Wiring of a trocar with a movable camera and fixed position sensor

Abstract

The medical device includes a trocar, a control handle, at least a first electrical wire, and at least a second electrical wire. The trocar is inserted into a patient's organ. The trocar includes a cannula having a longitudinal axis, a position sensor mounted inside the cannula, and a camera mounted inside the cannula and coupled to a movable element configured to move along the longitudinal axis to move the camera along the cannula. The control handle is coupled to a proximal end of the movable element and configured to move the movable element and the camera. The at least first electrical wire is coupled between the control handle and the camera. The at least second electrical wire is coupled between the control handle and the position sensor and has slack configured to compensate for camera movement.

Description

[Technical field]

[0001] The present invention relates generally to invasive medical devices, and more particularly to a method and system for an invasive medical device incorporating a camera. [Background technology]

[0002] Various techniques have been published in the patent literature for image-guided probing of a patient's organs using invasive instruments and their wiring.

[0003] For example, U.S. Patent Application Publication No. 2010 / 0152533 describes a tissue cutting instrument that is particularly suited for neurosurgical applications. The instrument includes a handpiece and an outer cannula having a reciprocating inner cannula disposed therein. The inner cannula includes a hinge between a body portion and a cutting portion that allows the cutting portion to pivot as the inner cannula pivots within the outer cannula. The tissue cutting instrument may be used in conjunction with imaging equipment, such as microscopes and endoscopes, during neurosurgical procedures.

[0004] US Patent Application Publication No. 2002 / 0010479 describes an introducer coupled to a patient, and in particular to the patient's skull. The introducer may include an advancer remote from the patient, which communicates with the introducer by a cable system. The introducer may also include a local position sensor indicating the position of the primary medical instrument being introduced. The introducer may also include a frameless reference system that locates the position of the primary medical instrument relative to a table on which the patient is secured.

[0005] U.S. Patent Application Publication No. 2002 / 0143236 describes an optical obturator including a sleeve having a longitudinal bore between a proximal end and a distal end. The longitudinal bore of the sleeve is configured to receive at least a portion of an endoscope or similar image transmitting system. An image passing member, such as an optical window, is disposed at the distal end of the sleeve and is provided to allow an optical image to pass into the longitudinal bore of the sleeve and to allow illumination light to pass to the surgical site. An automatically retracting blade is disposed distal to the image passing member to facilitate penetration of body tissue. Summary of the Invention [Means for solving the problem]

[0006] An embodiment of the invention described herein provides a medical device including a trocar, a control handle, at least a first electrical wire, and at least a second electrical wire. The trocar is used for insertion into an organ of a patient, the trocar including (i) a cannula having a longitudinal axis, (ii) a position sensor mounted inside the cannula, and (iii) a camera mounted inside the cannula and coupled to a movable element configured to move along the longitudinal axis to move the camera along the cannula. The control handle is coupled to a proximal end of the movable element and configured to move the movable element and the camera. The at least a first electrical wire is coupled between the control handle and the camera. The at least a second electrical wire is coupled between the control handle and the position sensor, and has slack configured to compensate for movement of the camera.

[0007] In some embodiments, the control handle is configured to accommodate slack in at least the second electrical wire. In another embodiment, the slack in at least the second electrical wire is wound within the control handle. In yet another embodiment, the medical device includes a camera control guide coupled between the movable element and the control handle and configured to move the movable element using the control handle.

[0008] In one embodiment, the at least first electrical wire is routed through the camera control guide. In another embodiment, the camera control guide is configured to move the camera and the at least first electrical wire as a rigid element. In yet another embodiment, the medical device includes (i) at least an electronics coupled to the movable element, and (ii) at least a third electrical wire coupled between the control handle and the electronics, the third electrical wire being routed through the camera control guide.

[0009] In some embodiments, the control handle includes a knob coupled to the camera control guide and configured to control the amount of movement of the movable element. In another embodiment, the at least first electrical wire includes two or more first electrical wires, and the medical device includes at least an electronic device coupled to a proximal end of the movable element, and at least one of the first electrical wires is coupled between the control handle and the electronic device. In yet another embodiment, a position sensor is attached to a distal end of the cannula, and the camera is mounted in a tilted configuration such that the position sensor does not obstruct the field of view of the camera.

