The present application claims the benefit of the Singapore patent application No. 201209102-1, filed on 11 Dec. 2012, the entire contents of which are incorporated herein by reference for all purposes.
The present disclosure describes embodiments generally relating to an endoscope, the endoscope including a system for improving visualization during operation of the endoscope.
Minimally invasive surgery (MIS) is a field of medical procedures which typically involves the use of entering the body through the skin or a body cavity or anatomical opening, with the intention of reducing, as far as possible, damage to body structures. MIS generally encompasses laparoscopic, robotic, robotic-assisted laparoscopic, endoscopic, single-port and natural orifice surgery, and is becoming increasingly adopted as facilitative technologies progress, surgeon acceptance grows, and patient demand increases. MIS brings with it the advantages of reduced pain and faster postoperative recoveries, and in certain instances, improved cosmesis and even increased visualization or operative dexterity as compared with open surgery.
The setup in MIS typically involves a port through which an imaging device is inserted in the body to enable intracavity visualization. Such an imaging device which enters the body for visualization is considered an endoscope, and for which as a category, imaging devices crafted for more specific purposes, such as arthroscopes, laparoscopes, rectoscopes, amongst other tools fall under. Endoscopes typically include a rigid or flexible tube in extension of an imaging system, and it is noted that endoscopes now extend to uses which stretch beyond typical medical procedures, for example internal inspection of complex technical solution, or examination of explosive devices by bomb disposal personnel, etc.
Endoscopes as utilized in MIS usually include a combination light source for illumination and can be inserted in to the body through cavities into the abdomen, pelvis, or a subcutaneous space created by surgical separation of tissue planes. Endoscopes can also include an air insufflation port, and two or more additional working ports through which specialized surgical instruments can be inserted for manipulation, dissection and hemostasis.
MIS generally poses specific challenges as compared with open surgery. The working space is limited, and visualization is dependent on an optical imaging system or camera in the endoscope, which has a restricted field of view.
Further, multiple varieties of debris may impinge on the lens of the optical imaging system or lens of the scope, or the tip of the scope, preventing the surgeon from clearly viewing the surgical field. Such debris can include water vapor from a humid body cavity, vaporized tissue particles from dissection, blood, and smear from fat and viscera. The latter becomes more prevalent when operating in narrow cavities such as the pelvis, retro-peritoneum, thoracic cavity, nasal sinuses etc.
Water vapor fogging and vaporized tissue are probably the most common sources of lens fouling or soiling. However, blood from vessel injury can be considered the most dangerous as a scenario. When significant bleeding is encountered during surgery, reduction or cessation of blood flow is critical. However, for effective hemostasis to take place, it is imperative to have rapid access to the bleeding vessel and precise visualization of the bleeding point or points for accurate placement of the hemostatic tool. Therefore, if spurting blood impinges on the scope lens during such an attempt at hemostasis, precious time could be lost while attempting to restore visualization, with potentially dire consequences for the patient.
At present, when visualization is impaired, surgical workflow stops. The scope is removed from the patient, and the tip cleaned with gauze. Typically, the tip is then submerged in a thermos of warm water then dried again with gauze before re-insertion into the patient. The whole process takes about one minute, and may be repeated anywhere from two to ten times in an hour throughout a surgical procedure.
Laparoscope sheaths have been developed with fluid irrigation channels that enable lens cleaning without scope removal. However, this still requires a brief cessation in surgical workflow while the cleaning is taking place. Preventing the lens from being fouled allows surgeons the luxury of a constant, clear view. However, the gentle, air currents provided with the fluid irrigation channel sheath are not particularly effective against blood splatter, and can fail to protect the lens during the most critical moments of the surgery.
There is as such a desire for a system for the improving of visualization of endoscopes during operation.
According to various embodiments in the present disclosure, there is provided an endoscope including: an elongate shaft body; an optical scope provided within the elongate shaft body, the optical scope including an optical aperture provided at the distal end of the optical scope, corresponding to a distal end of the elongate shaft body; an aperture cover provided at the distal end of the elongate shaft body for shielding the optical aperture from debris external to the elongate shaft body; and an actuation system provided at a proximal end of the elongate shaft body; wherein the actuation system drives the aperture cover to rotate.
In the drawings, like reference characters generally refer to the same parts throughout the different views. The drawings are not necessarily to scale, with emphasis instead generally being placed upon illustrating the principles of the present disclosure. It is to be noted that the accompanying drawings illustrate only examples of embodiments of this disclosure and are therefore not to be considered limiting of its scope, for the disclosure may admit to other equally effective embodiments. In the following description, various embodiments of the disclosure are described with reference to the following drawings, in which:
Embodiments of a method and system for communication channel distribution are described in detail below with reference to the accompanying figures. However, it should be understood that the disclosure is not limited to specific described embodiments. It will be appreciated that the embodiments described below can be modified in various aspects, features, and elements, without changing the essence of the disclosure. Further, any reference to various embodiments shall not be construed as a generalization of any inventive subject matter disclosed herein and shall not be considered to be an element or limitation of the appended claims except where explicitly recited in a claim(s).
According to various embodiments, depiction of a given element or consideration or use of a particular element number in a particular FIG. or a reference thereto in corresponding descriptive material can encompass the same, an equivalent, or an analogous element or element number, identified in another. FIG. or descriptive material associated therewith. The use of “I” herein means “and/or” unless specifically indicated otherwise.
The present disclosure can describe embodiments of a system or apparatus which can be operable in various orientations, and it thus should be understood that any of the terms “top”, “bottom”, “base”, “down”, “sideways”, “downwards” etc., when used in the following description are used for convenience and to aid understanding of relative positions or directions, and not intended to limit the orientation of a system or apparatus. It is also noted that the term “distal” is used to indicate a location or a portion situated away from a point of origin and the term “proximal” is used to indicate a location or a portion situated toward the point of origin.
According to various embodiments, an endoscope is provided with a capability to maintain visualization during minimally invasive surgery. According to various embodiments, the improved endoscope includes a rotating shield at the distal tip of the endoscope. Such a rotating shield maintains visualization by seeking to prevent impingement of debris on the optical lens or the optical aperture of the endoscope. Rotation of the shield dissipates large fluid droplets and remaining particles have a minimal effect on visual quality. In various embodiments, the endoscope includes additional elements or capabilities to augment the rotating shield. Such additional elements are useful, as centrifugal force, on its own, may be insufficient to handle large quantities of debris.
Further, according to the present disclosure, an improved endoscope is provided with a small sheath form factor. Such a form factor in the improved endoscope in various embodiments does not deviate greatly from the form factor of a comparable standard or typical endoscope, and allows the use of standard-sized ports, for example a standard-sized laparoscopic port of about 12-15 mm, for insertion into a body.
According to various embodiments, the improvements to the endoscope, for example, the rotatable aperture cover, can be provided in the form factor or housing of a standard-sized endoscope. In other embodiments, a sheath may be provided, which fits over the endoscope, to provide an improved endoscope according to the present disclosure. The endoscope according to various embodiments may provide an adaptation to angled scopes.
In embodiments, the outer sheath 102 houses an optical scope 104, which is arranged to be manipulated in accordance with the outer sheath 102 during operation. Scope 104 includes an optical imaging system or can be considered as part of an optical imaging system. In embodiments, the scope 104 typically includes a fiber optic bundle coupled to an image capture system at the proximal end of the scope 104. Distally, the fiber optic bundle is arranged to receive and transfer light and image details in an observation area through an optical aperture 106. In embodiments, the scope 104 could include a plurality of lenses which allow the conveyance of light and imaging from the distal end of the scope 104 to an optical imaging processing system.
In embodiments, the distal end of the scope 104 can include an optical lens which provides clarity and focus on the observation area. The distal end of the scope 104 can also include an imaging device, such as a charge-coupled device, which can allow for the additional image processing capabilities for the optical imaging system, including automatic focusing and light detection and adaptation, amongst others. Any optical apparatus provided over the optical aperture of the fiber optic bundle can also be considered to provide a further optical aperture of the scope 104.
