U.S. patent application number 12/344149 was filed with the patent office on 2009-04-23 for catheter driver system.
This patent application is currently assigned to HANSEN MEDICAL, INC.. Invention is credited to Brian Murphy, Barry Weitzner.
Application Number | 20090105639 12/344149 |
Document ID | / |
Family ID | 38560235 |
Filed Date | 2009-04-23 |
United States Patent
Application |
20090105639 |
Kind Code |
A1 |
Weitzner; Barry ; et
al. |
April 23, 2009 |
CATHETER DRIVER SYSTEM
Abstract
An apparatus for performing medical procedures on an anatomical
body includes an extension with an element near its distal end to
be extended into the body, and a driver that moves the extension
axially into the body, and that causes flexure of the distal end of
the extension. The movement and flexure of the extension is driven
by the driver from the proximal end of the extension, and an
electronic controller directs the operation of the driver.
Inventors: |
Weitzner; Barry; (Acton,
MA) ; Murphy; Brian; (Watertown, MA) |
Correspondence
Address: |
VISTA IP LAW GROUP LLP
12930 Saratoga Avenue, Suite D-2
Saratoga
CA
95070
US
|
Assignee: |
HANSEN MEDICAL, INC.
Mountain View
CA
|
Family ID: |
38560235 |
Appl. No.: |
12/344149 |
Filed: |
December 24, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10270743 |
Oct 11, 2002 |
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12344149 |
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10216067 |
Aug 8, 2002 |
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10270743 |
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10023024 |
Nov 16, 2001 |
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10216067 |
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10011371 |
Nov 16, 2001 |
7090683 |
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10023024 |
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10011449 |
Nov 16, 2001 |
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10011371 |
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10010150 |
Nov 16, 2001 |
7214230 |
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10011449 |
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10022038 |
Nov 16, 2001 |
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10010150 |
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10012586 |
Nov 16, 2001 |
7371210 |
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10022038 |
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60332287 |
Nov 21, 2001 |
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60313497 |
Aug 21, 2001 |
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60269200 |
Feb 15, 2001 |
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60276217 |
Mar 15, 2001 |
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60276086 |
Mar 15, 2001 |
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60276152 |
Mar 15, 2001 |
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60293346 |
May 24, 2001 |
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Current U.S.
Class: |
604/95.01 ;
606/41 |
Current CPC
Class: |
A61M 2025/1059 20130101;
A61B 17/12136 20130101; A61M 25/1011 20130101; A61M 2025/1052
20130101; A61M 25/0113 20130101; A61M 2025/0004 20130101; A61M
2025/0175 20130101; A61B 34/70 20160201; A61M 2025/0008 20130101;
A61M 2025/1072 20130101; A61B 17/12045 20130101; A61M 2025/1015
20130101; A61B 2090/0811 20160201; A61M 25/1002 20130101; A61B
2017/12127 20130101; A61B 2034/301 20160201; A61B 2017/3409
20130101; A61B 2017/22075 20130101; A61M 25/10184 20131105 |
Class at
Publication: |
604/95.01 ;
606/41 |
International
Class: |
A61M 25/092 20060101
A61M025/092; A61B 18/18 20060101 A61B018/18 |
Claims
1. A system for remotely controlling the positioning within the
body of a patient of an elongated medical device having a control
handle, the system comprising: a robotic device configured to
position the medical device within the body of the patient; and a
remote control mechanism configured to control the robotic device,
wherein the robotic device comprises a handle controller to receive
the control handle.
2. The system of claim 1, wherein the remote control mechanism
comprises a remote control station and a robotic device controller,
an operator using the remote control station to control the robotic
device.
3. The system of claim 2, wherein the remote control mechanism
includes one or more transmitters, receivers, and/or transceivers
to communicate information between the remote control station and
the robotic device controller.
4. The system of claim 1, wherein the robotic device is controlled
from a remote control station at a location that is remote from the
location of the patient.
5. The system of claim 2, wherein the remote control station
comprises a joystick that can be an operated by an operator to
control the robotic device.
6. The system of claim 1, wherein the robotic device is further
configured to insert the medical device within the body of the
patient.
7. The system of claim 1, wherein the medical device is a catheter
and the robotic device comprises a catheter control device.
8. The system of claim 7, wherein the handle controller of the
robotic device engages the control handle of the catheter.
9. The system of claim 8, wherein the handle controller uses the
standard features of the catheter control handle to, within the
body of the patient, insert the catheter, steer the catheter,
rotate the catheter, place the catheter, shape the catheter, or
deflect the catheter, or a combination of two or more thereof.
