Patent Application
20180078120
All publications and patent applications mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
Described here are a number of different endoscope, sheath, and endoscope tip cap configurations having one or more visual field improvement mechanisms, such as defogging, particle removal, or clearance.
An endoscope is a medical instrument having an elongate body that may take on a number of different form factors depending on the type of medical procedure being performed with the endoscope. An endoscope elongate body is generally categorized as being rigid, semi-rigid or flexible. Semi-rigid and flexible scopes typically include some form of steering or bending mechanism. Most importantly, an endoscope will include a lighting system and some visualization component to provide imaging information of the area at the distal end of the endoscope in the field of view of the visualization component.
Oftentimes the quality of the surgical field image provided by the endoscope visualization system is impaired either because of fogging caused by the environment (i.e., moist and humid) or because of by-products of a surgical procedure (e.g., tissue, blood, smoke) obstructing the view. Accordingly, improvements to endoscopes are needed that ensure that the visual field remains clear during use in a surgical procedure.
In general, in one embodiment, a scope includes an elongate body having a proximal end and a distal end, a lens at the distal end of the elongate body, at least one conduit extending from the proximal end to the distal end configured to connect to an air supply, and a view optimizing assembly extending from the distal end of the elongate body past the lens. The view optimizing assembly includes a first lumen and a second lumen, a plurality of dividers separating the lumens, and a deflector assembly configured such that air exiting the first and second lumens combines to keep debris off of the lens. The first and second lumens are in fluid communication with the at least one conduit and are configured such that a single velocity flow from the at least one conduit separates into a first flow through the first lumen and a second flow through the second lumen, the first flow having a higher velocity than the second flow.
This and other embodiments can include one or more of the following features. The at least one conduit can extend within the elongate body. The scope can further include a sheath extending around the elongate body. The at least one conduit can extend between an outer circumference of the elongate body and an inner circumference of the sheath. The at least one conduit can extend within the sheath. The at least one conduit can include a plurality of conduits. The deflector assembly can further include a plenum section configured to allow air from the plurality of conduits to combine into a single velocity air flow before entering the first and second lumens. The plurality of dividers can include a plurality of stand-offs configured to touch a surface of the lens. The at least one conduit can include a plurality of conduits, and the stand-offs can extend from a wall between the conduits. The at least one conduit can include a single conduit, and the stand-offs can divide the air into the first and second lumens. The deflector, the distal end of the elongate body, and the dividers together can form a first nozzle in communication with the first lumen and a second nozzle in communication with the second lumen. A length of each lumen can be between 0.005 inches and 0.010 inches. The air exiting the first and second lumens can combine to form a vortex to keep debris off of the lens. The elongate body can be flexible. The elongate body can be rigid. The view optimizing assembly can be attached to the elongate body with a locking mechanism. The view optimizing assembly can be integral with the elongate body. The first lumen can be larger than the second lumen such that the first flow has a higher velocity than the second flow.
In general, in one embodiment, a view optimizing assembly for a scope includes an elongate body configured to extend from a distal end of a scope past a lens of the scope, a first lumen and a second lumen within the elongate body, a plurality of dividers separating the lumens, and a deflector assembly configured such that air exiting the first and second lumens combines to keep debris off of the lens. The first and second lumens are in fluid communication with at least one conduit of a scope and are configured such that a single velocity flow from the at least one conduit separates into a first flow through the first lumen and a second flow through the second lumen, the first flow having a higher velocity than the second flow.
This and other embodiments can include one or more of the following features. The at least one conduit can include a plurality of conduits. The deflector assembly can further include a plenum section configured to allow air from the plurality of conduits to combine into a single velocity air flow before entering the first and second lumens. The plurality of dividers can include a plurality of stand-offs configured to touch a surface of the lens. A length of each lumen can be between 0.005 inches and 0.010 inches. The air exiting the first and second lumens can combine to form a vortex to keep debris off of the lens. The view optimizing assembly can be configured to attach to the scope with a locking mechanism. The first lumen can be larger than the second lumen such that the first flow has a higher velocity than the second flow.
In general, in one embodiment, a scope includes an elongate body having a proximal end and a distal end, an interior lumen within the elongate body extending from the proximal end to the distal end, a tip face, a gas conduit within the elongate body lumen, a visualization component in the tip face, and a tip cap. A distal end includes a tip engagement region. A tip face is adjacent to the tip engagement region and covering the interior lumen. A gas conduit within the elongate body lumen has an outlet in the tip face and an inlet at the proximal end of the elongate body. A tip cap is configured to releasably couple with the tip engagement region. The tip cap includes an opening sized for use with the visualization component and at least one stand-off. When the tip cap is coupled to the tip engagement region, the opening is positioned around the visualization component and the one or more stand offs engage a portion of the tip face such that a gas flow from the outlet is directed towards the opening to improve viewing through the visualization component.
