Patent Publication Number: US-2021161361-A1

Title: Medical device tracking systems and methods of using the same

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of priority from U.S. Provisional Application No. 62/942,959, filed Dec. 3, 2019, which is incorporated by reference herein in its entirety. 
    
    
     TECHNICAL FIELD 
     Various aspects of the disclosure relate generally to medical device tracking systems, devices, and related methods. More specifically, at least certain embodiments of the disclosure relate to systems, devices, and related methods for locating one or more target sites within a patient during an endoscopic procedure to facilitate the positioning of medical devices, among other aspects. 
     BACKGROUND 
     Technological developments have given users of medical systems, devices, and methods, the ability to conduct increasingly complex procedures on subjects. One challenge in the field of minimally invasive surgeries such as endoscopy, among other surgical procedures, is associated with the cannulation of target sites within a patient, such as an ampulla opening into the common bile duct. Placement of medical devices within a patient at precise locations of target sites may be difficult due to general lack of visualization at the target site and lack of control over a positioning of the medical device at a location of the target site. The limitations of medical devices in providing stability toward positioning an endoscope at a target treatment site of a patient may prolong the procedure, limit its effectiveness, and/or cause injury to the patient due to misalignment or instability of the medical device. There is a need for devices and methods that address one or more of these difficulties or other related problems. 
     SUMMARY 
     Aspects of the disclosure relate to, among other things, systems, devices, and methods for positioning a medical device at a target treatment site with a medical system including target identification logic, among other aspects. Each of the aspects disclosed herein may include one or more of the features described in connection with any of the other disclosed aspects. 
     According to an example, a medical system includes a medical device having an imaging device configured to capture images of a target site. A location of the target site is determined based on the images. The medical device further includes a light source configured to direct light onto the location of the target site, and a processor and non-transitory computer readable medium storing instructions that, when executed by the processor, causes the processor to move a sensor of a medical instrument toward the location of the target site based on the sensor detecting the light at the target site. 
     Any of the medical systems described herein may have any of the following features. The sensor is movable relative to the imaging device toward the location of the target site based on the sensor detecting the light at the target site. The instructions stored in the non-transitory computer readable medium causes the processor to detect a change in location of the imaging device relative to the target site, determine the location of the target site relative to the imaging device, and redirect the light to the location of the target site. The processor is configured to detect the change in location of the imaging device relative to the target site based on images periodically captured by the imaging device. The processor is configured to compare the location of the target site to an original location of the target site to determine a positional variance. The processor is configured to determine whether the positional variance exceeds a preprogrammed threshold. The light source includes a source to generate a laser beam. The imaging device includes a camera. The medical system may include a medical instrument, and wherein the sensor includes at least one of a photodetector, a photodiode, and a charged coupled device (CCD). The sensor is configured to generate a photodiode signal in response to detecting the light at the target site. A strength of the photodiode signal generated by the sensor includes a greater intensity when the sensor is positioned at a first distance from the light, and includes a smaller intensity when the sensor is positioned at a second distance from the light. The first distance is less than the second distance. The medical device includes a mirror configured to reflect the light generated by the light source toward the location of the target site. The mirror is configured to move to redirect the light toward the location of the target site in response to the processor detecting the change in location of the imaging device relative to the target site. The mirror includes a micro-mirror (MEMs mirror) configured to reflect the light along two axes. The mirror is positioned adjacent to the light source on the medical device. The processor is configured to generate a visual identifier along the images captured by the imaging device indicative of the location of the target site. 
     According to another example, a medical system includes a medical device including an imaging device configured to capture images of a target site, and a light source configured to direct light onto the target site. The medical system includes a medical instrument movable relative to the medical device. The medical instrument including a sensor configured to detect the light on the target site. The medical instrument is movable toward the target site in response to the sensor detecting the light on the target site. 
     Any of the medical systems described herein may have any of the following features. The medical system may include a processor configured to detect movement of the medical device relative to the target site based on images captured by the imaging device. The light source is configured to redirect the light based on the detected movement of the medical device. The medical device is an endoscope or duodenoscope, and the medical instrument is a catheter. 
     According to another example, a method of moving a medical instrument toward a target site includes capturing images of the target site with an imaging device. A first location of the target site is determined based on the images. The method includes transmitting light to the first location by a light source, detecting the light incident at the first location by a sensor of the medical instrument, and moving the medical instrument toward the target site based on the sensor detecting the light incident at the first location. 
