Patent Application
20210030394
The present disclosure relates generally to the inspection and imaging of the organs of a patient using transesophageal echocardiography (TEE). For example, some embodiments of the present disclosure are suited for modularly adapting TEE probes to be used with one or more modular gastroscopes. Other embodiments of the present disclosure are suited for wireless TEE procedures.
Observing the condition and function of a patient's heart can be a difficult and dangerous procedure. Echocardiography can mitigate risk of injury to the patient by using ultrasonic imaging techniques. In an echocardiogram, a physician uses an ultrasonic probe comprising one or more ultrasonic transducers to obtain images of various angles of the patient's heart. The ultrasonic transducers emit ultrasonic energy in the form of ultrasonic waves to create an image of the heart. Ultrasonic waves are partially reflected by discontinuities arising from tissue structures, red blood cells, and other features of interest. Echoes, or the reflected ultrasonic waves, are received by the ultrasonic transducer and transmitted to a signal processor. The signal processor processes the received ultrasound echoes to produce an image of the heart near the location where the ultrasonic transducer is placed.
One common echocardiography procedure is a transthoracic echocardiogram (TTE), which involves placing an ultrasonic probe on the chest or abdomen of a patient to obtain images of various angles of the patient's heart. Although TTE is a relatively non-invasive procedure, the ultrasonic waves must travel through several layers of tissue and bone to reach the heart, and the echoes must travel back through the same tissue and bone to reach the ultrasonic transducer. These thick layers of tissue and bone can weaken the strength of the echoes and degrade the quality of the image obtained.
Transesophageal echocardiography (TEE) involves obtaining an ultrasonic image of the heart using a TEE probe positioned within the patient's esophagus. TEE probes also use ultrasonic waves to obtain an image of a patient's heart. Transesophageal echocardiography can be advantageous because the heart is located near the esophagus, which can result in higher quality images. To obtain an image using a TEE probe, a physician inserts a gastroscope including an ultrasonic transducer into the patient's esophagus and guides the ultrasonic transducer to an area near the heart. The physician manipulates a distal portion of the gastroscope within the patient's esophagus to guide the ultrasonic transducer into place, and to maintain contact with the esophagus wall to facilitate the transmission and reception of the ultrasonic waves.
Conventional TEE probes include a handle and a gastroscope having an ultrasound transducer and an elongated body coupled to the handle. The handle may also be coupled to an interface cable leading to a console. In some conventional embodiments, the handle, gastroscope, and console interface cable comprise an integral unit in which the separate components are permanently fixed to one another. In other words, in conventional embodiments, the gastroscope is not configured to be repeatedly separated from and recoupled to a handle by a physician or other user.
The size and shape of the gastroscope portion of the TEE probe that the physician uses to obtain ultrasonic images may depend on the physiology of the patient and the particular type of image desired by the physician. In other words, when a physician desires to obtain an ultrasonic image of a patient's heart, she must select a gastroscope that matches the size and configuration of the patient's physiology. Because conventional TEE probes include permanently fixed gastroscopes and other components, the physician must have a separate TEE probe, including a handle and a console interface cable, for each gastroscope configuration she may use in her practice. This is true even though the handle and console interface cable do not vary between gastroscopes.
Cleaning conventional TEE probes can be difficult and damaging to TEE probe components. For example, the gastroscope, which contacts the patient's physiology, may require more rigorous cleaning while the handle and console interface cable may require less rigorous cleaning. Procedures suitable to clean one component of the TEE probe, may damage other parts of the TEE probe. The complexity of cleaning a TEE probe with components of differing resilience can lead to time-consuming and cumbersome cleaning procedures and damage to TEE probe components. When conventional TEE probe components are damaged, the entire TEE probe, including the handle and console interface cable, must be sent away for repair, or more expensively, for replacement.
Furthermore, in a conventional transesophageal echocardiogram, the physician uses x-ray imaging on the patient's esophagus to guide the TEE probe to the desired location, subjecting the physician to radiation. Because the controls for conventional TEE probes are placed on the handle, the physician must maintain a constant and steady grip on the handle of the TEE probe for long periods of time, and often at awkward angles.
Embodiments of the present disclosure provide an improved transesophageal echocardiography (TEE) probe for generating images of an organ. For example, the TEE probe can include components, such as a gastroscope and a handle, that are removably coupled to another to allow for detachment and substitution of one or more components. The systems, devices and methods described herein advantageously allow for a TEE probe to be disassembled and reassembled by a physician or user, using the same or different components. This advantageously improves the medical workflow for the patient and the physician, and mitigates damage to the TEE probe during cleaning procedures.
