Abstract: A system and method for recording and depicting ultrasound images of a moving object are disclosed. In a preferred embodiment, ultrasound images are acquired as the field of view of an ultrasound probe is advanced across the tissues of interest during a resting period between periods of relatively large-scale heart cycle motion. A series of images acquired during a particular resting period may be represented as a three-dimensional volume image, and the comparison of volume images from adjacent cardiac resting periods enables three-dimensional volume image modulation analysis which may be presented for a user as a moving volume image of the objects of interest within the field of view.

Abstract: A method for estimating the force on a distal end of a working catheter includes positioning a portion of a robotically controlled guide catheter and working catheter into a body lumen wherein a distal end of the working catheter projects distally from a distal end of the guide catheter. The working catheter and guide catheter are dithered with respect to one another using a dithering device operatively connected to a proximal portion of the working catheter. The coupling may occur directly to the working catheter or via a seal such as a Touhy seal. The force experienced by the working catheter at a proximal region is measured through at least one dithering cycle. The force at the distal end of the working catheter is then estimated based on the measured force at the proximal region. The estimated force may be displayed to a physician on, for example, a monitor.

Abstract: A method of manipulating an elongate member in at least two degrees of freedom includes holding an elongate member between two rotary members that define respective rotational axes, the elongate member having a flexible proximal portion, a distal rigid needle attached to the proximal portion, and an operative element for delivering energy, the needle having a distal port, actuating at least one of the rotary members in a rotational direction about its rotational axis to generate a corresponding linear motion of the elongate member along a longitudinal axis of the elongate member, and actuating at least one of the rotary members in a linear direction along its rotational axis to generate a corresponding rotational motion of the elongate member about the longitudinal axis of the elongate member.

Abstract: Systems and methods for controllably traversing a tissue wall. In one embodiment, a distal end of a catheter is positioned and/or repositioned utilizing direct visualization out the distal end of the catheter, as facilitated by an imaging element disposed within the distal tip of the catheter. An inflatable balloon may comprise a portion of the distal tip of the catheter for structural and/or visualization media purposes. A tissue traversing element may be forwarded through a working lumen defined by the catheter and controllably pushed through a tissue wall as observed with the imaging element. The tissue traversing element may comprise sensors and the like to facilitate monitoring of changes in pressure, color, oxygen saturation, flow rate, and echo timing, to determine the position of the tissue traversing member relative to the tissue wall.

Abstract: A robotic catheter system includes a controller including a master input device and instrument driver in communication with the controller. An elongate flexible guide instrument is operatively coupled to the instrument driver. A fluid injection needle may be advanced from, or retracted into, a distal portion of the guide instrument.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site. The accessory introducer can be resiliently biased to bias the accessories toward a predetermined position in the surgical site.

Abstract: An automated medical system comprises a first instrument assembly including a first ultrasound transducer having a first transducer field of view that transmits and receives ultrasound signals in imaging planes disposed circumferentially about a guide instrument, and a second instrument assembly including a second ultrasound transducer having a second transducer field of view coupled to one of a second flexible guide instrument and a working instrument. A computing system is operatively coupled to the respective first and second transducers and configured to determine a relative spatial orientation of the respective first and second transducers based at least in part on detecting a signal transmitted by one of the first and second transducers and received by the other of the first and second transducers, the received signal having an amplitude indicating the receiving one of the transducers is in the field of view of the transmitting one of the transducers.

Abstract: The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. A positively positionable multi-disk wrist mechanism includes a plurality of disks or vertebrae stacked in series. Each vertebra is configured to rotate in pitch or in yaw with respect to each neighboring vertebra. Actuation cables are used to manipulate and control movement of the vertebrae. In specific embodiments, some of the cables are distal cables that extend from a proximal vertebra through one or more intermediate vertebrae to a distal vertebra, while the remaining cables are medial cables that extend from the proximal vertebra to one or more of the intermediate vertebrae. The cables are actuated by a pivoted plate cable actuator mechanism.

