrillation where the device may be steered and configured to loop in a continuous manner about the pulmonary vessels in a first encirclement 602 over the left pulmonary vessels LPV and a second encirclement 604 over the right pulmonary vessels RPV.
- the encircled portions 602, 604 of the endoscope 212 may be activated to ablate the heart tissue only around the pulmonary vessels LPV, RPV or alternatively, it may be activated to ablate the heart tissue along the entire length of both distal portion 214 and proximal portion 216.
- a variety of ablation devices may be delivered to the desired areas, as described above. In another specific example, Fig.
- FIG. 10B shows another variation 650 of treating atrial fibrillation where the device may be steered and configured to loop in a continuous manner about the pulmonary vessels in a first encirclement 602 over the left pulmonary vessels LPV and a second encirclement 652 over the right pulmonary vessels RPV and then across a portion of the ventricle (654).
- the encircled portions 602, 652, 654 of the endoscope 212 may be activated to ablate the heart tissue around the pulmonary vessels LPV, RPV and the ventricular portion adjacent 654. Alternatively, it may be activated to ablate the heart tissue along the entire length of both distal portion 214 and proximal portion 216.
- Fig. 11 shows yet another example of a treatment for atrial fibrillation using the endoscopic device.
- Fig. 11 shows yet another variation 700 in which the endoscope 216 may be advanced and steered to contact the portions of tissue posteriorly adjacent to the pulmonary vessels LPV, RPV such that an encircled region is formed 702.
- embodiments of the steerable endoscope of the present invention may be positioned about a portion of the coronary vasculature or other coronary landmarks to facilitate treatments of the heart.
- the endoscope 216 has been maneuvered using the techniques described herein into a position interior and adjacent the pulmonary veins and extended towards the inferior vena cava.
- the extreme configurability and controllability of the space and position of steerable endoscopes of the present invention enable placement of therapeutic devices, elements and systems about the heart and elsewhere within the body to facilitate treatment.
- Figs. 12A and 12D illustrate additional alternative embodiments of steerable endoscopic devices of the present invention advanced about the posterior region of a heart to facilitate treatment of a supraventricular tachycardia and/or combinations of supraventricular and ventricular tachycardia. As described above with regard to Fig.
- Figure 12A illustrates an endoscopic device 1200 positioned about both the LPN and RPV and encircling one of the LPN and then proceeding anteriorly across a ventricular portion of the heart 1205.
- Figure 12B illustrates an endoscopic device 1200 positioned about both the LPN and RPN and encircling one of the LPV and then proceeding laterally across a ventricular portion of the heart 1210.
- Figure 12C illustrates an endoscopic device 1200 positioned about both the RPN, partially encircling the LPV and then proceeding anteriorly across a ventricular portion of the heart 1205.
- the first steerable endoscopic device 1250 is positioned laterally across the heart and partially encircling a LPV and a RPV.
- the second endoscopic device 1260 is positioned adjacent a LPV, encircling a RPV and then proceeding anteriorly across a ventricular surface of the heart 1205. It is to be appreciated that the first steerable endoscope 1250 may be used to facilitate a first ablation therapy at the same time, subsequent to or in a sequence with a second ablation therapy facilitated by the second steerable endoscope 1260.
- Fig. 13 shows an embodiment of a dual, steerable endoscope 1300 of the present invention utilized to facilitate treatment of the heart.
- the dual steerable endoscope 1300 includes a first steerable endoscope 1305 and a second steerable endoscope 1310 disposed within the first steerable endoscope 1305.
- both endoscopes 1305, 1310 are articulated to an initial condition (I).
- the second endoscope 1310 proceeds along the pathway (a) through (i) to encircle the LPN, RPV and then proceed across a ventricular portion of the heart.
- the second endoscope 1310 may proceed along the pathway under control of a user. Alternatively, the second endoscope 1310 may proceed along the pathway by automatically deploying based upon any or a combination of pre-surgical planning imagery, real time imagery, mapping system receiving inputs from a detection or tracking system. In another alternative, the second endoscope 1310 proceeds using a combination of automatic controls and user input. While described above in an application for treating the heart, it is to be appreciated that the first and second steerable endoscopes may be utilized to access portions of the neurovasculature, and other regions by maintaining the size of the second steerable endoscope to be much less than the size of the first endoscope.
- the first endoscope may positioned in a first position, affixed in that position to act as a stable platform and/or datum for the second steerable endoscope. From that stable base, the second endoscope may be deployed to facilitate treatments.
- Figs. 14A to 14C shows side and end views, respectively, of various electrode configurations on the endoscope for tissue ablation treatment.
- the endoscope 900 may be configured with a number of elements, devices or systems to facilitate treatment.
- a steerable endoscope of the present invention may have a plurality of electrodes disposed along its outer surface to facilitate the tissue ablation along the length, or selected regions of length, of the endoscope, as shown as described herein.
- the figure shows the steerable distal portion 904 and part of the automatically controllable proximal portion 902 as one example of electrode placement over the endoscope 900.
- one or any number of electrodes 906 may be circumferentially positioned, e.g., ring-shaped, along the length of endoscope 900 at intervals.
- the electrodes 906 are shown positioned at uniform intervals in this variation; however, they may be configured in any random, arbitrary, or specified locations over the outer surface of the endoscope 900.
- Each of the electrodes 906 may be electrically connected via corresponding wires 908 to a power supply and/or controller. Thus, all the electrodes 906 may be configured to operate simultaneously or to operate only selected electrodes 906 which may be in contact with tissue.
- Fig. 14B shows another variation in endoscope 910 in which electrodes 916 may be configured to extend longitudinally over the proximal portion 912 and/or distal portion 914.
- the electrodes may be configured to extend in a continuous strip along the endoscope length or the electrodes 916 may be alternatively configured to extend in a segmented manner longitudinally over the endoscope 910, as shown. Having segmented electrodes 916 may allow for selected electrodes to be activated during tissue ablation.
- Fig.l4B shows a single line of electrodes 916 for illustration purposes, multiple lines of electrodes may be positioned over the outer surface of the device, as shown in the example of Fig.
- a treatment device may be advantageous to increase the degree of contact or ensure the position between the treatment tool, element, or device and the tissue, organ or portion of the body receiving the treatment.
- means for increasing contact or affixing the position of a treatment device include: biocompatible adhesives, glues and gels either alone or in combination with staples, suction, wires, barbed and barb-less hooks or hook shaped to loop around specific anatomy.
- a hook shaped to loop around specific anatomy includes J-shaped hooks to loop, at least partially, about the coronary vasculature.
- a J-shaped hook may be shaped and configured to at least partially encircle a pulmonary vein.
- wires, staples or other fastening components may be formed from shape memory alloy material such as, nitinol or other suitable, biocompatible shape memory alloy material.
- shape memory alloy fastener could be held in a first or stowed condition while navigating to the site prior to facilitating treatment. Once the treatment device is positioned, the shape memory alloy fastener could be activated and use the shape memory effect to affix the treatment device into the desired position.
- a steerable endoscope having a magnetic portion could be deployed about the tissue, organ or region of the body to facilitate treatment. Thereafter, the steerable endoscope could be used as a guide for the placement of an ablation system.
- Permanent magnets or electromagnets could be used to magnetically couple the ablation system in a desired position adjacent the steerable endoscope. Once the treatment was completed, the magnetic field is broken and the ablation system and steerable endoscope withdrawn, could be deployed in proximity to the steerable endoscope and a
- the steerable endoscope itself may be looped around the organ, tissue or portion of the body to undergo treatment and then secured to itself in order to facilitate treatment.
- the distal end of the endoscope could be anchored with a dissolvable suture or other dissolvable biodegradable fastener that remains in place after the ablation treatment is completed and is then absorbed into the tissue or dissolves.
- an array of needles may be configured along the length or a portion of the length of the ablation device or steerable endoscope or both.
- an array of conductive needles are arranged to improve contact between an RF ablation based delivery system and the tissue undergoing treatment.
- other suitable elements may be employed to improve the effectiveness of other ablation modalities. It is to be appreciated therefore that while needle arrays are described as increasing the effectiveness of the delivery of RF ablation energy, other elements and configurations may be used to increase the effectiveness of other ablation therapy modalities. Alternatively, for non-energy based ablation, such as ablation techniques that use lacerations of the tissue, then the elements could be any suitable device for cutting or otherwise altering the tissue to achieve a therapeutic affect.
- Figs. 15A and 15B show an embodiment of a needle array in a retracted (Fig. 15 A) and a deployed (Fig. 15B) configuration.
- a portion of a steerable endoscope or ablation element 1500 is shown in cross section.
- Ablation needles 1505, 1510 are attached to backing plate 1515.
- the needles are maintained in the stowed configuration (Fig. 15 A) with the backing plate retracted to reduce the risk of inadvertent tissue damage as the steerable endoscope or ablation system is advanced to the treatment site.
- the needles 1505, 1510 remain below the steerable endoscope or ablation element exterior surface 1502.
- the backing plate 1515 is advanced to the deployed condition (Fig. 15B).
- the needles 1505, 1510 protrude beyond the steerable endoscope or ablation element exterior surface 1502.
- the needles 1505, 1510 When positioned in the body for treatment, the needles 1505, 1510 would make suitable contact with the surrounding tissue, organ or body portion to facilitate treatment.
- the backing plate may be moved between the retracted and deployed configuration utilizing any of a number of techniques. Examples of such techniques and methods include, mechanical drives, hydraulics, motors, actuators, permanent magnets, electromagnets, spring loaded actuators, vacuum, or other conventional actuation means.
- the actuation means could be any suitable actuation force capable of displacing the backing plate 1515 to urge a portion or all of a needle array from a retracted position into a deployed position and hence into suitable contact with the organ, tissue or body portion to receive treatment.
- the backing plate 1515 could be continuously biased outwardly, here, outwardly indicates a position where the needles would move into a deployed configuration.
- the ablation element or steerable endoscope having the needle array could be covered with a moveable sheath. Once the ablation element or moveable endoscope is in the desired position, the sheath is retracted releasing the backing plate bias and allowing the needles to move into a deployed configuration.
- the illustrated embodiment illustrates a pair of needles in cross section.
- the additional needles may be, for example, arrayed in a regular continuous pattern as in Fig. 16.
- a single needle or array on continuous, discontinuous or random arrangement of needles may be used.
- more than teo needles may be used.
- the illustrated needles 1505, 1510 have a separation angle ⁇ i The separation angle may vary from 0 to 180 degrees in one embodiment, from 0 to 70 degrees in another embodiment or from 0 - 30 degrees in yet another embodiment depending upon application.
- the needles may have a regular separation angle meaning that the needles are at regular angular intervals.
- the needles in a multiple needle configuration may be placed in non- regular or variable separation angles.
- the spacing between needles may also be continuous or variable.
- the needles may be arranged into a single continuous segment with uniform spacing. Such a uniform array of needles is illustrated in Fig. 16.
- the ablation element or steerable endoscope section configured for ablation 1600 is shown in Fig. 16.
- Needles 1610 are shown in a single segment or grouping of needles 1605.
- Fig. 17 shows an embodiment of a needle array segment 1700 having three sections
- Section 1705 includes an upper array of needles 1726, 1728 and 1730 aligned in a continuous uniform fashion above a lower array of needles 1720, 1722 and 1724. This configuration is similar to section 1600 in Figure 16.
- the upper array of section 1710 has evenly spaced needles 1732, 1734 and 1736.
- the lower array of needles have only one needle aligned to the upper array. Needle 1738 is aligned with needle 1732. There is no needle in the lower array that corresponds to needle 1736.
- a plurality of needles (1740, 1741 and 1742) are spaced across from upper array needle 1734.
- the section 1710 illustrates how there may be needle to needle correspondence (1732, 1738), no correspondence (1736) or one to many correspondence (1734, 1740, 1741, 1742) between the needles in the upper and lower arrays of a section.
- Section 1715 further illustrates the configurabilty of the needle arrangements. Both the upper needles 1750, 1752, 1754 1756 and lower needles 1766, 1768, 1770, 1771, 1772, 1773 illustrate variable spacing. In addition, there is no alignment between the upper and lower arrays.
- section 1715 illustrates a middle array having upper needles 1758, 1760 spaced apart from lower needles 1762, 1764.
- the upper and lower needles are aligned but that need not be the case in all embodiments.
- the middle array is illustrated without alignment to the upper array and the lower array. This need not be the case in all embodiments.
- the middle array may be aligned with all or part of either a lower or an upper array. Accordingly, a needle pattern within a section could be predetermined and selected to facilitate a desired ablation treatment. Moreover, using pre-surgical planning techniques, the type, number, amount and ablation pattern could be predetermined and an appropriate combination of segments, sections and needles arrays could be loaded into a steerable endoscope or otherwise delivered utilizing a steerable endoscope to facilitate treatment. Fig.
- the tunable treatment device 1800 includes an ablation element 1810 within a housing 1805.
- the housing 1805 also includes an opening 1815 that allows the energy generated by the ablation element 1810 to pass outside of the housing.
- the opening 1815 is fitted with a cover 1820 that forms a seal between the environment the tunable treatment device 1800 is positioned in and the interior of the housing 1805.
- the housing 1805 is made of a first material and the cover 1820 is made of a second material. With respect to the energy generated or provided by the ablation element 1810, the first material transmits less of the energy generated by the ablation element 1810 than the second material.
- the first material acts as a shield separating the ablation energy generated by the ablation element and the surrounding environment.
- the second material acts as a transmission window or opening in an otherwise shielded housing.
- the transmission window or opening thus allows energy provided by the ablation element to be selectively passed via the opening into the tissue, organ or environment positioned adjacent the cover 1820.
- the tunable ablation delivery device 1800 is also provided with a detector 1830 for detecting a physiological indication useful in administering the ablation therapy.
- the detector 1830 may comprise a plurality of detection elements arrayed about the housing 1805.
- the detector 1830 includes a plurality of detection elements 1835.
- the detection elements 1835 are arranged at regular intervals about the perimeter of the housing 1805. A reading may be obtained from each element and then analyzed to determine which element or elements obtained the best reading for the physiological parameter being measured. Once that determination is made, the tunable ablation device 1800 may then be oriented to place the opening 1815 into position to facilitate ablation treatment.
- the tunable ablation delivery device 1800 may be modified to facilitate an ablation treatment on the pericardium of the heart.
- the detection elements 1835 may be elements capable of detecting electrophysiological (EP) activity.
- the detection elements 1835 could detect electrophysiological (EP) activity by detecting ECG activity.
- FIG. 19 shows a graph illustrating a technique to optimize placement of a tunable ablation device to facilitate therapy.
- the detection elements 1835 may be used to localize the position, relative to the housing 1805, where the desired amount of physiological indication occurs.
- the desired activity is the peak EP activity.
- the peak EP activity occurs in proximity to sensor position 5. This information can then be used by the control system that articulates, rotates, translates or otherwise positions the tunable ablation element 1800 to position the tunable ablation element 1800 into a position that facilitates an ablation treatment in the vicinity of sensor 5.
- the tunable ablation device 1800 would be rotated under the control of a control system having the relative position and orientation of the plurality of elements 1835 and the opening 1815 and ablation element 1810.
- the tunable ablation device 1800 would be rotated under the control of a control system using for example, the engagement element 1845, to align the opening 1815 and/or cover 1820 into the orientation of sensor 5.
- An example of how a plurality of tunable ablation elements may be advantageously deployed to increase the effectiveness of an ablation therapy will now be described with reference to Figures 18C and 18D.
- Three tunable ablation elements 1800 A, 1800B and 1800C are positioned within a steerable endoscope 212 of the present invention. In Fig.
- the three ablation elements have reached the deployment point for ablation element 1800A.
- the windows 1820 are aligned.
- the detectors 1830 on ablation element 1800A are used to improve the effectiveness of the ablation element within the tunable ablation element 1800A by indicating a desired position for applying the ablation therapy.
- the determined position of the element 1800A is when the window 1820 rotated into a slightly upward position from the initial position. Additionally, the mechanical linkage 1845 has been disengaged so that the control cable/component 1880 no longer rotates the element 1800A.
- FIG. 18D also illustrates how the controller cable/component 1880 has utilized the detector 1830 onboard element 1800B to optimize the position of the window 1820. Note that the window 1820 for element 1800B is rotated downward. At this point, the fixation elements for element 1800B are engaged to fix the position of the element 1800B. Thereafter, the linkage 1845 for element 1800B is released so that element 1800C may be positioned and then optimized as described herein for elements 1800A and 1800B. Accordingly, there are configurations of the tunable ablation elements where the windows of adjacent ablation elements are not in alignment but rather reflect an alignment of localized optimization for that ablation element.