The present disclosure also describes TEE probes that can be controlled remotely, or wirelessly. Embodiments of the present disclosure also provide a TEE probe including a wireless module configured to receive and transmit electrical signals. For example, the wireless module can be configured to receive a command signal from a remote user, permitting the remote user to remotely or wirelessly control various aspects of the TEE procedure. The wireless module may also be configured to transmit ultrasonic imaging data to a console at or near the remote user to allow the remote user to observe an ultrasonic image. This can reduce the physician's exposure to radiation in an operating room, and can reduce the difficulty of the TEE procedure. Additionally, a TEE probe having a wireless module can include removable components as described above, thus enjoying both the benefits of the wireless module and the removable or modular components.
According to an exemplary embodiment, a transesophageal echocardiography (TEE) probe is provided. The TEE probe includes a handle comprising a proximal portion, a distal portion, and a handle-mating interface disposed at the distal portion. The TEE probe can further comprise a gastroscope coupled to the handle and configured to be positioned within an esophagus of a patient. The gastroscope can comprise a proximal portion, a distal portion, an ultrasonic transducer disposed at the distal portion of the gastroscope and configured to obtain ultrasonic imaging data, and a gastroscope-mating interface disposed at the proximal portion of the gastroscope. The handle and the gastroscope can be removably coupled via the handle-mating interface and the gastroscope-mating interface, such that when the handle-mating interface and the gastroscope-mating interface are coupled, the handle-mating interface is configured to transmit an electrical signal to the gastroscope via the gastroscope-mating interface to control movement of the distal portion of the gastroscope.
In some embodiments, the ultrasonic transducer comprises an ultrasonic transducer array, and the gastroscope comprises a microbeamformer in communication with the ultrasonic transducer array. The microbeamformer can be disposed at the distal portion of the gastroscope. In some embodiments, the handle comprises a beamformer in communication with the ultrasonic transducer array. In other embodiments, the gastroscope comprises a microbeamformer in communication with the ultrasonic transducer array and the beamformer. The handle-mating interface and the gastroscope-mating interface can comprise pogo pin interfaces, in some instances. At least one of the handle or the gastroscope can comprise a latch to secure the handle-mating interface and the gastroscope-mating interface.
In some embodiments, the gastroscope comprises an actuator and a pull cable coupled to the actuator and the distal portion of the gastroscope. The actuator can be configured to control movement of the distal portion of the gastroscope. The handle may comprise a controller in communication with the actuator and the ultrasonic transducer. The actuator can include a motor. The gastroscope may include a force sensor disposed at the distal portion of the gastroscope, and can be configured to detect a force applied to the distal portion of the gastroscope. In some instances, the TEE probe further includes a force sensor controller in communication with the force sensor and the actuator. The force sensor controller can be configured to control actuation of the pull cable by the actuator based on a force detected by the force sensor. The force sensor can comprise a flexible substrate positioned around the distal portion of the gastroscope. In other embodiments, the handle comprises a console-mating interface at the proximal portion of the handle. The console-mating interface may comprise at least one of a USB interface or a pogo pin interface.
In other embodiments, a TEE probe includes a gastroscope configured to be coupled to a handle and positioned within an esophagus of a patient. The gastroscope can comprise a distal portion, a proximal portion, an ultrasonic transducer disposed at the distal portion of the gastroscope and configured to obtain ultrasonic imaging data, a motor, and a pull cable. The pull cable is coupled to the motor and the distal portion of the gastroscope, in some instances. The motor may be configured to receive an electrical signal from the handle to control movement of the distal portion of the gastroscope using the pull cable. In some embodiments the gastroscope comprises a force sensor configured to detect a force applied to the distal portion of the gastroscope. The TEE probe can also comprise a force sensor controller in communication with the force sensor and the motor. The force sensor controller may be configured to control actuation of the pull cable by the motor based on a force detected by the force sensor. In other embodiments, the TEE probe comprises a motor sensor in communication with the motor and configured to detect a position of the motor. In still other embodiments, the ultrasonic transducer comprises an ultrasonic transducer array, and the gastroscope comprises a microbeamformer that is in communication with the ultrasonic transducer array and disposed at the distal portion of the gastroscope.