10. The system of claim 7, wherein the catheter is an
electrophysiology catheter.
11. The system of claim 7, wherein the catheter control device is
further configured to feed the catheter within the patient's
circulatory system.
12. The system of claim 7, wherein the catheter is used for a
cardiac procedure.
13. The system of claim 12, wherein the catheter is an
interventional catheter used to deliver therapy for the cardiac
procedure.
14. The system of claim 10, wherein the catheter is used for
mapping and catheter ablation.
15. The system of claim 7, wherein the catheter is used for a
dilation procedure.
16. The system of claim 8, wherein the handle controller further
comprises: means for holding said catheter firmly; means for
rotating said catheter; and means for shaping, deflecting,
steering, placing, or positioning the catheter, or a combination of
two or more thereof, within the patient.
17. The system of claim 10, wherein the electrophysiology catheter
is a mapping and/or ablation catheter.
18. The system of claim 17, which can be used to perform atrial
fibrillation ablation.
19. The system of claim 17, which can be used to perform
ventricular tachycardia ablation.
20. The system of claim 17, which can be used to perform atrial
flutter ablation.
21. The system of claim 17, which can be used to perform atrial
tachycardia ablation.
22. The system of claim 17, which can be used to perform pulmonary
vein isolation.
23. The system of claim 17, which can be used to perform simple
ablations.
24. The system of claim 17, which can be used to perform complex
ablations.
25. The system of claim 24, which can be used to perform complex
ablations for accessory pathway mediated tachycardias.
26. The system of claim 1, wherein the robotic device comprises: a
handle controller effective to receive a control handle of a
catheter, the catheter having at least three ranges of motion and a
distal end; a first motor connected to the handle controller and
effective to at least move the catheter forward and/or backward; a
second motor connected to the handle controller and effective to at
least rotate the catheter; a third motor connected to the handle
controller and effective to at least deflect the distal end in at
least a first direction; and a controller unit connected to the
first, second and third motors.
27. The system of claim 26, wherein: the first motor is connected
to an externally threaded drive screw; the handle controller is
connected to an internally threaded drive support; and the drive
screw is mated with the drive support.
28. The system of claim 26, wherein the catheter includes at least
one control member effective to control deflection of the distal
end and the third motor is connected to the at least one control
member.
29. In an improved method for mapping and catheter ablation by
inserting a mapping and ablation catheter into a patient, the
improvement wherein a remote positioning control system of claim 1
is used to position the catheter.
30. A system for remotely controlling the positioning of a medical
device within the body of a patient, the system comprising: a
robotic device configured to position the medical device within a
body of a patient, the robotic device comprising a handle
controller effective to manipulate controls on the medical device;
a driver effective to move the medical device forward and backward
inside the body; and a remote control mechanism effective to
control the robotic device.
31. A system for remotely controlling the positioning within the
body of a patient of an elongated medical device having a proximal
end, the system comprising: a robotic device configured to position
the medical device within the body of the patient; and a remote
control mechanism configured to control the robotic device, wherein
the robotic device comprises a handle controller to receive the
proximal end of the medical device.
Description
RELATED APPLICATION DATA
[0001] This application is a continuation of U.S. application Ser.
No. 10/270,743, which claims the benefit of U.S. Provisional
Application No. 60/332,287, filed Nov. 21, 2001, and is a
continuation in part of U.S. application Ser. No. 10/216,067, filed
Aug. 8, 2002, which claims the benefit of U.S. Provisional
Application No. 60/313,497, filed Aug. 21, 2001, and is a
continuation in part of U.S. application Ser. Nos. 10/023,024 (now
abandoned), 10/011,371 (now U.S. Pat. No. 7,090,683), 10/011,449
(now abandoned), 10/010,150 (now U.S. Pat. No. 7,214,230),
10/022,038 (now abandoned), and 10/012,586, all filed Nov. 16,
2001, and all of which claim the benefit of U.S. Provisional
Application Nos. 60/269,200, filed Feb. 15, 2001, 60/276,217, filed
Mar. 15, 2001, 60/276,086, filed Mar. 15, 2001, 60/276,152, filed
Mar. 15, 2001, and 60/293,346, filed May 24, 2001.
