1. Field of the Invention
The present invention relates to apparatus and methods for imaging body tissue during medical procedures. More particularly, the present invention relates to apparatus and methods that provide endoscopic viewing of the female genital tract during gynecological procedures.
2. Background of the Invention
A number of gynecological procedures require visual inspection of the genital tract of a female patient, which is often performed with the use of an endoscope, or hysteroscope. Conventional endoscopes are often constructed from a rigid body and oftentimes those rigid bodies include fluid conduits.
For example, colposcopy is a diagnostic procedure, in which a lighted binocular microscope called a colposcope is utilized to examine an illuminated, magnified view of the vulva, vagina, and cervix. Most women undergo colposcopic examination to investigate abnormalities in their pap smears, or to assess diethylstilbestrol (DES) exposure in utero, HIV infection or immunosuppression. The enlarged view provided by a colposcope enables a clinician to visually distinguish normal from abnormal appearing tissue and take directed biopsies for pathological examination.
Colposcopy is performed with the patient in the dorsal lithotomy position, in which the patient lies with her legs in stirrups and her buttocks close to the lower edge of the examining table. A speculum is placed in the vagina after the vulva is examined for any suspicious lesions, and an acetic acid solution (e.g., Lugol's or Schiller's) is applied to the cervix to improve visualization and to help the clinician assess whether a change in color or in the vascular pattern of the patient are indicative of abnormalities. After a complete examination, the clinician determines the areas with the highest degree of visual abnormality and obtains biopsies from these areas using a long biopsy instrument.
Colposcopy is an expensive procedure that requires a dedicated instrument, the colposcope, and a specially trained clinician. While colposcopy is considered a preferred procedure for diagnosing cervical abnormalities, it also has some drawbacks. The cost of the colposcope and of the clinical training required to perform it limit application. Additionally, the colposcope is a bulky instrument, usable only in dedicated clinical settings, and provides no view of the uterus. Due to the nature of the colposcope, separate instruments must be employed for taking biopsies and, when required, for endocervical curettage (ECC).
The uterine cavity may be examined by hysteroscopy, which is a diagnostic procedure that enables a clinician to diagnose intrauterine pathology and which may provide a method for surgical intervention (operative hysteroscopy).
Hysteroscopy is performed with an endoscopic device, called a hysteroscope. Some hysteroscopes include a stiff shaft coupled to a handle, a vision member at the tip of the shaft connected to fiber optics and to a video system, and a channel for delivering a distention medium. Because the uterus is a potential cavity, it is first distended either with a fluid (saline, sorbitol, or a dextrane solution) or a gas (CO2), and the stiff shaft carrying the vision member is introduced in the uterus through the cervical canal.
Different types of hysteroscopes may be used for different gynecological interventions. While the hysteroscope is typically a viewing device only, an operative hysteroscope includes a working channel that allows specialized instruments to enter the uterine cavity and perform surgery, and a resectoscope is a variation of the hysteroscope that contains an electric loop for resecting a submucous leiomyoma.
Hysteroscopy has been found useful to treat a variety of uterine conditions, such as polyps, leiomyomata, Asherman syndrome, gynecologic bleeding, and uterine malformations, but occasionally a uterine perforation occurs when the stiff shaft breaches the wall of the uterus leading to bleeding and to damage to other organs. Another drawback of known hysteroscopes is limited maneuverability, due to the rigidity of the shaft that makes it difficult to maneuver the instrument within the patient's genital system. Still other drawbacks relate to the use of fiber optics, which are manufactured from glass that breaks under bending stress, requiring frequent maintenance of the hysteroscope with consequent downtime and costs. Additionally, in known hysterocopes the camera, saline channel, and working channel all have distal openings at the distal tip of the shaft, causing an increase in the diameter of the tip and making the instrument more invasive to the patient. A corresponding decrease in channel diameters decreases the efficiency of the instrument and makes it more difficult to clean and sterilize.
Attempts have been made to remedy these drawbacks of conventional hysteroscopes. For example, U.S. Pat. No. 4,836,189 to Allred, III et al. describes a video hysteroscope having an elongated flexible insertion tube containing a video member at its distal end, as well as a channel for a surgical laser fiber and a saline channel that emits a continuous stream of saline solution. An articulation section joins the viewing head to a flexible tubular member.