According to various embodiments, the endoscope 100 includes a lens cover or aperture cover 110 provided at the distal end of the outer sheath 102. The lens cover 110 is provided over the lens or aperture of the scope 104 and provides a function of protecting the scope and maintaining visualization during operation. Such a lens cover 110 in performing an optical function is intended to be transparent and arranged as not to be an impediment to optical imaging. In embodiments, the lens cover 110 is an acrylic lens cover, but can be of any other construct. Acrylic is chosen because of its superior optical properties, but any other optically clear material such as polystyrene, polypropylene or PMMA could be utilized. According to various embodiments, the lens cover should be sized to substantially cover the area of the objective lens or aperture 106 of the scope 104. In embodiments, the lens cover 110 covers at least 50% of the objective area of the optical aperture 106. In an embodiment, the lens cover 110 is a clear acrylic disc, and which is 6.58 mm in diameter, the endoscope configured for use as a laparoscope. The circular shape of the disc assures the absence of sharp corners, which could potentially cause tissue injury should the rotation of the lens cover get caught in tissue.
According to various embodiments, the edges of the lens cover 110 are desirably protected by an outer sheath or collar, and the lens cover 110 is secured by strong adhesive or flanges such that no rotating edges are exposed. In embodiments, the lens cover 110 can be shaped to provide additional optical function, for example, modify optical focal length, etc. Further, in various embodiments, the outer or exposed surface of the lens cover 110 is made hydrophobic and oleophobic. This can be accomplished by fine polishing of the surface, surface etching, a thin layer of hydrophobic coating material, for example, Teflon or parylene, or by other methods known in the art.
In various embodiments, the lens cover 110 is configured to rotate during operation, and through centripetal action, reduces impingement or build-up of debris or foreign matter on the endoscope 100 which impedes observation through the scope 104. The lens cover 110 is configured to rotate about an axis central to the cross-sectional circumference of the outer sheath body 102. In other words, the lens cover 110 includes a central rotation axis which is the same longitudinal axis passing through the central axis of the outer sheath 102 or the endoscope 100. In embodiments, the lens cover 110 is coupled to the outer sheath 102 of the endoscope 100, such as to provide stability with respect to the body of the scope, as well as providing a further seal against debris, in various embodiments. In embodiments, the lens cover 110 is coupled distally to the outer sheath 102 of the endoscope, i.e. the lens cover 110 is provided at the end of the endoscope 100. This allows the scope 104 to be provided with a maximized field of view, when the scope 104 is provided as close to the edge of the outer sheath 102 or end of the endoscope 100, such that any surrounding outer sheath structure does not block the peripheral vision of the scope 104. In various embodiments, the lens cover 110 is not provided at the end of the endoscope 100, to perhaps allow for the outer sheath 102, or an additional jacket coupled on the outer sheath 102, to further extend to perform such as a safety function in keeping any internal body matter from the rotating lens, cover 110.
In various embodiments, the lens cover 110 is coupled to a rotating lens shaft 112. The lens shaft 112 extends laterally and in parallel with the outer sheath 102 and is intended to be housed within the outer sheath 102 in the endoscope. The lens shaft 112 is thus provided for rotating motion in between the stationary scope 104 and outer sheath 102. In various embodiments, a lubricant 113 is provided within any one of the gap between the outer sheath 102 and the lens shaft 112, and the lens shaft 112 and the scope 104. The lubricant 113 provides maintenance of the operating gap between the respective shafts, and also acts against any friction or heat which may be caused by the rotating motion of the lens shaft against the scope 104 or the sheath 102. In embodiments, the lens shaft 112 is coupled by adhesive to the circumference of the lens cover 110. In embodiments, other coupled methods can be used, for example flanges, or nut and bolt, or cut and groove, etc. The lens shaft 112 is configured to rotate the lens cover 110 in accordance to a predetermined rotational speed.
In embodiments, the lens shaft 112 is driven by an actuation system 114 provided at a proximal end of the outer sheath 102 of the endoscope 100. Providing the actuation system 114 at the proximal end of the endoscope 100 allows for a slender and consistent form factor of the distal outer sheath as compared with standard endoscopes in the art. Such a slender form factor is critical, especially in consideration of certain endoscopy procedures such as laparoscopic surgery, where small incisions (usually 5-15 mm) are made to allow for an operation in the abdomen or pelvis or a patient.
In various embodiments, the actuation system 114 is a motor or a drill input mechanism 116. Further, the actuation system 114 includes a drive system 118, which includes drivetrains, shafts and connecting gears which cause the lens shaft 112 to be rotated in accordance to operational control.
In embodiments, the motor 116 is coupled to an input shaft or a drivetrain 120. The motor 116 is further coupled to a control system provided in a processor (not shown) providing supervisory control of the endoscope 100. Fine control, rotational speed and various other motor-related controls which affect the lens cover rotational function can be operated via the control system and the processor. The drive system 118 further includes an input gear 122 coupled onto the input shaft 120 and which rotates in accordance with the input shaft. The input gear 122 is then coupled teeth-wise with a lens shaft gear 124 which is coupled onto the lens shaft 112. The motor 116 thus actuates the drive system 118 which thereafter causes the lens shaft 112 to rotate accordingly. In other embodiments, additional gears can be provided in the drive system, for example to step up or down the rotation speed of the lens shaft 112, or to provide a further rotational or translational function for further features in the endoscope 100.
The lens shaft 112 is held in place at a proximal end of the outer sheath 102 with respect to the scope 104 and the outer sheath 102 with a lens shaft flange 126. By way of the lens shaft flange 126 and the coupling of the lens cover 110 to the outer sheath 102, the position of the lens shaft 112 is controlled with respect to the outer sheath 102, at least at the proximal and distal ends of the lens shaft 112.
In embodiments, the endoscope 100 includes a housing 130 which can include the optical imaging processing system, and can also include the actuation system 114 and the drive system 118 of the actuation system for enabling the rotation of the shield or lens cover or aperture cover 110 according to various embodiments. In embodiments, the housing 130 is provided at the proximal end of the outer sheath 102, i.e. the outer sheath 102 terminates at the housing 130. The outer sheath 102 and the housing 130 form a portion of the external body of the endoscope 100, and at least a mechanical actuation portion of the endoscope 100.
According to various embodiments, the scope 104 extends through a housing 110 and is further coupled to an optical imaging processing system proximal in comparison to the housing 110. A scope flange 108 can be provided prior to the entry of the scope 104 into the enclosure of the housing 110, and provides a coupling of the scope 104 for stability to the housing 110.
In various embodiments, the endoscope 100 can also be provided or be coupled with one or more of a light source, a camera system, an air insufflation port, singular or multiple surgical instruments or any other relevant or necessary apparatus for function.
In use according to various embodiments, the tip or the distal end of the endoscope 100 can be inserted into a subcutaneous space and manipulated or guided accordingly by a surgeon undertaking an MIS procedure, either through a direct manipulation of the outer sheath, or through other manipulation control.
During the MIS procedure, there is expected to be accumulation of debris on the tip or distal end of the endoscope 100, which may affect visualization through the scope 104. When an operating surgeon determines that there is impingement or build-up of debris adversely affecting vision during the MIS procedure, the actuation system 114 can be activated to operate the rotating lens cover 110. The lens cover 110, through centripetal or spinning action, rotates sufficiently such that any collected on or soiling the lens cover 110 is displaced and vision is restored to the endoscope 100. In various embodiments, the actuation system 114 is continuously in operation and the lens cover 110 is constantly rotated during the MIS procedure. Continually rotating the lens cover 110 takes a static surface which makes it more difficult for debris to impinge on the endoscope 100 in affecting visualization.
