WO2003047673A1 - Extendable tube - Google Patents

Extendable tube Download PDF

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Publication number
WO2003047673A1
WO2003047673A1 PCT/IL2002/000347 IL0200347W WO03047673A1 WO 2003047673 A1 WO2003047673 A1 WO 2003047673A1 IL 0200347 W IL0200347 W IL 0200347W WO 03047673 A1 WO03047673 A1 WO 03047673A1
Authority
WO
WIPO (PCT)
Prior art keywords
medical insertion
automatically operative
operative medical
automatically
insertion device
Prior art date
Application number
PCT/IL2002/000347
Other languages
French (fr)
Inventor
Shlomo Besharim
Eliyahu Besharim
Original Assignee
Intumed Ltd.
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
Priority claimed from PCT/IL2001/001121 external-priority patent/WO2002045768A2/en
Application filed by Intumed Ltd. filed Critical Intumed Ltd.
Priority to EP02728003A priority Critical patent/EP1461104A4/en
Priority to AU2002258131A priority patent/AU2002258131A1/en
Priority to US10/496,857 priority patent/US20050076914A1/en
Priority to CA002469088A priority patent/CA2469088A1/en
Publication of WO2003047673A1 publication Critical patent/WO2003047673A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0488Mouthpieces; Means for guiding, securing or introducing the tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0488Mouthpieces; Means for guiding, securing or introducing the tubes
    • A61M16/049Mouthpieces
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0402Special features for tracheal tubes not otherwise provided for
    • A61M16/0411Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation

Definitions

  • the present invention seeks to provide improved systems and methods for automatic insertion of an element into a living organism in vivo
  • an automatically operative medical insertion device including an insertable element which is adapted to be inserted within a living organism m vivo, a surface following element, physically associated with the insertable element and being arranged to follow a physical surface within the living organism in vivo, a driving subsystem operative to at least partially automatically direct the insertable element along the physical surface and a navigation subsystem operative to control the driving subsystem based at least partially on a perceived location of the surface following element along a reference pathway stored in the navigation subsystem
  • an automatically operative medical insertion method which includes inserting an insertable element within a living organism in vivo, physically associating a surface following element with the insertable element and causing the surface following element to follow a physical surface within the living organism in vivo, directing the insertable element along the physical surface using a driving subsystem and controlling direction of the insertable element based at least partially on a perceived location of the surface following element along a reference pathway stored in a navigation subsystem
  • the driving subsystem is operative to fully automatically direct the insertable element along the physical surface
  • the driving subsystem is operative to automatically and selectably direct the insertable element along the physical surface
  • the navigation subsystem receives surface characte ⁇ stic information relating to the physical surface from the surface following element and employs the surface characteristic information to perceive the location of the surface following element along the reference pathway
  • the surface characteristic information includes surface contour information Additionally, the surface characteristic information includes surface hardness information. Preferably, the surface contour information is three- dimensional. Alternatively, the surface contour information is two-dimensional.
  • the insertable element is an endotracheal tube and the physical surface includes surfaces of the larynx and trachea.
  • the insertable element is a gastroscope and the physical surface includes surfaces of the intestine.
  • the insertable element is a catheter and the physical surface includes interior surfaces of the circulatory system.
  • the insertion device also includes a reference pathway generator operative to image at least a portion of the living organism and to generate the reference pathway based at least partially on an image generated thereby.
  • the reference pathway includes a standard contour map of a portion of the human anatomy.
  • the standard contour map is precisely adapted to a specific patient.
  • the standard contour map is automatically precisely adapted to a specific patient.
  • the reference pathway is operator adaptable to designate at least one impediment.
  • the insertable element includes a housing in which is disposed the driving subsystem, a mouthpiece, a tube inserted through the mouthpiece and a flexible guide inserted through the tube, the surface following element being mounted at a front end of the guide.
  • the mouthpiece includes a curved pipe through which the tube is inserted.
  • the driving subsystem is operative to move the guide in and out of the housing, through the curved pipe and through the tube.
  • the driving subsystem also operates to selectably bend a front end of the guide.
  • the driving subsystem is operative to move the insertable element in and out of the living organism.
  • the driving subsystem is also operative to selectably bend a front end of the insertable element.
  • the surface following element includes a tactile sensing element.
  • the surface following element includes a tip sensor including a tip integrally formed at one end of a short rod having a magnet on its other end, the rod extends through the center of a spring disk and is firmly connected thereto, the spring disk being mounted on one end of a cylinder whose other end is mounted on a front end of the insertable element.
  • a tip sensor including a tip integrally formed at one end of a short rod having a magnet on its other end, the rod extends through the center of a spring disk and is firmly connected thereto, the spring disk being mounted on one end of a cylinder whose other end is mounted on a front end of the insertable element.
  • the tip sensor also includes two Hall effect sensors, which are mounted inside the cylinder on a support and in close proximity to the magnet, the Hall effect sensors being spaced in the plane of the curvature of the curved pipe.
  • Each Hall effect sensor includes electrical terminals operative to provide electric current representing the distance of the magnet therefrom.
  • the tip sensor operates such that when a force is exerted on the tip along an axis of symmetry of the cylinder, the tip is pushed against the spring disk, causing the magnet to approach the Hall effect sensors and when a force is exerted on the tip sideways in the plane of the Hall effect sensors, the tip rotates around a location where the rod engages the spring disk, causing the magnet to rotate away from one of the Hall effect sensors and closer to the other of the Hall effect sensors.
  • the driving subsystem operates, following partial insertion of the insertable element into the oral cavity, to cause the guide to extend in the direction of the trachea and bend the guide clockwise until the surface following element engages a surface of the tongue, whereby this engagement applies a force to the surface following element.
  • the navigation subsystem is operative to measure the changes in the electrical outputs produced by the Hall effect sensors indicating the direction in which the tip is bent.
  • the navigation subsystem operates to sense the position of the tip and the past history of tip positions and to determine the location of the tip in the living organism and relative to the reference pathway.
  • the navigation subsystem operates to navigate the tip according to the reference pathway.
  • the navigation subsystem operates to sense that the tip touches the end of the trough beneath the epiglottis. Additionally or alternatively, the navigation subsystem is operative to sense that the tip reaches the tip of the epiglottis.
  • the navigation subsystem operates to sense that the tip reached the first cartilage of the trachea.
  • the navigation subsystem operates to sense that the tip reached the second cartilage of the trachea.
  • the navigation subsystem is operative to sense that the tip reached the third cartilage of the trachea.
  • the navigation subsystem operates to load the reference pathway from a memory.
  • the driving subsystem is operative to push the tube forward.
  • the driving subsystem includes a first motor which operates to selectably move the insertable element forward or backward, a second motor which operates to selectably bend the insertable element and electronic circuitry operative to control the first motor, the second motor and the surface following element.
  • the electronic circuitry includes a microprocessor operative to execute a program, the program operative to control the first and second motors and the surface following element and to insert and bend the insertable element inside the living organism along the reference pathway.
  • the driving subsystem is operative to measure the electric current drawn by at least one of the first and second motors to evaluate the position of the surface following element.
  • the reference pathway is operative to be at least partially prepared before the insertion process is activated.
  • the medical insertion device includes a medical imaging system and wherein the medical imaging system is operative to at least partially prepare the reference pathway.
  • the medical imaging subsystem includes at least one of an ultrasound scanner, an X-ray imager, a CAT scan system and an MRI system.
  • the medical imaging system operates to prepare the reference pathway by marking at least one contour of at least one organ of the living organism.
  • the medical imaging system operates to prepare the reference pathway by creating an insertion instruction table including at least one insertion instruction.
  • the insertion instruction includes instruction to at least one of extend, retract and bend the insertable element.
  • the navigation subsystem is operative to control the driving subsystem based at least partially on a perceived location of the surface following element and according to the insertion instruction table stored in the navigation subsystem.
  • the operative medical insertion device operates to at least partially store a log of a process of insertion of the insertable element. Additionally, the operative medical insertion device transmits the log of a process of insertion of the insertable element.
  • the computer operates to aggregate the logs of a process of insertion of the insertable element. Additionally, the computer prepares the reference pathway based at least partially on the aggregate.
  • the computer transmits the reference pathway to the medical insertion device.
  • the insertable element includes a guiding element and a guided element.
  • the driving subsystem operates to direct the guiding element and the guided element at least partially together. Additionally or alternatively, the driving subsystem is operative to at least partially automatically direct the guide in a combined motion comprising a longitudinal motion and lateral motion.
  • the mouthpiece includes a disposable mouthpiece.
  • the insertable element is extendable.
  • the insertable element includes a mounting element which is arranged to be removably engaged with an intubator assembly and an extendable tube operatively associated with the mounting element.
  • the extendable tube is arranged to be pulled by a flexible guide operated by the intubator assembly.
  • the extendable tube includes a coil spring. Additionally or alternatively, the extendable tube also includes a forward end member, on a distal end thereof.
  • the forward end member includes a diagonally cut pointed forward facing tube end surface.
  • the medical insertion device also includes a forward end member mounted inflatable and radially outwardly expandable circumferential balloon.
  • the forward end member mounted inflatable and radially outwardly expandable circumferential balloon receives inflation gas through a conduit formed in a wall of the forward end member and continuing through the tube to a one way valve.
  • the medical insertion device also includes a flexible guide having mounted at a distal end thereof a tip sensor.
  • the flexible guide is formed with an inflatable and radially outwardly expandable guide mounted balloon.
  • the inflatable and radially outwardly expandable guide mounted balloon receives inflation gas through a conduit formed in the flexible guide and extending therealong.
  • the conduit is connected to a source of pressurized inflation gas.
  • the source of pressurized inflation gas is located within the intubator assembly.
  • the inflation gas comprises pressurized air.
  • Figs. 1A to IL are a series of simplified pictorial illustrations of a process of employing a preferred embodiment of the present invention for the intubation of a human;
  • FIGS. 2A to 2F taken together are a flowchart illustrating a preferred implementation of the present invention, operative for an intubation process as shown in Figs lA to IL;
  • Fig. 3 is a simplified illustration of the internal structure of a preferred embodiment of the present invention for intubation of a human;
  • Fig. 4 is a simplified block diagram of a preferred embodiment of the present invention.
  • Figs. 5 A to 5H are electrical schematics of a preferred embodiment of the present invention for intubation of a human;
  • Figs. 6A to 6K are a series of simplified pictorial illustrations of a process of employing a preferred embodiment of the present invention for insertion of an element into the intestine of a human;
  • Fig. 7 is a preferred embodiment of a table comprising instruction, operative in accordance with a preferred embodiment of the present invention, for insertion of an element into the intestine of a human as shown in Figs. 5A to 5K;
  • Fig. 8 is a flowchart illustrating a preferred implementation of the present invention, operative for a process of insertion of an element into the intestine of a human as shown in Figs. 6 A to 6K;
  • Figs. 9A to 9F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with a preferred embodiment of the present invention in various operative orientations;
  • Figs. 10A to 10G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 9A - 9F employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human;
  • Figs. 11A to 11F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with another preferred embodiment of the present invention in various operative orientations; and
  • Figs. 12A to 12G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 9A - 9F employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human.
  • Appendices 1 to 3 are computer listings which, taken together, form a preferred software embodiment of the present invention.
  • FIGs. 1A to IL are a series of simplified pictorial illustrations of a system and methodology for the intubation of a human in accordance with a preferred embodiment of the present invention.
  • the general configuration of the mouth and trachea is generally the same for all humans except for differences in scale, such as between an infant, a child and an adult.
  • a standard contour map 10 of the human mouth and trachea is employed.
  • the scale of the map 10 may be further precisely adapted to the specific patient, preferably automatically.
  • the scale of the map 10 is adapted to the specific patient semi-automatically.
  • the operator can select the scale of the map 10, for example by selecting between a child and an adult. Thereafter the scale of the map 10 is automatically adapted to size of the specific patient as a part of the intubation process.
  • the operator is enabled to designate one or more typical impediments such as: a tumor, a swelling, an infection and an injury. Selecting an impediment preferably creates a suitable variation of the general map 10.
  • Fig. 1A shows the map 10 and the location therein where a tip sensor 11 of an intubator engages the mouth and trachea of the patient. It is a particular feature of the present invention that intubation is at least partially automatically effected by utilizing the contour map 10 to monitor the progress of tip sensor 11 and thus to navigate the intubator accordingly.
  • an intubator assembly 12 suitable for the intubation of a human, is partially inserted into an oral cavity of a patient.
  • the intubator assembly 12 preferably comprises a housing 14 in which is disposed a guide driver 15, a mouthpiece 16, a tube 18 inserted through the mouthpiece 16, a flexible guide 20 inserted through the tube 18, and tip sensor 11 mounted at the distal end of the guide 20.
  • the mouthpiece 16 preferably comprises a rigid curved pipe 24 through which the tube 18 is inserted.
  • the curved pipe 24 comprises a slit 49 on each side. Alternatively, the curved pipe 24 is eliminated.
  • the guide driver 15 is operative to move the guide 20 in and out of the housing 14, through the curved pipe 24 and through the tube 18.
  • the guide driver 15 is also operative to selectably bend the distal end of the guide 20 clockwise and counterclockwise in the plane of the curvature of the curved pipe 24 in the sense of Fig. 1A.
  • tip sensor 11 preferably comprises a tip 28 preferably integrally formed at one end of a short rod 30 having a magnet 32 on its other end.
  • the rod 30 preferably extends through the center of a spring disk 34 and is firmly connected thereto.
  • the spring disk 34 is preferably mounted on one end of a cylinder 36 whose other end is mounted on the distal end of the guide 20.
  • the tip sensor 11 also comprises two Hall effect sensors, 38 and 40, which are mounted inside the cylinder 36 on a support 41 and in close proximity to the magnet 32.
  • the Hall effect sensors 38 and 40 are preferably spaced in the plane of the curvature of the curved pipe 24.
  • each Hall effect sensor has electrical terminals operative to provide electric current representing the distance of the magnet 32 therefrom.
  • the output electric current of the Hall effect sensor 40 typically decreases and the output electric current of the Hall effect sensor 38 typically correspondingly increases.
  • the tip sensor 11 enables electronic circuitry (not shown) to measure the amplitude and the direction of force exerted on the tip 28 in the plane of the Hall effect sensors 38 and 40 and to compute the orientation of a surface of a tissue against which the sensor tip 28 is depressed, relative to the axis of symmetry 42. It is appreciated that sensors other than Hall effect sensors can be used to measure the direction and the amplitude of the force exerted on the tip 28, or otherwise to measure the proximity and the orientation of the adjacent surface.
  • the guide driver 15 typically causes the guide 20 to extend in the direction of the trachea 44 and bends the guide 20 clockwise until the tip 28 engages a surface of the tongue 46. This engagement applies a force to tip 28, which causes the tip to rotate counterclockwise wherein the magnet 32 approaches the Hall effect sensor 38.
  • Electronic circuitry (not shown) inside the housing 14, which measures the changes in the electrical outputs produced by the Hall effect sensors 38 and 40, indicates that the tip 28 is bent clockwise.
  • the system of the present invention determines the location of the tip sensor 11 in the oral cavity and relative to the map 10. This location is employed in order to navigate the intubator correctly, as described hereinbelow.
  • Fig. IB illustrates a further step in the intubation in accordance with the present invention.
  • Fig. IB shows the guide 20 extended further and reaching an area between the base of the tongue 46 and the epiglottis 48 of the patient.
  • the guide 20 extends further forward until the tip 28 touches the end of the trough beneath the epiglottis 48.
  • the guide 20 bends counterclockwise and touches the bottom surface of the epiglottis 48. Then the guide 20 retracts a little, while preserving continuous tactile contact between the tip 28 with the bottom surface of the epiglottis 48.
  • the guide 20 retracts further until the tip 28 of the tip sensor 11 reaches the tip 165 of the epiglottis 48 and then the tip 28 loses tactile contact with the surface of the tip 165 of the epiglottis 48.
  • the guide 20 bends further counterclockwise, then extends forward and then bends clockwise until the tip 28 touches the upper surface of the epiglottis 48. As seen in Fig. 1G, the guide 20 extends forward, preserving continuous tactile contact with the epiglottis 48, until the tip 28 senses the first trough of the trachea 44.
  • the guide 20 extends further forward until the tip 28 senses the second trough of the trachea 44.
  • the guide 20 extends further forward until the tip 28 senses the trough of the third cartilage of the trachea 44. Then the guide 20 further extends, typically for adults by 5 centimeters, to ensure that the tube 16 reaches to the third cartilage.
  • the guide driver 15 is pulled out with the guide 20 leaving the mouthpiece 16 and the tube 18 inside the patient's mouth and trachea 44.
  • FIGs. 2A to 2F are a flowchart of the process of the intubation of a human shown in Figs. 1A to IK.
  • Fig. 2A and 2B taken together, correspond to the step of the intubation process shown in Fig. 1A
  • step 100 of Fig. 2A the intubator assembly 12 is set to perform intubation.
  • step 102 the intubator loads an intubation pattern map 10 from its memory.
  • the intubator enables the operator to set the scale of the intubation pattern map to the corresponding size of the patient by selecting between an infant, a child and an adult.
  • the intubator enables the operator to adapt the intubation pattern map 10 to a type of intubation impediment, preferably by selecting from a menu.
  • the menu typically provides the operator with four optional impediments: an infection, a swelling, a tumor and an injury, and a fifth option not to select any impediment. It is appreciated that various types of impediments can be defined as is typical for a specific organ.
  • steps 120, 122, 124, 126, 128 and 130 cause the guide 20 to extend in the direction of the throat and simultaneously bend clockwise until the tip sensor is depressed against the surface of the tongue or until extension and bending limits are reached.
  • the bending limit is preferably 50 degrees and the extension limit is preferably 2 centimeters.
  • the scale of the intubation pattern map 10 is preferably updated (step 132) to match the particular scale or size of the intubated patient. If at least one of the extension limit and the bending limit is reached an error message is displayed (step 134) and the intubation process is stopped.
  • Fig. 2C corresponds to Figs. IB and IC.
  • the guide driver 15 performs sequential steps 140, 142, 144 and 146 in a loop, extending (step 140) guide 20 further into the patient's throat and along the throat surface, following the intubation pattern map 10 and keeping the tip in contact with the surface (steps 144, 146).
  • the intubator assumes (step 142) that the tip 28 has reached the end of the trough beneath the epiglottis 48.
  • the point of engagement between the tip 28 and the body is designated in Fig. IC by reference numeral 147.
  • the scale of the intubation pattern map 10 is then preferably updated to match the patient's organ structure (step 148).
  • Fig. 2D corresponds to Figs. ID and IE.
  • the guide driver 15 performs steps 150, 152 and 154 in a loop, bending the distal end of the guide 20 counterclockwise until the tip 28 touches the epiglottis 48, or until a bending limit, preferably of 45 degrees is reached (step 154) and the intubation stops (step 156).
  • the preferred point of engagement between the tip 28 and the surface of the epiglottis is designated in Fig. ID by reference numeral 155.
  • the guide driver 15 After sensing an engagement between the tip 28 and the surface of the epiglottis, the guide driver 15 performs steps 158, 160, 162, and 164 in a loop, retracting the guide 20 further (step 158), and increasing the bending of the guide 20 (step 164), until the tip of the guide reaches the tip of the epiglottis 48, designated in Fig. IE by reference numeral 165.
  • the tip 28 When the tip 28 reaches the tip of the epiglottis 48, the tip 28 is released and the output electric currents from both Hall effect sensors decrease to a minimum.
  • the intubation pattern map 10 is updated (step 166) to match the patient's organ structure.
  • Fig. 2E corresponds to Figs. IE and IF.
  • the guide driver 15 causes the guide 20 to move above and around the tip of the epiglottis 48 by causing the guide 20 to bend counterclockwise, preferably by 45 degrees, then to move forward down the throat by 5 millimeters and then to bend clockwise, preferably by 10 degrees (Step 170).
  • the guide driver 15 performs steps 172, 174 and 176 in a loop, bending and extending (step 174) until the tip 28 of the guide touches the upper surface of the epiglottis 48 or until an extension limit, preferably of 1 centimeter, or a bending limit, preferably of 50 degrees, is reached, and the intubation is stopped (step 178).
  • a preferred point of engagement between the tip 28 and the epiglottis is designated in Fig. IF by reference numeral 177.
  • a "cartilage crest counter N" is first zeroed (step 180). Then the guide driver 15, performing steps 182 to 198 in a loop, causes the guide 20 to move the sensor tip 1 1 forward (step 182) along the surface of the trachea 44, preserving contact between the tip 28 and the surface of the trachea (steps 186 and 188) by increasing the bend (step 188) as needed. Each time a crest (189 in Figs.
  • the "cartilage crest counter" is incremented (step 190)
  • the tip 28 is moved about the crest (steps 192, 194, 196 and 198) and the loop process repeats until the third cartilage is located.
  • the guide 20 further extends, typically for adults by 5 centimeters, to ensure that the tube 16 reaches to the third cartilage.
  • the guide driver 15 then signals to the operator that the insertion is completed successfully (step 200).
  • the intubator assembly 12 preferably comprises the housing 14, the guide driver 15, the mouthpiece 16, the tube 18, the flexible guide 20 inserted inside the tube 18 and the tip sensor 11 mounted at the distal end of the guide 20.
  • the mouthpiece comprises a curved pipe 24.
  • the guide driver 15 comprises a first motor 210 that drives a gearbox 212 that rotates a threaded rod 214.
  • a floating nut 216 is mounted on the threaded rod 214.
  • the floating nut 216 is operative to move a carriage 218 along a bar 220 and thus to push or pull the guide 20.
  • the stopper 222 moves with the carriage 218 along the bar 220 and pushes the tube 18 forward.
  • a second motor 224 is connected to a disk 226 to which two guide angulation wires 228 are attached at first end thereof.
  • the guide angulation wires 228 are threaded inside the guide 20 and their other ends are connected to the distal end of the guide just short of the tip sensor 11.
  • the motor 224 rotates the disk 226 clockwise one of the wires 228 is pulled and the second wire is loosened.
  • the wire that is pulled pulls and bends the distal end of the guide 20 counterclockwise in the sense of Fig. 3.
  • the motor 224 rotates counter-clockwise the second wire of the two wires 228 is pulled and the first wire is loosened.
  • the wire that is pulled pulls and bends the distal end of the guide 20 clockwise in the sense of Fig. 3.
  • Electronic circuitry 229 is provided within the housing 14 and is preferably electrically connected to operating switches 230, a display 232, the motors 210 and 224 and to the Hall effect sensors 38 and 40 (Fig. 1A) in the tip sensor 11.
  • the electronic circuitry 229 also comprises a microprocessor, operative to execute a program.
  • the program is preferably adapted to control the switches 230, the display 232, motors 210 and 224 and the Hall effect sensors 38 and 40 and to insert and bend the guide inside a living organism, according to a predefined map until the tip of the guide reaches a destination point inside the living organism.
  • the program is operative to cause the tip 28 of the guide 20 to follow a predefined internal contour of an organ of the living organism.
  • program is operative employ tactile sensing to measure the position of the tip of the guide relative to the surface organ of the living organism.
  • microprocessor also includes inter alia a "microcontroller”.
  • Electrical batteries are preferably provided within the housing 14 to supply electric power to the electronic circuitry, the tip sensor 11, the motors 210 and 224, the display 232 and all other elements of the present invention that consume electricity. It is appreciated that external sources of electricity can also be employed to provide power to the intubator assembly 12.
  • Communication interface (not shown), preferably employing infra-red communication technology, is provided to enable communication with external data processing equipment.
  • a balloon 234 is provided at the distal end of the tube 18 and a thin pipe (not shown) is inserted through the pipe 18 and is connected, through the side of the pipe, to the balloon.
  • the thin pipe enables an operator to inflate the balloon when the distal end of the pipe 18 reaches the appropriate place in the trachea, thus securing the distal end of the pipe to the trachea.
  • FIG. 4 is a simplified functional block diagram of a preferred embodiment of the guide driver 15 described hereinabove.
  • the guide 20 is driven by two drivers.
  • a longitudinal driver 240 preferably comprises a motor 210, the gear 212, the threaded rod 214, the floating nut 146 and the carriage 218 of Fig. 3.
  • a bending guide driver 242 preferably comprises the motor 224, the disk 226 and wires 228 (Fig. 3).
  • the longitudinal driver 240 and the bending guide driver 242 are controlled by two software driver modules.
  • a longitudinal software driver module 244 controls the longitudinal driver 240 and comprises two functions: an extend function 246 and a retract function 248.
  • a bending software driver 250 controls the bending guide driver 242 and comprises two functions: a bend counterclockwise function 252 and a bend clockwise function 254.
  • the functions 246, 248, 252 and 254 are operated by a propagation control software module 256.
  • the tip sensor 11 measures the proximity and orientation of an adjacent surface.
  • the tip sensor 11 performs the proximity and orientation measurements by measuring the force applied to a tactile tip by a surface of an adjacent tissue.
  • a tip sensor software driver module 260 operative to receive input signals from the tip sensor 11, provides two input functions: a counterclockwise tip rotation function 262 and a clockwise tip rotation function 264. The measurements of the tip positions as provided by the tip sensor software driver module 260 are collected and stored by a sensor log module 266.
  • the map 10 is loaded into memory and serves as an updatable map 268.
  • a comparator 270 compares the accumulated measurements from the tip sensor 11 with the updated reference map 268. The results of the comparisons are calculated by an update scale module 272 to provide a scaling factor that is applied to update the updated map 268. Consequently a navigation module 274 employs the updated map information to instruct the propagation control 256 to execute the next step of the insertion program. It is appreciated that a measurement of the electric current drawn by at least one of the longitudinal guide drive and the bending guide drive can also serve as an input to the comparator 270 to evaluate the position of the tip sensor.
  • Figs. 5A to 5H are, taken together, an electrical schematic of a preferred embodiment of the present invention useful for intubation of a human.
  • microprocessor 278 which is preferably operative to operate a program to control the elements of the intubator assembly 12, such as the operating switches 230, the display 232, the motors 210 and 224 (Fig. 3), and the Hall effect sensors 38 and 40 in the tip sensor 11 (Fig. 1A), and to perform the intubation process, such as the process shown and described hereinabove with reference to Figs. 2A to 2F.
  • FIGs. 6A to 6K are a series of simplified pictorial illustrations of ten typical steps in a process of employing a preferred embodiment of the present invention useful for insertion of an element into the intestine of a human.
  • a map of the organ is prepared before the insertion process is activated.
  • the required map is preferably prepared by employing an appropriate medical imaging system, such as an ultrasound scanner, an x-ray imager, a CAT scan system or a MRI system.
  • the map can be a two dimensional map or a three- dimensional map as appropriate for the specific organ. Typically for the intestine system a three dimensional map is required.
  • an inserter according to a preferred embodiment of the present invention for use in organs that are variable in three dimensions is similar to the intubator assembly 12, preferably with the following modifications:
  • the tube 18 may be replaced with a different insertable device
  • the tip sensor 11 preferably comprises four Hall effect sensors to sense the motion of the tip 28 in three dimensions. It is appreciated that it is possible to operate the tip sensor in a three-dimensional space also by employing three Hall effect sensors. It is also appreciated that other types of sensors can be employed to measure the proximity and orientation of an adjacent surface in three dimensions.
  • the guide 20 when the guide 20 performs longitudinal motion, such as insertion or retraction, the guide 20 also performs a small and relatively fast lateral motion.
  • the combined longitudinal and lateral motions are useful for sensing the surface of the organ in three dimensions and hence to better determine the location of the tip sensor 11 in the organ and relative to the map 10.
  • Figs. 6A to 6K Due to limitations of the graphical representation, a two-dimensional imaging and map is shown in Figs. 6A to 6K.
  • a human organ is imaged, typically by a CAT scan system 280, and an image 282 of the internal structure of the organ is produced.
  • the image 282 of the organ is used to create an insertion map 284.
  • the image 282 is displayed on a computer screen (not shown) and a pointing device, such as a computer mouse or a light pen, is used to draw a preferred path 286 that the tip of the guide is to follow.
  • the path is typically drawn by marking a contour of the organ, and optionally marking the guide bending points, as is shown and described with reference to Figs. 1A to 1 K.
  • a preferred path is created, such as path 286, not necessarily continuously following the contours of the organ.
  • the map 10 or the path 286 is converted into a set of insertion steps as is shown and described hereinbelow with reference to Fig. 7.
  • a table 290 is provided for storage in a computer memory and for processing by a computer processor.
  • the table 290 contains rows 292, wherein each row 292, preferably comprises an instruction to perform one step in the process of insertion of a medical insertion device into a living organism such as shown and described with reference to Figs. 6C to 6K.
