Abstract: An apparatus of the present technology generally includes an elongated shaft having a proximal portion and a distal portion, a first elongated channel extending from the proximal portion to the distal portion, a second channel extending from the proximal portion to the distal portion, and a slidable imaging probe disposed within the first elongated channel. The apparatus can be manually, robotically, and/or teleoperably steerable and is configured for delivery to a subject and/or positioning within a subject near or at a target location. Once the steerable apparatus has been successfully positioned at the target location, the imaging probe can be repositioned relative to the first elongated channel, thereby opening a working lumen. The working lumen and second channel are configured for removal of material from the target location within the subject by applying simultaneous activities including suction, irrigation, and/or deliver a tool to the target location.

Abstract: For position sensors, e.g., a fiber-based system, that build a shape of an elongated member, such as a catheter, using a sequence of small orientation measurements, a small error in orientation at the proximal end of the sensor will cause large error in position at distal points on the fiber. Exemplary methods and systems are disclosed, which may provide full or partial registration along the length of the sensor to reduce the influence of the measurement error. Additional examples are directed to applying selective filtering at a proximal end of the elongated member to provide a more stable base for distal measurements and thereby reducing the influence of measurement errors.

Abstract: Systems and methods are disclosed for the treatment and prevention of cardiac dysrhythmias and/or hypertension, and more specifically to systems and methods of treating cardiac dysrhythmias, including atrial fibrillation, as well as hypertension through noninvasive peripheral nerve stimulation.

Abstract: For position sensors, e.g., a fiber-based system, that build a shape of an elongated member, such as a catheter, using a sequence of small orientation measurements, a small error in orientation at the proximal end of the sensor will cause large error in position at distal points on the fiber. Exemplary methods and systems are disclosed, which may provide full or partial registration along the length of the sensor to reduce the influence of the measurement error. Additional examples are directed to applying selective filtering at a proximal end of the elongated member to provide a more stable base for distal measurements and thereby reducing the influence of measurement errors.

Abstract: A system may include an elongate flexible device, a flexible instrument, and a processor. The elongate flexible device may include a first shape sensor configured to generate first shape data corresponding to a shape of the elongate flexible device. The flexible instrument may include a second shape sensor configured to generate second shape data corresponding to a shape of the flexible instrument. The processor may be configured to register the flexible instrument to the elongate flexible device based on the first shape data and the second shape data. The first shape data and the second shape data may be generated while the flexible instrument is mated with the elongate flexible device.

Abstract: A system may comprise an elongate flexible instrument including an imaging device and a localization sensor. The system may capture a first 2D image with the imaging device in a first imaging configuration and receive first localization data for the distal portion of the elongate flexible instrument from the localization sensor while the imaging device is in the first imaging configuration. The system may also create a first image data set including the first localization data and the first 2D image, capture a second 2D image with the imaging device in a second imaging configuration, and receive second localization data for the distal portion while the imaging device is in the second imaging configuration. The system may also create a second image data set including the second localization data and the second 2D image and generate a 3D image based on a plurality of image data sets.

Abstract: A system may comprise an elongate flexible instrument including an imaging device disposed at a distal end portion of the elongate flexible instrument. The imaging device may include a multi-directional imaging array. The elongate flexible instrument may also include a localization sensor extending within the elongate flexible instrument. The system may also comprise a controller comprising one or more processors configured to register the localization sensor to a patient anatomy and receive orientation data for the distal end portion of the elongate flexible instrument from the localization sensor. Based on the orientation data, an imaging plane of the imaging device may be selected. An image in the selected imaging plane may be displayed. The image may be generated by imaging data from the multi-directional imaging array of the imaging device.

Abstract: Medical instrument guidance systems and associated devices and methods are disclosed herein. In some embodiments, a method for providing guidance for percutaneous access to a target within an anatomic structure, includes receiving point cloud data from a sensor system coupled to an internal instrument as the internal instrument is moved within the anatomic structure; generating a 3D model of the anatomic structure based at least in part on the point cloud data; and receiving information for identifying a substructure within the 3D anatomic model. The substructure can provide access to the target. The method can further include determining an entry to the substructure; determining an approach path through the entry; and providing a graphical representation of the approach path.

Abstract: A system may comprise a sensing instrument including an elongate flexible member with a channel extending therein. The elongate flexible member may include a proximal portion, a distal portion, and a flexure portion between the distal and proximal portions. The sensing instrument may also include a flexure at the flexure portion of the elongate flexible member, a sensing element coupled at the distal portion of the elongate flexible member, and a flexure control apparatus extending within the elongate flexible member and configured to bend the flexure to change an orientation of the sensing element relative to the proximal portion of the elongate flexible member. The sensing instrument may also include an exit port in the proximal portion of the elongate flexible member.

Abstract: A method comprises deploying a tool to a passageway exit site through a lumen of a flexible elongate device. The flexible elongate device comprises a proximal end, a distal end, and the lumen therebetween, and the tool comprises a needle. The method further comprises puncturing a passageway wall at the passageway exit site with the needle. The method further comprises deploying the needle through the passageway wall and through target tissue at a target location beyond the passageway wall. The method further comprises deploying an instrument to perform treatment on the target tissue at the target location. The instrument is deployed within the tool and through a perforation created in the target tissue by the needle.