- the detector for detecting a physiological indication could also be a single detector.
- the single detector could be actuated to move about the surface of the tunable ablation delivery device 1800 measuring the indication. The obtained measurements could then be used to assist in positioning the ablation element 1810 and opening 1815 to facilitate treatment.
- the single detector could move about the perimeter of the tunable ablation device and provide strength of indication relative to position information similar to Figure 19.
- a securing member 1840 is also provided to hold the tunable ablation device 1800 in the desired position during the readings from the indicator elements 1835, or after rotation of the ablation device into the desired position for facilitating treatment.
- the securing member 1840 may be a vacuum manifold 1855 having a plurality of suction ports 1860.
- the securing means is releasable from the surrounding tissue, organ or region of interest to facilitate movement to align the ablation element for treatment or for easy removal once the treatment is complete.
- the endoscope device may also be utilized for procedures within the peritoneal cavity. Potential applications may include minimally invasive surgery for urologic, bariatric, and liver surgery. Moreover, minimally invasive access may be achieved for treatments in spinal or orthopedic surgery as well.
- Fig. 20 shows an example of a procedure 2000 within the peritoneal cavity which may be performed with the endoscopic device.
- the endoscope 212 may be introduced into patient 2002 through an incision 2008 via a port, which may also function as a datum 2006, as described above.
- the distal portion 214 may be steered to avoid various organs while being 2004.
- the distal portion 214 of the endoscope 212 may accordingly be steered while the proximal portion 216 may be automatically controlled to follow a path defined by the distal portion 214 which minimizes contact with the surrounding and adjacent tissue and organs.
- One or more laparoscopes 2010 may optionally be used in combination with the endoscope 212 to assist with the surgical procedure.
- the distal portion 214 is posteriorly positioned of the liver 2004, various tools or treatment devices may be advanced through the endoscope 212 from the proximal end to effect the desired treatment.
- this example shows treatment of the liver 2004 using the endoscope 212, this is intended to be illustrative of other organs or procedures that may be effectively treated utilizing embodiments of the endoscope 212.
- steerable endoscopic systems of the present invention may advantageously utilized to facilitate a wide variety of procedures.
- the ablation element, device or system may be part of the segmented steerable endoscope, deployed within a working channel or other passage created by the steerable endoscope, or a combination of fixed and moveable treatment elements, device or systems.
- steerable endoscopes of the present invention may, in one embodiment, facilitate treatment by deploying an ablation element, device or system affixed to the endoscope to a treatment location in a treatment position.
- the endoscope remains in place during the treatment and, when complete, retracts from the treatment position.
- the steerable endoscope is utilized to deploy and/or inspect the placement of a treatment device, is then withdrawn while the treatment proceeds. Thereafter, the steerable endoscope retrieves the treatment device.
- the steerable endoscope may be inserted into a treatment area into a desired treatment pathway. Next, the steerable endoscope is retracted to leave the treatment device in place along the desired treatment pathway.
- the steerable endoscope may remain in place for visualization of the treatment as it proceeds, monitor a physiological indication or otherwise support the treatment.
- the steerable endoscope may withdraw from the treatment area or completely from the body.
- the steerable endoscope may be advanced along the treatment device to remove/store the treatment device as the endoscope proceeds distally along the treatment device. Once the treatment device has been collected into the endoscope, the endoscope is withdrawn. Accordingly, there have been shown various ways to position a treatment element, device or system within a body, affix or otherwise maintain the position of the treatment device relative to the area or areas of treatment to increase the effectiveness of the treatment or therapy being performed.
- various imaging and control systems may be used to facilitate control of the steerable endoscope.
- the steerable endoscope may proceed along and envelope a deployed treatment device utilizing a recorded pathway to retrace steps used to place the treatment device.
- the steerable endoscope may also track a way point set to indicate the next fastener where the fastener is in a preprogrammed position, in an position identifiable using an imaging system or the fastener is other wise configured for easy identification, such as through use of an RFLD, for example.
- the steerable endoscope may also use an imaging system for guidance in recovering a treatment device.
- the steerable endoscope may also utilize fly by wire techniques to fly by wire using the treatment device as the wire.
- the treatment device could be automatically withdrawn into the steerable endoscope using mapping, imaging or other system controls to retrace track or otherwise dislodge or disengage the treatment device from the internal position to perform a treatment.
- Embodiments of the present invention may also include tools, devices or systems to pierce, lacerate, cut, puncture, or otherwise provide a passage or controlled perforation of tissue to allow access of the steerable, guided endoscope into the region of interest.
- a neurological application for accessing the brain such as device would be suited for creating a suitable opening in the dura for example.
- a cardiovascular application for accessing the heart such as device would be suited for creating a suitable opening in the pericardium for example.
- the tools, devices or systems to pierce, lacerate, cut, puncture, or otherwise provide a passage or controlled perforation to enable passage of the endoscope may be disposed permanently on the distal end of the scope.
- the tools, devices or systems may be mounted on the distal end of the endoscope but be positionable between a retracted and extended position to help minimize the risk of inadvertent damage while the endoscope is moving within the body to the region of interest.
- the tools, devices or systems may be provided conventionally via a working channel in the endoscope. Examples of the tools, devices or systems include scissors, electrocaulitry devices and systems, small snips, shaped blades and shaped tips.
- embodiments of the present invention have been shown and described as dispensing treatment within the brain, cranial interior, the interior of the heart, the exterior of the heart, it is to be appreciated that embodiments of the methods and apparatus of the present invention may be used in other applications as well.
- embodiments of the invention may be used to facilitate treatment of disorders of other organs and portions of the body, for example, the stomach, the gastrointestinal tract, the esophagus, the bladder, the liver, the kidneys and the lungs.
- embodiments of the present invention may be used to facilitate treatment of localized disorders within the body, portions of the body or a disorder of a physiological system.
- the applications of the devices and methods discussed above are not limited to regions of the body but may include any number of further treatment applications.
- Other treatment sites may include other areas or regions of the body.
- the present invention may be used in other industrial and commercial environments such as exploratory procedures on piping systems, ducts, internal inspection of mechanical systems including automotive, aeronautical, aerospace, and marine systems and equipment, etc. Modification of the above-described assemblies and methods for carrying out the invention, and variations of aspects of the invention that are obvious to those of skill in the art are intended to t within the scope of the claims.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Engineering & Computer Science (AREA)
- Optics & Photonics (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Radiology & Medical Imaging (AREA)
- Pathology (AREA)
- Biophysics (AREA)
- Astronomy & Astrophysics (AREA)
- General Physics & Mathematics (AREA)
- Cardiology (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Multimedia (AREA)
- Endoscopes (AREA)
- Surgical Instruments (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
- Electrotherapy Devices (AREA)
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002554714A CA2554714A1 (en) | 2004-01-28 | 2005-01-28 | Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
EP05712548.6A EP1748723B1 (en) | 2004-01-28 | 2005-01-28 | Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
JP2006551580A JP5216986B2 (en) | 2004-01-28 | 2005-01-28 | Device for facilitating tissue treatment with improved application of energy and non-energy modalities |
IL176681A IL176681A0 (en) | 2004-01-28 | 2006-07-03 | Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/767,109 US20050165276A1 (en) | 2004-01-28 | 2004-01-28 | Methods and apparatus for accessing and treating regions of the body |
US10/767,109 | 2004-01-28 | ||
US10/850,360 | 2004-05-19 | ||
US10/850,360 US8517923B2 (en) | 2000-04-03 | 2004-05-19 | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2005072445A2 true WO2005072445A2 (en) | 2005-08-11 |
WO2005072445A3 WO2005072445A3 (en) | 2009-03-26 |
Family
ID=34830626
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2005/003140 WO2005072445A2 (en) | 2004-01-28 | 2005-01-28 | Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
Country Status (5)
Country | Link |
---|---|
US (4) | US8517923B2 (en) |
EP (1) | EP1748723B1 (en) |
JP (3) | JP5216986B2 (en) |
CA (1) | CA2554714A1 (en) |
WO (1) | WO2005072445A2 (en) |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8771170B2 (en) | 2008-08-01 | 2014-07-08 | Microaccess, Inc. | Methods and apparatus for transesophageal microaccess surgery |
US9138132B2 (en) | 2000-04-03 | 2015-09-22 | Intuitive Surgical Operations, Inc. | Steerable endoscope and improved method of insertion |
US9427282B2 (en) | 2000-04-03 | 2016-08-30 | Intuitive Surgical Operations, Inc. | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
US9808140B2 (en) | 2000-04-03 | 2017-11-07 | Intuitive Surgical Operations, Inc. | Steerable segmented endoscope and method of insertion |
US10105036B2 (en) | 2000-04-03 | 2018-10-23 | Intuitive Surgical Operations, Inc. | Connector device for a controllable instrument |
US10349819B2 (en) * | 2014-06-25 | 2019-07-16 | Olympus Corporation | Endoscope device, method for operating endoscope device, and computer-readable recording medium |
US11426141B2 (en) | 2012-12-31 | 2022-08-30 | Intuitive Surgical Operations, Inc. | Systems and methods for interventional procedure planning |
Families Citing this family (106)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040122456A1 (en) * | 2002-12-11 | 2004-06-24 | Saadat Vahid C. | Methods and apparatus for gastric reduction |
US7637905B2 (en) * | 2003-01-15 | 2009-12-29 | Usgi Medical, Inc. | Endoluminal tool deployment system |
US7416554B2 (en) | 2002-12-11 | 2008-08-26 | Usgi Medical Inc | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US7955340B2 (en) * | 1999-06-25 | 2011-06-07 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
EP1662972A4 (en) * | 2000-04-03 | 2010-08-25 | Intuitive Surgical Inc | Activated polymer articulated instruments and methods of insertion |
US6984203B2 (en) * | 2000-04-03 | 2006-01-10 | Neoguide Systems, Inc. | Endoscope with adjacently positioned guiding apparatus |
US6858005B2 (en) * | 2000-04-03 | 2005-02-22 | Neo Guide Systems, Inc. | Tendon-driven endoscope and methods of insertion |
US6837846B2 (en) * | 2000-04-03 | 2005-01-04 | Neo Guide Systems, Inc. | Endoscope having a guide tube |
US7628780B2 (en) * | 2001-01-13 | 2009-12-08 | Medtronic, Inc. | Devices and methods for interstitial injection of biologic agents into tissue |
US20040138621A1 (en) | 2003-01-14 | 2004-07-15 | Jahns Scott E. | Devices and methods for interstitial injection of biologic agents into tissue |
US7740623B2 (en) * | 2001-01-13 | 2010-06-22 | Medtronic, Inc. | Devices and methods for interstitial injection of biologic agents into tissue |
AU2002360767A1 (en) * | 2002-01-09 | 2003-07-30 | Neoguide Systems, Inc | Apparatus and method for spectroscopic examination of the colon |
AU2002359847A1 (en) | 2002-01-09 | 2003-07-30 | Neoguide Systems, Inc | Apparatus and method for endoscopic colectomy |
US7942884B2 (en) * | 2002-12-11 | 2011-05-17 | Usgi Medical, Inc. | Methods for reduction of a gastric lumen |
US7942898B2 (en) * | 2002-12-11 | 2011-05-17 | Usgi Medical, Inc. | Delivery systems and methods for gastric reduction |
US20040186349A1 (en) * | 2002-12-24 | 2004-09-23 | Usgi Medical Corp. | Apparatus and methods for achieving endoluminal access |
AU2003294347A1 (en) * | 2002-12-30 | 2004-07-29 | Fannie Mae | System and method for processing data pertaining to financial assets |
US20040186350A1 (en) * | 2003-01-13 | 2004-09-23 | Usgi Medical Corp. | Apparatus and methods for guiding an endoscope via a rigidizable wire guide |
US20040249367A1 (en) * | 2003-01-15 | 2004-12-09 | Usgi Medical Corp. | Endoluminal tool deployment system |
US8882657B2 (en) | 2003-03-07 | 2014-11-11 | Intuitive Surgical Operations, Inc. | Instrument having radio frequency identification systems and methods for use |
JP4540328B2 (en) * | 2003-11-19 | 2010-09-08 | カール事務器株式会社 | Multi-function drilling device |
US20050272977A1 (en) * | 2004-04-14 | 2005-12-08 | Usgi Medical Inc. | Methods and apparatus for performing endoluminal procedures |
