Endobronchial catheter

Abstract

An endobronchial probe includes a deflector having a bore extending therethrough at an angle to its long axis for passage of a tool. The probe includes a location sensor and an ultrasound imager. A push-pull anchoring system comprises a plurality of guides and wires that can extend beyond the guides and retract within the guides. When extended the wires diverge from the long axis sufficiently to engage a bronchus. The probe includes a balloon disposed on the distal segment contralateral to bore that when inflated urges the mouth of the bore into contact with the bronchial wall.

1 . An endoscopic apparatus comprising:
 an elongated assembly having a lumen, a long axis and a distal segment, the lumen extending generally along the long axis;   a deflector disposed in the distal segment and having a bore extending therethrough at an angle to the long axis, the bore having an exit pore and a sideward communication with the lumen, the lumen, the bore and the sideward communication being dimensioned to accept passage of a tool through the lumen, the sideward communication, the bore and the exit pore;   a location sensor disposed in the distal segment, the location sensor connectable to a position processor that is operative for computing a location of the distal segment responsively to signals from the location sensor;   an ultrasound imager disposed in the distal segment, the ultrasound imager connectable to electronic circuitry for processing data provided by the ultrasound imager;   a push-pull anchoring system comprising a plurality of guides and respective wires threaded therethrough, the wires operative to move between a first position wherein the wires are retracted within the guides and a second position wherein the wires extend beyond the guides and diverge from the long axis sufficiently to engage a bronchus when the assembly is inserted therein; and   an inflatable balloon disposed on the distal segment.   
     
     
         2 . The apparatus according to  claim 1 , wherein the assembly has another lumen and the deflector has an entrance pore that communicates with the other lumen, wherein the bore of the deflector leads to the entrance pore and accepts passage of the tool from the other lumen through the entrance pore and through the exit pore. 
     
     
         3 . The apparatus according to  claim 1 , further comprising a proximally located control handle, wherein the anchoring system is disposed between the deflector and the control handle, and the wires are controlled from the control handle. 
     
     
         4 . The apparatus according to  claim 1 , wherein in the second position, the wires extend outward from the long axis in a generally proximal direction. 
     
     
         5 . The apparatus according to  claim 1 , wherein the location sensor is a tri-axial magnetic field sensor. 
     
     
         6 . The apparatus according to  claim 1 , wherein the location sensor is an electrode that reports impedance measurement signals to the position processor cooperatively with a plurality of body surface electrodes. 
     
     
         7 . The apparatus according to  claim 1 , further comprising a retractable biopsy needle and at least one retractable ablation needle, the biopsy needle and the ablation needle being deployable via the deflector. 
     
     
         8 . An endoscopic apparatus, comprising:
 a probe having a proximal segment, a distal segment and a distal end configured to penetrate into a lung:   a location sensor configured to generate a signal indicative of a location with respect to the lung of the distal end;   an ultrasound imager, configured to image the lung;   a retractable biopsy needle, configured to aspirate a sample of the lung after deployment of the biopsy needle; and   at least one retractable ablation needle, configured to ablate a section of the lung after deployment of the at least one ablation needle.   
     
     
         9 . The apparatus according to  claim 8 , further comprising a balloon configured to surround a portion of the distal segment, and, upon inflation of the balloon, to seal the section of the lung. 
     
     
         10 . The apparatus according to  claim 8 , wherein the biopsy needle is configured to apply a sealant to a sampled portion of the lung. 
     
     
         11 . The apparatus according to  claim 8 , wherein the ablation needle is configured to apply a sealant to an ablated portion of the lung after ablation therewith. 
     
     
         12 . A method of endoscopy comprising the steps of:
 inserting into a bronchus of a lung an elongated assembly having a lumen, a long axis, a distal segment and a deflector disposed in the distal segment, the lumen extending generally along the long axis, the deflector having a bore extending therethrough at an angle to the long axis, the bore having an exit pore and a sideward communication with the lumen;   introducing a tool into the deflector;   transmitting signals from a location sensor disposed in the distal segment to a position processor that is operative for computing a location of the distal segment responsively to the signals from the location sensor;   imaging a target in the lung using an ultrasound imager disposed in the distal segment and transmitting data provided by the ultrasound imager to electronic circuitry for processing thereof;   urging the exit pore of the deflector against a wall of the bronchus by inflating an inflatable balloon disposed on the distal segment;   thereafter penetrating the wall of the bronchus with the tool via the exit pore to reach the target in the lung with the tool;   anchoring the assembly to provide counter-traction thereon while penetrating the wall of the bronchus using a push-pull anchoring system comprising a plurality of guides and respective wires threaded therethrough by moving the wires between a first position wherein the wires are retracted within the guides and a second position wherein the wires extend beyond the guides and diverge from the long axis sufficiently to engage the wall of the bronchus; and   performing an operation on the target using the tool.   
     
     
         13 . The method according to  claim 12 , wherein introducing the tool comprises passing the tool through the lumen, the sideward communication and the exit pore. 
     
     
         14 . The method according to  claim 12 , wherein the assembly has another lumen and the deflector has an entrance pore that communicates with the other lumen, wherein the bore of the deflector leads to the entrance pore, and wherein introducing the tool comprises passing the tool from the other lumen through the entrance pore and through the exit pore. 
     
     
         15 . The method according to  claim 12 , wherein the assembly further comprises a proximal segment and a handle having a wire control disposed on the proximal segment, wherein anchoring the assembly comprises moving the wires by activating the wire control. 
     
     
         16 . The method according to  claim 12 , wherein the location sensor is a tri-axial magnetic field sensor. 
     
     
         17 . The method according to  claim 12 , wherein the location sensor is an electrode that reports impedance measurement signals to the position processor cooperatively with a plurality of body surface electrodes.