System and method for solving camera pose with respect to working channel tip

Abstract

A system for performing surgical procedures includes: a first catheter defining a channel; and an orifice having an internal dimension smaller than the internal dimension of the catheter; a transition portion disposed on an inner surface of the channel and adjacent to the orifice; and a pattern disposed on the transition portion, the pattern storing positional information relating a position on the pattern to a position on the first catheter; a second catheter capable of being received within the channel and having a camera; and a workstation operatively coupled to the first catheter and the second catheter and including a processor and a memory storing instructions that, when executed by the processor, cause the processor to: receive an image captured by the camera; and analyze the pattern visible within the received image to determine the position of the second catheter relative to the first catheter.

Description

[0001] Cross-references to related applications

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 603,462, filed November 28, 2023, which is incorporated herein by reference in its entirety. Background Technology Technical Field

[0004] This disclosure relates to the field of navigating a medical device within a patient's body, and more specifically, to identifying the location of the medical device within the patient's lumen network and navigating the medical device to a target.

[0005] Related technologies

[0006] Several commonly used medical approaches (such as endoscopy or minimally invasive surgery) exist for treating a wide variety of diseases affecting organs including the liver, brain, heart, lungs, gallbladder, kidneys, and bones. Clinicians typically use one or more imaging modalities, such as magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), cone-beam computed tomography (CBCT), or fluoroscopy (including 3D fluoroscopy), to identify and navigate to regions of interest within the patient and ultimately to the target for biopsy or treatment. In some procedures, preoperative scans can be used for target identification and intraoperative guidance. However, real-time imaging may be necessary to obtain more accurate and current images of the target area. Furthermore, real-time image data showing the current position of the medical device relative to the target and its surroundings may be required to navigate the device to the target safely and accurately, e.g., without harming other organs or tissues.

[0007] However, if the region of interest is located near a small or narrow airway, access devices with integrated cameras may have difficulty navigating to it. It is understood that the difficulty in navigating large access devices (such as those with cameras) within narrow airways can lead to increased procedure time to navigate to the appropriate position relative to the region of interest, which can result in inaccurate navigation or the use of fluoroscopy, which incurs additional setup time and radiation exposure. Furthermore, target tissue is often not visible to white light cameras because it is located behind tissue walls or fluids (such as those generated by biopsy or treatment activities that produce bleeding and other obstructions). Summary of the Invention

[0008] A system for performing surgical procedures includes: a first catheter including an inner surface defining a channel extending through a proximal end portion and a distal end portion of the first catheter; an orifice disposed adjacent to the distal end portion of the first catheter, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; a transition portion disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension that increases from the internal dimension of the orifice to the internal dimension of the channel in a distal-to-proximal direction; and a pattern disposed on the transition portion. The above includes a pattern storage unit that associates positional information on the pattern with a position on a first conduit; a second conduit capable of being received within a channel, the second conduit including a camera having a field of view encompassing the pattern on the first conduit; and a workstation operatively coupled to the first and second conduits, the workstation including a processor and a memory storing instructions that, when executed by the processor, cause the processor to: receive an image captured by the camera on the second conduit, the pattern being visible within the received image; and analyze the pattern visible within the received image to determine the position of the second conduit relative to the first conduit.

[0009] In all respects, the second conduit may have an external dimension larger than the internal dimension of the orifice to inhibit the distal advancement of the second conduit through the orifice.

[0010] In some respects, the transition portion may define a tapering surface that extends toward the inner portion of the channel.

[0011] In other aspects, the pattern can be freely selected from the following groups: one-dimensional barcode, DataMatrix, Maxicode, PDF417, QR code, three-dimensional barcode, and PM code.

[0012] In some respects, position information can be rotational position and longitudinal position.

[0013] In various respects, the first conduit may include a position sensor, wherein the position sensor is disposed at a predetermined distance from the distal end portion of the first conduit.

[0014] In other respects, the position on the first conduit can be the position of the position sensor.

[0015] In some respects, position sensors can be electromagnetic sensors.

[0016] In other respects, a position sensor can be an inertial measurement unit.

[0017] In all aspects, patterns can be etched into the surface of the transition section.

[0018] According to another aspect of this disclosure, a catheter includes: a proximal end portion; a distal end portion; an inner surface defining a channel extending through the proximal end portion and the distal end portion; an orifice disposed adjacent to the distal end portion, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; a transition portion disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension that increases from the internal dimension of the orifice to the internal dimension of the channel in a distal-to-proximal direction; and a pattern disposed on the transition portion, the pattern storing positional information that associates a position on the pattern with a position on the catheter.

[0019] In all aspects, the pattern can be freely selected from the following groups: one-dimensional barcode, DataMatrix, Maxicode, PDF417, QR code, three-dimensional barcode, and PM code.

[0020] In other aspects, position information can be rotational position and longitudinal position.

[0021] In some aspects, the conduit may include a position sensor located at a predetermined distance from the distal end.

[0022] In various aspects, the position on the conduit can be the position of the position sensor.

[0023] According to another aspect of this disclosure, a method for navigating a medical device within a patient's lumen network includes: advancing a first catheter within the patient's lumen network; advancing a second catheter within a channel defined by the first catheter; capturing an image from a camera disposed on the second catheter, the captured image including a view of a pattern disposed on a portion of the inner surface of the channel of the first catheter, wherein the pattern stores positional information that associates a position on the pattern with a position on the first catheter; and analyzing the pattern visible within the captured image to determine the position of the second catheter relative to the position on the first catheter.

[0024] In some respects, analyzing patterns visible within the captured images may include analyzing patterns visible within the captured images to determine the rotational position (such as, for example, orientation) of the distal portion of the second catheter and the longitudinal position of the distal portion of the second catheter relative to the position on the first catheter.

[0025] In other respects, analyzing patterns visible within the captured images may include analyzing patterns visible within the captured images to determine the position of the second catheter relative to a position sensor disposed on the first catheter, wherein the position sensor is disposed at a predetermined distance from the distal end portion of the first catheter.

[0026] In some respects, analyzing patterns visible within a captured image may include analyzing patterns selected from the group consisting of: one-dimensional barcodes, DataMatrix, Maxicode, PDF417, QR codes, three-dimensional barcodes, and PM codes.