Accordingly, the speed of rotation of the lens cover 110 is an important consideration of the endoscope of the present disclosure. The rotational speed is configured in seeking to accomplish various objectives. Firstly, to prevent or remove debris sticking to the lens cover 110. Secondly, to break up larger debris particles such as fluid particles on the lens cover into smaller particles. Thirdly, the rotational speed of the lens cover should exceed the flicker fusion threshold of the human eye, which is about 15-60 Hz, thus rendering finer debris fouling invisible.
In various embodiments, the endoscope 100 of the present disclosure utilizes a rotating lens cover 110 configured to operate with a rotational speed selected from a range of between 500 rpm to 1000 rpm. In embodiments, the rotating lens cover 110 is configured to operate with a rotational speed of 1000 rpm. The inventors of the embodiments associated with present disclosure have established through empirical testing that a rotation speed of 1000 rpm can be sufficient to produce a flicker-free effect. It is also noted that balance is to taken in conjunction with the setting of the rotational speed of the lens cover. Although higher speeds will more effectively protect the lens due to the greater centrifugal forces, higher speeds may increase the theoretical risk of tissue injury.
For a flicker threshold of 60 Hz, the length of obstruction= 1/60s=16.6 ms
According to an embodiment, a lens cover rotational speed of 580 rpm is provided so as to meet the flicker fusion threshold of 60 Hz.
In various embodiments, the endoscope 100 terminates at its distal end with a circular edge perpendicular with the longitudinal central axis of the endoscope 100, i.e. with a zero degree angulation. The lens cover in this case is placed over the distal end of the outer sheath 102, and is similarly perpendicular with respect to the longitudinal central axis of the endoscope 100. In embodiments, the distal end of the endoscope can include an angled upward curved edge, or an angled distal end. A deviation from the perpendicular plane to the normal of the endoscope, as provided by an extension of the longitudinal central axis of the endoscope, provides an angulation of the endoscope. For example, the endoscope can be provided with angulations or views such as with a 0° angle, a 30° angle, a 45° angle or a 70° lens.
According to various embodiments, an endoscope with an angled distal tip is provided with certain modifications to the lens cover, or lens shaft, or the coupling of the lens cover to the outer sheath, to realize the provision of a visualization improvement system to allow for endoscopic operation with an endoscope with an angled distal tip. In various embodiments, suitable helical or worm gears and flexible couplings can be used to obtain rotation of the lens cover at a provided endoscopic angulation.
According to various embodiments, the lens cover 210 is a machine acrylic lens, and is set into place with respect to the lens shaft 212 by way of adhesive. The lens cover 210 thus provides a protective shield for a scope to be housed within the outer sheath 202. The lens cover 210 provides protection from debris from a patient's body and exterior to the outer sheath, and thus keeps a housed scope free from debris. The lens cover 210 is further arranged to maintain visualization of the endoscope 200 during operation in a MIS procedure.
In embodiments, the lens shaft 212 is arranged to rotate, and as a result, cause the lens cover 210 to correspondingly rotate. In embodiments, the lens cover 210 is held in place at the distal end of the outer sheath by a coupling to the outer sheath. In such a way, the lens cover 210 does not deviate in position along the shaft of the outer sheath 202, which may lead to abutment on and damage to a housed scope. Rotation of the lens cover 210 leads to dispersal of any foreign debris settling on or fouling the lens cover 210 through centripetal action, which provides a maintaining of visualization with the endoscope 200.
Housing 230 is shown to be provided at a proximal end of the external outer sheath 202. Outer sheath 202 is illustrated to terminate at the housing 230. In embodiments, the outer sheath 202 is provided as a stainless steel outer sheath. In other embodiments, the outer sheath can include one or a plurality of other materials, which is suitable for insertion into a patient's body, without any detriment to the body or to the endoscope housed within the outer sheath. In other embodiments, the outer sheath can include a flexible tube or a flexible metal conduit which allows flexibility in operation.
The outer sheath 202 houses within its cylindrical body a lens shaft 210, arranged to rotate about the longitudinal central axis of the shaft 210. The lens shaft 210 is shown to be extending proximally past the termination of the outer sheath 202 into the housing 230. The lens shaft 210 is also shown to be terminated with respect to an enclosure 232 which is arranged to receive a scope and to retain the scope in the enclosure 232 and the housing 230. In embodiments, an O-ring 234 is provided for retaining a scope received in the endoscope housing 230. Alternatively, other securing mechanisms can also be used to retain a scope.
According to various embodiments, the lens shaft 210 is retained in the housing 230 and is coupled to a lens shaft gear 224. The lens shaft gear 224 is coupled around the circumference of the lens shaft 210 and is configured to move in accordance with an input shaft gear 222. The lens shaft gear 224 includes a plurality of teeth which are correspondingly fit to the teeth of the input shaft gear 222 such that rotational motion of the input shaft gear 222 will be translated to the lens shaft gear 224, and vice versa.
In embodiments, the input shaft gear 222 is retained within the housing 230 and is coupled to and about the circumference of an input shaft 220. The input shaft 220 extends out of the housing 230 and is coupled on the extended free end to a driving motor. The motor rotationally drives the input shaft, which in turn cranks the input shaft gear 222 and the lens shaft gear 224 and subsequently the lens shaft 212. The rotation of the lens shaft 212 causes the lens cover 210 to rotate, which removes any foreign debris fouling the lens cover 210. In various embodiments, the lens shaft 212 is included of brass, but other suitable metal can be used. In embodiments, the lens shaft 212 can be a flexible tube or metal conduit which allows the lens shaft 212 to flex according with the endoscope in operation, whilst still allowing for a rotational actuation of the lens cover 210.
In embodiments, to securely retain the lens shaft 212 within the housing 230 for optimum control and rotational motion translation through the gears, an inner shaft flange 236 is provided for retention about the cylindrical circumference of the lens shaft 212. In embodiments, the flange 236 can be stacked to provide a better hold and retention. Further, a thrust bearing 238 can be provided within the housing 230 to allow for smooth rotation of the lens shaft 212 about its central longitudinal axis. In embodiments, multiple bearings 238 can be stacked for higher efficiency.
In various embodiments, the housing 230 can include an upper enclosure portion 240 and a lower enclosure portion 242. The expressions upper and lower are provided with respect to the provided figures and only provide reference to the features of the embodiment. The lower enclosure 242 is arranged to receive and retain the proximal end of the outer sheath 202 and is directed towards the scope extension for insertion into a patient's body. The lower enclosure 242 of the housing 230 is arranged to receive the inner shaft flange 236 and the thrust bearings 238 so as to secure the lens shaft 212 for controlled rotation.
In various embodiments, the input shaft 220 extends out of the upper enclosure 240 of the housing 230. Further, the upper enclosure 240 also includes the enclosure 232 for receiving the scope and the O-ring 234 for securely retaining the scope. In embodiments, the upper enclosure 240 can also include a set of inner shaft flange and thrust bearings 238, such that the lens shaft 212 is well secured within the housing 230.
Having two sets of flanges and bearings in the upper and lower enclosures are useful as the upper enclosure 240 and the lower enclosure 242 can be mechanically joined and separated. This allows for ease of repair and maintenance. In embodiments, one of the housing enclosures, in this case, the upper enclosure 240, includes a threaded insert 244. The other housing enclosure includes a corresponding receptacle, which allows insertion of a screw 246 which retains both sides of the housing enclosures together. Other retaining arrangements of course can be possible.
In various embodiments, the lens cover 210 is also coupled to the distal end of the outer sheath 202 and is held in place at the distal end of the outer sheath 202. In embodiments, the lens shaft 212 is coupled to a retaining rim 250, which is thereafter coupled to the circumference of the lens cover 210. According to various embodiments, the lens shaft 212 is coupled to the retaining rim 250 with adhesive at 251. In other embodiments, the lens shaft 212 is coupled to the retaining rim 250 by way of brazing, or any other suitable methods for connection. In embodiments, the lens cover 210 is coupled on its circumference to the retaining rim 250, by way of adhesive, crimping, pressing, or any other suitable method. A corresponding receiving rim 252 is coupled on the inner surface of the distal end of the outer sheath 202.
