DE19955180A1 - Video laryngoscope has handgrip and attached spatula provided with aligned openings in vicinity of standard coupling between them for supply of illumination light and reception of image - Google Patents

Abstract

The layngoscope has a handgrip (12) and a spatula (14) attached to the handgrip so that it extends perpendicularly and incorporating a light conductor (32) and an image conductor (34), respectively aligned with a light opening and an image opening in the vicinity of the coupling (16) between the spatula and the handgrip. The handgrip has corresponding light and image openings for supplying light to the light conductor and receiving the image from the image conductor, coupled to an optical cable with light and image cable conductors.

Description

The present invention relates to a laryngoscope, with a Handle and with a substantially transverse to it Spatula that releasably attaches to the handle via a coupling Stigt, further with a light guide and an image guide, which are fixed to the spatula, the light guide a proximal end with a light entry opening and wherein the image guide has a proximal end with an image exit opening has.

Such a laryngoscope is known from US 5,800,344.  

In the well-known laryngoscope, which is also called a video laryngoscope is designated, the image guide is used to create an image in the area the distal end of the spatula and to one of the Spatula to transmit separate image display unit. The Ka that the recorded image signal is for image reproduction is transported at the proximal end of the spatula attached. The spatula itself is via a standard coupling in accordance with the international standard ISO 7376-3 otherwise connected handle not described.

However, this known arrangement has the disadvantage that the Cable for the display unit exactly in the rear loading of the laryngoscope is struck by the patient Doctor needed as work area. This allows the common Handling of the known laryngoscope with other instruments, such as an intubation tube. This is particularly disadvantageous if the laryngoscope is like skin fig, in a hectic emergency situation for intubating the A patient's trachea is inserted.

Another laryngoscope is the starting point from US Pat. No. 5,846,186 Known type known that is attached to an image display unit can be closed. This well-known laryngoscope also has however the same disadvantage as previously explained.

It is therefore an object of the present invention to provide a Specify a laryngoscope of the type mentioned at the beginning Handling the attending doctor is less hindered.

This task is there with the laryngoscope mentioned at the beginning solved by that the light entry opening and the picture  outlet opening are arranged in the area of the coupling and that the handle in the area of the coupling has a light emission opening and an image entry opening having an on couple the light signal from the handle into the light guide as well as decoupling the image signal from the image guide lichen.

The result of the measure according to the invention is that both Light signal as well as the image signal from the spatula over the Coupling can be transferred to the handle. Hereby it is possible to generate, process and / or pass on the signals in the area of the handle. In consequently there is no need to connect an external cable the spatula of the laryngoscope. In particular, the working area at the proximal end of the spatula is free will be kept so that the attending doctor is not there in his Freedom of movement is restricted. The invention Laryngoscope is therefore easier and less complicated to use, which is especially its handling in a hectic emergency situation relieved.

In addition, however, the laryngoscope according to the invention has a number of other advantages, which are listed below, partly in Connection with preferred embodiments, explained in more detail become.

Another advantage of the laryngoscope according to the invention is that that due to the easier handling also the risk of loading damage is reduced. This is especially true in Often hectic in an emergency situation supplying measures, which may be based on a loading  damage to the laryngoscope can.

Furthermore, it is common with laryngoscopes, depending on the size of the patient to be treated with spatulas of different sizes use. The spatula connection that can be released via the coupling With the handle it is possible to find the right spatula to choose for treatment. The laryn according to the invention In this context, goskop has the advantage that the spa tel regardless of the connection of the laryngoscope to a Image display unit can be replaced. This will handling is even easier, since changing the spa a cable connection cannot be loosened got to. In addition, the usually removable plug connection of the laryngoscope to the image display unit protects the laryngoscope when replacing the spatula does not have to be disconnected from the image display unit.

In a preferred embodiment, the laryngoscope has one external cable feed on one of the coupling distal end of the handle is arranged.

Alternatively, it is also conceivable to connect the cable feed to arrange another point of the handle, whereby at least least the aforementioned advantage of the invention would be achieved. In contrast, the present embodiment has the additional advantage that the cable feed as far as possible removed from the working area of the laryngoscope, so that it can disturb as little as possible.  

In a further embodiment of the invention, the ones entrance and exit openings for the light and the image signal integrated inside the coupling.