Abstract: A device may operate a guide wire and be operable by a single operator digit. The device may include an insertion control device for advancing the guide wire in a forward and in a reverse direction and along a longitudinal axis of the guide wire; and a rotary device for rolling a guide wire about the longitudinal axis. A robotic instrument driver may be operatively coupled to the device and configured to control axial movement of the guide wire along the longitudinal axis according to input received from the insertion control device and to control rotational movement of the guide wire according to input received from the rotary device.

Abstract: Systems for performing a medical procedure and associated methods and devices are disclosed herein. In some embodiments, a system for performing a medical procedure includes an elongate flexible device configured to be introduced into an anatomic cavity of a patient, and a sensor system carried by the elongate flexible device and configured to obtain location data of the anatomic structure. The system can be configured to perform operations comprising: generating a 3D anatomic model based on first location data, the 3D anatomic model including an object within the anatomic cavity, based on second location data of the elongate flexible device when the object is within the image, and providing guidance for deploying an access tool along an access path through a patient's skin to the object based, at least in part, on the 3D anatomic model.

Abstract: A device may operate a guide wire and be operable by a single operator digit. The device may include an insertion control device for advancing the guide wire in a forward and in a reverse direction and along a longitudinal axis of the guide wire; and a rotary device for rolling a guide wire about the longitudinal axis. A robotic instrument driver may be operatively coupled to the device and configured to control axial movement of the guide wire along the longitudinal axis according to input received from the insertion control device and to control rotational movement of the guide wire according to input received from the rotary device.

Abstract: A system may comprise an elongated tool through which a lumen extends and may comprise a stylet including an expandable electrode portion. The expandable electrode portion may have a collapsed configuration within the lumen and may have an expanded configuration outside of the lumen. A diameter of the expandable electrode portion may be larger in the expanded configuration than the collapsed configuration. In the expanded configuration, the expandable electrode portion may be configured to create a plurality of path segments in a target tissue. Each path segment in the plurality of path segments may be extended in a different direction. The expandable electrode portion in the expanded configuration may be configured to deliver energy to ablate the target tissue.

Abstract: A medical system may comprise a flexible elongated tool in which a lumen extends. The lumen may be defined by an inner wall of the elongated tool. The medical system may also comprise a flexible stylet configured to extend within the lumen and contact the inner wall of the elongated tool at a plurality of points. Energy conducted through the stylet may be transmitted at the plurality of points to the elongated tool.

Abstract: A flexible instrument comprises an antenna having a distal tip portion, a proximal base, and an antenna body therebetween. The antenna body comprises a patterned cylindrical structure having a proximal end coupled to the proximal base and a distal end coupled to the distal tip portion. The flexible instrument is configured to generate a radiation pattern from the antenna to ablate tissue.

Abstract: A flexible instrument comprises an antenna having a distal tip portion shaped to perforate tissue, a proximal base, and an antenna body therebetween. The antenna body comprises a patterned cylindrical structure having antenna body elements spatially separated from each other and having a proximal end coupled to the proximal base and a distal end coupled to the distal tip portion. The distal tip portion is disposed distally of the distal end. The antenna comprises a first material having a flexible plastic deformation limit and a second material plated onto the first material. The second material is more conductive than the first material. The flexible instrument further comprises an adjustment device configured to adjust pitch lengths between adjacent antenna body elements and is configured to generate a radiation pattern from the antenna that varies based on the pitch length between the adjacent antenna body elements to ablate tissue.

Abstract: An energy delivery system includes a transmission member, an antenna at a distal end of the transmission member, a jacket surrounding the transmission member and the antenna, a fluid channel between the transmission member and the jacket, and a plug disposed at the distal end of the transmission member and a proximal end of the antenna. The plug is configured to prevent migration of a cooling fluid from the fluid channel to a cavity between the antenna and the jacket.

Abstract: An antenna system for tissue ablation includes an energy transmission member, a conductive hollow coil member coupled to the energy transmission member, and a fluid cooling system coupled to the conductive hollow coil member for providing a flow of cooling fluid through a member lumen of the conductive hollow coil member for cooling the conductive hollow coil member. In some examples, at least one of the antenna body, a choke member, and a hybrid choke member includes the conductive hollow coil member. In some examples, the hybrid choke member includes a choke portion wound around a portion of the energy transmission member, an antenna body portion wound around a portion of the energy transmission member, and an insulator portion extending between the choke portion and the antenna body portion. In some examples, the antenna system includes a sheath extending over the energy transmission member and the conductive hollow coil member.

Abstract: An antenna system for tissue ablation comprises an energy transmission member, an antenna body coupled to the energy transmission member, a fluid source, and a choke member including a choke body and a choke connector electrically coupling the choke body to the energy transmission member. The choke connector is in direct contact with fluid from the fluid source and forms a delivery path for the fluid between the choke body and the energy transmission member. The choke connector and the choke body are integrally formed of a continuous wire mesh.