A plurality of bearings 254 is provided between the retaining rim 250 and the receiving rim 252, and provides for the smooth rotation of the lens cover 210 in the endoscope 200. The provision of bearings 254 or micro-bearings provide a mechanical implementation of lubrication for the reduction of friction caused by the rotation of the lens cover 210. In embodiments, the bearings 254 are sealed 256 to provide consistency in performance. In other embodiments, the rotating surfaces of the lens cover with respect to the outer sheath can be made lubricious, with a friction-reducing coating of, for example, Teflon. In other embodiments, fluid lubrication can be used, with the provision of grease or oil. In other embodiments, a fluid cushion can be provided for reduction of friction. In such a case, a fluid actuation system can be provided at the proximal end of the endoscope, to provide for a fluid flow and a fluid cushion for acting at the rotating surfaces. In embodiments, the channel or gap between the outer sheath 202 and the lens shaft 212 may be slightly increased to provide for fluid channels for directing fluid flow. Advantageously, the endoscope according to various embodiments is provided with friction reducing features which achieve suitable lubrication and temperature control, which seeks to overcome the potential high frictional forces brought about by the rotating lens cover.
In other embodiments, the lens cover can be secured to the outer sheath with different mechanisms, the purpose of which is to allow operation without positional deviation or slippage of the lens cover.
In various embodiments, the endoscope 200 is a laparoscope for performing a MIS procedure through a small incision. One embodiment of the endoscope 200 is provided with dimensions suitable for use as a laparoscope, with the advantageous feature of providing a visualization improvement system of a rotating lens cover 210. The endoscope 200 is designed to retain a slim form factor, with the diameter of the endoscope 200 as determined by the diameter of the outer sheath 202, for insertion into a patient's body, being provided as 12.5 mm. The lens cover 210, including the rotation structure including the retaining rim 250, bearings 254 and receiving rim 252 have a diameter of 12 mm, and as can be noted, the rotation system is coupled directly to the internal surface of the outer sheath 202. Further, the exposed diameter of the lens cover 210 is provided as 8 mm. This allows a sufficient window for observation with the scope 206 through the lens cover 210. In embodiments, the thickness of the rotation system, as provided by the retaining and receiving rims 250, 252, is provided as 3.5 mm. Such a thickness allows for a suitable balance between protection of the optical lens or aperture of the scope 206 and providing a sufficient field of vision. It is of course noted that other dimensions are possible, in relation to the type and purpose of the endoscope, and any intended functions of the endoscope.
In various embodiments, the torque for rotating the lens cover of an endoscope is provided with fluid flow. In an embodiment, the endoscope includes an actuation system (not shown) provided at a proximal end of the end of the endoscope and the outer sheath. In embodiments, the actuation system generates a fluid flow for the actuation of the lens cover for rotation. It is noted that the provision of a fluid flow for actuation allows for a reduction of mechanical moving parts, which would dramatically decrease frictional occurrences, as well as lubrication considerations.
The actuation system can be provided with a self-contained pressurized gas canister which is used to generate a pressurized gas flow to motivate the lens cover 410 into rotation. In embodiments, the actuation system is coupled to a pressurized gas delivery system for providing the fluid flow. In embodiments, the actuation system includes a pressurized gas delivered by a gas tank. In embodiments, the actuation system includes a fluid inlet and a regulator which can receive a pressurized gas delivery from a hospital wall supply or an external gas tank. In various embodiments, the fluid is carbon dioxide gas, but any other gas which is inert and harmless in quantities.
In various embodiments, the actuation system includes a suction system, and the fluid flow for generating a rotation is created by suction provided by the actuation system and generated in the proximal end of the endoscope. In embodiments, the actuation system includes a combination gas delivery and suction system. The fluid flow for generating a rotation is initiated by a pressurized fluid actuation from the gas delivery system. The fluid flow progresses from the proximal end of the endoscope to the distal end, where interaction with a rotation module coupled to the lens cover causes rotation of the lens cover. Further, the suction system creates a negative pressure at the proximal end and draws in fluid from the distal end of the endoscope. The suction system accentuates and improves the fluid flow, for more efficient rotation of the lens cover. Advantageously, providing the rotation module actuated by fluid flow removes the need to provide an additional electrical power source, as fluid delivery can be obtained from existing sources, such as the hospital wall supply.
The velocity of fluid flow and total surface area of the turbine blades 424 result in a theoretical maximum fluid power according to the equation:
Fluid Power=(0.5)ρAν3 (2)
where ρ is the fluid density, A is the surface area of the turbine blades and v is the fluid velocity. It is noted that power transfer would not be 100% efficient. Practical efficiency rates are likely to be 20-40%, and therefore the required velocity and surface areas will be empirically determined according to the endoscope embodiment.
In various embodiments, visualization of the endoscope during a MIS procedure is improved with the provision of a rotating lens cover driven by an actuation system provided at a proximal end of the endoscope. Further, additional systems or modules can also be incorporated into the endoscope to work in combination with the rotating lens cover. The present disclosure provides accordingly a plurality of other visualization improvement features for use in combination. In describing such additional modules, the present disclosure may or may not illustrate the additional modules in combination. According to various embodiments, any one of the visualization improvement features can also be provided on an endoscope without the rotating lens cover, to provide an endoscope with a standalone visualization improvement system. A combination of the visualization improvement features can also be incorporated as such.
According to various embodiments, the fluid actuation system 520 can include a gas outlet port 540. Gas outlet port 540 similarly includes a nozzle 542 for coupling to a suction or vacuum module for receiving fluid in use in the endoscope 500 for improving visualization. Gas outlet port 540 is a manifold that can be coupled around the outer sheath 520 and over an opening to a fluid channel 546. In embodiments, the fluid channel 536 for fluid delivered to the endoscope and the fluid channel 546 for receiving fluid from the endoscope are distinct and do not interact.
In embodiments, the actuation system 520 can include where the fluid chamber 534 of the gas fluid inlet port 530 is coupled to a plurality of fluid channels 536 for delivery of fluid to the distal end of the endoscope 500. The actuation system 520 also includes where the fluid chamber 544 of the gas outlet port 540 is coupled to a plurality of fluid channels 546 for receiving fluid from the distal end of the endoscope 500. As can be observed in
Fluid actuation system 620 includes a regulator housing 622 and which is provided with a flow regulator dial or actuator 624. The regulator housing 622 is coupled to an air inlet port 626 which can be thereafter coupled to a gas delivery module or a gas insufflator machine or directly via a hospital wall supply. Fluid, and in most cases, compressed gas, is delivered through the air inlet port 626 and provided into the endoscope 600 through the regulator housing 622. The gas is provided to a fluid channel internal to the outer sheath 602, which directs the delivered gas from the inlet port to the distal end of the outer sheath 602. At the distal end of the endoscope 600 is provided with a gas column port, or an air jet port 610. The amount of gas output by the air jet port 610 can be controllable with the flow regulator dial 624, determining how strong or weak the air column output from the air jet port 610 is. The flow regulator 624 can also include a limiter to ensure that the fluid outlet pressure is within safety limits. Particularly, the flow and pressure of the air column is controlled such that the risk of causing air embolism is reduced.
The arrangement of the endoscope 600 according to various embodiments includes one or more fluid channels in close apposition to the endoscope optical channel, the fluid channel directing the fluid flow towards the surgical field with sufficient energy to displace oozing blood or other organic material, a fluid actuating element at the proximal end, and a flow regulating element to control the fluid pressure. In embodiments, the fluid used is carbon dioxide gas, but could also be saline, air etc. The system is built as part of the endoscope. In other embodiments, the system is integrated into a sheath that fits over the endoscope, with additional elements to secure the sheath to the endoscope.
