A system, includes (i) a processor, which is configured to receive, in a zone between first and second regions of an organ of a patient, one or more signals, at least a signal among the signals includes first and second components indicative of an electrophysiological (EP) property of the organ, and based on a relation between the first and second components, the processor is configured to estimate a location of at least a transition zone between the first and second regions, and (ii) a display, configured to display at least the estimated transition zone over a map of the organ.
A method includes obtaining an electroanatomical map, which maps a portion of a heart while the heart experiences an arrhythmia, obtaining a sequence of images of the heart acquired by an ultrasonic probe, the sequence including one or more arrhythmic images acquired while the heart experiences the arrhythmia and one or more rhythmic images acquired while the heart is in sinus rhythm, the ultrasonic probe including a sensor that outputs, during the acquisition of the sequence of images, a signal indicating a location and an orientation of the probe in a coordinate system of the electroanatomical map, based on the signal, identifying, in one of the arrhythmic images, an anatomical portion represented by a particular portion of the electroanatomical map, by tracking the anatomical portion through the sequence of images, identifying the anatomical portion in at least one of the rhythmic images, and displaying an output in response thereto.
A system includes an interface and a processor. The interface is configured to receive multiple electrophysiological (EP) signals from a tissue area along an ablation curve inside a cardiac chamber of a heart of a patient. The processor is configured to (i) generate local conduction vectors (LCVs) for the area based on the multiple EP signals, (ii) estimate a level of change between sets of LCVs along the ablation curve within the tissue area, and (iii) based on the level of change, identify a presence of a conduction gap in the ablation curve.
A medical system includes an ultrasound probe, a treatment probe, and processor. Ultrasound probe and treatment probe are configured for insertion into an organ, to, respectively, image a volume of the organ, and introduce a treatment device therein. The probes respectively include first sensor configured to output first signals indicative of first positions of an ultrasound transducer array of the probe inside the organ, and second sensor configured to output second signals indicative of second positions of the treatment device inside the organ. The processor is configured to receive tags added to ultrasound images acquired using the ultrasound probe and mark tissue regions of the organ, register first positions of ultrasound transducer array and second positions of treatment device with one another, using registration, track relative position between treatment device and tagged tissue regions, and (iv) alert user when treatment device is within predefined proximity to tagged tissue region.
A medical device includes a QR generator and a user access/activity log. The QR generator generates a QR code at least from a username of a user and at least one OTP (one-time password) for the user and enables access of the user to the medical device upon receiving an OTP from the user. The user sends the QR code to an online authorization server for the medical device for decryption upon authentication of the user. The log lists user activity once the user is authenticated by the server. The server receives the QR code, which includes at least an encrypted text containing at least the OTP and a user identification, and decrypts the encrypted text using a private key associated with the medical device. The authorization server enables the user to log in for authentication and, if authenticated, displays the at least one OTP to the user.
The disclosed methods and systems provide for working with the ever- increasing features of electroanatomical maps, displayed for use in various medical procedures. The features are represented, for example, as "map layers" or "layers" (these terms used interchangeably herein), and allow the operator of the electroanatomical mapping system to define and control all of the layers of the electroanatomical map being displayed from a single form.
G16H 30/20 - ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
G16H 10/00 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data
G16H 40/63 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
7.
ANATOMICAL MODELING WITH THE BALL-PIVOTING ALGORITHM
A system includes a display and a processor. The processor is configured to obtain a point cloud including multiple points representing different respective locations in a body of a subject, the points being labeled as corresponding to respective anatomical structures to which the locations, respectively, belong. The anatomical structures including a first structure and multiple second structures. The processor is further configured to compute a mesh including multiple triangles representing the anatomical structures, by applying a ball-pivoting algorithm to the point cloud with a constraint that none of the triangles include two of the points labeled as corresponding to different respective ones of the second structures. Other examples are also described.
A system (20) for tissue ablation includes a probe (22), an expandable capsule (50), a voltage discharge device (210), and a generator (49). The probe is configured to be inserted into a cavity of an organ of a patient. The expandable capsule is fitted at a distal end of the probe and configured to be expanded within the cavity and to be filled with a gas (250). The voltage discharge device is fitted inside the expandable capsule and is configured to create plasma by electrical excitation of the gas that fills the expandable capsule, the plasma emitting X-rays (270), so as to ablate tissue in the cavity using the X-rays. The generator is wired to the voltage discharge device to apply electrical signals that electrically excite the plasma.
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
A method includes, during arrhythmia occurrence, acquiring multiple sets of reference coronary sinus electrophysiological (CS-EP) signals with a first catheter in coronary sinus (CS) of a heart of a patient, while measuring multiple respective reference CS locations of the first catheter. One or more intra-cardiac electrophysiological (IC-EP) signals are acquired with a second catheter located in a cardiac chamber of the heart, while acquiring actual CS-EP signal with first catheter, and while measuring an actual CS location of first catheter. Using reference CS locations, reference CS-EP signal is identified. A signal-stability measure between actual CS-EP signal and identified reference CS-EP signal is estimated. If signal-stability measure is above given threshold, identified reference CS-EP is utilized to verify whether the one or more IC-EP signals acquired by the second catheter are acquired during occurrence of the arrhythmia.
A system includes a display and a processor. The processor obtains a three-dimensional mesh representing a first anatomical portion and a second anatomical portion, which is connected to the first anatomical portion. The processor receives, from a user, an input indicating a boundary between the first and second anatomical portions, fits a closed curve to multiple points on the mesh based on the input, and performs an iterative process, in response to the curve not segmenting the mesh into two separate parts, until the curve segments the mesh into two separate parts. Each iteration includes moving each of the points to another location on the mesh, and subsequently to moving each point, refitting the curve to the points. The processor is further configured to display the mesh on the display, based on the curve, so as to demarcate the first anatomical portion from the second anatomical portion.
Systems, devices, and techniques are disclosed for automatically generating CPM matrices. The system includes a processor configured to receive a plurality of historical, sparse CPM matrices and a plurality of historical, supplemented CPM matrices, wherein each sparse CPM matrix is associated with a respective supplemented CPM matrix; train a learning system based on the plurality of historical, sparse CPM matrices and the plurality of historical, supplemented CPM matrices, wherein the learning system is trained so as to generate a supplemented CPM matrix given a sparse CPM matrix; receive, by the trained learning system, a new, sparse CPM matrix; and generate, with the trained learning system, a new supplemented CPM matrix.
G16H 20/40 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
G16H 40/63 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
G16H 50/20 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
G16H 50/70 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
12.
