Micromanipulator-controlled local view with stationary overall views

#The present invention relates to tracking an object and to local imaging from the object and, more particularly, to local imaging from a location on the object.

#Ultrasound-assisted surgery using three-dimensional (3D) ultrasound images is developing rapidly, with advances in transducer technology being paralleled by advances in catheter technology.

#Minimally invasive intravascular surgery can be performed using a variety of possible devices disposed at the distal end of a catheter. The clinician advances the catheter into the body through an incision and up through a vein. Control exists at the proximal end, as on a handle, for steering the catheter through a tortuous path. At the destination, the device (or “micromanipulator”) is manipulated proximally to carry out the surgical procedure. Other types of surgical procedures carried out by means of a catheter are laparoscopy, thoracoscopy, pleuroscopy, atherectomy, laser ablation, etc.

#FIG. 1 is a schematic and conceptual diagram of surgical-instrument tracking and point-of-view-based imaging in accordance with the present invention;

#FIG. 2 is a conceptual diagram of possible display screen snapshots and configurations in accordance with the present invention;

#FIG. 3 is a structural and functional overview diagram of a surgical-instrument tracking, and point-of-view-based imaging, device in accordance with the present invention;

#FIG. 1 depicts exemplary surgical-instrument tracking and point-of-view-based imaging.

#The body of an elongated surgical instrument 102, such as a catheter for internal use, is shown disposed within a blood vessel 104 or organ cavity. At the distal tip 106 of instrument 102 is an electrode 108, for ablation or electrophysiology for example. The electrode 108 may be retractable and extendable. The retraction/extension and steering are controlled proximally at a handle (not shown) of the instrument 102. Also at the distal tip 106 are two echoic structures 110, 112 usable for ultrasonically tracking the tip. The structures 110, 112 may be hollowly annular and radially symmetric. The hollowness keeps free the axial center of the catheter body, for functions like stent advancement. The symmetry aids in identifying the center of each structure 110, 112. For instance, a position 114 of a location 116 at the distal tip 106 is central within the proximal structure 110, and a local viewing direction 118 from the location corresponds to a line from the location to the center of the distal structure 112. A local view 120 is from that location 116 and in the local viewing direction 118. The local view 120 is reconstructed from live imaging, as discussed in detail further below. Associated with the local view 120 is an orientation of the tip 106 about an axis 122 in the local viewing direction 118. The orientation is relevant for a catheter that, for example, has, for steering, a “left” pull wire and a “right” pull wire, as also discussed in more detail further below. One or both of the structures 110, 112 at the tip 106 may be circumferentially non-symmetrical to facilitate ultrasonic determination of the orientation. Alternatively, the distal tip 106 could include one or more magnetic field transducers for tracking as in Lockhart and Tgavalekos. Although the local viewing direction 118 is shown in FIG. 1 to be longitudinally straight ahead from the distal tip 106, it may alternatively be in another direction, such as a side-looking direction.

#A transesophageal (TEE) probe 124 is shown, by way of illustrative and non-limitative example, with forward-looking optics, such as those commonly provided for intravascular ultrasound (IVUS) catheters. However, the optics may instead, or in addition, include side-looking capability. TEE volumetric data 126 acquisition is in real time. The live imaging includes imaging of the distal tip 106 and surrounding anatomy.