JP2022050567A - Laser video endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope design which costs appropriately enough to allow and promote disposal of a used probe without relying on sterilization.

SOLUTION: A laser video endoscope includes a hard hand piece 32 which has a first open channel and a second open channel and in which the first open channel includes a first reduced diameter part extending distally from a distal end part; a hollow hard probe 30 including a laser guide fibre 40, an image guide fibre 37, and an illumination fiber bundle 42; a camera assembly 34; and an interruption filter. The laser guide fiber, the image guide fiber, and the illumination bundle proximally extend from a proximal part of the probe to the first opening channel. The image guide fiber extends to the proximal end part through a bond part and the first reduced diameter part. A major part of a first length of the image guide fiber is received within the first reduced diameter part.

SELECTED DRAWING: Figure 2

COPYRIGHT: (C)2022,JPO&INPIT

Description

The invention generally relates to medical laser video endoscopes, more particularly medical laser video in which the operating probe is economically disposable after each use and / or can have a relatively small gauge size. Regarding endoscopes.

Mutual reference to related applications This application is a US patent application filed on April 12, 2011, No. 13 / 084,789, and a US patent application filed on May 13, 2010, No. 12/779. , 214 is a partial continuation of US Patent Application No. 13 / 314,371 filed on December 8, 2011, the entire disclosure of which is hereby referenced by reference. It is incorporated in the book.

Other prior applications are US Pat. No. 5,121,740, filed June 16, 1992, and US Pat. No. 6,997,868, filed February 14, 2006. And all of these disclosures are incorporated herein by reference.

Laser video endoscopes are used in glaucoma, retina, and vitrectomy surgery, and some conventional endoscopes can be reused after pressure sterilization or other sterilization. Reuse is mainly due to the cost of the endoscope. The biggest cost factor is the image guide with a large number of micrometer-sized optical fibers. For example, an endoscope that uses 17,000 fibers to provide a 17,000 pixel image (17k endoscope) can cost about $ 340 with the image guide alone and is fully assembled. The price of a 17k endoscope can be as high as $ 2,000. This is a great motivation to reuse the endoscope after sterilization without disposing of the endoscope after each procedure.

The cost factor means that, as a practical matter, the endoscope is reused after sterilization without being disposed of. However, if the endoscopic probe can be disposed of after each use instead of being exposed to the possibility of human error in the sterilization process, it is safer against infection.

Another feature of conventional endoscopes is the use of a probe that passes through a 20 gauge (0.89 mm) tissue incision during eye surgery. A 20 gauge (0.89 mm) incision is standard in the field of eye surgery and is used for invasion by instruments used during eye surgery routines.

However, more recently, smaller 23 gauge (0.635 mm) sleeves have been used. This sleeve, such as a trocar sleeve, is a tube embedded in the body wall that allows the insertion and removal of surgical instruments without touching the body wall tissue. The value of a 23 gauge (0.635 mm) sleeve is that the incision is therefore smaller and therefore the recovery time is shorter. The 23 gauge (0.635 mm) sleeve has an opening smaller than the 20 gauge (0.89 mm) incision, thus allowing the probe to manage to pass through the 23 gauge (0.635 mm) sleeve. Need to be smaller.

One problem is that the 23 gauge (0.635 mm) probe is fragile and fragile due to its small diameter (25 mils or 0.635 mm). Most breakage occurs at the junction between the handpiece and the probe. This breakage problem is of great concern due to the cost of these endoscopes when using laser video endoscopes.

Exemplary embodiments of the invention are within the conventional by providing an endoscopic design that is reasonably cost-effective to enable and facilitate disposal of the probe after each use without resorting to sterility. Address at least some of the drawbacks of endoscopes.

Also, an exemplary embodiment of the invention includes a probe that can be inserted into, for example, a 23 gauge (0.635 mm) sleeve, an endoscope that can maintain sufficient robustness to minimize the amount of breakage. By providing the design, it addresses at least some of the shortcomings of conventional endoscopes.

Exemplary embodiments of the invention provide an endoscopic design that allows disposal of the probe after each use and / or includes a probe that can be inserted. For example, a 23 gauge (0.635 mm) sleeve has imaging, lighting, and laser oblation operating properties while maintaining the look and feel of the probe familiar to surgeons.

According to an exemplary embodiment of the invention, the laser video endoscope comprises a laser guide, a illumination guide, and an image guide, which extend through the probe portion of the endoscope and distal to the handpiece. It can be an optical fiber guide that extends through a handpiece that supports a probe portion that can project from the end.