SYSTEMS AND METHODS FOR CAVITY IMAGING IN PATIENT ORGAN BASED ON POSITION OF 4D ULTRASOUND CATHETER
A system includes a display and a processor a display and a processor. The display is configured to display multiple pixels of an image of an organ having a cavity and tissue surrounding the cavity. The processor is configured to: (1) receive an ultrasound (US) signal of at least the cavity and the tissue and one or more position signals in the organ indicative of one or more positions of one or more catheters having a known geometry, respectively, and (2) based on the one or more position signals, the known geometry, and the US signal: (i) identify in the image a given pixel at a given position, and (ii) display the given pixel as: (a) a first pixel indicative of the cavity responsively to identifying that the given position corresponds to the one or more positions, or (b) a second pixel indicative of the tissue.
A system includes a display and a processor. The display is configured to display at least a map of an organ having tissue including first and second surfaces that are facing one another. The processor is configured to: (i) receive a first position of a first lesion formed by ablating the first surface, (ii) calculate on the second surface, a second position that is facing the first position, and (iii) display, over the map, a marker indicative of the second position for guiding a user to produce in the tissue a second lesion facing the first lesion.
A system (10) for improving a cardiac ablation procedure includes a recommendation unit (14) configured to provide an initial recommendation for at least one proposed ablation line (4) for an ablation procedure on an anatomy of a patient. The system displays the at least one proposed ablation line on an anatomical map of the anatomy. The recommendation unit comprises a first and a second trained machine-learning model. Both the first and second trained machine-learning models have the same structure.
A system including a display and a processor. The processor is configured to: (i) receive multiple position measurements indicative of respective positions of an ablation electrode at respective times during an ablation procedure at an ablation site in an organ of a patient, (ii) estimate, based at least on the multiple position measurements, a quality index indicative of a stability of the ablation procedure at the ablation site, and (iii) visualize the quality index to a user on the display.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
16.
DISPLAYING ORTHOGRAPHIC AND ENDOSCOPIC VIEWS OF A PLANE SELECTED IN A THREE-DIMENSIONAL ANATOMICAL IMAGE
A method includes inserting a catheter into an organ of a patient and selecting, in a three-dimensional (3D) image of the organ, a plane of interest (POI). A first image, which includes an endoscopic view of the 3D image from a direction facing the POI, is produced. A second image, which includes a sectional view of the 3D image that is clipped by the POI, is produced, and the first and second images are displayed to a user.
Systems and methods are disclosed for generating an electro-anatomical map of the heart. Techniques disclosed include measuring groups of activation signals. The activation signals of each group are measured by respective electrodes of a mapping catheter that is placed at a respective position in the heart. Where at least one electrode of the mapping catheter that measured an activation signal of one group spatially overlapped with a respective electrode of the mapping catheter that measured an activation signal of another group. Techniques disclosed further include obtaining, based on the groups of activation signals, respective sets of time measurements, utilizing the overlapping electrodes. And, constructing the electro-anatomical map based on the obtained sets of time measurements.
An aspiration catheter (102) for assisting in the retrieval of a clot from a vessel of a patient including at least one electrode pair (202) and a first pressure sensor (204) positioned within an inner lumen of the aspiration catheter and a second and third pressure sensor (206, 208) positioned on an exterior surface of the aspiration catheter. The electrode pair and pressure sensors are in electrical communication with a control console. The control console is configured to modulate an aspiration vacuum pressure waveform pattern applied through the aspiration catheter based on electrical and pressure inputs from the one or more sensors, and optionally based on a blood pressure waveform pattern of the patient.
A method for identifying candidate locations for ablation includes receiving an electrophysiological (EP) map comprising anatomical surface of cardiac chamber overlaid with (i) activation wave velocity vectors, (ii) data points comprising positions on surface and respective local activation times (LAT), and (iii) areas designated by early meet late (EML) LAT range. Set of shortest paths on cardiac surface is identified between different EML areas. One or more ranges of LAT values are selected, being characterized by lowest prevalence over data points of EP map. Complex tags are generated for positions having the LAT values within the one or more ranges of LAT values having lowest prevalence. Subset of the shortest paths is selected based on (i) density of complex tags along shortest paths and (ii) directions of activation wave velocity vectors relative to each of shortest paths. Selected subset of shortest paths are presented as candidate slow-conduction areas for ablation.
An atrial flutter identification method includes placing a catheter comprising multiple electrodes in a coronary sinus (CS) of a heart of a patient, so that some of the electrodes overlap a left atrium (LA) of the heart and some of the electrodes overlap a right atrium (RA) of the heart. Intra cardiac (IC) electrophysiological (EP) signals are acquired with the electrodes. Respective signal-stability measures are estimated over the signals acquired by the electrodes overlapping the LA and over the signals acquired by the electrodes overlapping the RA. When one of the signal-stability measures is above a first threshold while the other of the signal-stability measures is below a second threshold, an atrium is indicated, that corresponds to a highest among the signal-stability measures as a source of atrial flutter.
A method includes receiving an electrophysiological (EP) map of a cardiac chamber, the EP map including data points comprising respective locations and EP values. The EP map is projected onto a sphere divided into a grid of unit areas. For at least some of the unit areas, a most likely data point is estimated that is representative of an EP activation in the unit area. The representative data points is inverse mapped onto the EP map. An updated EP map with the inverse mapped representative data points is presented to a user.
In one exemplary mode, a medical system includes an ultrasound probe configured to captured ultrasonic images of at least part of a body part of a living subject, a display, and a processor configured to render to the display respective representations of respective electro-anatomical data subsets superimposed over respective ones of the ultrasonic images.
A method for medical diagnosis, consisting of receiving electrophysiological data including first intracardiac electrogram (IEGM) signals acquired by a first pair of electrodes having a first intracardiac electrode. The data includes second IEGM signals acquired by a second pair of electrodes having a second intracardiac electrode in proximity to the first intracardiac electrode. The first and second IEGM signals are input to a first convolutional layer of a neural network and a second convolutional layer parallel to the first convolutional layer in the neural network to generate respective first and second interim results. The first and second interim results are input into one or more common layers of the neural network. The method includes receiving from an output layer of the neural network, responsively to inputting the first and second interim results, an indication of a local activation time at a location of the first and second intracardiac electrodes.
An apparatus includes a shaft assembly and a distal endoscope cap. A flexible distal portion of the shaft assembly is laterally deflectable relative to a rigid proximal portion of the shaft assembly. The shaft assembly defines a working channel sized and configured to enable advancement of a working element. The distal endoscope cap is configured to attach to the distal end of the shaft assembly. The distal endoscope cap has an outer diameter that is larger than the outer diameter of the flexible distal portion. The distal endoscope cap includes a body having at least one coupling member for attaching the distal endoscope cap to the distal end of the shaft assembly, at least one image sensor secured to the body for visualizing an anatomical structure, and at least one illuminating element secured to the body for illuminating a field of view of the at least one image sensor.