U.S. Pat. No. 5,823,940 to Newman discloses a sheath that receives an endoscope. In that device, the endoscope includes a bundle of fiber optics that is slid into a lumen in the sheath. The sheath is flexible and includes additional fluid conduits. After a procedure is performed with the sheath, the endoscope is removed from the sheath, which is then discarded.
U.S. Publication No. 2005/0288551 to Callister et al. discloses an endoscopic assembly having a flexible hysteroscope and an outer sheath disposed about a length of the shaft of the hysteroscope. An inflatable balloon seals the assembly within a body lumen or cavity.
A drawback of these devices is that although some of them contain disposable components, the hysteroscope and an associated eyepiece still require cleaning and sterilization, contain fragile fiber optics, and have tips with sizes that make the instruments uncomfortable or even painful when traveling through the cervical canal and into the uterus, and correspondingly limit the diameters of the lumens in the instrument. Another drawback is that the light colors provided by some of these instruments are within a limited palette, while different types of anomalies are better viewable with different light combinations.
It would be therefore be desirable to provide improved apparatus and methods for inspecting body tissues that, in various embodiments, remedy some or all of the aforementioned drawbacks of previous optical devices.
In some embodiments, the present invention relates to an optical apparatus for examining a female genital tract. The device includes a housing including a shaft portion, and a handle portion extending from a proximal end of the shaft portion and defining a cavity that contains an output connector, a camera assembly coupled to a distal end of the shaft, the camera assembly comprising a camera, and a removable cartridge having a limited number of uses and is receivable within the cavity and including an input connector matable with the output connector, an image processing engine, a power source, a light source, and a heat-absorption device for absorbing heat generated by the light source, wherein the light source is configured to direct light toward the input connector and illuminate a field of view for the camera.
In some embodiments, the present invention relates to an optical apparatus. The apparatus includes a housing including a shaft portion, and a handle portion extending from a proximal end of the shaft portion and defining a cavity that contains an output connector; a camera assembly coupled to a distal end of the shaft, the camera assembly comprising a camera; and a removable cartridge having a limited number of uses and is receivable within the cavity. The cartridge includes an input connector matable with the output connector; an image processing engine; a power source; a light source; a heat-absorption device for absorbing heat generated by the light source; a heat-monitoring device for monitoring temperature of the heat-absorption device during operation of the removable cartridge. The light source is configured to direct light toward the input connector and illuminate a field of view for the camera.
In some embodiments, the present invention relates to a method for examining a bodily cavity using an optical apparatus described above. The method includes the steps of using the light source, examining the bodily cavity; using the heat absorption device, absorbing heat generated by the light source during examination of the bodily cavity; determining a temperature of the heat absorption device; comparing the determined temperature to a predetermined threshold temperature; and turning off the light source when the determined temperature exceeds the predetermined threshold temperature.
In some embodiments, the present invention relates to an optical apparatus. The apparatus includes a housing including a shaft portion, and a handle portion extending from a proximal end of the shaft portion and defining a cavity that contains an output connector; a distal tip portion configured to be pivotally coupled to a distal end of the shaft portion; a first camera assembly coupled to a distal tip of the shaft, the first camera assembly comprising a first camera and a first light source, wherein the first camera assembly is disposed at a distal end of the distal tip; a second camera assembly coupled to a distal tip of the shaft, the second camera assembly comprising a second camera and a second light source, wherein the second camera assembly is disposed in a sidewall of the distal tip. The first and second light source are configured to illuminate respective fields of view for the first and second camera.
In some embodiments, the present invention relates to a method for examining a bodily cavity using an optical apparatus described above. The method includes the steps of inserting the device into a bodily cavity; pivoting the distal tip away from the shaft portion; and, using at least one or both of the first and second light sources and at least one or both of first and second cameras, examining the bodily cavity.
In some embodiments, the present invention relates to a optical apparatus. The apparatus includes a housing including a shaft portion, and a handle portion extending from a proximal end of the shaft portion and defining a cavity that contains an output connector; a distal tip portion configured to be removably coupled to a distal end of the shaft portion; a camera assembly coupled to the distal tip of the shaft, the camera assembly comprising a camera and a light source, wherein the camera assembly is disposed at a distal end of the distal tip; wherein the light source is configured to illuminate a field of view for the camera.
In some embodiments, the present invention relates to a method for examining a bodily cavity using an optical apparatus described above. The method includes the steps of: inserting the device into a bodily cavity; extending the distal tip away from the shaft portion; and, using the light source and the camera, examining the bodily cavity.
The foregoing summary is only illustrative of the inventions disclosed herein. Further features of the invention, its nature and various advantages will be more apparent from the accompanying drawings and the following detailed description of the preferred embodiments.
a-b illustrate an exploded view of the apparatus shown in
a-b illustrate exploded views of an exemplary cartridge disposed in the apparatus shown in
a is an exploded view of the exemplary bulkhead of the cartridge shown in
b is an exploded view of an exemplary lid for the cartridge shown in
a-b illustrate an alternative embodiment of a light source using an integrating sphere disposed within the cartridge shown in
a-d illustrate an exemplary tip of the apparatus shown in
a-d illustrate another exemplary tip of the apparatus shown in
The present invention relates to apparatus and methods for imaging body tissue during medical procedures. In particular, the present invention relates to apparatus and methods that provide endoscopic viewing of the female genital tract during gynecological procedures.
Referring back to
The tip control knob 114 is configured to control opening and closing the tip 106. The tip control knob 114 can be configured to include a pull wire (not shown in
Referring to
a-b illustrate an exploded view of the apparatus 100 shown in
Referring to
Referring back to
a-b illustrate exemplary exploded views of the cartridge 210, according to some embodiments of the present invention. The cartridge 210 includes a housing 315 that can include two connectable portions 315a and 315b. The two portions 315a and 315b can be secured together using connectors 345 and 347, which can be bolts, screws, or any other coupling means. The housing 315 is configured to enclose a printed circuit board 321 that includes connectors for connecting to the bulkhead 240 (shown in
The cartridge 210 can include a power source for providing power to the PCB 321 and the LED engine 319. The power source can be disposed on the PCB 321 or can be separately coupled to the PCB 321. The power source can be rechargeable. In some embodiments, a use counter can be included with the power source that determines the number of times, the power source has been used and/or recharged. Upon reaching a predetermined number of uses and/or recharges, the counter can generate a signal that indicates that no further uses and/or recharges are available and that the power source needs to be replaced with a new power source.
In some embodiments, the cartridge 210 can be recharged using a charger device. An operation of the charger device is discussed below with regard to
a. A power light that indicates that the power to the charger is connected;
b. A battery charge status light that has two states:
c. An error indicator light having two states:
In some embodiments, the charger can detect the presence of the cartridge 210 and automatically start the charging cycle. The charger can charge the Lithium Ion/Polymer battery in the cartridge 210 or any other battery based on design/requirements for the battery by the user, manufacturer, or any other party. Further, the charger can monitor current and voltage during charging procedure. Additionally, the charger can include an automatic shutoff feature so as to not overcharge the battery. As stated above, the charger can include a user counter to determine the number of times that the batter has been charged. Charger can be configured to adjust (either increment or decrement; for illustrative purposes of the following description, such adjustment will be referred to in terms of incrementing the charger counter) the “charge count” stored in the memory (e.g., EEPROM—a non-volatile) in the cartridge 210. In some embodiments, the memory can be read/written over the serial interface that goes to the camera and as such is accessible via the electrical connector on the cartridge 210. In some embodiments, every time the cartridge is inserted into the charger the “charge count” will be incremented. When the value of “charge count” approaches the number of charge cycles specified, for example, by the battery manufacturer the battery will no longer be charged and the “ERROR” light will indicate a solid red state discussed above.
In some embodiments, the charger can check whether the switch 323 on the cartridge 210 is in the ON position. This can serve as a preventative measure so that the cartridge 210 does not discharge power during its charging cycle. Such procedure can be performed by measuring the voltage on the “Camera Power” pin of the cartridge connector or, alternatively, effectuating a serial interface transaction by simulating an event on the Detector Switch input of the cartridge. Such procedure can be performed using an exemplary diagnostic system 800 illustrated in
In some embodiments, the cartridge can include a photodetector to determine LED engine malfunction. For that purpose, an auxiliary light source can be added in the cartridge for the purposes of measuring light output of the LED engine. Additionally, various testing and calibration circuitry can be added to test and calibrate devices coupled to the apparatus 100.
The system 800 includes an optical light filter 802, a photodetector 804, a microcontroller 806, a DigiPot device 808, a connector 810 to the cartridge 210, and a battery charger circuit 812. The optical light filter 802 is a filter that reduces the amount of transmitted light by a predetermined amount. In the embodiments using a very bright auxiliary LED, use of the optical light filter 802 prevents saturation of the photodetector 804 even if it is not within specification. The filter 802 can be configured to optically reduce the amount of light generated by the LED by a factor of 2, 4 or more times. The photodetector 804 is an electronic component capable of measuring the amount of incident light. The cartridge connector 806 is a connector that the cartridge 210 is configured to plug into. The battery charger circuit 812 is configured to charge cartridge power source (e.g., a lithium polymer battery). This circuit can be configured to include an enable signal that comes from the microcontroller 806 and send a charge status signal to the microcontroller 806. The DigiPOT device 808 is an electronically controlled resistance that allows simulation of a thermostat in a catheter that can be inserted through port 118 of the apparatus 100 (not shown in
In some embodiments, the above tests can be emulated by performing substitute actions for the actions typically performed by the user during operation of the apparatus 100 and any devices coupled to it. For example, pressing the actuation button 116 can be emulated by setting the corresponding signal high or low as required via software in the microcontroller 806. When the user opens the knob 114, the user closes the contact on a detector switch in the handle 102 of the apparatus 100. This sets a certain signal line to the microcontroller 806 in the cartridge 210 high. The same effect can be achieved by setting that signal line high in the charger's microcontroller which is connected to the signal line in the cartridge which would be set high in normal operation.
In some embodiments, the apparatus 100 can be used with a NovoSeal device, manufactured by Novomedics, LLC, Dickinson, Tex., where the NovoSeal device includes a catheter that can be inserted through the portal 118 on the apparatus 100. The catheter in the NovoSeal device can include a thermostat that measures temperature and generate a signal indicative of the measured temperature by adjusting its resistance to current flow. The same effect can be achieved by using the DigiPOT device 808, which is an electronically controllable resistance. The NovoSeal device includes a control circuit that can turn ON or OFF the heater disposed in the NovoSeal catheter. The control circuit does so by opening or closing a relay in the cartridge 210 that passes the current to the heater element in the catheter. Same effect can be achieved by determining whether or not the relay is open or closed by trying to signal through it and determining whether received sequence of signals matches the transmitted sequence of signals, which indicates that the relay is closed. If the sequences do not match, the relay is open.
For inter-integrated circuit (“12C”) serial bus commands, the charger base's microcontroller can be made into a slave when the cartridge microcontroller's signals to the image sensor are being tested. The base's microcontroller serves as a master when contents of the EEPROM memory device in the cartridge are read/written. As can be understood by one skilled in the art, the present invention's apparatus 100 can be used with the NovoSeal device or any other device that can be used during examination, visualization, sterilization, tissue-scarring, or any other procedure performed on the female genital tract. As such, the above reference to NovoSeal device is provided here for descriptive, exemplary, and non-limiting purposes only.
a-b illustrate an alternative embodiment of a light source 1200 using an integrating sphere disposed within a cartridge, according to some embodiments of the present invention. The light source is disposed within a cartridge 1202 and includes an integrating sphere 1204 that is suspended on a spring 1210, coupled to the cartridge 1202 via a pin 1212, and rails 1214 and 1216, where the rails 1214 and 1216 are coupled to the cartridge 1202 as well. The cartridge 1202 is similar to the cartridge 210 discussed above. The spring 1210 allows the sphere to move back and forth on the rails 1214 and 1216 as desired. In some embodiments, such movement allows the sphere to maintain a specific distance from the fiber 1246 into which the sphere 1204 is configured to shine the light it generates. In some embodiments, the sphere 1204 can consist of a hollow interior coated with a reflective material (e.g., a plurality of mirrors) and composed of two halves 1247a and 1247b configured to be coupled together to form a uniform sphere 1204, as shown in
In some embodiments, the sphere 1204 can be configured to be inserted sideways into the cartridge 1202. This allows the sphere 1204 to slide back and forth inside the cartridge on the rails 1214 and 1216.
The fiber 1246 can be configured to include a cone shaped adaptor 1242 at its one end disposed near the light source that can be configured to be inserted into the opening 1218. The opening 1218 can include a rubber gasket to accommodate placement and proper securing of the cone-shaped adaptor 1242 to the opening 1218.
Some advantages of the apparatus 100 include providing visualization and sterilization using any known means. The apparatus 100 can use any heating devices for scarring the tissue and/or can share some components with such devices, which can include electronics (e.g., one device can supply power to the other device and vice versa; power provided by the devices can be constant (such as X volts and Y amps); and power can be modulated using some control information; power can be generally defined as energy transfer from one device to the other for the purpose of operating the second device). Additionally, the apparatus 100 and the heating device can provide control information to each other (e.g., signals that indicate start or end of a specific procedure (such as sterilization, visualization, etc.); signals that direct the other device to perform some action (such as heating, etc.)). The apparatus 100 and the other device can also share some mechanical components. For example, one device can depend on the other device for delivery or mechanical support. This can be applicable in case where the sterilization device does not have a handle and shaft of its own, but is rather built into the distal end of the visualization device. In some embodiments, the visualization device can have a means that emerge from the tip for the sterilization part of the procedure, and after completion of the sterilization procedure, retract back into the distal end of the visualization device. Other shared components can include the handle, the shaft or other mechanical features. Additionally, the devices can include mechanical features specifically designed to hold the other device in a specific location and/or to manipulate it. In commercial setting, the devices can be supplied in a single or multiple packages.
As stated above, in some embodiments of the present invention an LED light source is disposed in the cartridge. Referring to
In some embodiments, during operation of the device, the heat absorption device can warm up less than 10 degrees C. over 45 minutes of usage. However, in some embodiments, the heat absorption device 1307 can warm up more than and in some instances overheat. These situations include adjustment of the light source 1305 to be brighter. Such cases could potentially lead to dangerous situations where the heat absorption device is surrounded by plastic or other heat susceptible material that could melt and potentially injure the user and/or patient and damage/destroy components of the examination device 1301.
In some embodiments, in order to limit the risk of injury and/or such damage(s), a heat monitoring device 1308 is provided within the cartridge 1302. In some embodiments, the device 1308 can be disposed outside the cartridge 1302 and monitor the temperature, TA, of the heat absorption device from the outside of cartridge. The device 1308 can also include an indicator that can be disposed on the housing of the examination device 1301. The device 1308 can be configured to warn the user that the temperature of the heat absorption device 1307 has reached a certain predetermined threshold temperature, TH. Additionally, an audio and/or audio-visual alert can be used to alert the user. In some embodiments, the device 1308 can include circuitry that is configured to detect temperature TA of the heat absorption device 1307 and using a microcontroller disposed within the circuitry of the device 1308 compare it to a preset threshold temperature TH. If TA is greater than TH, then the device 1308 can be configured to shut down the light source 1305 to prevent further overheating of the device 1307 and a potential damage to the device 1301 and/or injury to user/patient. In some embodiments, the heat monitoring device 1308 can include a switching device that can cut off power to the light source 1305 in the event overheating is detected. In some embodiments, the heat monitoring device 1308 can periodically monitor the temperature TA of the heat absorption device 1307. In some embodiments, the heat monitoring device 1308 can be configured to thermally shutdown in the cartridge 1302. If upon detection of the temperature TA and comparison of this temperature to the threshold temperature TH, TA is less than TH, the device 1301 can continue being used. In some embodiments, the heat monitoring device can be a thermistor or any other heat management device. The microcontroller can be configured to read the value of the thermistor and monitor the temperature of the heat absorption device 1305. The microcontroller can programmatically monitor the thermistor readout, and turn off the light source 1305 in the event the temperature exceeds a preset threshold level.
In step 1406, temperature TA of the heat absorption device 1307 is determined. The heat monitoring device 1308 compares TA to a preset threshold temperature TH. (Step 1408). If the TA is greater than TH, then the light source 1305 is shut down to prevent further generation of heat. (Step 1412). If not, then operation of the device is continued. (Step 1410).