BACKGROUND
[0002] Catheters are used extensively in the medical field in
various types of medical procedures, as well as other invasive
procedures. In general, minimally invasive medical procedures
involve operating through a natural body opening or orifice of a
body lumen, or through small incisions, typically 5 mm to 10 mm in
length, through which instruments are inserted. In general,
minimally invasive surgery is less traumatic than conventional
surgery, due, in part, because no incision is required in certain
minimally invasive procedures, or the significant reduction in the
incision size in other procedures. Furthermore, hospitalization is
reduced and recovery periods are shortened as compared with
conventional surgical techniques.
[0003] Catheters may be provided in a variety of different shapes
and sizes depending upon the particular application. It is typical
for a clinician to manipulate the proximal end of the catheter to
guide the distal end of the catheter inside the body, for example,
through a vein or artery. Because of the small size of the incision
or opening and the remote location of the distal end of the
catheter, much of the procedure is not directly visible to the
clinician. Although clinicians can have visual feedback from the
procedure site through the use of a video camera or endoscope
inserted into the patient, or through radiological imaging or
ultrasonic imaging, the ability to control even relatively simple
instruments remains difficult.
[0004] In some procedures, such as electrophysiology, the surgeon
manually places the distal end of an extension, such as a catheter,
at a site of interest in the patient's body. The distal end of the
catheter can be coupled to an energy generator to treat the site of
interest. Alternatively, or additionally, the catheter can be
connected to a detector which receives signals from the distal end
of the catheter for diagnostic purposes. The catheter is typically
connected to a handle that includes control devices such as dials
that enable the surgeon to articulate the catheter, and thus, to
maneuver the catheter through the patient.
[0005] In view of the above, some have proposed using robotic
tele-surgery to perform minimally invasive procedures. Typically,
these robotic systems use arms that reach over the surgical table
and manipulate the surgical instruments inserted into the patient,
while the surgeon sits at a master station located a distance from
the table and issues commands to the arms.
SUMMARY
[0006] An apparatus for performing medical procedures on an
anatomical body includes an extension with an element near its
distal end to be extended into the body, and a driver that moves
the extension axially into the body, and that causes flexure of the
distal end of the extension. The movement and flexure of the
extension is driven by the driver from the proximal end of the
extension, and an electronic controller directs the operation of
the driver.
[0007] In some embodiments, the driver includes control devices
which may include conventional handle dials. A first control device
is coupled to a first control wire, and a second control device is
coupled to a second control wire. The first and second control
wires extend along the length of the extension, and the terminal
ends of the first and second control wires are coupled to the
distal end of the extension. The first and second control devices
are operated to control the flexure movements of the distal end of
the extension with at least two degrees-of-freedom. The first and
second control devices can be part of a handle which is a plug-in
module that is removable from the driver.
[0008] In certain embodiments, the driver moves the extension with
a rotational movement. The driver may include a first drive
mechanism and a second drive mechanism that are coupled to a motor
array. The motor array in turn may be coupled to the controller,
which directs the operation of the motor array and consequent
operation of the drive mechanisms to move the extension with the
axial and rotational movements.
[0009] In some embodiments, the element may receive RF energy from
an RF generator for delivery to a target site in the body. In
particular embodiments, the element provides signals from the
target site to a detector. The signals are typically related to
properties of the target site.
[0010] Since the movements of the driver are under the direction of
the controller, these movements may be gentler than those produced
by the surgeon when the instrument is manually driven through the
patient. Furthermore, with the assistance of the driver, the
surgeon is less likely to become fatigued during the procedure.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] The foregoing and other objects, features and advantages of
the invention will be apparent from the following more particular
description of preferred embodiments of the invention, as
illustrated in the accompanying drawings in which like reference
characters refer to the same parts throughout the different views.
The drawings are not necessarily to scale, emphasis instead being
placed upon illustrating the principles of the invention.
[0012] FIG. 1 illustrates a manual catheter system;
[0013] FIG. 1A a close-up view of the terminal end of the catheter
shown in FIG. 2;
[0014] FIG. 2 is a block and schematic diagram of a catheter drive
system in accordance with the present invention;
[0015] FIG. 2A is a variation of the configuration shown in FIG.
3;
[0016] FIG. 3 is a block and schematic diagram of another version
of a catheter drive system in accordance with the present
invention;
[0017] FIG. 4 is a perspective view of an illustrative embodiment
of the catheter drive system of FIG. 3;
[0018] FIG. 4A is a top view of the catheter drive system of FIG.
4; and
[0019] FIG. 4B is a front view of the catheter drive system of FIG.
4.