A61B 1/233 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes
A61B 1/05 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
In one exemplary mode, a medical system includes a catheter configured to be inserted into a body part of a living subject, and comprising multiple electrodes configured to contact tissue of the body part, a display, and processing circuitry configured to receive a signal from one of the electrodes, find a noise measurement of the signal, and render to the display a dynamic indication of the noise measurement.
A61B 5/367 - Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
A61B 5/06 - Devices, other than using radiation, for detecting or locating foreign bodies
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A method includes acquiring intracardiac unipolar signals and intracardiac bipolar signals at a given region of a heart of a patient. The unipolar signals are pruned by eliminating ones of the unipolar signals that correspond in time to respective bipolar signals. One or more unipolar signals are identified among the pruned unipolar signals, that are associated with far-field P-waves. Using the identified P-waves, a window of interest (WOI) is set on electrograms acquired in an atrium of the heart, and, using the electrograms having the set WOI, an electrophysiological (EP) map is generated, of the atrium indicative of atrial tachycardia (AT) tissue locations therein.
A system for generating an electrophysiological (EP) map includes a display and a processor. The processor is configured to (i) receive multiple EP data points comprising respective locations and EP values, generated from signals acquired by one or more electrodes of a catheter that are in contact with tissue of a cardiac chamber, (ii) score the received data points with respective quality scores, (iii) for a given unit volume of the EP map, select, from among the data points whose locations fall in the unit volume, a data point with a highest quality score, for use in generating the EP map, and (iv) visualize the EP map to a user, on the display.
A method for generating a skeleton in an image of a cavity of an organ of a body includes receiving a map of the cavity, the map including surface voxels and interior voxels. A subset of the interior voxels is generated, of candidate locations to be on the skeleton. The subset is pruned by removing outlier candidate locations. Using a geometrical model including a statistical model, the candidate locations remaining in the pruned subset are spatially compressed. The compressed candidate locations are connected to produce one or more centerlines of the skeleton. At least the skeleton is displayed to user.
A method includes receiving a 3D image of a portion of an organ including a cavity, the image comprising voxels having respective values. A wall of the cavity is identified in the image, by (i) positioning virtual solid objects inside respective sub-volumes of the cavity, (ii) moving the virtual solid objects inside the cavity according to a predefined rule of motion, (iii) while the virtual solid objects move inside the cavity, adapting the traversed voxels to predefined value indicative of the interior of the cavity, (iv) responsively to detecting that a virtual solid object comes into contact with the wall, rolling the virtual solid object over the wall, and adapting a surface of the virtual solid object with the values of the voxels over which the surface rolls, and (v) converting adapted voxel values that are lower than a threshold voxel value into the predefined value indicative of the interior.
A method includes receiving a target location for performing a procedure in an organ of a patient and a mapping of a lumen located along a path to the target location. Based on the target location and the mapping received, the method further includes producing an endoscopic view of at least the lumen and displaying in the endoscopic view, on at least a wall of the lumen, one or more marks indicative of a progress of the procedure.
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61B 1/233 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes
31.
AUTOMATIC STORAGE AND DISPLAY OF ECG SIGNALS INDICATIVE OF ATRIAL FIBRILLATION
A method includes inserting, into a heart of a patient, a catheter having multiple electrodes, and placing the electrodes in contact with tissue of the heart. For each of the electrodes: (i) position signals indicative of a position of the electrode, and (ii) electrocardiogram (ECG) signals acquired by the electrode, are received during a predefined time interval. A positioning stability, along the predefined time interval, is calculated for each of the electrodes based on the position signals. For the electrodes whose positioning stability has an error smaller than a given threshold, calculating whether the ECG signals are indicative of an atrial fibrillation (AF) in the heart. The ECG signals that are indicative of the AF are stored.
A medical instrument may include an expandable balloon on a distal end and a handle with a knob thereon. The knob may be movable along the handle, and the handle may include a switch disposed between the handle and the knob so that the movement of the knob relative to the handle activates and deactivates a circuit connected to the switch to provide an indication of the position of the knob in relation to the handle to a console. A catheter may include an elongated catheter shaft, an expandable member distal of the elongated catheter shaft, and a handle with a knob disposed thereon. The catheter may include a switch disposed between the knob and handle so that movement of the knob activates and deactivates a circuit connected to the switch.
An apparatus includes a mounting portion and a sensor portion. The mounting portion is configured to fit over a nose of a preselected patient. The mounting portion includes a base and a pair of rigid nose pads fixedly coupled to the base. Each nose pad of the pair of nose pads includes a respective nose-gripping surface. The nose-gripping surfaces of the nose pads are configured to engage the nose of the preselected patient at respective predetermined locations along the nose. Each nose-gripping surface is sized and shaped to complement a corresponding unique structural feature of the nose of the preselected patient at the predetermined location. A sensor portion is fixedly attached to the mounting portion. The sensor portion includes a first sensor configured to generate a first signal corresponding to a position of the first sensor in three- dimensional space.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
B33Y 80/00 - Products made by additive manufacturing
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
34.
CONTROLLING AND VISUALIZING ROTATION AND DEFLECTION OF A 4D ULTRASOUND CATHETER HAVING MULTIPLE SHAFTS
A catheter includes: a shaft for insertion into an organ of a patient, and first and second position sensors. The shaft includes: (a) an inner shaft, which is configured to be deflected relative to an axis of the shaft, and (b) an outer shaft, which is coupled to a distal tip of the catheter and is configured to be: (i) coaxially disposed around the inner shaft, (ii) deflected together with the inner shaft, and (iii) rotated about the axis relative to the inner shaft. The first position sensor is coupled to the distal tip and is configured to produce a first signal, and the second position sensor is coupled to the inner shaft, and is configured to produce a second signal.
A61B 8/12 - Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61B 8/00 - Diagnosis using ultrasonic, sonic or infrasonic waves
A61B 8/08 - Detecting organic movements or changes, e.g. tumours, cysts, swellings
35.
AUTOMATIC SHAVING OF AN ANATOMICAL MAP DURING ABLATION TO EXPOSE INTERNAL POINTS OF INTEREST
A method includes receiving or generating (i) a volume map of at least a portion of a cavity of an organ of a body including a plurality of mapped locations, and (ii) ablation locations inside the cavity. The volume map is updated by removing a portion of the mapped locations, so that the ablation locations inside the cavity fall on a surface of the volume map. Using the updated volume map, a map of at least a portion of the cavity is generated, that includes the ablation locations located on a surface of the updated volume map. The map is displayed to a user.
An apparatus includes a body,, a shaft assembly, and a visualization assembly. The body includes first and second actuators. The shaft assembly extends distally from the body and includes a rigid proximal portion and a steerable distal portion. The steerable distal portion is positioned distally relative to the rigid proximal portion. The first actuator is operable to drive the steerable distal portion to deflect laterally relative to a longitudinal axis defined by the rigid proximal portion. The steerable distal portion is configured to fit within a nasal cavity of a patient. The visualization assembly is disposed within the shaft assembly. The visualization assembly includes a camera. The second actuator is operable to drive longitudinal translation of the visualization assembly relative to the shaft assembly.