     Any of the methods of using the medical systems described herein may have any of the following steps and/or features. In response to detecting movement of the medical device within the target site, the method includes capturing images of the target site with the imaging device to determine a second location of the target site, redirecting the light from the light source to the second location, and moving the medical instrument toward the target site based on the sensor detecting the light at the second location. 
     It may be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the disclosure and together with the description, serve to explain the principles of the disclosure. 
         FIG. 1  is a schematic view of an exemplary medical system, according to aspects of this disclosure; 
         FIG. 2  is a partial perspective view of a medical device of the medical system of  FIG. 1 , according to aspects of this disclosure; 
         FIG. 3  is a partial perspective view of a medical instrument of the medical system of  FIG. 1 , according to aspects of this disclosure; 
         FIG. 4  is a schematic view of the medical system of  FIG. 1  positioned at a target site of a patient, according to aspects of this disclosure; 
         FIG. 5A  is an image including locating a target site of a patient, according to aspects of this disclosure; 
         FIG. 5B  is an image including marking the target site of  FIG. 5A  with a light beam, according to aspects of this disclosure; 
         FIG. 5C  is an image including marking a target site with a light beam upon movement of the medical system, according to aspects of this disclosure; and 
         FIG. 6  is a block diagram of an exemplary method of locating a target site with the medical system of  FIG. 1 , according to aspects of this disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Embodiments of the disclosure include systems, devices, and methods for locating, tracking, and/or steering one or more tools or other medical devices at a target site within the body. Reference will now be made in detail to aspects of the disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numbers will be used through the drawings to refer to the same or like parts. The term “distal” refers to a portion farthest away from a user when introducing a device into a patient. By contrast, the term “proximal” refers to a portion closest to the user when placing the device into the patient. As used herein, the terms “comprises,” “comprising,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example,” rather than “ideal.” As used herein, the terms “about,” “substantially,” and “approximately,” indicate a range of values within +/−10% of a stated value. 
     Embodiments of the disclosure may be used to locate a target site with a medical system, such as, for example, a medical system having target identification logic. For example, some embodiments combine an imaging device and a light source with a medical device to locate a target site. The imaging device may capture images of the target site and the light source may direct light onto the target site in response to identifying a location of the target site based on the images. The target identification logic of the medical system may detect movements of the medical device and determine an adjusted location of the target site relative to the medical device in response, thereby redirecting the light from the light source toward the location of the target site. 
     Embodiments of the disclosure may relate to devices and methods for performing various medical procedures and/or treating portions of the large intestine (colon), small intestine, cecum, esophagus, any other portion of the gastrointestinal tract, and/or any other suitable patient anatomy (collectively referred to herein as a “target treatment site”). Various embodiments described herein include single-use or disposable medical devices. Reference will now be made in detail to examples of the disclosure described above and illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. 
       FIG. 1  shows a schematic depiction of an exemplary medical system  100  in accordance with an embodiment of this disclosure. The medical system  100  may include an image processing device  102 , a medical device  110 , and a medical instrument  140 . The image processing device  102  may be communicatively coupled to the medical device  110  via a cable  118 . It should be understood that in other embodiments the image processing device  102  may be in wireless communication with the medical device  110 . In embodiments, the image processing device  102  is a computer system incorporating a plurality of hardware components that allow the image processing device  102  to receive and monitor data, accurately display images of one or more features (e.g., a target site), and/or process other information described herein. Illustrative hardware components of the image processing device  102  may include at least one processor  104  and at least one memory  106 . 
     The processor  104  of the image processing device  102  may include any computing device capable of executing machine-readable instructions, which may be stored on a non-transitory computer-readable medium, such as, for example, the memory  106  of the image processing device  102 . By way of example, the processor  104  may include a controller, an integrated circuit, a microchip, a computer, and/or any other computer processing unit operable to perform calculations and logic operations required to execute a program. As described in greater detail herein, the processor  104  is configured to perform one or more operations in accordance with the instructions stored on the memory  106 , such as, for example, a target identification logic  108 . 
