WO2025217061A1

WO2025217061A1 - Systems and methods for using an umbilical in delivery of a thermal treatment

Info

Publication number: WO2025217061A1
Application number: PCT/US2025/023486
Authority: WO
Inventors: Robert L. Barry; Erik M. HENNE; Ryan R. BACSIK; Joshua P. KROON; Matthew R. CAVALIER; Tor C. Anderson; Wingman C. Tse
Original assignee: Intuitive Surgical Operations Inc
Current assignee: Intuitive Surgical Operations Inc
Priority date: 2024-04-08
Filing date: 2025-04-07
Publication date: 2025-10-16
Anticipated expiration: 2026-10-08

Abstract

A medical system may comprise a fluid generation system configured to provide a fluid, a medical instrument system configured to deliver the fluid for treatment, and an umbilical system coupled between the fluid generation system and the medical instrument system. The umbilical system may be configured to receive the fluid from the fluid generation system and provide the fluid to the medical instrument system. The medical system may also comprise a heating system configured to control a temperature of the fluid within the umbilical system.

Description

SYSTEMS AND METHODS FOR USING AN UMBILICAL IN DELIVERY OF A THERMAL TREATMENT

CROSS-REFERENCED APPLICATIONS

[0001] This application claims priority to and benefit of U.S. Provisional Application No. 63/631,219 filed April 8, 2024 and entitled “Systems and Methods for Using an Umbilical in Delivery of a Thermal Treatment,” which are incorporated by reference herein in its entirety.

FIELD

[0002] Examples described herein are related to systems and methods that use an umbilical system to deliver fluid at a predefined temperature to a medical instrument while accommodating access needs in a medical environment.

BACKGROUND

[0003] Minimally invasive medical techniques may generally be intended to reduce the amount of tissue that is damaged during medical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. Such minimally invasive techniques may be performed through natural orifices in a patient anatomy or through one or more surgical incisions. Through these natural orifices or incisions an operator may insert minimally invasive medical instruments such as therapeutic instruments, diagnostic instruments, imaging instruments, and surgical instruments. In some examples, a minimally invasive medical instrument may be a thermal energy treatment instrument for use within an endoluminal passageway of a patient anatomy. Systems and methods are needed to provide the thermal energy treatment while accommodating workflow and patient needs in a medical environment.

SUMMARY

[0004] The following presents a simplified summary of various examples described herein and is not intended to identify key or critical elements or to delineate the scope of the claims.

[0005] In some examples, a medical system may comprise a fluid generation system configured to provide a fluid, a medical instrument system configured to deliver the fluid for treatment, and an umbilical system coupled between the fluid generation system and the medical instrument system. The umbilical system may be configured to receive the fluid from the fluid generation system and provide the fluid to the medical instrument system. The medical system may also comprise a heating system configured to control a temperature of the fluid within the umbilical system.

[0006] In some examples, a method may comprise providing a fluid from a fluid generation system to an umbilical system coupled between the fluid generation system and a medical instrument system and controlling a temperature of the fluid with a heating system while the fluid is within the umbilical system. The method may also include providing fluid from the umbilical system to the medical instrument system. [0007] It is to be understood that both the foregoing general description and the following detailed description are illustrative and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following detailed description.

BRIEF DESCRIPTIONS OF THE DRAWINGS

[0008] FIG. 1 illustrates a medical system including an umbilical system according to some examples. [0009] FIG. 2 illustrates a medical system including an umbilical system that comprises a heating device, according to some examples.

[0010] FIG. 3 illustrates a medical system including an on-demand heating system that heats a fluid within an umbilical system, according to some examples.

[0011] FIG. 4 illustrates a medical system including an on-demand heating system that heats a fluid within a fluid generation system and/or within an umbilical system, according to some examples.

[0012] FIG. 5 illustrates a medical system including a circulating heating system that alternatively dispenses a fluid or circulates a fluid through the umbilical system, according to some examples.

[0013] FIG. 6 illustrates a medical system including a circulating heating system that alternatively dispenses a fluid or circulates a fluid through the umbilical system, according to some examples.

[0014] FIG. 7 illustrates a medical system including a static heating system that heats a fluid within an umbilical system, according to some examples.

[0015] FIG. 8 illustrates a medical system including a static heating system that heats a fluid within an umbilical system, according to some examples.

[0016] FIG. 9 is a flowchart illustrating a method for applying a thermal energy treatment passageway, according to some examples.

[0017] FIG. 10 illustrates a thermal treatment support system, according to some examples. [0018] FIG. 11 is a simplified diagram of a patient anatomy according to some examples.

[0019] FIG. 12 is robot-assisted medical system, according to some examples.

[0020] FIG. 13 A illustrates a medical system including an umbilical system that comprises a heating system, according to some examples.

[0021] FIG. 13B illustrates a cross-sectional view of the umbilical member of FIG. 13A.

[0022] FIG. 14 illustrates a medical system including an umbilical system that comprises a heating system and a valve system for controlling flow of fluid within the umbilical system, according to some examples.

[0023] FIG. 15 illustrates a medical system including an umbilical system that comprises a heating system and a valve system for controlling flow of fluid within the umbilical system, according to some examples.

[0024] FIG. 16 illustrates a medical system including an umbilical system that comprises a heating system and a valve system for controlling flow of fluid within the umbilical system, according to some examples.

[0025] FIG. 17 illustrates a medical system including an umbilical system that comprises a heating system and a valve system for controlling flow of fluid within the umbilical system, according to some examples.

[0026] Embodiments of the present disclosure and their advantages are best understood by referring to the detailed description that follows. It should be appreciated that like reference numerals are used to identify like elements illustrated in one or more of the figures, wherein showings therein are for purposes of illustrating embodiments of the present disclosure and not for purposes of limiting the same.

DETAILED DESCRIPTION

[0027] The technology described herein provides techniques and medical systems for endoluminal thermal treatment of diseased tissue. A medical instrument system may include a flexible elongate device for delivering a heated fluid into a patient anatomy to perform the endoluminal thermal treatment. In some examples, the medical instrument system may be directly coupled to a fluid generation system that heats the fluid to a treatment temperature. To minimize heat loss along the flexible elongate device, the length of the flexible elongate device may be minimized, and the fluid generation system may be located near the patient, for example near the patient’s head if the treatment is performed through the patient’s mouth. However, the fluid generation system may be large, heavy, immobile, or otherwise obstructive of access to the patient, objects in the medical environment, or passage within the medical environment. Lengthening the flexible elongate device to allow for more unobtrusive placement of the fluid generation system may cause the treatment fluid to cool as it travels from the fluid generation system to the patient. The medical systems described herein include an umbilical system that couples a fluid generation system to a medical instrument system. In some examples, the umbilical system may include an on-demand heating system that includes a heater device in the umbilical system. In some examples, the umbilical system may include a circulating heating system that allows heated fluid to alternatively circulate through the umbilical system to heat the umbilical member or dispense into the medical instrument system. In some examples, the umbilical system may include a static heating system that heats a treatment fluid along the length of the umbilical system as the treatment fluid is statically stored in the umbilical system (e.g., without circulation) prior to dispensing into the medical instrument system. Although the examples provided herein may refer to treatment of lung tissue and pulmonary disease, it is understood that the described technology may be used in treating artificially created lumens or any endoluminal passageway or cavity, including in a patient trachea, colon, intestines, stomach, liver, kidneys and kidney calices, brain, heart, circulatory system including vasculature, fistulas, and/or the like. In some examples, treatment described herein may be referred to as endobronchial thermal liquid treatment and may be used in procedures to treat lung tumors and/or chronic obstructive pulmonary disease (COPD) that may include one or more of a plurality of disease conditions including chronic bronchitis, emphysema, and bronchiectasis.

[0028] FIG. 1 illustrates a medical system 100. The medical system 100 includes a fluid generation system 102, a medical instrument system 104, and an umbilical system 106 extending between and coupling the fluid generation system 102 and the medical instrument system 104. The medical system 100 may also include a heating system 112. Together, the fluid generation system 102, the umbilical system 106, and the heating system 112 may comprise a thermal treatment support system (e.g., thermal treatment support system 700) for delivering a fluid 108 to the medical instrument system 104. More specifically, the fluid 108 may flow from the fluid generation system 102 to the medical instrument system 104 through a fluid channel 110 that extends through the umbilical system 106. A heating system 112 controls a temperature of the fluid 108. The fluid 108 may include, for example, water, saline, gel, glycerin, solution, oil, or another biocompatible liquid or vapor. In some examples, the fluid may be a steam vapor at or above a boiling point of 100C. In some examples, the fluid may be a heated saline at less than 100C that has a liquid state. In some examples, a control system (e.g., control system 220, 270, 320, 370, 420, 470, 812) may regulate the temperature of the fluid 108 and or heating system 112 as described in examples below.

[0029] In various examples, the fluid generation system 102 may include a housing 114 containing one or more fluid reservoirs for containing the fluid 108 and one or more fluid delivery devices such as pumps, syringes, valves, conduits, or other components for moving the fluid 108. In some examples, the fluid generation system 102 may be housed in a single housing 114 and in other examples, the housing 114 may include discrete and separated containers that house separated components of the fluid generation system 102. In some examples, the housing 114 may include wheels for moving along the floor of a medical environment. In some examples, the housing 114 may be coupled to a manipulator of a robot- assisted medical system.

[0030] The medical instrument system 104 may include a flexible elongate device 116 that may include a fitting or other feature for coupling to the umbilical system 106. In some examples, the medical system 104 may include a flexible elongate delivery device 120, such as a steerable bronchoscope, endoscope, or a catheter to guide the flexible elongate device 116. The flexible elongate device 116 may extend through a working channel of a flexible elongate delivery device 120. In some examples, the flexible elongate device 116 and/or the flexible elongated delivery device 120 may be robotically-assisted. In some examples, the flexible elongate device 116 and/or the flexible elongated delivery device 120 may be manually controlled. In some examples, the flexible elongate device 116 and/or the flexible elongated delivery device 120 may include one or more temperature sensors in communication with a control system (e.g., control system 220, 270, 320, 370, 420, 470, 812) to regulate the temperature of the fluid 108. In some examples, the temperature sensor may be an optical fiber sensor that performs additional functions including shape sensing, illumination, or imaging functions. In some examples, the flexible elongate device 116 may be steerable.

