JP2013208459A - Endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope capable of overcoming the problem of missing of a malignant (cancerous) polyp in a single forward viewing camera.SOLUTION: An endoscope 10 includes an imaging device 30 having a steerable extension at a distal end of an insertion tube 12. The base end of the extension is attached to the distal end of the insertion tube 12. The endoscope 10 includes a rearward view imaging device disposed inside a distal end area 13 of the insertion tube 12. The endoscope 10 includes an insertion tube having a distal end cap, an imaging device, and a link that couples the imaging device to the distal end cap of the insertion tube.

Description

Related applications

  This application claims the benefit of US Provisional Patent Application No. 60 / 761,475, filed Jan. 23, 2006, the entire disclosure of which is incorporated herein by reference.

  This application also claims the benefit of US Provisional Patent Application No. 60 / 802,056, filed May 19, 2006, the entire disclosure of which is incorporated herein by reference.

  In addition, this application claims the benefit of US patent application Ser. No. 11 / 609,838 filed Dec. 12, 2006, the entire disclosure of which is incorporated herein by reference.

  The entire disclosure of US patent application Ser. No. 11 / 609,660, filed Aug. 29, 2005, is hereby incorporated by reference.

TECHNICAL FIELD OF THE INVENTION

  The present invention relates to an endoscope.

Background of the Invention

  An endoscope is a medical device that includes a flexible tube and a camera mounted on the tip of the tube. An endoscope can be inserted into an internal body cavity through a body opening to examine and diagnose body cavities and tissues. The endoscope tube has one or more longitudinal channels through which the instrument can reach the body cavity, thereby taking a sample of suspicious tissue or other surgical procedures such as polypectomy. It can be performed.

  There are many types of endoscopes, and these endoscopes are named in relation to the organ or region in which they are used. For example, the gastroscope is used for examination and treatment of the esophagus, stomach and duodenum, the colonoscope is for the colon, the bronchoscope is for the bronchus, the laparoscope is for the abdominal cavity, and the sigmoidoscope is the rectum And for the sigmoid colon, the arthroscope is for the joint, the cystoscope is for the bladder, and the vascular endoscope is for examination of the blood vessels.

  Each endoscope has a single forward view camera mounted at the distal end of the endoscope for transmitting images to a proximal eyepiece or video display. The camera is used to help medical professionals push the endoscope into the body cavity to look for abnormal sites. The camera provides a medical professional with a two-dimensional field of view from the tip of the endoscope. In order to acquire images from different angles or at different parts, the endoscope must be repositioned or moved back and forth. Endoscope repositioning and movement prolongs the procedure and poses additional discomfort, complexity, and risk to the patient. Also, in environments such as the lower gastrointestinal tract, bends, tissue folds, and abnormal shapes of organs may prevent the endoscope camera from observing all areas of the organ. Invisible areas can cause potential malignant (cancerous) polyps to be missed.

  This problem can be overcome by providing an auxiliary camera that provides an image of an area that cannot be observed by the main camera of the endoscope. The auxiliary camera can be oriented backwards to face the main camera. This placement of the camera can provide both an anterior view and an posterior view of the region or anomalous site. In the case of polypectomy, where a polyp is removed by placing a wire loop around the base of the polyp, such a camera arrangement minimizes damage to adjacent healthy tissue by better placement of the wire loop. Can do.

  The present invention provides an endoscope having various advantages over the prior art. According to one aspect of the present invention, an endoscope includes an insertion tube having a distal end and an imaging device including a steerable extension portion having a distal end and a proximal end. The proximal end of the extension is attached to the distal end of the insertion tube.

  The tip of the steerable extension may be steered in various ways. For example, the tip of the steerable extension may be steered in one direction up to 180 °. Alternatively, the tip of the steerable extension may be steered up to 180 ° in any of the two opposite directions. In some cases, the tip of the steerable extension is steered in three or more directions.

  In a preferred embodiment, the steerable extension has a diameter of about 1/3 of the diameter of the insertion tube.

  In another preferred embodiment, the imaging device includes an imaging unit provided at the tip of the steerable extension. In addition to or instead of this, the imaging unit may be provided on the cylindrical side surface of the distal end region of the steerable extension portion. Furthermore, two imaging units may be provided on both sides of the tip region of the steerable extension portion.

  The steerable imaging device according to this aspect of the present invention allows the physician to successfully position the imaging device, thereby providing a larger field of view and the area behind the fold and bend portions. Can be observed. A steerable imaging device is beneficial because it can also move to a greater degree due to its small diameter and high flexibility compared to an imaging device mounted in the distal region of the insertion tube.

  In another aspect of the present invention, the endoscope includes an insertion tube having a distal end region and a rear visual field imaging device disposed at least partially inside the distal end region. The insertion tube may have a sheath with a window positioned in front of the rear view imaging device so that the imaging device can “see” objects outside the insertion tube. Alternatively, the rear visual field imaging device may protrude outside the insertion tube so that a window is not necessary.

  In a preferred embodiment, the distal region of the insertion tube may include a circular groove having a front side wall and a rear side wall. The side wall facing rear has a window disposed in front of the rear visual field imaging device. Alternatively, the rear visual field imaging device may protrude outside the side wall facing rearward so that a window is not necessary. The grooves of this embodiment provide a better field of view for the imaging device.

  In another preferred embodiment, the distal region of the insertion tube includes a circular protrusion having a front facing side and a rear facing side. The side facing the rear of the protrusion has a window disposed in front of the rear visual field imaging device. Alternatively, the rear visual field imaging device protrudes outside on the side facing the rear of the protrusion so that the window is not necessary. The circular protrusion of this embodiment provides a better field of view for the imaging device.

  In a further embodiment of the invention, the endoscope includes a plurality of rear field imagers and the image signals from the rear field imagers are combined to provide a 360 ° rear field imager.

  In a further aspect of the invention, the endoscope includes an insertion tube having a distal end cap, an imaging device, and a link coupling the imaging device to the distal end cap of the insertion tube. The imaging device may include a housing element, and the housing element, the link, and the tip cap may form a single unit. In a preferred embodiment, the endoscope further comprises a main imaging device located at the distal end of the insertion tube, in which case the two imaging devices provide different fields of view in the same area.

1 shows a perspective view of an endoscope according to an embodiment of the present invention. FIG. FIG. 2 shows a perspective cutaway view of the endoscope of FIG. 1. The other perspective cutaway figure of the endoscope of Drawing 1 is shown. FIG. 2 shows an exploded perspective view of the endoscope of FIG. 1. FIG. 7 shows a perspective view of a modification of the endoscope of FIG. 1 having a front-field imaging unit. FIG. 6 shows a perspective view of a mechanism for extending the sub imaging device from the insertion tube and pulling the sub imaging device into the insertion tube. The perspective view of the endoscope which has the back visual field imaging device concerning other embodiments of the present invention is shown. FIG. 8 shows a perspective view of the endoscope of FIG. 7 with a window for a rear-field imaging device. The perspective view of the other endoscope which has a back visual field imaging device is shown. FIG. 10 is a perspective view of the endoscope of FIG. 9 in which the rear visual field imaging device projects through the endoscope sheath. FIG. 6 shows a perspective view of a further endoscope having a rear view imaging device. FIG. 11 shows a perspective view of the endoscope of FIG. 10 in which the rear visual field imaging device protrudes through the side wall facing the rear of the groove. FIG. 9 shows a perspective view of a further endoscope in which the rear visual field imaging device is provided on the side facing the rear of the circular protrusion. FIG. 6 shows a perspective view of an endoscope having a steerable imaging device according to a further embodiment of the invention. FIG. 15 is a front perspective cutaway view of the endoscope of FIG. 14. The front view of the endoscope of FIG. 14 which shows the steering property of the steerable imaging device is shown. FIG. 15 is a rear perspective cutaway view of the endoscope of FIG. 14. Fig. 15 shows a modification of the endoscope of Fig. 14 having an imaging unit facing sideways. 14 shows another modification of the endoscope of FIG. 14 in which two imaging units facing sideways are arranged on both sides of the extension part.

Detailed Description of the Embodiments of the Invention

  FIG. 1 shows a first exemplary endoscope 10 of the present invention. The endoscope 10 can be used in various medical procedures that require imaging of living tissue, organs, body cavities, or lumens. Treatment types include, for example, anoscopy, arthroscopy, bronchoscopy, colonoscopy, cystoscopy, esophagogastroduodenoscopy, laparoscopy, and sigmoidoscopy It is done.

  The endoscope 10 in FIG. 1 includes an insertion tube 12 having a main imaging device 26 (FIG. 2) at its distal end, a control handle 14 connected to the insertion tube 12, and a secondary positioned at the distal end of the endoscope 10. The imaging device 30 may be included.

  The insertion tube 12 of the endoscope 10 may be removable from the control handle 14 or may be formed integrally with the control handle 14. The diameter, length, and flexibility of the insertion tube 12 depend on the procedure in which the endoscope 10 is used.

As shown in FIG. 2, the insertion tube 12 preferably has one or more longitudinal channels 22 through which the instrument can reach the body cavity, thereby collecting a sample of suspicious tissue. Alternatively, any desired procedure can be performed, such as performing other surgical procedures such as polypectomy. The instrument may be, for example, a telescopic needle for drug injection, a hydraulically actuated scissors, a clamp, a grasping instrument, an electrocoagulation system, an ultrasonic transducer, an electrical sensor, a heating element, a laser mechanism, and other ablation means. May be. In some embodiments, one of the channels can be used to supply a cleaning liquid, such as water, for cleaning. A cap (not shown) may be included in the opening of the cleaning channel 22 to deflect the cleaning liquid against the lens of the main imaging device 26 for cleaning. Another or the same channel 22 may be used to supply a gas, such as CO ₂ or air, to the organ. The channel 22 may also be used to draw fluid or inject fluid such as a drug in a liquid carrier into the body. Various biopsy devices, drug delivery devices, and other diagnostic and treatment devices may be inserted through channel 22 to perform specific functions.

  The insertion tube 12 is preferably steerable or has a steerable tip region 13 (FIG. 1). The length of the tip region 13 may be any suitable portion of the length of the insertion tube 12, for example 1/2, 1/3, 1/4, 1/6, 1/10 or 1/20. . The insertion tube 12 may have a control cable 18 (FIG. 2) for operation of the insertion tube 12. Preferably, the control cable 18 is positioned symmetrically within the insertion tube 12 and extends along the length of the insertion tube 12. The control cable 18 may be fixed at or near the distal end of the insertion tube 12. Each control cable 18 may be a Bowden cable including a wire housed in a flexible coated hollow tube. The wire of the Bowden cable is attached to a control device (not shown) in the handle 14. By using the control device, the distal end region 13 of the insertion tube 12 can be bent in a predetermined direction by pulling the wire. The Bowden cable can be used to connect the distal region of the insertion tube 12 in different directions.

  The main imaging device 26 at the distal end of the insertion tube 12 may include, for example, a lens, a single chip sensor, a multiple chip sensor, or an optical fiber mounting device. A main imaging device 26 in electrical communication with the processor and / or monitor may provide still images, recorded video images or raw video images. In addition to the main imaging device 26, the distal end of the insertion tube 12 may include one or more light sources 24, such as a light emitting diode (LED) or an optical fiber supply of light from an external light source. The light source 24 is preferably equidistant from the main imaging device 26 to provide uniform illumination. Each light source 24 can be individually turned on or off. The intensity of each light source 24 can be adjusted to achieve optimal imaging. Circuits for the main imaging device 26 and the light source 24 may be incorporated into a printed circuit board (PCB) 27 (FIG. 3) that can be mounted on the proximal end side of the end cap 29 of the insertion tube 12.

  As shown in FIG. 2, the insertion tube 12 can be used to protect the flexible ribbon coil 21 and the internal components of the insertion tube 12 such as channels 22 and wires and cables 25 from the body environment. A flexible sheath 23 may be included. The end cap 29 of the insertion tube 12 seals the open end of the shield 23 in order to close the distal end of the insertion tube 12. End cap 29 includes an outlet port for channel 22 and a peripheral metal port or socket (not shown) to which the wires of control cable 18 are attached.

  As shown in FIG. 1, the control handle 14 may include one or more control knobs 16 that are attached to the control cable 18 (FIG. 2) for operation of the insertion tube 12. Preferably, rotation of the control knob 16 pulls the control cable 18 and thus moves or bends the tip region 13 of the insertion tube 12 up and down and / or left and right. In some embodiments, in order to prevent inadvertent rotation of the knob 16, a clutch or restraint component (such that rotation can only be caused by applying a certain degree of torque to the control knob 16 ( (Not shown) may be included with the control knob 16.

  Preferably, as shown in FIG. 1, the control handle 14 has one or more ports and / or valves 20 for controlling access to the channel 22 (FIG. 2) of the insertion tube 12. The port and / or valve 20 may be an air or water supply valve, a suction valve, a measurement port, and a suction / measurement port.

  The control handle 14 may include a button for taking an image using the main imaging device 26, the sub imaging device 30, or both.

  The proximal end of the control handle 14 may include air channels, water channels, and auxiliary outlets 28 (FIG. 1) that provide fluid communication between the suction channels and the pump and associated accessories. The same or different outlets can be used for electrical lines to the illumination and imaging components at the distal end of the endoscope 10.

  As shown in FIG. 2, the link 36 is used to connect the sub imaging device 30 to the end cap 29 of the insertion tube 12. In the illustrated embodiment, the link 36 is generally an elongated flat straight bar, but the link may be configured in any suitable manner. For example, the link may be curved and may have a circular or square cross section. The link may comprise a single pole as shown in FIG. 2 or may comprise two or more poles to enhance support for the secondary imaging device 30. In some embodiments, the link may be formed from a transparent material, and the transparent link may be a transparent tube connected to the outer periphery of the secondary imaging device 30 and the end cap 29. Preferably, the link 36 has an appropriate elasticity in order to make it easier for the sub-imaging device 30 to pass through and respond to the bend along the body cavity.

  As shown in FIG. 3, the sub imaging device 30 preferably includes an imaging unit 42 and one or more light sources 44 such as LEDs. In this embodiment, the imaging unit 42 and the light source 44 are disposed on the base end 46 of the sub imaging device 30, which includes the sub imaging device 30 including the top of the sub imaging device 30, the side surface, or both. It may be placed in any suitable location above. Preferably, the imaging unit 42 faces rearward toward the main imaging device 26 and is oriented so that the imaging unit 42 and the main imaging device 26 can be used to provide different views of the same area. In the illustrated embodiment, the imaging unit 42 provides a rear view of the region, while the main imaging device 26 provides a front view of the region.

  Since the main imaging device 26 and the imaging unit 42 of the sub imaging device 30 face each other, the light sources 22 and 24 of one imaging device 26 and 30 may interfere with the other imaging device 30 and 26. A polarizing filter may be used with the imaging devices 26, 30 and the light sources 24, 44 to reduce interference. The main imaging device 26 and its light source 24 may be covered by a first set of polarizing filters in the same direction. The imaging unit 42 and the light source 44 may also be covered by a second set of polarizing filters that are oriented at 90 ° with respect to the first set of polarizing filters. Alternatively, only one of the imaging devices 26 and 30 may be covered by the first polarizing filter, and only the opposing light sources 24 and 44 are oriented at 90 ° with respect to the first polarizing filter. It may be covered with a polarizing filter. The use of polarizing filters to reduce light interference is well known and will not be described in detail here.

  As an alternative to the polarizing filter, the imaging devices 26, 30 and their light sources 24, 44 may be alternately turned on / off to reduce or prevent light interference. That is, when the main imaging device 26 and its light source 24 are turned on, the imaging unit 42 and its light source 44 are turned off. When the main imaging device 26 and its light source 24 are turned off, the imaging unit 42 and its light source 44 are turned on. The imaging devices 26 and 30 and their light sources 24 and 44 are preferably turned on and off at a sufficiently high frequency that the eyes do not feel that the light sources are turned on and off.

  As shown in FIG. 4, the sub imaging device 30 preferably includes housings 48 a and 48 b for housing the imaging unit 42 and the light source 44. The housings 48a and 48b of the sub imaging device 30 preferably include first and second housing elements 48a and 48b. The housing elements 48a, 48b preferably have mechanisms such as pins and sockets that allow the imaging unit 42 and the light source 44 to be securely mounted within the housing elements 48a, 48b. The housing elements 48 a and 48 b are attached to each other in a sealed state in order to maintain the biocompatibility of the sub imaging device 30 and prevent contaminants from entering the sub imaging device 30. The housing elements 48a, 48b may be sealed to each other in any suitable manner, including ultrasonic welding or friction welding or adhesion. The housing elements 48a, 48b may include windows for the imaging unit 42 and the light source 44, respectively. Each window is preferably sealed with a thin transparent cover attached to the housings 48a, 48b. In some embodiments, the window may be the polarizing filter described above.

  In a preferred embodiment, the first housing element 48a, the link 36, and the end cap 29 form a single unit made, for example, by injection molding. The second housing element 48b may be formed separately, for example by injection molding. The molded unit is preferably formed from a biocompatible material such as a biocompatible plastic. Alternatively, the housing elements 48a, 48b, the link 36, and the end cap 29 may be formed as separate parts from the same material or different materials and then attached to each other.

  As shown in FIG. 4, a circuit for the imaging unit 42 is formed on the PCB 54. A circuit for the light source 44 may also be formed on the PCB 54. The PCB 54 may also include a signal processing circuit and a power control circuit, and can be attached to one of the housing elements 48a by, for example, an adhesive or a screw. The imaging unit 42 may be an electronic device that converts light incident on the photosensitive semiconductor element into an electrical signal. Such an apparatus may detect color image data or black and white image data. The signal from the device is digitized and used to reproduce the image that has entered the device. Two commonly used types of imaging devices are charge coupled devices (CCD) such as LC99268FB manufactured by Sanyo in Osaka, Japan, and Complementary MetalOxide such as OVT 6910 manufactured by OmniVision, Sunnyvale, California. It is a Semiconductor (CMOS) camera chip.

  As shown in FIG. 2-4, the endoscope 10 has wiring 55 that extends through the link 36, the insertion tube 12, and the control handle 14 and connects the sub imaging device 30 to an external control box (not shown). May be included. By the wiring 55, the sub imaging device 30 can perform communication including transmission of a video signal to the external control box and reception of power and a control signal from the external control box with the external control box.

  Image data acquired by the main and sub imaging devices 26, 30 is transmitted to an external control box for processing. When the image signal is received by the external control box, it is supplied to a signal processing circuit that converts it into a video signal such as an NTSC composite image or RGB. This video signal is then sent to a connector suitable for output to a display device such as a monitor or television. In some embodiments, images from the main imaging device 26 and the secondary imaging device 30 can be simultaneously displayed on the same display device using a split screen. The display device may also have a text display area that is used to display patient information or reference numbers, dates, times and other information and to enter notes for acquired still images. . The text can be typed by a keyboard connected to the control box.

  The external control box may also be used as an interface to the patient record database. Today, many medical facilities utilize electronic medical records. During the procedure, it may be necessary to record relevant video and image data in a patient electronic medical record (EMR) file. The signal processing circuit can convert the image / video data into a format suitable for file in a patient EMR file, particularly an image in jpeg, tif, or bmp format. The processed signal can be sent to a medical professional computer or medical equipment server via a cable or a dedicated wireless link. A switch on the control panel can be used to enable this transmission. Alternatively, the data can be stored in an electronic memory provided in the control box itself, along with patient specific identification information. Signal processing circuitry can be utilized to convert video and image data to be compatible with electronic medical recording systems used by medical professionals. The processing may include data compression. Cables or wireless links may be used to send data to the computer.

  The image / signal processing circuitry of the external control box includes one or more integrated circuits and memory, optionally with associated components. With this circuit, video signals can be processed to improve image quality, still images can be extracted from the video, and video format conversion can be performed to provide multiple output formats. These functions can be interfaced for access via the control panel.

  The external control box may be used to adjust parameters of the primary and secondary imaging devices 26, 30 such as brightness, exposure time and mode settings. These parameters may be adjusted by writing digital commands to the specific registers that control the parameters. These registers can be addressed by their unique number, and digital commands can be read from these registers to change parameters, and digital commands can be sent to these registers. Can write. The control box is used to control these parameters by sending data commands to these registers. The signal processing circuit on the sub-imaging device 30 receives these signals, decodes them into commands, and supplies these signals to the imaging devices 26 and 30, thereby adjusting various parameters.

  As illustrated in FIG. 5, the sub imaging device 30 may further include a front visual field imaging unit 70 and a front facing light source 72. The front visual field imaging unit 70 enables more effective navigation of the endoscope 10. Further, in order to allow the accessory to reach the area in front of the sub imaging device 30, the sub imaging device 30 may be configured not to block one or more channels 22 of the insertion tube 12. For example, the sub imaging device 30 may be formed small enough so that it does not block the channel 22 of the insertion tube 12. Alternatively, the sub imaging device 30 may include a through hole (not shown) that is aligned with the channel 22 of the insertion tube 12. With this through hole, the accessory can reach the area in front of the sub imaging device 30.

  In a further embodiment of the present invention, the sub-imaging device has two imaging units 42 and 70, that is, one imaging unit on the proximal end side of the sub-imaging device and the other imaging unit on the distal end side of the sub-imaging device. However, the insertion tube 12 does not have the main imaging device 26. The increased space at the tip of the insertion tube 12 can be used to provide one or more additional channels.

  In other embodiments, the sub-imaging device 30 can be expanded and contracted from the insertion tube 12. As shown in FIG. 6, the endoscope 10 may include a linear actuator 73 disposed in the housing 75 and connected to the link 36. The linear actuator 73 can extend the link 36 from the hollow guide 77 and can retract the link 36 into the hollow guide 77. As a result, the doctor can retract the secondary imaging device 30 when pushing the endoscope 10 through a difficult region of the body, and then extend the secondary imaging device 30 when the endoscope 10 reaches its destination. it can. Further, the expansion and contraction of the sub imaging device adjusts the distance between the main imaging device and the sub imaging device.

  In operation, the power may be initially turned on to activate the imaging devices 26, 30 and the light sources 24, 44. At this time, the imaging devices 26 and 30 start to wirelessly transmit the acquired images to the external control box. The control box then processes the image signals and sends them to the display so that medical professionals can view the images in real time. At this point, the main imaging device 26 provides a front field of view of the region, while the sub-imaging device 30 provides a field of view behind or behind the same region. During the medical procedure, the endoscope 10 is inserted into the patient. The medical professional can view images from the main imaging device 26 and the sub imaging device 30 at the same time. At this time, a lesion that is not visible from the main imaging device 26 behind the fold portion and the bent portion can be viewed by a medical professional from the image supplied by the sub imaging device 30. When the procedure is complete, the endoscope 10 is removed from the patient.

  Using the external control box, the parameters of the imaging devices 26 and 30 and the light sources 24 and 44 can be adjusted to obtain optimum image quality. During the procedure, relevant video and image data may be recorded in the patient's electronic medical record (EMR) file.

  In other aspects of the invention, one or more rear view imaging devices may be mounted in or on the distal region of the insertion tube to provide a rear field of view. 7 and 8 illustrate one embodiment according to this aspect of the invention. In this embodiment, in addition to the main imaging device 226 and the main light source 224 (FIG. 8), the endoscope 210 also includes two rear-field imaging devices 230 mounted inside the distal end region of the insertion tube 212. However, the endoscope 210 may include any number of rear view imaging devices. Each rear visual field imaging device 230 includes an imaging unit 242 and a light source 244. The sheath 223 of the insertion tube 212 may have a window 250 through which each rear view imaging device 230 “sees”. In this embodiment, each window 255 forms part of a cylindrical sheath 223 and may be dimensioned to maximize the field of view of the corresponding imaging device 230.

  In this embodiment, the imaging device 230 is mounted on the proximal side of the end cap 229 of the insertion tube, but the rear view imaging device 230 may be any suitable insertion tube 212 as shown, for example, in FIG. It may be mounted on a structure. Each posterior-field imaging device 230 is preferably positioned to face within 90 ° from the longitudinal axis of the insertion tube 212, more preferably within 45 ° from the longitudinal axis of the insertion tube 212. Preferably, the direction that each rear-field imaging device 30 faces is optimized to provide the largest field of view for the rear-field imaging device 30.

  In addition to the embodiments shown in FIGS. 7 and 8, this aspect of the invention can have further variations. For example, FIG. 9 shows an embodiment 310 in which the rear view imaging device 330 is mounted at a 90 ° angle from the longitudinal axis of the insertion tube 312. Each imaging device 330 includes an imaging unit 342 and a light source 344. Each rear-field imaging device 330 may be provided with a window as shown in FIG. 8, or they may protrude from the sheath 323 as shown in FIG. The rear view imaging device 330 may be mounted on the proximal side of the end cap 329 of the insertion tube as shown in FIG. 9, or any suitable structure of the insertion tube 312 as shown, for example, in FIG. It may be worn on the body.

  Figures 11 and 12 show further embodiments 410, 510 according to this aspect of the invention. In each of these embodiments 410 and 510, the insertion tubes 412 and 512 have circular grooves 477 and 577 with side walls 479 and 579 facing forward and side walls 481 and 581 facing back. In the embodiment 410 shown in FIG. 11, a window for the rear view imaging device 430 installed inside the insertion tube 412 is provided on the side wall 481 facing the rear of the groove 477. In the embodiment 510 shown in FIG. 12, the imaging unit 542 protrudes from the side wall 581 facing the rear of the groove 577.