[0027] In various respects, analyzing the patterns visible within the captured image may include analyzing the patterns visible within the captured image to determine the position of the second conduit relative to the position sensor located on the first conduit. Attached Figure Description

[0028] Various aspects and embodiments of this disclosure are described below with reference to the accompanying drawings, in which: Figure 1 This is a schematic diagram of a surgical system provided in this disclosure; Figure 2 yes Figure 1 A cross-sectional view of the distal portion of the first catheter in the surgical system; Figure 3 yes Figure 1 A perspective view of the second catheter in the surgical system; Figure 3A yes Figure 1 A perspective view of another embodiment of the second catheter; Figure 4 yes Figure 2 A partial cross-sectional view of the first catheter, showing the advancement within the first catheter. Figure 3 The second catheter; Figure 5 It is a view through the distal end of the first catheter, as observed and imaged by the second catheter; Figure 6 yes Figure 1 A schematic diagram of a workstation for a surgical system; Figure 7A This is a flowchart of a method for navigating a medical device to a region of interest within a patient's lumen network; Figure 7B yes Figure 7A A continuation of the flowchart; Figure 8 yes Figure 1 A perspective view of a robotic surgical system; and Figure 9 yes Figure 1 Exploded view of the drive mechanism for the extended working channel of the surgical system. Detailed Implementation

[0029] This disclosure relates to a surgical system configured to enable the navigation of a medical device through a patient's luminal network, such as, for example, the lungs. The surgical system uses preoperative images (such as, for example, CT, CBCT, or MRI images) to generate a 3D representation of the patient's airways and identifies regions of interest or target tissue within the 3D representation. The surgical system includes a bronchoscope through which an extended working channel (EWC) is advanced to allow a catheter into the patient's luminal network. This extended working channel may be a smart extended working channel (sEWC) including an electromagnetic (EM) sensor. Compared to an EWC, the sEWC includes an EM sensor disposed on or near the distal end of the sEWC, configured to be used in conjunction with an electromagnetic navigation (EMN) or tracking system that tracks the position of the EM sensor (such as, for example, the EM sensor of the sEWC). The catheter includes a camera disposed on or near the distal end of the catheter, configured to capture real-time images of the patient's anatomy as the catheter is navigated through the patient's luminal network. In this manner, the catheter is advanced through the sEWC and into the patient's luminal network. It is envisioned that the catheter can be selectively locked to the sEWC to selectively inhibit or allow movement of the catheter relative to the sEWC. In embodiments, the catheter may include an EM sensor disposed on or near the distal end of the catheter. Although generally described as utilizing an EM sensor, it is envisioned that the sEWC and / or catheter can utilize any suitable sensor for detecting and / or identifying the position of the sEWC and / or catheter within the patient's luminal network, such as, for example, an inertial measurement unit (IMU).

[0030] The surgical system uses pre-procedure images (such as CT, CBCT, or MRI images) to generate a 3D representation of the patient's airway and identifies anatomical landmarks (such as bifurcations or lesions) within the 3D representation. During the registration process in surgery, the location of the EM sensor of the sEWC is periodically identified and stored as data points as the sEWC and catheter are navigated through the patient's luminal network. As can be understood, the registration process may require navigating and investigating the sEWC and catheter within specific portions of the patient's luminal network (such as the right upper lobe, left upper lobe, right lower lobe, left lower lobe, and right middle lobe). In an implementation, this registration step can be considered a first estimated registration of the EM sensor to the patient's anatomy, which, in addition to further data, can be used to augment and / or more robustly register the EM sensor to the patient's anatomy compared to a single registration step.

[0031] The working channel of the sEWC defines an orifice at its distal end, the orifice comprising an internal dimension smaller than the internal dimension of the working channel. The working channel of the sEWC includes a transition portion comprising an internal dimension that decreases from the internal dimension of the working channel to the internal dimension of the orifice in a proximal-to-distal direction. In this way, the transition portion abuts the distal end portion of the catheter to inhibit or otherwise prevent the catheter from completely passing through the working channel. Although generally described as a transition portion abutting the sEWC, it is contemplated that any suitable device positioned at any suitable location (e.g., at the proximal end portion of the sEWC or the catheter) can be used to inhibit distal extension of the catheter to the distal end portion of the sEWC. The transition portion includes a pattern disposed or defined thereon to identify or otherwise determine the rotational and / or longitudinal position of the distal end portion of the catheter relative to the sEWC, such as an EM sensor. It is contemplated that pattern 86 can be any suitable pattern configured to encode data, such as, for example, a one-dimensional barcode, DataMatrix, Maxicode, PDF417, or QR code. ® 3D barcodes and PM codes. The rotational and longitudinal positions encoded in pattern 86 refer to the position of the EM sensor 72 of the sEWC 70.

[0032] The envisioned system can synthesize or otherwise generate virtual images from a 3D representation at various camera poses approximating the estimated position of the EM sensor within the patient's airway. In this way, positions within the 3D representation corresponding to positional data obtained from the EM sensor can be identified. The system generates virtual 2D or 3D images from the 3D representation, corresponding to different viewpoints or poses of a virtual camera observing the patient's airway within the 3D representation. Real-time images captured by the camera are compared with the generated 2D or 3D virtual images, and the virtual 2D or 3D image with the viewpoint or pose closest to the camera is identified. In this way, the position of the identified virtual image within the 3D representation is correlated with the position of the EM sensor of the sEWC and / or the rotational and / or longitudinal position of the distal end of the catheter relative to the sEWC, and the pose of the sEWC within the patient's luminal network can be determined in six degrees of freedom. Although it is generally described as using anatomical landmarks to estimate the location of the second catheter within the patient’s lumen network, it is contemplated that, without departing from the scope of this disclosure, any suitable method may be used to estimate the location of the catheter and / or sEWC using images captured by a camera.

[0033] These and other aspects of this disclosure will be described in more detail below. Although the description is generally made with reference to the lungs, it is to be expected that the systems and methods described herein can be used in any structure within a patient's body, such as the liver, kidneys, prostate, organs affected by gynecological diseases, etc.

[0034] Now turn to the attached image. Figure 1 A system 10 according to this disclosure is shown, which helps a medical device navigate through a network of lumens and reach a region of interest. As will be described in further detail below, the surgical system 10 is generally configured to identify target tissue, automatically register real-time images captured by surgical instruments to a generated three-dimensional (3D) model, and navigate surgical instruments to the target tissue.

[0035] System 10 includes a catheter guidance assembly 12 comprising a first catheter, which can be any suitable catheter and, in embodiments, an extended working channel (EWC) 70, which can be a smart extended working channel (sEWC) including an electromagnetic (EM) sensor. In one embodiment, the sEWC 70 is inserted into a bronchoscope 16 to access the network of lumens in patient P. In this way, the sEWC 70 can be inserted into the working channel of the bronchoscope 16 for navigation through the network of lumens in patient P, such as, for example, the lungs. It is envisioned that the sEWC 70 itself may include imaging capabilities via an integrated camera or optical component (not shown), and therefore does not strictly require a separate bronchoscope 16. In embodiments, the sEWC 70 can be selectively locked to the bronchoscope 16 using a bronchoscope adapter 16a. In this manner, the bronchoscope adapter 16a is configured to allow movement of the sEWC 70 relative to the bronchoscope 16 (which may be referred to as the unlocked state of the bronchoscope adapter 16a) or to inhibit movement of the sEWC 14 relative to the bronchoscope 16 (which may be referred to as the locked state of the bronchoscope adapter 16a). The bronchoscope adapter 16a is currently manufactured by Medtronic PLC under the trade name EDGE. ® Bronchoscope adapter or ILLUMISITE ® Bronchoscope adapters are sold and distributed, and are intended to be used in conjunction with this disclosure.