  • each row 292 contains the expected values or the maximal values for the extension of an insertion guide such as guide 20, the bending of the insertion guide and the electrical outputs from the Hall effect sensors 38 and 40 (Fig. 1 A).
  • the row 292 contains five sets of values:
  • Initial bend 294 contains two values for bending the guide from a straight position, in two perpendicular planes.
  • Initial insertion 295 contains a longitudinal value for extending or retracting the guide in centimeters.
  • Initial sensor measurements 296 contains expected output values of four sensors such as four Hall effect sensors, for example, Hall effect sensors 38 and 40 of Fig. 1A.
  • the initial sensors measurements 296 are expected to be measured by the time the guide reaches the value of the initial insertion 295.
  • Insert distance 297 contains a longitudinal value for further extending or retracting the guide in centimeters. Typically the initial sensor measurements 296 are expected to be preserved, while the guide is extended or retracted, by adapting the bending of the guide.
  • Final sensor measurements 298 contain expected output values of the four sensors of step (c).
  • the initial sensor measurements 298 are expected to be measured by the time the guide reaches the value of the insert distance 297.
  • Fig. 6B can be employed to prepare a table of instructions, such as table 290 of Fig. 7.
  • FIG. 8 is a flowchart illustrating a preferred implementation of the present invention, operative for a process of insertion of an element into the intestine of a human as shown in Figs. 6 A to 6K.
  • the flowchart of Fig. 8 is a preferred embodiment of a program, operative to be executed by a processor, such as microprocessor 278 of Fig. 5A, comprised in a preferred embodiment of the present invention, for insertion of an element into a living organism, preferably by employing a table 290 shown and described with reference to Fig. 7.
  • the preferred flowchart shown in Fig. 8 starts by loading the table (step 300) such as the map shown in Fig. 7.
  • the program then reads a first row 292 from the map (step 302) and causes the distal end of the guide 20 to bend according to the initial bending values 294. Then the program causes the guide 20 to extend or retract according to the initial insertion distance 295 of the first row in the map.
  • the program continues to bend and insert the guide 20 until output values of the sensors match the expected initial sensor measurement 296 of the row (steps 304, 306 and 308), or until a limit is surpassed, an error message is displayed and the program is stopped (step 310).
  • the initial values of the sensors are measured and then the program continues to extend or retract the guide 20 (step 312) until the sensors produce the final sensors measurements 298 values (step 314), while keeping in contact with the surface (steps 316 and 318) or until at least one of predefined limits is surpassed (step 320) where the program is stopped (step 310). If the final sensor measurements 298 values are measured the program proceeds to step 320 and loops through steps 302 and 320 until all the rows 292 of the table are processed. Then the program displays an insertion success message on the display 232 and halts (step 322).
  • the guide is bent, preferably by up to 45 degrees, to the left in the plane of Fig. 6C and, while preserving contact with the left side of the intestine, is extended up to 5 centimeters or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 330.
  • the guide is bent by up to 45 degrees to the right in the plane of Fig. 6D and, while preserving contact with the left side of the intestine, is extended up to 2.5 centimeters or until the sensor tip does not sense the internal surface of the intestine at a point in the map 284 designated by reference numeral 332.
  • the guide is bent by up to 110 degrees to the left in the plane of Fig. 6E and, while preserving contact with the left side of the intestine, is extended by 1 centimeter to a point in the map 284 designated by reference numeral 334.
  • the guide is bent by up to 45 degrees to the right in the plane of Fig. 6F and is extended by 6 centimeter to a point in the map 284 designated by reference numeral 336.
  • the guide is bent by up to 20 degrees to the right in the plane of Fig. 5G and, while preserving contact with the right side of the intestine, is extended by 4 centimeters to a point in the map 284 designated by reference numeral 338.
  • the guide is bent by up to -60 degrees to the left in the plane of Fig. 6H and is extended by up to 3 centimeters or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 340.
  • the guide is bent by up to 45 degrees to the right in the plane of Fig. 61 and is extended by up to 1 centimeter or until the sensor tip engages the internal surface of the intestine with its right side in a point in the map 284 designated by reference numeral 342.
  • the guide is extended by up to 1 centimeters or until the sensor tip engages the internal surface of the intestine with its left side at a point in the map 284 designated by reference numeral 344.
  • the guide is bent by up to 45 degrees to the right in the plane of Fig. 6K and is extended by up to 1 centimeter or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 346.
  • the system and the method are operative for automatic operation.
  • the present invention can be operated manually, by providing to the operator the information collected by the sensor log 266 form the tip sensor 11 and enabling the operator to control manually the guide 20.
  • the guide 20 may be inserted automatically and a medical device, such as the tube 18 may be inserted manually.
  • a log of the process of insertion of an insertable element into a living organism such as a human body is preferably stored in an internal . memory of the present invention and that this log can be transmitted to a host computer. It is appreciated that the host computer can aggregate insertion process logs and thereby continuously improve relevant insertion pattern maps such as the standard contour map 10. Thereafter, from time to time or before starting an insertion process, the present invention is capable of loading an updated map such as standard contour map 10.
  • the accumulated logs of processes of insertions can be employed to improve the algorithm for processing the maps, such as the algorithms shown and described with reference to Figs. 2A - 2F and Fig. 8.
  • the improved algorithm can be transmitted to the present invention as necessary.
  • FIGs. 9A to 9F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with a preferred embodiment of the present invention, in various operative orientations.
  • the extendable endotracheal tube assembly preferably comprises a mounting element 402 which is arranged to be removably engaged with an intubator assembly (not shown) such as intubator assembly 12 (Figs. 1A - IL).
  • a mouthpiece 404 Fixed to or integrally formed with mounting element 402 is a mouthpiece 404, which is preferably integrally formed with a rigid curved pipe 406.
  • a mounting base 408 Fixedly mounted onto mounting element 402, interiorly of rigid curved pipe 406, is a mounting base 408 onto which is, in turn, mounted, an extendable tube 410, preferably including a coil spring 411, typically formed of metal.
  • Fixedly mounted onto a distal end of extendable tube 410 there is preferably provided a forward end member 412, preferably presenting a diagonally cut pointed forward facing tube end surface 414.
  • forward end member 412 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 416, which receives inflation gas, preferably pressurized air, preferably through a conduit 418 embedded in a wall of forward end member 412 and continuing through tube 410 to a one way valve 419.
  • inflation gas preferably pressurized air
  • the extendable endotracheal tube assembly 400 may comprise an integrally formed mouthpiece assembly and an integrally formed insertable extendable tube assembly.
  • the integrally formed mouthpiece assembly may comprise the mouthpiece 404 and the rigid curved pipe 406.
  • the integrally formed extendable tube assembly may comprise the extendable tube 410, the mounting element 402, the mounting base 408, the coil spring 411, the forward end member 412 with the end surface 414 and the circumferential balloon 416, the conduit 418 and the one way valve 419.
  • a flexible guide 420 which preferably corresponds in function inter alia to guide 20 in the embodiment of Figs 1A - IL and preferablv has mounted at a distal end thereof a tip 421, which preferably corresponds m structure and function inter aha to the tip 28 in the embodiment of Figs 1A - IL
  • Tip 421 forms part of a tip sensor, preferably enclosed in guide 420, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs 1A - 1L
  • the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 422, which receives inflation gas, preferably pressurized air, preferably through a conduit 424 formed in flexible guide 420 and extending therealong, preferably to a source of pressurized inflation gas, preferably located within the intubator assembly (not shown)
  • Fig 9B shows inflation of balloon 422 by means of pressurized air supplied via conduit 424, causing balloon 422 to tightly engage the interior of forward end member 412
  • Fig 9C illustrates extension of tube 410, which is preferably achieved by forward driven movement of flexible guide 420 in tight engagement with forward end member 412, thus pulling forward end member 412 and the distal end of tube 410 forwardly therewith
  • Fig 9D illustrates inflation of balloon 416 by means of pressurized air through one way valve 419 and conduit 418 As will be described hereinbelow, this inflation is employed for sealing the tube 410 within a patient's trachea
  • Fig 9E illustrates deflation of balloon 422 following inflation of balloon 416, corresponding to desired placement and sealing of tube 410 within the patient's trachea
  • Fig 9F illustrates removal of the flexible guide 420 from the tube 410
  • FIGs 10A to 10G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs 9 A - 9F employed with the medical insertion device of Figs 1 A - 8 for the intubation of a human
  • the extendable endotracheal tube assembly preferably comprises a mounting element (not shown) which is arranged to be removably engaged with an intubator assembly 503 which is preferably similar to intubator assembly 12 (Figs. 1A - IL) or any other intubator assembly described hereinabove but may alternatively be any other suitable intubator assembly.
  • a mouthpiece 504 Fixed to or integrally formed with the mounting element is a mouthpiece 504, which is preferably integrally formed with a rigid curved pipe 506.
  • the extendable entotracheal tube assembly 500 is shown inserted into a patient's oral cavity, similar to the placement shown in Fig. 1A.
  • a mounting base 508 onto which is, in turn, mounted, an extendable tube 510, preferably including a coil spring 511 (Fig. 10C), typically formed of metal.
  • an extendable tube 510 Fixedly mounted onto a distal end of extendable tube 510 there is preferably provided a forward end member 512, preferably presenting a diagonally cut pointed forward facing tube end surface 514.
  • forward end member 512 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 516, which receives inflation gas, preferably pressurized air, preferably through a conduit 518 embedded in a wall of forward end member 512 and continuing through tube 510 to a one way valve 519.
  • inflation gas preferably pressurized air
  • the extendable endotracheal tube assembly 500 may comprise a mouthpiece assembly and an extendable tube assembly, which is inserted therein.
  • the mouthpiece assembly comprises the mouthpiece 504, which is integrally formed with the rigid curved pipe 506.
  • the extendable tube assembly comprises the extendable tube 510, which is integrally formed together with the mounting element, the mounting base 508, the coil spring 511, the forward end member 512 with the end surface 514 and the circumferential balloon 516, the conduit 518 and the one way valve 519.
  • a flexible guide 520 Extending slidably through forward end member 512, tube 510, mounting base 508 and the mounting element is a flexible guide 520, which preferably corresponds in function inter alia to guide 20 in the embodiment of Figs. 1A - IL and preferably has mounted at a distal end thereof a tip, which preferably corresponds in structure and function inter alia to the tip 28 in the embodiment of Figs. 1A - IL.
  • the tip forms part of a tip sensor, preferably enclosed in guide 520, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs. 1A - IL.
  • the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 522, which receives inflation gas, preferably pressurized air, preferably through a conduit 524 formed in flexible guide 520 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly 503.
  • inflation gas preferably pressurized air
  • conduit 524 formed in flexible guide 520 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly 503.
  • the source of pressurized inflation gas may be an automatic inflator/deflator 526. Additionally or alternatively, a one way valve 528 may be provided for manual inflation.
  • the automatic inflator/deflator 526 may be fixed within intubator assembly 503 or alternatively may be mounted therewithin for motion together with flexible guide 520.
  • Fig. 10B shows inflation of balloon 522 by means of pressurized air supplied via conduit 524, causing balloon 522 to tightly engage the interior of forward end member 512.
  • Fig. 10C illustrates extension of tube 510, which is preferably achieved by forward driven movement of flexible guide 520 in tight engagement with forward end member 512, thus pulling forward end member 512 and the distal end of tube 510 forwardly therewith.
  • Fig. 10D illustrates further extension of tube 510, by forward driven movement of flexible guide 520 in tight engagement with forward end member 512, thus pulling forward end member 512 and the distal end of tube 510 forwardly therewith.
  • This further motion is preferably provided based on the navigation functionality described hereinabove with reference to Figs. 1A - 8. It is appreciated that the forward driven movement of tube 510 as described hereinabove with reference to Figs. 1A - 8, may be provided by driven forward motion of the flexible guide 520.
  • Fig. 10E illustrates inflation of balloon 516 by means of pressurized air through conduit 518 and one way valve 519. As will be described hereinbelow, this inflation is employed for sealing the tube 510 within a patient's trachea.
  • Fig. 10F illustrates deflation of balloon 522 following inflation of balloon 516, corresponding to desired placement and sealing of tube 510 within the patient's trachea
  • Fig 10G illustrates removal of the flexible guide 520 from the tube 510
  • Figs 11 A to 11F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with another preferred embodiment of the present invention in various operative orientations
  • the extendable endotracheal tube assembly preferably comprises a mounting element 602 which is arranged to be removably engaged with an intubator assembly (not shown) such as intubator assembly 12 (Figs 1A - IL) Fixed to or integrally formed with mounting element 602 is a mouthpiece 604
  • mounting element 602 Fixedly mounted onto mounting element 602 is a mounting base 608 onto which is, in turn, mounted, an extendable tube 610, preferably including a coil spring 611, typically formed of metal Fixedly mounted onto a distal end of extendable tube 610 there is preferably provided a forward end member 612, preferably presenting a diagonally cut pointed forward facing tube end surface 614
  • forward end member 612 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 616, which receives inflation gas, preferably pressurized air, preferably through a conduit 618 embedded in a wall of forward end member 612 and continuing through tube 610 to a one way valve 619
  • extendable endotracheal tube assembly 600 comprising at least one of mounting element 602, mouthpiece 604, mounting base 608, tube 610, coil spring 611, forward end member 612, end surface 614, circumferential balloon 616, conduit 618 and one way valve 619, may also be integrally formed as a unified structure
  • a flexible guide 620 Extending slidably through forward end member 612, tube 610, mounting base 608 and mounting element 602 is a flexible guide 620, which preferably corresponds in function inter aha to guide 20 m the embodiment of Figs 1A - IL and preferably has mounted at a distal end thereof a tip 621, which preferably corresponds in structure and function inter aha to the tip 28 in the embodiment of Figs 1A - IL Tip 621 forms part of a tip sensor (not shown), preferably enclosed in guide 620, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs. 1A - IL.
  • the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 622, which receives inflation gas, preferably pressurized air, preferably through a conduit 624 formed in flexible guide 620 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly (not shown).
  • inflation gas preferably pressurized air
  • conduit 624 formed in flexible guide 620 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly (not shown).
  • Fig. 11B shows inflation of balloon 622 by means of pressurized air supplied via conduit 624, causing balloon 622 to tightly engage the interior of forward end member 612.
  • Fig. 11C illustrates extension of tube 610, which is preferably achieved by forward driven movement of flexible guide 620 in tight engagement with forward end member 612, thus pulling forward end member 612 and the distal end of tube 610 forwardly therewith.
  • Fig. 11D illustrates inflation of balloon 616 by means of pressurized air through conduit 618 and one way valve 619. As will be described hereinbelow, this inflation is employed for sealing the tube 610 within a patient's trachea.
  • Fig. HE illustrates deflation of balloon 622 following inflation of balloon 616, corresponding to desired placement and sealing of tube 610 within the patient's trachea.
  • Fig. 11F illustrates removal of the flexible guide 620 from the tube 610.
  • FIGs. 12A to 12G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 11 A - 1 IF employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human.
  • the extendable endotracheal tube assembly preferably comprises a mounting element (not shown) which is arranged to be removably engaged with an intubator assembly 703 which is preferably similar to intubator assembly 12 (Figs. 1A - 1 L) or any other intubator assembly described hereinabove but may alternatively be any other suitable intubator assembly.
  • a mouthpiece 704 Fixed to or integrally formed with the mounting element is a mouthpiece 704
  • the extendable entotracheal tube assembly 700 is shown inserted into a patient's oral cavity, similar to the placement shown in Fig 1 A
  • an extendable tube 710 preferably including a coil spring 71 1 (Fig 12C), typically formed of metal
  • a forward end member 712 Fixedly mounted onto a distal end of extendable tube 710 there is preferably provided a forward end member 712, preferably presenting a diagonally cut pointed forward facing tube end surface 714
  • forward end member 712 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 716, which receives inflation gas, preferably pressurized air, preferably through a conduit 718 embedded in a wall of forward end member 712 and continuing through tube 710 to a one way valve 719
  • extendable endotracheal tube assembly 700 comprising at least one of mounting element, mouthpiece 704, mounting base 708, tube 710, coil spring 711 (Fig 12C), forward end member 712, end surface 714, circumferential balloon 716, conduit 718 and one way valve 719, may also be integrally formed as a unified structure
  • a flexible guide 720 Extending slidably through forward end member 712, tube 710, mounting base 708 and the mounting element is a flexible guide 720, which preferably corresponds in function inter aha to guide 20 in the embodiment of Figs 1A - IL and preferably has mounted at a distal end thereof a tip, which preferably corresponds m structure and function inter aha to the tip 28 m the embodiment of Figs 1A - IL
  • the tip forms part of a tip sensor, preferably enclosed in guide 720, which preferably corresponds m structure and function inter alia to the tip sensor 11 in the embodiment of
  • the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 722, which receives inflation gas, preferably pressurized air, preferably through a conduit 724 formed m flexible guide 720 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly 703
  • the source of pressurized inflation gas may be an automatic inflator/deflator 726 Additionally or alternatively, a one way valve 728 may be provided for manual inflation
  • the automatic inflator/deflator 726 may be fixed within intubator assembly 703 or alternatively may be mounted therewithin for motion together with flexible guide 720
  • Fig 12B shows inflation of balloon 722 by means of pressurized air supplied via conduit 724, causing balloon 722 to tightly engage the interior of forward end member 712
  • Fig 12C illustrates extension of tube 710, which is preferably achieved by forward driven movement of flexible guide 720 in tight engagement with forward end member 712, thus pulling forward end member 712 and the distal end of tube 710 forwardly therewith
  • Fig 12D illustrates further extension of tube 710, by forward driven movement of flexible guide 720 in tight engagement with forward end member 712, thus pulling forward end member 712 and the distal end of tube 710 forwardly therewith
  • This further motion is preferably provided based on the navigation functionality described hereinabove with reference to Figs 1A - 8 It is appreciated that the forward driven movement of tube 710 as described hereinabove with reference to Figs 1A - 8, may be provided by driven forward motion of the flexible guide 720
  • Fig 12E illustrates inflation of balloon 716 by means of pressurized air through conduit 718 and one way valve 719 As will be desc ⁇ bed hereinbelow, this inflation is employed for sealing the tube 710 within a patient's trachea
  • Fig 12F illustrates deflation of balloon 722 following inflation of balloon 716, corresponding to desired placement and sealing of tube 710 within the patient's trachea
  • Fig 12G illustrates removal of the flexible guide 720 from the tube 710
  • Appendices 1 to 3 are software listings of the following computer files
  • the method for providing the software functionality of the microprocessor 278 in accordance with a preferred embodiment of the present invention includes the following steps 1. Provide an Intel compatible computer with a Pentium II CPU or higher, 128MB RAM, a Super VGA monitor and an available serial port.
  • Testpoint Development kit version 40 available from Capital Equipment Corporation, 900 Middlesex Turnpike, Building 2, Billereca, MA 0821, USA.
  • COP8EM Flash Connected to the serial port of the Intel compatible computer.
  • the COP8EM flash processor loading device is available from National Semiconductors Corp. 2900 Semiconductor Dr., P.O.Box 58090, Santa Clara, CA 95052-8090, USA
  • the software components of the present invention may, if desired, be implemented in ROM (read-only memory) form.
  • the software components may, generally, be implemented in hardware, if desired, using conventional techniques.
  • Appendices 1 through 3 are as follows:
  • Id 01e,#0ff in first out) with "push a" and "pop a" instructions.
  • Id Olf Off The stack starts from leH until OH. ld s,#l ; Clean si 0-7fH. id b,#0 ;
  • timer 1 would be used in capture mode, meamng that pulse x a,tmrllo , received from linear motor will capture the value of timer 1
  • timer 3 - pwm toggle mode stopped sbit t2a,pl , enable linear motor and lock it by putting 0 in controll ,2 sbit t3a,pl .
  • Id a,#0 add a,linear__stat add a,ang_stat add a,autorun_stat add a,selft_stat add a,home_stat sbit enddata,flagsl ; if 2 motors are stopped, set enddata bit to stop transmitting to PC.
  • Id a,buttons_flags and a,#09e if one of the commands flags is set, reset enddata bit. rbit enddata, flags 1 ifbit enddata,flagsl rbit start, flags 1 ifbit fix_t_en,flags2 jsr data send
  • Id linear_stat,# 1 move linear forwards 1mm.
  • Id linear_stat,#l move linear forwards 10mm.
  • Id pls_cntrl,#high(6800) ; 50mm*136pulse per mm 6800. sbit direction flags ; turn motor forwards rbit t2c0,t2cntrl sbit t2a,pl rbit control2,pa sbit contrail, pa
  • l_stat6 ifbit pulse, lflags jmp l_stat6_01 Id a,nolpulsetmr ifne a,int_cntr jmp l_stat6__05 sbit stopl, lflags sbit stuck,flagsl jmp l_stat6__05 l_stat6_01 :rbit pulse,lflags Id a,int_cntr sc subc a,#20 x a,nolpulsetmr sbit limits_c_en,limits_flags sc ; dec. pls_cntr
  • Id a,pls_y 1 check if the the probe is not too high or to low. ifgt a,#094 jmp a_statl_00
  • sbit type_end,flags2 jmp a_statl_08 a_statl_03 : ifbit direction2,aflags ; check the previous direction, jmp a_statl_05 ifbit new_direction,rbytel ; the direction was down-check the new direction.
  • jmp a_statl_04 jmp a_stat3 a_statl_04:ld nxt_a_stat,#4 ; stop motor, wait and then change direction to up.
  • jmp a_statl_07 a_stat 1_05 ifbit new_direction,rbytel ; the direction was up-check the new direction, jmp a_stat4 a_statl_06:ld nxt_a_stat,#3 ; stop motor, wait and then change direction to down.
  • a_statl_07:ld ang_stat,#2 delay for the motor to make a complete stop.
  • a_stat3 rbit direction2,aflags ; turn motor backwards, rbit t3c0,t3cntrl sbit t3a,pl rbit control3,pa sbit control4,pa rbit t3a,pl jmp a_stat4_01 a_stat4: sbit direction2,aflags ; turn motor forwards rbit t3c0,t3cntrl sbit t3a,pl rbit control4,pa sbit control3,pa rbit t3a,pl a_stat4_01 :ld a,rbyte2 ; distanse update x a,plsy_cntr0 Id a,rbyte3 x a,plsy_cntrl
  • a_stat5_01 ifbit t3pndb,t3 cntrl jp a_stat5_02 jp a_stat5_01 a_stat5_02:rbit t3c0,t3cntrl ; stop timer 3 - pwm.
  • a_stat7 ifbit pulse2,aflags jmp a_stat7_01 jmp e_a_stat7 a_stat7_01 :rbit pulse2,aflags ifbit direction ⁇ , aflags ; y update jmp a_stat0_03 a_stat7_02:sc ; y down
  • Id ang_stat,#l move angular down 400 pulses.
  • Id linear_stat,#l move linear backwards 50mm.
  • Id rbyte3,#high(6850) ; 50mm*136pulse per mm 6800.
  • Id temp,#low(wordready) jsr type_st ⁇ ngl ret sect hm ⁇ ts_check,rom hm ⁇ ts_check Id a,pb ⁇ , general limits check (limits b5,b6,b7) and a,#060 , OeO - if the angular limit switch is on imp l ⁇ m ⁇ ts_checkO_0 rbit home,flagsl , signal to the pc that we are not m home position rbit bottom.flagsl , signal to the pc that we are not in buttom position ret hm ⁇ ts_checkO_0 x a,b ifbit home_l ⁇ m ⁇ t,b jmp hm ⁇ ts_checkl_0 sbit home,flagsl , signal to the pc that we are m home position rbit bottom,flagsl , signal to the pc that we are not in buttom position ifbit
  • buttons_test:rb it buttons_t_en,buttons_flags Id a,pli and a,#0a0 a,b ifeq b,#0a0 jmp b_t0_01 jmp b 0_03 b_t0_01 : ifeq ritut,#0 ; no key was pressed.
  • start/stop autorun key was pressed b_tl_01 • ifbit start_stop,buttons_flags jmp b_tl_02 sbit start_stop,buttons_flags ; start button was pressed to start operation.
  • Id s,#0 ld a.b add a,#90 x a,send_ptr jmp end_t_stat end_t_statl Id send_ptr,#0 rbit et ⁇ ,enu ⁇ Id trns__stat,#0 imp end_t_stat
  • Id rbyte_num,#4 number of bytes to be received
  • Id receive_ptr,#rbytel jmp end_r_stat r_stat2 Id a,receive_ ptr ; rbuf-> [receivejptr] a,x
  • Id send_ptr,#0 r_stat2_01 ifbit motor,rbytel ; O-motorl, l-motor2. jmp r_stat2_03
  • rbit limits_c_en,limits_flags rbit enddata flags 1 rbit stopl, lflags jmp r_stat2_05 r_stat2_03 :ld a,rbyte3 ; motor 2 ifne a,#0 jmp r_stat2_04
  • r_stat2_05 ld a,check_sum ; load byte to transmit x a,tbytel e_r_stat2:ld a,tbytel ifeq tms_stat,#0 x a,tbuf
  • Id b,#flagsl load data to ld a,[b-] ; flags 1 push a ld a,[b-] ; pls_yl niuicn ⁇ ⁇ - ld a,[b-] ; pls_yO push a l a,[b-] ; pls_xl push a ld a,[b-] ; pls_xO push a Id a,[b-] ; hal!2 push a lda,
  • Id a,save_ptr save data from stack.
  • Id s,#0 ; t_check a x a,t_check lda,x x a,save_ptr jmp end_d_s d_s2: Id b,#flagsl ; load data to stack.
  • lda,[b-] push a Id a,[b-] push a Id a,[b-] push a lda,[b-] push a lda,>
  • Id a,save_ptr save data from stack.
  • t_check a x a,t_check lda,x x a,save_ptr end d s: ret sect a2d_converter,rom a2d00 rbit a2den,flags2 , the a2d prog checks halll+2 and currentl+2
  • Id b,# 1 ; binary in 0 > decinmal in 1 ,2 bdl Id [b+],#0 ifbne #3 jmp bdl bd2: " id b,#0 bd3: ld a,[b] adc a,[b] x a,[b+] ifbne #1 jmp bd3 bd4: " id a,[b] add a,#066 adc a,[b] dcor a x a,[b+] ifbne #3 jmp bd4 drsz cntr jmp bd2 ret
  • This file include cop ⁇ cdr.inc, cop ⁇ .inc, cop8c3r.inc, ⁇ cdr.chp, ports, inc(shortcuts).
  • PORTED 0x90:BYTE ;
  • Port E Data PORTEC 0 ⁇ 91 :BYTE ;
  • Port E Configuration PORTEP 0x92:BYTE ;
  • ISPADLO 0xA8:BYTE ; ISP Address Register Low Byte
  • ISPADHI 0xA9:BYTE ; ISP Address Register High Byte
  • ISPRD OxAA.BYTE ; ISP Read Data Register
  • ISPWR 0xAB:BYTE ; ISP Write Data Register
  • TINTA 0xAD:BYTE ; High Speed Timers Interrupt A
  • TINTB 0xAE:BYTE ; High Speed Timers Interrupt B
  • HSTCR 0xAF:BYTE ; High Speed Timers Control Register
  • TMR3LO ' 0xB0:BYTE ; Timer 3 low byte
  • TMR3HI OxBLBYTE ; Timer 3 high byte
  • T3RALO 0xB2:BYTE ; Timer 3 RA register low byte
  • T3RAHI 0xB3:BYTE ; Timer 3 RA register high byte
  • T3RBLO 0xB4:BYTE ; Timer 3 RB register low byte
  • T3RBHI 0xB5:BYTE ; Timer 3 RB register high byte
  • T3CNTRL 0xB6:BYTE ; Timer 3 control register
  • ENU OxBA.BYTE ; UART control and status register
  • ENUI ; OxBC-.BYTE ; UART interrupt and clock source reg.
  • BAUD OxBD.BYTE ; BAUD register
  • T2RALO 0xC2:BYTE ; Timer 2 RA register low byte
  • T2RAHI 0xC3:BYTE ; Timer 2 RA register high byte
  • T2RBLO 0xC4:BYTE ; Timer 2 RB register low byte
  • T2RBHI 0xC5:BYTE ; Timer 2 RB register high byte
  • WDSVR 0xC7:BYTE ; Watch dog service register
  • WKEDG 0xC8:BYTE ; MIWU edge select register
  • WKEN 0xC9:BYTE ; MIWU enable register
  • WKPND OxCA:BYTE ; MIWU pending register
  • ENAD OxCB:BYTE ;
  • A/D Converter Control register ADRSTH OxCC:BYTE ;
  • ADRSTL 0xCD:BYTE ; A/D Converter Result Register Low Byte
  • ITMR OxCF:BYTE Idle Timer Control Register
  • PORTLD 0xD0:BYTE Port
  • data PORTLC OxDLBYTE Port
  • configuration PORTLP 0xD2:BYTE Port L pin
  • PORTGD 0xD4:BYTE Port
  • data PORTGC 0xD5:BYTE Port
  • configuration PORTGP 0xD6:BYTE Port G pin
  • PORTCD 0xD8:BYTE ;
  • Port C data PORTCC 0xD9:BYTE ;
  • Port C configuration PORTCP 0xDA:BYTE ;
  • SIOR 0xE9:BYTE ; SIO shift register
  • Timer TIB 2 ; Timer TIB output
  • Timer TIA 3 ; Timer TIA output
  • Timer T2A 4 ; Timer T2A output
  • Timer T2B 5 ; Timer T2B output
  • Timer T3A 6 ; Timer T3A output
  • Timer T3B 7 ; Timer T3B output
  • ACHO 0 ; A/D-Channel 0
  • ADIN 7 ; A/D Converter Input
  • TCI T1C3 ; COP880/840/820 control signal name
  • T1C2 6 ; Timer 1 mode control
  • TC2 T1C2 ; COP880/840/820 control signal name
  • T1C1 5 ; Timer 1 mode control
  • TC3 T1C1 ; COP880/840/820 control signal name
  • T1C0 4 ; Start/Stop timer in modes 1 and 2
  • TRUN T1C0 ; COP880/840/820 control signal name
  • IEDG 2 Selects external interr. edge polarity
  • T1PNDA 5 ; Timer TIA interrupt pending
  • T2C3 7 ; Timer T2 mode control
  • T2C2 6 ; Timer T2 mode control
  • T2C 1 5 ; Timer T2 mode control
  • T2C0 4 ; Timer T2A start/stop
  • T2PNDA 3 ; Timer T2A interr. pending flag
  • T2ENA 2 ; Timer T2A interr. enable
  • T2PNDB 1 ; Timer T2B interr. pending flag
  • T2ENB 0 ; Timer T2B interr. enable
  • T3C3 7 ; Timer T3 mode control
  • T3C2 6 ; Timer T3 mode control
  • T3C1 5 ; Timer T3 mode control
  • T3C0 4 ; Timer T3A start/stop
  • T3PNDA 3 ; Timer T3A interr. pending flag
  • T3ENA 2 ; Timer T3A interr. enable
  • T3PNDB 1 ; Timer T3B interr. pending flag
  • T3ENB 0 ; Timer T3B interr. enable
  • T9HS 7 ; Timer T9 High Speed Enable
  • T6HS 4 ; Timer T6 High Speed Enable
  • T4HS 2 ; Timer T4 High Speed Enable
  • T3HS 1 ; Timer T3 High Speed Enable
  • T2HS 0 Timer T2 High Speed Enable
  • T9INTA 7 Timer 9 Interrupt A
  • T7INTA 5 Timer 7 Interrupt A
  • T6INTA 4 Timer 6 Interrupt A
  • T5INTA 3 Timer 5 Interrupt A
  • T4INTA 2 Timer 4 Interrupt A
  • T3INTA 1 Timer 3 Interrupt A
  • T4INTB 2 ; Timer 4 Interrupt B
  • T3INTB 1 ; Timer 3 Interrupt B Bit definitions ENAD register
  • ADCH3 7 ; A/D Converter Channel Select bit 3
  • ADCH2 6 ; A/D Converter Channel Select bit 2
  • ADCH1 5 ; A/D Convenor Channel Select bit 1
  • ADCHO 4 ; A/D Converter Channel Select bit 0
  • ADMOD 3 ; A/D Converter Mode Select bit
  • ADMUX 2 ; A D Mux Out Control
  • ADBSY 0 ; A/D Converter Busy Bit oil uenmuons ci u register
  • RBIT9 3 ; Contains the ninth bit (nine bit frame!)
  • CHIP 8CDR specifies max ROM address 7FFF
  • cs_lcd 3 ; pa ; send the information in the led data pins upon rise and fall(_ ⁇ of cs_lcd.
  • type_start 0 lcd_flags ; if set led sould type “start” in line2.
  • type_stop l lcd_flags ; if set led sould type “stop” in line2.
  • type_end 2 lcd_flags ; if set led sould type "end” in line2.
  • type_stuck 3 lcd_flags ; if set led sould type "stuck” in line2.
  • lflags 020 ; flags that belongs to linear motor (motorl).
  • aflags 021 ; flags that belongs to angular motor (motor2).
  • rbytel 051 1
  • rbyte2 052
  • received bytes rbyte3 053 .
  • rbyte4 054

Abstract

An automatically operative medical insertion device (12) and method including an insertable element (18) which is adapted to be inserted within a living organism in vivo, a surface following element (20), physically associated with the insertable element and being arranged to follow a physical surface within the living organism in vivo, a driving subsystem (15) operative to at least partially automatically direct the insertable element along the physical surface and a navigation subsystem (274) operative to control the driving subsystem based at least partially on a perceived location of the surface following element along a reference pathway stored in the navigation subsystem.

