WO2017223350A1 - Suppression de l'énergie lumineuse d'une gaine de fibres - Google Patents

Suppression de l'énergie lumineuse d'une gaine de fibres Download PDF

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Publication number
WO2017223350A1
WO2017223350A1 PCT/US2017/038816 US2017038816W WO2017223350A1 WO 2017223350 A1 WO2017223350 A1 WO 2017223350A1 US 2017038816 W US2017038816 W US 2017038816W WO 2017223350 A1 WO2017223350 A1 WO 2017223350A1
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WO
WIPO (PCT)
Prior art keywords
optical fiber
cladding
coupling
sensor
fiber member
Prior art date
Application number
PCT/US2017/038816
Other languages
English (en)
Inventor
Eric E. Sanborn
Mark Froggatt
Jeffrey T. Lacroix
Original Assignee
Intuitive Surgical Operations, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Intuitive Surgical Operations, Inc. filed Critical Intuitive Surgical Operations, Inc.
Publication of WO2017223350A1 publication Critical patent/WO2017223350A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/35—Surgical robots for telesurgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/74—Manipulators with manual electric input means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/74—Manipulators with manual electric input means
    • A61B2034/742—Joysticks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

  • the present disclosure is directed to systems and methods for removing light energy from an optical fiber cladding.
  • Minimally invasive medical techniques are intended to reduce the amount of tissue that is damaged during medical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects.
  • Such minimally invasive techniques may be performed through natural orifices in a patient anatomy or through one or more surgical incisions. Through these natural orifices or incisions clinicians may insert minimally invasive medical instruments (including surgical, diagnostic, therapeutic, or biopsy instruments) to reach a target tissue location.
  • minimally invasive medical instruments including surgical, diagnostic, therapeutic, or biopsy instruments
  • One such minimally invasive technique is to use a flexible and/or steerable catheter that may be inserted into anatomic passageways and navigated toward a region of interest within the patient anatomy.
  • Medical tools such as sensor instruments, are deployed through the catheter to determine the shape of the medical tool during a procedure and to determine the position and orientation of a portion of the catheter such as the distal end.
  • Sensor instruments that incorporate an optical fiber shape sensor may experience sensor noise that adversely affects the measurements obtained by the sensor instruments.
  • Systems and method are needed for improving the signal to noise ratio in sensor instruments.
  • a system comprises a coupling member for coupling a first optical fiber member to a second optical fiber member, the second optical fiber member including a sensing region and a medical instrument into which a distal end of the second optical fiber member extends.
  • the system also comprises a cladding light remover positioned between the coupling member and the sensing region.
  • the cladding light remover includes a tubular member with a substantially linear lumen portion and a curved lumen portion.
  • the second optical fiber member extends through the tubular member to remove light energy traveling in a cladding of the second optical fiber member.
  • a system comprises a coupling member for coupling a first optical fiber member to a second optical fiber member.
  • the second optical fiber member includes a sensing region.
  • the system also includes an instrument into which a distal end of the second optical fiber member extends.
  • the system also includes a cladding light remover between the coupling member and the sensing region.
  • the cladding light remover includes a first tube having a first lumen extending between a first end and a second end and a second tube having a second lumen sized to receive the first tube and hold the first tube in a curved shape.
  • the second optical fiber member extends through the cladding light remover to remove light energy traveling in a cladding of the second optical fiber member.
  • a method comprises launching light energy into a cladding of an optical fiber sensor.
  • the optical fiber sensor has a distal end coupled to a termination element.
  • the method also comprises passing the optical fiber sensor through a curved lumen within a cladding light remover to remove the light energy from the cladding of the optical fiber sensor.
  • the optical fiber sensor forms a first localized bend as it enters the curved lumen and forms a second localized bend as it exits the curved lumen.
  • an optical fiber coupling apparatus comprises a coupling section for coupling a first optical fiber member to a second optical fiber member.
  • the second optical fiber member including a coated region and an uncoated region.
  • the apparatus also comprises a fastening member fastened to the uncoated region and a tubular body adjacent to the fastening member through which a portion of the uncoated region of and the coated region of the second optical fiber extends.
  • An adhesive material fills the tubular body around the uncoated region. The adhesive material has a higher index of refraction than a fiber coating of the coated region of the second optical fiber.
  • FIG. 1 is a simplified diagram of a teleoperated medical system according to some embodiments.
  • FIG. 2A is a simplified diagram of a medical instrument system according to some embodiments.
  • FIG. 2B is a simplified diagram of a medical instrument with an extended medical tool according to some embodiments.
  • FIG. 3 is a cross sectional view of an optical fiber according to some embodiments.
  • FIG. 4 is a schematic illustration of an optical fiber sensing system according to some embodiments.
  • FIG. 5 is a side view of a sensor instrument according to some embodiments.
  • FIG. 6 is a cladding light remover according to some embodiments.
  • FIG. 7 illustrates cladding light launch and removal according to some embodiments.
  • FIG. 8A illustrates a connector including a cladding light remover according to some embodiments.
  • FIG. 8B illustrates a detailed view of a portion of the connector of FIG.
  • FIG. 9 is a flowchart illustrating a method for removing light from a cladding layer of an optical fiber sensor.
  • FIG. 10A illustrates a connector including a cladding light removal portion according to some embodiments.
  • FIG. 10B illustrates in greater detail the cladding light removal portion of FIG. 10A.