According to a further exemplary embodiment, a TEE probe is provided. The TEE probe includes a handle, a gastroscope coupled to the handle, and a wireless module coupled to the handle and in communication with the gastroscope. The gastroscope can be configured to be positioned within an esophagus of a patient, and can include an ultrasonic transducer disposed at a distal portion of the gastroscope. The gastroscope can be configured to obtain ultrasonic imaging data. The wireless module can include a wireless communication element, and a microcontroller in communication with the wireless communication element. The wireless module can be configured to receive a command signal from a console spaced from the TEE probe and to transmit the ultrasonic imaging data to the console. The microcontroller, in response to the received command signal, may be configured to transmit an electrical signal to the gastroscope to control the distal portion of the gastroscope.
In some embodiments, the TEE probe further comprises a user interface coupled to the handle and configured to receive a manual input from a user to control the gastroscope. In other embodiments, the microcontroller is configured to transmit the electrical signal to control movement of the distal portion of the gastroscope, in response to the command signal. In yet other embodiments, the gastroscope comprises a pull cable coupled to the distal portion of the gastroscope, and an actuator coupled to the pull cable. The microcontroller can be configured to transmit the electrical signal to the actuator to actuate the pull cable to move the distal portion of the gastroscope. In some embodiments, the microcontroller is configured to transmit the electrical signal to control the ultrasonic transducer in response to the command signal. In other embodiments, the ultrasonic transducer comprises an ultrasonic transducer array, and the handle comprises a beamformer in communication with the ultrasonic transducer array. The handle can also comprise a signal processor in communication with the beamformer. In some instances, the gastroscope comprises a microbeamformer in communication with the ultrasonic transducer array and the beamformer. The TEE probe can further comprise a battery configured to power the wireless module and the gastroscope, in some instances.
In some embodiments, the TEE probe comprises a handle-mating interface disposed at a distal portion of the handle, and a gastroscope-mating interface disposed at a proximal portion of the gastroscope. The handle and the gastroscope can be removably coupled via the handle-mating interface and the gastroscope-mating interface. The handle-mating interface can be configured to transmit the electrical signal to the gastroscope via the gastroscope-mating interface to control the distal portion of the gastroscope. In some embodiments, the wireless module is disposed within the handle. In other embodiments, the wireless module comprises a housing coupled to the handle, such that when the wireless module is coupled to the handle, the wireless module transmits the electrical signal to the gastroscope. In some embodiments, the housing removable couples to the handle by at least one of a USB interface or a pogo pin interface.
According to an exemplary embodiment, a method for wirelessly controlling a transesophageal echocardiography (TEE) probe is provided. The method can include: wirelessly receiving, by a wireless communication element coupled to a handle of the TEE probe, a command signal transmitted by a console spaced from the TEE probe while a gastroscope of the TEE probe is positioned within an esophagus of a patient; transmitting, by the wireless communication element, the received command signal to a controller coupled to the handle; and applying, by the controller in response to the received command signal, a voltage to an actuator coupled to the gastroscope to control movement of a distal portion of the gastroscope within the esophagus.
In some embodiments, the method can further comprise receiving, at the controller coupled to the handle, a feedback signal from the actuator, and modifying, by the actuator and based on the feedback signal, the movement of the distal portion of the gastroscope. In some aspects, the step of receiving the feedback signal from the actuator comprises receiving a force detection signal, and the step of modifying movement of the distal portion of the gastroscope comprises halting, by the actuator, the movement of the distal portion of the gastroscope. In some embodiments, the method further comprises wirelessly transmitting, by the wireless communication element to the console, the feedback signal, and activating a force detection indicator in response to the received feedback signal. The feedback signal may comprise a force detection signal. In some embodiments, the method further comprises: obtaining, by an ultrasonic transducer at the distal portion of the gastroscope, ultrasonic imaging data; and wirelessly transmitting, by the wireless communication element, the ultrasonic imaging data to the console. The method can further comprise receiving the ultrasonic imaging data obtained by the ultrasonic transducer at a beamformer, and transmitting the beamformed ultrasonic imaging data to the wireless communication element. In some embodiments, the method further comprises receiving ultrasonic imaging data obtained by the ultrasonic transducer at a microbeamformer and transmitting the microbeamformed ultrasonic imaging data to the microbeamformer.
Additional aspects, features, and advantages of the present disclosure will become apparent from the following detailed description.