  FIG. 13 shows a further embodiment 610 according to this aspect of the invention. In this embodiment 610, the insertion tube 612 includes a circular protrusion 677 having a sidewall 679 facing forward and a sidewall 681 facing backward. In this embodiment, the imaging device 630 is provided on a side wall 681 facing the rear of the circular protrusion 677. However, in general, the imaging device may be provided on the tip of the circular protrusion 677, that is, on the side wall 679 facing forward.

  Image data received from the rear facing imaging device may be combined to provide a 360 ° rear field of view. This may be accomplished by digitally combining or “stitching” the complementary images provided by the rear facing individual imaging devices into a single image. This may be done using hardware and / or software tools that are well known in the image processing industry. The rear facing imaging device may be positioned to obtain a full 360 ° rear field of view with a certain amount of overlap between the fields of view of adjacent imaging devices. An algorithm executed in a computing device that is in or connected to the control box is used to compare image data from adjacent imaging devices and match image patterns that indicate overlapping parts of the image Also good. The overlap is then removed and the images are combined to produce a single 360 ° back image.

  Alternatively, the number of display devices corresponding to the number of rear-view imaging devices may be provided. Each display device may be used to display one separate image from one imaging device. The display devices may be arranged in a predetermined order to simulate a continuous 360 ° field of view.

  In a further aspect of the invention, the endoscope 710 includes an insertion tube 712, a control handle 714 connected to the insertion tube 712, and an imaging device 730 extending from the distal end of the insertion tube 712, as shown in FIG. Is included.

  The insertion tube 712 of this embodiment may be similar to the insertion tube 12 shown in FIG. 1, as shown in FIG. For example, the insertion tube 712 may be removable from the control handle 714 or may be integrally formed with the control handle 714. The insertion tube 712 preferably has a longitudinal channel 722 through which the instrument can reach the body cavity and thereby perform any desired procedure. Preferably, the distal region 713 of the insertion tube 712 is steerable and a control cable 718 (FIG. 15) may be used to steer the distal region 713. In this embodiment, the insertion tube 712 does not have a main imaging device at its tip, but in other embodiments, the insertion tube may have such an imaging device. The insertion tube 712 may include a flexible ribbon coil 721 and a flexible sheath 723 that is used to protect the internal components of the insertion tube 712 from the body environment. An end cap 729 may be used to seal the open end of the shield 723 and close the distal end of the insertion tube 712.

  As shown in FIG. 14, the control handle 714 may include one or more control knobs 716 that are attached to the control cable 718 (FIG. 15) for manipulation of the insertion tube 12. Preferably, rotation of the control knob 716 pulls the control cable 718 and thus moves or bends the tip region 713 of the insertion tube 712 up and down and / or left and right. Preferably, the control handle 714 has one or more ports and / or valves 720, as shown in FIG. Ports and / or valves 720 are in communication with respective corresponding channels 722 (FIG. 15) of the insertion tube 712. The port and / or valve 720 may be an air or water supply valve, a suction valve, a measurement port, and a suction / measurement port. The proximal end of the control handle 714 may include air channels, water channels, and auxiliary outlets 728 that provide fluid communication between the suction channels and the pump and associated accessories. The same or different outlets can be used for electrical lines to the illumination and imaging components at the distal end of the endoscope 10.

  The imaging device 730 includes an extending part 731 extending from the distal end of the insertion tube 712, one or more imaging units 750 and one or more light sources 752 attached to the distal end region of the extending part 731. In the illustrated embodiment, the extension 731 has a tubular shape, and its diameter is about 1/3 of the diameter of the insertion tube. Similar to the insertion tube 712, the extending portion 731 may have a ribbon coil and a flexible sheath. Electrical wiring for the imaging unit 750 and the light source 752 may be routed through a channel 725 in the extension 731. Alternatively, the imaging unit 750 may be a wireless unit described in US patent application Ser. No. 11 / 609,838.

  In this embodiment, in order to increase the area where the imaging unit 750 can be accessed, at least the tip area of the extending portion 731 can be steered. The extension 731 may be steered in a manner similar to the manner in which the insertion tube 712 is steered, for example by using a Bowden cable 733. The first end of the Bowden cable 733 may be attached to the proximal end of the end cap 735 of the extension, and the second end is attached to the control device (FIG. 14) of the handle 714. May be. Therefore, the handle 714 has two sets of control devices 716 for connecting the insertion tube 712 and the distal end region of the extending portion 731.