  • position refers to the location of an object or a portion of an object in a three- dimensional space (e.g., three degrees of translational freedom along Cartesian X-, y-, and z-coordinates).
  • orientation refers to the rotational placement of an object or a portion of an object (three degrees of rotational freedom - e.g. , roll, pitch, and yaw).
  • pose refers to the position of an object or a portion of an object in at least one degree of translational freedom and to the orientation of that object or portion of the object in at least one degree of rotational freedom (up to six total degrees of freedom).
  • shape refers to a set of poses, positions, or orientations measured along an object.
  • FIG. 1 is a simplified diagram of a teleoperated medical system 100 according to some embodiments.
  • teleoperated medical system 100 may be suitable for use in, for example, surgical, diagnostic, therapeutic, or biopsy procedures.
  • medical system 100 generally includes a teleoperational manipulator assembly 102 for operating a medical instrument 104 in performing various procedures on a patient P.
  • Teleoperational manipulator assembly 102 is mounted to or near an operating table O.
  • a master assembly 106 allows a clinician or surgeon S to view the interventional site and to control teleoperational manipulator assembly 102.
  • Master assembly 106 may be located at a surgeon's console which is usually located in the same room as operating table O, such as at the side of a surgical table on which patient P is located. However, it should be understood that surgeon S can be located in a different room or a completely different building from patient P. Master assembly 106 generally includes one or more control devices for controlling teleoperational manipulator assembly 102.
  • the control devices may include any number of a variety of input devices, such as joysticks, trackballs, data gloves, trigger-guns, hand-operated controllers, voice recognition devices, body motion or presence sensors, and/or the like.
  • the control devices may be provided with the same degrees of freedom as the associated medical instrument 104. In this manner, the control devices provide surgeon S with telepresence or the perception that the control devices are integral with medical instruments 104.
  • control devices may have more or fewer degrees of freedom than the associated medical instrument 104 and still provide surgeon S with telepresence.
  • the control devices may optionally be manual input devices which move with six degrees of freedom, and which may also include an actuatable handle for actuating instruments (for example, for closing grasping jaws, applying an electrical potential to an electrode, delivering a medicinal treatment, and/or the like).
  • Teleoperational manipulator assembly 102 supports medical instrument 104 and may include a kinematic structure of one or more non-servo controlled links (e.g., one or more links that may be manually positioned and locked in place, generally referred to as a set-up structure) and a teleoperational manipulator.
  • Teleoperational manipulator assembly 102 may optionally include a plurality of actuators or motors that drive inputs on medical instrument 104 in response to commands from the control system (e.g., a control system 112).
  • the actuators may optionally include drive systems that when coupled to medical instrument 104 may advance medical instrument 104 into a naturally or surgically created anatomic orifice.
  • Other drive systems may move the distal end of medical instrument 104 in multiple degrees of freedom, which may include three degrees of linear motion (e.g., linear motion along the X, Y, Z Cartesian axes) and in three degrees of rotational motion (e.g., rotation about the X, Y, Z Cartesian axes).
  • the actuators can be used to actuate an articulable end effector of medical instrument 104 for grasping tissue in the jaws of a biopsy device and/or the like.
  • Actuator position sensors such as resolvers, encoders, potentiometers, and other mechanisms may provide sensor data to medical system 100 describing the rotation and orientation of the motor shafts. This position sensor data may be used to determine motion of the objects manipulated by the actuators.
  • Teleoperated medical system 100 may include a sensor system 108 with one or more sub-systems for receiving information about the instruments of teleoperational manipulator assembly 102.
  • Such sub-systems may include a position/location sensor system (e.g., an electromagnetic (EM) sensor system); a shape sensor system for determining the position, orientation, speed, velocity, pose, and/or shape of a distal end and/or of one or more segments along a flexible body that may make up medical instrument 104; and/or a visualization system for capturing images from the distal end of medical instrument 104.
  • EM electromagnetic
  • Teleoperated medical system 100 also includes a display system 110 for displaying an image or representation of the surgical site and medical instrument 104 generated by sub-systems of sensor system 108.
  • Display system 110 and master assembly 106 may be oriented so surgeon S can control medical instrument 104 and master assembly 106 with the perception of telepresence.
  • medical instrument 104 may have a visualization system (discussed in more detail below), which may include a viewing scope assembly that records a concurrent or real-time image of a surgical site and provides the image to the clinician or surgeon S through one or more displays of medical system 100, such as one or more displays of display system 110.
  • the concurrent image may be, for example, a two or three dimensional image captured by an endoscope positioned within the surgical site.
  • the visualization system includes endoscopic components that may be integrally or removably coupled to medical instrument 104. However in some embodiments, a separate endoscope, attached to a separate manipulator assembly may be used with medical instrument 104 to image the surgical site.
  • the visualization system may be implemented as hardware, firmware, software or a combination thereof which interact with or are otherwise executed by one or more computer processors, which may include the processors of a control system 112.
  • the processors of control system 112 may execute instructions comprising instruction corresponding to processes disclosed herein and described in more detail below.
  • Display system 110 may also display an image of the surgical site and medical instruments captured by the visualization system.
  • teleoperated medical system 100 may configure medical instrument 104 and controls of master assembly 106 such that the relative positions of the medical instruments are similar to the relative positions of the eyes and hands of surgeon S. In this manner surgeon S can manipulate medical instrument 104 and the hand control as if viewing the workspace in substantially true presence.
