DETAILED ACTION
Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Response to Arguments
Regarding 35 U.S.C. 112(b)
Applicant's arguments filed 05/06/2026 have been fully considered but they are not persuasive. For example, applicant merely argues that “claim 3 is definite” due to amendments. Examiner notes that while amendments are made to the claim, it is noted that claim 1 remains to recite point cloud data from a sensor system and claim 3 now recites target location data form the sensor system. It is noted that although claim 3 further recites “indicating a pose of the internal instrument”, there is no clear distinction/correspondence between the target location data and the previously recited point cloud data. In other words, a person having ordinary skill in the art would have recognized that point cloud data may “indicate a pose of the internal instrument” where indicating a pose is broadly recited, thus it remains unclear if the point cloud data and the target location data which both come from the sensor system are the same or are different elements. For at least these reasons, the 112(b) rejection of claim 3 is maintained/updated in light of the amendments to the claims.
Regarding prior art,
Applicant’s arguments with respect to claim 1 have been considered but are moot in view of the new grounds of rejection necessitated by amendment. Specifically, new teachings are applied with respect to the cylindrical model of the substructure having a constant diameter. Although new teachings are applied, examiner will address any remarks which remain relevant to the current rejection.
Applicant's arguments filed 05/06/2026 with respect to Ayvali teaching a cylindrical model of a substructure have been fully considered but they are not persuasive. For example, Applicant argues “Ayvali’s surface map 1700 is not a ‘cylindrical model’ of the substructure within any reasonable construction of that term. As Ayvali’s own disclosure makes clear, the surface map 1700 is an irregular, interpolated surface that attempts to reconstruct the actual interior surface topology of the calyx” and points to [0198] and fig. 17 with further arguments that “a surface reconstruction is fundamentally different from a ‘cylindrical model’, as claimed. The Office Action’s reasoning that the surface map 1700 is considered to be cylindrical model simply because the underlying anatomy has a funnel/tubular’ shape conflates the shape of the anatomy with the shape of the model. Under this reasoning, any representation of any tubular anatomic structure would be a cylindrical model’ which would render the claim limitation meaningless. Ayvali doe s not disclose generating a cylindrical model; Ayvali discloses generating a surface estimate that follows whatever shape the underlying data produces” (REMARKS pg. 7-8). Examiner respectfully disagrees in that the surface map 1700 (which is a three-dimensional rendering) is considered a model, and as noted by applicant since the surface map attempts to reconstruct the actual interior surface topology of the calyx (or infundulum therewith) that the reconstruction of a tubular feature would necessarily result in the model (i.e. surface map) being tubular and therefore cylindrical. The language of the cylindrical model alone does not render any specific meaning that precludes a surface rendering (i.e. model) which is tubular (i.e. cylindrical) from being considered a cylindrical model. Nonetheless, as noted above, applicant further modifies the cylindrical model such that it has a constant diameter and new teachings are relied upon to teach such a cylindrical model, thus arguments associated therewith are considered moot as noted above.
Applicant's arguments filed 05/06/2026 regarding claims 17 and 3 have been fully considered but they are not persuasive.
Regarding claim 17, applicant’s argues that “throughout Ayvali’s disclosure the ‘target’ for the purpose of percutaneous access guidance is consistently and unambiguously the papilla (an anatomical landmark structure)” (REMARKS pg. 9) and that “the papilla serves as a navigational waypoint. It is the point through which the percutaneous needle passes to access the calyx and ultimately reach the kidney stone. The papilla is not treated. The actual thing being treated in Ayvali’s procedure –the kidney stone—is mentioned as the reason for performing the PCNL procedure. See Ayvali at [0059]. However, Ayvali never uses the kidney stone as the ‘target’ (REMARKS pg. 9-10). Examiner respectfully disagrees in that while Ayvali points to the papilla as a target, it is noted that the claimed target is broadly recited and is read on by the target calyx of Ayvali which is interpreted as a ‘target. For example, [0128] discloses target site (e.g. target calyx/papilla and associated infundibula) and [0125] discloses percutaneous-access instrument (e.g., needle) can be implemented in order to guide the physician/technician in aligning the percutaneous-access instruments with the treatment site (e.g., target calyx), where such a treatment site/target calyx reads on the currently recited target and is an object/tissue to be treated since the kidney stone as the kidney stone is within the target calyx as disclosed in [0059] and [0125] designates the target calyx as a treatment site. Examiner notes that removal/destruction of a kidney stone within a target calyx (i.e. treatment site) means the target calyx is an object/tissue to be treated (i.e. via removal/destruction of a kidney stone). Examiner thus notes that applicant’s general characterization that the papilla is the only “target” of Ayvali is not found persuasive. Furthermore, although the kidney stone is removed/treated where such a kidney stone may be considered a “target which is an object or tissue to be treated, the claim does not specify the nature of the target other than that it is an object/tissue to be treated. Therefore, the target is interpreted to be the target calyx (i.e. treatment site) within which the kidney stone is located, where removal/destruction/treatment of the kidney stone ultimately treats the calyx. For at least these reasons, applicant’s arguments against the teachings of Ayvali are not found persuasive.
