Patent Publication Number: US-2022218184-A1

Title: Magnetically controlled power button and gyroscope external to the lung used to measure orientation of instrument in the lung

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of, and priority to, U.S. Provisional Patent Application Ser. No. 63/137,483, filed on Jan. 14, 2021, the entire content of which is hereby incorporated by reference herein. 
    
    
     INTRODUCTION 
     This disclosure relates to surgical systems, and more particularly, to systems for intraluminal navigation such as navigation within the lungs. 
     BACKGROUND 
     There are several commonly applied medical methods, such as endoscopic procedures or minimally invasive procedures, for treating various maladies affecting organs including the liver, brain, heart, lungs, gall bladder, kidneys, and bones. Often, one or more imaging modalities, such as magnetic resonance imaging (MRI), ultrasound imaging, computed tomography (CT), or fluoroscopy are employed by clinicians to identify and navigate to areas of interest within a patient and ultimately a target for biopsy or treatment. In some procedures, pre-operative scans may be utilized for target identification and intraoperative guidance. However, real-time imaging may be required to obtain a more accurate and current image of the target area. Furthermore, real-time image data displaying the current location of a medical device with respect to the target and its surroundings may be needed to navigate the medical device to the target in a safe and accurate manner (e.g., without causing damage to other organs or tissue). 
     For example, an endoscopic approach has proven useful in navigating to areas of interest within a patient, and particularly so for areas within luminal networks of the body such as the lungs. To enable the endoscopic approach, and more particularly the bronchoscopic approach in the lungs, endobronchial navigation systems have been developed that use previously acquired Mill data or CT image data to generate a three-dimensional (3D) rendering, model, or volume of the particular body part such as the lungs. 
     The resulting volume generated from the MM scan or CT scan is then utilized to create a navigation plan to facilitate the advancement of a navigation catheter (or other suitable medical device) through a bronchoscope and a branch of the bronchus of a patient to an area of interest. A locating or tracking system, such as an electromagnetic (EM) tracking system, may be utilized in conjunction with, for example, CT data, to facilitate guidance of the navigation catheter through the branch of the bronchus to the area of interest. In certain instances, the navigation catheter may be positioned within one of the airways of the branched luminal networks adjacent to, or within, the area of interest to provide access for one or more medical instruments. 
     Despite the successes of these systems, improvements are always desired to promote the efficient use of these systems and overcome challenges in use of these systems. 
     SUMMARY 
     One aspect of the disclosure is directed to a luminal navigation system including: a catheter configured for insertion into a bronchoscope, the catheter including a five degree of freedom (5DOF) sensor at a distal portion of the catheter. The luminal navigation system also includes a locating module configured to receive signals from the 5DOF sensor to determine an X, Y, Z location and pitch and yaw orientation of the distal portion of the catheter. The luminal navigation system also includes a pod, configured to be received between a telescoping portion of the catheter and a hub of the catheter, the pod including a wireless communication device. The luminal navigation system also includes a gyroscopic sensor located in the pod, where the gyroscopic sensor determines an amount of roll experienced by the pod, where the pod is configured to receive signals from the 5DOF sensor and the gyroscopic sensor and to transmit to the locating module the received signals and the locating module can determine the position and orientation of the distal portion of the catheter in six degrees of freedom (6DOF). Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each configured to perform the actions of the methods and systems described herein. 
     Implementations of this aspect of the disclosure may include one or more of the following features. The luminal navigation system further including a locatable guide configured for insertion into a lumen of the catheter, the locatable guide including a 6DOF sensor at a distal end and a handle on a proximal end, where signals generated by the 6DOF sensor are transmitted to the locating module. The luminal navigation system where the 6DOF sensor and the 5DOF sensor are electromagnetic sensors configured to detected magnetic fields generated by a magnetic field generator. The luminal navigation system where the pod includes an EM field detector, wherein the pod fully powers on upon detection of a magnetic field. The luminal navigation system where the pod further includes a rechargeable battery. The luminal navigation system further including a charger configured to receive the pod and to charge the rechargeable battery. The luminal navigation system where the charger is configured for wireless charging of the rechargeable battery in the pod. 