Abstract: The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Abstract: A method for performing an interventional procedure using a robotically controlled guide instrument coupled to an instrument drive assembly, includes manipulating a user interface of a master controller to actuate the drive assembly and thereby position a distal portion of the guide instrument at an interventional procedure site in a patient's body; and providing on a first display a graphically rendered image of the distal portion of the guide instrument overlaying an image of the interventional procedure site, wherein manipulation of the user interface causes a corresponding movement of the instrument model relative to the image in the first display.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: A robotic catheter manipulator includes a guide catheter including proximal and distal ends and lumen extending there through. A flexible bellows is secured at one end to the proximal end of the guide catheter and at the other end to a seal configured to receive a working catheter. In a loaded state, the working catheter is fixed relative to the seal. A ditherer is operatively connected to the seal for dithering the working catheter relative to the guide catheter when placed therein. The robotic catheter manipulator includes at least one force sensor for measuring the force applied to the working catheter by the ditherer. Force measurements may be translated into an estimated force that is experienced at the distal end of the working catheter which may then be displayed to the physician via a monitor or display.

Abstract: Systems and methods for controllably traversing a tissue wall. In one embodiment, a distal end of a catheter is positioned and/or repositioned utilizing direct visualization out the distal end of the catheter, as facilitated by an imaging element disposed within the distal tip of the catheter. An inflatable balloon may comprise a portion of the distal tip of the catheter for structural and/or visualization media purposes. A tissue traversing element may be forwarded through a working lumen defined by the catheter and controllably pushed through a tissue wall as observed with the imaging element. The tissue traversing element may comprise sensors and the like to facilitate monitoring of changes in pressure, color, oxygen saturation, flow rate, and echo timing, to determine the position of the tissue traversing member relative to the tissue wall.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. A positively positionable multi-disk wrist mechanism includes a plurality of disks or vertebrae stacked in series. Each vertebra is configured to rotate in pitch or in yaw with respect to each neighboring vertebra. Actuation cables are used to manipulate and control movement of the vertebrae. In specific embodiments, some of the cables are distal cables that extend from a proximal vertebra through one or more intermediate vertebrae to a distal vertebra, while the remaining cables are medial cables that extend from the proximal vertebra to one or more of the intermediate vertebrae. The cables are actuated by a pivoted plate cable actuator mechanism.

Abstract: An apparatus for sealing a passage through tissue includes a plug including external threads, a lumen extending between its proximal and distal ends, and an annular collet slidably disposed within the lumen. The plug is carried on a distal end of a handle device that includes an inner member with a distal end that is slidable axially within the lumen of the body for moving the collet into a reduced cross-sectional region of the lumen, thereby compressing the collet to seal the lumen, and for deploying the plug from the handle device. During use, the plug is delivered into a passage through tissue over a guide wire. Once a desired location is reached, the plug is deployed from the handle device, thereby compressing the collet and sealing the lumen. The guide wire and handle device are removed, leaving the plug to seal the passage.

Abstract: The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Abstract: An automated medical system comprises a first instrument assembly including a first ultrasound transducer having a first transducer field of view that transmits and receives ultrasound signals in imaging planes disposed circumferentially about a guide instrument, and a second instrument assembly including a second ultrasound transducer having a second transducer field of view coupled to one of a second flexible guide instrument and a working instrument. A computing system is operatively coupled to the respective first and second transducers and configured to determine a relative spatial orientation of the respective first and second transducers based at least in part on detecting a signal transmitted by one of the first and second transducers and received by the other of the first and second transducers, the received signal having an amplitude indicating the receiving one of the transducers is in the field of view of the transmitting one of the transducers.

Abstract: A method for estimating the force on a distal end of a working catheter includes positioning a portion of a robotically controlled guide catheter and working catheter into a body lumen wherein a distal end of the working catheter projects distally from a distal end of the guide catheter. The working catheter and guide catheter are dithered with respect to one another using a dithering device operatively connected to a proximal portion of the working catheter. The coupling may occur directly to the working catheter or via a seal such as a Touhy seal. The force experienced by the working catheter at a proximal region is measured through at least one dithering cycle. The force at the distal end of the working catheter is then estimated based on the measured force at the proximal region. The estimated force may be displayed to a physician on, for example, a monitor.

Abstract: A robotic catheter system includes a controller including a master input device and instrument driver in communication with the controller. An elongate flexible guide instrument is operatively coupled to the instrument driver. A fluid injection needle may be advanced from, or retracted into, a distal portion of the guide instrument.