Patent Application
20140160261
The present disclosure relates generally to a system including a visualization instrument comprising a camera to view an internal space and, more particularly, to a visualization instrument comprising a camera to examine the interior of a patient.
Visualization instruments include endoscopes, laryngoscopes, borescopes and other medical instruments designed to look inside the body of a patient. Medical visualization instruments are used in a multitude of medical procedures including laryngoscopy, rhinoscopy, bronchoscopy, cystoscopy, hysteroscopy, laparoscopy, arthroscopy, etc. Visualization instruments are also used in non-medical applications such as to investigate the internal structures of machines, buildings, and explosive devices. Laryngoscopes are used to obtain views of the vocal folds and the glottis to perform noninvasive tracheal intubations. A conventional rigid laryngoscope consists of a handle with a light source and a blade. Direct laryngoscopy is usually carried out with the patient lying on his or her back. The laryngoscope is inserted into the mouth, typically on the right side, and pushed towards the left side to move the tongue out of the line of sight and to create a pathway for insertion of an endotracheal tube. The blade may be lifted with an upward and forward motion to move the epiglottis and make a view of the glottis possible. Once the laryngoscope is in place, the endotracheal tube may be inserted into the pathway. The blade may be provided with guide surfaces to guide the insertion of the endotracheal tube. Laryngoscopes may be outfitted with illumination devices and optical devices to provide views of the vocal cords externally of the patient's body. Optical devices include lenses, mirrors, prisms and fiberoptic fibers, all adapted to transfer an optical image. Imaging devices may also be provided to capture the optical images and display the optical images in high definition display monitors. Stylets and other visualization instruments have also been developed.
Traditional visualization instruments have limitations such as, for example, fogging, insufficient lighting to produce a good optical image, inability to project images remotely, additional procedural steps to insert the endotracheal tube, and cost, to name a few.
A visualization instrument and a method of using the visualization instrument are disclosed herein. In an exemplary embodiment, the visualization instrument is a video laryngoscope. In another exemplary embodiment, the visualization instrument is configured for non-medical uses. In a further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; and a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images.
In a further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; and a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images, wherein the wireless arrangement comprises a wireless transmitter and a wireless receiver coupled, respectively, to the camera assembly and the display portion, the wireless transmitter transmitting digital images from the camera assembly to the wireless receiver.
In a yet further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; and a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images, wherein the wireless arrangement comprises an inductive coupling having a primary portion coupled to the display portion and a secondary portion coupled to the camera assembly.
In a still further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; and a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images, wherein the wireless arrangement comprises a wireless transmitter and a wireless receiver coupled, respectively, to the camera assembly and the display portion, the wireless transmitter transmitting digital images from the camera assembly to the wireless receiver, and further comprising an inductive coupling having a primary portion coupled to the display portion and a secondary portion coupled to the camera assembly, wherein the primary portion inductively transmits energy to the secondary portion to power the camera assembly.
In another exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images; and wires having first ends spaced apart from second ends, the first ends coupled to the display portion, wherein the wireless arrangement is formed by an inductive coupling having a primary portion and a secondary portion, the primary portion coupled to the second ends of the wires and the secondary portion coupled to the camera assembly.
In a further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; and a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images; the camera assembly further comprising a lens, a light guide, and a light source, the light source generating a light, the camera positioned between the light source and the lens, and the light guide guiding the light to a space distal of the lens.
In a still further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images; and an orientation device for configuring the orientation of the visualization instrument.
In a yet further exemplary embodiment, the visualization instrument comprises a display portion including a housing and a display device affixed to the housing; a limited use blade having a proximal end and a distal end, the proximal end forming a handle with a cavity therein configured to removably receive the housing; a camera assembly supported by the distal end of the blade and providing digital images to the display portion; a wireless arrangement between the display portion and the camera assembly for transferring at least one of power and digital images; and at least one of a temperature sensor and a humidity sensor.