Illustrative embodiments of the present disclosure will be described with reference to the accompanying drawings, of which:
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, and specific language will be used to describe the same. It is nevertheless understood that no limitation to the scope of the disclosure is intended. Any alterations and further modifications to the described devices, systems, and methods, and any further application of the principles of the present disclosure are fully contemplated and included within the present disclosure 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 embodiment may be combined with the features, components, and/or steps described with respect to other embodiments of the present disclosure. For the sake of brevity, however, the numerous iterations of these combinations will not be described separately.
Permanent may be used to refer broadly to a mode of coupling or attachment that is not configured or designed for regular detachment and reattachment. Thus, although two coupled components can be physically separated, this disclosure may refer to the coupling or attachment as permanent when the components are not detached in the ordinary medical usage of the device. The terms coupled, coupling, coupled to, or connected, are used to refer broadly to any combination, attachment, or connection. This disclosure may refer to two components as coupled, even though they are permanently fixed to one another, or integrally formed as a single unit. Coupled, as used in this disclosure, contemplates direct and indirect modes of coupling or attachment, and modes of coupling or attachment that are removable. Two components may be referred to as coupled to one another even though they do not directly contact one another, or there are one or more conjoining components between the two components. Removable or separable may be used to refer to a mode of coupling or attachment that is configured to be separated and reattached in the normal course of use of a device or system, such as before, during, or after a medical procedure.
The gastroscope 30 includes an elongate body 37, a distal portion 39, and a proximal portion 32. The elongate body 37 may be flexible to be guided through the esophagus of the patient. The gastroscope 30 includes first and second pull cables 31, 33 that are mechanically connected to first and second movement controls 23, 25 coupled to the handle 20. Such a configuration may enable a physician to control movement of the distal portion of the gastroscope. Controlling movement of the distal portion 39 of the gastroscope 30 can aid the physician to guide the gastroscope 30 through the physiology of the patient to the desired imaging location. A rigid or fixed configuration of a gastroscope could injure the patient, and may be unsuitable for ultrasonic imaging, which demands accurate placement and sufficient contact with the patient's physiology to obtain ultrasonic images. Thus, pull cables 31, 33 and flexible components aid the physician in obtaining ultrasonic images of the patient's organs. Because the first and second pull cables 31, 33 are mechanically connected to the first and second movement controls 25, 27, a physician manipulating the first and second movement controls 23, 25 may receive tactile feedback from the distal portion 39 of the gastroscope 30 when the distal portion 39 presses against the walls of the esophagus.
Because conventional pull cables are manipulated by pull wires that extend from the gastroscope tip to movement controls disposed at the handle, gastroscopes cannot be separated or detached from the handle in the normal course of use. Thus, gastroscopes have typically been permanently fixed to a handle. But such configurations can lend themselves to disadvantages like those discussed above, such as unnecessary redundancy of TEE probe hardware, and costly or risky cleaning procedures.
As used with respect to this and other embodiments, handle may refer to a structure configured to be gripped, manipulated, or manually controlled by a physician. As described in further detail below, a handle may also be configured to perform various and functions and operations, and may comprise electronic components. For example, manipulating the distal portion 139 of the gastroscope 130 may involve manipulating a dial or other user control of the handle 120 that can retract and/or release one or more pull cables 131, 133 coupled to the distal portion of the gastroscope. For example, retracting and releasing the one or more pull cables can control the posterior/anterior flexion or the right/left flexion of the distal portion of the gastroscope. Thus, although the handle 120 shown in
Although the ultrasound device 110 discussed with respect to
It is understood that the ultrasound device 110 can be configured to obtain any suitable intraluminal imaging data. In some embodiments, the device 110 can include an imaging component of any suitable imaging modality, such as optical imaging, optical coherence tomography (OCT), etc. In some embodiments, the device 110 can be configured to obtain any suitable intraluminal data using a pressure sensor, a flow sensor, a temperature sensor, an optical fiber, a reflector, a mirror, a prism, an ablation element, a radio frequency (RF) electrode, a conductor, and/or combinations thereof. Generally, the device 110 can include an electronic, mechanical, optical, and/or acoustic sensing element to obtain intraluminal data associated with a body lumen of a patient. The device 110 may be sized and shaped, structurally arranged, and/or otherwise configured for insertion into a lumen of the patient.
