KR101105218B1 - Pressure-propelled system for body lumen - Google Patents

Abstract

A biologically compatible hydraulic source comprising an elongated carrier 26 adapted to be inserted through the front hole 18 of the body cavity 20 and a piston head 30 coupled to the distal portion of the carrier 26 ( Apparatus 10 for use with 16 is provided. The piston head 30 forms a consolidation with the lumen 20 wall after the carrier 26 is inserted into the lumen 20, and moves backward through the body lumen 20 in response to the pressure from the hydraulic source 16. It is adapted to move forward. The device 10 is configured to facilitate the forward advancement of the piston head 30 by facilitating the passage of fluid out of the lumen 20 from the interior portion of the lumen 20 behind the piston head 30. Device 10 further includes an optical system 32 coupled to carrier 26 near the distal portion, which optical system 32 has a distal end and a near end. The optical system 32 includes an image sensor 232 located at the proximal end of the optical system 32; An optical member 234 having a distal end and a proximal end, shaped to define a lateral surface and configured at least at its distal to be curved to provide an omnidirectional side view; And a convex mirror 240 coupled to the distal end of the optical member 234, wherein the optical member 234 and the mirror 240 have shapes to rotate about a common axis of rotation, respectively.

Body lumen, Pressure-propulsion system, Gastrointestinal tract, Imaging, Endoscope, Colon

Description

PRESSURE-PROPELLED SYSTEM FOR BODY LUMEN}

Cross reference of related application

This application is part of a continuation of the application, claiming priority from the following patent application:

(a) United States patent application filed on October 18, 2004 entitled "Intraluminal Pressure-Propulsion System",

(b) US Patent Application No. 10 / 838,648 to Gross et al., filed May 3, 2004, entitled "Intraluminal Pressure-Propulsion Systems," and

(c) United States Patent Application No. 10 / 753,424, filed Jan. 9, 2004, entitled “Intraluminal Pressure-Propulsion System”.

This application claims the wire rights from the following patent applications:

(a) United States Provisional Patent Application No. 60 / 607,986, filed September 8, 2004 entitled "Mechanical Aspects of Intraluminal Pressure-Propulsion Systems," and

(b) United States Provisional Patent Application No. 60 / 571,438, filed May 14, 2004, entitled "Forward and Forward-looking Imaging Devices."

All of the above mentioned applications have been assigned to the assignee of the present application and are incorporated herein by reference.

Technical Field

The present invention generally relates to a pressure-propulsion system suitable for imaging a body lumen, such as a gastrointestinal (GI) tract.

Many imaging devices are known for making medical images of the body lumen, such as the gastrointestinal (GI) tract. For example, endoscopy is widely used to observe and photograph tissue and to sample from lesions and the like. In conventional methods of testing the colon using an endoscope, for example, the endoscope is typically inserted manually into the colon. In this manual technique, the patient often complains of abdominal pain and distension as the colon is stretched or excessively widened, and therefore the endoscopic process needs to be stopped. Moreover, it is not uncommon for the colon to bleed or inadvertently penetrate. In addition, it may be difficult to insert the endoscope through the sigmoid colon into the descending colon, or through the groin, transverse colon, hooves, or previously operated portions. For these reasons, colonoscopy is typically performed only by a relatively few skilled practitioners, with a high rate of patient pain and discomfort.

U.S. Patent 5,337,732 (Grundfest et al.), Incorporated herein by reference, describes a robot performing an endoscopic process, which includes a plurality of segments attached to each other through segmented joints. The mover can move these segments together and separately to change their angular orientation, allowing the robot to move through the cavity or lumen inside the patient in the same way as a bug or snake. The inflatable balloon around the segment expands to hold the temporarily suspended segment against the lumen wall as it moves other segments. A compressed gas line attached to the rear segment provides compressed gas to inflate the balloon and optionally drive the actuator. The lead segment includes a television camera and bi-optic arm or other sensors and surgical instruments.

U.S. Patent Application 2003/0168068 (Poole and Young), which is incorporated herein by reference, (a) selectively controls the hydraulic pressure of the first chamber to externally advance the first chamber and (b) the second cavity. A method of lining the body cavity with a liner containing two chambers by selectively controlling the hydraulic pressure of the chamber to control the rigidity of the liner is described.

U.S. Patent Application Publication 2003/0105386 and U.S. Patent No. 6,485,409 (Voloshin et al.), Incorporated herein by reference, describe an endoscope apparatus that includes an expandable sleeve, in which the endoscope advances in the colon.

U.S. Patent Application Publication 2002/0107478 (Wendlandt), which is incorporated herein by reference, describes a self-propelled catheter, wherein the catheter is advanced into the body by applying pressure to an extraneous tube associated with the catheter.

US Pat. No. 6,702,735 to Kelly, which is incorporated herein by reference, describes an apparatus for moving a tool along a passageway. The tool is coupled to an inflatable cover, which expands and extends into the passageway to carry the tool along the passageway.

US Pat. No. 5,259,364 (Bob), incorporated herein by reference, describes an endoscope device that includes a flexible extruded tube, in which the extruded tube is expanded to advance the endoscope into the sieve cavity.

US Pat. No. 4,403,985 (Boretos), incorporated herein by reference, describes a catheter containing a port through which the high pressure fluid is pushed near the distal end, where the catheter is advanced and steered by the push of the high pressure fluid.

U.S. Patent No. 4,176,662 (Frazer), incorporated herein by reference, describes an endoscope having a propulsion mechanism and at least one transmitter in the distal end, which transmits an emission of energy waves to track the position of the distal end. The propulsion mechanism consists of two radially expandable pockets separated by an axially expandable bellows, with only the front pocket attached to the distal end and expanding and contracting them in the proper order to propel the endoscope.

U.S. Patent No. 4,148,307 (Utsugi), which is incorporated herein by reference, includes two cuffs disposed about the periphery of the flexible cover, which are spaced at regular intervals and extendable only in the radial direction of the flexible cover, between the two cuffs. A tubular medical device having one or more cuff assemblies is described that includes a deformable propulsion cuff having a dual back portion disposed about the periphery of the cover. When air is optionally introduced into or out of three cuffs, the flexible cover automatically advances stepwise into the human cavity.

US Pat. No. 5,906,591 (Dario et al.), Incorporated herein by reference, describes an endoscopic robot adapted to be inserted into the cavity of a patient and adapted to advance therein using a "worm-shaped" motion.

US Pat. No. 6,007,482 (Madni et al.), Incorporated herein by reference, describes an endoscope having a pair of telescope portions, one with a camera, at the distal end, which is moved through a body passage by a Bowden cable. It can also be operated in other ways. An inflatable bag is attached to each of the two cylindrical portions to provide movement.

US Pat. No. 5,662,587 (Grundfest et al.), Incorporated herein by reference, describes an endoscope robot having a plurality of segments attached to each other. Traction segments hug the walls of the lumen. The other segment includes a movable device that locally deforms the shape of the endoscope by bending, stretching, or some combination of bending and stretching. A method is provided for ordering the movement of a segment to cause a "worm-shaped" or "snake" movement through the curved and flexible lumen, or a combination thereof. A compressed gas line attached to the rear segment can blow the compressed gas into the lumen and, optionally, can be used to drive the actuator to control the operation of the endoscope segments.

US Pat. No. 4,690,131 (Lyddy, Jr. et al., Incorporated herein by reference) is a combination of components adapted for use with an endoscope that can at least partially extend into the lumen of a tubular body part, such as the large intestine, with an endoscope. Explain. The cover is adapted to be mounted over an endoscope. The endoscope and cover are provided with an optional inflatable cuff that can move relative to each other by sliding the cover over the endoscope axially.

US Pat. No. 4,040,413 to Ohshiro, incorporated herein by reference, describes an endoscope that includes a tube having one or more inflatable balloons on its outer surface. A bundle of optical fibers passes through the tube to the flexible distal end of the tube to view the interior of the cavity. When only one balloon is provided, it is provided on one side of the tube near its distal end, expanding the space within the cavity of the body in one direction to create enough space in this direction and the flexible part of the tube can be bent in this direction. As a result, a wide field of view is obtained. When one or more balloons are provided, one of the balloons is selectively inflated to expand the space in the cavity of the body in the desired direction. In one embodiment, an outer sleeve is provided around the tube, with a balloon on its outer surface, which can slide relative to the tube. The outer sleeve and tube are otherwise inserted into the cavity by expanding the balloon on the outer sleeve and the balloon on the tube to facilitate their insertion into the cavity.

US Pat. No. 6,503,192 (Ouchi), incorporated herein by reference, describes an insertable device for enteroscopy. The device has a cylindrical body into which the insert of the endoscope is inserted while supporting the patient's anus muscles in the open position. The cylindrical body is provided at one end with a conical opening. In one embodiment, the cylindrical body is provided on the inner surface of the endoscope with a pressure leak prevention ring made of sponge material to prevent leakage of air in the body of the patient's body.

US Patent Application Publication 2003/0083547 (Hamilton et al.), Incorporated herein by reference, describes a method and apparatus for inhibiting longitudinal expansion of the body portion of an endoscope cover during expansion of an inflatable member. In one embodiment, the lid assembly includes a body portion adapted to enclose the distal end of the insertion tube and an inflatable member coupled with the body portion adapted to radially expand outwardly from the body portion. Furthermore, the lid assembly includes an expansion-suppression mechanism associated with at least one of the inflatable member and the body portion. The expansion-suppression mechanism is described as inhibiting longitudinal expansion of the body portion during expansion of the inflatable member. The expansion-suppressing mechanism may include, for example, a non-compliant member, a longitudinal extension, a reinforcing spring member, a pressure relief device, or a suitable detent mechanism.

PCT publication WO 04/069057 (Gobel), which is incorporated herein by reference, describes a device for use in the treatment process comprising a double walled flexible expandable tubular segment surrounding a hollow space.

U.S. Patent Application Publication 2003/0000526 (Gobel), incorporated herein by reference, describes a technique for controlling the respiratory gas flow of a ventilator as a function of the bronchial airway pressure of a patient to assist or control the respiration of the patient. This technique involves introducing a ventilator tube, such as an tracheal tube or an tracheotomy tube, into the trachea. The tube receives the breathing gas and is mounted with the inflatable cuff and at least one lumen continuous from the distal end of the tube to the proximal end of the tube. The tube is suitable for detecting airway pressure by continuous or intermittent detection and evaluation of predominant intracuff pressure in the cuff of the tube. The breathing gas flow of the ventilator is controlled as a function of the pressure in the cuff detected.

PCT publication WO 03/045487 (Gobel), which is incorporated herein by reference, into the urinary bladder, which consists of an elastic catheter bag, which is connected to a filling channel which is secured with a fillable balloon component and coupled to the wall of the catheter bag. To describe a bladder catheter for introduction via the urethra. The balloon component and catheter bag are made of polyurethane, a polyurethane-polyvinylchloride mixture, or similar polyurethane-based material.

Summary of the Invention

Certain embodiments of the present invention provide an imaging system that is hydraulically driven through a body lumen, such as a gastrointestinal (GI) tract. While embodiments of the invention are described below in connection with the GI tract, it is understood that these embodiments are not limited to those used in the GI tract and may be used in other body lumens. In an attempt to overcome the low friction of the GI tract, in contrast to the prior art capable of inflating and securing balloons and similar devices with respect to the walls of the GI tract, embodiments of the present invention promote the imaging system in the very case of the GI tract. It uses a low friction environment and typically does not have a need for fixing.

Thus, according to an embodiment of the present invention, there is provided a system comprising a guide member that is at least partially insertable into a front opening of a body cavity, the guide member sliding through a first passageway, a guide member connectable to a hydraulic source. An elongated carrier arranged to be and a piston head mounted on the carrier, wherein greater hydraulic pressure acts on the front side of the piston head than on the rear side of the piston head to propel the piston head and carrier back in the body cavity. .

The system of this embodiment in the present invention may have different features. For example, the piston head can expand. The carrier may comprise a second passage in fluid communication with the piston head, which may be connected to a hydraulic source for inflating the piston head. The discharge tube can pass through the piston head, which has a hole in the back of the piston head through which the fluid can be discharged to the outside. An image-capturing device can be mounted on the carrier, for example behind the piston head. The power supply can pass through the carrier and can be connected to the image-capturing device. The fluid supply tube may pass through the carrier and may be connected to the fluid supply source.