US8512229B2 (en) * | 2004-04-14 | 2013-08-20 | Usgi Medical Inc. | Method and apparatus for obtaining endoluminal access |
US8277373B2 (en) | 2004-04-14 | 2012-10-02 | Usgi Medical, Inc. | Methods and apparaus for off-axis visualization |
US8562516B2 (en) | 2004-04-14 | 2013-10-22 | Usgi Medical Inc. | Methods and apparatus for obtaining endoluminal access |
US7837615B2 (en) * | 2004-05-10 | 2010-11-23 | Usgi Medical, Inc. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US20050251091A1 (en) * | 2004-05-10 | 2005-11-10 | Usgi Medical Inc. | Apparatus and methods for transgastric tissue manipulation |
US9463012B2 (en) * | 2004-10-26 | 2016-10-11 | P Tech, Llc | Apparatus for guiding and positioning an implant |
JP4874259B2 (en) * | 2004-11-23 | 2012-02-15 | ヌームアールエックス・インコーポレーテッド | Steerable device for accessing the target site |
US20060235458A1 (en) * | 2005-04-15 | 2006-10-19 | Amir Belson | Instruments having an external working channel |
US7740627B2 (en) * | 2005-04-29 | 2010-06-22 | Medtronic Cryocath Lp | Surgical method and apparatus for treating atrial fibrillation |
US7794455B2 (en) * | 2005-04-29 | 2010-09-14 | Medtronic Cryocath Lp | Wide area ablation of myocardial tissue |
EP1931237A2 (en) * | 2005-09-14 | 2008-06-18 | Neoguide Systems, Inc. | Methods and apparatus for performing transluminal and other procedures |
US9808280B2 (en) | 2005-10-12 | 2017-11-07 | Atricure, Inc. | Diaphragm entry for posterior surgical access |
EP1945292A4 (en) | 2005-10-12 | 2009-11-11 | Ncontact Surgical Inc | Diaphragm entry for posterior surgical access |
US8721597B2 (en) * | 2006-11-09 | 2014-05-13 | Ncontact Surgical, Inc. | Diaphragm entry for posterior surgical access |
US8211011B2 (en) * | 2006-11-09 | 2012-07-03 | Ncontact Surgical, Inc. | Diaphragm entry for posterior surgical access |
US20070161857A1 (en) | 2005-11-22 | 2007-07-12 | Neoguide Systems, Inc. | Method of determining the shape of a bendable instrument |
WO2007062066A2 (en) * | 2005-11-23 | 2007-05-31 | Neoguide Systems, Inc. | Non-metallic, multi-strand control cable for steerable instruments |
US8726909B2 (en) * | 2006-01-27 | 2014-05-20 | Usgi Medical, Inc. | Methods and apparatus for revision of obesity procedures |
WO2007137208A2 (en) | 2006-05-19 | 2007-11-29 | Neoguide Systems, Inc. | Methods and apparatus for displaying three-dimensional orientation of a steerable distal tip of an endoscope |
US9242073B2 (en) * | 2006-08-18 | 2016-01-26 | Boston Scientific Scimed, Inc. | Electrically actuated annelid |
US10166070B2 (en) * | 2007-01-02 | 2019-01-01 | Baylis Medical Company Inc. | Electrosurgical pericardial puncture |
US20090209849A1 (en) * | 2007-05-02 | 2009-08-20 | Philip Stephen Rowe | Medical Device Placement and Monitoring System Utilizing Radio Frequency Identification |
US8251992B2 (en) * | 2007-07-06 | 2012-08-28 | Tyco Healthcare Group Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight-loss operation |
US9220398B2 (en) | 2007-10-11 | 2015-12-29 | Intuitive Surgical Operations, Inc. | System for managing Bowden cables in articulating instruments |
US12035964B2 (en) * | 2007-12-27 | 2024-07-16 | Boston Scientific Medical Device Limited | Electrosurgical pericardial puncture |
US8182418B2 (en) * | 2008-02-25 | 2012-05-22 | Intuitive Surgical Operations, Inc. | Systems and methods for articulating an elongate body |
JP5580540B2 (en) * | 2009-03-02 | 2014-08-27 | オリンパス株式会社 | Guide device |
JP5476564B2 (en) * | 2009-04-16 | 2014-04-23 | 国立大学法人 東京大学 | Medical electrode device |
US8926602B2 (en) | 2010-01-28 | 2015-01-06 | Medtronic Cryocath Lp | Triple balloon catheter |
WO2012048005A2 (en) * | 2010-10-05 | 2012-04-12 | Emory University | Devices, systems, and methods for improving access to cardiac and vascular chambers |
CA2862611C (en) * | 2011-02-24 | 2020-11-03 | Eximo Medical Ltd. | Hybrid catheter for tissue resection |
EP4275634A3 (en) | 2011-06-10 | 2024-01-10 | Board of Regents of the University of Nebraska | Surgical end effector |
US10456185B2 (en) | 2011-06-14 | 2019-10-29 | Aerin Medical, Inc. | Methods and devices to treat nasal airways |
US11241271B2 (en) | 2011-06-14 | 2022-02-08 | Aerin Medical Inc. | Methods of treating nasal airways |
US11033318B2 (en) | 2011-06-14 | 2021-06-15 | Aerin Medical, Inc. | Methods and devices to treat nasal airways |
EP3549543B8 (en) | 2011-06-14 | 2023-08-23 | Aerin Medical, Inc. | Device for treating nasal airways |
US9415194B2 (en) | 2011-06-14 | 2016-08-16 | Aerin Medical Inc. | Post nasal drip treatment |
US11304746B2 (en) | 2011-06-14 | 2022-04-19 | Aerin Medical Inc. | Method of treating airway tissue to reduce mucus secretion |
US10722282B2 (en) | 2011-06-14 | 2020-07-28 | Aerin Medical, Inc. | Methods and devices to treat nasal airways |
US9387031B2 (en) | 2011-07-29 | 2016-07-12 | Medtronic Ablation Frontiers Llc | Mesh-overlayed ablation and mapping device |
US9265514B2 (en) | 2012-04-17 | 2016-02-23 | Miteas Ltd. | Manipulator for grasping tissue |
US9113911B2 (en) | 2012-09-06 | 2015-08-25 | Medtronic Ablation Frontiers Llc | Ablation device and method for electroporating tissue cells |
JP2015534845A (en) * | 2012-10-17 | 2015-12-07 | ウースター・ポリテクニック・インスティテュートWorcester Polytechnic Institute | System and method for underactuated control of insertion path of asymmetric tip needle |
WO2014097014A1 (en) * | 2012-12-17 | 2014-06-26 | Koninklijke Philips N.V. | Micromanipulator-controlled local view with stationary overall view |
US9687288B2 (en) | 2013-09-30 | 2017-06-27 | Arrinex, Inc. | Apparatus and methods for treating rhinitis |
US10688284B2 (en) | 2013-11-22 | 2020-06-23 | Massachusetts Institute Of Technology | Steering techniques for surgical instruments |
US20150245868A1 (en) * | 2014-02-28 | 2015-09-03 | Tenjin LLC | Bendable and rebendable endoscopic electrosurgical device |
US9763743B2 (en) | 2014-07-25 | 2017-09-19 | Arrinex, Inc. | Apparatus and method for treating rhinitis |
KR20170093112A (en) * | 2014-09-29 | 2017-08-14 | 클리어마인드 바이오메디컬 인코포레이티드 | Surgical tool |
JP2017531482A (en) * | 2014-09-30 | 2017-10-26 | マサチューセッツ インスティテュート オブ テクノロジー | Surgical instruments with minimal invasion |
US9867656B2 (en) * | 2014-11-17 | 2018-01-16 | Covidien Lp | Multi-function surgical instruments |
WO2017041052A1 (en) * | 2015-09-03 | 2017-03-09 | Neptune Medical | Device for endoscopic advancement through the small intestine |
US10143526B2 (en) * | 2015-11-30 | 2018-12-04 | Auris Health, Inc. | Robot-assisted driving systems and methods |
US11857263B2 (en) * | 2016-02-10 | 2024-01-02 | Amir Belson | Personalized atrial fibrillation ablation |
WO2017139609A1 (en) | 2016-02-12 | 2017-08-17 | Aerin Medical, Inc. | Hyaline cartilage shaping |
US10864035B2 (en) | 2016-03-04 | 2020-12-15 | Aerin Medical, Inc. | Eustachian tube modification |
US11684420B2 (en) | 2016-05-05 | 2023-06-27 | Eximo Medical Ltd. | Apparatus and methods for resecting and/or ablating an undesired tissue |
US11116586B2 (en) * | 2016-06-30 | 2021-09-14 | Intuitive Surgical Operations, Inc. | Systems and methods of steerable elongate device |
EP3500151A4 (en) | 2016-08-18 | 2020-03-25 | Neptune Medical Inc. | Device and method for enhanced visualization of the small intestine |
US10507323B2 (en) * | 2016-08-19 | 2019-12-17 | Pacesetter, Inc. | Medical tool employing a warning mechanism notifying that a rotational limit has been reached |
US11806071B2 (en) | 2016-12-22 | 2023-11-07 | Aerin Medical Inc. | Soft palate treatment |
AU2017382212A1 (en) | 2016-12-22 | 2019-07-04 | Aerin Medical, Inc. | Soft palate treatment |
CA3061352A1 (en) | 2017-04-28 | 2018-11-01 | Arrinex, Inc. | Systems and methods for locating blood vessels in the treatment of rhinitis |
USD880694S1 (en) | 2017-05-01 | 2020-04-07 | Aerin Medical, Inc. | Nasal airway medical instrument |
US11096738B2 (en) | 2017-05-05 | 2021-08-24 | Aerin Medical, Inc. | Treatment of spinal tissue |
WO2019012602A1 (en) * | 2017-07-11 | 2019-01-17 | オリンパス株式会社 | Endoscope system and image diagnosis system |
WO2019071269A2 (en) | 2017-10-06 | 2019-04-11 | Powell Charles Lee | System and method to treat obstructive sleep apnea |
US11596477B2 (en) | 2017-11-20 | 2023-03-07 | Covidien Lp | Systems and methods for generating energy delivery heat maps |
CN110384474B (en) * | 2018-04-23 | 2022-03-08 | 克力迈生医股份有限公司 | Intracranial endoscope and method of use thereof |
US20190365487A1 (en) * | 2018-06-04 | 2019-12-05 | Epica International, Inc. | Articulated apparatus for surgery |
AU2019307743A1 (en) | 2018-07-19 | 2021-01-28 | Neptune Medical Inc. | Dynamically rigidizing composite medical structures |
USD902412S1 (en) | 2018-10-31 | 2020-11-17 | Aerin Medical, Inc. | Electrosurgery console |
USD881904S1 (en) | 2018-10-31 | 2020-04-21 | Aerin Medical Inc. | Display screen with animated graphical user interface |
EP3677186A1 (en) * | 2019-01-03 | 2020-07-08 | Siemens Healthcare GmbH | Medical imaging device, system, and method for generating a motion-compensated image, and corresponding storage medium |
US12011213B2 (en) * | 2019-03-29 | 2024-06-18 | Acclarent, Inc. | System and method for treating epistaxis |
US11793392B2 (en) | 2019-04-17 | 2023-10-24 | Neptune Medical Inc. | External working channels |
WO2020257533A1 (en) * | 2019-06-19 | 2020-12-24 | Neotract, Inc. | Devices and methods for targeting implant deployment in tissue |
AU2021245989A1 (en) | 2020-03-30 | 2022-10-27 | Neptune Medical Inc. | Layered walls for rigidizing devices |
CN115697173A (en) * | 2020-05-26 | 2023-02-03 | 捷锐士阿希迈公司(以奥林巴斯美国外科技术名义) | Endoscope with variable flexibility |
WO2021258113A1 (en) | 2020-06-19 | 2021-12-23 | Remedy Robotics, Inc. | Systems and methods for guidance of intraluminal devices within the vasculature |
US11707332B2 (en) | 2021-07-01 | 2023-07-25 | Remedy Robotics, Inc. | Image space control for endovascular tools |
CA3222522A1 (en) | 2021-07-01 | 2023-01-05 | David James Bell | Vision-based position and orientation determination for endovascular tools |
US20230346205A1 (en) | 2022-04-27 | 2023-11-02 | Neptune Medical Inc. | Multi-lumen port adapter manifold devices and methods of use |
US12038322B2 (en) | 2022-06-21 | 2024-07-16 | Eximo Medical Ltd. | Devices and methods for testing ablation systems |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5018509A (en) | 1989-02-21 | 1991-05-28 | Olympus Optical Co., Ltd. | Endoscope insertion controlling apparatus |
US5269289A (en) | 1990-12-25 | 1993-12-14 | Olympus Optical Co., Ltd. | Cavity insert device using fuzzy theory |
US5347987A (en) | 1991-04-08 | 1994-09-20 | Feldstein David A | Self-centering endoscope system |
US6068629A (en) | 1997-02-04 | 2000-05-30 | Medtronic, Inc. | System and methods for tissue mapping and ablation |
Family Cites Families (577)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US616672A (en) | 1898-12-27 | kelling | ||
US1590919A (en) | 1926-06-29 | of brooklyn | ||
US2241576A (en) | 1940-03-20 | 1941-05-13 | Charles L Barton | Figure toy |
US2510198A (en) | 1947-10-17 | 1950-06-06 | Earl B Tesmer | Flexible positioner |
US2533494A (en) | 1949-02-18 | 1950-12-12 | Jr Iverson O Mitchell | Adjustable article support |
US2767705A (en) | 1954-10-08 | 1956-10-23 | Technical Oil Tool Corp | Sigmoidoscope with suction attachment for immobilizing adjacent tissue |
US3060972A (en) | 1957-08-22 | 1962-10-30 | Bausch & Lomb | Flexible tube structures |
NL106631C (en) | 1960-02-04 | 1963-11-15 | Pieter Johannes Meijs | SUPPORT AND LOCKING DEVICE, IN PARTICULAR FOR A TIMER |
US3071161A (en) | 1960-05-16 | 1963-01-01 | Bausch & Lomb | Bidirectionally flexible segmented tube |
US3190286A (en) | 1961-10-31 | 1965-06-22 | Bausch & Lomb | Flexible viewing probe for endoscopic use |
GB983560A (en) | 1962-09-18 | 1965-02-17 | Polymathic Engineering Company | Supporting stand for instruments, tools and the like |
US3162214A (en) | 1963-01-16 | 1964-12-22 | American Optical Corp | Flexible tubular structures |
US3266059A (en) | 1963-06-19 | 1966-08-16 | North American Aviation Inc | Prestressed flexible joint for mechanical arms and the like |
US3430662A (en) | 1964-09-21 | 1969-03-04 | Stephen Guarnaschelli | Flexible segmented tube |
JPS4712705Y1 (en) | 1967-04-20 | 1972-05-10 | ||
US3610231A (en) | 1967-07-21 | 1971-10-05 | Olympus Optical Co | Endoscope |
US3546961A (en) | 1967-12-22 | 1970-12-15 | Gen Electric | Variable flexibility tether |
US3497083A (en) | 1968-05-10 | 1970-02-24 | Us Navy | Tensor arm manipulator |
JPS4831554B1 (en) | 1968-12-24 | 1973-09-29 | ||
US3625084A (en) | 1970-09-21 | 1971-12-07 | Nasa | Flexible/rigidifiable cable assembly |
US3739770A (en) | 1970-10-09 | 1973-06-19 | Olympus Optical Co | Bendable tube of an endoscope |
US3946727A (en) | 1971-06-15 | 1976-03-30 | Olympus Optical Co., Ltd. | Flexible tube assembly for an endoscope |
US3773034A (en) | 1971-11-24 | 1973-11-20 | Itt Research Institute | Steerable catheter |
US3871358A (en) | 1972-08-04 | 1975-03-18 | Olympus Optical Co | Guiding tube for the insertion of an admissible medical implement into a human body |
US3780740A (en) | 1972-11-01 | 1973-12-25 | J Rhea | Intubation device and method of advancing a tube past the pylorus |
JPS506192A (en) | 1973-05-18 | 1975-01-22 | ||
US3897775A (en) | 1973-09-07 | 1975-08-05 | Olympus Optical Co | Endoscope with facile bending operation |
US3858578A (en) | 1974-01-21 | 1975-01-07 | Pravel Wilson & Matthews | Surgical retaining device |
US3990434A (en) | 1975-02-18 | 1976-11-09 | The United States Of America As Represented By The Department Of Health, Education And Welfare | Reversible intravasal occlusive device |
US4054128A (en) | 1976-09-28 | 1977-10-18 | Universite De Sherbrooke | Device for carrying observation and/or manipulation instruments |
DE2657255A1 (en) | 1976-12-17 | 1978-06-29 | P H Dr Schomacher | DEVICE FOR CLOSING SEPARATED BODY BARRELS |
JPS5940002Y2 (en) | 1976-12-28 | 1984-11-12 | 株式会社メドス研究所 | Bending device in endoscope |
US4176662A (en) | 1977-06-17 | 1979-12-04 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Apparatus for endoscopic examination |
DE2818437C2 (en) | 1978-04-27 | 1983-07-07 | J.M. Voith Gmbh, 7920 Heidenheim | Stone roller |