Applicant’s arguments that Ayvali does not disclose ‘generating a representation of the target at a location within the 3D model’ (See REMARKS pg. 10-11) seem to follow the same logic in that the surface map does not generate a representation of the papilla nor the kidney stone. As noted above, the target is interpreted as the target calyx, where the surface map (i.e. 3D model) corresponds with a mapping of the target site (e.g. target calyx/papilla) as disclosed in [0128] and [0195] discloses such points 1501-1504 may be used to reconstruct the shape of the calyx and [0198] discloses shows a generated three-dimensional surface map 1700 generated in any suitable manner, such as using a Gaussian interpolation. For example, with the calyx and/or infundibulum surface determine/generated, the calyx/infundibulum axis 1715 can be determined based at least in part on the estimated surface(s). Examiner notes that the three-dimensional surface map of the calyx surface necessarily includes a representation of the target (i.e. target calyx) at a location within the 3D model. For at least these reasons, applicant’s arguments are not found persuasive.
Regarding claim 3, Applicant argues “Ayvali additionally does not disclose determining target location based on data ‘indicating a pose of the internal instrument as the internal instrument is pointed toward the target,’ as recited in amended claim 3. Rather Ayvali’s two target localization methods are (1) a contact-based method in which the scope physically contacts the papilla and records the electromagnetic sensor position at contact (see Ayvali [0118]) and (2) and offset-based metho in which the target position is maintained by applying a positional translation from a parked scope position to a previously-recorded contact position (see Ayvali [0130]-[0133]) (REMARKS pg. 11). Examiner respectfully disagrees in that first the claim does not specifically require any determining and merely requires that the location of the target within the 3D model is based at least in part on target location data from the sensor system indicating a pose of the internal instrument as the internal instrument is pointed toward the target and claim 1 merely requires generating a representation of the target at a location within the 3D model without any determination required. Nonetheless, regarding applicant’s arguments that the does not disclose this feature in light of the two target localization methods, it is noted that the claim is broadly recited and merely requires that the location is based at least in part on target location data from the sensor system indicating a pose of the internal instrument. Absent any special definition upon which Applicant does not appear to rely, the scope of the claim was given its broadest reasonable interpretation such that the location is based at least in part on the sensor position data from the sensor on the internal instrument as disclosed in [0105] which discloses the sensor position data can indicate a position and/or orientation of the medical instrument and/or can be used to determine/infer a position/orientation of the medical instrument and [0195] discloses that the operator of the ureteroscope 1540 may be directed to articulate the scope to tag multiple points 1501-1504 inside the target calyx. Such points 1501-1504 may be used to construct the shape of the calyx, wherein the center of the constructed calyx can be used as a percutaneous access target and [0197]-[0198] disclose the features of generating a three-dimensional surface map using the scatterplot-type mapping of the calyx network through tagged/recorded position of the distal end portion of the scope. Examiner notes that first the 3D model and any representation therein is based on the sensor position data (used for tagging) which indicates a position and/or orientation (i.e. pose) of the medical instrument, furthermore, due to the breadth of based at least in part on, it is noted that the 3D model/representation therein is considered to be based on any data from the sensor system which is provided/received/sensed during the procedure as a whole including any other “target location data” which indicates a pose of the internal instrument if applicant intends for the target location data to be something other than the sensor position data. For at least these reasons, applicant’s arguments against the teachings of Ayvali with respect to claim 3 are not found persuasive.
Claim Rejections - 35 USC § 112
The following is a quotation of 35 U.S.C. 112(b):
(b) CONCLUSION.—The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the inventor or a joint inventor regards as the invention.
The following is a quotation of 35 U.S.C. 112 (pre-AIA ), second paragraph:
The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the applicant regards as his invention.
Claim 3 is rejected under 35 U.S.C. 112(b) or 35 U.S.C. 112 (pre-AIA ), second paragraph, as being indefinite for failing to particularly point out and distinctly claim the subject matter which the inventor or a joint inventor (or for applications subject to pre-AIA 35 U.S.C. 112, the applicant), regards as the invention.
Claim 3 recites the limitation “target location data from the sensor system”. It is unclear if the target location data is the same as or different from the point cloud data. If they are the same, it is unclear why the limitations are listed with separate modifiers and if they are intended to be different, it is unclear what target location data from the sensor system is provided other than the point cloud data. For examination purposes, it has been interpreted to mean any target location data indicating a pose of the internal instrument and may be the same as the point cloud data, however, clarification is required.
Claim Rejections - 35 USC § 102
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of the appropriate paragraphs of 35 U.S.C. 102 that form the basis for the rejections under this section made in this Office action:
A person shall be entitled to a patent unless –
(a)(1) the claimed invention was patented, described in a printed publication, or in public use, on sale, or otherwise available to the public before the effective filing date of the claimed invention.
