Robotic catheter system and methods

Abstract

The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

1 . A method of robotic surgery on a patient, comprising:
 a. positioning a distal portion of an electromechanically steerable catheter into a blood vessel, the distal portion comprising an ablation element coupled to the distal portion;   b. controllably navigating the distal portion into a configuration wherein the ablation element is adjacent a targeted vascular structure; and   c. selectively ablating the targeted vascular structure with the ablation element.   
     
     
         2 . The method of  claim 1 , further comprising capturing image information regarding the targeted vascular structure from the patient and identifying the targeted vascular structure based at least in part upon the captured image information. 
     
     
         3 . The method of  claim 2 , further comprising capturing image information regarding structures that surround the targeted vascular structure and creating a three dimensional map of the targeted vascular structure and structures that surround the targeted vascular structure. 
     
     
         4 . The method of  claim 2 , wherein the image information is acquired after selectively ablating. 
     
     
         5 . The method of  claim 1 , further comprising selectively contacting one or more structures adjacent the targeted vascular structure with an electrode element to create an electrical map. 
     
     
         6 . The method of  claim 5 , wherein the electrode element comprises a distinct structure relative to the ablation element. 
     
     
         7 . The method of  claim 1 , wherein positioning the electromechanically steerable catheter comprises manually advancing the electromechanically steerable catheter. 
     
     
         8 . The method of  claim 1 , wherein positioning the electromechanically steerable catheter comprises electromechanically advancing the electromechanically steerable catheter in response to an advancement command by an operator. 
     
     
         9 . The method of  claim 1 , wherein controllably navigating the distal portion comprises initiating navigation commands with an electromechanical master input device. 
     
     
         10 . The method of  claim 1 , wherein controllably navigating comprises automatically moving the distal portion in response to commands initiated by a controller operatively coupled to the electromechanically steerable catheter, the commands being based at least in part upon image information regarding nearby structures. 
     
     
         11 . The method of  claim 1 , wherein controllably navigating comprises automatically moving the distal portion in response to commands initiated by a controller operatively coupled to the electromechanically steerable catheter, the commands being based at least in part upon a predetermined plan for navigating nearby structures. 
     
     
         12 . The method of  claim 1 , wherein the ablation element is selected from the group consisting of: an RF ablation element, a cryo-ablation element, a laser ablation element, and an ultrasound ablation element. 
     
     
         13 . The method of  claim 1 , wherein the blood vessel is selected from the group consisting of: a renal artery, a carotid artery, and a femoral artery. 
     
     
         14 . A method of robotic surgery, comprising:
 a. positioning a distal portion of an electromechanically steerable catheter into a renal artery of a patient, the distal portion comprising an ablation element coupled to the distal portion;   b. controllably navigating the distal portion into a configuration wherein the ablation element is adjacent a targeted vascular structure; and   c. selectively ablating the targeted vascular structure with the ablation element.   
     
     
         15 . The method of  claim 14 , further comprising capturing image information regarding the targeted vascular structure from the patient and identifying the targeted vascular structure based at least in part upon the captured image information. 
     
     
         16 . The method of  claim 15 , further comprising capturing image information regarding structures that surround the targeted vascular structure and creating a three dimensional map of the targeted vascular structure and structures that surround the targeted vascular structure. 
     
     
         17 . The method of  claim 14 , further comprising selectively contacting one or more structures adjacent the targeted vascular structure with an electrode element to create an electrical map. 
     
     
         18 . The method of  claim 14 , wherein positioning the electromechanically steerable catheter comprises manually advancing the electromechanically steerable catheter. 
     
     
         19 . The method of  claim 14 , wherein positioning the electromechanically steerable catheter comprises electromechanically advancing the electromechanically steerable catheter in response to an advancement command by an operator. 
     
     
         20 . The method of  claim 14 , wherein controllably navigating the distal portion comprises initiating navigation commands with an electromechanical master input device. 
     
     
         21 . The method of  claim 14 , wherein controllably navigating comprises automatically moving the distal portion in response to commands initiated by a controller operatively coupled to the electromechanically steerable catheter, the commands being based at least in part upon image information regarding nearby structures. 
     
     
         22 . The method of  claim 14 , wherein controllably navigating comprises automatically moving the distal portion in response to commands initiated by a controller operatively coupled to the electromechanically steerable catheter, the commands being based at least in part upon a predetermined plan for navigating nearby structures. 
     
     
         23 . The method of  claim 14 , wherein the ablation element is selected from the group consisting of: an RF ablation element, a cryo-ablation element, a laser ablation element, and an ultrasound ablation element. 
     
     
         24 . A method of robotic surgery, comprising:
 a. initiating an advancement of a steerable catheter by generating an advancement command with a master input device;   b. positioning a distal portion of the steerable catheter into a renal artery of a patient in response to the advancement command, the distal portion comprising an ablation element coupled to the distal portion;   b. controllably navigating the steerable catheter wherein the ablation element is adjacent a targeted vascular structure; and   c. selectively ablating the targeted vascular structure with the ablation element.   
     
     
         25 . The method of  claim 24 , wherein controllably navigating comprises automatically moving the steerable catheter in response to commands initiated by a controller, the commands being based at least in part upon image information regarding the targeted vascular structure. 
     
     
         26 . The method of  claim 24 , wherein controllably navigating comprises automatically moving the steerable catheter in response to commands initiated by a controller, the commands being based at least in part upon a predetermined plan for navigating structures adjacent to the targeted structure. 
     
     
         27 . The method of  claim 24 , further comprising capturing image information regarding the targeted vascular structure from the patient and creating a three dimensional map of the targeted vascular structure and structures that surround the targeted vascular structure. 
     
     
         28 . The method of  claim 27 , wherein initiating an advancement further comprises a user consulting the three dimensional map, and controlling the master input device to initiate the advancement. 
     
     
         29 . The method of  claim 24 , further comprising selectively contacting one or more structures adjacent the targeted vascular structure with an electrode element to create an electrical map.