DETAILED DESCRIPTION OF THE INVENTION
[0020] A description of preferred embodiments of the invention
follows.
[0021] The present invention provides a drive system that can be
used to manipulate a surgical implement from its proximal end. For
example, a manually operable instrument can be coupled to the drive
system without requiring any modification to the instrument. The
drive system can be operated by a surgeon at a master station of a
master-slave telerobotic system. In some embodiments, the drive
apparatus is in the form of a housing in which the instrument is
inserted, which is then driven as the surgeon manipulates the
housing.
[0022] In electrophysiology procedures, as shown in FIG. 1, a
extension such as a catheter 30 is used for diagnostic purposes or
sensing conditions at a predetermined target site 31 as the
catheter 30 extends through an artery or vein 34. The distal end 36
of the catheter 30 can be considered as an operative segment of the
catheter and thus is capable of flexing or bending to assist
guiding the catheter through the anatomic body, and curving to a
desired location, for example, to lean against an inner surface of
the heart. In this regard, there is schematically illustrated
wiring 40 that may extend along the length of the catheter 30 that
transmits mechanical inputs of a manual handle 60. As shown in FIG.
1A, there can be additional wiring 61a, 61b, and 61c that are
connected to respective electrophysiology elements 62a, 62b, and
62c and extend from the distal end 36 to an RF generator 45, as
well as a detector 50, associated with the handle 60 (FIG. 1).
[0023] In some embodiments, the RF generator 45 couples energy
through the handle 60 by way of the catheter 30 to the elements
62a, 62b, and 62c at the distal end 36 for the application of RF
energy at the target site 31 for therapeutic purposes. In
association with the RF generator 45, the detector 50 may receives
signals from a probe, such as the elements 62a, 62b, and 62c,
positioned at the target site. Typically, these signals are related
to physiological properties at the target site.
[0024] As can be seen in FIG. 1, the handle 60 has wheels or dials
62 and 64 that can be manually operated by the surgeon during a
procedure. Manipulation of the dials 62 and 64 are transmitted
through the control wiring 40 to the distal end 36 to control the
flexing or bending of the distal end in respective orthogonal
directions. In a particular embodiment, as shown in FIG. 2, the
operation of the drive system of FIG. 1 is automated. That is, the
system shown in FIG. 2 modifies the construction of that shown in
FIG. 1 by providing for automatic control of a catheter 130, which
at its distal end is substantially the same as the catheter 30
shown in FIGS. 1 and 1A.
[0025] Like the catheter 30, the catheter 130 is able to move at
its end with at least two degrees-of-freedom under control of wires
128a and 128b. In addition, the catheter 130 is coupled at its
distal end to a support block 132 that includes wheels 134 that
provide linear translation of the catheter 130 in the direction
136. A further mechanism 137 provides rotational motion of the
catheter 130, such as depicted by the arrow 138. Moreover, there
are also wires extending through the catheter 130 associated with
the RF generator 145 and the detector 150.
[0026] In the embodiment illustrated in FIG. 2, a guide wire is not
used, nor is a guide wire used in the device shown in FIGS. 1 and
1A. Accordingly, only a single support block 132 is used with this
catheter construction. However, the particular catheter 130 is
provided with the flex control, and hence is provided with control
wires that extend through the catheter 130 like those described
previously in reference with FIG. 1.
[0027] As shown in FIG. 2, the support or drive block 132 is
coupled to an electromechanical drive member or motor array 120.
Also included in the system is an input device 124 at which a
surgeon provides control actuations. The input device 124 is
coupled to a controller 122 which in turn is coupled to the motor
array 120. Thus, instructions from the input device 124 are
received by the controller 122 which then directs the operation of
the motor array 120.
[0028] As mentioned previously, movement of the motors of the array
120 is transmitted to the catheter 130 through mechanically cabling
extending through the catheter. In particular, a mechanical cabling
126 coupled directly to the block 132 controls the rotational and
linear degrees-of-freedom of the catheter 130 through the mechanism
137 and wheels 134, respectively. In addition, there is a cabling
128 from the motor array 120 to the block 132 which controls the
bending and flexing movement of the catheter 130. As such, one
cable 128a may be used to control the bending movements of the
catheter with one degree-of-freedom, and another cable 128b may
control the bending movements with a second degree-of-freedom.