According to an exemplary implementation of an embodiment of the invention, the handpiece comprises one or more channels having a distal end at the distal end of the handpiece. One or more channels may be configured to accept at least one of a laser guide, an illumination guide, and / or an image guide extending from the probe portion into the handpiece.

According to another exemplary embodiment of the embodiment of the invention, the handpiece comprises a first channel having a distal end at the distal end of the handpiece and thus a first of the handpiece. Through the channel, the illumination guide and the laser guide continue to extend from the probe portion to the illumination source and the laser energy source, respectively, through a relatively long flexible fiber optic cable connected to the handpiece at the proximal end of the first channel. be able to.

According to yet another exemplary implementation of the embodiment of the invention, the handpiece is such that the optical image guide extends from the probe portion through the second channel of the handpiece and at the proximal end of the second channel. Includes a second channel with a distal end at the distal end of the handpiece to terminate.

According to still another exemplary implementation of the embodiment of the invention, the proximal end of the second channel is at the proximal end of the handpiece, and the proximal end of the handpiece is the camera assembly. It is configured to be removable and attached to the camera assembly so that it can be optically coupled to the end of the fiber optic image guide.

An exemplary embodiment of the invention provides an endoscope system, which is a laser video endoscope comprising a handpiece supporting a probe, a laser guide, a lighting guide, and an image guide. Is optically coupled to the laser video endoscope, which extends through the probe and handpiece, and the end of the image guide, which can be detachably and directly attached to the handpiece and extends through the handpiece. Includes a camera assembly with inputs.

According to yet another exemplary implementation of the embodiment of the invention, the camera assembly sends an electrical image signal from the camera assembly to an image processor, image display device, or any site where the image can be provided for surgery. Includes an output with an electrical cable extending from the camera assembly for transmission. According to still another exemplary implementation of the embodiment of the invention, the camera assembly and its electrical cable can be removed from the handpiece and reused in multiple endoscopic routines, while including a probe portion and a handpiece. Laser video endoscopes can be disposed of after each medical routine, thereby guaranteeing disinfection procedures.

An exemplary embodiment of the invention provides a laser video endoscope for use in ophthalmic surgery, the endoscope passing through a 23 gauge (0.635 mm) sleeve, such as a trocar sleeve. Including the probe part.

According to an exemplary implementation of an embodiment of the invention, the laser video endoscope has a distal portion and a proximal portion such that the proximal portion extends from the distal end of the handpiece of the laser video endoscope. The outer diameter (OD) of the proximal portion measured at least near the distal end of the handpiece is greater than the OD of the distal portion, including, for example, a probe made of stainless steel having a portion.

According to another exemplary implementation of the embodiment of the invention, the distal portion is 25 mils (1000 minutes of an inch) so that at least the distal portion of the probe can be inserted into a 23 gauge (0.635 mm) sleeve. 1) or OD less than about 0.64 mm, and a wall thickness of 2 mils or 0.05 mm.

According to yet another exemplary implementation of the embodiment of the invention, the proximal portion of the probe exiting the handpiece has an OD of about 31 mils or 0.79 mm and a wall thickness of about 5 mils or 0.13 mm. Have.

According to yet another exemplary implementation of the embodiment of the invention, the distal portion has an OD of about 25 mils or less than 0.64 mm and a length of about 710 mils or 18 mm.

According to yet another exemplary implementation of the embodiment of the invention, the distal portion of the probe of a laser video endoscope comprises a laser guide with a laser fiber disposed within the inner diameter of the distal portion of the probe. And an image guide with an image bundle, the image bundle is a plurality of fibers arranged in an essentially circular configuration arranged within the inner diameter of the distal portion of the probe not occupied by the laser fiber. Illumination with an image guide and an illumination bundle comprising a plurality of fibers that fill the balance of the inner diameter of the distal portion of the probe that is not occupied by the laser fiber and the image bundle. Includes a guide.

According to still another exemplary implementation of the embodiment of the invention, the inner diameter of the distal portion of the probe is about 21 mils or 0.54 mm and the laser fiber of the laser guide is about 100 micrometer or 0. It has about 6,000 fibers arranged in an essentially circular configuration that is 1 mm and has an OD of about 14 mils or 0.36 mm, and the illumination bundle of the illumination guide is by laser fiber and image bundle. It has about 210 fibers that fill the remaining 21 mils or 0.54 mm inner diameter of the distal portion of the unoccupied probe.