  • true presence it is meant that the presentation of an image is a true perspective image simulating the viewpoint of a surgeon that is physically manipulating medical instrument 104.
  • display system 110 may present images of a surgical site recorded pre-operatively or intra-operatively using image data from imaging technology such as, computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and/or the like.
  • CT computed tomography
  • MRI magnetic resonance imaging
  • OCT optical coherence tomography
  • thermal imaging impedance imaging
  • laser imaging nanotube X-ray imaging
  • display system 110 may present images of a surgical site recorded pre-operatively or intra-operatively using image data from imaging technology such as, computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and/or the like.
  • the pre -operative or intra-operative image data may be presented as two-dimensional, three-dimensional, or four
  • display system 110 may display a virtual navigational image in which the actual location of medical instrument 104 is registered (i.e., dynamically referenced) with the preoperative or concurrent images/model. This may be done to present the clinician or surgeon S with a virtual image of the internal surgical site from a viewpoint of medical instrument 104.
  • the viewpoint may be from a tip of medical instrument 104.
  • An image of the tip of medical instrument 104 and/or other graphical or alphanumeric indicators may be superimposed on the virtual image to assist surgeon S controlling medical instrument 104.
  • medical instrument 104 may not be visible in the virtual image.
  • display system 1 10 may display a virtual navigational image in which the actual location of medical instrument 104 is registered with preoperative or concurrent images to present the clinician or surgeon S with a virtual image of medical instrument 104 within the surgical site from an external viewpoint.
  • An image of a portion of medical instrument 104 or other graphical or alphanumeric indicators may be superimposed on the virtual image to assist surgeon S in the control of medical instrument 104.
  • visual representations of data points may be rendered to display system 1 10. For example, measured data points, moved data points, registered data points, and other data points described herein may be displayed on display system 1 10 in a visual representation.
  • the data points may be visually represented in a user interface by a plurality of points or dots on display system 1 10 or as a rendered model, such as a mesh or wire model created based on the set of data points.
  • the data points may be color coded according to the data they represent.
  • a visual representation may be refreshed in display system 110 after each processing operation has been implemented to alter data points.
  • Teleoperated medical system 100 may also include control system 112.
  • Control system 1 12 includes at least one memory and at least one computer processor (not shown) for effecting control between medical instrument 104, master assembly 106, sensor system 108, and display system 1 10.
  • Control system 1 12 also includes programmed instructions (e.g., a non-transitory machine-readable medium storing the instructions) to implement some or all of the methods described in accordance with aspects disclosed herein, including instructions for providing information to display system 110. While control system 1 12 is shown as a single block in the simplified schematic of FIG. 1 , the system may include two or more data processing circuits with one portion of the processing optionally being performed on or adjacent to teleoperational manipulator assembly 102, another portion of the processing being performed at master assembly 106, and/or the like.
  • control system 112 supports wireless communication protocols such as Bluetooth, IrDA, HomeRF, IEEE 802.11, DECT, and Wireless Telemetry.
  • control system 112 may receive force and/or torque feedback from medical instrument 104. Responsive to the feedback, control system 112 may transmit signals to master assembly 106. In some examples, control system 112 may transmit signals instructing one or more actuators of teleoperational manipulator assembly 102 to move medical instrument 104. Medical instrument 104 may extend into an internal surgical site within the body of patient P via openings in the body of patient P. Any suitable conventional and/or specialized actuators may be used. In some examples, the one or more actuators may be separate from, or integrated with, teleoperational manipulator assembly 102. In some embodiments, the one or more actuators and teleoperational manipulator assembly 102 are provided as part of a teleoperational cart positioned adjacent to patient P and operating table O.
  • Control system 1 12 may optionally further include a virtual visualization system to provide navigation assistance to surgeon S when controlling medical instrument 104 during an image-guided surgical procedure.
  • Virtual navigation using the virtual visualization system may be based upon reference to an acquired preoperative or intraoperative dataset of anatomic passageways.
  • the virtual visualization system processes images of the surgical site imaged using imaging technology such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and/or the like.
  • Software which may be used in combination with manual inputs, is used to convert the recorded images into segmented two dimensional or three dimensional composite representation of a partial or an entire anatomic organ or anatomic region.
  • An image data set is associated with the composite representation.
  • the composite representation and the image data set describe the various locations and shapes of the passageways and their connectivity.
  • a virtual visualization system may use standard representations (i.e., not patient specific) or hybrids of a standard representation and patient specific data.
  • the composite representation and any virtual images generated by the composite representation may represent the static posture of a deformable anatomic region during one or more phases of motion (e.g., during an inspiration/ expiration cycle of a lung).
  • sensor system 108 may be used to compute an approximate location of medical instrument 104 with respect to the anatomy of patient P.
  • the location can be used to produce both macro-level (external) tracking images of the anatomy of patient P and virtual internal images of the anatomy of patient P.
  • the system may implement one or more electromagnetic (EM) sensor, fiber optic sensors, and/or other sensors to register and display a medical implement together with preoperatively recorded surgical images. , such as those from a virtual visualization system, are known.
  • EM electromagnetic
  • Teleoperated medical system 100 may further include optional operations and support systems (not shown) such as illumination systems, steering control systems, irrigation systems, and/or suction systems.