[0031] The umbilical system 106 may include an umbilical member 118 with a compliant body that allows limited or no expansion, thus enabling accurate volumetric fluid delivery. The umbilical system 106 may have a length sufficient to allow the fluid generation system 102 to be positioned away from the patient or the medical personnel workflow. For example, the umbilical system 106 may have a length between approximately 3 and 7 feet. In some examples, the umbilical system 106 may include an insulation material to minimize heat loss along its length. The umbilical system 106 may be unsupported between the fluid generation system 102 and the medical instrument system 104 or may be supported by an of various supports including an IV pole, a human assistant, a mechanical support arm (e.g., support arm 601), or other support device.

[0032] The heating system 112 may include one or more components including heating devices, temperature sensors, pressure sensors, heat circulating channels, and or/other components for heating and/or controlling a temperature of the fluid 108. A heating device may include a heat generating device such as one or more resistive coil heaters, induction heaters, radiofrequency heaters, or another type of heat generating device. The heating system 112 may heat the fluid to a predefined temperature. The predefined temperature within the umbilical system 106 may greater than a treatment temperature at which the fluid is dispensed from the medical instrument system 104 to perform a fluid ablation treatment in the patient anatomy. The predefined temperature generated by the heating system 112 may be greater than the treatment temperature due to a known heat loss may be expected as the fluid moves from the umbilical system 106 and through the medical instrument system 104. The components of the heating system 112 may be housed in the fluid generation system 102 and/or the umbilical system 106. In some examples, components of the heating system 112 may be located in separate parts of the medical system 100. For example, one heating device of the heating system 112 may be located in the umbilical system 106 and another heating device of the heating system 112 may be located in the fluid generation system 102.

[0033] In some examples, one or more components of the heating system 112 may be integrated with components of a robotically-assisted medical system that facilitates steering of the medical instrument system 104 through anatomy. For example, such as inductive sensors (e.g., located in an anti-bucking support system for the flexible elongated delivery device 120) used for medical instrument detection or identification may be used as a heat generating device of the heating system 112 or to actuate a component of the heating system 112.

[0034] In various examples, components of the medical system that interact directly with the fluid 108 may be replaceable or disposable. For example, the fluid reservoir, tubing through the pump, umbilical system, heating system components in the umbilical system, and/or a connector member to the medical instrument system may be replaceable.

[0035] FIG. 2 illustrates a medical system 150. The medical system 150 includes a fluid generation system 152 that may be substantially similar to fluid generation system 102, a medical instrument system 154 that may be substantially similar to medical instrument system 104, and an umbilical system 156 that may be substantially similar to umbilical system 106, with differences as described. The umbilical system 156 may include an umbilical member 168 and may extend between and couple the fluid generation system 152 and the medical instrument system 154. The fluid 108 flows from the fluid generation system 152 to the medical instrument system 154 through a fluid channel 160 that extends through the umbilical system 156. A heating system 162 which may be substantially similar to heating system 112 controls a temperature of the fluid 108. The heating system 162 may heat the fluid to a predefined temperature within the umbilical system 156 as the fluid travels in a continuous forward path from the fluid generation system 152, through the umbilical system 156, and to the medical instrument system 154. Fluid movement in a continuous forward path may include fluid that does not remain static and/or does not flow in a reverse direction. The heating system 162 may include a heating device 163 located in the umbilical system 156 to heat and control the temperature of the fluid 108 within the umbilical system 156. The heating device 163 may include, for example, as a resistive coil heater, an induction heater, a radiofrequency heater, or another type of heat generating device. In various examples, the heating device 163 may be located at a proximal portion, a mid-portion, a distal portion, or along the length of the umbilical system 156. In some examples, the entire heating system 112 may be located in the umbilical system. In other examples, a heating device 163 may be located in the umbilical system 156 and other components of the heating system 162 may be located outside of the umbilical system 156. In some examples, the fluid generation system 152 may include a reversible pump that may switch a flow direction of the fluid from a forward flow direction to a reverse flow direction. The reversible pump may allow the umbilical system to be warmed or pre-heated during forward and reverse movement of the heated fluid, prior to delivering the fluid to the medical instrument system.

[0036] FIG. 3 illustrates a medical system 200 including an umbilical system 206 that comprises an on-demand heating system 212. The medical system 200 includes a fluid generation system 202 that may be substantially similar to fluid generation system 102, a medical instrument system 204 that may be substantially similar to medical instrument system 104, and the umbilical system 206 that may be substantially similar to umbilical system 106, with differences as described. The umbilical system 206 may include an umbilical member 218 and may extend between and couple the fluid generation system 202 and the medical instrument system 204. The fluid 108 flows from the fluid generation system 202 to the medical instrument system 204 through a fluid channel 210 that extends through the umbilical system 206. In this example, the fluid generation system may include a fluid reservoir 203 and a fluid delivery device 205. The fluid reservoir 203 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 205 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108. [0037] The on-demand heating system 212, which may include components similar to heating system 112, heats the fluid 108 to control the fluid temperature. In this example, a distal portion of the umbilical system 206 may include a connector member 207 that includes hardware for connecting the umbilical system 206 to the medical instrument system 204. In this example, a heating device 213 of the heating system 212 may be located in the distal portion of the umbilical system 206 such as in the connector member 207. In other examples, the heating device 213 may be attached to the connector member 207 or another section of the distal portion of the umbilical system 206. Locating the heating device near the distal portion of the umbilical system may reduce or eliminate the need for insulation along the length of the umbilical member, thus potentially allowing for a longer, smaller diameter, and/or more umbilical system. The fluid 108 may enter the umbilical system 206 from the fluid generation system 202 at, for example, an ambient temperature, and flow through the fluid channel 210. The fluid 108 may flow through or in close proximity to the heating device 213 and may be rapidly or instantly heated to the predefined temperature during the brief period it is inside or near the heating device 213, before dispensing into the medical instrument system 204. In some examples, the heating device 213 may be an on-demand heating device that rapidly heats to a predefined temperature. For example, the heating device may heat to the predefined temperature in less than sixty seconds. In some examples, the heating device 213 may heat the fluid 108 to a predefined temperature greater than a treatment temperature at which the fluid is dispensed from the medical instrument system, for example, if fluid heat loss in the medical instrument system is expected. In some examples, the treatment temperature may be a specific temperature or a range of temperatures between approximately 50° C and 99° C. In some examples, the treatment temperature may be a specific temperature or a range of temperatures between approximately 95° C and 99° C. In some examples, for liquids that have vaporization temperatures greater than 99° C, the treatment temperature may be a specific temperature or a range of temperatures greater than 99° C.

[0038] The medical system 200 may also include a control system 220 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. In some examples, the control system 220 may vary or adjust the fluid temperature or another fluid parameter during a treatment process. In some examples, the control system 220 may simultaneous, sequentially, or in other combinations, vary or adjust any of a plurality of fluid parameters include a flowrate, a volume, and a temperature during a treatment process. In some examples, the control system 220 may be a component of or operate in coordination with a control system of a robot- assisted medical system (e.g., the control system 812). Optionally, the heating system 212 may include a temperature sensor 222 and a temperature sensor 224. Sensor data from the temperature sensors 222, 224 may be sent to the control system 220 which may generate signals to the heating device 213 to regulate the temperature of the fluid 108. For example, sensor data from the temperature sensor 222 located before the heating device 213 may be compared to sensor data from the temperature sensor 224 located after the heating device 213. Based on the comparison, the control system 220 may send control signals to the heating device 213 to raise or lower the heat generated by the heating device 213. In some examples, pressure sensors, flow sensors, or other sensors may be located in the umbilical member and may communicate with the control system 220 to control other fluid parameters. In some examples, the heating system may be manually controlled by input devices on the umbilical system. In some examples, the control system for monitoring and/or regulating heating, pressure, and/or flow rate is at least partially located in the heating system 212, within the connector member 207.

[0039] FIG. 4 illustrates a medical system 250 comprising an on-demand heating system 262 including multiple heating devices. The medical system 250 includes a fluid generation system 252 that may be substantially similar to fluid generation system 102, a medical instrument system 254 that may be substantially similar to medical instrument system 104, and an umbilical system 256 that may be substantially similar’ to umbilical system 106, with differences as described. The umbilical system 256 may include an umbilical member 268 and may extend between and couple the fluid generation system 252 and the medical instrument system 254. The fluid 108 flows from the fluid generation system 252 to the medical instrument system 254 through a fluid channel 260 that extends through the umbilical system 256. In this example, the fluid generation system may include a fluid reservoir 253 and a fluid delivery device 255. The fluid reservoir 253 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 255 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108.

[0040] The on-demand heating system 262, which may include components similar to heating system 112, heats the fluid 108 to control the fluid temperature. In this example, the heating system 262 includes a heating device 263 located in the umbilical system 256 and a heating device 265 located in the fluid generation system 252. Using two heating devices may reduce the power requirements each device. In alternative examples, heating devices may be located in additional or different locations within the medical system 250. In this example, the fluid 108 may be heated within the fluid generation system 252 by the heating device 265 before the fluid moves to the umbilical system 256. In various examples, the heating device 265 may be located before or after the fluid delivery device 255 in the fluid flow path. For example, the heating device 265 may heat the fluid 108 in an intravenous fluid bag. The fluid 108 may flow through or in close proximity to the heating device 265 and may be rapidly or instantly heated during the brief period it is inside or near the heating device 265, before dispensing into the umbilical system 256. In some examples, the fluid 108 may be heated by the heating device 265 to an initial temperature that is lower than the predefined temperature. The initial temperature may be, for example, an ambient temperature that makes controlling the temperature of the heating device 263 more predictable. In other examples, the fluid 108 may be heated to approximately the predefined temperature or the treatment temperature by the heating device 265.

[0041] In this example, a distal portion of the umbilical system 256 may include a connector member 257 that includes hardware for connecting the umbilical system 256 to the medical instrument system 254. In this example, the heating device 263 of the heating system 262 may be located in the distal portion of the umbilical system 206 such as in the connector member 257. In other examples, the heating device 263 may be attached to the connector member 257 or another section of the distal portion of the umbilical system 256. The fluid 108 may flow through or in close proximity to the heating device 263 and may be rapidly or instantly heated to the predefined temperature during the brief period it is inside or near' the heating device 263, before dispensing into the medical instrument system 254.