This and other embodiments can include one or more of the following features. The scope can be configured such that viewing through the visualization component is improved by one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The scope can further include a visualization component cable connected to the visualization component and in communication with the proximal end of the elongate body. An overall dimension, such as a diameter, of the tip engagement region can be less than the overall dimension, such as a diameter, of the elongate body proximal portion. An overall dimension of the tip engagement region when coupled to the tip cap can be more than the overall dimension of an elongate body proximal portion. An overall dimension of the tip engagement region when coupled to the tip cap can be about the same as an overall dimension of an elongate body proximal portion. The tip cap can be configured to releasably couple with the tip engagement region using a complementary pair of elastic snap fit features. The tip cap can be configured to releasably couple with the tip engagement region using a threaded connection. The scope can further include a handle on the elongate body proximal end supporting the gas conduit inlet and a visualization component cable. The scope can further include a liquid conduit within the elongate body lumen having a liquid outlet in the tip face and an inlet at the proximal end of the elongate body. The tip cap can further include one or more liquid stand offs positioned such that, when the tip cap is coupled to the tip engagement region, the one or more liquid stand offs are configured to engage a portion of the tip face such that a liquid flow from the liquid outlet is directed towards the opening to further improve viewing through the visualization component. The scope can further include a handle on the elongate body proximal end supporting the gas conduit inlet, the liquid conduit inlet, and a visualization component cable. The elongate body can be rigid, semi-rigid or flexible. The elongate body can be flexible or semi-rigid, and in the scope can further include a handle including a steering mechanism for controlling a bend angle of the elongate body.
In general, a scope includes an elongate body having a proximal end and a distal end, an interior lumen within the elongate body extending from the proximal end to the distal end, a tip face, a first gas conduit and a second gas conduit, a visualization component in the tip face, and a tip cap. The distal end includes a tip engagement region. A tip face is adjacent to the tip engagement region and covering the interior lumen distal end. A tip cap is configured to releasably couple with the tip engagement region. The tip cap includes an opening sized for use with the visualization component and at least one stand-off. When the tip cap is coupled to the tip engagement region, the opening is around the visualization component and the one or more stand offs are engaged with a portion of the tip face such that the gas flows from the first and second gas conduits towards the opening to improve viewing through the visualization component.
This and other embodiments can include one or more of the following features. The first and second gas conduits can be within the elongate body. The scope can further include a gas inlet and a manifold. The gas inlet can be in communication with the manifold, and the manifold can be in communication with the first and second gas conduits. The scope can be configured such that viewing through the visualization component is improved by one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The scope can further include a visualization component cable connected to the visualization component and in communication with the proximal end of the elongate body. An overall dimension, such as a diameter, of the tip engagement region can be less than an overall dimension, such as a diameter of a proximal portion of the elongate body. An overall dimension of the tip engagement region when coupled to the tip cap can be more than an overall dimension of an elongate body proximal portion. An overall dimension of the tip engagement region when coupled to the tip cap can be about the same as an overall dimension of the elongate body proximal portion. The tip cap can be configured to releasably couple with the tip engagement region using a complementary pair of elastic snap fit features. The tip cap can be configured to releasably couple with the tip engagement region using a threaded connection. The scope can further include a handle on the elongate body proximal end supporting the first and the second gas conduits and a visualization component cable. The scope can further include a liquid conduit within the elongate body lumen having a liquid outlet in the tip face and an inlet at the proximal end of the elongate body. The tip cap can further include one or more liquid stand offs such that, when the tip cap is coupled to the tip engagement region, the one or more liquid stand offs are configured to engage a portion of the tip face such that a liquid flow from the liquid outlet is directed towards the opening to further improve viewing through the visualization component. The elongate body can be rigid. The elongate body can be semi-rigid. The elongate body can be flexible. The scope can have an elongate body that can be flexible or semi-rigid. The scope can further include a handle including a steering mechanism for controlling a bend angle in the elongate body.
In general, in one embodiment, a surgical scope includes an elongate body having a proximal end and a distal end, an interior lumen within the elongate body extending from the proximal end to the distal end, a recessed portion at the elongate body distal end, a tip face directly adjacent to the recessed portion, two or more gas conduits within the elongate body lumen, a gas inlet at the proximal end of the elongate body, a visualization component in the tip face, and a visualization component cable connected to the visualization component and in communication with the proximal end of the elongate body. A recessed portion at the elongate body distal end is configured to releasably couple to a tip cap. A tip face directly adjacent to the recessed portion covers the interior lumen distal end. Each of said two or more gas conduits have an outlet in the tip face and an inlet at a gas manifold. A gas inlet at the proximal end of the elongate body is in communication with the gas manifold. An overall dimension, such as a diameter, of the recessed portion of the elongate body distal end is less than the overall dimension, such as a diameter, of the elongate body proximal portion.
This and other embodiments can include one or more of the following features. The surgical scope can further include a handle on the elongate body proximal end supporting the gas conduit inlet and the visualization component cable. The surgical scope can further include a liquid conduit within the elongate body lumen having an outlet in the tip face and an inlet at the proximal end of the elongate body. The surgical scope can further include a handle on the elongate body proximal end supporting the gas conduit inlet, the liquid conduit inlet and the visualization component cable. The gas manifold can be disposed within the handle. The elongate body can be rigid, semi-rigid or flexible. The scope can have an elongate body that can be flexible or semi-rigid. The handle can further include a steering mechanism for controlling a bend angle in a portion of the flexible or semi-rigid elongate body.