     The memory  106  of the image processing device  102  is a non-transitory computer readable medium that stores machine-readable instructions thereon, such as, for example, the target identification logic  108 . As described in further detail below, the target identification logic  108  may include executable instructions that allow the medical device  110  to track a location of a target site for the medical instrument  140  to lock onto and steer toward for the performance of one or more procedures on or near the target site. It should be understood that various programming algorithms and data that support an operation of the medical system  100  may reside in whole or in part in the memory  106 . The memory  106  may include any type of computer readable medium suitable for storing data and algorithms, such as, for example, random access memory (RAM), read only memory (ROM), a flash memory, a hard drive, and/or any device capable of storing machine-readable instructions. The memory  106  may include one or more data sets, including, but not limited to, image data  109  from one or more components of the medical system  100  (e.g., the medical device  110 , the medical instrument  140 , etc.). 
     Still referring to  FIG. 1 , the medical device  110  may be configured to facilitate positioning one or more components of the medical system  100  relative to a patient, such as, for example, the medical instrument  140 . In embodiments, the medical device  110  may be any type of endoscope and may include a handle  112 , an actuation mechanism  114 , at least one port  116 , and a shaft  120 . The handle  112  of the medical device  110  may have one or more lumens (not shown) that communicate with a lumen(s) of one or more other components of the medical system  100 . The handle  112  further includes the at least one port  116  that opens into the one or more lumens of the handle  112 . As described in further detail herein, the at least one port  116  is sized and shaped to receive one or more instruments therethrough, such as, for example, the medical instrument  140  of the medical system  100 . 
     The shaft  120  of the medical device  110  may include a tube that is sufficiently flexible such that the shaft  120  is configured to selectively bend, rotate, and/or twist when being inserted into and/or through a patient&#39;s tortuous anatomy to a target treatment site. The shaft  120  may have one or more lumens (not shown) extending therethrough that include, for example, a working lumen for receiving instruments (e.g., the medical instrument  140 ). In other embodiments, the shaft  120  may include additional lumens such as a control wire lumen for receiving one or more control wires for actuating one or more distal parts/tools (including an articulation joint and an elevator, for example), a fluid lumen for delivering a fluid, an illumination lumen for receiving at least a portion of an illumination assembly (not shown), and/or an imaging lumen for receiving at least a portion of an imaging assembly (not shown). 
     Still referring to  FIG. 1 , the medical device  110  may further include a tip  122  at a distal end of the shaft  120 . In some embodiments, the tip  122  may be attached to the distal end of the shaft  120 , while in other embodiments the tip  122  may be integral with the shaft  120 . For example, the tip  122  may include a cap configured to receive the distal end of the shaft  120  therein. The tip  122  may include one or more openings that are in communication with the one or more lumens of the shaft  120 . For example, the tip  122  may include a working opening  124  through which the medical instrument  140  may exit from a working lumen of the shaft  120 . In other embodiments, the tip  122  of the shaft  120  may include additional and/or fewer openings thereon, such as, for example, a fluid opening or nozzle through which fluid may be emitted from a fluid lumen of the shaft  120 , an illumination opening/window through which light may be emitted, and/or an imaging opening/window for receiving light used by an imaging device to generate an image. 
     The actuation mechanism  114  of the medical device  110  is positioned on the handle  112  and may include one or more knobs, buttons, levers, switches, and/or other suitable actuators. The actuation mechanism  114  is configured to control at least one of deflection of the shaft  120  (through actuation of a control wire, for example), delivery of a fluid, emission of illumination, and/or various imaging functions. As described in greater detail herein, in some embodiments the medical device  110  includes one or more control wires for actuating an elevator  126  of the medical device  110  at the tip  122  (see  FIGS. 2-3 ). Accordingly, a user of the medical device  110  may manipulate the actuation mechanism  114  to selectively exert at least one of a pulling force and a pushing force on the one or more control wires to control a position of the elevator  126 , and thereby control a position of an instrument adjacent to the elevator  126  (e.g., the medical instrument  140 ). 
