Adjustable instrument for dilation of anatomical passageway

Abstract

An apparatus includes a body, a shaft assembly, a deflection actuation assembly, and a dilation catheter. The shaft assembly includes a rigid proximal portion and a flexible distal portion. The deflection actuation assembly includes a rotary actuator and a first translatable actuation member at least partially disposed within the first rotary actuator. A second translatable actuation member extends through the shaft assembly and couples the first translatable actuation member with the flexible distal portion of the shaft assembly. The first rotary actuator is rotatable about a longitudinal axis to thereby drive the first and second translatable actuation members longitudinally. The flexible distal portion is configured to deflect away from the longitudinal axis in response to translation of the first and second translatable actuation members longitudinally. The dilation catheter is slidable relative to the shaft assembly and includes an expandable dilator.

1 .- 20 . (canceled) 
     
     
         21 . An apparatus comprising:
 (a) a body;   (b) a shaft assembly extending distally from the body and defining a longitudinal axis, wherein the shaft assembly comprises:
 (i) a rigid proximal portion, and 
 (ii) a flexible distal portion; 
   (c) a dilation catheter slidable relative to the shaft assembly, wherein the dilation catheter comprises an expandable dilator; and   (d) a deflection actuation assembly comprising:
 (i) a first rotary actuator, 
 (ii) a first translatable actuation member operatively coupled with the first rotary actuator, wherein the first translatable actuation member includes a cam channel, 
 (iii) a second translatable actuation member extending through the shaft assembly, wherein the second translatable actuation member couples the first translatable actuation member with the flexible distal portion of the shaft assembly, wherein the first rotary actuator is configured to drive the first and second translatable actuation members longitudinally, wherein the flexible distal portion is configured to deflect away from the longitudinal axis in response to translation of the first and second translatable actuation members longitudinally, and 
 (iv) a cam fixably coupled with the first rotary actuator, wherein the cam is configured to travel along the cam channel. 
   
     
     
         22 . The apparatus of  claim 21 , wherein the first translatable actuation member comprises a cam barrel, wherein the cam barrel includes the cam channel. 
     
     
         23 . The apparatus of  claim 22 , wherein the cam barrel is configured to translate the second translatable actuation member to cause straightening or bending of the flexible distal portion in response to translation of the cam barrel. 
     
     
         24 . The apparatus of  claim 22 , wherein the second translatable actuation member comprises a pull-wire having proximal and distal ends, wherein the distal end of the pull-wire is secured with a distal end of the flexible distal portion. 
     
     
         25 . The apparatus of  claim 24 , wherein the pull-wire is configured to translate with the cam barrel relative to the rigid proximal portion in response to rotation of the first rotary actuator relative to rigid proximal portion. 
     
     
         26 . The apparatus of  claim 21 , wherein the cam channel has a plurality of channel portions, wherein the channel portions are in communication with each other. 
     
     
         27 . The apparatus of  claim 26 , wherein the cam channel includes at least one detent feature providing transitions between the channel portions. 
     
     
         28 . The apparatus of  claim 27 , wherein the at least one detent feature of the cam channel is positioned at a location corresponding to at least one predetermined deflection angle of the flexible distal portion of the shaft assembly. 
     
     
         29 . The apparatus of  claim 28 , wherein the first rotary actuator is configured to provide tactile feedback corresponding to the at least one predetermined deflection angle in response to rotation of the first rotary actuator. 
     
     
         30 . The apparatus of  claim 28 , wherein the at least one predetermined deflection angle includes a first angle, a second angle, and a third angle, wherein the first angle is in a range from approximately 50 degrees to approximately 60 degrees, wherein the second angle is in a range from approximately 65 degrees to approximately 70 degrees, wherein the third angle is in a range from approximately 105 degrees to approximately 115 degrees. 
     
     
         31 . The apparatus of  claim 30 , wherein the first angle is approximately 55 degrees, wherein the second angle is approximately 70 degrees, wherein the third angle is approximately 110 degrees. 
     