An exemplary embodiment of the invention provides an endoscopic design, in which the laser fiber is from laser energy with different wavelengths, for example a green laser with a wavelength of 532 nanometers. You can selectively accept the input.

The present invention and many of its accompanying advantages are better understood by reference to the detailed description below and a complete understanding of them is readily available when considered in connection with the accompanying drawings. Let's do it.

It is a schematic diagram of the conventional endoscope design. It is a schematic diagram of an endoscope system according to an exemplary embodiment of the present invention. FIG. 3 is a vertical view of a camera assembly of an endoscope system according to an exemplary embodiment of the present invention. FIG. 6 is a partial longitudinal sectional view of a camera assembly including an exemplary implementation of a camera assembly component according to an exemplary embodiment of the present invention. FIG. 3 is a cross-sectional view of a handpiece of an endoscope according to an exemplary embodiment of the present invention. FIG. 3 is a cross-sectional view of a handpiece of an endoscope according to an exemplary embodiment of the present invention. It is a schematic diagram of an endoscope system including a probe, a handpiece, and a camera assembly according to an exemplary embodiment of the present invention. FIG. 3 is a diagram of a distal end of a handpiece and a probe according to an exemplary embodiment of the invention. FIG. 7 is a cross-sectional view of the distal portion of the probe of the exemplary embodiment shown in FIG. It is a figure which shows the distal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the distal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the distal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the distal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the proximal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the proximal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the proximal part of the handpiece by an exemplary embodiment of this invention. It is a figure which shows the proximal part of the handpiece by an exemplary embodiment of this invention. FIG. 3 is a cross-sectional view of an assembled handpiece and probe of an endoscope according to an exemplary embodiment of the invention, including distal and proximal portions. Sectional View of Assembled Handpieces and Probes Including Distal and Proximal Parts Showing an exemplary Configuration of Laser Guides, Illumination Guides, and Image Guides for Endoscopes According to Exemplary Embodiments of the Invention. Is. FIG. 3 is a cross-sectional view of an endoscopic system including a probe, a handpiece, and a camera system according to an exemplary embodiment of the invention. FIG. 3 is a cross-sectional view of an assembled handpiece and probe of an endoscope according to another exemplary embodiment of the invention, including distal and proximal portions. An assembled handpiece and probe comprising a distal portion and a proximal portion showing an exemplary configuration of a laser guide, a lighting guide, and an image guide of an endoscope according to another exemplary embodiment of the invention. It is a cross-sectional view. FIG. 6 is a cross-sectional view of an endoscopic system including a probe, a handpiece, and a camera system according to another exemplary embodiment of the invention. It is a schematic diagram showing the components of an endoscopy system according to an exemplary embodiment of the invention, including an illumination source, a laser energy source, and an image processing and / or display device interface.

The matters defined in the description, such as detailed structure and elements, are provided only to aid in a comprehensive understanding of the invention. Accordingly, one of ordinary skill in the art will recognize that various modifications and modifications of the embodiments described herein may be made without departing from the scope and gist of the invention. Also, well-known functions or configurations are omitted for clarity and brevity. Some exemplary embodiments of the invention may be described below in the context of commercial application. Such exemplary implementations are not intended to limit the scope of the invention as defined in the appended claims.

Descriptive terms such as "handpiece," "probe," and "fiber" are used throughout the specification, but components that may be used in combination or individually to implement various aspects of the embodiments of the invention. Note that it is not intended to limit.

Next, with reference to the drawings, similar reference numbers show the same or corresponding portions through several drawings, and the embodiments of the present invention are shown in detail graphically.

FIG. 1 shows the configuration of a conventional laser video endoscope 10 having an operating probe 24, a handpiece 22, and a cable 18, where the cable 18 holds a laser guide 12, a lighting guide 14, and an image guide 16. These are all fiber optic guides that extend from the distal end of the probe 24 to terminals 12C, 14C, and 16C, respectively. Distal of the three-branch zone 20, fiber optic guides are geometrically combined to provide the smallest diameter cable.

Referring to FIGS. 2 to 6, a laser video endoscope according to an exemplary embodiment of the present invention comprises a handpiece 32, a probe 30 extending from the distal end of the handpiece 32, and a proximal handpiece 32. Includes a camera assembly 34 detachably coupled to the end. In an exemplary implementation of the invention, the camera assembly 34 is directly connected to the proximal end of the handpiece 32 by engagement of the nose 54 of the handpiece 32 with the recess 52 of the camera assembly 34. The probe 30 is shown essentially straight, but is interchangeable with other probes, such as a bent probe, without departing from the scope of the exemplary embodiments of the invention described herein. May be used for.