     Another aspect of the disclosure is directed to a luminal navigation system including: a catheter configured for insertion into a bronchoscope, the catheter including a five degree of freedom (DOF) sensor at a distal portion of the catheter. The luminal navigation system also includes a locating module configured to receive signals from the 5DOF sensor to determine an X, Y, Z location and pitch and yaw orientation of the distal portion of the catheter. The luminal navigation system also includes a locatable guide configured for insertion into a lumen of the catheter, the locatable guide including a 6DOF sensor at a distal end and a handle on a proximal end, where signals generated by the 6DOF sensor are transmitted to the locating module. The luminal navigation system also includes a pod, configured to be received between a telescoping portion of the catheter and a hub of the catheter, the pod including a wireless communication device; where the locating module receives the output from the 6DOF sensor via a cable while the locatable guide is secured in the catheter and from the 5DOF sensor via the wireless communication device following removal of the locatable guide from the catheter. Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each configured to perform the actions of the methods and systems described herein. 
     Implementations of this aspect of the disclosure may include one or more of the following features. The luminal navigation system further including a gyroscopic sensor located in the pod, where the gyroscopic sensor determines an amount of roll experienced by the pod. The luminal navigation system where the pod is configured to receive signals from the 5DOF sensor and the gyroscopic sensor and to transmit to the locating module the received signals and the locating module can determine the position and orientation of the distal portion of the catheter in six degrees of freedom (6DOF). The luminal navigation system wherein the pod includes an EM field detector, wherein the pod fully powers on upon detection of a magnetic field. The luminal navigation system where the 6DOF sensor and the 5DOF sensor are electromagnetic sensors configured to detected magnetic fields generated by a magnetic field generator. The luminal navigation system where the pod further includes a rechargeable battery. The luminal navigation system further including a charger configured to receive the pod and to charge the rechargeable battery. The luminal navigation system where the charger is configured for wireless charging of the rechargeable battery in the pod. Implementations of the described techniques may include hardware, a method or process, or computer software on a computer-accessible medium, including software, firmware, hardware, or a combination of them installed on the system that in operation causes or cause the system to perform the actions. One or more computer programs can be configured to perform particular operations or actions by virtue of including instructions that, when executed by data processing apparatus, cause the apparatus to perform the actions. 
     A further aspect of the disclosure is directed to a wireless transmitter pod for a luminal navigation catheter, including: a housing configured to mate with a catheter, the catheter including a five degrees of freedom (5DOF) sensor formed on a distal end. The wireless transmitter pod also includes a rechargeable battery secured within the housing. The wireless transmitter pod also includes a wireless communication device secured within the housing. The wireless transmitter pod also includes a gyroscopic sensor secured within the housing. The wireless transmitter pod also includes a microcontroller configured to receive signals from the 5DOF sensor and the gyroscopic sensor and to output via the wireless communication device a signal from which a position and orientation of distal portion of the catheter in six degrees of freedom (6DOF). Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each configured to perform the actions of the methods and systems described herein. 