[0036] Compared to the EWC, the sEWC 70 may include one or more EM sensors 72 disposed in or on the sEWC 70 at a predetermined distance from the distal end 74 of the sEWC 70. It is contemplated that the EM sensors 72 may be five-degree-of-freedom (DOF) or six-degree-of-freedom (DOF) sensors. The position and orientation of the EM sensors 72 of the sEWC 70 relative to a reference coordinate system within the electromagnetic field can be determined, and thus the distal portion of the sEWC 70 can be determined. The conduit guidance assembly 12 is currently manufactured by Medtronic under the trade name SUPERDIMENSION. ® Surgical kit, ILLUMISITE ™ Endobronchial surgical kit, ILLUMISITE ™ Navigation catheter or EDGE ®The surgical kits are sold and distributed for a period of time and are intended to be used in conjunction with this disclosure.

[0037] continue Figure 1 And refer to other sources Figure 2 The sEWC 70 includes an inner surface 76 that defines a working channel 78 extending through a proximal end 80 and a distal end 74 of the sEWC 70. The working channel 78 defines an orifice 82 adjacent to and extending through the distal end 74, and includes an internal dimension smaller than the internal dimension of the working channel 78. In this way, the inner surface 76 of the working channel 78 defines a transition portion 84 where the internal dimension of the working channel 78 transitions to the smaller internal dimension of the orifice 82. Although generally shown as defining a tapered truncated section or tapered profile, it is contemplated that, without departing from the scope of this disclosure, the transition portion 84 of the working channel 76 may define any suitable profile, such as, for example, concave, convex, stepped, and curved, as required by the design of the system 10. As will be described in further detail below, the internal dimension of the orifice 82 defines an internal dimension smaller than the external dimension of a second medical device, which in an embodiment may be a camera catheter 90 ( Figure 3 In this manner, when the camera conduit 90 is advanced toward the distal end 74 within the working channel 76 of the sEWC 70, the distal end 96 of the camera conduit 90 abuts or otherwise contacts the transition portion 84 and inhibits the camera conduit 90 from extending through the orifice 82. Although generally described as abutting the transition portion 84 of the sEWC 70, it is contemplated that any suitable means located at any suitable location (such as, for example, at the proximal end portion of the sEWC 70 or the camera conduit 90) can be used to inhibit the distal extension of the camera conduit 90 toward the distal end 74 of the sEWC 70.

[0038] Continue to refer to Figure 2 Pattern 86 is disposed on the transition portion 84 of the working channel 78. Pattern 86 encodes or otherwise defines a rotational position about the circumference of the sEWC 70 and relative to the longitudinal distance of the distal end 74 of the sEWC 70. It is contemplated that pattern 86 can be any suitable pattern configured to encode data, such as, for example, a one-dimensional barcode, DataMatrix, Maxicode, PDF417, or QR code. ®3D barcodes and PM codes. The rotational and longitudinal positions (e.g., attitude) encoded in pattern 86 reference the position of the EM sensor 72 of sEWC 70. It is understood that referencing the position of the EM sensor 72 enables the system to identify the position of the distal end 96 of the camera duct 90 with six degrees of freedom. It is contemplated that pattern 86 can be set on the transition portion 84 using any suitable method, such as, for example, a separate component attached to the transition portion 84 (e.g., adhesive label, paint, stain, 3D printing, and 2D printing). It is also contemplated that pattern 86 can be integrally formed within the transition portion 84 (e.g., by etching and machining).

[0039] refer to Figure 3 The camera conduit 90 includes one or more EM sensors 92 and is configured to insert into and selectively lock into place relative to the sEWC 70. As understood, the EM sensors 92 disposed on the camera conduit 90 are separate from the EM sensors 72 disposed on the sEWC 70. As described above, the distal end 96 of the camera conduit 90 is configured to abut or otherwise contact a portion of the transition portion 84 of the sEWC 70, thereby inhibiting further distal insertion or translation of the camera conduit 90 relative to the sEWC 70. In this manner, the external dimensions of the camera conduit 90 are larger than at least a portion of the internal dimensions of the transition portion 84 of the sEWC 70. In an embodiment, the EM sensors 92 of the camera conduit 90 may be disposed on or within the camera conduit 90 at a predetermined proximal distance from the distal end portion 96 of the camera conduit 90. In this manner, system 10 can determine the position of the distal end 96 of camera catheter 90 within the lumen network of patient P or relative to the distal end 74 of sEWC 70. It is envisioned that camera catheter 90 can be selectively locked relative to sEWC 70 at any time, regardless of the position of the distal end 96 of camera catheter 90 relative to sEWC 70. It is envisioned that camera catheter 90 can be selectively locked to the handle 12a of catheter guiding assembly 12 using any suitable means, such as snap-fit, press-fit, friction fit, cam, one or more pawls, threaded engagement, or chuck clamp. It is envisioned that the EM sensor 92 of camera catheter 90 can be a five-DOF or six-DOF sensor. As will be described in further detail below, the position and orientation of the EM sensor 92 of camera catheter 90 relative to a reference coordinate system within the electromagnetic field can be determined, and thus the position and orientation of the distal end 96 of camera catheter 90 can be determined.

[0040] At least one camera 94 is disposed on or near the distal end surface 96a of the camera conduit 90 and is configured to capture, for example, still images, live images, or live video. In embodiments, the camera conduit 90 may include one or more light sources 98 disposed on or near the distal end surface 96a of the camera conduit 90 or disposed at any other suitable location (such as, for example, a side surface or protrusion). The light source 98 may be, or for example, a light-emitting diode (LED), an optical fiber connected to a light source located outside the patient P, or a combination thereof, and may emit one or more of white light, IR light, or near-infrared (NIR) light. In this way, the camera 94 may be, for example, a white light camera, an IR camera, or a NIR camera, a camera capable of capturing both white light and NIR light, or a combination thereof. In a non-limiting embodiment, the camera 94 is a white light miniature complementary metal-oxide-semiconductor (CMOS) camera; however, it is contemplated that the camera 94 may be any suitable camera, such as, for example, a charge-connected device (CCD), CMOS, N-type metal-oxide-semiconductor (NMOS), and in embodiments, may be an IR camera, depending on the design requirements of system 10. In an embodiment, camera 94 may be a dual-lens camera or an RGB-D camera, configured to identify the distance between camera 94 and anatomical features within the anatomical structure of patient P without departing from the scope of this disclosure. As described above, it is envisioned that camera 94 may be mounted on camera catheter 90, sEWC 70, or bronchoscope 16.

[0041] In embodiments, the camera catheter 90 may include a working channel 100 defined by a proximal portion (not shown) and a distal end surface 96a; however, in embodiments, it is contemplated that the working channel 100 may extend through the sidewalls of the camera catheter 90 as required by the design of the camera catheter 90. As will be understood, the working channel 100 is configured to receive a positionable guide (not shown) or surgical instrument, such as, for example, a biopsy tool 110. Figure 1 Although typically described as having a working channel, it is contemplated that the camera conduit 90 may not have a working channel, but may instead include only the camera 94, and in some embodiments, include a light source 98. Figure 3A ).

[0042] return Figure 1System 10 typically includes: an operating table 52 configured to support a patient P; and a monitoring device 24 coupled to the sEWC 70, bronchoscope 16, or second endoscopic catheter 90 (e.g., a video display for displaying video images received from a video imaging system of the bronchoscope 12 or a camera 94 of the camera catheter 90); a positioning or tracking system 46 including a tracking module 48, multiple reference sensors 50, and a transmitter pad 54 including multiple combined markers; and a workstation 20 having a computing device 22 including software and / or hardware for facilitating: target identification, path planning to the target, navigating medical devices to the target, and / or, for example, confirming and / or determining the placement of the sEWC 70, bronchoscope 16, camera catheter 90, or surgical instruments relative to the target.