[0010] There is further provided, in accordance with an embodiment of the present invention, a method of manufacturing a medical device. The method includes providing a trocar for insertion into an organ of a patient. The trocar includes (i) a cannula having a longitudinal axis, a position sensor mounted inside the cannula, and (ii) a camera coupled to a movable element mounted inside the cannula and movable along the longitudinal axis to move the camera along the cannula. A control handle for moving the movable element and the camera is coupled to a proximal end of the movable element. At least a first electrical wire is coupled between the control handle and the camera. At least a second electrical wire having slack to compensate for camera movement is coupled between the control handle and the position sensor.

[0011] According to an embodiment of the present invention, there is further provided a method including inserting a trocar into an organ of a patient. The trocar includes: (i) a cannula having a longitudinal axis; (ii) a position sensor mounted on a distal end of the cannula and configured to generate a signal indicative of a position of the distal end within the organ; and (iii) a camera configured to acquire images of tissue of the organ, the camera mounted inside the cannula and coupled to a movable element configured to move along the longitudinal axis to move the camera along the cannula. The movable element and the camera are moved using a control handle coupled to a proximal end of the movable element. At least a first electrical wire is coupled between the control handle and the camera, and at least a second electrical wire is coupled between the control handle and the position sensor, with slack to compensate for movement of the camera. A medical procedure is performed within the organ using at least one of the signal generated by the position sensor and the image acquired by the camera.

[0012] The invention will be more fully understood from consideration of the following detailed description taken in conjunction with the drawings, in which: [Brief description of the drawings]

[0013] [Figure 1] 1 is a schematic, pictorial illustration of a neurosurgical procedure using a system for performing therapeutic and diagnostic procedures on a patient's head, according to an embodiment of the present invention; [Diagram 2] 1 is a schematic, pictorial illustration of a trocar for use in a neurosurgical procedure, in accordance with one embodiment of the present invention; [Diagram 3] 1 is a flow chart that generally illustrates a method of manufacturing a trocar having a moveable camera and a stationary position sensor, in accordance with one embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Overview Some minimally invasive medical procedures may employ trocars for inserting diagnostic and / or therapeutic tools to target locations within a patient's organs.

[0015] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The embodiments of the present invention described below provide methods and devices for improving the functionality of minimally invasive procedures that apply trocars. In some embodiments, a medical device comprises a trocar for insertion into an organ of a patient, such as the patient's head.

[0016] In some embodiments, the trocar is inserted into the patient's head by a physician to serve as a port for inserting medical instruments to perform a medical procedure within the patient's brain.

[0017] During the procedure, the physician may need to obtain images of the brain tissue. In some embodiments, the trocar comprises a cannula having a longitudinal axis and a position sensor attached inside the cannula at a predetermined location, e.g., at a distal end of the cannula located at the distal end of the trocar. The position sensor is configured to generate a position signal indicative of the location of the distal end of the trocar within the patient's head.

[0018] In some embodiments, the trocar comprises a camera configured to acquire images of tissue of interest within the patient's brain, the camera coupled to a movable element mounted inside the cannula, the movable element configured to move along a longitudinal axis to move the camera along the cannula.

[0019] In some embodiments, the medical device comprises a control handle coupled to a proximal end of the moveable element and configured to move the moveable element and the camera.

[0020] In one embodiment, the medical device includes a camera control guide coupled between the control handle and the movable element, in this embodiment, the camera control guide may function as the proximal end of the movable element.

[0021] In some embodiments, the medical device comprises a first electrical wire coupled between the control handle and the camera and a second electrical wire coupled between the control handle and the position sensor.

[0022] In some cases, the first and second electrical wires may be routed through a trocar and physically contact one another such that as the first electrical wire moves with the camera, the second electrical wire is moved by physical contact with the first electrical wire. In some embodiments, the second electrical wire has slack to compensate for camera movement. In such embodiments, the slack allows movement of the second electrical wire without stretching or tearing the second electrical wire.

[0023] In some embodiments, the control handle comprises a knob configured to control the amount of movement of the camera, hi such embodiments, the knob controls the distance between the camera and the tissue of interest to improve the quality of one or more images acquired from the tissue of interest.