     Implementations of this aspect of the disclosure may include one or more of the following features. The wireless transmitter pod further including at least one light-emitting diode configured to indicate a status of the rechargeable battery. The wireless transmitter pod further including at least one light emitting diode configured to indicate a connection status of the wireless communication device. The wireless transmitter pod further configured to receive a hub of the catheter, where the hub enables electrical connectivity of the sensor to the microcontroller. The wireless transmitter pod where the sensor is an electromagnetic sensor. Implementations of the described techniques may include hardware, a method or process, or computer software on a computer-accessible medium, including software, firmware, hardware, or a combination of them installed on the system that in operation causes or cause the system to perform the actions. One or more computer programs can be configured to perform particular operations or actions by virtue of including instructions that, when executed by data processing apparatus, cause the apparatus to perform the actions. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various aspects and features of the disclosure are described hereinbelow with references to the drawings, wherein: 
         FIG. 1  is a schematic illustration of a system in accordance with the disclosure; 
         FIG. 2A  is a profile view of a catheter in accordance with the disclosure; 
         FIG. 2B  is a detailed view of a portion of  FIG. 2A  showing the insertion of a cable; 
         FIG. 3A  is a profile view of a locatable guide in accordance with the disclosure; 
         FIG. 3B  is a profile view of the locatable guide of  FIG. 3A  inserted into the catheter of  FIG. 2A ; 
         FIG. 3C  is a profile view of a portion of  FIG. 3A  showing the insertion of a cable; 
         FIG. 4  is a perspective view of a wireless transmission pod incorporated as part of the catheter of  FIG. 2A ; 
         FIG. 5  is a perspective view of a wireless transmission pod; 
         FIG. 6A  is a top perspective view of a charger in accordance with the disclosure; 
         FIG. 6B  is a side perspective view of the charger of  FIG. 6A  in accordance with the disclosure; 
         FIG. 7A  is an end view of the wireless transmission pod of  FIG. 5 ; 
         FIG. 7B  is a cross-sectional view of the wireless transmission pod of  FIG. 5 ; 
         FIG. 8A  is a comparative view of the wireless transmission pod incorporated as part of a catheter of  FIG. 4  and the wireless transmission pod of  FIG. 5 ; 
         FIG. 8B  depicts the wireless transmission pod incorporated as part of a catheter being held by a user; 
         FIGS. 9A-9E  depict an alternative form of a wireless transmission pod and its incorporation into a catheter in accordance with the disclosure; 
         FIGS. 10A-10C  depict a charger for use with the wireless transmission pods of  FIG. 9A ; 
         FIGS. 11A-11E  depict an alternative form of a wireless transmission pod and its incorporation into a catheter in accordance with the disclosure; 
         FIGS. 12A-12D  depict a charger for use with the wireless transmission pods of  FIG. 11A ; 
         FIGS. 13A and 13B  depict an alternative form of a wireless transmission pod and its incorporation into a catheter in accordance with the disclosure; 
         FIGS. 14A-14E  depict an alternative form of a wireless transmission pod and its incorporation into a catheter in accordance with the disclosure; and 
         FIGS. 15A-15D  depict a charger for use with the wireless transmission pods of  FIG. 14A . 
     
    
    
     DETAILED DESCRIPTION 
     This disclosure is directed to improvements to electromagnetic (EM) navigation systems such as the ILLUMISITE system sold by MEDTRONIC PLC. In one aspect the disclosure is directed to a system enabling wireless (e.g., BLUETOOTH, or others) communication between a catheter or extended working channel (EWC) and navigation software components of the EM navigation system. Such wireless communication helps eliminate wire entanglement issues that can present themselves in currently available systems. A further aspect of the disclosure is directed to a system and method that can determine in six degrees of freedom (6DOF), X, Y, Z, pitch, yaw, and roll, the position and orientation of the distal end of the catheter or EWC within the patient. In particular, the disclosure is directed to determining the amount of roll experienced at the distal end of the catheter utilizing a gyroscopic sensor located on a proximal end of the catheter. This data can be combined with a 5DOF EM sensor located on the distal end of the catheter to provide accurate position and orientation data of the distal portion of the catheter. 
       FIG. 1  is a perspective view of an exemplary system  100  in accordance with the disclosure. System  100  includes a table  102  on which a patient P is placed. A bronchoscope  104  is inserted into an opening in the patient. The opening could be a natural opening such as the mouth, nose, or anus. Alternatively, the opening may be formed in the patient, for example a surgical port or a simple incision. The bronchoscope  104  may include one or more optical sensors for capturing live images and video as the bronchoscope  104  is navigated into the patient P. A catheter  106  may be inserted into the bronchoscope  104  for navigating to portions of the anatomy into which the bronchoscope  104  cannot pass. A variety of tools (not shown) such as a biopsy needle, ablation needle, clamp, forceps, or others may be inserted into the catheter  106  to achieve a desired therapeutic or diagnostic purpose. One or more sensors  107  may be located at a distal end of the catheter  106 . A monitor  108  may be employed to display images captured by the optical sensor on the bronchoscope  104  as it is navigated within the patient P. 
