JP2018538069A - Laser video endoscope - Google Patents

Abstract

The laser video endoscope has a laser guide, an illumination guide, and an image guide that extend through an optical probe and a handpiece that supports the probe. The handpiece is connected to the laser energy source and the illumination source by a fiber optic cable. The image is transmitted from the handpiece to the image processing interface via an electrical cable extending from the camera assembly by a camera assembly that is optically coupled and mounted directly to the handpiece. The camera and its electrical cable can be removed from the handpiece and reused. The remainder of the product, including the probe and handpiece, can be disposed of after each medical routine. The probe can have a proximal portion and a distal portion such that the proximal portion extends from the distal end of the handpiece, the proximal portion being measured at least near the distal end of the handpiece. The outer diameter is larger than the outer diameter of the distal portion.

Description

  The present invention relates generally to medical laser video endoscopes, and more particularly to medical laser video in which an operating probe can be economically disposed of after each use and / or have a relatively small gauge size. It relates to an endoscope.

REFERENCE APPLICATION CROSS REFERENCE This application is filed in U.S. Patent Application No. 13 / 084,789 filed April 12, 2011 and U.S. Patent Application No. 12/779 filed May 13, 2010. No. 13 / 314,371, filed on Dec. 8, 2011, which is a continuation of the specification of U.S. Pat. No. 13,214, the entire disclosure of which is hereby incorporated by reference. Embedded in the book.

  Other prior applications include US Pat. No. 5,121,740 filed Jun. 16, 1992 and US Pat. No. 6,997,868 filed Feb. 14, 2006. The entire disclosures of which are incorporated herein by reference.

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

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

  Another feature of conventional endoscopes is that they utilize a probe that passes through a 20 gauge (0.89 mm) tissue incision during ophthalmic surgery. A 20 gauge (0.89 mm) incision is standard in the field of ophthalmic surgery and is used for intrusion with instruments utilized during ophthalmic surgery routines.

  Recently, however, smaller 23 gauge (0.635 mm) sleeves have been utilized. This sleeve, such as the trocar sleeve, is a tube embedded in the body wall that allows insertion and removal of surgical instruments without touching the body wall tissue. The value of a 23 gauge (0.635 mm) sleeve is thereby a smaller incision and therefore a shorter recovery time. A 23 gauge (0.635 mm) sleeve has an opening that is smaller than a 20 gauge (0.89 mm) incision, so the diameter of the probe can be adjusted so that the probe can somehow pass through the 23 gauge (0.635 mm) sleeve. It needs to be smaller.

  One problem is that the 23 gauge (0.635 mm) probe has a small diameter (25 mil or 0.635 mm), so it is fragile and prone to breakage. Most breaks occur at the joint between the handpiece and the probe. This breakage problem is a major concern when using laser video endoscopes due to the cost of these endoscopes.

  An exemplary embodiment of the present invention provides a conventional internal design by providing an endoscope design that is reasonably costly to allow and facilitate the disposal of the probe after each use without resorting to sterilization. Address at least some of the drawbacks of endoscopes.

  An exemplary embodiment of the present invention also includes a probe that can be inserted through, for example, a 23 gauge (0.635 mm) sleeve, which can maintain sufficient robustness to minimize the amount of breakage. By providing a design, at least some of the shortcomings of conventional endoscopes are addressed.

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

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

  According to an exemplary implementation of an embodiment of the present invention, the handpiece includes one or more channels having a distal end at the distal end of the handpiece. The one or more channels may be configured to receive at least one of a laser guide, an illumination guide, and / or an image guide that extends from the probe portion into the handpiece.

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

  According to yet another exemplary implementation of an embodiment of the present invention, the handpiece has an optical image guide extending from the probe portion through the second channel of the handpiece and at the proximal end of the second channel. A second channel having a distal end at the distal end of the handpiece is included to terminate.

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

  Exemplary embodiments of the present invention provide an endoscopic system, which is a laser video endoscope that includes a handpiece that supports a probe, the laser guide, an illumination guide, and an image guide. Extends through the probe and handpiece, and can be removably attached directly to the handpiece and optically coupled to the end of the image guide extending through the handpiece A camera assembly having an input.

  According to yet another exemplary implementation of an embodiment of the present invention, the camera assembly transmits an electrical image signal from the camera assembly to an image processor, image display device, or any site where an image can be provided for surgery. For transmission, it includes an output having an electrical cable extending from the camera assembly. According to yet another exemplary implementation of an embodiment of the present invention, the camera assembly and its electrical cable can be removed from the handpiece and reused in multiple endoscopic routines, while including a probe portion and a handpiece. The laser video endoscope can be disposed of after each medical routine, thereby ensuring a disinfection procedure.

