Trajectory tracking for medical devices

Abstract

A steerable medical device includes a handle and an elongate shaft extending distally from the handle to a distal tip. A motor control assembly including a motor control housing is configured to be removably coupled with the handle. The motor control assembly comprises a first driving assembly and a second driving assembly which are arranged in the motor control shell. The motor control assembly includes an input device and a controller operably coupled with the first drive assembly, the second drive assembly, and the input device. The controller is configured to control operation of the first drive assembly and / or the second drive assembly in order to move the distal tip, receive one or more user inputs from a user via the input device, and modify operation of the first drive component and / or the second drive component in accordance with the received one or more inputs.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 344,245, filed on May 20, 2022, entitled “Trajectory Tracking for Medical Devices,” which is incorporated herein by reference. Technical Field

[0002] The present invention relates to a motorized control for a medical device. More particularly, the present invention relates to a medical device, such as an endoscope or a steerable catheter, having a motor control assembly configured to provide trajectory tracking. Background Art

[0003] Medical devices, such as steerable and / or deflectable endoscopes and / or catheters, can be used to perform a variety of diagnostic and / or therapeutic procedures. Different procedures may require different devices and / or different physical actions of the practitioner. Each of the known medical devices, systems, and methods has certain advantages and disadvantages. There is a need to provide alternative medical devices and systems, including controls for operating and manipulating such medical devices. Summary of the invention

[0004] The present invention provides alternative medical devices and systems, including controls for operating and manipulating such medical devices. An example can be found in a steerable medical device. The steerable medical device includes a handle and an elongated shaft extending distally from the handle to a distal tip; and a motor control assembly, the motor control assembly including a motor control housing configured to be removably connected to the handle. The motor control assembly includes a first drive assembly disposed in the motor control housing, a second drive assembly disposed in the motor control housing, an input device, and a controller operably connected to the first drive assembly, the second drive assembly, and the input device. The controller is configured to control the operation of the first drive assembly and / or the second drive assembly to move the distal tip, receive one or more user inputs from a user via the input device, and modify the operation of the first drive assembly and / or the second drive assembly based on the one or more inputs received.

[0005] Alternatively or additionally, the first drive assembly may include a first motor and a first gear assembly operably coupled to the first motor, and the second drive assembly may include a second motor and a second gear assembly operably coupled to the second motor.

[0006] Alternatively or additionally, the steerable medical device may also include a first drive shaft, the first drive shaft being configured to engage the first gear assembly with a first deflection mechanism disposed within the handle, the first deflection mechanism being configured to deflect the distal tip in a first plane; and a second drive shaft, the second drive shaft being configured to engage the second gear assembly with a second deflection mechanism disposed within the handle, the second deflection mechanism being configured to deflect the distal tip in a second plane different from the first plane.

[0007] Alternatively or additionally, one or more user inputs may include a command for locking movement in a first plane or a second plane, such that when the command is to lock movement in the first plane, the controller is configured to prevent the first drive component from moving the first deflection mechanism, while the second drive component is allowed to move the second deflection mechanism; and when the command is to lock movement in the second plane, the controller is configured to prevent the second drive component from moving the second deflection mechanism, while the first drive component is allowed to move the first deflection mechanism.

[0008] Alternatively or additionally, the one or more user inputs may include a command to move the distal tip along a user-defined trajectory.

[0009] Alternatively or additionally, the user input means may be configured to allow a user to input a user defined trajectory.

[0010] Alternatively or additionally, the controller may also be configured to operate the first drive assembly and / or the second drive assembly to move the distal tip along a user-defined trajectory.

[0011] Alternatively or additionally, the controller may also be configured to implement a learning model, wherein the controller learns how encoder values ​​for each of the first drive assembly and the second drive assembly relate to corresponding movements of the distal tip.

[0012] Alternatively or additionally, the controller may be further configured to minimize a difference between a desired encoder value and a current encoder value when moving the first drive assembly and / or the second drive assembly.

[0013] Alternatively or additionally, the one or more user inputs may include a command to move the distal tip to a user-defined target.

[0014] Alternatively or additionally, the user input device may be configured to allow a user to input a user defined target.

[0015] Alternatively or additionally, the controller may be further configured to determine a trajectory between the distal tip and a position defined by a user-defined target; and operate the first drive assembly and / or the second drive assembly to move the distal tip along the determined trajectory.

[0016] Another example can be found in a steerable medical device. A steerable medical device includes a handle and an elongated shaft extending distally from the handle to a distal tip. A first drive motor is configured to deflect the distal tip within a first plane, and a second drive motor is configured to deflect the distal tip within a second plane different from the first plane. The steerable medical device includes an input device and a controller operably connected to the first drive motor, the second drive motor, and the input device. The controller is configured to receive instructions to move the distal tip along a trajectory; implement a learning model that indicates how encoder values ​​for each of the first motor and the second motor correspond to movement of the distal tip; and control the operation of the first drive motor and / or the second drive motor so as to move the distal tip along the trajectory while minimizing the difference between the desired encoder value and the current encoder value.

[0017] Alternatively or additionally, the trajectory may comprise a user defined trajectory input to the controller.

[0018] Alternatively or additionally, the input device may be configured to allow a user to input a user defined trajectory.

[0019] Alternatively or additionally, the trajectory may include a controller-determined trajectory based on a current position of the distal tip and a desired target position of the distal tip.

[0020] Alternatively or additionally, the controller may be further configured to determine whether a target position of the distal tip is reachable given a current position of the steerable medical device.

[0021] Alternatively or additionally, the controller may also be configured to automatically calculate a controller-determined trajectory when the target position of the distal tip is reachable given the current position of the steerable medical device; and to provide instructions to a user to move the steerable medical device to a new position that will facilitate reaching the target position of the distal tip when the target position of the distal tip is not reachable given the current position of the steerable medical device.

[0022] Alternatively or additionally, the controller may also be configured to estimate the depth of the target location.

[0023] Another example can be found in a steerable medical device. A steerable medical device includes a handle and an elongated shaft extending distally from the handle to a distal tip. The first drive motor is configured to deflect the distal tip in a first plane, and the second drive motor is configured to deflect the distal tip in a second plane different from the first plane. The steerable medical device includes an input device and a controller, which is operably connected to the first drive motor, the second drive motor and the input device. The controller is configured to control the operation of the first drive motor and / or the second drive motor to move the distal tip. The controller is configured to receive a command to limit movement along the first plane or the second plane. When the command locks movement in the first plane, the controller is configured to prevent the first drive motor from causing movement along the first plane while allowing movement along the second plane. When the command locks movement in the second plane, the controller is configured to prevent the second drive motor from causing movement along the second plane while allowing movement along the first plane.

[0024] The above summary of some embodiments, aspects and / or examples is not intended to describe every embodiment or every implementation of the present invention. The following figures and detailed description more particularly exemplify these embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] The present invention may be more fully understood by considering the following detailed description taken in conjunction with the accompanying drawings, in which:

[0026] Figure 1 is a perspective view of an illustrative endoscope system;

[0027] Figure 2 yes Figure 1 A perspective view of an illustrative endoscope system with a portion of the housing removed;

[0028] Figure 3 yes Figure 1 A perspective view of an illustrative endoscope system with a portion of the housing removed;

[0029] Figure 4 yes Figure 1 A side view of an illustrative endoscope system with a portion of the housing removed;

[0030] Figure 5 yes Figure 1 A side view of an illustrative endoscope system with a portion of the housing removed;

[0031] Figure 6 yes Figure 1 A side view of an illustrative endoscope system with a portion of the housing removed;

[0032] Figure 7 It is available with Figure 1 a schematic block diagram of an illustrative motorized control unit for use with an illustrative endoscope system;

[0033] Figure 8 Yes Figure 7 a schematic block diagram of an illustrative system of an illustrative motorized control unit;

[0034] Fig. 9A , Fig. 9B and Fig. 9C It shows that it can be Figure 7 an illustrative motorized control unit implementing a motion pattern of the distal tip;

[0035] Fig. 10A , Fig. 10B , Fig. 10C and Fig. 10D shows an illustrative screen that may be displayed on a graphical user interface (GUI) when a user enters a user-defined trajectory;

[0036] Fig.11 Schematically Figure 1 Movement of the distal tip of an illustrative endoscope system is compared with a corresponding trajectory;

[0037] Fig.12 is a flow chart showing an illustrative method;

[0038] Fig.13 is a flow chart showing an illustrative method;

[0039] Fig.14 is a flow chart showing an illustrative method; and

[0040] Fig.15 It is available with Figure 1 A schematic diagram of a distal region of an illustrative endoscope for use with an illustrative endoscope system.