     The system  100  includes a locating module  110  which receives signals from catheter  106  and sensors  107  and processes the signals to generate useable data, as described in greater detail below. A computer  112 , including a display  114  receives the useable data from the locating module  110 , and incorporates the data into one or more applications running on the computer  112  to generate one or more user-interfaces that are presented on the display  114 . Both the locating module  110  and the monitor  108  may be incorporated into or replaced by applications running on the computer  112  and images presented via a user interface on the display  114 . Also depicted in  FIG. 1  is a fluoroscope  116  which may be employed to construct fluoroscopic based three-dimensional volumetric data of a target area from 2D fluoroscopic images and other imaging techniques. As will be appreciated the computer  112  incudes a computer readable recording medium such as a memory for storing image data and applications that can be executed by a processor in accordance with the disclosure to perform some or all of the steps of the methods described herein. 
     There are known in the art a variety of pathway planning applications for pre-operatively planning a path through a luminal network such as the lungs or the vascular system. Typically, a pre-operative image data set such as one acquired from a CT scan or an MM scan is presented to a user. The target identification may be automatic, semi-automatic, or manual, and allows for determining a pathway through patient P&#39;s airways to tissue located at and around the target. In one variation the user scrolls through the image data set, which is presented as a series of slices of the 3D image data set output from the CT scan. By scrolling through the images, the user manually identifies targets within the image data set. The slices of the 3D image data set are often presented along the three axes of the patient (e.g., axial, sagittal, and coronal) allowing for simultaneous viewing of the same portion of the 3D image data set in three separate 2D images. 
     Additionally, the 3D image data set (e.g., acquired from the CT scan) may be processed and assembled into a three-dimensional CT volume, which is then utilized to generate a 3D model of patient P&#39;s airways by various segmentation and other image processing techniques. Both the 2D slices images and the 3D model may be displayed on a display  114  associated with computer  112 . Using computer  112 , various views of the 3D or enhanced 2D images may be generated and presented. The enhanced two-dimensional images may possess some three-dimensional capabilities because they are generated from the 3D image data set. The 3D model may be presented to the user from an external perspective view, an internal “fly-through” view, or other views. After identification of a target, the application may automatically generate a pathway to the target. In the example of lung navigation, the pathway may extend from the target to the trachea, for example. The application may either automatically identify the nearest airway to the target and generate the pathway, or the application may request the user identify the nearest or desired proximal airway in which to start the pathway generation to the trachea. Once selected, the pathway plan, three-dimensional model, and 3D image data set and any images derived therefrom, can be saved into memory on the computer  112  and made available for use during a procedure, which may occur immediately following the planning or at a later date. 
     Following, the planning phase, where targets are identified and pathways to those targets are created, a navigation phase can be commenced. With respect to the navigation phase, the locating module  110  is employed to detect the position and orientation of a distal portion of the catheter  106 . The locating module  110  may utilize a transmitter mat  118  to generate an electromagnetic field in which the position of sensors  107  are placed. The sensors  107  generate a current when placed in the electromagnetic field is received by the locating module  110  and either five or six degrees of freedom (DOF) of the position of the sensor  107  and catheter  106  is determined. To accurately reflect the detected position of the catheter  106  in the pre-procedure image data set (e.g., CT or MRI images) or 3D models generated therefrom, a registration process must be undertaken. 
     Registration of the patient P&#39;s location on the transmitter mat  118  may be performed by moving sensor  107  through the airways of the patient P. More specifically, data pertaining to locations of sensor  107 , while catheter  106  is moving through the airways, is recorded using transmitter mat  118  and locating module  110 . A shape resulting from this location data is compared to an interior geometry of passages of the three-dimensional model generated in the planning phase, and a location correlation between the shape and the three-dimensional model based on the comparison is determined, e.g., utilizing the software on computer  112 . In addition, the software identifies non-tissue space (e.g., air filled cavities) in the three-dimensional model. The software aligns, or registers, an image representing a location of sensor  107  with the three-dimensional model and/or two-dimensional images generated from the three-dimension model, which are based on the recorded location data and an assumption that sensor  104  locatable guide  110  remains located in non-tissue space in patient P&#39;s airways. 
