Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.

Display screen or portion thereof with graphical user interface

The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Robotic catheter system and methods

A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Robotic catheter system

A robot system for use in surgical procedures has two movable arms each carried on a wheeled base with each arm having a six of degrees of freedom of movement and an end effector which can be rolled about its axis and an actuator which can slide along the axis for operating different tools adapted to be supported by the effector. Each end effector including optical force sensors for detecting forces applied to the tool by engagement with the part of the patient. A microscope is located at a position for viewing the part of the patient. The position of the tool tip can be digitized relative to fiducial markers visible in an MRI experiment. The workstation and control system has a pair of hand-controllers simultaneously manipulated by an operator to control movement of a respective one or both of the arms. The image from the microscope is displayed on a monitor in 2D and stereoscopically on a microscope viewer. A second MRI display shows an image of the part of the patient the real-time location of the tool. The robot is MRI compatible and can be configured to operate within a closed magnet bore. The arms are driven about vertical and horizontal axes by piezoelectric motors.

Microsurgical robot system

A methods using a robotic catheter system to perform a procedure on a patient includes generating a control signal corresponding to movement of a master input device, and moving a plurality of drive elements of an instrument driver in response to the control signal, the drive elements operatively coupled to a corresponding plurality of control elements of an elongate guide instrument, the control elements secured to a distal end of the guide instrument and moveable axially relative to the guide instrument such that movement of the drive elements causes a corresponding movement of the guide instrument distal end.

Methods using a robotic catheter system

Visual-assisted guidance of an ultra-thin flexible endoscope to a predetermined region of interest within a lung during a bronchoscopy procedure. The region may be an opacity-identified by non-invasive imaging methods, such as high-resolution computed tomography (HRCT) or as a malignant lung mass that was diagnosed in a previous examination. An embedded position sensor on the flexible endoscope indicates the position of the distal tip of the probe in a Cartesian coordinate system during the procedure. A visual display is continually updated, showing the present position and orientation of the marker in a 3-D graphical airway model generated from image reconstruction. The visual display also includes windows depicting a virtual fly-through perspective and real-time video images acquired at the head of the endoscope, which can be stored as data, with an audio or textual account.

Catheterscope 3D Guidance and Interface System

In modern endoscopy, wide field of view and full color are considered necessary for navigating inside the body, inspecting tissue for disease and guiding interventions such as biopsy or surgery. Current flexible endoscope technologies suffer from reduced resolution when device diameter shrinks. Endoscopic procedures today, using coherent fiber-bundle technology on the scale of 1 mm, are performed with such poor image quality that the clinician's vision meets the criteria for legal blindness. Here, we review a new and versatile scanning fiber-imaging technology and describe its implementation for ultrathin and flexible endoscopy. This scanning fiber endoscope (SFE) or catheterscope enables high-quality, laser-based, video imaging for ultrathin clinical applications, while also providing new options for in vivo biological research of subsurface tissue and high resolution fluorescence imaging.

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Scanning fiber endoscopy with highly flexible, 1 mm catheterscopes for wide-field, full-color imaging

A scanning fiber endoscope (SFE) system selectively operable in a plurality of different modes. One or more illumination optical fibers convey different types of light to an internal site. A scanner that is resonantly driven in a desired pattern collects light from the internal site. The scanner can be a cantilevered distal end of a scanning optical fiber or a scanning mirror. The illumination optical fiber(s) can be moved in a non-resonant manner to alter the direction at which the light is emitted. In a therapy mode, a relatively high-power light can be applied to the site, while in a monitoring mode, the scanner can be used to image the tissue at the internal site after or during therapy. Exemplary SFE probes are disclosed for measuring scattering angle (which can detect larger cancer cell nuclear-to-cytoplasmic ratio), absorption depth, axial distance to tissue, and other conditions at the internal site.

Optical fiber scope with both non-resonant illumination and resonant collection/imaging for multiple modes of operation

Flexible cystoscopy is frequently performed for recurrent bladder cancer surveillance, making it the most expensive cancer to treat over the patient's lifetime. An automated bladder surveillance system is being developed to robotically scan the bladder surface using an ultrathin and highly flexible endoscope. Such a system would allow cystoscopic procedures to be overseen by technical staff while urologists could review cystoscopic video postoperatively. In this paper, we demonstrate a method for reconstructing the surface of the whole bladder from endoscopic video using structure from motion. Video is acquired from a custom ultrathin and highly flexible endoscope that can retroflex to image the entire internal surface of the bladder. Selected frames are subsequently stitched into a mosaic and mapped to a reconstructed surface, creating a 3-D surface model of the bladder that can be expediently reviewed. Our software was tested on endoscopic video of an excised pig bladder. The resulting reconstruction possessed a projection error of 1.66 pixels on average and covered 99.6% of the bladder surface area.

Surface Mosaics of the Bladder Reconstructed From Endoscopic Video for Automated Surveillance

Transbronchial biopsy of peripheral lung nodules is hindered by the inability to access lesions endoluminally due to the large diameter of conventional bronchoscopes. An ultrathin scanning fiber bronchoscope has recently been developed to advance image-guided biopsy several branching generations deeper into the peripheral airways. However, navigating a potentially complex 3-D path to the region of interest presents a challenge to the bronchoscopist. An accompanying guidance system has also been developed to track the bronchoscope through the airways, and display its position and intended path on a virtual display. Intraoperative localization of the bronchoscope was achieved by combining electromagnetic tracking (EMT) and image-based tracking (IBT). An error-state Kalman filter was used to model the disagreement between the two tracking sources. The positional tracking error was reduced from 14.22 and 14.92 mm by independent EMT and IBT, respectively, to 6.74 mm using the hybrid approach. Hybrid tracking of the scope orientation and respiratory motion compensation further improved tracking accuracy and stability, resulting in an average tracking error of 3.33 mm and 10.01°.

Timothy D. Soper

Papers

Catheterscope 3D Guidance and Interface System

Scanning fiber endoscopy with highly flexible, 1 mm catheterscopes for wide-field, full-color imaging

Optical fiber scope with both non-resonant illumination and resonant collection/imaging for multiple modes of operation

Surface Mosaics of the Bladder Reconstructed From Endoscopic Video for Automated Surveillance

In Vivo Validation of a Hybrid Tracking System for Navigation of an Ultrathin Bronchoscope Within Peripheral Airways