[0041] Although embodiments of the present invention are suitable for various modifications and alternative forms, the specific details thereof have been shown in the accompanying drawings by way of example and will be described in more detail. However, it should be understood that the present invention is not intended to limit the various aspects of the present invention to the specific embodiments described. On the contrary, the present invention is intended to encompass all modifications, equivalents and substitutes that fall within the spirit and scope of the present invention. DETAILED DESCRIPTION

[0042] The following description should be read with reference to the accompanying drawings, which are not necessarily drawn to scale, in which the same reference numerals in several views indicate the same elements. The detailed description and the accompanying drawings are intended to illustrate, but not to limit, the claims. Those skilled in the art will recognize that the various elements described and / or shown may be arranged in various combinations and configurations without departing from the scope of the present invention. The detailed description and the accompanying drawings illustrate example embodiments. However, for the purpose of clarity and ease of understanding, although each feature and / or element may not be shown in each drawing, the features and / or elements may also be understood to be present unless otherwise stated.

[0043] For the following defined terms, these definitions shall apply unless a different definition is given in the claims or elsewhere in this specification.

[0044] All numerical values ​​are assumed to be modified by the term "about" herein, whether or not explicitly indicated. In the context of numerical values, the term "about" generally refers to a numerical range that is considered by those skilled in the art to be equivalent to the quoted value (e.g., having the same function or result). In many cases, the term "about" may include numbers rounded to the nearest significant figure. Unless otherwise specified, the term "about" (e.g., in contexts other than numerical values) may be assumed to have its ordinary and customary definition, as understood and consistent with the context of this specification.

[0045] The recitation of numerical ranges by endpoints includes all numbers within that range, inclusive of the endpoints (eg, 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

[0046] Although some suitable sizes, ranges and / or values ​​are disclosed for various components, properties and / or specifications, those skilled in the art to which the present invention relates will understand that the desired sizes, ranges and / or values ​​may be derived from those explicitly disclosed.

[0047] As used in this specification and the appended claims, the singular forms "a", "an" and "the" include plural referents unless the content clearly indicates otherwise. As used in this specification and the appended claims, the term "or" is generally used in a sense that includes "and / or" unless the content clearly indicates otherwise. It should be noted that, for ease of understanding, certain features of the present invention may be described in the singular, even if those features may be plural or repeated in the disclosed embodiments. Each instance in a feature may include and / or contain a singular disclosure unless explicitly indicated to the contrary. For simplicity and clarity, not all elements of an embodiment of the present invention will necessarily be shown in each figure or discussed in detail below. However, it should be understood that, unless explicitly stated to the contrary, the following discussion may be equally applicable to any and / or all of the components where there is more than one. Additionally, for clarity, all instances of some elements or features may not be shown in each figure.

[0048] Relative terms, such as "proximal," "distal," "advance," "retract," variations thereof, and the like, may generally be considered with respect to the positioning, orientation, and / or operation of various elements relative to a user of the device, with "proximal" and "retract" meaning or referring to closer to or toward the user and "distal" and "advance" meaning or referring to farther from or away from the user. In some cases, the terms "proximal" and "distal" may be arbitrarily assigned in order to facilitate understanding of the present invention, and such circumstances will be apparent to a skilled artisan. Other relative terms, such as "upstream," "downstream," "inflow," and "outflow" refer to the direction of fluid flow in a cavity, such as a body cavity, a blood vessel, or within a device.

[0049] It should be noted that references to "one embodiment," "some embodiments," "other embodiments," etc. indicate that the described embodiments may include a particular feature, structure, or characteristic, but each embodiment may not necessarily include the particular feature, structure, or characteristic. Furthermore, such phrases do not necessarily refer to the same embodiment. Furthermore, when a particular feature, structure, or characteristic is described in conjunction with an embodiment, it is within the knowledge of those skilled in the art to affect the particular feature, structure, or characteristic in conjunction with other embodiments, whether or not explicitly described, unless explicitly stated to the contrary. That is, the various individual elements described below, even if not explicitly shown in a particular combination, may still be considered to be combinable or arranged with each other to form other additional embodiments, or to supplement and / or enrich the described embodiments, as will be understood by those of ordinary skill in the art.

[0050] For the sake of clarity, certain identifying digital nomenclature (e.g., first, second, third, fourth, etc.) can be used throughout the specification and / or claims to name and / or distinguish various descriptions and / or claimed features. It is to be understood that the digital nomenclature is not intended to be limiting and is merely exemplary. In certain embodiments, for the sake of brevity and clarity, the digital nomenclature previously used can be changed and deviate from. That is, the feature identified as a "first" element can be referred to as a "second" element, a "third" element, etc., later, or can be omitted completely, and / or different features can be referred to as a "first" element. The meaning and / or name in each case will be apparent to the technician.

[0051] Some medical / surgical procedures - for example: kidney stone management, ERCP (endoscopic retrograde pancreatocholangiopancreatography), lung biopsy, colonoscopy, bladder mapping, cardiac mapping, heart valve replacement and / or repair, and others - may require navigation of the elongated shaft of the medical device through tortuous anatomical structures to position the elongated shaft of the medical device, such as the distal tip of the elongated shaft, at a specific position and / or orientation. Some of these procedures may be long and / or may involve difficult body movements that may cause physician fatigue and / or musculoskeletal injuries. In some medical / surgical procedures, physicians may be at risk for work-related strain injuries due to repetitive motions, extended awkward postures, high forces, contact stresses, and / or vibrations. For example, some physicians may be at risk for de Quervain's tenosynovitis (swelling and pain at the base of the thumb), carpal tunnel syndrome, ganglion cysts, "trigger fingers," and / or other conditions. In some cases, the size of the physician's hands may negatively affect his or her ability to control a medical device and / or perform a medical / surgical procedure. The current invention is directed to features that can reduce and / or eliminate physician fatigue caused by procedures, can improve the usability and / or ergonomics of medical devices for different hand sizes, can provide more accuracy and / or more precise movement and stability when using medical devices, and can make it easier to learn to use medical devices and / or perform certain procedures.

[0052] Figures 1 to 6Various features of an illustrative endoscope system 100 are shown. In some embodiments, the endoscope system 100 may include an endoscope 110. The endoscope 110 may be specific to a particular endoscopic procedure, such as, for example, a ureteroscope, a cystoscope, a nephroscope, a duodenoscope, etc., or may be a general purpose device suitable for a variety of procedures. In some embodiments, the endoscope 110 includes a handle 112 and an elongated shaft 114 extending distally from the handle 112 to a distal tip 116, wherein the handle 112 includes a first deflection mechanism 120 configured to deflect and / or articulate the distal tip 116 of the elongated shaft 114 in a first plane, and a second deflection mechanism 122 configured to deflect and / or articulate the distal tip 116 of the elongated shaft 114 in a second plane different from the first plane. In some embodiments, the first plane may be oriented at a non-zero angle to the second plane. In some embodiments, the first plane may be oriented perpendicular to the second plane. As an example, the first plane may correspond to up and down, while the second plane may correspond to left and right. It should be understood that this is merely illustrative and will of course depend at least in part on the particular orientation of the endoscope 100. Other configurations may also be envisioned. Although depicted as an endoscope system 100 comprising an endoscope 110, it should be noted and understood that the features, components, and / or functions described herein may be incorporated into another medical device, such as a steerable catheter or other medical device having one or more deflection mechanisms for controlling the deflection and / or articulation of the distal tip of the elongated shaft of the medical device to facilitate navigation of the elongated shaft through the patient's anatomical structure. Therefore, as desired, the described components, such as handles, elongated shafts, deflection mechanisms, motor control assemblies, and other components may be associated with another medical device having a deflectable / steerable distal tip of an elongated shaft.

