U.S. patent application number 16/789918 was filed with the patent office on 2020-06-11 for cable arranger.
This patent application is currently assigned to BIOSENSE WEBSTER (ISRAEL) LTD. The applicant listed for this patent is Biosense Webster (Israel) Ltd.. Invention is credited to Dudu HAIMOVICH, Roee HAIMOVICH, Yoav LICHTENSTEIN.
Application Number | 20200179208 16/789918 |
Document ID | / |
Family ID | 52292756 |
Filed Date | 2020-06-11 |
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United States Patent
Application |
20200179208 |
Kind Code |
A1 |
LICHTENSTEIN; Yoav ; et
al. |
June 11, 2020 |
CABLE ARRANGER
Abstract
Catheterization employing a cable extending from the catheter to
a fixed point of attachment is performed by providing a sensor to
detect rotation of the catheter about its longitudinal axis, the
rotation causing the cable to form a twist. The cable extends
through a cable arranger that operates to remove the twist. A
controller receives signals from the sensor and generates control
signals to actuate the cable arranger responsively to the signals
from the sensor.
Inventors: |
LICHTENSTEIN; Yoav;
(Raanana, IL) ; HAIMOVICH; Dudu; (Ramat Yishai,
IL) ; HAIMOVICH; Roee; (Nesher, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Biosense Webster (Israel) Ltd. |
Yokneam |
|
IL |
|
|
Assignee: |
BIOSENSE WEBSTER (ISRAEL)
LTD
Yokneam
IL
|
Family ID: |
52292756 |
Appl. No.: |
16/789918 |
Filed: |
February 13, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
14147831 |
Jan 6, 2014 |
10588809 |
|
|
16789918 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2034/2048 20160201;
A61G 13/101 20130101; A61B 2034/2051 20160201; A61M 25/0133
20130101; A61B 2090/031 20160201; A61B 2090/066 20160201; A61G
2203/20 20130101; A61G 2203/42 20130101; A61B 2090/067
20160201 |
International
Class: |
A61G 13/10 20060101
A61G013/10; A61M 25/01 20060101 A61M025/01 |
Claims
1-12. (canceled)
13. A method, comprising the steps of: inserting a catheter into a
living subject, the catheter having a longitudinal axis; connecting
a cable between the catheter and a fixed point of attachment;
forming a twist in a portion of the cable by rotating the catheter
about the longitudinal axis; automatically detecting rotation of
the catheter about the longitudinal axis; and responsively to
detecting rotation removing the twist from the portion of the
cable.
14. The method according to claim 13, wherein detecting rotation is
performed using a magnetic field sensor.
15. The method according to claim 13, wherein detecting rotation is
performed using an accelerometer adapted to measure tangential
acceleration of the catheter about the longitudinal axis.
16. The method according to claim 13, wherein detecting rotation is
performed using a torque transducer.
17. The method according to claim 13, wherein removing the twist is
performed by operating a cable arranger comprising: a shaft holding
a segment of the cable; and a drive motor for rotating the shaft,
wherein removing the twist comprises imparting a compensatory
rotation about the longitudinal axis of the cable.
18. The method according to claim 13, further comprising providing
a cable arranger, wherein removing the twist comprises displacing
the cable through the cable arranger.
19. The method according to claim 18, wherein the cable arranger
has a drive gear, the drive gear having grooves formed therein, the
drive gear being attached to a drive motor having a shaft having
spiral grooves formed therein for carrying the cable, the drive
gear meshing with gear teeth formed on the shaft, wherein the cable
is urged into contact with the grooves of the drive gear when the
spiral grooves and the grooves of the drive gear are in
alignment.
20. The method according to claim 19, further comprising providing
a radial slot in the drive gear for ingress and egress of the cable
therethrough.
21. The method according to claim 13, wherein the cable comprises a
bundle of electrical and hydraulic channels.
Description
BACKGROUND OF THE INVENTION
Field of the Invention
[0001] This invention relates to medical devices. More
particularly, this invention relates to placement and operation of
probes within the body of a subject.
Description of the Related Art
[0002] When a physician manipulates a catheter during a medical
procedure, the catheter may become twisted or tangled. Several
methods and systems have been proposed in order to detect or avoid
such situations. For example, U.S. Pat. No. 5,921,978, whose
disclosure is incorporated herein by reference, describes a
catheter that includes fluoroscopic marker components. Some of the
disclosed catheter configurations are used for providing visual
information to the physician regarding the direction and degree of
twist of the catheter distal end.