[0029] The input device 124 may include separate manipulators for
the different movements of the catheter 130. As described in
connection with FIG. 1, the input device can take on one of many
different forms including joysticks, wheels, dials, and other types
of manual interfaces. For the control desired in FIG. 2, one input
member controls the mechanical cabling 126 for providing the two
degrees-of-freedom of action of the catheter 130, in particular,
the linear and rotational movement. Another input member in input
device 124 controls the flexing and bending of the catheter 130 by
way of the mechanical cabling 128. The input instructions from the
input device 124 are transmitted to the motor array 120 by way of
the controller 122 which may be a microprocessor.
[0030] In an alternative arrangement, as shown in FIG. 2A, an
intermediate drive device 59 may be interposed between the motor
array 120 and the catheter 130. In such an arrangement, the motor
array 120 communicates with the drive device 59 over the lines 128,
which may be electrical. In turn, the drive device 59 is coupled to
the cabling extending through the length of the catheter, and
actuates the cabling to cause the distal end of the catheter 130 to
bend and flex with one or more degrees-of-freedom.
[0031] Details of an automated catheter drive system are describe
in the U.S. Application entitled "Coaxial Catheter System," by
Weitzer, Rogers, and Solbjor, U.S. application Ser. No. 10/270,740,
filed Oct. 11, 2002, now abandoned, the entire contents of which
are incorporated herein by reference. Details of an imaging system
that aids the movement of the catheter through an anatomic body are
described in the U.S. application entitled "Catheter Tracking
System," by Weitzner and Lee, U.S. application Ser. No. 10/270,741,
filed Oct. 11, 2002, the entire contents of which are incorporated
herein by reference.
[0032] Referring now to FIG. 3, there is shown a further embodiment
of a catheter drive system. In FIG. 3, like reference characters
are used to identify like features shown in FIG. 2. Thus, in the
embodiment of FIG. 3, there is an input device 124, a controller
122, and a motor array 120. FIG. 3 also depicts the support block
132 which provides both linear and rotational movement of the
catheter 130. As before, these movements are provide by wheels 134
for the linear translation as noted by the arrow 136, and the
member or mechanism 137 for the rotational translation as noted by
the arrow 138.
[0033] In the embodiment of FIG. 3, the handle 60 is depicted with
its pair of actuating wheels or dials 62 and 64 shown earlier in
FIG. 1. Rather than replacing the handle 60, as in the embodiment
of FIG. 2, the handle 60 here remains intact so that the wheels 62
and 64 are used to control the flexing and bending of the catheter
130. For this purpose, there are included drive pieces 63 and 65
associated, respectively, with the wheels 62 and 64. Each of the
drive pieces engages its corresponding wheel to drive the wheels in
either direction to provide the appropriate flex control of the
catheter 130. Note in FIG. 3, the separate lines 127 and 129, which
may be mechanical or electrical, coupling the drive pieces 65 and
63 to the motor array 120. Hence, actuation of respective drive
units in the motor array 120 results in a consequent actuation of
the wheels 62 and 64 via the control line 129 and drive piece 63,
and the control line 127 and drive piece 65, respectively. Note
that with this embodiment the proper support and housings are
provided such that the drive pieces 63 and 65 maintain proper
engagement with the wheels 62 and 64.
[0034] With the particular arrangement shown in FIG. 3, the
existing catheter construction need not be modified. Rather, the
drive system shown in FIG. 3 is simply coupled to an existing
catheter system, such as the handle 60 and catheter 130
combination.
[0035] Although the motor array 120 is illustrated as having two
separate lines for two separate drive pieces, in other embodiments,
the handle 60 may have only a single control dial. In such
implementations, there may be only a single line and associated
drive piece that couples the motor array 120 to the handle 60.
Thus, unlike the handle 60 with wheels 62 and 64 which provide flex
control in orthogonal planes, if only a single wheel is used, the
catheter typically flexes only in a single plane. However, in
arrangements in which the catheter support block 132 provides for
rotational movement of the catheter 130, the movement of the
catheter is not limited to this single plane, since as the catheter
is being rotated it moves out of this plane.
[0036] A particular embodiment of the system of FIG. 3 is
illustrated in FIGS. 4, 4A, and 4B, where like reference characters
are used to identify like features shown in FIG. 3. In this
embodiment, the handle 60 is clamped in a clamp or vise 200 with a
screw 202. The clamp 200 is connected to a shaft 201 supported in a
carriage 202 that moves back and forth on a guide bar 204 mounted
in the drive block 132. Associated with the shaft 201 is a set of
gears 206 that engage with another set of gears 208 of the rotary
drive mechanism 137. The drive mechanism 137 includes a motor 210
driven by the array 120 located in the drive block 132 and under
the direction of the controller 122 as it receives instructions
from the user through the input device 124. Thus, as the motor 210
rotates the gears 208, a consequent rotary motion is induced in the
gears 206 to rotate the clamp 200, and hence the handle 60 and
catheter 130, in the rotational direction 138.