(a)(2) the claimed invention was described in a patent issued under section 151, or in an application for patent published or deemed published under section 122(b), in which the patent or application, as the case may be, names another inventor and was effectively filed before the effective filing date of the claimed invention.
Claims 3, 17-19 and 63 are rejected under 35 U.S.C. 102(a)(1)/102(a)(2) as being anticipated by Ayvali et al. (US 20210298590 A1) and cited in applicant’s IDS filed 05/01/2024)
Regarding claim 17,
Ayvali discloses a method for providing guidance for percutaneous access to a target within an anatomic structure, the method comprising:
Receiving point cloud data ([0179] which discloses a position of a medical device can be represented with coordinates of a point/point-set within a coordinate system (e.g. one or more X, Y, Z coordinates) from a sensor system ([0105] which discloses the medical instrument (e.g., scope) 440 includes a sensor that is configured to generate and/or send sensor position data to another device. The sensor position data can indicate a position and/or orientation of the medical instrument 440 (e.g., the distal end 442 thereof) and/or can be used to determine/infer a position/orientation of the medical instrument. For example, a sensor (sometimes referred to as a “position sensor”) can include an electromagnetic (EM) sensor with a coil of conductive material, or other form/embodiment of an antenna. [0084] which discloses For example, the localization component 314 can process input data (e.g., sensor data from a medical instrument, model data regarding anatomy of a patient, position data of a patient, pre-operative data, robotic command and/or kinematics data, etc.) to generate position/orientation data 320 for one or more medical instruments) coupled to an internal instrument (at least fig. 4 (440) and corresponding disclosure in at least [0105]) as the internal instrument is moved within the anatomic structure ([0197] which discloses while driving the scope to the target papilla/calyx, a plurality of positions associated with the distal end portion of the scope may be tagged/recorded along the path to provide a scatterplot-type mapping of at least a portion of the calyx network (e.g., the target calyx and/or associated infundibulum);
Generating a 3D model (at least figs. 16 (1600) /17 (1700) and corresponding disclosure in at least [0197]-[0198]) including the anatomic structure, wherein the 3D model is based at least in part on the point cloud data ([0197] which discloses a plurality of positions associated with the distal end portion of the scope may be tagged/recorded along the path to provide a scatterplot-type mapping and a gaussian interpolation may be implemented to generate the three-dimensional surface map 1700 as disclosed in [0198]) ;
Receiving information for identifying a substructure within the 3D anatomic model, wherein the substructure provides access to the target ([0199] which discloses in some embodiments, as shown in FIG. 15, circular motions may be effected in the scope to generate a sufficient position plot of the target calyx, wherein the calyx map to be formed therefrom. The calyx orientation 1715 can be estimated from the calyx map 1700, wherein such trajectories 1715 can provide a path along which scope/papilla offset may be projected/determined. This may allow the target position to be updated more robustly for cases where the scope heading changes with respect to the calyx, infundibulum, and/or papilla axis due to tissue deformation during needle insertion. Depending on the particular procedure, it may not be necessary to map out the entire calyx network of the kidney for the purpose of percutaneous access targeting. For example, only the calyx associated with the target papilla may be mapped in some implementations. In some implementations, multiple calyces may be mapped to provide increased spatial information/mapping see also [0114]-[0115] which disclose locating a kidney stone using an image-capturing device and identifying a target papilla that is exposed within a target Calyx through which access to the kidney stone may be achieved);
Determining an entry point to the substructure ([0117] which discloses the process 500 involves tagging/recording the position of the exposed papilla 579 within the target calyx 575 through which the desired access is to be achieved. See also [0116] which discloses by targeting entry in the area of the axial center of the calyx 575, major arteries and/or other blood vessels can be avoided in some instances, [0009] which discloses some embodiments involve the presentation of one or more icons representing a projected needle entry point into the target anatomical feature (e.g., papilla), and [0177] which discloses For example, where the projected needle entry point into the target calyx and/or through the target papilla 914 is outside of the field of view 952 of the scope camera, the interface feature(s) 956 can notify the physician 5 of the direction the scope 92 can be moved to bring the projected needle entry point into the camera view 952);
Determining an approach path through the entry ([0176] which discloses The control system 50 can include control circuitry configured to determine a target trajectory 902 for inserting the needle 17 to assist the physician 5 in reaching the target location (e.g., the papilla 914). See also [0092] which discloses target/trajectory component 316 can also be configured to determine a target trajectory for a medical instrument or another object. A target trajectory can represent a desired path for accessing a target location and/or anatomical feature. A target trajectory can be determined based on a variety of information, such as a position of a medical instrument(s) (e.g., a needle, a scope, etc.), a target location within the human anatomy, a position and/or orientation of a patient, the anatomy of the patient (e.g., the location of organs within the patient relative to the target location), and so on) ; and