     Still referring to  FIG. 1 , the medical instrument  140  of the medical system  100  may include a catheter having a longitudinal body  142  between a proximal end of the longitudinal body  142  and a distal end  144 . A handle  141  is at the proximal end of the longitudinal body  142 . The longitudinal body  142  of the medical instrument is flexible such that the medical instrument  140  is configured to bend, rotate, and/or twist when being inserted into a working lumen of the medical device  110 . The handle  141  of the medical instrument  140  may be configured to move, rotate, and bend the longitudinal body  142 . Further, the handle  141  may define one or more ports (not shown) sized to receive one or more tools through the longitudinal body  142  of the medical instrument  140 . The medical device  110  is configured to receive the medical instrument  140  via the at least one port  116  and through the shaft  120  to the working opening  124  at the tip  122  via a working lumen. In this instance, the medical instrument  140  may extend distally out of the working opening  124  and into a surrounding environment of the tip  122 , such as, for example, at a target treatment site of a patient as described in further detail below. The distal end  144  of the medical instrument  140  may extend distally from the working opening  124  in response to a translation of the longitudinal body  142  through the working lumen of the shaft  120 . It should be understood that in other embodiments the medical instrument  140  may include various other devices than those show and described herein, including but not limited to, a guidewire, cutting or grasping forceps, a biopsy device, a snare loop, an injection needle, a cutting blade, scissors, a retractable basket, a retrieval device, an ablation and/or electrophysiology catheter, a stent placement device, a surgical stapling device, a balloon catheter, a laser-emitting device, an imaging device, and/or any other suitable instrument. 
     Referring now to  FIG. 2 , the tip  122  of the shaft  120  is depicted with the medical instrument  140  omitted from the working opening  124 . The tip  122  includes the elevator  126  positioned adjacent to the working opening  124  and partially disposed within a working lumen of the shaft  120 . It should be understood that the elevator  126  is shown and described herein in an unactuated position and that actuation of the actuation mechanism  114  on the handle  112  may provide for an extension of the elevator  126  to an actuated position (see  FIG. 3 ). As described in further detail below, the elevator  126  is configured to position an instrument received through a working lumen of the shaft  120  (e.g., the medical instrument  140 ) outward from the working opening  124  when in the actuated position. 
     The tip  122  of the medical device  110  further includes a light source  128 , an imaging device  130 , and a laser  132  positioned adjacent to the working opening  124  of the shaft  120 . In embodiments, the light source  128  of the medical device  110  is configured and operable to direct light outwardly from the tip  122  of the shaft  120  to thereby illuminate a surrounding environment of the tip  122 , such as, for example, a target treatment site of a patient in which the medical device  110  may be located in (see  FIGS. 5A-5C ). The light source  128  may include a light emitter, such as, for example, a light-emitting diode (LED), or the like. The imaging device  130  of the medical device  110  is configured and operable to capture images of a surrounding environment of the tip  122 , such as, for example, the target treatment site of a patient (see  FIGS. 5A-5C ). In some embodiments, the imaging device  130  may include a camera capable of high resolution imaging. It should be understood that in other embodiments the medical device  110  may omit the imaging device  130  on the tip  122  entirely such that a separate imaging device may be received by the medical device  110  through the shaft  120 . 
     Still referring to  FIG. 2 , the laser  132  of the medical device  110  is configured and operable to generate a light/laser beam outwardly from the tip  122  of the shaft  120 . In some embodiments, the laser  132  is further configured to selectively direct the light/laser beam to a predetermined location to thereby mark the predetermined location with the light/laser beam. It should be understood that the light/laser beam generated by the laser  132  may be independently steerable relative to the light emitted by the light source  128  and/or any other component of the medical system  100 . As described further below, a target site within a patient may be marked with a light/laser beam from the laser  132  for tracking a location of said target site during use of the medical system  100  in a procedure (see  FIGS. 5A-5C ). 
     In some embodiments, the medical device  110  may further include a mirror positioned along and/or adjacent to the tip  122  of the shaft  120 . The mirror of the medical device  110  may be disposed adjacent to the laser  132  thereby forming a unitary structure such that the mirror is coincident with a beam of light emitted by the laser  132 . In embodiments, the mirror of the medical device  110  is configured and operable to selectively reflect the light/laser beam generated by the laser  132  toward a predetermined location of a target site. The mirror of the medical device  110  is configured to move, pivot, translate, and/or rotate relative to the laser  132  and/or the tip  122  of the shaft  120  to thereby redirect the light/laser beam to a predetermined location of the target site. In embodiments, the mirror includes a micro-mirror (MEMS mirror) configured to reflect the light/laser beam along two axes (e.g., x-y directions of a coordinate axis) and/or to optical scanning angles ranging up to approximately 32 degrees. As described in further detail below, a predetermined location of a target site may be determined based on images (e.g., the image data  109 ) captured by the imaging device  128  of the medical device  110 . 