[0024] The disclosed technology improves position tracking and image quality obtained during interventional procedures using trocars by enabling the combination of a stationary position sensor and a camera integrated into a single trocar.

[0025] System Description 1 is a schematic, pictorial illustration of a neurosurgical procedure using a system 20, according to one embodiment of the present invention. In some embodiments, the system 20 is configured to perform therapeutic and diagnostic procedures on a head 41 of a patient 22.

[0026] In some embodiments, system 20 comprises a medical device, in this example a surgical device 28, configured to perform a neurosurgical procedure, also referred to herein as a brain procedure, such as, but not limited to, removing infected or cancerous tissue from the brain of patient 22.

[0027] In some embodiments, the surgical device 28 includes a trocar 38 having a camera 48 slidable along the trocar 38 as described below and configured to capture images at a distal end of the trocar 38. The trocar 38 further includes a position sensor 50 of a position tracking system configured to generate a position signal indicative of the position of the position sensor 50. The camera 48 and the position sensor 50 are shown in FIG. 2 below, and their respective positions are displayed in FIG. 1 on the display 36 of the system 20.

[0028] During a procedure, physician 24 or other user of system 20 applies a trocar 38 to penetrate the skull of patient 22 and then insert a medical instrument, such as a probe 39 through the trocar 38 into brain tissue to perform the procedure. In some embodiments, physician 24 can use images acquired by camera 48 and position signals received from position sensor 50 to position the distal end of trocar 38 and operate probe 39 at a target location within the brain. In some cases, probe 39 may be operated by a second physician (not shown).

[0029] In some embodiments, the system 20 includes a control handle 60 having a knob 66 ​​configured to move the camera along the trocar 38 and control the position of the camera within the cannula of the trocar 38, as described in detail in FIG. 2 below.

[0030] In some embodiments, the system 20 includes a camera control guide 58 coupled onto a movable element (not shown) configured to penetrate at the proximal end of the trocar 38 and move the camera 48 within the trocar 38. In some embodiments, the physician 24 may rotate a knob 66 ​​to slide the camera 48 inside the trocar 38 along its longitudinal axis (shown in FIG. 2 below) to adjust the position of the camera 48 to obtain the best image of the tissue of interest, as further described in FIG.

[0031] In some embodiments, the system 20 includes at least two sets of one or more electrical wires (not shown): a first set of electrical wires is coupled between the control handle 60 and the position sensor 50, and a second set of electrical wires is coupled between the control handle 60 and the camera 48.

[0032] In some embodiments, the system 20 includes additional control elements to assist the physician 24 in performing the procedure, such as command buttons for capturing images from the camera 48 and matching the captured images with reference medical images.

[0033] In some embodiments, the aforementioned position tracking system may comprise a magnetic position tracking system configured to track the location of the sensor 50 in the brain. The magnetic position tracking system comprises a location pad 40 fixed on a frame 46 and comprising magnetic field generators 44 configured to generate a magnetic field sensed by the position sensor 50. In the exemplary configuration shown in FIG. 1, the pad 40 comprises five magnetic field generators 44, but may alternatively comprise any other suitable number of generators 44. The pad 40 further comprises a pillow (not shown) positioned under the head 41 of the patient 22 such that the generators 44 are positioned at a fixed, known location outside the head 41.

[0034] In some embodiments, the position sensor 50 generates a position signal in response to sensing the magnetic field generated by the magnetic field generator 44, thereby enabling the processor 34 to estimate the position of the sensor 50, and therefore the position of the distal edge of the trocar 38 within the head 41 of the patient 22.

[0035] This technology of position sensing has been implemented in a variety of medical applications, for example in the CARTO™ system produced by Biosense Webster, Inc. (Irvine, Calif.), and is described in detail in U.S. Pat. Nos. 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612, and 6,332,089, in International Publication No. WO 96 / 05768, and in U.S. Patent Application Publication Nos. 2002 / 0065455(A1), 2003 / 0120150(A1), and 2004 / 0068178(A1), the disclosures of all of which are incorporated herein by reference in their entireties.

[0036] In some embodiments, the system 20 comprises a console 33 comprising a memory 49 and a drive circuit 42 configured to drive a magnetic field generator 44 with a suitable signal via a cable 37 to generate a magnetic field within a defined working volume in the space surrounding the head 41.