Providing a graphical representation of the approach path (See at least fig. 13 (902) and corresponding disclosure in at least [0176]. See also [0092] which discloses in examples, a physician can analyze images or models of the human anatomy and provide input to designate a target trajectory, such as by drawing a line on an image of the internal anatomy of a patient. In some embodiments, the target/trajectory component 316 can calculate a target trajectory initially and/or update the target trajectory throughout the procedure),
Wherein the target is an object to be treated or a tissue to be treated ([0059] which discloses once at the site of the kidney stone 80 (e.g., within a target calyx 75 of the kidney 70 through which the stone 80 is accessible) and the process 500 involves identifying a target papilla 579 that is exposed within a target calyx 575 through which access to the kidney stone 580 may be achieved.. See also [0125] which discloses guide the physician/technician in aligning the percutaneous-access instruments with the treatment site (e.g., target calyx). Examiner therefore notes that since the target Calyx is the treatment site as disclosed in [0125] and since the kidney stone is within the target calyx as disclosed in [0059], the target calyx is considered an object and/or a tissue to be treated (e.g. treated to have a kidney stone removed/destroyed)),
Wherein generating the 3D model further includes generating a representation of the target at a location within the 3D model ([0128] which discloses in some embodiments, as described in greater detail below with respect to FIGS. 15-17, a mapping of the target site (e.g., target calyx/papilla and associated infundibula) may be generated based on a plurality of recorded positions from EM sensor data and [0199] which discloses In some embodiments, as shown in FIG. 15, circular motions may be effected in the scope to generate a sufficient position plot of the target calyx, wherein the calyx map to be formed therefrom. The calyx orientation 1715 can be estimated from the calyx map 1700, wherein such trajectories 1715 can provide a path along which scope/papilla offset may be projected/determined. This may allow the target position to be updated more robustly for cases where the scope heading changes with respect to the calyx, infundibulum, and/or papilla axis due to tissue deformation during needle insertion. Depending on the particular procedure, it may not be necessary to map out the entire calyx network of the kidney for the purpose of percutaneous access targeting. For example, only the calyx associated with the target papilla may be mapped in some implementations. In some implementations, multiple calyces may be mapped to provide increased spatial information/mapping. Examiner thus notes that the calyx map 1700 generates a representation of the target (i.e. target calyx) at a location within the 3D model)
wherein the approach path is based at least in part on a location of the target ([0176] which discloses the control system 50 can include control circuitry configured to determine a target trajectory 902 for inserting the needle 17 to assist the physician 5 in reaching the target location (e.g., the papilla 914). See also [0175] which discloses The trajectory may be generally in-line with the axis of the infundibulum associated with the target calyx. See also [0092] which discloses target/trajectory component 316 can also be configured to determine a target trajectory for a medical instrument or another object. A target trajectory can represent a desired path for accessing a target location and/or anatomical feature. A target trajectory can be determined based on a variety of information, such as a position of a medical instrument(s) (e.g., a needle, a scope, etc.), a target location within the human anatomy).
Regarding claim 3,
Ayvali further discloses wherein the location of the target within the 3D model is based at least in part on target location data from the sensor system indicating a pose of the internal instrument is pointed toward the target (see at least figs. 16 (1600) and 17 (1700) and [0197] which discloses a Gaussian interpolation may be implemented along the reported trajectory, or portion thereof, within a target calyx 1612 and/or associated infundibulum 1613. [0084] which discloses For example, the localization component 314 can process input data (e.g., sensor data from a medical instrument, model data regarding anatomy of a patient, position data of a patient, pre-operative data, robotic command and/or kinematics data, etc.) to generate position/orientation data 320 for one or more medical instruments. See also [0195] which discloses operator of the ureteroscope 1540 may be directed to articulate the scope to tag multiple points inside the target calyx. Such points 1501-1504 may be used to construct the shape of the calyx, wherein the center of the constructed In some implementations, the scope 1550 may be articulated in sweeping motions, as shown, to outline/cover the traversed area. Examiner notes that the location of the target (i.e. target calyx) within the 3D model is necessarily based in part on the location/position of the ureteroscope as well as any localization data associated therewith including the position/orientation data 320 of the medical instrument which is considered target location data indicating a pose of the internal instrument. See also [0154] which discloses the target position targeted by the percutaneous access instrument (not shown) may be determined based on a known offset distance, orientation, and/or position of the scope 1040 relative to the target papilla 1079 or other anatomical feature.).
Regarding claim 18,
Ayvali further discloses wherein providing the graphical representation includes representing the approach path as a line from the target (i.e. target calyx at which the probe is positioned) through a center of the distal opening of the substructure (see at least figs. 10A (1006) and 10B (1003) and corresponding disclosure in at least [0157]-[0158] where the approach path is from the center of a distal opening of the calyx 1012 (considered a substructure). See also at least fig. 6-2 in which the needle (thus the approach path associated therewith) is through a center of an opening of the papilla).