According to various embodiments, the fluid column enables directed displacement of visual-impeding matter to facilitate visualization. Although it is envisioned that the fluid column will be most useful for displacement of blood or semi-solid blood clots, for exact location of points of bleeding, it is understood that the fluid column can also be used to displace other types of soft tissue or body fluids, in order to aid in visualization of underlying organ or tissue structures, for example critical nerves.
It can be noted that there may be two important safety concerns associated with the use of this air column feature: barotrauma and gas embolism. The present disclosure provides that both of these concerns can be mitigated by controlling the direction and pressure of the fluid stream at the point of impact with the patient's tissues and blood vessels.
In embodiments, an additional safety feature is provided to impose a minimum safety distance between the fluid outlet and the nearest anatomical structure. This distance is preferably set at 3-5 mm, which is the minimum depth of field achievable by current state of the art surgical scopes.
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In providing a fluid column feature for visualization improvement the risk of gas embolism is to be considered. Literature suggests that a net intracavity positive pressure of less than 20 mmHg above atmospheric pressure appears safe. CO2 is the most widely used insufflation gas as it is well-suited for creating a pneumoperitoneum because of its properties of being chemically inert, colorless, inexpensive, readily available and less combustible than air. CO2 is also highly water soluble which reduces its probability of causing embolism compared to a less soluble gas.
The likelihood of CO2 embolism occurring via insufflation depends on the balance between the volume of undissolved CO2 entering the enclosed body cavity and the amount of CO2 that is being removed. An excess of CO2 entering increases the likelihood of embolism. Direct insufflation into the vasculature will also produce emboli even if gas is removed from the body cavity.
Further, it is provided that parameters such as hydrational and volaemic state, cumulative intra-abdominal pressures above atmospheric, or excess pressures over insufflation pressures and/or intravascular pressures should also be considered in leading to using the endoscope of various embodiments safely and in consideration of air emboli.
In embodiments, the endoscope includes a lens shaft 912 coupled to the circumference of the lens cover 910 on one end and to an actuation system 914 for driving the lens shaft 912 on the other end. The lens cover 910 is actuated to rotate and thus disperse debris gathered on the external surface of the lens cover 910 and improving visualization.
The wiper element 960 is a single elongate element or a band coupled diametrically across the outer sheath 902. The wiper element 960 is intended to be a passive element arranged to abut the external surface of the lens cover 910. While the lens cover 910 rotates, the wiper element 960 provides a counteracting sweeping motion across the lens cover 910, thereby cleaning the lens cover and improving visualization of the endoscope 900. In embodiments, the outer sheath 902 can include a drainage channel 962 or multiple drainage channels through the outer sheath structure, thereby allowing debris accumulated by the sweeping wiper element 960 and propelled radially outward towards the outer sheath 902 to be expelled.
Deployable wiper 1060 includes at least one wiper element 1062 arranged to be raised from the external surface of the optical aperture or optical lens 1006 of the scope 1004 in an unengaged position. In embodiments, there are provided four wiper elements 1062, each wiper element set out with respect to quarterly points of the circumference of the outer sheath 1002. Other embodiments may include a different number of wiper elements. In the unengaged position, the wiper element 1062 is intended to be elevated such that observation with the scope 1004 is minimally impeded. In embodiments, the stationary outer sheath 1002 encloses internally the scope 1004 as like a sleeve or a sheath. The outer sheath 1002 includes tip retention portion 1008, which is an extension of the sheath cylindrically inward such that the scope 1004 is retained within the outer sheath 1002.
The wiper elements 1062 are coupled to a rotating inner cylinder 1064 provided in between the outer sheath 1002 and the scope 1004. The inner cylinder 1064 is coupled to an actuation system 1066 arranged to rotatably drive the inner cylinder 1064 through an electromagnetic motor and a corresponding gear system. Further, the actuation system 1066 includes a positional actuator which actuates the inner cylinder 1064 longitudinally bi-directionally towards and away from the distal end of the outer sheath 1002. The positional actuator also provides determination for the transition of the deployable wiper 1060 from the unengaged position to an engaged position.
In embodiments, the wiper elements 1062 are hingedly coupled to the inner cylinder 1064. In the unengaged position, the inner cylinder 1064 is drawn proximally by the positional actuator to a first retracted position such that the wiper elements 1062 are elevated above the optical aperture 1006 of the scope 1004. The wiper elements 1062 are elevated with respect to a fulcrum point provided by the edge of the scope 1004 due to the longitudinal proximal motion of the inner cylinder 1064. Further, the wiper elements 1062 are held in place in the unengaged position due to the counteracting position of the tip retention portion 1008.
In various embodiments, the endoscope 1000 is provided with a rotating lens cover and the deployable wiper 1060. In embodiments, the inner cylinder 1064 is arranged to rotate with the same rotational axis as the rotating lens cover. In embodiments, the inner cylinder 1064 is arranged to rotate in the same direction as the rotating lens cover. In embodiments, the inner cylinder 1064 is arranged to rotate at a greater rotational speed as the rotational lens cover. In embodiments, the inner cylinder 1064 is arranged to rotate at a lower rotational speed as the rotational lens cover. In embodiments, the inner cylinder 1064 is arranged to rotate in the opposite direction as the rotating lens cover. In embodiments, a resting or pivot point of the wiper elements are provided in a lateral or inferior location, such that accumulated debris moving inferiorly due to gravity is not translated across the lens.
Moving wiper 1160 includes at least one wiper element 1162 arranged to be raised from the external surface of the optical aperture or optical lens 1106 of the scope 1104 in an unengaged position. In embodiments, there are provided four wiper elements 1162, each wiper element set out with respect to quarterly points of the circumference of the outer sheath 1102. Other embodiments may include a different number of wiper elements. In the unengaged position, the wiper element 1162 is intended to be elevated such that observation with the scope 1104 is minimally impeded. In embodiments, the stationary outer sheath 1102 enclosed internally the scope 1104 as like a sleeve or a sheath.
The wiper elements 1162 are coupled to a rotating inner cylinder 1164 provided in between the outer sheath 1102 and the scope 1104. The inner cylinder 1164 is coupled to an actuation system 1166 arranged to rotatably drive the inner cylinder 1164 through an electromagnetic motor and a corresponding gear system. According to various embodiments, the wiper elements 1162 are hingedly coupled to the rotating inner cylinder 1164. The inner cylinder 1164 is also coupled to the outer sheath 1102 such that the inner cylinder 1164 does not displace longitudinally with respect to the outer sheath 1102. Accordingly, such a coupling includes a rotational function such that the inner cylinder 1164 can rotate with respect to the stationary outer sheath 1102. According to various embodiments, the wiper elements are further hingedly coupled to a wiper activation linkage 1168. The wiper activation linkage 1168 is further provided in between the inner cylinder and the scope 1004.
In embodiments, the actuation system 1066 includes a positional actuator which actuates the wiper activation linkage longitudinally bi-directionally towards and away from the distal end of the outer sheath 1102. The positional actuator also provides determination for the transition of the deployable wiper 1160 from the unengaged position to an engaged position. The wiper activation linkage 1168 is arranged to rotate correspondingly with the inner cylinder 1164.
In embodiments, the wiper elements 1162 are hingedly coupled to both the inner cylinder 1164 and the wiper activation linkage 1168. In the unengaged position, the wiper activation linkage 1168 is actuated distally to a first extended position by the positional actuator such that the wiper elements 1162 are elevated above the optical aperture 1106 of the scope 1104. According to various embodiments, the distal end of the wiper activation linkage 1168 abuts the rigid wiper elements 1162 and causes the wiper elements 1162 to be elevated with respect to the hinged pivot point of the coupling with the inner cylinder 1164. Further, the wiper elements 1162 are held in place in the unengaged position by the wiper activation linkage 1168 in the first extended position.