According to one embodiment of the invention, an auxiliary piston head can be mounted on the carrier in front of the first mentioned piston head. The auxiliary piston head may expand and may be axially fixed to the carrier at a fixed or variable distance from the first mentioned piston head. The carrier may comprise a third passage in fluid communication with the auxiliary piston head, which may be connected to a hydraulic source for expanding the auxiliary piston head.

Thus, according to an embodiment of the invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

When the carrier is inserted into the lumen, it directly contacts the lumen wall, advances back through the lumen in response to pressure from a hydraulic source, and suitably facilitates fluid passage out of the lumen from the interior portion of the lumen behind the piston head. Rear piston head coupled to the distal portion of the carrier

Provided is a device for use with a biologically compatible hydraulic source comprising a.

In some embodiments, the outer surface of the piston head in contact with the lumen wall includes a low friction coating suitable to facilitate sliding of the piston head relative to the lumen wall.

In one embodiment, the lumen includes a gastrointestinal (GI) tube and the piston head is adapted to make direct contact with the GI tube wall when the carrier is inserted into the GI tube. For example, the GI tract includes the colon and the piston head is adapted to make direct contact with the colon wall when the carrier is inserted into the colon.

In one embodiment, the device includes a discharge tube and the piston head is adapted to facilitate fluid passage out of the lumen through the discharge tube. In some applications, the discharge pipe is shaped to limit the internal diameter of the discharge pipe to 1 to 5 mm, for example 1 to 3 mm. In one embodiment, the discharge canal is adapted to passively allow fluid passage out of the lumen. Alternatively, the discharge tube is adapted to actively facilitate fluid passage out of the lumen by being associated with a suction source. For example, the discharge line may be associated with a suction source such that the pressure behind the piston head is adapted to be -5 millibars to +15 millibars during operation of the apparatus.

In some embodiments, the piston head is inflated to be adapted to achieve and maintain direct contact with the colon wall.

In some applications,

(i) the device comprises an auxiliary piston head coupled to the carrier in a position in front of the rear piston head,

(ii) the auxiliary piston head is adapted to expand to achieve and maintain direct contact with the colon wall,

(iii)

(a) at least some time while the carrier is in the body lumen, the rear piston head is at least partially already retracted, while at the same time the auxiliary piston head is already inflated and through the colon in response to pressure from the hydraulic source Is adapted to move forward,

(b) At least any other time while the carrier is in the body cavity, the auxiliary piston head is at least partially already retracted, while at the same time the rear piston head is already inflated and responds to the colon in response to pressure from the hydraulic source. It is adapted to move forward through the back.

In one embodiment, the piston head is intermittently at least partially contracted while in the colon, such that the piston head is adapted to facilitate fluid passage out of the lumen from an interior portion of the lumen behind the piston head.

In one embodiment, the device comprises a piston head-pressure sensor adapted to sense the internal pressure of the piston head. Or alternatively, or in addition, the apparatus includes a back pressure sensor adapted to sense the internal pressure of the colon behind the piston head. Furthermore, or alternatively, or in addition, the apparatus includes a front pressure sensor adapted to sense the internal pressure of the colon in front of the piston head. In some applications, one, two, or three of these sensors are provided.

In one embodiment, the device is

A pressure sensor adapted to measure a first pressure associated with operation of the device; And

Control unit adapted to adjust the second pressure associated with the operation of the device according to the measured value of the pressure sensor

.

For example, the pressure sensor may be adapted to measure a pressure selected from the list consisting of the pressure behind the piston head, the pressure in front of the piston head, and the pressure inside the piston head.

In one embodiment, the control unit is adapted to adjust the pressure measured by the pressure sensor. Alternatively, the control unit is adapted to adjust a pressure other than the pressure measured by the pressure sensor.

In one embodiment, the piston head is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

In some applications,

(a) the volume of the first lobe is adapted to decrease in response to the confinement of the colon adjacent thereto,

(b) the volume of the second lobe is adapted to remain constant without change in the colon diameter adjacent thereto, even if the volume of the first lobe decreases, and / or

(c) The pressure in the first and second lobes is the same in rectified state regardless of the volume reduction of the first lobe.

In one embodiment, the piston head is adapted to be at an inflation pressure of 10 to 60 millibars while advancing through the colon (eg, 20-50 millibars, or 30-45 millibars). Alternatively, or in addition, the piston head is adapted to advance through the colon in response to pressure from a hydraulic source that is 30% to 100% of the inflation pressure. For example, the piston head is adapted to advance through the colon in response to pressure from a hydraulic source that is 50% to 100% of the inflation pressure (eg 50% to 80% of the inflation pressure).

In one embodiment, the piston head is shaped to define a posterior-narrow portion and is adapted to be inserted into the colon so that the tip of the posterior-narrow portion points in the posterior direction when the piston head is in the colon. In some applications, the anterior base of the posterior-narrow portion is characterized in that the fully expanded diameter is at least greater than the diameter of the colon portion through which the posterior-narrow portion can pass, such that the base of the posterior-narrow portion is It does not swell completely when in this part of the colon.

Furthermore, according to an embodiment of the present invention,

Placing the rear piston head in direct contact with the lumen wall;

Applying hydraulic pressure to the rear piston head to advance the piston head backward through the body cavity; And

Facilitating passage of fluid out of the lumen from the interior portion of the lumen behind the piston head

There is provided a method comprising a.

In one embodiment, the method includes applying a low friction coating to an outer surface of the piston head in contact with the lumen wall, wherein the low friction coating is suitable to facilitate sliding of the piston head relative to the lumen wall.

In one embodiment, the lumen includes a gastrointestinal (GI) tube, and positioning the piston head includes placing the piston head in direct contact with the GI tube wall. In one embodiment, the GI tract includes the colon, and positioning the piston head includes placing the piston head in direct contact with the colon wall.

In one embodiment, facilitating fluid passage includes facilitating passage of fluid out of the lumen through a discharge tube extending from the region behind the piston head to the portion outside the lumen. In some applications, facilitating fluid passage includes passively allowing fluid to pass out of the lumen through the discharge duct. Or alternatively, facilitating fluid passage includes actively removing fluid from the lumen. For example, active removal of the fluid may include applying a pressure of -5 millibars to +15 millibars to an area behind the piston head.

In one embodiment, placing the piston head in direct contact with the wall includes inflating the piston head to an extent sufficient to achieve and maintain direct contact with the colon wall.

In one embodiment, the method is

Placing an auxiliary piston head in front of the rear piston head;

Inflating the auxiliary piston head to an extent sufficient to achieve and maintain direct contact with the colon wall;

At least some time while the rear piston head is in the body lumen, at least partially retracting the rear piston head, at a time after the rear piston head contraction, when the rear piston head is already at least partially contracted, the auxiliary piston head Expanding and advancing backward through the colon in response to the applied hydraulic pressure; And

At least some other time while the rear piston head is in the body cavity, at least partially retracting the auxiliary piston head, so that the rear piston at a time after the auxiliary piston head contraction, when the auxiliary piston head is at least partially already retracted The head expands and advances backward through the colon in response to the applied pressure

It includes.

In one embodiment, facilitating passage of fluid out of the lumen includes intermittently contracting the piston head at least partially.

In one embodiment, the method includes sensing the internal pressure of the piston head, the internal pressure of the colon behind the piston head, and / or the internal pressure of the colon in front of the piston head.

In one embodiment, the method is

Sensing a first pressure associated with performing the method; And

Adjusting a second pressure associated with performing the method according to sensing the first pressure

It includes.

For example, sensing the first pressure includes sensing a pressure selected from a list consisting of pressure behind the piston head, pressure in front of the piston head, and pressure inside the piston head.

In some applications, adjusting the second pressure includes adjusting the first pressure. Or alternatively, adjusting the second pressure does not include adjusting the first pressure.

In one embodiment, inflating the piston head comprises inflating the piston head at an inflation pressure of 10 to 60 millibars. Or alternatively, or additionally, applying the hydraulic pressure includes setting the hydraulic pressure to 30% to 100% of the inflation pressure (eg, 50% to 100% of the inflation pressure, or 50% to 80% of the inflation pressure). %).

In one embodiment, inflating the piston head comprises inflating the piston head at an inflation pressure of 20 to 50 millibars (eg, 30 to 45 millibars).

Thus, according to an embodiment of the invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

After the carrier is inserted into the lumen, it directly contacts the lumen wall, advances backward through the body lumen in response to pressure from a hydraulic source, and suitably facilitates fluid passage out of the lumen from the interior portion of the lumen behind the piston head. A rear piston head coupled to the distal portion of the carrier; And

An image sensor located at the proximal end of the optical system; An optical member shaped to define a lateral surface and having a distal end and a proximal end, at least the distal portion of which is curved to provide an omnidirectional side view; And a convex mirror coupled to the distal end of the optical member, wherein the optical member and the convex mirror are each shaped to rotate about a common axis of rotation.

A device is provided for use with a biologically compatible hydraulic source comprising a.

In some applications, the convex mirror is shaped to define a hole through which back light can pass.

In addition, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An expandable rear piston head coupled to the distal portion of the carrier, the rear piston head is shaped to define a forward and rear lobe in fluid communication with each other, the rear piston head being inflated after the carrier is inserted into the lumen and Is adapted to achieve direct contact with and advance backward through the body cavity in response to pressure from the hydraulic source; And

Flexible discharge conduit passing through the front and rear lobes of the piston head and adapted to facilitate fluid passage therefrom, which is open at the interior portion of the lumen behind the piston head.

A device is provided for use with a biologically compatible hydraulic source comprising a.

Furthermore, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

A balloon coupled to the distal portion of the carrier, adapted to be in direct contact with the lumen wall after the carrier has been inserted into the lumen; And

Hydrophilic material placed on the outer surface of the balloon

Provided is an apparatus comprising a.

Furthermore, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

A balloon coupled to the distal portion of the carrier, characterized in that it is adapted to be in direct contact with the lumen wall after being inserted into the lumen and has a thickness of 20 microns or less

Provided is an apparatus comprising a.

In some applications, the balloon is characterized as having a thickness of less than 10 microns.

In addition, according to embodiments of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

The rear piston head coupled to the distal portion of the carrier, after the carrier has been inserted into the lumen and in direct contact with the lumen wall and adapted to be pulled forward through the lumen in response to pressure from a hydraulic source.

Provided is a device for use with a biologically compatible hydraulic source comprising a.

In some applications, the carrier is adapted to facilitate fluid passage out of the lumen from the interior portion of the lumen in front of the piston head.

In addition, according to an embodiment of the present invention there is provided an apparatus for use with an elongated carrier which inserts through the front opening of the lumen.

An annular balloon shaped to form a hole into which the carrier is inserted and capable of expanding to form a seal between the balloon and the body lumen wall near the front hole;

First and second hydraulic sources;

A first tube coupled between the first pressure source and the interior of the balloon; And

A second tube coupled between a second pressure source and the interior of the lumen behind the annular balloon

.

In some applications, at least one of the first and second pressure sources is adapted to be located outside the body lumen.

Moreover, according to the specific example of this invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

An inflatable cuff shaped to define a hole into which the carrier can be inserted and adapted to form a seal with the luminal wall near the front hole when the cuff is in the inflated state.

Provided is an apparatus comprising a.

Furthermore, according to an embodiment of the invention, there is provided an apparatus for use with a fluid source, the apparatus

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An image-capturing device fixed to the carrier near the distal end of the carrier; And

At least one fluid supply tube coupled to the carrier and to the fluid source

Wherein the distal end of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the image-capturing device when the fluid is provided by the fluid source.

Furthermore, according to an embodiment of the invention, there is provided an apparatus for use in a body cavity having a front hole and a wall, the apparatus

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An image-capturing device fixed near the first distal end of the carrier, adapted to provide an omnidirectional side view; And

The distal end portion, adapted to increase the diameter of the carrier in the vicinity of the second distal end portion to an extent sufficient to position the image-capturing apparatus at a distance far enough from the wall to enable the image-capturing device to focus in all directions. Inflatable component secured near the second

It includes.