In general, in one embodiment, a scope includes an elongate body having a proximal end and a distal end and a non-round cross section, a visualization component at the elongate body distal end, and an attachment mechanism on the elongate body configured for attachment to a sheath such that, when a sheath is placed around the elongate body and attached thereto with the attachment mechanism, at least one conduit is configured to attach to an air supply and extends from the proximal end to the distal end between an outer circumference of the elongate body and an inner circumference of the sheath.
This and other embodiments can include one or more of the following features. The attachment mechanism can be on a proximal portion of the elongate body and can be configured for sealing engagement with the sheath. The sheath can include a sidewall with an exterior wall having a circular cross section shape and an interior wall configured for complementary engagement with the non-round cross section of the elongate body. The at least one conduit can include a plurality of conduits. The plurality of conduits can be configured to direct air over the visualization component in a vortex. A fluid flow through the conduits can be apportioned so as to adjust the flow characteristics of the fluid discharged from the plurality of conduits relative to the visualization component. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, the at least one conduit can be connected to a gas nozzle at the distal portion of the conduit. The gas nozzle can be configured to direct air across the visualization component to provide at least one visual field improvement action. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, one or more stand offs in a distal portion of the sheath can engage with a portion of the elongate body distal end. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, one or more stand offs in a distal portion of the sheath can engage with a portion of the elongate body distal end and at least two conduits are formed along the elongate body in communication with a sheath gas inlet. A fluid flowing through the sheath gas inlet can pass through the at least two conduits and exit adjacent to the visualization component via one or more openings bounded at least in part by a portion of one or more stand offs and a portion of the elongate body distal end. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, a distal portion of the sheath having one or more stand offs can be configured to engage a portion of the elongate body distal portion such that a gas flow introduced into the conduit is directed towards the visualization component. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, a distal portion of the sheath having one or more stand offs can engage a portion of the elongate body distal portion such that a gas flow introduced into the conduit provides at least one visual field improvement action. When the sheath is placed around the elongate body and attached thereto with the attachment mechanism, one or more stand offs in a distal portion of the sheath can engage with a portion of the elongate body distal end and at least two conduits are formed along the elongate body in communication with a sheath gas inlet. A fluid flowing through the sheath gas inlet can pass through the at least two conduits and exit via one or more openings bounded at least in part by a portion of one or more stand offs and a portion of the elongate body distal end. The exiting gas flows can provide at least one visual field improvement action for the visualization component. The sheath can further include one or more features configured to apportion gas between the at least two conduits. The sheath can further include one or more features distal to a sheath inlet to adjust the flow characteristics of the fluid discharged from the at least one conduit relative to the visualization component. The one or more features can adjust the relative velocity of the flow through the at least two conduits. The at least one conduit can include a first conduit and a second conduit. The first conduit can be configured to have a first flow of air and the second conduit can be configured to have a second flow of air, the first flow having a higher velocity than the second flow. The scope can further include a channel disposed completely within the sheath and in communication with an inlet at the sheath proximal end and having an outlet adjacent to the elongate body distal end. The outlet can be positioned adjacent to the exiting gas flows whereby the fluid provided via the outlet cooperates with the exiting gas flows to provide at least one visual field improvement action for the visualization component. The visual field improvement action can be one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The scope can further include a visualization component cable connected to the visualization component. The at least one attachment mechanism can be configured to releasably couple with the sheath using one or more snap fit features. The at least one attachment mechanism can be configured to releasably couple with the sheath using a gas tight friction fit. The at least one attachment feature can be configured to releasably couple with the sheath and an o-ring in a compression fit. The elongate body can be rigid, semi-rigid or flexible. The scope having an elongate body that can be flexible or semi-rigid can further include a handle having a steering mechanism for controlling a bend angle in a portion of the flexible or semi-flexible elongate body. The non-round cross section shape can have a substantially circular perimeter with at least a portion of the perimeter having at least one flattened portion. The non-round cross section shape can have a substantially circular perimeter with at least a portion of the perimeter having at least one non-circular portion. The non-round cross section shape can have a substantially ovoid perimeter with at least a portion of the perimeter having at least one flattened portion. The non-round cross section shape can have a substantially ovoid perimeter with at least a portion of the perimeter having at least one non-ovoid portion. The non-round cross section shape can have a substantially elliptical perimeter with at least a portion of the perimeter having at least one flattened portion. The non-round cross section shape can have a substantially elliptical perimeter with at least a portion of the perimeter having at least one non-elliptical portion. The non-round cross section shape can have a substantially triangular perimeter. The non-round cross section shape can have a substantially triangular perimeter with at least a portion of each corner of the triangular perimeter having at least one flattened portion. The non-round cross section shape can have a substantially triangular perimeter and each of the corners are rounded. The non-round cross section shape can have a substantially triangular perimeter and each of the corners are rounded and at least two of the corners have about the same radius of curvature. The non-round cross section shape can have a substantially circular perimeter with at least one cut out portion. The non-round cross section shape can have a substantially circular perimeter with a plurality of cut outs along the perimeter. The sheath can have an exterior wall having a substantially circular cross section shape and an interior wall forming a lumen sized, shaped, adapted and can be configured for a complimentary fit with the elongate body non-round cross section shape.