As shown in FIG. 2, according to an exemplary embodiment of the invention, a laser guide comprising fiber 40, a lighting guide comprising fiber 42, and an image guide comprising fiber 35 are at the distal end of the probe 30. Extends into the handpiece 32. The proximal end of the probe 30 may be fixed and attached to the distal end of the handpiece 32, for example by joining together by a known process.

As further shown in FIGS. 2, 5A, and 5B, according to embodiments of the exemplary implementation of the invention, the handpiece 32 includes channels 55, 56, and 57. In an exemplary implementation, the handpiece 32 separates the image guide fiber 37, the laser guide fiber 40, and the illumination guide fiber 42 that enter the channel 55 at the distal end of the handpiece 32 from the proximal end of the probe 30. Only the image guide fiber 37 extends through the channel 57, and the laser guide fiber 40 and the illumination guide fiber 42 extend through the channel 56. The channel 57 terminates at a surface 58 at the proximal end of the handpiece 32 to optically couple the image guide fiber 37 extending from the distal end of the probe 30 to the lens or input optics of the camera assembly 34. Used for. The channel 56 is used to terminate at the handpiece surface 59 and receive the laser guide fiber 40 and the illumination guide fiber 42 extending from the distal end of the probe 30 so as to be held proximally by the cable 38. In an exemplary implementation, channels 56 and 57 extend from channel 55 at a non-zero angle to each other and channel 56 and channel 15 extend (or intersect) at an acute angle, as shown in the example of FIG. 5A.

In an exemplary implementation of an embodiment of the invention, the image guide fiber 37 extending through the probe 30 and the handpiece 32 carries the image and is detachably directly coupled to the optical element of the camera assembly 34. In an exemplary implementation of an embodiment of the invention, the distal end of the camera assembly 34 is removable to the nose 54 of the handpiece 32, as shown in FIGS. 4, 5A, 5B, and 6. Has a recess 52 that engages with. The placement of the camera assembly 34 with the handpiece 32 allows for standard optical coupling of the image output at the proximal end of the optical image guide fiber 37 to the optical elements of the camera assembly 34.

In an exemplary implementation of an embodiment of the invention, the camera assembly 34 can provide an electrical image transmitted proximally along an electrical cable 36 connected at the output of the camera assembly 34. The camera may be any one of several known types, including, for example, optical and / or image processing elements, and the image available from the image guide fiber 37 at the proximal end of the handpiece 32. It may be specifically designed to fit the shape of the camera assembly to ensure input.

In an exemplary implementation of an embodiment of the invention, the optical guide cable 38 extends proximally from the handpiece 32 to transfer laser energy and illumination energy to the probe 30, respectively, to transfer the laser guide fiber 40 and the illumination guide. Holds the fiber 42. In a further exemplary implementation of the embodiment of the invention, the cable 38 extends proximally to the branch junction 44, where the laser guide fiber 40 and the illumination guide fiber 42 are separated at terminals 40C and 42C, respectively. Terminate and connect to laser and illumination energy sources. In yet another exemplary implementation of the embodiment of the invention, the image transfer electrical cable 36 terminated at the terminal 36C can be approximately the same length as the optical guide cable 38, with each cable 36 and 38 being It can be as long as required for installation.

According to an exemplary embodiment of the invention, the image guide at the proximal end of the handpiece 32 is provided by the direct optical coupling of the image guide fiber 37 to the optical element of the camera assembly 34 provided by the handpiece 32. It becomes possible to terminate the fiber 37. The camera assembly 34 can be removed from the handpiece 32, thus allowing the relatively expensive camera to be reused. Also, by arranging the camera assembly 34 with the handpiece 32, the long and expensive optical image guide proximal to the handpiece 32 is avoided.

Therefore, the laser video endoscope according to the exemplary embodiment of the present invention can eliminate the conventional expensive and long image fiber extending from the handpiece 22 to the terminal 16C as shown in FIG. Alternatively, in a laser video endoscope according to an exemplary embodiment of the invention, the image may be conveyed to the terminal 36C via an electrical cable 36 in the proximal direction of the camera assembly 34 directly coupled to the handpiece 32. For example, a relatively long electrical cable 36 can extend from the proximal end of the camera assembly 34 to a terminal 36C coupled to a suitable image processing or display mechanism, such as a video screen, thus the surgeon. , The image can be seen in the process of operating the probe 30.