Regarding claim 19,
Ayvali further teaches wherein providing the graphical providing the graphic representation includes representing the approach path as a cylindrical range of vectors (at least figs. 10A (1002, 1004, and 1006)/10B (1001, 1003, and 1005) and corresponding disclosure in at least [0156]-[0158]) from the target through the distal opening of the substructure (See at least figs. 10A-10B ).
Regarding claim 63,
Ayvali further discloses wherein providing the graphical representation includes representing the approach path from the target (i.e. target calyx 1012 at which the probe is positioned) through a center of a distal opening of the substructure (see at least figs. 10A (1006) and 10B (1003) and corresponding disclosure in at least [0157]-[0158] where the approach path is from the calyx 1012 (i.e. a substructure) (See also at least fig. 6-2 in which the needle (thus the approach path associated therewith) is through a center of an opening of the papilla)
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
Claims 1-2, 4-7 and 9-11 are rejected under 35 U.S.C. 103 as being unpatentable over Ayvali in view of Duindam et al. (US 20130303894 A1), hereinafter Duindam.
Regarding claim 1,
Ayvali teaches a method for providing guidance for percutaneous access to a target within an anatomic structure, the method comprising:
Receiving point cloud data ([0179] which discloses a position of a medical device can be represented with coordinates of a point/point-set within a coordinate system (e.g. one or more X, Y, Z coordinates) from a sensor system ([0105] which discloses the medical instrument (e.g., scope) 440 includes a sensor that is configured to generate and/or send sensor position data to another device. The sensor position data can indicate a position and/or orientation of the medical instrument 440 (e.g., the distal end 442 thereof) and/or can be used to determine/infer a position/orientation of the medical instrument. For example, a sensor (sometimes referred to as a “position sensor”) can include an electromagnetic (EM) sensor with a coil of conductive material, or other form/embodiment of an antenna. [0084] which discloses For example, the localization component 314 can process input data (e.g., sensor data from a medical instrument, model data regarding anatomy of a patient, position data of a patient, pre-operative data, robotic command and/or kinematics data, etc.) to generate position/orientation data 320 for one or more medical instruments) coupled to an internal instrument (at least fig. 4 (440) and corresponding disclosure in at least [0105]) as the internal instrument is moved within the anatomic structure ([0197] which discloses while driving the scope to the target papilla/calyx, a plurality of positions associated with the distal end portion of the scope may be tagged/recorded along the path to provide a scatterplot-type mapping of at least a portion of the calyx network (e.g., the target calyx and/or associated infundibulum);
Generating a 3D model (at least figs. 16 (1600) /17 (1700) and corresponding disclosure in at least [0197]-[0198]) including the anatomic structure, wherein the 3D model is based at least in part on the point cloud data ([0197] which discloses a plurality of positions associated with the distal end portion of the scope may be tagged/recorded along the path to provide a scatterplot-type mapping and a gaussian interpolation may be implemented to generate the three-dimensional surface map 1700 as disclosed in [0198]) ;
Receiving information for identifying a substructure within the 3D anatomic model, wherein the substructure provides access to the target ([0199] which discloses in some embodiments, as shown in FIG. 15, circular motions may be effected in the scope to generate a sufficient position plot of the target calyx, wherein the calyx map to be formed therefrom. The calyx orientation 1715 can be estimated from the calyx map 1700, wherein such trajectories 1715 can provide a path along which scope/papilla offset may be projected/determined. This may allow the target position to be updated more robustly for cases where the scope heading changes with respect to the calyx, infundibulum, and/or papilla axis due to tissue deformation during needle insertion. Depending on the particular procedure, it may not be necessary to map out the entire calyx network of the kidney for the purpose of percutaneous access targeting. For example, only the calyx associated with the target papilla may be mapped in some implementations. In some implementations, multiple calyces may be mapped to provide increased spatial information/mapping see also [0114]-[0115] which disclose locating a kidney stone using an image-capturing device and identifying a target papilla that is exposed within a target Calyx through which access to the kidney stone may be achieved);
Generating a cylindrical model of the substructure based at least in part on the point cloud data (at least fig. 17 (1700) and corresponding disclosure in at least [0198]) of the substructure based at least in part on the point cloud data ([0198] which discloses a three-dimensional surface map 1700 generated such as using a gaussian interpolation. Examiner notes that the three-dimensional surface map is considered to be include a cylindrical model of the substructure (i.e. the calyx and/or infundibula). See also [0058] discloses the funnel/tubular shaped anatomy associated with the calyces can be referred to as the infundibulum)
Determining an entry point to the substructure ([0117] which discloses the process 500 involves tagging/recording the position of the exposed papilla 579 within the target calyx 579 through which the desired access is to be achieved. See also [0116] which discloses by targeting entry in the area of the axial center of the calyx 575, major arteries and/or other blood vessels can be avoided in some instances, [0009] which discloses some embodiments involve the presentation of one or more icons representing a projected needle entry point into the target anatomical feature (e.g., papilla), and [0177] which discloses For example, where the projected needle entry point into the target calyx and/or through the target papilla 914 is outside of the field of view 952 of the scope camera, the interface feature(s) 956 can notify the physician 5 of the direction the scope 92 can be moved to bring the projected needle entry point into the camera view 952);
Determining an approach path through the entry ([0176] which discloses The control system 50 can include control circuitry configured to determine a target trajectory 902 for inserting the needle 17 to assist the physician 5 in reaching the target location (e.g., the papilla 914). See also [0092] which discloses target/trajectory component 316 can also be configured to determine a target trajectory for a medical instrument or another object. A target trajectory can represent a desired path for accessing a target location and/or anatomical feature. A target trajectory can be determined based on a variety of information, such as a position of a medical instrument(s) (e.g., a needle, a scope, etc.), a target location within the human anatomy, a position and/or orientation of a patient, the anatomy of the patient (e.g., the location of organs within the patient relative to the target location), and so on) ; and
Providing a graphical representation of the approach path (See at least fig. 13 (902) and corresponding disclosure in at least [0176]. See also [0092] which discloses in examples, a physician can analyze images or models of the human anatomy and provide input to designate a target trajectory, such as by drawing a line on an image of the internal anatomy of a patient. In some embodiments, the target/trajectory component 316 can calculate a target trajectory initially and/or update the target trajectory throughout the procedure).