A61B 1/05 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
A61B 1/233 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes
A61B 1/12 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/16 - Indifferent or passive electrodes for grounding
37.
VISUALIZING A MEDICAL PROBE IN A FOUR-DIMENSIONAL ULTRASOUND IMAGE
Medical systems and methods are provided in which a processor receives the 3D ultrasound images and receives position signals from a position tracking device, indicating the position of a corresponding probe relative to the 3D ultrasound images. Based on the probe position, a region of interest is selected that contains the position the medical probe within the 3D ultrasound images, and the selected region of interest is rendered to a display together with a representation of the medical probe superimposed on the region of interest.
G16H 30/20 - ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
G16H 40/63 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
39.
DIRECTING AN ULTRASOUND PROBE USING KNOWN POSITIONS OF ANATOMICAL STRUCTURES
A method includes manipulating a catheter, which includes an ultrasound transducer array, inside an organ of a patient so as to acquire ultrasound images of at least part of the organ. One or more reference positions are identified of one or more respective reference anatomical structures in or near the organ. The ultrasound images are annotated with annotations indicating the identified reference anatomical structures.
A system includes (a) a catheter for insertion into an organ of a patient, a distal end of the catheter, the distal end including: (i) one or more ultrasound transducers (UT), which are configured to apply ultrasound (US) waves to the organ and to produce one or more US signals indicative of a surface topography of the organ, and (ii) a position sensor, which is configured to produce one or more position signals indicative of one or more respective positions of the distal end inside the organ, and (b) a processor, which is configured, based on the US signals and the position signals, to: (i) produce an anatomical map of the surface topography, and (ii) visualize a change in a slope of the surface topography.
In one example, method includes receiving an electrophysiological (EP) map of at least a portion of a surface of a cardiac chamber, the EP map including multiple EP values overlayed at multiple respective positions on the surface. A clinical input is identified, that was marked on the EP map by a user using an input device. One or more of the EP values are automatically adjusted to be consistent with the clinical input.
A method is implemented by a mapping engine executed by a processor. The method includes receiving electrical activity from electrodes of a catheter. The method includes performing a spatial electrode signal analysis of the electrical activity for each electrode of the catheter. The method includes scaling a common signal component of the electrical activity identified by the spatial electrode signal analysis to determine a residual signal.
A method for configuring an electroanatomical (EA) mapping procedure, the method includes receiving user input including a type of arrhythmia to be diagnosed. A confidence level is received for data points acquired in a heart of a patient in the EA mapping procedure. One or more data collection parameters for the data points are automatically set based on the type of arrhythmia and the confidence level. An EA map is constructed and presented, the EP map including at least some of the acquired data points, in accordance with the automatically-set data collection parameters.
A computing system is provided. The computing system includes a memory storing processor executable code. The computing system includes processors executing the code. The code causes the computing system to generate a graphical user interface that includes topological maps constructed from a three-dimensional anatomical model of a portion of an anatomical feature. The topological maps include an interior map view of the portion of the anatomical feature from a perspective of a device inserted into a patient. The code causes the computing system to generate a device icon on each of the topological maps. The device icon presents a real time position of an ablating surface of the device in relation to each map view of the topological maps.
In an example, a method includes receiving a cardiac signal that is sensed by an electrode at a tissue location inside the heart. Fractionations are identified in the cardiac signal. The fractionations identified at the tissue location are compared between first and second cardiac cycles of the cardiac signal. Based on the comparing, a likelihood is estimated, that the tissue location is causing a stable arrhythmia. Based on the estimated likelihood, the tissue location is indicated to a user as likely to be causing the stable arrhythmia.
A system and method for non-invasively detecting abnormal electrical propagation in the heart are disclosed. The system and method (700) include an interface for receiving a pacing signal applied to a heart of a patient, the pacing signal (710) comprising (i) a sequence of regular pacing stimuli shorter than the sinus-rate intervals, and (ii) one or more extra pacing stimuli at intervals that are shorter than the regular pacing stimuli, a processor to: - assess the envelope of a body-surface ECG component after the regular pacing stimuli, (720) - assess the envelope of a body surface ECG component after the one or more extra pacing stimuli, (740) and - compare the assessed component after the extra pacing stimuli to the assessed component after the regular pacing stimuli (750). An interface is configured to output the comparison (760) as an indication of regions of arrhythmogenicity and ablation targets in the heart.
Systems and methods for optimal selection of beats for a 3D mapping are disclosed. A method in accordance with the present disclosure may be performed on a processor and may comprise receiving a plurality of beats from a catheter. The catheter may be located at a target mapping site, such as a chamber of the heart. A plurality of dynamic filters may be applied to the plurality of collected beats. The optimal beats may be determined and integrated as a beat in the 3D mapping system. This method enables the selection of more beats for a more comprehensive 3D mapping, as well as the selection of more quality beats that are representative of the target anatomy.
An ablation procedure guidance method is provided herein. The ablation procedure guidance method is implemented by a generation engine executing on a processor. The ablation procedure guidance method includes receiving inputs including images and conduction velocity vector estimations and generating a digital twin of an anatomical structure utilizing the images and the conduction velocity vector estimations. The ablation procedure guidance method also includes presenting, via a user interface of the generation engine, the digital twin to provide precision ablation guidance of the anatomical structure and provide electrophysiology information of the anatomical structure.
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 34/00 - Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
G16H 20/40 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
49.
DEVICES AND METHODS FOR AN EXPANDABLE ASSEMBLY CATHETER
A catheter apparatus includes an elongated deflectable element including a distal end, a coupler connected to the distal end, a pusher including a distal portion, and configured to be advanced and retracted through the deflectable element, and an expandable assembly including flexible polymer circuit strips, each strip including electrodes disposed thereon. The strips can be configured to bow radially outward when the pusher is retracted expanding the expandable assembly from a collapsed form to an expanded form. A covering can at least partially enclose the flexible polymer circuit strip and the multiple electrodes. The covering can include a plurality of apertures at each electrode so that a portion of the conductive surface of each electrode is exposed through each aperture.
A method for securely storing (and/or securely retrieving) medical data, MD, the method for storing comprising at least steps of: - obtaining, in a secure environment, medical data which include patient property data as well as patient identifier data wherein the patient identifier data indicate at least one patient to which the patient property data correspond; - generating, in the secure environment de-identified medical data by replacing the patient identifier data in the medical data, MD, with non-patient-identifying coded identifiers, NPICI; - generating, in the secure environment, a re-identifying database indicating correspondences between the non-patient-identifying coded identifiers, NPICI and the PID; - generating an encrypted re-identifying database by applying, in the secure environment, at least one symmetric and/or asymmetric encryption method to the re-identifying database, RIDB; - storing the encrypted re-identifying database and the de-identified medical data on a cloud storage outside of the secure environment.