Description

EXTENDABLE TUBE FIELD OF THE INVENTION The present invention relates to systems and methods for automatic insertion of an element into a living organism m vivo and to an extendable insertable element and a method of insertion thereof
REFERENCE TO CO-PENDING APPLICATION Applicants hereby claim priority of PCT Application No PCT/ILOl/01121 filed December 5, 2001, entitled "Apparatus For Self-Guided Intubation"
BACKGROUND OF THE INVENTION The following U S Patents are believed to represent the current state of the art
6,248,112, 6,236,875, 6,235,038 6,226,548 6,211,904 6,203,497, 6,202,646, 6,196,225, 6,190,395, 6,190,382, 6,189,533 6,174,281 6,173,199, 6,167,145, 6 164,277, 6,161,537, 6,152,909 6,146,402 6,142,144 6,135,948, 6, 132,372, 6 129,683, 6,096,050, 6,096,050 6,090,040 6,083,213 6,079,731, 6,079,409, 6,053,166, 5,993,424, 5,976,072 5,971,997 5,957,844 5,951,571, 5,951,461 , 5,885,248, 5,720,275, 5,704,987 5,592,939 5,584,795 5,506,912, 5,445,161 , 5,400,771, 5,347,987, 5,331,967 5,307,804 5,257,636 5,235,970, 5,203,320, 5,188,111, 5,184,603, 5,172,225 5,109,830 5,018,509 4,910,590, 4,672,960, 4,651,746
Reference is also made to http //www airwaycam com/system html
SUMMARY OF THE INVENTION
The present invention seeks to provide improved systems and methods for automatic insertion of an element into a living organism in vivo
There is thus provided in accordance with a preferred embodiment of the present invention an automatically operative medical insertion device including an insertable element which is adapted to be inserted within a living organism m vivo, a surface following element, physically associated with the insertable element and being arranged to follow a physical surface within the living organism in vivo, a driving subsystem operative to at least partially automatically direct the insertable element along the physical surface and a navigation subsystem operative to control the driving subsystem based at least partially on a perceived location of the surface following element along a reference pathway stored in the navigation subsystem
There is also provided in accordance with a preferred embodiment of the present invention an automatically operative medical insertion method, which includes inserting an insertable element within a living organism in vivo, physically associating a surface following element with the insertable element and causing the surface following element to follow a physical surface within the living organism in vivo, directing the insertable element along the physical surface using a driving subsystem and controlling direction of the insertable element based at least partially on a perceived location of the surface following element along a reference pathway stored in a navigation subsystem
Further m accordance with a preferred embodiment of the present invention the driving subsystem is operative to fully automatically direct the insertable element along the physical surface Alternatively, the driving subsystem is operative to automatically and selectably direct the insertable element along the physical surface
Additionally in accordance with a preferred embodiment of the present invention the navigation subsystem receives surface characteπstic information relating to the physical surface from the surface following element and employs the surface characteristic information to perceive the location of the surface following element along the reference pathway
Preferably, the surface characteristic information includes surface contour information Additionally, the surface characteristic information includes surface hardness information. Preferably, the surface contour information is three- dimensional. Alternatively, the surface contour information is two-dimensional.
In accordance with a further preferred embodiment of the present invention, the insertable element is an endotracheal tube and the physical surface includes surfaces of the larynx and trachea. Alternatively, the insertable element is a gastroscope and the physical surface includes surfaces of the intestine. In accordance with another preferred embodiment, the insertable element is a catheter and the physical surface includes interior surfaces of the circulatory system.
Further in accordance with a preferred embodiment of the present invention the insertion device also includes a reference pathway generator operative to image at least a portion of the living organism and to generate the reference pathway based at least partially on an image generated thereby.
Preferably, the reference pathway includes a standard contour map of a portion of the human anatomy. Additionally, the standard contour map is precisely adapted to a specific patient. Alternatively, the standard contour map is automatically precisely adapted to a specific patient.
Further in accordance with a preferred embodiment of the present invention the reference pathway is operator adaptable to designate at least one impediment.
Additionally in accordance with a preferred embodiment of the present invention the insertable element includes a housing in which is disposed the driving subsystem, a mouthpiece, a tube inserted through the mouthpiece and a flexible guide inserted through the tube, the surface following element being mounted at a front end of the guide.
Preferably, the mouthpiece includes a curved pipe through which the tube is inserted. Additionally, the driving subsystem is operative to move the guide in and out of the housing, through the curved pipe and through the tube. Preferably, the driving subsystem also operates to selectably bend a front end of the guide. Additionally or alternatively, the driving subsystem is operative to move the insertable element in and out of the living organism. Additionally, the driving subsystem is also operative to selectably bend a front end of the insertable element. Further in accordance with a preferred embodiment of the present invention the surface following element includes a tactile sensing element.
Preferably, the surface following element includes a tip sensor including a tip integrally formed at one end of a short rod having a magnet on its other end, the rod extends through the center of a spring disk and is firmly connected thereto, the spring disk being mounted on one end of a cylinder whose other end is mounted on a front end of the insertable element.
Further in accordance with a preferred embodiment of the present invention the tip sensor also includes two Hall effect sensors, which are mounted inside the cylinder on a support and in close proximity to the magnet, the Hall effect sensors being spaced in the plane of the curvature of the curved pipe. Each Hall effect sensor includes electrical terminals operative to provide electric current representing the distance of the magnet therefrom. The tip sensor operates such that when a force is exerted on the tip along an axis of symmetry of the cylinder, the tip is pushed against the spring disk, causing the magnet to approach the Hall effect sensors and when a force is exerted on the tip sideways in the plane of the Hall effect sensors, the tip rotates around a location where the rod engages the spring disk, causing the magnet to rotate away from one of the Hall effect sensors and closer to the other of the Hall effect sensors.
Still further in accordance with a preferred embodiment of the present invention the driving subsystem operates, following partial insertion of the insertable element into the oral cavity, to cause the guide to extend in the direction of the trachea and bend the guide clockwise until the surface following element engages a surface of the tongue, whereby this engagement applies a force to the surface following element.
Additionally in accordance with a preferred embodiment of the present invention the navigation subsystem is operative to measure the changes in the electrical outputs produced by the Hall effect sensors indicating the direction in which the tip is bent.
Moreover in accordance with a preferred embodiment of the present invention the navigation subsystem operates to sense the position of the tip and the past history of tip positions and to determine the location of the tip in the living organism and relative to the reference pathway. In accordance with yet another preferred embodiment, the navigation subsystem operates to navigate the tip according to the reference pathway. Additionally, the navigation subsystem operates to sense that the tip touches the end of the trough beneath the epiglottis. Additionally or alternatively, the navigation subsystem is operative to sense that the tip reaches the tip of the epiglottis. In accordance with another preferred embodiment, the navigation subsystem operates to sense that the tip reached the first cartilage of the trachea. Additionally, the navigation subsystem operates to sense that the tip reached the second cartilage of the trachea. Additionally or alternatively, the navigation subsystem is operative to sense that the tip reached the third cartilage of the trachea. Preferably, the navigation subsystem operates to load the reference pathway from a memory.
Further in accordance with a preferred embodiment of the present invention the driving subsystem is operative to push the tube forward.
Still further in accordance with a preferred embodiment of the present invention the driving subsystem includes a first motor which operates to selectably move the insertable element forward or backward, a second motor which operates to selectably bend the insertable element and electronic circuitry operative to control the first motor, the second motor and the surface following element.
Preferably, the electronic circuitry includes a microprocessor operative to execute a program, the program operative to control the first and second motors and the surface following element and to insert and bend the insertable element inside the living organism along the reference pathway.
Further in accordance with a preferred embodiment of the present invention the driving subsystem is operative to measure the electric current drawn by at least one of the first and second motors to evaluate the position of the surface following element.
Still further in accordance with a preferred embodiment of the present invention the reference pathway is operative to be at least partially prepared before the insertion process is activated. Preferably, the medical insertion device includes a medical imaging system and wherein the medical imaging system is operative to at least partially prepare the reference pathway. Preferably, the medical imaging subsystem includes at least one of an ultrasound scanner, an X-ray imager, a CAT scan system and an MRI system.
Further in accordance with a preferred embodiment of the present invention the medical imaging system operates to prepare the reference pathway by marking at least one contour of at least one organ of the living organism.
In accordance with another preferred embodiment, the medical imaging system operates to prepare the reference pathway by creating an insertion instruction table including at least one insertion instruction. Preferably, the insertion instruction includes instruction to at least one of extend, retract and bend the insertable element.
Further in accordance with a preferred embodiment of the present invention the navigation subsystem is operative to control the driving subsystem based at least partially on a perceived location of the surface following element and according to the insertion instruction table stored in the navigation subsystem.
Additionally in accordance with a preferred embodiment of the present invention the operative medical insertion device operates to at least partially store a log of a process of insertion of the insertable element. Additionally, the operative medical insertion device transmits the log of a process of insertion of the insertable element.
Further in accordance with a preferred embodiment of the present invention the computer operates to aggregate the logs of a process of insertion of the insertable element. Additionally, the computer prepares the reference pathway based at least partially on the aggregate.
Still further in accordance with a preferred embodiment of the present invention the computer transmits the reference pathway to the medical insertion device.
Further in accordance with a preferred embodiment of the present invention the insertable element includes a guiding element and a guided element. Additionally, the driving subsystem operates to direct the guiding element and the guided element at least partially together. Additionally or alternatively, the driving subsystem is operative to at least partially automatically direct the guide in a combined motion comprising a longitudinal motion and lateral motion.
In accordance with yet another preferred embodiment, the mouthpiece includes a disposable mouthpiece.
In accordance with still another preferred embodiment of the present invention, the insertable element is extendable. In accordance with yet another preferred embodiment, the insertable element includes a mounting element which is arranged to be removably engaged with an intubator assembly and an extendable tube operatively associated with the mounting element. Preferably, the extendable tube is arranged to be pulled by a flexible guide operated by the intubator assembly.
In accordance with yet another preferred embodiment of the present invention, the extendable tube includes a coil spring. Additionally or alternatively, the extendable tube also includes a forward end member, on a distal end thereof.
Preferably, the forward end member includes a diagonally cut pointed forward facing tube end surface. Additionally or alternatively, the medical insertion device also includes a forward end member mounted inflatable and radially outwardly expandable circumferential balloon.
Preferably, the forward end member mounted inflatable and radially outwardly expandable circumferential balloon receives inflation gas through a conduit formed in a wall of the forward end member and continuing through the tube to a one way valve.
In accordance with another preferred embodiment, the medical insertion device also includes a flexible guide having mounted at a distal end thereof a tip sensor. Preferably, the flexible guide is formed with an inflatable and radially outwardly expandable guide mounted balloon. Additionally, the inflatable and radially outwardly expandable guide mounted balloon receives inflation gas through a conduit formed in the flexible guide and extending therealong. Preferably, the conduit is connected to a source of pressurized inflation gas. Additionally or alternatively, the source of pressurized inflation gas is located within the intubator assembly. Preferably, the inflation gas comprises pressurized air.
It is appreciated that the distances and angles referenced in the specification and claims are typical values and should not be construed in any way as limiting values. BRIEF DESCRIPTION OF THE DRAWINGS AND APPENDICES
The present invention will be understood and appreciated more fully from the following detailed description, taken in conjunction with the drawings and appendices in which:
Figs. 1A to IL are a series of simplified pictorial illustrations of a process of employing a preferred embodiment of the present invention for the intubation of a human;
Figs. 2A to 2F taken together are a flowchart illustrating a preferred implementation of the present invention, operative for an intubation process as shown in Figs lA to IL;
Fig. 3 is a simplified illustration of the internal structure of a preferred embodiment of the present invention for intubation of a human;
Fig. 4 is a simplified block diagram of a preferred embodiment of the present invention;
Figs. 5 A to 5H are electrical schematics of a preferred embodiment of the present invention for intubation of a human;
Figs. 6A to 6K are a series of simplified pictorial illustrations of a process of employing a preferred embodiment of the present invention for insertion of an element into the intestine of a human;
Fig. 7 is a preferred embodiment of a table comprising instruction, operative in accordance with a preferred embodiment of the present invention, for insertion of an element into the intestine of a human as shown in Figs. 5A to 5K;
Fig. 8 is a flowchart illustrating a preferred implementation of the present invention, operative for a process of insertion of an element into the intestine of a human as shown in Figs. 6 A to 6K;
Figs. 9A to 9F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with a preferred embodiment of the present invention in various operative orientations;
Figs. 10A to 10G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 9A - 9F employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human; Figs. 11A to 11F are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with another preferred embodiment of the present invention in various operative orientations; and
Figs. 12A to 12G are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 9A - 9F employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human.
LIST OF APPENDICES Appendices 1 to 3 are computer listings which, taken together, form a preferred software embodiment of the present invention.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
Reference is now made to Figs. 1A to IL, which are a series of simplified pictorial illustrations of a system and methodology for the intubation of a human in accordance with a preferred embodiment of the present invention.
It is appreciated that the general configuration of the mouth and trachea is generally the same for all humans except for differences in scale, such as between an infant, a child and an adult. In a preferred implementation of the present invention, a standard contour map 10 of the human mouth and trachea is employed. The scale of the map 10 may be further precisely adapted to the specific patient, preferably automatically. Alternatively, the scale of the map 10 is adapted to the specific patient semi-automatically. In this alternative the operator can select the scale of the map 10, for example by selecting between a child and an adult. Thereafter the scale of the map 10 is automatically adapted to size of the specific patient as a part of the intubation process. As a further alternative or in addition the operator is enabled to designate one or more typical impediments such as: a tumor, a swelling, an infection and an injury. Selecting an impediment preferably creates a suitable variation of the general map 10.
Fig. 1A shows the map 10 and the location therein where a tip sensor 11 of an intubator engages the mouth and trachea of the patient. It is a particular feature of the present invention that intubation is at least partially automatically effected by utilizing the contour map 10 to monitor the progress of tip sensor 11 and thus to navigate the intubator accordingly.
As seen in Fig. 1A, an intubator assembly 12, suitable for the intubation of a human, is partially inserted into an oral cavity of a patient. The intubator assembly 12 preferably comprises a housing 14 in which is disposed a guide driver 15, a mouthpiece 16, a tube 18 inserted through the mouthpiece 16, a flexible guide 20 inserted through the tube 18, and tip sensor 11 mounted at the distal end of the guide 20. The mouthpiece 16 preferably comprises a rigid curved pipe 24 through which the tube 18 is inserted. Preferably the curved pipe 24 comprises a slit 49 on each side. Alternatively, the curved pipe 24 is eliminated.
It is appreciated that some of the components comprising the intubator assembly 12 may be disposable, for example, the tube 18 and the mouthpiece 16. The guide driver 15 is operative to move the guide 20 in and out of the housing 14, through the curved pipe 24 and through the tube 18. The guide driver 15 is also operative to selectably bend the distal end of the guide 20 clockwise and counterclockwise in the plane of the curvature of the curved pipe 24 in the sense of Fig. 1A.
Referring now to an enlargement of the tip sensor 11, it is seen that tip sensor 11 preferably comprises a tip 28 preferably integrally formed at one end of a short rod 30 having a magnet 32 on its other end. The rod 30 preferably extends through the center of a spring disk 34 and is firmly connected thereto. The spring disk 34 is preferably mounted on one end of a cylinder 36 whose other end is mounted on the distal end of the guide 20. Preferably, the tip sensor 11 also comprises two Hall effect sensors, 38 and 40, which are mounted inside the cylinder 36 on a support 41 and in close proximity to the magnet 32. The Hall effect sensors 38 and 40 are preferably spaced in the plane of the curvature of the curved pipe 24. Typically, each Hall effect sensor has electrical terminals operative to provide electric current representing the distance of the magnet 32 therefrom.
When a force is exerted on the tip 28 along the axis of symmetry 42 of cylinder 36, the tip 28 is pushed against the spring disk 34, causing the magnet 32 to approach the Hall effect sensors 38 and 40. Since the distance between the magnet 32 and each of the Hall effect sensors 38 and 40 decreases, both Hall effect sensors 38 and 40 produce an increase in their output electric current. When a force is exerted on the tip 28 sideways in the plane of the Hall effect sensors 38 and 40, the tip 28 rotates around the location where the rod 30 engages the spring disk 34, as is shown in Fig. 1A. This causes the magnet 32 to rotate away from the Hall effect sensor 40 and closer to the Hall effect sensor 38. The output electric current of the Hall effect sensor 40 typically decreases and the output electric current of the Hall effect sensor 38 typically correspondingly increases. Thus, it may be appreciated that the tip sensor 11 enables electronic circuitry (not shown) to measure the amplitude and the direction of force exerted on the tip 28 in the plane of the Hall effect sensors 38 and 40 and to compute the orientation of a surface of a tissue against which the sensor tip 28 is depressed, relative to the axis of symmetry 42. It is appreciated that sensors other than Hall effect sensors can be used to measure the direction and the amplitude of the force exerted on the tip 28, or otherwise to measure the proximity and the orientation of the adjacent surface.
During automatic operation of the system, following partial insertion of the intubator assembly 12 into the oral cavity, as shown in Fig. 1A, the guide driver 15 typically causes the guide 20 to extend in the direction of the trachea 44 and bends the guide 20 clockwise until the tip 28 engages a surface of the tongue 46. This engagement applies a force to tip 28, which causes the tip to rotate counterclockwise wherein the magnet 32 approaches the Hall effect sensor 38. Electronic circuitry (not shown) inside the housing 14, which measures the changes in the electrical outputs produced by the Hall effect sensors 38 and 40, indicates that the tip 28 is bent clockwise.
By sensing the position of the tip and employing the past history of tip positions, the system of the present invention determines the location of the tip sensor 11 in the oral cavity and relative to the map 10. This location is employed in order to navigate the intubator correctly, as described hereinbelow.
Reference is now made to Fig. IB, which illustrates a further step in the intubation in accordance with the present invention. Fig. IB shows the guide 20 extended further and reaching an area between the base of the tongue 46 and the epiglottis 48 of the patient.
As seen in Fig. IC, the guide 20 extends further forward until the tip 28 touches the end of the trough beneath the epiglottis 48.
As seen in Fig. ID, the guide 20 bends counterclockwise and touches the bottom surface of the epiglottis 48. Then the guide 20 retracts a little, while preserving continuous tactile contact between the tip 28 with the bottom surface of the epiglottis 48.
As seen in Fig. IE, the guide 20 retracts further until the tip 28 of the tip sensor 11 reaches the tip 165 of the epiglottis 48 and then the tip 28 loses tactile contact with the surface of the tip 165 of the epiglottis 48.
As seen in Fig. IF, the guide 20 bends further counterclockwise, then extends forward and then bends clockwise until the tip 28 touches the upper surface of the epiglottis 48. As seen in Fig. 1G, the guide 20 extends forward, preserving continuous tactile contact with the epiglottis 48, until the tip 28 senses the first trough of the trachea 44.
As seen in Figs. IH and II, the guide 20 extends further forward until the tip 28 senses the second trough of the trachea 44.
As seen in Figs. U and IK, the guide 20 extends further forward until the tip 28 senses the trough of the third cartilage of the trachea 44. Then the guide 20 further extends, typically for adults by 5 centimeters, to ensure that the tube 16 reaches to the third cartilage.
As seen in Fig. IL, the guide driver 15 is pulled out with the guide 20 leaving the mouthpiece 16 and the tube 18 inside the patient's mouth and trachea 44.
Reference is now made to Figs. 2A to 2F, which, taken together, are a flowchart of the process of the intubation of a human shown in Figs. 1A to IK.
Fig. 2A and 2B, taken together, correspond to the step of the intubation process shown in Fig. 1A
In step 100 of Fig. 2A the intubator assembly 12 is set to perform intubation.
In step 102 the intubator loads an intubation pattern map 10 from its memory.
In steps 104, 106 and 108 the intubator enables the operator to set the scale of the intubation pattern map to the corresponding size of the patient by selecting between an infant, a child and an adult.
In steps 110, 1 12 and 114 the intubator enables the operator to adapt the intubation pattern map 10 to a type of intubation impediment, preferably by selecting from a menu. As seen in Fig. 2A the menu typically provides the operator with four optional impediments: an infection, a swelling, a tumor and an injury, and a fifth option not to select any impediment. It is appreciated that various types of impediments can be defined as is typical for a specific organ.
As seen in Fig. 2B, steps 120, 122, 124, 126, 128 and 130 cause the guide 20 to extend in the direction of the throat and simultaneously bend clockwise until the tip sensor is depressed against the surface of the tongue or until extension and bending limits are reached. As seen in step 128, the bending limit is preferably 50 degrees and the extension limit is preferably 2 centimeters. If the tip sensor is depressed, the scale of the intubation pattern map 10 is preferably updated (step 132) to match the particular scale or size of the intubated patient. If at least one of the extension limit and the bending limit is reached an error message is displayed (step 134) and the intubation process is stopped.
Reference is now made to Fig. 2C, which corresponds to Figs. IB and IC. As illustrated in Fig. 2C, the guide driver 15 performs sequential steps 140, 142, 144 and 146 in a loop, extending (step 140) guide 20 further into the patient's throat and along the throat surface, following the intubation pattern map 10 and keeping the tip in contact with the surface (steps 144, 146). When the output electric currents from both Hall effect sensors 38 and 40 increase, the intubator assumes (step 142) that the tip 28 has reached the end of the trough beneath the epiglottis 48. The point of engagement between the tip 28 and the body is designated in Fig. IC by reference numeral 147. The scale of the intubation pattern map 10 is then preferably updated to match the patient's organ structure (step 148).
Reference is now made to Fig. 2D, which corresponds to Figs. ID and IE. As seen in Fig. 2D the guide driver 15 performs steps 150, 152 and 154 in a loop, bending the distal end of the guide 20 counterclockwise until the tip 28 touches the epiglottis 48, or until a bending limit, preferably of 45 degrees is reached (step 154) and the intubation stops (step 156). The preferred point of engagement between the tip 28 and the surface of the epiglottis is designated in Fig. ID by reference numeral 155. After sensing an engagement between the tip 28 and the surface of the epiglottis, the guide driver 15 performs steps 158, 160, 162, and 164 in a loop, retracting the guide 20 further (step 158), and increasing the bending of the guide 20 (step 164), until the tip of the guide reaches the tip of the epiglottis 48, designated in Fig. IE by reference numeral 165. When the tip 28 reaches the tip of the epiglottis 48, the tip 28 is released and the output electric currents from both Hall effect sensors decrease to a minimum. Preferably the intubation pattern map 10 is updated (step 166) to match the patient's organ structure.
Reference is now made to Fig. 2E, which corresponds to Figs. IE and IF. As seen in Fig. 2E, the guide driver 15 causes the guide 20 to move above and around the tip of the epiglottis 48 by causing the guide 20 to bend counterclockwise, preferably by 45 degrees, then to move forward down the throat by 5 millimeters and then to bend clockwise, preferably by 10 degrees (Step 170). Then the guide driver 15 performs steps 172, 174 and 176 in a loop, bending and extending (step 174) until the tip 28 of the guide touches the upper surface of the epiglottis 48 or until an extension limit, preferably of 1 centimeter, or a bending limit, preferably of 50 degrees, is reached, and the intubation is stopped (step 178). A preferred point of engagement between the tip 28 and the epiglottis is designated in Fig. IF by reference numeral 177.
Reference is now made to Fig. 2F, which corresponds to Figs. 1G to IK. As seen in Fig. 2F, a "cartilage crest counter N" is first zeroed (step 180). Then the guide driver 15, performing steps 182 to 198 in a loop, causes the guide 20 to move the sensor tip 1 1 forward (step 182) along the surface of the trachea 44, preserving contact between the tip 28 and the surface of the trachea (steps 186 and 188) by increasing the bend (step 188) as needed. Each time a crest (189 in Figs. IH, II, IJ) of a cartilage of the trachea 44 is located the "cartilage crest counter" is incremented (step 190), the tip 28 is moved about the crest (steps 192, 194, 196 and 198) and the loop process repeats until the third cartilage is located. Then the guide 20 further extends, typically for adults by 5 centimeters, to ensure that the tube 16 reaches to the third cartilage. The guide driver 15 then signals to the operator that the insertion is completed successfully (step 200).
Reference is now made to Fig. 3, which is a simplified illustration of the internal structure of a preferred embodiment of the present invention useful for intubation of a human. The intubator assembly 12 preferably comprises the housing 14, the guide driver 15, the mouthpiece 16, the tube 18, the flexible guide 20 inserted inside the tube 18 and the tip sensor 11 mounted at the distal end of the guide 20. Preferably the mouthpiece comprises a curved pipe 24.
Preferably, the guide driver 15 comprises a first motor 210 that drives a gearbox 212 that rotates a threaded rod 214. A floating nut 216 is mounted on the threaded rod 214. As the motor 210 rotates the threaded rod 214, the floating nut 216 is moved forward or backward according to the direction of the rotation. The floating nut 216 is operative to move a carriage 218 along a bar 220 and thus to push or pull the guide 20. When the carriage 218 touches a stopper 222 the stopper 222 moves with the carriage 218 along the bar 220 and pushes the tube 18 forward. A second motor 224 is connected to a disk 226 to which two guide angulation wires 228 are attached at first end thereof. The guide angulation wires 228 are threaded inside the guide 20 and their other ends are connected to the distal end of the guide just short of the tip sensor 11. When the motor 224 rotates the disk 226 clockwise one of the wires 228 is pulled and the second wire is loosened. The wire that is pulled pulls and bends the distal end of the guide 20 counterclockwise in the sense of Fig. 3. Accordingly, when the motor 224 rotates counter-clockwise the second wire of the two wires 228 is pulled and the first wire is loosened. The wire that is pulled pulls and bends the distal end of the guide 20 clockwise in the sense of Fig. 3.
Electronic circuitry 229 is provided within the housing 14 and is preferably electrically connected to operating switches 230, a display 232, the motors 210 and 224 and to the Hall effect sensors 38 and 40 (Fig. 1A) in the tip sensor 11. Preferably, the electronic circuitry 229 also comprises a microprocessor, operative to execute a program. The program is preferably adapted to control the switches 230, the display 232, motors 210 and 224 and the Hall effect sensors 38 and 40 and to insert and bend the guide inside a living organism, according to a predefined map until the tip of the guide reaches a destination point inside the living organism. Preferably the program is operative to cause the tip 28 of the guide 20 to follow a predefined internal contour of an organ of the living organism. Preferably program is operative employ tactile sensing to measure the position of the tip of the guide relative to the surface organ of the living organism.