In general, in one embodiment, a sheath for use with a non-round scope includes a tube having a proximal end and a distal end and a gas inlet in the proximal end of the sheath. An interior wall of the tube defines an interior lumen extending from the proximal end to the distal end sized to receive the scope. The shape of the interior lumen is selected for a complementary fit with the exterior shape of the non-round scope. A first portion of the interior wall has a first shape, and a second portion of the interior wall has a second shape. When the scope is positioned within the interior lumen, the interior wall of the tube and the exterior wall of the scope are positioned such that a first channel is formed by the first portion of the interior wall and a first portion of the exterior wall of the scope and a second channel is formed by the second portion of the interior wall and a second portion of the exterior wall of the scope such that a gas introduced in a proximal end of the first and second channels flows across a distal face of the non-round scope.
This and other embodiments can include one or more of the following features. The first gas conduit can be in communication with a first gas outlet at the distal end of the sheath, and the second gas conduit can be in communication with a second gas outlet at the distal end of the sheath. The sheath can further include a visualization component in the scope distal end and an opening in a distal portion of the sheath sized for use with the visualization component. The sheath can have one or more stand offs such that when the scope is positioned within the sheath, the opening can be appropriately positioned relative to the visualization component and the one or more stand offs engage a portion of the scope distal face such that the gas flows from the first gas outlet and the second gas outlet can be directed towards the opening to further at least one visual field improvement action. The first channel can be configured to have a first flow of air, and the second channel can be configured to have a second flow of air. The first flow can have a higher velocity than the second flow. The sheath can further include a manifold in communication the gas inlet and with the first channel and the second channel. The sheath can further include one or more features distal to the gas inlet. The flow into the sheath from the inlet can be apportioned between the at least two conduits. The sheath can further include one or more features distal to the gas inlet to adjust the flow characteristics of the fluid discharged from the first channel and the second channel relative to the visualization component. The sheath can further include one or more features distal to the gas inlet to apportion the flow between the first conduit and the second conduit to adjust the flow characteristics of the gas flow relative to the visualization component. The one or more features can adjust the relative velocity of the flow through the first channel and the second channel. The exiting gas flows from the first channel and the second channel can provide at least one visual field improvement action for the visualization component. The visual field improvement action can be one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The sheath can further include one or more liquid stand offs positioned within the distal portion of the sheath. When the sheath is coupled to the scope, the one or more liquid stand offs can be adapted and configured to engage a portion of the distal portion of the scope such that a liquid flow from the liquid outlet can be directed towards the opening to further at least one visual field improvement action. The sheath can further include a liquid conduit within the sheath or formed as a third conduit between the sheath and the scope having a liquid outlet in relation to the scope distal end and an inlet at the sheath proximal end. The sheath can further include a channel disposed completely within the sheath and can be in communication with an inlet at the sheath proximal end and having an outlet adjacent to the scope distal end. The outlet can be positioned adjacent to the exiting gas flows such that the fluid provided via the outlet cooperates with the exiting gas flows to provide at least one visual field improvement action for the visualization component. The visual field improvement action can be one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The sheath can be adapted and configured for cooperative operation with an scope having an elongate body that is rigid, semi-rigid or flexible. The sheath can further include a handle coupled to the scope having a steering mechanism or a bending mechanism for controlling a bend angle in a portion of the flexible or semi-flexible elongate body of the scope. The sheath can further include at least one attachment feature adapted and configured using one or more snap fit features, a gas tight friction fit or an o-ring in a compression fit to releasably couple the sheath with the non-round scope inserted into the sheath. The non-round scope can have an elongate body that is rigid, semi-rigid or flexible. The non-round scope can have an elongate body that is flexible or semi-rigid, and the scope can further include a handle for use with the sheath and non-round scope combination having a bending or steering mechanism for controlling a bend angle in a portion of the flexible or semi-rigid elongate body.
In general, in one embodiment, a method of using the scope of any of the above includes: (1) inserting the scope into a human or animal body during a procedure; (2) visualizing a portion of the body using a visualization component of the scope; and (3) operating a view optimizing assembly to perform at least one visual improvement action.
This and other embodiments can include one or more of the following features. The visual field improvement action can be one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an gas barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component. The visual improvement action can be performed without removing the scope from the human or animal body during the procedure. The method can further include steering the scope by bending or orienting a flexible section of the scope. The visual improvement action can continue during the steering step. The method can further include supplying gas to the view optimizing assembly from a gas supply. The gas supply can be an insufflator. A portion of the human or animal body can be insufflated during the procedure.
Any of the above embodiments can include one or more of the following features. The sheath or scope or tip can be adapted and configured for use with a visualization component positioned within an scope distal end that can be one of 90 degrees, 45 degrees and 30 degrees. The visualization component can include a lens system. The visualization component can further include a solid state sensor, wherein the solid-state sensor can be selected from the following group: a Charge Coupled Device (CCD); an Intensified Charge Coupled Device (ICCD); an Electron Multiplying Charge Coupled Device (EMCCD); and a Complementary Metal Oxide Semiconductor (CMOS) device. The visualization component can be a part of a tip face of a sterilizable elongate body of a non-round scope. The visualization component of a non-round scope can include a lens system having a plurality of lens that together form an image with a field of view of between 60 and 140 degrees. The non-round scope, the sheath and the visualization component can be adapted and configured for carrying out a procedure selected from the following group: (a) a gastroscopy procedure by forming an image with a field of view of 120 to 140 degrees; (b) an ERCP procedure by forming an image with a field of view of the camera head of the invention 120 to 140 degrees in a motherscope and by forming an image with a field of view of 100 degrees in a baby scope; (c) a colonoscopy procedure by forming an image with a field of view of 120 to 140 degrees; (d) a gynecology procedure by forming an image with a field of view of 100 to 120 degrees; (e) a bronchoscopy procedure by forming an image with a field of view of 80 to 100 degrees; (f) an ENT procedure by forming an image with a field of view of 80 to 100 degrees; and (g) a transgastric procedure by forming an image with a field of view of 120 to 140 degrees in the motherscope and by forming an image with a field of view of 100 to 120 degrees in the baby scope. The visualization component can include a sensor having a diagonal size in the range from approximately 0.5 mm, 1 mm, 1.5 mm, 2 mm, 2.5 mm, 3 mm, or 3.5 mm, or 4 mm. The first and second channels can be together configured to direct air over the lens in a vortex.