[0053] In some embodiments, the first deflection mechanism 120 may include a first pulley or rotating member disposed within the handle 112 and operably connected to the distal tip 116. In some embodiments, one or more first cables, wires, or other filaments may be engaged with and / or connected to the first pulley within the handle 112. In some embodiments, the one or more first cables, wires, or filaments may be engaged with and / or connected to the distal tip 116 such that tension applied by the first pulley to the one or more first cables, wires, or filaments causes the distal tip 116 to deflect and / or articulate in a first plane. In some embodiments, the second deflection mechanism 122 may include a second pulley or rotating member disposed within the handle 112 and operably connected to the distal tip 116. In some embodiments, one or more second cables, wires, or other filaments may be engaged with and / or connected to a second pulley within the handle 112. In some embodiments, one or more second cables, wires, or filaments may be engaged with and / or connected to distal tip 116 such that tension applied to the one or more second cables, wires, or filaments by a second pulley causes distal tip 116 to deflect and / or articulate in a second plane. Other configurations are also contemplated.

[0054] Thus, in some embodiments, the endoscope system 100 may include a motor control assembly 140 including a motor control housing 142 configured to be removably connected to the handle 112 of the endoscope 110. In some embodiments, the motor control housing 142 may include a removable cover 141 (e.g., Figure 1 ), wherein after removing the removable cover 141, the internal components of the motor control assembly 140 can be accessed, such as Figure 2 Additionally, in some embodiments, the motor control assembly 140 may include one or more internal covers 143 disposed within the motor control housing 142 that may protect certain components and / or groups of components from each other, contamination, etc. In some embodiments, the one or more internal covers 143 may provide structural support to selected internal components. Figure 3 , one or more inner covers 143 have been removed to facilitate discussion related to selected internal components of the motor control assembly 140. It should be understood that the presence and / or use of all, some, or any of the one or more inner covers 143 is optional and not required.

[0055] In some embodiments, the motor control assembly 140 may include at least one motor (eg, Figures 3 to 5 In some embodiments, the at least one motor may include a first motor 144 disposed within a motor control housing 142, such as Figure 3In some embodiments, the at least one motor may include a second motor 146 disposed within the motor control housing 142, such as Figure 4 and Figure 5 In some embodiments, the at least one motor may include a first motor 144 disposed within a motor control housing 142 and a second motor 146 disposed within a motor control housing 142. In some embodiments, for each controlled degree of freedom of the distal tip 116, a separate motor may be added to the at least one motor.

[0056] At least one motor can be electric, and can be a brushed or brushless DC motor. At least one motor can provide partial force assistance to the user for deflecting the distal tip 116, from 0% to 100% force assistance, thereby allowing full manual control, assisted control with reduced lever / knob force, or full actuation control. Each motor can be attached to a rotary encoder that provides the relative position of the motor to a controller that at least partially regulates the operation of each motor. As will be described with respect to Figure 7 As discussed, motor control assembly 140 may include motorized control unit 200. In some embodiments, additional inputs for a CPU, microprocessor, and / or combinations thereof may include components of a user interface, tactile feedback electronics, and the like.

[0057] In some embodiments, the motor control assembly 140 may include a user input mechanism. In some embodiments, the user input mechanism may include one or more of a joystick control, a scroll wheel, a knob, a slider, a keypad, a touch screen interface or control, a voice interface or control, etc. The user input mechanism may, for example, be associated with a user input mechanism. Figure 7 The motorized control unit 200 discussed is operatively connected. Simply return to Figures 1 to 3 In some embodiments, the motor control assembly 140 may include a joystick control 190 configured to operate at least one motor disposed within the motor control housing 142. In some embodiments, the joystick control 190 may be configured to operate the first motor 144. In some embodiments, the joystick control 190 may be configured to operate the second motor 146. In some embodiments, the joystick control 190 may be configured to operate the first motor 144 and the second motor 146. In some embodiments, the joystick control 190 may be configured to operate the first motor 144 and the second motor 146 simultaneously. In some embodiments, the joystick control 190 may be configured to operate the first motor 144 and the second motor 146 independently of each other. Other configurations are also contemplated.

[0058] In some embodiments, the motor control assembly 140 may include a homing feature configured to return the distal tip 116 to an original position (e.g., to a straightened and / or non-deflected configuration) and / or a speed control feature configured to control the speed and / or responsiveness of the movement of the distal tip 116. In some embodiments, the homing feature and / or the speed control feature may each include an input mechanism. For example, the input mechanism may be one or more buttons, a voice interface and / or controls, a gesture interface and / or controls, or other suitable means for providing input to the motor control assembly 140 and / or a user interface.

[0059] In some embodiments, the motor control assembly 140 may include one or more buttons 192. In some embodiments, the one or more buttons 192 may include a first button (e.g., a home button) configured to return the distal tip 116 to an original position (e.g., to a straightened configuration), wherein activation of the first button automatically actuates the at least one motor to move the distal tip 116 to the original position. In some embodiments, the one or more buttons 192 may include a second button that may be configured by a user to maintain a saved position or configuration, wherein activation of the second button automatically actuates the at least one motor to move the distal tip 116 to a saved position and / or configuration. Additional buttons and / or other configurations are also contemplated. Additionally, while the one or more buttons 192 are discussed herein by way of example, the motor control assembly 140 is not limited to the use of physical buttons and may include other input mechanisms.

[0060] In some embodiments, the motor control assembly 140 may include a self-homing feature and / or program. In one example, when the motor control assembly 140 is connected to the handle 112, a homing program and / or algorithm is sequentially activated and / or executed for the first motor 144 and the second motor 146 (if present) (e.g., the program is completed on the first motor 144 and then completed on the second motor 146). In some cases, when the motor control assembly 140 is connected to the handle 112, the motor control unit 200 ( Figure 7) automatically initiates the homing procedure and / or algorithm. In other cases, when the motor control assembly 140 is connected to the handle 112, the user can press a button, or manually initiate the homing procedure and / or algorithm in other ways. When the current is being monitored by the homing procedure and / or algorithm, the first motor 144 can start to rotate in the first direction. When a sudden increase in the amount of current drawn by the first motor 144 is registered, encountered and / or identified, the position of the braider is saved as a checkpoint of the upper or lower limit. Then, the first motor 144 starts to rotate in a second direction opposite to the first direction, and again when a sudden increase in the amount of current drawn by the first motor 144 is registered, encountered and / or identified, the value of the braider is saved as a second checkpoint for another limit of the range of motion of the shaft and / or the first motor 144. After determining the upper and lower limits of the first motor 144 (and finding their corresponding values ​​according to the encoder value), the algorithm can divide the number of scales between the upper and lower limits by two. The corresponding encoder value will be the middle or original position of the range of motion of the shaft and / or the first motor 144.

[0061] Then repeat the same procedure for the second motor 146, wherein when the current is being monitored by the homing procedure and / or algorithm, the second motor 146 can start to rotate in the first direction.When registering, encountering and / or identifying the sudden increase in the amount of current drawn by the second motor 146, the position of the weaver is saved as the checkpoint of the upper or lower limit.Then, the second motor 146 starts to rotate in the second direction opposite to the first direction, and again when registering, encountering and / or identifying the sudden increase in the amount of current drawn by the second motor 146, the value of the weaver is saved as the second checkpoint of another limit of the range of motion for the shaft and / or the second motor 146.After determining the upper and lower limits of the second motor 146 (and finding their corresponding values ​​according to the encoder value), the algorithm can be divided by two by the number of scales between the upper and lower limits.The corresponding encoder value will be the middle or original position of the range of motion of the shaft and / or the second motor 146.

[0062] In another example, the homing feature and / or procedure may be manually activated after engaging the motor control assembly 140 to the handle 112 of the endoscope 110. Other configurations are also contemplated.

[0063] In some embodiments, the joystick control 190 can be configured to control the movement of the distal tip 116. In some embodiments, the joystick control 190 can be configured to control the speed of movement of the distal tip 116 and / or the responsiveness of the joystick control 190. In some embodiments, the motor control assembly 140 can include a speed change control button. In some embodiments, the speed change control button can be built into and / or can be integrated into the joystick control 190. For example, in some embodiments, pressing the joystick control 190 axially toward the motor control housing 142 can actuate the speed change control button. The speed change control feature and / or the speed change control button can actuate and / or cycle through multiple speed settings to allow at least a certain degree of customization of the speed and / or responsiveness of the movement of the distal tip 116. In some embodiments, the multiple speed settings can include at least a high speed setting that allows faster control and / or faster movement of the distal tip 116, and a low speed setting that allows finer control and / or slower movement of the distal tip 116. In some embodiments, the plurality of speed settings may also include a medium speed setting and / or other speed settings (eg, medium-high, medium-low, ultra-low, etc.).