G16H 10/60 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
G06F 21/62 - Protecting access to data via a platform, e.g. using keys or access control rules
Planar end effector designs having irrigation are presented. The example end effectors are configured to be affixed to a distal end of a catheter and delivered through vasculature in a collapsed configuration and expand at an intracardiac treatment site to a deployed configuration. In some instances, the end effector can have an electrode array with sufficient density to perform mapping and irrigation for mapping. The end effector can include dedicated irrigation tubes and/or irrigating electrode-carrying spines to irrigate within the electrode array. Flow rate at positions within the electrode array can be controlled in a predetermined manner by varying pore/port size, flow direction, and/or flow path cross-section throughout an irrigation flow path in the end effector.
A surgical instrument includes a sheath and an energy catheter. The sheath is configured to be inserted into a nasal cavity of a patient's head. The energy catheter includes a shaft and an end effector. The end effector is configured to selectively expand radially outwardly. The end effector includes an energy member that includes a flexible wire and electrodes disposed along the wire. The energy catheter is selectively translatable relative to the sheath. In a proximal position, the end effector is housed coaxially within the sheath to thereby prevent the end effector from radially expanding. In a distal position, the end effector is exposed from the sheath to thereby permit the end effector to expand for contacting tissue in the nasal cavity of the patient's head. When the end effector is in the expanded state, the end effector has a width and a length greater than the width.
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 90/30 - Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
54.
ADAPTIVE NAVIGATION AND REGISTRATION INTERFACE FOR MEDICAL IMAGING
A method is provided. The method is implemented by an interface engine stored as processor executable code on a memory coupled to a processor. The method includes aggregating data from completed cases, analyzing the data for accuracy, consistency, or error within or across the one completed cases, and generating one or more grades based on the analysis of the data. Note that the data includes location information and registration information, and the completed cases include at least one ear, nose, and throat navigation and registration procedure.
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
G16H 50/70 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
A control handle for a steerable catheter allows for precise manipulation of the distal catheter tip in a target organ or vessel using only one hand. The control handle can have a single articulating knob capable of both linear translation along and rotation about the axis of the handle. These functions of the articulating knob actuate both the expansion and retraction of an expandable member, as well as bi-directional deflection of the distal catheter tip. The articulating knob functions with consistency regardless of the orientation of the handle, with ergonomic movements allowing the user to comfortably keep their attention on the procedure's monitoring equipment. These improvements can lead to safe and more rapid procedure times for procedures such as diagnostics and cardiac ablation.
A system, device and method of using an ultrasound sensor with a balloon catheter are disclosed. The system, device and method include collecting an ultrasound reading from the ultrasound sensor, comparing a vein diameter to the collected ultrasound reading, and calculating an inflation index based on a generated map and the respective positions of the ACL electrodes. If the vein diameter is the same as the ultrasound reading, the balloon catheter is too far into the vein and needs to be retracted. The ultrasound reading may be compared to the inflation index of the balloon and/or to the vein diameter. The system, device and method include obtaining a baseline characterization of the vein (ostium), obtaining a current characterization of the vein (ostium) after a catheter is in position for a PV ablation, comparing the respective characterizations, and determining a location of the catheter based on the comparison.
A method includes, using a processor, identifying a septum and a Left Atrium Appendage (LAA) of a heart of a patient in an anatomical map of at least part of the heart. An entry surface over which a medical device is defined on the anatomical map, which is to be delivered via a sheath that penetrates the septum, is to engage with the LAA. A normal to the entry surface is calculated. A plurality of curves is calculated that each (i) have one end that is tangent to the normal, (ii) have a second end touching the septum, and (iii) comply with specified mechanical properties of the sheath. Multiple candidate locations on the septum are derived from the curves, for transseptal puncture with the sheath. The multiple candidate locations are presented to a user.
Apparatus and methods are provided for receiving an image of a portion of a body anatomy of a patient, registering the image to patient coordinates, inserting a probe into the portion of the body anatomy, the probe comprising a tool tip configured to identify the position of the probe relative to the registered image, performing the procedure, the procedure comprising navigating the probe within the portion of the body anatomy, generating a procedure report comprising one or more components related to the procedure, the one or more components comprising a visual indication of areas of the portion of the body anatomy navigated to by the probe, and providing the procedure report in a selected format upon termination of the procedure.
A system and method for detecting and reducing noise in an ECG environment is disclosed. The system and method include inputting data regarding the ECG and ECG noise into a database, the database including data on other ECG patients and their respective signals, modeling the noise of the ECG in a quiet environment to provide samples to train and model to identify noise in an ECG system, and identifying the noise signals within the ECG data and removing the noise from the signals. The noise may include per site noise signals, additive noises, contact noise and deflection noise. The quiet environment may include an aquarium.
A system and method for detecting and reducing noise in an ECG environment is disclosed. The system and method include inputting data regarding the ECG and ECG noise into a database, the database including data on other ECG patients and their respective signals, modeling the noise of the ECG in a quiet environment to provide samples to train and model to identify noise in an ECG system, and identifying the noise signals within the ECG data and removing the noise from the signals. The noise may include per site noise signals, additive noises, contact noise and deflection noise. The quiet environment may include an aquarium.
A61B 5/367 - Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
G01R 31/00 - Arrangements for testing electric properties; Arrangements for locating electric faults; Arrangements for electrical testing characterised by what is being tested not provided for elsewhere
A system and method for predicting the outcome of therapy for a cardiac arrhythmia patient are disclosed. The system and method include inputting data regarding the arrhythmia into a database, the database including data on other arrhythmia patients and their respective therapy, modeling the arrhythmia based on training and modeling of the other arrhythmia data, and predicting the outcome of therapy for the cardiac arrhythmia patient. The system and method may include the input data including patient records, prior examination information, drug protocol, demographics, age and gender, surface ECG, at least one MRI, and modeling information. The modeling may include at least one of a digital model, mapping information, and CARTO® information.
G16H 20/00 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
A guiding sheath has a hemostatic valve and a central lumen into which a diagnostic or treatment catheter can be introduced and guided into a patient. The hemostatic valve also includes an electrically conducting element or proximity sensing element on its proximal end that interacts with a second electrically conducting element or proximity sensing element on a proximal end of the diagnostic or treatment catheter that can be passed through the central lumen of the guiding sheath and into the patient's heart. The interaction between the two electrically conducting elements or proximity sensing elements enables the location of the distal end of the diagnostic or treatment catheter in the patient's heart without the need for irradiating the patient.