[0042] The medical system 200 may also include a control system 270 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. In some examples, the control system 270 may be a component of or operate in coordination with a control system of a robot-assisted medical system (e.g., the control system 812). Optionally, the heating system 262 may include temperature sensors at any of various locations within the fluid generation system, umbilical system, or medical instrument system which may measure the fluid 108 temperature and send sensor data to the control system 270. The control system 270 may generate signals to the heating device 263 or the heating device 265 to regulate the temperature of the fluid 108 I in a closed loop control system. For example, if temperature sensor data from a location just after the heating device 265 indicates the fluid 108 is at the predefined temperature and temperature sensor data from a location just before the heating device 263 indicates the fluid 108 temperature is below the predefined temperature as it travels through umbilical system, the heating device 263 may be controlled to add additional heat to the fluid. 108. Additionally or alternatively, the heating device 265 may be controlled to heat the fluid 108 to a temperature above the predefined temperature to accommodate the heat loss along the umbilical system 256. In some examples, pressure sensors, flow sensors, or other sensors may be located in the umbilical member and may communicate with the control system 270 to control other fluid parameters.

[0043] FIG. 5 illustrates a medical system 300 comprising a circulating heating system 312. The medical system 300 also includes a fluid generation system 302 that may be substantially similar to fluid generation system 102, a medical instrument system 304 that may be substantially similar’ to medical instrument system 104, and an umbilical system 306 that may be substantially similar- to umbilical system 106, with differences as described. The umbilical system 306 may include an umbilical member 318 and may extend between and couple the fluid generation system 302 and the medical instrument system 304. In this example, the fluid generation system 302 may include a fluid reservoir 303 and a fluid delivery device 305. The fluid reservoir 303 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 305 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108. A valve 307 may control fluid flow between the fluid reservoir 303 and the fluid delivery device 305.

[0044] The circulating heating system 312, which may include components similar to heating system 112, heats the fluid 108 to control the fluid temperature. In this example, the heating system 312 includes a heating device 315 located in the fluid generation system 302. In various examples, the heating device 315 may be located before or after the fluid delivery device 305 in the fluid flow path. In some examples, the heating device may heat the fluid 108 in the fluid reservoir 303. In this example, the heating system 312 may also be considered to include fluid channels 310, 311 of the umbilical system 306. The fluid channel 310 extends within the umbilical system 306 between the fluid generation system 302 and the medical instrument system 304. The umbilical system 306 also includes a return fluid channel 311. A valve 313 may be located within the umbilical system 306 (e.g., in a connector portion of the umbilical system) at an intersection of the fluid channels 310, 311. The valve 313 may be, for example, a three way valve that may alternatively, block fluid flow from the fluid channel 310 to the medical instrument system 304 or fluid channel 311, direct fluid 108 flow from the fluid channel 310 into the medical instrument system 304, or direct fluid 108 flow from the fluid channel 310 to the fluid channel 311. The fluid channel 311 may recirculate the fluid 108 back to the fluid generation system 302 for reuse (e.g., to the fluid reservoir 303) or for drainage and disposal. During an umbilical warming phase the valve 313 may have a first state in which the heated fluid 108 may flow along the fluid channel 310 and through the valve 313 which may be switched to block flow to the medical instrument system 304 and direct flow to the fluid channel 311 to be returned to the fluid generation system 302. While passing through the fluid channels 310, 311, the fluid 108 may warm or prc-hcat the umbilical system to reduce heat loss along the umbilical during a subsequent delivery phase. During the delivery phase the valve 313 may have a second state in which the heated fluid 108 may flow along the fluid channel 310, and the valve 313 may be adjusted to block flow to the fluid 108 to the fluid channel 311 and instead direct the fluid 108 into the medical instrument system 304 for treatment.

[0045] In this example, the fluid 108 may be heated within the fluid generation system 302 by the heating device 315 before the fluid moves to the umbilical system 306. The fluid 108 may flow through or in close proximity to the heating device 315 and may be heated by the heating device 315, before dispensing into the umbilical system 306. In some examples, the fluid 108 may be heated to the predefined temperature or to a temperature higher than the predefined temperature (given that some heat may be lost in transit through the umbilical system).

[0046] The medical system 300 may also include a control system 320 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. The control system 320 may also control operation of the valves 307, 313. In some examples, the control system 320 may be a component of or operate in coordination with a control system of a robot-assisted medical system (e.g., the control system 812). Optionally, the heating system 312 may include temperature sensors at any of various locations within the fluid generation system, umbilical system, or medical instrument system which may measure the fluid 108 temperature and send sensor data to the control system 320. The control system 320 may generate signals to the heating device 315 to regulate the temperature of the fluid 108. For example, the control system 320 may receive temperature data from temperature sensors along the channel 310 near proximal and distal portions of the umbilical system 306 during a warm-up phase. When the temperatures are both at the predefined temperature or within a threshold range of similarity (indicating that the umbilical member has been warmed by the circulating fluid 108 and minimal heat is being lost along the forward flow path through channel 310), the control system 320 may signal the valve 313 to block circulation to the channel 311 and direct the heated fluid 108 to the medical instrument system 304 for delivery to the patient.

[0047] FIG. 6 illustrates a medical system 350 comprising a circulating heating system 362. This example may be similar to the medical system 350 but with a different valve configuration to control the fluid flow. The medical system 350 includes a fluid generation system 352 that may be substantially similar to fluid generation system 102, a medical instrument system 354 that may be substantially similar to medical instrument system 104, and an umbilical system 356 that may be substantially similar to umbilical system 106, with differences as described. The umbilical system 356 may include an umbilical member 368 and may extend between and couple the fluid generation system 352 and the medical instrument system 354. In this example, the fluid generation system 352 may include a fluid reservoir 353 and a fluid delivery device 355. The fluid reservoir 353 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 355 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108. A valve 357, such as a pinch valve, may control fluid flow between the fluid reservoir 303 (or a fluid dump station) and a return fluid channel 361.

[0048] The circulating heating system 362, which may include components similar to heating system 112, heats the fluid 108 to control the fluid temperature. In this example, the heating system 362 includes a heating device 365 located in the fluid generation system 352. In various examples, the heating device 365 may be located before or after the fluid delivery device 355 in the fluid flow path. In some examples, the heating device may heat the fluid 108 in the fluid reservoir 353. In this example, the heating system 352 may also be considered to include fluid channels 360, 361 of the umbilical system 356.

[0049] The umbilical system 356 includes the fluid channel 360 extending between the fluid generation system 352 and the medical instrument system 354. The umbilical system 356 also includes the return fluid channel 361. A valve 363 may be located within the umbilical system 356 (e.g., in a connector portion of the umbilical system) at an intersection of the fluid channels 360, 361. The valve 363 may be, for example, a pressure valve that may alternatively direct fluid 108 flow from the fluid channel 360 into the medical instrument system 354 or direct fluid 108 flow from the fluid channel 360 to the return fluid channel 361. The return fluid channel 361 may recirculate the fluid 108 back to the fluid generation system 352 for reuse (e.g., to the fluid reservoir 353) or for drainage and disposal. During an umbilical warming phase, the pinch valve 357 may be in an open state, allowing heated fluid 108 to flow along the fluid channel 360 and past the pressure valve 363, which may be closed to block flow to the medical instrument system 304. The fluid 108 may be directed to the fluid channel 361 to be returned to the fluid generation system 352 or drained from the system. While passing through the fluid channels 360, 361, the fluid 108 may warm or pre-heat the umbilical system to reduce heat loss along the umbilical during a subsequent delivery phase. During the delivery phase, the pinch valve 357 may be pinched or in a closed state which may increase pressure in the channel 361 and cause the pressure valve 363 to open. Thus, in the delivery phase, the heated fluid 108 may flow along the fluid channel 360, through the pressure valve 363, and into the medical instrument system 354 for treatment.

[0050] In this example, the fluid 108 may be heated within the fluid generation system 352 by the heating device 365 before the fluid moves to the umbilical system 356. The fluid 108 may flow through or in close proximity to the heating device 365 and may be heated by the heating device 365, before dispensing into the umbilical system 356. In some examples, the fluid 108 may be heated to the predefined temperature or to a temperature higher than the predefined temperature (given that some heat may be lost in transit through the umbilical system).

[0051] The medical system 300 may also include a control system 370 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. The control system 320 may also control operation of the pinch valve 357. In some examples, the control system 370 may be a component of or operate in coordination with a control system of a robot-assisted medical system (e.g., the control system 812). Optionally, the heating system 362 may include temperature sensors at any of various locations within the fluid generation system, umbilical system, or medical instrument system which may measure the fluid 108 temperature and send sensor data to the control system 370. The control system 370 may generate signals to the heating device 365 to regulate the temperature of the fluid 108. For example, the control system 370 may receive temperature data from temperature sensors along the channel 360 near proximal and distal portions of the umbilical system 356 during the warm-up phase. When the temperatures are both at the predefined temperature or within a threshold range of similarity (indicating that the umbilical member has been warmed by the circulating fluid 108 and minimal heat is being lost along the forward flow path through channel 360), the control system 370 may signal the pinch valve 357 to close which may create pressure on the pressure valve 363, causing it to open and direct the heated fluid 108 to the medical instrument system 354 for delivery to the patient.

[0052] FIG. 7 illustrates a medical system 400 comprising a static heating system 412 that heats treatment fluid in the umbilical system as it flows through to the medical instrument system. The medical system 400 also includes a fluid generation system 402 that may be substantially similar to fluid generation system 102, a medical instrument system 404 that may be substantially similar’ to medical instrument system 104, and an umbilical system 406 that may be substantially similar to umbilical system 106, with differences as described. The umbilical system 406 may include an umbilical member 418 and may extend between and couple the fluid generation system 402 and the medical instrument system 404. In this example, the fluid generation system 402 may include a fluid reservoir 403 and a fluid delivery device 405. The fluid reservoir 403 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 405 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108. In this example, the fluid 108 may be a treatment fluid.

[0053] The umbilical system 406 includes a fluid channel 410 between the fluid generation system 402 and the medical instrument system 404. In some examples, the fluid 108 entering the fluid channel 410 from the fluid generation system 402 may be unheated. In alternative examples, the fluid generation system 402 may include a heat device and the fluid 108 may be heated. The umbilical system 406 may also include a heating channel 423 for circulating a heating fluid 421 from and back to the static heating system 412. The heating channel 423 may extend along the fluid channel 410 from a proximal portion to a distal portion of the umbilical member 406 to heat the treatment fluid 108 within the fluid channel 410 to the predefined temperature. In some examples, multiple heating channels may circulate the heating fluid through the umbilical member to heat the treatment fluid.