  • teleoperated medical system 100 may include more than one teleoperational manipulator assembly and/or more than one master assembly. The exact number of teleoperational manipulator assemblies will depend on the surgical procedure and the space constraints within the operating room, among other factors.
  • Master assembly 106 may be collocated or they may be positioned in separate locations. Multiple master assemblies allow more than one operator to control one or more teleoperational manipulator assemblies in various combinations.
  • FIG. 2A is a simplified diagram of a medical instrument system 200 according to some embodiments.
  • medical instrument system 200 may be used as medical instrument 104 in an image-guided medical procedure performed with teleoperated medical system 100.
  • medical instrument system 200 may be used for non-teleoperational exploratory procedures or in procedures involving traditional manually operated medical instruments, such as endoscopy.
  • Medical instrument system 200 includes catheter system 202 coupled to a drive unit 204.
  • Catheter system 202 includes a flexible body 216 having proximal end 217 and distal end 218 (also called "tip portion 218") ⁇
  • flexible body 216 has an approximately 3 mm outer diameter and an approximately 2mm inner diameter surrounding a working channel. Other flexible body outer diameters may be larger or smaller.
  • a working channel 221 may extend through the flexible body 216.
  • Catheter system 202 may optionally include shape sensor 222 for determining the position, orientation, speed, velocity, pose, and/or shape of the catheter tip at distal end 218 and/or of one or more segments 224 along flexible body 216.
  • the sensor 222 may extend through the working channel 221 or may extend through a separate and dedicated sensor lumen. The entire length of flexible body 216, between distal end 218 and proximal end 217, may be effectively divided into segments 224. If medical instrument system 200 is a medical instrument 104 of a teleoperated medical system 100, shape sensor 222 may be a component of sensor system 108. If medical instrument system 200 is manually operated or otherwise used for non-teleoperational procedures, shape sensor 222 may be coupled to a tracking system 230 that interrogates shape sensor 222 and processes received shape data.
  • Shape sensor 222 may optionally include an optical fiber aligned with flexible body 216 (e.g., provided within an interior channel of the catheter wall (not shown) or mounted externally).
  • the optical fiber has a diameter of approximately 200 ⁇ . In other embodiments, the dimensions may be larger or smaller.
  • the optical fiber of shape sensor 222 forms a fiber optic bend sensor for determining the shape of catheter system 202.
  • optical fibers including Fiber Bragg Gratings (FBGs) are used to provide strain or temperature measurements in structures in one or more dimensions.
  • FBGs Fiber Bragg Gratings
  • FIG. 3 is a cross sectional view of an optical fiber 300 according to some embodiments.
  • the optical fiber 300 includes a plurality of fiber cores 302 through which light energy is propagated.
  • the fiber cores 302 are surrounded by cladding layer 304.
  • the cladding layer 304 is surrounded by a coating or buffer layer 306 that protects the cladding.
  • the optical fiber 300 is a multi-core (three core) fiber, but in alternative embodiments, a single core or a different number of cores may be used.
  • the index of refraction of the cladding layer 304 is lower than the core(s) which results in total internal light reflection, guiding the light through the core even when the optical fiber is bent at least moderately.
  • Sensors in some embodiments may employ other suitable strain sensing techniques, such as Rayleigh scattering, Raman scattering, Brillouin scattering, and Fluorescence scattering.
  • the shape of the catheter may be determined using other techniques. For example, a history of the distal end pose of catheter system 202 can be used to reconstruct the shape of flexible body 216 over the interval of time. As another example, historical pose, position, or orientation data may be stored for a known point of an instrument system along a cycle of alternating motion, such as breathing. This stored data may be used to develop shape information about flexible body 216. In some examples, a series of positional sensors, such as electromagnetic (EM) sensors, positioned along flexible body 216 can be used for shape sensing.
  • EM electromagnetic
  • a history of data from a positional sensor, such as an EM sensor, on the instrument system during a procedure may be used to represent the shape of the instrument, particularly if an anatomic passageway is generally static.
  • a wireless device with position or orientation controlled by an external magnetic field may be used for shape sensing. The history of the position of the wireless device may be used to determine a shape for the navigated passageways.
  • medical instrument system 200 may, optionally, include position sensor system 220.
  • Position sensor system 220 may be a component of an EM sensor system with positional sensor system 220 including one or more conductive coils that may be subjected to an externally generated electromagnetic field. Each coil of an example EM sensor system implementing a position sensor system 220 then produces an induced electrical signal having characteristics that depend on the position and orientation of the coil relative to the externally generated electromagnetic field.
  • the example EM sensor system implementing the position sensor system 220 may be configured and positioned to measure six degrees of freedom, e.g., three position coordinates X, Y, Z and three orientation angles indicating pitch, yaw, and roll of a base point or five degrees of freedom, e.g., three position coordinates X, Y, Z and two orientation angles indicating pitch and yaw of a base point.
  • six degrees of freedom e.g., three position coordinates X, Y, Z and three orientation angles indicating pitch, yaw, and roll of a base point
  • five degrees of freedom e.g., three position coordinates X, Y, Z and two orientation angles indicating pitch and yaw of a base point.
  • shape sensor 222 may also function as the position sensor because the shape of shape sensor 222 together with information about the location of the base of shape sensor 222 (in the fixed coordinate system of patient P) allows the location of various points along shape sensor 222, including distal end 218, to be calculated.