[0003] U.S. Pat. No. 5,352,197, whose disclosure is incorporated
herein by reference, describes a turn limiter for a catheter with a
twistable tip. The catheter has a flexible wall for use in complex
twisting anatomy, and contains a torque wire or a torquable guide
wire lumen. The torque wire or torquable guide wire lumen extends
through the length of the catheter and is attached to the catheter
at or near the distal end thereof. The proximal end of the torque
wire protrudes from the proximal end of the catheter and is
attached to a turn limiter. The turn limiter allows limited
rotation of the proximal end of the torque wire or torquable guide
wire lumen without axial dislocation.
[0004] U.S. Patent Application Publication No. 2012/0035467,
commonly assigned herewith and herein incorporated by reference,
describes a catheter entanglement limiter. An operator of an
elongated probe manipulates the proximal end of the probe so as to
move the distal end within a body of a patient, automatically
measuring a cumulative angle of rotation that is applied by the
operator to the proximal end. An indication of the cumulative angle
of rotation is presented to the operator.
SUMMARY OF THE INVENTION
[0005] There is provided according to embodiments of the invention
a catheter adapted for insertion into a living subject, the
catheter having a longitudinal axis, a cable having one end
attached to the catheter and another end to a fixed point, a sensor
for detecting rotation of the catheter about the longitudinal axis,
the rotation causing a portion of the cable to form a twist, a
cable arranger for removing the twist from the portion of the
cable, and a controller receiving signals from the sensor and
operative for generating control signals to actuate the cable
arranger responsively to the signals of the sensor.
[0006] According to an aspect of the apparatus, the sensor is a
magnetic field sensor.
[0007] According to another aspect of the apparatus, the sensor is
an accelerometer adapted to measure tangential acceleration of the
catheter about the longitudinal axis.
[0008] According to another aspect of the apparatus, the sensor is
a rotary torque transducer.
[0009] According to one aspect of the apparatus, the cable arranger
includes a shaft holding a segment of the cable, and a drive motor
for rotating the shaft.
[0010] According to a further aspect of the apparatus, the shaft
has a lumen, the cable passing through the lumen and is in contact
with the shaft for rotation therewith.
[0011] An additional aspect of the apparatus includes a gear train
linked to the drive motor and the shaft.
[0012] According to another aspect of the apparatus, the gear train
includes a drive gear attached to the drive motor, two linking
gears meshing with the drive gear, and a shaft gear meshing with
the two linking gears. The shaft gear is concentric with the shaft
and has a radial slot for insertion and removal of the cable
therethrough. The cable is wound about the shaft.
[0013] According to still another aspect of the apparatus, spiral
grooves are formed in the shaft for carrying the cable therein.
[0014] One aspect of the apparatus includes a drive gear attached
to the drive motor that meshes with gear teeth formed on the shaft.
The cable is urged into contact with grooves in the drive gear when
the spiral grooves and the grooves of the drive gear are in
alignment.
[0015] There is further provided according to embodiments of the
invention a method, which is carried out by inserting a catheter
into a living subject, connecting a cable between the catheter and
a fixed point of attachment, forming a twist in a portion of the
cable by rotating the catheter about its longitudinal axis,
automatically detecting rotation of the catheter about the
longitudinal axis, and responsively to detecting rotation removing
the twist from the portion of the cable.
[0016] According to a further aspect of the method, detecting
rotation is performed using a magnetic field sensor.
[0017] According to one aspect of the method, detecting rotation is
performed using an accelerometer adapted to measure tangential
acceleration of the catheter about the longitudinal axis.
[0018] According to another aspect of the method, detecting
rotation is performed using a torque transducer.
[0019] According to an additional aspect of the method, removing
the twist is performed by operating a cable arranger including a
shaft holding a segment of the cable, and a drive motor for
rotating the shaft, and imparting a compensatory rotation about the
longitudinal axis of the cable.