[0054] The static heating system 412, which may include components similar to heating system 112, may heat the heating fluid 421 which, in turn, heats the fluid 108 in the umbilical system 406 to control the temperature of fluid 108. In this example, the heating system 412 includes a heating device 415, a fluid delivery device 417, and a fluid reservoir 419 for preparing the heated fluid 421 to circulate through the channel 423 in the umbilical system 406. These components of the static heating system 412 may be housed in a common housing with the fluid generation system 402 or may be housed separately. The heating system 412 may also include the heating channel 423. In some examples, the fluid delivery device 417, the heating device 415, and the fluid reservoir 419 may be considered pail of the fluid generation system 402.

[0055] The fluid delivery device 417 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 421. The fluid reservoir 419 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 421. The heating device 415 may include one or more resistive coil heaters, induction heaters, radiofrequency heaters, or another type of heat generating device. In various examples, the heating device 415 may be located before or after the fluid delivery device 417 in the fluid flow path. In some examples, the heating device may heat the fluid 421 in the fluid reservoir 419.

[0056] In some examples, during an umbilical wanning phase, the heating fluid 421 may circulate through the channel 423 before the fluid 108 is introduced into the fluid channel 410. While passing through the fluid channel 423, the fluid 421 may warm or pre-heat the channel 410 of the umbilical system 406. In some examples, the fluid 421 may have a circulating temperature higher than the predefined temperature to ensure that sufficient heat may be transferred to the fluid 108. During the delivery phase, the fluid 108 may flow along the fluid channel 410, and the heat from the fluid 421 in the channel 423 may heat the fluid 108 to the predefined temperature by the time the fluid reaches and dispenses into the medical instrument system 404.

[0057] In this example, the fluid 421 may be heated by the heating device 415 before the fluid moves to the umbilical system 406. The fluid 421 may flow through or in close proximity to the heating device 415 and may be heated by the heating device 415, before dispensing into the umbilical system 406. In some examples, the fluid 421 may be heated to the predefined temperature or to a temperature higher than the predefined temperature (given that some heat may be lost in transit through the umbilical system).

[0058] The medical system 400 may also include a control system 420 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. In some examples, the control system 420 may be a component of or operate in coordination with a control system of a robot-assisted medical system (e.g., the control system 812). Optionally, the heating system 412 may include temperature sensors at any of various locations, including within the umbilical system or medical instrument system which may measure the temperature of fluid 108 and/or fluid 421 and send sensor data to the control system 420. The control system 420 may generate signals to the heating device 415 to regulate the temperature of the fluid 421 and accordingly the fluid 108.

[0059] FIG. 8 illustrates a medical system 450 comprising a static heating system 462 including a heating device 465 such as a heat trace. The medical system 450 includes a fluid generation system 452 that may be substantially similar to fluid generation system 102, a medical instrument system 454 that may be substantially similar’ to medical instrument system 104, and an umbilical system 456 that may be substantially similar to umbilical system 106, with differences as described. The umbilical system 456 may include an umbilical member 468 and may extend between and couple the fluid generation system 452 and the medical instrument system 454. The fluid 108 flows from the fluid generation system 452 to the medical instrument system 454 through a fluid channel 460 that extends through the umbilical system 456. In this example, the fluid generation system 452 may include a fluid reservoir 453 and a fluid delivery device 455. The fluid reservoir 453 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. The fluid delivery device 455 may include, for example, one or more pumps, syringes, valves, conduits, or other components for moving the fluid 108.

[0060] In this example, the static heating system 462 may include the heat trace of the heat device 465 that extends along the fluid channel 460 to heat the fluid 108 and control the fluid temperature. The heat trace may include an elongated strip with a resistant element that provides a generally uniform temperature along a length of the umbilical system 456. In various examples, a plurality of heat traces may be used. For example, heat traces may be arranged radially around the fluid channel 460. The fluid 108 may flow through the channel 460, in close proximity to the heating device 465 and may heat to approximately the predefined temperature by the time the fluid 108 reaches and is dispensed into medical instrument system 454.

[0061] The medical system 400 may also include a control system 470 that controls or regulates one or more fluid parameters such as temperature, pressure, duration of flow, flow rate, initiation of flow, and/or cessation of flow. In some examples, the control system 470 may be a component of or operate in coordination with a control system of a robot-assisted medical system (e.g., the control system 812). Optionally, the heating system 462 may include temperature sensors at any of various locations within the fluid generation system, umbilical system, or medical instrument system which may measure the fluid 108 temperature and send sensor data to the control system 470. In some examples, the heating device 465 may be controlled to heat the fluid 108 to approximately the predefined temperature. In some examples, pressure sensors, flow sensors, or other sensors may be located in the umbilical member and may communicate with the control system 470 to control other fluid parameters.

[0062] FIG. 9 is a flowchart illustrating a method 500 for applying a thermal energy treatment to an endoluminal passageway. The method 500 is illustrated as a set of operations or processes that may be performed in the same or in a different order than the order shown in FIG. 9. One or more of the illustrated processes may be omitted in some embodiments of the method. Additionally, one or more processes that are not expressly illustrated in FIG. 9 may be included before, after, in between, or as part of the illustrated processes. In some embodiments, one or more of the processes of method 500 may be implemented, at least in part, by a control system executing code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of a control system) may cause the one or more processors to perform one or more of the processes.

[0063] At a process 502, a fluid from a fluid generation system is provided to an umbilical system. For example, a fluid 108 may be provided from a fluid generation system (e.g., fluid generation system 102, 152, 202, 252, 302, 352, 402, 452) to an umbilical system (e.g., umbilical system 106, 156, 206, 256, 306, 356, 406, 456). In various examples, the fluid generation system include one or more fluid reservoirs for retaining a fluid such as water, saline, gel, glycerin, solution, oil, or another biocompatible liquid or vapor. The fluid may be conveyed from the fluid generation system with one or more fluid delivery devices such as pumps, syringes, valves, conduits, or other components for moving the fluid. In various examples, the umbilical system may include an expansion-resistant compliant body that enables accurate volumetric fluid delivery. In some examples, the umbilical member may be insulated to minimize heat loss along its length.

[0064] At a process 504, a temperature of the fluid may be controlled with a heating system. For example, the temperature of the fluid may be controlled by a heating system (e.g., heating system 112, 162, 212, 262, 312, 362, 412, 462). In various examples, at least a portion of the heating system may be located in the umbilical system to control the temperature of the fluid as the fluid flows through the umbilical system. In various examples, the portion of the heating system located in the umbilical system may be a heating device such as a resistive coil heater, an induction heater, a radiofrequency heater, or another type of heat generating device. In various examples, the heating system may control the temperature of the fluid by heating the fluid to or maintaining the fluid at a predefined temperature. In various examples, the heating system may control the temperature of the fluid by heating the fluid to or maintaining the fluid at a temperature higher or lower than the predefined temperature. In various examples, the heating system may include temperature sensors that measure the temperature at various locations in the umbilical system and communicate with a control system to adjust the temperature generated by the heating device.

[0065] At a process 506, the fluid is provided from the umbilical system to a medical instrument system. For example, the fluid 108 may move from the umbilical system to a medical instrument system (e.g., the medical instrument system 104, 154, 204, 254, 304, 354, 404, 454). In various examples, the fluid may exit the umbilical system at the predefined temperature. In various examples, if a temperature drop is expected over the length of the medical instrument system, the predefined temperature may be higher than the treatment temperature at which the fluid is dispensed from the medical instrument system. [0066] FIG. 10 illustrates a thermal treatment support system 600 including a fluid generation system 602 (e.g., the fluid generation system 102), an umbilical system 606 (e.g., the umbilical system 106), and a heating system 612 (e.g., the heating system 112). The umbilical system 606 may include an umbilical member 618. A connector member 607 of the umbilical system 606 may couple to a medical instrument system (e.g., the medical instrument system 104). Although the heating system 612 is shown in the umbilical system 606, and more specifically in a connector member 607 of the umbilical system 606, it is understood that portions of the heating system 612 may be located outside of the umbilical system 606 as described above. The fluid generation system 602 may include a housing 614 containing or supporting one or more fluid reservoir, pumps, syringes, valves, conduits, and/or other components for moving the fluid 108. The housing 614 may include wheels 615 or other moving devices for easily moving the fluid generation system 202 relative to the medical instrument system.

[0067] In this example, the thermal treatment support system 600 may also include a support arm 601 for supporting the length of the umbilical system 606. The support arm 601 may include a plurality of adjustable links 603 and joints 605 that hold the umbilical system 606 and that allow the support arm to be configured in a variety of arrangements to accommodate access to the patient, other equipment in the medical environment, and the workflow of personnel in the medical environment. The support arm 601 may be adjustable in multiple degrees of freedom and may be frictionally or mechanically locked in place to support the umbilical system during a medical procedure. The supported umbilical system 606 allows the fluid generation system 602 to be moved, as needed, to remove equipment congestion near the patient. [0068] The systems and methods described herein may be used to deliver a thermal treatment with heated fluid (e.g., heated fluid 108) delivered through a medical instrument system extended into anatomic passageways such as the passageways in any of a variety of anatomic systems including the lung, the colon, the intestines, the stomach, the liver, the kidneys and kidney calices, the brain, the heart, the circulatory system including vasculature, and/or the like. FIG. 11 illustrates a medical instrument system 700 (e.g., the medical instrument system 104, 154, 204, 254, 304, 354, 404, 454) extending within branched anatomic passageways or airways 702 of an anatomical structure 704. In some examples the anatomic structure 704 may be a lung and the passageways 702 that include the trachea 706, primary bronchi 708, secondary bronchi 610, and tertiary bronchi 712. The anatomic structure 704 has an anatomical frame of reference (XA, YA, ZA). A distal end portion 718 of the medical instrument 700 may be advanced into an anatomic opening (e.g., a patient mouth) and through the anatomic passageways 702 to perform a medical procedure, such as an endoluminal thermal energy treatment, at or near- target tissue located in a region 713 of the anatomic structure 704.

[0069] In some examples, the systems and methods disclosed herein may be used in a medical procedure performed with a robot-assisted medical system as described in further detail below. FIG. 11 is a simplified diagram of a medical system 800 according to some embodiments. The medical system 800 may be suitable for use in, therapeutic procedures such as ablation or electroporation. While some embodiments arc provided herein with respect to such procedures, any reference to medical or surgical instruments and medical or surgical methods is non-limiting. The systems, instruments, and methods described herein may be used for animals, human cadavers, animal cadavers, portions of human or animal anatomy, non-surgical diagnosis, as well as for industrial systems, general or special purpose robotic systems, general or special purpose robot-assisted medical systems.

