Endoscopic system including a catheter control system and method of operating an endoscopic system - Patent application

Abstract

A ureteroscope system is described that includes a handpiece, a catheter, and a control system. The handpiece has a proximal end region, a distal end region opposite the proximal end region, and an interior region. The catheter extends from the distal end region of the handpiece and includes an active bending portion distal to the handpiece. The control system includes a sensor positioned in the interior region of the handpiece and configured to detect movement of the handpiece. The control system includes a motor positioned in the interior region of the handpiece and operatively coupled to the sensor, and is effective to activate the motor when the sensor detects movement of the handpiece. The ureteroscope system includes one or more wires secured to the active bending portion of the catheter and adjustable in response to activation of the motor, and is effective to at least partially bend the active bending portion of the catheter.

Description

[Background technology]

[0001] Small size endoscopes are desirable in many industrial and medical applications. For example, when the natural openings and lumens of the human body are small, small endoscopes are used to insert through such openings and lumens to a target location within the body. In the case of single incision laparoscopy, especially when the incision itself is of minimal dimensions, a smaller endoscope is preferred to provide an internal view of the surgical site. In some cases, the patient may feel irritation when the endoscope is being inserted into the patient's body, and a smaller endoscope can reduce such an unpleasant experience and minimize trauma to the patient. Furthermore, physicians can improve diagnostic and surgical protocols using smaller endoscopes. For example, transnasal endoscopy may replace oral endoscopy in some cases. There is a need to provide a ureteroscope system that potentially allows further minimization of trauma to the patient. Summary of the Invention [Means for solving the problem]

[0002]

[0003] Embodiments disclosed herein relate to a ureteroscope system and a method of operating a ureteroscope system. In one embodiment, the ureteroscope system includes a handpiece, a catheter, and a control system. The handpiece has a proximal end region, a distal end region opposite the proximal end region, and an interior region. The catheter extends from the distal end region of the handpiece and includes an active bending portion distal to the handpiece. The control system includes a sensor positioned in the interior region of the handpiece and configured to detect movement of the handpiece, a motor positioned in the interior region of the handpiece and operatively coupled to the sensor, the motor configured to be activated in response to the sensor detecting movement of the handpiece, and one or more wires secured to the active bending portion of the catheter and adjustable in response to activation of the motor, the one or more wires effective to at least partially bend the active bending portion of the catheter.

[0003] In one embodiment, a method of operating a ureteroscope system is disclosed. The method includes inserting at least a distal end of a ureteroscope catheter into a patient, the distal end of the catheter including an image sensor and an active bending portion. The method also includes detecting movement of the hand piece with a sensor positioned in an interior region of the hand piece. The method also includes at least partially bending the active bending portion of the catheter in response to detecting movement of the hand piece. The ureteroscope includes a motor positioned in the interior region of the hand piece and operatively coupled to the sensor, the motor configured to be activated in response to the sensor detecting movement of the hand piece, and one or more wires secured to the active bending portion of the catheter and adjustable in response to activation of the motor, the one or more wires effective to at least partially bend the active bending portion of the catheter.

[0004] Features from any of the disclosed embodiments may be used in combination with each other without limitation.In addition, other features and advantages of the present disclosure will become apparent to those skilled in the art upon consideration of the following detailed description and accompanying drawings.

[0005] The drawings illustrate several embodiments of the present disclosure, with the same reference numbers referring to the same or similar elements or features in different figures or embodiments shown in the drawings. [Brief description of the drawings]

[0006] [Figure 1A] 1 illustrates a ureteroscope as part of an endoscopy system, according to one embodiment. [Figure 1B] FIG. 1B illustrates an end view of the distal end of the ureteroscope catheter of FIG. 1A, according to one embodiment. [Diagram 2] FIG. 1B is a side view of the handpiece of the ureteroscope of FIG. 1A with a side of the handpiece removed, according to one embodiment. [Figure 3A]1B is a side view of the ureteroscope of FIG. 1A illustrating automatic movement of an active bending portion of a ureteroscope catheter in response to and relative to movement of a ureteroscope handpiece, according to one embodiment. [Figure 3B] 1B is a side view of the ureteroscope of FIG. 1A illustrating automatic movement of an active bending portion of a ureteroscope catheter in response to and relative to movement of a ureteroscope handpiece, according to one embodiment. [Figure 4] FIG. 1 is an isometric view of a ureteroscope, according to one embodiment. [Diagram 5] FIG. 2 is a schematic diagram of a controller that can be used in the systems and methods described herein, according to one embodiment. [Figure 6] 1 is a flow diagram of a method of operating a ureteroscope system, according to one embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0007] The embodiments disclosed herein relate to devices, systems, and methods that use endoscopes, such as ureteroscopes. The endoscopic system includes a handpiece and a catheter. At least one, some, or all of the embodiments of the systems and methods described herein include a control system built into the ureteroscope handpiece. The configuration of the control system may result in a technical effect of allowing a user to control an active bending portion of the catheter through movement of the handpiece. For example, the configuration of at least one, some, or all of the embodiments of the systems and methods described herein may result in a technical effect of sensing the acceleration (e.g., movement) of the handpiece, and a processor of the system may use data or signals from the control system to determine data corresponding to at least one of the direction and / or magnitude of the movement or motion of the handpiece. At least one, some, or all of the embodiments of the processor described herein may then use this data corresponding to at least one of the direction and / or magnitude of the movement of the handpiece to coordinate the movement of one or more actuators (e.g., servo or linear actuators) to retract or release a control wire through a mechanical mechanism. This retraction and / or release of the control wire results in the technical effect of bending or other movement of the active bending section of the catheter. The combination of features of the embodiments disclosed herein may result in smoother advancement of the catheter and associated reduced trauma to the patient. In some embodiments described herein, the system may include a controller positioned on the handpiece configured to selectively activate and / or deactivate the control system.

[0008] FIG. 1A illustrates an endoscopic system 10. In one embodiment, the endoscopic system 10 includes a digital ureteroscope 100 operatively coupled to one or more electronic devices, such as a host machine 170, and one or more external terminals, including a display 190 and a computer 180. The ureteroscope 100 can be operatively coupled to one or more of the host machine 170, the computer 180, or the display 190 wirelessly or through a cable 102. The ureteroscope 100 includes a catheter 104 and a handpiece 110 having a catheter end (e.g., a distal end region) 114 and a control end (e.g., a proximal end region) 112 opposite the catheter end 114. Because the control end 112 is opposite the catheter end 114, the control end 112 and the catheter end 114 can be at different ends of the handpiece 110 and face in different directions relative to each other. In one embodiment, both the catheter 104 and the handpiece 110 are disposable. In some embodiments, the catheter 104 and the handpiece 110 are manufactured as an integral part, or the catheter 104 is fixed to the handpiece 110 via the handpiece-catheter connector 103. Alternatively, only the catheter 104 is disposable and the handpiece 110 can be sterilized and reused multiple times. In this case, the catheter 104 is removably connected to the handpiece 110 and the catheter end 114 via the handpiece-catheter connector 103.

[0009] The catheter 104 of the ureteroscope 100 may be used to image the interior surface of a tubular structure, such as a lumen, within a human or animal body. For example, the catheter 104 may be inserted through a subject's urethra to access various portions of the urinary tract. However, it should be understood that the ureteroscope 100 may be used as an industrial endoscope when the tubular structure is part of an industrial device, equipment, product, machine, manufacturing line, or the like. In some embodiments, the catheter 104 may include a number of scale markings or fiducials that may act as a tether and allow a physician to measure the distance the optoelectronic module advances into the tubular structure, such as a body lumen. Other structures may be incorporated into the ureteroscope 100 as desired.

[0010] The catheter 104 also includes an active bending section 106 at the distal end region 105 of the catheter 104. The active bending section 106 is configured to selectively bend in one or more directions. For example, the hand piece 110 may include a control system 200 (FIG. 2) configured to control one or more steering wires 158 (FIG. 2) connected to the active bending section 106 of the catheter 104 to deflect the distal end 105 to a desired location. Thus, a user may selectively bend or curve the catheter 104 using the control system 200, as described in more detail below. In some embodiments, the active bending section 106 of the catheter 104 is made from certain flexible medical grade polymeric materials to enable maneuverability of the catheter and reduce discomfort for the patient. The catheter 104 may include an active bending section 106 and a passive bending section 107. The active bending section 106 may generally be distal to the hand piece 110 and may be controlled by one or more (e.g., two) control wires 158 (e.g., steel wires) to bend in two directions, one used to bend the active bending section 106 in one direction having a range of 0° to 275° and the other used to bend the active bending section 106 in the opposite direction having the same angular range. Here, other numbers of steering wires (e.g., one, three or four) may be implemented. In contrast, the passive bending section 107 may be between the active bending section 106 and the hand piece 110 and may bend according to the shape of the urinary tract during insertion. Suitable active bending sections for catheters are disclosed in U.S. Pat. No. 11,129,519 and U.S. Patent Application Publication No. 2018 / 0140177, the disclosures of which are incorporated herein by reference in their entirety.

[0011] The ureteroscope 100 may include an optoelectronic module (e.g., a camera or other imager) for imaging the interior of a subject. For example, referring to FIG. 1B, the optoelectronic module 109 and at least one light source 111 may be disposed at the distal end 105 of the catheter 104 or elsewhere in the catheter 104. The optoelectronic module 109 may include a micro-camera module having an image sensor microchip, a set of micro-lenses, and a micro-illumination module. A suitable optoelectronic module is disclosed in U.S. Pat. No. 9,942,452, which is incorporated herein by reference in its entirety. In some embodiments, the optoelectronic module 109 may be positioned within a rigid or semi-rigid shell-like housing at the distal end 105 configured for insertion into a tubular structure to image the inner surface of the tubular structure. For example, the optoelectronic module 109 may be inserted into the patient's body through a natural body orifice, such as the mouth, nose, urethra, bladder, vagina, or anus. Thus, the ureteroscope 100 may have different configurations for use as a gastrointestinal, colonoscopic, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), or other suitable application. Applications of the ureteroscope 100 include diagnostic observations associated with endometrial polyps, infertility, abnormal bleeding, and pelvic pain, as well as surgical procedures such as embryonic growth arrest and uterine malformations.

[0012] The ureteroscope 100 may include a receiving device or communication interface 150 (FIG. 2), generally located outside the catheter 104, for receiving signals from an image sensor in the optoelectronic module 109. For example, the catheter 104 may include at least one electrical lead 162 (FIG. 2) coupled to the optoelectronic module 109 and transmitting electrical signals from the optoelectronic module 109 to the communication interface 150. The communication interface 150 may be positioned within or adjacent to the handpiece 110.

[0013] The catheter 104 may be configured to couple the optoelectronic module 109 to the circuitry in the handpiece 110 in any suitable manner. For example, the availability of low-cost modular imaging system components allows for the manufacture of disposable components of the ureteroscope 100 at a very low cost. In one embodiment, the catheter 104 is configured to removably couple the optoelectronic module 109 to the circuitry in the handpiece 110. In this manner, the catheter 104 and optoelectronic module 109 are disposable and may be removed from the handpiece 110 after a single patient use, thereby eliminating the need for sterilization or reprocessing and reducing the risk of contamination. The handpiece 110 may be sterilized for subsequent reuse with the catheter 104 and optoelectronic module 109 for a different patient.

[0014] Returning to FIG. 1A, the endoscopic system 10 may include one or more electronic devices for processing and displaying image data received from the optoelectronic module 109 of the ureteroscope 100. For example, the endoscopic system 10 may include one or more of a host machine 170 having a microprocessor, a computer 180 having a microprocessor, and a display 190. The host machine 170 may be connected to one or more terminals of the computer 180 and the display 190 for further processing and displaying image data from the optoelectronic module 109. The host machine 170 or the computer 180 may be programmed with image processing software that takes as input image data output from the optoelectronic module 109 of the ureteroscope 100 and generates a two-dimensional or three-dimensional reconstruction of a body lumen that can be displayed on the display 190. Thus, a processor in at least one of the host machine 170, the computer 180, or the display 190 may be programmed with software that receives as input a plurality of still images of an object generated by the optoelectronic module 109, and then outputs a three-dimensional rendering of the object for display based on the plurality of still images. Display 190 may include any suitable display and may be configured to display moving images (movies) or still images collected by the image sensor of optoelectronic module 109. Although shown as separate blocks in Figure 1A, host machine 170, computer 180 and display 190 may comprise a single device, two devices, three devices or more than three devices.

[0015] The endoscopic system 10 may also include a cable 102 configured to operatively couple the ureteroscope to at least one of a host machine 170, a computer 180, or a display 190. The cable 102 may electrically couple a communication interface 150 (FIG. 2) of the ureteroscope 100 to at least one of the host machine 170, the computer 180, or the display 190. The cable 102 may also enable the communication interface 150 to communicate with and receive power from the host machine 170 or other power source. The cable 102 may also be configured to enable the communication interface 150 to transmit image data captured in the optoelectronic module 109 to the host machine 170 for processing, storage, and display.

[0016] Referring to FIG. 2 , which shows a side view of the handpiece 110 with a portion of the handpiece 110, the ureteroscope 100 may include a communication interface 150 or host interface housed within the handpiece 110. The communication interface 150 may contain, for example, one or more of a processor board, a camera board and a frame grabber, or a power supply. The processor board may be coupled to a host machine 170 by a cable 102 for storage and retrieval of images generated by the ureteroscope 100. The communication interface 150 may also be configured to communicate with and receive power from the host machine 170 or other power source via the cable 102. The communication interface 150 may also transmit image data captured at the distal end 105 to the host machine 170 for processing, storage and display. The communication interface 150 may be connected to the cable 102 through one or more wires 154 and / or to the optoelectronic module 109 through one or more electrical leads 162.

[0017] Alternatively or in addition, the communication interface 150 or handpiece 110 may include an antenna and a wireless chipset, e.g., compliant with the IEEE 802.11 WiFi standard, for wirelessly transmitting video or still images generated by the ureteroscope 100 to the host machine 170, computer 180, or display 190 without the cable 102. For example, the communication interface 150 may include a wireless interface configured to implement various protocols, including, but not limited to, Wi-Fi, Bluetooth, ZigBee, Z-Wave, and the like. This configuration may be useful in a physician's office, as it allows the computer and display to be located outside of the sterile field while allowing the physician greater maneuverability during use of the ureteroscope 100. In other embodiments, the communication interface 150 may be omitted and image data may be transmitted directly to the host machine 170 and / or computer 180.

[0018] The ureteroscope 100 may include one or more controls 122 positioned at or near the control end 112 of the handpiece 110. In some embodiments, at least one of the one or more controls 122 is positioned between the control end 112 and the catheter end 114. For example, at least one (e.g., all) of the one or more controls 122 may be positioned closer to the catheter end 114 than the control end 122, such as near the working channel port 118. The one or more controls 122 may include one or more of a switch, a button, a rotatable knob, a movable tab, or the like. The one or more controls may be electrically coupled to the communication interface 150 through one or more wires 154, 156. In some embodiments, the one or more controls 122 are configured to adjust a view presented on the display 190. For example, the one or more controls may be configured to adjust at least one of the brightness, zoom, focus, or contrast of one or more images displayed on the display 190. Thus, the one or more controls 122 allow a user to adjust the views presented on the display 190 and / or computer 180 as needed during use of the ureteroscope 100 according to the user's preferences.

[0019] The ureteroscope 100 may include one or more wires coupling the one or more controls 122 to the opto-electronic module 109 and / or the control system 200 to enable a user to adjust at least one of the brightness, zoom, focus, or contrast on the opto-electronic module 109. For example, at least one of the one or more controls 122 may be connected to the opto-electronic module 109 through the communication interface 150 and / or the control system 200, as well as one or more wires connected to at least one of the one or more controls 122 and electrical leads 162 connected to the communication interface 150 and the opto-electronic module 109. In some embodiments, one or more wires or electrical leads may be directly connected to the opto-electronic module 109 and at least one of the one or more controls 122. Coupling the one or more controls 122 to the communication interface 150 may enable a user to adjust at least one of the brightness, zoom, focus, or contrast on the display 190 wirelessly or through the cable 102.

[0020] In some embodiments, the processor of the host machine 170 or another processor coupled to the ureteroscope 100 is configured to display one or more view settings on the display 190. The one or more view settings may be displayed in response to activation of one or more controls 122, or alternatively, additional buttons on the handpiece 110 or the display 190. The one or more view settings displayed on the display 190 and / or the computer 180 may include at least one of brightness, zoom, contrast, or focus. For example, a brightness setting may be displayed on the display 190 in response to activation of at least one of the one or more controls 122. After the brightness setting is displayed on the display 190, the user may adjust the brightness of one or more images displayed on the display 190 using at least one of the one or more controls. Other view settings may be similarly displayed on the display 190 and adjusted by the user using one or more controls 122. In some embodiments, the one or more view settings may also be displayed on a processor display in the handpiece 110 or the host machine 170.

[0021] In some embodiments, at least one of the controls 122 is configured to activate (e.g., turn on) or deactivate (e.g., turn off) at least one light source 111 (FIG. 1B) at the distal end 105 of the catheter 104. For example, the light source 111 may include a light emitting diode (LED) positioned at the distal end 105 of the catheter. Alternatively or additionally, the ureteroscope 100 may include an LED light source positioned elsewhere, such as in the handpiece 110, that provides illumination to the at least one light source 111 at the distal end 105 via one or more sets of optical fibers extending through the catheter 104. In some use cases, it is desirable to completely turn off at least one light source 111 of the ureteroscope 100 during backloading of the ureteroscope 100 over the guidewire, rather than simply incrementally adjusting the light. Thus, at least one of the one or more controls allows a user to selectively turn the light source 111 off and on when desired.

[0022] In some embodiments, at least one of the one or more controllers 122 may be configured to activate and deactivate the optoelectronic module 109. At least one of the one or more controllers 122 may also be configured to switch an image mode in at least one of the optoelectronic module 109, the ejection device 150, or the one or more electronic devices between a still image mode in which a still image is recorded and a video image mode in which a video stream is recorded. At least one of the one or more controllers 122 may also be configured to activate a frame grabber mode in at least one of the optoelectronic module 109, the ejection device 150, or the one or more electronic devices to generate a still image from a video stream output generated by the optoelectronic module 109. For example, at least one of the one or more controllers 122 may be configured to communicate with one or more of the host machine 170, the computer 180, or the display 190 to enable a user to create a still image from a video stream displayed on the display 190 and store or record the still image in at least one of the host machine 170 or the computer 180.

[0023] In some embodiments, at least one of the one or more controls 122 is configured to activate and deactivate the control system 200. In at least one, some, or all embodiments, at least one of the one or more controls 122 may activate the control system 200 to provide a technical effect that allows a user to control the active bending portion 106 by moving the hand piece 110, and at least one of the one or more controls 122 may deactivate the control system 200 such that movement of the hand piece 110 does not control the active bending portion 106. In at least one, some, or all embodiments, at least one of the one or more controls 122 may activate the control system 200 to provide a technical effect that allows a user to control at least one of brightness, zoom, contrast, or focus by moving the hand piece 110, and at least one of the one or more controls 122 may deactivate the control system 200 such that movement of the hand piece 110 does not control at least one of brightness, zoom, contrast, or focus. In at least one, some, or all embodiments, at least one of the one or more controls 122 may activate the control system 200 to provide a technical effect of allowing a user to control switching between still image mode and video image mode by moving the hand piece 110, and at least one of the one or more controls 122 may deactivate the control system 200 such that movement of the hand piece 110 does not control switching between still image mode and video image mode. In at least one, some, or all embodiments, at least one of the one or more controls 122 may activate the control system 200 to provide a technical effect of allowing a user to control activation and deactivation of the at least one light source 111 by moving the hand piece 110, and at least one of the one or more controls 122 may deactivate the control system 200 such that movement of the hand piece 110 does not control activation and deactivation of the at least one light source 111.In at least one, some, or all embodiments, at least one of the one or more controls 122 may activate control system 200 to provide the technical effect of allowing a user to initiate a frame grab to record a still image during video stream mode by moving the handpiece, and at least one of the one or more controls 122 may deactivate control system 200 such that movement of the handpiece does not initiate a frame grab during video stream mode.

[0024] The ureteroscope 100 may operate to perform or complete selected tasks manually, automatically, or a combination thereof. Some ureteroscope functions may be implemented through the use of components including hardware, software, firmware, or a combination thereof. General-purpose components such as a general-purpose computer or oscilloscope may be used in the ureteroscope 100, but dedicated or custom components such as circuits, integrated circuits, or software may also be used. For example, some functions are implemented with a number of software instructions executed by one or more data processors that are part of a general-purpose or custom computer. The one or more data processors may be in at least one of the communication interface 150, the host machine 170, the computer 180, or the display 190. In some embodiments, the data processor or computer includes a volatile memory for storing instructions and / or data and / or non-volatile storage, such as a magnetic hard disk and / or a removable medium for storing instructions and / or data. In some embodiments, the implementation includes a network connection. In some embodiments, the implementation includes a user interface, generally including one or more input devices (e.g., allowing for input of commands and / or parameters), and output devices (e.g., allowing for reporting of operation and result parameters).

[0025] According to one embodiment, the hand piece 110 also includes a working channel port 118 and a working channel opening 107 (FIG. 1B) that provide fluid communication between the working channel port 118 and the distal end 105 of the catheter 104. The hand piece 110 may also include a working channel connector 130 connected or attached to the working channel port 118 and the working channel 152 (FIG. 2) that provides fluid communication between the working channel port 118 and the working channel opening 107 through the hand piece 110 and / or the catheter 104. The working channel port 118, the working channel connector 130, and the working channel 152 are optional and may not be present in some embodiments. The working channel 152 may include a single continuous material that runs through the hand piece 110 and the catheter 104. In some embodiments, the working channel 152 includes a first portion within an interior region 155 of the hand piece 110 and a second portion within the catheter 104. The first and second portions of the catheter 152 may include different materials or configurations that are fluidly connected to one another. At least one of the working channel port 118 or working channel connector 130 is configured to engage various surgical instruments and cleaning devices, as needed, for operations such as stone fragmentation and removal. The working channel port 118 may be positioned near the catheter end 114 of the hand piece 110, at the lower / bottom or upper / top of the hand piece 110. The working channel port 118 may be positioned less than half the distance from the catheter end 114 to the control end 112, less than one-third the distance from the catheter end 114 to the control end 112, less than one-quarter the distance from the catheter end 114 to the control end 112, or less than one-fifth the distance from the catheter end 114 to the control end 112.

[0026] The hand piece 110 may also include a cable port 120 (FIG. 1A) for receiving or connecting the cable 102 to operatively couple the ureteroscope 100 to at least one of a host machine 170, a computer 180, or a display 190. Also, both the cable port 120 and the working channel port 118 may be positioned on a lower or bottom portion of the hand piece 110 near the catheter end 114 of the hand piece 110. For example, both the cable port 120 and the working channel port 118 may be positioned less than half the distance from the catheter end 114 to the control end 112, less than one-third the distance from the catheter end 114 to the control end 112, less than one-quarter the distance from the catheter end 114 to the control end 112, or less than one-fifth the distance from the catheter end 114 to the control end 112. Alternatively, the hand piece 110 may further include a miniature battery module for powering the optoelectronic module 109 and the at least one light source 111. The power source in handpiece 110 may be, for example, one or more conventional disposable dry batteries or lithium ion secondary batteries.

[0027] 1-3 includes a cable port 120 positioned near the catheter end 114 and distal from the control end 112, in some embodiments the cable port 120 is not in the handpiece 110 or is positioned near the control end 112 and distal from the catheter end 114. Thus, in some embodiments the cable port 120 is not in the handpiece 110 or is positioned near the control end 112, but the handpiece 110 includes one or more controls 122 positioned at the control end 112 of the handpiece 110 and a working channel port 118 disposed on a curved first surface along a longitudinal centerplane near the catheter end 114. In yet other embodiments, the one or more controls 122 are not on the handpiece 110 and the cable port 120 is not on the handpiece 110 or is positioned near the control end 112, but the handpiece includes a working channel port 118 disposed on a curved first surface along the longitudinal control surface near the catheter end 114.

[0028] Additionally, although the ureteroscope 100 shown in FIGS. 1-3 includes a working channel port 118 disposed on a curved first surface along a longitudinal centerline near the catheter end 114 and distal from the control end 112, in some embodiments, the working channel port 118 may be disposed elsewhere on the handpiece 110. Thus, in some embodiments, the working channel port 118 may be disposed other than along a longitudinal centerline near the catheter end 114, but the handpiece may include one or more controls 122 positioned at the control end 112 of the handpiece 110 and a cable port 120 positioned near the catheter end 114. In still other embodiments, the one or more controls 122 are absent from the handpiece 110, and the working channel port 118 may be disposed other than along a longitudinal centerline near the catheter end 114, but the handpiece 110 includes a cable port 120 positioned near the catheter end 114. In some embodiments, the cable port 120 may be absent from the handpiece 110 or positioned near the control end 112, and the working channel port 118 may be disposed other than along the longitudinal center plane near the catheter end 114, but the handpiece 110 includes one or more controls 122 positioned at the control end 112 of the handpiece 110.

[0029] 2, the endoscopic system 10 may include a control system 200. In some embodiments, the control system 200 is primarily a catheter control system configured to control the bending of the active bending section 106 of the catheter 104 in response to movement or motion of the hand piece 110. The control system 200 may also or alternatively control other aspects of the endoscopic system 10 in response to movement or motion of the hand piece 110, such as activating and / or deactivating the light source 111, activating and / or deactivating the image sensor of the optoelectronic module 109, changing the image acquisition mode of the image sensor from a still image mode to a video stream mode, activating a frame grab to record a still image while in the video stream mode, adjusting the zoom of the image sensor, deploying a tool in the working channel 152, and / or adjusting at least one of the brightness, zoom, focus, or contrast of one or more images from the image sensor that are displayed on the display 190.

[0030] In some embodiments, the control system 200 includes at least a sensor 202 positioned within the interior region 155 of the hand piece 110. The sensor 202 may be configured to detect at least one (e.g., all) of the movement of the hand piece 110, the direction of movement of the hand piece 110, and / or the magnitude of movement of the hand piece 110. In some embodiments, the sensor 202 includes at least one of an accelerometer, a MEMS sensor, and / or a gyroscope. In some embodiments, the sensor 202 includes any sensor configured to detect at least one (e.g., all) of the movement of the hand piece 110, the direction of movement of the hand piece 110, and / or the magnitude of movement of the hand piece 110.

[0031] In some embodiments, the sensor 202 is configured to detect at least directional movement of at least a portion of the hand piece 110. For example, the sensor 202 may be configured to detect directional movement of the portion of the hand piece 110 (e.g., the control end 112) in at least two directions, such as a first hand piece direction and a second hand piece direction different from the first hand piece direction. More specifically, the sensor 202 may be configured to detect directional movement of the portion of the hand piece 110 (e.g., the control end 112) in upward and downward directions and / or right and left directions relative to a starting point of the portion of the hand piece 110. In some embodiments, the sensor 202 is configured to detect directional movement of the portion of the hand piece 110 (e.g., the control end 112) in three or more directions. For example, the sensor 202 may be configured to detect movement of the portion of the hand piece 110 (e.g., the control end 112) in a Cartesian coordinate system of x, y, z.

[0032] In some embodiments, the sensor 202 is configured to detect at least the magnitude of movement or motion of at least a portion of the hand piece 110. For example, the sensor 202 may be configured to detect how far and / or how quickly a portion of the hand piece 110 (e.g., the control end 112) has moved in a direction relative to an initial starting point. More specifically, the sensor 202 may be configured to detect how far and / or how quickly a portion of the hand piece 110 (e.g., the control end 112) has moved (e.g., its speed) in a first hand piece direction relative to an initial starting point, and also to detect how far and / or how quickly that portion of the hand piece 110 has moved in a second hand piece direction relative to the initial starting point of that portion of the hand piece 110.

[0033] In at least one, some, or all embodiments, the sensor 202 is positioned within the interior region 155, at least near the control end region 112 (e.g., the proximal end region) of the hand piece 110. Positioning the sensor 202 near or within the control end region 112 of the hand piece 110 results in the technical effect of allowing the sensor to detect movement or motion of the control end region 112 as the user pivots the control end region 112 about an axis generally defined by the catheter end 114 of the hand piece 110. The catheter end 114 of the hand piece 110 may remain substantially motionless or move less than the control end region 112, thus avoiding potential discomfort to the subject due to movement of the catheter end 114 and catheter 104 as the hand piece 110 moves. 3A-3B show, for example, that the control end 112 can be pivoted about an axis generally defined by the catheter end 114 and / or the handpiece-catheter connector 103 to move the active bending portion 106 on the catheter 104, while the catheter end 114 and / or the handpiece-catheter connector 103 remain substantially motionless or move less than the control end 112.

[0034] The control system 200 also includes a processor (e.g., microprocessor) 250 configured to communicate with at least the sensor 202. In the ureteroscope 100, the processor 250 is positioned at the control end 112 near the sensor 202. In some embodiments, the processor 250 is positioned elsewhere within the interior region 155 of the handpiece 110, such as being included with the communications interface 150. In some embodiments, the processor 250 may be included with one or more of the host machine 170, the computer 180 and / or the display 190.

[0035] According to one embodiment, the processor 250 is configured to receive data or signals from the sensor 202. For example, as described in more detail above, the processor 250 may be configured to receive data from the sensor 202 that is at least partially related to at least one (e.g., all) of the movement of the hand piece 110, the direction of the movement of the hand piece 110, and / or the magnitude of the movement of the hand piece 110 detected by the sensor 202. The processor 250 may be configured to use the data received from the sensor 202 to determine at least one (e.g., all) of the movement of the hand piece 110, the direction of the movement of the hand piece 110, and / or the magnitude of the movement of the hand piece 110. According to one embodiment, the processor 250 is configured to use this data received from the sensor 202 to adjust the movement of the active flexure 106 in response to the movement of at least a portion of the hand piece 110. The processor 250 may be configured to use this data received from the sensor 202 to, in response to movement of at least a portion of the handpiece 110, activate and / or deactivate the light source 111, activate and / or deactivate the image sensor of the optoelectronic module 109, change the image collection mode of the image sensor from a still image mode to a video stream mode, activate a frame grab to record a still image while in the video stream mode, adjust the zoom of the image sensor, coordinate the deployment of a tool in the working channel 152, and / or adjust at least one of the brightness, zoom, focus or contrast of one or more images from the image sensor displayed on the display 190.

[0036] In some embodiments, the processor 250 is configured to use the data received from the sensor 202 to program or otherwise command one or more actuators to move the active bending portion 106 in response to movement of at least a portion of the hand piece 110. For example, the ureteroscope may include a servo actuator and / or a linear actuator configured to move the active bending portion 106 in response to movement of at least a portion of the hand piece 110. According to one embodiment, in some embodiments, the control system 200 includes a motor 206 positioned in an interior region of the hand piece 110 and operatively coupled to the sensor 202 and / or the processor 250. The processor 250 may be configured to activate the motor 206 when the sensor 202 detects movement of the hand piece 110. For example, the motor 206 may be positioned in an interior region 155 of the hand piece 110 and operatively coupled to the sensor 202, with the motor 206 configured to be activated in response to the sensor 202 detecting movement of the hand piece 110. In some embodiments, the control system 200 comprises a driver 204 operatively coupled to a processor 250 and a motor 206. In some embodiments, the processor 250 is configured to coordinate movement of the driver 204 and is effective to adjust or move the motor 206 in response to movement of at least a portion of the handpiece 110 to move the active flexure 106. In some embodiments, the driver 204 comprises a stepper driver and the motor 206 comprises a stepper motor.

[0037] The ureteroscope 100 may also include one or more wires 158 secured to the active bending portion 106 of the catheter 104 and adjustable (e.g., movable or tightened) in response to activation of the motor 206, effective to at least partially bend the active bending portion 106 of the catheter 104. The one or more wires 158 may be secured directly to the motor 206 or may be secured to one or more components (such as a wire wheel 207) secured directly or indirectly to the motor 206. The one or more wires 158 are secured to the active bending portion 106 such that when the motor 206 turns or rotates in a first direction, a first wire (or a first portion) of the one or more wires 158 pulls the active bending portion 106 in a first bending direction, and when the motor 206 turns or rotates in a second (or opposite) direction, a second wire (or a second portion) of the one or more wires 158 pulls the active bending portion 106 in a second (or opposite) direction. In some embodiments, the one or more wires 158 are configured to move or bend the active bending portion 106 in more than two directions, for example, to move or bend the active bending portion 106 on an x, y, z Cartesian coordinate system in response to movement of a portion of the hand piece (e.g., the control end 112) on the x, y, z Cartesian coordinate system.

[0038] The degree of bending in the active bending section 106 in either the first bending direction or the second bending direction may be determined by the extent of rotation of the motor 206 in the first direction or the second direction, respectively. In some embodiments, when the motor 206 turns or rotates in a first direction, a first wire (or a first portion) of the one or more wires 158 is tightened, effective to pull the active bending section 106 towards the first bending direction, and when the motor 206 turns or rotates in a second (or opposite) direction, a second wire (or a second portion) of the one or more wires 158 is tightened, effective to pull the active bending section 106 towards the second (or opposite) bending direction. In some embodiments, the motor 206 includes a wire wheel 207 rotatable in a first direction and a second (opposite) direction, with one or more wires fixed directly to the wire wheel 207.

[0039] Reference is now made to Figures 3A-3B, which illustrate movement of the active bending section 106 in response to movement of at least a portion of the handpiece 110, according to one embodiment. To use and operate the control system 200, a user (e.g., a ureteroscope operator) may selectively activate the control system 200 using at least one of the one or more controls 122 in the handpiece 110. For example, the user may press, rotate, turn, flip, or otherwise adjust at least one of the one or more controls 122 to activate the control system 200. When the control 122 activates the control system 200, the motor 206 adjusts one or more wires 158 in response to the sensor 202 detecting movement of the handpiece 110.

[0040] For example, with particular reference to FIG. 3A, when the control system 200 is activated, a user may move the control end 112 in a first handpiece direction (upward in FIG. 3A), etc. A sensor 202 at the control end 112 detects the movement of the control end 112 in the first handpiece direction, and the processor 250 receives data from the sensor 202 related to the movement of the control end 112 in the first handpiece direction. Based on this data from the sensor 202, the processor 250 coordinates the movement of the driver 204 and the motor 206, which is effective to at least achieve the technical effect of moving, adjusting, or tightening the first portion or first wire of the one or more wires 158. This moving, adjusting, or tightening of the first portion or first wire of the one or more wires 158 causes the active bending portion 106 to at least partially bend in a first bending direction. 3A, in some embodiments, the first hand piece direction of movement of the control end 112 is generally opposite to the first bending direction of bending of the active bending portion 106. In some embodiments, the first hand piece direction of movement of the control end 112 is generally the same as the first bending direction of bending of the active bending portion 106. As explained above, the sensor 202 may also detect the magnitude (e.g., amount and / or speed) of the movement of the control end 112, and the processor 250 receives data from the sensor 202 related to the magnitude of movement of the control end 112 in the first hand piece direction. Based on this data from the sensor 202, the processor 250 coordinates the magnitude of movement of the driver 204 and the motor 206, which in turn is effective to achieve the technical effect of at least moving, adjusting, or tightening the first portion or first wire of the one or more wires 158, correlating with the magnitude of movement of the control end 112 in the first hand piece direction. For example, moving or pivoting the control end 112 a first amount in a first handpiece direction causes the active bending portion 106 to bend a first amount, and moving or pivoting the control end 112 a second amount in the first handpiece direction that is greater than the first amount causes the active bending portion 106 to bend a second amount that is greater than the first amount of bending in the active bending portion 106.

[0041] With particular reference to FIG. 3B, when the control system 200 is activated, the user may move the control end 112 in a second hand piece direction (downward in FIG. 3B), etc. A sensor 202 at the control end 112 detects the movement of the control end 112 in the v direction, and the processor 250 receives data from the sensor 202 related to the movement of the control end 112 in the second hand piece direction. Based on this data from the sensor 202, the processor 250 coordinates the movement of the driver 204 and the motor 206, which is effective to at least achieve the technical effect of moving, adjusting, or tightening the second portion or second wire of the one or more wires 158. This moving, adjusting, or tightening of the second portion or second wire of the one or more wires 158 causes the active bending portion 106 to at least partially bend in the second bending direction. 3B, in some embodiments, the second hand piece direction of movement of the control end 112 is generally opposite to the second bending direction of the active bending portion 106. In some embodiments, the second hand piece direction of movement of the control end 112 is generally the same as the second bending direction of the active bending portion 106. As explained above, the sensor 202 may also detect the magnitude (e.g., amount and / or speed) of the movement of the control end 112, and the processor 250 receives data from the sensor 202 related to the magnitude of movement of the control end 112 in the second hand piece direction. Based on this data from the sensor 202, the processor 250 coordinates the magnitude of movement of the driver 204 and the motor 206, which in turn is effective to achieve the technical effect of at least moving, adjusting, or tightening the second portion or second wire of the one or more wires 158, correlating with the magnitude of movement of the control end 112 in the second hand piece direction. For example, moving or pivoting the control end 112 a first amount in the second handpiece direction causes the active bending portion 106 to bend a first amount, and moving or pivoting the control end 112 a second amount greater than the first amount in the second handpiece direction causes the active bending portion 106 to bend a second amount greater than the first amount of bending in the active bending portion 106.When the user deactivates the control system 200 using at least one of the one or more controls 122, the motor 206 does not adjust the one or more wires 158 in response to the sensor 202 detecting movement of the handpiece 110 or the sensor 202 does not detect movement of the handpiece 110.

[0042] In use, at least one of the one or more controls 122 may be configured to activate the control system 200 for control of mechanisms other than the active bending portion 106 of the catheter 104. For example, the configuration of at least one of the one or more controls 122 may result in a technical effect of enabling at least one of the one or more controls 122 to activate the control system 200 for control of one or more of the light source 111, the image sensor of the optoelectronic module 109, the image acquisition mode of the image sensor, a frame grab, zoom of the image sensor, tool deployment in the working channel 152, and / or the brightness, zoom, focus or contrast of one or more images from the image sensor that are displayed on the display 190. In some embodiments, the one or more controllers 122 include multiple controllers, and different controllers of the multiple controllers are configured to activate the control system 200 to control different of the active bending portion 106 of the catheter, the light source 111, the image sensor of the optoelectronic module 109, the image acquisition mode of the image sensor, frame grabbing, zoom of the image sensor, tool deployment in the working channel 152, and / or the brightness, zoom, focus or contrast of one or more images from the image sensor that are displayed on the display 190.

[0043] In some embodiments, with the control system 200 activated for one or more light sources 111, a user may move the control end 112 in a first hand piece direction to provide the technical effect of activating one or more light sources 111 (without bending the active flexure 106), and a user may move the control end 112 in a second hand piece direction to provide the technical effect of deactivating one or more light sources 111. According to one embodiment, with the control system 200 activated for the image sensor of the optoelectronic module 109, a user may move the control end 112 in a first hand piece direction to provide the technical effect of activating the image sensor of the optoelectronic module (without bending the active flexure 106), and a user may move the control end 112 in a second hand piece direction to provide the technical effect of deactivating the image sensor of the optoelectronic module. According to one embodiment, with the control system 200 activated for the image acquisition mode of the endoscope system 10, the user may move the control end 112 in a first hand piece direction to provide the technical effect of changing the image acquisition mode of the image sensor to a still image mode (without bending the active flexure 106) and may move the control end 112 in a second hand piece direction to provide the technical effect of changing the image acquisition mode to a video stream mode. According to one embodiment, with the control system 200 activated for a frame grab, the user may move the control end 112 in either the first hand piece direction or the second hand piece direction to provide the technical effect of recording a still image during the video stream mode (without bending the active flexure 106). According to one embodiment, with the control system 200 activated for tool deployment, a user may move the control end 112 in a first handpiece direction to provide the technical effect of deploying a tool in the working channel 152 (without bending the active bending portion 106) and may move the control end 112 in a second handpiece direction to retract the tool into the working channel 152.According to one embodiment, with the control system 200 activated for display control, a user may move the control end 112 in a first handpiece direction to provide the technical effect of increasing at least one of the brightness, zoom, contrast and / or focus of one or more images from the image sensor displayed on the display 190 (without bending the active bending portion 106), and may move the control end 112 in a second handpiece direction to provide the technical effect of decreasing at least one of the brightness, zoom, contrast and / or focus of one or more images from the image sensor displayed on the display 190.

[0044] 4, in some embodiments, the ureteroscope 400 may include a steering controller 424 secured to the hand piece 110 and positioned at least partially outside the interior region 155 of the hand piece 110. The steering controller 424 may be operatively secured to the wire wheel 207 and selectively movable, and is effective to move the wire wheel 207 and adjust one or more wires 158 secured to the wire wheel 207 to bend the active bending portion 106 of the catheter 104. Unless otherwise noted, the ureteroscope 400 may include any aspect of the ureteroscope 100. For example, the ureteroscope 400 may include any aspect of the control system 200 described above. In some embodiments, the steering controller 424 is configured to selectively bend the active bending portion 106 in one or more first axes, and the control system 200 is configured to selectively bend the active bending portion 106 in one or more second axes different from the one or more first axes. In some embodiments, the ureteroscope 400 includes a steering controller 424, but the control system 200 is not configured to control bending of the active bending portion 106 of the catheter 104. That is, the ureteroscope 400 may include a steering controller 424 for controlling bending of the active bending portion 106 of the catheter 104, and may include a control system 200 for controlling one or more of the light source 111, the image sensor of the optoelectronic module 109, the image acquisition mode of the image sensor, frame grab, zoom of the image sensor, tool deployment in the working channel 152, and / or brightness, zoom, focus, or contrast of one or more images from the image sensor that are displayed on the display 190.

[0045] The systems and methods described herein may include a controller for executing one or more aspects of the systems and methods. For example, a controller may be used to perform one or more operations performed by the processor in the systems and methods described herein. Additionally, the processor 250, the communication interface 150 in the handpiece 110, the host machine 170, the computer 180, and / or the display 190 in the endoscopic system 10 may utilize or otherwise include a controller. For example, the processor 250 described in connection with the endoscopic system 10 may include or utilize a controller. FIG. 5 is a schematic diagram of a controller 500 that may be utilized in any of the exemplary systems and methods described herein, according to one embodiment. The controller 500 may be configured to perform one or more operations of any of the exemplary methods and systems disclosed herein. The controller 500 includes at least one computing device 510. The at least one computing device 510 is an exemplary computing device that may be configured to perform one or more of the operations described above, such as operation 415 of the method 400. At least one computing device 510 may include one or more servers, one or more computers (e.g., desktop computers, laptop computers), or one or more mobile computing devices (e.g., smartphones, tablets, etc.). The computing device 510 may include at least one processor 520, memory 530, storage devices 540, input / output ("I / O") devices / interfaces 550, and communication interfaces 560. Although an exemplary computing device 510 is illustrated in FIG. 5, the components illustrated in FIG. 5 are not intended to limit the controller 500 or computing device 510. In some examples, additional or alternative components may be used. Furthermore, in some examples, the controller 500 or computing device 510 may include fewer components than those illustrated in FIG. 5.For example, the controller 500 may not include the one or more additional computing devices 512. In some examples, the at least one computing device 510 may include multiple computing devices, such as a server farm, a computing network, or a cluster of computing devices. The components of the computing device 510 shown in FIG. 5 are described in further detail below.

[0046] In some examples, the processor 520 includes hardware for executing instructions, such as instructions constituting a computer program (e.g., instructions for performing one or more portions of the methods disclosed herein). For example, to execute instructions, the processor 520 may retrieve (or fetch) instructions from an internal register, an internal cache, memory 530, or storage device 540, decode and execute them. By way of example, the processor 520 may include one or more instruction caches, one or more data caches, and one or more translation lookaside buffers (TLBs). Instructions in an instruction cache may be copies of instructions in memory 530 or storage device 540. In some examples, the processor 520 may be configured to perform one or more portions of any of the example methods and systems disclosed herein (e.g., including instructions stored on or executed by the processor 520).

[0047] In some examples, the processor 520 is configured to perform any of the operations disclosed herein and / or to cause one or more portions of the computing device 510 or the controller 500 to perform at least one of the operations disclosed herein. Such a configuration may include one or more operating programs (e.g., computer program products) executable by at least one processor 520. For example, the processor 520 may be configured to automatically identify received data or signals from the sensor 202 and coordinate movement of the motor 206 to selectively bend the active bending portion 106.

[0048] At least one computing device 510 (e.g., a server) may include at least one memory storage medium (e.g., memory 530 and / or storage device 540). The computing device 510 may include memory 530 operatively coupled to the processor 520. The memory 530 may be used to store data, metadata, and programs for execution by the processor 520. The memory 530 may include one or more of volatile and non-volatile memory, such as random access memory (RAM), read-only memory (ROM), solid-state disk (SSD), flash, phase-change memory (PCM), or other types of data storage. The memory 530 may be internal or distributed memory.

[0049] The computing device 510 may include a storage device 540 having storage for storing data or instructions. The storage device 540 may be operatively coupled to at least one processor 520. In some examples, the storage device 540 may include a non-transitory memory storage medium, such as any of those described above. The storage device 540 (e.g., a non-transitory storage medium) may include a hard disk drive (HDD), a floppy disk drive, a flash memory, an optical disk, a magneto-optical disk, a magnetic tape, or a universal serial bus (USB) drive, or a combination of two or more of these. The storage device 540 may include a removable or non-removable (or fixed) medium. The storage device 540 may be internal or external to the computing device 510. In some examples, the storage device 540 may include a non-volatile solid-state memory. In some examples, the storage device 540 may include a read-only memory (ROM). Where appropriate, the ROM may be a mask-programmed ROM, a programmable ROM (PROM), an erasable PROM (EPROM), an electrically erasable PROM (EEPROM), an electrically alterable programmable ROM (EAROM), or a flash memory, or a combination of two or more of these. In some examples, one or more portions of the memory 530 and / or the storage device 540 (e.g., a memory storage medium) may store one or more databases.

[0050] In some examples, data from one or more sensors of endoscopic system 10 may be stored in a memory storage medium, such as, for example, at least one processor 520 (e.g., an internal cache of the processor), memory 530, or one or more of storage devices 540. In some examples, at least one processor 520 may be configured to access (e.g., via bus 570) a memory storage medium, such as one or more of memory 530 or storage devices 540. For example, at least one processor 520 may receive and store data (e.g., a lookup table) as multiple data points in the memory storage medium.

[0051] The computing device 510 also comprises one or more I / O devices / interfaces 550 provided to enable a user to provide input, receive output, and otherwise transfer data to and from the computing device 510. These I / O devices / interfaces 550 may include a mouse, a keypad or keyboard, a touch screen, a camera, an optical scanner, a network interface, web-based access, a modem, a port, other known I / O devices, or a combination of such I / O devices / interfaces 550. The touch screen may be activated by a stylus or a finger.

[0052] The I / O device / interface 550 may include one or more devices for presenting output to a user, including, but not limited to, a graphics engine, a display (e.g., a display screen or monitor), one or more output drivers (e.g., a display driver), one or more audio speakers, and one or more audio drivers. In some examples, the I / O device / interface 550 is configured to provide graphics data to a display for presentation to a user. The graphics data may represent one or more graphical user interfaces and / or any other graphical content as long as it is capable of serving a particular implementation.

[0053] The computing device 510 may further include a communication interface 560. The communication interface 560 may include hardware, software, or both. The communication interface 560 may provide one or more interfaces for communication (e.g., packet-based communication, etc.) between the computing device 510 and one or more additional computing devices 512 or one or more networks. For example, the communication interface 560 may include a network interface controller (NIC) or network adapter for communicating with an Ethernet or other wire-based network, or a wireless NIC (WNIC) or wireless adapter for communicating with a wireless network such as WI-FI, etc.

[0054] Any suitable network and any suitable communication interface 560 may be used. For example, the computing device 510 may communicate with one or more portions of an ad-hoc network, a personal area network (PAN), a local area network (LAN), a wide area network (WAN), a metropolitan area network (MAN), or the Internet, or a combination of two or more of these. One or more portions of one or more of these networks may be wired or wireless. By way of example, the controller 500 or one or more portions of the computing device 510 may communicate with a wireless PAN (WPAN) (e.g., a BLUETOOTH WPAN, etc.), a WI-FI network, a WI-MAX network, a cellular telephone network (e.g., a Global System for Mobile Communications (GSM) network, etc.), or other suitable wireless network, or a combination of two or more of these. The computing device 510 may include any suitable communication interface 560 for any of these networks, where appropriate.

[0055] Computing device 510 may include a bus 570. Bus 570 may include hardware, software, or both that couples components of computing device 510 to one another. For example, bus 570 may include an Accelerated Graphics Port (AGP) or other graphics bus, an Enhanced Industry Standard Architecture (EISA) bus, a Front Side Bus (FSB), a HYPERTRANSPORT (HT) interconnect, an Industry Standard Architecture (ISA) bus, an INFINIBAND interconnect, a Low Pin Count (LPC) bus, a memory bus, a MicroChannel Architecture (MCA) bus, a Peripheral Component Interconnect (PCI) bus, a PCI Express (PCIe) bus, a Serial Advanced Technology Attachment (SATA) bus, a Video Electronics Standards Association Local (VLB) bus, or another suitable bus, or a combination of two or more of these.

[0056] FIG. 6 is a flow diagram of a method 600 of operating a ureteroscope system, according to an embodiment. The method includes an operation 605 of inserting at least a distal end of a ureteroscope catheter into a patient, the distal end of the catheter including an image sensor and a bending section. The method includes an operation 610 of detecting movement of the hand piece with a sensor positioned in an interior region of the hand piece. The method includes an operation 615 of at least partially bending an active bending section of the catheter in response to detecting movement of the hand piece. The ureteroscope may include any ureteroscope described herein. For example, the ureteroscope may include a motor positioned in an interior region of the hand piece and operatively coupled to the sensor. The motor may be configured to be activated in response to the sensor detecting movement of the hand piece, with one or more wires secured to the active bending section of the catheter and adjustable in response to activation of the motor, effective to at least partially bend the active bending section of the catheter. In some embodiments, the method may include an operation of activating a catheter control system with a control positioned on the hand piece.

[0057] In some embodiments, the hand piece comprises a working channel port positioned near the distal end region and a cable port, and the catheter comprises a working channel in fluid communication with the working channel port and an image sensor positioned at a distal end of the active bend distal to the hand piece. In these and other embodiments, the method 600 may further include an act of communicating with one or more electronic devices and providing power to at least one of the image sensor and the catheter control system using a cable connected to the hand piece at the cable port.

[0058] In some embodiments, operation 610 may include sensing, with a sensor, movement of the hand piece in a first hand piece direction, and operation 615 may include bending the active flexure at least partially in a first bending direction in response to sensing the movement of the hand piece in the first hand piece direction. In these and other embodiments, method 600 may include sensing, with a sensor, movement of the hand piece in a second hand piece direction, and bending the active flexure at least partially in a second bending direction in response to sensing the movement of the hand piece in the second hand piece direction. The first bending direction may be substantially opposite the first hand piece direction of movement of the hand piece, and the second bending direction may be substantially opposite the second hand piece direction of movement of the hand piece.

[0059] In some embodiments, operation 610 includes sensing a first magnitude of movement of the hand piece, and operation 615 includes bending the active flexure a first amount in response to sensing the first magnitude of movement of the hand piece. In these and other embodiments, method 600 may include an operation of sensing a second magnitude of movement of the hand piece with a sensor positioned in an interior region of the hand piece, the second magnitude of movement being greater than the first magnitude of movement. Method 600 may also include an operation of bending the active flexure a second amount in response to sensing the second magnitude of movement of the hand piece, the second amount of bending being greater than the first amount of bending.

[0060] In some embodiments, the method 600 further includes an act of at least partially bending an active bending section of the catheter by moving a steering controller secured to the hand piece and positioned at least partially outside an interior region of the hand piece. In some embodiments, the method 600 further includes an act of sensing movement of the hand piece in an additional direction with a sensor positioned in the interior region of the hand piece. In response to sensing movement of the hand piece in the additional direction, the method 600 may further include activating or deactivating one or more of a light at the distal end of the catheter, an image sensor, an image acquisition mode of the image sensor, a frame grab to record a still image during a video stream mode, a zoom adjustment of the image sensor, tool deployment in the working channel, and / or adjusting at least one of the brightness, zoom, focus, or contrast of one or more images from the image sensor that are displayed on a display.

[0061] The operations of method 600 described above are for illustrative purposes. For example, the operations of method 600 may be performed in a different order, divided into multiple operations, modified, supplemented, or combined. In embodiments, one or more of the operations of method 600 may be omitted from method 600. Any of the operations of method 600 may include using any of the handpiece 110, ureteroscopes 100 or 400, or systems 10 disclosed herein.

[0062] As used herein, the terms "about" or "substantially" refer to an acceptable variation of ±10% or ±5% of the term modified by "about" or "in an embodiment." Additionally, the terms "less than," "less than," "greater than," "greater than," or "more than" include the value modified by the term "less than," "less than," "greater than," or "more than" as an endpoint.

[0063] While various aspects and embodiments are disclosed herein, other aspects and embodiments are contemplated. The various aspects and embodiments disclosed herein are intended to be illustrative and not limiting.

Claims

1. 1. A ureteroscope system comprising: a handpiece having a proximal end region, a distal end region opposite the proximal end region, and an interior region; a catheter extending from the distal end region of the handpiece, the catheter including an active bending section distal to the handpiece; 1. A catheter control system comprising: a sensor positioned in the interior region of the handpiece and configured to detect movement of the handpiece; a motor positioned in the interior region of the handpiece and operatively coupled to the sensor, the motor configured to be activated in response to the sensor detecting movement of the handpiece; and one or more wires secured to the active bending portion of the catheter and adjustable in response to activation of the motor, the one or more wires being effective to at least partially bend the active bending portion of the catheter; A catheter control system comprising: A ureteroscope system comprising:

2. 2. The ureteroscope system of claim 1, the handpiece including a working channel port positioned near the distal end region and a cable port; the catheter includes a working channel in fluid communication with the working channel port and an image sensor positioned at a distal end of the active bend section distal to the handpiece; The ureteroscope system further comprises a cable connected or connectable to the handpiece at the cable port, the cable providing power to at least one of the image sensor and the catheter control system, and configured to communicate with one or more electronic devices.

3. 3. The ureteroscope system according to claim 1, 11. A ureteroscope system, comprising: a controller positioned on the handpiece and operatively coupled to the catheter control system, the controller configured to selectively activate and deactivate the catheter such that: (1) when the controller activates the catheter control system, the motor adjusts the one or more wires in response to the sensor detecting movement of the handpiece; and (2) when the controller deactivates the catheter control system, the motor does not adjust the one or more wires in response to the sensor detecting movement of the handpiece.

4. The ureteroscope system according to any one of claims 1 to 3, the sensor is configured to detect movement of the handpiece in a first handpiece direction and in a second handpiece direction different from the first handpiece direction; the motor is configured to adjust the one or more wires in response to movement of the handpiece in the first handpiece direction, effective to bend the active bending section in a first bending direction; The motor is configured to adjust the one or more wires in response to movement of the hand piece in the second hand piece direction, effective to bend the active bending portion in a second bending direction different from the first bending direction.

5. 5. The ureteroscope system of claim 4, the one or more wires include at least a first wire portion and a second wire portion each extending at least partially between the motor and the active flexure; the motor is configured to adjust the first wire portion in response to movement of the handpiece in the first handpiece direction, effective to bend the active bending section in the first bending direction; The ureteroscope system, characterized in that the motor is configured to adjust the second wire in response to movement of the hand piece in the first hand piece direction, effective to bend the active bending portion in the second bending direction.

6. The ureteroscope system according to claim 4 or 5, The ureteroscope system, wherein the first bending direction is substantially opposite to the first handpiece direction of movement of the handpiece, and the second bending direction is substantially opposite to the second handpiece direction of movement of the handpiece.

7. The ureteroscope system according to any one of claims 1 to 6, the sensor is configured to detect a magnitude of movement of the handpiece; The ureteroscope system, characterized in that the motor is configured to adjust the one or more wires approximately proportional to the magnitude of movement of the hand piece so that the active bending portion bends in proportion to the magnitude of movement of the hand piece.

8. The ureteroscope system according to any one of claims 1 to 7, The catheter control system includes a driver operably coupled to the sensor and the motor.

9. 9. The ureteroscope system of claim 8, The ureteroscope system, wherein the driver comprises a stepper driver and the motor comprises a stepper motor.

10. The ureteroscope system according to any one of claims 1 to 9, a wire wheel secured to the interior region of the handpiece and to the motor, one or more wires being secured to the wire wheel, the motor configured to rotate the wire wheel in one or more directions and effective to adjust the one or more wires in response to movement detected by the sensor.

11. The ureteroscope system of claim 10, The ureteroscope system further comprises a steering controller secured to the handpiece and positioned at least partially outside the interior region of the handpiece, the steering controller being operatively secured to the wire wheel and selectively movable and effective to move the wire wheel and adjust the one or more wires secured to the wire wheel to bend the active bending portion of the catheter.

12. The ureteroscope system according to any one of claims 2 to 11, A ureteroscope system further comprising a light at the distal end of the active bending portion, the sensor configured to detect movement of the handpiece in a further direction and effective to activate or deactivate the light, activate or deactivate the image sensor, change an image collection mode of the image sensor from a still image mode to a video stream mode, activate a frame grab to record a still image during the video stream mode, adjust the zoom of the image sensor, deploy a tool in the working channel, and / or adjust at least one of the brightness, zoom, focus or contrast of the one or more images from the image sensor that are displayed on a display.

13. 1. A method of operating a ureteroscope system, the method comprising: inserting at least a distal end of a ureteroscope catheter into a patient, the distal end of the catheter including an image sensor and an active bend; sensing movement of the handpiece with a sensor positioned in an interior region of the handpiece; at least partially bending the active bending portion of the catheter in response to detecting the movement of the hand piece, the ureteroscope comprising: a motor positioned in the interior region of the hand piece and operatively coupled to the sensor, the motor configured to be activated in response to the sensor detecting movement of the hand piece; and one or more wires secured to the active bending portion of the catheter and adjustable in response to activation of the motor, the one or more wires effective to at least partially bend the active bending portion of the catheter; A method comprising:

14. 14. The method of claim 13, the handpiece including a working channel port positioned near the distal end region and a cable port; the catheter includes a working channel in fluid communication with the working channel port and an image sensor positioned at a distal end of the active bend section distal to the handpiece; The method further comprises communicating with one or more electronic devices and providing power to at least one of the image sensor and the catheter control system using a cable connected to the handpiece at the cable port.

15. 15. The method of claim 13 or 14, The method, further comprising initiating the catheter control system with a control positioned on the handpiece.

16. The method according to any one of claims 13 to 15, Sensing movement of the handpiece with a sensor positioned in an interior region of the handpiece includes sensing movement of the handpiece in a first handpiece direction with the sensor; at least partially bending the active bending portion of the catheter in response to detecting the movement of the hand piece includes at least partially bending the active bending portion in a first bending direction in response to detecting the movement of the hand piece in the first hand piece direction; The method comprises: Detecting movement of the handpiece in a second handpiece direction with the sensor; and bending the active bending section at least partially in a second bending direction in response to detecting the movement of the hand piece in the second hand piece direction; The method of claim 1, further comprising:

17. 17. The method of claim 16, the first bending direction is substantially opposite to the first handpiece direction of movement of the handpiece and the second bending direction is substantially opposite to the second handpiece direction of movement of the handpiece.

18. The method according to any one of claims 13 to 17, Sensing the movement of the hand piece with a sensor positioned in an interior region of the hand piece includes sensing a first magnitude of movement of the hand piece; bending the active bending portion of the catheter at least partially in response to detecting the movement of the hand piece includes bending the active bending portion a first amount in response to detecting a first magnitude of the movement of the hand piece; The method comprises: sensing a second magnitude of movement of the handpiece with the sensor positioned in an interior region of the handpiece, the second magnitude of movement being greater than the first magnitude of movement; bending the active flexure a second amount in response to sensing a second magnitude of the movement of the handpiece, the second amount of bending being greater than the first amount of bending; The method of claim 1, further comprising:

19. The method according to any one of claims 13 to 18, the method further comprising at least partially bending the active bending portion of the catheter by moving a steering controller secured to the handpiece and positioned at least partially outside the interior region of the handpiece.

20. The method according to any one of claims 13 to 19, Detecting movement of the handpiece in a further direction with the sensor positioned in an interior region of the handpiece; in response to detecting the movement of the hand piece in the further direction, activating or deactivating one or more of a light at the distal end of the catheter, the image sensor, an image acquisition mode of the image sensor, a frame grab to record a still image during a video stream mode, a zoom adjustment of the image sensor, tool deployment in the working channel, and / or adjusting at least one of the brightness, zoom, focus, or contrast of the one or more images from the image sensor that are displayed on a display; The method of claim 1, further comprising:

Images