Elongate medical instrument with distal end orientation control

A medical device comprises an elongate insertion member such as a catheter or a laparoscopic instrument shaft having a flexible distal end portion, the insertion member being adapted for insertion into a patient, and a drive mounted to the insertion member about a distal end thereof for flexing the distal end portion of the insertion member. A power supply is operatively connected to the drive for energizing the drive, while a control component such as a wireless receiver is operatively connected to the drive for selectively controlling the energization thereof, thereby controlling the direction of flexing of the distal end portion. The receiver and the power supply are mounted to the insertion member proximally of the flexible distal end portion thereof.

BACKGROUND OF THE INVENTION 
This invention relates to an elongate, at least partially flexible 
instrument for insertion into a patient's body during a medical procedure. 
More particularly, the present invention relates to a device and method 
wherein the orientation of a distal end portion of such an elongate 
insertion member is controllable. 
Typically, flexible endoscopic and laparoscopic insertion members have 
distal end portions whose orientations are controllable via a plurality of 
cables extending longitudinally along the insertion members from proximal 
ends thereof. Such a method for controlling orientation, however, is not 
utilizable with angiographic catheters. Such catheters are much thinner 
and usually longer than endoscopic or laparoscopic insertion members. 
Consequently, control of the distal end orientation of angiographic 
catheters is practically impossible via conventional cable mechanisms. 
OBJECTS OF THE INVENTION 
An object of the present invention is to provide a device or assembly for 
controlling distal end orientation of elongate medical instruments which 
are inserted into patients' bodies. 
Another, more particular, object of the present invention is to provide 
such a device or assembly which is particularly practicable with 
angiographic catheters. 
A further object of the present invention is to provide a new method for 
controlling the orientation of a flexible distal end portion of an 
elongate medical instrument when the instrument, or a distal segment 
thereof, is inserted into a patient. 
Another particular object of the present invention is to provide such a 
method which is useful in angiographic applications. 
SUMMARY OF THE INVENTION 
A medical device comprises, in accordance with the present invention, an 
elongate insertion member having a flexible distal end portion, the 
insertion member being adapted for insertion into a patient, and an 
energizable drive mounted to the insertion member about a distal end 
thereof for flexing the distal end portion of the insertion member. A 
power supply is operatively connected to the drive for energizing the 
drive, while a control component is operatively connected to the drive for 
selectively controlling the energization thereof, thereby controlling the 
direction of flexing of the distal end portion. 
Pursuant to another feature of the present invention, the drive includes a 
plurality of actuators mounted to the insertion member proximally of the 
distal end portion of the insertion member. The actuators have moving 
components connected to the distal end portion. The actuators may, for 
example, take the form of minute motors, in which case the moving 
components are connected the rotors. The actuators may alternatively take 
the form of tiny solenoids, in which case the moving components are 
coupled to the armatures thereof. 
Preferably, the control component includes a wireless receiver mounted to 
the elongate insertion member about the distal end thereof. The receiver 
is operatively connected to the actuators, either directly, or indirectly. 
In a specific embodiment of the invention, one or more switches 
controllable by the receiver are connected between the power supply and 
the actuators. 
Pursuant to another feature of the present invention, the power supply is 
also mounted to the insertion member about the distal end thereof. 
An insertion member with distal end orientation control in accordance with 
the present invention is especially useful if in the form of an 
angiographic catheter. However, such a device may also be used in other 
applications, such as laparoscopy, for controlling orientation of 
instruments such as laparoscopes and laparoscopic forceps, graspers, 
scissors, irrigators, etc. 
Preferably, the drive elements or actuators are mounted to the insertion 
member proximally of the distal end portion. The drive elements or 
actuators have moving components connected to the distal end portion for 
bending the distal end portion relative to the body of the insertion 
member. 
A method for use in a diagnostic or surgical application comprises, in 
accordance with the present invention, the steps of (a) inserting into a 
patient an elongate insertion member having a flexible distal end portion, 
(b) emitting a wireless signal towards the patient so that the signal is 
transmitted through organic tissues of the patient to a distal end of the 
insertion member, (c) receiving the wireless signal via a receiver mounted 
to the insertion member about a distal end thereof, and (d) in response to 
the reception of the wireless signal, automatically energizing a drive 
element connected to the insertion member about the distal end thereof and 
thereby bending the distal end portion. 
An elongate medical device or instrument with distal end orientation 
control in accordance with the present invention provides a capability not 
readily obtainable through by conventional techniques. Distal end 
orientation control in accordance with the present invention is 
particularly efficacious in angiographic applications.

