Endoscope structures and techniques for navigating to a target in a branched structure

Abstract

Systems and methods employing a small gauge steerable catheter including a locatable guide with a sheath, particularly as an enhancement to a bronchoscope. A typical procedure is as follows. The location of a target in a reference coordinate system is detected or imported. The catheter is navigated to the target which tracking the distal tip of the guide in the reference coordinate system. Insertion of the catheter is typically via a working channel of a convention bronchoscope. Once the tip of the catheter is positioned at the target, the guide is withdrawn, leaving the sheath secured in place. The sheath is then used as a guide channel to direct a medical tool to target.

1 - 11 . (canceled) 
     
     
         12 . A method of steering a locatable guide of a catheter assembly comprising: rotating an actuator relative to a handle of the catheter assembly to select one or more steering elements from a plurality of steering elements, the plurality of steering elements extending between the handle and a distal end of a locatable guide and configured to articulate the distal end of the locatable guide; and
 sliding the actuator relative to the handle to actuate the selected one or more steering elements to articulate the distal end of the locatable guide.   
     
     
         13 . A method according to  claim 12 , wherein rotating the actuator relative to the handle includes aligning a step of the actuator with the selected one or more steering elements. 
     
     
         14 . A method according to  claim 13 , wherein rotating the actuator relative to the handle includes aligning the step with two adjacent steering elements of the plurality of steering elements to select the two adjacent steering elements. 
     
     
         15 . A method according to  claim 13 , wherein when the actuator slides relative to the handle, the step of the actuator engages the selected one or more steering elements to slide the selected one or more steering elements relative to the handle. 
     
     
         16 . A method according to  claim 12 , wherein rotating the actuator relative to the handle includes aligning a clearance slot of the actuator with one or more steering elements of the plurality of steering elements that are not selected. 
     
     
         17 . A method according to  claim 16 , wherein each steering element includes a flange and the clearance slots are aligned with the flanges of the one or more steering elements that are not selected when the actuator is rotated relative to the handle. 
     
     
         18 . A method according to  claim 17 , wherein when the actuator slides relative to the handle, the one or more steering elements that are not selected remain in place due to alignment of the flanges with the clearance slots. 
     
     
         19 . A method according to  claim 12 , wherein sliding the actuator relative to the handle includes sliding the actuator from a first position to a second position, the second position located proximal of the first position. 
     
     
         20 . A method according to claim  11 , wherein rotating the actuator relative to the handle of the catheter assembly includes rotating the actuator to select one of: a first of the steering elements to articulate the distal end of the locatable guide in a first direction, a second of the steering elements to articulate the distal end of the locatable guide in a second direction, or both the first and the second of the steering elements to articulate the distal end of the locatable guide in a third direction intermediate to the first direction and the second direction.