While Ayvali discloses that the infundibulum is a funnel/tubular feature, it is not made explicitly clear if the cylindrical model of the substructure has a constant diameter.
Nonetheless, Duindam, in a similar field of endeavor involving navigation through anatomical passageways, teaches generating a cylindrical model of a substructure (at least fig. 5 (304, 305, 306, 307, 308, 310, 312, 314, or 316) and corresponding disclosure in at least [0048] and/or at least fig. 6 (304) and corresponding disclosure in at least [0049]) based at least in part on a three dimensional model (at least fig. 4 (200) and corresponding disclosure in at least [0048]-[0049] which discloses the connected cylindrical linkage elements are determined from the anatomic centerline 218 and [0049] which discloses the cylindrical linkage element is formed about a branch 320 of anatomic centerline 218)), wherein the cylindrical model has a constant diameter (see at least fig. 5 and corresponding disclosure in at least [0048]. See also fig. 6 is an illustration of cylindrical linkage element 304 formed about a branch 320 of anatomic centerline 218) having a total radius RT and radius R1 is the maximum deviation between the anatomic centerline and the cylindrical centerline, the radius R2 is the average radius of the passageway 204, for example, from the model 200) and further teaches the systems and methods of the disclosure are also suited for navigation and treatment of other tissues in any of a variety of anatomical systems including the kidneys in [0060].
It would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali to include a cylindrical model of the substructure as taught by Duindam in order to reduce the search space for determining the specific passageway/substructure in which an instrument point is located (Duindam [0048]). Furthermore, it is noted that all of the claimed elements were known in the prior art and one skilled in the art could have combined the elements as claimed by known methos with no change in their respective functions, yielding predictable results with respect to anatomical modeling of branched passageways, thereby rendering the claim obvious (MPEP 2143).
Examiner notes that in the modified method the cylindrical model of Duindam (which is based on a centerline of a three-dimensional model [0048]-[0049]) would be based on the center line/axis determined by Ayvali as disclosed in at least [0198] which discloses the surface normal vectors may be summed to determine the central axis for each respective portion of the calyx network 1700. Thus the cylindrical model of the substructure in the modified method is based at least in part on the point cloud data.
Regarding claim 2,
Ayvali further teaches wherein the approach path is based at least in part on geometry of the substructure ([0175] which discloses the control system 50 can include control circuitry configured to determine a target trajectory 902 for inserting the needle 17 to assist the physician 5 in reaching the target location (e.g., the papilla 914). The target trajectory 902 can represent a desired path for accessing the target location. The target trajectory 902 can be determined based on a position of one or more medical instruments (e.g., the needle 17, the scope 92, etc.), a target location within the patient anatomy, a position and/or orientation of the patient 13, the anatomy of the patient (e.g., the location of organs within the patient relative to the target location), and so on. In some implementations, the target trajectory 902 represents a straight line that passes through the papilla 914 and the point of the needle 17. The trajectory may be generally in-line with the axis of the infundibulum associated with the target calyx. Examiner thus notes that the approach path is therefore based at least in part on geometry (e.g. tubular shape) and axis thereof of the substructure)
Regarding claim 4,
Ayvali further teaches wherein the information for identifying the substructure includes user input for selection of the substructure ([0118] which discloses in order to record the position of the papilla 579, the scope 540 may be advanced to physically touch/contact the target papilla 579, as shown by the advanced scope tip 543, in connection with which such contact position may be identified and/or otherwise indicated as the target position by the scope 540 and/or operator, a user input device (e.g., pendant) can be used to inform the system that contact has been made with the target anatomical feature. See also [0131] which discloses the user may provide input to notify the relevant control/medical system of the feature-contact position of the target anatomical feature by tagging/registering the position of the exposed face of the target anatomical feature (e.g., papilla face exposed within the target calyx) in some manner. Such tagging may be implemented through provision of user input in some manner or may be substantially automatic based on perceived tissue contact, or the like.).
