Method and apparatus for advancing an instrument along an arbitrary path

Abstract

An endoscope with guiding apparatus is described herein. A steerable endoscope is described having an elongate body with a manually or selectively steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable tracking rod or guide. The tracking rod or guide is positioned within a guide channel within the endoscope and slides relative to the endoscope. When the guide is in a flexible state, it can conform to a curve or path defined by the steerable distal portion and the automatically controlled portion. The guide can then be selectively rigidized to assume that curve or path. Once set, the endoscope can be advanced over the rigidized guide in a monorail or “piggy-back” fashion so that the flexible proximal portion follows the curve held by the guide until the endoscope reaches a next point of curvature within a body lumen.

1 - 34 . (canceled)  
     
     
         35 . A method of advancing an instrument along an arbitrary path, comprising: 
 selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path;    advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion, wherein the controllable portion is proximal of the distal portion;    advancing an elongate guide along the instrument such that a portion of the guide conforms to and assumes the selected shape; and    maintaining a position of the guide while advancing the instrument along the guide such that a proximal portion of the instrument assumes the selected shape defined by the guide,    wherein the elongate guide is freely slidable along the instrument such that advancing of the instrument along the guide is unconstrained.    
     
     
         36 . The method of  claim 35  further comprising measuring a depth change of the instrument while advancing the instrument distally.  
     
     
         37 . The method of  claim 36  further comprising incrementing a current depth by the depth change.  
     
     
         38 . The method of  claim 35  further comprising releasing the position of the guide and further advancing the guide along the instrument.  
     
     
         39 . The method of  claim 35  further comprising withdrawing the guide from the instrument.  
     
     
         40 . The method of  claim 35  wherein the elongate guide is advanced along by passing the instrument through a lumen within the elongate guide.  
     
     
         41 . The method of  claim 35  wherein the distal portion of the instrument selectively assumes a second shape when the instrument is advanced along the guide.  
     
     
         42 . The method of  claim 35  wherein maintaining the position of the guide comprises rigidizing the guide such that the guide rigidly assumes a position of the selected shape.  
     
     
         43 . The method of  claim 42  wherein rigidizing the guide comprises applying tension to a tensioning member disposed within the guide such that a plurality of adjacent segments comprising the guide are compressed.  
     
     
         44 . The method of  claim 42  wherein rigidizing the guide comprises applying a compressive force to an exterior of the elongate guide such that a plurality of adjacent segments comprising the guide are compressed.  
     
     
         45 . An apparatus for insertion into a body cavity, comprising: 
 an elongate body having a proximal portion and a selectively steerable distal portion and defining a lumen therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;    an elongate guide having a proximal section, a distal section, and a length therebetween, the guide being slidably disposed without constraint over the elongate body to selectively support the elongate body,    wherein the guide is configured to conform to and selectively maintain the selected shape assumed by the steerable distal portion, and wherein the proximal portion of the elongate body when advanced distally is configured to conform to the selected curve maintained by the guide.    
     
     
         46 . The apparatus of  claim 45  further comprising a controllable portion located proximally of the distal portion, wherein the controllable portion is configured to propagate the selected shape to the controllable portion.  
     
     
         47 . The apparatus of  claim 46  wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.  
     
     
         48 . The apparatus of  claim 45  wherein the proximal section comprises a flexible tubular member.  
     
     
         49 . The apparatus of  claim 48  wherein the elongate guide comprises a plurality of pivotally connected segments.  
     
     
         50 . The apparatus of  claim 45  wherein the elongate guide is configured to assume the selected shape when the guide is in a flexible state and wherein the guide is further configured to maintain the selected shape when the guide is in a rigidized state.  
     
     
         51 . The apparatus of  claim 50  wherein the elongate guide is configured to selectively rigidize along the length of the guide to maintain the selected shape in the rigidized state.  
     
     
         52 . The apparatus of  claim 50  wherein the proximal section of the elongate guide is in communication with a guide controller for selectively rigidizing the guide along its length.  
     
     
         53 . The apparatus of  claim 50  wherein the elongate guide comprises a plurality of adjacent segments each defining a channel therethrough such that a common channel is defined through the length of the guide.  
     
     
         54 . The apparatus of  claim 53  further comprising a tensioning member slidably extending through the plurality of adjacent segments such that applying a force to the tensioning member compresses the adjacent segments together.  
     
     
         55 . The apparatus of  claim 53  wherein the elongate guide is configured to maintain a position of adjacent segments relative to each other upon applying a compressive force to an exterior of the plurality of adjacent segments.  
     
     
         56 . The apparatus of  claim 55  further comprising an expandable balloon.  
     
     
         57 . The apparatus of  claim 45  further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.  
     
     
         58 . A method of advancing an instrument along an arbitrary path, comprising: 
 selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path;    advancing an elongate guide along the instrument such that a portion of the guide conforms to and assumes the selected shape;    maintaining a position of the guide while advancing the instrument along the guide such that a proximal portion of the instrument assumes the selected shape defined by the guide; and    measuring a depth change of the instrument while advancing the instrument distally,    wherein the elongate guide is freely slidable along the instrument such that advancing of the instrument along the guide is unconstrained.    
     
     
         59 . The method of  claim 58  wherein, prior to advancing the elongate guide along the instrument, further comprising advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion, wherein the controllable portion is proximal of the distal portion.  
     
     
         60 . The method of  claim 58  further comprising incrementing a current depth by the depth change.  
     
     
         61 . The method of  claim 58  further comprising releasing the position of the guide and further advancing the guide along the instrument.  
     
     
         62 . The method of  claim 58  further comprising withdrawing the guide from the instrument.  
     
     
         63 . The method of  claim 58  wherein the elongate guide is advanced along by passing the instrument through a lumen within the elongate guide.  
     
     
         64 . The method of  claim 58  wherein the distal portion of the instrument selectively assumes a second shape when the instrument is advanced along the guide.  
     
     
         65 . The method of  claim 58  wherein maintaining the position of the guide comprises rigidizing the guide such that the guide rigidly assumes a position of the selected shape.  
     
     
         66 . The method of  claim 65  wherein rigidizing the guide comprises applying tension to a tensioning member disposed within the guide such that a plurality of adjacent segments comprising the guide are compressed.  
     
     
         67 . The method of  claim 65  wherein rigidizing the guide comprises applying a compressive force to an exterior of the elongate guide such that a plurality of adjacent segments comprising the guide are compressed.  
     
     
         68 . An apparatus for insertion into a body cavity, comprising: 
 an elongate body having a selectively steerable distal portion, a controllable portion located proximally of the distal portion, and a lumen defined therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;    an elongate guide having a proximal section, a distal section, and a length therebetween, the guide being slidably disposed without constraint over the elongate body to selectively support the elongate body,    wherein the guide is configured to conform to and selectively maintain the selected shape assumed by the steerable distal portion, and wherein the controllable portion of the elongate body when advanced distally is configured to propogate the selected shape to the contollable portion and conform to the selected curve maintained by the guide.    
     
     
         69 . The apparatus of  claim 68  wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.  
     
     
         70 . The apparatus of  claim 68  wherein the proximal section comprises a flexible tubular member.  
     
     
         71 . The apparatus of  claim 70  wherein the elongate guide comprises a plurality of pivotally connected segments.  
     
     
         72 . The apparatus of  claim 68  wherein the elongate guide is configured to assume the selected shape when the guide is in a flexible state and wherein the guide is further configured to maintain the selected shape when the guide is in a rigidized state.  
     
     
         73 . The apparatus of  claim 72  wherein the elongate guide is configured to selectively rigidize along the length of the guide to maintain the selected shape in the rigidized state.  
     
     
         74 . The apparatus of  claim 72  wherein the proximal section of the elongate guide is in communication with a guide controller for selectively rigidizing the guide along its length.  
     
     
         75 . The apparatus of  claim 72  wherein the elongate guide comprises a plurality of adjacent segments each defining a channel therethrough such that a common channel is defined through the length of the guide.  
     
     
         76 . The apparatus of  claim 75  further comprising a tensioning member slidably extending through the plurality of adjacent segments such that applying a force to the tensioning member compresses the adjacent segments together.  
     