[0064] In some embodiments, the motor control housing 142, the speed change control feature, the speed change control button, and / or the multiple speed settings may be user-customizable. In some embodiments, the user may be able to set the speed mode, select and / or set the desired speed, and / or set or save the speed mode and / or the desired speed. In some embodiments, the speed change control button may be pressed and held to set or save the speed mode and / or the desired speed. In some embodiments, the motor control housing 142 and / or the user interface may include additional buttons, keypads, scroll wheels, dials, touch interfaces, or other input mechanisms for setting and / or adjusting the speed mode and / or the desired speed. These are examples only, and other configurations may also be envisioned.

[0065] In some embodiments, other control mechanisms may be used in place of joystick control 190. In some embodiments, motor control assembly 140 may include a keypad. In some embodiments, motor control assembly 140 may include a scroll wheel. In some embodiments, motor control assembly 140 may include a touch screen. Other control configurations are also contemplated.

[0066] In some embodiments, the distal tip 116 may include a camera and may, for example, have deflection and / or articulation capabilities in one or more directions to view the patient's anatomy. In some embodiments, the endoscope 110 may be a duodenoscope, such as an Exal TM However, other medical devices, such as another endoscope (e.g., ureteroscope, etc.) or related systems (e.g., LithovueTM 、SpyScope TM DS, SpyGlass TM DS) can be used to supplement or replace the duodenoscope and / or endoscope 110. In some embodiments, the endoscope 110 can be configured to deliver fluid from the fluid management system to the treatment site via the elongated shaft 114. The elongated shaft 114 can include one or more working lumens for receiving a fluid flow and / or other medical devices therethrough. In some embodiments, the endoscope 110 can be connected to the fluid management system via one or more supply lines.

[0067] In some embodiments, the handle 112 of the endoscope 110 may include a plurality of elements configured to facilitate endoscopic surgery. In some embodiments, an umbilicus 118 extends from the handle 112 and is configured to be attached to an electronic device (not shown), such as, for example, a computer system, a console, a microcontroller, etc., for providing power, analyzing endoscopic data, controlling endoscopic intervention, or performing other functions. In some embodiments, the electronic device to which the umbilicus 118 is connected may have the function of identifying and exchanging data with other endoscopic accessories. The handle 112 may include a gripping area 124 for the surgeon to grasp while performing endoscopic surgery. In some embodiments, the handle 112 may include a side port 126 that communicates with the elongated shaft 114 and / or one or more working cavities of the endoscope 110.

[0068] In some embodiments, the motor control umbilicus 138 may extend from the motor control housing 142 and may be configured to attach to an electronic device, which may be the same electronic device to which the umbilicus 118 is attached or may be a different electronic device, as desired, for providing power, controlling the endoscopic intervention and / or motor control components and / or other functions. In some embodiments, the motor control umbilicus 138 may be secured to the umbilicus 118. In some embodiments, the motor control umbilicus 138 may be releasably and / or removably secured to the umbilicus 118. In some embodiments, the motor control umbilicus 138 may be secured to the umbilicus 118 with a hook and loop closure (e.g., Velcro TM ), tape, ties or other fixation devices are secured to the umbilicus 118.

[0069] In some embodiments, the endoscope 110 can be in electronic communication with the workstation via a wired connection (e.g., umbilicus 118). In some embodiments, the workstation can include, among other features, a touch screen computer, an interface box for receiving a wired connection (e.g., umbilicus 118), a cart, and a power supply. In some embodiments, the interface box can be configured with a wired or wireless communication connection to a controller of the fluid management system. The touch screen computer can include at least a display screen and an image processor. In some embodiments, the workstation can be a multi-purpose component (e.g., for more than one surgery), while the endoscope 110 can be a single-purpose device, however this is not required. In some embodiments, the workstation can be omitted, and the endoscope 110 can be directly electronically coupled to a controller of the fluid management system (where it is used).

[0070] In some embodiments, the handle 112 may include at least one communication interface for attaching an accessory device. In some examples, the handle 112 may include a universal serial bus Type-C (USB-C) port, a universal serial bus (USB) port, an Ethernet port, and / or other types of ports. In some embodiments, more, less, and / or other various types of communication interfaces may be used, including, for example, custom interfaces. In some embodiments, the handle 112 has only one communication interface, but may be connected to, for example, a USB hub having multiple ports for connecting multiple accessories. In some embodiments, at least one communication interface may provide power to the accessory device in addition to exchanging data with the accessory device. Therefore, the accessory device does not need to have a separate cable that travels to the connected electronic device or battery, which would add additional weight to the handle 112. In some embodiments, the accessory device may be uniquely associated with the endoscope 110 and recognized by the electronic device through a "plug and play" function without requiring any user settings.

[0071] In some embodiments, the endoscope 110 may include one or more sensors adjacent to the distal tip 116 and / or the distal end of the elongated shaft 114. For example, the endoscope 110 may include a pressure sensor at the distal tip 116 of the elongated shaft 114 to measure the intracavitary pressure within the treatment site. The endoscope 110 may also include other sensors, such as, for example, a temperature sensor, a fiber Bragg grating optical fiber for detecting stress, and / or an antenna or an electromagnetic sensor (e.g., a position sensor). In some embodiments, the distal tip 116 and / or the distal end of the endoscope 110 may also include at least one camera to provide visual feedback to the user on a display screen of a touch screen computer. In another embodiment, the endoscope 110 may include two cameras with different communication requirements or protocols so that different information can be forwarded to the user by each camera. When so provided, the user can switch back and forth between cameras at will through a touch screen interface and / or a touch screen computer. Although not explicitly shown, the elongated shaft 114 may include one or more working cavities for receiving fluids and / or other medical devices. In some embodiments, the distal tip 116 may include an elevator configured to manipulate a guidewire, tool, medical device, etc. extending through the elongated shaft 114. The handle 112 may include an elevator control 128 operably connected to the elevator. In some embodiments, the at least one motor may include a motor configured to control movement of the elevator and / or provide power to the elevator. In some embodiments, the elevator motor may be disposed within the handle 112 of the endoscope 110.

[0072] In some embodiments, the position of the distal tip 116 and / or the distal end of the elongated shaft 114 can be tracked during use. For example, the mapping and navigation system may include an operating table (or other operating or examination table or chair, etc.) configured to act or be used as an electromagnetic generator for generating a magnetic field having a known geometry. Alternatively or additionally, an electromagnetic generator separate from the operating table may be provided. The operating table and / or the electromagnetic generator may be operably coupled to a control unit, which may include a processor, a memory, a display, and an input device, etc. A position sensor (e.g., an electromagnetic sensor, etc.) or an antenna may be incorporated into the distal tip 116 and / or the distal end of the elongated shaft 114 of the endoscope 110. The position sensor may be configured to sense the position of the position sensor in the magnetic field of the mapping and navigation system. In some embodiments, the position sensor may be electronically coupled to a workstation. When the position sensor is in the magnetic field, the position of the position sensor may be mathematically determined relative to the electromagnetic field source (e.g., the operating table and / or the electromagnetic generator). The workstation and the control unit may communicate to determine the position of the position sensor relative to the patient.

[0073] In some embodiments, the motor control assembly 140 may include a first gear assembly 150 disposed within the motor control housing 142, such as in Figure 3 and Figure 4 In some embodiments, the first gear assembly 150 can include a first worm gear 154 and a first worm gear shaft 152 configured to engage the first worm gear 154. In some embodiments, the first worm gear shaft 152 can be coupled to the first motor 144 by a first motor coupling 156. In some embodiments, the first worm gear shaft 152 can be directly coupled to the first motor 144. Other configurations are also contemplated. In some embodiments, the motor control assembly 140 can include a second gear assembly 160 disposed within the motor control housing 142, as shown in FIG. Figure 4 and Figure 5 In some embodiments, the second gear assembly 160 can include a second worm gear 164 and a second worm gear shaft (not visible) configured to engage the second worm gear 164. In some embodiments, the second worm gear shaft can be coupled to the second motor 146 by a second motor coupling 166. In some embodiments, the second worm gear shaft can be directly coupled to the second motor 146. Other configurations are also contemplated. In some embodiments, the motor control assembly 140 can include a first gear assembly 150 and a second gear assembly 160 disposed within the motor control housing 142.