     Though described herein with respect to EMN systems using EM sensor sensors  107  are not so limited, and the sensors may be one or more of an inertial measurement unit, shape sensor, optical sensor, ultrasound sensor, and others. Additionally, the methods described herein may be used in conjunction with robotic systems such that robotic actuators (not shown) drive the catheter  106  proximate the target. 
       FIG. 2A  depicts a detailed view of the catheter  106 , with sensor  107  located at the distal end. On a proximal end of the catheter  106 , a hub  202  connects to the a telescopic portion  204  having a telescope hub  206  for connection to a bronchoscope adapter (not shown) such that the catheter  106  can be inserted into the working channel of a bronchoscope  104 . The hub  202  is electrically connected to the sensor  107 . As shown in  FIG. 2B , a cable  208  is inserted into the hub  202  to connect the hub  202  and therewith the sensor  107  to the locating module  110  and the computer  112  via a wired connection. As described, above, the data output by the sensor  107  is used to determine the position and orientation of the catheter  106  in the patient. 
       FIG. 3A  depicts a locatable guide  300 . The locatable guide  300  is a sensor catheter that includes a sensor  107  at the distal end of a catheter  302  and a handle  304  at the proximal end. The locatable guide  300  is configured for insertion into the catheter  106 , as depicted in  FIG. 3B . The handle  304  is in electrical communication with the sensor  107 .  FIG. 3C  depicts the insertion of a cable  306  into the handle  304  to therewith electrically connect the sensor  107  with the locating module  110  and the computer  112  via a wired connection. 
     In practice, while navigating the catheter  106  to a target in the lung, following the navigation pathway, the data from the sensor  107  in the locatable guide  300  is employed for detecting location and orientation of the locatable guide  300 , and therewith the distal portion of the catheter  106 . The sensor  107  in the locatable guide  300  is a 6DOF sensor and provides X, Y, Z coordinates as well as pitch, yaw, and roll orientations of the sensor  107  and therewith the position and orientation of the locatable guide  300  within the EM field generated by the transmitter mat  118 . 
     Upon reaching a desired position opposite a target, the locatable guide  300  is removed from the catheter  106  so that the lumen in the catheter is freed for insertion of other tools such as biopsy or therapeutic tools such as microwave ablation catheters, and others. With removal of the locatable guide  300  sensor data from the sensor  107  in the catheter  106  is now employed to detect the position of the catheter  106 . It will be appreciated that with the removal of the locatable guide  300  and insertion of other tools the position of the distal portion of the catheter  106  may move and its position must be updated in the display  114  of the navigation view to accurately show the position of the catheter  106  in the 3D models and therewith in the patient. However, the sensor  107  in the catheter  106  is a 5DOF sensor and outputs only X, Y, Z, coordinates and pitch and yaw orientation data. Utilizing current EM sensor technology, and because of the need to maintain the lumen opening through the catheter  106 , the sensor  107  in the catheter  106  does not provide an output that can be used to determine the roll orientation of the distal portion of the catheter  106 . 
     Though described above as using the sensor  107  in the LG  300  to perform the navigation of the catheter  106  to the target following the pathway plan, the disclosure is not so limited. In some embodiments the sensor  107  in the catheter  106  may be employed for this navigation. 
     Another challenge of this arrangement is the use of cables  208  and  306 . As can be imagined manipulating the catheter  106  through the luminal network of a patient requires repeated steps of rotation and advancement. With cable  306  extending from the handle  304  and cable  208  extending from hub  202 , but both leading to the locating system  110  or to computer  112 , the cables are likely to become intertwined and entangled with one another. This entanglement results in challenges when the locatable guide  300  must be removed from the catheter  106 . 