In this context, "integrated" means that the named Entry and exit openings in this way inside the dome tion are arranged in the event that the spatula and the handle are attached to each other, no longer from the outside are accessible. As a result, the entry and outlet openings particularly well in this embodiment protected against external damage that would otherwise occur with a hectic handling of the laryngoscope in an emergency situation on could occur.

In a further preferred embodiment of the invention the coupling has at least one mechanical centering element, that the light entry opening and the light exit opening so like the image entry opening and the image exit opening in a predetermined position rigidly fixed to each other.

This measure has the advantage that they are assigned to each other openings even with vigorous handling of the laryn goscopes always in their optimal alignment ten, whereby the losses in the coupling of the Si signals can be kept comparatively low. As a result this helps this measure to be as equal as possible consistently high image quality with the laryn according to the invention get goskop.

In a further embodiment of the measure mentioned above the centering element fixes the inlet and outlet openings  conditions rigid in both the radial and axial directions each other.

This measure is particularly advantageous with regard to that it is not only a radial shift of the associated th openings, but also an axial displacement a Ver image quality may deteriorate. To reach For optimal image quality, it is therefore advantageous the mutually associated openings in each of the above To fix directions rigidly to each other.

In a further embodiment of the measures mentioned above the centering element fixes the inlet and outlet openings with an inaccuracy of less than 0.5 mm before pulls less than 0.1 mm.

The size ranges mentioned have changed in practical Versu chen as part of the development of the laryn according to the invention Goscopes have been shown to be beneficial to a consistent image quality even with a rough and forceful ver bound application of the laryngoscope, especially in an emergency case situation.

In a further embodiment of the measures mentioned above the centering element has at least one cone and one corresponding counter cone, one of which on the handle and the other is arranged on the spatula.

Such a design has been found for Zen Trierelement proven to be particularly advantageous because they are one  on the one hand is simple and robust, while on the other hand the before mentioned advantageous measures united.

In a further preferred embodiment of the invention the laryngoscope has an electronic image centering unit.

Such an image centering unit can, for example by realizing that in the handle of the laryngoscope electronic image sensor, for example a CCD chip is arranged, the light-sensitive, active area larger is than the area actually required. In this case the electronic imager will be able to get that from the image conductively transmitted image signal even if the Adjustment of the image entry and exit opening no longer is adhered to exactly. With measures known per se Electronic image processing can then be the "right" picture extract. The measure owns both for taken as well as in addition to a mechanical Zen trierelement the advantage that the image quality of the Invention according to the laryngoscope even under stress and force can be kept evenly high.

In a further, particularly preferred embodiment of the Er are the image entry opening and the light exit opening in different, axially offset Kop pel levels arranged.

This measure has the advantage that it makes it easy Prevents a scattering of the light signal in the image guide can be changed, whereby the image quality of the invention ity laryngoscope can also be improved.  

In a further preferred embodiment of the invention an electronic image in the handle of the laryngoscope arranged subscriber to which the image signal from the image conductor leads is.

This measure also helps to achieve an optimal picture quality, because in this case on further coupling points the image signal must go through, can be dispensed with. Derar coupling points are always with a significant, associated with inevitable levels of losses. Furthermore are Image signals in electronic form much less sensitive against interference as optical image signals. Finally be the measure sits in comparison to the previously known laryn goskopen the advantage that within the handle comparison as much space is available to the electronic Imager in a simple and safe way in the laryngoscope to accommodate.

In a further embodiment of the laryn according to the invention goskops a light source is arranged in the handle.

This measure also contributes to the number of optical heads reduce the number of spots as much as possible. Consequently can have a comparatively high light output at the exit end of the light guide can be reached. It also owns Measure the advantage that the laryngoscope according to the invention, possibly also without a connection to a picture display unit that can be used with lighting. As a result of which it is more universal, especially in emergency situations settable.  

In a further preferred embodiment of the invention the coupling is a standard coupling for connecting Laryn goscopic spatulas with handles.

In this context, every clutch is the standard clutch referred to, the ge in laryngoscopes such a spread has found that a significant number of laryngoscopes are used this clutch are in use. The measure has the advantage partly that the spatula and handles already used this Laryngoscopes optionally with the spatula and the handle of the laryngoscope according to the invention can be combined, although in this case the image may be displayed unit cannot be used. In an emergency situation however, due to this measure there is the possibility of a spatula with the To combine the handle of the laryngoscope according to the invention. Overall, the Ver application width increased.

In a further embodiment of the measure mentioned above the coupling meets the international standard ISO 7376-3.

This standard defines a standard coupling for the connection of spatulas and handles in laryngoscopes. Accordingly are numerous laryngoscopes with this standard coupling in the Use for which the combination options previously explained opportunities exist.

In a further embodiment of the measure mentioned above the coupling has one at the proximal end of the image guide  Coupling area outside of one by the internatio nal standard ISO 7376-3 defined coupling range.

As an alternative to this measure, it is possible in principle that proximal end of the image guide within the ISO standard 7376-3 to integrate the specified dimensions into the coupling. The measure mentioned has the advantage that the the area defined by the standard does not have to be changed, which makes compliance with the standard much easier. About that in addition, due to the measure mentioned, a second coupling area, which provides stability and support the clutch improved. This is particularly with regard to the fit with which the mutually assigned one entry and exit openings are to be positioned in front partial.

In a further embodiment of the invention, the picture is ter a flexible optical fiber image guide.

This measure has the advantage that the image guide very much can easily be laid along the curvature of the spatula.

In an alternative embodiment, the image guide has demge opposite a lens system.

Image guides with lens systems are usually rigid leads what regarding the adaptation of the image guide to the Curving the spatula requires increased effort. The before however, part of this measure is higher image quality, because In this respect, lens systems are superior to optical fiber conductors are.  

It is understood that the above and the following standing features to be explained not only in each specified combination, but also in other combinations or can be used alone, without the scope of to leave the present invention.

Embodiments of the invention are in the drawing are shown and are described in more detail in the following description explained. Show it:

Fig. 1 shows a first embodiment of an inventive SEN laryngoscope in a side view;

Fig. 2, the laryngoscope of Fig. 1 in a perspective representation, wherein the spatula from the handle from being separated,

Fig. 3, the laryngoscope of Fig. 1 taken along the section line III-III,

Fig. 4 shows the coupling of the laryngoscope of Fig. 3 in a detailed view,

Fig. 5 shows the coupling of Fig. 4, wherein the spatula and the handle are separated from each other,

Fig. 6 shows a second embodiment of an inventive laryngoscope in a side view

Fig. 7 shows a third embodiment of an inventive laryngoscope.

In FIGS. 1 through 3 shows an inventive laryngoscope is designated in its entirety with the reference number 10.

The laryngoscope 10 has a handle 12 and a spa tel 14 , which are connected via a coupling 16 . The spatula-side part of the coupling 16 is designated with the reference number 18 and the handle-side part with the reference number 20 .

The spatula 14 has a spatula blade 22 in a manner known per se, from which a side wall 24 is substantially perpendicular upwards. The spatula blade 22 has a bead 28 at its distal end 26 . On the side of the side wall 24 facing away from the spatula 22 , a tube 30 is placed which houses both a light guide 32 and an image guide 34 . In the present exemplary embodiment, the light guide 32 consists of three individual light guide strands 32 a, 32 b, 32 c, which are arranged radially around the image guide 34 , as can be seen in the opened coupling 16 in FIG. 2.

The tube 30 extends on the back of the side wall 24 to an elongated hole 36 and occurs there through the wall 24 since Liche on the spatula blade 22nd At the distal end of the tube 30 , the light guide 32 has a light exit opening 38 . Likewise, the image guide 34 has an image entry opening 40 there . The common arrangement of the light guide 32 and the image guide 34 in a tube 30 is known per se in the prior art and therefore need not be shown in more detail here.

The coupling 16 of the laryngoscope 10 is a bayonet-type coupling, in which the parts 18 , 20 to be connected to one another are fixed by a retaining nut 42 . The further structure of the clutch is described below with reference to FIGS . 4 and 5 in more detail.

The handle 12 of the laryngoscope 10 has a tubular shaft 44 in a manner known per se, in which further components of the laryngoscope 10 are accommodated. In this exemplary embodiment, this includes in particular two external cable feeds 46 , 48 , as can be seen from the sectional illustration in FIG. 3. The cable feed 48 includes at her rem in FIGS. 4 and 5 lying above an image recording module that converts a recorded optical image signal into an electrical image signal.