DE2823025C2 (en) | 1978-05-26 | 1986-02-06 | Rolf 2300 Quarnbek Emeis | Device for transporting an instrument (colonoscope) for colon diagnostics and / or therapy |
JPS5754724Y2 (en) | 1978-10-03 | 1982-11-26 | ||
SU871786A1 (en) | 1978-12-04 | 1981-10-15 | Сктб Средств Неразрушающего Контроля | Pipe for endoscopy |
JPS5586436A (en) | 1978-12-22 | 1980-06-30 | Olympus Optical Co | Endoscope |
JPS5586435A (en) | 1978-12-22 | 1980-06-30 | Olympus Optical Co | Endoscope |
US4494417A (en) | 1979-03-16 | 1985-01-22 | Robotgruppen Hb | Flexible arm, particularly a robot arm |
SE419421B (en) | 1979-03-16 | 1981-08-03 | Ove Larson | RESIDENTIAL ARM IN SPECIAL ROBOT ARM |
JPS6041203Y2 (en) | 1979-04-03 | 1985-12-14 | 富士写真光機株式会社 | Curved tube part of endoscope |
JPS606652B2 (en) | 1979-11-16 | 1985-02-19 | オリンパス光学工業株式会社 | Flexible tube for endoscope |
US4366810A (en) | 1980-08-28 | 1983-01-04 | Slanetz Jr Charles A | Tactile control device for a remote sensing device |
DE3214615C2 (en) | 1981-04-21 | 1985-04-25 | Kabushiki Kaisha Medos Kenkyusho, Tokio/Tokyo | Curvature control arrangement for an endoscope |
US4418688A (en) | 1981-07-06 | 1983-12-06 | Laserscope, Inc. | Microcatheter having directable laser and expandable walls |
EP0077526B1 (en) | 1981-10-15 | 1987-09-16 | Olympus Optical Co., Ltd. | Endoscope system with an electric bending mechanism |
EP0078017B1 (en) | 1981-10-22 | 1988-03-30 | Olympus Optical Co., Ltd. | Endoscope apparatus with motor-driven bending mechanism |
JPS5878639A (en) | 1981-11-04 | 1983-05-12 | オリンパス光学工業株式会社 | Endoscope |
US4601283A (en) | 1981-12-07 | 1986-07-22 | Machida Endoscope Co., Ltd. | Endoscope with a memory shape alloy to control tube bending |
US4489826A (en) | 1982-02-05 | 1984-12-25 | Philip Dubson | Adjustable apparatus |
US4517652A (en) | 1982-03-05 | 1985-05-14 | Texas Instruments Incorporated | Hand-held manipulator application module |
JPS5953188A (en) | 1982-09-22 | 1984-03-27 | 株式会社日立製作所 | Multiple articulated manipulator |
US4643184A (en) | 1982-09-29 | 1987-02-17 | Mobin Uddin Kazi | Embolus trap |
US4551061A (en) | 1983-04-18 | 1985-11-05 | Olenick Ralph W | Flexible, extensible robot arm |
GB2145691B (en) | 1983-08-29 | 1987-06-03 | Toshiba Kk | Extendible and contractable arms |
US4534339A (en) | 1983-10-17 | 1985-08-13 | Warner-Lambert Technologies, Inc. | Endoscope |
US5090956A (en) | 1983-10-31 | 1992-02-25 | Catheter Research, Inc. | Catheter with memory element-controlled steering |
US4601705A (en) | 1983-10-31 | 1986-07-22 | Mccoy William C | Steerable and aimable catheter |
US4543090A (en) | 1983-10-31 | 1985-09-24 | Mccoy William C | Steerable and aimable catheter |
JPS60179713A (en) | 1984-02-28 | 1985-09-13 | Olympus Optical Co Ltd | Endoscope device |
JPS60176417U (en) | 1984-05-02 | 1985-11-22 | 株式会社 町田製作所 | Guide tube for endoscope insertion |
GB8413058D0 (en) | 1984-05-22 | 1984-06-27 | Minvade Ltd | Endoscopes |
JPS60187737U (en) | 1984-05-23 | 1985-12-12 | オリンパス光学工業株式会社 | Indwelling tube guide device |
US4651718A (en) | 1984-06-29 | 1987-03-24 | Warner-Lambert Technologies Inc. | Vertebra for articulatable shaft |
DE3426024C2 (en) | 1984-07-14 | 1987-01-02 | Robert 5441 Bell Merkt | Kit for producing an assembly jig for pipelines, in particular pipelines for hydraulic or pneumatic circuits or working circuits |
US4754909A (en) | 1984-08-09 | 1988-07-05 | Barker John M | Flexible stapler |
US4577621A (en) | 1984-12-03 | 1986-03-25 | Patel Jayendrakumar I | Endoscope having novel proximate and distal portions |
US4646722A (en) | 1984-12-10 | 1987-03-03 | Opielab, Inc. | Protective endoscope sheath and method of installing same |
DE3447642C1 (en) | 1984-12-28 | 1986-09-18 | Bernhard M. Dr. 5600 Wuppertal Cramer | Steerable guidewire for catheters |
SU1256955A1 (en) | 1985-01-17 | 1986-09-15 | Всесоюзный Проектно-Технологический Институт Тяжелого Машиностроения | Manipulator |
JPH0762737B2 (en) | 1985-03-08 | 1995-07-05 | オリンパス光学工業株式会社 | Endoscope device |
JPH055529Y2 (en) | 1985-03-25 | 1993-02-15 | ||
US4624243A (en) | 1985-04-08 | 1986-11-25 | American Hospital Supply Corp. | Endoscope having a reusable eyepiece and a disposable distal section |
US4601713A (en) | 1985-06-11 | 1986-07-22 | Genus Catheter Technologies, Inc. | Variable diameter catheter |
US4683773A (en) | 1985-06-27 | 1987-08-04 | Gary Diamond | Robotic device |
SU1301701A1 (en) | 1985-11-04 | 1987-04-07 | Государственный Научно-Исследовательский Институт Машиноведения Им.А.А.Благонравова | Industrial robot actuating device |
JPS62113125A (en) | 1985-11-13 | 1987-05-25 | Olympus Optical Co Ltd | Endoscope |
US4696544A (en) | 1985-11-18 | 1987-09-29 | Olympus Corporation | Fiberscopic device for inspection of internal sections of construction, and method for using same |
JPS62139626A (en) | 1985-12-13 | 1987-06-23 | オリンパス光学工業株式会社 | Flexible tube for endoscope |
DE3704247A1 (en) | 1986-02-14 | 1987-08-20 | Olympus Optical Co | ENDOSCOPE INSERTION DEVICE |
JPS62192134A (en) | 1986-02-17 | 1987-08-22 | オリンパス光学工業株式会社 | Curved part device for endoscope |
US4686963A (en) | 1986-03-05 | 1987-08-18 | Circon Corporation | Torsion resistant vertebrated probe of simple construction |
US4799474A (en) | 1986-03-13 | 1989-01-24 | Olympus Optical Co., Ltd. | Medical tube to be inserted in body cavity |
US4672961A (en) * | 1986-05-19 | 1987-06-16 | Davies David H | Retrolasing catheter and method |
DE3734979A1 (en) | 1986-10-16 | 1988-04-28 | Olympus Optical Co | ENDOSCOPE |
US4917114A (en) | 1986-10-17 | 1990-04-17 | United States Surgical Corporation | Surgical fastener and surgical stapling apparatus |
US4790624A (en) | 1986-10-31 | 1988-12-13 | Identechs Corporation | Method and apparatus for spatially orienting movable members using shape memory effect alloy actuator |
US4753223A (en) | 1986-11-07 | 1988-06-28 | Bremer Paul W | System for controlling shape and direction of a catheter, cannula, electrode, endoscope or similar article |
JPS63123011A (en) | 1986-11-12 | 1988-05-26 | Olympus Optical Co Ltd | Endoscope |
US4895431A (en) | 1986-11-13 | 1990-01-23 | Olympus Optical Co., Ltd. | Method of processing endoscopic images |
JPS63136014A (en) | 1986-11-28 | 1988-06-08 | Res Dev Corp Of Japan | Active bending device for flexible tube |
US4793326A (en) | 1986-12-08 | 1988-12-27 | Olympus Optical Co., Ltd. | Endoscope having insertion end guide means |
FR2610236B1 (en) | 1987-02-04 | 1991-07-12 | Logabex | MODULAR TYPE REDUNDANT ROBOT |
US4832473A (en) | 1987-02-06 | 1989-05-23 | Olympus Optical Co., Ltd. | Endoscope with elastic actuator comprising a synthetic rubber tube with only radial expansion controlled by a mesh-like tube |
CA1307177C (en) | 1987-02-09 | 1992-09-08 | Ichiro Sogawa | Mechanism for bending elongated body |
JPS63136014U (en) | 1987-02-25 | 1988-09-07 | ||
DE3707787A1 (en) | 1987-03-11 | 1988-09-22 | Patrik Dr Med Gruendler | Endoscope |
US4846573A (en) | 1987-04-10 | 1989-07-11 | Identechs Corporation | Shape memory effect alloy pull wire articulator for borescopes |
JPS63272322A (en) | 1987-05-01 | 1988-11-09 | Olympus Optical Co Ltd | Apparatus for detecting curvature of leading end part of endoscope |
US4807593A (en) | 1987-05-08 | 1989-02-28 | Olympus Optical Co. Ltd. | Endoscope guide tube |
US4884557A (en) | 1987-05-15 | 1989-12-05 | Olympus Optical Co., Ltd. | Endoscope for automatically adjusting an angle with a shape memory alloy |
US4796607A (en) | 1987-07-28 | 1989-01-10 | Welch Allyn, Inc. | Endoscope steering section |
IT1235460B (en) | 1987-07-31 | 1992-07-30 | Confida Spa | FLEXIBLE ENDOSCOPE. |
US4787369A (en) | 1987-08-14 | 1988-11-29 | Welch Allyn, Inc. | Force relieving, force limiting self-adjusting steering for borescope or endoscope |
US4890602A (en) | 1987-11-25 | 1990-01-02 | Hake Lawrence W | Endoscope construction with means for controlling rigidity and curvature of flexible endoscope tube |
JPH01152413A (en) | 1987-12-09 | 1989-06-14 | Olympus Optical Co Ltd | Guide tube for endoscope |
JPH01153292A (en) | 1987-12-10 | 1989-06-15 | Komatsu Ltd | Overrun detector for flexible arm robot |
US4815450A (en) | 1988-02-01 | 1989-03-28 | Patel Jayendra I | Endoscope having variable flexibility |
JP2619912B2 (en) | 1988-04-13 | 1997-06-11 | オリンパス光学工業株式会社 | Shape memory actuator |
US4930494A (en) | 1988-03-09 | 1990-06-05 | Olympus Optical Co., Ltd. | Apparatus for bending an insertion section of an endoscope using a shape memory alloy |
JPH01229220A (en) | 1988-03-09 | 1989-09-12 | Olympus Optical Co Ltd | Guide tube for endoscope |
US4834068A (en) | 1988-03-18 | 1989-05-30 | Gottesman James E | Barrier shield method and apparatus for optical-medical devices |
US5372138A (en) * | 1988-03-21 | 1994-12-13 | Boston Scientific Corporation | Acousting imaging catheters and the like |
JPH01244732A (en) | 1988-03-28 | 1989-09-29 | Asahi Optical Co Ltd | Endoscope with sheath |
US4987314A (en) | 1988-04-21 | 1991-01-22 | Olympus Optical Co., Ltd. | Actuator apparatus utilizing a shape-memory alloy |
US5005558A (en) | 1988-05-16 | 1991-04-09 | Kabushiki Kaisha Toshiba | Endoscope |
EP0413000B1 (en) | 1988-05-19 | 1995-03-08 | EDWARDS, Eric Frank Rhys | Improvements relating to movement actuators |
US4873990A (en) | 1988-09-23 | 1989-10-17 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Circumferential pressure probe |
GB2226245A (en) | 1988-11-18 | 1990-06-27 | Alan Crockard | Endoscope, remote actuator and aneurysm clip applicator. |
EP0382974A1 (en) | 1989-01-23 | 1990-08-22 | C.R. Bard, Inc. | Braided guide wire and method for the use thereof |
US5083549A (en) | 1989-02-06 | 1992-01-28 | Candela Laser Corporation | Endoscope with tapered shaft |
US4977886A (en) | 1989-02-08 | 1990-12-18 | Olympus Optical Co., Ltd. | Position controlling apparatus |
JP2981556B2 (en) | 1989-02-28 | 1999-11-22 | 旭光学工業株式会社 | Endoscope tip |
JPH02246986A (en) | 1989-03-20 | 1990-10-02 | Olympus Optical Co Ltd | In-vivo guiding tool |
US4919112B1 (en) | 1989-04-07 | 1993-12-28 | Low-cost semi-disposable endoscope | |
US5421337A (en) | 1989-04-14 | 1995-06-06 | Massachusetts Institute Of Technology | Spectral diagnosis of diseased tissue |
JPH0651018B2 (en) | 1989-05-02 | 1994-07-06 | 株式会社東芝 | Endoscope |
JP2778739B2 (en) | 1989-05-10 | 1998-07-23 | オリンパス光学工業株式会社 | Measurement endoscope device |
JPH03109021A (en) | 1989-05-19 | 1991-05-09 | Olympus Optical Co Ltd | Bending apparatus |
JP2750153B2 (en) | 1989-05-31 | 1998-05-13 | オリンパス光学工業株式会社 | Endoscope |
US5014709A (en) | 1989-06-13 | 1991-05-14 | Biologic Systems Corp. | Method and apparatus for high resolution holographic imaging of biological tissue |
US5207695A (en) | 1989-06-19 | 1993-05-04 | Trout Iii Hugh H | Aortic graft, implantation device, and method for repairing aortic aneurysm |
DE3921233A1 (en) | 1989-06-28 | 1991-02-14 | Storz Karl Gmbh & Co | ENDOSCOPE WITH A VIDEO DEVICE AT THE DISTAL END |
JP2886588B2 (en) | 1989-07-11 | 1999-04-26 | 日本碍子株式会社 | Piezoelectric / electrostrictive actuator |
JPH0716478B2 (en) | 1989-07-12 | 1995-03-01 | 富士写真光機株式会社 | Endoscope angle mechanism |
US5005559A (en) | 1989-07-27 | 1991-04-09 | Massachusetts Institute Of Technology | Video-graphic arthroscopy system |
DE3925484A1 (en) | 1989-08-01 | 1991-02-07 | Bob Konstantin | DEVICE FOR INSERTING A MEDICAL ENDOSCOPE INTO A BODY CHANNEL |
JPH042322A (en) | 1990-04-20 | 1992-01-07 | Olympus Optical Co Ltd | Endoscope apparatus |
US5060632A (en) | 1989-09-05 | 1991-10-29 | Olympus Optical Co., Ltd. | Endoscope apparatus |
US5681260A (en) * | 1989-09-22 | 1997-10-28 | Olympus Optical Co., Ltd. | Guiding apparatus for guiding an insertable body within an inspected object |
US4957486A (en) | 1989-10-02 | 1990-09-18 | Davis Emsley A | Rectal-stomal insert apparatus and method |
US4949927A (en) | 1989-10-17 | 1990-08-21 | John Madocks | Articulable column |
DE3935256C1 (en) | 1989-10-23 | 1991-01-03 | Bauerfeind, Peter, Dr., 8264 Waldkraiburg, De | |
JPH03136630A (en) | 1989-10-24 | 1991-06-11 | Olympus Optical Co Ltd | Endoscope guide tube |
JPH03139325A (en) | 1989-10-24 | 1991-06-13 | Olympus Optical Co Ltd | Bending-active body for endoscope |
US5257617A (en) | 1989-12-25 | 1993-11-02 | Asahi Kogaku Kogyo Kabushiki Kaisha | Sheathed endoscope and sheath therefor |
JPH03218723A (en) | 1990-01-24 | 1991-09-26 | Toshiba Corp | Endoscope |
DE4102211A1 (en) | 1990-01-26 | 1991-08-01 | Asahi Optical Co Ltd | Endoscope bending guide - has coaxial cylindrical components joined by pair of metal spirals |
US5025778A (en) | 1990-03-26 | 1991-06-25 | Opielab, Inc. | Endoscope with potential channels and method of using the same |
US5253647A (en) | 1990-04-13 | 1993-10-19 | Olympus Optical Co., Ltd. | Insertion position and orientation state pickup for endoscope |
US5059158A (en) | 1990-05-08 | 1991-10-22 | E.B.T., Inc. | Electronic transmission control system for a bicycle |
US5431645A (en) | 1990-05-10 | 1995-07-11 | Symbiosis Corporation | Remotely activated endoscopic tools such as endoscopic biopsy forceps |
JP2987452B2 (en) | 1990-05-17 | 1999-12-06 | オリンパス光学工業株式会社 | Endoscope |
US5092901A (en) | 1990-06-06 | 1992-03-03 | The Royal Institution For The Advancement Of Learning (Mcgill University) | Shape memory alloy fibers having rapid twitch response |
US5203319A (en) | 1990-06-18 | 1993-04-20 | Welch Allyn, Inc. | Fluid controlled biased bending neck |
JPH0454970A (en) | 1990-06-25 | 1992-02-21 | Olympus Optical Co Ltd | Medical treatment device |
JPH04122233A (en) | 1990-09-11 | 1992-04-22 | Toshiba Corp | Endoscope |
US5125395A (en) | 1990-09-12 | 1992-06-30 | Adair Edwin Lloyd | Deflectable sheath for optical catheter |
JP3029657B2 (en) * | 1990-09-28 | 2000-04-04 | カヤバ工業株式会社 | Position detection device |
GB9023394D0 (en) | 1990-10-26 | 1990-12-05 | Gore W L & Ass Uk | Segmented flexible housing |
JPH03170125A (en) | 1990-11-02 | 1991-07-23 | Olympus Optical Co Ltd | Endoscope |
JP2598568B2 (en) | 1990-11-20 | 1997-04-09 | オリンパス光学工業株式会社 | Electronic endoscope device |
JP3136630B2 (en) | 1991-03-05 | 2001-02-19 | 株式会社日立製作所 | Nuclear magnetic resonance equipment |
US5531664A (en) | 1990-12-26 | 1996-07-02 | Olympus Optical Co., Ltd. | Bending actuator having a coil sheath with a fixed distal end and a free proximal end |