     To alleviate the entangling issue, one aspect of the disclosure is directed to a wireless communication pod  400  as depicted in  FIG. 4 . The pod  400  is configured to mount between the hub  202  of the catheter  106 , and the telescopic portion. The pod  400  may be formed of a translucent material and include one or more light emitting diodes  402  (LED). The LEDs can provide indicators that the pod  400  is properly mated to the hub  202  and capable of receiving signals from the sensor  107  at the distal end of the catheter  106  when placed in an EM field. A rechargeable battery  404  is housed within the pod  400 . Those of skill in the art will recognize that a non-rechargeable battery may also be employed without departing from the scope of the disclosure. The rechargeable battery  404  is electrically connected to one or more circuit boards (not shown). The circuit boards include a BLUETOOTH transmitter or transmitter-receiver  406  capable of bidirectional or unidirectional communication with the locating module  110  and computer  112 . One or more microcontrollers  407  may be employed to provide logical functions for the transmitter  406 , or to translate the signals derived from the sensor  107  to configure them for transmission via the transmitter  406 . The pod  400  may further include a display  408  (e.g., a liquid crystal display or an LED indicator) indicating the battery level and other information such as connection to the sensor  107 , and to the computer  112 . The pod  400  is intended to be re-useable, however, disposable versions are also possible. 
     In one aspect of the disclosure, as depicted in  FIGS. 6A and 6B  the pods  400  are supplied as a pair of pods  400  and include a charger  410  configured to receive the two pods  400 . The charger includes two cavities  412  configured to receive a pod  400 . The cavity includes an interface for electrically connecting the charger  410  to the pod  400  to charge the battery  404 . The charger  410  may also include a data connection, not shown, to enable updates of the firmware and software operating on rechargeable battery or the microcontroller  407  or other components of the pod  400 . The charger  410  may optionally include one or more LEDs  418  to provide an indication of the power level of batteries  404  of the pods  400  while they are in the charger  410 . The charger may optionally also include a display  420  for displaying information regarding the status of the batteries  404 , state of charge, number of recharges before replacement of the pod  400 , and other useful information to the user. Either the display  420  or the LEDs (or both) may initiate when the pod  400  is placed in the charger  410 . Colored LEDS may indicate battery status. 
     The charger  410  may be placed in the operating room proximate the system  100  such that should a battery of a pod  400  run low of power during a procedure, the pod  400  may be replaced. The charger  410  may be a wireless charger (e.g., inductive charging) requiring no direct electrical connection between the charger  410  and the battery  404  in the pod  400 . In addition to the second pod  400 , which can be charging during the procedure where the first pod  400  is being used, the connection of the cable  208  remain available for connection to the hub  202 . Accordingly, a clinician can have confidence that they will never be without a means of receiving the data from the sensor  107  on the catheter  106 . 
     The pod  400  is configured to rest comfortably in the hand of the user. In accordance with this aspect, the battery  404  is located on one side of the pod  400  and the opposite side of the pod  400  houses the circuit boards and other aspects related to the BLUETOOTH transmitter or transmitter receiver  406 . This arrangement allows the weight of the battery to be counterbalanced by the weight of the transmitter  406  and other electrical components. The pod  400  may automatically power up when removed from the charger  410 , lighting one of the LEDs  402 , and further LEDs  402  may light when electrically connected to the sensor  107 , and to the computer  112  via the BLUETOOTH transmitter  406 . A speaker  416  may also be employed to provide audible reminders, for example to remove the pod  400  following a procedure or in combination with the connections described above and the lighting of the LEDs. 
     Alternatively, the pod  400  may include an EM field detector  417 . The EM field detector  417  can detect whenever it is placed in an EM field, such as that generated by the transmitter mat  118 . Thus rather than requiring an external on/off switch to turn the pod  400  on or off, whenever the pod  400  is within the EM field, the pod  400  fully powers on. In one embodiment the pod  400  may be powered by the magnetic field. Alternatively, the EM field detector  417  can energize a switch not shown, connecting the battery  404  to the wireless transmitter  406 . In either configuration the user can be assured that pod  400  is on and transmitting to the locating module  110  and the computer  112  throughout the procedure so long as the pod  400  is in the EM field. 