The features of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings.
Corresponding reference characters indicate corresponding parts throughout the several views. Although the drawings represent embodiments of the present invention, the drawings are not necessarily to scale and certain features may be exaggerated to better illustrate and explain the embodiments. The exemplifications set out herein illustrate embodiments of the invention in several forms and such exemplification is not to be construed as limiting the scope of the invention in any manner.
The embodiments of the disclosure discussed below are not intended to be exhaustive or limit the invention to the precise forms disclosed in the following detailed description. Rather, the embodiments are chosen and described so that others skilled in the art may utilize their teachings.
A visualization instrument and a method of using the visualization instrument are disclosed herein. The visualization instrument is insertable into a space to capture images representing internal views of the space. Additional features of the visualization instrument are disclosed in U.S. patent application Ser. No. 12/874,035, entitled VISUALIZATION INSTRUMENT filed on Sep. 1, 2010, which is expressly incorporated by reference herein in its entirety. Advantageously, embodiments of components of visualization instruments according with the disclosure are configured to be produced at low cost.
While the embodiments of the disclosure are applicable in medical and non-medical applications, exemplary features of visualization instruments will be described below with reference to medical instruments such as laryngoscopes and stylets although the invention is not limited to medical applications and instruments. In some embodiments, visualization instruments include a display device. In other embodiments, the visualization instruments are not attached to a display device and, instead, are adapted to transmit images to another device.
In one exemplary embodiment, a visualization instrument is an intubation device comprising a blade. The blade has a passageway or guide pathway configured to guide insertion of an elongate tubular component. Exemplary elongate tubular components include an airway device, an endotracheal tube and the like. A camera in a camera assembly captures images of the patient being intubated, which are shown with a display device. A distal end of the tubular component may also be visible in the images as the tubular component slides through the guide pathway towards the vocal cords. Exemplary embodiments of blades and intubation devices are disclosed further below which facilitate reusability of portions of the intubation device to reduce intubation costs. In some embodiments, the laryngoscope blade is configured to be discarded after a single use. In other embodiments, the laryngoscope blade is configured to be discarded after a limited number of uses. Features to control limited uses are further described in U.S. patent application Ser. No. 12/874,035, entitled VISUALIZATION INSTRUMENT.
In some exemplary embodiments, a plurality of wires establish a data pathway, a power pathway, or both data and power pathways between the camera and the video device through the blade. The plurality of wires may be referred to as a wire bundle. In one variation, the wire bundle comprises a wire assembly or conductor assembly. The wire bundle is removed from the blade and reused while the blade is discarded. In one example, the wire bundle is removably attached to the display portion. The display portion is reusable while the wire bundle is capable of a limited number of uses.
In one exemplary embodiment, the wire bundle is inductively coupled to the display portion, which is reusable. The wire bundle is attached to the camera assembly and insertable through a blade opening such that the inductive coupling end passes through a blade cavity until it comes near an inductive coupling end of the display portion, thus enabling power to be transferred inductively therefrom. After use, the wire bundle and camera assembly are removed and the blade is discarded.
In another exemplary embodiment, the wire bundle is inductively coupled to the camera assembly and permanently attached to the display portion. The wire bundle is inserted through the blade cavity as the blade is assembled with the display portion, thus making a primary inductive coupling portion attached to the wire bundle available at the distal end of the blade. A secondary inductive coupling portion is attached to the camera assembly. The camera assembly is then coupled to the blade and an electronic pathway is established through the inductive coupling. In one variation, the data pathway is wireless. In another variation, the camera assembly is mechanically and removably attached to the wire bundle.