US5228429A (en) | 1991-01-14 | 1993-07-20 | Tadashi Hatano | Position measuring device for endoscope |
US5250058A (en) | 1991-01-17 | 1993-10-05 | Ethicon, Inc. | Absorbable anastomosic fastener means |
US5188111A (en) | 1991-01-18 | 1993-02-23 | Catheter Research, Inc. | Device for seeking an area of interest within a body |
US5400769A (en) | 1991-02-18 | 1995-03-28 | Olympus Optical Co., Ltd. | Electrically bendable endoscope apparatus having controlled fixed bending speed |
JPH074075B2 (en) | 1991-02-28 | 1995-01-18 | 工業技術院長 | Actuator element |
US5217453A (en) | 1991-03-18 | 1993-06-08 | Wilk Peter J | Automated surgical system and apparatus |
WO1992016140A1 (en) * | 1991-03-21 | 1992-10-01 | Winston Thomas R | Catheter for laser treatment of atherosclerotic plaque and other tissue abnormalities |
JP3063784B2 (en) | 1991-03-26 | 2000-07-12 | オリンパス光学工業株式会社 | Endoscope device |
JP3065702B2 (en) | 1991-04-23 | 2000-07-17 | オリンパス光学工業株式会社 | Endoscope system |
US6485413B1 (en) | 1991-04-29 | 2002-11-26 | The General Hospital Corporation | Methods and apparatus for forward-directed optical scanning instruments |
US5251611A (en) | 1991-05-07 | 1993-10-12 | Zehel Wendell E | Method and apparatus for conducting exploratory procedures |
CA2042075C (en) | 1991-05-08 | 2001-01-23 | Branko Palcic | Endoscopic imaging system |
US5127393A (en) | 1991-05-28 | 1992-07-07 | Medilase, Inc. | Flexible endoscope with rigid introducer |
US5239982A (en) | 1991-06-07 | 1993-08-31 | Baxter International Inc. | Catheter depth gauge and method of use |
US5503616A (en) | 1991-06-10 | 1996-04-02 | Endomedical Technologies, Inc. | Collapsible access channel system |
US5159446A (en) | 1991-06-21 | 1992-10-27 | Olympus Optical Co., Ltd. | Electronic endoscope system provided with a separate camera controlling unit and motor controlling unit |
JPH051999A (en) | 1991-06-25 | 1993-01-08 | Kawasaki Steel Corp | Measurement method and device for complex structure |
US5769792A (en) | 1991-07-03 | 1998-06-23 | Xillix Technologies Corp. | Endoscopic imaging system for diseased tissue |
US5456714A (en) | 1991-07-04 | 1995-10-10 | Owen; Earl R. | Tubular surgical implant having a locking ring and flange |
JPH0511196A (en) | 1991-07-08 | 1993-01-19 | Olympus Optical Co Ltd | Visual field direction conversion optical system for endoscope |
JPH0523291A (en) | 1991-07-24 | 1993-02-02 | Machida Endscope Co Ltd | Curved tube of endoscope |
JP2735747B2 (en) * | 1991-09-03 | 1998-04-02 | ゼネラル・エレクトリック・カンパニイ | Tracking and imaging system |
JPH05177002A (en) | 1991-09-17 | 1993-07-20 | Olympus Optical Co Ltd | Mechanochemical actuator and medical tube |
JPH05184531A (en) | 1991-09-17 | 1993-07-27 | Olympus Optical Co Ltd | Tube for medical purpose |
JPH05184526A (en) | 1991-09-17 | 1993-07-27 | Olympus Optical Co Ltd | Bending mechanism for flexible tube |
US5343874A (en) | 1991-09-27 | 1994-09-06 | Applied Medical Technology, Inc. | Tract measuring device |
JPH05111458A (en) | 1991-10-21 | 1993-05-07 | Asahi Optical Co Ltd | Structure for covering signal cable of endoscope |
US5370108A (en) | 1991-10-02 | 1994-12-06 | Asahi Kogaku Kogyo Kabushiki Kaisha | Endoscope |
JP3149219B2 (en) | 1991-10-15 | 2001-03-26 | 旭光学工業株式会社 | Covering structure of curved part of endoscope |
US5197649A (en) | 1991-10-29 | 1993-03-30 | The Trustees Of Columbia University In The City Of New York | Gastrointestinal endoscoptic stapler |
US5486182A (en) | 1991-11-05 | 1996-01-23 | Wilk & Nakao Medical Technology Inc. | Polyp retrieval assembly with separable web member |
JP3131871B2 (en) | 1991-11-05 | 2001-02-05 | セイコーエプソン株式会社 | Micro robot |
US5271381A (en) | 1991-11-18 | 1993-12-21 | Vision Sciences, Inc. | Vertebrae for a bending section of an endoscope |
JP3004830B2 (en) | 1991-12-09 | 2000-01-31 | 松下電器産業株式会社 | Apparatus and method for evaluating semiconductor integrated circuit |
US5217001A (en) | 1991-12-09 | 1993-06-08 | Nakao Naomi L | Endoscope sheath and related method |
US5469840A (en) | 1991-12-10 | 1995-11-28 | Olympus Optical, Ltd. | Electromotive warping type endoscope with velocity control |
US6808520B1 (en) | 1991-12-13 | 2004-10-26 | Endovascular Technologies, Inc. | Dual valve, flexible expandable sheath and method |
ES2048086B1 (en) | 1992-01-17 | 1994-10-01 | Univ Pais Vasco | LAMINARY DEVICES USING CONDUCTIVE POLYMERS CAPABLE OF CAUSING MECHANICAL MOVEMENTS. |
US5699796A (en) * | 1993-01-29 | 1997-12-23 | Cardima, Inc. | High resolution intravascular signal detection |
WO1993015648A1 (en) | 1992-02-07 | 1993-08-19 | Wilk Peter J | Endoscope with disposable insertion member |
US5348259A (en) | 1992-02-10 | 1994-09-20 | Massachusetts Institute Of Technology | Flexible, articulable column |
US5658238A (en) | 1992-02-25 | 1997-08-19 | Olympus Optical Co., Ltd. | Endoscope apparatus capable of being switched to a mode in which a curvature operating lever is returned and to a mode in which the curvature operating lever is not returned |
US5234448A (en) | 1992-02-28 | 1993-08-10 | Shadyside Hospital | Method and apparatus for connecting and closing severed blood vessels |
US5279559A (en) | 1992-03-06 | 1994-01-18 | Aai Corporation | Remote steering system for medical catheter |
US5624380A (en) | 1992-03-12 | 1997-04-29 | Olympus Optical Co., Ltd. | Multi-degree of freedom manipulator |
US5425738A (en) | 1992-04-08 | 1995-06-20 | American Cyanamid Company | Endoscopic anastomosis ring insertion device and method of use thereof |
US5396879A (en) | 1992-04-09 | 1995-03-14 | Wilk; Peter J. | Elongate medical instrument with distal end orientation control |
US5602449A (en) | 1992-04-13 | 1997-02-11 | Smith & Nephew Endoscopy, Inc. | Motor controlled surgical system and method having positional control |
JPH05305073A (en) | 1992-05-01 | 1993-11-19 | Olympus Optical Co Ltd | Position detection display device for insertion tool |
US6096289A (en) | 1992-05-06 | 2000-08-01 | Immunomedics, Inc. | Intraoperative, intravascular, and endoscopic tumor and lesion detection, biopsy and therapy |
US5324284A (en) | 1992-06-05 | 1994-06-28 | Cardiac Pathways, Inc. | Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method |
US5325845A (en) | 1992-06-08 | 1994-07-05 | Adair Edwin Lloyd | Steerable sheath for use with selected removable optical catheter |
US5250167A (en) | 1992-06-22 | 1993-10-05 | The United States Of America As Represented By The United States Department Of Energy | Electrically controlled polymeric gel actuators |
JPH067287A (en) | 1992-06-25 | 1994-01-18 | Toshiba Corp | Endoscope apparatus |
US5482029A (en) | 1992-06-26 | 1996-01-09 | Kabushiki Kaisha Toshiba | Variable flexibility endoscope system |
US5297443A (en) | 1992-07-07 | 1994-03-29 | Wentz John D | Flexible positioning appendage |
US5720718A (en) * | 1992-08-12 | 1998-02-24 | Vidamed, Inc. | Medical probe apparatus with enhanced RF, resistance heating, and microwave ablation capabilities |
JPH0670940A (en) | 1992-08-27 | 1994-03-15 | Olympus Optical Co Ltd | Arrhythmia treatment device |
EP0658090B1 (en) | 1992-09-01 | 1998-11-04 | Edwin L. Adair | Sterilizable endoscope with separable disposable tube assembly |
US5402768A (en) | 1992-09-01 | 1995-04-04 | Adair; Edwin L. | Endoscope with reusable core and disposable sheath with passageways |
US5772597A (en) | 1992-09-14 | 1998-06-30 | Sextant Medical Corporation | Surgical tool end effector |
US5337732A (en) | 1992-09-16 | 1994-08-16 | Cedars-Sinai Medical Center | Robotic endoscopy |
US5662587A (en) | 1992-09-16 | 1997-09-02 | Cedars Sinai Medical Center | Robotic endoscopy |
US5279610A (en) | 1992-11-06 | 1994-01-18 | Cook Incorporated | Oroesophageal, instrument introducer assembly and method of use |
US5383467A (en) | 1992-11-18 | 1995-01-24 | Spectrascience, Inc. | Guidewire catheter and apparatus for diagnostic imaging |
EP0669820B1 (en) | 1992-11-18 | 1997-04-16 | Spectrascience, Inc. | Apparatus for diagnostic imaging |
US5383852A (en) | 1992-12-04 | 1995-01-24 | C. R. Bard, Inc. | Catheter with independent proximal and distal control |
DE4244990C2 (en) | 1992-12-15 | 2002-03-14 | Stm Medtech Starnberg | Device for moving an endoscope shaft along a channel-like cavity |
US5460168A (en) | 1992-12-25 | 1995-10-24 | Olympus Optical Co., Ltd. | Endoscope cover assembly and cover-system endoscope |
ES2062930B1 (en) | 1992-12-28 | 1995-06-16 | Univ Pais Vasco | ARTIFICIAL MUSCLES FORMED BY MULTILAYERS: CONDUCTIVE POLYMERS-NON-CONDUCTIVE POLYMERS. |
US5653690A (en) | 1992-12-30 | 1997-08-05 | Medtronic, Inc. | Catheter having a balloon with retention enhancement |
JP3322356B2 (en) | 1993-01-29 | 2002-09-09 | オリンパス光学工業株式会社 | Flexible tube |
US5405337A (en) | 1993-02-24 | 1995-04-11 | The Board Of Trustees Of The Leland Stanford Junior University | Spatially distributed SMA actuator film providing unrestricted movement in three dimensional space |
US5460166A (en) | 1993-03-11 | 1995-10-24 | Olympus Optical, Ltd. | Endoscope of an endoscope cover system wherein, at the time of the maximum curvature, a fluid tube path will be curved as twisted so as to move to the side on which the radius of curvature will become larger |
US5551945A (en) | 1993-03-16 | 1996-09-03 | Olympus Optical Co., Ltd. | Endoscope system including endoscope and protection cover |
JP3250759B2 (en) | 1993-04-02 | 2002-01-28 | オリンパス光学工業株式会社 | Flexible tubular insert bending device |
JP3362906B2 (en) | 1993-04-07 | 2003-01-07 | オリンパス光学工業株式会社 | Body cavity position detector |
US5413108A (en) | 1993-04-21 | 1995-05-09 | The Research Foundation Of City College Of New York | Method and apparatus for mapping a tissue sample for and distinguishing different regions thereof based on luminescence measurements of cancer-indicative native fluorophor |
US5693082A (en) * | 1993-05-14 | 1997-12-02 | Fidus Medical Technology Corporation | Tunable microwave ablation catheter system and method |
US5507717A (en) | 1993-05-24 | 1996-04-16 | Olympus Optical Co., Ltd. | Device for bending the insertion section of an endoscope |
US5487757A (en) | 1993-07-20 | 1996-01-30 | Medtronic Cardiorhythm | Multicurve deflectable catheter |
US5556370A (en) | 1993-07-28 | 1996-09-17 | The Board Of Trustees Of The Leland Stanford Junior University | Electrically activated multi-jointed manipulator |
US5415633A (en) | 1993-07-28 | 1995-05-16 | Active Control Experts, Inc. | Remotely steered catheterization device |
EP0740522B1 (en) | 1993-08-30 | 2000-03-08 | STM Medizintechnik Starnberg GmbH | Piezo-electric linear drive element |
JPH0788788A (en) | 1993-09-20 | 1995-04-04 | Olympus Optical Co Ltd | Active bending type pipe-shaped manipulator |
US5651785A (en) | 1993-09-20 | 1997-07-29 | Abela Laser Systems, Inc. | Optical fiber catheter and method |
US5389222A (en) | 1993-09-21 | 1995-02-14 | The United States Of America As Represented By The United States Department Of Energy | Spring-loaded polymeric gel actuators |
US5577992A (en) | 1993-10-05 | 1996-11-26 | Asahi Kogaku Kogyo Kabushiki Kaisha | Bendable portion of endoscope |
US5558091A (en) | 1993-10-06 | 1996-09-24 | Biosense, Inc. | Magnetic determination of position and orientation |
US6059718A (en) | 1993-10-18 | 2000-05-09 | Olympus Optical Co., Ltd. | Endoscope form detecting apparatus in which coil is fixedly mounted by insulating member so that form is not deformed within endoscope |
JP3273676B2 (en) | 1993-10-22 | 2002-04-08 | オリンパス光学工業株式会社 | Double curved endoscope |
JPH07120684A (en) | 1993-10-25 | 1995-05-12 | Olympus Optical Co Ltd | Multijoint flexible tube |
JP3411655B2 (en) | 1994-03-15 | 2003-06-03 | ペンタックス株式会社 | Endoscope tip |
US5402793A (en) | 1993-11-19 | 1995-04-04 | Advanced Technology Laboratories, Inc. | Ultrasonic transesophageal probe for the imaging and diagnosis of multiple scan planes |
US5487385A (en) * | 1993-12-03 | 1996-01-30 | Avitall; Boaz | Atrial mapping and ablation catheter system |
JP3170125B2 (en) | 1993-12-22 | 2001-05-28 | セイコーエプソン株式会社 | Method and apparatus for compressing character dot data |
US5451221A (en) | 1993-12-27 | 1995-09-19 | Cynosure, Inc. | Endoscopic light delivery system |
US5449206A (en) | 1994-01-04 | 1995-09-12 | Lockwood Products, Inc. | Ball and socket joint with internal stop |
US6099524A (en) * | 1994-01-28 | 2000-08-08 | Cardiac Pacemakers, Inc. | Electrophysiological mapping and ablation catheter and method |
US5911715A (en) | 1994-02-14 | 1999-06-15 | Scimed Life Systems, Inc. | Guide catheter having selected flexural modulus segments |
US5860581A (en) | 1994-03-24 | 1999-01-19 | United States Surgical Corporation | Anvil for circular stapler |
US5556700A (en) | 1994-03-25 | 1996-09-17 | Trustees Of The University Of Pennsylvania | Conductive polyaniline laminates |
US5590660A (en) | 1994-03-28 | 1997-01-07 | Xillix Technologies Corp. | Apparatus and method for imaging diseased tissue using integrated autofluorescence |
US5429118A (en) | 1994-04-07 | 1995-07-04 | Cook (Canada) Incorporated | Disposable medical scope sheath |
US5662585A (en) | 1994-05-05 | 1997-09-02 | Imagyn Medical, Inc. | Endoscope with protruding member and method of utilizing the same |
US5842973A (en) | 1994-05-17 | 1998-12-01 | Bullard; James Roger | Nasal intubation apparatus |
JPH0866351A (en) | 1994-06-21 | 1996-03-12 | Gunji Haga | Robot endoscope |
US5558665A (en) | 1994-06-24 | 1996-09-24 | Archimedes Surgical, Inc. | Surgical instrument and method for intraluminal retraction of an anatomic structure |
US5530757A (en) | 1994-06-28 | 1996-06-25 | International Business Machines Corporation | Distributed fingerprints for information integrity verification |
JPH0810336A (en) | 1994-06-30 | 1996-01-16 | Agency Of Ind Science & Technol | Medical tube |
JP3213481B2 (en) | 1994-07-07 | 2001-10-02 | トヨタ自動車株式会社 | Polypropylene resin composition for automotive interior |
US5624381A (en) | 1994-08-09 | 1997-04-29 | Kieturakis; Maciej J. | Surgical instrument and method for retraction of an anatomic structure defining an interior lumen |
ATE253864T1 (en) | 1994-08-19 | 2003-11-15 | Biosense Inc | MEDICAL DIAGNOSIS, TREATMENT AND DISPLAY SYSTEM |