A surgical instrument includes a sheath and an ablation catheter disposed within the sheath. The sheath is configured to be inserted into a cavity of a patient's head. The ablation catheter extends along a longitudinal axis and includes at least one expandable ablation member configured to selectively radially expand outwardly from a non-expanded state to an expanded state for selectively ablating tissue within the patient's head. The ablation catheter is selectively translatable relative to the sheath between a proximal retracted position and a distal extended position. In the retracted position, the at least one expandable ablation member is housed within the sheath to thereby prevent the at least one expandable ablation member from radially expanding outwardly. In the extended position, the at least one expandable ablation member is exposed from the sheath to thereby permit the at least one expandable ablation member to radially expand outwardly for contacting tissue.
An ablation instrument includes a shaft that extends from a grip portion. A curved portion of the shaft is shaped to allow insertion into the head of a patient, and to position an ablation tip that extends from a distal tip of the shaft proximate to an ablation target, such as the posterior nasal nerve. When activated the ablation tip projects radiofrequency energy to ablate nearby tissue. An ablation assistance features of an image guided surgery navigation system is configured to segment and identify ablation targets within a set of pre-operative images. When a position tracked ablation instrument is configured for use, the system begins to monitor the proximity of the ablation tip to the ablation targets. When the tip is within an effective distance of the target for ablation, the system provides an alert and activates the instrument so that RF energy may be projected.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 34/00 - Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
An apparatus includes a shaft assembly and an electrode assembly at a distal end of the shaft assembly. The electrode assembly includes a first conductive segment extending along a first angular range at the distal end of the shaft assembly. The first conductive segment is operable to apply RF energy to tissue at a first polarity. The electrode assembly further includes a second conductive segment angularly spaced apart from the first conductive segment. The second conductive segment extends along a second angular range at the distal end of the shaft assembly. The second conductive segment is operable to apply RF energy to tissue at a second polarity such that the first and second conductive segments are operable to apply bipolar RF energy to tissue.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A method is provided. The method includes pacing, by electrodes of a catheter, a heart tissue with pulses. The method includes observing, by the electrodes, a period of electrophysiological repolarization for the heart tissue. The period of electrophysiological repolarization is caused by the pacing. The method also includes measuring, by the electrodes, an electrical signal within the heart tissue after the period of electrophysiological repolarization.
A medical tool testing apparatus comprising a vessel. The vessel comprises a scaffold formed from biomaterial, live cardiac tissue, generated from cardiac cells, proliferating on the scaffold, the live cardiac tissue configured to generate electrical activity. The vessel also comprises a medical tool, in contact with live cardiac tissue, used for a medical procedure within patient anatomy. Operational features of the medical tool are determined by a visually perceptible condition of the live cardiac tissue.
A method includes receiving a medical imaging scan of at least a part of a body of a patient. Voxels of the scan are identified, that correspond to regions in the body that are traversable by a probe inserted therein. The scan is displayed on a screen and selected termination and start points for the probe are marked thereon. Using a processor, a backward path is found from the termination point to the start point comprising a connected set of the identified voxels. The backward path is visualized on the screen in association with the scan.
An apparatus includes a shaft, a balloon, a tip member, and a heating feature. The tip member is distal to the balloon and has a larger outer diameter than the shaft. The heating feature is operable to ablate tissue of the Eustachian tube contacting the balloon in the expanded state. The heating feature may include an illuminating element and a photosensitive coating on the balloon. Alternatively, the heating feature may include a thermal heating element that heats the balloon inflation fluid and thereby heats the wall of the balloon. Another apparatus includes a shaft, a tip member, and an electrode assembly. The electrode assembly includes a plurality of electrodes positioned along the shaft near the distal end, proximal to the tip member. The electrodes are spaced apart from each other along a longitudinal axis and are operable to apply RF energy to tissue to thereby ablate the tissue.
A61B 18/06 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating caused by chemical reaction
A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
An apparatus includes a body, a shaft assembly, and a shaft actuation assembly. The shaft assembly extends distally from the body and defines a longitudinal axis. A portion of the shaft assembly is configured to be inserted into an anatomical passageway associated with an ear, nose, or throat of a patient. The shaft assembly further defines a working passageway that is dimensioned to receive an instrument. An actuator of the body is operable to drive the instrument longitudinally relative to the shaft assembly. The shaft actuation assembly is operatively coupled with a proximal portion of the shaft assembly. Further, the shaft actuation assembly is translatable in a distal direction to extend the shaft assembly distally along the longitudinal axis and is translatable in a proximal direction to retract the shaft assembly proximally along the longitudinal axis.
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
71.
PRE-OPERATIVE REGISTRATION OF ANATOMICAL IMAGES WITH A POSITION-TRACKING SYSTEM USING ULTRASOUND MEASUREMENT OF SKIN TISSUE
A method includes receiving multiple measurements, which are acquired using a registration tool including an ultrasound (US) transducer and a position sensor of a position-tracking system. The measurements are acquired by positioning the registration tool, while maintaining a gap from skin tissue, at multiple respective locations on a patient head and acquiring respective position measurements of the position sensor and respective US measurements of the skin tissue at the locations. First positions are calculated based on the position measurement and the US measurements obtained using the registration tool. Second positions are identified in an anatomical image of the patient head. The anatomical image is registered with a coordinate system of the position tracking system, by correlating the first positions and the second positions, so as to enable tracking a medical instrument, which is inserted into the patient head and includes another position sensor.
A system includes a medical instrument, a position sensor, and a processor. The medical instrument includes a handle and a head, the head being configured for insertion into an organ of a patient and having a feature that is rotationally-asymmetric about a longitudinal axis of the medical instrument. The position sensor, which is disposed on the head and is configured to generate signals in response to an externally-applied magnetic field. The processor is configured to receive the signals generated by the position sensor on the head, and estimate, based on the received signals, a roll angle of the rotationally-asymmetric feature of the head.
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A jig (55) includes a base (90) and one or more movable blocks (77A, 77B, 77C,77D). The base (90) has an upper surface (92), which is configured to receive a substrate (99) shaped as a flattened polyhedron having multiple facets (88A, 88B, 88C, 88D, 88F). The one or more movable blocks (77A, 77B, 77C, 77D) are configured to move on the base (90) so as to fold respective ones of the multiple facets (88A, 88B, 88C, 88D, 88E, 88F), and to hold the substrate (99) In a folded three-dimensional configuration.
B23P 19/00 - Machines for simply fitting together or separating metal parts or objects, or metal and non-metal parts, whether or not involving some deformation; Tools or devices therefor so far as not provided for in other classes
A61B 5/06 - Devices, other than using radiation, for detecting or locating foreign bodies
An apparatus includes a catheter body and an end effector. The catheter body has a distal end and is sized and configured to fit within regions of a cardiovascular system. The end effector is at the distal end of the catheter body and is sized and configured to fit within regions of a cardiovascular system. The end effector includes an end effector body, an electrode, and a sensor. The end effector body has an outer surface. The electrode has a tissue contact surface. The sensor has a tissue contact surface. The sensor is configured to sense at least one condition associated with tissue contacting the tissue contact surface of the sensor. The tissue contact surface of the sensor is configured to protrude relative to one or both of the outer surface of the end effector body member or the tissue contact surface of the electrode.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
75.