In addition, according to an embodiment of the present invention, there is provided a device for use in a body cavity having a front hole, the device comprising:

First and second hydraulic sources;

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An inflatable rear piston head coupled to the distal portion of the carrier, adapted to be in direct contact with the lumen wall after the carrier has been inserted into the lumen;

A first passage in fluid communication with the first pressure source and the proximal portion of the lumen in front of the piston head;

A second passage in fluid communication with the second pressure source and the piston head;

First and second pressure sensors adapted to measure pressure at the proximal lumen and pressure at the piston head, respectively; And

While the first pressure source applies pressure to the proximal portion of the lumen, the piston head is driven by driving the second pressure source to adjust the pressure at the piston head to add a positive value to equal the pressure at the proximal portion of the lumen. Control unit adapted to advance the vehicle backwards in the lumen

.

In some applications, the device includes a third passage in fluid communication with the lumen portion behind the piston head and the portion outside the lumen.

In addition, according to embodiments of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

A piston head coupled to the distal portion of the carrier, the carrier head being adapted to form consolidation with the lumen wall after insertion of the carrier into the lumen and adapted to advance backward through the body cavity in response to pressure from the hydraulic source; And

An image sensor located at the proximal end of the optical system; An optical member shaped to define a lateral surface and having a distal end and a proximal end, at least the distal portion of which is curved to provide an omnidirectional side view; And a convex mirror coupled to the distal end of the optical member, wherein the optical member and the convex mirror have a distal end and a proximal end, each having a shape that rotates about a common axis of rotation, and an optical system coupled with the carrier near the distal end.

An apparatus is provided for use with a biologically compatible hydraulic source, the apparatus configured to facilitate forward movement of the piston head by facilitating fluid passage out of the lumen from an interior portion of the lumen behind the piston head.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In one embodiment, the piston head is adapted to make direct contact with the GI duct wall after the carrier is inserted into the GI tract.

In some applications, the convex mirror is shaped to define a hole through which back light can pass. In some applications, the optical member is shaped to define the rear recess in the distal end of the optical member. In some applications, the optical member is shaped to define the front recess in the proximal end of the optical member. In some applications, the optical system includes a rear lens positioned behind the mirror, which rear lens has a shape that rotates about a common axis of rotation. In some applications, the optical system provides different levels of magnification for the back light reaching the image sensor through the distal end of the optical system and the side light reaching the image sensor through the curved distal portion of the side surface of the optical member. It is composed.

In some applications, the outer surface of the piston head forming a consolidation with the GI tube wall includes a low friction coating suitable to facilitate sliding of the piston head relative to the GI tube wall.

In some applications, the apparatus includes a fluid supply and at least one fluid supply tube associated with and in fluid communication with the carrier, the distal portion of the carrier being shaped to define one or more apertures in fluid communication with the fluid supply tube. The holes are oriented to be distributed in at least a portion of the optical member when the fluid is provided by the fluid source.

In some applications, the device is adapted to increase the diameter of the carrier near the distal portion of the carrier to an extent sufficient to position the optical member at a distance far enough from the wall to enable the optical system to focus in all directions. An inflatable component fixed near the distal portion of the carrier.

In one embodiment, the device comprises an outlet tube, which device is adapted to facilitate fluid flow out of the TI tube through the outlet tube. In some applications, the discharge canal is adapted to passively allow fluid passage out of the GI canal. Alternatively, the outlet tube is adapted to engage the suction source to actively facilitate fluid passage out of the GI tube.

In one embodiment, the piston head is adapted to expand and form and maintain consolidation with the GI duct wall. In some applications, the piston head is intermittently at least partially retracted while in the GI tract, so that fluid passage out of the GI tract from the interior portion of the GI tract behind the piston head is facilitated. In some applications, the piston head is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

In some applications, the device includes a piston head-pressure sensor adapted to sense the internal pressure of the piston head. In some applications, the piston head-pressure sensor is adapted to be placed inside the piston head. Alternatively, the piston head-pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the piston head-pressure sensor is adapted to be placed outside the GI tract.

In addition, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

An inflatable piston head coupled to the distal portion of the carrier,

The piston head is shaped to define a forward lobe and a backward lobe in fluid communication with each other, and the piston head expands after the carrier is inserted into the lumen to form consolidation with the lumen wall and responds to pressure from the hydraulic source into the body. A device is provided for use with a biologically compatible hydraulic source that is adapted to advance backward through the steel.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In one embodiment, the piston head is adapted to make direct contact with the GI duct wall after the carrier is inserted into the GI tract.

In some applications, the volume of the first lobe is adapted to decrease in response to the confinement of the GI tube adjacent thereto, and the volume of the second lobe changes within the diameter of the GI tube adjacent thereto even if the volume of the first lobe decreases. It is adapted to remain constant without pressure, and the pressure in the first and second lobes is the same in a steady state regardless of the volume reduction of the first lobe.

In some applications, the rearward lobe has a diameter substantially the same as the diameter of the GI tract. In some applications, the rearward lobe has a length of 3-5 cm. In some applications, the piston head is shaped to define at least one lobe in addition to the first and second lobes.

In some applications, the piston head is shaped to define an intermediate portion where the forward and rearward lobes are segmented. In some applications, the middle portion has a diameter equal to 10% to 40% of the rearward lobe diameter.

In one embodiment, the device passes through the front and back lobes of the piston head and is open at the interior portion of the GI duct behind the piston head, thereby facilitating the forward advancement of the piston head by facilitating fluid passage therefrom. It includes a flexible discharge line adapted to facilitate.

In some applications, the volume of the first lobe is adapted to decrease in response to the confinement of the GI tube adjacent thereto, and the volume of the second lobe changes within the diameter of the GI tube adjacent thereto even if the volume of the first lobe decreases. It is adapted to remain constant without pressure, and the pressure in the first and second lobes is the same in a steady state regardless of the volume reduction of the first lobe.

In some applications, the rearward lobe has a diameter substantially the same as the diameter of the GI tract. In some applications, the rearward lobe has a length of 3-5 cm. In some applications, the piston head is configured to define at least one lobe in addition to the first and second lobes.

In some applications, the piston head is formed to define an intermediate portion where the forward and backward lobes are segmented. In some applications, the middle portion has a diameter equal to 10% to 40% of the rearward lobe diameter.

Furthermore, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

A balloon coupled to the distal portion of the carrier, adapted to be in direct contact with the lumen wall after the carrier has been inserted into the lumen; And

Hydrophilic material placed on the outer surface of the balloon

Provided is an apparatus comprising a.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In some applications, the balloon is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

Furthermore, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

The carrier is adapted to be in direct contact with the lumen wall after being inserted into the lumen, and the outer surface of the balloon in direct contact with the lumen wall comprises a low friction coating suitable for facilitating the balloon sliding against the lumen wall. Balloon attached to distal end of carrier

Provided is an apparatus comprising a.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In some applications, the low friction coating includes a lubricant.

In some applications, the balloon is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

In addition, according to embodiments of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

A balloon coupled to the distal portion of the carrier, characterized in that it is adapted to be in direct contact with the lumen wall after being inserted into the lumen and has a thickness of 20 microns or less

Provided is an apparatus comprising a.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In some applications, the balloon is characterized as having a thickness of less than 10 microns. In some applications, the outer surface of the balloon in contact with the GI duct wall includes a low friction coating suitable for facilitating sliding of the balloon with respect to the GI duct wall. In some applications, the outer surface of the balloon in contact with the GI duct wall comprises a hydrophilic material suitable for facilitating sliding of the balloon with respect to the wall of the GI tract.

In some applications, the balloon is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

In addition, according to embodiments of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

A piston head coupled to the distal portion of the carrier, after the carrier is inserted into the lumen, forming a consolidation with the lumen wall and adapted to be pulled forward through the body lumen in response to pressure from the hydraulic source.

Provided is a device for use with a biologically compatible hydraulic source comprising a.

In one embodiment, the lumen includes a gastrointestinal (GI) tube and the piston head is adapted to form consolidation with the GI tube wall after the carrier is inserted into the GI tube. In one embodiment, the GI tract includes the colon and the piston head is adapted to form consolidation with the colon wall after the carrier is inserted into the colon.

In one embodiment, the piston head is adapted to make direct contact with the GI duct wall after the carrier is inserted into the GI tract.

In some applications, the outer surface of the piston head forming a consolidation with the GI tube wall includes a low friction coating suitable to facilitate sliding of the piston head relative to the GI tube wall.

In some applications, the piston head is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other.

In some applications, the apparatus includes (a) a pressure application tube adapted to introduce pressure to the distal portion of the interior of the GI tube behind the piston head and (b) in fluid communication with the hydraulic source.

In some applications, the device

Fluid source;

An image-capture device coupled to the carrier near the distal end of the carrier; And

At least one fluid supply tube coupled to the carrier and in fluid communication with the fluid source

Wherein the distal end of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the image-capturing device when the fluid is provided by the fluid source.

In one embodiment, the device is adapted to facilitate fluid passage out of the GI tube from the proximal portion of the interior of the GI tube in front of the piston head. In some applications, the device includes an outlet tube in fluid communication with the proximal portion and the exterior of the GI tube, which outlet tube is adapted to facilitate fluid passage from the proximal portion to the outside, thereby reducing pressure at the proximal portion. In some applications, the discharge canal is adapted to passively allow fluid passage from the proximal portion. In some applications, the device includes a suction source associated with the discharge tube, adapted to actively facilitate fluid passage from the proximal portion.

 In one embodiment, the piston head is adapted to expand and form and maintain consolidation with the GI duct wall. In some applications, the device includes a piston head-pressure sensor adapted to sense the internal pressure of the piston head. In some applications, the piston head-pressure sensor is adapted to be placed inside the piston head. In some applications, the piston head-pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the piston head-pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device includes a back pressure sensor adapted to sense the internal pressure of the GI tube behind the piston head. In some applications, the rear pressure sensor is adapted to be placed behind the piston head. In some applications, the back pressure sensor is adapted to be placed near the front hole of the GI tract. In some applications, the back pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device includes a front pressure sensor adapted to sense the internal pressure of the GI tube in front of the piston head. In some applications, the front pressure sensor is adapted to be placed near the piston head. In some applications, the front pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the front pressure sensor is adapted to be placed outside the GI tract.

In some applications, the apparatus includes a pressure sensor adapted to measure a first pressure associated with operation of the apparatus; And a control unit adapted to adjust a second pressure associated with the operation of the device in accordance with the measurement of the pressure sensor. In some applications, the pressure sensor is adapted to measure a pressure selected from the list consisting of the pressure behind the piston head, the pressure in front of the piston head, and the pressure inside the piston head.

In addition, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An annular balloon shaped to form a hole into which the carrier is inserted, at least partially inserted into the front hole and adapted to form a consolidation between the balloon and the body lumen wall near the front hole;

First and second hydraulic sources;

A first tube coupled between the first pressure source and the interior of the balloon; And

A second tube coupled between a second pressure source and the interior of the lumen behind the annular balloon

Provided is an apparatus comprising a.

In one embodiment, the body lumen comprises the colon, the anterior opening comprises the rectum, and the balloon is at least partially inserted into the rectum and is adapted to expand to form a consolidation between the balloon and the colon wall.

 In some applications, at least one of the first and second pressure sources is adapted to be located external to the colon.

In some applications, the device includes a ring associated with the balloon, which is adapted to rest against the rectum and is shaped to form a hole into which the carrier is inserted.

In some applications, the first pressure source comprises a powered hydraulic source. Or alternatively, the first pressure source comprises a manually-operated hydraulic source. In some applications, the manually-operated pressure source comprises a syringe.

Furthermore, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

Inflatable cuff shaped to define a hole into which the carrier can be inserted, adapted to form consolidation with the lumen wall near the front hole when the cuff is in the inflated state

Provided is an apparatus comprising a.

In one embodiment, the body lumen comprises the colon, the anterior aperture comprises the rectum, and the carrier is adapted to be inserted through the rectum of the colon.

Furthermore, according to an embodiment of the invention, there is provided an apparatus for use with a fluid source, the apparatus

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An image-capturing device fixed to the carrier near the distal end of the carrier; And

At least one fluid supply tube coupled to the carrier and in fluid communication with the fluid source

Wherein the distal end of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the image-capturing device when the fluid is provided by the fluid source.