The combination of such reuse of the camera assembly 34 and the removal of a wide range of lengths of expensive fiber optic image guides is such that the laser guide fiber 40 and the illumination guide fiber 42 in the handpiece 32 and cable 38 are after each medical routine. This means that the probe 30 is economically acceptable to dispose of, even if disposed of.

In an exemplary embodiment, the camera assembly 34 provides a laser filter 46, for example, to protect the camera film from laser energy and to allow the surgeon to observe the surgery when a laser pulse is being emitted. Can include. In yet another exemplary implementation, there may be filters for lasers of multiple wavelengths, for example 810 nm and 532 nm lasers may be used.

In another exemplary implementation of an embodiment of the invention, the camera assembly 34 facilitates attachment of the camera assembly 34 to the handpiece 32 and easy removal of the camera assembly 34 from the handpiece 32. Can include a manually operated spring latch (not shown).

In yet another exemplary implementation, the camera assembly 34 may include a focus ring 50, whereby an image guide fiber extending from the distal end of the probe 30 through channels 55 and 57 of the handpiece 32. It ensures proper focus of the image provided on the receiver of the camera assembly 34 located at the proximal end of 37.

For example, in a modification of the exemplary embodiment of the invention shown in FIGS. 2-6, removal at the proximal end of the handpiece 32 not only removes the camera assembly 34 at the surface 58, but also, for example, the surface 59. The cable 38 is also disconnected at or near it, so that only the probe 30 and the handpiece 32 will be disposed of between each operation.

In the exemplary implementation of FIGS. 1-6, the image guide 37 in the probe 30 and handpiece 32 can be an optical fiber bundle, but due to other exemplary configurations, refraction often referred to as, for example, a GRIN lens. It is possible to provide an image guide function like a rate distribution type lens.

Referring to FIGS. 7 and 8, a laser video endoscope according to an exemplary embodiment of the invention includes a probe 78 and a handpiece 74 (partially illustrated). The probe 78 has a proximal portion 70 and a distal portion 72 such that the proximal portion 70 extends from the distal end 73 of the handpiece 74 of the laser video endoscope and the distal end of the handpiece 74. The outer diameter (OD) of the proximal portion 70 measured at least near 73 is greater than the OD of the distal portion 72.

Referring to FIG. 8, a cross-sectional view of the distal portion 72 of the probe 78 according to an exemplary implementation of the embodiment of the invention is an image guide comprising a fiber 86, a laser guide comprising a fiber 88, in the probe 78. And the configuration of the illumination guide including the fiber 80 are shown. As shown in FIG. 8, in the image guide 86 and the laser guide 88, the OD of the fiber of the image guide 86 and the OD of the fiber of the laser guide 88 do not intersect or intersect in any cross section of the distal portion 72 of the probe 78. Arranged so that they do not overlap. As further shown in FIG. 8, according to an exemplary embodiment of the embodiment of the invention, the fiber 80 of the illumination guide fills the remaining volume of the distal portion 72 and thus of the fiber of the image guide 86. The OD and the OD of the fiber of the laser guide 88 will not intersect or overlap with the OD of any fiber of the illumination guide 80 in any cross section of the distal portion 72 of the probe 78.

In an exemplary implementation of an embodiment of the invention, the proximal portion 70 has an outer diameter between about 20 gauge and about 22 gauge (35 mils and 31 mils, or 0.89 mm and 0.79 mm), as well as about. It can have a wall thickness of 5 mils or 0.13 mm thick. The probe can be made of stainless steel. The proximal portion 70 extends into the handpiece 74. Therefore, at the connection between the end of the handpiece 74 and the probe 78, the possibility of breakage at the junction between the distal end 73 of the handpiece 74 and the proximal end of the probe 78 should be minimized. There is a diameter that is robust enough to contribute to.

In an exemplary implementation of an embodiment of the invention, the length of the proximal portion 70 of the probe 78 can be about 120 mils or 3 mm, as opposed to a probe 78 length of about 830 mils or 21 mm. The length of the position portion 72 can be about 710 mils or 18 mm.

In an exemplary implementation of an embodiment of the invention, the distal portion 72 of the probe 78 can have an OD of about 25 mils or 0.64 mm or less, and illumination and laser energy in the eye during the surgical procedure. It can be extended through a 23 gauge (0.635 mm) sleeve to provide delivery and transmit images from the eye. The distal portion 72 can have a wall thickness of about 2 mils or 0.05 mm, and a length of about 710 mils or 18 mm. The length of about 710 mils or 18 mm is long enough for most applications and short enough to minimize breakage.