[0037] The processor 34 is typically a general-purpose computer with appropriate front-end and interface circuitry for receiving images from the camera 48 and signals from the position sensor 50 via the cable 32 and for controlling the other components of the system 20 described herein.

[0038] In some embodiments, processor 34 is configured to receive an anatomical image of at least a portion of head 41, typically acquired using a medical imaging system such as, but not limited to, a magnetic resonance imaging (MRI) system. Processor 34 is configured to select a two-dimensional (2D) slice of the anatomical image and display the 2D slice as image 35 on display 36.

[0039] In some embodiments, the processor 34 is configured to match the coordinate system of the image 35 with the magnetic position tracking system and overlay the position of the position sensor 50 on the image 35 .

[0040] In some embodiments, the console 33 includes a video display 52 configured to display images 55 acquired by the camera 48 and processed by the processor 34. In the example of Figure 1, the image 55 shows the distal end of the probe 39 engaging brain tissue of the patient 22.

[0041] In some embodiments, the processor 34 is further configured to display on the display 52 the position of the distal end of the trocar 38 superimposed on the image 55 using the position signal received from the position sensor 50. The processor 34 is further configured to match the camera image and the anatomical image with the coordinate system of the magnetic position tracking system and / or the coordinate system of the image 35.

[0042] In some embodiments, processor 34 is configured to match selected 2D slices of the anatomical image with a real-time camera image, such as image 55, generate a composite image, and display the composite image on display 36 and / or display 52. ​​In the example of FIG. 1, composite image 35 shows a coronal cross-sectional view of the forebrain tissue of patient 22.

[0043] In some embodiments, the console 33 further comprises input devices, such as a keyboard and a mouse, for controlling the operation of the console 33. The display 36 is configured to simultaneously display at least one of the aforementioned images and inputs received and inserted by a user (e.g., physician 24) by manipulating the input devices.

[0044] For simplicity and clarity, Figure 1 shows only elements relevant to the disclosed technique. System 20 typically includes additional or alternative modules and elements that are purposely omitted from Figure 1 and the corresponding description as not directly relevant to the disclosed technology. In alternative embodiments, knob 66 ​​of control handle 60 may include a slider button instead of or in addition to a rotatable knob, as shown in detail in Figure 2 below.

[0045] In some embodiments, the processor 34 may be programmed in software to perform functions used by the system and to store data in memory 49 for processing or otherwise used by the software. This software may be downloaded to the processor in electronic form, for example over a network, or may be provided on a non-transitory tangible medium, such as an optical, magnetic, or electronic memory medium. Alternatively, some or all of the functions of the processor 34 may be performed by dedicated or programmable digital hardware components.

[0046] Trocar with slidable camera and built-in position sensor - Patents.com Figure 2 is a schematic, pictorial view of a trocar 38 used in the procedure of Figure 1, according to one embodiment of the present invention. In some embodiments, the trocar 38 has a cannula 69 with a channel 70 along the longitudinal axis 85 of the trocar 38. The channel 70 serves as a track for sliding the camera control guide 58 along the longitudinal axis 85.

[0047] In some embodiments, camera 48 is coupled to a movable element 77, also referred to herein as a sliding adapter, configured to be moved by camera control guide 58 inside cannula 69. In such embodiments, movable element 77 is configured to move camera 48 distally or proximally along longitudinal axis 85 inside cannula 69.

[0048] In some embodiments, the physician 24 rotates the knob 66 ​​of the control handle 60 in a first direction (e.g., clockwise) to slide the camera control guide 58 distally. In the exemplary configuration of FIG. 2, the knob 66 ​​is coupled to a gear that moves back and forth along a direction 80 in response to rotation of the knob. As shown in FIG. 2, rotation of the knob 66 ​​moves the knob 66 ​​forward along with the camera control guide 58 such that the knob 66 ​​is disposed in a distal-most position within the control handle 60. This position translates into movement of the camera 48 in a distal direction inside the cannula 69 (e.g., by a substantially right angle rotation of the camera control guide 58) such that the movable element 77 and camera 48 are disposed in a distal-most position within the cannula 69.