Via the cable feed 46 , which has a plug contact 52 at the lower end 50 of the handle 12 , a light signal can be supplied to the laryngoscope 10 . The cable feed 48 , on the other hand, serves to transmit the optical image signal of an image recorded at the image entry opening 40 in the form of the electrical image signal to an image display unit (not shown).

In the cross-sectional view in Fig. 3 it can also be seen that the cable feed 46 splits in the interior of the handle 12 into three individual strands 46 a, 46 b and 46 c, which in the area of the coupling 16 to the individual strands of the light guide 32nd connect (see Fig. 2).

In the enlarged cross-sectional view of the Fig. 4 and 5 are only the strands 32 a and 32 b of the light guide 32 and the strand 46 a cable feed 46 recognizable. The strand 32 a of the light guide 32 , like the remaining strands 32 b, 32 c, has a light entry opening 64 at its lower end 62 , which is also referred to hereinafter as the proximal end. The light entry opening 64 is located in the handle-side part 20 of the laryngoscope 10, the light exit opening 66 of the strand 46 a of the cable feed 46 . If the spatula 14 is firmly connected to the handle 12 , as shown in FIG. 4, the light entry opening 64 and the light exit opening 66 lie directly opposite one another.

In a comparable manner, the image guide 34 has at its proximal end 62 an image exit opening 68 which lies opposite an image entry opening 70 of the image recording module 49 . The mentioned inlet and outlet openings 64 to 70 are each closed by a cover glass to prevent the ingress of dirt or dust particles.

As can be seen in particular in the illustration in FIG. 5, the light exit opening 66 and the image entry opening 70 are arranged in two different coupling planes 72 , 74 which are axially displaced relative to one another in the direction of the longitudinal central axis 76 of the handle 12 . This ensures that a scattered light which arises in the area of the light exit opening 66 cannot directly scatter through the image entry opening 70 into the image tract. Correspondingly, in the present exemplary embodiment, the light entry opening 64 and the image exit opening 68 are also arranged in different planes which are axially displaced relative to one another.

The light guide 32 and the image guide 34 are in the vorlie embodiment of the laryngoscope 10 exclusively from optical fiber bundles. However, the image guide 34 in particular can alternatively also contain a lens system.

The mechanical part of the coupling 16 includes, in addition to the holding nut 42, above all a cone 82 at the proximal end 62 of the spatula 14 and a corresponding counter cone 84 at the upper end of the handle 12 . Furthermore, an orientation pin 86 is provided which, when connecting the spatula 14 with the hand 12 , must be inserted into a corresponding bore 88 . The orientation pin 86 ensures that the spatula 14 can only be placed on the handle 12 in such a way that the mutually assigned inlet and outlet openings 64 to 70 face each other with a precise fit. In combination with the Hal nut 42 , said elements form a centering element 90 , which ensures that the mutually associated inlet and outlet openings 64 to 70 are rigidly fixed to one another with an inaccuracy of at most 0.1 mm, both in the radial direction ( Arrow 92 ) and in the axial direction (arrow 94 ).

In the image recording module 49 , a magnifying lens 96 is included , which enlarges the optical image signal entering through the image entry opening 70 by a factor of 1: 5 and then feeds it to an electronic image sensor, not shown here. The electronic image sensor is a CCD chip in the present case, which converts the optical image signal into the electrical image signal. However, the other electronic image sensor can also be used here. According to a particularly preferred embodiment of the invention, the CCD chip also includes means for performing an electronic image centering in addition to the mechanical centering element 90 . This is particularly realized by the fact that the CCD chip has a larger active area than required, so that, with the aid of measures of image processing known per se, the relevant image section can also be extracted if the image exit opening 68 and the image entry opening 70 are due to a force on the laryngoscope 10 are not optimally positioned to each other.

In the following description of the further exemplary embodiments of the invention, the same reference symbols designate the same elements as in FIGS. 1 to 5.

In Fig. 6, a second embodiment of a laryngoscope according to the Invention is generally designated by the reference numeral 100 be.