It is appreciated that the term "microprocessor" also includes inter alia a "microcontroller".
Electrical batteries (not shown) are preferably provided within the housing 14 to supply electric power to the electronic circuitry, the tip sensor 11, the motors 210 and 224, the display 232 and all other elements of the present invention that consume electricity. It is appreciated that external sources of electricity can also be employed to provide power to the intubator assembly 12.
Communication interface (not shown), preferably employing infra-red communication technology, is provided to enable communication with external data processing equipment. Preferably, a balloon 234 is provided at the distal end of the tube 18 and a thin pipe (not shown) is inserted through the pipe 18 and is connected, through the side of the pipe, to the balloon. The thin pipe enables an operator to inflate the balloon when the distal end of the pipe 18 reaches the appropriate place in the trachea, thus securing the distal end of the pipe to the trachea.
Reference is now made to Fig. 4, which is a simplified functional block diagram of a preferred embodiment of the guide driver 15 described hereinabove. In Fig. 4 the guide 20 is driven by two drivers. A longitudinal driver 240 preferably comprises a motor 210, the gear 212, the threaded rod 214, the floating nut 146 and the carriage 218 of Fig. 3. A bending guide driver 242 preferably comprises the motor 224, the disk 226 and wires 228 (Fig. 3). The longitudinal driver 240 and the bending guide driver 242 are controlled by two software driver modules. A longitudinal software driver module 244 controls the longitudinal driver 240 and comprises two functions: an extend function 246 and a retract function 248. A bending software driver 250 controls the bending guide driver 242 and comprises two functions: a bend counterclockwise function 252 and a bend clockwise function 254. The functions 246, 248, 252 and 254 are operated by a propagation control software module 256.
At the other end of the guide 20, the tip sensor 11 measures the proximity and orientation of an adjacent surface. In a preferred embodiment of the present invention the tip sensor 11 performs the proximity and orientation measurements by measuring the force applied to a tactile tip by a surface of an adjacent tissue. A tip sensor software driver module 260, operative to receive input signals from the tip sensor 11, provides two input functions: a counterclockwise tip rotation function 262 and a clockwise tip rotation function 264. The measurements of the tip positions as provided by the tip sensor software driver module 260 are collected and stored by a sensor log module 266.
The map 10 is loaded into memory and serves as an updatable map 268. A comparator 270 compares the accumulated measurements from the tip sensor 11 with the updated reference map 268. The results of the comparisons are calculated by an update scale module 272 to provide a scaling factor that is applied to update the updated map 268. Consequently a navigation module 274 employs the updated map information to instruct the propagation control 256 to execute the next step of the insertion program. It is appreciated that a measurement of the electric current drawn by at least one of the longitudinal guide drive and the bending guide drive can also serve as an input to the comparator 270 to evaluate the position of the tip sensor.
Reference is now made to Figs. 5A to 5H, which are, taken together, an electrical schematic of a preferred embodiment of the present invention useful for intubation of a human. Reference is especially made to microprocessor 278, which is preferably operative to operate a program to control the elements of the intubator assembly 12, such as the operating switches 230, the display 232, the motors 210 and 224 (Fig. 3), and the Hall effect sensors 38 and 40 in the tip sensor 11 (Fig. 1A), and to perform the intubation process, such as the process shown and described hereinabove with reference to Figs. 2A to 2F.
Reference is now made to Figs. 6A to 6K, which are a series of simplified pictorial illustrations of ten typical steps in a process of employing a preferred embodiment of the present invention useful for insertion of an element into the intestine of a human.
It is appreciated that some of the organ systems of a living organism are generally similar up to a scale factor, such as the mouth and trachea system. Other organs, such as the intestine system, are generally different from one human body to the other. Therefore, in order to employ the present invention to insert a medical device or apply a medicine to a specific location within a generally variable organ, a map of the organ, at least from the entry point and until the required location, is prepared before the insertion process is activated. The required map is preferably prepared by employing an appropriate medical imaging system, such as an ultrasound scanner, an x-ray imager, a CAT scan system or a MRI system. The map can be a two dimensional map or a three- dimensional map as appropriate for the specific organ. Typically for the intestine system a three dimensional map is required.
It is appreciated that an inserter according to a preferred embodiment of the present invention for use in organs that are variable in three dimensions is similar to the intubator assembly 12, preferably with the following modifications:
(1) The tube 18 may be replaced with a different insertable device;
(2) An additional guide bending system employing elements similar to motor 222, disk 224 and wires 226 is added and mounted perpendicularly to the first system of motor 222, disk 224 and wires 26, so that it is possible to bend the end of the guide in three dimensions. It is appreciated that three-dimensional manipulation is possible also by employing three or more motors; and
(3) The tip sensor 11 preferably comprises four Hall effect sensors to sense the motion of the tip 28 in three dimensions. It is appreciated that it is possible to operate the tip sensor in a three-dimensional space also by employing three Hall effect sensors. It is also appreciated that other types of sensors can be employed to measure the proximity and orientation of an adjacent surface in three dimensions.
In a preferred embodiment of the present invention, when the guide 20 performs longitudinal motion, such as insertion or retraction, the guide 20 also performs a small and relatively fast lateral motion. The combined longitudinal and lateral motions are useful for sensing the surface of the organ in three dimensions and hence to better determine the location of the tip sensor 11 in the organ and relative to the map 10.
Due to limitations of the graphical representation, a two-dimensional imaging and map is shown in Figs. 6A to 6K.
As seen in Fig. 6A, a human organ, the intestine in this example, is imaged, typically by a CAT scan system 280, and an image 282 of the internal structure of the organ is produced.
In Fig. 6B the image 282 of the organ is used to create an insertion map 284. Typically the image 282 is displayed on a computer screen (not shown) and a pointing device, such as a computer mouse or a light pen, is used to draw a preferred path 286 that the tip of the guide is to follow. The path is typically drawn by marking a contour of the organ, and optionally marking the guide bending points, as is shown and described with reference to Figs. 1A to 1 K. Alternatively, a preferred path is created, such as path 286, not necessarily continuously following the contours of the organ. As a further alternative, the map 10 or the path 286 is converted into a set of insertion steps as is shown and described hereinbelow with reference to Fig. 7.
Reference is now made to Fig. 7 together with Fig. 8 and with Figs. 6C to 6K. As shown in Fig. 7, a table 290 is provided for storage in a computer memory and for processing by a computer processor. The table 290 contains rows 292, wherein each row 292, preferably comprises an instruction to perform one step in the process of insertion of a medical insertion device into a living organism such as shown and described with reference to Figs. 6C to 6K. Preferably each row 292 contains the expected values or the maximal values for the extension of an insertion guide such as guide 20, the bending of the insertion guide and the electrical outputs from the Hall effect sensors 38 and 40 (Fig. 1 A). In a preferred embodiment of the present invention the row 292 contains five sets of values:
(a) Initial bend 294 contains two values for bending the guide from a straight position, in two perpendicular planes.
(b) Initial insertion 295 contains a longitudinal value for extending or retracting the guide in centimeters.
(c) Initial sensor measurements 296 contains expected output values of four sensors such as four Hall effect sensors, for example, Hall effect sensors 38 and 40 of Fig. 1A. The initial sensors measurements 296 are expected to be measured by the time the guide reaches the value of the initial insertion 295.
(d) Insert distance 297 contains a longitudinal value for further extending or retracting the guide in centimeters. Typically the initial sensor measurements 296 are expected to be preserved, while the guide is extended or retracted, by adapting the bending of the guide.
(e) Final sensor measurements 298 contain expected output values of the four sensors of step (c). The initial sensor measurements 298 are expected to be measured by the time the guide reaches the value of the insert distance 297.
It is appreciated that the path drawn in Fig. 6B can be employed to prepare a table of instructions, such as table 290 of Fig. 7.
Referring to Fig. 8, which is a flowchart illustrating a preferred implementation of the present invention, operative for a process of insertion of an element into the intestine of a human as shown in Figs. 6 A to 6K. The flowchart of Fig. 8 is a preferred embodiment of a program, operative to be executed by a processor, such as microprocessor 278 of Fig. 5A, comprised in a preferred embodiment of the present invention, for insertion of an element into a living organism, preferably by employing a table 290 shown and described with reference to Fig. 7.
The preferred flowchart shown in Fig. 8 starts by loading the table (step 300) such as the map shown in Fig. 7. The program then reads a first row 292 from the map (step 302) and causes the distal end of the guide 20 to bend according to the initial bending values 294. Then the program causes the guide 20 to extend or retract according to the initial insertion distance 295 of the first row in the map. The program continues to bend and insert the guide 20 until output values of the sensors match the expected initial sensor measurement 296 of the row (steps 304, 306 and 308), or until a limit is surpassed, an error message is displayed and the program is stopped (step 310).
Preferably, the initial values of the sensors are measured and then the program continues to extend or retract the guide 20 (step 312) until the sensors produce the final sensors measurements 298 values (step 314), while keeping in contact with the surface (steps 316 and 318) or until at least one of predefined limits is surpassed (step 320) where the program is stopped (step 310). If the final sensor measurements 298 values are measured the program proceeds to step 320 and loops through steps 302 and 320 until all the rows 292 of the table are processed. Then the program displays an insertion success message on the display 232 and halts (step 322).
As indicated by row No. 1 of Fig. 7 and Fig. 6C the guide is bent, preferably by up to 45 degrees, to the left in the plane of Fig. 6C and, while preserving contact with the left side of the intestine, is extended up to 5 centimeters or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 330.
As indicated by row No.2 of Fig. 7 and Fig. 6D the guide is bent by up to 45 degrees to the right in the plane of Fig. 6D and, while preserving contact with the left side of the intestine, is extended up to 2.5 centimeters or until the sensor tip does not sense the internal surface of the intestine at a point in the map 284 designated by reference numeral 332.
As indicated by row No.3 of Fig. 7 and Fig. 6E the guide is bent by up to 110 degrees to the left in the plane of Fig. 6E and, while preserving contact with the left side of the intestine, is extended by 1 centimeter to a point in the map 284 designated by reference numeral 334.
In accordance with row 4 of Fig. 7 and Fig. 6F the guide is bent by up to 45 degrees to the right in the plane of Fig. 6F and is extended by 6 centimeter to a point in the map 284 designated by reference numeral 336.
As indicated by row No.5 of Fig. 7 and Fig. 6G the guide is bent by up to 20 degrees to the right in the plane of Fig. 5G and, while preserving contact with the right side of the intestine, is extended by 4 centimeters to a point in the map 284 designated by reference numeral 338.
As indicated by row No.6 of Fig. 7 and Fig. 6H the guide is bent by up to -60 degrees to the left in the plane of Fig. 6H and is extended by up to 3 centimeters or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 340.
As indicated by row No.7 of Fig. 7 and Fig. 61 the guide is bent by up to 45 degrees to the right in the plane of Fig. 61 and is extended by up to 1 centimeter or until the sensor tip engages the internal surface of the intestine with its right side in a point in the map 284 designated by reference numeral 342.
As indicated by row No.8 of Fig. 7 and Fig. 6J the guide is extended by up to 1 centimeters or until the sensor tip engages the internal surface of the intestine with its left side at a point in the map 284 designated by reference numeral 344.
As indicated by row No.9 of Fig. 7 and Fig. 6K the guide is bent by up to 45 degrees to the right in the plane of Fig. 6K and is extended by up to 1 centimeter or until the sensor tip engages the internal surface of the intestine head on at a point in the map 284 designated by reference numeral 346.
In a preferred embodiment of the present invention the system and the method are operative for automatic operation. Alternatively the present invention can be operated manually, by providing to the operator the information collected by the sensor log 266 form the tip sensor 11 and enabling the operator to control manually the guide 20. In another alternative part of the procedure is performed automatically and another part is performed manually. For example, the guide 20 may be inserted automatically and a medical device, such as the tube 18 may be inserted manually.
It is appreciated that a log of the process of insertion of an insertable element into a living organism such as a human body is preferably stored in an internal . memory of the present invention and that this log can be transmitted to a host computer. It is appreciated that the host computer can aggregate insertion process logs and thereby continuously improve relevant insertion pattern maps such as the standard contour map 10. Thereafter, from time to time or before starting an insertion process, the present invention is capable of loading an updated map such as standard contour map 10.
It is also appreciated that the accumulated logs of processes of insertions can be employed to improve the algorithm for processing the maps, such as the algorithms shown and described with reference to Figs. 2A - 2F and Fig. 8. The improved algorithm can be transmitted to the present invention as necessary.
Reference is now made to Figs. 9A to 9F, which are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with a preferred embodiment of the present invention, in various operative orientations.
Turning to Fig. 9A, it is seen that the extendable endotracheal tube assembly, designated generally by reference numeral 400, preferably comprises a mounting element 402 which is arranged to be removably engaged with an intubator assembly (not shown) such as intubator assembly 12 (Figs. 1A - IL). Fixed to or integrally formed with mounting element 402 is a mouthpiece 404, which is preferably integrally formed with a rigid curved pipe 406. Fixedly mounted onto mounting element 402, interiorly of rigid curved pipe 406, is a mounting base 408 onto which is, in turn, mounted, an extendable tube 410, preferably including a coil spring 411, typically formed of metal. Fixedly mounted onto a distal end of extendable tube 410 there is preferably provided a forward end member 412, preferably presenting a diagonally cut pointed forward facing tube end surface 414.
Upstream of end surface 414, forward end member 412 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 416, which receives inflation gas, preferably pressurized air, preferably through a conduit 418 embedded in a wall of forward end member 412 and continuing through tube 410 to a one way valve 419.
It is noted that the extendable endotracheal tube assembly 400 may comprise an integrally formed mouthpiece assembly and an integrally formed insertable extendable tube assembly. The integrally formed mouthpiece assembly may comprise the mouthpiece 404 and the rigid curved pipe 406. The integrally formed extendable tube assembly may comprise the extendable tube 410, the mounting element 402, the mounting base 408, the coil spring 411, the forward end member 412 with the end surface 414 and the circumferential balloon 416, the conduit 418 and the one way valve 419.
Extending slidably through forward end member 412, tube 410, mounting base 408 and mounting element 402 is a flexible guide 420 which preferably corresponds in function inter alia to guide 20 in the embodiment of Figs 1A - IL and preferablv has mounted at a distal end thereof a tip 421, which preferably corresponds m structure and function inter aha to the tip 28 in the embodiment of Figs 1A - IL Tip 421 forms part of a tip sensor, preferably enclosed in guide 420, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs 1A - 1L
As distinct from that described hereinabove with reference to Figs 1A - 8 the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 422, which receives inflation gas, preferably pressurized air, preferably through a conduit 424 formed in flexible guide 420 and extending therealong, preferably to a source of pressurized inflation gas, preferably located within the intubator assembly (not shown)
Fig 9B shows inflation of balloon 422 by means of pressurized air supplied via conduit 424, causing balloon 422 to tightly engage the interior of forward end member 412
Fig 9C illustrates extension of tube 410, which is preferably achieved by forward driven movement of flexible guide 420 in tight engagement with forward end member 412, thus pulling forward end member 412 and the distal end of tube 410 forwardly therewith
Fig 9D illustrates inflation of balloon 416 by means of pressurized air through one way valve 419 and conduit 418 As will be described hereinbelow, this inflation is employed for sealing the tube 410 within a patient's trachea
Fig 9E illustrates deflation of balloon 422 following inflation of balloon 416, corresponding to desired placement and sealing of tube 410 within the patient's trachea Fig 9F illustrates removal of the flexible guide 420 from the tube 410
Reference is now made to Figs 10A to 10G, which are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs 9 A - 9F employed with the medical insertion device of Figs 1 A - 8 for the intubation of a human
Turning to Fig 10A, it is seen that the extendable endotracheal tube assembly, designated generally by reference numeral 500, preferably comprises a mounting element (not shown) which is arranged to be removably engaged with an intubator assembly 503 which is preferably similar to intubator assembly 12 (Figs. 1A - IL) or any other intubator assembly described hereinabove but may alternatively be any other suitable intubator assembly. Fixed to or integrally formed with the mounting element is a mouthpiece 504, which is preferably integrally formed with a rigid curved pipe 506. The extendable entotracheal tube assembly 500 is shown inserted into a patient's oral cavity, similar to the placement shown in Fig. 1A.
Fixedly mounted onto the mounting element, interiorly of rigid curved pipe 506, is a mounting base 508 onto which is, in turn, mounted, an extendable tube 510, preferably including a coil spring 511 (Fig. 10C), typically formed of metal. Fixedly mounted onto a distal end of extendable tube 510 there is preferably provided a forward end member 512, preferably presenting a diagonally cut pointed forward facing tube end surface 514.
Upstream of end surface 514, forward end member 512 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 516, which receives inflation gas, preferably pressurized air, preferably through a conduit 518 embedded in a wall of forward end member 512 and continuing through tube 510 to a one way valve 519.
It is noted that the extendable endotracheal tube assembly 500 may comprise a mouthpiece assembly and an extendable tube assembly, which is inserted therein. The mouthpiece assembly comprises the mouthpiece 504, which is integrally formed with the rigid curved pipe 506. The extendable tube assembly comprises the extendable tube 510, which is integrally formed together with the mounting element, the mounting base 508, the coil spring 511, the forward end member 512 with the end surface 514 and the circumferential balloon 516, the conduit 518 and the one way valve 519.
Extending slidably through forward end member 512, tube 510, mounting base 508 and the mounting element is a flexible guide 520, which preferably corresponds in function inter alia to guide 20 in the embodiment of Figs. 1A - IL and preferably has mounted at a distal end thereof a tip, which preferably corresponds in structure and function inter alia to the tip 28 in the embodiment of Figs. 1A - IL. The tip forms part of a tip sensor, preferably enclosed in guide 520, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs. 1A - IL.
As distinct from that described hereinabove with reference to Figs. 1A - 8, the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 522, which receives inflation gas, preferably pressurized air, preferably through a conduit 524 formed in flexible guide 520 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly 503.
The source of pressurized inflation gas may be an automatic inflator/deflator 526. Additionally or alternatively, a one way valve 528 may be provided for manual inflation. The automatic inflator/deflator 526 may be fixed within intubator assembly 503 or alternatively may be mounted therewithin for motion together with flexible guide 520.
Fig. 10B shows inflation of balloon 522 by means of pressurized air supplied via conduit 524, causing balloon 522 to tightly engage the interior of forward end member 512.
Fig. 10C illustrates extension of tube 510, which is preferably achieved by forward driven movement of flexible guide 520 in tight engagement with forward end member 512, thus pulling forward end member 512 and the distal end of tube 510 forwardly therewith.
Fig. 10D illustrates further extension of tube 510, by forward driven movement of flexible guide 520 in tight engagement with forward end member 512, thus pulling forward end member 512 and the distal end of tube 510 forwardly therewith. This further motion is preferably provided based on the navigation functionality described hereinabove with reference to Figs. 1A - 8. It is appreciated that the forward driven movement of tube 510 as described hereinabove with reference to Figs. 1A - 8, may be provided by driven forward motion of the flexible guide 520.
Fig. 10E illustrates inflation of balloon 516 by means of pressurized air through conduit 518 and one way valve 519. As will be described hereinbelow, this inflation is employed for sealing the tube 510 within a patient's trachea.
Fig. 10F illustrates deflation of balloon 522 following inflation of balloon 516, corresponding to desired placement and sealing of tube 510 within the patient's trachea Fig 10G illustrates removal of the flexible guide 520 from the tube 510
Reference is now made to Figs 11 A to 11F, which are a series of simplified pictorial illustrations of an extendable endotracheal tube assembly constructed and operative in accordance with another preferred embodiment of the present invention in various operative orientations
Turning to Fig 11 A, it is seen that the extendable endotracheal tube assembly, designated generally by reference numeral 600, preferably comprises a mounting element 602 which is arranged to be removably engaged with an intubator assembly (not shown) such as intubator assembly 12 (Figs 1A - IL) Fixed to or integrally formed with mounting element 602 is a mouthpiece 604
Fixedly mounted onto mounting element 602 is a mounting base 608 onto which is, in turn, mounted, an extendable tube 610, preferably including a coil spring 611, typically formed of metal Fixedly mounted onto a distal end of extendable tube 610 there is preferably provided a forward end member 612, preferably presenting a diagonally cut pointed forward facing tube end surface 614
Upstream of end surface 614, forward end member 612 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 616, which receives inflation gas, preferably pressurized air, preferably through a conduit 618 embedded in a wall of forward end member 612 and continuing through tube 610 to a one way valve 619
It is noted that the extendable endotracheal tube assembly 600, comprising at least one of mounting element 602, mouthpiece 604, mounting base 608, tube 610, coil spring 611, forward end member 612, end surface 614, circumferential balloon 616, conduit 618 and one way valve 619, may also be integrally formed as a unified structure
Extending slidably through forward end member 612, tube 610, mounting base 608 and mounting element 602 is a flexible guide 620, which preferably corresponds in function inter aha to guide 20 m the embodiment of Figs 1A - IL and preferably has mounted at a distal end thereof a tip 621, which preferably corresponds in structure and function inter aha to the tip 28 in the embodiment of Figs 1A - IL Tip 621 forms part of a tip sensor (not shown), preferably enclosed in guide 620, which preferably corresponds in structure and function inter alia to the tip sensor 11 in the embodiment of Figs. 1A - IL.
As distinct from that described hereinabove with reference to Figs. 1A - 8, the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 622, which receives inflation gas, preferably pressurized air, preferably through a conduit 624 formed in flexible guide 620 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly (not shown).
Fig. 11B shows inflation of balloon 622 by means of pressurized air supplied via conduit 624, causing balloon 622 to tightly engage the interior of forward end member 612.
Fig. 11C illustrates extension of tube 610, which is preferably achieved by forward driven movement of flexible guide 620 in tight engagement with forward end member 612, thus pulling forward end member 612 and the distal end of tube 610 forwardly therewith.
Fig. 11D illustrates inflation of balloon 616 by means of pressurized air through conduit 618 and one way valve 619. As will be described hereinbelow, this inflation is employed for sealing the tube 610 within a patient's trachea.
Fig. HE illustrates deflation of balloon 622 following inflation of balloon 616, corresponding to desired placement and sealing of tube 610 within the patient's trachea. Fig. 11F illustrates removal of the flexible guide 620 from the tube 610.
Reference is now made to Figs. 12A to 12G, which are a series of simplified pictorial illustrations of the extendable endotracheal tube assembly of Figs. 11 A - 1 IF employed with the medical insertion device of Figs. 1A - 8 for the intubation of a human.
Turning to Fig. 12A, it is seen that the extendable endotracheal tube assembly, designated generally by reference numeral 700, preferably comprises a mounting element (not shown) which is arranged to be removably engaged with an intubator assembly 703 which is preferably similar to intubator assembly 12 (Figs. 1A - 1 L) or any other intubator assembly described hereinabove but may alternatively be any other suitable intubator assembly. Fixed to or integrally formed with the mounting element is a mouthpiece 704 The extendable entotracheal tube assembly 700 is shown inserted into a patient's oral cavity, similar to the placement shown in Fig 1 A
Fixedly mounted onto the mounting element is a mounting base 708 onto which is m turn, mounted an extendable tube 710, preferably including a coil spring 71 1 (Fig 12C), typically formed of metal Fixedly mounted onto a distal end of extendable tube 710 there is preferably provided a forward end member 712, preferably presenting a diagonally cut pointed forward facing tube end surface 714
Upstream of end surface 714, forward end member 712 is preferably provided with an inflatable and radially outwardly expandable circumferential balloon 716, which receives inflation gas, preferably pressurized air, preferably through a conduit 718 embedded in a wall of forward end member 712 and continuing through tube 710 to a one way valve 719
It is noted that the extendable endotracheal tube assembly 700, comprising at least one of mounting element, mouthpiece 704, mounting base 708, tube 710, coil spring 711 (Fig 12C), forward end member 712, end surface 714, circumferential balloon 716, conduit 718 and one way valve 719, may also be integrally formed as a unified structure
Extending slidably through forward end member 712, tube 710, mounting base 708 and the mounting element is a flexible guide 720, which preferably corresponds in function inter aha to guide 20 in the embodiment of Figs 1A - IL and preferably has mounted at a distal end thereof a tip, which preferably corresponds m structure and function inter aha to the tip 28 m the embodiment of Figs 1A - IL The tip forms part of a tip sensor, preferably enclosed in guide 720, which preferably corresponds m structure and function inter alia to the tip sensor 11 in the embodiment of
Figure imgf000031_0001
As distinct from that described hereinabove with reference to Figs 1A - 8, the flexible guide is preferably formed with an inflatable and radially outwardly expandable balloon 722, which receives inflation gas, preferably pressurized air, preferably through a conduit 724 formed m flexible guide 720 and extending therealong, preferably to a source of pressurized inflation gas preferably located within the intubator assembly 703
The source of pressurized inflation gas may be an automatic inflator/deflator 726 Additionally or alternatively, a one way valve 728 may be provided for manual inflation The automatic inflator/deflator 726 may be fixed within intubator assembly 703 or alternatively may be mounted therewithin for motion together with flexible guide 720
Fig 12B shows inflation of balloon 722 by means of pressurized air supplied via conduit 724, causing balloon 722 to tightly engage the interior of forward end member 712
Fig 12C illustrates extension of tube 710, which is preferably achieved by forward driven movement of flexible guide 720 in tight engagement with forward end member 712, thus pulling forward end member 712 and the distal end of tube 710 forwardly therewith
Fig 12D illustrates further extension of tube 710, by forward driven movement of flexible guide 720 in tight engagement with forward end member 712, thus pulling forward end member 712 and the distal end of tube 710 forwardly therewith This further motion is preferably provided based on the navigation functionality described hereinabove with reference to Figs 1A - 8 It is appreciated that the forward driven movement of tube 710 as described hereinabove with reference to Figs 1A - 8, may be provided by driven forward motion of the flexible guide 720
Fig 12E illustrates inflation of balloon 716 by means of pressurized air through conduit 718 and one way valve 719 As will be descπbed hereinbelow, this inflation is employed for sealing the tube 710 within a patient's trachea
Fig 12F illustrates deflation of balloon 722 following inflation of balloon 716, corresponding to desired placement and sealing of tube 710 within the patient's trachea Fig 12G illustrates removal of the flexible guide 720 from the tube 710
Appendices 1 to 3 are software listings of the following computer files
Appendix 1 containing file mtumed asm
Appendix 2 containing file cδcdr mc
Appendix 3 containing file ram mc
The method for providing the software functionality of the microprocessor 278 in accordance with a preferred embodiment of the present invention includes the following steps 1. Provide an Intel compatible computer with a Pentium II CPU or higher, 128MB RAM, a Super VGA monitor and an available serial port.
2. Install Microsoft Windows 95 or Microsoft Windows 98 Operating System.
3. Install the Testpoint Development kit version 40 available from Capital Equipment Corporation, 900 Middlesex Turnpike, Building 2, Billereca, MA 0821, USA.