The novel features of the invention are set forth with particularity in the claims that follow. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
Described herein are various view optimizing assemblies for use with a scope, such as an endoscope, laparoscope, or other surgical scope. The view optimizing assembly can be configured to extend distally past the lens of the scope and direct air thereacross, thereby improving visualization through the lens. The view optimizing assembly thus facilitates inter-operative defogging, surgical debris reflection, and cleaning of the scope lens during minimally invasive surgery, while also maintaining visualization of the surgical site.
As described herein, the view optimizing assembly can be: (1) a sheath that extends over the scope; (2) a tip cap that attaches to the end of the scope; (3) and/or can be integrated with the scope. The term “scope” as used herein can be interchangeable with “laparoscope” or “endoscope.”
As can best be seen in
Referring to
Referring to
Referring to
The inner distal face of the tip cap can thus function as a deflector assembly. The deflector assembly projects beyond the distal end of the scope and also a predetermined distance towards the central axis of the scope and the lens. The deflector assembly overhangs the distal face of the scope by a prescribed transverse distance sufficient to change the direction of gas flowing axially through conduits into a non-axially, transverse path across the laparoscopic lens. The distance of the deflection width does not extend to the point that it obstructs the field of the view of the laparoscopic lens. The deflector assembly also projects axially beyond the distal terminus of the scope by a prescribed axial distance, defining an air channel 622 or nozzle (see
The stand-offs or gas diverters redirect gas or fluids introduced into the tip cap 102 towards the opening 443. In one embodiments, the stand-offs direct the air in such a way as to form a vortex over or proximate to the lens, as described further below.
The fit between the tip cap 102 and the tip face/tip engagement region 510 is adapted and configured to prevent gas loss and seal relative thereto either through the engagement alone or with an additional seal mechanism. As a result, most of the gas or fluid introduced into the tip cap 102 is directed through the gas channels 622a,b to opening 443 and over the lens.
There are a number of advantages to providing visual field improvement to a re-usable scope, such as with the tip cap as described herein. For example, the tip caps may be disposable. Moreover, the tip caps may be designed to accommodate a variety of combinations of diameter and angles as well as working channels or other ports, depending upon the design characteristics of a particular endoscope. In each of these different configurations, the tip cap is adapted and configured direct the gas over the lens (i.e., one or more visualization components) from a single gas supply lumen or from multiple gas supply lumen in the endoscope.
Still further, re-usable scopes (for use with the tip cap) can be readily decontaminated and re-sterilized. Further, the scope 101 can be made (or interchanged with other scopes) of different lengths depending upon application or surgical need. Similarly, the distal end of the scope 101 can be made (or interchanged with other scopes) in different angles (0, 30, 45 degrees) and in different diameters (5 mm, 10 mm). In each case, the corresponding tip cap 101 can be adapted and configured for use with the angle and diameter.
Advantageously, the tip cap can also be used with a scope that is rigid, flexible, or semi-rigid, as the stiff cap can be placed on portions of the scope that do not bed, thereby not interfering with any flexibility and/or steering.
Additional details of the modified endoscope system of
Any of the tip caps described herein may be formed partially or completely from an x-ray detectable material. Alternatively, one or more radio-opaque or x-ray detectable markers may be positioned on, in or within a portion of the tip cap. The position, number, of or size of the markers can be selected in order to aid in location of the tip cap while in use with an endoscope during a medical procedure.
As shown in
Freed from the design constraints of the round exterior walls, circular cross section shape and overall cylindrical body style, non-round scopes may be embodied in a wide variety of different shapes, as best seen in
The non-round scope may further take advantage of the shrinking sizes of visualization components such as high definition cameras, fiber optic systems, LED and other lighting systems and the like. The result is to uncouple the design requirements of the scope from being circular or round to permit sealing with other surgical introducers (i.e., trocars, cannulas, and the like).
Referring to
Referring to
The deflector assembly (distal end 4423) can further include stand-offs 4412, similar to as described above with respect, for example, to
In some embodiments, the sheath 4422 can attach to the scope 4401 at the proximal end of the scope. The proximal end 4493 of the non-round scope 4401 is shown more closely in
Referring to
The sheath 4422 thus has grooves or shaped portions placed around the circumference of the interior sheath wall and running the length of the sheath. Once the non-round endoscope 1401 is placed within this complementary sheath design, the grooves or shaped portions of the sheath interior walls align with the exterior walls of the endoscope to form the conduits 4434a,b of the endoscope-sheath combination.
In one aspect, there is a non-round endoscope having working channels that are formed in part by grooves, cut outs or conduits extending along the length of a non-disposable or re-useable component. When inserted into and engaged with an appropriately configured complementary sheath, the grooves, cut outs, or conduits are covered up by an interior portion of the sheath. After use, the sheath is removed and discarded. Advantageously, the grooves, cut outs, or conduits that were used as working channels can be readily cleaned since they were formed in the external surface of the scope. Wiping down and sterilizing an external surface is a greatly simplified sterilization procedure, unlike the conventional working channels that are positioned on the inside of a scope. In another aspect, one or more channels for gas or CO2 are be formed when an external sheath is placed over the scope.
Advantageously, using the interior sidewall to accommodate the non-round scope while maintaining a circular outer dimensions allows for a gas seal when the non-round scope-sheath combination is placed through a trocar. In one aspect, the inner portion of the sheath (i.e., that which engages with exterior of the scope) has orientation features that match those of the grooves on the scope. As a result, channels for gas, fluid or passage of instruments or other uses common to the field of endoscopy are formed, by way of illustration only, when: (1) a portion of a channel wall is formed by a portion of an inner wall of the sheath and a portion of the outer wall of the scope, (2) a portion of a channel is formed by a circular inner diameter of a disposable member such as the sheath thus forming the outer wall of the channel, (3) the exterior walls of the grooved outer diameter portion of the non-round scope are used to form the inner portion and remainder of the channel perimeter or circumference, (4) or the disposable member or complementary sheath may have one of more fully contained lumens, channels or conduits configured to fit into one or more of the grooves in the scope external walls. In such configurations, instead of forming part of an active gas conduit, fluid conduit or working channel, a scope groove acts as a registration feature for a conduit or channel provided completely by the sheath.
In some embodiments, the outside of the endoscope includes one or more grooves sized and shaped for various uses as is common in endoscopic procedures and surgery. The grooves extend along the length of the scope and are positioned where needed according to the specific design considerations for a particular scope or procedure. In this embodiment, there are no unsealed internal channels in the endoscope. Instead, an endoscope according to one aspect would have a lighting system and visualization component sealed within the distal portion and scope interior along with the external grooves, placed around the circumference of the scope casing and running the length of the scope external encasement. Once placed within a complementary sheath, the sheath interior walls and the external grooves align to form the working channels and conduits of the endoscope-sheath combination.
Referring to
Various additional shapes for non-round endoscopes are shown in
Any of these non-round scopes can be used with a sheath as described herein that can form conduits when engaged therewith and/or that make the cross-section of the combined scope/sheath substantially round. For example,
Referring to
Further, referring to
A number of gas diverters or stand offs are illustrated in the various views of
There are a number of advantages to providing visual field improvement to a re-usable non-round cross section endoscope, especially when configured as an endoscope or laparoscope, since such instruments can be readily decontaminated and re-sterilized. As with conventional scopes, the non-round scopes described herein may be made in different lengths depending upon application or surgical need. Similarly, the distal end of the non-round scopes can be made in different angles (0, 30, 45 degrees) and in different diameters (5 mm, 10 mm). In each case, the corresponding sheath distal end, gas and fluid conduits, and stand offs are also adapted and configured for use with the associated camera angle and non-round scope shape and dimensions.
Still further, the complementary sheath may be disposable as well as designed to accommodate the combinations of sizes and angles as well as working channels or other ports, depending upon the design characteristics of a particular non-round endoscope. In each of these different configurations, the complementary shaped sheath has a distal portion that is adapted and configured direct the gas around the endoscope tip (i.e., in proximity to one or more visualization components of the scope) from a single gas supply lumen or from multiple gas supply lumen in communication with the sheath.
The scopes, tip caps, and/or sheaths described herein can be configured to provide one or more visual field improvement actions during imaging with the scope. In one aspect, a visual field improvement action is one or more of: a gas flow pattern relative to the visualization component to remove condensation therefrom, a gas flow pattern relative to the visualization component to form an air barrier to reduce or minimize particles in the visual field of the visualization component and a gas flow pattern relative to the visualization component to facilitate removal of a fluid applied to the visualization component.
To achieve the improved visualization, the scope, tip caps, and/or sheaths can include one or more gas and/or fluid channels for providing a vortex of gas/air and/or a cleaning fluid across the lens as described in the '084 application.
Referring to 26B, in one embodiment, the deflector assembly 2623 can include stand-offs 2612a,b,c that serve to direct the flow of gas (shown by the arrows) from a single gas lumen 2634. Because nozzle opening 2666 is closer to the gas lumen 2634 and/or because the nozzle opening is smaller in diameter (i.e., has a greater restriction), the flow of gas through opening 2666 can have a higher velocity than the flow of gas through opening 2668, thereby providing for the formation of a vortex.
Referring to
In embodiments where the difference in velocity changed by a restriction in the opening of a higher velocity nozzle relative to a lower velocity nozzle, the nozzle with the larger restriction (i.e., the smaller diameter, length, perimeter, cross section, and/or width) will produce the higher velocity.