As can be understood by one skilled in the art, the threshold temperature TH can be preset by the manufacturer or can be predetermined by the user according to various operating parameters, e.g., length of time during which the device will be used, power output of the light source, voltage level, operational power of other components, and/or physiological parameters of the patient being examined. As can be further understood by one skilled in the art, the light source can be any energy source.
a-d illustrate another exemplary configuration of a tip for the device 100, according to some embodiments of the present invention. Referring to
As shown in
In some embodiments, the device 100 can be configured to be used for examination of female genital tract. As such, while inserting the tip 1500, the wall of the cervical canal can be examined by the user while passing though it.
a-d illustrate another configuration of the tip 1600, according to some embodiments of the present invention. The tip 1600 can be configured to be similar to the tip 106 or the tip 1500 discussed above (i.e., it may have one camera disposed at its distal end or have more than one camera disposed at its distal end and one disposed in a sidewall of the tip). As shown in
Other exemplary configurations of the tip are disclosed in the co-owned, co-pending U.S. patent application Ser. No. 11/975,409 to Sanders et al., filed Oct. 19, 2007, and entitled “Optical Surgical Device and Methods of Use”, the disclosure of which is incorporated by reference in its entirety. In view of the different features of the embodiments of the apparatus disclosed herein, a person skilled in the art will readily appreciate that different embodiments of the method of use of the optical apparatus of the present invention are also possible, in accordance with the specific features of the optical device in the related embodiments. Such alternative embodiments of the method of use are all within the scope and spirit of the present invention.
In view of the different features of the embodiments of the apparatus disclosed herein, a person skilled in the art will readily appreciate that different embodiments of the method of use of the optical apparatus of the present invention are also possible, in accordance with the specific features of the optical device in the related embodiments. Such alternative embodiments of the method of use are all within the scope and spirit of the present invention.
Thus it is seen that apparatus for examining a body cavity and methods of use are provided. Although particular embodiments have been disclosed herein in detail, this has been done by way of example for purposes of illustration only, and is not intended to be limiting with respect to the scope of the appended claims, which follow. In particular, it is contemplated that various substitutions, alterations, and modifications may be made without departing from the spirit and scope of the invention as defined by the claims. Other aspects, advantages, and modifications are considered to be within the scope of the following claims. The claims presented are representative of the inventions disclosed herein. Other, unclaimed inventions are also contemplated. The applicant reserves the right to pursue such inventions in later claims.
The present application claims priority to U.S. Provisional Patent Application No. 61/132,735 to Sanders et al., filed Jun. 19, 2008, and entitled “Optical Surgical Device and Methods of Use”, U.S. Provisional Patent Application No. 61/137,350 to Sanders et al., filed Jul. 29, 2008, and entitled “Optical Surgical Device and Methods of Use”, and to U.S. Provisional Patent Application No. 61/207,696 to Sanders et al., filed Feb. 12, 2009, and entitled “Optical Surgical Device and Methods of Use”. The present application is also a continuation-in-part application of U.S. patent application Ser. No. 11/975,409 to Sanders et al., filed Oct. 19, 2007, and entitled “Optical Surgical Device and Methods of Use”, which claims priority to U.S. Provisional Patent Application Nos. 60/853,161, filed Oct. 20, 2006, 60/878,892, filed Jan. 4, 2007, 60/903,583, filed Feb. 26, 2007, 60/921,925, filed Apr. 4, 2007, 60/925,486, filed Apr. 20, 2007, and 60/933,233, filed Jun. 4, 2007. The present application incorporates the disclosures of all of the above application by reference herein in their entireties.
Number | Date | Country | |
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61132735 | Jun 2008 | US | |
61137350 | Jul 2008 | US | |
61207696 | Feb 2009 | US | |
60853161 | Oct 2006 | US | |
60878892 | Jan 2007 | US | |
60903583 | Feb 2007 | US | |
60921925 | Apr 2007 | US | |
60925486 | Apr 2007 | US | |
60933233 | Jun 2007 | US |
Number | Date | Country | |
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Parent | 11975409 | Oct 2007 | US |
Child | 12456666 | US |