# US 2019/0167353 A1 · Adjustable Length Medical Instrument Assembly with Localization Elements for Tracking Medical Instrument Extension > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167353 A1 - Document ID: US20190167353A1 - Status: Published application - Kind: A1 - Application number: 16/142,589 - Filed: 2018-09-26 - Published: 2019-06-06 - Earliest claimed: 2015-05-11 - Assignees: Veran Medical Technologies, Inc. - Applicants: Veran Medical Technologies, Inc. - Inventors: Christopher Lee; Mark Hunter; Troy L. Holsing - Web page: https://patentgrep.com/patent/US20190167353A1 ## CPC - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 10/0233: {Pointed or sharp biopsy instruments} - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/3403: {Needle locating or guiding means} - A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)} - A61B 90/10: for stereotaxic surgery, e.g. frame-based stereotaxis - A61B 90/361: {Image-producing devices, e.g. surgical cameras} - A61B 90/37: {Surgical systems with images on a monitor during operation} - A61B 10/0283: {with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe (A61B10/025, A61B10/0266 take precedence)} - A61B 10/06: Biopsy forceps {, e.g. with cup-shaped jaws} - A61B 2010/0216: {Sampling brushes} - A61B 2010/045: {Needles (pointed biopsy devices with vacuum aspiration A61B10/0283)} - A61B 2017/003: {Steerable} - A61B 2017/00309: {Cut-outs or slits} - A61B 2017/00331: {with preformed bends} - A61B 2017/00336: {with a protective sleeve, e.g. retractable or slidable} - A61B 2017/00424: {ergonomic, e.g. fitting in fist} - A61B 2017/00809: {Lung operations} - A61B 2017/00867: {shape memory effect} - A61B 2017/06095: {pliable} - A61B 2034/2051: {Electromagnetic tracking systems} - A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument} - A61B 2090/3966: {Radiopaque markers visible in an X-ray image} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A medical instrument assembly including a handle assembly having a first handle portion and a second handle portion proximate the second end, wherein the second handle portion is slidably engaged with the first handle portion. A first localization element is attached to the first handle portion and a second localization element is attached to the second handle portion. A medical instrument is mechanically coupled to the second handle portion and a translation of the second handle portion with respect to the first handle portion causes a coincident and coextensive translation of the medical instrument. The amount of translation of the medical instrument is adapted to be determined by calculating the distance between the first localization element and the second localization element. The first and second localization elements may be electromagnetic sensors which positions may be determined by a navigation system. ## Claims ### Claim 1 A medical instrument assembly comprising: a handle assembly having a first end and a second end, the handle assembly comprising a first handle portion proximate the first end and a second handle portion proximate the second end, wherein the second handle portion is slidably engaged with the first handle portion; a first localization element attached to the first handle portion; a second localization element attached to the second handle portion; and a medical instrument having a proximal end and a distal end, wherein the proximal end is mechanically coupled to the second handle portion and wherein a translation of the second handle portion with respect to the first handle portion causes a coincident and coextensive translation of the medical instrument; and wherein the amount of translation of the medical instrument is adapted to be determined by calculating the distance between the first localization element and the second localization element. ### Claim 2 (depends on 1) The medical instrument assembly of claim 1, wherein the first handle portion comprises an adjustment collar and an adjustment handle slidably engaged with the adjustment collar. ### Claim 3 (depends on 2) The medical instrument assembly of claim 2, wherein the first localization element is attached to the adjustment handle or the adjustment collar. ### Claim 4 (depends on 2) The medical instrument assembly of claim 2, further comprising a protective sheath having a proximal end affixed to and extending from the adjustment handle to a distal end proximate the distal end of the medical instrument. ### Claim 5 (depends on 4) The medical instrument assembly of claim 4, further comprising a third localization element attached to the distal end of the protective sheath. ### Claim 6 (depends on 2) The medical instrument assembly of claim 2, wherein the second handle portion comprises an actuation handle slidably engaged with the adjustment handle and a stroke regulator adjustably secured to actuation handle to control the amount of translation of the medical instrument. ### Claim 7 (depends on 6) The medical instrument assembly of claim 6, wherein the second localization element is attached to the actuation handle or the stroke regulator. ### Claim 8 (depends on 2) The medical instrument assembly of claim 2, wherein the medical instrument is adapted to be inserted into a catheter, the catheter comprising an elongate flexible shaft having a proximal end portion comprising a port, an opposite distal end portion terminating in a tip, a working channel extending from the port to an exit proximate the tip, and wherein the handle assembly of the adjustable length medical instrument is adapted to be releasably connected to the port of the catheter. ### Claim 9 (depends on 8) The medical instrument assembly of claim 8, wherein the adjustment handle is adapted to be translated with respect to the adjustment collar to control the position of the distal end of the medical instrument with respect to the exit of the catheter. ### Claim 10 (depends on 8) The medical instrument assembly of claim 8, further comprising a third localization element located on or in the distal end portion of the elongate flexible shaft of the catheter proximate the tip. ### Claim 11 (depends on 1) The medical instrument assembly of claim 1, wherein the medical instrument includes a lumen and a flexible guidewire insertable therein, wherein the flexible guidewire includes a tip and a third localization element is located on or in the tip of flexible guidewire. ### Claim 12 (depends on 1) The medical instrument assembly of claim 1, wherein a third localization element is located on or in the medical instrument proximate the distal end thereof. ### Claim 13 (depends on 1) The medical instrument assembly of claim 1, wherein the first handle portion and the second handle portion each comprise a groove in which the first and second localization elements, respectively, are adapted to be releasably retained. ### Claim 14 (depends on 1) The medical instrument assembly of claim 1, wherein the first and second localization elements are adapted to be coupled to a processor and adapted to send to the processor information associated with a first position in three-dimensional space of the first localization element and information associated with a second position in three-dimensional space of the second localization element. ### Claim 15 (depends on 14) The medical instrument assembly of claim 14, wherein the amount of translation of the medical instrument is adapted to be determined by calculating the distance between the first position of the first localization element and the second position of the second localization element. ### Claim 16 (depends on 1) The medical instrument assembly of claim 1, wherein the first and second localization elements are adapted to produce outputs corresponding to the positions of the first and second localization elements, wherein the outputs of the first and second localization elements are adapted to be received by a navigation system, and wherein the navigation system is adapted to determine the amount of translation of the medical instrument by calculating the distance between the first localization element and the second localization element based on the outputs received from the first and second localization elements. ### Claim 17 (depends on 16) The medical instrument assembly of claim 16, wherein the first and second localization elements are electromagnetic sensors. ### Claim 18 (depends on 17) The medical instrument assembly of claim 17, wherein the output of the first and second localization elements is generated using an electromagnetic field generator. ### Claim 19 (depends on 1) The medical instrument assembly of claim 1, wherein the proximal end of the medical instrument is mechanically coupled to the second handle portion by an elongate flexible guidewire. ### Claim 20 (depends on 1) The medical instrument assembly of claim 1, wherein the medical instrument comprises a needle, a forceps, an auger, a boring bit, or a brush. ### Claim 21 (depends on 1) The medical instrument assembly of claim 1, wherein the medical instrument comprises a needle and wherein the proximal end of the needle is connected to the second handle portion by a flexible guidewire. ### Claim 22 (depends on 1) The medical instrument assembly of claim 1, wherein the needle comprises an outer wall extending from the proximal end to the distal end and wherein at least a portion of the outer wall is cut to increase flexibility of the needle.