System, method and devices for navigated flexible endoscopy

Abstract

The invention provides a method and system for method of determining the shape of a flexible endoscope. The invention may include registering image-space coordinates of a path of a flexible endoscope within the anatomy of a patient to patient-space coordinates of the path of the flexible endoscope within the anatomy of the patient. In some embodiments, the image space coordinates of the path of the flexible endoscope may be predicted coordinates such as, for example, a calculated centerline through a conduit-like organ, or a calculated “most likely path” of the flexible endoscope within the anatomy of the patient. In other embodiments, the path of the flexible endoscope may be an actual path determined using intra-operative images of the patient's anatomy with the flexible endoscope inserted therein. The registered instrument may then be navigated to one or more items of interest for performance of the endoscopic medical procedure.

1 - 24 . (canceled) 
     
     
         25 : A method of determining the shape of a flexible endoscope inserted into a portion of an anatomy of a patient, comprising:
 inserting the flexible endoscope into the portion of the anatomy of the patient, wherein the endoscope includes at least one working channel;   inserting a tracked elongated member into the working channel of the flexible endoscope, wherein the tracked elongated member is equipped with at least one sensor element whose position and orientation is tracked by a position sensing system;   recording a locus of positions of the at least one sensor elements as the tracked elongated member is moved within the working channel of the flexible endoscope;   determining the path of the flexible endoscope inserted into the portion of the anatomy of the patient using the locus of positions.   
     
     
         26 : The method of  claim 25 , wherein motion of the portion of the anatomy of the patient is measured and accounted for using one or more of a cardiac gating device, a respiratory gating device, an externally placed motion tracking device, and ian internally placed motion tracking device. 
     
     
         27 : The method of  claim 25 , wherein the step of determining a path of the flexible endoscope comprises:
 on a computing device,   receiving one or more preoperative images of the anatomy of the patient that are preoperative to insertion of the flexible endoscope including one or more items of interest;   calculating coordinates of a predicted path in a first preoperative frame of reference corresponding to the one or more preoperative images based on predicted collisions with interior walls of a conduit within the anatomy of the patient in the first preoperative frame of reference;   determining coordinates of the one or more items of interest within the anatomy of the patient in the first preoperative frame of reference;   obtaining coordinates of an actual path of the flexible endoscope within the anatomy of the patient in a second intra-operative frame of reference during the insertion of the flexible endoscope corresponding to a position sensing system associated with one or more sensor elements within the anatomy of the patient;   registering the coordinates of the preoperative predicted path of the flexible endoscope with the coordinates of the actual intra-operative path of the flexible endoscope based on the predicted collisions with the interior walls of the conduit to produce at least one transformation matrix relating the first preoperative frame of reference to the second intra-operative frame of reference; and   creating a display indicating relative locations of the flexible endoscope and the one or more items of interest using the at least one transformation matrix.   
     
     
         28 : A system for determining the shape of a flexible endoscope inserted into a portion of an anatomy of a patient, the system comprising:
 a flexible endoscope insertable into the portion of the anatomy of the patient, wherein the endoscope includes at least one working channel;   a tracked elongated member insertable into the working channel of the flexible endoscope, wherein the tracked elongated member is equipped with at least one sensor element, a position and orientation of which sensor element being tracked by a position sensing system;   a control application comprising a non-transitory program of instructions that are configured to determine, using the position and orientation, the path of the flexible endoscope inserted into the portion of the anatomy of the patient.   
     
     
         29 : The system of  claim 28 , further comprising:
 a memory device that records the position of the at least one sensor element as the tracked elongated member is moved within the working channel of the flexible endoscope;   the control application being configured to receive one or more preoperative images of the anatomy of the patient that are preoperative to insertion of a tracked instrument;   the control application being further configured to
 calculate coordinates of a predicted path in a first preoperative frame of reference corresponding to the one or more preoperative images based on predicted collisions with interior walls of a conduit within the anatomy of the patient in the first preoperative frame of reference, and 
 determine coordinates of the one or more items of interest within the anatomy of the patient in the first preoperative frame of reference corresponding to the one or more preoperative images; 
   the at least one sensor element and the position sensing system being configured to provide coordinates of an actual path of the tracked elongated member during an insertion of the tracked instrument within the anatomy of the patient in a second intra-operative frame of reference corresponding to the position sensing system;   wherein the control application registers the coordinates of the predicted path of the tracked endoscope with the coordinates of the actual path of the tracked instrument based on the predicted collisions with the interior walls of the conduit to produce at least one transformation matrix relating the first preoperative frame of reference to the second intra-operative frame of reference; and   a display module that creates a display indicating the relative locations of the instrument and the one or more points of interest using the at least one transformation matrix.   
     
     
         30 : The system of  claim 28 , further comprising one or more of a cardiac gating device, a respiratory gating device, an externally placed motion tracking device or an internally placed motion tracking device, whereby motion of the portion of the anatomy of the patient is measured and accounted for.