In one embodiment, the body lumen comprises the colon and the carrier is adapted to be inserted through the front hole of the colon.

In some applications, the distal end of the carrier is shaped to define four to ten holes, and fluid flows through these holes when provided by the fluid source. In some applications, the holes are disposed in all directions relative to the distal end of the carrier. In some applications, the holes are circumferentially positioned to create a vortex around the image-capturing device when fluid is provided by the fluid source.

In some applications, the image-capturing device includes an optical member shaped to define a side surface configured to provide an omnidirectional side view, and the holes are oriented to distribute at least a portion of the side surface of the optical member. In some applications, the optical member is shaped to define a front surface configured to provide a front view, and the holes are oriented to distribute at least a portion of the front surface of the optical member.

In addition, according to an embodiment of the present invention, there is provided a device for use in a body cavity having a front hole, the device comprising:

An elongated carrier adapted to be inserted through the front hole of the lumen;

An image-capturing device fixed near the first distal end of the carrier, adapted to provide an omnidirectional side view; And

A distal end adapted to increase the diameter of the carrier in the vicinity of the second end of the distal end to an extent sufficient to position the image-capturing end at a distance far enough from the lumen wall to allow the image-capturing device to focus in all directions Inflatable component fixed near second of part

It includes.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract.

In some applications, the inflatable component is adapted to increase the diameter of the carrier in the vicinity of the second such that the image-capturing device is at least 15 mm away from the wall.

In some applications, the inflatable component includes an expandable sponge. Alternatively, or in addition, the inflatable component includes a set of one or more rings selected from the list consisting of inflatable rings, and expandable rings. Furthermore, or alternatively, or in addition, the inflatable component includes an inflatable balloon.

In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon. In some applications, the inflatable component is adapted to increase the diameter of the carrier to 30-45 mm in the vicinity of the second.

In addition, according to an embodiment of the present invention, there is provided a device for use in a body cavity having a front hole, the device comprising:

First and second hydraulic sources;

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An inflatable piston head coupled to the distal portion of the carrier, adapted to form consolidation with the lumen wall after the carrier has been inserted into the lumen;

A first passage in fluid communication with the first pressure source and the proximal portion of the lumen in front of the piston head;

A second passage in fluid communication with the second pressure source and the piston head;

First and second pressure sensors adapted to measure a first measurable pressure in the proximal portion of the lumen and a second measurable pressure in the piston head, respectively; And

While the first pressure source applies the first applied pressure proximal to the lumen, the second pressure source is driven to add a positive value by applying a second applied pressure to the first at the proximal end of the lumen. A control unit adapted to advance the piston head backwards in the lumen by adjusting a second measurable pressure at the piston head to be equal to the measurable pressure of

.

In one embodiment, the lumen comprises a gastrointestinal (GI) tract and the carrier is adapted to be inserted through the front hole of the GI tract. In one embodiment, the GI tract includes the colon and the carrier is adapted to be inserted through the front hole of the colon.

In one embodiment, the piston is adapted to make direct contact with the GI duct wall after the carrier is inserted into the GI tract.

In some applications, the device includes a GI tubular portion behind the piston head and a third passage in fluid communication with a portion outside the GI tubing.

In some applications, the first passageway has a diameter of 3 to 6 mm.

In some applications, the first pressure sensor is adapted to be disposed near the piston head. Alternatively, in some applications, the first pressure sensor is adapted to be placed near the front hole of the GI tract. In some applications, the first pressure sensor is adapted to be placed outside the GI tract.

In some applications, the second pressure sensor is adapted to be placed inside the piston head. In some applications, the second pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the second pressure sensor is adapted to be placed outside the GI tract.

In some applications, the positive value is 1-5 millibars. In some applications, the positive value is 1.5 to 2.5 millibars.

In some applications, the control unit drives the second pressure source to apply a second applied pressure, thereby setting the second measurable pressure at the piston head to an initial value before applying the first applied pressure. It is adapted to do so. In some applications, the initial value is 5 to 15 milliseconds and the control unit is adapted to set the second measurable pressure at 5 to 15 millibars. In some applications, the control unit is adapted to adjust the second measurable pressure equal to the greater of (a) the initial value and (b) the first measurable pressure plus the positive value.

In addition, according to an embodiment of the present invention,

An elongated carrier adapted to be inserted through the front opening of the body cavity; And

The back coupled to the distal portion of the carrier, after the carrier is inserted into the lumen, forms a consolidation with the lumen wall and is adapted to advance backward through the body cavity in response to pressure from a hydraulic source applied to the outer surface of the rear piston head. Piston head

Provided is a device for use with a biologically compatible hydraulic source comprising a.

In one embodiment, the lumen includes a gastrointestinal (GI) tube and the rear piston head is adapted to form consolidation with the GI tube wall after the carrier is inserted into the GI tube. In one embodiment, the GI tract includes the colon and the rear piston head is adapted to form consolidation with the colon wall after the carrier is inserted into the colon.

In one embodiment, the rear piston head is adapted to make direct contact with the GI duct wall after the carrier is inserted into the GI tract.

In some applications, the outer surface of the rear piston head forming a consolidation with the GI tube wall comprises a low friction coating suitable for facilitating sliding of the distal piston head relative to the GI tube wall.

In some applications, the device

Fluid source;

An optical member coupled near the distal portion of the carrier; And

At least one fluid supply tube coupled to the carrier and in fluid communication with the fluid source

Wherein the distal portion of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the optical member when the fluid is provided by the fluid source.

In some applications, the device

An optical system comprising an optical member configured to provide an omnidirectional side view; And

Fixed near the distal portion of the carrier, adapted to increase the diameter of the carrier near the distal portion of the carrier to an extent sufficient to position the optical member at a distance far enough from the wall to enable the optical system to focus in all directions Inflatable components

It includes.

In one embodiment, the device is adapted to facilitate rearward advancement of the rear piston head by facilitating fluid passage out of the GI tube from the distal portion of the interior of the GI tube behind the rear piston head. In some applications, the device is adapted to facilitate the passage of fluid from the distal portion out of the GI tract sufficient to keep the distal pressure below 10 millibars. In some applications, the device is adapted to facilitate passage of at least 100 cc of fluid out of the GI tract from the distal per minute the rear piston head is advanced backwards. In some applications, the device is adapted to facilitate passage of at least 300 cc of fluid out of the GI tract from the distal per minute the rear piston head is advanced backwards.

In some applications, the device is adapted to facilitate passage of at least 3 cc of fluid out of the GI tract from the distal per centimeter where the rear piston head is advanced backwards. In some applications, the device is adapted to facilitate passage of at least 10 cc of fluid out of the GI tract from the distal per centimeter where the rear piston head is advanced backwards.

In some applications, the device includes a discharge tube, and the device is adapted to facilitate fluid flow out of the GI tube from the distal portion inside the GI tube via the discharge tube. In some applications, the discharge pipe is formed to define an inner diameter of 1 to 3 mm. In some applications, the discharge canal is adapted to passively allow fluid passage out of the GI canal from the distal portion inside the GI canal.

In some applications, the discharge canal is combined with a suction source, thereby making it suitable to actively facilitate fluid passage out of the GI canal from the distal portion inside the GI canal. In some applications, the discharge line is associated with a suction source such that the pressure behind the rear piston head is adapted to be -5 millibars to +15 millibars during operation of the apparatus.

In some applications, the device includes a suction source associated with an outlet tube adapted to actively facilitate fluid passage out of the GI tube from a distal portion inside the GI tube. In some applications, the suction source is adapted to maintain the pressure behind the rear piston head at -5 millibars to +15 millibars.

In some applications, the rear piston head is adapted to expand and form and maintain consolidation with the GI duct wall, while the rear piston head is intermittently at least partially contracted while in the GI tract so that the GI tract behind the rear piston head is It is adapted to facilitate fluid passage out of the GI tract from an internal portion of the.

In one embodiment, the rear piston head is adapted to expand and form and maintain consolidation with the GI duct wall. In some applications, the device includes an auxiliary piston head coupled to the carrier in a position before the rear piston head; The auxiliary piston head is adapted to expand to form and maintain an auxiliary consolidation with the GI duct wall; (a) At least some time while the carrier is in the GI tract, the rear piston head is already at least partially retracted, while at the same time the auxiliary piston head is already inflated and responds to the GI tract in response to pressure from the hydraulic source. (B) at least some other time while the carrier is in the GI tract, the auxiliary piston head is at least partially already retracted, and at the same time the rear piston head is already inflated, It is adapted to advance backward through the GI tract in response to pressure from the hydraulic source.

In some applications, the device includes a piston head-pressure sensor adapted to sense the internal pressure of the rear piston head. In some applications, the piston head-pressure sensor is adapted to be placed inside the rear piston head. In some applications, the piston head-pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the piston head-pressure sensor is adapted to be placed outside the GI tract. In some applications, the device includes a rear pressure sensor adapted to sense the internal pressure of the GI tract behind the rear piston head. In some applications, the rear pressure sensor is adapted to be placed behind the rear piston head. Alternatively, in some applications, the back pressure sensor is adapted to be placed near the front hole of the GI tract. In some applications, the back pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device includes a front pressure sensor adapted to sense a first measurable pressure inside the proximal portion of the GI tract in front of the rear piston head. In some applications, the device includes a rear pressure sensor adapted to sense pressure behind the rear piston head. In some applications, the rear pressure sensor is adapted to be placed near the rear piston head.

In some applications, the front pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the front pressure sensor is adapted to be placed outside the GI tract. In some applications, the apparatus includes a piston head-pressure sensor adapted to sense a second measurable pressure inside the rear piston head. In some applications, the pressure source comprises a first pressure source adapted to apply a first applied pressure proximal to the GI tract, the apparatus comprising

A second pressure source adapted to apply a second applied pressure inside the rear piston head; And

While the first pressure source applies the first applied pressure proximally, by driving the second pressure source to apply the second applied pressure, a positive value is added to the first measurement at the proximal portion of the GI tract. A control unit adapted to advance the rear piston head backwards in the GI tract by adjusting the second measurable pressure at the rear piston head to be equal to the possible pressure

.

In some applications, the apparatus includes a pressure sensor adapted to measure a first pressure associated with operation of the apparatus; And a control unit adapted to adjust a second pressure associated with the operation of the device in accordance with the measurement of the pressure sensor. In some applications, the pressure sensor is adapted to measure a pressure selected from the list consisting of pressure behind the rear piston head, pressure in front of the rear piston head, and pressure inside the rear piston head. In some applications, the control unit is adapted to adjust the pressure measured by the pressure sensor. In some applications, the control unit is adapted to adjust a pressure other than the pressure measured by the pressure sensor.

In some applications, the rear piston head is shaped to define a front lobe and a rear lobe, and the lobes are in fluid communication with each other.

In some applications, the volume of the first lobe is adapted to decrease in response to the confinement of the adjacent GI tube, and the volume of the second lobe is within the diameter of the adjacent GI tube even if the volume of the first lobe decreases. It is adapted to remain constant without change, and the pressures in the first and second lobes are the same in rectified state regardless of the volume reduction of the first lobe.

In some applications, the rear piston head is adapted to be at an inflation pressure of 10 to 60 millibars while advancing through the GI tract. In some applications, the rear piston head is adapted to advance through the GI tract in response to pressure from a hydraulic source that is 30% to 100% of the inflation pressure. In some applications, the rear piston head is adapted to advance through the GI tract in response to pressure from a hydraulic source that is between 50% and 100% of the inflation pressure.

In some applications, the rear piston head is adapted to be at an inflation pressure of 20-50 millibars while advancing through the GI tract. In some applications, the rear piston head is adapted to be at an inflation pressure of 30 to 45 millibars while advancing through the GI tract. In some applications, the rear piston head is adapted to advance through the GI tract in response to pressure from a hydraulic source that is 30% to 100% of the inflation pressure. In some applications, the rear piston head is adapted to advance through the GI tract in response to pressure from a hydraulic source that is between 50% and 100% of the inflation pressure. In some applications, the rear piston head is adapted to advance through the GI tract in response to pressure from a hydraulic source that is between 50% and 80% of the inflation pressure.

In some applications, the rear piston head is shaped to define a rear-narrow portion and is adapted to be inserted into the GI tube so that the tip of the rear-narrow portion points in the rear direction when the rear piston head is in the GI tube. In some applications, the anterior base of the posterior-narrow portion is characterized in that the fully expanded diameter is at least greater than the diameter of the GI tubular portion through which the posterior-narrow portion can pass, so that the base of the posterior-narrow portion is It does not fully expand when the base is in this part of the GI tract.

Furthermore, according to an embodiment of the invention, there is provided a device for use in a lumen having a frontal opening, the device

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An inflatable piston head coupled to the distal portion of the carrier, adapted to form consolidation with the lumen wall after the carrier has been inserted into the lumen; And

Biologically compatible anterior hydraulic source in fluid communication with the proximal portion of the lumen in front of the piston head and adapted to apply sufficient pressure to advance the carrier backwards through the body lumen.

.

In one embodiment, the lumen includes a gastrointestinal (GI) tube and the piston head is adapted to form a consolidation with the GI tube wall. In one embodiment, the GI tract includes the colon and the piston head is adapted to form consolidation with the colon wall.

In one embodiment, the piston head is adapted to be in direct contact with the GI duct wall.

In some applications, the device includes a first passageway through which the front pressure source is in fluid communication with the proximal portion of the GI tract.

In some applications, the apparatus includes a piston pressure source in fluid communication with the piston head and adapted to inflate the piston head by applying pressure to the piston head.

In some applications, the apparatus includes a second passageway through which the piston pressure source is in fluid communication with the piston head.

In some applications, the device includes a front pressure sensor adapted to measure pressure in the proximal portion of the GI tract; And a piston pressure sensor adapted to measure pressure at the piston head.

In some applications, the device includes a front pressure sensor adapted to measure pressure at the proximal portion of the GI tract. In some applications, the front pressure sensor is adapted to be placed near the piston head. Alternatively, in some applications, the front pressure sensor is adapted to be placed near the front hole of the GI tract. In some applications, the front pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device includes a piston pressure sensor adapted to measure the pressure of the piston head. In some applications, the piston pressure sensor is adapted to be placed inside the piston head. In some applications, the piston pressure sensor is adapted to be placed near the front hole of the GI tube. In some applications, the piston pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device may be in fluid communication with the distal portion of the GI tract behind the piston head and with the outside of the GI tract and adapted to facilitate the forward advancement of the piston head by facilitating fluid passage out of the GI tract from the distal portion. Include. In some applications, the device includes a back pressure sensor adapted to measure pressure at the distal portion of the GI tract. In some applications, the rear pressure sensor is adapted to be placed behind the piston head. In some applications, the back pressure sensor is adapted to be placed near the front hole of the GI tract. In some applications, the back pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device is adapted to facilitate the passage of fluid sufficient from the distal portion out of the GI tract to maintain pressure at the distal portion less than 10 millibars.

In some applications, the discharge canal is adapted to passively allow fluid passage out of the GI canal from the distal portion.

In some applications, the device includes a suction source associated with the discharge tube, adapted to actively facilitate fluid passage from the distal portion out of the GI tube.

In some applications, the device is adapted to facilitate passage of at least 100 cc of fluid out of the GI tract from the distal per minute the piston head is advanced backwards. In some applications, the device is adapted to facilitate passage of at least 300 cc of fluid out of the GI tract from the distal per minute the piston head is advanced backwards.

In some applications, the device is adapted to facilitate passage of at least 3 cc of fluid out of the GI tract from the distal per centimeter where the piston head is advanced backwards. In some applications, the device is adapted to facilitate passage of at least 10 cc of fluid out of the GI tract from the distal per centimeter where the piston head is advanced backwards.

Furthermore, according to an embodiment of the invention, there is provided a device for use in a lumen having a frontal opening, the device

An elongated carrier adapted to be inserted through the front opening of the body cavity;

An inflatable piston head coupled to the distal portion of the carrier, adapted to form consolidation with the lumen wall after the carrier has been inserted into the lumen;

A biologically compatible anterior hydraulic source in fluid communication with the proximal portion of the lumen in front of the piston head and adapted to apply sufficient pressure to advance the carrier back through the body lumen; And

Piston head-pressure sensor, positioned in front of the lumen of the lumen, in fluid communication with the interior of the piston head, adapted to sense piston head pressure at the piston head

It includes.

In one embodiment, the lumen includes a gastrointestinal (GI) tube and the piston head is adapted to form a consolidation with the GI tube wall. In one embodiment, the GI tract includes the colon and the piston head is adapted to form consolidation with the colon wall.

In one embodiment, the piston head is adapted to be in direct contact with the GI duct wall.

In some applications, the piston head-pressure sensor is adapted such that its proximal end is in fluid communication with the interior of the piston head via a passage disposed near the front hole of the GI tube.

In some applications, the piston head-pressure sensor is adapted to be placed outside the GI tract.

In some applications, the apparatus includes a biologically compatible piston head hydraulic source adapted to be in fluid communication with the interior of the piston head through the passage, wherein the piston head pressure source is in fluid communication with the interior of the piston head through the passage. It becomes suitable.

In some applications, the device includes a proximal pressure sensor disposed near the front opening of the GI tract, which is adapted to sense proximal pressure at the proximal GI tract. In some applications, the proximal pressure sensor is adapted to be placed outside the GI tract.

In some applications, the device includes a distal pressure sensor disposed near the front hole of the GI tube, adapted to sense distal pressure at the distal portion of the GI tube behind the piston head. In some applications, the distal pressure sensor is adapted to be placed outside the GI tract.

In addition, according to embodiments of the present invention,

Forming a consolidation between the piston head and the lumen wall;

Advancing the piston head back through the body lumen by applying hydraulic pressure to an outer surface of the piston head and facilitating fluid passage out of the lumen from an interior portion of the lumen behind the piston head; And

Providing an omnidirectional side view near the piston head

It provides a method comprising a.

In addition, according to embodiments of the present invention,

Forming a consolidation between the piston head and the body cavity wall shaped to define a forward lobe and a backward lobe in fluid communication with each other; And

Advancing the piston head backwards through the body lumen by applying pressure to an outer surface of the piston head

There is provided a method comprising a.

In addition, according to an embodiment of the present invention,

Providing an elongated carrier having a balloon disposed on the outer surface thereof, the balloon being distal to the distal end; And

Contacting the balloon directly with the lumen wall by inserting an elongated carrier through the front hole of the lumen

There is provided a method comprising a.

Furthermore, according to an embodiment of the present invention,

Providing an elongated carrier having a low friction coating suitable for facilitating sliding of the balloon against the lumen wall on its outer surface, the elongated carrier having a distal connection; And

Contacting the balloon directly with the lumen wall by inserting an elongated carrier through the front hole of the lumen

There is provided a method comprising a.

Furthermore, according to an embodiment of the present invention,

Providing an elongated carrier having a balloon coupled to the distal end, the balloon having a thickness of 20 microns or less; And

Contacting the balloon directly with the lumen wall by inserting an elongated carrier through the front hole of the lumen

There is provided a method comprising a.

In addition, according to embodiments of the present invention,

Forming a consolidation between the piston head and the lumen wall; And

Applying hydraulic pressure to the outer surface of the piston head to pull the piston head forward through the body cavity

There is provided a method comprising a.

In addition, according to embodiments of the present invention,

At least partially inserting the annular balloon into the front opening of the body cavity;

Expanding the balloon to form a seal between the balloon and the lumen wall near the front opening;

Inserting an elongated carrier into the lumen through a hole passing through the balloon; And

Applying pressure to the interior of the lumen behind the balloon

There is provided a method comprising a.

Moreover, according to the specific example of this invention,

At least partially inserting the inflatable cuff into the front opening of the body cavity;

Inflating the cuff to form a seal with the lumen wall near the front opening; And

Inserting an elongated carrier into the lumen through a hole passing through the cuff

There is provided a method comprising a.

Furthermore, according to an embodiment of the present invention,

Inserting an elongated carrier secured near the first distal end of the carrier through the front hole of the body cavity, the image-capturing device providing an omnidirectional side view; And

Increasing the diameter of the carrier in the vicinity of the second end of the distal end to an extent sufficient to position the image-capturing device at a distance far enough from the wall to enable the image-capturing device to focus in all directions

There is provided a method comprising a.

In addition, according to embodiments of the present invention,

Forming a consolidation between the inflatable piston head and the body lumen wall;

Measuring a first measurable pressure in the proximal portion of the lumen in front of the piston head and a second measurable pressure in the piston head; And

By applying a first applied pressure proximal to the lumen and a second applied pressure to the piston head, the positive value is added to equal the first measurable pressure in the proximal lumen. Advancing the piston head backwards through the lumen by adjusting a second measurable pressure of the

There is provided a method comprising a.

In addition, according to embodiments of the present invention,

Forming a consolidation between the posterior piston head and the lumen wall; And

Advancing the piston head back through the lumen by applying hydraulic pressure to the outer surface of the rear piston head

There is provided a method comprising a.

Moreover, according to the specific example of this invention,

Forming a consolidation between the piston head and the lumen wall;

Applying hydraulic pressure to an outer surface of the rear piston head to advance the piston head back through the lumen; And

Detecting the piston head pressure at the piston head, near the front hole of the lumen

There is provided a method comprising a.

The invention will be more fully understood and appreciated through the following detailed description taken in conjunction with the drawings.

1 is a simplified diagram of a system constructed and operated in accordance with embodiments of the present invention, which may be suitable for imaging a lumen, such as a GI tract.

2 and 3 are simplified cross-sectional views of the back and front portions of the system of FIG. 1, respectively.

4 is a simplified cross-sectional view of the carrier of the system of FIG. 1, in accordance with an embodiment of the present invention, which is taken transversely with respect to the longitudinal axis of the carrier.

5A, 5B and 5C are simplified diagrams illustrating three stages of operation of the system of FIG. 1, in accordance with embodiments of the present invention, wherein the inflatable piston head expands and contracts to penetrate an obstacle in the body cavity. .

6 is a diagram of a system for use within the body lumen constructed and operated in accordance with an embodiment of the present invention.

7 is a view of an inflated conical balloon adapted to be used in accordance with an embodiment of the present invention.

8 is a view of a conical balloon partially inflated within the body cavity, in accordance with an embodiment of the present invention.

9A is a cross-sectional view of a fully inflated portion of a conical balloon, in accordance with an embodiment of the present invention.

9B is a cross-sectional view of a partially inflated portion of a conical balloon, in accordance with an embodiment of the invention.

10A and 10B are illustrations of a system for use within the body lumen constructed and operated in accordance with embodiments of the present invention.

11A and 11B are illustrations of the multi-lobe piston head of FIGS. 10A and 10B, in accordance with embodiments of the present invention.

12 is a cross-sectional view of an optical system according to an embodiment of the present invention.

13A and 13B are diagrams of yet another system for use in the body lumen, in accordance with an embodiment of the present invention.

14 is a view of an insertion apparatus according to an embodiment of the present invention.

15 is a diagram of a cleaning system according to an embodiment of the invention.

Detailed Description of Embodiments

Reference is now made to FIGS. 1-3 that illustrate a system 10 constructed and operated in accordance with embodiments of the present invention.

As best seen in FIG. 3, the system 10 may include a guide member 12, which may be composed of any medically safe material, such as but not limited to plastic or metal. The guide member 12 is formed with a first passage 14 connected to a constant pressure bio-compatible fluid source 16 (“hydraulic source 16”), such as but not limited to a source of constant pressure air, carbon dioxide or water. Can be. The guide member 12 may be at least partially insertable into the front hole 18 (eg rectum) of the body lumen 20 (eg colon). The guide member 12 may include an annular ring 22 for holding against the front hole 18.

Guide member 12 may be formed with perforation hole 24 and may be arranged such that elongated carrier 26 slides through it. An o-ring 28 may be provided to dynamically seal the carrier 26 as the carrier 26 slides relative to the guide member 12. Carrier 26 may be any thin wire, catheter or tube, etc. made of any medically safe material such as, but not limited to, flexible plastic or metal. The carrier 26 can be safely bent and manipulated in the lumen 20, including its tip.