Regarding claim 5,
Ayvali further teaches wherein the information for identifying the substructure includes position and orientation of the substructure relative to the target ([0199] which discloses in some embodiments, as shown in FIG. 15, circular motions may be effected in the scope to generate a sufficient position plot of the target calyx, wherein the calyx map to be formed therefrom. The calyx orientation 1715 can be estimated from the calyx map 1700, wherein such trajectories 1715 can provide a path along which scope/papilla offset may be projected/determined. This may allow the target position to be updated more robustly for cases where the scope heading changes with respect to the calyx, infundibulum, and/or papilla axis due to tissue deformation during needle insertion. Depending on the particular procedure, it may not be necessary to map out the entire calyx network of the kidney for the purpose of percutaneous access targeting. For example, only the calyx associated with the target papilla may be mapped in some implementations. In some implementations, multiple calyces may be mapped to provide increased spatial information/mapping see also [0114]-[0115] which disclose locating a kidney stone using an image-capturing device and identifying a target papilla that is exposed within a target Calyx through which access to the kidney stone may be achieved. Examiner thus notes that the information for identifying the substructure necessarily includes its position and orientation relative to the target. See also [0092] which discloses a target trajectory can be determined based on a variety of information including the anatomy of the patient (e.g. the location of organs with int eh patient relative to the target location).
Regarding claim 6,
Ayvali further teaches wherein the approach path is a linear, percutaneous approach path ([0175] which discloses the target trajectory 902 represents a straight line that passes through the papilla 914 and the point of the needle 17. See also at least fig. 13)
Regarding claim 7,
Ayvali further teaches wherein the entry into the substructure is a distal opening of the substructure (see at least fig. 13 and/or 14)
Regarding claim 9,
Ayvali further teaches wherein the approach path is along a centerline of the cylindrical model ([0175] which discloses the trajectory may be generally in-line with the axis of the infundibulum associated with the target calyx. See also at least fig. 10A 1006 depicting an approach path along a centerline of the target calyx and/or infundibulum, thus the approach path is along a centerline of the cylindrical model accordingly. And [0194] which discloses the percutaneous access path to the target anatomical site may be determined and/or aligned with the orientation of the target papilla/calyx, which may be generally in-line with the central axis of the associated infundibulum in some cases)
Regarding claim 10,
Ayvali, as modified, teaches the elements of claim 9 as previously stated. Ayvali, further teaches wherein providing the graphical representation includes representing the approach path as a line along the centerline of the substructure (see at least fig. 10A/10B and 13).
It is not made explicitly clear if the graphical representation includes representing the approach path as a line along the centerline of the cylindrical model.
Nonetheless, it would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali to include representing the approach path in the manner depicted in figs. 10A/10B and 13 around the centerline of the cylindrical model in order to allow a user to readily recognize the trajectories of the probe at various parked positions with respect to the calyx mapping. Such a modification would enhance a user’s ability to recognize the probe position and various trajectories associated therewith with respect the mapping of the Calyx.
Regarding claim 11,
Ayvali, as modified, teaches the elements of claim 9 as previously stated. Ayvali furth teaches wherein providing the graphical representation includes representing the approach path as a cylindrical range of vectors around the centerline of the substructure (see at least fig. 10A/10B and corresponding disclosure in at least [0157] and [0158]).
It is not made explicitly clear if the graphical representation includes representing the approach path as a cylindrical range of vectors around the centerline of the cylindrical model.
Nonetheless, it would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali to include representing the approach path in the manner depicted in figs. 10A/10B around the centerline of the cylindrical model in order to allow a user to readily recognize the trajectories of the probe at various parked positions with respect to the calyx mapping. Such a modification would enhance a user’s ability to recognize the probe position and various trajectories associated therewith with respect the mapping of the Calyx.
Claims 12-16 are rejected under 35 U.S.C. 103 as being unpatentable over Ayvali and Dyundam, as applied to claim 9 above, and further in view of Lachmanovich et al. (US 20160000520 A1), hereinafter Lachmanovich.
Regarding claim 12,
Ayvali, as modified, teaches the elements of claim 9 as previously stated. Ayvali fails to explicitly teach wherein providing the graphical representation includes presenting the approach path as a cone of vectors converging at a point along the centerline of the cylindrical model.