In embodiments, the wiper elements 1162 can include a soft wiper portion 1170 providing on the inner surface of the wiper elements 1162, directed towards the external surface of the scope 1104. The soft wiper portion 1170 is designed to compress gently against the external surface of the optical aperture 1106 of the scope 1104 and providing a resilient contact with the external surface. Further, the soft wiper portion 1170 also provides adequate pressure on the external surface of the optical aperture to provide a scrub function which can remove more viscous debris from the optical aperture. Rotation actuation is provided by the actuation system 1166 on inner cylinder 1164, which allows the wiper elements 1162 to provide a sweeping motion in cleaning the external surface of the optical aperture 1106 in improving visualization of the endoscope 1100. Additionally, the inner cylinder 1164 can be arranged to rotate in a direction dissimilar to the direction of rotation of the lens cover. Further, one or more drainage channels can be provided in the outer sheath 1102 for debris accumulated by the wiper elements 1162 to be expelled.
Wiper module 1260 is arranged to be provided over the external face of the rotating lens cover 1210. The wiper module 1260 further includes a first wiper element 1262 arranged to be pivoted at a circumference of the rotating lens cover 1210. The first wiper element 1262 is an elongate element arranged to be in sweeping contact with the rotating lens cover 1260, and to be rotatably pivoted about a pivot point 1264. The wiper element 1262 is arranged to carry out a sweeping motion covering an arcuate area which includes the external surface area of the lens cover 1210.
In embodiments, the wiper element 1262 is coupled to a rotating shaft at the pivot point 1264, the rotating shaft stretching proximally along the length of the outer sheath 1202 to a wiper element actuation system at the proximal end of the endoscope 1260. The wiper element 1262 is thus driven in operation by the wiper element actuation system. In other embodiments, the wiper element 1262 can be coupled to an electrically actuated pivoting element at the pivot point 1264. The electrically actuated pivoting element can be electrically coupled to a control module including a driving signal generator provided at the proximal end of the endoscope 1200. In other embodiments, the wiper element can be coupled to a hydraulically actuated pivoting element at the pivot point 1264. In embodiments the pivoting element at the pivot point 1264 can be a spindle.
According to various embodiments, the wiper module 1260 includes a second wiper element 1266 rotatably pivoted about a pivot point 1268. The second, wiper element 1266 is arranged to be pivoted at a circumference of the rotating lens cover 1210, diametrically opposite to the pivot point 1264 of the first wiper element 1262. The second wiper element 1266 is an elongate element arranged to be in sweeping contact with the rotating lens cover 1260, and to be rotatably pivoted about a pivot point 1268. The wiper element 1266 is arranged to carry out a sweeping motion covering an arcuate area which includes the external surface area of the lens cover 1210.
According to various embodiments, the second wiper element 1266 is provided with a rotation actuation system arranged to pivot the second wiper element 1266 to provide a sweeping motion over the lens cover, where the rotation actuation system for the second wiper element is similar to the rotation actuation system for the first wiper element. In other embodiments, the wiper module 1260 includes two different actuation systems.
According to various embodiments, the first and second wiper elements 1262 and 1266 are arranged to provide sweeping motions on the external face of the lens cover 1210. In embodiments, the sweep of the first wiper element 1262 in synchronization with the sweep of the second wiper element 1264. In embodiments, the first wiper 1262 is arranged to complete one sweep from one side to another of the arcuate area to be covered, before the second wiper 1264 begins its sweep. In such a way any accidental collision between the first and second wipers can be averted. Further, the first wiper 1262 and the second wiper 1264 can be arranged to sweep in opposing or alternate directions in each successive sweep.
Displaceable wiper 1360 includes a flexible wiper element 1362 coupled to an axle at a fixed pivot point 1364. In an embodiment, the flexible wiper element 1362 is retained on one end at a point on the circumference of the elongate outer sheath 1302. In an embodiment, the flexible wiper element 1362 is coupled at the other end to a carrier 1366 which is received in a guide track 1368. The carrier 1366 is arranged to guide the wiper element 1362 between predetermined operational positions.
In a first position, the flexible wiper element 1362 is displaced to the circumference of the outer sheath 1302. In an embodiment, the outer sheath 1302 includes an upraised groove for receiving and retaining the flexible wiper element 1362. In an embodiment, the flexible wiper element 1362 is a resilient element and in the first position, the flexible wiper element 1362 is at rest and in an unstretched condition. The first position of the carrier 1366 also corresponds to a right side limit of the guide track 1368.
In the second position, the resilient flexible wiper element 1362 is in a stretched condition and also provides sufficient tension such that the wiper element 1362 is effective for carrying out a sweeping and cleaning function. It is noted that in the second position, the stationary flexible wiper element 1362 can operate efficiently with respect to a rotating lens cover, the wiper element being in contact with the external surface of the lens cover. In embodiments, the flexible wiper element 1362 is arranged to be in contact with the optical aperture of the scope 1304 or the lens cover once the flexible wiper element departs from the outer sheath 1302.
The carrier 1366 is configured to be reversibly actuable back from the third position to the second position to the first position. According to various embodiments, by actuating the carrier 1366 and thus the flexible wiper element 1362 between positions, for example from the first position to the second position to the third position, the flexible wiper element 1362 carries out a sweeping motion and cleans off debris from the optical aperture or lens cover. Further, one or more drainage channels can be provided in the outer sheath 1302 for debris accumulated by the wiper element 1362 to be expelled. In other embodiments, the flexible wiper element, instead of being resilient, is retractably coupled to the pivot point 1364. This provides for a predetermined amount of tension to be applied to the flexible wiper with respect to the coupling at the other end to carrier 1366. The tension is applied through the positional translation by the carrier 1366, allowing the flexible wiper to carry out the sweeping function for improving visualization.
Displaceable wiper 1460 includes a resilient wiper element 1462 coupled to a first axle 1464 at a first pivot point. In an embodiment, the resilient wiper element 1462 is retained on one end at a point on the circumference of the elongate outer sheath 1402. In an embodiment, the resilient wiper element 1462 is coupled at the other end to a second axle. 1466 at a second pivot point. The resilient wiper element 1462 is retained at diametrically opposing points on the circumference of the outer sheath 1402. In embodiments, the first axle 1464 is arranged to be a driving axle, for actuation of the resilient wiper element 1462 from a first position to a second position. The second axle 1466 is arranged to be a passive axle. In embodiments, the first axle and the second axle are swivels and are rotatable about axes parallel to the length of the outer sheath 1402. It is noted that the resilient wiper element 1462 is arranged for motion only in the plane parallel to the external distal face of the endoscope 1400, which can also be considered normal to the longitudinal central axis of the endoscope 1400.
In a first position, the resilient wiper element 1462 is displaced to the circumference of the outer sheath 1402. In an embodiment, the outer sheath 1402 includes an upraised groove for receiving and retaining the resilient wiper element 1462. In an embodiment, in the first position, the resilient wiper element 1362 is at rest and in an unmodified condition. The resilient wiper element 1462 is arranged to elastically return the resilient element on a modification of its condition or shape.
In an embodiment, the first axle 1464 is coupled to the outer sheath 1402 and is driven by an actuation system to rotate from one side to the other.
Spoolable wiper 1560 includes a wiper element 1562 coupled at one end to a first spool port 1564 provided at a first point of the circumference of the outer sheath 1502, and coupled at another end to a second spool port 1566 provided at a second point of the circumference of the outer sheath 1502. In embodiments, the first spool port 1564 is coupled on a shuttle 1568 arranged to displace about the circumference of the outer sheath. In embodiments, the spoolable wiper 1560 is configured to be received in a spooling channel 1570 provided in between the outer sheath 1502 and the scope 1504. An actuation system for spooling and retaining excess provision of the wiper element can be provided at the proximal end of the endoscope to facilitate operation of the spoolable wiper 1560.