     As shown in  FIG. 3 , the medical instrument  140  is depicted extending outwardly from the tip  122  of the shaft  120  with the elevator  126  engaged against the longitudinal body  142  of the medical instrument  140 . With the elevator  126  in an actuated position, an anterior-facing surface of the elevator  126  engages the longitudinal body  142  of the medical instrument  140  to thereby deflect the distal end  144  laterally outward from the working opening  124 . In some embodiments, the anterior-facing surface of the elevator  126  has a curvature that facilitates a deflection and/or bend of the longitudinal body  142  of the medical instrument  140 . It should be appreciated that the elevator  126  may include various other shapes, sizes, and/or configurations than those shown and described herein without departing from a scope of the disclosure. 
     The medical instrument  140  further includes a sensor  146  positioned along the longitudinal body  142  adjacent to the distal end  144 . In embodiments, the sensor  146  may be located on a distally-facing surface and/or a distal-most surface of the medical instrument  140 . The sensor  146  of the medical instrument  140  is configured to detect one or more objects, properties, characteristics, and/or features present at and/or proximate to the distal end  144  of the medical instrument  140 . By way of example, in some embodiments the sensor  146  may be configured to detect light, such as the light generated by the light source  128  of the medical device  110 . In other embodiments, the sensor  146  may be configured to detect the light/laser beam generated by the laser  132  of the medical device  110 , for example a point on a target site on which the light/laser beam  132  is incident. The sensor  146  may include at least one of a photodetector, a photodiode, a charged coupled device (CCD), and/or various other suitable detectors. 
     In embodiments, the sensor  146  includes a four-quadrant photodiode configured to convert light into an electrical current. As described in greater detail herein, in embodiments the sensor  146  is configured and operable to identify a predetermined location of a target site in response to detecting a light/laser beam directed by the laser  132  onto that target site (see  FIGS. 5A-5C ). In some embodiments, the sensor  146  may be positioned along a proximal end of the longitudinal body  142  adjacent to the handle  141  of the medical instrument  140  with a fiber that is communicatively coupled to the sensor  146  positioned adjacent to the distal end  144 . In this instance, the distal end  144  of the medical instrument  140  may have a relatively smaller profile. It should be understood that in other embodiments the medical instrument  140  may omit the sensor  146  on the distal end  144  entirely such that a separate sensing device may be received by the medical instrument  140  through the longitudinal body  142 , such as, for example, via one or more guidewires. 
     Referring now to  FIGS. 4-5C  in conjunction with the flow diagram of  FIG. 6 , an exemplary method  200  of using the medical system  100  to locate and access a target site is schematically depicted. The depiction of  FIGS. 4-6  and the accompanying description below is not meant to limit the subject matter described herein to a particular method. 
     At step  202  and as shown in  FIG. 4 , the medical device  110  of the medical system  100  may be inserted within a patient&#39;s body  10 . The shaft  120  of the medical device  100  is guided through a digestive tract of the patient  10  by inserting the tip  122  into a nose or mouth (or other suitable natural body orifice) of the patient&#39;s body  10 . In embodiments, the medical device  110  is inserted through a gastrointestinal tract of the patient&#39;s body  10 , including an esophagus  12 , a stomach  16 , and into a small intestine  18  until reaching a target treatment site. It should be appreciated that a length of the shaft  120  may be sufficient so that a proximal end of medical device  110  (including the handle  112 ) is external of the patient&#39;s body  10  while the tip  122  of the medical device  110  is internal to the patient&#39;s body  10 . While this disclosure relates to the use of the medical system  100  in a digestive tract of the patient&#39;s body  10 , it should be understood that the features of this disclosure could be used in various other locations (e.g., other organs, tissue, etc.) within the patient&#39;s body  10 . 
     The shaft  120  of the medical device  110  may extend into the patient&#39;s body  10  until it reaches a position in which tools disposed within the medical device  110  can access the target treatment site, such as the medical instrument  140  of the medical system  100 . In examples in which the medical device  110  is used to access and visualize aspects of the pancreatico-biliary system, this position may be, for example, the duodenum of the small intestine  18 . In such examples, a target site may be the ampulla/papilla of Vater  22  located in a portion of the duodenum of the small intestine  18 . It should be understood that the ampulla/papilla of Vater  22  generally forms an opening where the pancreatic duct and the common bile duct  20  empty into the duodenum of the small intestine  18 , with the hepatic ducts and the gall bladder emptying into the common bile duct  20 . 