     In a further embodiment, the sensors  107  may effectively be the EM field detector. In such an embodiment, the sensor  107  is in communication with the POD  400 , and particularly the microcontroller  407 . When the sensor  107  is in the EM field, a current and a voltage are generated and used to determine the location of the sensor  107  in the EM field. The voltage may additionally be applied to the microcontroller  407 , and logic stored in or applied by the microcontroller  407  upon receipt of this voltage signal can trigger the battery  404  to fully power the pod  400 . Additionally or alternatively, the current induced in the sensor  107  may be applied to the battery  404  to charge the battery  404  while it is in the EM field. 
     This arrangement allows for continued use of the locatable guide  300  during initial navigation to a target. Further the entanglement issues stemming from having two cables  208  and  306  are eliminated. Further, the wireless transmitter  406  ensures that position and orientation in 5DOF continues to be provided to the locating module  110  and computer  112  from the sensor  107  at the distal end of the catheter  106 . 
     In a further aspect of the disclosure, in addition to the wireless transmitter  406  and the battery  404 , there is housed in the pod  400  a gyroscopic sensor  414 . The gyroscopic sensor  414  is able to determine the orientation of the pod  400  with respect to roll. Thus, there is a 0 position, and based on that known 0 position as the pod  400  is rotated, a determination can be made of how far removed from the 0 position, angle of roll the pod  400  has experienced. 
     The catheter  106  is typically formed of several layers of polymeric material sandwiching a braided mesh. During manufacturing, reflowing of the polymeric materials results in the formation of a substantially uniform construction. The catheter  106  is flexible but retains substantial resistance to torsion along its length. As a result, a roll of the pod  400  corresponds to a roll experienced at the distal end of the catheter  106  within some factor (e.g., 5, 10, 15, 20, 25%). Thus, by knowing the amount of roll experienced at the pod  400  the direction of roll of the distal end of the catheter  106  is known and an estimate of the magnitude of the roll can be ascertained. 
     The display  408  on the pod  400  may present an indicator of the number of degrees relative to a 0 position. For example, a +10 degree indicator could indicate a 10 degree rotation in the clockwise direction, and a −10 degree indicator a 10 degree rotation in the counterclockwise direction. 
     As will be appreciated, algorithms may be developed to refine the estimate based on a number of factors including rigidity of the catheter to twist, the lubricity of the outer material of the catheter, the general lubricity of the airways of a patient, the number of bends the catheter has experienced to achieve its current position, the magnitude in degrees of the bends the catheter  106  has experienced to achieve its current position, the size of the airway in which the distal end of the catheter  106  is currently located, an observed rate of change of position of the distal end of the catheter  106  while the pod is being rotated, and other factors. 
     The roll experienced by the pod  400 , and the estimate that provides for the roll experienced by the distal end of the catheter  106 , when combined with the 5 DOF data provided by the sensor at the distal end of the catheter  106  can be combined to provide 6 DOF sensor information about the sensor  107  and the distal end of the catheter  106  to the locating module  110  and computer  112 . Such an arrangement may be used with the locatable guide  300 , as described above, and simply provide greater clarity of information after removal of the locatable guide  300  from the catheter  106 . For instance, in its simplest form, the data may be used to provide an indicator to the clinician on the display  114  that the catheter  106  has likely experienced a roll greater than a preset amount (e.g., 5 degrees). Alternatively, it may be actively relied upon to provide updated roll information to the locating module  110  and computer  112  such that the position of the catheter  106  in the 3D model displayed on the display  114  is constantly updated much the same way it was when employing the locatable guide  300 . 
     Alternatively, the use of the gyroscopic sensor  414  in the pod  400  may enable elimination of the use of the locatable guide  300  from the procedure entirely. This will result in fewer times that a clinician will have to remove a very long instrument from the catheter  106 , and in general ease the workflow of the procedure. In addition, elimination of the locatable guide  300  reduces the number of components necessary for a procedure and thus the overall cost of a procedure, while at the same time promoting efficiency and speeding up the time of the procedure. And because the pod  400  is reusable, the overall number of disposable components is also reduced. 
     In this aspect of the disclosure, only the catheter  106  need be navigated along the planned pathway to a target. The lumen of the catheter  106  may remain open throughout the navigation phase or a tool such as a biopsy or therapy tool may be present in the lumen through the navigation. The data from the sensor  107  at the end of the catheter  106  is combined with the data from the gyroscopic sensor  414  and transmitted via the transmitter  406  to locating module  110  and computer  112  such that the position of the catheter  106  within the patient can be accurately reflected in the 3D model. 
