EP3386372A1 - Endoscope vidéo laser - Google Patents

Endoscope vidéo laser

Info

Publication number
EP3386372A1
EP3386372A1 EP16873968.8A EP16873968A EP3386372A1 EP 3386372 A1 EP3386372 A1 EP 3386372A1 EP 16873968 A EP16873968 A EP 16873968A EP 3386372 A1 EP3386372 A1 EP 3386372A1
Authority
EP
European Patent Office
Prior art keywords
probe
hand piece
endoscope
laser
guide
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP16873968.8A
Other languages
German (de)
English (en)
Other versions
EP3386372A4 (fr
Inventor
Martin Uram
Paula ENDER
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Beaver Vistec International Inc
Beaver Visitec International Inc
Original Assignee
Beaver Vistec International Inc
Beaver Visitec International Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US14/966,151 external-priority patent/US20160095507A1/en
Application filed by Beaver Vistec International Inc, Beaver Visitec International Inc filed Critical Beaver Vistec International Inc
Publication of EP3386372A1 publication Critical patent/EP3386372A1/fr
Publication of EP3386372A4 publication Critical patent/EP3386372A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, e.g. handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00105—Constructional details of the endoscope body characterised by modular construction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00112—Connection or coupling means
    • A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
    • A61B1/00126—Connectors, fasteners and adapters, e.g. on the endoscope handle optical, e.g. for light supply cables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/042—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by a proximal camera, e.g. a CCD camera
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser

Definitions

  • This invention relates in general to a medical laser video endoscope and more particularly to one in which the operating probe can be economically disposed of after each use and/or can have a relatively small gage size.
  • Laser video endoscopes are used in glaucoma, retinal and vitrectomy operations, and some conventional endoscopes can be reused after autoclaving or other sterilization. Reuse occurs in large part because of the expense of the endoscope. The most significant expense factor is the image guide which has a large number of micron size optical fibers. For example, for an endoscope employing 17,000 fibers to provide a 17,000 pixel image (a 17k endoscope) image guide alone can cost about $340.00, while the price of a fully assemble 17k endoscope can be in the $2,000 range. This is a major incentive for the re-use of the endoscope after sterilization rather than disposing of the endoscope after each procedure.
  • the expense factor means that as a practical matter the endoscope will be reused after sterilization rather than disposed of However, there is greater security from infection if the probe of the endoscope can be disposed of after each usage instead of being subject to the possibilities of human error in the sterilization process.
  • Another feature of conventional endoscopes is employing a probe passing through a 20 gauge tissue incision during ophthalmological surgery.
  • a 20 gauge incision has been a standard in the art of ophthalmological surgery and is used for entry by instruments employed during an ophthalmological surgical routine.
  • This sleeve such as a trocar sleeve is a tube implanted in a body wall which permits insertion and removal of a surgical instrument without touching the body wall tissue.
  • the value of the 23 gauge sleeve is that it involves a smaller incision and therefore quicker recovery time.
  • the 23 gauge sleeve provides an opening smaller than the 20 gauge incision and thus requires the probes thereof to be smaller in diameter so that they can fit through the 23 gauge sleeve.
  • Exemplary embodiments of the present invention address at least some of the drawbacks of conventional endoscopes by providing endoscope designs for which the cost is reasonable enough to permit and encourage disposal of the probe after each use rather than have recourse to sterilization.
  • exemplary embodiments of the present invention address at least some of the drawbacks of conventional endoscopes by providing endoscope designs which include a probe that can be inserted through, for example, a 23 gauge sleeve and can maintain sufficient robustness so as to minimize the amount of breaking.
  • Exemplary embodiments of the present invention provide endoscope designs, which permit disposal of the probe after each use and/or include a probe that can be inserted through, for example, a 23 gauge sleeve, while maintaining a probe look and feel familiar to surgeons and including operating characteristics of imaging, Ulumination, and laser oblation.
  • a laser video endoscope comprises a laser guide, an illumination guide and an image guide, which can be fiber optical guides extending through a probe portions of the endoscope and through a hand piece that supports the probe portion which can protrude from the distal end of the hand piece.
  • the hand piece includes one or more channels having a distal end at the distal end of the hand piece.
  • the one or more channels can be configured to accommodate at least one of the laser guide, an illumination guide and/or an image guide extending from the probe portion into the hand piece.
  • the hand piece includes a first channel having a distal end at the distal end of the hand piece such that an illumination guide and a laser guide can continue to extend from the probe portion to an illumination source and a laser energy source, respectively, via the first channel of the hand piece and through a relatively long flexible optical fiber cable connected to the hand piece at a proximal end of the first channel.
  • the hand piece includes a second channel having a distal end at the distal end of the hand piece such mat an optical image guide extends from the probe portion through the second channel of the hand piece and ends at a proximal end of a second channel.
  • the proximal end of the second channel is at the proximal end of the hand piece, and the proximal end of the hand piece is configured for removable attachment to a camera assembly such that the camera assembly can be optically coupled to the end of the optical fiber image guide.
  • Exemplary embodiments of the present invention provide an endoscope system comprising: a laser video endoscope including a hand piece supporting a probe, with a laser guide, an illumination guide and an image guide extending through the probe and the hand piece; and a camera assembly, which can be removably attached directly to the hand piece and has an input optically coupled to an end of the image guide extending though the hand piece.
  • the camera assembly includes an output having an electrical cable extended from the camera assembly to transmit an electrical image signal from the camera assembly to an image processor, an image display device, or any site where an image can be provided for the surgery.
  • camera assembly and its electrical cable can be uncoupled from the hand piece and reused in a plurality of endoscopic routines, while the laser video endoscope including the probe portion and the hand piece can be disposed of after each medical routine thereby providing assurance of an antiseptic procedure,
  • Exemplary embodiments of the present invention provide laser video endoscopes for use in ophthalmology operations, the endoscopes including a probe portion which, for example, can be passed through a 23 gauge sleeve, such as a trocar sleeve.
  • a laser video endoscope includes a, for example stainless steel, probe having a distal portion and a proximal portion, such that the proximal portion extends from the distal end of a hand piece of the laser video endoscope, and the outside diameter (OD) of the proximal portion as measured at least near the distal end of the hand piece is greater than the OD of the distal portion.
  • the distal portion has an OD less than 25 mils (thousandths of an inch), or about 0.64 mm, and about 2 mils, or 0.0S mm, wall thickness, such that at least the distal portion of the probe can be inserted through a 23 gauge sleeve.
  • the proximal portion of the probe, exiting from the hand piece has an OD of about 31 mils, or 0.79 mm, and about 5 mil, or 0.13 mm, wall thickness.
  • the distal portion has a length of about 710 mils, or 18 mm, at OD of less than about 25 mils, or 0.64 mm.
  • a distal portion of a probe of a laser video endoscope includes: a laser guide comprising a laser fiber disposed within the inner diameter of the distal portion of the probe; an image guide comprising an image bundle, which has a plurality of fibers arranged in an essentially circular configuration, disposed within the inner diameter of the distal portion of the probe not occupied by the laser fiber; and an illumination guide comprising an illumination bundle, which has a plurality of fibers filling the remaining of the inner diameter of the distal portion of the probe not occupied by the laser fiber and the image bundle.
  • the inner diameter of the distal portion of the probe is about 21 mils, or 0.54 mm
  • the laser fiber of the laser guide has an OD of about 100 microns, or 0.1 mm
  • the image bundle of the image guide has about 6,000 fibers arranged in an essentially circular configuration having an OD of about 14 mils, or 0.36 mm
  • the illumination bundle of the illumination guide has about 210 fibers filling the remaining 21 mils, or 0.54 mm, inner diameter of the distal portion of the probe not occupied by the laser fiber and the image bundle.
  • Exemplary embodiments of the present invention provide endoscope designs where a laser fiber can selectively accommodate input from laser energy sources having different wavelengths, such as for example a green laser having a wavelength of 532 nanometers.
  • FIG. 1 is a schematic illustration of a conventional endoscope design.
  • FIG. 2 is a schematic illustration of an endoscope system according to an exemplary embodiment of the present invention.
  • FIG. 3 is a longitudinal view of a camera assembly of an endoscope system according to an exemplary embodiment of the present invention.
  • FIG. 4 is a partial longitudinal sectional view of a camera assembly including exemplary implementation of camera assembly components according to an exemplary embodiment of the present invention.
  • FIGS. SA and FIG. SB are sectional views of a hand piece of an endoscope according to an exemplary embodiment of the present invention.
  • FIG. 6 is a schematic illustration of an endoscope system, including a probe, a hand piece, and a camera assembly, according to an exemplary embodiment of the present invention.
  • FIG. 7 is an illustration of a distal end of a hand piece and a probe according to an exemplary embodiment the present invention.
  • FIG. 8 is a cross sectional view of a distal portion of the probe of an exemplary embodiment illustrated in FIG. 7.
  • FIGS. 9A, 9B, 9C and 9D are multiple views illustrating a distal portion of a hand piece according to an exemplary embodiment of the present invention.
  • FIGS. 10A, 10B, 10C and 10D are multiple views illustrating a proximal portion of a hand piece according to an exemplary embodiment of the present invention.
  • FIG. 11 is a sectional view of an assembled hand piece, including distal and proximal portions, and a probe, of an endoscope according to an exemplary embodiment of the present invention.
  • FIG. 12 is a sectional view of an assembled hand piece, including distal and proximal portions, and a probe, showing an exemplary configuration of a laser guide, an illumination guide and an image guide, of an endoscope according to an exemplary embodiment of the present invention.
  • FIG. 13 is a sectional view of an endoscope system including probe, hand piece and camera system, according to an exemplary embodiment of the present invention.
  • FIG. 14 is a sectional view of an assembled hand piece, including distal and proximal portions, and a probe, of an endoscope according to another exemplary embodiment of the present invention.
  • FIG. 15 is a sectional view of an assembled hand piece, including distal and proximal portions, and a probe, showing an exemplary configuration of a laser guide, an illumination guide and an image guide, of an endoscope according to another exemplary embodiment of the present invention.
  • FIG. 16 is a sectional view of an endoscope system including probe, hand piece and camera system, according to another exemplary embodiment of the present invention.
  • FIG. 17 is a schematic diagram illustrating components of an endoscopy system according to exemplary embodiments of the present invention including illumination source, laser energy source, and image processing and/or display device interface.
  • FIG. 1 illustrates a configuration of a conventional laser video endoscope 10 having an operating probe 24, a hand piece 22, and a cable 18 which carries a laser guide 12, an illumination guide 14 and an image guide 16.
  • These are all fiber optic guides which extend from the distal end of the probe 24 to the terminals 12C, 14C and 16C, respectively. Distal of the trifurcation zone 20, the fiber optic guides are combined geometrically to provide a minimum diameter cable.
  • a laser video endoscope according to an exemplary embodiment of the present invention includes a hand piece 32, a probe 30 extending from the distal end of the hand piece 32, and a camera assembly 34 removably coupled to the proximal end of the hand piece 32.
  • the camera assembly 34 is directly connected to the proximal end of the hand piece 32 through engagement of a nose 54 of the hand piece 32 and recess 52 of the camera assembly 34.
  • probe 30 is illustrated as an essentially straight, other probes, such as curved probes can be interchangeably used without departing from the scope of the exemplary embodiments of the present invention described herein.
  • a laser guide comprising fiber 40, an illumination guide comprising fibers 42, and an image guide comprising fibers 35 extend form distal end of probe 30 into hand piece 32.
  • the proximal end of probe 30 can be fixedly attached to distal end of hand piece 32, for example by being cemented together by a known process.
  • the hand piece 32 contains channels 55, 56 and 57.
  • the hand piece 32 separates the image guide fibers 37, laser guide fiber 40, and illumination guide fibers 42 entering channel 55 at the distal end of hand piece 32 from the proximal end of probe 30, such that only image guide fibers 37 extend through channel 57, while the laser guide fiber 40 and the illumination guide fibers 42 extend through channel 56.
  • Channel 57 terminates at surface 58 at the proximal end of hand piece 32 and is used to optically couple the image guide fibers 37 extending from distal end of probe 30 to the lens or input optics of the camera assembly 34.
  • Channel 56 terminates at hand piece surface 59 and is used to accommodate the laser guide fiber 40 and the illumination guide fibers 42 extending from the distal end of probe 30 to be carried proximately by the cable 38.
  • channels 56 and 57 extend from channel 55 at a non-zero angle with respect to ache other, as shown in the example of FIG. 5 A where channels 56 and 15 extend
  • image guide fibers 37 which extend through the probe 30 and hand piece 32 carry the image and can be removably coupled directly to the optics of the camera assembly 34.
  • the distal end of the camera assembly 34 has a recess 52 which removably engages a nose 54 of the hand piece 32.
  • Positioning of the camera assembly 34 at the hand piece 32 can permit a standard optical coupling of the image output at the proximal end of the optical image guide fibers 37 to the optics of camera assembly 34.
  • camera assembly 34 can provide an electrical image that is transmitted proximally along the electrical cable 36 connected at the output of camera assembly 34.
  • the camera may be any one of a number of known types, which include for example optica) and/or image processing elements, and may be specially designed to fit the geometry of the camera assembly to ensure usable image input from image guide fibers 37 at the proximal end of hand piece 32.
  • an optical guide cable 38 extends in the proximal direction from the hand piece 32 and carries the laser guide fiber 40 and the illumination guide fibers 42 for conveying the laser energy and the illumination energy, respectively, to the probe 30.
  • cable 38 extends in the proximal direction to a bifurcation junction 44 where the laser guide fiber 40 and illumination guide fibers 42 are separated and terminated at terminals 40C and 42C for connection to sources of laser energy and illumination energy, respectively.
  • image carrying electrical cable 36 terminating at terminal 36C can be about as long as the optical guide cable 38, and each cable 36 and 38 can be as long as required for an installation.
  • the resent invention it becomes possible to terminate image guide fibers 37 at the proximal end of hand piece 32 due to direct optical coupling of image guide fibers 37 to the optics of camera assembly 34 as provided by hand piece 32.
  • the camera assembly 34 can be uncoupled from the hand piece 32 so that the relatively expensive camera assembly can be reused. Also, by positioning the camera assembly 34 at the hand piece 32, the lengthy and expensive optical image guide proximal of the hand piece 32 is avoided.
  • laser video endoscopes can eliminate the conventional costly and lengthy image fibers such as those extending from the hand piece 22 to terminal 16C as shown in FIG. 1.
  • the image can be carried to terminal 36C in an electric cable 36 proximally of the camera assembly 34 coupled directly to hand piece 32.
  • a relatively long electrical cable 36 can extend from proximal end of camera assembly 34 to a terminal 36C which is coupled to an appropriate image processing or display mechanism, for example a video screen so that the operating surgeon can view the image during the course of manipulating the probe 30.
  • camera assembly 34 can include a laser filter 46 for example to protect the camera film from laser energy and to permit the surgeon to observe the operation when laser pulses are firing.
  • a filter for multiple wavelength lasers can be present, such that for example 810nm and 532nm laser can be used.
  • camera assembly 34 can include a manually operated spring latch (not shown) to facilitate readily mounting the camera assembly 34 to the hand piece 32 and readily removing the camera assembly 34 from the hand piece 32.
  • the camera assembly 34 can include a focus ring 50 to assure adequate focus of the image provided onto the image receptors of the camera assembly 34 positioned at the proximal end of image guide fibers 37 which extends from the distal end of the probe 30 and through channels 55and 57 of the hand piece 32.
  • a variant on exemplary embodiments of the present invention as illustrated for example in FIGs. 2 through 6 is an arrangement in which the uncoupling at the proximal end of the hand piece 32 will uncouple not only the camera assembly 34 at surface 58, but also the cable 38, for example at or near surface 59, so that only the probe 30 and the hand piece 32 would be disposed of between each operation.
  • the image guide 37 within the probe 30 and hand piece 32 can be a fiber optic bundle; however, other exemplary configurations can provide an image guide function, such as for example a gradient index lens, often referred to as a GRIN lens.
  • a laser video endoscope according to an exemplary embodiment of the present invention includes a probe 78, and a hand piece 74 (partially illustrated).
  • the probe 78 has a proximal portion 70 and a distal portion 72 such that the proximal portion 70 extends from the distal end 73 of hand piece 74 of the laser video endoscope, and the outside diameter (OD) of the proximal portion70 as measured at least near the distal end 73 of hand piece 74 is greater than the OD of the distal portion 72.
  • a cross sectional view of distal portion 72 of probe 78 illustrates a configuration of image guide comprising fibers 86, laser guide comprising fiber 88, and illumination guide comprising fibers 80 within probe 78.
  • image guide 86 and laser guide 88 are arranged such that OD of fibers of image guide 86 and OD of fiber of laser guide 88 do not intersect or overlap at any cross section of distal portion 72 of probe 78.
  • FIG. 8 shows that OD of fibers of image guide 86 and OD of fiber of laser guide 88 do not intersect or overlap at any cross section of distal portion 72 of probe 78.
  • fibers of illumination guide 80 fill the remaining volume of distal portion 72 of probe 78 such that OD of fibers of image guide 86 and OD of fiber of laser guide 88 do not intersect or overlap OD of any fiber of illumination guide 80 at any cross section of distal portion 72 of probe 78.
  • the proximal portion 70 can have between about 20 and 22 gauge (35 and 31 mils, or 0.89 and
  • the proximal portion 70 extends into the hand piece 74.
  • there is a diameter having sufficient robustness to contribute to minimizing the likelihood of breaking at the juncture between distal end 73 of hand piece 74 and the proximal end of probe 78.
  • the length of the proximal portion 70 of the probe 78 can be about 120 mils, or 3 mm, and the length of the distal portion 72 can be about 710 mils, or 18mm, for a probe 78 length of about 830 mils, or 21 mm.
  • the distal portion 72 of the probe 78 can have OD of about 25 mils, or 0.64 mm, or less, and can extend through a 23 gauge sleeve to provide illumination and laser energy delivery within the eye during a surgical procedure and to transmit image from the eye.
  • This distal portion 72 can have a wall thickness of about 2 mils, or 0.05 mm, and a length of about 710 mils, or 18 mm. The 710 mil, or 18 mm, length is long enough for most applications and short enough to rninimize breaking.
  • Probe 78 having OD of about 25 mil, or 0.64 mm, according to exemplary
  • embodiments of the present invention can meet the need of providing enough light and enough laser energy while maintaining an adequate image guide by providing trade-off of dimensions for each of respective fibers transmitting illumination light, laser energy, and images as follows.
  • image guide 86 comprises a bundle of about 6,000 fibers arranged in an essentially circular cross-sectional configuration with OD of about 14 mils, or 0.36 mm
  • laser guide 88 comprises a fiber with OD of about a 100 micron, or 0.1 mm.
  • Image guide 86 and laser guide 88 are contained within the distal portion 72 of the probe 78 having OD of approximately 25 mils, or 0.64 mm, wall thickness of
  • probe 78 can be made robust enough to minimize breakage by a combination of: (a) rigid construction for probe 78 wall, (b) two-diameter design for proximal portion 70 and distal portion 72 and (c) limited length for distal portion72.
  • a particularly advantageous configuration according to an exemplary implementation of probe 78 includes a combination of: (a) probe 78 having a metallic wall, (b) proximal portion 70 having OD of 35 mil and wall thickness of 5 mils that extends through the hand piece 74, and distal portion 72 having OD of 25 mil and wall thickness of 2 mils, and (c) distal portion 72 having a length of no more than 710 mils.
  • a design according to exemplary embodiments of the present invention as illustrated in FIGs. 7 and 8 can provides sufficient illumination to illuminate a 90 degree field.
  • One of the compromises made in order to get a small diameter probe is to reduce the laser guide 88 fiber diameter from 200 microns to 100 microns.
  • a 532 nanometer (nm) laser source, or a green laser can be advantageously provide a desirable laser energy.
  • output of a 532 nm laser is more coherent and less divergent than the 810 run laser.
  • the use of a 532 nm laser in combination with the reduced size of the laser fiber 88 provides a reasonable amount of laser energy for the ophthalmological operations involved.
  • the illumination guide 80 can be reduced from approximately 220 fibers to about 70 fibers thereby materially contributing to a smaller diameter of probe 78.
  • Exemplary embodiments of the present invention have been described in connection with an implementation that permits use with a 23 gauge sleeve. It should be understood that variations could be made to adapt the design described to use with sleeves having variations on the 23 gauge or to be used without a sleeve.
  • the exemplary embodiments of the present invention describe combinations of a number of features and trade-offs designed to work together to provide an operable and useful laser video endoscope having a small probe that provides access for eye operations with minimum trauma and reduced healing time.
  • an exemplary embodiment of the present invention provides a hand piece design comprising a distal portion 90 and a proximal portion 100 fixedly assembled to form hand piece, such as hand piece 110 as illustrated for example in FIG. 11.
  • distal portion 90 includes an opening 92 terminating at surface 94 of the distal end or portion 90, and an opening 93 terminating at the proximal end of portion 90.
  • Opening 92 is configured for accommodating the proximal end of a probe, such as proximal end 114 of probe 112 as illustrated for example in FIG.
  • Distal portion 90 contains channel 95 and defines at least a first portion 99 of the inner wall of channel 96 by a protruding section 91, which can also serve as a guide for holding the hand piece.
  • Proximal portion 100 contains channel 97, which extends from surface 103 of distal end 102 and terminates at surface 105 of the proximal end of portion 100.
  • Proximal portion 100 defines at least a second portion 109 of the inner wall of channel 96.
  • hand piece 120 comprising distal portion 90 and proximal portion 100 separates the image guide fibers 37, laser guide fiber 40, and Ulumination guide fibers 42 entering channel 95 at the distal end of distal portion 90 from the proximal end 114 of probe 112, such that only image guide fibers 37 extend through channel 97, while the laser guide fiber 40 and the illumination guide fibers 42 extend through channel 96.
  • Channel 97 terminates at surface 105 at the proximal end of proximal portion 100 and is used to optically couple the image guide fibers 97 extending from distal end of probe 112 to the lens or input optics 130 of the camera assembly 134.
  • Channel 96 terminates at exterior side surface 101 of proximal portion 100 and is used to accommodate the laser guide fiber 40 and the illumination guide fibers 42 extending from the distal end of probe 112 to be carried proximately by a cable, such as cable 38.
  • camera assembly 134 can provide an electrical image that is transmitted proximally along the electrical cable 136 connected at the output of camera assembly 134.
  • a connection 138 of camera assembly 134 with hand piece 110 can comprise, for example, a snap fit connection achieved by physical characteristics of the proximal end of proximal portion 100 and the distal end of camera assembly 135 to facilitate readily mounting the camera assembly 134 to the hand piece 110 and readily removing the camera assembly 134 from the hand piece 110.
  • the camera assembly 134 can include a focus ring ISO to assure adequate focus of the image provided onto the image receptors of the camera assembly 134 positioned at the proximal end of the image guide fibers 37 which extends from the distal end of the probe 30 and through channels 95 and 97 of the hand piece 110.
  • hand piece 140 comprising distal portion 90 and proximal portion 200 separates the image guide fibers 37, laser guide fiber 40, and illumination guide fibers 42 entering channel 95 at the distal end of distal portion 90 from the proximal end 114 of probe 112, such that only image guide fibers 37 extend through channel 207, while the laser guide fiber 40 and the illumination guide fibers 42 extend through channel 96.
  • channel 207 terminates at surface 205 at distal end of a cavity 220 having an opening 222 at proximal end face 105 of portion 200.
  • Channel 207 is used to optically couple the image guide fibers 97 extending from distal end of probe 112 to the lens or input optics 165 disposed in a protruding portion 162, which extends distally from surface 163 of the camera assembly 164 into cavity 220 of hand piece 140.
  • Channel 96 terminates at exterior side surface 101 of proximal portion 200 and is used to accommodate the laser guide fiber 40 and the illumination guide fibers 42 extending from the distal end of probe 112 to be carried proximately by a cable, such as cable 38.
  • camera assembly 164 can provide an electrical image that is transmitted proximally along the electrical cable 166 connected at the output of camera assembly 164.
  • a connection 168 of camera assembly 164 with hand piece 140 can comprise, for example, a snap fit connection achieved when protruding portion 162 is inserted into cavity 220 to facilitate readily mounting the camera assembly 164 to the hand piece 140 and readily removing the camera assembly 164 from the hand piece 140.
  • a snap fit connection achieved when protruding portion 162 is inserted into cavity 220 to facilitate readily mounting the camera assembly 164 to the hand piece 140 and readily removing the camera assembly 164 from the hand piece 140.
  • connection 168 allows hand piece 140 and probe 112 to be axially rotated (about axis A- A) with respect to camera assembly 164.
  • image output from the image guide 37 of a probe 112 can be properly oriented in the camera assembly 164 for display and/or further image processing output via electrical cable 166 connected at the output of camera assembly 164.
  • Such desired orientation of the image for display and/or further image processing can be performed through electronic image processing, or optically, using components disposed within camera assembly 164 or connected to cable 166 at output of camera assembly 164, or any combination thereof.
  • the hand piece 140 is connected to the camera assembly 164 no manual orientation of probe 112 with respect to subject such as an operating site (not shown) at distal end of probe 112 is needed.
  • Endoscope user can rotate probe 112 with respect to the subject by rotating hand piece 140, which rotates with respect to the camera assembly 164, without disrupting the image of the subject, which may be particularly advantageous when using a curved endoscopes.
  • the camera assembly 164 can include a focus ring 160 to assure adequate focus of the image provided onto the image receptors of the camera assembly 164 positioned at the proximal end of the image guide fibers 37 which extends from the distal end of the probe 30 and through channels 95 and 97 of the hand piece 110.