According to various embodiments, the second spool port 1566 is fixed in relation to its second point on the circumference of the outer sheath 1502. In embodiments, the first spool port 1564 is arranged to receive the spoolable wiper element 1562 and is coupled to a consolidation module of the actuation system in the proximal end, the consolidation module is arranged to draw in the spoolable wiper element 1562 and maintain a tension and drawing in any slack of the spoolable wiper element 1562. In embodiments, the second spool port 1566 is arranged to receive the wiper element 1562 and is coupled to a spool module of the actuation system in the proximal end, the spool model arranged to feed spoolable wiper element 1562 towards the distal end to provide new portion of spoolable wiper element upon request or design. In other embodiments, the first spool port 1564 feeds the wiper element, and the second spool port 1566 draws in the wiper element.
In embodiments, the shuttle 1568 is mechanically actuated and is arranged to circumferentially rotate the shuttle 1568 about the scope 1504. In embodiments, the shuttle 1568 is arranged to actuate towards one side of the endoscope 1500, as defined a line from the fixed spool port 1566 down to a diametrically opposing point of the outer sheath 1502 separating the endoscope into two sides. A first position of the spoolable wiper is provided when the shuttle 1568 is actuated to a left side limit. In embodiments, the shuttle 1568 is an elongate guide, and the spool port 1564 is provided in the middle of the elongate guide. A left arm of the elongate guide limits rotation of the shuttle 1568 when the left arm abuts the fixed spool port 1566, which can be referred to as a left side limit. Correspondingly, a right arm of the elongate guide limits rotation of the shuttle 1568 when the right arm abuts the fixed spool port 1566, which can be referred to as a right side limit.
In embodiments, the shuttle 1568 is actuated to circumferentially rotate the shuttle and the first spool port 1564 from a first position corresponding to a left side limit to a second position corresponding to a right side limit.
In spooling, a consolidation module in the actuation system is controlled to drawn in a certain amount of the spoolable wiper element 1562, and for which the spooling module correspondingly allows for the amount to be drawn out from a spool. In such a way, the wiper element 1562 is exchanged, which provides for a continuous provision of clean wiper elements. In embodiments, the actuation system is configured to exchange a used portion for a new portion of wiper element after every sweep or transition from one point of the shuttle to the other.
Spoolable wiper 1660 includes a wiper element 1662 coupled to a spooling actuation system provided at a proximal end of the endoscope 1600. In embodiments, the wiper element 1662 is a broad strip and is arranged to clean an optical aperture or optical lens 1606 of the scope 1604. The strip needs to be flexible yet strong enough to withstand the frictional forces during spooling. In embodiments, the broad strip could include a woven material such as cotton gauze, and/or be reinforced on the top surface with tape. The tape reinforcement allows for fluid absorption while strengthening the strip against tearing during spooling. In embodiments, the broad strip can include holes or apertures to allow for unimpeded observation with the scope while the broad strip is continually spooled over the optical aperture 1606. In various embodiments, the wiper element 1662 is a clear flexible material for protecting the optical aperture of the scope. Such an arrangement can be considered a spoolable shield feature. When the material over the optical aperture is fouled, an adjacent clean section of strip is advanced across the lens, and the fouled section is withdrawn into the outer sheath.
The spooling actuation system allows for the wiper element 1662 to be spooled such that the wiper element 1662 is refreshed for effective cleaning. The spooling actuation system draws in the wiper element 1662 on one end and correspondingly releases the wiper element on the other end, through a spooling channel 1670 provided in between the outer sheath 1602 and the scope 1604.
Running a broad strip of material along and across the circular surface of a cylinder (such as a laparoscope) usually results in the highest tension forces being generated in the middle of the strip. This would mean that the sides of the optical lens 1606 are less effectively cleaned. In embodiments, this effect is mitigated with a highly absorbent cleaning material such as cotton or paper. In embodiments, a domed lens 1672 is provided over the optical aperture 1606 to mitigate such effect. Advantageously, the domed lens 1672 is arranged such that the dome lens does not affect observation with the scope 1604. Further, the dome lens is arranged over the scope 1604 at the distal end of the endoscope 1600 and allows for a smooth transition for the spoolable wiper element 1662 in and out of the spooling channel 1670, which evens tension on the wiper element 1662.
In embodiments, the wiper element 1662 includes a plurality of holes 1674, which allows for the wiper element to sit low on the domed surface 1672. Upon spooling, the force required for the wiper element 1662 to overcome in motion due to the dome sitting in the hole 1674 provides for greater tension at the sides of the holes during spooling, and may create a more even tension distribution and cleaning efficacy. In embodiments, a dome height of about 3 mm is provided for a 10 mm scope. Such an arrangement allows for smooth spooling, due to a more gradual curvature of the strip as compared with the abrupt 90 degree angles without the dome, and a good cleaning coverage of the sides of the lens.
According to various embodiments, the spoolable wiper 1760 includes a pair of arms 1764, the arms 1764 being relatively extendable and retractable with respect to the outer sheath 1702. The arms 1764 arranged to be contained within the outer sheath 1702 of the endoscope. The arms 1764 are arranged to receive and retain a spoolable and elongated wiper element 1762 which is coupled at both ends to a spooling actuation system provided at a proximal end of the endoscope 1700. In embodiments, the wiper element 1762 is a broad strip that entirely covers an optical aperture 1706 of the scope 1704 when overlaid on the aperture 1706. According to various embodiments, the wiper element 1762 is configured to spool or advance such that a clean portion of the wiper element 1762 is provided to replace a fouled portion.
According to various embodiments, a distal portion of the outer sheath 1702 is arranged to be retractable. In a first rest position, the outer sheath 1702 is unretracted and houses the various features and functions of the endoscope 1700 within the outer sheath. In a second retracted position, the outer sheath 1702 is retracted and exposes the arms 1764, supporting a portion of the spoolable wiper element 1762 and the distal end of the scope 1704. In embodiments, in the retracted position, the arms 1764 are arranged to flare open and flatten out. In such a case, the wiper element 1762 is also allowed to rest on and contact the external surface of the optical aperture 1706.
In embodiments, the spooling actuation system is configured to carry out a spooling action of the wiper element 1762 when the outer sheath 1702 is in the retracted position, and the wiper element 1762 is resting on the external surface of the optical aperture 1706. Spooling while the wiper element 1762 is in contact with the optical aperture allows an efficient cleaning of the optical aperture 1706. In various embodiments, the wiper element 1762 is a broad strip. In embodiments, the wiper element 1762 is a tape with intermittent clear portions and cleaning portions.
According to various embodiments, the set of guides 1820 provide an intermediate structure which changes the points and angle of inflection of the wiper element 1862 in transiting to and from a spooling channel 1870 perpendicularly onto the external face of the optical aperture 1806. In embodiments, the wiper element 1862 is an elongate rectangular broad strip, which has a breadth sufficiently large to overlay the surface area of the optical aperture 1806, to provide cleaning of the entire optical aperture surface. However, with such a breadth, the sides of the wiper element 1862 may not be able to clean effectively as the main inflection point can be identified towards the center of the strip. Advantageously, providing such a set of guides 1820 allows the provision of greater tension on both sides of the scope 1804, such that there is provided effective cleaning of the optical aperture.
In an embodiment, the actuation system includes a motor at a proximal end of the elongate shaft body.
In an embodiment, the motor drives a rotating shaft coupled to the circumference of the aperture cover.
In an embodiment, the rotating shaft is provided between the elongate shaft body and the optical scope.
In an embodiment, the aperture cover is coupled to the elongate shaft body through a plurality of bearings.
In an embodiment, the actuation system is a fluid flow actuation system.
In an embodiment, the actuation system includes any one of a pressurized gas delivery system and a suction system. In an embodiment, the actuation system can include a pressurized gas delivery system. In an embodiment, the actuation system can include a suction system.
In an embodiment, the actuation system includes a pressurized gas delivery system or a suction system.
In an embodiment, the aperture cover is circumferentially coupled to a turbine ring including a plurality of blades.
In an embodiment, an inner surface of the elongate shaft body includes a plurality of fluid guides for directing fluid onto the turbine ring blades.
