Intuitive Surgical Operations, Inc.

Voyage Medical, Inc.

Nidus Medical, LLC

Edmund A Tam

Vahid Saadat

Ruey-Feng Peh

Chris A Rothe

David John Miller

Zachary John Malchano

Christopher A Rothe

Aseem K Thakur

N Parker Willis

Amir Abolfathi

Jason Paul Watson

Isidro Matias Gandionco

Veerappan Swaminathan

David Miller

John Paul Watson

A manipulation assembly comprises: a delivery catheter having a lumen extending therethrough; and a deployment catheter positioned within the lumen of the delivery catheter. The delivery catheter is manipulatable within multiple planes. The deployment catheter is independently manipulatable with respect to the delivery catheter and includes a first lumen and a second lumen. The assembly further comprises an elongate, flexible visualization element positioned within the first lumen of the deployment catheter and extendable distally beyond the delivery catheter. The visualization element is articulatable with respect to the delivery catheter. The assembly further comprises an ablation probe positioned within the second lumen of the deployment catheter and comprises an illumination tool routed through the deployment catheter. The ablation probe is extendable distally beyond the deployment catheter and is positionable off-axis with respect to a longitudinal axis of the delivery catheter. The illumination tool is manipulatable with respect to the delivery catheter.

Methods and apparatus for treatment of atrial fibrillation

A medical manipulation assembly comprises a sheath steerable in response to rotational movement of a sheath steering mechanism. The assembly also comprises a catheter extendable through the sheath. The catheter is steerable in response to rotational movement of a catheter steering mechanism. The sheath and catheter are independently steerable. The assembly also comprises a set of control wires. At least one of the sheath or the catheter includes a plurality of lumens with at least two of the plurality of lumens each sized for passage of one of the control wires of the set of control wires. The steerable catheter includes a working channel sized to receive a visualization instrument therethrough.

Complex shape steerable tissue visualization and manipulation catheter

A system for visualizing a tissue region of interest includes an imaging element, a sheath, and a dilator. The imaging element is configured to visualize tissue. The sheath includes a channel configured to receive the imaging element. The imaging element is positionable along a central longitudinal axis of the sheath and positionable in an off-axis position relative to the central longitudinal axis. The sheath comprises a flexible section defining at least a portion of the channel. The dilator is configured to advance through the channel to force the imaging element into the off-axis position. The dilator is configured to cause the imaging element to bulge the flexible section as the dilator is advanced through the channel.

Off-axis visualization systems

A tissue treatment assembly comprising an elongate flexible energy delivery device extending along a longitudinal axis and terminating at a distal opening and a circuit assembly including a plurality of conductors wrapped in a spiral configuration around the elongate flexible energy delivery device.

Integral electrode placement and connection systems

A system may comprise a first catheter having a first steerable segment and a second catheter disposed within the first catheter. The second catheter may have a second steerable segment. The system may also comprise an imaging element supported at a distal end of the second catheter, a coil reference sensor supported at a distal portion of the second catheter, and a processor in electrical communication with the coil reference sensor. The processor may be configured to determine a position of a distal portion of the first catheter with reference to the coil reference sensor.

Electrophysiology mapping and visualization system

A tissue visualization system comprises a flexible elongate shaft through which a lumen extends. The system also comprises a pliable visualization device coupled to a distal portion of the flexible elongate shaft. The pliable visualization device includes a chamber configured to receive a fluid. The system also comprises a piercing instrument configured to extend through the lumen and to penetrate a surface of the pliable visualization device.

Methods and apparatus for efficient purging

A robotic assembly comprises a deployment catheter including a steerable distal region and further comprises a balloon assembly coupled to the steerable distal region.