In some illustrated embodiments, the ultrasound device 110 is a TEE probe. In some embodiments, the ultrasound device is a catheter, a guide catheter, or a guide wire. The ultrasound device 110 can include a flexible elongate member 137. As used herein, elongate member or flexible elongate member includes at least any thin, long, flexible structure structurally arranged (e.g., sized and/or shaped) to be positioned within a lumen of the anatomy. For example, a distal portion 139 of the flexible elongate member 137 can be positioned within a lumen, while a proximal portion 132 of the flexible elongate member 137 can be positioned outside of the body of the patient. The flexible elongate member 137 can include a longitudinal axis. In some instances, the longitudinal axis can be a central longitudinal axis of the flexible elongate member 137. In some embodiments, the flexible elongate member 137 can include one or more polymer/plastic layers formed of various grades of nylon, Pebax, polymer composites, polyimides, and/or Teflon. In some embodiments, the flexible elongate member 137 can include one or more layers of braided metallic and/or polymer strands. The braided layer(s) can be tightly or loosely braided in any suitable configuration, including any suitable per in count (pic). In some embodiments, the flexible elongate member 137 can include one or more metallic and/or polymer coils. All or a portion of the flexible elongate member 137 may have any suitable geometric cross-sectional profile (e.g., circular, oval, rectangular, square, elliptical, etc.) or non-geometric cross-sectional profile. For example, the flexible elongate member 137 can have a generally cylindrical profile with a circular cross-sectional profile that defines an outer diameter of the flexible elongate member 137. For example, the outer diameter of the flexible elongate member 137 can be any suitable value for positioning within the anatomy 102, including between approximately 1 Fr and approximately 80 Fr, including values such as 3 Fr, 7 Fr, 8.2 Fr, 9 Fr, 25 Fr, 30 Fr, 34 Fr, 51 Fr, 60 Fr, and/or other suitable values both larger and smaller.
The ultrasound device 110 may or may not include one or more lumens extending along all or a portion of the length of the flexible elongate member 137. The lumen of the ultrasound device 110 can be structurally arranged (e.g., sized and/or shaped) to receive and/or guide one or more other diagnostic and/or therapeutic instruments. If the ultrasound device 110 includes lumen(s), the lumen(s) may be centered or offset with respect to the cross-sectional profile of the device 110. In some embodiments, the ultrasound device 110 may be used in conjunction with a guide wire. Generally, a guide wire is a thin, long, flexible structure that is structurally arranged (e.g., sized and/or shaped) to be disposed within the lumen of the anatomy. During a diagnostic and/or therapeutic procedure, a medical professional typically first inserts the guide wire into the lumen of the anatomy and moves the guide wire to a desired location within the anatomy, such as adjacent to an intravascular occlusion. The guide wire facilitates introduction and positioning of one or more other diagnostic and/or therapeutic instruments, including the ultrasound device 110, at the desired location within the anatomy. For example, the ultrasound device 110 moves through the lumen of the anatomy along the guide wire. In some embodiments, the lumen of the ultrasound device 110 can extend along the entire length of the flexible elongate member 137. In some embodiments, the ultrasound device 110 is not used with a guide wire, and the exit/entry port can be omitted from the ultrasound device 110.
The anatomy may represent any fluid-filled or surrounded structures, both natural and man-made. For example, the anatomy can be within the body of a patient. Fluid can flow through the lumen of the anatomy. In some instances, the ultrasound device 110 can be referenced as a transesophageal device. The anatomy can be the mouth, throat, esophagus, and/or stomach of a patient. In other instances, the ultrasound device 110 can be referenced as an intracardiac or intravascular device. In various embodiments, the anatomy is an artery or a vein of a patient's vascular system, including cardiac vasculature, peripheral vasculature, neural vasculature, renal vasculature, and/or any other suitable anatomy/lumen inside the body. The anatomy can be tortuous in some instances. For example, the device 110 may be used to examine any number of anatomical locations and tissue types, including without limitation, organs including the liver, heart, kidneys, gall bladder, pancreas, lungs, esophagus; ducts; intestines; nervous system structures including the brain, dural sac, spinal cord and peripheral nerves; the urinary tract; as well as valves within the blood, chambers or other parts of the heart, and/or other systems of the body. In addition to natural structures, the device 110 may be used to examine man-made structures such as, but without limitation, heart valves, stents, shunts, filters and other devices.