The exemplary length described herein for the distal portion 72 has been found to contribute to the robustness of the probe 78, but is dimensioned to provide a probe that can be used with other smaller size sleeves. Can be changed slightly.

According to an exemplary embodiment of the invention, the probe 78 with an OD of about 25 mils or 0.64 mm is a dimensional compromise for each fiber transmitting illumination light, laser energy, and images, as follows: By giving points, the need to provide sufficient light and sufficient laser energy while maintaining proper image guidance can be met.

In the example of FIG. 8, the image guide 86 comprises a bundle of about 6,000 fibers arranged in a substantially circular cross-section configuration with an OD of about 14 mils or 0.36 mm, and the laser guide 88 is , With a fiber having an OD of 100 micrometers or 0.1 mm. The image guide 86 and laser guide 88 are in the distal portion 72 of the probe 78 having an OD of about 25 mils or 0.64 mm, a wall thickness of about 2 mils or 0.05 mm, and an inner diameter of about 21 mils or 0.54 mm. The fiber of the illumination guide 80 fills the remaining volume of the distal portion 72 of the probe 78.

According to an exemplary embodiment of the invention, the probe 78 has (a) a rigid structure of the probe 78 wall, (b) a two-diameter design of the proximal portion 70 and the distal portion 72, and (c) a distance. Combined with the limited length of the position portion 72, it can be robust enough to minimize breakage. Particularly advantageous configurations with exemplary mounting embodiments of the probe 78 are (a) a probe 78 with a metal wall and (b) a 35 mil (0.89 mm) OD and 5 mil (b) extending through the handpiece 74. Proximal portion 70 with a wall thickness of 0.13 mm, and distal portion 72 with a wall thickness of 25 mils (0.64 mm) and OD and 2 mils (0.05 mm), and (c) 710 mils (18 mm). ) Includes a combination with a distal portion 72 having the following length.

It has been found that such a design according to an exemplary embodiment of the invention as shown in FIGS. 7 and 8 can provide sufficient illumination to illuminate a 90 degree region. One of the compromises made to obtain a probe with a smaller diameter is to reduce the laser guide 88 fiber diameter from 200 micrometers to 100 micrometers. In an exemplary implementation, a 532 nanometer (nm) laser source or green laser can advantageously provide the desired laser energy. For example, the output of a 532 nm laser is more coherent and less divergent than an 810 nm laser. Accordingly, in an exemplary implementation of the invention, the use of a 532 nm laser in combination with a reduced size laser fiber 88 provides a reasonable amount of laser energy for the relevant eye surgery.

In yet another exemplary implementation of the embodiment of the invention, the illumination guide 80 is reduced from about 220 fibers to about 70 fibers, thereby substantially contributing to the smaller diameter of the probe 78. can do.

An exemplary embodiment of the invention is described in connection with an embodiment that allows for use with a 23 gauge (0.635 mm) sleeve. It should be appreciated that the described design may be modified to fit for use with or without sleeves with variations from 23 gauge (0.635 mm). Exemplary embodiments of the invention work together to provide an operable and useful laser video endoscope with a small probe that allows eye surgery with minimal trauma and reduced healing time. Describes a combination of several features and compromises designed to.

Referring to FIGS. 9A, 9B, 9C, 9D, and 10A, 10B, 10C, 10D, exemplary embodiments of the invention include, for example, the handpiece 110 as shown in FIG. Provided is a handpiece design comprising a distal portion 90 and a proximal portion 100 fixedly assembled to form a handpiece of. According to an exemplary implementation of an embodiment of the invention, the distal portion 90 has an opening 92 that terminates at the distal end or surface 94 of the portion 90, and an opening 93 that terminates at the proximal end of the portion 90. including. The opening 92 may be fixed and adhered to extend distally from the surface 94, for example to accept the proximal end of the probe, such as the proximal end 114 of the probe 112, as shown in FIG. It is composed. The opening 93 is configured to join with the distal end 102 of the proximal portion 100, whereby the distal portion 90 and the proximal portion 100 form a handpiece, for example as shown in FIG. Can be assembled in a fixed manner. The distal portion 90 defines at least the first portion 99 of the inner wall of the channel 96 by a protruding section 91 that includes the channel 95 and can also serve as a guide for holding the handpiece. The proximal portion 100 comprises a channel 97, which extends from the surface 103 of the distal end 102 and terminates at the surface 105 of the proximal end of the portion 100. Proximal portion 100 defines at least a second portion 109 of the inner wall of channel 96.