TROCAR WITH MOVABLE CAMERA AND BUILT-IN POSITION SENSOR
A trocar for insertion into an organ of a patient includes a cannula having a longitudinal axis, a camera fitted inside the cannula, and a movable element, which is coupled to the camera and is configured to be moved along the longitudinal axis of the cannula and to move the camera along the cannula.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
76.
POSITION REGISTERED SIDEVIEW ULTRASOUND (US) IMAGER INSERTED INTO BRAIN VIA TROCAR
An apparatus includes a medical probe and a trocar. The medical probe includes a distal end configured to be inserted into an organ of a patient, the distal end including a magnetic position sensor and a sideview-looking ultrasound imager. The trocar has a channel for insertion of the probe therethrough.
A trocar for insertion into an organ of a patient includes a cannula, a channel inside the cannula, and a camera. The cannula has a longitudinal axis, and the channel inside the cannula is fitted parallel to the longitudinal axis. The camera is disposed at a distal end of the channel and is configured to provide images in a direction of a distal opening of the cannula.
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 1/05 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
78.
THREE DIMENSIONAL MAPPING SYSTEM FOR CRANIAL SURGICAL PATHWAYS WITH SEMI-TARGETS AND METHOD
Methods and apparatus are provided for mapping and displaying a three dimensional (3D) surgical pathway. Entry and target voxels are selected along with a semi-target voxel therebetween. Where voxels representing bone are between the entry and target voxels, the semi-target voxel is selected such that voxels representing bone are not within a shortest line between it and the entry voxel. A series of voxels through the semi-target voxel define the pathway. For each voxel V in the series between the semi-target voxel and one of the endpoint voxels, the immediately succeeding voxel of voxel V is selected from among the group of neighbor voxels of voxel V by comparing selection weights of each voxel determined a selected basis including relative distances with respect to the endpoint voxel and the semi-target voxel. The pathway voxels are selectively highlighted in a displayed view to provide a visualization of the 3D surgical pathway.
A medical probe includes a guide wire, and a connector at a proximal end of the probe. The guidewire is configured to be inserted into an organ of a patient and includes one or more electrical devices fitted at a distal end of the guidewire, and two or more conductors, which connect the electrical devices to a proximal end of the guidewire. The conductors have proximal ends that are exposed at different positions along the proximal end of the guidewire. The connector is fitted with multiple conductive rings that are positioned to mate with the respective exposed proximal ends of the conductors, and to maintain electrical contact with the conductors while the guidewire is rotated.
A catheter includes a catheter body and a distal tip section that includes an elongated member that extends along a longitudinal axis. An anchor mechanism can be disposed along an outer surface of the elongated member and/or within the elongated member in a first configuration. In a second configuration, the anchor mechanism can be configured to extend radially outward with respect to the longitudinal axis to surround at least a portion of the distal tip section.
A medical probe includes a shaft and a frame. The shaft is configured for insertion into an organ of a patient. The frame is coupled to a distal end of the shaft, and includes (i) a plurality of electrodes disposed on an outer surface of the frame and configured to apply irreversible electroporation (IRE) to tissue by applying voltage pulses, and (ii) one or more irrigation channels, configured to flow irrigation fluid in a vicinity of the electrodes.
A location pad includes multiple field-generators and a frame. The multiple field-generators are configured to generate respective magnetic fields in a region-of-interest of a patient organ, so as to measure a position of a medical instrument in the region-of-interest. The frame is transparent to an X-ray radiation, and is configured to fix the multiple field-generators at respective positions surrounding the region-of-interest.
A trocar for insertion into an organ of a patient includes a cannula, an obturator body, and two or more interchangeable obturator heads. The cannula has a longitudinal axis. The obturator body is configured to be inserted into the cannula. The two or more interchangeable obturator heads are each configured to be detachably fitted at a distal end of the obturator body.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
84.
NON-CIRCULAR WORKING CHANNEL OF AN EAR-NOSE-THROAT TOOL
A medical tool includes a rotatable hollow tube and one or more electrical wires. The rotatable hollow tube is defining a working channel therein for insertion of a medical instrument into a cavity of a patient body. The one or more electrical wires traverse the working channel for exchanging electrical signals with one or more electronic devices located at a distal end of the rotatable hollow tube. The working channel has a non-circular cross section for passing both the medical instrument and the one or more electrical wires, and for allowing rotation of the rotatable hollow tube relative to the medical instrument located inside the working channel in the presence of the one or more electrical wires.
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61B 1/012 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
A61B 1/233 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes
A61B 1/018 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
iiiiiiiiiiiii. The selection is made by comparing selection weights determined based on relative distances with respect to the endpoint voxels and relative distance from voxels within a predetermined distance that represent at least a threshold density. The voxels of the pathway are then selectively highlighted in a displayed view to provide a visualization of the 3D surgical pathway.
A medical tool includes, a deflectable distal end, at least a pull wire, and a coupling element. The at least pull wire has a first end coupled to the distal end of the medical tool, and configured to be moved for deflecting the distal end. The coupling element is coupled to a second end of the pull wire and having at least two boreholes configured to receive at least two respective rods traversing therethrough. The coupling element is configured to be moved along a rotation axis of a rotatable element coupled thereto, and the boreholes and the respective rods are configured to prevent rotation of the coupling element.
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A trocar for insertion into an organ of a patient includes a cannula having a distal opening, a channel inside the cannula, and an optical assembly including a camera. The optical assembly is disposed at a distal end of the channel and is configured to provide camera images of the distal opening with a field-of-view (FOV) that is tilted relative to a longitudinal axis of the cannula.
A medical tool includes, a deflectable distal end, at least a pull wire, and a deflection assembly. The at least pull wire having a first end coupled to the distal end of the medical tool and configured to be moved for deflecting the distal end. The deflection assembly is coupled to a second end of at least the pull wire and is configured to control a deflection of the distal end. The deflection assembly includes a first gear having a first rotation axis, and a second gear, having a second rotation axis and including a jagged surface for integrating with the first gear. The jagged surface is slanted relative to the second rotation axis, and when the first gear rotates, the second gear is configured to be rotated by the first gear, to move along the second rotation axis and to deflect the distal end by moving the pull wire.
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A medical apparatus includes, a trocar, a control handle, at least a first electrical wire, and at least a second electrical wire. The trocar is inserted into an organ of a patient. The trocar includes a cannula having a longitudinal axis, a position sensor that is fitted inside the cannula, and a camera that is coupled to a movable element, which is fitted inside the cannula and configured to be moved along the longitudinal axis for moving the camera along the cannula. The control handle is coupled to a proximal end of the movable element and is 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 a slack configured to compensate for a motion of the camera.