  • tracking system 230 may optionally include position sensor system 220 and shape sensor 222 for determining the position, orientation, speed, pose, and/or shape of distal end 218 and of one or more segments 224 of medical instrument system 200.
  • Tracking system 230 may optionally be implemented as hardware, firmware, software or a combination thereof which interact with or are otherwise executed by one or more computer processors, which may include the processors of control system 112 in FIG. 1.
  • Flexible body 216 includes a channel 221 sized and shaped to receive a medical instrument 226.
  • the working channel 221 may have a diameter of approximately 2 mm.
  • Medical instrument 226 may include, for example, image capture probes, biopsy instruments, laser ablation fibers, and/or other surgical, diagnostic, or therapeutic tools.
  • Medical tools may include end effectors having a single working member such as a scalpel, a blunt blade, an optical fiber, an electrode, and/or the like.
  • Other end effectors may include, for example, forceps, graspers, scissors, clip appliers, and/or the like.
  • Other end effectors may further include electrically activated end effectors such as electrosurgical electrodes, transducers, sensors, and/or the like.
  • medical instrument 226 may be an image capture probe that includes a distal portion with a stereoscopic or monoscopic camera at or near distal end 218 of flexible body 216 for capturing images (including video images) that are processed by a visualization system 231 for display.
  • the image capture probe may include a cable coupled to the camera for transmitting the captured image data.
  • the image capture instrument may be a fiber-optic bundle, such as a fiberscope, that couples to visualization system 231.
  • the image capture instrument may be single or multi-spectral, for example capturing image data in one or more of the visible, infrared, and/or ultraviolet spectrums.
  • Medical instrument 226 may additionally house cables, linkages, or other actuation controls (not shown) that extend between proximal end 217and distal end 218 of medical instrument 226 to controllably bend distal end 218 of medical instrument 226.
  • Steerable instruments are described in detail in U.S. Patent No. 7,316,681 (filed on Oct. 4, 2005) (disclosing "Articulated Surgical Instrument for Performing Minimally Invasive Surgery with Enhanced Dexterity and Sensitivity") and U.S. Patent Application No. 12/286,644 (filed Sept. 30, 2008) (disclosing "Passive Preload and Capstan Drive for Surgical
  • Flexible body 216 may also house cables, linkages, or other steering controls (not shown) that extend between drive unit 204 and distal end 218 to controllably bend distal end 218 as shown, for example, by broken dashed line depictions 219 of distal end 218.
  • at least four cables are used to provide independent "up-down" steering to control a pitch of distal end 218 and "left-right” steering to control a yaw of distal end 281.
  • Steerable catheters are described in detail in U.S. Patent Application No. 13/274,208 (filed Oct. 14, 2011) (disclosing "Catheter with Removable Vision Probe"), which is incorporated by reference herein in its entirety.
  • drive unit 204 may include drive inputs that removably couple to and receive power from drive elements, such as actuators, of the teleoperational assembly.
  • medical instrument system 200 may include gripping features, manual actuators, or other components for manually controlling the motion of medical instrument system 200.
  • Catheter system 202 may be steerable or, alternatively, the system may be non-steerable with no integrated mechanism for operator control of the bending of distal end 218.
  • one or more lumens, through which medical instruments can be deployed and used at a target surgical location, are defined in the walls of flexible body 216.
  • medical instrument system 200 may include a flexible bronchial instrument, such as a bronchoscope or bronchial catheter, for use in examination, diagnosis, biopsy, or treatment of a lung.
  • Medical instrument system 200 is also suited for navigation and treatment of other tissues, via natural or surgically created connected passageways, in any of a variety of anatomic systems, including the colon, the intestines, the kidneys and kidney calices, the brain, the heart, the circulatory system including vasculature, and/or the like.
  • the information from tracking system 230 may be sent to a navigation system 232 where it is combined with information from visualization system 231 and/or the preoperatively obtained models to provide the surgeon or other operator with real-time position information.
  • the real-time position information may be displayed on display system 110 of FIG. 1 for use in the control of medical instrument system 200.
  • control system 116 of FIG. 1 may utilize the position information as feedback for positioning medical instrument system 200.
  • Various systems for using fiber optic sensors to register and display a surgical instrument with surgical images are provided in U.S. Patent Application No. 13/107,562, filed May 13, 2011 , disclosing, "Medical System Providing Dynamic Registration of a Model of an Anatomic Structure for Image-Guided Surgery," which is incorporated by reference herein in its entirety.
  • medical instrument system 200 may be teleoperated within medical system 100 of FIG. 1.
  • teleoperational manipulator assembly 102 of FIG. 1 may be replaced by direct operator control.
  • the direct operator control may include various handles and operator interfaces for hand-held operation of the instrument.
  • FIG. 2B is a simplified diagram of a medical instrument with an extended medical tool 226 according to some embodiments.
  • extended medical tool 226 may be used for procedures such as surgery, biopsy, ablation, illumination, irrigation, or suction.
  • Medical tool 226 can be deployed through working channel 221 of flexible body 216 and used at a target location within the anatomy. If, for example, medical tool 226 is a biopsy instrument, it may be used to remove sample tissue or a sampling of cells from a target anatomic location.
  • Medical tool 226 may be used with an image capture probe also within flexible body 216. Alternatively, medical tool 226 may itself be the image capture probe. Medical tool 226 may be advanced from the opening of channel 221 to perform the procedure and then retracted back into the channel when the procedure is complete. Medical tool 226 may be removed from proximal end 217 of flexible body 216 or from another optional instrument port (not shown) along flexible body 216.