[0070] As shown in FIG. 11, a medical system 800 may include a manipulator assembly 802 that controls the operation of a medical instrument 804 in performing various procedures on a patient P in a medical environment 801. The medical instrument 804 may be, for example, the medical instrument system 104, 154, 204, 254, 304, 354, 404, 454, 700, or 904. Medical instrument 804 may extend into an internal site within the body of patient P via an opening in the body of patient P. The manipulator assembly 802 may be robot-assisted, non-assisted, or a hybrid robot-assisted and non-assisted assembly with select degrees of freedom of motion that may be motorized and/or robot-assisted and select degrees of freedom of motion that may be non-motorized and/or non-assisted. The manipulator assembly 802 may be mounted to and/or positioned near a patient table T. A master assembly 806 allows an operator O (e.g., a surgeon, a clinician, a physician, or other user) to control the manipulator assembly 802. In some examples, the master assembly 806 allows the operator O to view the procedural site or other graphical or informational displays. In some examples, the manipulator assembly 802 may be excluded from the medical system 800 and the instrument 804 may be controlled directly by the operator O. In some examples, the manipulator assembly 802 may be manually controlled by the operator O. Direct operator control may include various handles and operator interfaces for hand-held operation of the instrument 804.

[0071] The medical system 800 may also include a thermal treatment support system 803 (e.g., the thermal treatment support system 600) that includes including a fluid generation system, an umbilical system 606, and a heating system 612 that work in cooperation with the instrument 804 as described in the examples above.

[0072] The master assembly 806 may be located at a surgeon’s console which is in proximity to (e.g., in the same room as) a patient table T on which patient P is located, such as at the side of the patient table T. In some examples, the master assembly 806 is remote from the patient table T, such as in in a different room or a different building from the patient table T. The master assembly 806 may include one or more control devices for controlling the manipulator assembly 802. The control devices may include any number of a variety of input devices, such as joysticks, trackballs, scroll wheels, directional pads, buttons, data gloves, trigger-guns, hand-operated controllers, voice recognition devices, motion or presence sensors, and/or the like.

[0073] The manipulator assembly 802 supports the medical instrument 804 and may include a kinematic structure of links that provide a set-up structure. The links may include one or more non-servo controlled links (e.g., one or more links that may be manually positioned and locked in place) and/or one or more servo controlled links (e.g., one or more links that may be controlled in response to commands, such as from a control system 812). The manipulator assembly 802 may include a plurality of actuators (e.g., motors) that drive inputs on the medical instrument 804 in response to commands, such as from the control system 812. The actuators may include drive systems that move the medical instrument 804 in various ways when coupled to the medical instrument 804. For example, one or more actuators may advance medical instrument 804 into a naturally or surgically created anatomic orifice. Actuators may control articulation of the medical instrument 804, such as by moving the distal end (or any other portion) of medical instrument 804 in multiple degrees of freedom. These degrees of freedom may include three degrees of linear motion (e.g., linear motion along the X, Y, Z Cartesian axes) and in three degrees of rotational motion (e.g., rotation about the X, Y, Z Cartesian axes). One or more actuators may control rotation of the medical instrument about a longitudinal axis. Actuators can also be used to move an articulable end effector of medical instrument 804, such as for grasping tissue in the jaws of a biopsy device and/or the like or may be used to move or otherwise control tools (e.g., imaging tools, ablation tools, biopsy tools, electroporation tools, etc.) that are inserted within the medical instrument 804.

[0074] The medical system 800 may include a sensor system 808 with one or more sub-systems for receiving information about the manipulator assembly 802 and/or the medical instrument 804. Such subsystems may include a position sensor system (e.g., that uses electromagnetic (EM) sensors or other types of sensors that detect position or location); a shape sensor system for determining the position, orientation, speed, velocity, pose, and/or shape of a distal end and/or of one or more segments along a flexible body of the medical instrument 804; a visualization system for capturing images, such as from the distal end of medical instrument 804 or from some other location; and/or actuator position sensors such as resolvers, encoders, potentiometers, and the like that describe the rotation and/or orientation of the actuators controlling the medical instrument 804. [0075] The medical system 800 may include a display system 810 for displaying an image or representation of the procedural site and the medical instrument 804. Display system 810 and master assembly 806 may be oriented so physician O can control medical instrument 804 and master assembly 806 with the perception of telepresence.

[0076] In some embodiments, the medical instrument 804 may include a visualization system 809, which may include an image capture assembly that records a concurrent or real-time image of a procedural site and provides the image to the operator O through one or more displays of display system 810. The image capture assembly may include various types of imaging devices. The concurrent image may be, for example, a two-dimensional image or a three-dimensional image captured by an endoscope positioned within the anatomical procedural site. Tn some examples, the visualization system may include endoscopic components that may be integrally or removably coupled to medical instrument 804. Additionally or alternatively, a separate endoscope, attached to a separate manipulator assembly, may be used with medical instrument 804 to image the procedural site. The visualization system may be implemented as hardware, firmware, software or a combination thereof which interact with or are otherwise executed by one or more computer processors, such as of the control system 812.

[0077] Display system 810 may also display an image of the procedural site and medical instruments, which may be captured by the visualization system. In some examples, the medical system 800 provides a perception of telepresence to the operator O. For example, images captured by an imaging device at a distal portion of the medical instrument 804 may be presented by the display system 810 to provide the perception of being at the distal portion of the medical instrument 804 to the operator O. The input to the master assembly 806 provided by the operator O may move the distal portion of the medical instrument 804 in a manner that corresponds with the nature of the input (e.g., distal tip turns right when a trackball is rolled to the right) and results in corresponding change to the perspective of the images captured by the imaging device at the distal portion of the medical instrument 804. As such, the perception of telepresence for the operator O is maintained as the medical instrument 804 is moved using the master assembly 806. The operator O can manipulate the medical instrument 804 and hand controls of the master assembly 806 as if viewing the workspace in substantially true presence, simulating the experience of an operator that is physically manipulating the medical instrument 804 from within the patient anatomy.

[0078] In some examples, the display system 810 may present virtual images of a procedural site that are created using image data recorded pre-operatively (e.g., prior to the procedure performed by the medical instrument system 100) or intra-operatively (e.g., concurrent with the procedure performed by the medical instrument system 100), such as image data created using computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X- ray imaging, and/or the like. The virtual images may include two-dimensional, three-dimensional, or higher-dimensional (e.g., including, for example, time based or velocity-based information) images. In some examples, one or more models are created from pre-operative or intra-operative image data sets and the virtual images are generated using the one or more models.

[0079] In some examples, for purposes of imaged guided medical procedures, display system 810 may display a virtual image that is generated based on tracking the location of medical instrument 804. For example, the tracked location of the medical instrument 804 may be registered (e.g., dynamically referenced) with the model generated using the pre-operative or intra-operative images, with different portions of the model correspond with different locations of the patient anatomy. As the medical instrument 804 moves through the patient anatomy, the registration is used to determine portions of the model corresponding with the location and/or perspective of the medical instrument 804 and virtual images are generated using the determined portions of the model. This may be done to present the operator O with virtual images of the internal procedural site from viewpoints of medical instrument 804 that correspond with the tracked locations of the medical instrument 804.

[0080] The medical system 800 may also include the control system 812, which may include processing circuitry that implements the some or all of the methods or functionality discussed herein. The control system 812 may include at least one memory 816 and at least one processor 814 for controlling the operations of the manipulator assembly 802, the medical instrument 804, the master assembly 806, the sensor system 808, and/or the display system 810. Control system 812 may include programmed instructions (e.g., a non-transitory machine-readable medium storing the instructions) that when executed by the at least one processor, configures the one or more processors to implement some or all of the methods or functionality discussed herein. For example, the programmed instructions may implement some or all of the processes described in accordance with aspects disclosed herein, including, for example, expanding an expandable device, regulating a temperature of the heating system, regulating valves to control fluid delivery, controlling fluid flow rate, controlling insertion and retraction of the treatment instrument, controlling actuation of a distal end of the treatment instrument, receiving sensor information, altering signals based on the sensor information, and/or selecting a treatment location. While the control system 812 is shown as a single block in FIG. 12, the control system 812 may include two or more separate data processing circuits with one portion of the processing being performed at the manipulator assembly 802, another portion of the processing being performed at the master assembly 806, and/or the like. In some examples, the control system 812 may include other types of processing circuitry, such as application- specific integrated circuits (ASICs) and/or field-programmable gate array (FPGAs). The control system 812 may be implemented using hardware, firmware, software, or a combination thereof.

[0081] In some examples, the control system 812 may receive feedback from the medical instrument 804, such as force and/or torque feedback. Responsive to the feedback, the control system 812 may transmit signals to the master assembly 806. In some examples, the control system 812 may transmit signals instructing one or more actuators of the manipulator assembly 802 to move the medical instrument 804. In some examples, the control system 812 may transmit informational displays regarding the feedback to the display system 810 for presentation or perform other types of actions based on the feedback.

[0082] The control system 812 may include a virtual visualization system to provide navigation assistance to operator O when controlling the medical instrument 804 during an image-guided medical procedure. Virtual navigation using the virtual visualization system may be based upon an acquired preoperative or intra-operative dataset of anatomic passageways of the patient P. The virtual visualization system processes images of the surgical site imaged using imaging technology such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and/or the like. The control system 812 may use a pre-operative image to locate the target tissue (using vision imaging techniques and/or by receiving user input) and create a pre-operative plan, including an optimal first location for performing bronchial passageway and vasculature occlusion. The preoperative plan may include, for example, a planned size to expand the expandable device, a treatment duration, a treatment temperature, and/or multiple deployment locations.

[0083] Medical system 800 may further include operations and support systems (not shown) such as illumination systems, steering control systems, irrigation systems, and/or suction systems. In some embodiments, the medical system 800 may include more than one manipulator assembly and/or more than one master assembly. The exact number of manipulator assemblies may depend on the medical procedure and space constraints within the procedural room, among other factors. Multiple master assemblies may be co-located or they may be positioned in separate locations. Multiple master assemblies may allow more than one operator to control one or more manipulator assemblies in various combinations.