In an embodiment, the aperture cover is coated with any one of a hydrophobic coating or an oleophobic coating. In an embodiment, the aperture cover is coated with a hydrophobic coating. In an embodiment, the aperture cover is coated with an oleophobic coating.
In an embodiment, the endoscope further includes any one of a helical gear or a worm gear for angulated operation of the aperture cover. In an embodiment, the endoscope further includes a helical gear. In an embodiment, the endoscope further includes a worm gear.
In an embodiment, the aperture cover is configured to operate at a rotation speed which exceeds the flicker fusion threshold.
In an embodiment, the rotation speed is selected from a range of between 500 rpm to 10,000 rpm.
In an embodiment, the endoscope further includes a secondary cleaning module coupled to the distal end of the elongate shaft body, for cooperation with the aperture cover for improving visualization.
In an embodiment, the secondary cleaning module is a fluid flow actuator arranged to provide a fluid flow over an external surface of the aperture cover.
In an embodiment, the fluid flow actuator is coupled to a fluid port on a distal tip on the elongate shaft body.
In an embodiment, the fluid port is coupled to a fluid channel provided in the elongate shaft body.
In an embodiment, the fluid port is directed to displace debris from in front of the external surface of the aperture cover with a fluid flow.
In an embodiment, the endoscope further includes a safety mechanism to indicate a safety distance from the fluid port.
In an embodiment, the safety mechanism is any one of a protruding rod or a protruding hood. In an embodiment, the safety mechanism is a protruding rod. In an embodiment, the safety mechanism is a protruding hood.
In an embodiment, the safety mechanism is a proximity sensor.
In an embodiment, the proximity sensor is arranged to provide a feedback indication to a user.
In an embodiment, the secondary cleaning module is a fluid flow circulator arranged to provide a fluid flow circulation over an external surface of the aperture cover.
In an embodiment, the fluid flow circulator includes a gas inlet port and a gas outlet port provided at the proximal end of the elongate shaft body.
In an embodiment, the gas inlet port is coupled to a gas inlet channel, and the gas outlet port is coupled to a gas outlet channel, the gas inlet channel and the gas outlet channel directed to open at the distal end of the elongate shaft body.
In an embodiment, the secondary cleaning module is a wiper arranged to be in contact with an external surface of the aperture cover for improving visualization.
In an embodiment, the wiper is an elongate band coupled on a first end to the elongate shaft body and coupled on a second end to the elongate shaft body and diametrically opposite to the first end.
In an embodiment, the wiper is coupled to a retractable shaft actuated at the proximal end of the elongate shaft body.
In an embodiment, the coupling to the retractable shaft is hinged to elevate the wiper when the retractable shaft is actuated in a first direction and to deploy wiper on the surface of the aperture cover when the retractable shaft is actuated in the opposite direction.
In an embodiment, the wiper is arranged to rotate about the aperture cover.
In an embodiment, the retractable shaft is arranged to rotate about a rotating shaft coupled to the aperture cover.
In an embodiment, the wiper is further hinged to a rotating cylinder for rotating the wiper about the aperture cover.
In an embodiment, the wiper is coupled to a pivoting element provided at a point on the circumference of the elongate shaft body and actuated to rotate the wiper in a sweeping motion across the aperture cover.
In an embodiment, the endoscope further includes a second wiper coupled to a second pivoting element provided at a diametrically opposing point on the circumference of the elongate shaft body as the first pivoting element.
In an embodiment, the second wiper is arranged to rotate in a sweeping motion across the aperture cover in succession to the sweeping motion rotation of the first wiper.
In an embodiment, the second wiper is arranged to rotate in a sweeping motion across the aperture cover in a direction opposing the sweeping motion rotation of the first wiper and in succession to the sweeping motion rotation of the first wiper.
In an embodiment, the wiper is a flexible elongate band coupled at a first end to the elongate shaft body and coupled at a second end to a carrier, the carrier received in a guide track on the circumference of the elongate shaft body.
In an embodiment, the carrier is arranged to traverse from a first position on the guide track where the wiper is deployed across the aperture cover to a second position on the guide track where the wiper is displaced to the circumference of the aperture cover.
In an embodiment, at the first position on the guide track, the carrier is diametrically opposed to the coupling of the first end of the flexible elongate band to the elongate shaft body.
In an embodiment, the flexible elongate band is a resilient band.
In an embodiment, the coupling of the first end of the flexible elongate band to the elongate shaft body is a retractable coupling for maintaining a tension on the flexible elongate band.
In an embodiment, the wiper is a flexible elongate band coupled at a first end and a second end on the elongate shaft body at diametrically opposing points.
In an embodiment, each of the first end and the second end of the flexible elongate band is coupled to an axle, each axle rotatable about an axis parallel to the length of the elongate shaft body.
In an embodiment, the flexible elongate band is arranged for motion only in a plane parallel to the external surface of the aperture cover.
In an embodiment, the axle coupled to the first end of the flexible elongate band is driven to rotate such that the flexible elongate band is actuated from side to side of the elongate shaft bisected by the diametrically opposing coupling points.
In an embodiment, the flexible elongate band is a resilient band.
In an embodiment, the elongate shaft body further includes a drainage channel to allow removal of debris accumulated by the wiper.
In an embodiment, the endoscope further includes a spooling actuation system coupled to the wiper.
In an embodiment, the wiper is elongated and is actuable with the spooling actuation system such that a clean portion of the wiper can replace a soiled portion for cleaning the aperture cover.
In an embodiment, the wiper is coupled at a first point on the circumference of the elongate shaft body and coupled at a second point to a shuttle, the shuttle arranged to traverse about the circumference of the elongate shaft body.
In an embodiment, the endoscope further includes a retention module for receiving a portion of the wiper, the retention module for causing the wiper to contact the external surface of the aperture cover.
In an embodiment, the wiper is any one of a floss, a thread, or a bundle of threads. In an embodiment, the wiper is a floss. In an embodiment, the wiper is a thread. In an embodiment, the wiper is a bundle of threads.
In an embodiment, the wiper is a strip and includes a plurality of regularly spaced holes in the strip.
In an embodiment, the strip is reinforced with a layer of tape on a side of the strip which faces away from the aperture cover.
In an embodiment, an optical lens is provided for mounting over the optical aperture.
In an embodiment, the optical lens is a dome-shaped lens.
In an embodiment, optical lens is the aperture cover.
In an embodiment, the endoscope further includes a pair of arms arranged to retain the wiper over the pair of arms.
In an embodiment, the pair of arms is provided on opposing sides of the optical scope, the pair of arms arranged to be retained within the elongate shaft body.
In an embodiment, the elongate shaft body is arranged to be retractable proximally.
In an embodiment, the pair of arms is arranged to flare open and lower the wiper onto the aperture cover for cleaning.
In an embodiment, the elongate shaft body further includes a set of guides on an inner surface of the elongate shaft body.
In an embodiment, the set of guides is provided by assembling a guide supplement onto the inner surface of the elongate shaft body.
In an embodiment, the set of guides provide an additional point of inflection of the wiper in transiting the wiper from a spooling channel parallel to the elongate shaft body to being contact with the aperture cover.
In an embodiment, the wiper is a clear flexible material for protecting the optical aperture, and is spooled to replace a soiled portion.
The above apparatus, method and/or system as described and illustrated in the corresponding figures, is not intended to limit an or any apparatus, method or system as according to an embodiment, and the scope of the present disclosure. The description further includes, either explicitly or implicitly, various features and advantages of the method or system according to the present disclosure, which can be encompassed within an apparatus, method or system according to the disclosure.
While embodiments of the disclosure have been particularly shown and described with reference to specific embodiments, it should be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the disclosure as defined by the appended claims. The scope of the disclosure is thus indicated by the appended claims and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced.
Number | Date | Country | Kind |
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201209102-1 | Dec 2012 | SG | national |
Filing Document | Filing Date | Country | Kind |
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PCT/SG2013/000528 | 12/11/2013 | WO | 00 |