  The tip of the extension 731 may be steered to 45 °, 60 °, 90 °, 120 °, 150 °, or preferably up to 180 ° as shown in FIG. The distal end region of the extension 731 may be steered in the direction of the channel 722 of the insertion tube 712 or in the direction of the axis of the insertion tube 712, or may be steered in the opposite direction. That is, the tip region of the extension 731 may be steered up to 180 ° in one direction and up to 180 ° in the opposite direction. In general, the tip region may be steered in any number of directions, such as only one direction or more than two directions.

  The imaging unit 750 may have an image sensor (not shown) and a lens assembly (not shown) with associated circuitry integrated on the PCB 754. As shown in FIG. 17, this PCB 754 is preferably attached to the base end side of the end cap 735 of the extending portion. Data output lines, control lines and power lines for the imaging unit 750 may be supplied to the proximal end of the endoscope 710 to be connected to the control box via the handle 714. Any further processing of the signal may be performed in the control box and finally fed to the display device.

  A lens assembly with a lens or multi-lens in the housing can be mounted directly on the PCB 754 so that it lies on the image sensor and focuses the light entering the lens system onto the photosensitive area of the image sensor. .

  The imaging unit 750 and the light source 752 may be disposed at one or more arbitrary appropriate locations in the tip region of the extending portion 731. For example, as illustrated in FIG. 15, the imaging unit 750 and the light source 752 are disposed on the tip of the extending portion 731. In addition to or instead of this, as shown in FIG. 18, the imaging unit 750 and the light source 752 may be disposed on the side surface of the distal end region of the extending portion 731. Furthermore, as shown in FIG. 19, in addition to or instead of this, the imaging unit 750 and the light source 752 may be disposed on two opposing side surfaces of the distal end region of the extending portion 731.

  According to this aspect of the invention, both the extension 731 and the distal region of the insertion tube 712 can be steered 180 degrees in two directions. As a result, the physician can successfully position both the imaging unit 750 and the distal end of the insertion tube 712, thereby providing a larger field of view and observing the area behind the folds and bends be able to. The steerable extension 731 is beneficial because it can move to a greater degree due to its small diameter and high flexibility compared to the distal region of the insertion tube 712.

  While particular embodiments of the present invention have been illustrated and described, it will be appreciated by those skilled in the art that changes and modifications can be made in a wide variety of aspects of the invention without departing from the invention. Accordingly, the appended claims may encompass within their scope all such changes and modifications as fall within the true spirit and scope of this invention.

DESCRIPTION OF SYMBOLS 10 Endoscope 12 Insertion tube 13 Tip area 14 Control handle 16 Control knob 18 Control cable 20 Valve 21 Ribbon coil 22 Washing channel 24 Light source 25 Cable 26, 30 Imaging device 28 Exit 29 End cap 30 Sub imaging device 30 Rear visual field imaging device 36 Link 42, 70 Imaging unit 44 Light source 46 Base end 48a, 48b Housing element 55 Wiring 70 Front visual field imaging unit 72 Front facing light source 73 Linear actuator 75 Housing 77 Hollow guide 210 Endoscope 212 Insertion tube 223 Sheath 223 Cylindrical sheath 224 Main light source 226 Main imaging device 229 End cap 230 Rear visual field imaging device 242 Imaging unit 244 Light source 250 Window 312 Insertion tube 323 Sheath 329 End cap 330 Rear visual field imaging device 342 Unit 344 Light source 412, 512 Insertion tube 430 Rear view imaging device 477, 577 Circular groove 479, 579 Side wall 481, 581 Side wall 542 Imaging unit 577 Groove 581 Side wall 612 Insertion tube 630 Imaging device 677 Circular protrusion 679 Side wall 681 Side wall 710 Internal view Mirror 712 Insertion tube 713 Tip region 714 Control handle 716 Control knob 718 Control cable 720 Valve 721 Ribbon coil 722 Longitudinal channel 723 Sheath 725 Channel 728 Exit 729 End cap 730 Imaging device 731 Extension 733 Bowden cable 735 End cap 750 Imaging unit 752 Light source / Suction EMR Patient

Claims (1)

An insertion tube having a tip;
An endoscope including a steerable extension portion having a distal end and a proximal end, and an imaging device in which a proximal end of the extension portion is attached to a distal end of the insertion tube.

Images