With reference to FIGS. 11, 12, and 13, in an exemplary embodiment of the embodiment of the invention, the handpiece 120 with the distal portion 90 and the proximal portion 100 is the proximal end 114 of the probe 112. Separating the image guide fiber 37, the laser guide fiber 40, and the illumination guide fiber 42 that enter the channel 95 at the distal end of the distal portion 90, only the image guide fiber 37 extends through the channel 97 and is a laser guide. The fiber 40 and the illumination guide fiber 42 extend through the channel 96. The channel 97 terminates at the surface 105 at the proximal end of the proximal portion 100 and optically couples the image guide fiber 97 extending from the distal end of the probe 112 to the lens or input optics 130 of the camera assembly 134. Used to do. The channel 96 terminates at the outer surface 101 of the proximal portion 100 and receives the laser guide fiber 40 and the illumination guide fiber 42 extending from the distal end of the probe 112 so as to be carried proximally by a cable such as a cable 38. ,used.

In an exemplary implementation of an embodiment of the invention, the camera assembly 134 can provide an electrical image transmitted proximally along an electrical cable 136 connected at the output of the camera assembly 134.

In another exemplary embodiment of the embodiment of the invention, the connection 138 of the camera assembly 134 with the handpiece 110 is such that the camera assembly 134 is easily attached to the handpiece 110 and the camera assembly 134 is handed, for example. To facilitate easy removal from the piece 110, snap-fit couplings achieved by the physical properties of the proximal end of the proximal portion 100 and the distal end of the camera assembly 135 can be provided.

In yet another exemplary implementation, the camera assembly 134 may include a focus ring 150, whereby an image guide fiber extending from the distal end of the probe 30 through channels 95 and 97 of the handpiece 110. It ensures proper focus of the image provided on the receiver of the camera assembly 134 located at the proximal end of 37.

Referring to FIGS. 14, 15, and 16, in an exemplary embodiment of the embodiment of the invention, the handpiece 140 with the distal portion 90 and the proximal portion 200 is the proximal end 114 of the probe 112. Separating the image guide fiber 37, the laser guide fiber 40, and the illumination guide fiber 42 that enter the channel 95 at the distal end of the distal portion 90, only the image guide fiber 37 extends through the channel 207 and is a laser guide. The fiber 40 and the illumination guide fiber 42 extend through the channel 96. In contrast to the exemplary embodiments of FIGS. 11, 12 and 13, channel 207 terminates at a surface 205 at the distal end of the cavity 220 having an opening 222 at the proximal end surface 105 of portion 200. do. The channel 207 is used to optically couple the image guide fiber 97 extending from the distal end of the probe 112 to a lens or input optics 165 disposed on the protrusion 162, where the protrusion 162 is a camera. It extends distally from the surface 163 of the assembly 164 into the cavity 220 of the handpiece 140. The channel 96 terminates at the outer surface 101 of the proximal portion 200 to receive the laser guide fiber 40 and the illumination guide fiber 42 extending from the distal end of the probe 112 and to be carried proximally by a cable such as a cable 38. used.

In an exemplary implementation of an embodiment of the invention, the camera assembly 164 can provide an electrical image transmitted proximally along an electrical cable 166 connected at the output of the camera assembly 164.

In another exemplary implementation of the embodiment of the invention, the connecting portion 168 of the camera assembly 164 with the handpiece 140 is, for example, an easy attachment of the camera assembly 164 to the handpiece 140 and a handing of the camera assembly 164. To facilitate easy removal from the piece 140, snap-fit couplings achieved when the overhanging portion 162 is inserted into the cavity 220 can be provided. In an exemplary implementation, the coupling 168 allows the handpiece 140 and probe 112 to rotate axially (around axis AA) with respect to the camera assembly 164.

In yet another exemplary implementation of the embodiment of the invention, the image output from the image guide 37 of the probe 112 is displayed and / or further image processed via an electrical cable 166 connected by the output of the camera assembly 164. It can be properly oriented in the camera assembly 164 for output. Such desirable orientation of the image for display and / or further image processing is a component disposed to cable 166 by electronic image processing, or disposed within camera assembly 164, or at the output of camera assembly 164. It can be done optically using or using any combination of these. For example, when the handpiece 140 is attached to the camera assembly 164, there is no need for manual orientation of the probe 112 with respect to the subject, such as the surgical position (not shown) at the distal end of the probe 112. The endoscope user can rotate the rotating probe 112 with respect to the subject by rotating the rotating handpiece 140 with respect to the camera assembly 164 without disturbing the image of the subject, which is a curved interior. It can be particularly advantageous when using an endoscope.