  Exemplary embodiments of the present invention provide a laser video endoscope for use in ophthalmic surgery, where the endoscope passes through a 23 gauge (0.635 mm) sleeve, such as a trocar sleeve, for example. Including a probe portion.

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

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

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

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

  According to yet another exemplary implementation of an embodiment of the present invention, the distal portion of the probe of the laser video endoscope comprises a laser fiber disposed within the inner diameter of the distal portion of the probe. An image guide comprising an image bundle, wherein the image bundle is disposed within an inner diameter of the distal portion of the probe not occupied by the laser fiber, and is a plurality of fibers arranged in an essentially circular configuration An illumination guide comprising an image guide and an illumination bundle, the illumination bundle having a plurality of fibers filling the remainder of the inner diameter of the distal portion of the probe not occupied by the laser fiber and the image bundle Including a guide.

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

  Exemplary embodiments of the present invention provide an endoscopic design in which the laser fiber is from laser energy having different wavelengths, such as a green laser having a wavelength of 532 nanometers, for example. Input can be selectively accepted.

  The invention and many of its attendant advantages will be better understood and a full understanding thereof will be readily obtained by reference to the following detailed description when considered in connection with the accompanying drawings. Let's go.

It is the schematic of the conventional endoscope design. 1 is a schematic view of an endoscope system according to an exemplary embodiment of the present invention. FIG. 1 is a longitudinal view of a camera assembly of an endoscope system according to an exemplary embodiment of the present invention. FIG. 2 is a partial longitudinal cross-sectional view of a camera assembly including an exemplary implementation of camera assembly components according to an exemplary embodiment of the present invention. FIG. 1 is a cross-sectional view of an endoscope hand piece according to an exemplary embodiment of the present invention. FIG. 1 is a cross-sectional view of an endoscope hand piece according to an exemplary embodiment of the present invention. FIG. 1 is a schematic view of an endoscope system including a probe, a handpiece, and a camera assembly, according to an illustrative embodiment of the invention. FIG. FIG. 3 is a view of a distal end of a handpiece and a probe according to an exemplary embodiment of the present invention. FIG. 8 is a cross-sectional view of the distal portion of the example embodiment probe shown in FIG. 7. FIG. 4 shows a distal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a distal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a distal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a distal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a proximal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a proximal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a proximal portion of a handpiece according to an exemplary embodiment of the present invention. FIG. 4 shows a proximal portion of a handpiece according to an exemplary embodiment of the present invention. 1 is a cross-sectional view of an assembled handpiece including a distal portion and a proximal portion and a probe of an endoscope according to an exemplary embodiment of the present invention. FIG. Sectional view of an assembled handpiece including a distal portion and a proximal portion and a probe showing exemplary configurations of a laser guide, illumination guide, and image guide of an endoscope according to an exemplary embodiment of the present invention It is. 1 is a cross-sectional view of an endoscope system including a probe, a handpiece, and a camera system according to an exemplary embodiment of the present invention. FIG. 6 is a cross-sectional view of an assembled handpiece and probe including a distal portion and a proximal portion of an endoscope according to another exemplary embodiment of the present invention. FIG. 4 is an assembled handpiece including a distal portion and a proximal portion and a probe illustrating an exemplary configuration of a laser guide, illumination guide, and image guide of an endoscope according to another exemplary embodiment of the present invention. It is sectional drawing. FIG. 6 is a cross-sectional view of an endoscope system including a probe, handpiece, and camera system according to another exemplary embodiment of the present invention. FIG. 2 is a schematic diagram illustrating components of an endoscopy system according to an exemplary embodiment of the present invention, including an illumination source, a laser energy source, and an image processing and / or display device interface.

  Matters defined in the description such as detailed structure and elements are provided merely to aid a comprehensive understanding of the invention. Accordingly, those skilled in the art will recognize that various changes and modifications to the embodiments described herein can be made without departing from the scope and spirit of the invention. Also, well-known functions or constructions are omitted for clarity and brevity. Some exemplary embodiments of the invention may be described below in the context of commercial applications. Such exemplary implementations are not intended to limit the scope of the invention as defined in the appended claims.

  Although descriptive terms such as “handpiece”, “probe” and “fiber” are used throughout this specification, components that can be used in combination or individually to implement various aspects of embodiments of the present invention. Note that it is not intended to be limited.

  Referring now to the drawings, wherein like reference numerals designate identical or corresponding parts throughout the several views, embodiments of the present invention are schematically shown in detail.