[0043] Tracking system 46 is, for example, a six-degree-of-freedom electromagnetic positioning or tracking system, or other suitable system for determining the position and orientation of, for example, the distal portion of sEWC 70, bronchoscope 16, camera catheter 90, or surgical instrument 110, to perform registration of the detected positions of one or more of EM sensors 72 or 92 with a three-dimensional (3D) model generated from CT, CBCT, or MRI image scans. Tracking system 46 is configured for use with sEWC 70 and camera catheter 90, and particularly with EM sensors 72 and 92.

[0044] continue Figure 1The transmitter pad 54 is positioned below the patient P. The transmitter pad 54 generates an electromagnetic field around at least a portion of the patient P, within which the tracking module 48 can be used to determine the positions of multiple reference sensors 50 and EM sensors 72 and 92. In a non-limiting embodiment, the transmitter pad 54 generates three or more electromagnetic fields. One or more reference sensors 50 are attached to the pleural cavity of the patient P. In an embodiment, the coordinates of the reference sensors 50 within the electromagnetic field generated by the transmitter pad 54 are sent to a computing device 22, where they are used to calculate a patient reference coordinate system (e.g., a reference coordinate system). As will be described in further detail below, coordinate positions from 3D models and 2D images from the planning phase are typically used to perform airway registration with the patient P as observed via the bronchoscope 12 or camera cannula 90, and allow for a navigation phase with the positions of EM sensors 72 and 92 known. It is envisioned that either of the EM sensors 72 and 92 can be a single-coil sensor that enables the system 10 to identify the position of the sEWC 70 or the camera conduit 90 within the EM field generated by the transmitter pad 54. However, it is anticipated that the EM sensors 72 and 92 can be any suitable sensor and can be sensors that enable the system 10 to represent the position, orientation, and / or attitude of the sEWC 70 or the camera conduit 90 within the EM field.

[0045] Although the description generally pertains to EMN systems using EM sensors, this disclosure is not limited thereto and may be used in conjunction with flexible sensors (e.g., fiber Bragg grating sensors), inertial measurement units (IMUs), ultrasonic sensors, optical sensors, attitude sensors (e.g., ultra-wideband, GPS, fiber Bragg, transmissive markers), or without sensors, or combinations thereof. In a non-limiting embodiment, instead of EM sensors 72 and 92, or in addition to EM sensors, sEWC 70 may include IMU 88 and / or camera conduit 90 may include IMU 102. It is envisioned that the apparatus and systems described herein can be used in conjunction with robotic systems to enable robotic actuators to drive sEWC 70 or bronchoscope 16 toward a target.

[0046] According to various aspects of this disclosure, visualization of in vivo navigation of a medical device (e.g., a biopsy tool or therapeutic tool) toward a target (e.g., a lesion) can be part of a larger workflow of the navigation system. Imaging devices 56 capable of acquiring 2D and 3D images or videos of patient P (e.g., CT imaging devices, such as cone-beam computed tomography (CBCT) devices, including but not limited to Medtronic's O-arm) ™The system is also included in a specific aspect of system 10. Images, image sequences, or videos captured by imaging device 56 can be stored within imaging device 56 or transmitted to computing device 22 for storage, processing, and display. In an embodiment, imaging device 56 can be moved relative to patient P, allowing images to be acquired from different angles or viewpoints relative to patient P to create image sequences such as, for example, fluoroscopic video. The orientation of imaging device 56 relative to patient P during image capture can be estimated via markers attached to transmitter pad 54. The markers are positioned below patient P, between patient P and operating table 52, and between patient P and radiation source or sensing unit of imaging device 56. The markers attached to transmitter pad 54 can be two separate elements that can be fixedly coupled or alternatively manufactured as a single unit. It is contemplated that imaging device 56 may include a single imaging device or more than one imaging device.

[0047] continue Figure 1 And refer to other sources Figure 3 Workstation 20 includes a computer 22 and a monitor 24 configured to display one or more user interfaces 26 and / or 28. Workstation 20 may be a desktop computer or a tower configuration with monitor 24, or it may be a laptop computer or other computing device. Workstation 20 includes a processor 30 that executes software stored in memory 32. Memory 32 may store video or other imaging data captured by bronchoscope 16 or camera catheter 90, or preoperative images from, for example, computed tomography (CT) scans, positron emission tomography (PET), magnetic resonance imaging (MRI), cone-beam CT, etc. Additionally, memory 32 may store one or more software applications 34 to be executed on processor 30. Although not explicitly shown, monitor 24 may be incorporated into a head-mounted display, such as an augmented reality (AR) head-mounted device, such as the HoloLens provided by Microsoft Corp.

[0048] Network interface 36 enables workstation 20 to communicate with various other devices and systems via the Internet. Network interface 36 can connect workstation 20 to the Internet via a wired or wireless connection. Additionally or alternatively, communication may be via self-organizing Bluetooth, which allows communication with wide area networks (WANs) and / or local area networks (LANs). ®This can be done wirelessly. Network interface 36 can connect to the Internet via one or more gateways, routers, and Network Address Translation (NAT) devices. Network interface 36 can communicate with cloud storage system 38, where additional image data and video can be stored. Cloud storage system 38 can be located remotely from the hospital or within a hospital building, such as in a control or hospital IT room. Input module 40 receives input from input devices such as keyboards, mice, voice commands, etc. Output module 42 connects processor 30 and memory 32 to various output devices, such as display 24. In some embodiments, workstation 20 may include its own display 44, which may be a touchscreen display.

[0049] During the planning or preoperative phase, the software application uses preoperative CT image data (stored in memory 32 or retrieved via network interface 36) to generate and view a 3D model of the patient's anatomy, enabling the identification of the target tissue TT on the 3D model (automatically, semi-automatically, or manually), and allowing selection of pathways through the patient's anatomy to the target tissue in the implementation. An example of this application is ILOGIC, currently sold by Medtronic PLCs. ® Planning and navigation kits and ILLUMISITE ® Planning and navigation suite. The 3D model can be displayed on monitor 24 or another suitable monitor (e.g., monitor 44) associated with workstation 20, or in any other suitable manner. By using workstation 20, various views of the 3D model and / or manipulation of the 3D model can be provided to facilitate identification of target organizations on the 3D model and / or selection of appropriate paths to the target organizations.