     Where fluoroscope  116  is employed, the clinician may navigate the bronchoscope  104  and catheter  106  proximate a target. Once proximate the target, a fluoroscopic sweep of images may be acquired. This sweep is a series of images (e.g., video) acquired for example from about 15-30 degrees left of the AP position to about 15-30 degrees right of the AP position. Once acquired, the clinician may be required to mark one or more of the bronchoscope  104 , catheter  106 , or target  308  in one or more images. Alternatively, image processing techniques may also be used to automatically identify the bronchoscope  104 , catheter  106 , or target  308 . For example, an application running on computer  112  may be employed to identify pixels in the images having relevant Hounsfield units that signify the density of the bronchoscope  104  and catheter  106 . The last pixels before a transition to a less dense material may be identified as the distal locations of the bronchoscope  104  and catheter  106 . This may require a determination that the pixels having the Hounsfield unit value indicating a high-density material extent in a longitudinal direction at least some predetermined length. In some instances, the target may also be identified based on its difference in Hounsfield unit value as compared to surrounding tissue. With the bronchoscope  104  and catheter  106  positively identified, a 3D volumetric reconstruction of the luminal network can be generated. The 3D volumetric construction may then be analyzed using similar image processing techniques to identify those pixels in the image having a Hounsfield unit signifying the density of the airway wall. Alternatively, the imaging processing may seek those pixels having a Hounsfield unit signifying air. In this process, all of the pixels having a density of air are identified until a change in density is detected. By performing this throughout the 3D volumetric construction, the relative position and orientation of the target and the catheter  106  can be determined and used to update their depicted positions in the 3D model on computer  112 . 
       FIG. 7A  depicts a top end view of the wireless transmission pod  400  and  FIG. 7B  depicts a cross sectional view of the wireless transmission pod.  FIG. 8A  depicts a comparative view of the wireless transmission pod  400  incorporating the catheter  106  and hub  200 .  FIG. 8B  shows the wireless transmission pod  400 , hub  200 , and catheter  106  in the hand of the user as it might be used during a procedure. 
     While the foregoing has described specific functionality of the wireless transmission pod  400  and its incorporation with the catheter  106 .  FIGS. 9A and 9B  depict an alternative form of the wireless transmission pod  400 .  FIGS. 9C-9E  depict various views of insertion of the wireless pod  400  of inserted into the hub  200  with catheter  106 .  FIGS. 10A-C  depict a charger for receiving and recharging the internal battery of the wireless transmission pod  400  of  FIGS. 9A and 9B . 
       FIGS. 11A and 11B  depict another alternative form of the wireless transmission pod  400 . The version in  FIGS. 11A and 11B  are similar in form to that depicted in  FIG. 5 .  FIGS. 11C-11E  depict various views of insertion of the wireless pod  400  of inserted into the hub  200  with catheter  106 .  FIGS. 12A-D  depict a charger for receiving and recharging the internal battery of the wireless transmission pod  400  of  FIGS. 11A and 11B . 
       FIGS. 13A and 13B  depict another alternative form of the wireless transmission pod  400 . As shown in  FIG. 13B  the wireless transmission pod  400  receives the hub  200  and also provides for a convenient handle for grasping the assembly.  FIGS. 14A and 14B  depict another alternative form of the wireless transmission pod  400 .  FIGS. 14C-14E  depict various views of insertion of the wireless pod  400  of inserted into the hub  200 .  FIGS. 15A-D  depict a charger for receiving and recharging the internal battery of the wireless transmission pod  400  of  FIGS. 14A and 14B . 
     Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closer to the clinician and the term “distal” refers to the portion of the device or component thereof that is farther from the clinician. Additionally, in the drawings and in the description above, terms such as front, rear, upper, lower, top, bottom, and similar directional terms are used simply for convenience of description and are not intended to limit the disclosure. In the description hereinabove, well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. 
     While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments.