Steerable medical devices and steering assemblies
A surgical apparatus includes an elongated handle assembly having opposed proximal and distal end portions and an interior cavity. An elongated sheath extends from the proximal end of the handle assembly, through the interior cavity of the handle assembly and out from the distal end portion of the handle assembly. The sheath includes an interior lumen extending therethrough and a distal end portion of the sheath is deflectable. The surgical apparatus includes a steering mechanism operatively associated with the handle assembly for controlling deflection of the deflectable distal end portion of the sheath. The steering mechanism includes a pull wire retraction assembly configured to selectively retract a pull wire to deflect the distal end portion of the sheath and a telescoping tube system for straightly guiding the pull wire as the pull wire retraction assembly moves within the interior cavity of the handle assembly.
1. A surgical apparatus comprising:
a) an elongated handle assembly having opposed proximal and distal end portions and an interior cavity;
b) an elongated sheath extending from the proximal end portion of the handle assembly, through the interior cavity of the handle assembly and out from the distal end portion of the handle assembly, the sheath having an interior lumen extending therethrough, wherein a distal end portion of the sheath is deflectable; and
c) a steering mechanism operatively associated with the handle assembly for controlling deflection of the deflectable distal end portion of the sheath, the steering mechanism including:
i) a pull wire extending from the distal end portion of the sheath into the interior cavity of the handle assembly;
ii) a pull wire retraction assembly supported within the interior cavity of the handle assembly and configured to selectively retract the pull wire to deflect the distal end portion of the sheath, the pull wire retraction assembly including a worm gear mounted for reciprocal longitudinal movement within the interior cavity of the handle assembly, and an axially rotatable drive nut meshed with the worm gear for effectuating the reciprocal longitudinal movement thereof; and
iii) a telescoping tube system for straightly guiding the pull wire as the pull wire retraction assembly moves within the interior cavity of the handle assembly, the telescoping tube system including a longitudinally straight, unbent stationary outer tube affixed at a distal end thereof to the sheath and a longitudinally straight telescoping inner tube disposed partially within the unbent stationary outer tube and secured at a proximal end thereof to the worm gear within a set screw anchor by a set screw that crimps the proximal end of the telescoping inner tube that extends through the set screw anchor so as to secure the pull wire within the telescoping inner tube member, wherein the pull wire extends from the telescoping inner tube member, through an outer wall of the sheath, to an anchor member in the deflectable distal end portion of the sheath, passing through a composite tube that extends through the sheath along an inner lining of the outer wall of the sheath.
2. The apparatus of claim 1 , wherein the handle assembly includes a rotatable torque handle directly connected to the drive nut in the interior cavity of the handle assembly.
3. The apparatus of claim 1 , wherein the handle assembly includes a hemostatic valve seated at a proximal end thereof to seal a proximal opening of the interior lumen of the sheath.
4. The apparatus of claim 1 , wherein the handle assembly includes a side port tube in fluid communication with the interior lumen of the sheath.
5. The apparatus of claim 4 , wherein the side port tube includes a manual valve.
6. The apparatus of claim 1 , wherein the distal end portion of the sheath includes a radiopaque marker distal to the anchor member.