[0020] Yet another aspect of the method includes providing a cable
arranger having a drive gear, the drive gear having grooves formed
therein. The drive gear is attached to a drive motor and a shaft
having spiral grooves formed therein for carrying the cable, the
drive gear meshing with gear teeth formed on the shaft, wherein the
cable is urged into contact with the grooves of the drive gear when
the spiral grooves of the shaft and the grooves of the drive gear
are in alignment, wherein removing the twist comprises rotating the
shaft to displace the cable through the cable arranger.
[0021] A further aspect of the method includes providing a radial
slot in the drive gear for ingress and egress of the cable
therethrough.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0022] For a better understanding of the present invention,
reference is made to the detailed description of the invention, by
way of example, which is to be read in conjunction with the
following drawings, wherein like elements are given like reference
numerals, and wherein:
[0023] FIG. 1 is a schematic illustration of a cable arranger for
use with a position tracking system, in accordance with an
embodiment of the present invention;
[0024] FIG. 2 is a series of images showing a progression of twists
of a cable that are compensated using the embodiment of FIG. 1, in
accordance with an embodiment of the invention;
[0025] FIG. 3 is a perspective top view of a cable arranger in
accordance with an embodiment of the invention;
[0026] FIG. 4 is an exploded view in slight perspective of the
cable arranger shown in FIG. 3, in accordance with an embodiment of
the invention;
[0027] FIG. 5 is a perspective view of the cable arranger shown in
FIG. 3 with the housing removed, in accordance with an embodiment
of the invention;
[0028] FIG. 6 is an elevation of a gear shown in FIG. 4, in
accordance with an embodiment of the invention;
[0029] FIG. 7 is a schematic diagram of a cable arranger, in
accordance with an alternate embodiment of the invention;
[0030] FIG. 8 is a schematic diagram of the cable arranger shown in
FIG. 7 with the housings removed;
[0031] FIG. 9 is a schematic diagram of a control arrangement for a
cable arranger, which is constructed and operative in accordance
with an embodiment of the invention; and
[0032] FIG. 10 is a schematic cross sectional view of a rotary
torque transducer in accordance with an alternate embodiment of the
invention.
DETAILED DESCRIPTION OF THE INVENTION
[0033] In the following description, numerous specific details are
set forth in order to provide a thorough understanding of the
various principles of the present invention. It will be apparent to
one skilled in the art, however, that not all these details are
necessarily always needed for practicing the present invention.
[0034] Turning now to the drawings, Reference is initially made to
FIG. 1, which is a schematic, pictorial illustration of a position
tracking system 10, in accordance with an embodiment of the present
invention. Typically, a catheter 12 that can be navigated with a
handle 13 is used for diagnostic or therapeutic treatment performed
by medical practitioner 16, such as mapping electrical potentials
in the heart or performing ablation of heart tissue. The catheter
12 or other intrabody device may alternatively be used for other
purposes, by itself or in conjunction with other treatment devices.
The catheter 12 enters a subject 14 at an insertion point 30, which
in this example is a femoral vessel. Processors and circuitry
related to the medical procedure are found in a control unit 18.
The system 10 typically includes a subsystem for tracking the
position of the catheter 12 within the body of the subject 14. One
tracking sub-system of the system 10 is known as an active current
localization ACL subsystem 36, in which a plurality of body-surface
electrodes are placed in galvanic contact with a body-surface,
e.g., the skin of the subject 14, and receive body surface currents
therefrom. Additionally or alternatively, the system 10 may include
a magnetic tracking sub-system 38 comprising magnetic sensors and
field generators for tracking the catheter 12. Processors for the
subsystems 36, 38 are typically located in the control unit 18.
Peripheral elements of the position tracking sub-systems 36, 38 are
generally connected to the control unit 18 by a cable 32.
Operational information relating to the catheter 12 and the system
10 may be displayed on a monitor 34. One system that embodies the
above-described features of the system 10 is the CARTO.RTM. 3
System, available from Biosense Webster, Inc., 3333 Diamond Canyon
Road, Diamond Bar, Calif. 91765. This system may be modified by
those skilled in the art to embody the principles of the invention
described herein.
[0035] A cable arranger 40 is operative to prevent undesired
twisting and entanglement of a segment 15 of cable near the handle
13 of the catheter 12, where the twisted cable would interfere with
the practitioner 16, The cable passes from the catheter 12 through
the cable arranger 40 to a fixed point of attachment, such as the
control unit 18. The cable may include or be accompanied by one or
more hydraulic lines.
