Abstract: Articulation devices and methods include balloon arrays interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may include a helical coil, and the array can be under control of a processor. Inflation fluid may be directed to the balloons from an inflation system including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems.

Abstract: User interface devices, systems, and methods can be used for selectively bending of, altering the bend characteristics of, and/or altering the lengths of catheter bodies, guidewires, steerable trocars, and other flexible structures inserted into a patient during use. Optionally, a housing is coupled to a proximal end of a catheter, and movement of the housing by a hand of a system user is sensed and used as a movement command for articulation of the catheter. Alternatively, a sensor can be coupled to an elongate flexible body flexing outside of the patient so as to alter bending of a catheter within the patient. Movements generated through a combination of manual manipulation and powered articulations are facilitated.

Abstract: Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. The array can be formed using separate strings of balloons formed along single-lumen balloon tube material. The balloon strings can be twisted together to form a multi-channel bundle, or the balloon strings may be circumferentially separated, each extending axially. Regardless, the balloons along a common lumen may be aligned so as to bend the catheter in a desired lateral direction. The fluid-expandable bodies may include an elastomeric bladder with a fiber braid so that inflation of the bladder shortens the assembly and applies axial tension to articulate the catheter. The elongate flexible structures may be pre-biased so as to form a bend when in a relaxed configuration, with the structures being articulatable from the bend.

Abstract: Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. A user may alter a bend characteristic of the flexible structure by manually moving a handle of a pump. The pump may induce a flow of inflation fluid into a subset of the expandable bodies, and the resulting expansion can change a bend characteristic of the flexible structure. The pump may comprise a threaded syringe pump, one or more balloon that is manually compressed by movement of the handle (so that the balloon acts as a displacement pump), a multi-axis displacement pump (optionally with laterally offset piston-cylinder assemblies coupled to the handle to induce laterally offset bending of the flexible structure), or the like, providing easily-modulated articulation with a low-cost, light-weight, and/or at least partially disposable user interface.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may include a simple helical coil. Liquid inflation fluid may be directed to the balloons from an inflation fluid canister, and may vaporize within the articulation system, with the inflation system preferably including valves controlled by a processor. The articulation structures can be employed in minimally invasive medical catheter systems.

Abstract: Catheter-supported therapeutic and diagnostic tools can be introduced into a patient body with a sheath slidably disposed over the tool. Once the tool is aligned with a target tissue, a first fluid-driven actuator can move the sheath axially from over the tool, for example, to allow a stent, stent-graft, prosthetic valve, or other self-expanding tool, to expand radially within the cardiovascular system, without having to transmit large deployment forces along the catheter shaft and sheath from outside the patient. A second fluid-driven actuator can be arranged in opposition to the first actuator to control release of the expanding tool or to recapture the tool within the sheath. The first and/or second actuators may comprise a balloon having a diameter larger than the sheath to provide the desired deployment and recapture forces with moderate fluid pressure.

Abstract: Disclosed herein is a medical leadless pacemaker delivery system adapted to engage and disengage with leadless pacemakers to allow for the repeated use of the leadless pacemaker delivery system in delivering and implanting multiple leadless pacemakers into a patient heart in a serial or repeated manner. The leadless pacemaker delivery system includes a handle, an attachment mechanism, a torque portion, and a rotation limiter. The handle includes a housing. The attachment mechanism is operably coupled to the housing and configured to actuate between a released state and an engaged state. The torque portion is operably coupled to the housing and rotatable relative to the housing to transition the attachment mechanism between the released and engaged states. The torque portion includes a shaft. The rotation limiter is in sliding engagement with the shaft between a first stop and a second stop. The rotation limiter includes a first helical thread.

Abstract: User interface devices, systems, and methods can be used for selectively bending of, altering the bend characteristics of, and/or altering the lengths of catheter bodies, guidewires, steerable trocars, and other flexible structures inserted into a patient during use. Optionally, a housing is coupled to a proximal end of a catheter, and movement of the housing by a hand of a system user is sensed and used as a movement command for articulation of the catheter. Alternatively, a sensor can be coupled to an elongate flexible body flexing outside of the patient so as to alter bending of a catheter within the patient. Movements generated through a combination of manual manipulation and powered articulations are facilitated.

Abstract: Disclosed herein is a medical tool adapted to engage and disengage with leadless pacemakers to allow for the repeated use of the tool in delivering and implanting multiple leadless pacemakers into a patient heart in a serial or repeated manner. The tool includes a handle, an attachment mechanism, a torque portion, and a rotation limiter. The handle includes a housing. The attachment mechanism is operably coupled to the housing and configured to actuate between a released state and an engaged state. The torque portion is operably coupled to the housing and rotatable relative to the housing to transition the attachment mechanism between the released and engaged states. The torque portion includes a shaft. The rotation limiter is in sliding engagement with the shaft between a first stop and a second stop. The rotation limiter includes a first helical thread. The tool also includes a second helical thread in threaded engagement with the first helical thread and operably coupled to the housing.