[0050] The idea is to generate a 3D model by segmenting and reconstructing the airways of patient P's lungs to create a 3D airway tree. The reconstructed 3D airway tree includes various branches and bifurcations, which, in the implementation, can be labeled using, for example, recognized nomenclature, such as RB1 (right branch 1), LB1 (left branch 1), or B1 (bifurcation 1). Figure 5In the implementation, segmentation and labeling of the patient's lung airways are performed to a resolution including terminal bronchioles with a diameter of approximately less than 1 mm. As will be understood, segmenting the airways of patient P's lungs into terminal bronchioles improves the accurate registration between the positions of the sEWC 70 and camera cannula 90 and the 3D model, improves the accuracy of the path to the target, and improves the ability of the software application to identify the positions of the sEWC 70 and camera cannula 90 within the airways and to navigate the sEWC 70 and camera cannula 90 to the target tissue. Those skilled in the art will recognize that various different algorithms can be employed to segment CT image datasets, including, for example, connected component analysis, region growing, thresholding, clustering, watershed segmentation, or edge detection. It is envisioned that the entire reconstructed 3D airway tree can be labeled, or only branches or branch points within the reconstructed 3D airway tree adjacent to the path to the target tissue can be labeled.

[0051] In one implementation, software stored in memory 32 can identify and segment target critical structures within the 3D model. It is conceivable that the segmentation process can be performed automatically, manually, or a combination of both. The segmentation process isolates the target critical structures within the 3D model from surrounding tissue and identifies their location within the 3D model. In one implementation, the software application segments the CT image into terminal bronchioles with a diameter less than 1 mm, such that branches and / or bifurcations are identified and marked deep within the patient's luminal network. As will be understood, this location can be updated based on the view selected on display 24, such that the view of the segmented target critical structures approximates the view captured by camera 94 of camera catheter 90.

[0052] As can be understood, 3D models generated from previously acquired images may not provide a sufficient basis for accurately registering or guiding medical devices or tools to their target during the navigation phase of surgery. In some cases, inaccuracies arise from deformation of the patient's lungs during surgery relative to when the previously acquired images were taken. This distortion (CT-to-body difference) can be caused by a number of different factors, including, for example, changes in the patient P's body when switching between sedation and desedation, changes in the patient P's posture caused by the bronchoscopy 16, sEWC 70, or camera catheter 90, tissue movement caused by the bronchoscopy 16, sEWC 70, or catheter 90, different lung volumes (e.g., if the previously acquired images were acquired during inspiration, while navigation was performed while the patient P was breathing), different beds, the time period between when the previous images were captured and when the surgery was performed, changes in lung shape due to, for example, changes in temperature or time of day between when the previous images were captured and when the surgery was performed, the effect of gravity on the patient P's lungs due to the length of time the patient P lay on the operating table 52, or disease that was not present or has progressed since the previous images were captured.

[0053] For further reference Figure 3 and Figure 4 Registration of the patient P's position on the transmitter pad 54 can be performed by moving the EM sensors 72 and / or 92 through the patient P's airway. In this manner, when the sEWC 70 and / or camera cannula 90 are moved through the airway using the transmitter pad 54, reference sensor 50, and tracking system 46, software stored in memory 32 periodically determines the position of the EM sensors 72 or 92 in a coordinate system. The position data can be represented on the user interface 26 as markers or other suitable visual indicators, where multiple visual indicators form a point cloud of shapes with an internal geometry that approximates the 3D model. The shape obtained from this position data is compared with the internal geometry of the passage in the 3D model, and the positional correlation between the shape and the 3D model is determined based on this comparison. Furthermore, the software identifies non-organic spaces in the 3D model (e.g., air-filled cavities). The software aligns or registers the image representing the location of EM sensors 72 or 92 with the 3D model and / or the 2D image generated from the 3D model, based on the recorded location data and the assumption that the sEWC 70 or camera catheter 90 is still positioned in the non-tissue space within the patient's airway. In an embodiment, manual registration can be employed by navigating the sEWC 70 or the second catheter 72 with EM sensors 72 and 92 to a pre-designated location in the lung of patient P and manually associating images from the bronchoscope 16 or camera catheter 90 with model data from the 3D model. Although generally described herein as utilizing point clouds (e.g., multiple location data points), it is contemplated that registration can be performed using any number of location data points, and in a non-limiting embodiment, a single location data point may be used. It is envisioned that the registration of EM sensors 72 and / or 92 can be a first estimated registration, which, in addition to additional data, can be used to increase the accuracy or robustness of the registration of EM sensors 72 and / or 92 with the anatomical structures of patient P, as will be described in further detail below, compared to using a single registration step.

[0054] Go to Figures 3 to 6During registration, and in an embodiment, during navigation, as the sEWC 70 with its coupled camera conduit 90 moves through the airway of patient P, CT deviation from the body can be mitigated by integrating real-time images captured by camera 94 of the camera conduit 90. In this manner, software stored on memory 32 analyzes the pre-segmented pre-procedure CT model and identifies the location of anatomical landmarks, such as bifurcations, airway walls, or lesions; however, it is contemplated that, without departing from the scope of this disclosure, system 10 may utilize any suitable method of analyzing real-time images to identify and / or determine the location of camera 94 within the anatomical structures of patient P. In embodiments that identify anatomical landmarks, the anatomical landmarks may be displayed on user interface 26 (… Figure 5 The bifurcation is marked as B1 in the image. As the sEWC 70 and camera tube 90 move through the airway, the camera 94 captures images I of the patient P's anatomy in real time from the distal end 96 of the camera tube 90. The real-time images I captured by the camera 94 are continuously segmented by software stored on memory 32 to identify anatomical landmarks within the real-time images I. Figure 5 The software stored on memory 32 continuously analyzes the captured image I in real time and identifies commonalities between anatomical landmarks identified by the software application in the real-time image I and the preoperative image, such as... Figure 5 The bifurcation B1 in the diagram is shown. The distance between camera 94 and the anatomical landmarks identified in the real-time image I is determined using, for example, EM sensors 72 or 92, a predetermined distance between EM sensors 72 or 92, a known zoom level of the real-time image I captured by camera 94, and a pattern 86 set on the transition portion 84 of camera conduit 90. However, it is contemplated that any suitable method can be used to determine the distance between camera 94 and the identified anatomical landmarks without departing from the scope of this disclosure, such as data obtained, for example, from a twin-lens camera or an RGB-D camera. Using the distance between camera 94 and the anatomical landmarks, in addition to the position data obtained from EM sensors 72 and 92, the position of sEWC 70 and / or camera conduit 90 in the coordinate system is recorded and utilized to register the position of sEWC 70 or camera conduit 90 to a 3D model. In a twin-lens camera embodiment utilizing an RGB-D camera, determining the determined distance between camera 94 and the identified anatomical landmarks increases redundancy and increases the accuracy of distance determination. It is envisioned that, during registration, data points related to the distance determined using camera 94 and the distance determined using EM sensor 72 and / or 92 can be weighted or otherwise given greater importance.

[0055] Continue to refer to Figures 3 to 6As described above, the sEWC 70 can be configured without a camera, resulting in a smaller external size and enabling further navigation into the patient P's luminal network, or otherwise advancement into airways with a smaller diameter compared to an sEWC with a camera. As can be understood, although the camera-free configuration of the sEWC 70 allows for a smaller external size, as the sEWC 70 and camera catheter 90 are navigated within the patient's luminal network, the camera 94 of the camera catheter 90 can rotate or otherwise translate with the sEWC 70 relative to its distal end 74, to which the camera catheter 90 is locked. Although the proximal end portion of the camera catheter 90 is locked relative to the sEWC 70, the camera catheter 90 may twist or otherwise move relative to the sEWC 70, and this movement may increase along the length of the camera catheter 90 in a proximal-to-distal direction. Furthermore, when the camera catheter 90 is released from or otherwise unlocked from the sEWC 70, the rotation and longitudinal position of the distal end 96 may be displaced relative to the distal end 74 of the sEWC, resulting in inaccuracies in positioning surgical tools (such as biopsy tools 110) relative to the target tissue.