4. Connect a flash processor loading device COP8EM Flash, COP8 In Circuit Emulator for Flash Based Families to the serial port of the Intel compatible computer. The COP8EM flash processor loading device is available from National Semiconductors Corp. 2900 Semiconductor Dr., P.O.Box 58090, Santa Clara, CA 95052-8090, USA
5. Place a COP8CDR9HVA8 microcontroller available from National Semiconductors Corp, 2900 Semiconductor Dr., P.O.Box 58090, Santa Clara, CA 95052-8090, USA in the COP8EM Flash.
6. Copy the files intumed.asm, cδcdr.inc, and raminc, respectively labeled Appendix 1, Appendix 2 and Appendix 3 to a temporary directory.
7. Load the file intumed.asm by using the operating software available with the COP8EM Flash device from National Semiconductors.
8. To run the intumed.asm; Install the COP8CDR9HVA8 microcontroller in its socket in the electrical circuit, which detailed electronic schematics are provided in Figs. 5A to 5H, where the microcontroller is designated by reference numeral 278.
It is appreciated that the software components of the present invention may, if desired, be implemented in ROM (read-only memory) form. The software components may, generally, be implemented in hardware, if desired, using conventional techniques.
It is appreciated that the particular embodiment implemented by the Appendix is intended only to provide an extremely detailed disclosure of the present invention and is not intended to be limiting.
It is appreciated that various features of the invention which are, for clarity, described in the contexts of separate embodiments may also be provided in combination in a single embodiment. Conversely, various features of the invention which are, for brevity, described in the context of a. single embodiment may also be provided separately or in any suitable subcombination.
It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove as well as variations and modifications which would occur to persons skilled in the art upon reading the specification and which are not in the prior art.
Appendices 1 through 3 are as follows:
Appendix 1
; Files: intumed.asm, ram.inc and c8cdr.inc.
UPPERCASE
; verify
.TITLE intumed
.LIST Off complete listing. ; X'040
.CONTRL 3 ; 0- disable all code alteration, 3- re-enable code alteration.
.incld cδcdr.inc ; File that include all the definitions of copδcdr. .incld ra inc ; File that include all the variables, constants, registers and
; bits definitions.
; CONFIGURATION
.sect option,conf
. db 01 ; 5=0 security dis, 2=0 wdog dis, 1=0 halt dis, 0=1 flex.
; flex=l -execution following reset will be from flash memory. ; flex=0 -flash memory is erased, execution following reset will be from
; boot rom with the mictowire plus isp routines.
.sect begin _rst,rom,abs=0 reset: rpnd
) Clear memory
Id s,#0 Clean segmentO 0-6fH.
Id b,#0
Id a,#06f ; Cleans the memory between stOO: Id [b+],#0 b to a ifgt a,b jmp stOO
LD SP,#01e ; Stack Pointer in Memory leH. The stack works in LIFO
(last
Id 01e,#0ff ; in first out) with "push a" and "pop a" instructions. Id Olf Off ; The stack starts from leH until OH. ld s,#l ; Clean si 0-7fH. id b,#0 ;
Id a,#07f ; Cleans the memory between stOl : ld [b+] 0 ; b to a ifgt a,b ; jmp stOl
Id s,#2 , Clean s2 0-7fh
Id b,#0
Id a,#07f , Cleans the memory between st02
Figure imgf000036_0001
Id 05c 'E' , when the pc send moving command, the cop8 transmit packets of
Id 05d,#'D' , information every 160 msec in every packet We have 10 blockes of
, 9 bytes in si and 10 in s2 At the end of the packet there is 1 , byte of check sum and then the 2 bytes of 'E','D' to signal , end of transmιtιon
Id s,#0 , — port definitions — see ram mc for bits definitions
Id pgc,#033, clkdly enabled , g2=tlb=cha2,g3=tla=chal - inputs
Id pg,#0 , sk idle phase=0
Id plc,#057
Id pl,#0af
Id pbc,#010, b0-3 = a2d(m), b5-7 = limit swιtches(m)
Id pb,#0f0
Id pac,#0ff
Id pa,#03
UART initialization — Id enu,#0 , no parity, 8 bit data Id enur,#0 Id enuι,#022 , 1 stop bit, Asynch mode,psr+baud clock
, enable receive int , disable trans int Id baud,#4 , 38400 baud rate Id psr,#060 , 10MHz*2 /(16*(4+1)*6 5)
LCD initialization jsr lmtjcd
Id temp,#low(wordmm), type in line 1 of led " mm ", in the left side there is jsr type_stπng0 , space for 3 digits of mm, and in the right side 3 spaces for
, direction (+/- up/down) and 2 digits of movement Id temp,#low(wordpoweron) jsr type_stπngl
PWM,T0,interupts initialization Id cntrl,#080 , timer 1 - pwm mode - stopped
Id a,#0ff , timer 1 would be used in capture mode, meamng that pulse x a,tmrllo , received from linear motor will capture the value of timer 1
Id a Off , in timer 1 auto reload A (tlrahi/lo) and pulse from angular
\ a,tmrlhι , motor in B (tlrbhi/lo)
Id t2cntrl,#0a0 , timer 2 - pwm toggle mode stopped
Id t3cntrl #0a0 , timer 3 - pwm toggle mode stopped sbit t2a,pl , enable linear motor and lock it by putting 0 in controll ,2 sbit t3a,pl . enable angular motor and lock it by putting 0 m control3,4 sbit t2hs,hstcr sbit t3hs,hstcr Id cntrl,#060 , timer 1 - capture mode rbit tlpndb,ιcntrl sbit tlenb,ιcntrl , timer 1 - capture mode, t2enB=l rbit tlpnda,psw sbit tlena,psw , timer 1 - capture mode, t2enA=l sbit ιtsel0,ιtmr , 8,192 inst cycles - 4,096 m sec timer 0 interrupts rbit t0pnd,icntrl sbit tOeiycntrl , start timerO
Program initialization sbιt 7,pis_yl , pls_y=08000H
, over 80 is positive angle and under 80 is negative angel Id data_cntr,#21 sbit stop2,aflags sbit dιrectιon,lflags sbιt stopl ,lflags sbit en_calc,lflags Id pls_xl,#068 sbit lιmιts_c_en,hmιts_flags sbit home_command,buttons_flags sbit gιe,psw , enable interupts
Figure imgf000037_0001
sect pc_module,rom main ifbit lιmιts_c_en,lιmιts_flags jsr hmιts_check ifbit start_stop buttons_flags jsr autorun_states ifbit stop_command,buttons_flags jsr stop_operation ifbit buttons_t_en,buttons_flags jsr buttons_test ifbit home_command,buttons_flags jsr home_p_states ifbit self_t_command,buttons_flags jmp self_t_states mainO jmp hnear_states ; hnear_states + angular_states. mainl . jsr updatelcd ifbit a2den,flags2 ; a2d check, jsr a2d00
Id a,#0 add a,linear__stat add a,ang_stat add a,autorun_stat add a,selft_stat add a,home_stat
Figure imgf000038_0001
sbit enddata,flagsl ; if 2 motors are stopped, set enddata bit to stop transmitting to PC.
Id a,buttons_flags and a,#09e , if one of the commands flags is set, reset enddata bit.
Figure imgf000038_0002
rbit enddata, flags 1 ifbit enddata,flagsl rbit start, flags 1 ifbit fix_t_en,flags2 jsr data send
Figure imgf000038_0003
.sect autorun_select,rom,inpage autorun_states:ld a,autorun_stat add a,#low(jmp_a__r_stat) jid ; jmp pcu,[a] jmp_a_r_stat addr a_r0,a_rl,a_r2,a_r3,a_r4,a_r5,a_r6,a_r7,a_r8,a_r9,a_rl0,a_rll,a_rl2;,a_rl3,a_rl4 a_r0 jmp a_r_stat0 a_rl jmp a_r_statl a_r2 jmp a_r_stat2 a_r3 jmp a_r_stat3 a r4 jmp a_r_stat4 a_r5 jmp a_r_stat5 a r6 jmp a_r_stat6 a_r7 jmp a_r_stat7 a r8 jmp a_r_stat8 a_r9 jmp a_r_stat9 a_rl D: jmp a_r_statl0 a_rl 1 : jmp a_r_statl l a_rl 2: jmp a_r_statl2
;a_r 13 : j mp a_r_stat 13
;a_rl4: jmp a_r_statl4 end_a_r_stat:ret
.sect autorun,rom a_r_statO:ld autorun_stat,#l
Id home_stat,#0 sbit home_command,buttons_flags a_r_statl : ifbit home_command,buttons_flags ret
Id linear_stat,# 1 ; move linear forwards 1mm.
Id rbytel ,#08 ; 0,1,2=0= speed 1 ; 3=1= direction forwards ; 4=0= linear motor. ld rbyte2,#136
Id rbyte3,#0 ; lmm*136pulse per mm = 136 pulses.
Id autorun_stat,#2
Id temp,#low(wordautorun) jsr type_stringl a_r_statl_l :rbit limits_c_en,limits_flags rbit stop l,lflags rbit stuck,flagsl a_r_stat 1 _2 : s bit fix_t_en,flags2 jmp end_a_r_stat a_r_stat2:ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp a_r_stat2_0 jmp end_a_r_stat a_r_stat2_0:ld a,halll x a,zero_hl Id a,hal!2 x a,zero_h2 rbit home,flagsl
Id ang_stat,#l , move angular down 2000 pulses ld rbytel,#010 , 0,1,2=0= speedl , 3=0= direction down , 4=1= angular motor
Id rbyte2,#low(2000) ld rbyte3,#hιgh(2000) rbit stop2,aflags Id autorun_stat,#3 rbit stuck,flagsl imp a_r_statl_2 a_r_stat3 Id lmear_stat,# l , move linear forwards 40mm ld rbytel,#08 0,1,2=0= speedl , 3=1= direction forwards , 4=0= linear motor
Id rbyte2,#low(5440)
Id rbyte3,#hιgh(5440) , 40mm*136pulse per mm = 5440
Id autorun_stat,#4 imp a_r_statl_l a_r_stat4 jsr epι_check , check if epiglotis sensed ifbit epι,flagsl imp a_r_stat4_0 ifeq lmear_stat,#0 , wait until linear motor complete mission jmp a_r_stat7_0 imp end_a_r_stat a_r_stat4_0 Id lιnear_stat,# 1 , move linear backwards 6mm ld rbytel,#0 , 0,1,2=0= speedl , 3=0= direction backwards ,
4=0= linear motor ld rbyte2,#low(816)
Id rbyte3,#hιgh(816), 6mm*136pulse per mm = 816
Id autorun_stat#5 jmp a_r_statl_l a_r_stat5 ifeq hnear_stat,#0 , wait until linear motor complete mission )mp a_r_stat5_0 jmp end_a_r_stat a_r_stat5_0 Id ang_stat,#l , move angular up 70 pulses ld rbytel,#018 , 0,1,2=0= speedl , 3=1= direction up , 4=1= angular motor
Id rbyte2,#70
Id rbyte3,#0
Id autorun_stat,#6 rbit stop2,aflags jmp a_r_statl_2 a_r_stat6:ifeq ang_stat,#0 ; wait until angular motor complete mission, jmp a_r_stat6_0 jmp end_a_r_stat a_r_stat6_0:rbit epi,flagsl
Id linear_stat,#l ; move linear forwards 10mm.
Id rbytel,#08 ; 0,1,2=0= speedl ; 3=1= direction forwards ; 4=0= linear motor.
Id rbyte2,#low(1360) ld rbyte3,#high(1360) ; 10mm*136pulse per mm = 1360.
Id autorun_stat,#7 jmp a_r_statl_l a_r_stat7:ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp a_r_stat7_0 jmp end_a_r_stat
a_r_stat7_0:ld ang_stat,#l ; move angular down 2000 pulses. ld rbytel,#010 ; 0,1,2=0= speedl ; 3=0= direction down ; 4=1= angular motor.
Id rbyte2,#low(2000) ld rbyte3,#high(2000)
Id autorun_stat,#8 rbit stop2,aflags rbit stuck,flagsl jmp a_r_statl_2 a_r_stat8:;ld linear_stat,#l ; move linear forwards 50mm.
;ld rbytel,#08 . ; 0,1,2=0= speedl ; 3=1= direction forwards ; 4=0= linear motor.
;ld rbyte2,#low(8160)
;ld rbyte3,#high(8160) ; 50mm*136pulse per mm = 6800.
Id pls_cntr0,#low(6800)
Id pls_cntrl,#high(6800) ; 50mm*136pulse per mm = 6800. sbit direction flags ; turn motor forwards rbit t2c0,t2cntrl sbit t2a,pl rbit control2,pa sbit contrail, pa
Id linear_stat,#6 rbit en_calc,lflags
Id autorun_stat,#9 jmp a_r_statl_l a_r_stat9:ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp a_r_stat9_0 jmp end_a_r_stat a_r_stat9_0:ld ang_stat,#l ; move angular up 2000 pulses. ld rbytel,#018 ; 0,1,2=0= speedl ; 3=1= direction up ; 4=1= angular motor.
Id rbyte2,#low(2000) ld rbyte3,#high(2000)
Id autorun_stat,#10 rbit stop2,aflags jmp a_r_statl_2 a_r_statl O:;ld linear_stat,#l ; move linear forwards 70mm.
;ld rbytel ,#08 ; 0, 1,2=0= speedl ; 3=1= direction forwards ; 4=0= linear motor.
;Id rbyte2,#low(9520)
;ld rbyte3,#high(9520) ; 70mm*136pulse per mm = 9520.
Id pls_cntr0,#low(9520)
Id pls_cntrl,#high(9520) ; 70mm*136pulse per mm = 9520. sbit direction,lflags ; turn motor forwards rbit t2c0,t2cntrl sbit t2a,pl rbit control2,pa sbit controll,pa
Id linear_stat,#6
Id autorun_stat,#l l jmp a_r_statl_l a_r_statl 1 :ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp a_r_statl l_0 jmp end_a_r_stat
a_r_statl l_0:sbit stop2,aflags rbit I3c0,t3cntrl sbit t3a,pl sbit control3,pa ; turn off motor 2 sbit control4,pa
;ld linear_stat,#l ; move linear forwards 50mm. ;ld rbytel,#08 ; 0,1,2=0= speedl ; 3=1= direction forwards ; 4=0= linear motor.
;ld rbyte2,#low(6800)
;ld rbyte3,#high(6800) ; 50mm*136pulse per mm = 6800.
Id pls_cntr0,#low(6800)
Id pls_cntrl,#high(6800) ; 50mm*136pulse per mm = 6800. sbit direction,lflags ; turn motor forwards rbit t2c0,t2cntrl sbit t2a,pl rbit control2,pa sbit controll,pa
Id linear_stat,#6
Id autorun_stat,#12 jmp a_r_statl_l a_r_stat 12 : ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp a_r_statl2_0 jmp end_a_r_stat a_r_statl2_0:ld autorun_stat,#0 jsr stop2motors sbit en_calc,lflags rbit start_stop,buttons_flags rbit stuck, flags 1 Id temp,#Iow(wordinplace) jsr type_stringl jmp end_a_r_stat
epi_check:;ld a,#4
;ifgt a,pls_xl
;ret sc
Id a,halll ifgt a,zero_hl jmp epi_checkO_l
Id a,zero_hl subc a,halll jmp epi_check0_2 epi_checkO_l :subc a,zero_hl epi_check0_2:ifgt a,#20 sbit epi,flagsl sc
Id a,hall2 ifgt a,zero_h2 jmp epi_check0_3
Id a,zero_h2 subc a,hall2 jmp epi_check0_4 epi_check0_3:subc a,zero_h2 epi_checkO_4:ifgt a,#20 sbit epi,flagsl ret sect l_s_select,rom,mpage hnear_states Id a,hnear_stat add a,#low(]mp_l_stat)
Figure imgf000044_0001
jmp_l_stat addr l_sO,l_s 1 ,l_s2,l_s3 ,1_S4,1_S5,1_S6 l_sO imp l_statO l_sl )mp l_statl l_s2 )mp l_stat2 l_s3 jmp l_stat3 l_s4 imp l_stat4 l_s5 imp l_stat5 l_s6 imp l_stat6 end_l_stat jmp angular_states sect hnear_states,rom l_statO ifbit pulse,lflags imp l_statO_01 , the motor made another pulse after stop order jmp e_l_stat0 l_stat0_01 rbιt pulse,lflags ifbit dιrectιon,lflags , x update jmp l_stat0_03 , x forwards
Id a,pls_xl , before decreasing pls_x, check if pls__x>l lfne a,#0
Figure imgf000044_0002
imp e_l_stat0 , do not decrease pls_x if 0 statO 02 sc
Id a,pls_x0 , x downwards subc a,#l x a,pls_x0
Id a,pls_xl subc a,#0 x a,pls_xl jmp e_l_stat0 l_stat0_03:rc ; x forwards
Id a,pls_x0 adc a,#l x a,pls_x0 Id a,pls_xl adc a,#0 x a,pls_xl e_l_statO:jmp end_l_stat ; ->0
l_statl : ifbit direction,lflags ; check the previous direction, jmp l_statl_02
; the direction was backwards, ifbit new_direction,rbytel ; check the new direction, jmp l_statl_01 jmp l_stat3 l_statl_01 :ld nxt_l_stat,#4 ; change direction to forwards, jmp l_statl_05
; the direction was forwards. l_statl_02: ifbit new_direction,rbytel ; check the new direction, jmp l_stat4
Id a,pls_xl ; before changing diretion to backwards ifne a,#0 ; check if pls_x=0. jmp l_statl_04 ; if not then...
Id a,pls_x0 ifne a,#0 jmp l_statl_04 l_statl_03:ld linear_stat,#0 ; if 0 thenjust stop motor, sbit stopl ,lflags ; stop motor 1. rbit stop,flagsl sbit limits_c_en,limits_flags sc ifbit stop2,aflags re ifc jmp l_statl_06 rbit start, flags 1 sbit end,flagsl sbit type_end,lcd_flags jmp l_statl_06 l_statl_04:ld nxt_l_stat,#3 ; stop motor, wait and then ; change direction to backwards. l_statl_05:ld linear_stat,#2
Id cd_dly,#020 l_statl_06:rbit t2c0,t2cntrl sbit t2a,pl rbit controll ,pa ; stop motor 1. rbit control2,pa jmp end_l_stat ; ->O l_stat2: ifeq cd_dly,#0 ; delay before changing direction. jmp l_stat2_01 jmp end_l_stat ; ->0 l_stat2_01 :ld a,nxt_l_stat x a,linear_stat jmp end_l_stat ; ->0 l_stat3: Id a,pls_xl ; the direction is still backwards, ifne a,#0 ; check if pls_x=0 jmp l_stat3_01 ; if not then... Id a,pls_xO ifne a,#0 jmp l_stat3_01 jmp l_statl_03 ; if 0 then just stop motor and
; return to linear stat 0. l_s tat3 _01 : ifb it home_limit,pbi jmp l_stat3_02 jmp l_statl_03 l_stat3_02:rbit direction,lflags ; turn motor backwards. rbit t2c0,t2cntrl sbit t2a,pl rbit controll, pa sbit control2,pa rbit t2a,pl jmp l_stat4_02 l_stat4: ;ld a,pls_xl ; 255mm*128pulsepermm=7f80H
;ifgt a,#0fe ; if pls_x>7f00H then stop motorl . ymp l_statl_03 ifbit bottom_limit,pbi jmp l_stat4_01 jmp l_statl_03 Id linear_stat,#0 sbit sto l,lflags jmp end_l_stat l_stat4_01 :sbit direction,lflags ; turn motor forwards rbit t2c0,t2cntrl sbit t2a,pl rbit control2,pa sbit controll, pa rbit t2a,pl l_stat4_02:ld a,rbyte2 ; distanse update x a,pls_cntrO Id a,rbyte3 x a,pls_cntrl Id a,rbytel ; velosity update and a,#7 ifne a,#0 jmp l_stat4_03 ld t_ref0,#Iow(1000) 1000 -> 500u per pulse Id t_refl,#high(1000) jmp end_l_stat4 l_stat4__03:ifne a,#l jmp l_stat4_04 Id t_ref0,#low(2000) ; 2000 -> 1000u per pulse ld t_refl,#high(2000) jmp end_l_stat4 l_stat4_04:ifne a,#2 jmp l_stat4_05 Id t_refϋ,#low(3000) ; 3000 -> 1500u per pulse Id t_refl,#high(3000) jmp end_I_stat4 l_stat4_05:ifne a,#3 jmp end_l_stat4 Id t_ref0,#low(4000) ; 4000 -> 2000u per pulse ld t_refl,#high(4000) end_l_stat4: l_stat5: ifbit t2c0,t2cntrl ; if motor 1 is already on. jmp e_l_stat5 rbit fιrst_pulse,lflags rbit t2cl,t2cntrl ; turn off the toggle output. rbit t2a,pl
Id ptlhi,#020 Id pt2hi,#080
Id tmr21o,#0ff ld tmr2hi,#0ff Id t2ralo,#0ff Id t2rahi,#0ff Id t2rblo,#0ff Id t2rbhi,#0ff rbit t2pndb,t2cntrl sbit t2cO,t2cntrl ; start timer 2 - pwm. I_stat5_01 :ifbit t2pndb,t2cntrl jp l_stat5_02 jp l_stat5_01 l_stat5_02:rbit t2c0,t2cntrl ; stop timer 2 - pwm.
Id tmr21o,#250 ; 250->t2.
Id tmr2hi,#0
Id t2ralo,#low(400) ; 400->r2a.
Id t2rahi,#high(400)
Id t2rblo,#low(600) ; 600->r2b.
Id t2rbhi,#high(600) rbit t2a,pl sbit t2cl,t2cntrl ; turn on the toggle output. sbit t2c0,t2cntrl ; start timer 2 - pwm. ; rbit stop l,lflags e_l_stat5:ld a,int_cntr sc subc a,#20 x a,nolpulsetmr sbit limits_c_en,limits_flags
Id linear_stat,#6
Id nxt_l_stat,#0 jmp end_l_stat ; ->0
l_stat6: ifbit pulse, lflags jmp l_stat6_01 Id a,nolpulsetmr ifne a,int_cntr jmp l_stat6__05 sbit stopl, lflags sbit stuck,flagsl jmp l_stat6__05 l_stat6_01 :rbit pulse,lflags Id a,int_cntr sc subc a,#20 x a,nolpulsetmr sbit limits_c_en,limits_flags sc ; dec. pls_cntr
Id a,pls_cntrO subc a,#l x a,pls__cntrO Id a,pls_cntrl subc a,#0 x a,pls_cntrl
Id a,pls_cntrl ; check if pls_cntr=0 ifne a,#0 jmp l_stat6_02
Id a,pls_cntrO ifne a,#0 jmp l_stat6_02 sbit stop 1, lflags l_stat6_02:;ifbit first_pulse,lflags sbit en_calc, lflags sbit first_pulse,lflags ifbit direction,lflags ; xjαpdate jmp I_stat6_04
Id a,pls_xl ; check if pls_x>l ifne a,#0 jmp l_stat6_03
Id a,pls_x0 ifgt a,#0 jmp l_stat6_03 ld pls_xO,#0 sbit stopl, lflags
Id nxt_l_stat,#0 jmp l_stat6_05
l_stat6_03:sc ; x_downwards
Id a,pls_xO subc a,#l x a,pls_xO
Id a,pls_xl subc a,#0 x a,pls_xl jmp l_stat6__05 l_stat6_04:rc ; x_forwards
Id a,pls_xO adc a,#l x a,pls_xO
Id a,pls_xl adc a,#0 x a,pls_xl ifgt a,#086 ; the led can show only 256 mm (= 256*136=34816=08800H). sbit sto l, lflags l_stat6_05:ifbit stopl, lflags jmp e_l_stat6 ifbit enl_calc,lflags jsr v_calc jmp end_l_stat ; ->0 e_l_stat6:rbit t2c0,t2cntrl sbit t2a,pl rbit controll ,pa ; turn off motor 2. rbit control2,pa Id a,nxt_l_stat x a,linear_stat ifbit stop2,aflags jmp e_l_stat6_0 jmp end_l_stat ; ->0 e_l_stat6_0 : rbit startflagsl rbit stop,flagsl ifbit self_t_command,buttons_flags jmp end_l_stat ; ->0 ifbit start_stop,buttons_flags jmp end_l_stat ; ->0 ifbit home_command,buttons_flags jmp end_l_stat ; ->0 sbit type_end,lcd_flags sbit end,flagsl jmp end_l_stat ; ->0
.sect a_s_select,rom,inpage angular_states:ld a,ang_stat add a,#low(jmp_a_stat) jid ;jmp pcu,[a] jmp_a_stat: .addr a_s0,a_sl,a_s2,a_s3,a_s4,a_s5,a_s6,a_s7 a_s0: jmp a_statO a_sl : jmp a_statl a_s2: jmp a_stat2 a_s3: jmp a_stat3 a_s4: jmp a_stat4 a_s5: jmp a_stat5 a_s6: jmp a_stat6 a_s7: jmp a_stat7 end_a_stat:jmp mainl
.sect angular_states,rom a_statO: ifbit pulse2,aflags jmp a_stat0_01 jmp e_a_statO a_stat0_01 :rbit pulse2,aflags ifbit direction2,aflags ; y update jmp a_stat0_02 jmp a_statO_03 a_statO_02:sc ; y down
Id a,pls_yO subc a,#l x a,pls_yO Id a,pls_yl subc a,#0 x a,pls_yl jmp e_a_statO a_statO_03:rc ; y up
Id a,pls_yO adc a,#l x a,pls_yO Id a,pls_yl adc a,#0 x a,pls_yl e_a_s tatO : j mp end_a_stat ; ->0 a_statl :
Id a,pls_y 1 ; check if the the probe is not too high or to low. ifgt a,#094 jmp a_statl_00
Id a,#066 ifgt a,pls_yl jmp a_statl_01 jmp a_statl_03 ;a_statl_00: ifbit new_direction,rbytel ; if too high enable only down movment. jmp a_statl_02 jmp a_statl_03 ;a_statl_01 :ifbit new_direction,rbytel ; if too low enable only up movment. jmp a_statl_03 jmp a_statl_02
;a_statl_02 : Id ang_stat,#0 ; just stop motor. Id nxt_a_stat,#0 sbit stop2,aflags ; stop motor 2. sbit type_end,flags2 jmp a_statl_08 a_statl_03 : ifbit direction2,aflags ; check the previous direction, jmp a_statl_05 ifbit new_direction,rbytel ; the direction was down-check the new direction. jmp a_statl_04 jmp a_stat3 a_statl_04:ld nxt_a_stat,#4 ; stop motor, wait and then change direction to up. jmp a_statl_07 a_stat 1_05 : ifbit new_direction,rbytel ; the direction was up-check the new direction, jmp a_stat4 a_statl_06:ld nxt_a_stat,#3 ; stop motor, wait and then change direction to down. a_statl_07:ld ang_stat,#2 ; delay for the motor to make a complete stop. ld cd_dly,#17 a_statl_08:rbit t3cO,t3cntrl sbit t3a.pl sbit control3,pa ; stop motor 2. sbit control4,pa jmp end_a_stat ; ->0 a_stat2: ifeq cd_dly,#0 ; delay before changing direction. jmp a_stat2_01 jmp end_a_stat ; ->0 a_stat2_01 :ld a,nxt_a_stat x a,ang_stat jmp end_a_stat ; ->0
* a_stat3: rbit direction2,aflags ; turn motor backwards, rbit t3c0,t3cntrl sbit t3a,pl rbit control3,pa sbit control4,pa rbit t3a,pl jmp a_stat4_01 a_stat4: sbit direction2,aflags ; turn motor forwards rbit t3c0,t3cntrl sbit t3a,pl rbit control4,pa sbit control3,pa rbit t3a,pl a_stat4_01 :ld a,rbyte2 ; distanse update x a,plsy_cntr0 Id a,rbyte3 x a,plsy_cntrl
Id a,rbytel ; velosity update and a,#7 ifne a,#0 jmp a_stat4_02
'id at_ref0,#low(6000) ; 6000 -> 3000u per pulse
Id at_refl,#high(6000) jmp end_a_stat4 a_stat4_02:ifne a,#l jmp a_stat4_03
'id at_ref0,#low(7000) ; 7000 -> 3500u per pulse ld at_refl,#high(7000) jmp end_a_stat4 a_stat4_03:ifne a,#2 jmp a_stat4_04
'id at_ref0,#low(8000) 8000 -> 4000u per pulse ld at_refl,#high(8000) jmp end_a_stat4 a_stat4_04:ifne a,#3 jmp end_a_stat4
'id at_ref0,#low(9000) 9000 -> 4500u per pulse
Id at_refl,#high(9000) end_a_stat4:ld nxt_a_Stat,#6 ***************************************************** a_stat5: ;ifbit t3c0,t3cntrl ; if motor 2 is already on. mp e_a_stat5
Id aptlhi,#020 Id apt2hi,#080 rbit firsty_pulse,aflags rbit t3 c 1 ,t3 cntrl ; turn off the toggle output, rbit t3a,pl ld tmr31o,#0ff Id tmr3hi,#0ff Id t3ralo,#0ff Id t3rahi,#0ff Id t3rblo,#0ff Id t3rbhi,#0ff rbit t3pndb,t3 cntrl sbit t3c0,t3cntrl ; start timer 3 - pwm. a_stat5_01 : ifbit t3pndb,t3 cntrl jp a_stat5_02 jp a_stat5_01 a_stat5_02:rbit t3c0,t3cntrl ; stop timer 3 - pwm.
Id tmr31o:#250 ; 250->t3.
Id tmr3hi,#0
Id t3ralo,#low(500) ; 500->r3a.
Id t3rahi,#high(500)
Id t3rblo,#low(500) ; 500->r3b.
Id t3rbhi,#high(500) rbit t3a,pl sbit t3cl,t3cntrl ; turn on the toggle output. sbit t3c0,t3 cntrl ; start timer 3 - pwm. e_a_stat5:;ld a,int_cntr
;sc
;subc a,#50
;x a,noapulsetmr
Id a,nxt_a_stat x a,ang_stat
Id nxt_a_stat,#0 jmp end_a_stat ; ->O a_stat6: ifbit pulse2,aflags jmp a_stat6_01
;ld a,noapulsetmr ;ifne a,int_cntr ;jmp a_stat6_06 ;sbit stop2,aflags ;sbit stuck,flagsl jmp a_stat6_06 a_stat6_01 :rbit pulse2,aflags ;ld a,int_cntr ;sc
;subc a,#50 ;x a,noapulsetmr sc ; dec. plsy_cntr
Id a,plsy_cntrO subc a,#l x a,plsy_cntrO Id a,plsy_cntrl subc aJO x a,plsy_cntrl
Id a,plsy_cntrl ; check if plsy_cntr=0 ifne a,#0 jmp a_stat6_02 Id a,plsy_cntr0 ifne a,#0 jmp a_stat6_02 sbit stop2,aflags Id nxt a stat,#0 a_stat6_02 ,ιfbιt fιrsty_pulse,aflags sbit en_calc2,aflags sbit firsty_pulse,aflags ifbit dιrectιon2,aflags , y_update jmp a_stat6_04
Id a,pls_y 1 , check if pls_y>6500H ifgt a,#0 , 065 jmp a_stat6_03 sbit stop2,aflags
Id nxt_a_stat,#0 imp a_stat6_06 a_stat6_03 sc , y_down
Id a,pls_yO subc a,#l \ a,pls_yO Id a,pls_yl subc a,#0 a,pls_yl jmp a_stat6_06 a_stat6_04 Id a,#Off , 096 ifgt a,pls_yl jmp a_stat6_05 sbit stop2,aflags Id nxt_a_stat,#0 jmp a_stat6_06 a_stat6_05 re , y_up
Id a,pls_yO adc a,#l \ a,pls_yO Id a,pls_yl adc a,#0 \ a,pls_yl a_stat6_06 ifbit stop2,aflags jmp e_a_stat6 ifbit enl_calc2 aflags jsr v2_calc jmp end_a_stat , ->0 e a stat6 rbit t3c0,t3 cntrl
Figure imgf000055_0001
sbit controls. pa ; turn off motor 2 sbit control4,pa Id a,nxt_a_stat x a,ang_stat ifbit stopl, lflags jmp e_a_stat6_0 jmp end_a_stat ; ->0 e__a_stat6_0:rbit start,flagsl rbit stop,flagsl ifbit self_t_command,buttons_flags jmp end_a_stat ; ->0 ifbit start_stop,buttons_flags jmp end_a_stat ; ->0 ifbit home_command,buttons_flags jmp end_l_stat ; ->0 sbit end,flagsl sbit type_end,lcd_flags ifbit stuck,flagsl sbit type_stuck,lcd_flags jmp end_a_stat ; ->0
a_stat7: ifbit pulse2,aflags jmp a_stat7_01 jmp e_a_stat7 a_stat7_01 :rbit pulse2,aflags ifbit direction^, aflags ; y update jmp a_stat0_03 a_stat7_02:sc ; y down
Id a,pls_yO subc a,#l x a,pls_yO Id a,pls__yl subc a,#0 a,pls_yl jmp e_a_stat7 a_stat7_03:rc ; y up
Id a,pls_yO adc a,#l x a,pls_yO ld a,pls_yl adc a,#0 x a,pls_yl e_a_stat7:jmp end_a_stat ; ->0
.sect stop_subroutines,rom stop2motors:sbit stopl, lflags ; turn off motor 1 rbit t2c0,t2cntrl sbit t2a,pl rbit controIl,pa rbit control2,pa
Id linear_stat,#0
Id nxt_l_stat,#0 sbit stop2,aflags ; turn off motor 2 rbit t3c0,t3 cntrl sbit t3a,pl sbit control3,pa sbit control4,pa
Id ang_stat,#0
Id nxt_a_stat,#0 ret stop_operation:rbit stop_command,buttons_flags jsr stop2motors sbit en_calc,lflags sbit fix_t_en,flags2 rbit enddata, flags 1 rbit start,flagsl rbit end,flagsl sbit stop,flagsl sbit type_stop,lcd_flags rbit self_t_command,buttons_flags
Id selft_stat,#0 rbit start_stop,buttons_flags
Id autorun_stat,#0 rbit home_command_pc,buttons_flags rbit home_command,buttons_flags
Id home_stat,#0 ret
.sect s_t_select,rom,inpage self_t_states:ld a,selft_stat add a,#low(jmp_st_stat) jid ; jmp pcu,[a] jmp_st_stat: .addr S_t0,s_tl,s_t2,s_t3,s_t4,s_t5,s_t6 s_t0 jmp self_test0 s_tl jmp self estl s_t2 jmp self_test2 s_t3 jmp self_test3 s t4 jmp self_test4 s_t5 jmp self_test5
Figure imgf000058_0001
end_st_stat jmp mainO sect self_test,rom self estO Id temp,#low(wordselftest) jsr type_strmgl ifbit home_hmιt,pbι imp self_test0_0 , 1-mιcro switch open - not in home position rbit home_command,buttons_flags
Id home_stat,#0 jmp self_testl_0 , 0-mιcro switch closed - in home position self_testO_0 sbit home_command,buttons_flags Id home_stat,#0 Id selft_stat,#l jmp end_st_stat self_testl ifbit home_command,buttons_flags imp end_st_stat self_testl_0 Id hnear_stat,#l , move linear forwards 50mm ld rbytel,#08 , 0,1,2=0= speedl , 3=1= direction forwards , 4=0= linear motor
Id rbyte2,#low(6850)
Id rbyte3,#hιgh(6850) , 50mm*136pulse per mm = 6800
Id selft_stat,#2 self_testl_l rbit lιmιts_c_en,lιmιts_flags rbit stopl, lflags self_testl_2 ]mp end_st_stat self_test2 ifeq hnear_stat,#0 , wait until linear motor complete mission jmp self_test2_0 imp end_st_stat self_test2_0 Id ang_stat#l , move angular up 150 pulses ld rbytel,#018 , 0,1,2=0= speedl , 3=1= direction up , 4=1= angular motor
Id rbyte2,#150
Id rbyte3,#0
Id selft_stat.#3 rbit stop2.aflags sbit en_calc2,aflags imp self__testl_2 self_test3 ifeq ang_stat,#0 , wait until angular motor complete mission jmp self_test3_0 jmp end_st_stat self _test3_0:rbit en_calc2,aflags
Id ang_stat,#l ; move angular down 400 pulses. ld rbytel ,#010 ; 0,1,2=0= speedl ; 3=0= direction down ; 4=1= angular motor.
Id rbyte2,#low(300) ld rbyte3,#high(300)
Id selft_stat,#4 rbit stop2,aflags jmp self_testl_2
self_test4:ifeq ang_stat,#0 ; wait until angular motor complete mission, jmp self _test4_0 jmp end_st_stat self_test4_0:ld ang_stat,#l ; move angular again up 150 pulses. ld rbytel ,#018 ; 0,1,2=0= speedl ; 3=1= direction up ; 4=1= angular motor.
Id rbyte2,#150 ld rbyte3,#0
Id selfl_stat,#5 rbit stop2,aflags sbit en_calc2,aflags jmp self_testl_2 self_test5:ifeq ang_stat,#0 ; wait until angular motor complete mission, jmp self_test5_0 jmp end_st_stat
self_test5_0:rbit en_calc2,aflags
Id linear_stat,#l ; move linear backwards 50mm.
Id rbytel ,#0 ; 0,1,2=0= speedl ; 3=0= direction backwards 4=0= linear motor.
Id rbyte2,#low(6850)
Id rbyte3,#high(6850) ; 50mm*136pulse per mm = 6800.
Id selft_stat,#6 jmp self_testl_l self_test6:ifeq linear_stat,#0 ; wait until linear motor complete mission, jmp self_test6_0 jmp end_st_stat
self_test6_0:ld selft_stat,#0 rbit self_t_command,buttons_flags rbit stuck, flags 1
Id temp,#low(wordready) jsr type_stπngl imp end_st_stat
sect h_p_select,rom,ιnpage home_p_states Id a,home_stat add a,#low(]mp_h_stat) μd , jm pcu,[a] jmp_h_stat addr h_pO,h_pl h_pO jmp home_pO h_p 1 j mp home_p 1
sect home__posιtιonmg,rom home_pO ifbit home_hmιt,pbι , O-micro switch closed - in home position, imp home_p0_2 , 1 -micro switch open - not in home position imp home_pl_0 home_p0_2 jsr stop2motors
Id lcd_flags,#0 rbit dιrectιon,lflags , so the bottom wouldn't shut down the motor
Id lmear_stat,#l , move linear backwards 200mm
Id rbytel ,#0 , 0, 1,2=0= speedl , 3=0= direction backwards , 4=0= linear motor
Id rbyte2,#low(27200)
Id rbyte3,#hιgh(27200) , 200mm*136pulse per mm = 27200 rbit sto l, lflags sbit fix_t_en,flags2 rbit startflagsl rbιt stop,flagsl rbιt end,flagsl rbit enddata, flags 1
Id home_stat,#l ifbit self _t_command,buttons_flags ret
Id temp,#low(wordhome) jsr type_strmgl home_p 1 ifeq linear_stat.#0 , wait until linear motor complete mission imp home_p 1_0 ret home_pl_0 Id home_stat #0 rbit home_command,buttons_flags rbit epi flags 1 ifbit stuck flags 1 imp home_ l_l
Id pls_x0,#O
Id pls_xl,#0
Id pls_yO,#0 ld pls_yl,#080 home_pl__l ifbit self_t_command,buttons_flags ret ifbit stuck,flagsl ret
Id temp,#low(wordready) jsr type_stπngl ret sect hmιts_check,rom hmιts_check Id a,pbι , general limits check (limits = b5,b6,b7) and a,#060 , OeO - if the angular limit switch is on
Figure imgf000061_0001
imp lιmιts_checkO_0 rbit home,flagsl , signal to the pc that we are not m home position rbit bottom.flagsl , signal to the pc that we are not in buttom position ret hmιts_checkO_0 x a,b ifbit home_lιmιt,b jmp hmιts_checkl_0 sbit home,flagsl , signal to the pc that we are m home position rbit bottom,flagsl , signal to the pc that we are not in buttom position ifbit dιrectιon,lflags jmp hmιts_checkO_l sbit stopl , lflags , turn off motor 1 rbit t2c0,t2cntrl
Figure imgf000061_0002
rbit controll, pa rbit control2,pa
Id Unear_stat#0 ifbit stop2,aflags rbit start, flags 1
Id temp,#low(wordready) jsr type_strιngl limits_checkO_l :
Id pls_xl,#0 Id pls_x0,#0 Id pls_y0,#0 ld pls_yl,#080 jmp limits_check2_l
Iimits_checkl_0.rbit home,flagsl ; signal to the pc that we are not in home position, ifbit bottom_limit,b jmp limits_check2_0 sbit bottom,flagsl ; signal to the pc that we are in buttom position, ifbit direction,lflags jmp limits_checkl_l jmp limits_checkl_2 limits_checkl_l:jsr stop2motors rbit start,flagsl Id temp,#low(wordbottom) jsr type_stringl limits_checkl_2:ld pls_xl,#066 ; to be calibrated. Id pls_x0,#088 jmp limits_check2_l limits_check2_0:rbit bottom,flagsl , signal to the pc that we are not in buttom position.
Iimits_check2_l :
;ifbit angular_limit,b ret
buttons_test:rb it buttons_t_en,buttons_flags Id a,pli and a,#0a0 a,b ifeq b,#0a0 jmp b_t0_01 jmp b 0_03 b_t0_01 : ifeq ritut,#0 ; no key was pressed. jmp b_t0_02
Id a,ritut dec a x a,ritut b_t0_02: Id start_stop_cntr,#0
Id home_position_cntr,#0 jmp end_b_test b_t0_03 : ifeq ritut,#0 : a key was pressed, ritut checks if it is a real press on jmp b_tl_O0 ; a key, or just a vibration of the key. b_t0_°4; I ritut,#5
; Id start_stop__cntr,#0
; Id home position_cntr,#0 jmp b_t0_02 b_tl_00: ifbit start_stop,b jmp b_t2_00 ; start-stop key was not pressed. ifbit start_stop,buttons_flags ; start-stop key was pressed to stop operatio. jmp b_tl_02 ifbit home_command,buttons_flags jmp b_tl_02 ifbit self_t_command,buttons_flags jmp b_tl_02
Id a,start_stop_cntr ; start-stop key was pressed to start operation. inc a x a,start_stop_cntr ifgt a,#150 jmp b_tl_01 jmp b_t2_00
; start/stop autorun key was pressed b_tl_01 ifbit start_stop,buttons_flags jmp b_tl_02 sbit start_stop,buttons_flags ; start button was pressed to start operation.
Id autorun_stat,#0 jmp b_t0_04 b_tl_02: sbit stop_command,buttons_flags; start button was pressed again to stop operation. rbit start_stop,buttons_flags
Id autorun_stat,#0 jmp b_t0_04 b_t2_00: ifbit home jposition,b jmp end_b_test
Id a,home_position_cntr inc a x a,homejposition_cntr ifgt a,# 150 jmp b_t2_01 jmp end_b__test
; home positon/self test key was pressed b_t2_01. ifbit home_ imit,pbi ; 0-micro switch closed - in home position, jmp b_t2_03 b_t2_02: rbit home_command,buttons_flags ; not in home position - go to home position. sbit self_t_command,buttons_flags
Id selft_stat,#0 sbit fix_t_en,flags2
Id data_cntr,#21
Id save_ptr,#0
Id send_ptr,#0 rbit enddata,flagsl rbit start, flags 1 rbit end,flagsl rbit stop,flagsl jmp b_t0_04 b t2 03: Id a,pls_xO ifgt a,#0 jmp b_t2_04 ifeq pls_xl,#0 jmp b_t2_02 b_t2_04: sbit home_command,buttons_flags ; not in home position - go to home position.
Id home_stat,#0 sbit fix_t__en,flags2 Id data_cntr,#21 Id save_ptr,#0 Id send_ptr,#0 rbit enddata, flags 1 rbit start, flags 1 rbit end,flagsl rbit stop,flagsl jmp b_t0_04 end_b_test:ret
.sect interups,rom,abs=Off interrupts address push a Id a,s push a ld a,b push a Id a,x push a Id a,psw push a Id s,#0 vis end intr: re rbit hc,psw pop a and a,#0c0 ;save only c and he or a,psw x a,psw pop a x a,x pop a x a,b pop a x a,s pop a reti
.sect int addres,rom,abs=01e0
.addrw reset vis without any interrupt .addrw reset port 1 or wake up interupts .addrw reset t3 b .addrw reset t3 a .addrw reset t2 b .addrw reset .12 a .addrw trnsO transmit .addrw recO receive .addrw reset reserved .addrw reset micro wire .addrw tmrlb tmrl ;tlb .addrw tmrl a tmrl ;tla .addrw tmrO timerO .addrw reset external interrupt-gO .addrw reset reserved
.addrw reset software intr interrupt
.sect timerO,rom tmrO: rbit tOpnd,icntrl drsz lcd_cntr ; led counter to enable led update every 0. lsec (25*4msec). jmp tmr0_01 sbit lcdupdate,flags2 tmrO 01: Id a,int_cntr ; timerO interrupts counter, used to help timing a2d,fix dec a ; transmit, and other actions according to timerO cycles. x a,int_cntr ifbit 0,int_cntr ; odd - ; enable fix transmit. jmp tmr0_011 sbit a2den,flags2 ; even - ; enable a2d. jmp tmr0_02 tmr0_011 sbit fix_t_enl ,flags2 sbit buttons_t_en,buttons_flags tmr0_02 ifbit stop 1 ,lflags imp tmr0_04 ifbit en_calc lflags imp tmr0_03 μnp tmr0_04 tmr0_03 sc , pt=pt2-ptl =tιme per pulse