[0074] In some embodiments, the endoscope system 100 may include a first drive shaft 170 extending from the first gear assembly 150 to a first deflection mechanism 120 disposed within the handle 112, such as Figure 4 and Figure 5 In some embodiments, the first drive shaft 170 can be configured to engage the first gear assembly 150 with the first deflection mechanism 120 disposed within the handle 112. In some embodiments, the first drive shaft 170 can be configured to engage the first gear assembly 150. In some embodiments, the first drive shaft 170 can be fixedly secured to the first deflection mechanism 120.

[0075] In some embodiments, the endoscope system 100 may include a second drive shaft 180 extending from the first gear assembly 150 to the first deflection mechanism 120 disposed within the handle 112, such as Figure 4 and Figure 5 In some embodiments, the second drive shaft 180 can be configured to engage the second gear assembly 160 with the second deflection mechanism 122 disposed within the handle 112. In some embodiments, the second drive shaft 180 can be configured to slidably engage the second gear assembly 160. In some embodiments, the second drive shaft 180 can be fixedly secured to the second deflection mechanism 122.

[0076] In some embodiments, the first drive shaft 170 can be oriented parallel to the second drive shaft 180. In some embodiments, the first drive shaft 170 can be coaxially disposed relative to the second drive shaft 180, such as Figure 5 . In some embodiments, the first portion of the first drive shaft 170 can include a circular cross-sectional shape, and the second portion of the first drive shaft 170 can include a non-circular cross-sectional shape (e.g., polygonal, oblong, triangular, square, star-shaped, hexagonal, etc.). The second portion of the first drive shaft 170 can be configured to engage with the first worm gear 154. In some embodiments, the first drive shaft 170 can be non-rotatable relative to the first worm gear 154. Other configurations are also contemplated.

[0077] In some embodiments, the first portion of the second drive shaft 180 can include a circular cross-sectional shape, and the second portion of the second drive shaft 180 can include a non-circular cross-sectional shape (e.g., polygonal, oblong, triangular, square, star-shaped, hexagonal, etc.). The second portion of the second drive shaft 180 can be configured to engage with the second worm gear 164. In some embodiments, the second drive shaft 180 can be non-rotatable relative to the second worm gear 164. Other configurations are also contemplated.

[0078] In some embodiments, a first portion of the first drive shaft 170 can be disposed within a cavity of the second drive shaft 180. Thus, in some embodiments, at least a portion of the first drive shaft 170 can be coaxially disposed within a cavity of the second drive shaft 180. The first drive shaft 170 can rotate relative to the second drive shaft 180. Thus, the first drive shaft 170 and the second drive shaft 180 can rotate independently of each other. For example, in some embodiments, the first drive shaft 170 can rotate and the second drive shaft 180 can remain stationary. In some embodiments, the second drive shaft 180 can rotate and the first drive shaft 170 can remain stationary. In some embodiments, the first drive shaft 170 can rotate in a first direction and the second drive shaft 180 can rotate in a second direction, wherein the second direction can be the first direction, or the second direction can be different from the first direction. In some embodiments, the first drive shaft 170 can rotate at a different speed than the second drive shaft 180.

[0079] In some embodiments, the first drive shaft 170 can define a first maximum outer range, and the second drive shaft 180 can define a second maximum outer range, wherein the second maximum outer range is greater than the first maximum outer range, such as Figure 5 Thus, the first worm gear 154 can define a first maximum interior range 155, and the second worm gear 164 can define a second maximum interior range 165, wherein the second maximum interior range 165 is greater than the first maximum interior range 155, as shown in FIG. Figure 6 Additional details regarding an exemplary medical device depicted as endoscope system 100 may be found in U.S. Provisional Patent Application Serial No. 63 / 187,988, filed on May 13, 2021, and entitled Motorized Controls for a Medical Device, and U.S. Patent Application No. 17 / 741,887, filed on May 11, 2022, and entitled Motorized Controls for a Medical Device, which are incorporated herein by reference.

[0080] Figure 7 is a schematic block diagram of an illustrative motorized control unit 200. It should be understood that the motorized control unit 200 can be incorporated into the motor control assembly 140. As can be seen, the motorized control unit 200 includes a first motor 144 and a second motor 146. In some embodiments, the first motor 144 is operably coupled to a first motor driver 144a. In some embodiments, the second motor 146 is operably coupled to a second motor driver 146a. The first motor driver 144a and the second motor driver 146a can, for example, be configured to bidirectionally communicate with the first motor 144 and the second motor 146, respectively. In some embodiments, the first motor driver 144a and the second motor driver 146a can receive motor position information from the first motor 144 and the second motor 146, respectively. For example, the first motor 144 and the second motor 146 can each include an orthogonal encoder, which provides information about the precise motor position of the first motor 144 and the second motor 146, respectively, to the first motor driver 144a and the second motor driver 146a. The orthogonal encoder can be considered as an example of the rotary encoder previously mentioned with respect to the motor control assembly 140. In some embodiments, the first motor driver 144a and the second motor driver 146a provide power to the first motor 144 and the second motor 146, respectively, so as to operate the first motor 144 and the second motor 146, respectively. The first motor driver 144a and the second motor driver 146a may alternatively or additionally provide specific instructions to the first motor 144 and the second motor 146, respectively. In some cases, one or more Hall effect sensors may alternatively or additionally be used to provide feedback about the precise position of the distal tip 116.

[0081] The controller 202 can be operably coupled to the first motor driver 144a and the second motor driver 146a, and thus can be operably coupled to the first motor 144 and the second motor 146. Although shown as separate, in some embodiments, the first motor driver 144a and the second motor driver 146a, or at least the functionality of the first motor driver 144a and the second motor driver 146a, can be incorporated into the controller 202. The controller 202 can be operably coupled to a control input 204. The control input 204 can schematically represent any device that allows a user to provide control input to the controller 202. In some embodiments, the control input 204 can include a joystick, such as the joystick 190. In some embodiments, the control input 204 can include one, two, three, or more buttons, such as the button 192.

[0082] In some embodiments, as shown, the motorized control unit 200 includes a graphical user interface (GUI) 206. In some embodiments, the GUI 206 may include a screen that can be used to display information. The GUI 206 may include a touch screen display that can be used not only to display information, but also to solicit and receive information. Therefore, the GUI 206 can be configured to receive input from a user and is therefore considered part of the control input 204 in some cases.

[0083] It should be understood that the motorized control unit 200 may include additional components that are not explicitly described. For example, each of the individual components of the motorized control unit 200 may include its own power supply, with power being supplied to each individual component at a voltage and current appropriate for that particular individual component. The controller 202 may include a memory as part of the controller 202 itself or operably coupled to the controller 202 for storing algorithms utilized by the controller 202 in controlling various aspects of the operation of the motor control assembly 140.

[0084] Figure 8 200. As can be seen, in some embodiments, the motorized control unit 200 may be operably coupled to a computing device 210. The computing device 210 may represent a desktop computer, a laptop computer, or a workstation. In some embodiments, the computing device 210 may represent a mobile device, such as a tablet computer, a phablet, or even a smart phone. In some embodiments, the computing device 210 may represent a computer server, such as a cloud-based server that may be remote from the motorized control unit 200. The computing device 210 may include an information input device, such as, but not limited to, a keyboard, a mouse, a trackball, a touchpad, a touch screen, etc., and thus may be viewed as providing an additional path (in addition to a keyboard) for providing commands to the motorized control unit 200. Figure 7 204). The computing device 210 may be used for monitoring purposes. In some embodiments, the computing device 210 may provide additional functionality to the motor control assembly 140 and, therefore, to the endoscope system 100.