Abstract: Catheter-supported therapeutic and diagnostic tools can be introduced into a patient body with a sheath slidably disposed over the tool. Once the tool is aligned with a target tissue, a fluid-driven actuator can move the sheath axially from over the tool, for example, to allow a stent, stent-graft, prosthetic valve, or the like to expand radially within the cardiovascular system, without having to transmit large deployment forces along the catheter shaft and sheath from outside the patient. Well-behaved articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to improve articulation behavior of the skeleton. The array can be used to improve uniformity of bending along a segment of a flexible body such as a catheter.

Abstract: Medical devices, systems, and methods provide improved control over the flexing of an articulated catheter adjacent a therapeutic or diagnostic tool by laterally bending the catheter so as to anchor an articulated portion of the catheter locally relative to an internal tissue site. Alternative embodiments may be used for a wide variety of non-medical applications, including with borescope systems and for other industrial applications.

Abstract: A robotic system that includes a mobile robot linked to a plurality of remote stations. One of the remote stations includes an arbitrator that controls access to the robot. Each remote station may be assigned a priority that is used by the arbitrator to determine which station has access to the robot. The arbitrator may include notification and call back mechanisms for sending messages relating to an access request and a granting of access for a remote station.

Abstract: A robotic system that includes a mobile robot linked to a plurality of remote stations. One of the remote stations includes an arbitrator that controls access to the robot. Each remote station may be assigned a priority that is used by the arbitrator to determine which station has access to the robot. The arbitrator may include notification and call back mechanisms for sending messages relating to an access request and a granting of access for a remote station.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures make use of balloon arrays, with inflation of the balloons locally altering articulation. Inflation fluid may be directed toward the balloons from an inflation fluid source via a series of channels, the balloons and channels included in a helical multi-balloon assembly. The balloons may be supported by encasing the helical balloon assembly in a polymer matrix, such as by winding the balloon assembly onto a mandrel and dip-coating some or all of the assembly in an elastomer such as a silicone, a urethane, or the like. The balloons may be supported by one or more spring, with loops of the spring(s) optionally being inward of the balloons, outward of the balloons, or interspersed between the balloons, and/or a mesh tube, braid, or other compliant materials may be included.

Abstract: A remote controlled robot system that includes a mobile robot and a remote control station. A user can control movement of the robot from the remote control station. The mobile robot includes a camera system that can capture and transmit to the remote station a zoom image and a non-zoom image. The remote control station includes a monitor that displays a robot view field. The robot view field can display the non-zoom image. The zoom image can be displayed in the robot view field by highlighting an area of the non-zoom field. The remote control station may also store camera locations that allow a user to move the camera system to preset locations.

Abstract: Medical devices, systems, and methods for catheter-based structural heart therapies, including positioning of prosthetic mitral valves, make use of catheter structures that can flex when advanced over a pre-bent guidewire. Telescoping transseptal access systems use steering segments that are disposed proximal of a relatively rigid catheter segment (the segment optionally supporting a prosthetic valve) by engaging tissue adjacent the right atrium near the proximal end of the valve, and by telescoping a relatively rigid needle guide distally from the valve across the right atrium to engage tissue of the fossa ovalis. Hybrid pull-wire/balloon articulation systems may optionally employ relatively stiff pull-wire articulation within the right atrium, and relatively flexible balloon articulation systems within the left atrium. More generally, hybrid systems may have catheter systems with pullwires or movable sheath, along with fluid drive and robotic control components.

Abstract: Improved systems for diagnosing and/or treating arrhythmia of a heart makes use of an array of articulation balloons to control movement of a distal portion of a catheter inside the heart, and may be used to align a diagnostic or treatment tool with a target tissue surface region along or adjacent an inner surface of one of the chambers of the heart. The articulation balloons can generate articulation forces at the site of articulation, and the movement may provide greater dexterity than movements induced by transmitting articulation forces proximally along a catheter body that winds through a tortuous vascular pathway.

Abstract: Articulation devices, systems, and methods for articulating elongate flexible structures can locally contract a flexible elongate frame or skeleton of an elongate flexible body such as a catheter. Balloons along one side of an axial segment of the elongate flexible body can be inflated so as to help define a resting shape of the elongate body. The skeleton may have pairs of corresponding axially oriented surface regions coupled to each other by a loop of a deformable helical coil structure. Balloons may be between the regions, and the pairs may be separated by an offset that increases when the axis of the skeleton is axially compressed. Inflation of the balloons can axially contract or shorten the skeleton adjacent the balloons so that the elongate body bends toward the balloons.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may comprise a simple helical coil or interlocking helical channels, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Liquid inflation fluid may be directed so as to pressurize the balloons from an inflation fluid canister, and may vaporize within a plenum or the channels or balloons of the articulation system, with the inflation system preferably including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems, and also for industrial robotics, for supporting imaging systems, for entertainment and consumer products, and the like.

Abstract: A robotic system that includes a mobile robot linked to a plurality of remote stations. One of the remote stations includes an arbitrator that controls access to the robot. Each remote station may be assigned a priority that is used by the arbitrator to determine which station has access to the robot. The arbitrator may include notification and call back mechanisms for sending messages relating to an access request and a granting of access for a remote station.