Referring to
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An exemplary embodiment of a blade 90 without posterior and lateral guide walls is illustrated in
In a further exemplary embodiment, the blade is assembled without glue. In one example, the blade comprises two portions which are ultrasonically bonded. In another example, the two portions are mechanically fastened. Additional features are provided to enable soaking of the blade. In one example of the present embodiment, a molded cover is provided which is attached to the blade to seal the electrical contacts. In another example of the present embodiment, a disposable plastic sheath is provided which covers the blade during use. In a further example of the present embodiment, the blade comprises a stylet and the sheath covers the stylet. In a yet further example of the present embodiment, the optical components of the imaging assembly are potted in the blade.
In another variation of the present embodiment, the camera barrel and the camera holder are formed by single-mold inserts which cause the distal lens and second lens to self-align relative to the optical axis of the camera assembly which simplifies the assembly process and reduces cost by eliminating the need for focusing features. In yet another variation thereof, the camera assembly comprises a distal lens having a negative meniscus, and a doublet comprised of biconvex and negative meniscus elements. The distal and doublet lenses have aspheric surfaces which, combined with the meniscus and biconvex elements, achieve nearly diffraction limited performance.
A commercially available camera, such as a camera used in cellular phones and personal digital assistants (PDAs), comprises an image sensor and electronic components configured to convert pixel data captured by the image sensor to image data, e.g., digital images, and to output streams of digital images in a standard format. Image sensors may comprise CCD, CMOS sensors with active or passive pixels, or other photo sensors well known in the art. Operational signals are provided to the image sensor to control its operation. Advantageously, the cost of the disposable portion of the visualization instrument is reduced further by locating the components providing the operational signals in the display portion. In one embodiment, a display driver configured to receive the image stream and drive the display device accordingly, also comprises the components necessary to control the camera. In one example thereof, the input/output signals are provided by signal conductors, e.g., a multi-conductor flexible ribbon. In another example thereof, a control component is provided intermediate the camera and the display driver to transform the standard image stream into a differently structured image stream conforming to the size of the display device and/or transforming the standard image stream to a different format corresponding to the format required by the display driver. In a further example thereof, the operational circuits are integrated with the camera, which is configured to output a preconfigured image stream upon the application of power, and which is usable directly by the display device. In yet another example, control components supported by the display portion housing provide control signals to the camera to define the size of the images output by the camera. In a further example, the image stream output by the camera is transmitted wirelessly by a wireless transmitter located in the insertion portion. In yet a further example, the wireless transmitter is integrated with the camera. In a variation thereof, the wireless transmitter is positioned in the proximal end of the insertable portion or in the distal cavity. In one example, the camera forms a digital image stream using radiation having wavelengths ranging between 10 nanometers and 14,000 nanometers. The wavelengths include the visible light, ultraviolet, and infrared spectrums. In one variation, the camera is an infrared camera. In another variation, the camera is an ultraviolet light camera. In another variation, the camera is a visible light camera.
In one exemplary embodiment of a video processing scheme applicable in combination with any of the foregoing or following visualization instrument embodiments, the camera supplies a first image stream which is 8-bits wide. The resolution of the camera is 640×480 (VGA) pixels per frame. There are 30 frames per second. The data format is 2 bytes per pixel (i.e., the so called YUV (4:2:2) format). Intensity Y is specified at every pixel, color information U or V every second time. A FPGA is programmed to convert the data stream to a second image stream with a format compatible with the display device 14 which comprises an OLED display. In an alternative embodiment, the camera data is provided to the video processing chip, and the video processing chip, after adding information such as colors, symbols or other information, outputs a video stream to the FPGA for the FPGA to convert to the VGA format. The display resolution is 320×240 (QVGA) pixels per frame, 30 frames per second. The data format, however, is RGB (6, 6, 6). This format uses a 6-bit value for red, a 6-bit value for green, and a 6-bit value for blue. There are specific well known equations for conversion from the YUV color space to the RGB color space. The FPGA implements this conversion. It also performs the conversion (e.g. dropping every second pixel) to convert from VGA to QVGA resolution. The FPGA also provides signals for writing the converted data stream into the OLED display's memory/buffer. The FPGA also sends the camera data to the NTSC/S-video conversion chip. The video chip having the video processor is capable of accepting the VGA, YUV format almost directly. The FPGA provides the necessary operational signals to load the video chip's memory. In a variation thereof, the FPGA also verifies the identity of the camera against a database of approved cameras. The FPGA extracts camera information from the camera, for example a built-in camera ID or a programmable camera ID, and checks the identity against an approved list which is periodically updated. If the camera identification is not on the approved list, the FPGA does not convert the first image stream or, optionally, inserts a warning into the second image stream to alert a practitioner that the insertable portion is not an approved device. Approval may be desirable to ensure the insertable portion meets quality specifications.