[0085] In some embodiments, system 208 includes peripherals 212 operably coupled to computing device 110. Peripherals 212 may include any peripherals that are advantageously used in conjunction with endoscope system 100. As an example, peripherals 212 may include a camera attached to endoscope 110 as part of endoscope system 100. In some embodiments, the camera may include a light source, such as an LED or fiber optic. The camera may be used to capture images endoscopically, which may be displayed on a display provided as part of computing device 110, for example. Other peripherals are also contemplated. In some embodiments, peripherals 212 are operably coupled to computing device 210 and may be controlled by computing device 210. In some embodiments, at least some of the peripherals may include, for example, their own controllers. In some embodiments, peripherals 212 may alternatively or additionally be directly coupled to motorized control unit 200.

[0086] In some embodiments, a physician operating an endoscope, such as endoscope 110, may desire to improve accuracy in moving a distal tip, such as distal tip 116 of endoscope 110, by locking or preventing movement along one plane while allowing movement along another plane. This may be useful when performing tasks such as, but not limited to, intubation, tissue sampling, specimen extraction, etc. Figure 7 , controller 202 may be configured to enable a physician or other user to selectively select between the various modes by providing appropriate input via control input 204. This may include the use of a button, such as, for example, one of buttons 192. Fig. 9A shows a first mode, Fig. 9B The second mode is shown, and Fig. 9C A third mode is shown.

[0087] In the first mode, if Fig. 9AAs shown, the distal tip 116 of the endoscope 110 is able to move freely within a first plane 214 and is able to move freely within a second plane 216. In some cases, the first plane 214 can be considered a left-right plane, and the second plane 216 can be considered an up-down plane. In some cases, the first plane 214 can be perpendicular to the second plane 216. In this example, the first plane 214 includes movement of the distal tip 116 to the left and right along an arc 214a that falls within the first plane 214, and the second plane 216 includes movement of the distal tip 116 up and down along an arc 216a that falls within the second plane 216. When in the first mode, the physician is able to control the movement of the distal tip 116 in two directions (i.e., in the up-down plane and in the left-right plane). In the second mode, as Fig. 9B As shown, the distal tip 116 of the endoscope 110 is able to move freely within the first plane 214, but is restricted from moving within the second plane 216. In this example, the first plane 214 includes movement of the distal tip 116 to the left and right along an arc 214a that falls within the first plane 214, but there is no movement along an arc 216a that falls within the second plane 216. In the third mode, as shown in FIG. Fig. 9C As shown, the distal tip 116 of the endoscope 110 is restricted from moving along the arc 214a in the first plane 214, but is able to move freely along the arc 216a falling in the second plane 216. In the second and third modes, the physician is able to move the distal tip 116 of the endoscope 110 in a single direction while being prevented from moving the distal tip 116 of the endoscope 110 in the second direction. In other words, in the second mode, the controller 202 locks the movement of the distal tip in the second plane 216 (e.g., up and down direction), thus only allowing the movement of the distal tip in the first plane 214 (e.g., right and left direction), regardless of whether the joystick 190 is actuated in the upward and / or downward direction. In the third mode, the controller 202 locks the movement of the distal tip in the first plane 214 (e.g., right and left direction), thus only allowing the movement of the distal tip in the second plane 216 (e.g., up and down direction), regardless of whether the joystick 190 is actuated in the right and / or left direction. A locked axis will maintain its last commanded position.

[0088] In some embodiments, the controller 202 is configured to be able to track a trajectory input by a physician or other user. In some embodiments, a physician or other user can utilize the GUI 206 to input the trajectory that they want the motor control assembly 140 to follow when controlling the movement of the distal tip 166 of the endoscope 100. FIG. 10A to FIG. 10DAn example screen that may be displayed on the GUI 206 when a physician or other user wants to input a trajectory using an input device, such as, but not limited to, a joystick 190 is shown. For example, the trajectory may be input using a computing device 210 or a touch screen. In some embodiments, the desired trajectory may be defined as a set of waypoints, a starting position and an ending position, or even a tracked path. The trajectory may be constrained by the configuration space of the distal tip 116, and the initial and final positions indicated by the trajectory must exist within the configuration space. If not already present, the physician or other user may then use their free hand (the hand not used to manipulate the joystick 190) to translate the distal tip 116.

[0089] Fig. 10A Screen 220 is shown, which can be viewed as representing a starting position. The screen includes a graphical element 222 that indicates the current position of the distal tip 116. In some embodiments, screen 220 includes an indication of the current speed mode and can, for example, display a current torque value. For example, in some cases, information related to the distal tip position of the scope may be provided in a first area of ​​a window on screen 220, the distal tip speed may be provided in a second area of ​​a window on screen 220, and an indication of the amount of force / torque applied to the distal tip may be provided in a third area of ​​a window on screen 220. In other embodiments, information may be displayed in more than one window. For example, although not explicitly shown, the distal tip position, distal tip speed, and force / torque of the distal tip may each be displayed in a separate window. It is also contemplated that a camera feed of the endoscope may be displayed in an additional window on screen 220 or on a separate screen. A physician or other user may enter trajectory tracking mode by selecting a button, such as one of buttons 192, or by some other data input mechanism. This results in display of screen 224, such as Fig. 10B As shown. Fig. 10B As shown, a joystick, stylus, user's finger, or other data input mechanism may be used to draw a trajectory 226 having a starting point 223 aligned with a graphical element 222 indicating the current position of the distal tip 116, and an end point 228. In some embodiments, if the physician or other user is not satisfied with the trajectory 226 they have drawn, they may have the option of deleting the trajectory 226 and redrawing it.

[0090] Fig. 10C Screen 230 including a play button 232 is shown. The physician or other user may cause the motor control assembly 140, including the motorized control unit 200, to continue moving the distal tip 116 along the trajectory 226. Once completed, a display such as Fig. 10DScreen 234 is shown, indicating that the operation has been completed. It should be understood that the graphical element 222 that originally indicated the starting point of the track 226 has now become a graphical element 236 indicating the end point of the track 226 and is aligned with the end point 228 of the track 226.

[0091] In some embodiments, trajectory 226 may be viewed as including a plurality of trajectory waypoints. Each of the trajectory waypoints may be viewed as representing a short segment or segment of trajectory 226. Thus, trajectory 226 may be approximated by a series of continuous segments, such as linear segments in some cases. In some embodiments, each of the trajectory waypoints may be a short linear approximation of trajectory 226, as this may simplify the process of following trajectory 226. In some embodiments, controller 202 may convert each of the trajectory waypoints into a posture of the distal tip, which gives controller 202 a translational and rotational position of the distal tip in a Cartesian coordinate system.

[0092] In some embodiments, a regression-based technique can be used to estimate the encoder values ​​for each motor that produce the desired posture of the distal tip 116. In some cases, a regression-based technique called local weighted projection regression (LWPR) can be used, but other techniques can also be envisioned. In some embodiments, the algorithm executed by the controller 202 can approximate nonlinear functions in a high-dimensional space. At its core, the algorithm uses a local linear model to estimate nonlinearity. A learning-based approach can be used to learn a function that maps the posture of the distal tip 116 to the motor encoder value. The learned model can be used to calculate the corresponding encoder values ​​based on the desired position of the distal tip 116 of the endoscope 110, and those encoder values ​​are fed to the controller 202 and ultimately fed to the first motor driver 144a and the second motor driver 146a. In some embodiments, the controller 202 calculates the error between the current encoder value and the desired encoder value, and sends appropriate commands to the first motor driver 144a and the second motor driver 146a as needed to appropriately drive the first motor 144 and the second motor 146 so as to minimize the error between the current encoder value and the desired encoder value. This process can continue until the current encoder value for each of the motors 144, 146 is within a defined threshold from the desired encoder value. In some embodiments, the defined threshold can be predefined. In some cases, the defined threshold can be user defined.

[0093] Fig.11A schematic example of how the distal tip 116 of the endoscope 110 may actually move when following a trajectory 226 is provided. In some embodiments, the starting point 223 of the trajectory 226 shows where the distal tip 116 is pointing at the beginning of the trajectory. The end point 228 of the trajectory 226 can show where the distal tip 116 should be pointing at the end of the trajectory. It should be understood that the relative orientation of the distal tip 116 of the endoscope 110 may not be discernible by the shape of the trajectory 226. As shown, for example, the relative orientation of the distal tip 116 changes more between the starting point 223 and the end point 228 than the trajectory 226 would indicate. The trajectory 226 is intended more to indicate the change between the starting point 223 and the end point 228 than to indicate the relative orientation of the distal tip 116.