US5492131A (en) | 1994-09-06 | 1996-02-20 | Guided Medical Systems, Inc. | Servo-catheter |
US5647840A (en) * | 1994-09-14 | 1997-07-15 | Circon Corporation | Endoscope having a distally heated distal lens |
US5606975A (en) | 1994-09-19 | 1997-03-04 | The Board Of Trustees Of The Leland Stanford Junior University | Forward viewing ultrasonic imaging catheter |
US5765561A (en) | 1994-10-07 | 1998-06-16 | Medical Media Systems | Video-based surgical targeting system |
CA2201877C (en) | 1994-10-07 | 2004-06-08 | Richard D. Bucholz | Surgical navigation systems including reference and localization frames |
US5645520A (en) | 1994-10-12 | 1997-07-08 | Computer Motion, Inc. | Shape memory alloy actuated rod for endoscopic instruments |
US5522788A (en) | 1994-10-26 | 1996-06-04 | Kuzmak; Lubomyr I. | Finger-like laparoscopic blunt dissector device |
US5535759A (en) | 1994-11-02 | 1996-07-16 | Wilk; Peter J. | Endoscopic method of cleaning and operating on a site within a patient |
US5868760A (en) | 1994-12-07 | 1999-02-09 | Mcguckin, Jr.; James F. | Method and apparatus for endolumenally resectioning tissue |
US6690963B2 (en) | 1995-01-24 | 2004-02-10 | Biosense, Inc. | System for determining the location and orientation of an invasive medical instrument |
US5728044A (en) | 1995-03-10 | 1998-03-17 | Shan; Yansong | Sensor device for spacial imaging of endoscopes |
DE19510962C2 (en) | 1995-03-25 | 1998-02-05 | Winter & Ibe Olympus | Medical endoscopic device with super elastic element |
FR2732225A1 (en) | 1995-03-27 | 1996-10-04 | Mazars Paul | Catheter with externally controlled deformation |
JP3139325B2 (en) | 1995-03-30 | 2001-02-26 | 日本鋼管株式会社 | Zn-Ni alloy plated steel sheet with excellent laser weldability |
JPH08322783A (en) | 1995-03-30 | 1996-12-10 | Gunji Haga | Robot endoscope for large intestine |
JP3543027B2 (en) | 1995-04-10 | 2004-07-14 | オリンパス株式会社 | Curved sheath for probe |
US5620408A (en) | 1995-04-14 | 1997-04-15 | Vennes; Jack A. | Endoscopic over-tube |
US5771902A (en) | 1995-09-25 | 1998-06-30 | Regents Of The University Of California | Micromachined actuators/sensors for intratubular positioning/steering |
JPH08322786A (en) | 1995-05-30 | 1996-12-10 | Toshiba Medical Eng Co Ltd | Diagnosing/treating apparatus for inside of organism |
US5667476A (en) | 1995-06-05 | 1997-09-16 | Vision-Sciences, Inc. | Endoscope articulation system to reduce effort during articulation of an endoscope |
US6210337B1 (en) | 1995-06-07 | 2001-04-03 | Atl Ultrasound Inc. | Ultrasonic endoscopic probe |
US5759151A (en) | 1995-06-07 | 1998-06-02 | Carnegie Mellon University | Flexible steerable device for conducting exploratory procedures |
US5752912A (en) | 1995-06-26 | 1998-05-19 | Asahi Kogaku Kogyo Kabushiki Kaisha | Manipulator for flexible portion of an endoscope |
US5662621A (en) | 1995-07-06 | 1997-09-02 | Scimed Life Systems, Inc. | Guide catheter with shape memory retention |
JPH0928662A (en) | 1995-07-17 | 1997-02-04 | Olympus Optical Co Ltd | Endscope shape sensing system |
US5776050A (en) * | 1995-07-24 | 1998-07-07 | Medical Media Systems | Anatomical visualization system |
US5848972A (en) * | 1995-09-15 | 1998-12-15 | Children's Medical Center Corporation | Method for endocardial activation mapping using a multi-electrode catheter |
US6428470B1 (en) | 1995-09-15 | 2002-08-06 | Pinotage, Llc | Imaging system and components thereof |
GB9519194D0 (en) | 1995-09-20 | 1995-11-22 | Univ Wales Medicine | Anorectal angle measurement |
US5810717A (en) | 1995-09-22 | 1998-09-22 | Mitsubishi Cable Industries, Ltd. | Bending mechanism and stereoscope using same |
DE19535179A1 (en) | 1995-09-22 | 1997-03-27 | Wolf Gmbh Richard | Angled pipe and process for its manufacture |
US5810715A (en) | 1995-09-29 | 1998-09-22 | Olympus Optical Co., Ltd. | Endoscope provided with function of being locked to flexibility of insertion part which is set by flexibility modifying operation member |
EP1317908B1 (en) | 1995-10-13 | 2011-07-06 | Medtronic Vascular, Inc. | A device and system for interstitial transvascular intervention |
US5651769A (en) | 1995-10-16 | 1997-07-29 | The Beth Israel Hospital Association | Method for retrieving pancreatic juice utilizing and endoscopically wire-guided catheter |
US5704898A (en) | 1995-11-17 | 1998-01-06 | Circon Corporation | Articulation mechanism for an endoscope |
AU708568B2 (en) | 1995-12-11 | 1999-08-05 | Zoob Corporation | Construction system |
JP3221824B2 (en) | 1995-12-19 | 2001-10-22 | 富士写真光機株式会社 | Endoscope with bending section protection mechanism |
US5749828A (en) | 1995-12-22 | 1998-05-12 | Hewlett-Packard Company | Bending neck for use with invasive medical devices |
IT1277690B1 (en) | 1995-12-22 | 1997-11-11 | Bieffe Medital Spa | VERTEBRAL SUPPORT AND IMPLEMENTATION SYSTEM IN PARTICULAR FOR SURGICAL AND DIAGNOSTIC INSTRUMENTS |
CA2242356C (en) | 1996-01-08 | 2005-08-23 | Biosense, Inc. | Methods and apparatus for myocardial revascularization |
US5989230A (en) | 1996-01-11 | 1999-11-23 | Essex Technology, Inc. | Rotate to advance catheterization system |
AU7671696A (en) | 1996-01-18 | 1997-08-11 | University Of New Mexico | Soft actuators and artificial muscles |
US5827265A (en) | 1996-02-07 | 1998-10-27 | Regents Of The University Of California | Intraluminal tissue welding for anastomosis |
US5810776A (en) | 1996-02-13 | 1998-09-22 | Imagyn Medical, Inc. | Method and apparatus for performing laparoscopy |
DE69719030T2 (en) | 1996-02-15 | 2003-10-23 | Biosense, Inc. | METHOD FOR CONFIGURING AND USING A PROBE |
IL125781A (en) | 1996-02-15 | 2003-06-24 | Biosense Inc | Precise position determination of endoscopes |
ES2295767T3 (en) | 1996-02-15 | 2008-04-16 | Biosense Webster, Inc. | MOBILE TRANSMISSION AND RECEPTION COILS FOR LOCATION SYSTEM. |
US6321109B2 (en) | 1996-02-15 | 2001-11-20 | Biosense, Inc. | Catheter based surgery |
JP4166277B2 (en) | 1996-02-15 | 2008-10-15 | バイオセンス・ウェブスター・インコーポレイテッド | Medical method and apparatus using in-vivo probe |
US5647368A (en) | 1996-02-28 | 1997-07-15 | Xillix Technologies Corp. | Imaging system for detecting diseased tissue using native fluorsecence in the gastrointestinal and respiratory tract |
US5813976A (en) | 1996-04-02 | 1998-09-29 | Filipi; Charles J. | Stabilizing instrumentation for the performing of endoscopic surgical procedures |
US5762613A (en) | 1996-05-07 | 1998-06-09 | Spectrascience, Inc. | Optical biopsy forceps |
US5746694A (en) | 1996-05-16 | 1998-05-05 | Wilk; Peter J. | Endoscope biopsy channel liner and associated method |
GB9610765D0 (en) | 1996-05-23 | 1996-07-31 | Axon Anthony T R | Improvements in or relating to endoscopes |
US5773835A (en) | 1996-06-07 | 1998-06-30 | Rare Earth Medical, Inc. | Fiber optic spectroscopy |
US5800421A (en) | 1996-06-12 | 1998-09-01 | Lemelson; Jerome H. | Medical devices using electrosensitive gels |
US6119913A (en) | 1996-06-14 | 2000-09-19 | Boston Scientific Corporation | Endoscopic stapler |
DE19626433A1 (en) | 1996-06-19 | 1998-01-15 | Jan Henrik Dr Wilkens | Endoscope head arrangement with integrated image production arrangement |
US5882346A (en) * | 1996-07-15 | 1999-03-16 | Cardiac Pathways Corporation | Shapable catheter using exchangeable core and method of use |
US5902254A (en) | 1996-07-29 | 1999-05-11 | The Nemours Foundation | Cathether guidewire |
US6016440A (en) | 1996-07-29 | 2000-01-18 | Bruker Analytik Gmbh | Device for infrared (IR) spectroscopic investigations of internal surfaces of a body |
US5685822A (en) | 1996-08-08 | 1997-11-11 | Vision-Sciences, Inc. | Endoscope with sheath retaining device |
US5993447A (en) | 1996-08-16 | 1999-11-30 | United States Surgical | Apparatus for thermal treatment of tissue |
US7018331B2 (en) | 1996-08-26 | 2006-03-28 | Stryker Corporation | Endoscope assembly useful with a scope-sensing light cable |
JP2000501320A (en) | 1996-08-27 | 2000-02-08 | シー・アール・バード・インコーポレーテッド | Low-bulk medical guidewire capable of torque loading |
US6096009A (en) | 1996-09-13 | 2000-08-01 | Boston Scientific Corporation | Guidewire and catheter locking device and method |
US5971767A (en) * | 1996-09-16 | 1999-10-26 | The Research Foundation Of State University Of New York | System and method for performing a three-dimensional virtual examination |
GB9619470D0 (en) | 1996-09-18 | 1996-10-30 | Univ London | Imaging apparatus |
JP3109021B2 (en) | 1996-09-24 | 2000-11-13 | 株式会社小糸製作所 | Vehicle lighting |
US6464697B1 (en) * | 1998-02-19 | 2002-10-15 | Curon Medical, Inc. | Stomach and adjoining tissue regions in the esophagus |
US5912147A (en) | 1996-10-22 | 1999-06-15 | Health Research, Inc. | Rapid means of quantitating genomic instability |
IT1285533B1 (en) | 1996-10-22 | 1998-06-08 | Scuola Superiore Di Studi Universitari E Di Perfezionamento Sant Anna | ENDOSCOPIC ROBOT |
US6840936B2 (en) | 1996-10-22 | 2005-01-11 | Epicor Medical, Inc. | Methods and devices for ablation |
US6058323A (en) | 1996-11-05 | 2000-05-02 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6036702A (en) | 1997-04-23 | 2000-03-14 | Vascular Science Inc. | Medical grafting connectors and fasteners |
US5941908A (en) | 1997-04-23 | 1999-08-24 | Vascular Science, Inc. | Artificial medical graft with a releasable retainer |
US5810716A (en) | 1996-11-15 | 1998-09-22 | The United States Of America As Represented By The Secretary Of The Navy | Articulated manipulator for minimally invasive surgery (AMMIS) |
US6371907B1 (en) | 1996-11-18 | 2002-04-16 | Olympus Optical Co., Ltd. | Endoscope apparatus driving manipulation wires with drive motor in drum portion |
DE19748795B4 (en) | 1996-11-18 | 2006-08-17 | Olympus Corporation | endoscope |
WO1998022184A1 (en) * | 1996-11-21 | 1998-05-28 | Boston Scientific Corporation | Mucosal ablation using light |
GB9624486D0 (en) | 1996-11-26 | 1997-01-15 | Univ Bristol | Control means |
US5968052A (en) | 1996-11-27 | 1999-10-19 | Scimed Life Systems Inc. | Pull back stent delivery system with pistol grip retraction handle |
JP3615890B2 (en) | 1996-12-04 | 2005-02-02 | フジノン株式会社 | Electronic endoscope device |
US5779624A (en) | 1996-12-05 | 1998-07-14 | Boston Scientific Corporation | Sigmoid splint device for endoscopy |
US5885208A (en) | 1996-12-24 | 1999-03-23 | Olympus Optical Co., Ltd. | Endoscope system |
AU741737B2 (en) | 1997-01-03 | 2001-12-06 | Biosense, Inc. | Bend-responsive catheter |
US6809462B2 (en) | 2000-04-05 | 2004-10-26 | Sri International | Electroactive polymer sensors |
US5928136A (en) | 1997-02-13 | 1999-07-27 | Karl Storz Gmbh & Co. | Articulated vertebra for endoscopes and method to make it |
US5855565A (en) | 1997-02-21 | 1999-01-05 | Bar-Cohen; Yaniv | Cardiovascular mechanically expanding catheter |
US5893369A (en) | 1997-02-24 | 1999-04-13 | Lemole; Gerald M. | Procedure for bypassing an occlusion in a blood vessel |
US6201989B1 (en) | 1997-03-13 | 2001-03-13 | Biomax Technologies Inc. | Methods and apparatus for detecting the rejection of transplanted tissue |
US5857962A (en) | 1997-03-13 | 1999-01-12 | Circon Corporation | Resectoscope with curved electrode channel and resiliently deflectable electrode section |
US5876373A (en) | 1997-04-04 | 1999-03-02 | Eclipse Surgical Technologies, Inc. | Steerable catheter |
JPH10337274A (en) | 1997-04-09 | 1998-12-22 | Olympus Optical Co Ltd | Endoscopic spectrometry device |
US6656110B1 (en) | 1997-04-16 | 2003-12-02 | Karl Storz Gmbh & Co. Kg | Endoscopic system |
JP4002322B2 (en) | 1997-04-25 | 2007-10-31 | 東芝エレベータ株式会社 | Escalator with step for wheelchair |
US5908381A (en) | 1997-04-30 | 1999-06-01 | C. R. Bard Inc. | Directional surgical device for use with endoscope, gastroscope, colonoscope or the like |
US5921915A (en) | 1997-04-30 | 1999-07-13 | C.R. Bard, Inc. | Directional surgical device for use with endoscope, gastroscope, colonoscope or the like |
US5879297A (en) | 1997-05-08 | 1999-03-09 | Lucent Medical Systems, Inc. | System and method to determine the location and orientation of an indwelling medical device |
US5873817A (en) | 1997-05-12 | 1999-02-23 | Circon Corporation | Endoscope with resilient deflectable section |
JP3477570B2 (en) | 1997-06-02 | 2003-12-10 | 正喜 江刺 | Active conduit and method of manufacturing the same |
US6149581A (en) | 1997-06-12 | 2000-11-21 | Klingenstein; Ralph James | Device and method for access to the colon and small bowel of a patient |
GB9713680D0 (en) | 1997-06-27 | 1997-09-03 | Keymed Medicals & Ind Equip | Improvements in or relating to optical scopes with measuring systems |
DE19729499A1 (en) | 1997-07-10 | 1999-01-14 | Friedrich Schiller Uni Jena Bu | Guide for flexible endoscope, with reinforcements |
JP3723327B2 (en) | 1997-07-25 | 2005-12-07 | 田淵 和久 | Internal / external medical examination table |
US5921926A (en) | 1997-07-28 | 1999-07-13 | University Of Central Florida | Three dimensional optical imaging colposcopy |
JPH1152413A (en) | 1997-07-30 | 1999-02-26 | Matsushita Electric Ind Co Ltd | Liquid crystal display element and its production |
JPH1156754A (en) | 1997-08-18 | 1999-03-02 | Asahi Optical Co Ltd | Operating part of endoscope |
US5916147A (en) | 1997-09-22 | 1999-06-29 | Boury; Harb N. | Selectively manipulable catheter |
US6685726B2 (en) | 1997-09-26 | 2004-02-03 | Cryolife, Inc. | Sutureless anastomotic technique using a bioadhesive and device therefor |
JP4636683B2 (en) | 1997-10-10 | 2011-02-23 | ボストン サイエンティフィック リミテッド | Soft tissue coagulation probe |
US6147480A (en) | 1997-10-23 | 2000-11-14 | Biosense, Inc. | Detection of metal disturbance |
NL1007349C2 (en) | 1997-10-24 | 1999-04-27 | Suyker Wilhelmus Joseph Leonardus | System for the mechanical production of anastomoses between hollow structures; as well as device and applicator for use therewith. |
JP3231707B2 (en) | 1997-10-28 | 2001-11-26 | 譲 土井 | Endoscope measuring tool |
US6056743A (en) | 1997-11-04 | 2000-05-02 | Scimed Life Systems, Inc. | Percutaneous myocardial revascularization device and method |
IL122111A (en) | 1997-11-04 | 2004-06-01 | Sightline Techn Ltd | Video rectoscope |
GB2331807B (en) * | 1997-11-15 | 2002-05-29 | Roke Manor Research | Catheter tracking system |