In a further exemplary embodiment of a visualization instrument, the visualization instrument comprises the components described in the preceding paragraph except that the FPGA is substituted with a suitable integrated circuit configured to perform the functions described in the preceding paragraph and other functions further described throughout the disclosure. Suitable integrated circuits include digital signal processors. In a variation of the present embodiment, the visualization instrument comprises both FPGA and digital signal processor.
A program and data structures are embedded in the memory. The program comprises a plurality of processing sequences operable by the processor to interact with data structures containing data. Data includes video instructions, security feature instructions, landmark patterns and the like. In a further exemplary embodiment of a display portion suitable for use in any of the visualization instruments described herein, a display portion comprises at least one of temperature and humidity sensors, and data includes at least one of status information and environmental information. Exemplary status information includes battery charge level and number of uses. Exemplary environmental information includes temperature and humidity levels. Such data can be displayed by the display device or transmitted to a remote device to assist the practitioner. Suitable alarm functions can be implemented if the data falls outside a predetermined range. Ranges can be predetermined to alert practitioners to situations where, due to environmental or status conditions, image quality or instrument reliability is negatively and materially affected.
Referring to
In one exemplary embodiment, the visualization instrument comprises orientation devices configured to determine the orientation of the visualization instrument. Exemplary orientation devices include inertial devices, such as accelerometers and gyroscopes, and inclinometers. In one example, the visualization instrument utilizes the orientation devices to determine that its position is reversed, and causes video circuits 192 to reverse the video image presented in video display 14. For example, while the instrument is typically used with the anterior side “up”, it may also be used with the anterior side “down”, in which case, according to the present embodiment, the image in the video display is reversed. This feature is useful when the patient is not laying on his/her back.
Connectors 204 and 206 are replaced with an inductive coupling comprising the power pathway and including a primary induction assembly and a secondary induction assembly. The primary induction assembly generates a high frequency oscillating signal which induces a corresponding signal in the secondary induction assembly. In one example, the assemblies are tuned to a resonating frequency which enables inductive transfers at longer gap distances than are possible without resonance. The primary induction assembly is coupled to conductors 202 and includes a primary induction coil adapted to transfer power to a secondary induction coil included with the secondary induction assembly from a power storage device included in the display portion. The primary induction assembly generates a high frequency oscillating signal which induces a corresponding signal in the secondary induction assembly. The secondary induction assembly converts an induced high frequency signal to DC power usable by the camera assembly to illuminate, capture images, and transmit video wirelessly to display portion 4. In one example, the power storage device is a battery located in the housing of the display portion. Wireless transceivers comprise the data pathway. A wireless transceiver is electronically coupled to the imaging assembly and another is electronically coupled to the display portion. Camera assembly 100 also comprises logic to decode wireless transmissions, including data and control information. The wireless transceiver and the camera assembly are inductively powered. In one variation, the wireless transceiver and the camera assembly are integrated and detachable from the blade. The housing of the display portion and connectors 204 are inserted into the blade through the handle while the integrated transceiver/camera assembly is inserted into a cavity in the electronics pathway. In one example, the integrated transceiver/camera assembly are inserted through the distal cavity. In another example, the integrated transceiver/camera assembly is inserted through a side opening (not the distal cavity). An exemplary side opening is shown in
