Medical tool positioning devices, systems, and methods of use and manufacture

An ultrasound probe positioning system, comprising:

• a handle assembly;
• a steerable sheath;
• and an ultrasound probe,
• the handle assembly in operable communication with the steerable sheath and the ultrasound probe,
• the handle assembly including a handle body with an outer surface positioned to be gripped by a user, a distal ultrasound probe actuator adapted to be moved relative to the handle body, and a proximal steerable sheath actuator proximal to the distal actuator adapted to be moved relative to the handle body,
• the steerable sheath having a distal deflectable region that is in operable communication with at least one axially actuatable member, wherein the proximal steerable sheath actuator is in operable communication with the axially actuatable member such that actuation of the proximal steerable sheath actuator relative to the handle body causes deflection of the distal deflectable region, and
• wherein the distal actuator is adapted to be rotated relative to the handle body and also adapted to be moved axially relative to the handle body, and wherein the distal actuator is in operable communication with the ultrasound probe such that axial movement of the distal actuator relative to the handle body causes axial movement of the ultrasound probe relative to a distal end of the steerable sheath, and such that rotation of the distal actuator relative to the handle body causes rotation of the ultrasound probe relative to the distal end of the steerable sheath,
• wherein the handle assembly comprises an ultrasound probe displacement system that is attached to the distal ultrasound probe actuator and to an ultrasound probe shaft such that it creates rotational and axial communication between the distal ultrasound probe actuator and the ultrasound probe shaft,
• wherein the ultrasound probe displacement system comprises a central gear with a lumen through which the steerable sheath and the ultrasound probe shaft extend, the central gear in rotational communication with a second gear, the second gear in rotational communication with the ultrasound probe shaft, and
• wherein at least part of the ultrasound probe displacement system is disposed within the handle body and extends further proximally in the handle body than a proximal end of the steerable sheath and is attached to the ultrasound probe shaft at a location proximal to the proximal end of the steerable sheath, and
• wherein the ultrasound probe displacement system bypasses the steerable sheath within the handle body such that it is not in operable communication with the steerable sheath within the handle body so that the ultrasound probe shaft can be rotated and axially moved without causing movement of the steerable sheath within the handle body.