In an embodiment of the invention, the guide member 12 includes a microcuff that forms a seal with the wall of the lumen 20, thereby maintaining positive pressure in the lumen 20. For example, microcuffs are prepared by Microcuff GmbH (Weinheim, Germany) and / or in the aforementioned PCT publication WO 04/069057, US patent application publication 2003/0000526, and / or PCT publication WO 03/045487. The cuff described may be included. The promotion of such a positive pressure is described below.

Piston head 30 may be mounted on carrier 26. The piston head 30 may be inflatable and may be made of any medically safe elastomeric material, such as, but not limited to, a bag or membrane made of polyurethane or silicone rubber, for example. The image-capturing device 32 may be mounted on the carrier 26 behind the piston head 30. The piston head 30 is typically fixed to the carrier 26 and sealed to the carrier 26 using an o-ring 33, but optionally stopping movement of the piston head 30 further away. It may be arranged to slide on the carrier 26 to any rear stop (eg, the image-capture device 32 may act as a rear stop). Image-capturing device 32 may include, without limitation, a camera (eg, CCD or CMOS) or x-ray, ultrasound, MRI, infrared, and / or microwave imaging device.

Other therapeutic or diagnostic devices, such as but not limited to magnets, drug delivery devices (eg, by iontophoresis), gene therapy devices, and the like, may be mounted on or in the carrier 26.

The carrier 26 may include a second passage 34 in fluid communication with the piston head 30 and connected to a hydraulic source 36 (eg, constant pressure air or water) for expanding the piston head 30. . In some applications, the piston head-expanded hydraulic source 36 is adjusted to generally maintain a constant pressure inside the piston head 30 regardless of the piston head volume change that occurs in response to the diameter change of the lumen 20. .

A discharge tube 38 having a hole 40 through which the fluid can be discharged to the outside behind the piston head 30 may pass through or around the piston head 30. That is, the proximal end of the discharge pipe 38 discharges the fluid to the outside through the guide member 12. In some applications, the proximal end of the discharge conduit 38 may be connected to a suction source (not shown) for sucking fluid through the discharge conduit 38. As used herein, including in the claims, “fluid” includes liquids and gases.

In one embodiment, the discharge conduit 38 is not used, but instead the piston head 30 contracts temporarily (at least partially) in response to and / or intermittently accumulated excess pressure behind the piston head 30. do. Temporary contraction of the piston head allows the release of back pressure through the passage 14, typically with the temporary separation of the passage 14 from the hydraulic source 16.

A power supply tube 42 (containing wires, optical fibers, etc.) may be passed through the carrier 26 and connected to the image-capturing device 32. Alternatively, the electrical or optical component of image-capturing device 32 may have an internal power source that does not require external wires. The image-capturing device 32 may wirelessly transmit data to or receive data from an external processor (not shown). The components of system 10 can be fully automated using sensors and operate in a closed control loop or an open control loop.

The fluid supply tube 44 may pass through the carrier 26, which may be connected to a fluid supply source (not shown), for example, to constant pressure water for cleaning an area close to the image-capturing device 32, or Or may be connected to a fluid supply with an outlet tube 38 to clean the body cavity 20 (eg, colon).

Experiments conducted by the inventors have shown that the system described above can safely and effectively advance colonoscopy or other tools through the colon of anesthetized 90 kg pigs. In these experiments, the elongated carrier 26 was generally radio-impermeable and its movement was tracked in real time using fluoroscopy images. A discharge pipe 38 having an inner diameter of 2 mm was used. The discharge pipe 38 was manually operated (not connected to the suction source), whereby the pressure accumulated behind the piston head 30 is discharged to the outside.

In these experiments the range of working pressures was tested. The front pressure and internal pressure of the piston head (in-head pressure) were controlled and satisfactory movement of the piston head 30 recorded the observed values. In general, at in-head pressure in the range of 25-40 millibars, movement of the piston head 30 was observed when the front pressure reached 30-100% of the in-head pressure.

Typically no movement was observed when the anterior pressure was below the threshold. When the front pressure rose above the threshold, the piston head 30 advanced through the colon. If the anterior pressure increased significantly above the threshold pressure (eg, greater than or equal to 2-10 millibars of the threshold pressure), there was a pressure leak between the piston head 30 and the lumen 20 wall and the Advancing has stopped. In response to such a leak, the front pressure was lowered, the discharge pipe 38 discharged the excess accumulated back pressure to the outside, and the movement of the piston head 30 was resumed.

In the experiment, the inflatable piston head was formed of thin silicone and shaped to have a rear lobe, a front lobe, and an intermediate portion connecting the back lobe and the forward lobe (see FIGS. 10A and 10B). The piston head advanced through the colon when the front pressure was maintained at 10-20 millibars at 30 millibar in-head pressure. During the advancement of the piston head, the discharge pipe 38 discharged the accumulated pressure due to the advancement of the piston head to the outside. Leakage was observed around the piston head when the anterior pressure was above about 20 millibars. The piston head advanced through the colon in both the straight and curved portions of the colon when the anterior pressure was maintained at 27-30 millibars at an in-head pressure of 40 millibars. In the straight part of the colon, a low frontal pressure of 20 millibars was sufficient to cause satisfactory movement of the piston head.

We found that the forward speed of the two-lobe piston head varies with the selected pressure, but in one experiment with a thin-walled two-lobe piston head, a total of two minutes while the colonoscope advanced 1.5 meters in the swine colon The time has passed. In another experiment using a thick-walled two-lobe piston head, the colonoscope advanced 1.5 meters for 1 minute 41 seconds at 70 millibar in-head pressure and 50 millibar forward pressure. Thin wall piston heads useful in these experiments of the invention typically have a head wall thickness of 10 to 100 microns, for example less than 50 microns or 20 microns, or a head wall thickness of less than 10 microns. Thick wall piston heads useful in these experiments of the present invention typically have a head wall thickness of at least 100 microns, for example 150 microns, or 250 microns.

In another experiment, the piston head was formed of polyurethane and shaped conical as described below with reference to FIGS. In this experiment satisfactory advancement of the piston head was obtained at a pressure of 35 millibars when the in-head pressure was 35 millibars. Satisfactory advancement was obtained in both the straight and curved portions of the colon.

In these experiments, it is noted that the piston head volume actively changed in response to changes in the lumen 20 diameter during the time that the in-head pressure remained constant.

Reference is now made to FIGS. 1, 2 and 5A-C illustrating the operation of system 10 in accordance with an embodiment of the present invention. In this embodiment, the auxiliary piston head 46 can be mounted on the carrier in front of the rear piston head 30. The auxiliary piston head 46 can be inflatable like the piston head 30 and can be axially fixed to the carrier 26 at a fixed distance from the piston head 30. The auxiliary piston head 46 may be sealed against the carrier 26 using an o-ring 47. The carrier 26 may include a third passage 48 in fluid communication with the auxiliary piston head 46 and connected to a hydraulic source 50 for expanding the auxiliary piston head 46.

To facilitate insertion, the system 10 can be inserted into the rectum initially with the piston heads 30 and 46 retracted. The rear piston head 30 can then be gently inflated until it extends to the inner wall of the lumen 20. This structure is shown in FIG. Hydrostatic fluid (eg, air) from the hydraulic source 16 may be introduced into the colon through the first passage 14 of the guide member 12. The hydrostatic fluid makes the hydraulic pressure acting on the front side of the piston head 30 larger than the back side of the piston head 30. Holes 40 in the outlet pipe 38 may help to create a pressure differential across the piston head 30 manually or by applying suction. As indicated by the arrow 60, this pressure difference, together with the carrier 26, pushes the piston head 30 back in the body cavity (the colon in this example). Image-capturing device 32 may capture images as system 10 moves through the body lumen.

In an embodiment of the invention, the technique described herein to create and propagate a pressure differential is directed to actively propel the piston head 30 forward with the carrier 26, ie from the lumen 20 to the system 10. To subtract it is applied in the reverse way. Hydrostatic fluid (eg air) from the hydraulic source is introduced to the rear of the piston head 30 by pressure application tubes passing through or around the piston head 30. Optionally it acts as a pressure application tube while the discharge tube 38 is withdrawn. The static fluid increases the hydraulic pressure acting on the rear side of the piston head 30 than the front side of the piston head 30, thereby pushing the piston head and carrier forward. A discharge tube between the outside of the lumen and the front side of the piston head may help to create a pressure differential across the piston head 30 manually or by applying suction. Optionally, passage 14 acts as a discharge line during the extraction operation.

As shown in FIG. 5A, the system 10 may eventually reach the obstacle or difficult turning point indicated by arrow 62. As shown in FIG. 5B, the front piston head 46 may expand and the rear piston head 30 may contract. In this structure, the static pressure fluid increases the hydraulic pressure acting on the rear side of the rear piston head 46 than the front side of the front piston head 46. As indicated by the arrow 64, this pressure difference, together with the carrier 26, pushes the front piston head 46 backwards. As shown in FIG. 5B, this backward movement causes the retracted rear piston head 30 to pass through the obstacle. The system 10 continues to move backward in the lumen 20 until the front piston head 46 reaches an obstacle. As shown in FIG. 5C, at this point the rear piston head 30 is expanded and the front piston head 46 can once again be retracted. Once again the hydrostatic fluid increases the hydraulic pressure acting on the front side of the rear piston head 30 than the rear side of the rear piston head 30. The pressure differential propels the system 10 backward in the lumen 20 and the retracted front piston head 46 passes the obstacle. This cycle can be repeated as often as necessary.

Reference is now made to FIG. 6, which illustrates a system 68 constructed and operative in accordance with embodiments of the present invention. The system 68 shows FIGS. 1 to 4 in that a seal is formed between the piston head 30 and the lumen 20 by expanding the rear piston head 30 until it contacts the body lumen 20. It operates in substantially the same manner as the system 10 described above with reference. Then, a static pressure fluid is introduced by the first passage 14, causing a greater pressure against the front face of the piston head 30 than the back face of the piston head 30, and consequently the piston head 30 to the rear Get a net force that acts to move. Sufficient net pressure moves the piston head 30 back together with the elongated carrier 26 and the tool 79. Tool 79 may include an imaging device, biopsy device, or other device that may be used in body lumen 20.

In addition, in some applications of the present invention, the suction source 78 is coupled to the hole 40 through the discharge pipe 38, thereby sucking at the rear side of the piston head 30 to move backward of the piston head 30. To facilitate. Also, in some applications, suctioning in the hole 40 can be used to remove the contents of the lumen, such as excess fluid or stool, which impedes movement of the piston head 30. In some applications, aspiration reduces gas buildup behind the piston head 30 which can make the patient uncomfortable.

System 68 typically includes one or more pressure sensors, which allow for improved or optimized performance of the system with respect to ease and speed as the system 68 moves, for example, through lumen 20. For that. In particular, the system 68 typically includes one or more of the following pressure sensors:

A first pressure sensor 70 suitable for measuring the pressure acting on the front face of the rear piston 30;

A second pressure sensor 72 suitable for measuring the inflation pressure of the rear piston head; And / or

A third pressure sensor 74 suitable for measuring the pressure acting on the backside of the piston head 30

In some applications, the three pressure sensors are coupled with a pressure sensor bus 76 whereby various electromechanical or mechanical control units, in which the various pressure values adjust different pressures automatically or using input from the system actuator ( (Not shown). In some applications, only one pressure sensor is included in the system 68 (eg, sensor 70, sensor 72, or sensor 74). In other applications, two pressure sensors are included and one is omitted (eg, sensor 70, sensor 72, or sensor 74).

In some applications, the first pressure sensor 70 is located in front of the rear piston head 30 near the piston head. Alternatively, the first pressure sensor 70 is located near the hydraulic source 16, typically outside of the patient's body. In the latter structure, (a) the first pressure sensor is integrated with the pressure source 16 or is located separately from the pressure source 16; (b) The first pressure sensor 70 is connected to the piston head 30 through the first passage 14 or through a separate passage in fluid communication with the proximal portion of the first pressure sensor 70 and lumen 20. Anteriorly in fluid communication with the proximal portion of lumen 20 (separate passage not shown). The distal end of such a separate passage is adapted to be located proximal to the lumen 20 near the guide member 12 or further back of the lumen 20, for example in the vicinity of the piston head 30 in front of the piston head. Done.