Id a,pt21o subc a,ptllo x a,ptlo Id a,pt2hι subc a,ptlhι x a,pthι sbit enl_calc,lflags tmr0_04 ifbit stop2,aflags jmp tmr0_06 ifbit en_calc2,aflags jmp tmr0_05 imp tmr0_06 tmr0_05 sc , pt=pt2-ptl =tιme per pulse
Id a,apt2lo subc a,aptllo \ a,aptlo Id a,apt2hι subc a,aptlhι x a,apthι sbit enl_calc2,aflags tmr0_06 end_tmr0 Id a,cd_dly , delay before changing direction ifne a,#0 dec a x a,cd_dly drsz uart_tmr jmp end_ιntr
"id rec_stat,#0 imp end_ιntr
*************************************************** sect timer rom S9
Figure imgf000067_0001
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Is_'os"~ι jppυ- :iBis_ι-dιu
Figure imgf000067_0002
(reιs_ ~dtu[) 0i#'i3 ppB lBis"~suμ'ι3 pi :osu-ti
3g-Bduι'uιoj'ιιuιsuτ34_}ji3n pas-
Figure imgf000067_0003
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I4uoι 'qpud U li qi : q I Juμ
4uι_pu9 d μ-BμurTpus sSBUi'sspid iiqs
Figure imgf000067_0004
}ψι\ v pi oj i 'B x
Figure imgf000067_0005
iqzid'u x iqildΕpi oizid'-B x
Figure imgf000067_0006
MsdΕpudu iqj il^I-πui
BIJ il'pus duif
Figure imgf000067_0007
s Tφudiniqji
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Z.1 00/Z01I/I3d £L9LΪ0/£0 OΛV Id trns_stat,#0 jmp end_t_stat
t_statl Id a,send_ptr ifgt a,#89 , 0-89 => 90 bytes jmp t_statl_01
Id a,send_ptr x a,b
Id s,#l
Id a.[b+] x a,tbuf
Id s #0 ld a.b x a,send_ptr imp end_t_stat t_statl_01 ifgt a,#183 , 90-179 => 90 bytes+1 (buttons_flags)+l (t_check)+2('ED'[=END]) jmp end_t_statl
Id a,send_ptr sc subc a,#90 x a,b
Id s,#2
Id a,[b+] x a tbuf
Id s,#0 ld a.b add a,#90 x a,send_ptr jmp end_t_stat end_t_statl Id send_ptr,#0 rbit etι,enuι Id trns__stat,#0 imp end_t_stat
sect uart_receιve,rom,mpage recO Id a,rbuf , receive interrupt a,b
Id a,check_sum add a,b x a,check_sum Id a,rec_stat add a,#low(ιmp_r_stat) jid ;jmp pcu,[a] jmp_r_stat .addr r_s0,r_sl,r_s2,r_s3 r sO jmp r_statO r_sl jmp r_statl r s2 jmp r_stat2 r_s3 jmp r_stat3 end_r_stat:jmp end__intr
.sect receive_states,rom r_statO: Id check_sum,#0 ld a,b ifne a,#0f5 jmp e_r_statO
Id rec_stat,#l Id check_sum,#0f5 e_r_statO:ld uart_tmr,#Off jmp end_r_stat r_statl : Id a,b ifeq a,#'A' ; (041) ; Advance - moving command. jmp r_stat2_00 ifeq a,#'S' ; Stop command. jmp r_statl_01 ifeq a,#'H' ; Home position command. jmp r_statl_02 ifeq a,#T' ; Self Test command. jmp r_statl_03 ifeq a,#'0' ; Operate auto run command. jmp r_statl_04 ifeq a,#'P' ; Ping (test communication) command. jmp r_statl_05
Id rec_stat,#0 jmp end_r_stat r_statl_01 :sbit stop_command,buttons_flags ; 'S' - Stop. Id tbytel,#0f5 jmp e_r_stat2 r_statl_02:sbit home_command,buttons_flags ; 'H' - Home position.
Id home_stat,#0 e_r_statl :ld tbytel,#0f5 sbit fix_t_en,flags2
Id data cntr,#21 Id save_ptr,#0 Id send_ptr,#0 rbit enddata,flagsl rbit start, flags 1 rbit end,flagsl rbit stop,flagsl jmp e_r_stat2 r_statl_03:sbit self_t_command,buttons_flags ; 'T' - Self Test. Id selft_stat,#0 jmp e_r_statl r_statl_04:sbit start_stop,buttons_flags ; '0' - Operate auto run command. Id autorun_stat,#0 jmp e__r_statl r_statl_05:ld tbytel,#0f5 ; 'P' - Ping.
Id pb,#OfO jmp e_r_stat2 r_stat2_00:ld rec_stat,#2
Id rbyte_num,#4 ; number of bytes to be received
Id receive_ptr,#rbytel jmp end_r_stat r_stat2: Id a,receive_ ptr ; rbuf-> [receivejptr] a,x
Id a,b ; receive__ptr + 1 -> receive_ptr x a,[x+] ld a,x x a,receive_jptr drsz rbyte_num jmp end_r_stat sbit start,flagsl rbit stop,flagsl rbit end,flagsl sbit fix_t_en,flags2 ifeq trns_stat,#l jmp r_stat2_01
Id data cntr#21 - *************
Id save_ptr,#0
Id send_ptr,#0 r_stat2_01 : ifbit motor,rbytel ; O-motorl, l-motor2. jmp r_stat2_03
Id a,rbyte3 ; motor 1 ifne a,#0 jmp r_stat2_02
Id a,rbyte2 ifgt a,#0 jmp r_stat2_02 sbit stopl , lflags ; distance=0 ->Stop motor! ! rbit start, flags 1 sbit end,flagsl Id nxt_l_stat,#0 Id linear_stat,#6 jmp r_stat2_05 r_stat2_02:ld linear_stat,#l sbit type_start,lcd_flags; type 'start' at line 2 of led. rbit limits_c_en,limits_flags rbit enddata, flags 1 rbit stopl, lflags jmp r_stat2_05 r_stat2_03 :ld a,rbyte3 ; motor 2 ifne a,#0 jmp r_stat2_04
Id a,rbyte2 ifgt a,#0 jmp r_stat2_04 sbit stop2,aflags ; distance=0 ->Stop motor! ! rbit startflagsl sbit end,flagsl
Id nxt_a_stat,#0
Id ang_stat,#6 jmp r_stat2_05 r_stat2_04 : Id ang_stat,# 1 ; motor 2 sbit type_start,lcd_flags; type 'start' at line 2 of led. rbit enddata,flagsl rbit stop2,aflags
r_stat2_05:ld a,check_sum ; load byte to transmit x a,tbytel e_r_stat2:ld a,tbytel ifeq tms_stat,#0 x a,tbuf
Id rec_stat,#0 rbit stuck,flagsl jmp end_r_stat r_stat3: jmp end_r_stat
.sect datasend,rom data_send: ifbit fix_t_enl,flags2 jmp d_sO ret d_sO: rbit fix_t_enl,flags2 drsz data_cntr jmp d_sl
; transmit s2 and s3 Id a,#13 ; 13 is the sync. sign, x a,tbuf ; then send the data to the computer Id a.buttons_flags x a,b
Id a,t_check Id s,#2 x a,05a ld a,b x a,05b Id s,#l Id a,059 Id s,#0 x a,0 ifbit enddata,0 ifbit enddata,flagsl rbit fix_t_en,flags2 Id t_check,#0 Id trns_stat,#l Id data_cntr,#21 Id save_ptr,#0 Id send_ptr,#0 sbit eti,enui jmp end_d_s d_s 1 : ifeq data_cntr,# 10
Id save_ptr,#0 ld a,#ll ifgt a,data_cntr jmp d_s2
Id b,#flagsl ; load data to ld a,[b-] ; flags 1 push a ld a,[b-] ; pls_yl niuicn ι α- ld a,[b-] ; pls_yO push a l a,[b-] ; pls_xl push a ld a,[b-] ; pls_xO push a Id a,[b-] ; hal!2 push a lda,|>] ;halll push a
Id a,[b-] ; current2 push a
Id a,[b-] ; currentl push a
Id a,save_ptr ; save data from stack. x a,b lda,b x a.x
Ids l pop a x a,[b+] pop a x a,[b+] pop a xa,[b+] pop a x a,[b+] pop a x a,[b+] pop a x a,[b+j pop a xa,[b+] pop a a,[b+] pop a x a,[b+]
Id a,t_check ; compute check sum. x a,b
Id a,[x+] ; b=t_check, a = currentl add a,b ; a = currentl + b x a,b ; b = a l a,[x+] add a,b xa,b
Id a,[x+] add a,b xa,b lda,[x+] adda,b xa,b
Id a,[xτ] add a,b x a,b lda,[x+] add a,b x a,b
Id a,[x+] add a,b a,b
Id a,[x+] add a,b a,b lda,[x+] ;a = flags 1 adda,b ;a = flagsl + b
Id s,#0 ; t_check = a x a,t_check lda,x x a,save_ptr jmp end_d_s d_s2: Id b,#flagsl ; load data to stack. lda,[b-] push a Id a,[b-] push a Id a,[b-] push a lda,[b-] push a lda,>| ] push a Id a,[b-] push a lda,[b-] push a Id a,[b-] push a Id a,[b-] push a
Id a,save_ptr ; save data from stack. xa,b lda,b x a,x Id s,#2 pop a xa,[b+] pop a xa,[b+] pop a xa,[b+] pop a a,[b+] pop a xa,[b+] pop a xa,[b+] pop a xa,[b+] pop a a,[b+] pop a x a,[b+]
Id a,t_check . compute check sum. xa,b
Id a,[x+] ; b=13, a = currentl add a,b ; a = currentl + b x a,b ; b = a
Id a,[x+] add a,b xa,b
Id a,[x+] add a,b x a,b lda,[x+] adda,b xa,b
Id a,[x+] add a,b xa,b
Id a,[x+] add a,b x a,b
Id a,[x+] adda,b x a,b
Id a,[x+] add a,b x a,b lda,[x+] ,a = flags 1 adda,b ;a = flagsl+b
Id s,#0 ; t_check = a x a,t_check lda,x x a,save_ptr end d s: ret sect a2d_converter,rom a2d00 rbit a2den,flags2 , the a2d prog checks halll+2 and currentl+2
Id enad,#082 , c=>adch8=b0, 2=>psr=l=mclk divide by 16 sbit adbsy,enad a2d01 ifbit adbsy,enad imp a2d01
Id a,adrsth x a,halll
Id enad.#092 , c=>adch9=bl, 2=>psr=l=mclk divide by 16 sbit adbsy,enad a2d02 ifbit adbsy,enad jmp a2d02
Id a,adrsth x a,hall2
Id enad,#0a2 , c=>adchl0=b2, 2=>psr=l=mclk divide by 16 sbit adbsy,enad a2d03 ifbit adbsy,enad jmp a2d03
Id a,adrsth x a,currentl
Id enad,#0b2 c=>adchll=b3, 2=>psr=l=mclk divide by 16 sbit adbsy,enad a2d04 ifbit adbsy,enad imp a2d04
Id a,adrsth x a,current2 ret sect velosιty_caculatιon,rom v calc rbit enl_calc,lflags
Id a,t_refO \ a,0
Id a,t_refl \ a,l
Figure imgf000076_0001
jmp tooslow "ld a,l ifgt a,pthι ]mp toofast Id a,ptlo ifgt a,0 jmp tooslow ld a,0 ifgt a,ptlo jmp toofast ret ; if they are equal the speed is ok tooslow: sc err= (pt - t_ref) => (4,5)
Id a,ptlo ; if t2ra + err*k >1000 then pwm=1000 (fastest) subc a,0 a,4
Id a,pthi subc a,l xa,5
Id a,t2ralo x a,2
Id a,t2rahi xa,3 jsr mybyk
Id a,0 xa,2 lda.1 x a,3 lda,4 xa,0 lda,5 xa,l jmp end__v_calc toofast: sc ; err= (t_ref - pt) => (4,5)
Id a,0 ; if t2rb + err*k >1000 then pwm=0 (slowest) subc a,ptlo xa,4
Id a,l subc a,pthi x a,5
Id a,t2rblo xa,2
Id a,t2rbhi x a,3 jsr mybyk
'id a,4 xa,2 lda,5 xa,3 end_v_calc:ld b.#t2ralo ldx,#0 Id a,#l Id tmr2hi,#2
;loop2: ifgt a,tmr2hi jp loop2
'id a,[x+] xa,[b+]
Id a.[x+] xa,[b+] lda,[x+] xa,[b+] lda,[x] xa,[b] ret
.******************************************************* v2_calc: rbit enl_calc2,aflags
Id a,at_refO xa,0
Id a,at_refl x a,l
Id a,apthi ifgta,l jmp atooslow lda,l ifgt a,apthi jmp atoofast
Id a,aptlo ifgt a,0 jmp atooslow
"lda,0 ifgt a,aptlo jmp atoofast ret ; if they are equal the speed is ok atooslow: sc ; err= (pt2 - at_ref) => (4,5)
Id a,aptlo ; if t3ra + err*k >1000 then pwm=l 000 (fastest) subc a,0 xa,4
Id a,apthi subc a,l xa,5
Id a,t3ralo xa,2
Id a,t3rahi xa,3 jsr mybyk
"lda,0 xa,2 lda,l xa,3 lda,4 xa,0 lda,5 a,l jmp end_v2_calc atoofast: sc ; err= (at_ref - pt2) => (4,5)
Id a,0 ; if t3rb + err*k >1000 then pwm=0 (slowest) subc a,aptlo xa,4 lda,l subc a,apthi xa,5
Id a,t3rblo xa,2
Id a,t3rbhi x a,3 jsr mybyk
'id a,4 xa,2 lda,5 x a,3
end_v2_calc:ld b,#t3ralo
Id x,#0 lda,#l
Id tmr3hi,#2 ;Ioop3: ifgt a,tmr3hi jp loop3
"id a,[x+] xa,[b+]
Id a,[x+] x a,[b+]
Id a,[x+] xa,[b+]
Id a,[x] xa,[b] ret
.sect math_functions,rom mybyk: Id cntr,#6 ; div. by 64 (=2Λ6) dvby2: re lda,5 rrca xa,5 lda,4 rrc a x a,4 drsz cntr jmp dvby2 re ; 4,5 <- err*k + 12 ld a,4 adc a,2 x a,4 ld .5 adc a,3 x a,5 ifeq 5,#0 jmp lowedge
'id a,5 ifgt a,#high(980) jmp highedge
'id a,#high(980) ifgt a,5 jmp end_mybyk ; not edge
"id a,4 ifgt a,#low(980) jmp highedge jmp end_mybyk ; not edge highedge: Id 4,#low(980) Id 5,#high(980) Id 0,#2Q Id 1,#0 ret lowedge: ld a,4 ifgt a,#20 jmp end_mybyk
"id 0,#low(980)
Id l,#high(980)
Id 4.#20
Id 5,#0 ret end_mybyk:sc ld a,#low(1000) subc a,4 x a,0
Id a,#high(1000) subc a,5 x a,l ld a,l ifgt a,#0 ret ld a,0 ifgt a,#20 ret
Id 0,#20
Id 4,#low(980)
Id 5,#high(980) ret
.****** FDvi68 - Fast 16 by 8 division subroutine *******************
; 490 instruction cycles maximum - 245usec.
; dividend in [1,0] (dd) divisor in [3] (dr)
; quotient in fl ,0] (quot) remainder in [2] (test field) fdvl68: ld cntr,#16 ; load cntr with length of dividend field.
Id 2.#0 : clear test field. fdl 68s: Id b,#0 fdl681: re
Id a,[b] adc a,[b] ; left shift dividend lo x a,[b+] l a,[b] adc a,[b] ; left shift dividend hi x a,[b+] l a,[b] adc a,[b] ; left shift test field x a,[b]
Id a,[b+] ; test field to ace ifc ; 1 :est if bit shiefted out of test field**** jp fdl68b sc subc a,[b] ; test subtract divisor from test field ifne ; test if borrow from subtraction jp fdl68t fdl68r: Id b,#2 ; subtraction result to test field x a,[b] Id b,#0 sbit 0,[b] ; set quotient bit drsz cntr ; dectement and test cntr for zero jp fdl681 ret ; return from subroutine fdl 68t: drsz cntr ; dectement and test cntr for zero jp fdl68s ret ; return from subroutine fdl 68b: subc a,[b] ; subtract divisor from test field*** jp fdl68r .******* BINDEC - Binary to Decimal (packed BCD) ********************** bindec: Id cntr,#8 ; Bindec - Binary to Decimal (packed BCD) re ; 856 cycles * 0.5 ~ 428 cycles = 213usec.
Id b,# 1 ; binary in 0 => decinmal in 1 ,2 bdl Id [b+],#0 ifbne #3 jmp bdl bd2: "id b,#0 bd3: ld a,[b] adc a,[b] x a,[b+] ifbne #1 jmp bd3 bd4: "id a,[b] add a,#066 adc a,[b] dcor a x a,[b+] ifbne #3 jmp bd4 drsz cntr jmp bd2 ret
.sect lcd_update,rom up datelcd .ifbit lcdupdate,flags2 jmp updatelcdO ifeq lcd_flags,#0 ret jmp updatelcd4 updatelcdO: rbit lcdupdate,flags2 Id lcd_cntr,#50 Id a,pls_xO x a,0
Id a,pls_xl x a,l
Id a,#lpulsepermm ; linear pulses per mm x a,3 jsr fdv 168 ; mm = pls_x/linear_pulses_per_mm jsr bindec
Id pd,#080 ; cursor home - address 0. jsr lcd_com "id a,2 and a,#0f add a,#'0' a,pd jsr lcd_dat lda,l swap a and a,#Of add a,#'0' x a,pd jsr lcd_dat lda,l and a,#0f add a,#'0' xa,pd jsr lcd_dat
Id pd,#085 ; cursor address 5. jsr lcd_com ifbit epi, flags 1 jmp updatelcd5 ifbit 7,pls_yl jmp updatelcdl sc ; angel= - 08000-pls_y
Id a,#0 subc a,pls_yO xa,0 Id a,#080 subc a,pls yl xa,l Id pd,#'-' jmp updatelcd2 updatelcdl :ld a,pls_yl ; angel= + pls_y-08000 and a,#07f xa,l
Id a,pls_yO a,0 Id pd,#'+' updatelcd2:jsr lcd_dat
Id cntr,#3 updatelcd3:rc lda.l rrca xa.1 lda.0 rrc a xa,0 drsz cntr jmp updatelcd3 Id 1 #0 jsr bindec ld a,l swap a and a,#0f add a,#'0' a,pd jsr lcd_dat ld a,l and a,#0f add a,#'0' \ a,pd )sr lcd_dat jmp updatelcd4 updatelcd5 Id pd,#'e' jsr lcd_dat Id pd,#'p'
Figure imgf000084_0001
updatelcd4 ifeq lcd_flags,#0 ret ifbit self_t__command,buttons_flags Id lcd_flags,#0 ifbit start_stop,buttons_flags Id lcd_flags,#0 ifeq lcd_flags,#0 ret ifbit type_start,lcd_flags
Id temp,#low(wordstart), type 'start' at line 2 of led ifbit type_end,lcd_flags
Id temp,#low(wordend) ifbit type_Stuck,lcd_flags
Id temp,#Iow(wordstuck) ifbit type_stop,lcd_flags
Id temp,#low(wordstop) jsr type_strιngl Id lcdJlagsjO
end__updatelcd ret
********************************************** sect lcd_orders,rom clean cd Id pdJOl jsr lcd_com jmp del 16 ret type_stπngO Id pd,#080 , type string from the start of line 0 jsr lcd_com imp type_stπng type_stπngl Id pd #0c0 , type string from the start of line 0
)sr lcd_com type_strmg Id a,temp inc a x a,temp jsr get_char
Figure imgf000085_0001
ret x a,pd
]sr lcd_dat jmp type_strιng
******** sut)rul:lne to initialize led display lnitjcd Id a l O ιnιt_lcdl |sr dell6 dec a
Figure imgf000085_0002
jp lmtjcdl ιnιt_lcd2 Id pd,#01 , display clear jsr lcd_com jsr dell 6
Id pd,#06 increment cursor (cursor moves left to right) jsr lcd_com
Id pd,#0c , display on , cursor off )sr lcd_com
Figure imgf000085_0003
jmp lcd_com ret ,********** subrutine to transfer command to led display lcd__com rbit rs,pa ,command end_com_dat
Figure imgf000085_0004
loopl drsz cntr jp loopl ret ********** SUDruu-ne to transfer data to led display lcd_dat: sbit rs.pa ommand jmp end_com_dat fipIflV ^ψψ; Jlϊ'iϊϊi'ϊι>ϊliιϊϊi*Ψϊtϊli**i*
dellό: Id cntr,#2 dell60: Id temp,#250 ;1.6 msec delay dellόl: drsz temp jmp del 161 ldtemp,#150 dell 62: drsz temp jmp del 162 drsz cntr jmp del 160 ret
.sect string_table,rom,inpage get_char:laid ret wordmm: .db ' mm @' wordstart: .db 'start @' wordstop: .db 'stop @' wordpoweron: .db 'power on@' wordhome: .db 'home @' wordstuck: .db 'stuck @' wordend: .db 'end @' wordbottom: .db 'bottom @' wordready: .db 'ready @' wordselftest: .db 'selftest@' wordautorun: .db 'autorun @' wordinplace: .db 'inplace@'
.endsect
.ENDO ;end of program listing of intumed.asm Appendix 2
: This is cδcdr.inc
; This file include copδcdr.inc, copδ.inc, cop8c3r.inc, δcdr.chp, ports, inc(shortcuts).
;port definitions in cop8 with flash. ped =090 ; port e data (output) ; pe is already taken by parity enable, pec =091 ; port e configuration pei =092 ; port e input pf =094 ; port f data (output) pfc =095 ; port f configuration pfi =096 ; port f input pa =0a0 ; port a data (output) pac =0al ; port a configuration pai =0a2 ; port a input pb =0a4 ; port b data (output) pbc =0a5 ; port b configuration pbi =0a6 ; port b input
pi =0d0 ; port 1 data (output) pic =0dl ; port 1 configuration pli=0d2 ; port 1 input pg =0d4 ; port g data (output) pgc =0d5 ; port g configuration pgi =0d6 ; port g input
pc =0d8 ; port c data (output) pec =0d9 ; port c configuration pci =0da ; port c input pd =0dc ; port d data (output)
This is copδ.inc ;* Primary Chip Names with Designators
ANYCOP = 0
COP912C = 1 ; Basic Family
COP820 = 2
COP840 = 3
COP880 = 4
COP820CJ= 5
COP840CJ= 6
COP8620 = 7
COP8640 = 8
COP8720 = 9
COP8780 = 10
COP943 =11
COP888CF = 20 ; Feature Family
COP888CG = 21
COP888CL = 22
COP888CS=23
COP888EG = 24
COP888EK = 25
COP8ACC =26
COP888BC = 27
COP888EB=28
COP888EW = 29
COP888FH = 30
COP888GD = 31
COP888GG = 32
COP888GW=33
COP888HG = 34
COP888KG = 35
COP8SAA =36
COP8SAB =37
COP8SAC =38
COP8SGR =39
COP8SGE =40
COP8SEC =41
COP8SER = 42
COP8AJC =43
COP8AKC =44
; Flash based devices from here on
COP8CBR = 60 COP8CCR =61 COP8CDR =62 COP8SBR = 63 COP8SCR = 64 COP8SDR = 65
COPy8 = 99
; End of C0P8.INC
COPCHIP = COP8CDR ; Chip Definition
This is cop8C3R.inc
PLEASE: Consider update for CBR,CDR, and CCR.
Predeclare I/O and control registers frequently used by COP8 programmer, .macro setopt .mloc sec,wd,halt,flex ι
.ifb @1 ; if null sec = 0 ; default value (not secure)
.else sec = @1
.endif
.ifb @2 ; if null wd = 0 ; default value (Watchdog enabled)
.else wd = @2
.endif
.ifb @3 ; if null halt = 0 ; default value (HALT enabled)
.else halt = @3
.endif
.ifb @4 ; if null flex = 1 ; default value (Execute from Flash)
.else flex = @4
.endif
.sect OPTION, CONF CONFIG: .db ((sec shl 3 or wd) shl 1 or halt) shl 1 or flex .endm
; End of setecon Macro Definition SFR Names and Register Bit Names Agree with the Feature Family User's Manual Redundant names match corresponding functions on Basic Family Documentation
PORTED = 0x90:BYTE ; Port E Data PORTEC = 0χ91 :BYTE ; Port E Configuration PORTEP = 0x92:BYTE ; Port E input pins (read only)
PORTFD 0x94:BYTE ; Port F Data PORTFC 0x95:BYTE ; Port F Configuration PORTFP 0x96:BYTE ; Port F input pins (read only)
PORTAD 0xA0:BYTE ; Port A Data PORTAC 0xAl:BYTE ; Port A Configuration PORTAP 0xA2:BYTE ; Port A input pins (read only)
PORTBD 0xA4:BYTE Port B Data PORTBC 0xA5:BYTE Port B Configuration PORTBP 0xA6:BYTE Port B input pins (read only)
ISPADLO = 0xA8:BYTE ; ISP Address Register Low Byte
ISPADHI = 0xA9:BYTE ; ISP Address Register High Byte
ISPRD = OxAA.BYTE ; ISP Read Data Register
ISPWR = 0xAB:BYTE ; ISP Write Data Register
TINTA = 0xAD:BYTE ; High Speed Timers Interrupt A
TINTB = 0xAE:BYTE ; High Speed Timers Interrupt B
HSTCR = 0xAF:BYTE ; High Speed Timers Control Register
TMR3LO ' = 0xB0:BYTE ; Timer 3 low byte
TMR3HI = OxBLBYTE ; Timer 3 high byte
T3RALO = 0xB2:BYTE ; Timer 3 RA register low byte
T3RAHI = 0xB3:BYTE ; Timer 3 RA register high byte
T3RBLO = 0xB4:BYTE ; Timer 3 RB register low byte
T3RBHI = 0xB5:BYTE ; Timer 3 RB register high byte
T3CNTRL = 0xB6:BYTE ; Timer 3 control register
TBUF = = 0xB8:BYTE ; UART transmit buffer
RBUF = = 0xB9:BYTE ; UART receive buffer
ENU = OxBA.BYTE ; UART control and status register
ENUR : = 0xBB:BYTE ; UART receive control and status reg.
ENUI = ; OxBC-.BYTE ; UART interrupt and clock source reg.
BAUD = OxBD.BYTE ; BAUD register
PSR = 0xBE:BYTE ; UART prescaler select register
TMR2LC > = 0xC0:BYTE ; Timer 2 low byte TMR2HI = OxCLBYTE ; Timer 2 high byte
T2RALO = 0xC2:BYTE ; Timer 2 RA register low byte
T2RAHI = 0xC3:BYTE ; Timer 2 RA register high byte
T2RBLO = 0xC4:BYTE ; Timer 2 RB register low byte
T2RBHI = 0xC5:BYTE ; Timer 2 RB register high byte
T2CNTRL = = 0xC6:BYTE ; Timer 2 control register
WDSVR = 0xC7:BYTE ; Watch dog service register
WKEDG = 0xC8:BYTE ; MIWU edge select register
WKEN = 0xC9:BYTE ; MIWU enable register
WKPND = OxCA:BYTE ; MIWU pending register
ENAD = OxCB:BYTE ; A/D Converter Control register ADRSTH = OxCC:BYTE ; A/D Converter Result Register High
Byte
ADRSTL = 0xCD:BYTE ; A/D Converter Result Register Low Byte
ITMR = OxCF:BYTE Idle Timer Control Register
PORTLD = 0xD0:BYTE Port L data PORTLC = OxDLBYTE Port L configuration PORTLP = 0xD2:BYTE Port L pin
PORTGD = 0xD4:BYTE Port G data PORTGC = 0xD5:BYTE Port G configuration PORTGP = 0xD6:BYTE Port G pin
PORTCD = 0xD8:BYTE ; Port C data PORTCC = 0xD9:BYTE ; Port C configuration PORTCP = 0xDA:BYTE ; Port C pin
PORTD 0xDC:BYTE Port D
PGMTIM = OxELBYTE ; E2 and Flash Write Timing Register ISPKEY = 0xE2:BYTE ; ISP Key Register
T1RBLO = 0xE6:BYTE ; Timer 1 RB register low byte T1RBHI = 0xE7:BYTE ; Timer 1 RB register high byte
ICNTRL = 0xE8:BYTE ; Interrupt control register
SIOR = 0xE9:BYTE ; SIO shift register
SIO = 0xE9:BYTE SIO shift register
TMR1LO = 0xEA:BYTE ; Timer 1 low byte TMR1HI = 0xEB:BYTE ; Timer 1 high byte T1RALO = 0xEC:BYTE ; Timer 1 RA register low byte T1RAHI = OxED:BYTE ; Timer 1 RA register high byte
CNTRL = OxEE:BYTE ; control register PSW = 0xEF:BYTE ; PSW register
BYTECOUNTLO = OxF BYTE ; When JSRB Boot Rom used
S = OxFF:BYTE ; Segment register, only COP888CG/CS!
; Bit Constant Declarations.
; Alternate function bit definitions on port G
INT = 0 ; Interrupt input
INTR = 0 ; Interrupt input
WDOUT = 1 ; Watchdog output
TIB = 2 ; Timer TIB output
TIA = 3 ; Timer TIA output
SO = 4 ; Seriell output
SK = 5 ; Seriell clock
SI = 6 ; Seriell input
CKO = 7 ; Halt,restart input
; Alternate function bit definitions on port L
CKX = 1 ; ext. clock I/O-pin/UART
TDX = 2 ; transmit data/UART
RDX = 3 ; receive data/UART
T2A = 4 ; Timer T2A output
T2B = 5 ; Timer T2B output
T3A = 6 ; Timer T3A output
T3B = 7 ; Timer T3B output
; Alternate function bit definitions on port A
ACHO = 0 ; A/D-Channel 0
ACH1 = 1 ; A/D-Channel 1
ACH2 = 2 ; A/D-Channel 2
ACH3 = 3 ; A/D-Channel 3
ACH4 = 4 ; A/D-Channel 4
ACH5 = 5 ; A/D-Channel 5
ACH6 = 6 ; A/D-Channel 6
ACH7 = 7 ; A/D-Channel 7
Alternate function bit definitions on port B ACH8 = 0 ; A/D-Channel 8
ACH9 = 1 ; A D-Channel 9 ACH10 = 2 A D-Channel 10 ACHll = 3 A/D-Channel 11 ACH12 = 4 A/D-Channel 12 ACH13 = 5 A/D-Channel 13
MUXOUTN = ; A/D Mux Negative Output ACH14 = 6 ; A/D-Channel 14
MUXOUTP = ; A/D Mux Positive Output ACH15 = 7 ; A D-Channel 15
ADIN = 7 ; A/D Converter Input
Figure imgf000093_0001
T1C3 7 ; Timer 1 mode control
TCI = T1C3 ; COP880/840/820 control signal name
T1C2 = 6 ; Timer 1 mode control
TC2 = T1C2 ; COP880/840/820 control signal name
T1C1 = 5 ; Timer 1 mode control
TC3 = T1C1 ; COP880/840/820 control signal name
T1C0 = 4 ; Start/Stop timer in modes 1 and 2
, ; U T UTlni derflow interrupt pending in mode 3
TRUN = T1C0 ; COP880/840/820 control signal name
MSEL = 3 ; Enable Microwire
IEDG 2 ; Selects external interr. edge polarity
SL1 = 1 Microwire clock divide select
SLO 0 Microwire clock divide select Bit del Ini tions PS
HC = 7 ; Half Historical Redundant carry flag
C = 6 ; Carry flag
T1PNDA = 5 ; Timer TIA interrupt pending
TPND = T1PNDA ; Historical Redundant T1ENA = 4 ; Timer TIA interrupt enable
ENTI = T1ENA ; Historical Redundant
EXPND = 3 External interrupt pending IPND = EXPND ; Historical Redundant
BUSY = 2 ; Microwire busy shifting EXEN = 1 ; External interurpt enable ENI = EXEN ; Historical Redundant GIE = 0 Global interr. enable
Bit definitions ICNTRL register
LPEN = 6 , L-Port interr. enable T0PND = 5 ; Timer TO interr. pending T0EN = 4 , Timer TO interr. enable WPND = 3 ; Microwire interr. pending WEN = 2 ; Microwire interr. enable T1PNDB = 1 ; Timer TIB interr. pending flag T1ENB = 0 ; Timer TIB interr. enable Dii uenmuons 1 Γ i JΛJ_, register
T2C3 = 7 ; Timer T2 mode control
T2C2 = 6 ; Timer T2 mode control
T2C 1 = 5 ; Timer T2 mode control
T2C0 = 4 ; Timer T2A start/stop
T2PNDA = 3 ; Timer T2A interr. pending flag
T2ENA = 2 ; Timer T2A interr. enable
T2PNDB = 1 ; Timer T2B interr. pending flag
T2ENB = 0 ; Timer T2B interr. enable
----- Bit definitions T3CNTRL register
T3C3 = 7 ; Timer T3 mode control
T3C2 = 6 ; Timer T3 mode control
T3C1 = 5 ; Timer T3 mode control
T3C0 = 4 ; Timer T3A start/stop
T3PNDA = 3 ; Timer T3A interr. pending flag
T3ENA = 2 ; Timer T3A interr. enable
T3PNDB = 1 ; Timer T3B interr. pending flag
T3ENB = 0 ; Timer T3B interr. enable
' Bit definitions HSTCR register
T9HS = 7 ; Timer T9 High Speed Enable
T8HS = 6 ; Timer T8 High Speed Enable
T7HS = 5 ; Timer T7 High Speed Enable
T6HS = 4 ; Timer T6 High Speed Enable
T5HS = 3 ; Timer T5 High Speed Enable
T4HS = 2 ; Timer T4 High Speed Enable
T3HS = 1 ; Timer T3 High Speed Enable
T2HS = 0 Timer T2 High Speed Enable
; Bit definitions 1 TNTA register
T9INTA= 7 Timer 9 Interrupt A
T8INTA= 6 Timer 8 Interrupt A
T7INTA= 5 Timer 7 Interrupt A
T6INTA= 4 Timer 6 Interrupt A
T5INTA= 3 Timer 5 Interrupt A
T4INTA= 2 Timer 4 Interrupt A
T3INTA= 1 Timer 3 Interrupt A
; Bit definitions 1 ^INTB register
T9INTB = 7 , Timer 9 Interrupt B
T8INTB= 6 Timer 8 Interrupt B
T7INTB = 5 , Timer 7 Interrupt B
T6INTB= 4 , Timer 6 Interrupt B
T5INTB = 3 , Timer 5 Interrupt B
T4INTB = 2 ; Timer 4 Interrupt B
T3INTB= 1 ; Timer 3 Interrupt B Bit definitions ENAD register
ADCH3 = 7 ; A/D Converter Channel Select bit 3
ADCH2 = 6 ; A/D Converter Channel Select bit 2
ADCH1 = 5 ; A/D Convenor Channel Select bit 1
ADCHO = 4 ; A/D Converter Channel Select bit 0
ADMOD = 3 ; A/D Converter Mode Select bit
ADMUX = 2 ; A D Mux Out Control
PSC = 1 ; A/D Converter Prescale Select bit
ADBSY = 0 ; A/D Converter Busy Bit oil uenmuons ci u register
PEN = 7 ; Parity enable
PSEL1 = 6 ; Parity select
PSELO = 5 ; Parity select
XBIT9 = 5 ; 9th transmission bit in 9bit data mode
CHLl = 4 ; Select character frame format
CHLO = 3 ; Select character frame format
ERR = 2 ; Error flag
RBFL = 1 ; Received character
TBMT = 0 ; Transmited character Bit definitions ENUR register
DOE = 7 ; Data overrun error
FE = 6 ; Framing error
PE = 5 ; Parity error
BD = 4 ; Break Detect
RBIT9 = 3 ; Contains the ninth bit (nine bit frame!)
ATTN = 2 ; Attention mode
XMTG = 1 ; indicate transmitting mode
RCVG = 0 ; indicate framing error Bit definition I iNUI register
STP2 = 7 ; Select number of stop bits
BRK = 6 ; Holds TDX low to Generate a BREAK
ETDX = 5 ; Select transmit-pin 12
SSEL = 4 ; Select UART-mode
XRCLK = 3 ; Select clock source for the receiver
XTCLK = 2 ; Select clock source for the transmitter
ERI = 1 ; Enable interr. from the receiver
ETI = 0 ; enable interr. from the transmitter
Bit Definitions for ITMR Register LSON = 7 ; Low Speed Oscillator Enable
HSON = 6 ; High Speed Oscillator Enable
DCEN = 5 ; Dual Clock Enable - Switches TO To
; Low Speed Clock CCKSEL = 4 ; Core Clock Select - Switches Instr
; Execution To Low Speed Clock ITSEL2 = 2 , IDLE Timer Period Select bit 2 ITSEL1 = 1 , IDLE Timer Period Select bit 1 ITSELO = 0 , IDLE Timer Period Select bit 0
KEY = 0x98 , Required Value for ISP Key End of COP8C3R INC
Figure imgf000096_0001
CHIP 8CDR , specifies max ROM address 7FFF
, RAM = 1K
,CHIP_SPEC (chip able) for COP8CDR9xxxx parts
, PLEASE Consider also update of files for CBR and CCR when modifying
, 0 value if undefined, address value otherwise mole = 0 romsize = 0x8000 , ROM size ramhi = 0x6F , segment 0 high address eelo = 0 , on-chip eerom range
Figure imgf000096_0002
t3lo = OxBO , timer 3 registers t3hι = 0xB6 comp = 0 , comparator uartlo = 0xB8 , uart registers uarthi = OxBE t2lo = OxCO , timer 2 registers t2hι = 0xC6 wdog = 0xC7 , watch dog service register miwulo = 0xC8 , miwu registers miwuhi = OxCA a2dlo = OxCB , a/d registers a2dhι = OxCD lportlo = = OxDO , 1 port registers lporthi = = 0xD2 gportlo = 0xD4 , g port registers gporthi = 0xD6 iport = 0 , i port cportlo = 0xD8 , c port cporthi = OxDA dport = OxDC , d port eecr = 0 , eerom control register eromdr = 0 , eerom data register eearlo = 0 , eerom address registers eearhi = 0
;icntrl = 0xE8 ; icntrl register ; already defined microwire = 0xE9 ; uWire SIO tlalo = 0xE6 ; tl auto Id tlrb tlahi = 0xE7 tlblo = OxEA ; tl reg tl bhi = OxED
;cntrl = OxEE ; cntrl reg ; already defined
;psw = OxEF ; psw reg ; already defined mlo = OxFO ; RAM reg range mhi = OxFF segramlo = 0x0100 ; segments low to high segramhi = 0x077F cntrl2 = 0 igctr = 0 modrel = 0 econ = 0x7FFF ; econ hex-file location cfgsize = i ; econ array cell address.
;family = 0 for basic family, family = 1 for feature family
family = 1
Appendix 3
• TT T' T T 'P T' V'I' T 'ΓT
Figure imgf000098_0001
'P lpulsepermm=136 ; 16 * 22 / 2.54 = 138.58 = linear pulse per mm fO =0f0 ; not used uart_tmr =0fl ; used as receive watch dog - when 0, return rec_stat(receivinε state) to 0. rbyte_num =0f2 ; number of bytes to be received. tbyte_num =0f3 ; number of bytes to be transmitted. temp =0f4 ; used for temporary calculations as variable or counter.
=0f5 ; not used cntr =0f6 ; used for temporary calculations as counter. lcd_cntr =0f7 ; used to refresh led every 0.1 sec (according to timerO -
25*4msec) f8 =0f8 ; not used data_cntr =0f9 ; used to count 20 data packets. fa =0fa ; not used fb =0fb ; not used rs=2 ; pa ; determines if the LCD gets command(0) or data(l). cs_lcd=3 ; pa ; send the information in the led data pins upon rise and fall(_Λ of cs_lcd. controll=4 ; pa ; \ control2=5 ; pa / control 1+2 determine the direction of motor 1 control3=6 ; pa \ control4=7 ; pa / control 3+4 determine the direction of motor 2 ;home_position=5; pi ;start_stop=7 ; pi home_limit=5 ; pb bottom_limit=6 ; pb angular_limit=7; pb flags direction=0 direction of motor 1 first_pulse=l if set then there was already 1 pulse, enables calculation of time per pulse, enables calculation of velosity every, signals that motorl sould be stopped signals that there was a pulse from motor 1 direction of motor 2 if set then there was already 1 pulse, enables calculation of time per pulse, enables calculation of velosity every, signals that motor2 sould be stopped
Figure imgf000098_0002
signals that there was a pulse from motor 2 start=0 ; flags 1 ; 1 when start command is received, 0 when stop command is issued. home=l ; flags 1 ; 1 when home micro switch (Normally Closed) is closed, o when open. bottom=2 ; flags 1 ; 1 when bottoming micro switch (NO) is closed, o when open. epi=3 ; flags 1 ; 1 when Epiglottis is sensed. stop=4 ; flags 1 ; 1 when stop command is received, 0 when start command is issued. end=5 ; flags 1 ; 1 when planned mission ends. stuck=6 ; flags 1 ; 1 when a motor is stuck. enddata=7 ; flags 1 ; additional bit for the PC to know when the micro stops sending data. fιx_t_en=0 flags2 generatl enable for saving and transmitting the blockes of data, fιx_t_enl=l flags2 enable 1 block saving, and set every 8msec by timerO. a2den=2 flags2 enables a/d lcdupdate=3 flags2 being set every O.lsec by timer 0 to refresh led.
type_start=0 lcd_flags ; if set led sould type "start" in line2. type_stop=l lcd_flags ; if set led sould type "stop" in line2. type_end=2 lcd_flags ; if set led sould type "end" in line2. type_stuck=3 lcd_flags ; if set led sould type "stuck" in line2. new_direction=3; rbytel ; the new direction for the motors as received from the pc. motor=4 ; rbytel ; 0 - motorl, 1 - motor2.
buttons_t_en=0 ; buttons_flags home_command=l ; buttons_flags home_command_pc=2 ; buttons_flags self_t_command=3 ; buttons_flags stop_command=4 ; buttons_flags home_position=5 ; buttons_flags + pi start_stop=7 ; buttons_flags + pi limits_c_en=0 ; limits_flags _to be shifted if it is the only bit in this byte. lflags =020 ; flags that belongs to linear motor (motorl). aflags =021 ; flags that belongs to angular motor (motor2). ang_stat =022 ; angular motor work states, nxt_a_stat=023 save the next ang_stat that come after a subroutine or an ang_stat. plsy_cntr0=024 lsb ; angular distance that motor 2 sould do in start command, plsy_cntr 1=025 msb pls_cntrO =026 ; lsb ; linear distance that motor 1 sould do in start command. pls_cntrl =027 ; msb linear stat=028 ; linear motor work states. nxt_l_stat=029 save the next linear stat that come after a subroutine or an hnear_stat flags2 =02a , save flags of led, a/d and fιx_t_en cd_dly =02b , delay before changing direction to alow the motor to reach a complete stop rec_stat =02c , us art receiving work state trns_stat =02d , usart transmitting work state int cntr =02e , counter to help with timmmg decreased by 1 every 4msec ccuurrrreennttll =030 , digital current from motor 1 ccuurrrreenntt22 =031 digital current from motor 2
=032 , digital hall senssor from motor 1 hhaallll22 =033 . digital hall senssor from motor 2 ppllss__xxO0 =034 lsb , total linear distance in pulses ppllss__\\ll =035 , msb ppllss__yyO0 =036 lsb , total angular distance in pulses ppllss__yyll =037 , msb ffllaaggss 11 =038 tt_ cchheecckk =039 , check sum of 1 packet of 20 blocks of currentl+ +flagsl check_sum =03 a , check sum of received bytes in 1 command from the pc save_ptr =03 b , pointer to show where the next byte should be saved in the packet of 20 blocks (sl,s2) send_ptr =03 c , pointer to show from where the next byte should be sent in the packet of 20 blocks (sl,s2) zero hi =03 d zero_h2 =03 e ptllo =040 lsb , save the capture time of motor 1 last pulse timer la ptlhi =041 , msb ptllo =042 , lsb , save the capture time of 1 pulse before motor 1 last pulse pt2hι =043 , msb ptlo =044 , lsb , save the time between the last 2 pulses of motor 1 calculated m timerO
Figure imgf000100_0001
t_ref0 =046 , lsb , the desired time between pulses of motor 1 as received from the pc t_refl =047 , msb aptllo =048 , lsb , save the capture time of motor 2 last pulse timer lb aptlhi =049 , msb apt21o =04a , lsb , save the capture time of 1 pulse before motor 2 last pulse apt2hι =04b , msb aptlo ==0044cc , lsb , save the time between the last 2 pulses of motor 2 calculated m timerO apthi =04d ; msb at_ref0 =04e ; lsb ; the desired time between pulses of motor 2 as received from the pc. atjrefl =04f ; msb receive_ptr=050 ; pointer where to store the byte that will be received next. rbytel =051 1 rbyte2 =052 ; received bytes rbyte3 =053 . rbyte4 =054 , rbyte5 =055 trns_ptr =056 ; pointer where th tbytel =057 tbyte2 =058 ; bytes to be trai tbyte3 =059 1 tbyte4 =05 a tbyte5 =05b tbyte6 =05 c tbyte7 =05 d packet_cntr=05f ; counts the packets that are send every 160msec untill the micro returns to work state 0. limits_flags =060 ; micro(limit) switches - normally closed. buttons_flags =061 ; buttons - normally closed. ritut =062 ; ritut - counter to prevent buttons vibrations, only 3 sec push is considered a prese. start_stop_cntr=063 ; counter of 3 sec. home_position_cntr=064 ; counter of 3 sec. selft_stat=065 ; work states of self test. autorun_stat=066 ; work states of auto run. lcd_flags=067 ; led flags - if set, something should be typed. nolpulsetmr=068 ; timer to turn off motor if no pulses received - assuming the motor is stuck. noapulsetmr=069 home_stat=06a ; work states of home position.