In some embodiments, the gastroscope 130 transmits the ultrasonic imaging data to the console 180 through the handle 120. In some embodiments, the console interface 175 may be situated at a proximal portion of the handle 120, such as the proximal end of the handle 120. In some embodiments, the console interface 175 may comprise at least one of a USB interface or a pogo pin interface. In other embodiments, the console interface 175 may comprise a cable permanently fixed to the handle 120. As will be illustrated in more detail below, in some embodiments, the handle 120 includes electronic components to modulate or process the ultrasonic imaging data being transmitted to the console 180.
Although the beamformer 128, signal processor 124, and scan controller 126 of the embodiment of
In this disclosure, transmit may refer to an electrical component directing, routing, or permitting passage of an electrical signal to another component of the device. For example, an electrical wire may transmit an electrical signal even though the electrical wire does not contain electronics that can execute commands or selectively route an electrical signal to various electrical components.
Although the gastroscope-mating interface 160 and handle-mating interface 150 of the embodiment of
TEE probes having detachable or modular components can eliminate some of the equipment redundancy required by conventional TEE probes that comprise an integral unit. For example, a TEE probe 110 according to an embodiment of the present disclosure may allow a physician to attach one of a number of gastroscopes 130 to a handle 120 of the TEE probe 110. A physician may use a variety of gastroscopes 130 in her practice that correspond to the varying anatomy and physiology of her patients (e.g., gastroscopes of different diameters and/or lengths), as well as the different types of imaging she desires to perform. As the same handle can couple to a variety of gastroscopes 130, the physician need not have a separate complete TEE probe unit, including a handle and console interface cable, for each gastroscope. Additionally, TEE probes 110 having detachable components may have advantages in the cleaning of the devices. Components that require one type of cleaning process, such as a gastroscope 130, can be cleaned separately from other components that do not require the same cleaning process. For example, a handle 120, which can be damaged by the cleaning processes of the gastroscope 130, can be cleaned using a cleaning process more appropriate for its design and components.
Positioning the motor 135 within the gastroscope 130 may permit for a less complex interfacing or coupling between the gastroscope 130 and handle 120 while maintaining the operability, or maneuverability, of the gastroscope 130. Recalling
The gastroscope tip 140 includes a tip housing 141 that houses an ultrasonic transducer 142, and ultrasonic transducer wiring 143 in communication with the ultrasonic transducer 142 to carry ultrasonic imaging data to the handle 120. The gastroscope 130 also includes a first pull cable 131 and a second pull cable 133 that are coupled to, and span between, the handle 120 and the distal portion 139 of the gastroscope 130.
The first and second pull cables 31, 33 are coupled to a first movement control 23 and a second movement control 25, respectively. The first and second movement controls 23, 25 are coupled to the handle 20 and correspond to a direction of movement, or a degree of freedom, of the distal portion 39 of the gastroscope 30. For example, the first movement control 23 may correspond to a posterior and anterior flexion of the distal portion 39 of the gastroscope 30, while the second movement control 25 may correspond to a right and left flexion of the distal portion 39 of the gastroscope 30. Thus, by manipulating the first and second movement controls 23, 25, a user can control the movement and orientation of the distal portion 39 of the gastroscope 30 within the esophagus of a patient.
Although the gastroscope 130 shown in
Referring generally to
For example, as a force is applied to the distal portion 139 of the gastroscope 130, the force sensor controller 138 may receive a force sensor signal including a detected force value from the force sensor 145, and compare the detected force value to a predetermined threshold. If the detected force value exceeds the predetermined threshold, the force sensor controller 138 can send instructions to the motor controller 134 to reduce or halt the motor's output, or to reverse the motor output to reverse the movement of the distal portion 139 of the gastroscope 130 to reduce or eliminate the force applied by the distal portion 139 of the gastroscope 130 to the patient's esophagus. Such a configuration may allow a physician to control movement of the distal portion 139 of the gastroscope 130 without applying force in excess of safety limits. Excessive force applied to the walls of the esophagus could result in injury to the patient.
