System, method and devices for navigated flexible endoscopy

25:

• A method of determining the shape of a flexible endoscope inserted into a portion of an anatomy of a patient, comprising:
• inserting the flexible endoscope into the portion of the anatomy of the patient, wherein the endoscope includes at least one working channel;
• inserting a tracked elongated member into the working channel of the flexible endoscope, wherein the tracked elongated member is equipped with at least one sensor element whose position and orientation is tracked by a position sensing system;
• recording a locus of positions of the at least one sensor elements as the tracked elongated member is moved within the working channel of the flexible endoscope;
• determining the path of the flexible endoscope inserted into the portion of the anatomy of the patient using the locus of positions.

27:

• The method of claim 25, wherein the step of determining a path of the flexible endoscope comprises:
• on a computing device,
• receiving one or more preoperative images of the anatomy of the patient that are preoperative to insertion of the flexible endoscope including one or more items of interest;
• calculating coordinates of a predicted path in a first preoperative frame of reference corresponding to the one or more preoperative images based on predicted collisions with interior walls of a conduit within the anatomy of the patient in the first preoperative frame of reference;
• determining coordinates of the one or more items of interest within the anatomy of the patient in the first preoperative frame of reference;
• obtaining coordinates of an actual path of the flexible endoscope within the anatomy of the patient in a second intra-operative frame of reference during the insertion of the flexible endoscope corresponding to a position sensing system associated with one or more sensor elements within the anatomy of the patient;
• registering the coordinates of the preoperative predicted path of the flexible endoscope with the coordinates of the actual intra-operative path of the flexible endoscope based on the predicted collisions with the interior walls of the conduit to produce at least one transformation matrix relating the first preoperative frame of reference to the second intra-operative frame of reference;
• and
• creating a display indicating relative locations of the flexible endoscope and the one or more items of interest using the at least one transformation matrix.

28:

• A system for determining the shape of a flexible endoscope inserted into a portion of an anatomy of a patient, the system comprising:
• a flexible endoscope insertable into the portion of the anatomy of the patient, wherein the endoscope includes at least one working channel;
• a tracked elongated member insertable into the working channel of the flexible endoscope, wherein the tracked elongated member is equipped with at least one sensor element, a position and orientation of which sensor element being tracked by a position sensing system;
• a control application comprising a non-transitory program of instructions that are configured to determine, using the position and orientation, the path of the flexible endoscope inserted into the portion of the anatomy of the patient.

29:

• The system of claim 28, further comprising:
• a memory device that records the position of the at least one sensor element as the tracked elongated member is moved within the working channel of the flexible endoscope;
• the control application being configured to receive one or more preoperative images of the anatomy of the patient that are preoperative to insertion of a tracked instrument;
• the control application being further configured to
• calculate coordinates of a predicted path in a first preoperative frame of reference corresponding to the one or more preoperative images based on predicted collisions with interior walls of a conduit within the anatomy of the patient in the first preoperative frame of reference, and
• determine coordinates of the one or more items of interest within the anatomy of the patient in the first preoperative frame of reference corresponding to the one or more preoperative images;
• the at least one sensor element and the position sensing system being configured to provide coordinates of an actual path of the tracked elongated member during an insertion of the tracked instrument within the anatomy of the patient in a second intra-operative frame of reference corresponding to the position sensing system;
• wherein the control application registers the coordinates of the predicted path of the tracked endoscope with the coordinates of the actual path of the tracked instrument based on the predicted collisions with the interior walls of the conduit to produce at least one transformation matrix relating the first preoperative frame of reference to the second intra-operative frame of reference;
• and
• a display module that creates a display indicating the relative locations of the instrument and the one or more points of interest using the at least one transformation matrix.