[0056] To address or otherwise resolve positional and rotational differences between the distal end 74 of the sEWC 70 and the camera guide tube 90, the system 10 utilizes a pattern 86 provided on the transition portion 84 of the sEWC 70 to identify or otherwise determine the rotational and / or longitudinal position of the distal end 96 of the camera guide tube 90 relative to the EM sensor 72 of the sEWC 70, and vice versa. In this way, when the distal end 96 of the camera guide tube 90 is advanced within the working channel 78 of the sEWC 70, it is positioned by abutting or otherwise contacting the transition portion 84 (…). Figure 4 Part of the device is designed to prevent the distal end 96 from extending beyond the distal end 74 of the sEWC 70, and pattern 86 is located in the camera catheter 90, except for the anatomical structures of the patient P distal to the distal end 74 of the sEWC 70. Figure 5The camera 94 is also visible within its field of view (FOV). As described above, pattern 86 encodes, or otherwise defines, a rotational position about the circumference of the sEWC 70 and a longitudinal distance relative to the distal end 74 of the sEWC 70. The rotational and longitudinal positions encoded in pattern 86 reference the position of the EM sensor 72 of the sEWC 70. In this way, software stored in memory 32 analyzes the image I captured by camera 94 and identifies or otherwise determines the position of the distal end 96 of the camera conduit 90 relative to the EM sensor 72 of the sEWC 70 in six degrees of freedom (e.g., as if the camera 94 is registered to the EM sensor 72). By relating the estimated registration of camera 94 to the airway of patient P to the estimated registration of camera 94 to EM sensor 72, the registration of camera 94 to the anatomical structure of patient P is converted from camera 94 to patient P anatomical coordinates to EM sensor 72 to patient P anatomical coordinates. In this manner, a second estimated registration of the EM sensor 94 with the anatomical structure of the patient P is generated. As can be understood, using, or otherwise combining, the first estimated registration of the EM sensor 72 with the anatomical structure of the patient P and the second estimated registration of the EM sensor 72 with the anatomical structure of the patient P more accurately or robustly than using a single registration step. It is envisioned that the software stored in memory 32 can continuously analyze the real-time images I captured by camera 94 and update the position of the camera conduit 90 in real time with six degrees of freedom. In an implementation, the real-time position of the camera catheter 90 can be used as an additional data point for locating the position of the camera catheter 90 and / or sEWC 70 within the airway of the patient P. Image orientation information can be attached to or otherwise assigned to the real-time image (e.g., the position of the patient P's head, feet, left hand, right hand, back, and front), which can be displayed on the user interface 26 or stored in the memory 32 to enhance the user experience, or can be utilized by software stored in the memory 32 to align or otherwise register a virtual navigation view with the real-time image captured by the camera 94.

[0057] In one implementation, software stored in memory 32 associates the determined location of anatomical landmarks identified in image I captured by camera 94 of camera catheter 90 with the identified location information of the distal end 96 of camera catheter 90 relative to EM sensor 72 of sEWC 70. In this way, the position and orientation or posture of the distal end 74 of sEWC 70 and / or the posture of the distal end 96 of camera catheter 90 can be identified using six degrees of freedom. With the position and orientation of the distal end 74 of sEWC 70 and / or the distal end 96 of camera catheter 90 identified using six degrees of freedom, camera catheter 90 can be disengaged from sEWC 70 and withdrawn from the working channel 78 of sEWC 70, and the target tissue TT can be treated.

[0058] return Figure 1 Registration of the patient P's position on the transmitter pad 54 can be performed by moving the EM sensors 72 and / or 92 through the patient P's airway. In this manner, as the sEWC 70 and camera cannula 90 are moved through the airway using the transmitter pad 54, reference sensor 50, and tracking system 46, software stored in memory 32 periodically determines the position of the EM sensors 72 or 92 in a coordinate system. The position data can be represented on the user interface 26 as markers or other suitable visual indicators, where multiple visual indicators form a point cloud of shapes with an internal geometry that approximates the 3D model. The shape generated from this position data is compared to the internal geometry of the passage in the 3D model, and a positional correlation between the compared shape and the 3D model is determined. Furthermore, the software identifies non-organic spaces in the 3D model (e.g., air-filled cavities). The software aligns or registers the image representing the position of EM sensors 72 or 92 with the 3D model and / or the 2D image generated from the 3D model, based on the recorded position data and the assumption that the sEWC 70 or camera catheter 90 is still positioned in the non-tissue space of the patient P's airway. In an embodiment, manual registration techniques can be employed by navigating the sEWC 70 or camera catheter 90 with EM sensors 72 and 92 to a pre-designated position in the patient P's lung and manually associating images from the bronchoscope 16 or camera catheter 90 with model data from the 3D model. Although generally described herein as utilizing point clouds (e.g., multiple position data points), it is contemplated that registration can be performed using any number of position data points, and in a non-limiting embodiment, a single position data point may be used. As described above, the identified rotational and longitudinal positions of the distal end 96 of the camera catheter 90 relative to the EM sensor 72 of the sEWC 70 can be used as additional data points during registration to improve registration accuracy.

[0059] refer to Figure 7A and Figure 7BThis describes a method for navigating a medical device within a patient's luminal network, generally identified by reference numeral 200. Initially, in step 202, the lungs of patient P are imaged using any suitable imaging modality (such as, for example, CT, MRI, and CBCT), and the images are stored in memory 32 associated with workstation 20. As will be understood, imaging of patient P's lungs at step 202 can be performed at any suitable time, such as, for example, preoperatively, intraoperatively, or before and after surgery. In step 204, a 3D representation of the airways of patient P's lungs is generated and viewed using the images stored in memory 32. Subsequently, in step 206, a region of interest or target tissue is identified in the 3D representation. If a region of interest is identified, in step 208, a second catheter is advanced within a first catheter until the distal end of the second catheter. In step 210, the first catheter, together with the second catheter advanced therein, is advanced within the luminal network of patient P's lungs. Optionally, in step 212, the second catheter may be locked to the first catheter before advancing the first and second catheters within the luminal network of the patient P's lungs. In step 214, the first and second catheters are navigated toward a region of target tissue adjacent to the patient P's lungs. In parallel with step 214, in step 216, as the first and second catheters navigate within the luminal network of the patient P's lungs, a real-time image of the patient P's anatomy is captured by a camera on the second catheter, wherein the pattern of the first catheter is visible within the captured real-time image. In parallel with steps 214 and 216, in step 218, the temporal output of the first catheter's EM sensor is monitored to generate a first estimated registration of the EM sensor with the patient P's luminal network. In step 220, as the second catheter's camera captures image I in real time, the pattern of the first catheter visible within the FOV of the second catheter's camera is analyzed in real time to identify the camera's position relative to the position within the pattern. In step 222, the registration of the second catheter's camera with the first catheter's EM sensor is estimated based on the position within the pattern relative to the position information of the EM sensor encoded within the pattern. In parallel with step 220, in step 224, real-time images of the patient's anatomy captured by the camera of the second catheter are analyzed and compared with a 3D representation of the patient P's airway to estimate the registration of the camera with the patient P's airway. In step 226, the estimated registration of the second catheter's camera with the patient P's airway is converted into a second estimated registration of the first catheter's EM sensor within the patient P's airway by correlating the estimated registration of the second catheter's camera with the estimated registration of the EM sensor of the first catheter. In step 228, the EM sensor is registered to the patient P's anatomy by combining the first estimated registration of the EM sensor and the second estimated registration of the EM sensor within the patient P's airway.In step 230, it is determined whether the distal end of the first catheter is positioned adjacent to the target tissue or region of interest, or positioned at a desired location relative to the target tissue or region of interest. If it is determined that the distal end of the first catheter is not positioned adjacent to the target tissue or region of interest, or positioned at a desired location relative to the target tissue or region of interest, the method returns to steps 214, 216, and 218. If it is determined that the distal end of the first catheter is positioned adjacent to the target tissue or region of interest, or positioned at a desired location relative to the target tissue or region of interest, the method terminates at step 232. As will be understood, the above method can be repeated multiple times as needed and can be performed globally and locally within the airway of patient P.