The gastroscope of
Although some embodiments provide a microbeamformer 144 used in combination with a beamformer (128,
As depicted in
For example, the scan controller 126 may receive a command signal from the microcontroller 121 to begin a scan sequence, as well as control data and timing signals regarding the scan sequence to be performed. The scan controller 126 may transmit the control data and timing signals to the beamformer 128 and signal processor 124 to control various aspects of obtaining an ultrasound image. The beamformer 128 may transmit one or more firing signals to the ultrasonic transducer 142, causing the ultrasonic transducer 142 to emit ultrasonic energy in the form of ultrasonic waves into the patient's anatomy. The one or more firing signals may also comprise a command signal to measure or record echoes of the emitted ultrasonic waves. The ultrasonic transducer 142 may then measure the echoes, and translate the ultrasonic echoes into electrical signals comprising ultrasonic image data to be transmitted to the beamformer 128. The beamformer 128 may then process, modulate, or beamform the ultrasonic image data based on criteria from the scan controller 126, and transmit the beamformed ultrasonic image data to the signal processor 124 for further processing of the ultrasonic image data. The signal processor 124 may then transmit the processed ultrasonic image data to the microcontroller 121. On receiving processed ultrasonic image data from the signal processor 124, the microcontroller 121 may direct the processed ultrasonic image data to the console 180 via a console interface.
In another example, the microcontroller 121 sends a power control signal to the power supply 123 to apply a voltage or current to the motor 135 to control the function or output of the motor 135. The motor 135 may be coupled to one or more pull cables 131, 133, which may be coupled to the tip housing 141. As the motor 135 turns to actuate the pull cables 131, 133, the force sensor 145 may detect a force applied to a portion of the gastroscope, such as the tip housing 141, translate the detected force to an electrical signal, and transmit the electrical signal to the force sensor controller 138. The electrical signal from the force sensor 145 may include force data, such as an amount of force applied to the force sensor 145 and/or tip housing 141. The force sensor controller 138 may perform a variety of functions, including comparing the force data to a threshold value, and transmitting at least one of a command signal and a detected force value to the microcontroller 121.
In some embodiments, when the force sensor controller 138 receives a detected force signal from the force sensor 145 indicating that a force applied to the force sensor 145 exceeds a threshold value, the force sensor controller 138 transmits a command signal to the microcontroller 121 to adjust a voltage or current applied to the motor 135 to adjust the output of the motor 135. In other embodiments, the microcontroller 121 receives the force data from the force sensor controller 138, compares the detected force value to a threshold value, and instructs the power supply 123 to adjust a voltage or current applied to the motor 135 to adjust the output of the motor 135. In still other embodiments, if the force sensor 145 detects a force that exceeds the predetermined threshold, the force sensor controller 138 may transmit an electrical signal directly to the motor 135 to adjust the output of the motor 135. In other embodiments, the microcontroller 121 may send instructions to the power supply 123 to halt power to the motor 135 to halt the motor's movement of the distal portion 139 of the gastroscope 130, or may instruct the motor 135 to reverse the movement of the motor 135 to return the distal portion 139 of the gastroscope 130 to a default position. The motor 135 may also send motor position data to the microcontroller 121 to allow a physician or user to predictably control movement of the distal portion 139 of the gastroscope 130.
Turning to another aspect of the present disclosure,
In addition to the housing 197 and the first module-mating interface 195a, the wireless module of
The radio module 191 may be in communication with the antenna 194 and configured to receive a wireless signal from a console. In some embodiments, the wireless signal may comprise commands or instructions from the console to carry out one or more functions, such as a TEE scan. The radio module 191 may also be in communication with the microcontroller 192 to transmit the commands or instructions to various components of the handle 120 and/or gastroscope 130 via the console interface. For example, in some embodiments, the radio module 191 may receive instructions from a console 180 to control movement of the distal portion 139 of the gastroscope 130. The wireless module 190 may transmit the instructions to a controller in the handle 120. The controller may then instruct the power manager 199 to provide power (e.g., voltage, current) to a motor in the gastroscope or handle to actuate a pull cable configured to control movement of the distal portion of the gastroscope. In some embodiments, the microcontroller 192 may transmit the instructions directly to one or more components of the gastroscope, such as the motor or a motor controller. In some embodiments, the wireless module 190 may also comprise a user interface 198 and an audible indicator 196 configured to indicate a status or function of the wireless module 190. For example, in some embodiments, the audible indicator 196 may comprise a speaker, and may make an audible noise such as a beep to indicate that the wireless module 190 is correctly coupled to the handle.