     Still referring to  FIG. 4 , with the tip  122  of the shaft  120  located proximate to the target site (e.g., the ampulla of Vater  22 ), the medical instrument  140  of the medical system  100  may be slidably received within the medical device  110  to thereby position the distal end  144  proximate to the target site. Advancement of the medical instrument  140  into the port  106  and through the shaft  120  to the tip  122  may be provided in response to actuation of the handle  142 . It should be understood that in other embodiments the medical instrument  140  may be received through the medical device  110  prior to an insertion of the shaft  120  through the patient body  10  at step  202 . 
     In some embodiments, rotation of the tip  122  near the target site may be desirable to facilitate positioning the working opening  124  toward a location of the target site. For example, it may be desired that the distal end  144  of the medical instrument  140  reach the ampulla/papilla of Vater  22  when deflected outwardly from the working opening  124  by the elevator  126  ( FIG. 3 ). In this instance, the tip  122  of the shaft  120  may be rotated until the working opening  124 , in which the medical instrument  140  may exit the medical device  110 , is facing the ampulla/papilla of Vater  22 . Rotation of the tip  122  and/or the shaft  120  may be provided in response to actuating the actuation mechanism  114  on the handle  112 , and/or by rotating all of the handle  112 , and identification of a relative orientation and/or position of the tip  122  may be provided in response to actuating the imaging device  130  on the tip  122 . 
     At step  204 , with the working opening  124  on the tip  122  facing the target site, a surrounding environment of the target site may be illuminated in response to actuating the light source  128 . It should be understood that in other embodiments the light source  128  may already be actuated to direct light outwardly from the tip  122 , such as, for example, prior to and/or as the medical device  110  is inserted into the patient body  10  at step  202 . 
     At step  206 , with the target site illuminated by the lighting source  128 , the processor  104  of the image processing device  102  executes the target identification logic  108  to actuate the imaging device  130  of the medical device  110 . Accordingly, the imaging device  130  captures images of the target site. With the imaging device  130  facing the target site (e.g., the ampulla of Vater  22 ), images of a location of the target site may be obtained by the medical device  110  and communicated to the image processing device  102  for storing in the memory  106  as image data  109 . 
     At step  208  and referring to  FIG. 5A , with the image data  109  received from the medical device  110  and stored within the memory  106 , the processor  104  of the image processing device  102  executes the target identification logic  108  to determine a first location  52 A of the target site (e.g., the ampulla of Vater  22  within the small intestine  18 ) relative to the imaging device  130  on the tip  122 . The processor  104  analyzes the image data  109  captured by the imaging device  130  and determines a coordinate position of the target site relative to the tip  122 , pursuant to executing the machine-readable instructions of the target identification logic  108 . Alternatively, in other embodiments a user of the medical system  100  may manually identify the first location  52 A of the target site based on the image data  109 , such as, for example, via a touch-screen user interface display (not shown) that is communicatively coupled to the image processing device  102 . 
     In some embodiments, the processor  104 , when executing the target identification logic  108 , may generate a visual identifier at the first location  52 A (e.g., highlights, geometric figures, arrows, and the like) to thereby visually designate the first location  52 A of the target site for reference. As seen in  FIG. 5A , the visual identifier of the first location  52 A may include a box and/or “X” superimposed on the images of the target site for purposes of visually designating the target site in the image data  109 . The visual identifier of the first location  52 A may be displayed on a user interface display (not shown) that is communicatively coupled to the image processing device  102 . Alternatively, in other embodiments a user of the medical system  100  may manually mark the first location  52 A of the target site with a visual identifier based on the image data  109 , such as, for example, via a touch-screen user interface display (not shown) that is communicatively coupled to the image processing device  102 . In this instance, the processor  104  may analyze the image data  109  to determine the first location  52 A of the target site in accordance with the manual mark and/or identification by the user of the medical system  100  for continued tracking in subsequent images of the target site. 