[0060] Go to Figure 8 and Figure 9 It is envisioned that system 10 may include a robotic surgical system 600 having a drive mechanism 602 including a robotic arm 604 operably coupled to a base or cart 606, which in an embodiment may be a workstation 20. The robotic arm 604 includes a bracket 608 configured to receive a portion of sEWC 14 thereon. sEWC 14 is coupled to bracket 608 using any suitable component (e.g., a strap, mechanical fastener, and / or connector). It is envisioned that the robotic surgical system 600 may communicate with sEWC 14 via an electrical connection (e.g., contacts and / or plugs) or wirelessly with sEWC 70 to control or otherwise implement one or more motors disposed within sEWC 70. Figure 8 The movement of the sEWC 70 is described, and in an embodiment, images captured by a camera (not shown) associated with the sEWC 70 can be received. In this way, it is envisioned that the robotic surgical system 600 may include a wireless communication system 610 operably coupled thereto, allowing the sEWC 70 to communicate via, for example, Wi-Fi, Bluetooth. ® Wireless communication with the robotic surgical system 600 and / or workstation 20. As will be understood, the robotic surgical system 600 may completely omit electrical contacts and may communicate wirelessly with the sEWC 70, or utilize both electrical contacts and wireless communication. The wireless communication system 610 is substantially similar to the network interface 36 described above. Figure 6 Therefore, for the sake of brevity, this will not be described in detail here. As indicated above, the robotic surgical system 600 and workstation 20 may be the same, or in some embodiments, they may be widely distributed above multiple locations within the operating room. Contemplated, workstation 20 may be located in a separate location, and display 44 ( Figure 1 and Figure 6 It could be an overhead monitor installed in the operating room.

[0061] As noted above, it is envisioned that the sEWC 70 can be manually actuated via cable or push-wire, or electronically operated, for example, via one or more buttons, joysticks, toggle switches, or actuators (not shown), operatively coupled to a drive mechanism 614 disposed within an internal portion of the sEWC 70. This drive mechanism is operatively coupled to the proximal portion of the sEWC 70, but it is envisioned that the drive mechanism 614 can be operatively coupled to any part of the sEWC 70. The drive mechanism 614 enables manipulation or hinged operation of the distal end of the sEWC 70 in four degrees of freedom or two articulated planes (e.g., left, right, up, or down) controlled by two push-pull cables. However, it is envisioned that, without departing from the scope of this disclosure, the drive mechanism 614 may include any suitable number of cables to enable movement or hinged operation of the distal end of the sEWC 70 in larger or smaller degrees of freedom. Contemplate that the distal end of the sEWC 70 can be manipulated in more than two articulated planes (e.g., in polar coordinates), or that the azimuth angle of the distal end of the sEWC 70 can be changed while maintaining the angle of the distal end relative to the longitudinal axis of the sEWC 70, or vice versa. In a non-limiting embodiment, the system 10 may define the vector or trajectory of the distal end of the sEWC 70 relative to the two articulated planes.

[0062] Contemplate that the drive mechanism 614 may be actuated using a bundle of artificial reinforcing bars or a cable 616 (e.g., metallic, non-metallic, and / or composite), or it may be a nitinol wire mechanism. In an embodiment, the drive mechanism 614 may include a motor 618 or other suitable means capable of moving the cable 616. In this manner, the motor 618 is disposed within the sEWC 70 such that rotation of the output shaft of the motor 618 achieves a corresponding hinge at the distal end of the sEWC 70.

[0063] Although typically described as having a motor 618 disposed within the sEWC 70, it is contemplated that the sEWC 70 may not include a motor 618 disposed therein. More precisely, a drive mechanism 614 disposed within the sEWC 14 may interface with a motor 622 disposed within a bracket 608 of the robotic surgical system 600. In embodiments, the sEWC 70 may include one or more motors 618 for controlling the hinge of the distal end 74 of the sEWC 70 in a plane (e.g., left / empty or right / empty), and the drive mechanism 624 of the robotic surgical system 600 may include at least one motor 622 to achieve a second axis of rotation and for axial movement. In this way, the motors 618 of the sEWC 70 and the motors 622 of the robotic surgical system 600 cooperate to achieve four-way hinge of the distal end of the sEWC 70 and to achieve rotation of the sEWC 70. As can be understood, by removing motor 618 from sEWC 70, the manufacture of sEWC 70 becomes increasingly cheaper, and it can be a disposable unit. In implementations, sEWC 70 can be integrated into robotic surgical system 600 (e.g., as a one-piece unit) and may not be a separate component.

[0064] Based on the foregoing and with reference to the accompanying drawings, those skilled in the art will understand that certain modifications may be made to this disclosure without departing from its scope.

[0065] Although the description of computer-readable media contained herein refers to solid-state storage devices, those skilled in the art will understand that computer-readable storage media can be any available medium accessible to processor 30. That is, computer-readable storage media can include non-transitory, volatile and non-volatile, removable and non-removable media implemented using any method or technique for storing information such as computer-readable instructions, data structures, program modules, or other data. For example, computer-readable storage media can include RAM, ROM, EPROM, EEPROM, flash memory or other solid-state memory technologies, CD-ROM, DVD, Blu-ray or other optical storage devices, magnetic tape cassettes, magnetic tape, disk storage devices or other magnetic storage devices, or any other medium that can be used to store desired information and is accessible to workstation 20.

[0066] The present invention may also be described with reference to the following numbered paragraphs: 1. A surgical system comprising: a first catheter, the first catheter including: an inner surface defining a channel extending through a proximal end portion and a distal end portion of the first catheter; an orifice disposed adjacent to the distal end portion of the first catheter, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; a transition portion disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension increasing from the internal dimension of the orifice to the internal dimension of the channel in a direction from distal to proximal; and a pattern disposed on the channel. In the transition section, the pattern stores positional information that associates a position on the pattern with a position on the first conduit; a second conduit, which can be received within the channel, includes a camera having a field of view encompassing the pattern on the first conduit; and a workstation operatively coupled to the first and second conduits, the workstation including a processor and a memory storing instructions that, when executed by the processor, cause the processor to: receive an image captured by the camera on the second conduit, the pattern being visible within the received image; and analyze the pattern visible within the received image to determine the position of the second conduit relative to the first conduit.

