# US 11,026,564 B2 · Apparatus and methods for facilitating treatment of tissue via improved delivery of energy based and non-energy based modalities

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- Number: US 11,026,564 B2
- Document ID: US11026564B2
- Status: Granted
- Kind: B2
- Application number: 16/443,070
- Filed: 2019-06-17
- Published: 2019-12-05
- Granted: 2021-06-08
- Earliest claimed: 2000-04-03
- Assignees: Intuitive Surgical Operations, Inc.
- Applicants: Intuitive Surgical Operations, Inc.
- Inventors: Amir Belson; Robert Matthew Ohline
- Web page: https://patentgrep.com/patent/US11026564B2

## CPC

- A61B 1/0055: {Constructional details of insertion parts, e.g. vertebral elements}
- A61B 1/0051: {with controlled bending of insertion part}
- A61B 1/0053: {using distributed actuators, e.g. artificial muscles}
- A61B 1/0058: {using shape-memory elements}
- A61B 1/0125: {Endoscope within endoscope}
- A61B 1/018: for receiving instruments
- A61B 1/05: characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B 1/31: for the rectum, e.g. proctoscopes or sigmoidoscopes
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- G02B 23/2469: {using optical fibres}
- G02B 23/2476: {Non-optical details, e.g. housings, mountings, supports}
- G02B 23/2484: {Arrangements in relation to a camera or imaging device (processing or control of video signals generated by an endoscope H04N23/60, H04N23/70)}
- A61B 1/0052: {Constructional details of control elements, e.g. handles}
- A61B 18/02: by cooling, e.g. cryogenic techniques
- A61B 2017/00296: {mounted on an endoscope}
- A61B 2017/003: {Steerable}
- A61B 2018/00351: {Heart}
- A61B 2018/00446: {Brain}
- A61B 2018/0212: {using an instrument inserted into a body lumen, e.g. catheter}
- A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G02B: OPTICAL ELEMENTS, SYSTEMS OR APPARATUS

## Abstract

Methods and apparatus for accessing and treating regions of the body are disclosed herein. Using an endoscopic device having an automatically controllable proximal portion and a selectively steerable distal portion, the device generally may be advanced into the body through an opening. The distal portion is selectively steered to assume a selected curve along a desired path within the body which avoids contact with tissue while the proximal portion is automatically controlled to assume the selected curve of the distal portion. The endoscopic device can then be used for accessing various regions of the body which are typically difficult to access and treat through conventional surgical techniques because the device is unconstrained by “straight-line” requirements. Various applications can include accessing regions of the brain, thoracic cavity, including regions within the heart, peritoneal cavity, etc., which are difficult to reach using conventional surgical procedures.

## Claims

### Claim 1

A surgical system comprising:
a first elongate device and a second elongate device, each of the first elongate device and the second elongate device having a steerable distal portion and a proximal portion, wherein the second elongate device is disposed at least partially within the first elongate device and is configured to extend and retract relative to the first elongate device;
a position system comprising a sensor configured to sense a position of at least one of the first elongate device and the second elongate device; and
a controller configured to:
receive user input,
receive sensed position information from the positioning system,
receive information identifying a location within a body, and
control movement of at least one of the first elongate device and the second elongate device along a pathway to reach the location in the body based on the user input and the received sensed position information, and
maintain a portion of the at least one of the first elongate device and the second elongate device at the location.

### Claim 2 (depends on 1)

The surgical system of claim 1, wherein the controller is further configured to automatically maintain the portion of the at least one of the first elongate device and the second elongate device at the location.

### Claim 3 (depends on 1)

The surgical system of claim 1, wherein the sensor of the positioning system is configured to produce a signal indicative of the location of the portion of the at least one of the first elongate device and the second elongate device with regard to a point of reference.

### Claim 4 (depends on 1)

The surgical system of claim 1, wherein the controller is further configured to receive image data correlating the location within the body and a frame of reference.

### Claim 5 (depends on 1)

The surgical system of claim 1, wherein the sensor of the position system is configured to detect a change in position of the at least one of the first elongate device and the second elongate device.

### Claim 6 (depends on 1)

The surgical system of claim 1, wherein the controller is further configured to control the movement of the at least one of the first elongate device and the second elongate device to maintain the at least one of the first elongate device and the second elongate device in a predetermined fixed position.

### Claim 7 (depends on 1)

The surgical system of claim 1, wherein the surgical system further comprises an imaging device to image the location within the body.

### Claim 8 (depends on 1)

The surgical system of claim 1, wherein the controller is further configured to record the movement of the at least one of the first elongate device and the second elongate device along the pathway.

### Claim 9 (depends on 1)

The surgical system of claim 1, wherein the information identifying the location within the body is chosen from at least one of position, location, tissue type, and disease state.

### Claim 10 (depends on 1)

The surgical system of claim 1, wherein the first elongate device and the second elongate device each comprise steerable endoscopes.

### Claim 11 (depends on 1)

The surgical system of claim 1, wherein the second elongate device is configured to traverse along a path defined at least partially within the first elongate device.

### Claim 12 (depends on 11)

The surgical system of claim 11, wherein the controller is further configured to control the movement of the second elongate device traversing along the path defined within the first elongate device.

### Claim 13 (depends on 1)

The surgical system of claim 1, wherein the controller is configured to maintain the position of the first elongate device while the second elongate device extends from the first elongate device to perform a treatment within the body at the location.

### Claim 14 (depends on 1)

The surgical system of claim 1, wherein the sensor comprises a motion transducer configured to measure at least one of axial and rotational displacement of the at least one of the first elongate device and the second elongate device.

### Claim 15 (depends on 1)

The surgical system of claim 1, wherein the second elongate device comprises a surgical tool to perform a surgical procedure.

### Claim 16 (depends on 15)

The surgical system of claim 15, wherein the surgical tool comprises an ablation element.