  • Fiber optic sensor systems used with the medical instrument system 200 or in other sensing applications determine the shape of the optical fiber (and therefore the shape of the catheter) by interrogating light energy signals reflected along the optical fiber. If the signals become noisy, the accuracy of the shape sensor information becomes compromised.
  • Coupling devices such as fiber optic connectors or fanout devices create discontinuities that may reduce the efficiency of light transfer. For example, at a connector, light energy exits the core of one fiber and enters the core of a mating connector's fiber. The light transfer is not 100% efficient. For example, some of the light reflects back in the direction that in came, and some light is launched into the cladding of the mating fiber rather than into the mating fiber core.
  • standard optical fiber such as the type used in telecommunications systems
  • light in the cladding propagates in the cladding until it reaches the interface between the cladding and the coating.
  • standard telecommunication fiber uses an acrylate or polyimide coating that has a higher index of refraction than the cladding, the light in the cladding is stripped out or removed from the cladding by the coating so that it cannot be reintroduced to the core(s) and adversely impact the system performance as noise.
  • some low index coating materials may be transparent to ultraviolet light used to write Fiber Bragg Gratings in a post processing operation after the fiber has been drawn.
  • examples of such low index coating materials include silicone which has an index of refraction lower than the fused silica used in the fiber cladding. Silicone is also particularly suitable for medical applications because it is biocompatible and adheres well to glass.
  • Light energy travelling in the cladding propagates at a different rate than light energy propagating in the core. If the cladding light is not removed by the coating, it may be coupled back into the core at a later fiber discontinuity such as a connector or a termination member. In other examples, using fiber with a lower numerical aperture like standard telecommunication fiber, light may be launched into the cladding simply by bending the fiber, without the light passing through a fiber discontinuity. The re-coupled light results in the addition of a time shifted signal that mixes with the light signal traveling in the core to cause system noise that may make interpretation of the light reflected by the Fiber Bragg Gratings difficult and inaccurate.
  • a termination member is typically located at or near the distal tip of the sensing fiber. At this location the termination member may reintroduce cladding light where it has the greatest disruption on the main signal.
  • FIG. 4 an optical fiber sensing system 400.
  • the sensing system 400 may be a component of a sensor system 108 and tracking system 230.
  • the sensing system 400 includes an interrogation system 402 that includes electronics and optical equipment for passing light energy through the system and decoding light energy reflected through the system.
  • the interrogation system 402 is coupled to an optical fiber 403 or to multiple optical fibers.
  • a coupling member 404 connects the optical fiber 403 to an optical fiber 405.
  • the optical fiber 405 has a low index of refraction coating.
  • the coupling member 404 may be, for example, an optical fiber connector that connects light traveling in the core of one fiber to the core of a mating fiber.
  • the coupling member 404 may be a fanout device that receives light from multiple single core fibers and facilitates the transfer of light to one multi- core fiber.
  • the fanout device may be a fused tapered device.
  • Coupling member 404 may not be entirely efficient in transferring light between cores and causes some of the light from the entering fiber to become launched into the cladding of the exiting fiber(s) rather than the core(s).
  • the optical fiber 405, distal of the coupling member 404 has light propagating in the cladding. If not removed, the time shifted light energy from the cladding may be reintroduced to the optical fiber core at a fiber terminator 408.
  • the fiber terminator 408 is distal of a sensed region 407 of the instrument through which a sensing region of the multicore fiber 405 extends. Reintroduction of the cladding mode for reflection into the sensing region provides distortion in the signals reflected from the sensing region.
  • an in-line cladding light remover 406 is located distal of the coupling member and proximal of the sensing region to strip the cladding mode and prevent its reintroduction to the core.
  • the in-line cladding light remover 406 provides a localized bend in the optical fiber 405 (with a low index of refraction coating) that allows the cladding mode to overcome the total internal reflection and exit the cladding into the coating where it becomes removed.
  • the light remover 406 removes the cladding mode via one or more in-line bends, without the creating a full loop in the fiber 405.
  • FIG. 5 illustrates a sensor system 500 (e.g., sensor 222) including a connector body 502 that connects with a connector body 503.
  • An optical fiber 505 extends within the connector body 503 to connect with an optical fiber 507 extending within connector body 502.
  • the optical fiber 507 may have a low index of refraction coating surrounding the fiber cladding.
  • the discontinuity at the connection of fibers 505, 507 may cause light energy from fiber 505 to enter the cladding of fiber 507.
  • the low index of refraction coating of fiber 507 may inhibit the stripping of the light propagating in the cladding, as compared to a high index of refraction coating.
  • the connector 502 includes a protective boot 504.
  • a furcation tube 512 may be coupled at a proximal end to the connector body 502 and at a distal end to an in-line cladding light remover 518.
  • An axis Al extends centrally through the furcation tube.
  • a catheter 520 extends from the cladding light remover 518.
  • the fiber 507 extends through the furcation tube, the cladding light remover 518, and the catheter 520 to a termination device 522 such as a termination tube that houses the distal tip of the fiber 507.
  • FIG. 6 illustrates a cross-sectional view of the in-line cladding light remover 518.
  • the light remover 518 includes a rigid tubular body 550 through which extends a channel 552 having a diameter Dl .
  • the channel 552 is centered along a generally linear axis Al .