     
         77 . The apparatus of  claim 75  wherein the elongate guide is configured to maintain a position of adjacent segments relative to each other upon applying a compressive force to an exterior of the plurality of adjacent segments.  
     
     
         78 . The apparatus of  claim 77  further comprising an expandable balloon.  
     
     
         79 . The apparatus of  claim 68  further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.  
     
     
         80 . An apparatus for insertion into a body cavity, comprising: 
 an elongate body having a proximal portion, a selectively steerable distal portion, and a lumen defined therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;    an elongate guide having a proximal section, a distal section, and a length therebetween, the proximal section comprising a flexible tubular member, the guide comprising a plurality of pivotally connected segments and being slidably disposed without constraint over the elongate body to selectively support the elongate body,    wherein the guide is configured to conform to and selectively maintain the selected shape assumed by the steerable distal portion, and wherein the proximal portion of the elongate body when advanced distally is configured to conform to the selected curve maintained by the guide.    
     
     
         81 . The apparatus of  claim 80  further comprising a controllable portion located proximally of the distal portion, wherein the controllable portion is configured to propagate the selected shape to the controllable portion.  
     
     
         82 . The apparatus of  claim 81  wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.  
     
     
         83 . The apparatus of  claim 80  wherein the elongate guide is configured to assume the selected shape when the guide is in a flexible state and wherein the guide is further configured to maintain the selected shape when the guide is in a rigidized state.  
     
     
         84 . The apparatus of  claim 83  wherein the elongate guide is configured to selectively rigidize along the length of the guide to maintain the selected shape in the rigidized state.  
     
     
         85 . The apparatus of  claim 83  wherein the proximal section of the elongate guide is in communication with a guide controller for selectively rigidizing the guide along its length.  
     
     
         86 . The apparatus of  claim 83  wherein the plurality of pivotally connected segments of the elongate guide further comprises a plurality of adjacent segments each defining a channel through the guide such that a common channel is defined through the length of the guide.  
     
     
         87 . The apparatus of  claim 86  further comprising a tensioning member slidably extending through the plurality of adjacent segments such that applying a force to the tensioning member compresses the adjacent segments together.  
     
     
         88 . The apparatus of  claim 86  wherein the elongate guide is configured to maintain a position of adjacent segments relative to each other upon applying a compressive force to an exterior of the plurality of adjacent segments.  
     
     
         89 . The apparatus of  claim 88  further comprising an expandable balloon.  
     
     
         90 . The apparatus of  claim 80  further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.  
     
     
         91 . A method of advancing an instrument along an arbitrary path, comprising: 
 selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path;    advancing an elongate guide along the instrument by passing the instrument through a lumen within the elongate guide, such that a portion of the guide conforms to and assumes the selected shape; and    maintaining a position of the guide while advancing the instrument along the guide such that a proximal portion of the instrument assumes the selected shape defined by the guide,    wherein the elongate guide is freely slidable along the instrument such that advancing of the instrument along the guide is unconstrained.    
     
     
         92 . The method of  claim 91  wherein, prior to advancing the elongate guide along the instrument, further comprising advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion, wherein the controllable portion is proximal of the distal portion.  
     
     
         93 . The method of  claim 91  further comprising measuring a depth change of the instrument while advancing the instrument distally.  
     
     
         94 . The method of  claim 93  further comprising incrementing a current depth by the depth change.  
     
     
         95 . The method of  claim 91  further comprising releasing the position of the guide and further advancing the guide along the instrument.  
     
     
         96 . The method of  claim 91  further comprising withdrawing the guide from the instrument.  
     
     
         97 . The method of  claim 91  wherein the distal portion of the instrument selectively assumes a second shape when the instrument is advanced along the guide.  
     
     
         98 . The method of  claim 91  wherein maintaining the position of the guide comprises rigidizing the guide such that the guide rigidly assumes a position of the selected shape.  
     
     
         99 . The method of  claim 98  wherein rigidizing the guide comprises applying tension to a tensioning member disposed within the guide such that a plurality of adjacent segments comprising the guide are compressed.  
     
     
         100 . The method of  claim 98  wherein rigidizing the guide comprises applying a compressive force to an exterior of the elongate guide such that a plurality of adjacent segments comprising the guide are compressed.