In some applications, the second pressure sensor 72 is located inside the rear piston head 30. Alternatively, the second pressure sensor 72 is located near the hydraulic source 36, typically outside of the patient's body. In the latter structure, the second pressure sensor 72 is passed through the second passage 34 or through a separate passage in fluid communication with the second pressure sensor 72 and the piston head 30. In fluid communication with a separate passage (not shown).

In some applications, the third pressure sensor 74 is located behind the rear piston head 30. Alternatively, the third pressure sensor 74 is typically located outside of the patient's body, in the vicinity of the front opening of the discharge conduit 38 (in the application where the suction source 78 is provided, it is near the suction source). . In the latter structure, (a) the third pressure sensor 74 is integrated with the suction source 78 or is located separately from the suction source 78; (b) The third pressure sensor 74 is at the rear of the piston head 30 through the discharge pipe 38 or through a separate passage in fluid communication with the third pressure sensor 74 and the distal portion of the lumen 20. In fluid communication with the distal portion of lumen 20 (separate passage not shown).

In some applications where the third pressure sensor 74 is in fluid communication with the distal portion of lumen 20 via outlet tube 38, a source, such as suction source 78, is fluid (ie liquid or gas) into outlet tube 38. It is adapted to generate a burst periodically, for example once every 5 to 15 seconds, for example once every 10 seconds, thereby allowing any substances that may have entered the outlet line through the hole 40 to exit the outlet line. Washed. Similarly, in some applications where the third pressure sensor 74 is in fluid communication with the distal portion of lumen 20 via a separate passage, an additional pressure source coupled to the proximal end of the separate passage periodically causes a burst of fluid into the separate passage. .

In some embodiments of the present invention, satisfactory system 68 performance can be achieved by varying the pressure on the front side of the piston head 30 to about 25 millibar gauge, the pressure on the back side of the piston head 30 to about 5 millibar gauge, This is accomplished by maintaining a pressure inside the piston head 30 at about 20 millibar gauge. These values typically range from about +10 to +50 millibars, -5 to +15 millibars, and +10 to +60 millibars, respectively.

In some applications, the pressure inside the piston head 30 is maintained within about 5 millibars of the pressure differential across either side of the piston head 30 while the system 68 advances backwards. For example, using the typical number recited above, the pressure difference across the piston head is 25 millibars-5 millibars = 20 millibars. If the pressure inside the piston head 30 is maintained within 5 millibars of the pressure differential, the pressure inside the piston head 30 will generally be between 15 and 25 millibars. The pressure inside the piston head 30 typically includes a material that the piston head 30 is flexible but substantially inelastic (eg, a material such as polyurethane that stretches less than 10% while expanding below 50 millibars). The pressure difference is maintained. In embodiments in which the piston head 30 comprises a flexible and elastic material (eg, a material comprising silicon that extends at least 10% while expanding below 50 millibars), the pressure inside the piston head 30 is Typically greater than the pressure difference.

In one embodiment of the invention, the pressure inside the piston head 30 is set to an initial value, for example about 5 to 15 millibars, for example about 10 millibars, while the system 68 is advanced backwards. The pressure on the front side of the piston head 30 typically increases gradually, while at the same time the internal pressure of the piston head 30 adds some value such as a constant value such that (a) the initial value and (b) the piston head 30 Is adjusted to be above the pressure on the front side. Typically, this constant value is about 1 to about 5 millibars, for example about 1.5 to 2 millibars, for example about 2 millibars. Once the system 68 begins to move backwards, the pressure on the front head 30 generally decreases or maintains its level despite the continuous application of pressure by the pressure source 16. The diameter of the first passageway 14 is typically a value small enough to limit the anterior pressure of the piston head 30 to increase with time as the system 68 advances backwards. For example, the diameter of the first passageway may be about 3 mm to about 6 mm. In general, in this embodiment, substantial real-time control of the pressure in the piston head 30 is practiced, but real-time control of the pressure in the lumen 20 in front of the piston head need not be practiced.

Other combinations of back, front, and internal pressures of the piston head 30 may be more suitable in some applications, and the number does not mean limiting the various operating pressures of embodiments of the present invention. In addition, in some applications of the present invention, the various pressures acting on the piston head 30 are adjusted depending on where the piston head is located in the lumen.

FIG. 6 shows only the rear piston head, but the scope of the invention includes the front piston head shown in FIG. 1 and includes the various pressure control and measurement devices described above with respect to the rear piston head 30 of FIG. 6. It should be understood that it includes a system to

Reference is now made to FIG. 7 which illustrates an inflatable piston head 80 constructed and operative in accordance with an embodiment of the present invention. The inflatable piston head 80 comprises an inflatable balloon having the general form of a body that pivots about an axis formed by an elongated carrier 26, where the diameter of the distal end is smaller than the diameter of the proximal end. The piston head 80 typically includes a material that is flexible but substantially inelastic in the pressure range it impinges on, so that the shape of the piston head is substantially unchanged by elastic deformation when the piston head is inflated. Alternatively, the piston head 80 includes a flexible and elastic material. In some embodiments of the invention, inflatable piston head 80 has a conical shape as shown in FIG. 7. While the cone is formed by rotating a straight line about the pivot axis, it is noted that other shapes of the inflatable piston head 80 are formed by rotating a curve about the pivot axis. For example, parabolas or circles can be used to create a suitable shape. In this patent application and claims, those shapes that become narrower toward the distal end are all referred to as "back-narrow".

In one embodiment of the invention, the base of the inflatable piston head 80 is flat. In some other embodiments, the base of inflatable piston head 80 is curved, and the curved shape may be concave or convex.

8 shows the application of an inflatable piston head 80 according to an embodiment of the invention. The piston head 80 is typically inserted into the lumen 20 in a retracted state and then inflated until proper contact with the lumen. Due to the shape of the inflatable piston head 80, once the piston head is fully pressurized, most of the fully-expanded portion 82 of the piston head is not substantially in contact with the lumen 20, The inflation portion 84 is in contact with the lumen 20. Typically a good seal between the piston head 80 and the lumen 20 is obtained where the fully-expanded portion 82 meets the partially-expanded portion 84.

9A and 9B show cross-sectional views of fully-expanded and partially-expanded portions, respectively, according to embodiments of the present invention. The resistance of the lumen 20 to radial expansion prevents the entire piston head from fully expanding (eg, as shown in FIG. 7). As such, the partially-expanded portion 84 typically becomes somewhat corrugated along the length in contact with the lumen 20.

The expandable piston head 80 is adjusted in response to the diameter change of the lumen 20 by further expanding as the lumen diameter increases and contracting as the lumen diameter decreases while maintaining satisfactory contact with the lumen. The inflatable piston head 80 is typically made of a substantially inelastic material that requires relatively moderate pressure to inflate the piston head. The inflation pressure is selected to maintain a suitable seal between the piston head and the lumen without undue pressure on the lumen.

10A and 10B are illustrations of a multi-lobe piston head for use in the body lumen 20 constructed and operative in accordance with embodiments of the present invention. Except for the well-known differences, the apparatus and techniques described above with respect to other piston heads are typically suitable for use with the piston head 100.

The piston head 100 has a backward lobe 102 and a forward lobe 104. The lobes 102, 104 are segmented in the middle portion 106. In one embodiment, the dimensions of the piston head 100 are (a) the diameters D1, (b) D1 of the rearward lobe 102, which are substantially the same as the diameter of the lumen 20, thereby creating a satisfactory seal with the lumen. A diameter D2 of the middle portion 106 in the range of about 10% to 40%, and (c) a length D3 of the rearward lobe 102 in the range of about 3 cm to 5 cm. Although the multi-lobe piston head 100 includes only two lobes, the scope of the present invention also includes multi-lobe piston heads with more lobes (eg 3, 4 or 5 lobes). It is noted.

The rear lobe 102 and the front lobe 104 are in fluid communication with each other via the intermediate portion 106. At the level of movement that is typically encountered while advancing through the colon as well as in the rectified state, the internal pressure of lobe 102 and the internal pressure of lobe 104 are substantially the same. Thus, passage 34 and hydraulic source 36 (FIG. 2) regulate the internal pressure of the two lobes at substantially the same time. However, the diameter of the two lobes typically varies independently in response to the change in shape of the lumen 20 adjacent to each lobe. Typically, the inflatable piston head described herein, in all, fluid is actively applied to or removed from the piston head to maintain a generally constant pressure inside the piston head.

In the present embodiment, the piston head 30 and / or carrier 26 of the system 10 and / or system 68 acts to reduce the friction between the piston head 30 and the lumen 20 such that the lumen is reduced. A low friction coating to facilitate movement of the piston head 30 and / or carrier 26 at 20. For example, the piston head 30 and / or carrier 26 may comprise a biocompatible low friction coating. Alternatively or in addition, or in addition, the piston head 30 and / or carrier 26 may comprise a hydrophilic coating. Alternatively, or in addition, the low friction coating includes a suitable lubricant.

11A and 11B are illustrations of a multi-lobe piston head 100 in accordance with embodiments of the present invention. In Figures 11A and 11B the following tubes described above are shown:

A second passage 34 connected to the hydraulic source 36 and in fluid communication with the two lobes 102, 104 of the piston head 100;

A discharge tube 38 passing through the lobes 102 and 104 of the piston head 100 and having a hole 40 at the rear of the piston head 100 through which fluid can be discharged to the outside;

A fluid supply pipe 44 which passes through the piston head 100 to clean the area near the image-capturing device 32 or with the discharge pipe 38 to clean the lumen 20.

The second passage 34, the discharge pipe 38, and the fluid supply pipe 44 are typically flexible and allow the piston head 100 to bend, as shown in FIG. 11B.

12 is a cross-sectional view of an optical system 220 in accordance with an embodiment of the present invention. In some applications, the image-capturing device 32 includes an optical system 220. Optical system 220 includes optical assembly 230 and image sensor 232, such as a CCD or CMOS.

Optical system 220 is typically configured to allow forward and omnilateral side views simultaneously. Light arriving from the front end of the optical member 234 and light arriving from the side surface of the optical member pass through a substantially separate non-overlapping optical path. Front light and side light are typically (but not necessarily) processed to produce two separate images rather than an integrated image. In some applications, the front view is mainly used to navigate inside the body region, and the omnilateral side view is mainly used for inspection of the body region.

The optical assembly 230 includes a convex mirror 240 having the same rotational shape as that of the optical member 234 and the distal end thereof. Optical member 234 is typically shaped to define a distal portion of the optical member, ie a back recess that coincides with the central portion of mirror 240. Alternatively, instead of the optical member 234 being shaped without the recess 244, the mirror 240 includes a non-reflective portion at its center.

Typically, optical assembly 230 further includes a rear lens 252 having the same axis of rotation as optical member 234. In some applications, optical assembly 230 further includes one or more front lenses 258, for example two front lenses 258. The front lens 258 is located between the optical member 234 and the image sensor 232 and focuses light from the optical member onto the image sensor.

In some applications, optical system 220 is configured to enable omni-directional side viewing without enabling forward viewing.

In some applications, a hydrophobic coating is applied to one or more of the transparent surfaces of the optical assembly 220 in contact with the body lumen 20.

The technology described herein is described in US Provisional Patent Application No. 60 / 571,438, filed May 14, 2004 entitled "Forward and Forward-View Imaging Devices," assigned to the assignee of this application, which is incorporated herein by reference. In combination with the known techniques.

Reference is now made to FIGS. 13A and 13B which are diagrams of a system 310 (not to scale) according to an embodiment of the present invention. System 310 is generally similar to system 10 and / or system 68 except as described below. The image-capturing device 32 of the system 310 typically includes the optical system 220 described above with reference to FIG. 12, or other omnidirectional imaging device. System 310 typically advances back in lumen 20 using the techniques described above with reference to systems 10 and / or 68.