Precision control systems for tissue visualization and manipulation assemblies

A system for visualizing a tissue region of interest comprises a deployment catheter defining a lumen and a hood coupled to and extending distally from the deployment catheter. The hood has a low-profile configuration within a delivery sheath and a deployed configuration when extended distally of the delivery sheath. The hood in the deployed configuration defines an open area in fluid communication with the lumen. A distal portion of the deployment catheter extends into the open area. An imaging element is coupled to an imager support member. When in the deployed configuration, the imaging element is configured to extend distally of the distal portion while the imager support member extends within the deployment catheter. The imaging element comprises a tapered surface and the deployment catheter comprises a complementary tapered surface. Retraction of the imaging element causes the imaging element to shift radially outward from a longitudinal axis.

Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

A manipulation assembly includes a delivery catheter having a lumen extending therethrough and a deployment catheter positioned within the delivery catheter. The deployment catheter is independently manipulatable with respect to the delivery catheter. The assembly further includes a visualization element extendable distally beyond the deployment catheter and an ablation probe comprising an energy transmitting surface positionable to ablate tissue adjacent to a distal end of the ablation probe. The ablation probe is extendable distally beyond the deployment catheter.

An apparatus for inhibiting tissue migration during a procedure comprises a deployment catheter defining at least one lumen therethrough and a non-inflatable hood projecting distally from the deployment catheter and defining an open area. The open area is in fluid communication with the at least one lumen. The apparatus also comprises a visualization element disposed within or along the non-inflatable hood for visualizing tissue adjacent to the open area. The apparatus also comprises a tissue grasping end effector positioned within the open area and configured to temporarily engage the tissue adjacent to the open area such that distal migration of the tissue relative to the barrier or membrane is inhibited.

Methods and apparatus for preventing tissue migration

A method of cannulating a coronary sinus within a heart chamber includes deploying, from a catheter, an imaging hood to a deployed configuration by extending the imaging hood from a distal end of the catheter and radially expanding the imaging hood to define a constant deployed volume within an open area of the imaging hood. The method further includes positioning a contact edge of the imaging hood and the open area of the imaging hood in the deployed configuration over or upon an ostium of the coronary sinus, displacing an opaque fluid with a transparent fluid from the open area defined by the imaging hood and tissue surrounding the ostium, visualizing the ostium through the transparent fluid by viewing the ostium via an imaging element attached to an inner surface of the imaging hood, and introducing a guidewire through the imaging hood and into the ostium while under visual guidance.

Coronary sinus cannulation

A method of inhibiting flow of a purging fluid from a device comprises positioning an imaging hood in proximity to a tissue region to be visualized. The imaging hood includes a distal membrane which defines a main aperture. The imaging hood and the distal membrane define an open area. The method also comprises introducing the purging fluid into a proximal portion of the open area. The proximal portion is bounded by a proximal membrane including a plurality of apertures. The method also comprises pressurizing the proximal membrane with the purging fluid to a partially extended state in which the purging fluid flows through the plurality of apertures and through the main aperture. The method also comprises pressurizing the proximal membrane with the purging fluid to a blocking extended state in which the proximal membrane obstructs the main aperture to block the flow of the purging fluid through the main aperture.

A method of ablating a tissue region within a blood-filled environment comprises restraining a fluid within a visualization field in a portion of the blood-filled environment and visualizing the tissue region through the fluid within the visualization field. The method also includes transmitting ablating electrical energy from the fluid into the visualized tissue region.

Visual electrode ablation systems

A method of treatment comprises intravascularly securing an anchor extending from an anchor member at least partially within a vessel lumen such that blood flows unobstructed through or past the anchor. While the anchor is secured, a distance of the anchor member, between the anchor and a barrier or membrane projecting distally from a deployment catheter, is adjusted such that an open area defined by the barrier or membrane is placed against or adjacent to a portion of a patient tissue. Adjusting the distance of the anchor member comprises moving the deployment catheter distally with respect to the anchor member. The method also comprises displacing blood with a transparent fluid from the open area, and while the anchor is secured, articulating the barrier or membrane circumferentially around the anchor. The method also includes treating the tissue while visualizing through the transparent fluid.

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Mountain View, CA, United States of America

Edmund A Tam