[0049] Similarly, the physician 24 may rotate the knob 66 ​​in the opposite direction (e.g., counterclockwise) such that the knob 66 ​​moves toward the distal end of the control handle 60. In this configuration, the control handle 60 pulls the camera control guide 58 toward the proximal end of the trocar 38, which translates into movement of the camera 48 in the proximal direction inside the cannula 69.

[0050] In some embodiments, the position sensor 50 is secured to the inner wall of the cannula 69 and electrically coupled to the control handle 60 via one or more wires 88. In such embodiments, the position signal generated by the position sensor 50 is transmitted to the processor 34 via the wires 88 and the cable 32 described in FIG.

[0051] In some embodiments, the trocar 38 includes one or more wires for electrically coupling between the control handle 60 and the camera 48. In some embodiments, the camera 48 is mounted in an angled configuration with a central distal gaze direction pointing toward the center of the opening 78 at the distal end of the cannula 69. Note that the position sensor 50 is small enough and mounted to the wall of the cannula 69 so that the position sensor 50 does not obstruct the field of view 79 of the camera 48.

[0052] In some embodiments, the trocar 38 may include electronics (not shown), such as, but not limited to, a light emitting diode (LED). The LED may be coupled to the movable element 77, for example, proximate the camera 48, and configured to illuminate tissue of interest during a neurosurgical procedure. In such embodiments, the trocar 38 includes one or more electrical wires coupling between the electronics and the control handle 60. In the exemplary configuration of the trocar 38, the electrical wires coupling between the control handle 60 and (i) the camera 48 and / or (ii) the LED are routed within the camera control guide 58 and therefore are not shown.

[0053] In such an embodiment, the camera control guide 58 and the wires coupled to the camera 48 and LEDs move as a rigid body in response to rotation of the knob 66 ​​by the physician 24 .

[0054] Reference is now made to inset 100, which shows a cross-sectional view of the distal end of trocar 38 from a different perspective than that of the schematic diagram of Figure 2. In some embodiments, position sensor 50 is attached to the distal end of cannula 69.

[0055] Referring again to the schematic diagram of Figure 2, in some embodiments, the position sensor 50 is mounted inside (e.g., coupled to a wall of) the cannula 69 without movement along the longitudinal axis 85, such that one or more electrical wires 88 coupled to the position sensor 50 are threaded through the trocar 38 but not inserted into the camera control guide 58. It should be noted that as the camera control guide 58 moves within the trocar 38, the one or more electrical wires 88 may move to some extent due to, for example, friction induced by the movement of the camera control guide 58.

[0056] Reference is now made to inset 99, which shows a bottom view of control handle 60. In some embodiments, the electrical wires 88 have slack 90 to prevent damage to the electrical wires 88 when the camera control guide 58 is being moved. For example, the slack 90 can prevent stretching and / or tearing of one or more electrical wires 88 in response to movement of the camera control guide 58. In such embodiments, when the camera control guide 58 is moved by the knob 66, the slack 90 allows some movement of the electrical wires 88 with the camera control guide 58 (caused by the friction discussed above) without having excessive tension applied to the electrical wires 88.

[0057] In some embodiments, the control handle 60 is configured to accommodate slack 90 so that loose portions of one or more electrical wires 88 do not undesirably wrap around the camera control guide 58 and / or the knob 66 ​​and / or any other portions of the trocar 38.

[0058] In alternative embodiments, the trocar 38 may have any other suitable mechanism for retaining the slack 90 within a predetermined volume other than within the control handle 60 .

[0059] In some embodiments, during a medical procedure, physician 24 inserts trocar 38 into head 41, or any other organ, of patient 22. Processor 34 displays the position of position sensor 50 within head 41 to assist physician 24 in positioning opening 78 at a target location within head 41. It should be noted that at any stage of the procedure, physician 24 may apply camera 48 to record an image, such as image 55 of brain tissue of patient 22, or a video clip.

[0060] In some embodiments, physician 24 can move movable element 77 and camera 48 using knob 66 ​​of control handle 60 coupled to a proximal end of movable element 77. After positioning opening 78 at a target location in head 41, physician 24 can insert one or more medical instruments, such as probe 39, through trocar 38 to perform a medical procedure. It should be noted that processor 34 can use position signals, for example, from position sensor 50 and / or from an additional position sensor coupled to the distal end of probe 39, to indicate the respective positions of the distal ends of trocar 38 and probe 39 to assist physician 24 in performing the procedure.

[0061] In some embodiments, physician 24 can use the aforementioned images and / or video clips captured by camera 48 and displayed by processor 34 to perform a medical procedure.

[0062] The configuration of trocar 38 in Figure 2 is depicted as an example for conceptual clarity, in alternative embodiments, additional elements may be included, such as additional ports in trocar 38 for inserting medical tools into a target brain location.

[0063] 3 is a flow chart that generally illustrates a method of manufacturing a trocar 38 having a moveable camera 48 and a stationary position sensor 50, in accordance with one embodiment of the present invention. The method begins in a trocar providing step 202 with providing a trocar 63 for insertion into the patient's head 41, the trocar 63 having a cannula 69 as described in FIG. 2 above.

[0064] In a position sensor attachment step 204, the position sensor 50 is attached to the inside of the cannula 69. It should be noted that in the example of the trocar 38, the position sensor 50 is coupled to the inner wall of the cannula 69, however, in alternative embodiments, the position sensor 50 may be coupled to any other suitable element of the trocar 38 and remain stationary in the coupled position.

[0065] In a camera coupling step 206, the camera 48 is coupled to a movable element 77 that is mounted inside the cannula 69 and coupled to the camera control guides 58. In this configuration, the movable element 77 is configured to move with the camera 48 by the camera control guides 58 as described in FIG. 2 above.

[0066] In a control handle coupling step 208 , the control handle 60 is coupled to the proximal end of the movable element 77 such that the physician 24 can apply the control handle 60 to move the movable element 77 and camera along the longitudinal axis 85 of the cannula 69 .

[0067] In a first wire coupling step 210, one or more wires are coupled between the control handle 60 and the camera 48. As described in Figure 2 above, these wires are routed through the camera control guide 58 and are therefore not shown in Figure 2. Note that the camera control guide 58 is moved as a rigid element along with the camera 48 and the movable element 77 by the knob 66 ​​of the control handle 60.

[0068] In a second connect wires step 212, one or more wires 88 are connected between the control handle 60 and the position sensor 50. In some embodiments, the wires 88 have slack to compensate for movement of the camera 48, as described in FIG. 2 above.

[0069] In one embodiment, the slack 90 is wound within the control handle 60 to prevent loose portions of one or more of the electrical wires 88 from undesirably wrapping around any other portion of the camera control guide 58 and / or trocar 38, as described above in FIG. 2.

[0070] In some embodiments, the wire coupling step 212 terminates the method of Figure 3. In other embodiments, the order of steps 202-212 may differ from the order shown in Figure 3. For example, at least one of the wire coupling steps 210 and 212 may be performed before the control handling coupling step 208.

[0071] Also, the method steps of FIG. 3 have been simplified for clarity of understanding, and the complete manufacturing process for trocar 38 may include additional and / or alternative steps.

[0072] Although the embodiments described herein primarily address neurosurgical procedures, the methods and systems described herein may be used in other applications.

[0073] Therefore, it will be understood that the above-described embodiments are cited by way of example, and that the present invention is not limited to what has been particularly shown and described above. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described in the above specification, as well as variations and modifications thereof not disclosed in the prior art that would occur to one skilled in the art upon reading the foregoing description. Documents incorporated by reference into this patent application shall be considered an integral part of this application, except that to the extent that any term is defined in such incorporated documents in a manner that is inconsistent with the definition expressly or impliedly made herein, only the definition in this specification shall be considered.

[0074] [Embodiment] (1) A medical device comprising: 1. A trocar for insertion into an organ of a patient, said trocar comprising: a cannula having a longitudinal axis; a position sensor mounted inside the cannula; a camera mounted inside the cannula and coupled to a moveable element configured to move along the longitudinal axis to move the camera along the cannula; A trocar comprising: a control handle coupled to a proximal end of the movable element and configured to move the movable element and the camera; at least a first electrical wire coupled between the control handle and the camera; at least a second electrical wire coupled between the control handle and the position sensor, the second electrical wire having slack configured to compensate for movement of the camera; A medical device comprising: (2) The medical device of embodiment 1, wherein the control handle is configured to accommodate the slack in the at least second electrical wire. (3) The medical device of embodiment 2, wherein the slack of the at least second electrical wire is wound within the control handle. (4) The medical device of embodiment 1, comprising a camera control guide coupled between the movable element and the control handle and configured to move the movable element using the control handle. (5) A medical device as described in embodiment 4, wherein the at least a first electrical wire is passed through the camera control guide.