The system 310 is pulled out in an anterior direction by (a) inflating the lumen 20 using a conventional dilation technique that pulls out the endoscope and (b) pulling the carrier 26 in the forward direction. During extraction, the distal end of the system is sometimes near or in contact with the lumen 20 wall, as shown in FIG. 13A. For example, lumen 20 may be expanded to a diameter D1 of about 40 to about 70 mm, and system 310 may have an initial posterior diameter D2 of about 8 to about 15 mm near image-capturing device 32. have. When the system 310 is near the lumen 20 wall, the distance between the side portions of the optical system 220 of the image-capturing device 32 may be less than the minimum focal length required for clear omnidirectional side views.

System 310 includes inflatable component 320, which is suitable for increasing the rear diameter of system 310 from D2 (FIG. 13A) to D3 (FIG. 13B). D3 is typically about 30 to 45 mm. This increased rear diameter ensures that the image-capturing device 32 is at a distance sufficient to be able to focus on the omnidirectional side image. For example, this increased posterior diameter ensures that the central axis of the image-capturing device 32 is at a distance D4 of at least 15 mm from the lumen 20 wall. In some applications, inflatable component 320 includes a sponge, which expands when exposed to liquid, for example. Alternatively, inflatable component 320 includes a set of inflatable or expandable rings. Further or alternatively, inflatable component 320 includes an inflatable balloon, which is typically contained within the body of system 310.

Reference is now made to FIG. 14, which is a diagram of an insertion apparatus 330 for use with system 10 and / or system 68 in accordance with embodiments of the present invention. The insertion device 330 is adapted to be at least partially insertable into the front hole 18 (eg rectal) of the body lumen 20 (eg colon). Insertion device 330 typically includes an annular ring 332 to rest against the front hole 18, and an annular balloon 336 associated with the ring 332. The ring 332 and balloon 336 are shaped to define a drilled hole 334 in which the carrier 26 is arranged to slide. The balloon 336 expands to form a seal between the lumen 20 wall and the balloon near the front hole 18, thereby helping to maintain positive pressure created in the body cavity 20.

Insertion device 330 applies positive pressure to inflate balloon 1 336 and first passageway 14 associated with hydraulic source 16 (eg, as described above in connection with FIGS. 1-3). A tube 338 for application. The tube 338 is connected to a hydraulic source 340, which may be a powered hydraulic source (eg available in an operating room) or may comprise a manually-operated hydraulic source (eg a syringe). Can be. If the hydraulic source 340 includes a syringe, the syringe is typically removed after the balloon 336 is inflated, and the tube 338 and / or balloon 336 are sealed, for example using a check valve. Maintain pressure (valve not shown). In some applications, the pressure source 16 and the pressure source 340 are from a common hydraulic source.

Reference is now made to FIG. 15, which is a diagram of a cleaning system 350 used in conjunction with system 10 and / or system 68 in accordance with embodiments of the present invention. The cleaning system 350 is shaped to define one or more holes 360 (eg, about 4 to about 10) associated with the fluid supply tube 44. The aperture 360 is disposed circumferentially with respect to the distal end of the carrier 26 and is oriented so as to be distributed in at least a portion of the image-capturing device 32. In applications where the image-capturing device 32 includes the optical system 220 described above with reference to FIG. 12, the aperture 360 is typically in at least a portion of the lateral forward portion of the optical assembly 230. Or is distributed over a portion of the rear front portion of the assembly. In some applications, the holes 360 are circumferentially positioned to swirl around the image-capturing device 32.

Although embodiments of the invention have been described in which the piston head is in direct contact with the GI duct wall, the scope of the invention is also to establish contact between the piston head and the GI duct wall via a media such as a sheath surrounding the piston head. Include.

The technology described herein is incorporated herein by reference and assigned to the assignee of this application: (a) Gross et al., Filed May 3, 2004 entitled “Intraluminal Pressure-Propulsion System,” US Patent Application 10 / 838,648, and (b) Gross et al., Filed on or near January 9, 2004 entitled "Intraluminal Pressure-Propulsion Systems," may be performed with the techniques described in the patent application.

Those skilled in the art will recognize that the invention is not particularly limited to those shown and described above. Rather, the scope of the present invention includes combinations and subcombinations of the various features described above, as well as variations and modifications not present in the prior art that would occur to those skilled in the art having read the foregoing description.

Claims (374)

An elongated carrier configured and operative to be inserted through the front opening of the body cavity; And A piston head coupled to the distal portion of the carrier, which is configured to operate after the carrier is inserted into the lumen and form consolidation with the lumen wall and to be pulled forward through the body lumen in response to pressure from a hydraulic source Apparatus for use with a biologically compatible hydraulic source comprising a. The device of claim 1, wherein the lumen includes a gastrointestinal (GI) tube, and the piston head is configured to operate to form consolidation with the GI tube wall after the carrier is inserted into the GI tube. The device of claim 2, wherein the GI tract comprises a colon and the piston head is configured and operative to form consolidation with the colon wall after the carrier is inserted into the colon. 3. The device of claim 2, wherein the piston head is configured to operate in direct contact with the GI duct wall after the carrier is inserted into the GI tract. 3. The apparatus of claim 2, wherein the outer surface of the piston head forming a consolidation with the GI tube wall comprises a low friction coating that facilitates sliding of the piston head relative to the GI tube wall. 3. The apparatus of claim 2, wherein the piston head is shaped to define a forward lobe and a backward lobe, the lobes in fluid communication with each other. The pressure application tube of claim 2 comprising (a) a distal portion of the interior of the GI tube behind the piston head, and (b) a pressure application tube in fluid communication with the hydraulic source, the pressure application tube configured to introduce pressure into the distal portion. And operate the device. The method of claim 2, Fluid source; An image-capture device coupled to the carrier near the distal end of the carrier; And At least one fluid supply tube coupled to the carrier in fluid communication with the fluid source Wherein the distal end of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the image-capturing device when the fluid is provided by the fluid supply source. Device. The device of claim 1, wherein the device is configured and operates to facilitate fluid passage out of the GI tube from a proximal portion of the interior of the GI tube in front of the piston head. 10. The apparatus of claim 9, further comprising a discharge tube in fluid communication with the proximal portion and outside of the GI tube, the discharge tube being configured to operate to reduce pressure at the proximal portion by facilitating fluid passage from the proximal portion to the outside. Device. 9. The device of claim 1, wherein the piston head is configured to operate to expand and form and maintain consolidation with the GI duct wall. 10. 12. The apparatus of claim 11, comprising a piston head-pressure sensor configured and operative to sense internal pressure of the piston head. 12. The device of claim 11, comprising a back pressure sensor configured and operative to sense the internal pressure of the GI tube behind the piston head. 12. The apparatus of claim 11, comprising a front pressure sensor constructed and operative to sense an internal pressure of the GI tube in front of the piston head. The method of claim 11, A pressure sensor configured and operative to measure a first pressure associated with operation of the device; And A control unit configured and operative to adjust a second pressure associated with the operation of the device according to the measured value of the pressure sensor Apparatus comprising a. An elongated carrier configured and operative to be inserted through the front opening of the body cavity; And After the carrier is inserted into the lumen, it forms a consolidation with the lumen wall and is coupled to the distal portion of the carrier, which is configured and operative to advance backward through the body cavity in response to pressure from a hydraulic source applied to the outer surface of the rear piston head. Rear piston head Apparatus for use with a biologically compatible hydraulic source comprising a. 17. The apparatus of claim 16, wherein the lumen comprises a gastrointestinal (GI) tube and the rear piston head is configured and operates to form consolidation with the GI tube wall after the carrier is inserted into the GI tube. 18. The apparatus of claim 17, wherein the GI tract comprises a colon and the rear piston head is configured to operate to form consolidation with the colon wall after the carrier is inserted into the colon. 18. The apparatus of claim 17, wherein the rear piston head is configured to operate in direct contact with the GI duct wall after the carrier is inserted into the GI tract. 18. The apparatus of claim 17, wherein the outer surface of the rear piston head forming a consolidation with the GI tube wall comprises a low friction coating that facilitates sliding of the rear piston head relative to the GI tube wall. The method of claim 17, Fluid source; An optical member coupled near the distal portion of the carrier; And At least one fluid supply tube coupled to the carrier in fluid communication with the fluid source Wherein the distal portion of the carrier is shaped to define one or more apertures in fluid communication with the fluid supply tube, the apertures being oriented to be distributed in at least a portion of the optical member when the fluid is provided by the fluid source. The method of claim 17, An optical system comprising an optical member configured to provide an omnidirectional side view; And Fixed near the distal portion of the carrier, configured and operative to increase the diameter of the carrier near the distal portion of the carrier to an extent sufficient to position the optical member at a distance far enough from the wall to allow the optical system to focus in all directions Inflatable components Apparatus comprising a. 23. The device according to any one of claims 16 to 22, configured and operated to facilitate rearward advancement of the rear piston head by facilitating fluid passage out of the GI tube from the distal portion of the interior of the GI tube behind the rear piston head. Device characterized in that. 24. The apparatus of claim 23, comprising an outlet tube, wherein the apparatus is configured and operative to facilitate passage of fluid out of the GI tube from a distal portion within the GI tube through the outlet tube. 25. The device of claim 24, wherein the discharge tube is configured and operative to passively allow fluid passage out of the GI tube from a distal portion within the GI tube. 25. The device of claim 24, wherein the outlet tube is coupled to the suction source to operate so as to actively facilitate fluid passage out of the GI tube from a distal portion within the GI tube. 23. The apparatus of any one of claims 16 to 22, wherein the rear piston head is configured to operate to expand and form and maintain consolidation with the GI duct wall. 28. The apparatus of claim 27, comprising an auxiliary piston head coupled to the carrier in a position in front of the rear piston head, the auxiliary piston head being configured to operate to form and maintain an auxiliary consolidation with the GI duct wall, (a) At least some time while the carrier is inside the GI tract, the rear piston head is at least partially already retracted, while at the same time the auxiliary piston head is already inflated and responds to the pressure from the hydraulic source. Is configured to operate backward through the (b) at least some other time while the carrier is inside the GI tract, the auxiliary piston head is at least partially already retracted, while at the same time the rear piston head is already inflated and the GI in response to pressure from the hydraulic source And configured to operate forward through the tube. 28. The apparatus of claim 27, comprising a piston head-pressure sensor constructed and operative to sense internal pressure of the rear piston head. 28. The apparatus of claim 27, comprising a rear pressure sensor configured and operative to sense an internal pressure of the GI tract behind the rear piston head. 28. The apparatus of claim 27, comprising a front pressure sensor configured and operative to sense a first measurable pressure within the proximal portion of the GI tract in front of the rear piston head. 32. The apparatus of claim 31, comprising a rear pressure sensor configured and operative to sense pressure behind the rear piston head. 28. The method of claim 27, A pressure sensor configured and operative to measure a first pressure associated with operation of the device; And A control unit configured and operative to adjust a second pressure associated with the operation of the device according to the measured value of the pressure sensor Apparatus comprising a. 28. The apparatus of claim 27, wherein the rear piston head is shaped to define a front lobe and a rear lobe, the lobes in fluid communication with each other. 35. The method of claim 34, wherein the volume of the first lobe is configured to operate to decrease in response to the confinement of the GI tube adjacent thereto, wherein the volume of the second lobe is adjacent to the GI tube adjacent to the volume of the first lobe. And configured to operate constant within the diameter without change, wherein the pressure in the first and second lobes are the same in a steady state regardless of the volume reduction of the first lobe. 17. The device of claim 16, comprising an image-capturing device coupled to the carrier. 18. The apparatus of claim 16, comprising an optical member coupled to the carrier configured to provide omnidirectional side views. 17. The apparatus of claim 16, wherein the piston head is configured and operative to withdraw forward through the body cavity in response to pressure from a hydraulic source. 17. The apparatus of claim 16, wherein the hydraulic pressure source comprises a gas pressure source and the rear piston head is configured and operated to advance backwards in response to gas pressure from the gas pressure source. 18. The device of claim 17, comprising a hydrophilic material disposed on an outer surface of the rear piston head. The apparatus of claim 16, wherein the body lumen comprises a colon, the anterior cavity comprises a rectum, is at least partially inserted into the rectum, and is configured to operate to form a consolidation between the balloon and the colon wall near the rectum, And an annular balloon shaped to form a hole into which the carrier is inserted. delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete delete

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