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: Devices, systems, and methods are provided for image-guided interventional procedures and other uses. Nested articulated catheter shaft systems may have an imaging catheter with an ultrasound transducer supported by a fluid-driven articulated sheath portion. Drive fluid can be transmitted distally along an asymmetric sheath via eccentric passages to an articulated portion of the imaging catheter distal of a port. An articulated shaft supporting a therapeutic tool can be advanced within a working lumen of the imaging sheath to the port so that the tool is within a field of view of the transducer. The fluid transmission channels may take much less cross-sectional area of the sheath than a mechanical pull-wire system, allowing the nested sheath/shaft system to provide safer access to a chamber of the heart and to facilitate precise independent control over 3D ultrasound imaging and image-guided structural heart therapies or the like.

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 are provided for control over automated movement of catheters and other elongate bodies. Fluid and/or pull-wire drive systems can be used to provide robotically coordinated lateral bending motions and a processor of the system can generate synchronized actuator drive signals to move the tool along an at least partially laterally constrained path, with the path optionally extending along the axis of a virtual model of the catheter that has been driven in silico into alignment with a target tissue adjacent an open workspace such as an open chamber of the heart.

Abstract: A surgical instrument for use with a mechanized surgical system that includes a roll drive unit operable by a motor. The instrument includes an elongate shaft having a longitudinal axis, and an end effector and handle on the shaft. The handle includes an actuator manually operable by a user to mechanically actuate the end effector. The shaft includes a roll joint positioned between proximal and distal shaft portions, such that the distal shaft portion is longitudinally rotatable relative to the proximal shaft portion at the roll joint. The instrument further includes a drive segment on the distal shaft portion, the drive segment including first features rotationally engageable with second features of the roll drive unit such that operation of the motor causes the distal shaft portion to axially roll relative to the proximal shaft portion.

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: 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: 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: 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: Devices, systems, and methods are provided for user input to control automated movement of catheters and other elongate bodies. Fluid drive systems can be used to provide robotically coordinated motion. Precise control over actual robotic catheter-supported tools are enhanced by moving a virtual version of the tool from a starting location of an actual tool to a desired ending position and orientation. A processor of the system can then generate synchronized actuator drive signals to move the tool without following the (often meandering) path input by the system user. The progress of the tool along a multi-degree-of-freedom trajectory can be controlled with a simple 1D input. Standard planar or proprietary input devices can be used for orientation and translation movements. Hybrid image display with 2D and 3D components is provided, along with spacial constrained movement to workspace boundaries.

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: Image-guided interventional systems, devices, and method make use of fluid-driven articulated structures having an asymmetric cross-section. An inner sheath may be offset eccentrically within an outer sheath with an axial series of asymmetric plates disposed between them. Balloons may be mounted between adjacent plates, a series of the balloons coupled end-to-end by neck regions having smaller diameters than those of the balloons to define balloon strings. The necks can extend through channels in the plates, so that the balloons of a particular balloon string can be inflated as a unit. Ends of the balloons engage the plates where the space between the inner and outer sheaths is relatively large, and can push the adjacent plates apart with a relatively high bending force. Passages through the plates near the center of lateral bending can accommodate additional inflation fluid tubes to articulate distal segments, and a pair of articulation balloon strings may be included.

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: Devices, systems, and methods can articulate catheters and other tools using fluid drive systems that provide robotically coordinated motion. The drive power will often be transmitted from a fluidic driver to the catheter through a series of pneumatic or hydraulic channels and the driver can be isolated from a sterile field by encasing the driver in a sterile housing and directing drive fluid through a sterile junction between the catheter and driver. Interventional physicians can retain tactile feedback by manually advancing the catheter over a wire or the like, and can subsequently bring an interface of the catheter down into engagement with a corresponding driver interface once a therapeutic tool approaches a target site. A sensor may provide signals during manual advancement of the driver and catheter along the catheter axis.

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 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 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: 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: Fluid control devices, systems, and methods are useful for articulating catheters and other elongate flexible structures. A modular manifold architecture includes plate-mounted valves to facilitate fluid communication along a plurality of fluid channels included in one or more multi-lumen shafts for articulating actuators comprising balloons within a balloon array, with the balloons often mounted on two or more extruded multi-lumen shafts. Valve/plate modules can be assembled in an array, and a proximal interface of the shaft(s) may have ports for accessing the balloon channels distributed along an axis of the interface. By aligning and engaging the proximal interface with a receptacle that traverses the plates of the manifold assembly, the ports can be quickly and easily sealed to associated channels of the various valve/plate modules using a quick-disconnect fitting.

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.