[0084] FIG. 13A illustrates a medical system 900. The medical system 900 includes a fluid generation system 902, a medical instrument system 904, and an umbilical system 906 extending between and coupling the fluid generation system 902 and the medical instrument system 904. The medical system 900 may also include a heating system 912 that controls a temperature of the fluid 108. Together, the fluid generation system 902, the umbilical system 906, and the heating system 912 may comprise a thermal treatment support system (e.g., thermal treatment support system 700) for delivering a fluid 108 to the medical instrument system 904. The medical system 900 may also include a control system 926 for controlling operations of the components of medical system 900. In some examples, the control system 926 may be a part of the control system 812.

[0085] In this example, the fluid generation system 902 may include a fluid reservoir 940 for containing the fluid 108 and a pump 942 for pressurizing and moving the fluid 108 through the umbilical system 906. A reservoir valve 944 may control fluid flow between the fluid reservoir 940 and the pump 942. A pump valve 946 may control fluid flow between the pump 942 and the umbilical system 906. A pressure sensor 948 may be positioned to measure the pressure of fluid 108 entering the fluid delivery channel 910. The fluid generation system 902 may also comprise a waste reservoir 950. In some examples, a control valve 952 may control fluid flow between the umbilical system 906 and waste reservoir 950.

[0086] The fluid reservoirs 940, 950 may include, for example, a bag for containing saline, a fluid chamber of a syringe, or another other container for holding the fluid 108. In some examples, the fluid reservoirs 940, 950 may be a common reservoir or may be connected to allow for the recirculation of the fluid 108. In some examples, the waste reservoir 950 may include a drain to allow for disposal of the fluid 108. In some examples, the fluid generation system 902 may be housed in a single housing 914 and in other examples, the housing 914 may include discrete and separated containers that house separated components of the fluid generation system 902. In some examples, the housing 914 may include wheels for moving along the floor of a medical environment. In some examples, the housing 914 may be coupled to a manipulator of a robot-assisted medical system.

[0087] The medical instrument system 904 may include a flexible elongate device 916 that may include a connector system 915 for coupling to the umbilical system 906. In some examples, the connector system may include a fluid duct 922 coupled to a connector mechanism 924. In some examples, the medical system 904 may include a flexible elongate delivery device 920, such as a bronchoscope, endoscope, or a catheter to guide the flexible elongate device 916. The flexible elongate device 916 may extend through a working channel of a flexible elongate delivery device 920. In some examples, the flexible elongate device 916 and/or the flexible elongate delivery device 920 may be robotically-assisted. In some examples, the flexible elongate device 916 and/or the flexible elongate delivery device 920 may be manually controlled. In some examples, the flexible elongate device 916 and/or the flexible elongate delivery device 920 may be steerable.

[0088] The umbilical system 906 may include an umbilical member 918 with a compliant body that allows limited or no expansion, thus enabling accurate volumetric fluid delivery. A fluid delivery channel 910 and a fluid return channel 911 may extend within the umbilical member 918. The umbilical system 906 may have a length sufficient to allow the fluid generation system 902 to be positioned away from the patient or the medical personnel workflow. For example, the umbilical system 906 may have a length between approximately 3 and 7 feet. In some examples, the umbilical system 906 may include an insulation material to minimize heat loss along its length. The umbilical system 906 may be unsupported between the fluid generation system 902 and the medical instrument system 904 or may be supported by an of various supports including an IV pole, a human assistant, a mechanical support arm (e.g., support arm 601), or other support device.

[0089] As shown in the cross-sectional view provided at FIG. 13B, the umbilical member 918 may include the fluid delivery channel 910 that provides a conduit for delivering the fluid 108 from the fluid generation system 902 to a distal end portion of the umbilical member 918 and may include the fluid return channel 911 that provides a conduit for delivering the fluid 108 from the distal end portion of the umbilical member 918 to the fluid generation system 902. The umbilical member 918 may also house one or more data channels 934 through which cables (e.g., coaxial, optical fiber, twisted pair) may extend to transfer data signals to the heating system 912 or a manipulator assembly 932. The umbilical member may also house one or more electrical channels 936 through which electrical cables may extend to deliver electricity to the heating system 912 or the manipulator assembly 932.

[0090] The heating system 912 may include a heating device 928 and a temperature sensor 930 and or/other components for heating and/or controlling a temperature of the fluid 108. A heating device may include a heat generating device such as one or more resistive coil heaters, induction heaters, radiofrequency heaters, or another type of heat generating device. The heating system 912 may heat the fluid to a predefined temperature. The predefined temperature within the umbilical system 906 may greater than a treatment temperature at which the fluid is dispensed from the medical instrument system 904 to perform a fluid ablation treatment in the patient anatomy. The predefined temperature generated by the heating system 912 may be greater than the treatment temperature due to a known heat loss may be expected as the fluid moves from the umbilical system 906 and through the medical instrument system 904. In this example, the components of the heating system 912 may be housed in the umbilical system 906, and more specifically in a portion of the umbilical system 906 that is located within or supported by the manipulator assembly 932 (e.g., the manipulator assembly 802). A delivery valve 954 may control delivery of the fluid 108 from the umbilical system 906 to the connector system 915 for the medical instrument system 904.

[0091] In the example of FIG. 13 A, the fluid 108 flows from the fluid generation system 902 to the medical instrument system 904 through the fluid delivery channel 910 of the umbilical system 906. The fluid 108 may be heated by the heating system 912 prior to release into the connector system 915 and the medical instrument system 904.

[0092] FIG. 14 illustrates a medical system 1000. The medical system 1000 includes the medical instrument system 904 and a fluid generation system 1002 that may be similar to the fluid generation system 902 with differences as described. The medical system 1000 may also include an umbilical system 1006 that may be similar to the umbilical system 906 with differences as described. The umbilical system 1006 may extend between and couple the fluid generation system 1002 and the medical instrument system 904. The medical system 1000 may also include the heating system 912.

[0093] In this example, the fluid generation system 1002 may include the fluid reservoir 940 for containing the fluid 108 and the pump 942 for pressurizing and moving the fluid 108 through the umbilical system 1006. In this example, a reservoir valve 1044 may be a one-way valve to limit fluid flow to a single direction, namely from the fluid reservoir 940 to the pump 942. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. In this example, a pump valve 1046 may be a one-way valve to limit fluid flow to a single direction, namely from the pump 942 to the fluid delivery channel 910 of the umbilical system 1006. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. A pressure sensor 948 may be positioned to measure the pressure of fluid 108 entering the fluid delivery channel 910. In this example, the fluid generation system 1002 may include a control valve 1052 to control fluid flow between the fluid return channel 911 and the waste reservoir 950. In this example, the control valve 1052 may include a pinch valve that may be actively managed such as by an actuator (e.g., a motor) responsive to the control system 926 or manually by an operator.

[0094] In this example, the umbilical system 1006 may include the fluid delivery channel 910 that provides a conduit for the fluid 108 received from the fluid generation system 902 and may include the fluid return channel 911 that provides a conduit for delivering the fluid 108 back to the fluid generation system 902. The umbilical system 1006 may also house one or more data and/or electrical channels as previously described. In this example, the umbilical system 1006 may also include a one-way delivery valve 1054 to control delivery of the fluid 108 from the umbilical system 1006 to the connector system 915 for the medical instrument system 904. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942 and/or the control valve 1052.

[0095] In the example of FIG. 14, the medical system 1000 may be operated in a plurality of phases including a delivery initialization phase and a delivery phase. In the delivery initialization phase, the control valve 1052 may be activated to an open state, the pump 942 may be activated, and the heating device 928 may be activated. In the delivery initialization phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1044, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1046 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At a junction 1057, distal of the heating system 912, the heated fluid 108 may flow into the fluid return channel 911. The heated fluid may then flow through the fluid return channel 911, through the control valve 1052 and into the waste reservoir 950. During the delivery initialization phase, the open control valve 1052 prevents the development of sufficient fluid pressure to open the delivery valve 1054, and thus the fluid 108 is shunted to the fluid return channel 911.

[0096] In the delivery phase, the control valve 1052 may be activated to a closed state while the pump 942 and the heating device 928 remain activated. In the delivery phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1044, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1046 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At the junction 1057, the heated fluid 108 may flow through the delivery valve 1054. The heated fluid 108 may then flow through the connector system 915 and into the medical instrument system 904. During the delivery phase, the closed control valve 1052 allows for the development of sufficient fluid pressure to open the delivery valve 1054 and thus the fluid 108 is shunted to the instrument system 904. [0097] FIG. 15 illustrates a medical system 1100. The medical system 1100 includes the medical instrument system 904 and a fluid generation system 1102 that may be similar to the fluid generation system 902 with differences as described. The medical system 1100 may also include an umbilical system 1106 that may be similar to the umbilical system 906 with differences as described. The umbilical system 1106 may extend between and couple the fluid generation system 1102 and the medical instrument system 904. The medical system 1100 may also include the heating system 912.

[0098] In this example, the fluid generation system 1102 may include the fluid reservoir 940 for containing the fluid 108 and the pump 942 for pressurizing and moving the fluid 108 through the umbilical system 1106. In this example, a reservoir valve 1144 may be a one-way valve to limit fluid flow from the fluid reservoir 940 to the pump 942. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. In this example, a pump valve 1146 may be a one-way valve to limit fluid flow from the pump 942 to the fluid delivery channel 910 of the umbilical system 1106. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. A pressure sensor 948 may be positioned to measure the pressure of fluid 108 entering the fluid delivery channel 910. In this example, a control valve (e.g., the control valve 952) may be omitted from the fluid generation system 1102.

[0099] In this example, the umbilical system 1106 may include the fluid delivery channel 910 that provides a conduit for the fluid 108 received from the fluid generation system 902 and may include the fluid return channel 911 that provides a conduit for delivering the fluid 108 back to the fluid generation system 902. The umbilical system 1106 may also house one or more data and/or electrical channels as previously described. In this example, the umbilical system 1106 may also include a three-way delivery valve 1154 to control delivery of the fluid 108 from the umbilical system 1106 to the connector system 915 for the medical instrument system 904. In various examples, the three-way valve may include, for example, an actively actuated valve such as a solenoid, electrical, or pneumatic valve that may be actively managed by the control system 926 or by an operator.

[0100] In the example of FIG. 15, the medical system 1100 may be operated in a plurality of phases including a delivery initialization phase and a delivery phase. In the delivery initialization phase, the delivery valve 1154 may be activated to an initialization state, the pump 942 may be activated, and the heating device 928 may be activated. In the delivery initialization phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1144, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1146 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. The heated fluid 108 may flow through the delivery valve 1154 in the initialization state and into the fluid return channel 911. The heated fluid 108 may then flow through the fluid return channel 911 and into the waste reservoir 950. During the delivery initialization phase, the initialization state of the delivery valve 1154 prevents the heated fluid 108 from flowing to the medical instrument system 904.