US6348058B1 (en) | 1997-12-12 | 2002-02-19 | Surgical Navigation Technologies, Inc. | Image guided spinal surgery guide, system, and method for use thereof |
US5989182A (en) | 1997-12-19 | 1999-11-23 | Vista Medical Technologies, Inc. | Device-steering shaft assembly and endoscope |
WO1999033392A1 (en) | 1997-12-29 | 1999-07-08 | Falko Skrabal | Deformable probe with automatic detection of the position of the probe |
US6537211B1 (en) | 1998-01-26 | 2003-03-25 | Massachusetts Institute Of Technology | Flourescence imaging endoscope |
US6129667A (en) | 1998-02-02 | 2000-10-10 | General Electric Company | Luminal diagnostics employing spectral analysis |
EP1054634A4 (en) | 1998-02-10 | 2006-03-29 | Artemis Medical Inc | Entrapping apparatus and method for use |
DE69805209T2 (en) | 1998-02-23 | 2002-11-28 | Algotec Systems Ltd., Raanana | SYSTEM AND METHOD FOR AUTOMATIC ROUTE PLANNING |
US20020138082A1 (en) | 1998-02-24 | 2002-09-26 | Brock David L. | Surgical instrument |
US7169141B2 (en) * | 1998-02-24 | 2007-01-30 | Hansen Medical, Inc. | Surgical instrument |
US7297142B2 (en) | 1998-02-24 | 2007-11-20 | Hansen Medical, Inc. | Interchangeable surgical instrument |
CA2263214A1 (en) | 1998-02-27 | 1999-08-27 | Eclipse Surgical Technologies, Inc. | Viewing surgical scope for minimally invasive procedures |
US6312429B1 (en) | 1998-09-01 | 2001-11-06 | Senorx, Inc. | Electrosurgical lesion location device |
US6066102A (en) | 1998-03-09 | 2000-05-23 | Spectrascience, Inc. | Optical biopsy forceps system and method of diagnosing tissue |
US6174291B1 (en) | 1998-03-09 | 2001-01-16 | Spectrascience, Inc. | Optical biopsy system and methods for tissue diagnosis |
DE19815598B4 (en) | 1998-04-07 | 2007-01-18 | Stm Medizintechnik Starnberg Gmbh | Flexible access tube with everting tube system |
US6249076B1 (en) | 1998-04-14 | 2001-06-19 | Massachusetts Institute Of Technology | Conducting polymer actuator |
JPH11299725A (en) | 1998-04-21 | 1999-11-02 | Olympus Optical Co Ltd | Hood for endoscope |
US6106510A (en) | 1998-05-28 | 2000-08-22 | Medtronic, Inc. | Extruded guide catheter shaft with bump extrusion soft distal segment |
JPH11342106A (en) | 1998-06-03 | 1999-12-14 | Masazumi Takada | Self-traveling colon endoscope |
US6616600B2 (en) | 1998-06-11 | 2003-09-09 | Fritz Pauker | Endoscope shaft |
US6066132A (en) | 1998-06-30 | 2000-05-23 | Ethicon, Inc. | Articulating endometrial ablation device |
US6352503B1 (en) | 1998-07-17 | 2002-03-05 | Olympus Optical Co., Ltd. | Endoscopic surgery apparatus |
US6117296A (en) | 1998-07-21 | 2000-09-12 | Thomson; Timothy | Electrically controlled contractile polymer composite |
US6593884B1 (en) | 1998-08-02 | 2003-07-15 | Super Dimension Ltd. | Intrabody navigation system for medical applications |
JP3514979B2 (en) | 1998-08-06 | 2004-04-05 | オリンパス株式会社 | Endoscope device |
US6517563B1 (en) | 1998-08-17 | 2003-02-11 | Coroneo, Inc. | Pericardium retraction device for positioning a beating heart |
US6511417B1 (en) | 1998-09-03 | 2003-01-28 | Olympus Optical Co., Ltd. | System for detecting the shape of an endoscope using source coils and sense coils |
DE19840986A1 (en) | 1998-09-08 | 2000-03-09 | Etm Endoskopische Technik Gmbh | Quick release for an endoscope |
US6432041B1 (en) | 1998-09-09 | 2002-08-13 | Olympus Optical Co., Ltd. | Endoscope shape detecting apparatus wherein form detecting processing is controlled according to connection state of magnetic field generating means |
US6185448B1 (en) | 1998-09-29 | 2001-02-06 | Simcha Borovsky | Apparatus and method for locating and mapping a catheter in intracardiac operations |
US6544215B1 (en) | 1998-10-02 | 2003-04-08 | Scimed Life Systems, Inc. | Steerable device for introducing diagnostic and therapeutic apparatus into the body |
US6245062B1 (en) * | 1998-10-23 | 2001-06-12 | Afx, Inc. | Directional reflector shield assembly for a microwave ablation instrument |
US6178346B1 (en) * | 1998-10-23 | 2001-01-23 | David C. Amundson | Infrared endoscopic imaging in a liquid with suspended particles: method and apparatus |
US6508803B1 (en) | 1998-11-06 | 2003-01-21 | Furukawa Techno Material Co., Ltd. | Niti-type medical guide wire and method of producing the same |
US6174280B1 (en) | 1998-11-19 | 2001-01-16 | Vision Sciences, Inc. | Sheath for protecting and altering the bending characteristics of a flexible endoscope |
US6468265B1 (en) | 1998-11-20 | 2002-10-22 | Intuitive Surgical, Inc. | Performing cardiac surgery without cardioplegia |
WO2000032129A1 (en) | 1998-11-23 | 2000-06-08 | C.R. Bard, Inc. | Intracardiac grasp catheter |
JP3448228B2 (en) | 1998-11-30 | 2003-09-22 | 富士写真光機株式会社 | Endoscope insertion guide tube |
AU1405600A (en) | 1998-12-01 | 2000-06-19 | Atropos Limited | A medical device comprising an evertable sleeve |
US6162171A (en) | 1998-12-07 | 2000-12-19 | Wan Sing Ng | Robotic endoscope and an autonomous pipe robot for performing endoscopic procedures |
US7125403B2 (en) | 1998-12-08 | 2006-10-24 | Intuitive Surgical | In vivo accessories for minimally invasive robotic surgery |
JP2000193893A (en) | 1998-12-28 | 2000-07-14 | Suzuki Motor Corp | Bending device of insertion tube for inspection |
US6293908B1 (en) | 1999-02-12 | 2001-09-25 | Fuji Photo Optical Co., Ltd. | Mouthpiece and insertion assisting device for endoscope |
US6203494B1 (en) | 1999-03-02 | 2001-03-20 | Olympus Optical Co., Ltd. | Endoscope capable of varying hardness of flexible part of insertion unit thereof |
US6179776B1 (en) | 1999-03-12 | 2001-01-30 | Scimed Life Systems, Inc. | Controllable endoscopic sheath apparatus and related method of use |
US6569084B1 (en) | 1999-03-31 | 2003-05-27 | Olympus Optical Co., Ltd. | Endoscope holder and endoscope device |
JP2000279367A (en) | 1999-03-31 | 2000-10-10 | Olympus Optical Co Ltd | Endoscope device |
US6902528B1 (en) | 1999-04-14 | 2005-06-07 | Stereotaxis, Inc. | Method and apparatus for magnetically controlling endoscopes in body lumens and cavities |
US6569173B1 (en) | 1999-12-14 | 2003-05-27 | Integrated Vascular Interventional Technologies, L.C. | Compression plate anastomosis apparatus |
US6459481B1 (en) | 1999-05-06 | 2002-10-01 | David F. Schaack | Simple system for endoscopic non-contact three-dimentional measurement |
JP2002543865A (en) | 1999-05-10 | 2002-12-24 | ブロック ロジャース サージカル インコーポレイティド | Surgical instruments |
US6482149B1 (en) | 1999-05-12 | 2002-11-19 | Fuji Photo Optical Co., Ltd. | Curved part of endoscope |
DE19922363A1 (en) | 1999-05-14 | 2000-11-23 | Rexroth Star Gmbh | Device for determining the relative position of two bodies movable relative to one another and method for producing such a device |
US6233476B1 (en) | 1999-05-18 | 2001-05-15 | Mediguide Ltd. | Medical positioning system |
DE60037731T2 (en) | 1999-06-05 | 2009-01-15 | Wilson-Cook Medical Inc. | Markers for a medical endoscopic device |
JP3490932B2 (en) | 1999-06-07 | 2004-01-26 | ペンタックス株式会社 | Swallowable endoscope device |
JP3490933B2 (en) | 1999-06-07 | 2004-01-26 | ペンタックス株式会社 | Swallowable endoscope device |
US6664718B2 (en) | 2000-02-09 | 2003-12-16 | Sri International | Monolithic electroactive polymers |
JP3565099B2 (en) | 1999-08-02 | 2004-09-15 | 富士写真光機株式会社 | Endoscope fluid supply device |
JP3365981B2 (en) | 1999-08-05 | 2003-01-14 | オリンパス光学工業株式会社 | Endoscope shape detector |
US20030187460A1 (en) * | 1999-08-10 | 2003-10-02 | Chin Albert K. | Methods and apparatus for endoscopic cardiac surgery |
JP2001096478A (en) | 1999-09-27 | 2001-04-10 | Ueda Seni Kagaku Shinkokai | Rope type bending mechanism, manipulator equipped with rope type bending mechanism, bending type in-liquid propelling body, and endscope |
JP4454078B2 (en) | 1999-10-08 | 2010-04-21 | 株式会社町田製作所 | Endoscope bending tube and method of manufacturing the same |
GB9927358D0 (en) | 1999-11-19 | 2000-01-19 | Marconi Electronic Syst Ltd | Endoscope suitable for magnetic resonance imaging |
US6533752B1 (en) | 2000-01-05 | 2003-03-18 | Thomas C Waram | Variable shape guide apparatus |
US6517477B1 (en) | 2000-01-27 | 2003-02-11 | Scimed Life Systems, Inc. | Catheter introducer system for exploration of body cavities |
JP3765218B2 (en) | 2000-02-03 | 2006-04-12 | フジノン株式会社 | Endoscope operation wire guide device |
US6911764B2 (en) | 2000-02-09 | 2005-06-28 | Sri International | Energy efficient electroactive polymers and electroactive polymer devices |
US7993368B2 (en) | 2003-03-13 | 2011-08-09 | C.R. Bard, Inc. | Suture clips, delivery devices and methods |
US6464693B1 (en) | 2000-03-06 | 2002-10-15 | Plc Medical Systems, Inc. | Myocardial revascularization |
IL141665A (en) | 2001-02-26 | 2007-02-11 | Minelu Zonnenschein | Ultrasonic positioning |
US6817973B2 (en) | 2000-03-16 | 2004-11-16 | Immersion Medical, Inc. | Apparatus for controlling force for manipulation of medical instruments |
NZ521288A (en) | 2000-03-16 | 2004-12-24 | Medigus Ltd | Fundoplication apparatus and method |
IL138632A (en) | 2000-09-21 | 2008-06-05 | Minelu Zonnenschein | Multiple view endoscopes |
IL139788A (en) | 2000-11-20 | 2006-10-05 | Minelu Zonnenschein | Stapler for endoscopes |
EP1265522A1 (en) | 2000-03-23 | 2002-12-18 | Atropos Limited | An insertion device for an endoscope |
US6428203B1 (en) | 2000-03-23 | 2002-08-06 | Ta Instruments, Inc. | Power compensation differential scanning calorimeter |
US6511418B2 (en) | 2000-03-30 | 2003-01-28 | The Board Of Trustees Of The Leland Stanford Junior University | Apparatus and method for calibrating and endoscope |
US8517923B2 (en) | 2000-04-03 | 2013-08-27 | Intuitive Surgical Operations, Inc. | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
US6837846B2 (en) | 2000-04-03 | 2005-01-04 | Neo Guide Systems, Inc. | Endoscope having a guide tube |
US20050165276A1 (en) | 2004-01-28 | 2005-07-28 | Amir Belson | Methods and apparatus for accessing and treating regions of the body |
US6984203B2 (en) | 2000-04-03 | 2006-01-10 | Neoguide Systems, Inc. | Endoscope with adjacently positioned guiding apparatus |
US6800056B2 (en) | 2000-04-03 | 2004-10-05 | Neoguide Systems, Inc. | Endoscope with guiding apparatus |
US6858005B2 (en) | 2000-04-03 | 2005-02-22 | Neo Guide Systems, Inc. | Tendon-driven endoscope and methods of insertion |
US8888688B2 (en) | 2000-04-03 | 2014-11-18 | Intuitive Surgical Operations, Inc. | Connector device for a controllable instrument |
US6468203B2 (en) | 2000-04-03 | 2002-10-22 | Neoguide Systems, Inc. | Steerable endoscope and improved method of insertion |
EP1662972A4 (en) | 2000-04-03 | 2010-08-25 | Intuitive Surgical Inc | Activated polymer articulated instruments and methods of insertion |
US6974411B2 (en) | 2000-04-03 | 2005-12-13 | Neoguide Systems, Inc. | Endoscope with single step guiding apparatus |
US6610007B2 (en) | 2000-04-03 | 2003-08-26 | Neoguide Systems, Inc. | Steerable segmented endoscope and method of insertion |
EP1274480B1 (en) | 2000-04-21 | 2006-07-05 | Universite Pierre Et Marie Curie Paris Vi | Device for positioning, exploring and/or operating in particular in the field of endoscopy and/or minimally invasive surgery |
FR2807960B1 (en) | 2000-04-21 | 2002-07-26 | Univ Paris Curie | DEVICE FOR POSITIONING, EXPLORING AND / OR INTERVENING IN PARTICULAR IN THE FIELD OF MINIMALLY INVASIVE ENDOSCOPY AND / OR SURGERY |
US6309346B1 (en) | 2000-06-29 | 2001-10-30 | Ashkan Farhadi | Creeping colonoscope |
US6871084B1 (en) * | 2000-07-03 | 2005-03-22 | Srico, Inc. | High-impedance optical electrode |
US6544257B2 (en) | 2000-07-03 | 2003-04-08 | Olympus Optical Co., Ltd. | Thermal treatment apparatus |
JP2002017746A (en) * | 2000-07-03 | 2002-01-22 | Terumo Corp | Laser irradiation device |
JP4083398B2 (en) * | 2000-07-03 | 2008-04-30 | オリンパス株式会社 | Heat treatment device |
WO2002047549A1 (en) | 2000-07-13 | 2002-06-20 | Wilson Cook Medical, Inc. | System of indicia for a medical device |
EP1174076A3 (en) | 2000-07-18 | 2002-10-16 | BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin | Device for automatically performing diagnostic and/or therapeutic actions in body cavities |
JP3574844B2 (en) | 2000-07-19 | 2004-10-06 | 大阪大学長 | Method for oxidizing a compound using an aldehyde in the presence of a copper catalyst comprising a copper salt and a nitrogen-containing compound |
AU2002224519A1 (en) | 2000-07-21 | 2002-02-05 | Atropos Limited | A surgical instrument |
WO2002007618A1 (en) | 2000-07-21 | 2002-01-31 | Atropos Limited | A cannula |
JP2002078674A (en) | 2000-09-08 | 2002-03-19 | Fuji Photo Optical Co Ltd | Curved surface structure of endoscope |
AU2001292836A1 (en) | 2000-09-23 | 2002-04-02 | The Board Of Trustees Of The Leland Stanford Junior University | Endoscopic targeting method and system |
US6423014B1 (en) | 2000-09-29 | 2002-07-23 | University Of Vermont | Therapeutic and diagnostic needling device and method |
JP2002177198A (en) | 2000-10-02 | 2002-06-25 | Olympus Optical Co Ltd | Endoscope |
JP2002177201A (en) | 2000-10-02 | 2002-06-25 | Olympus Optical Co Ltd | Endoscope |
US6640120B1 (en) * | 2000-10-05 | 2003-10-28 | Scimed Life Systems, Inc. | Probe assembly for mapping and ablating pulmonary vein tissue and method of using same |
US6461294B1 (en) | 2000-10-30 | 2002-10-08 | Vision Sciences, Inc. | Inflatable member for an endoscope sheath |
US6514237B1 (en) | 2000-11-06 | 2003-02-04 | Cordis Corporation | Controllable intralumen medical device |
US6569085B2 (en) | 2001-08-16 | 2003-05-27 | Syntheon, Llc | Methods and apparatus for delivering a medical instrument over an endoscope while the endoscope is in a body lumen |
US6503259B2 (en) | 2000-12-27 | 2003-01-07 | Ethicon, Inc. | Expandable anastomotic device |
US20030163128A1 (en) * | 2000-12-29 | 2003-08-28 | Afx, Inc. | Tissue ablation system with a sliding ablating device and method |
US20050203339A1 (en) | 2001-03-08 | 2005-09-15 | Atropos Limited | Colonic overtube |
US6793621B2 (en) | 2001-03-08 | 2004-09-21 | Atropos Limited | Colonic overtube |
EP1385415A2 (en) | 2001-03-08 | 2004-02-04 | Atropos Limited | Inserting device for colonoscopes |
JP2002264048A (en) | 2001-03-08 | 2002-09-18 | Hitachi Ltd | Positioning control device for towed mechanism |