In one embodiment, a medical apparatus, includes a medical instrument configured to move within a passage in a body of a patient, a position tracking system to track coordinates of the medical instrument within the body, a display screen, and a processor to register the position tracking system and a 3D computerized tomography (CT) image of at least a part of the body within a common frame of reference, find a 3D path of the medical instrument through the passage from a start point to a termination point within the common frame of reference, compute a direction to the 3D path from the medical instrument responsively to the tracked coordinates, and render and simultaneously display on the display screen respective 2D CT slices, based on the 3D CT image, including respective 2D indications of the direction to the 3D path from the instrument projected onto the respective 2D CT slices.
A method includes, using a probe, applying irreversible electroporation (IRE) pulses to tissue over a time period to form a lesion in the tissue. A contact force applied to the tissue by the probe is measured over the time period. An IRE index is calculated based on the measured contact force and on a power level of the IRE pulses. Application of the IRE pulses to the tissue is ceased in response to the calculated IRE index reaching a prespecified target IRE index value.
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
92.
MEDICAL PROBE WITH A DEFLECTABLE DISTAL TUBE COMPRISING AN INTRUSION FACING A PROTRUSION AND A METHOD FOR PRODUCING A MEDICAL PROBE
A medical probe (28) includes a shaft (38), for insertion into a cavity of a patient body, and a distal end assembly (134), which is coupled to a distal end of the shaft and includes a hollow tube (66), which is configured to deflect relative to a longitudinal axis of the hollow tube and to rotate about the longitudinal axis. The hollow tube has an intrusion (99A) having at least a first surface and a protrusion (88A) facing the intrusion and having a second surface.
In one embodiment, an apparatus includes a medical instrument, a position tracking system to track coordinates of the instrument within a passage in a body, a processor to register the system and a 3D CT image of at least a part of the body, find a path of the instrument through the passage, compute segments of the path, compute respective locations along the path of respective virtual cameras responsively to the computed segments, select the respective virtual cameras for rendering respective virtual endoscopic images responsively to the tracked coordinates, compute respective orientations of the respective virtual cameras, and render and display the respective virtual endoscopic images, based on the 3D CT image, of the passage in the body viewed from the respective locations and orientations of the respective virtual cameras including an animated representation of the instrument positioned in the respective virtual endoscopic images in accordance with the tracked coordinates..
A medical probe (21) includes a tubular distal end section (22), which is configured to be inserted into a cavity of a patient, and includes (a) a visually guiding object (32) disposed over a perimeter of the distal end section, and (b) a magnetic field sensor (34) including two sensor coils (34a, 34b) aligned non-parallel with each other, the sensor attached to the distal end section (22), and having: (i) a first axis of symmetry, of one of the coils, which is aligned perpendicular to a central longitudinal axis of the distal end section, and (ii) a second axis of symmetry, of the remaining coil, which is aligned perpendicular to the central longitudinal axis of the distal end section and not parallel to the first axis of symmetry.
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 34/00 - Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
A61B 17/24 - Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
95.
GUIDEWIRE ULTRASOUND (US) PROBE FOR A MINIMALLY PERTURBING MEASUREMENT OF BLOOD FLOW IN BRAIN VESSEL
A medical probe includes a guidewire, a magnetic position sensor, and an ultrasound (US) transducer. The guidewire is configured for insertion into a blood vessel of a patient. The magnetic position sensor is fitted at a distal end of the guidewire and is configured to produce signals indicative of a position of the distal end. The US transducer is fitted at the distal end of the guidewire and is configured to transmit US waves inside the blood vessel, and acquire respective US echoes indicative of blood velocity in the blood vessel.
A calibration method includes receiving magnetic field values, which are generated by a plurality of real magnetic transmitters (26) and are measured at multiple positions on a grid in a region containing a magnetic field perturbing element. Approximate locations of the real magnetic transmitters are received. Using the approximate locations, a respective plurality of imaginary magnetic sources (55) is characterized inside the field perturbing element (40). Using the measured magnetic field values, the approximate locations, and the characterized imaginary sources, there are iteratively calculated (i) actual locations of the real and imaginary magnetic sources in the region, and (ii) modeled magnetic field values that would result from the real and imaginary magnetic sources at the actual locations. Using the calculated locations, and the modeled magnetic field values at the multiple positions on the grid, a magnetic field calibration function is derived for the region.
An apparatus includes a handle, a catheter, an end effector, and a deflection drive assembly. The end effector includes at least one electrode. The deflection drive assembly includes an input member, a translating assembly coupled to the end effector, and a rack and pinion assembly. The rack and pinion assembly is configured to drive the translating assembly to deflect the end effector away at an angle relative to the longitudinal axis and consists of a rack and a pinion. The rack and pinion assembly is configured to either transfer rotational motion of the pinion from the input member into linear motion of the rack to push distally or pull proximally the translating member; or transfer linear motion of the rack from the input member into rotational motion of the pinion to move a first end of the translating member proximally and a second end of the translating member distally.
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A stabilized coronary sinus catheter system having a proximal section and a distal section with a memory shape portion, and a tip, distal of the memory shape portion. A handle having a body, a tip deflection actuator, a memory shape portion deployment actuator, and an axis. The tip is in line with the axis and the tip deflection actuator is at a first position. The tip is deflected out of alignment with the axis when the tip deflection actuator is at a second position. A third position is a delivery configuration where the memory shape portion and the tip are in line with the axis. The memory shape portion deployment actuator is at a first location. A deployed configuration allows the memory shape portion to form a predetermined shape conforming to the shape of the coronary sinus when the memory shape portion deployment actuator is at a second location.
A method of manufacturing a catheter tip by electroplating a conductive material over an insert comprising a negative to a domelike shape thereby forming a shape of the catheter tip comprising a dome with the domelike shape, selectively positioning a plurality of irrigation holes between outer and inner surfaces of the catheter tip, removing the insert thereby leaving the catheter tip and the plurality of irrigation holes, and electropolishing the catheter tip. In other examples, the insert is not removed and instead the step of electroplating causes the insert to be encapsulated with the conductive material thereby forming the catheter tip.
A medical probe includes a shaft and an expandable balloon. The shaft is configured for insertion into an organ of a patient. The expandable balloon is coupled to a distal end of the shaft, with the expandable balloon including: (a) an expandable membrane having an outer surface and an inner surface, wherein the expandable membrane is configured to be expanded from a collapsed shape to a balloon shaped member, (b) a plurality of electrodes disposed on the outer surface of the expandable membrane, (c) one or more wires connected to the plurality of electrodes, the wires extending from the distal end to the electrode, (d) and an expandable cover that encapsulates the wires between the expandable cover and the expandable membrane so that the wires are constrained between the cover and the expandable membrane but the electrodes are exposed to ambient environment.
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