  • the body is crimped to the furcation tube 512 by a crimp ring 553.
  • the tubular body 550 may serve as an adapter for coupling the tubular body 550 to the catheter system 202 and may include threads 562 or other connection systems for coupling to the catheter system.
  • a tube 556 extends within the channel 552.
  • the tube 556 has a channel 557 extending between a distal end 560 and a proximal end 558.
  • the tube 556 is formed from a pre -bent section of low friction tubing.
  • the tube 556 has an outer diameter D2
  • the channel 557 has a diameter slightly larger than the fiber 507.
  • the tube 556 is affixed within the channel 552 by an adhesive 554 but could also be molded or formed in place in a similar geometry.
  • the pre -bent tube 556 has a smaller radius of curvature than it does inside the rigid tube body 550 because the channel 552 forces the tube 556 into a shallower curve with a larger radius of curvature.
  • the channel 557 thus has a curved path within the straight channel 552.
  • the proximal end 558 of the tube 556 abuts the furcation tube 512 so that the relatively linear channel 555 of the furcation tube joins to the curved channel 557.
  • the distal end of the tube 556 may also be constrained relatively linearly, compared to the curved channel 557, by structures extending immediately adjacent to the distal exit of the fiber.
  • the fiber 507 extends through the channel 555, in generally parallel alignment with the axis Al . And, the fiber 507 continues through the channel
  • a localized bend is formed in the fiber 507 by directing the fiber away from the axis Al and along the curved channel 557.
  • a localized bend is formed in the fiber 507 by directing the fiber toward the axis Al (or generally parallel to axis Al) by structures or lumens immediately adjacent to the distal exit of the fiber.
  • the fiber is not subjected to damaging forces or tensions that could negatively impact the sensing.
  • the cladding mode is stripped from the cladding so that it cannot be later reintroduced at the termination device 522.
  • the lumen of the tube 556 may have a series of inline curves, a serpentine curve, or other curved shapes that create one or more localized bends in the optical fiber without looping the fiber.
  • the pre-bent tube may be eliminated and the outer tubular body 550 may be cast or machined to include an integral curved channel that creates one or more localized bends in the passing through optical fiber.
  • FIG. 7 illustrates light propagation at a localized bend area substantially similar to areas located at distal end 558 and proximal end 560.
  • an optical fiber 600 is coupled to an optical fiber 602 at a connection location
  • the optical fiber 600 includes a core 608.
  • the optical fiber 602 includes a core 610 surrounded by a cladding 612 which is surrounded by a covering 614.
  • Covering 614 may be a coating of material or some material applied in some other manner.
  • the discontinuity in the fibers causes light energy 620 to propagate into the cladding 612.
  • the light energy 620 travels within the cladding 612 until it reaches the localized bend at bend area 622 (e.g. bend areas that may be located at distal end 558 or proximal end 560).
  • the light energy 620 is stripped from the cladding 612 and removed through the covering 614.
  • FIGs. 8A and 8B provide cross-sectional views of a connector 700 with a connector body 701 housing an in-line cladding light remover 702 and a boot portion 703. This example efficiently packages the source of the discontinuity and the cladding light remover in a common housing.
  • the connector 700 connects a proximal end 704 of a fiber 706 at a connection location 707 to a mating fiber (e.g. fiber 505) which creates a discontinuity where the fibers are connected.
  • the cladding light modes may be launched at the connection location (i.e., the discontinuity) into the cladding of the fiber 706.
  • cladding light remover 702 in the connector body 701 distal of the connection location 707 may eliminate the need for an external cladding light remover at a more distal location.
  • the cladding light remover 702 may be located at any location along the path of the fiber 706 distal of the connection location 707 within the connector body 701. In this example, the cladding light remover 702 may function substantially similar to the cladding light remover 518.
  • the cladding light remover 702 includes a pre-bent curved tube 710 extending within a channel 712 of the connector 700.
  • the channel 712 is generally linear.
  • the channel 712 may be curved but having a radius of curvature greater than the radius of curvature of curved tube 710 so that the curved tube 710 is able to maintain a smaller radius of curvature than the channel 712.
  • the diameter of the channel 712 is sized sufficiently larger than the curved tube 710 to allow the curved tube to maintain a tighter radius of curvature than the channel 712.
  • the tube 710 is formed from a pre -bent section of low friction tubing and is affixed within the channel 712 by an adhesive.
  • the pre-bent tube may be eliminated and the outer channel may be cast or machined to include an integral curved channel that creates one or more localized bends in the passing through optical fiber.
  • the cladding of the fiber 706 propagates the cladding mode proximal of the light remover 702.
  • a localized bend is formed in the fiber 706 by directing the fiber away from the central axis of the channel 712 and along the curve of the lumen of tube 710.
  • locations 714, 716 may also be referred to as localized bend areas.
  • the cladding mode is stripped from the cladding so that it cannot be later reintroduced into the core of the fiber 706.
  • the proximal end of the connector body 708 may include strain relief devices, such as the boot portion 703 , to reduce or eliminate strain in the optical fiber.
  • FIG. 9 illustrates a method 800 for removing light energy from a cladding of an optical fiber sensor.
  • the method 800 is illustrated as a set of operations or processes 802-808. Not all of the illustrated processes 802-808 may be performed in all embodiments of method 800. Additionally, one or more processes that are not expressly illustrated in FIG. 9 may be included before, after, in between, or as part of the processes 802-808. In some embodiments, one or more of the processes 802-808 are optional and may be omitted.