Nonetheless, Lachmanovich, in a similar field of endeavor involving endoscopic procedures, teaches providing a graphical representation including presenting an approach path (at least fig. 4A (404) and corresponding disclosure in at least [0049]) as a cone of vectors converging at center point at a distal end of an extended working channel (196) of a bronchoscope (150) ([0050] which discloses In this instance by a cone shaped projection emanating from the center point of distal tip 193 of EWC 196 or locatable guide 192 and The cone length L indicates the maximum useful or effective distance a laparoscopic tool (e.g., a biopsy tool, a microwave or radiation ablation tool, a chemotherapy tool, a therapeutic medication application tool, a brachytherapy tool, a marker placement tool, or other similar laparoscopic tools) can extend beyond the distal end of EWC 196. The cone diameter D indicates the maximum probable distribution or deflection of a tool when extended beyond EWC 196).
It would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali to include a graphical representation as taught by Lachmanovich in order to allow user to readily recognize the maximum distance and probable deflection/distribution of the needle from the endoscope of Ayvali. Such a modification would allow a user to readily recognize whether the needle of Ayvali would be capable of effectively reaching/treating the target as the endoscope if driven toward the target position.
It would have been further obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali, as currently modified to include presenting the approach path along the centerline of the cylindrical model in order to present the approach path with respect to the calyx mapping, thereby allowing the user to readily recognize that approach path with respect to the three-dimensional data mapping of the Calyx for appropriately positioning the tool.
Regarding claim 13,
Ayvali, as modified, further teaches wherein the point is at a proximal entry of the cylindrical model (Examiner notes that by positioning the approach path at the central axis of the tool, that the point is at a proximal entry of the cylindrical model (see for example fig. 13 in which the tool is positioned at a proximal entry of the infundibula/calyx), thus when presenting the approach path on the cylindrical model, it is noted that the point of convergence is at the proximal entry of the cylindrical model).
Regarding claim 14,
Ayvali, as modified, further teaches wherein the anatomic structure is the kidney (see at least fig. 10A/10B) and the point is near a renal pelvis of the kidney (see at least fig. 10A/10B in which the endoscope is positioned near the renal pelvis 71 (see [0058]), thus the point of convergence (i.e. the central axis of the working channel/endoscope) is near the renal pelvis of the kidney).
Regarding claim 15,
Ayvali, as modified, further teaches wherein a radius of the cone expands away from the tool (thus examiner notes that in the modified method the cone would expand toward a distal opening of the cylindrical model)
Regarding claim 16,
Ayvali, as modified, further teaches wherein the radius of the cone is limited by the deflection capabilities of the tool/needle (The cone diameter D indicates the maximum probable distribution or deflection of a tool when extended beyond EWC 196), however, fails to explicitly teach wherein the radius of the cone is limited by a radius of the distal opening of the cylindrical model.
Nonetheless, it would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified the teachings of Ayvali, as currently modified, to further limit the radius of the cone by a radius of the distal opening of the cylindrical model in order to ensure that the needle would be capable of passing through the distal opening to the target accordingly.
Claim 20 is rejected under 35 U.S.C. 103 as being unpatentable over Ayvali in view of Lachmanovich.
Regarding claim 20,
Ayvali teaches the elements of claim 17 as previously stated. Ayvali fails to explicitly teach wherein providing the graphical representation includes representing the approach path as a range of vectors at different angles converging at the target.
Nonetheless, Lachmanovich, in a similar field of endeavor involving endoscopic procedures, teaches providing a graphical representation including presenting an approach path (at least fig. 4A (404) and corresponding disclosure in at least [0049]) as a range of vector at different angles converging at a center point at a distal end of an extended working channel (196) of a bronchoscope (150) ([0050] which discloses In this instance by a cone shaped projection emanating from the center point of distal tip 193 of EWC 196 or locatable guide 192 and The cone length L indicates the maximum useful or effective distance a laparoscopic tool (e.g., a biopsy tool, a microwave or radiation ablation tool, a chemotherapy tool, a therapeutic medication application tool, a brachytherapy tool, a marker placement tool, or other similar laparoscopic tools) can extend beyond the distal end of EWC 196. The cone diameter D indicates the maximum probable distribution or deflection of a tool when extended beyond EWC 196).
It would have been obvious to a person having ordinary skill in the art before the effective filing date to have modified Ayvali to include a graphical representation as taught by Lachmanovich in order to allow user to readily recognize the maximum distance and probable deflection/distribution of the needle from the endoscope of Ayvali. Such a modification would allow a user to readily recognize whether the needle of Ayvali would be capable of effectively reaching/treating the target as the endoscope if driven toward the target position.
Examiner notes that in the modified system the target may be interpreted as the final (or parking) position of the tool, thus the range of vectors at different angles in the modified system are considered to converge at the target.
Conclusion
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to BROOKE L KLEIN whose telephone number is (571)270-5204. The examiner can normally be reached Mon-Fri 7:30-4.
Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice.
If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Anne Kozak can be reached at 5712700552. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300.
Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000.
/BROOKE LYN KLEIN/Primary Examiner, Art Unit 3797
Prosecution Insights