[0094] Fig.12 2 is a flow chart showing an illustrative method 240 for following a trajectory, such as trajectory 226. Method 240 can be viewed as an example of how controller 202 follows a trajectory. The method begins with distal tip 116 being in an initial or current position, as shown in block 242. This can be viewed as being determined by, for example Fig. 10A Controller 202 enters trajectory tracking mode, as shown in block 244. This can be viewed as, for example Fig. 10B The desired trajectory is input by the physician or other user, as shown in box 246. The controller 202 exits the trajectory tracking mode, as shown in box 248. The controller 202 moves the distal tip 116 along the trajectory, as shown in box 250. Once the physician or other user has selected the play button 232, this can be considered as a Fig. 10C express.

[0095] In some embodiments, controller 202 may be configured to accept a target destination from a physician or other user and automatically determine an appropriate trajectory to move distal tip 116 from its current position to the desired position. As an example, a physician or other user may use an input device such as control input 204 ( Figure 7 ) to select the desired anatomical feature as shown in the current frame of the camera feed. In some embodiments, the physician or other user may use a joystick, such as joystick 190, a stylus, a user's finger, a touch screen, or possibly a computer device 210 ( Figure 8 ) to select the desired anatomical feature. This causes the distal tip 116 to present a position of the camera frame that will maintain a centered view of the selected feature. This is particularly beneficial in applications where it is desirable to have a continuous and stable line of sight to a particular anatomical structure during surgery.

[0096] In some embodiments, it may be desirable for the endoscope 110 to maintain a relative position and distance between its distal tip 116 and a desired anatomical landmark or specific anatomical structure in order to provide the physician or other user with stability at the distal tip 116 and facilitate the performance of portions of the surgery that require minimal tremor and uninterrupted sight lines to specific anatomical structures. The controller 202 is configured to move the distal tip 116 in a manner such that the desired anatomical feature remains in the center of the camera frame at all times. After the physician or other user has selected the desired landmark by placing a virtual marker point at the location, the controller 202 is configured to require the physician or other user to verify the location. If correct, the physician or other user can then verify using any suitable input device, such as by pressing one of the buttons 192, accepting a pop-up message on a touch screen, or even by voice input. If the physician or other user does not verify the location, the controller 202 can then allow them to reselect the marker point.

[0097] After verifying the selection of the marker point, an algorithm executed by the controller 202 can calculate the depth and position of the selected anatomical feature relative to the camera frame, and calculate a desired distal tip position of the endoscope 10 that results in the selected feature being centered relative to the camera frame, and calculate a trajectory to move to the desired distal tip position. Thus, the trajectory can be calculated by the controller 202 in a semi-autonomous manner. The trajectory is calculated by the algorithm, where the initial starting point of the trajectory is the current position of the distal tip 116, and its final position is the position of the distal tip 116 that produces a centered camera frame relative to the desired anatomical feature selected by the physician or other user, while maintaining a comfortable buffer distance between the desired anatomical feature and the distal tip 116. The calculated trajectory is divided into trajectory waypoints that can be followed by the distal tip. The process of following a trajectory determined by the controller is substantially the same as the process of following a user-defined trajectory. In some cases, one difference is that while following a controller-defined trajectory, the controller 202 may continually be in a loop and generate a new trajectory for the distal tip 116 to always minimize its position error (the difference between the current encoder value and the expected encoder value) until the physician or other user cancels the process.

[0098] In some embodiments, the algorithm executed by the controller 202 evaluates the calculated position of the desired distal tip position and determines whether the distal tip 116 can reach the position given the current position of the endoscope 110. The calculation can be based on the total reachable workspace of the distal tip 116 based on its current position. It should be understood that the total reachable workspace is a three-dimensional volume around the current position of the distal tip 116. If the desired point falls within the three-dimensional volume, the controller 202 will continue to automatically generate a feasible path (trajectory) from the current position of the distal tip 116 to the desired final position of the distal tip 116. However, if there is no feasible trajectory from the current position of the distal tip to the desired final position of the distal tip 116, the controller 202 is configured to notify the physician or other user that they need to move the endoscope 110 to a position that will provide a feasible trajectory from the current position of the distal tip to the desired final position of the distal tip 116. In some embodiments, the controller 202 can use auditory and / or visual cues to guide the physician or other user to appropriately reposition the endoscope 110.

[0099] Fig.13 2 is a flow chart showing an illustrative method 260 for determining and following a trajectory to reach a desired anatomical feature. The method 260 begins with the distal tip 116 being in an initial or current position, as shown in block 262. A physician or other user can select and indicate a desired feature, such as a desired anatomical feature, as shown in block 264. The controller 202 calculates a final position based on the selected feature, as shown in block 266. Next, the controller 202 calculates an optimal trajectory, as shown in block 268. The controller 202 moves the distal tip 116 along the optimal trajectory by providing appropriate encoder values ​​to the first motor 144 and / or the second motor 146, as shown in block 270. The method 260 terminates with the distal tip 116 being in its final desired position, as shown in block 272.

[0100] Fig.14 It shows how data flows through Fig.13280 . The desired distal tip position is given in Cartesian coordinates (x, y, z), as shown in box 282. The trained LWPR model receives the (x, y, z) Cartesian coordinates and converts the Cartesian coordinates to encoder steps (encL and encR), where encL and encR represent the encoder steps of the left encoder and the right encoder (where left and right are arbitrary and are only selected to refer to the encoder assigned to each of the first motor 144 and the second motor 146, respectively). These values ​​are provided to the motor command calculator, as shown in box 186, which determines errL and errR values, which represent the difference (error) between the current encoder count and the desired encoder count for each of the first motor 144 and the second motor 146. The determined errL and errR values ​​are provided to the first motor driver 144a and the second motor driver 146a, as shown in box 288.

[0101] Fig.15 is a schematic diagram of the distal tip 116 of the endoscope 110. Fig.15 An example is provided of how a Cartesian coordinate system (x, y, z) may be applied to the endoscope 110 . Fig.15 Examples of components that may be included as part of the endoscope 110 are also provided. In some embodiments, the distal tip 116 of the endoscope 110 may include an RGB (red, green, blue) camera 290. In some embodiments, the distal tip 116 of the endoscope 110 may include a light source 292, such as one or more LEDs. In some embodiments, the distal tip 116 of the endoscope 110 may include a depth sensor 294.

[0102] The depth sensor 294 can be used to directly measure the depth of the desired anatomical feature (relative to the current position). The depth sensor 294 can be a three-dimensional camera based on time of flight. In some embodiments, the depth can be estimated using various techniques. Depth can be estimated using a monocular camera-based algorithm. Parallel Tracking and Mapping (PTAM), which uses subsequent video frames to generate a three-dimensional map of point features to approximate the camera pose, and therefore approximate the depth of the camera relative to the selected feature.

[0103] In some embodiments, the system and / or components thereof may be made of metals, metal alloys, polymers (some examples of which are disclosed below), metal-polymer composites, ceramics, combinations thereof, or the like, or other suitable materials.

[0104] Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxyethylene (POM, e.g., commercially available from DuPont ), polyether block esters, polyurethanes (e.g., polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether esters (e.g., commercially available from DSM Engineering Plastics ), ether- or ester-based copolymers (e.g., butylene phthalate / poly(alkylene ether) and / or other polyester elastomers such as those commercially available from DuPont ), polyamide (for example, commercially available from Bayer or commercially available from Elf Atochem ), elastomeric polyamides, block polyamide / ether, polyether block amide (PEBA, for example, available under the trade name Commercially available), ethylene-vinyl acetate copolymer (EVA), silicone, polyethylene (PE), High density polyethylene, Low-density polyethylene, linear low-density polyethylene (e.g. ), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), poly(p-phenylene terephthalamide) (e.g., ), polysulfone, nylon, nylon-12 (such as commercially available from EMS American Grilon ), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefins, polystyrene, epoxy resins, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (e.g., SIBS and / or SIBS 50A), polycarbonate, polyurethane silicone copolymers (e.g., Aortech Biomaterials' or AdvanSource Biomaterials ), biocompatible polymers, other suitable materials or mixtures, combinations, copolymers, polymer / metal composites, etc. In some embodiments, the sheath can be mixed with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 6% LCP.