  • light energy is launched into a cladding of the optical fiber sensor.
  • Light energy may be launched into a cladding mode, for example, by a fanout device and/or a connector as previously described.
  • the optical fiber sensor has a distal end coupled to a termination element.
  • the cladding modes may be reintroduced to the fiber by other distally located discontinuities such as a connector or by the termination element. This time-shifted, reintroduced light may interfere with the accuracy of the sensor.
  • a first localized bend is created in the optical fiber sensor as the fiber enters a curved channel.
  • the optical fiber sensor is passed through the curved channel within a cladding light remover.
  • a second localized bend is created in the optical fiber sensor as the fiber exits the curved channel. The localized bends remove the light energy from the cladding of the optical fiber sensor.
  • FIG. 10A illustrates a connector 900 including a cladding light removal portion 902 according to some embodiments.
  • FIG. 10B illustrates the cladding light removal portion 902 in greater detail.
  • the connector 900 includes a fastener such as a ferrule 904 with a distal end inserted into a tubular ferrule holder 906.
  • An optical fiber 908 is stripped of its low index coating 910 to fit tightly within the ferrule 904.
  • the fiber 908 may be bonded to the ferrule to prevent longitudinal movement of the optical fiber relative to the ferrule 904.
  • the fiber 908 is stripped of its coating 910 along the length of the ferrule until approximately the guide feature 911.
  • the proximal beginning of the coating 910 is at or a short distance distally from the guide feature 911. In this embodiment, however, to provide for cladding light removal, the proximal beginning of the coating 910 is at a distance LI from the guidance feature 911 at the distal end of the ferrule 904. This bare length LI of the fiber 908 extending distally of the ferrule 904 is also stripped of the low index coating 910. A filling material 912 fills the area of the channel of holder 906 around the fiber 908 between the ferrule 904 and the coating 910.
  • the filling material 912 may be a high refractive index epoxy or other high index adhesive or bonding material that surrounds the uncoated portion of the fiber 908 and functions to remove cladding mode light energy from the fiber 908.
  • the filling material 912 may have a higher refractive index than the cladding of the fiber 908 and the coating 910. In this embodiment, the distance
  • One or more elements in embodiments of the invention may be implemented in software to execute on a processor of a computer system, such as control system 112.
  • the elements of the embodiments of the invention are essentially the code segments to perform the necessary tasks.
  • the program or code segments can be stored in a non-transitory machine-readable storage media, including any media that can store information including an optical medium, semiconductor medium, and magnetic medium.
  • Machine-readable storage media examples include an electronic circuit; a semiconductor device, a semiconductor memory device, a read only memory (ROM), a flash memory, an erasable programmable read only memory (EPROM); a floppy diskette, a CD-ROM, an optical disk, a hard disk, or other storage device.
  • the code segments may be downloaded via computer networks such as the Internet, Intranet, etc.
  • operations of accessing, detecting, initiating, registered, displaying, receiving, generating, determining, moving data points, segmenting, matching, etc. may be performed at least in part by the control system 112 or the processors thereof.

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Abstract

La présente invention concerne un système comprenant un élément de couplage en vue de coupler un premier élément de fibre optique à un second élément de fibre optique, le second élément de fibre optique comportant une région de détection et un instrument médical dans lequel s'étend une extrémité distale du second élément de fibre optique. Le système comprend également un suppresseur de lumière de gaine positionné entre l'élément de couplage et la région de détection. Le suppresseur de lumière de gaine comporte un élément tubulaire doté d'une partie lumière sensiblement linéaire et d'une partie lumière incurvée. Le second élément à fibre optique s'étend à travers l'élément tubulaire en vue de supprimer l'énergie lumineuse se propageant dans une gaine du second élément de fibre optique.
PCT/US2017/038816 2016-06-23 2017-06-22 Suppression de l'énergie lumineuse d'une gaine de fibres WO2017223350A1 (fr)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5247171A (en) * 1992-04-17 1993-09-21 Fiberoptic Sensor Technologies, Inc. Drift correction for fiberoptic pressure sensors
US20030077043A1 (en) * 2001-10-24 2003-04-24 Scimed Life Systems, Inc. Optical catheter connector
US7349596B2 (en) * 2006-03-16 2008-03-25 Northrop Grumman Corporation System and method to remove light from cladding
US20140275997A1 (en) * 2013-03-15 2014-09-18 Intuitive Surgical Operations, Inc. Shape sensor systems for tracking interventional instruments and mehods of use
US9195006B1 (en) * 2012-11-19 2015-11-24 Nlight Photonics Corporation Fiber termination assembly

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5247171A (en) * 1992-04-17 1993-09-21 Fiberoptic Sensor Technologies, Inc. Drift correction for fiberoptic pressure sensors
US20030077043A1 (en) * 2001-10-24 2003-04-24 Scimed Life Systems, Inc. Optical catheter connector
US7349596B2 (en) * 2006-03-16 2008-03-25 Northrop Grumman Corporation System and method to remove light from cladding
US9195006B1 (en) * 2012-11-19 2015-11-24 Nlight Photonics Corporation Fiber termination assembly
US20140275997A1 (en) * 2013-03-15 2014-09-18 Intuitive Surgical Operations, Inc. Shape sensor systems for tracking interventional instruments and mehods of use

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