The laryngoscope 100 differs from the laryngoscope 10 primarily in that the coupling 16 in this case is a standard coupling according to the international standard ISO 7376-3. This type of clutch has a transverse pin 102 which is arranged on the handle-side part 20 of the clutch 16 . The spatula-side part 18 has a U-shaped recess, which cannot be seen in this illustration, with which the spatula 14 can be placed on the cross pin 102 . The spatula 14 can be pivoted in the direction of arrow 104 around the cross pin 102 , which facilitates the assembly and disassembly of the laryngoscope 100 .

In order to prevent an unintentional pivoting movement in the direction of arrow 104 when using the laryngoscope 100 , locking elements which are not recognizable here are present in the interior of the coupling 16 .

The ISO 7376-3 standard only defines that part of the coupling 16 which is to the left of the line 106 in FIG. 6. This coupling area is referred to below with reference numeral 108 . To the right of line 106 , in this exemplary embodiment, there is an additional coupling area 110 , by means of which the contact area of coupling 16 is expanded compared to standard ISO 7376-3. The additional coupling area 110 is arranged accordingly to a preferred variant here diametrically opposite from the distal end 26 of the spatula 14 .

In the additional coupling region 110 , the coupling for the image conductor 34 is arranged in this exemplary embodiment. The consequence of this is that the handle 12 of the laryngoscope 100 can also be connected to a standard spatula which has no image guide, since this standard spatula only reaches up to the line 106 . Likewise, the spatula 14 shown here can be connected to the handle of a standard laryngoscope, the handle-side part 20 of which does not have the coupling region 110 .

In the present exemplary embodiment, the coupling region 110 on the handle-side part 20 has a flange 112 which has an inner cone 114 at its upper end. The spatula-side part 18 has a corresponding outer cone 116 . The inner cone 114 and the outer cone 116 are, as in the previous exemplary embodiment, part of a centering element 90 which, in conjunction with the latching means (not shown here), fixes the inlet and outlet openings 64 to 70 in their predetermined position relative to one another. For reasons of clarity, the last-mentioned reference symbols are not shown in the illustration in FIG. 6.

If the locking means provided in the standard coupling 16 are not sufficient to rigidly ensure the required accuracy of fit, further locking means can be added, which are also preferably arranged in the coupling area 110 . Preferably, a retaining nut similar to that in Fig. 1 or another, only manually releasable locking mechanism is used.

In the partially cut-away representation of the clutch area 110 , an electronic image sensor 118 in the form of a CCD chip can be seen. Its signals are fed to an evaluation and control unit 120 , which is also arranged in the handle 12 of the laryngoscope 100 . Furthermore, the laryngoscope 100 has a light source 122 in the handle-side part 20 , the light of which is directly coupled into the light guide 32 .

Otherwise, the mode of operation of the laryngoscope 100 corresponds to that of the laryngoscope 10 .

In the embodiment shown in Fig. 7 is a fiction, according laryngoscope is designated in its entirety by reference numeral 130.

The laryngoscope 130 differs from the laryngoscope 100 according to FIG. 6 essentially by a different extension of the standard coupling 16 , which, however, is only limited to the additional coupling region 110 . That part of the coupling 16 , which is in Fig. 7 to the left of line 106 , corresponds fully to the standard ISO 7363-3.

In the laryngoscope 130 , the electronic image sensor 118 is arranged in a flange 112 which extends in the axial direction of the handle 12 to the upper, proximal end of the spatula 14 . The spatula 14 is centered on the flange 112 by conical locating pins 132, the fen eingrei into corresponding cone-shaped recesses on the side wall 24 of the spatula fourteenth The dowel pins 132 are mounted on springs 134 so that a spatula which does not have the required recesses can push the dowel pins 132 aside. This makes it possible to use a normal standard spatula also with the laryngoscope 130 .

Due to the fact that, when the laryngoscope 130 of Bildlei ter 34 extends far less curved, it is possible ei here NEN image guide 34 to be used, which constitutes a lens system 136 including. Otherwise, the mode of operation of the laryngoscope 130 corresponds to that of the laryngoscope 100 .

Further exemplary embodiments of the invention result if features of the exemplary embodiment illustrated here are combined with one another. For example, it is also possible to equip the laryngoscope 10 with an internal light source 122 . Conversely, the laryngoscopes 100 , 130 can be provided with a cable feed 46 , via which the light of a light source can be fed from the outside. Furthermore, the laryngoscopes 100 , 130 can also be equipped with an electronic image centering unit.