[0036] Reference is now made to FIG. 2, which is a series of images
showing a progression of twists of a cable 44 having one end
attached to a catheter and another end attached to a fixed point,
e.g., the control unit 18 (FIG. 1). Such twisting can be caused by
rotation of the catheter about its longitudinal axis during a
catheterization session in the absence of the cable arranger 40. In
a worst case 46, the cable 44 becomes a severe encumbrance and can
greatly hinder the practitioner 16 in performing the medical
procedure.
[0037] Reference is now made to FIG. 3, which is a perspective top
view of a cable arranger 48, which is a variant of the cable
arranger 40 (FIG. 1) in accordance with an embodiment of the
invention. A cover 50 and a base 52 comprise a housing for a drive
assembly (not shown in this view). A torsion rod 54 extends outward
from the cover 50 and grips a cable 56 passing through the torsion
rod 54. A clamp 58 is provided for affixing the cable arranger 48
to a convenient attachment point to assure mechanical stability.
One or more hydraulic lines, e.g., irrigation tubes may be included
in the cable 56 or accompany the cable 56 as separate channels to
form a bundle of electrical and hydraulic channels.
[0038] The torsion rod 54 comprises two portions joined together at
a seam 60. The two portions can be readily snapped together,
allowing the operator to accordingly engage and disengage the cable
56 sideways through a slot 62 formed in the base 52.
[0039] Reference is now made to FIG. 4, which is an exploded view
in slight perspective of the cable arranger 48 (FIG. 3). Mounted
beneath the base 52 are a motor cover 64, motor 66 and gear train
for rotating the torsion rod 54. The gear train is a modified
planetary arrangement comprising a drive gear 68 that is rotated by
a drive shaft 70 of the motor 66.
[0040] Reference is now made to FIG. 5, which is a perspective view
of the cable arranger 48 with the housing removed. The gear train
is best appreciated in FIG. 5. The drive gear 68 meshes with
linking gears 72, 74, both of which mesh with a gear 76 that
rotates the torsion rod 54 about its longitudinal axis.
[0041] The gear 76 is provided with a slot 82, which provides
lateral egress and ingress to the cable 56 when the slot 82 is
aligned with the slot 62 (FIG. 3). When the gear 76 is rotated such
that the slot 82 opposes one of the gears 72, 74 and is thus unable
to mesh with its teeth, the other of the gears 72, 74 continues to
mesh and enables further rotation of the gear 76 in either
direction.
[0042] Reference is now made to FIG. 6, which is an elevation of
the gear 76. The slot 82 extends radially from the center outward
and interrupts the gear teeth. The slot 82 accommodates the cable
56 (FIG. 5).
First Alternate Embodiment
[0043] Reference is now made to FIG. 7, which is a schematic
diagram of a cable arranger 84, in accordance with an alternate
embodiment of the invention. In this embodiment, a drive motor 86
within a housing 88 is geared to a cable collector 90, such that
actuation of the drive motor 86 causes a shaft in the cable
collector 90 to rotate about its longitudinal axis within its
housing 92.
[0044] A cable 94 passes into the housing 92 via a sleeve adaptor
96, which is fitted loosely about the cable 94 and can rotate about
the cable 94 and not grip the cable 94 when the drive motor 86 is
actuated. Referring again to FIG. 1, in normal operation the cable
94 extends from the catheter 12 through the cable arranger 84 to
the control unit 18. The cable 94 can be inserted or removed
through the housing via a slot 97.
[0045] Reference is now made to FIG. 8, which is a schematic
diagram of the cable arranger 84 (FIG. f7|) with the housings
removed. The drive motor 86 is connected to a cylindrical drive
gear 98 by a drive shaft 100. The drive gear 98 meshes with gear
teeth formed on the surface of a cable collector 102, causing the
drive gear 98 to contrarotate about its longitudinal axis. Two
series of helical grooves 104, 106 are formed in the cable
collector 102, one series of grooves having a right-handed and the
other a left-handed winding direction. The grooves 104 align with
grooves 108 in the drive gear 98. The cable 94 is taken up in the
grooves 104, and fits into opposing series of grooves 108 as the
drive gear 98 rotates and the grooves 104 align with the grooves
108. The grooves 108 permit take-up of the cable 94 without its
being compressed between the drive gear 98 and cable collector 102.