[0067] 2. The system according to paragraph 1, wherein the second conduit has an external dimension larger than the internal dimension of the orifice to inhibit the distal advancement of the second conduit through the orifice.

[0068] 3. The system according to paragraph 1, wherein the transition portion defines a tapered surface extending toward the interior portion of the channel.

[0069] 4. According to the system described in paragraph 1, the pattern is selected from the group consisting of: one-dimensional barcodes, DataMatrix, Maxicode, PDF417, QR codes, three-dimensional barcodes, and PM codes.

[0070] 5. The system according to paragraph 1, wherein the position information is rotational position and longitudinal position.

[0071] 6. The system according to paragraph 1, wherein the first conduit includes a position sensor, wherein the position sensor is disposed at a predetermined distance from the distal end portion of the first conduit.

[0072] 7. The system according to paragraph 6, wherein the position on the first conduit is the position of the position sensor.

[0073] 8. The system according to paragraph 6, wherein the position sensor is an electromagnetic sensor.

[0074] 9. The system according to paragraph 6, wherein the position sensor is an inertial measurement unit.

[0075] 10. The system according to paragraph 1, wherein the pattern is etched into the surface of the transition portion.

[0076] 11. A catheter comprising: a proximal end portion; a distal end portion; an inner surface defining a channel extending through the proximal end portion and the distal end portion; an orifice disposed adjacent to the distal end portion, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; a transition portion disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension increasing from the internal dimension of the orifice to the internal dimension of the channel in a direction from distal to proximal; and a pattern disposed on the transition portion, the pattern storing positional information that associates a position on the pattern with a position on the catheter.

[0077] 12. The conduit according to paragraph 11, wherein the pattern is selected from the group consisting of: one-dimensional barcode, DataMatrix, Maxicode, PDF417, QR code, three-dimensional barcode, and PM code.

[0078] 13. The system according to paragraph 11, wherein the position information is rotational position and longitudinal position.

[0079] 14. The system according to any one of the preceding paragraphs, the system further comprising a position sensor, wherein the position sensor is disposed at a predetermined distance from the distal end portion.

[0080] 15. The system according to paragraph 14, wherein the position on the conduit is the position of the position sensor.

[0081] 16. A method of navigating a medical device within a patient's lumen network, the method comprising: advancing a first catheter within the patient's lumen network; advancing a second catheter within a channel defined by the first catheter; capturing an image from a camera disposed on the second catheter, the captured image including a view of a pattern disposed on a portion of an inner surface of the channel of the first catheter, wherein the pattern stores positional information relating a position on the pattern to a position on the first catheter; and analyzing the pattern visible within the captured image to determine a position of the second catheter relative to the position on the first catheter.

[0082] 17. The method according to paragraph 16, wherein analyzing the pattern visible within the captured image comprises: analyzing the pattern visible within the captured image to determine the rotational position of the distal portion of the second catheter and the longitudinal position of the distal portion of the second catheter relative to the position on the first catheter.

[0083] 18. The method according to paragraph 16, wherein analyzing the pattern visible within the captured image comprises: analyzing the pattern visible within the captured image to determine the position of the second catheter relative to a position sensor disposed on the first catheter, wherein the position sensor is disposed at a predetermined distance from the distal end portion of the first catheter.

[0084] 19. The method according to paragraph 16, wherein analyzing the pattern visible within the captured image includes analyzing patterns selected from the group consisting of: one-dimensional barcodes, DataMatrix, Maxicode, PDF417, QR codes, three-dimensional barcodes, and PM codes.

[0085] 20. The method according to paragraph 16, wherein analyzing the pattern visible within the captured image comprises: analyzing the pattern visible within the captured image to determine the position of the second conduit relative to the position sensor disposed on the first conduit.

Claims

1. A system for performing surgical procedures, the system comprising: A first catheter, the first catheter comprising: An inner surface that defines a channel extending through the proximal end portion and the distal end portion of the first catheter; An orifice is provided adjacent to the distal end portion of the first conduit, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; A transition portion, wherein the transition portion is disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension that increases from the internal dimension of the orifice to the internal dimension of the channel in a direction from distal to proximal; and A pattern is disposed on the transition portion, and the pattern stores position information that associates the position on the pattern with the position on the first conduit. A second conduit, receptacle capable of being received within the channel, the second conduit including a camera having a field of view encompassing the pattern of the first conduit; and A workstation operatively connected to the first conduit and the second conduit, the workstation including a processor and a memory, the memory storing instructions that, when executed by the processor, cause the processor to: Receive an image captured by the camera in the second conduit, the pattern being visible within the received image; and The pattern visible within the received image is analyzed to determine the position of the second catheter relative to the first catheter.

2. The system of claim 1, wherein the second conduit has an external dimension larger than the internal dimension of the orifice to inhibit distal advancement of the second conduit through the orifice.

3. The system of claim 1, wherein the transition portion defines a tapered surface extending toward the inner portion of the channel.

4. The system of claim 1, wherein the pattern is selected from the group consisting of: one-dimensional barcode, DataMatrix, Maxicode, PDF417, QR code, three-dimensional barcode, and PM code.

5. The system according to claim 1, wherein the position information is rotational position and longitudinal position.

6. The system of claim 1, wherein the first conduit includes a position sensor, wherein the position sensor is disposed at a predetermined distance from the distal end portion of the first conduit.

7. The system of claim 6, wherein the position on the first conduit is the position of the position sensor.

8. The system according to claim 6, wherein the position sensor is an electromagnetic sensor.

9. The system of claim 6, wherein the position sensor is an inertial measurement unit.

10. The system of claim 1, wherein the pattern is etched into the surface of the transition portion.

11. A catheter, the catheter comprising: Proximal end portion; The distal end portion; An inner surface that defines a channel extending through the proximal end portion and the distal end portion; An orifice is provided adjacent to the distal end portion, the orifice having an internal dimension smaller than the internal dimension of the channel, wherein the orifice is in open communication with the channel; A transition portion is disposed on the inner surface of the channel and adjacent to the orifice, wherein the transition portion has an internal dimension that increases from the internal dimension of the orifice to the internal dimension of the channel in a direction from distal to proximal. and A pattern is disposed on the transition portion, and the pattern stores position information that associates the position on the pattern with the position on the conduit.

12. The catheter of claim 11, wherein the pattern is selected from the group consisting of: one-dimensional barcode, DataMatrix, Maxicode, PDF417, QR code, three-dimensional barcode, and PM code.

13. The system of claim 11, wherein the position information is rotational position and longitudinal position.

14. The system according to any one of the preceding claims, the system further comprising a position sensor, wherein the position sensor is disposed at a predetermined distance from the distal end portion.

15. The system of claim 14, wherein the position on the conduit is the position of the position sensor.

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