     
         32 . The apparatus of  claim 21 , further comprising:
 (a) a guidewire slidably disposed in the dilation catheter; and   (b) a guidewire actuation assembly, wherein the guidewire actuation assembly is operable to translate the guidewire relative to the body, wherein the guidewire actuation assembly is operable to rotate the guidewire about the longitudinal axis.   
     
     
         33 . The apparatus of  claim 21 , wherein the body comprises a body portion and a grip portion, wherein the grip portion is selectively removable from the body portion. 
     
     
         34 . The apparatus of  claim 33 , wherein the body portion and the grip portion include complementary rail and recess features that are configured to provide sliding longitudinal engagement between the body portion and the grip portion, wherein the body portion and the grip portion further include complementary detent features that are configured to selectively maintain a longitudinal position of the grip portion relative to the body portion. 
     
     
         35 . The apparatus of  claim 21 , wherein the flexible distal portion includes a flex section that is formed by a series of ribs that are separated by a series of V-shaped notches. 
     
     
         36 . An apparatus comprising:
 (a) a body;   (b) a shaft assembly extending distally from the body and defining a longitudinal axis, wherein the shaft assembly comprises:
 (i) a rigid proximal portion, and 
 (ii) a flexible distal portion that includes a distal end; and 
   (c) a deflection actuation assembly comprising:
 (i) a first rotary actuator, 
 (ii) a first translatable actuation member operatively coupled with the first rotary actuator, wherein the first translatable actuation member comprises a cam barrel, wherein the cam barrel includes a cam channel, and 
 (iii) a second translatable actuation member extending through the shaft assembly, wherein the second translatable actuation member comprises a pull-wire, wherein the pull-wire includes proximal and distal ends, wherein the distal end of the pull-wire is secured to the distal end of the flexible distal portion, 
 wherein the first rotary actuator is configured to drive the cam barrel and the pull-wire longitudinally, wherein the flexible distal portion is configured to deflect away from the longitudinal axis in response to translation of the cam barrel and the pull-wire. 
   
     
     
         37 . The apparatus of  claim 36 , wherein the first rotary actuator includes a projection configured to move along the cam channel. 
     
     
         38 . The apparatus of  claim 36 , further comprising a shaft rotation assembly, wherein the shaft rotation assembly is operable to rotate the shaft assembly about the longitudinal axis, wherein the shaft rotation assembly comprises a second rotary actuator that is rotatable about an axis that is perpendicular to the first rotary actuator. 
     
     
         39 . The apparatus of  claim 36 , further comprising a dilation catheter slidable relative to the shaft assembly, wherein the dilation catheter comprises an expandable dilator. 
     
     
         40 . An apparatus comprising:
 (a) a body comprising:
 (i) body portion, and 
 (ii) a grip portion that is selectively removable from the body portion, wherein the body portion and the grip portion include complementary rail and recess features that are configured to provide sliding longitudinal engagement between the body portion and the grip portion, wherein the body portion and the grip portion further include complementary detent features that are configured to selectively maintain a longitudinal position of the grip portion relative to the body portion, 
   (b) a shaft assembly extending distally from the body and defining a longitudinal axis, wherein the shaft assembly comprises:
 (i) a rigid proximal portion, and 
 (ii) a flexible distal portion; and 
   (c) a deflection actuation assembly comprising:
 (i) a first rotary actuator, 
 (ii) a first translatable actuation member operatively coupled with the first rotary actuator, and 
 (iii) a second translatable actuation member extending through the shaft assembly, wherein the second translatable actuation member couples the first translatable actuation member with the flexible distal portion of the shaft assembly, wherein the first rotary actuator is configured to drive the first and second translatable actuation members longitudinally, wherein the flexible distal portion is configured to deflect away from the longitudinal axis in response to translation of the first and second translatable actuation members longitudinally.