[0075] (6) A medical device as described in embodiment 4, wherein the camera control guide is configured to move the camera and the at least first electrical wire as a rigid element. (7) The medical device of embodiment 4, comprising: (i) at least an electronic device coupled to the movable element; and (ii) at least a third wire coupled between the control handle and the electronic device, the third wire being threaded within the camera control guide. (8) The medical device of embodiment 4, wherein the control handle is coupled to the camera control guide and comprises a knob configured to control the amount of movement of the movable element. (9) The medical device of embodiment 1, wherein the at least first electrical wire comprises two or more first electrical wires and at least one electronic device coupled to the proximal end of the movable element, and at least one of the first electrical wires is coupled between the control handle and the electronic device. (10) The medical device of embodiment 1, wherein the position sensor is mounted at a distal end of the cannula and the camera is mounted in an angled configuration such that the position sensor does not obstruct the camera's field of view.

[0076] (11) A method for manufacturing a medical device, comprising: A trocar for insertion into an organ of a patient is provided, the trocar comprising: a cannula having a longitudinal axis; a position sensor mounted inside the cannula; a camera coupled to a movable element mounted inside the cannula and movable along the longitudinal axis to move the camera along the cannula; and coupling a control handle to a proximal end of the movable element for moving the movable element and the camera; coupling at least a first electrical wire between the control handle and the camera; coupling at least a second electrical wire between the control handle and the position sensor, the second electrical wire having slack for compensating for movement of the camera; The method includes: (12) The method of embodiment 11, wherein coupling the at least second electrical wire includes accommodating the slack of the at least second electrical wire within the control handle. (13) The method of embodiment 12, wherein accommodating the slack within the control handle includes winding the slack of the at least second electrical wire within the control handle. (14) The method of claim 11, further comprising coupling a camera control guide between the movable element and the control handle for moving the movable element using the control handle. (15) The method of embodiment 14, wherein coupling the at least a first electrical wire includes threading the at least a first electrical wire within the camera control guide.

[0077] (16) The method of embodiment 14, wherein the camera control guide is for moving the camera and the at least first electrical wire as a rigid element. (17) The method of claim 14, comprising: (i) coupling at least an electronic device to the movable element; (ii) coupling at least a third electrical wire between the control handle and the electronic device; and (iii) passing the at least a third electrical wire through the camera control guide. (18) The method of claim 14, wherein coupling the camera control guide includes coupling a knob of the control handle to the camera control guide to control the amount of movement of the movable element. (19) The method of embodiment 11, wherein the at least first electrical wire comprises two or more first electrical wires, and further comprising coupling at least an electronic device to the movable element, and wherein coupling the at least first electrical wires comprises coupling at least one of the first electrical wires between the control handle and the electronic device. (20) The method of embodiment 11, wherein the position sensor is attached to a distal end of the cannula and the camera is mounted in an angled configuration such that the position sensor does not obstruct the camera's field of view.

[0078] (21) A method comprising the steps of: Inserting a trocar into an organ of a patient, the trocar comprising: a cannula having a longitudinal axis; a position sensor attached to a distal end of the cannula and configured to generate a signal indicative of a position of the distal end within the organ; a camera configured to acquire images of tissue of the organ, the camera being mounted inside the cannula and coupled to a moveable element configured to move along the longitudinal axis to move the camera along the cannula; and moving the movable element and the camera using a control handle coupled to a proximal end of the movable element, At least a first electrical wire is coupled between the control handle and the camera; at least a second electrical wire is coupled between the control handle and the position sensor, the second electrical wire having slack to compensate for movement of the camera; performing a medical procedure within the organ using at least one of the signals generated by the position sensor and the images acquired by the camera; The method includes:

Claims

1. 1. A medical device, comprising:

1. A trocar for insertion into an organ of a patient, said trocar comprising: a cannula having a longitudinal axis; a position sensor mounted inside the cannula; a camera mounted inside the cannula and coupled to a moveable element configured to move along the longitudinal axis to move the camera along the cannula; A trocar comprising: a control handle coupled to a proximal end of the movable element and configured to move the movable element and the camera; at least a first electrical wire coupled between the control handle and the camera; at least a second electrical wire coupled between the control handle and the position sensor, the second electrical wire having slack configured to compensate for movement of the camera; Equipped with a camera control guide coupled between the movable element and the control handle and configured to move along the longitudinal axis upon manipulation of the control handle to move the movable element; the at least first electric wire is passed through the camera control guide; the at least second electrical wire is threaded through the cannula but not through the camera control guide; A medical device wherein when the camera control guide is moving and the camera control guide is in contact with the at least second electrical wire, the slack allows the at least second electrical wire to move with the camera control guide and prevents the at least second electrical wire from being torn by the movement of the camera control guide.

2. The medical device of claim 1 , wherein the control handle is configured to accommodate the slack in the at least second electrical wire.

3. The medical device of claim 2 , wherein the slack of the at least second electrical wire is wound within the control handle.

4. The medical device of claim 1 , wherein the camera control guide is configured to move the camera and the at least first electrical wire as a rigid element.

5. 10. The medical device of claim 1, comprising: (i) at least an electronic device coupled to the movable element; and (ii) at least a third electrical wire coupled between the control handle and the electronic device, the third electrical wire being threaded within the camera control guide.

6. The medical device of claim 1 , wherein the control handle comprises a knob coupled to the camera control guide and configured to control the amount of movement of the movable element.

7. 2. The medical device of claim 1, wherein the at least first electrical wire comprises two or more first electrical wires and at least one electronic device coupled to the proximal end of the movable element, and at least one of the two or more first electrical wires is coupled between the control handle and the electronic device.

8. The medical device of claim 1 , wherein the position sensor is mounted at a distal end of the cannula, and the camera is mounted in an angled configuration such that the position sensor does not obstruct the camera's field of view.

9. 1. A method of manufacturing a medical device, comprising: A trocar for insertion into an organ of a patient is provided, the trocar comprising: a cannula having a longitudinal axis; a position sensor mounted inside the cannula; a camera coupled to a movable element mounted inside the cannula and movable along the longitudinal axis to move the camera along the cannula; and coupling a control handle to a proximal end of the movable element for moving the movable element and the camera; coupling at least a first electrical wire between the control handle and the camera; coupling at least a second electrical wire between the control handle and the position sensor, the second electrical wire having slack for compensating for movement of the camera; coupling a camera control guide between the movable element and the control handle for movement along the longitudinal axis by manipulation of the control handle to move the movable element; Including, coupling the at least first electrical wire includes threading the at least first electrical wire within the camera control guide; coupling the at least second electrical wire includes threading the at least second electrical wire through the cannula but not through the camera control guide; The method, wherein when the camera control guide is moving and the camera control guide is in contact with the at least second electrical wire, the slack allows the at least second electrical wire to move with the camera control guide and prevents the at least second electrical wire from being torn by the movement of the camera control guide.

10. The method of claim 9 , wherein coupling the at least a second electrical wire comprises accommodating the slack of the at least a second electrical wire within the control handle.

11. The method of claim 10 , wherein accommodating the slack within the control handle comprises winding the slack of the at least second electrical wire within the control handle.

12. The method of claim 9 , wherein the camera control guide is for moving the camera and the at least first electrical wire as a rigid element.

13. 10. The method of claim 9, comprising: (i) coupling at least electronics to the movable element; (ii) coupling at least a third electrical wire between the control handle and the electronics; and (iii) passing the at least a third electrical wire through the camera control guide.

14. The method of claim 9 , wherein coupling the camera control guide comprises coupling a knob of the control handle to the camera control guide to control the amount of movement of the moveable element.

15. 10. The method of claim 9, wherein the at least first electrical wire comprises two or more first electrical wires, and further comprising coupling at least an electronic device to the movable element, and wherein coupling the at least first electrical wire comprises coupling at least one of the two or more first electrical wires between the control handle and the electronic device.

16. 10. The method of claim 9, wherein the position sensor is attached to a distal end of the cannula, and the camera is mounted in an angled configuration such that the position sensor does not obstruct the camera's field of view.

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