Various components of the wireless module 190 may receive power from the battery 193. The battery 193 may be in communication with the power manager 199 configured to distribute power from the battery 193 to the other components of the wireless module 190. In some embodiments, the battery 193 of the wireless module 190 may also provide power to various electrical components of the handle and/or the gastroscope. For example, the motor of the gastroscope may receive power from the battery 193 of the wireless module 190. As in the embodiment shown in
Referring to
A user interface 198, which may comprise one or more user input selectors, such as buttons, dials, knobs, switches, levers, joysticks, touch sensors, etc., can be coupled to the housing of the wireless module 190 and configured to receive an input from a user. In some embodiments, the user may control one or more aspects of the wireless module 190 and/or TEE probe 110 by manipulating the user interface 198 (e.g., by pressing a button). The user interface 198 then sends a user input signal to the microcontroller 192b. The microcontroller 192b is configured to receive the user input signal and route the user input signal to the appropriate component, such as the power manager 199, or the microcontroller 192a. For example, the user interface 198 may be configured to receive an input command from a user to turn off one or more components of the wireless module 190. In other embodiments, the user interface 198 may be configured to control one or more aspects of a TEE scan, or the movement of the distal portion 139 of the gastroscope 130.
In one embodiment, microcontroller 192a of the wireless module 190 can receive ultrasound image data from handle 120. The microcontroller 192a can route the ultrasonic image data to the radio module 191, which then wirelessly transmits the ultrasonic image data to the console 180 via the antenna 194. Radio module 191 may be configured to translate the ultrasonic image data transmitted by the microcontroller 192a from an electrical signal into a radio signal.
Referring now to
In block 310, a TEE probe comprising a wireless module receives a wireless command signal from a console. The command signal may include instructions to move a gastroscope tip. The command signal may be wirelessly received by a radio module of the wireless module. In block 320, the radio module transmits the command signal to a controller. In block 330, the controller, on receiving the command signal, applies a voltage to an actuator, such as a motor, to activate the actuator. The application of voltage to the actuator by the controller may include instructing a power supply to distribute power to the actuator. In block 340, the actuator operates to retract a pull cable coupled to the gastroscope tip, or a distal portion of the gastroscope, to move or deflect the distal portion of the gastroscope.
As the gastroscope tip or distal portion of the gastroscope moves or deflects, the gastroscope tip may apply a force on the patient's esophagus, and vice versa. In block 350, a force sensor in the gastroscope tip measures a detected force applied to the gastroscope tip. In block 360, the force sensor transmits a force detection signal, which may include the amount of force applied to the gastroscope tip, to a force sensor controller in communication with the actuator and the wireless module. In block 365, the force sensor controller compares the detected amount of force to a predetermined threshold. In lock 370, if the detected force exceeds the threshold, the force sensor controller instructs the motor to adjust or halt the motor's output. In some embodiments, the step of instructing the motor to adjust or halt the motor's output may include instructing a power supply to decrease power distribute to the motor. In some embodiments, if the detected force exceeds the threshold, the force sensor controller may instruct the motor to reverse movement to return the gastroscope tip to a previous position within the patient's esophagus.
In block 380, when the force sensor controller determines that the detected force exceeds the predetermined force threshold, the forces sensor controller also transmits an excess force signal to the console. The transmission may be performed wirelessly by the wireless module. In block 390, when the console receives the excess force signal, the console activates a force detection indicator to indicate to a physician or user that the detected force exceeds the predetermined force threshold. Thus, the physician or user may be aware that too much force is being applied to the esophagus, and that the motor may halt movement of the gastroscope tip within the patient's esophagus. Such feedback may be helpful to a physician wirelessly controlling the TEE probe. Without such feedback, the physician may encounter difficulties in maneuvering the distal portion of the gastroscope within the patient's esophagus. In some embodiments, the force detection indicator may comprise a light, an icon on a screen, an alert sound, or a combination of indicators.
In block 410, an ultrasonic transducer may obtain ultrasonic image data by emitting ultrasonic energy in the form of ultrasonic waves into the body of a patient. The ultrasonic transducer detects the reflected ultrasonic waves, or echoes, and transforms the reflected ultrasonic waves into electrical signals comprising the ultrasonic image data. In block 420, the ultrasonic transducer transmits the ultrasonic image data to a microbeamformer, which may be similar or identical to the microbeamformer 144 illustrated in
Persons skilled in the art will also recognize that the apparatus, systems, and methods described above can be modified in various ways. Accordingly, persons of ordinary skill in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the particular exemplary embodiments described above. In that regard, although illustrative embodiments have been shown and described, a wide range of modification, change, and substitution is contemplated in the foregoing disclosure. It is understood that such variations may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in a manner consistent with the present disclosure.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/EP2019/053065 | 2/7/2019 | WO | 00 |
| Number | Date | Country | |
|---|---|---|---|
| 62627968 | Feb 2018 | US |