     At step  210  and referring to  FIG. 5B , with the first location  52 A of the target site determined relative to the tip  122 , the processor  104  of the image processing device  102  executes the target identification logic  108  to mark the first location  52 A of the target site with a light/laser beam  134  by actuating the laser  132  of the medical device  110 . The processor  104  actuates the mirror of the medical device  110  to reflect the light/laser beam  134  generated by the laser  132  to redirect the light/laser beam  132  toward the first location  52 A of the target site, pursuant to executing the machine-readable instructions of the target identification logic  108 . 
     At step  212  and still referring to  FIG. 5B , with the light/laser beam  134  of the laser  132  directed (e.g., by the mirror) to the first location  52 A of the target site (e.g., the ampulla of Vater  22 ), the medical instrument  140  may be moved toward the target site in response to sensor  146  detecting the light/laser beam  132 . The handle  141  of the medical instrument  140  may be actuated to automatically translate the longitudinal body  142  through a working lumen of the shaft  120  to position the distal end  144  adjacent to the target site. Accordingly, the medical device  110  tracks the first location  52 A of the target site to allow the medical instrument  140  to lock onto the first location  52 A with the sensor  146  and autonomously steer the distal end  144  toward the target site to perform one or more procedures thereon, such as, for example, cannulate the ampulla duct opening  22  of the common bile duct  20 . 
     With the sensor  146  positioned along the distal end  144 , the sensor  146  is configured to generate a feedback in response to detecting the incidence of the light/laser beam  132  onto the target site, relative to the distal end  144 . In some embodiments, the sensor  146  includes a photodiode configured to convert the light/laser beam  134  into an electrical current such that the feedback generated by the sensor  146  includes a photodiode signal transmitted to a user of the medical instrument  140 . A strength of the photodiode signal generated by the sensor  146  may be indicative of a spatial (e.g., three-dimensional) proximity of the sensor  146  to the point of incidence of the light/laser beam  134 . Accordingly, with the light/laser beam  134  directed to the first location  52 A of the target site, it should be understood that a strength of the photodiode signal generated by the sensor  146  may increase as a distance between the distal end  144  of the medical instrument  140  and the target site decreases as the sensor  146  may detect the light/laser beam  132  in a relatively close proximity. 
     It should be further understood that a strength (e.g., intensity variation) of the photodiode signal generated by the sensor  146  may decrease as a distance between the distal end  144  of the medical instrument  140  and the target site increases, as the sensor  146  may detect the light/laser beam  132  in a relatively further proximity. Although the sensor  146  in embodiments described herein includes a photodiode or CCD that is configured to generate a feedback in response to detecting the light/laser beam  132  in the form of a photodiode signal, it should be appreciated that various other suitable sensors and/or forms of feedback may be generated by a sensor on the medical instrument  140  without departing from a scope of this disclosure. 
     In some embodiments, the medical instrument  140  may include a processor and memory similar to the processor  104  and the memory  106  of the image processing device  102  shown and described above. In this instance, the processor of the medical instrument  140 , when executing target identification logic stored on the memory of the medical instrument  140 , may provide for autonomous steering of the medical instrument  140  relative to the first location  52 A of the target site by tracking the light/laser beam  134  with the sensor  146 . In other embodiments, the medical instrument  140  may be manually navigated to the first location  52 A of the target site by a user of the medical system  100  by visually tracking a position of the distal end  144  relative to the first location  52 A via a user interface display (not shown). In this instance, a user may visually navigate the distal end  144  of the medical instrument  140  toward the visual identifier generated by the light/laser beam  132 . By way of illustrative example only, the distal end  144  of the medical instrument  140  may be displayed on a user interface display by a visual identifier, such as, for example, cross-hairs superimposed on the user interface display that are indicative of a position of the distal end  144 . Further, the feedback generated by the sensor  146  may be utilized in addition to and/or in lieu of the user interface display for manually steering the medical instrument  140  toward the first location  52 A of the target site. 
     In some instances, the medical device  110  of the medical system  100  may move, intentionally and/or inadvertently, relative to the target site during a procedure as the medical instrument  140  moves toward the target site at step  212 . Such movements may occur due to difficulties in maintaining the medical device  110  stable during a procedure. In this instance, a position of the target site (e.g., the ampulla of Vater  22 ) relative to the tip  122  of the shaft  120  and/or the distal end  144  of the medical instrument  140  may be modified and/or vary relative to an initial corresponding position between the target site and the medical device  110 . Accordingly, the image data  109  initially obtained by the medical system  100  at step  206  may include inaccuracies and/or deficiencies in providing a current location of the target site (e.g., the ampulla of Vater  22 ). As a result, continued movement of the distal end  144  of the medical instrument  140  toward the first location  52 A, as initially determined by the processor  104  of the imaging processing device  102  at step  208 , may not allow a user of the medical system  100  to adequately access the target site. 