[0037] The linear drive mechanism 134 of this embodiment includes a
motor 212 connected to a screw drive 214. The motor 212 and screw
drive 214 are mounted to the drive block 132 in a manner to allow
the screw drive 214 to rotate. The screw drive 214 has threads 215
about its periphery that engage with the carriage 202. Accordingly,
under the direction of the controller 122 via the array 120, the
motor 212 rotates the screw drive 214 to induce the carriage 202,
and hence the handle 60 and catheter 130, to move back and forth in
the linear direction 136.
[0038] As previously mentioned, the drive pieces 63 and 65 engage
with the dials or wheels 62 and 64 of the handle 60 so that upon
instructions from the user through the input device 124, the drive
pieces 63 and 65 manipulate the dials 62 and 64 to control the
desired bending and flexing movements of the catheter 130.
[0039] This invention can be implemented and combined with other
applications, systems, and apparatuses, for example, those
discussed in greater detail in U.S. Provisional Application No.
60/332,287, filed Nov. 21, 2001, the entire contents of which are
incorporated herein by reference, as well as those discussed in
greater detail in each of the following documents, all of which are
incorporated herein by reference in their entirety:
[0040] U.S. application Ser. No. 09/783,637 filed Feb. 14, 2001,
which is a continuation of PCT application Serial No.
PCT/US00/12553 filed May 9, 2000, which claims the benefit of U.S.
Provisional Application No. 60/133,407 filed May 10, 1999; U.S.
application entitled "Articulated Apparatus for Telemanipulator
System," by Brock and Lee, U.S. application Ser. No. 10/208,087,
filed Jul. 29, 2002, now abandoned, which is a continuation of U.S.
application Ser. No. 09/827,503 filed Apr. 6, 2001, which is a
continuation of U.S. application Ser. No. 09/746,853 filed Dec. 21,
2000, which is a divisional of U.S. application Ser. No. 09/375,666
filed Aug. 17, 1999, now U.S. Pat. No. 6,197,017 which issued on
Mar. 6, 2001, which is a continuation of U.S. application Ser. No.
09/028,550 filed Feb. 24, 1998, which is now abandoned; PCT
application Serial No. PCT/US01/11376 filed Apr. 6, 2001, which
claims priority to U.S. application Ser. No. 09/746,853 filed Dec.
21, 2000, and U.S. application Ser. No. 09/827,503 filed Apr. 6,
2001; U.S. application Ser. Nos. 10/014,143, 10/012,845,
10/008,964, 10/013,046, 10/011,450, 10/008,457, and 10/008,871, all
filed Nov. 16, 2001 and all of which claim benefit to U.S.
Provisional Application No. 60/279,087 filed Mar. 27, 2001; U.S.
application Ser. No. 10/077,233 filed Feb. 15, 2002, which claims
the benefit of U.S. Provisional Application No. 60/269,203 filed
Feb. 15, 2001; U.S. application Ser. No. 10/097,923 filed Mar. 15,
2002, which claims the benefit of U.S. Provisional Application No.
60/276,151 filed Mar. 15, 2001; U.S. application Ser. No.
10/034,871 filed Dec. 21, 2001, which claims the benefit of U.S.
Provisional Application No. 60/257,816 filed Dec. 21, 2000; U.S.
application Ser. No. 09/827,643 filed Apr. 6, 2001, which claims
the benefit of U.S. Provisional Application No. 60/257,869 filed
Dec. 21, 2000, and U.S. Provisional Application No. 60/195,264
filed Apr. 7, 2000.
[0041] While this invention has been particularly shown and
described with references to preferred embodiments thereof, it will
be understood by those skilled in the art that various changes in
form and details may be made therein without departing from the
scope of the invention encompassed by the appended claims. For
example, the catheter need not be limited for use in
electrophysiology procedures. That is, there may be other types of
probes or end effectors located at the distal end of the catheter.
The end effector may be, for example, an articulated tool such a
grasper, scissor, needle holder, micro dissector, staple applier,
tacker, suction irrigation tool, and clip applier. The end effector
can also be a non-articulated tool, such as a cutting blade, probe,
irrigator, catheter or suction orifice, and dilation balloon.
* * * * *