In yet another exemplary implementation, the camera assembly 164 may include a focus ring 160, whereby an image guide fiber extending from the distal end of the probe 30 through channels 95 and 97 of the handpiece 110. It ensures proper focus of the image provided on the receiver of the camera assembly 164 located at the proximal end of 37.

Referring to the conceptual diagram of FIG. 17, exemplary embodiments of the present invention provide a system 1000 comprising a console 170 and an endoscope 500, the endoscope 500 with reference to FIGS. 2 to 16. Included are camera assemblies 179, handpieces 177, and probes 175 that can be configured and constructed with various combinations of camera assemblies, handpieces, and exemplary implementations of probes as described herein.

In an exemplary implementation of an embodiment of the invention, the console 170 is a plurality of laser energy sources 172 and / or connected to the laser guide fiber 40 via, for example, uniquely configured connectors 152C and / or 158C, respectively. 178, one or more illumination sources 174 connected to the illumination guide fiber 42 via the connector 154C, and one or more image display or image processing interfaces connected to the image guide fiber 37 via the connector 156C. It may comprise one or any combination of 176. For example, the laser energy source 172 can be a 532 nm laser source that can be connected to the endoscope 500 configured as in the examples of FIGS. 7 and 8, and the laser energy source 178 is FIG. 2, FIG. 13 or an 810 nm laser source that can be connected to an endoscope 500 configured as in the example of FIG. 16 (notably of the handpiece of FIG. 2, FIG. 13 or 16). Both can be configured with the probes of FIGS. 7 and 8).

Further, referring to the example of FIG. 17, the image output from the image guide fiber 37 of the probe 175 is a component disposed within the camera assembly 179, a component disposed within the image processing interface 176, and / or a console. The other components of 170 can be oriented in the camera assembly 179, so when the handpiece 177 is attached to the camera 179, no manual image orientation is required and the user can orient the handpiece 177. By manipulating, the probe 175 can be rotated relative to the camera assembly 179 without disturbing the image output.

The present invention has been shown and described with reference to particular exemplary embodiments, but various modifications of the form and details are made without departing from the spirit and scope of the invention and the claims. Those skilled in the art will understand what can be done.

Claims (8)

A laser video endoscope for eye surgery,
Proximal and distal ends, a first opening channel extending between the proximal and distal ends, extending at a non-zero angle from the first opening channel and terminating at the surface of the handpiece. The longitudinal axis of the first opening channel intersects the longitudinal axis of the second opening channel at a junction located along the first opening channel. A rigid handpiece in which the first opening channel comprises a first reduced diameter portion extending distally from the proximal end, the first reduced diameter portion being defined by a solid portion around the handpiece. When,
A hollow rigid probe extending distal to the distal end of the handpiece, the probe having a distal portion and a proximal portion, the probe having a laser guide fiber, an image component, and an illumination. The laser guide fiber, which comprises a fiber bundle, comprises a hollow rigid probe, which is adapted to carry laser energy.
A camera assembly that is rigidly coupled to the proximal end of the handpiece,
The proximal end of the handpiece comprises a cutoff filter arranged across the first aperture channel and configured to cut off the laser energy.
The laser guide fiber, the imaging component, and the illumination bundle extend proximally from the proximal portion of the probe to the first aperture channel, where the imaging component has the junction and the first reduced diameter. Extending through the portion to the proximal end and adjacent to the cutoff filter, the first reduced diameter portion minimizes lateral slip between the imaging component and the cutoff filter.
A first length of the imaging component extends from the junction adjacent to the blocking filter and most of the first length of the imaging component is received within the first reduced diameter portion. A laser video endoscope featuring. The laser guide fiber has a diameter of about 100 micron and has a diameter of about 100 micron.
The endoscope according to claim 1, wherein the image component has a diameter of about 14 mils. The endoscope according to claim 1, wherein the proximal portion of the probe has an outer diameter of at least about 35 mils and a side wall having a thickness of at least about 5 mils. The endoscope according to claim 1, wherein the proximal portion of the probe has a length of 120 mils. The endoscope according to claim 1, wherein the imaging component includes an optical fiber bundle having about 6,000 fibers. The endoscope according to claim 1, wherein the illumination fiber bundle includes about 70 fibers that essentially surround the laser guide fiber and the imaging component. The endoscope according to claim 1, wherein the probe is made of metal. The endoscope according to claim 1, wherein the output of the imaging component is adapted to be transmitted by the camera assembly to a remote display.

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