WO2002089692A1 (en) | 2001-05-04 | 2002-11-14 | Areall | Method and device for guiding the movement of at least one reference point in relation to a body |
JP3720727B2 (en) | 2001-05-07 | 2005-11-30 | オリンパス株式会社 | Endoscope shape detection device |
US6846286B2 (en) | 2001-05-22 | 2005-01-25 | Pentax Corporation | Endoscope system |
FR2825013B1 (en) | 2001-05-28 | 2004-01-09 | Univ Paris Curie | ORIENTABLE ACTIVE TUBULAR STRUCTURE AND ENDOSCOPE FORMED FROM SUCH A STRUCTURE |
US20030065373A1 (en) | 2001-10-02 | 2003-04-03 | Lovett Eric G. | Medical device having rheometric materials and method therefor |
US6835173B2 (en) | 2001-10-05 | 2004-12-28 | Scimed Life Systems, Inc. | Robotic endoscope |
WO2003039354A1 (en) | 2001-10-18 | 2003-05-15 | Atropos Limited | A device to aid advancement of a colonoscope |
KR100396558B1 (en) | 2001-10-25 | 2003-09-02 | 삼성전자주식회사 | Apparatus and method for converting frame and/or field rate using adaptive motion compensation |
JP2003135381A (en) | 2001-10-31 | 2003-05-13 | Machida Endscope Co Ltd | Curved tube and its manufacturing method |
EP1455648A4 (en) | 2001-11-09 | 2009-03-11 | Olympus Corp | Coronary sinus access catheter with forward-imaging |
US6960161B2 (en) | 2001-12-28 | 2005-11-01 | Karl Storz Imaging Inc. | Unified electrical and illumination cable for endoscopic video imaging system |
US7493156B2 (en) | 2002-01-07 | 2009-02-17 | Cardiac Pacemakers, Inc. | Steerable guide catheter with pre-shaped rotatable shaft |
AU2002360767A1 (en) | 2002-01-09 | 2003-07-30 | Neoguide Systems, Inc | Apparatus and method for spectroscopic examination of the colon |
AU2002359847A1 (en) | 2002-01-09 | 2003-07-30 | Neoguide Systems, Inc | Apparatus and method for endoscopic colectomy |
US7277833B2 (en) | 2002-02-06 | 2007-10-02 | Siemens Corporate Research, Inc. | Modeling of the workspace and active pending behavior of an endscope using filter functions |
AU2003209967A1 (en) | 2002-03-06 | 2003-09-16 | Atropos Limited | A steerable colonoscope probe with variable stiffness |
EP2380487B1 (en) | 2002-04-17 | 2021-03-31 | Covidien LP | Endoscope structures for navigating to a target in branched structure |
WO2003101287A2 (en) | 2002-05-30 | 2003-12-11 | The Board Of Trustees Of The Leland Stanford Junior University | Apparatus and method for coronary sinus access |
US7250027B2 (en) | 2002-05-30 | 2007-07-31 | Karl Storz Endovision, Inc. | Articulating vertebrae with asymmetrical and variable radius of curvature |
JP4054970B2 (en) | 2002-05-31 | 2008-03-05 | ブリヂストンスポーツ株式会社 | Golf ball |
US7041052B2 (en) | 2002-06-13 | 2006-05-09 | Usgi Medical Inc. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US6783491B2 (en) | 2002-06-13 | 2004-08-31 | Vahid Saadat | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US20050137454A1 (en) | 2002-06-13 | 2005-06-23 | Usgi Medical Corp. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US6715552B2 (en) | 2002-06-20 | 2004-04-06 | Halliburton Energy Services, Inc. | Well cementing methods and compositions |
US6679836B2 (en) | 2002-06-21 | 2004-01-20 | Scimed Life Systems, Inc. | Universal programmable guide catheter |
US20060089535A1 (en) | 2002-07-11 | 2006-04-27 | Dan Raz | Piston-actuated endoscopic steering system |
US7442192B2 (en) | 2002-07-14 | 2008-10-28 | Knowlton Edward W | Method and apparatus for surgical dissection |
US7331967B2 (en) | 2002-09-09 | 2008-02-19 | Hansen Medical, Inc. | Surgical instrument coupling mechanism |
GB0222265D0 (en) | 2002-09-25 | 2002-10-30 | Imp College Innovations Ltd | Control of robotic manipulation |
US20040186350A1 (en) | 2003-01-13 | 2004-09-23 | Usgi Medical Corp. | Apparatus and methods for guiding an endoscope via a rigidizable wire guide |
EP1593337B1 (en) | 2003-02-11 | 2008-08-13 | Olympus Corporation | Overtube |
US20040176683A1 (en) | 2003-03-07 | 2004-09-09 | Katherine Whitin | Method and apparatus for tracking insertion depth |
US8882657B2 (en) | 2003-03-07 | 2014-11-11 | Intuitive Surgical Operations, Inc. | Instrument having radio frequency identification systems and methods for use |
US8187288B2 (en) | 2003-03-10 | 2012-05-29 | Boston Scientific Scimed, Inc. | Re-shapeable medical device |
US7285088B2 (en) | 2003-05-13 | 2007-10-23 | Olympus Corporation | Endoscope apparatus |
US7615005B2 (en) | 2003-05-16 | 2009-11-10 | Ethicon Endo-Surgery, Inc. | Medical apparatus for use with an endoscope |
CN1870930A (en) | 2003-08-20 | 2006-11-29 | 新引导***公司 | Activated polymer articulated instruments and methods of insertion |
DE10339201B4 (en) | 2003-08-22 | 2005-07-21 | Hohmann, Jörg | Double nut for controlled clamping of a component by means of a screw connection |
US7134993B2 (en) | 2004-01-29 | 2006-11-14 | Ge Inspection Technologies, Lp | Method and apparatus for improving the operation of a remote viewing device by changing the calibration settings of its articulation servos |
WO2005084542A1 (en) | 2004-03-04 | 2005-09-15 | Agency For Science, Technology And Research | Apparatus for medical and/or simulation procedures |
US7837615B2 (en) | 2004-05-10 | 2010-11-23 | Usgi Medical, Inc. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
JP2006068393A (en) | 2004-09-03 | 2006-03-16 | Olympus Corp | Endoscope |
US20060235458A1 (en) | 2005-04-15 | 2006-10-19 | Amir Belson | Instruments having an external working channel |
EP1919672A1 (en) | 2005-06-21 | 2008-05-14 | Oliver Crispin Robotics Limited | Robotic arm comprising a plurality of articulated elements and means for determining the shape of the arm |
EP1931237A2 (en) | 2005-09-14 | 2008-06-18 | Neoguide Systems, Inc. | Methods and apparatus for performing transluminal and other procedures |
US20070161857A1 (en) | 2005-11-22 | 2007-07-12 | Neoguide Systems, Inc. | Method of determining the shape of a bendable instrument |
WO2007062066A2 (en) | 2005-11-23 | 2007-05-31 | Neoguide Systems, Inc. | Non-metallic, multi-strand control cable for steerable instruments |
WO2007137208A2 (en) | 2006-05-19 | 2007-11-29 | Neoguide Systems, Inc. | Methods and apparatus for displaying three-dimensional orientation of a steerable distal tip of an endoscope |
ATE441735T1 (en) | 2007-04-04 | 2009-09-15 | Applied Materials Inc | DEVICE AND METHOD FOR COATING A PLASTIC SUBSTRATE |
JP5184531B2 (en) | 2007-07-31 | 2013-04-17 | 株式会社ミクニ | Multiple throttle device |
JP3136630U (en) | 2007-08-22 | 2007-11-01 | ▲たい▼港科技股▲ふん▼有限公司 | Observation case for breeding fireflies |
US9220398B2 (en) | 2007-10-11 | 2015-12-29 | Intuitive Surgical Operations, Inc. | System for managing Bowden cables in articulating instruments |
US8182418B2 (en) | 2008-02-25 | 2012-05-22 | Intuitive Surgical Operations, Inc. | Systems and methods for articulating an elongate body |
JP5011196B2 (en) | 2008-04-14 | 2012-08-29 | 株式会社東芝 | Semiconductor device and manufacturing method thereof |
JP5305073B2 (en) | 2008-07-16 | 2013-10-02 | 富士ゼロックス株式会社 | Printing system, image forming apparatus, post-processing apparatus, image forming program, and post-processing program |
JP5177002B2 (en) | 2009-02-18 | 2013-04-03 | 株式会社セガ | Dustproof cover, information processing apparatus, and dustproof structure of information processing apparatus |
JP5111458B2 (en) | 2009-07-24 | 2013-01-09 | 帝人化成株式会社 | Method for reducing pearl luster of aromatic polycarbonate resin composition |
JP5001999B2 (en) | 2009-12-16 | 2012-08-15 | 三菱重工業株式会社 | Wind power generator |
CN106456256B (en) | 2014-05-13 | 2019-03-26 | 柯惠Lp公司 | Robotic surgical system and instrument driving unit |
EP3193767B1 (en) | 2014-09-15 | 2022-04-20 | Covidien LP | Robotically controlling surgical assemblies |
CN107735044B (en) | 2015-05-11 | 2021-02-05 | 柯惠Lp公司 | Coupling instrument drive unit and robotic surgical instrument |
JP6007287B1 (en) | 2015-05-14 | 2016-10-12 | 西芝電機株式会社 | Engine-driven pump with generator |
EP3310288A4 (en) | 2015-06-19 | 2019-03-06 | Covidien LP | Controlling robotic surgical instruments with bidirectional coupling |
CN108025445A (en) | 2015-07-23 | 2018-05-11 | 斯里国际 | Robots arm and robotic surgical system |
JP7088788B2 (en) | 2018-08-31 | 2022-06-21 | 旭有機材株式会社 | Chemical composition for polyurethane foam |
KR102222105B1 (en) | 2019-07-31 | 2021-03-03 | 덕산하이메탈(주) | Conductive Particle, Conductive Materials and Structure of Connection |
-
2004
- 2004-05-19 US US10/850,360 patent/US8517923B2/en not_active Expired - Lifetime
-
2005
- 2005-01-28 JP JP2006551580A patent/JP5216986B2/en active Active
- 2005-01-28 WO PCT/US2005/003140 patent/WO2005072445A2/en active Application Filing
- 2005-01-28 EP EP05712548.6A patent/EP1748723B1/en active Active
- 2005-01-28 CA CA002554714A patent/CA2554714A1/en not_active Abandoned
-
2013
- 2013-08-08 US US13/962,264 patent/US9427282B2/en not_active Expired - Lifetime
-
2014
- 2014-12-09 JP JP2014249104A patent/JP2015083157A/en active Pending
-
2016
- 2016-08-05 US US15/229,177 patent/US10327625B2/en not_active Expired - Fee Related
- 2016-11-17 JP JP2016224175A patent/JP6302035B2/en active Active
-
2019
- 2019-06-17 US US16/443,070 patent/US11026564B2/en not_active Expired - Lifetime
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5018509A (en) | 1989-02-21 | 1991-05-28 | Olympus Optical Co., Ltd. | Endoscope insertion controlling apparatus |
US5269289A (en) | 1990-12-25 | 1993-12-14 | Olympus Optical Co., Ltd. | Cavity insert device using fuzzy theory |
US5347987A (en) | 1991-04-08 | 1994-09-20 | Feldstein David A | Self-centering endoscope system |
US6068629A (en) | 1997-02-04 | 2000-05-30 | Medtronic, Inc. | System and methods for tissue mapping and ablation |
Non-Patent Citations (2)
Title |
---|
See also references of EP1748723A4 |
SLATKIN A B ET AL.: "THE DEVELOPMENT OF A ROBOTIC ENDOSCOPE", PROCEEDINGS OF THE 1995 IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS, 5 August 1995 (1995-08-05), pages 162 - 171 |
Cited By (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9138132B2 (en) | 2000-04-03 | 2015-09-22 | Intuitive Surgical Operations, Inc. | Steerable endoscope and improved method of insertion |
US9427282B2 (en) | 2000-04-03 | 2016-08-30 | Intuitive Surgical Operations, Inc. | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
US9808140B2 (en) | 2000-04-03 | 2017-11-07 | Intuitive Surgical Operations, Inc. | Steerable segmented endoscope and method of insertion |
US10105036B2 (en) | 2000-04-03 | 2018-10-23 | Intuitive Surgical Operations, Inc. | Connector device for a controllable instrument |
US10327625B2 (en) | 2000-04-03 | 2019-06-25 | Intuitive Surgical Operations, Inc. | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
US10736490B2 (en) | 2000-04-03 | 2020-08-11 | Intuitive Surgical Operations, Inc. | Connector device for a controllable instrument |
US10893794B2 (en) | 2000-04-03 | 2021-01-19 | Intuitive Surgical Operations, Inc. | Steerable endoscope and improved method of insertion |
US11026564B2 (en) | 2000-04-03 | 2021-06-08 | Intuitive Surgical Operations, Inc. | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities |
US8771170B2 (en) | 2008-08-01 | 2014-07-08 | Microaccess, Inc. | Methods and apparatus for transesophageal microaccess surgery |
US11426141B2 (en) | 2012-12-31 | 2022-08-30 | Intuitive Surgical Operations, Inc. | Systems and methods for interventional procedure planning |
US11871898B2 (en) | 2012-12-31 | 2024-01-16 | Intuitive Surgical Operations, Inc. | Systems and methods for interventional procedure planning |
US10349819B2 (en) * | 2014-06-25 | 2019-07-16 | Olympus Corporation | Endoscope device, method for operating endoscope device, and computer-readable recording medium |
Also Published As
Publication number | Publication date |
---|---|
US9427282B2 (en) | 2016-08-30 |
JP6302035B2 (en) | 2018-03-28 |
EP1748723A2 (en) | 2007-02-07 |
US11026564B2 (en) | 2021-06-08 |
US20140046324A1 (en) | 2014-02-13 |
EP1748723A4 (en) | 2012-08-08 |
US20050020901A1 (en) | 2005-01-27 |
JP2007526801A (en) | 2007-09-20 |
JP5216986B2 (en) | 2013-06-19 |
US10327625B2 (en) | 2019-06-25 |
CA2554714A1 (en) | 2005-08-11 |
JP2015083157A (en) | 2015-04-30 |
US8517923B2 (en) | 2013-08-27 |
WO2005072445A3 (en) | 2009-03-26 |
EP1748723B1 (en) | 2020-07-08 |
JP2017080422A (en) | 2017-05-18 |
US20170027419A1 (en) | 2017-02-02 |
US20190365205A1 (en) | 2019-12-05 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11026564B2 (en) | Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities | |
JP2012024596A (en) | Apparatus and method for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities | |
US20240032776A1 (en) | Precision control systems for tissue visualization and manipulation assemblies | |
US11889982B2 (en) | Electrophysiology mapping and visualization system | |
US11678788B2 (en) | Systems and methods for use of a variable stiffness flexible elongate device | |
US6332089B1 (en) | Medical procedures and apparatus using intrabody probes | |
EP2632526B1 (en) | Catheter with coronary sinus ostium anchor | |
US8934962B2 (en) | Electrophysiology mapping and visualization system | |
US20090062602A1 (en) | Apparatus for robotic instrument having variable flexibility and torque transmission | |
WO2008028022A2 (en) | Tissue visualization device having multi-segmented frame |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A2 Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW |
|
AL | Designated countries for regional patents |
Kind code of ref document: A2 Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LT LU MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG |
|
WWE | Wipo information: entry into national phase |
Ref document number: 176681 Country of ref document: IL |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2006551580 Country of ref document: JP |
|
WWE | Wipo information: entry into national phase |
Ref document number: 200580003513.7 Country of ref document: CN Ref document number: 2554714 Country of ref document: CA |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
WWW | Wipo information: withdrawn in national office |
Country of ref document: DE |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2005712548 Country of ref document: EP |
|
WWP | Wipo information: published in national office |
Ref document number: 2005712548 Country of ref document: EP |