[0101] In the delivery phase, the delivery valve 1154 may be activated to a delivery state while the pump 942 and the heating device 928 remain activated. In the delivery phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1144, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1146 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. The heated fluid 108 may flow into the delivery valve 1154 in the delivery state and may then flow through the connector system 915 and into the medical instrument system 904. During the delivery phase, the delivery state of the delivery valve 1154 prevents the heated fluid from flowing into the fluid return channel 911.

[0102] FIG. 16 illustrates a medical system 1200. The medical system 1200 includes the medical instrument system 904 and a fluid generation system 1202 that may be similar to the fluid generation system 902 with differences as described. The medical system 1200 may also include an umbilical system 1206 that may be similar to the umbilical system 906 with differences as described. The umbilical system 1206 may extend between and couple the fluid generation system 1202 and the medical instrument system 904. The medical system 1200 may also include the heating system 912.

[0103] In this example, the fluid generation system 1202 may include the fluid reservoir 940 for containing the fluid 108 and the pump 942 for pressurizing and moving the fluid 108 through the umbilical system 1006. In this example, a reservoir valve 1244 may be a one-way valve to limit fluid flow from the fluid reservoir 940 to the pump 942. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. In this example, a pump valve 1246 may be a one-way valve to limit fluid flow from the pump 942 to the fluid delivery channel 910 of the umbilical system 1206. In various examples, the one-way valve may include, for example, a check valve or a pressure relief valve. The one-way valve may be passively activated or spring activated in response to activation of the pump 942. A pressure sensor 948 may be positioned to measure the pressure of fluid 108 entering the fluid delivery channel 910. In this example, the fluid generation system 1202 may include a control valve 1252 to control fluid flow between the fluid return channel 911 and the waste reservoir 950. In this example, the control valve 1252 may include a pinch valve that may be actively managed such as by an actuator (e.g., a motor) responsive to the control system 926 or manually by an operator.

[0104] In this example, the umbilical system 1206 may include the fluid delivery channel 910 that provides a conduit for the fluid 108 received from the fluid generation system 902 and may include the fluid return channel 911 that provides a conduit for delivering the fluid 108 back to the fluid generation system 902. The umbilical system 1206 may also house one or more data and/or electrical channels as previously described. In this example, the umbilical system 1206 may also include a delivery valve 1254 to control delivery of the fluid 108 from the umbilical system 1206 to the connector system 915 for the medical instrument system 904. In various examples, the delivery valve 1254 may include, for example, an actively actuated valve such as a solenoid, electrical, or pneumatic valve that may be actively managed by the control system 926 or by an operator.

[0105] In the example of FIG. 16, the medical system 1200 may be operated in a plurality of phases including a delivery initialization phase and a delivery phase. In the delivery initialization phase, the control valve 1252 may be activated to an open state, the delivery valve 1254 may be activated to a closed state, the pump 942 may be activated, and the heating device 928 may be activated. In the delivery initialization phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1244, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1246 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At a junction 1257, distal of the heating system 912, the heated fluid 108 may flow into the fluid return channel 911. The heated fluid may then flow through the fluid return channel 911, through the control valve 1252 and into the waste reservoir 950. During the delivery initialization phase, the open control valve 1252 and the closed delivery valve 1254 prevent the fluid 108 from flowing to the medical instrument system 904.

[0106] In the delivery phase, the control valve 1252 may be activated to a closed state and the delivery valve 1254 may be activated to an open state. The pump 942 and the heating device 928 may remain activated. In the delivery phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1244, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1246 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At the junction 1257, the heated fluid 108 may flow through the open delivery valve 1254. The heated fluid 108 may then flow through the connector system 915 and into the medical instrument system 904. During the delivery phase, the closed control valve 1252 prevents the fluid 108 from flowing to the waste reservoir 950.

[0107] FIG. 17 illustrates a medical system 1300. The medical system 1300 includes the medical instrument system 904 and a fluid generation system 1302 that may be similar to the fluid generation system 902 with differences as described. The medical system 1300 may also include an umbilical system 1306 that may be similar to the umbilical system 906 with differences as described. The umbilical system 1306 may extend between and couple the fluid generation system 1302 and the medical instrument system 904. The medical system 1300 may also include the heating system 912.

[0108] In this example, the fluid generation system 1302 may include the fluid reservoir 940 for containing the fluid 108 and the pump 942 for pressurizing and moving the fluid 108 through the umbilical system 1306. In this example, a reservoir valve 1344 may include, for example, an actively actuated valve such as a solenoid, electrical, or pneumatic valve that may be actively managed by the control system 926 or by an operator. In this example, a pump valve 1346 may include, for example, an actively actuated valve such as a solenoid, electrical, or pneumatic valve that may be actively managed by the control system 926 or by an operator. A pressure sensor 948 may be positioned to measure the pressure of fluid 108 entering the fluid delivery channel 910. In this example, the fluid generation system 1302 may include a control valve 1352 to control fluid flow between the fluid return channel 911 and the waste reservoir 950. In this example, the control valve 1352 may include a pinch valve that may be actively managed such as by an actuator (e.g., a motor) responsive to the control system 926 or manually by an operator.

[0109] In this example, the umbilical system 1306 may include the fluid delivery channel 910 that provides a conduit for the fluid 108 received from the fluid generation system 902 and may include the fluid return channel 911 that provides a conduit for delivering the fluid 108 back to the fluid generation system 902. The umbilical system 1306 may also house one or more data and/or electrical channels as previously described. In this example, the umbilical system 1306 may also include a delivery valve 1354 to control delivery of the fluid 108 from the umbilical system 1306 to the connector system 915 for the medical instrument system 904. In various examples, the delivery valve 1354 may include, for example, an actively actuated valve such as a solenoid, electrical, or pneumatic valve that may be actively managed by the control system 926 or by an operator.

[0110] In the example of FIG. 17, the medical system 1300 may be operated in a plurality of phases including a delivery initialization phase and a delivery phase. In the delivery initialization phase, reservoir valve 1344 may be activated to an open state, the pump valve 1346 may be activated to an open state, the control valve 1352 may be activated to an open state, the delivery valve 1354 may be activated to a closed state, the pump 942 may be activated, and the heating device 928 may be activated. In the delivery initialization phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1344, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1346 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At a junction 1357, distal of the heating system 912, the heated fluid 108 may flow into the fluid return channel 911. The heated fluid may then flow through the fluid return channel 911, through the control valve 1352 and into the waste reservoir 950. During the delivery initialization phase, the closed delivery valve 1354 prevents the heated fluid 108 from flowing to the medical instrument system 904.

[0111] In the delivery phase, the control valve 1352 may be activated to a closed state and the delivery valve 1354 may be activated to an open state. The reservoir valve 1344 and the pump valve 1346 may remain open, and the pump 942 and the heating device 928 remain activated. In the delivery phase, the fluid 108 may flow from the reservoir 940, through the reservoir valve 1344, and to the pump 942. The pump 942 may pump the fluid 108 through the pump valve 1346 and into the fluid delivery channel 910. The fluid 108 may be heated by the heating device 928. At the junction 1357, the heated fluid 108 may flow into the delivery valve 1354. The heated fluid 108 may then flow through the connector system 915 and into the medical instrument system 904. During the delivery phase, the closed control valve 1352 prevents the fluid 108 from flowing to the waste reservoir 950.

[0112] In the description, specific details have been set forth describing some examples. Numerous specific details are set forth in order to provide a thorough understanding of the examples. It will be apparent, however, to one skilled in the art that some examples may be practiced without some or all of these specific details. The specific examples disclosed herein are meant to be illustrative but not limiting. One skilled in the art may realize other elements that, although not specifically described here, are within the scope and the spirit of this disclosure.

[0113] Elements described in detail with reference to one example, implementation, or application optionally may be included, whenever practical, in other examples, implementations, or applications in which they are not specifically shown or described. For example, if an element is described in detail with reference to one example and is not described with reference to a second example, the element may nevertheless be claimed as included in the second example. Thus, to avoid unnecessary repetition in the following description, one or more elements shown and described in association with one example, implementation, or application may be incorporated into other examples, implementations, or aspects unless specifically described otherwise, unless the one or more elements would make an example or implementation non-functional, or unless two or more of the elements provide conflicting functions.

[0114] Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or steps described with respect to one example may be combined with the features, components, and/or steps described with respect to other examples of the present disclosure. In addition, dimensions provided herein are for specific examples and it is contemplated that different sizes, dimensions, and/or ratios may be utilized to implement the concepts of the present disclosure. To avoid needless descriptive repetition, one or more components or actions described in accordance with one illustrative example can be used or omitted as applicable from other illustrative examples. For the sake of brevity, the numerous iterations of these combinations will not be described separately. For simplicity, in some instances the same reference numbers are used throughout the drawings to refer to the same or like parts.

[0115] The systems and methods described herein may be suited for imaging, via natural or surgically created connected passageways, in any of a variety of anatomic systems, including the lung, colon, the intestines, the stomach, the liver, the kidneys and kidney calices, the brain, the heart, the circulatory system including vasculature, and/or the like. While some examples are provided herein with respect to medical procedures, any reference to medical or surgical instruments and medical or surgical methods is nonlimiting. For example, the instruments, systems, and methods described herein may be used for nonmedical purposes including industrial uses, general robotic uses, and sensing or manipulating non-tissue work pieces. Other example applications involve cosmetic improvements, imaging of human or animal anatomy, gathering data from human or animal anatomy, and training medical or non-medical personnel. Additional example applications include use for procedures on tissue removed from human or animal anatomies (without return to a human or animal anatomy) and performing procedures on human or animal cadavers. Further, these techniques can also be used for surgical and non surgical medical treatment or diagnosis procedures.

[0116] The methods described herein are illustrated as a set of operations or processes. Not all the illustrated processes may be performed in all examples of the methods. Additionally, one or more processes that are not expressly illustrated or described may be included before, after, in between, or as part of the example processes. In some examples, one or more of the processes may be performed by the control system (e.g., control system 812) or may be implemented, at least in part, in the form of executable code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors 814 of control system 812) may cause the one or more processors to perform one or more of the processes.