DETAILED DESCRIPTION 
As illustrated in FIG. 1, an angiographic catheter 12 comprises an elongate 
tubular member 14 have a flexible distal end portion 16. Proximally of 
distal end portion 16, catheter 12 is provided with an orientation control 
assembly 18 including a wireless receiver 20, a power supply 22, a 
switching circuit 24, and a plurality of energizable drive members or 
actuators 26a and 26b all mounted inside or at least substantially 
embedded in the wall of a relatively long main body portion 54 of tubular 
member 14. Distal end portion 16 is movably connected to main body portion 
54 for effectuating a steering of the catheter during use. 
Receiver 10 is capable of receiving and demodulating wireless control 
signals arriving at distal end portion 16 through organic tissues of a 
patient into which catheter 12 has been inserted. A surgeon causes the 
generation of the wireless control signals by a transmitter (not 
illustrated) disposed outside the patient. 
In response to the wireless control signals, receiver 20 induces switching 
circuit 24 to selectively connect actuators 26a and 26b to power supply 
22. The actuator or actuators 26a or 26b so connected to power supply 22 
are thereby energized to retract a respective plunger or rotor member 28a 
or 28b. Plungers 28a and 28b are connected to respective tension wires or 
threads 30a and 30b. The retraction of plunger 28a or 28b accordingly 
pulls a respective tension wire 30a or 30b and bends distal end portion 16 
to the corresponding side, as shown in FIG. 2. 
Wires 30a and 30b extend partially around guide elements or deflectors 32a 
and 32b and alongside an outer surface 36 of tubular member 14 to 
respective anchors 34a and 34b in distal end portion 16. 
Actuators 26a and 26b preferably take the form of minute motors. However, 
other equivalent actuators are possible within the scope of the invention. 
Although only two actuators 26a and 26b are shown in FIG. 1, at least 
three and preferably four actuators are provided in order to fully control 
the orientation of distal end portion 16. 
FIG. 3 illustrates a laparoscopic instrument 40 having a pair of handle 
actuators 42 and 44 connected to a proximal end of an elongate rigid shaft 
46. Shaft 46 is provided with a flexible distal end portion 48 carrying an 
operative member 50 such as a forceps, graspers, scissors, etc. which is 
connected to handle actuators 42 and 44 for being operated thereby. 
Laparoscopic instrument 40 is provided proximally of distal end portion 48 
with the same distal end orientation control components as shown in FIG. 
1, namely, a wireless receiver, a power supply, a switching circuit (none 
shown) and a plurality of motors or other drives 52. 
Although the invention has been described in terms of particular 
embodiments and applications, one of ordinary skill in the art, in light 
of this teaching, can generate additional embodiments and modifications 
without departing from the spirit of or exceeding the scope of the claimed 
invention. For example, other drives equivalent to motors may be used, 
provided that sufficient displacement power is generated to bend the 
distal end portion of the catheter or, for example, a laparoscopic 
insertion member. Such equivalent bending drives may include solenoids or 
hydraulic mechanisms using a saline solution as a hydraulic fluid. 
In addition, the wireless control of bending may find applications in areas 
of medicine other than laparoscopy and angiography. For example, certain 
endoscopic investigations or operations may benefit from wireless control. 
In addition, endotracheal tubes, Foley catheters, gastroesophageal tubes 
and other tubular inserts may have in some circumstances a distal end 
orientation control, as disclosed hereinabove with reference to FIG. 1, 
for facilitating placement of the respective flexible tube. 
Accordingly, it is to be understood that the drawings and descriptions 
herein are proferred by way of example to facilitate comprehension of the 
invention and should not be construed to limit the scope thereof.