In a further exemplary embodiment, the laryngoscopes shown do not have a cable feed 48 , but instead an image display unit which is attached directly to the handle 12 of the laryngoscope or even integrated therein. In this case, a completely autonomous video laryngoscope results, which does not require external cable feeds.

Claims (16)

1. Laryngoscope, with a handle ( 12 ) and with a spatially arranged we spatula ( 14 ) which is releasably attached to the handle ( 12 ) via a coupling ( 16 ), further with a light guide ( 32 ) and one Bildlei ter ( 34 ), which are fixed to the spatula ( 14 ), where in the light guide ( 32 ) has a proximal end ( 62 ) with a light entry opening ( 64 ) and wherein the image guide ( 34 ) has a proximal end ( 62 ) opening with an image outlet (68), characterized in that the light entry opening (64) and the image outlet opening (68) in the region of the coupling (16) are arranged and that the handle (12) in the region of the coupling (16) has a light exit opening ( 66 ) and an image entry opening ( 70 ), which enable coupling of the light signal from the handle ( 12 ) into the light guide ( 32 ) and decoupling of the image signal from the image guide ( 34 ). 2. Laryngoscope according to claim 1, characterized in that it has an external cable feed ( 46 , 48 ) which is arranged at one end of the coupling ( 16 ) remote end ( 50 ) of the handle ( 12 ). 3. Laryngoscope according to claim 1 or 2, characterized in that the inlet and outlet openings ( 64 - 70 ) for the light and the image signal in the interior of the hitch be ( 16 ) are integrated. 4. Laryngoscope according to one of claims 1 to 3, characterized in that the coupling ( 16 ) has at least one mechanical centering element ( 90 ) which the light inlet opening ( 64 ) and the light outlet opening ( 66 ) as well as the image entry opening ( 68 ) and the image exit opening ( 70 ) each rigidly fixed to each other in a predetermined position. 5. Laryngoscope according to claim 4, characterized in that the centering element ( 90 ), the inlet and outlet openings ( 64-70 ) both in the radial ( 92 ) and in axia ler ( 94 ) direction rigidly fixed to each other. 6. Laryngoscope according to claim 4 or 5, characterized in that the centering element ( 90 ) fixes the inlet and outlet openings ( 64-70 ) with an inaccuracy of less than 0.5 mm, preferably less than 0.1 mm . 7. Laryngoscope according to one of claims 4 to 6, characterized in that the centering element ( 90 ) has at least one cone ( 82 ; 114 ) and a corresponding counter-cone ( 84 ; 116 ), one of which on the handle ( 12 ) and the other is arranged on the spatula ( 14 ). 8. Laryngoscope according to one of claims 1 to 7, characterized in that it has an electronic image centering unit ( 118 , 120 ). 9. Laryngoscope according to one of claims 1 to 8, characterized in that the image entry opening ( 70 ) and the light exit opening ( 66 ) are arranged in different, axially offset coupling planes ( 72 , 74 ). 10. Laryngoscope according to one of claims 1 to 9, characterized in that an electronic image sensor ( 118 ) is arranged in the handle ( 12 ), to which the image signal from the image conductor ( 34 ) is supplied. 11. Laryngoscope according to one of claims 1 to 10, characterized in that a light source ( 122 ) is arranged in the handle ( 12 ). 12. Laryngoscope according to one of claims 1 to 11, characterized in that the coupling ( 16 ) is a standard coupling for connecting laryngoscope spatulas ( 14 ) with handles ( 12 ). 13. Laryngoscope according to claim 12, characterized in that the coupling ( 16 ) fills the international standard ISO 7376-3. 14. Laryngoscope according to claim 13, characterized in that the coupling ( 16 ) at the proximal end ( 62 ) of the image conductor ( 34 ) has a coupling region ( 110 ) which is defined outside by an international standard ISO 7376-3 Coupling area ( 108 ) is. 15. Laryngoscope according to one of claims 1 to 14, characterized in that the image guide ( 34 ) is a flexible light fiber image guide. 16. Laryngoscope according to one of claims 1 to 15, characterized in that the image guide ( 34 ) has a lens system ( 136 ).