[0117] One or more components of the embodiments discussed in this disclosure, such as control system 812, may be implemented in software for execution on one or more processors of a computer system. The software may include code that when executed by the one or more processors, configures the one or more processors to perform various functionalities as discussed herein. The code may be stored in a non-transitory computer readable storage medium (e.g., a memory, magnetic storage, optical storage, solid-state storage, etc.). The computer readable storage medium may be part of a computer readable storage device, such as an electronic circuit, a semiconductor device, a semiconductor memory device, a read only memory (ROM), a flash memory, an erasable programmable read only memory (EPROM); a floppy diskette, a CD-ROM, an optical disk, a hard disk, or other storage device. The code may be downloaded via computer networks such as the Internet, Intranet, etc. for storage on the computer readable storage medium. The code may be executed by any of a wide variety of centralized or distributed data processing architectures. The programmed instructions of the code may be implemented as a number of separate programs or subroutines, or they may be integrated into a number of other aspects of the systems described herein. The components of the computing systems discussed herein may be connected using wired and/or wireless connections. In some examples, the wireless connections may use wireless communication protocols such as Bluetooth, near-field communication (NFC), Infrared Data Association (EDA), home radio frequency (HomeRF), IEEE 802.11, Digital Enhanced Cordless Telecommunications (DECT), and wireless medical telemetry service (WMTS).

[0118] Note that the processes and displays presented may not inherently be related to any particular computer or other apparatus. Various general-purpose systems may be used with programs in accordance with the teachings herein, or it may prove convenient to construct a more specialized apparatus to perform the operations described. The required structure for a variety of these systems will appear as elements in the claims. In addition, the examples of the invention are not described with reference to any particular programming language. It will be appreciated that a variety of programming languages may be used to implement the teachings of the invention as described herein.

[0119] In some instances well known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the examples. This disclosure describes various instruments, portions of instruments, and anatomic structures in terms of their state in three- dimensional space. As used herein, the term “position” refers to the location of an object or a portion of an object in a three-dimensional space (e.g., three degrees of translational freedom along Cartesian x-, y- , and z-coordinates). As used herein, the term “orientation” refers to the rotational placement of an object or a portion of an object (three degrees of rotational freedom - e.g., roll, pitch, and yaw). As used herein, the term “pose” refers to the position of an object or a portion of an object in at least one degree of translational freedom and to the orientation of that object or portion of the object in at least one degree of rotational freedom (up to six total degrees of freedom). As used herein, the term “shape” refers to a set of poses, positions, or orientations measured along an object. As used herein, the term “distal” refers to a position that is closer to a procedural site and the term “proximal” refers to a position that is further from the procedural site. Accordingly, the distal portion or distal end of an instrument is closer to a procedural site than a proximal portion or proximal end of the instrument when the instrument is being used as designed to perform a procedure.

[0120] While certain exemplary examples of the invention have been described and shown in the accompanying drawings, it is to be understood that such examples are merely illustrative of and not restrictive on the broad invention, and that the examples of the invention not be limited to the specific constructions and arrangements shown and described, since various other alternatives, modifications, and equivalents will be appreciated by those with ordinary skill in the art.

Claims

CLAIMS What is claimed is:

1. A medical system comprising: a fluid generation system configured to provide a fluid; a medical instrument system configured to deliver the fluid for treatment; an umbilical system coupled between the fluid generation system and the medical instrument system, the umbilical system configured to receive the fluid from the fluid generation system and provide the fluid to the medical instrument system; and a heating system configured to control a temperature of the fluid within the umbilical system.

2. The medical system of claim 1, wherein at least a portion of the heating system is located in the umbilical system.

3. The medical system of claim 2 wherein the heating system includes a heating device located in the umbilical system.

4. The medical system of claim 1, wherein the heating system is configured to heat the fluid to a predefined temperature as the fluid travels in a continuous forward path from the fluid generation system, through the umbilical system, and to the medical instrument system.

5. The medical system of claim 4, wherein the heating system includes a heating device located at a distal portion of the umbilical system.

6. The medical system of claim 5, wherein the umbilical system includes a connector member configured to couple the umbilical system to the medical instrument system and wherein the heating device is in the connector member.

7. The medical system of claim 4, wherein the predefined temperature is higher than a treatment temperature of the fluid when dispensed from the medical instrument system for treatment.

8. The medical system of claim 1, further including a control system configured to control a fluid parameter.

9. The medical system of claim 8, wherein the fluid parameter is a fluid pressure from the fluid generation system and wherein the fluid pressure is controlled based on pressure sensor data.

10. The medical system of claim 9, wherein the umbilical system includes a pressure sensor configured to generate the pressure sensor data.

11. The medical system of claim 8, wherein the fluid parameter is a fluid temperature and wherein the fluid temperature is controlled based on temperature sensor data.

12. The medical system of claim 11, wherein the umbilical system includes a temperature sensor configured to generate the temperature sensor data.

13. The medical system of claim 8, wherein the fluid parameter is a fluid temperature, and the control system is configured to vary the fluid temperature during a treatment process.

14. The medical system of claim 8, wherein the fluid parameter is a flow rate, and the control system is configured to vary the flow rate during a treatment process.

15. The medical system of claim 8, wherein the fluid parameter is a flow duration, and the control system is configured to vary the flow duration during a treatment process.

16. The medical system of claim 8, wherein the fluid parameter is one of a plurality of fluid arameters controlled by the control system and wherein the plurality of fluid parameters include a flowrate, a volume, and a temperature that are simultaneously varied during a treatment process.

17. The medical system of claim 1, wherein the heating system includes a first heating device located in the umbilical system and a second heating device located at the fluid generation system.

18. The medical system of claim 17, wherein the second heating device maintains the fluid within the fluid generation system at an initial temperature and the first heating device is configured to heat the fluid to a predetermined temperature, wherein the initial temperature is lower than the predetermined temperature.

19. The medical system of claim 1, wherein the fluid generation system is movable relative to the medical instrument system.

20. The medical system of claim 1 , wherein the fluid generation system includes a pump.

21. The medical system of claim 1, wherein the fluid generation system includes a syringe.

22. The medical system of claim 1, wherein the fluid generation system includes a fluid reservoir.

23. The medical system of claim 1, wherein the fluid generation system include a reversible pump configured switch a flow direction of the fluid from a forward flow direction to a reverse flow direction.

24. The medical system of claim 1, wherein the umbilical system includes a flexible elongate member through which a channel configured to convey the fluid extends.

25. The medical system of claim 1, wherein the umbilical system includes insulation.

26. The medical system of claim 1, wherein the heating system includes a resistive coil.

27. The medical system of claim 1, wherein the heating system includes an induction heating device.

28. The medical system of claim 1, wherein the heating system includes a radiofrequency heating device.

29. The medical system of claim 1, wherein, the medical instrument system includes a flexible elongate device.

30. The medical system of claim 29, wherein the medical instrument system further includes a flexible elongate delivery device and wherein the flexible elongate device is extendable through the flexible elongate delivery device.

31. The medical system of claim 29, wherein the flexible elongate device includes a temperature sensor.

32. The medical system of claim 31, wherein the temperature sensor include an optical fiber sensor.

33. The medical system of claim 1, wherein the heating system includes a heat trace located in the umbilical system.

34. The medical system of claim 1 , wherein the heating system includes a heating device located in the fluid generation system.

35. The medical system of claim 34, wherein the umbilical system includes a valve configured to switch between a first state in which the fluid flows through the umbilical system and recirculates to the fluid generation system and a second state in which the fluid flows through the umbilical system and into the medical instrument system.

36. The medical system of claim 34, wherein the fluid is a treatment fluid and wherein the umbilical system includes a first channel configured to deliver the treatment fluid to the medical instrument system and a second channel configured to circulate a heating fluid through the umbilical system.

37. The medical system of claim 34, wherein the umbilical system includes a pressure valve and the fluid generation system includes a pinch valve, wherein the pinch valve has an open state in which the pressure valve is closed and fluid circulates within the umbilical system and a closed state wherein the pressure valve is open and fluid flows through the pressure valve.

38. The medical system of claim 1, wherein the fluid generation system includes a control valve configured to switch between a first state in which the fluid flows through the umbilical system and recirculates to the fluid generation system and a second state in which the fluid flows through the umbilical system and into the medical instrument system.

39. The medical system of claim 38, where in the control valve includes a pinch valve.

40. The medical system of claim 38, wherein the control valve is an actively controlled valve.

41. The medical system of claim 38, wherein the umbilical system includes a delivery valve configured to switch between a first state in which the fluid flows through the umbilical system and recirculates to the fluid generation system and a second state in which the fluid flows through the umbilical system and into the medical instrument system.

42. The medical system of claim 41, wherein the delivery valve includes a passively activated valve.

43. The medical system of claim 41, wherein the delivery valve includes an actively controlled valve.

44. The medical system of claim 38, wherein the fluid generation system includes a fluid reservoir, a pump, a reservoir valve configured to control flow of the fluid from the fluid reservoir, and a pump valve configured to control flow of the fluid into the umbilical system.

45. The medical system of claim 44, wherein the reservoir valve is passively activated and the pump valve is passively activated.

46. The medical system of claim 44, where in the reservoir valve is actively controlled and the pump valve is actively controlled.

47. A method comprising: providing a fluid from a fluid generation system to an umbilical system coupled between the fluid generation system and a medical instrument system; controlling a temperature of the fluid with a heating system while the fluid is within the umbilical system; and providing fluid from the umbilical system to the medical instrument system.

48. The method of claim 47, wherein controlling the temperature of the fluid with the heating system includes heating the fluid to a predefined temperature as the fluid travels in a continuous forward path from the fluid generation system, through the umbilical system, and to the medical instrument system.

49. The method of claim 48, wherein the predefined temperature is higher than a treatment temperature of the fluid when dispensed from the medical instrument system for treatment.

50. The method of claim 47, further comprising: controlling a fluid parameter for the fluid in the umbilical system.

51. The method of claim 50, wherein the fluid parameter is a fluid pressure from the fluid generation system.

52. The method of claim 50, wherein the fluid parameter is a fluid temperature.

53. The method of claim 50, wherein the fluid parameter is a flow rate.

54. The method of claim 50, wherein the fluid parameter is a flow duration.

55. The method of claim 47, wherein controlling the temperature of the fluid includes heating the fluid with the heating system located in the umbilical system.

56. The method of claim 55, wherein the heating system includes a heating device located at a distal portion of the umbilical system.

57. The method of claim 56, wherein the umbilical system includes a connector member configured to couple the umbilical system to the medical instrument system and wherein the heating device is in the connector member.