Claims

C L A I M S
1. An automatically operative medical insertion device comprising: an insertable element which is adapted to be inserted within a living organism in vivo; a surface following element, physically associated with said insertable element and being arranged to follow a physical surface within said living organism in vivo; a driving subsystem operative to at least partially automatically direct said insertable element along said physical surface; and a navigation subsystem operative to control said driving subsystem based at least partially on a perceived location of said surface following element along a reference pathway stored in said navigation subsystem.
2. An automatically operative medical insertion device according claim 1 and wherein said driving subsystem is operative to fully automatically direct said insertable element along said physical surface.
3. An automatically operative medical insertion device according to claim 1 and wherein said driving subsystem is operative to automatically and selectably direct said insertable element along said physical surface.
4. An automatically operative medical insertion device according to any of the preceding claims and wherein said navigation subsystem receives surface characteristic information relating to said physical surface from said surface following element and employs said surface characteristic information to perceive the location of said surface following element along said reference pathway.
5. An automatically operative medical insertion device according to claim 4 and wherein said surface characteristic information comprises surface contour information.
6. An automatically operative medical insertion device according to claim 4 and wherein said surface characteristic information comprises surface hardness information.
7. An automatically operative medical insertion device according to claim 5 and wherein said surface contour information is three-dimensional.
8. An automatically operative medical insertion device according to claim 5 and wherein said surface contour information is two-dimensional.
9. An automatically operative medical insertion device according to any of the preceding claims and wherein said insertable element is an endotracheal tube and wherein said physical surface comprises surfaces of the larynx and trachea.
10. An automatically operative medical insertion device according to any of claims 1 - 8 and wherein said insertable element is a gastroscope and wherein said physical surface comprises surfaces of the intestine.
11. An automatically operative medical insertion device according to any of claims 1 - 8 and wherein said insertable element is a catheter and wherein said physical surface comprises interior surfaces of the circulatory system.
12. An automatically operative medical insertion device according to any of the preceding claims and also comprising a reference pathway generator operative to image at least a portion of said living organism and to generate said reference pathway based at least partially on an image generated thereby.
13. An automatically operative medical insertion device according to claim
12 and wherein said reference pathway comprises a standard contour map of a portion of the human anatomy.
14. An automatically operative medical insertion device according to claim
13 and wherein said standard contour map is precisely adapted to a specific patient.
15 An automatically operative medical insertion device according to claim 13 or claim 14 and wherein said standard contour map is automatically precisely adapted to a specific patient
16 An automatically operative medical insertion device according to any of claims 12 to 15 and wherein said reference pathway is operator adaptable to designate at least one impediment
17 An automatically operative medical insertion device according to any of the preceding claims and wherein said insertable element comprises a housing m which is disposed said driving subsystem, a mouthpiece, a tube inserted through the mouthpiece and a flexible guide inserted through the tube, said surface following element being mounted at a front end of said guide
18 An automatically operative medical insertion device according to claim
17 and wherein said mouthpiece comprises a curved pipe through which said tube is inserted
19 An automatically operative medical insertion device according to claim
18 and wherein said driving subsystem is operative to move said guide in and out of said housing, through said curved pipe and through said tube
20 An automatically operative medical insertion device according to claim
19 and wherein said driving subsystem is also operative to selectably bend a front end of said guide
21 An automatically operative medical insertion device according to any of the preceding claims and wherein said driving subsystem is operative to move said insertable element in and out of said living organism
22 An automatically operative medical insertion device according to any of the preceding claims and wherein said driving subsystem is also operative to selectably bend a front end of said insertable element.
23. An automatically operative medical insertion device according to any of the preceding claims and wherein said surface following element comprises a tactile sensing element.
24. An automatically operative medical insertion device according to any of the preceding claims and wherein said surface following element comprises a tip sensor including a tip integrally formed at one end of a short rod having a magnet on its other end, said rod extends through the center of a spring disk and is firmly connected thereto, said spring disk being mounted on one end of a cylinder whose other end is mounted on a front end of said insertable element.
25. An automatically operative medical insertion device according to claim 24 and wherein said tip sensor also comprises two Hall effect sensors which are mounted inside said cylinder on a support and in close proximity to said magnet, said Hall effect sensors being spaced in the plane of the curvature of the curved pipe, each Hall effect sensor having electrical terminals operative to provide electric current representing the distance of the magnet therefrom, said tip sensor being operative such that when a force is exerted on the tip along an axis of symmetry of said cylinder, said tip is pushed against said spring disk, causing said magnet to approach said Hall effect sensors and when a force is exerted on said tip sideways in the plane of said Hall effect sensors, said tip rotates around a location where said rod engages said spring disk, causing said magnet to rotate away from one of said Hall effect sensors and closer to the other of the Hall effect sensors.
26. An automatically operative medical insertion device according to claim 17 and wherein said driving subsystem is operative, following partial insertion of said insertable element into the oral cavity, to cause the guide to extend in the direction of the trachea and bend the guide clockwise until said surface following element engages a surface of the tongue, whereby this engagement applies a force to said surface following element.
27. An automatically operative medical insertion device according to claim 25 and wherein said navigation subsystem is operative to measure the changes in the electrical outputs produced by the Hall effect sensors indicating the direction in which the tip is bent.
28. An automatically operative medical insertion device according to claim 27 and wherein said navigation subsystem is operative to sense the position of said tip and the past history of tip positions and to determine the location of said tip in said living organism and relative to said reference pathway.
29. An automatically operative medical insertion device according to claim 27 and wherein said navigation subsystem is operative to navigate said tip according to said reference pathway.
30. An automatically operative medical insertion device according to claim 29 and wherein said navigation subsystem is operative to sense that said tip touches the end of the trough beneath the epiglottis.
31. An automatically operative medical insertion device according to claim 27 and wherein said navigation subsystem is operative to sense that said tip reaches the tip of the epiglottis.
32. An automatically operative medical insertion device according to claim 27 and wherein said navigation subsystem is operative to sense that the tip reached the first cartilage of the trachea.
33. An automatically operative medical insertion device according to claim 32 and wherein said navigation subsystem is operative to sense that the tip reached the second cartilage of the trachea.
34. An automatically operative medical insertion device according to claim 33 and wherein said navigation subsystem is operative to sense that the tip reached the third cartilage of the trachea.
35. An automatically operative medical insertion device according to any of the preceding claims and wherein said navigation subsystem is operative to load said reference pathway from a memory.
36. An automatically operative medical insertion device according to claim 17 and wherein said driving subsystem is operative to push said tube forward.
37. An automatically operative medical insertion device according to any of the preceding claims and wherein said driving subsystem comprises: a first motor operative to selectably move said insertable element forward or backward; a second motor operative to selectably bend said insertable element; and electronic circuitry operative to control said first motor, said second motor and said surface following element.
38. An automatically operative medical insertion device according to claim 37 and wherein said electronic circuitry comprises a microprocessor operative to execute a program, said program operative to control the said first and second motors and said surface following element and to insert and bend said insertable element inside said living organism along said reference pathway.
39. An automatically operative medical insertion device according to claim 37 or claim 38 and wherein said driving subsystem is operative to measure the electric current drawn by at least one of said first and second motors to evaluate the position of said surface following element.
40. An automatically operative medical insertion device according to any of the preceding claims and wherein said reference pathway is operative to be at least partially prepared before the insertion process is activated
41 An automatically operative medical insertion device according to claim
40 and wherein said medical insertion device comprises a medical imaging system and wherein said medical imaging system is operative to at least partially prepare said reference pathway
42 An automatically operative medical insertion device according to claim
41 and wherein said medical imaging subsystem compnses at least one of an ultrasound scanner, an X-ray imager a CAT scan system and an MRI system
43 An automatically operative medical insertion device according to claim
40 and wherein said medical imaging system is operative to prepare said reference pathway by marking at least one contour of at least one organ of said living organism
44 An automatically operative medical insertion device according to claim
41 and wherein said medical imaging system is operative to prepare said reference pathway by creating an insertion instruction table compπsmg at least one insertion instruction
45 An automatically operative medical insertion device according to claim 44 and wherein said insertion instruction comprises instruction to at least one of extend, retract and bend said insertable element
46 An automatically operative medical insertion device according to claim 44 and wherein said navigation subsystem is operative to control said driving subsystem based at least partially on a perceived location of said surface following element and according to said insertion instruction table stored in said navigation subsystem
47 An automatically operative medical insertion device according to any of the preceding claims and wherein said operative medical insertion device is operative to at least partially store a log of a process of insertion of said insertable element
48. An automatically operative medical insertion device according to claim
47 and wherein said medical insertion device comprises a computer and wherein said medical insertion device is operative to transmit said log of a process of insertion of said insertable element.
49. An automatically operative medical insertion device according to claim
48 and wherein said computer is operative to aggregate said logs of a process of insertion of said insertable element.
50. An automatically operative medical insertion device according to claim
49 and wherein said computer is operative to prepare said reference pathway based at least partially on said aggregate.
51. An automatically operative medical insertion device according to claim
50 and wherein said computer transmits said reference pathway to said medical insertion device.
52. An automatically operative medical insertion device according to claim 1 and wherein said insertable element comprises a guiding element and a guided element.
53. An automatically operative medical insertion device according to claim 52 and wherein said driving subsystem is operative to direct said guiding element and said guided element at least partially together.
54. An automatically operative medical insertion device according to any of claims 17 - 51 and wherein said mouthpiece comprises a disposable mouthpiece.
55. An automatically operative medical insertion device according to claim 17 and wherein said driving subsystem is operative to at least partially automatically direct said guide in a combined motion comprising a longitudinal motion and lateral motion.
56. An automatically operative medical insertion device according to any of the preceding claims and wherein said insertable element is extendable.
57. An automatically operative medical insertion device according to claim
56 and wherein said insertable element comprises: a mounting element which is arranged to be removably engaged with an intubator assembly; and an extendable tube operatively associated with said mounting element.
58. An automatically operative medical insertion device according to claim
57 and wherein said extendable tube is arranged to be pulled by a flexible guide operated by said intubator assembly.
59. An automatically operative medical insertion device according to claim 57 or claim 58 and wherein said extendable tube comprises a coil spring.
60. An automatically operative medical insertion device according to any of claims 57-59 and wherein said extendable tube also comprises a forward end member, on a distal end thereof.
61. An automatically operative medical insertion device according to claim 60 and wherein said forward end member includes a diagonally cut pointed forward facing tube end surface.
62. An automatically operative medical insertion device according to claim 60 or claim 61 and also comprising a forward end member mounted inflatable and radially outwardly expandable circumferential balloon.
63. An automatically operative medical insertion device according to claim 62 and wherein said forward end member mounted inflatable and radially outwardly expandable circumferential balloon receives inflation gas through a conduit formed in a wall of said forward end member and continuing through said tube to a one way valve.
64. An automatically operative medical insertion device according to any of claims 57 - 63 and also comprising a flexible guide having mounted at a distal end thereof a tip sensor.
65. An automatically operative medical insertion device according to claim
64 and wherein said flexible guide is formed with an inflatable and radially outwardly expandable guide mounted balloon.
66. An automatically operative medical insertion device according to claim
65 and wherein said inflatable and radially outwardly expandable guide mounted balloon receives inflation gas through a conduit formed in said flexible guide and extending therealong.
67. An automatically operative medical insertion device according to claim
66 and wherein said conduit is connected to a source of pressurized inflation gas.
68. An automatically operative medical insertion device according to claim
67 and wherein said source of pressurized inflation gas is located within said intubator assembly.
69. An automatically operative medical insertion device according to claim 63 and wherein said inflation gas comprises pressurized air.
70. An automatically operative medical insertion device according to claim 66 and wherein said inflation gas comprises pressurized air.
71. An automatically operative medical insertion method comprising: inserting an insertable element within a living organism in vivo; physically associating a surface following element with said insertable element and causing said surface following element to follow a physical surface within said living organism in vivo, directing said insertable element along said physical surface using a driving subsystem, and controlling direction of said insertable element based at least partially on a perceived location of said surface following element along a reference pathway stored in a navigation subsystem
72 An automatically operative medical insertion method according to claim 71 and wherein said directing comprises fully automatic directing
73 An automatically operative medical insertion method according to claim 71 and wherein said directing comprises automatically and selectably directing
74 An automatically operative medical insertion method according to any of claims 71 - 73 and wherein said controlling comprises receiving surface characteristic information relating to said physical surface from said surface following element and employing said surface characteristic information to perceive the location of said surface following element along said reference pathway
75 An automatically operative medical insertion method according to claim 74 and wherein said surface characteristic information comprises surface contour information
76 An automatically operative medical insertion method according to claim
74 and wherein said surface characteristic information comprises surface hardness information
77 An automatically operative medical insertion method according to claim
75 and wherein said surface contour information is three-dimensional
78 An automatically operative medical insertion method according to claim 75 and wherein said surface contour information is two-dimensional
79. An automatically operative medical insertion method according to any of claims 71 to 78 and wherein said insertable element is an endotracheal tube and wherein said physical surface comprises surfaces of the larynx and trachea.
80. An automatically operative medical insertion method according to any of claims 71 to 78 and wherein said insertable element is a gastroscope and wherein said physical surface comprises surfaces of the intestine.
81. An automatically operative medical insertion method according to any of claims 71 to 78 and wherein said insertable element is a catheter and wherein said physical surface comprises interior surfaces of the circulatory system.
82. An automatically operative medical insertion method according to any of claims 71 to 81 and also comprising generating an image by imaging at least a portion of said living organism and generating said reference pathway based at least partially on said image.
83. An automatically operative medical insertion method according to any of claims 71 to 82 and wherein said reference pathway comprises a standard contour map of a portion of the human anatomy.
84. An automatically operative medical insertion method according to claim
83 and also comprising precisely adapting said standard contour map to a specific patient.
85. An automatically operative medical insertion method according to claim
84 and also comprising automatically precisely adapting said standard contour map to a specific patient.
86. An automatically operative medical insertion method according to any of claims 71 to 85 and also comprising adapting said reference pathway.
Ill
87. An automatically operative medical insertion method according to claim 86 and wherein said adapting comprises receiving inputs from an operator.
88. An automatically operative medical insertion method according to any of claim 87 and wherein said adapting comprises designating at least one impediment.
89. An automatically operative medical insertion method according to any of claims 71 to 88 and also comprising: providing: a flexible guide, said surface following element being mounted at a front end of said flexible guide; a housing in which is disposed said driving subsystem; a mouthpiece and a tube; inserting said flexible guide through said tube; inserting said tube through said mouthpiece; and driving said flexible guide employing said driving subsystem.
90. An automatically operative medical insertion method according to claim
89 and wherein said mouthpiece comprises a curved pipe through which said tube is inserted.
91. An automatically operative medical insertion method according to claim
90 and also comprising moving said guide in and out of said housing, through said curved pipe and through said tube employing said driving subsystem.
92. An automatically operative medical insertion method according to claim
91 and also comprising selectably bending a front end of said guide employing said driving subsystem.
93. An automatically operative medical insertion method according to any of claims 71 to 92 and also comprising moving said insertable element in and out of said living organism employing said driving subsystem.
94 An automatically operative medical insertion method according to any of claims 71 to 93 and also comprising selectably bending a front end of said insertable element
95 An automatically operative medical insertion method according to any of claims 71 to 94 and wherein said surface following element comprises a tactile sensing element
96 An automatically operative medical insertion method according to any of claims 71 to 95 and wherein said physically associating a surface following element with said insertable element comprises integrally forming a tip at one end of a short rod having a magnet on its other end. extending said rod through the center of a spring disk, firmly connecting said spring disk to said rod, mounting said spring disk on one end of a cylinder, mounting another end of said cylinder on a front end of said insertable element
97 An automatically operative medical insertion method according to claim
96 and wherein said surface following element also comprises two Hall effect sensors, each Hall effect sensor having electrical terminals operative to provide electric current representing the distance of the magnet therefrom and also comprising mounting said Hall effect sensors inside said cylinder on a support and in close proximity to said magnet, spacing said Hall effect sensors m the plane of the curvature of said curved pipe, said tip sensor being operative such that when a force is exerted on said tip along an axis of symmetry of said cylinder, said tip is pushed against said spring disk, causing said magnet to approach said Hall effect sensors and when a force is exerted on said tip sideways in the plane of said Hall effect sensors, said tip rotates around a location where said rod engages said spring disk, causing said magnet to rotate away from one of said Hall effect sensors and closer to the other of the Hall effect sensors
98 An automatically operative medical insertion method accordmg to claim 89 and also comprising partially inserting said insertable element into the oral cavity, causing said insertable element to extend in the direction of the trachea, bending said guide clockwise until said surface following element engages a surface of the tongue, whereby this engagement applies a force to said surface following element
99 An automatically operative medical insertion method according to claim 96 and also comprising measuring the changes m the electrical outputs produced by the Hall effect sensors indicating the direction m which the tip is bent by employing said navigation subsystem
100 An automatically operative medical insertion method accordmg to claim 99 and also comprising sensing the position of said tip and determining the location of said tip in said living organism and relative to said reference pathway based on the past history of tip positions
101 An automatically operative medical insertion method accordmg to claim 99 and also comprising navigating said tip according to said reference pathway employing said navigation subsystem
102 An automatically operative medical insertion method according to claim 101 and also comprising sensing said tip touching the end of the trough beneath the epiglottis
103 An automatically operative medical insertion method according to claim 99 and also comprising sensing said tip reachmg the tip of the epiglottis
104 An automatically operative medical insertion method according to claim 99 and also comprising sensing the tip reaching the first cartilage of the trachea
105 An automatically operative medical insertion method accordmg to claim
104 and also comprising sensing the tip reaching the second cartilage of the trachea
106 An automatically operative medical insertion method according to claim
105 and also comprising sensing the tip reaching the third cartilage of the trachea
107 An automatically operative medical insertion method according to any of claims 71 to 106 and also comprising loading said reference pathway from a memory to said navigation subsystem
108 An automatically operative medical insertion method according to claim 89 and also comprising pushing said tube forward employing said driving subsystem
109 An automatically operative medical insertion method according to any of claims 71 to 108 and also comprising operating a first motor to selectably move said insertable element forward or backward, operating a second motor to selectably bend said insertable element, and controlling said first motor, said second motor and said surface following element by employing electronic circuitry
110 An automatically operative medical insertion method according to claim 109 and wherein said electronic circuitry comprises a microprocessor and also comprising executing a program, said executing a program comprising controlling said first and second motors and said surface following element, and inserting and bending said insertable element inside said living organism along said reference pathway
11 1 An automatically operative medical insertion method according to claim 109 or claim 110 and also comprising measuring the electric current drawn by at least one of said first and second motors, and evaluating the position of said surface following element, by employing said driving subsystem
1 12 An automatically operative medical insertion method according to any of claims 71 to 111 and also comprising preparing said reference pathway at least partially before the insertion process is activated
113 An automatically operative medical insertion method according to claim
112 and also comprising providing a medical imaging system, and preparing said reference pathway at least partially by employing said medical imaging system
114 An automatically operative medical insertion method accordmg to claim
113 and wherein said medical imaging subsystem comprises at least one of an ultrasound scanner, an X-ray imager, a CAT scan system and an MRI system
115 An automatically operative medical insertion method according to claim 112 and also comprising preparing said reference pathway by marking at least one contour of at least one organ of said living organism
116 An automatically operative medical insertion method according to claims 71 to 115 and also comprising preparing said reference pathway by creating an insertion instruction table comprising at least one insertion instruction
117 An automatically operative medical insertion method according to claim 116 and wherein said insertion mstruction comprises instruction to at least one of extend, retract and bend said insertable element
118 An automatically operative medical insertion method according to claim 1 16 and also comprising controlling said driving subsystem based at least partially on a perceived location of said surface following element and accordmg to said msertion instruction table stored m said navigation subsystem
119 An automatically operative medical insertion method according to any of claims 71 to 118 and also comprising storing at least partially a log of a process of insertion of said insertable element
120 An automatically operative medical insertion method according to claim
1 19 and also comprising providing a computer, and transmitting said log of a process of insertion of said insertable element to said computer
121 An automatically operative medical insertion method according to claim
120 and also comprising aggregating said logs of a process of insertion of said insertable element by employing said computer
122 An automatically operative medical msertion method accordmg to claim
121 and also comprising preparing said reference pathway based at least partially on the output of said aggregating
123 An automatically operative medical insertion method according to claim
122 and also comprising transmitting said reference pathway from said computer to said medical insertion device
124 An automatically operative medical insertion method according to any of claims 71 to 123 and wherein said insertable element comprises a guiding element and a guided element
125 An automatically operative medical insertion method according to claim 124 and also comprising directing said guiding element and said guided element at least partially together
126 An automatically operative medical insertion method accordmg to claim 73 and wherein said directing comprises automatically and selectably directing said insertable element in a combined motion comprising a longitudinal motion and lateral motion
127 An automatically operative medical insertion method according to any of claims 71 - 126 and wherein said inserting also comprises extending said insertable element
128 An automatically operative medical insertion method according to claim
127 and also comprising removably engaging said insertion element with an intubator assembly, and operatively associating an extendable tube with said insertion element
129 An automatically operative medical insertion method accordmg to claim
128 and wherein said extending comprises operating a flexible guide, and pulling said extendable tube by said flexible guide
130 An automatically operative medical insertion method according to claim 128 or claim 129 and wherein said extending compnses at least one of expanding and contracting a coil spring
131 An automatically operative medical insertion method according to any of claims 128 - 130 and also comprising forming a forward end member, on a distal end of said extendable tube
132. An automatically operative medical insertion method according to claim 131 and also comprising forming a diagonally cut pointed forward facing tube end surface on said forward end member.
133. An automatically operative medical insertion method according to claim 131 or claim 132 and also comprising forming an inflatable and radially outwardly expandable circumferential balloon on said forward end member.
134. An automatically operative medical insertion method according to claim 133 and also comprising receiving inflation gas into said circumferential balloon through a conduit formed in a wall of said forward end member and continuing through said tube to a one way valve.
135. An automatically operative medical insertion method according to any of claims 129 - 134 and also comprising mounting a tip sensor at a distal end of said flexible guide.
136. An automatically operative medical insertion method according to claim
135 and also comprising forming an inflatable and radially outwardly expandable guide balloon on said flexible guide.
137. An automatically operative medical insertion method according to claim
136 and also comprising receiving inflation gas into said guide balloon through a conduit formed in said said flexible guide and extending therealong.
138. An automatically operative medical insertion method according to claim
137 and also comprising connecting said conduit to a source of pressurized inflation gas.
139. An automatically operative medical insertion method according to claim
138 and also comprising locating said source of pressurized inflation gas within said intubator assembly.
140. An automatically operative medical insertion method according to any of claims 136 - 139 and also comprising inflating said guide mounted balloon to tightly engage the interior of said forward end member to provide extension of said tube in response to forward driven movement of said flexible guide.
141. An automatically operative medical insertion method according to claim 134 and wherein said inflating comprises inflating said circumferential balloon with pressurized air.
142. An automatically operative medical insertion method according to claim 137 and wherein said inflating comprises inflating said guide balloon with pressurized air.
PCT/IL2002/000347 2000-12-06 2002-05-02 Extendable tube WO2003047673A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP02728003A EP1461104A4 (en) 2001-12-05 2002-05-02 Extendable tube
AU2002258131A AU2002258131A1 (en) 2001-12-05 2002-05-02 Extendable tube
US10/496,857 US20050076914A1 (en) 2000-12-06 2002-05-02 Extendable tube
CA002469088A CA2469088A1 (en) 2001-12-05 2002-05-02 Extendable tube

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ILPCT/IL01/01121 2001-12-05
PCT/IL2001/001121 WO2002045768A2 (en) 2000-12-06 2001-12-05 Apparatus for self-guided intubation

Publications (1)

Publication Number Publication Date
WO2003047673A1 true WO2003047673A1 (en) 2003-06-12

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PCT/IL2002/000347 WO2003047673A1 (en) 2000-12-06 2002-05-02 Extendable tube

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Country Link
EP (1) EP1461104A4 (en)
AU (1) AU2002258131A1 (en)
CA (1) CA2469088A1 (en)
WO (1) WO2003047673A1 (en)

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US8323203B2 (en) 2008-02-28 2012-12-04 Boston Scientific Scimed, Inc. Imaging catheter
CN103041495A (en) * 2011-10-12 2013-04-17 上海凯旦医疗科技有限公司 Endovascular interventional catheter tactile probe
PT106730A (en) * 2013-01-10 2014-07-10 Univ Do Porto DIGITAL LARINGOSCOPE
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WO2020000032A1 (en) 2018-06-25 2020-01-02 Airway Medical Innovations Pty Ltd Intubation device improvements

Also Published As

Publication number Publication date
AU2002258131A1 (en) 2003-06-17
EP1461104A4 (en) 2005-01-19
EP1461104A1 (en) 2004-09-29
CA2469088A1 (en) 2003-06-12

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