  • an exemplary embodiment of the present invention provides a system 1000 comprising a console 170 and an endoscope 500 including camera assembly 179, hand piece 177 and probe 175 which can be configured and constructed in various combinations of exemplary implementations of camera assembly, hand piece, and probe as described herein with reference to FIGs. 2 through 16.
  • console 170 can comprise one or any combination of multiple laser energy sources 172 and/or 178 for connection to laser guide fiber 40 via, for example uniquely configured connectors 152C and/or 158C respectively, one or more illumination light sources 174 for connection to illumination guide fibers 42 via connector 154C, and one or more image display or image processing interfaces 176 for connection to image guide fibers 37 via connector 156C.
  • laser energy source 172 can be a 532 nm laser source which can be connected to endoscope 500 whose probe is configured as in the example of FIGs.
  • laser energy source 178 can be a 810 nm laser source which can be connected to endoscope 500 whose probe is configured as in the example of FIG.2, FIG. 13, or FIG 16 (notably, any of the hand pieces in FIGs.2, 13 or 16 can be configured with a probe of FIGs. 7 and 8).
  • endoscope 500 whose probe is configured as in the example of FIG.2, FIG. 13, or FIG 16 (notably, any of the hand pieces in FIGs.2, 13 or 16 can be configured with a probe of FIGs. 7 and 8).
  • image output from image guide fibers 37 of probe 17S can be oriented in the camera assembly 179 using components disposed within camera assembly 179, components disposed within image processing interface 176, and/or other components of console 170, so that when hand piece 177 is connected to camera assembly 179 no manual image orientation is needed and the user can rotate probe 175 with respect to camera assembly 179 without disrupting the image output by manipulating handpiece 177 .

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Optics & Photonics (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biophysics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Laser Surgery Devices (AREA)

Abstract

La présente invention concerne un endoscope vidéo laser présentant un guide laser, un guide d'éclairage et un guide d'image qui s'étendent à travers la sonde optique et à travers une pièce à main qui soutient la sonde. La pièce à main est raccordée par un câble à fibre optique à la source d'énergie laser et à la source d'éclairage. L'image est transmise depuis la pièce à main à une interface de traitement d'image par un ensemble caméra optiquement couplé et monté directement sur la pièce à main et par l'intermédiaire d'un câble électrique s'étendant depuis l'ensemble caméra. La caméra et son câble électrique peuvent être débranchés de la pièce à main et réutilisés. Le reste du produit, notamment la sonde et la pièce à main, peut être jeté après chaque routine médicale. La sonde peut présenter une partie proximale et une partie distale de sorte que la partie proximale s'étend depuis l'extrémité distale de la pièce à main, et que le diamètre externe de la partie proximale tel que mesuré au moins près de l'extrémité distale de la pièce à main est supérieur au diamètre externe de la partie distale.
EP16873968.8A 2015-12-11 2016-12-09 Endoscope vidéo laser Withdrawn EP3386372A4 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US14/966,151 US20160095507A1 (en) 2010-05-13 2015-12-11 Laser video endoscope
PCT/US2016/065939 WO2017100651A1 (fr) 2015-12-11 2016-12-09 Endoscope vidéo laser

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EP3386372A1 true EP3386372A1 (fr) 2018-10-17
EP3386372A4 EP3386372A4 (fr) 2019-09-18

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JP (2) JP2018538069A (fr)
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EP2790580A4 (fr) 2011-12-14 2015-08-12 Univ Pennsylvania Surveillance d'oxygénation et de flux par fibre optique à l'aide d'une corrélation diffuse et d'un coefficient de réflexion
US10492662B2 (en) 2012-03-27 2019-12-03 Medigus Ltd. Integrated endoscope irrigation
US11395406B2 (en) 2015-06-11 2022-07-19 Scoutcam Ltd. Camera head
JP2021153781A (ja) 2020-03-26 2021-10-07 株式会社フジクラ 内視鏡
CN112842523B (zh) * 2021-01-27 2022-05-17 北京航空航天大学 一种偏心性内窥镜激光导管

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JP2022050567A (ja) 2022-03-30
CN108601513A (zh) 2018-09-28
JP2018538069A (ja) 2018-12-27
EP3386372A4 (fr) 2019-09-18
WO2017100651A1 (fr) 2017-06-15

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