     At step  214  and referring to  FIG. 5C , in response to the processor  104  of the image processing device  102  detecting a movement of the medical device  110  relative to the target site (e.g., the ampulla of Vater  22 ), the processor  104  may execute the target identification logic  108  to actuate the imaging device  130  to obtain updated image data  109  of the target site. In some embodiments, the processor  104  of the image processing device  102 , when executing the target identification logic  108 , may be configured to determine whether the medical device  110  has moved relative to the target site by periodically capturing images with the imaging device  130  for comparison to the image data  109  stored in the memory  106  at step  206 . Accordingly, movement of the medical device  110  relative to the target site may be based on determining that a positional variance between the first location  52 A and a detected position of the target site is equal to or greater than a preprogrammed threshold (e.g., a millimeter(s), a micrometer(s), a nanometer(s), etc.). 
     In this instance, upon determining that a recorded position of the first location  52 A varies relative to a detected position of the target site via the periodically-captured images, the processor  104  of the image processing system  102  repeats steps  206 ,  208 ,  210 , and  212  of the method  200  described above. The processor  104  executes the target identification logic  108  to capture images (e.g., image data  109 ) of the target site at step  206 , determine a second location  52 B of the target site (e.g., the ampulla of Vater  22 ) at step  208 , and mark the second location  52 B with the light/laser beam  134  at step  210 . It should be understood that the method  200  performs these steps substantially similar to those shown and described above to facilitate locating the target site with the medical system  100  in accordance with the new, second location  52 B of the target site. 
     In other embodiments, the image processing device  102  of the medical system  100  may be communicatively coupled to a remote station (not shown) for purposes of dynamically updating the target identification logic  108  stored on the memory  106 . By way of illustrative example, the image processing device  102  may be operable to receive neural network data from a remote station (e.g., a computer server), such as, for example, via a wired and/or wireless connection. The neural network data received by the imaging processing device  102  may include supplemental image data  109 , similar to the image data  109  shown and described above, recorded from a plurality of prior procedures, devices, systems, etc. Such image data may be from a plurality of different patients, acquired over time, of the same or similar patient anatomy. The supplemental image data  109  may be stored in the memory  106  and utilized by the processor  104  of the image processing device  102  to artificially determine and/or identify common physical properties and/or characteristics of one or more target sites, such as, for example, the ampulla of Vater  22  within the small intestine  18 , the ampulla duct opening  22  of the common bile duct  20 , etc. 
     In the embodiment, the processor  104  of the image processing device  102 , when executing the machine-readable instructions of the target identification logic  108 , may reference the supplemental image data  109  when analyzing the image data  109  captured by the imaging device  130  of the medical device  110  to determine the first location  52 A of the target site (e.g., the ampulla of Vater  22  within the small intestine  18 ). Accordingly, it should be appreciated that the supplemental image data  109  may facilitate determining a coordinate position of a target site relative to the medical device  110  during a procedure by providing the image processing device  102  additional data for artificial learning of a size, shape, and/or configuration of similar target sites. 
     Each of the aforementioned devices, assemblies, and methods may be used to detect, mark and track a location of a target site. By providing a medical assembly, a user may accurately interact with a patient&#39;s tissue using artificial intelligence software in an image processing device during a procedure, allowing a user to reduce overall procedure time, increase efficiency of procedures, and avoid unnecessary harm to a patient&#39;s body caused by lack of control over a motion and positioning of a medical device when accessing target tissue of a patient. 
     It will be apparent to those skilled in the art that various modifications and variations may be made in the disclosed devices and methods without departing from the scope of the disclosure. It should be appreciated that the disclosed devices may include various suitable computer systems and/or computing units incorporating a plurality of hardware components, such as, for example, a processor and non-transitory computer-readable medium, that allow the devices to perform one or more operations during a procedure in accordance with those described herein. Other aspects of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the features disclosed herein. It is intended that the specification and examples be considered as exemplary only.