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In further exemplary embodiments, the visualization instruments include an actuation mechanism to adjust the distance between camera assembly 100 and the distal end of display portion 4. In one example thereof, the actuation mechanism comprises a biased component which is biased towards the distal end of display portion 4 and adapted to couple the proximal end of the wire harness such that, when camera assembly 100 and the wire harness are inserted into a cavity of the blade, camera assembly 100 bottoms-out on the distal end of the cavity of the blade and pushes the wire harness against the biased component, which retracts away from the distal end of display portion 4. Advantageously, the actuation mechanism permits use of a standard length wire harness with differently sized blades. In one variation of the present embodiment, the actuation mechanism comprises two retraction guides, a biased component and a sliding element adapted to couple the retraction guides and slide therein. The retraction guides are coupled to internal surfaces of the housing of the display portion. An exemplary biased component is a spring. If the wire harness comprises a connector, the sliding element comprises a mating connector adapted to mate with the connector of the wire harness. In one example, the retraction guides comprise slots and the sliding element extends between the slots and slides therein. In another example, the retraction guides comprise elongate ridges and the sliding element comprises, at its opposite ends, slots configured to slide on the ridges. A stop prevents the sliding element from retracting more than a predetermined amount into the housing. In one example, the biased component is coupled between the stop and the sliding element to bias the sliding element towards the distal end of the housing. Application of an external force opposite the bias causes the sliding element to retract. In one example, the predetermined amount is less than 10 mm. In one example, the mating connector is electrically coupled to looped wires which are, at their opposite ends, electrically coupled to the display portion. The loops in the wires enable the mating connector to retract while maintaining an electrical connection between the mating connector and the connector of the wire harness. In another variation of the present embodiment, the actuation mechanism comprising the two retraction guides, the biased component and the sliding element is configured in a cartridge affixed to the wire harness. Retraction occurs within the cartridge.
In one example the biased component includes a connector adapted to couple with connector 224. In another example, the biased component includes a primary induction assembly and is adapted to couple secondary induction assembly 224. In one variation of the present embodiment, the actuation mechanism automatically matches the length of the wire harness to a selected blade or stylet. In one example, a biasing force is provided by a spring to bias the biased component. In another example, the actuation mechanism comprises a motor configured to translate the biased component in response to a measured pressure. In another variation of the present embodiment, the actuation mechanism manually matches the length of the wire harness to a selected blade or stylet. In one example, the actuation mechanism comprises a sliding lever sliding in a slot in the housing with a knob attached to the slide and externally accessible such that a user can actuate the knob to move the slide. Inside the housing, the slide is coupled to the mating connector which mates with the wire harness connector. In another example, a rotatable knob positioned externally of the housing is connected to an axis that extends into the housing. When the knob is rotated, the wire harness retracts or extends. In one example the actuation mechanism includes a gear rotatable by the knob and coupled to a linear gear axially aligned with the display portion and adapted to retract or extend the wire harness.
Referring to
Another exemplary embodiment of an intubation instrument is provided in
While the invention has been described as having exemplary designs, the present disclosure may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the disclosure using its general principles. In another variation, the wire bundle is provided in different lengths to suit different blades. In a further variation, a system is provided comprising one camera assembly and multiple blades, which may be the same or different. In another variation, the display portion includes a housing without a display device but including video circuits and a communication component to transfer video images to another display device. Exemplary communication components include a connector and a wireless transceiver. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.
This application is a continuation of International Application PCT/US12/21122, with an international filing date of Jan. 12, 2012, which claims the benefit of priority from U.S. Provisional Patent Application Ser. No. 61/431,939 entitled VISUALIZATION INSTRUMENT filed Jan. 12, 2011; the disclosures of said applications are expressly incorporated by reference herein in their entirety.
| Number | Date | Country | |
|---|---|---|---|
| 61431939 | Jan 2011 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/US12/21122 | Jan 2012 | US |
| Child | 13941183 | US |