Manipulations of the cable 94 by the operator may cause a
left-handed or a right-handed twist to form in a segment 116 of the
cable 94, and the cable collector 102 rotates in one direction or
the other as the case may be so as to compensate. When it is
necessary to rotate the cable collector 102 in the opposite
direction from that shown in FIG. 8, the cable 94 is carried in the
grooves 106 rather than the grooves 104. The grooves 106 align with
corresponding grooves 110 in the drive gear 98 and perform the same
function as the grooves 108.
[0046] When the drive motor 86 is actuated, rotation of the cable
collector 102 rotates the cable 94 within the sleeve adaptor 96 in
a direction that tends to counteract twisting motion that it may
have been subjected to by rotatory movement of the catheter 12
(FIG. 1) as indicated by an arrow 112. However, the principal
effect produced by the cable collector 102 is displacement of the
twist away from the operator (as indicated by arrow 114), such that
the twisted portion of the cable 94 does not occur near the
operator (in segment 116), but instead appears beyond the cable
collector 102 in segment 118, far enough removed from the operator
so as not encumber him during the medical procedure.
Control
[0047] Reference is now made to FIG. 9, which is a schematic
diagram of a control arrangement for a cable arranger, which is
constructed and operative in accordance with any of the embodiments
of the invention described herein. A cable arranger 120, typically
located on a portion of a cable 122 proximal to the operator (not
shown), acts in response to rotation of the catheter about its
longitudinal axis. Rotation is sensed by a sensor 124, which can be
disposed on the shaft of the catheter 122 or near its tip 126, or
in the handle (not shown) of the catheter.
[0048] When a reading of the sensor 124 by a controller 128
indicates that rotation of the catheter is occurring distal to the
cable arranger 120 thereby inducing the cable to twist, a drive
motor 130 of the cable arranger 120 is actuated by the controller
128, causing the cable arranger 120 to act on the cable by
imparting another rotary motion to the catheter 122 that
counteracts the twisting force or displaces the twist away from the
operator.
[0049] In the embodiment of FIG. 9, the sensor 124 is a magnetic
field sensor having three mutually orthogonal coils 132. In the
presence of magnetic fields generated by one or more magnetic field
generators 134. This arrangement has been implemented for location
tracking in the above-described CARTO system, and is capable of
detecting changes in orientation, position, and rotation of the
catheter 122.
[0050] In another embodiment, the sensor 124 may be replaced by an
array of three mutually orthogonal accelerometers mounted at fixed
radial distances from the longitudinal axis of the catheter 122.
The angular velocity of the catheter 122 and its angular
displacement from a nominal position can be derived from the
tangential accelerations measured by the accelerometers.
[0051] In yet another embodiment, the sensor 124 may be replaced by
a strain gauge, wherein the torsion rod 54 (FIG. 5) is embodied as
a rotary torque transducer applied to the cable. Reference is now
made to FIG. 10, which is a schematic cross sectional of a view of
a rotary torque transducer 136 in accordance with an alternate
embodiment of the invention. A cable 138 passing through the torque
transducer 136 is held against a resilient upper segment 140 of a
torsion rod 142. Two preloaded strain gauges 144 are incorporated
in the upper segment 140, enabling measurement of rotational torque
in positive and negative directions.
[0052] A lower segment 146 The cable 138 is gripped against the
upper segment 140 and lower segment 146 by clasps 148, 150,
respectively. The strain gauges 144 are in electrical contact with
a slotted gear 152 via fixed electrical contacts 154. The opposite
face of the gear 152 has a series of moving electrical contacts 156
of stationary electrical brushes 158 that are mounted on a base
160.
[0053] In yet another embodiment, the sensor 124 may be replaced by
incorporating a torque encoder in the cable arranger 40 (FIG. 1). A
suitable torque encoder is taught in commonly assigned, copending
application Ser. No. 14/139,974, filed Dec. 24, 2013, which is
herein incorporated by reference.
[0054] It will be appreciated by persons skilled in the art that
the present invention is not limited to what has been particularly
shown and described hereinabove. Rather, the scope of the present
invention includes both combinations and sub-combinations of the
various features described hereinabove, as well as variations and
modifications thereof that are not in the prior art, which would
occur to persons skilled in the art upon reading the foregoing
description.
* * * * *