In some embodiments, where various gas conduits are used down the length of the scope, a plenum section can be provided within the distal tip (sheath or tip cap) that allows air from each of the conduits to combine into a single velocity airflow before entering the nozzles. This plenum section can be configured similarly to the plenum described in the '084 application.
As described above, a single velocity flow (either from a gas conduit or a plenum) can thus be divided up between two or more flows of differing velocities to form the desired vortex.
In some embodiments, the gas is provided by a gas supply, insufflator, or recirculating gas system, as described in the '084 application. As used herein, the terms “air,” “gas,” “CO2”, or “surgical gas” can be used interchangeably.
In some alternatives, the tip cap, sheath, and/or scope may be modified as need to provide one or more visual field improvement actions to any of the following endoscope, gas line and fluid line combinations I to VIII:
It is to be appreciated that the features of any embodiment of the scope, sheath, and/or tip cap described herein can be combined with any other embodiment. Likewise, any features may be subtracted and/or added from each of the embodiments.
Various aspects of gas and fluid supply lines, scope, complementary sheath and/or tip may be provided to correspond to the various alternative environments described in the applications and patents that follow. As such, endoscopes, sheaths, and/or tip caps—including those that work with rigid, semi-rigid and flexible systems—may be modified, adapted and configured as described herein to adjust interior lumen space allocation, provide for the inclusion of one or more gas and/or fluid conduits, include gas manifolds along with various complementary sheaths, and/or have scope exterior walls/sheath interior wall engagement regions, each of which may be modified or adapted for providing visual field improvement actions to numerous different surgical or operating environment or tools used in those environments or procedures. Still further improvements to visualization components, lighting systems, camera, optical sensors and the like are described in the following, each of which is incorporated by reference in its entirety:
Non-circular shaped endoscopes having more than one visualization component on different axis or orientation and other aspects are described in U.S. Patent Application Publication No. 2013/0172670 to Levy et al., titled “REMOVABLE TIP ENDOSCOPE,” filed Dec. 13, 2012 as well as in U.S. Patent Application Publication No. 2013/0317295 to Morse, titled “LIGHT ASSEMBLY FOR REMOTE VISUAL INSPECTION APPARATUS,” filed Dec. 29, 2006.
Endoscopes with various different working channels and interior lumen utilization designs and other aspects that may be incorporated into the scopes herein are described in U.S. Pat. No. 8,517,921 to Tremaglio et al., titled “ENDOSCOPIC INSTRUMENT HAVING REDUCED DIAMETER FLEXIBLE SHAFT,” filed Apr. 18, 2005.
Optional, additional details for variations to the scope and sheath/cap tip systems described herein may be obtained by reference to FIGS. 20, 6 and 7, respectively, of U.S. Pat. No. 6,206,825 to Tsuyuki, titled “ILLUMINATION SYSTEM FOR ENDOSCOPES AND AN ENDOSCOPE HAVING THE ILLUMINATION SYSTEM,” filed Jan. 15, 1999, incorporated herein by reference.
Endoscopes adapted for use with flexible, multiple scope or also various robotic applications and other aspects that may be incorporated into the scopes herein are described in U.S. Patent Application Publication No. 2010/0331856 to Carlson et al., titled “MULTIPLE FLEXIBLE AND STEERABLE ELONGATE INSTRUMENTS FOR MINIMALLY INVASIVE OPERATIONS,” filed Dec. 14, 2009. Various aspects of gas and fluid supply lines, complementary sheath and other alternatives may be provided to correspond to the various alternative environments of, for example,
Additional robotic applications and systems are described in U.S. Patent Application Publication No. US 2014/0371763 to Poll, et al., titled “SHEATH FOR HAND-HELD AND ROBOTIC LAPAROSCOPES,” published on Dec. 18, 2014. Various aspects of gas and fluid supply lines, complementary sheath and scope aspects and alternatives may be provided to correspond to the various alternative environments of, for example,
In still other aspects, flexible multiple segment endoscopes are described in U.S. Pat. No. 7,087,013 to Belson et al., titled “STEERABLE SEGMENTED ENDOSCOPE AND METHOD OF INSERTION,” issued Aug. 8, 2006. Various aspects of gas and fluid supply lines, working channels and other aspects of the complementary sheath/tip cap and scope alternatives may be provided to correspond to the various alternative environments of, for example,
In still other aspects, flexible multiple segment, tendon driven endoscopes are described in U.S. Pat. No. 6,858,005 to Ohline et al., titled “TENDON-DRIVEN ENDOSCOPE AND METHODS OF INSERTION,” issued Feb. 22, 2005. Various aspects of gas and fluid supply lines, working channels and other aspects of the complementary sheath and scope alternatives may be provided to correspond to the various alternative environments of, for example,
Various aspects of gas and fluid supply lines, working channels and other aspects of the complementary sheath and scope alternatives may be modified or provided to correspond to include one or more aspects of the designs in U.S. Patent Application Publication No. 2015/0038785 to Govrin et al., titled “INTEGRATED ENDOSCOPE IRRIGATION,” filed Sep. 15, 2014, modified for use in providing one or more visual field improvement actions.
Various aspects of gas and fluid supply lines, working channels and other aspects of the complementary sheath and scope alternatives may be provided to correspond to the various endoscopes of various sizes and alternative configurations—including other aspects as described in U.S. Pat. No. 5,857,961 to Vanden Hoek et al., titled “SURGICAL INSTRUMENT FOR USE WITH A VIEWING SYSTEM,” filed Feb. 6, 1996.