[0105] Some examples of suitable metals and metal alloys include stainless steels, such as 304V, 304L, and 316LV stainless steel; low carbon steel; nickel titanium alloys, such as linear elastic and / or superelastic Nitinol; other nickel alloys, such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625, such as 625, UNS:N06022, such as UNS:N10276, such as other alloys, etc.), nickel-copper alloys (e.g., UNS: N04400, such as 400, 400, 400, etc.), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035, such as etc.), nickel-molybdenum alloys (e.g., UNS: N10665, such as ALLOY ), other nickel-chromium alloys, other nickel-molybdenum alloys, other nickel-cobalt alloys, other nickel-iron alloys, other nickel-copper alloys, other nickel-tungsten or tungsten alloys, etc.; cobalt-chromium alloys; cobalt-chromium-molybdenum alloys (e.g., UNS: R30003, such as etc.); platinum-rich stainless steel; titanium; platinum; palladium; gold; combinations thereof; or any other suitable material.

[0106] In at least some embodiments, part or all of the system and / or portions thereof may also be doped with, made of, or otherwise include radiopaque materials. Radiopaque materials are understood to be capable of producing relatively bright images on a fluoroscopic screen or with another imaging technique during a medical procedure. Such relatively bright images assist the user of the system in determining its position. Some examples of radiopaque materials may include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloys, polymer materials loaded with radiopaque fillers, and the like. Additionally, other radiopaque marker bands and / or coils may also be incorporated into the design of the system to achieve the same results.

[0107] In some embodiments, a degree of magnetic resonance imaging (MRI) compatibility is imparted to the systems and / or other elements disclosed herein. For example, the system and / or its components or portions may be made of materials that do not substantially distort the image and do not create a large number of artifacts (i.e., gaps in the image). For example, certain ferromagnetic materials may be unsuitable because they may create artifacts in MRI images. The system or portions thereof may also be made of materials that can be imaged by an MRI machine. Some materials that exhibit these properties include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003, such as etc.), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035, such as etc.), Nitinol, etc.

[0108] In some embodiments, the system and / or other elements disclosed herein may include and / or be treated with a suitable therapeutic agent. Some examples of suitable therapeutic agents may include anticoagulants (such as heparin, heparin derivatives, urokinase, and PPack (dextrophenylalanine proline arginine chloromethyl ketone); antiproliferative agents (such as enoxaparin, angiopeptin, monoclonal antibodies capable of blocking smooth muscle cell proliferation, hirudin, and acetylsalicylic acid); anti-inflammatory drugs (such as dexamethasone, prednisolone, corticosterone, budesonide, estrogen, sulfasalazine, and mesalazine); anti-tumor / antiproliferative / anti-mitotic agents (such as paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine, epothilone, endostatin, angiostatin, and thymidine kinase inhibitors); anesthetics (such as lidocaine, bupivacaine, and ropivacaine); anticoagulants (such as D-Phe-Pro-Arg chloromethyl ketone); ketones, compounds containing RGD peptides, heparin, antithrombin compounds, platelet receptor antagonists, antithrombin antibodies, antiplatelet receptor antibodies, aspirin, prostaglandin inhibitors, platelet inhibitors and tick antiplatelet peptides); vascular cell growth promoters (such as growth factor inhibitors, growth factor receptor antagonists, transcription activators and translation promoters); vascular cell growth inhibitors (such as growth factor inhibitors, growth factor receptor antagonists, transcription inhibitors, translation inhibitors, replication inhibitors, inhibitory antibodies, antibodies to growth factors, bifunctional molecules composed of growth factors and cytotoxins, bifunctional molecules composed of antibodies and cytotoxins); cholesterol-lowering agents; vasodilators; and agents that interfere with endogenous vasoactive mechanisms.

[0109] It should be understood that the present invention is in many respects merely illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps, without exceeding the scope of the present invention. To the extent appropriate, this may include using any of the features of an example embodiment used in other embodiments. Of course, the scope of the present invention is defined by the language of the appended claims.

Claims

1. A steerable medical device, comprising: a handle and an elongated shaft extending distally from the handle to a distal tip; a motor control assembly including a motor control housing configured to be removably coupled to the handle; The motor control component comprises: a first drive assembly disposed within the motor control housing; a second drive assembly disposed within the motor control housing; input device; and a controller operably coupled to the first drive assembly, the second drive assembly, and the input device, the controller being configured to: controlling operation of the first drive assembly and / or the second drive assembly to move the distal tip; receiving one or more user inputs from a user via the input device; and Operation of the first drive assembly and / or the second drive assembly is modified based on the one or more inputs received.

2. The steerable medical device according to claim 1, wherein: The first drive assembly includes a first motor and a first gear assembly operably coupled to the first motor; and The second drive assembly includes a second motor and a second gear assembly operably coupled to the second motor.

3. The steerable medical device according to claim 2, further comprising: a first drive shaft configured to engage the first gear assembly with a first deflection mechanism disposed within the handle, the first deflection mechanism configured to deflect the distal tip in a first plane; as well as A second drive shaft is configured to engage the second gear assembly with a second deflection mechanism disposed within the handle, the second deflection mechanism being configured to deflect the distal tip in a second plane different from the first plane.

4. The steerable medical device of any one of claims 1 to 3, wherein the one or more user inputs comprise a command for locking movement in the first plane or the second plane such that: When the command locks movement in the first plane, the controller is configured to prevent the first drive assembly from moving the first deflection mechanism, while the second drive assembly is permitted to move the second deflection mechanism; and When the command locks movement in the second plane, the controller is configured to prevent the second drive assembly from moving the second deflection mechanism, while the first drive assembly is permitted to move the first deflection mechanism.

5. The steerable medical device of any one of claims 1 to 4, wherein the one or more user inputs comprises a command to move the distal tip along a user defined trajectory.

6. A steerable medical device according to any one of claims 1 to 5, wherein the controller is further configured to implement a learning model, wherein the controller learns how encoder values ​​for each of the first drive component and the second drive component relate to corresponding movements of the distal tip.

7. The steerable medical device of claim 6, wherein the controller is further configured to minimize a difference between a desired encoder value and a current encoder value when moving the first drive assembly and / or the second drive assembly.

8. The steerable medical device of any one of claims 1 to 7, wherein the one or more user inputs comprises a command to move the distal tip to a user-defined target.

9. The steerable medical device of claim 8, wherein the controller is further configured to: determining a trajectory between a current position of the distal tip and a position defined by the user-defined target; and The first drive assembly and / or the second drive assembly are operated to move the distal tip along the determined trajectory.

10. A steerable medical device comprising: a handle and an elongated shaft extending distally from the handle to a distal tip; a first drive motor configured to deflect the distal tip within a first plane; a second drive motor configured to deflect the distal tip in a second plane different from the first plane; Input device; as well as a controller operably coupled to the first drive motor, the second drive motor, and the input device, the controller being configured to: receiving a command to move the distal tip along a trajectory; implementing a learning model that indicates how encoder values ​​for each of the first motor and the second motor correspond to movement of the distal tip; as well as Operation of the first drive motor and / or the second drive motor is controlled to move the distal tip along the trajectory while minimizing a difference between a desired encoder value and a current encoder value.

11. The steerable medical device of claim 10, wherein the trajectory comprises a user-defined trajectory input to the controller.

12. The steerable medical device of claim 10, wherein the trajectory comprises a controller-determined trajectory based on a current position of the distal tip and a desired target position of the distal tip.

13. The steerable medical device of claim 12, wherein the controller is further configured to determine whether a target position of the distal tip is attainable given a current position of the steerable medical device.

14. The steerable medical device according to any one of claims 12 or 13, wherein the controller is further configured to: the controller automatically calculating a trajectory determined by the controller when the target position of the distal tip is reachable given the current position of the steerable medical device; and When the target position of the distal tip is not reachable given the current position of the steerable medical device, the controller provides instructions to the user to move the steerable medical device to a new position that will facilitate reaching the target position of the distal tip.

15. The steerable medical device of any one of claims 12 to 14, wherein the controller is further configured to estimate a depth of the target location.

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