Additional details and alternatives for visualization components for use in the herein described scope—sheath combinations may be provided in U.S. Patent Application Publication No. 2007/0182842 to Sonnenschein et al., titled “REUSABLE MINIATURE CAMERA HEAD,” filed Nov. 27, 2006; PCT Publication No. WO2005/002210 to Sonnenschein et al., titled “AUTOCLAVABLE IMAGER ASSEMBLY,” filed Jul. 31, 2003; EP Publication No. EP 0 790 652 to Sano et al., titled “SOLID-STATE IMAGE PICKUP DEVICE AND ITS MANUFACTURE,” filed Jul. 30, 1996; PCT Publication No. WO2005/115221 to Sonnenschein et al., titled “A REUSABLE MINIATURE CAMERA HEAD,” filed May 30, 2005.
In still further aspects, the visualization component comprises a lens system and a solid state sensor. In some embodiments, the solid-state sensor is selected from the following group: a Charge Coupled Device (CCD); an Intensified Charge Coupled Device (ICCD); an Electron Multiplying Charge Coupled Device (EMCCD); and a Complementary Metal Oxide Semiconductor (CMOS) device. In some embodiments, the visualization device includes a sensor as in claim 42 having a diagonal size in the range from approximately 0.5 mm, 1 mm, 1.5 mm, 2 mm, 2.5 mm, 3 mm, or 3.5 mm, or 4 mm.
In some embodiments, the scope includes a visualization device with a lens system having a plurality of lens that together form an image with a field of view of between 60 and 140 degrees. In still further alternatives and variations, the scope-sheath combination systems described herein are adapted such that the scope, complementary sheath and visualization device are adapted and configured for carrying out a procedure selected from the following: (1) a gastroscopy procedure by forming an image with a field of view of 120 to 140 degrees; (2) an ERCP procedure by forming an image with a field of view of the camera head of the invention 120 to 140 degrees in the motherscope and by forming an image with a field of view of 100 degrees in the baby scope; (3) a colonoscopy procedure by forming an image with a field of view of 120 to 140 degrees; (4) a gynecology procedure by forming an image with a field of view of 100 to 120 degrees; (5) a bronchoscopy procedure by forming an image with a field of view of 80 to 100 degrees; (6) an ENT procedure by forming an image with a field of view of 80 to 100 degrees; and (7) a transgastric procedure by forming an image with a field of view of 120 to 140 degrees in the motherscope and by forming an image with a field of view of 100 to 120 degrees in the baby scope.
When a feature or element is herein referred to as being “on” another feature or element, it can be directly on the other feature or element or intervening features and/or elements may also be present. In contrast, when a feature or element is referred to as being “directly on” another feature or element, there are no intervening features or elements present. It will also be understood that, when a feature or element is referred to as being “connected”, “attached” or “coupled” to another feature or element, it can be directly connected, attached or coupled to the other feature or element or intervening features or elements may be present. In contrast, when a feature or element is referred to as being “directly connected”, “directly attached” or “directly coupled” to another feature or element, there are no intervening features or elements present. Although described or shown with respect to one embodiment, the features and elements so described or shown can apply to other embodiments. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “adjacent” another feature may have portions that overlap or underlie the adjacent feature.
Terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. For example, as used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items and may be abbreviated as “/”.
Spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms “upwardly”, “downwardly”, “vertical”, “horizontal” and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.
Although the terms “first” and “second” may be used herein to describe various features/elements, these features/elements should not be limited by these terms, unless the context indicates otherwise. These terms may be used to distinguish one feature/element from another feature/element. Thus, a first feature/element discussed below could be termed a second feature/element, and similarly, a second feature/element discussed below could be termed a first feature/element without departing from the teachings of the present invention.
As used herein in the specification and claims, including as used in the examples and unless otherwise expressly specified, all numbers may be read as if prefaced by the word “about” or “approximately,” even if the term does not expressly appear. The phrase “about” or “approximately” may be used when describing magnitude and/or position to indicate that the value and/or position described is within a reasonable expected range of values and/or positions. For example, a numeric value may have a value that is +/−0.1% of the stated value (or range of values), +/−1% of the stated value (or range of values), +/−2% of the stated value (or range of values), +/−5% of the stated value (or range of values), +/−10% of the stated value (or range of values), etc. Any numerical range recited herein is intended to include all sub-ranges subsumed therein.
Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.
The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived there from, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term “invention” merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is, in fact, disclosed. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description.
This application claims priority to U.S. Provisional Patent Application No. 62/148,438, filed Apr. 16, 2015, titled “ENDOSCOPE HAVING INTEGRATED VISUAL FIELD ENHANCEMENT SYSTEM,” and to U.S. Provisional Patent Application No. 62/164,163, filed May 20, 2015, and titled “NON-ROUND ENDOSCOPE WITH SHEATH HAVING INTEGRATED VISUAL FIELD ENHANCEMENT SYSTEM,” each of which is incorporated by reference in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US16/27986 | 4/15/2016 | WO | 00 |
| Number | Date | Country | |
|---|---|---|---|
| 62148438 | Apr 2015 | US | |
| 62164163 | May 2015 | US |