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

  With reference to FIGS. 2-6, a laser video endoscope according to an exemplary embodiment of the present invention includes a handpiece 32, a probe 30 extending from the distal end of the handpiece 32, and a proximal of the handpiece 32. And a camera assembly 34 removably coupled to the end. In an exemplary implementation of the invention, the camera assembly 34 is coupled directly to the proximal end of the handpiece 32 by engagement of the nose 54 of the handpiece 32 and the recess 52 of the camera assembly 34. The probe 30 is shown essentially straight, but other probes, such as a bent probe, can be replaced without departing from the scope of the exemplary embodiments of the invention described herein. May be used.

  As shown in FIG. 2, according to an exemplary embodiment of the present invention, a laser guide that includes fiber 40, an illumination guide that includes fiber 42, and an image guide that includes fiber 35 are disposed at the distal end of probe 30. Extends into the handpiece 32. The proximal end of the probe 30 can be fixedly attached to the distal end of the handpiece 32, for example by being joined together by known processes.

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

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

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

  In an exemplary implementation of an embodiment of the present invention, a light guide cable 38 extends proximally from the handpiece 32 and a laser guide fiber 40 and illumination guide for transmitting laser energy and illumination energy to the probe 30, respectively. The fiber 42 is held. In a further exemplary implementation of an embodiment of the present invention, cable 38 extends proximally to branch junction 44, where laser guide fiber 40 and illumination guide fiber 42 are separated, at terminals 40C and 42C, respectively. Terminate and couple to laser energy source and illumination energy source. In yet another exemplary implementation of an embodiment of the present invention, the image carrying electrical cable 36 that terminates at terminal 36C can be approximately the same length as the light guide cable 38, with each cable 36 and 38 being It can be as long as needed for installation.

  According to an exemplary embodiment of the present invention, the image guide at the proximal end of the handpiece 32 by direct optical coupling of the image guide fiber 37 to the optical elements of the camera assembly 34 provided by the handpiece 32. The fiber 37 can be terminated. The camera assembly 34 can be removed from the handpiece 32, thus allowing a relatively expensive camera to be reused. Also, positioning the camera assembly 34 with the handpiece 32 avoids a long and expensive optical image guide proximal to the handpiece 32.

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

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

  In an exemplary implementation, the camera assembly 34 includes a laser filter 46, for example, to protect the camera film from laser energy and to allow the surgeon to observe the surgery when a laser pulse is being fired. Can be included. In still other exemplary implementations, filters for multiple wavelength lasers may exist, for example, 810 nm and 532 nm lasers may be used.

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

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

  For example, a variation of the exemplary embodiment of the present invention shown in FIGS. 2-6 is that removal at the proximal end of the handpiece 32 not only removes the camera assembly 34 at the surface 58 but also, for example, surface 59. Alternatively, the cable 38 is also disconnected in the vicinity thereof, so that only the probe 30 and the handpiece 32 are disposed between each operation.

  In the exemplary implementation of FIGS. 1-6, the probe 30 and the image guide 37 in the handpiece 32 can be a fiber optic bundle, but other exemplary configurations allow for refraction, often referred to as a GRIN lens, for example. An image guide function like a rate distribution type lens can be provided.

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

  Referring to FIG. 8, a cross-sectional view of the distal portion 72 of the probe 78 in accordance with an exemplary implementation of an embodiment of the present invention shows an image guide including a fiber 86, a laser guide including a fiber 88 within the probe 78, 2 shows a configuration of an illumination guide including the fiber 80. As shown in FIG. 8, the image guide 86 and the laser guide 88 are such that the fiber OD of the image guide 86 and the fiber OD of the laser guide 88 do not intersect at any cross-section of the distal portion 72 of the probe 78 or Arranged so as not to overlap. As further shown in FIG. 8, according to an exemplary implementation of an embodiment of the present invention, the illumination guide fiber 80 fills the remaining volume of the distal portion 72, so that the fiber of the image guide 86 The OD and the fiber OD of the laser guide 88 do not intersect or overlap any fiber OD of the illumination guide 80 at any cross-section of the distal portion 72 of the probe 78.

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

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

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

  Although the exemplary lengths described herein for distal portion 72 have been found to contribute to the robustness of probe 78, dimensional values are provided to provide a probe that can be used with other small size sleeves. Can be changed slightly.

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

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

  In accordance with an exemplary embodiment of the present invention, the probe 78 comprises (a) a rigid structure of the probe 78 wall, (b) a two-diameter design of the proximal portion 70 and the distal portion 72, and (c) a far-end. In combination with the limited length of the central portion 72, it can be made sufficiently robust to minimize breakage. A particularly advantageous configuration according to an exemplary implementation of the probe 78 includes: (a) a probe 78 having a metal wall; and (b) an OD of 35 mils (0.89 mm) and 5 mils extending through the handpiece 74 ( A proximal portion 70 having a wall thickness of 0.13 mm) and a distal portion 72 having an OD of 25 mils (0.64 mm) and a wall thickness of 2 mils (0.05 mm); and (c) 710 mils (18 mm) ) Including a combination with a distal portion 72 having the following length:

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

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

  Exemplary embodiments of the present invention are described in connection with an implementation that allows for use with a 23 gauge (0.635 mm) sleeve. It should be understood that the described design may be modified to be used with or without a sleeve having a variation from 23 gauge (0.635 mm). Exemplary embodiments of the present invention work together to provide an operable and useful laser video endoscope with a small probe that allows eye surgery with minimal trauma and shortened healing time. Describes a combination of several features and compromises designed to:

  With reference to FIGS. 9A, 9B, 9C, 9D, and FIGS. 10A, 10B, 10C, and 10D, an exemplary embodiment of the present invention is, for example, a handpiece 110 as shown in FIG. A handpiece design is provided that includes a distal portion 90 and a proximal portion 100 that are fixedly assembled to form a handpiece. According to an exemplary implementation of an embodiment of the present invention, the distal portion 90 includes an opening 92 that terminates at the surface 94 of the distal end or portion 90 and an opening 93 that terminates at the proximal end of the portion 90. including. The opening 92 may be fixedly attached to extend distally from the surface 94, such as to receive a proximal end of a probe, such as the proximal end 114 of the probe 112, as shown in FIG. Composed. The opening 93 is configured to mate with the distal end 102 of the proximal portion 100 so that the distal portion 90 and the proximal portion 100 form a handpiece, for example, as shown in FIG. Can be fixedly assembled. The distal portion 90 includes a channel 95 and defines at least a first portion 99 of the inner wall of the channel 96 by a protruding section 91 that can also serve as a guide for holding the handpiece. Proximal portion 100 includes a channel 97 that 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.

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

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

  In another exemplary implementation of an embodiment of the present invention, the coupling 138 of the camera assembly 134 to the handpiece 110 can, for example, easily attach the camera assembly 134 to the handpiece 110 and the camera assembly 134 to the handpiece. To facilitate easy removal from the piece 110, a snap-fit connection achieved by physical properties of the proximal end of the proximal portion 100 and the distal end of the camera assembly 135 can be provided.

  In yet another exemplary implementation, the camera assembly 134 can include a focus ring 150 that extends from the distal end of the probe 30 through the channels 95 and 97 of the handpiece 110. Ensure proper focus of the image provided on the receiver of the camera assembly 134 located at the proximal end of 37.

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

  In an exemplary implementation of an embodiment of the present invention, the camera assembly 164 may provide an electrical image that is transmitted proximally along an electrical cable 166 coupled at the output of the camera assembly 164.

  In another exemplary implementation of an embodiment of the present invention, the coupling 168 of the camera assembly 164 with the handpiece 140 can, for example, easily attach the camera assembly 164 to the handpiece 140 and hand the camera assembly 164. To facilitate easy removal from the piece 140, a snap-fit connection can be provided that is achieved when the protruding portion 162 is inserted into the cavity 220. In the exemplary implementation, coupling 168 allows handpiece 140 and probe 112 to be rotated axially (about axis AA) relative to camera assembly 164.

  In yet another exemplary implementation of an embodiment of the present invention, the image output from the image guide 37 of the probe 112 is displayed and / or further image processed via an electrical cable 166 coupled at the output of the camera assembly 164. It can be properly oriented in the camera assembly 164 for output. Such desirable orientation of the image for display and / or further image processing may be achieved by electronic image processing or by a component disposed within camera assembly 164 or coupled to cable 166 at the output of camera assembly 164. Or optically using any combination of these. For example, when the handpiece 140 is coupled to the camera assembly 164, manual orientation of the probe 112 relative to an object, such as a surgical position (not shown), at the distal end of the probe 112 is not required. The endoscopic user can rotate the rotating probe 112 relative to the object by rotating the handpiece 140 that rotates relative to the camera assembly 164 without disturbing the image of the object, which is It can be particularly advantageous when using an endoscope.

  In yet another exemplary implementation, the camera assembly 164 can include a focus ring 160 that extends from the distal end of the probe 30 through the channels 95 and 97 of the handpiece 110. Ensure proper focusing of the image provided on the receiver of the camera assembly 164 located at the proximal end of 37.

  Referring to the conceptual diagram of FIG. 17, an exemplary embodiment of the present invention provides a system 1000 comprising a console 170 and an endoscope 500, which endoscope 500 is referenced with reference to FIGS. It includes a camera assembly 179, a handpiece 177, and a probe 175 that can be constructed and constructed with various combinations of exemplary implementations of camera assemblies, handpieces, and probes, as described herein.

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

  Further, referring to the example of FIG. 17, the image output from the image guide fiber 37 of the probe 175 may include components disposed within the camera assembly 179, components disposed within the image processing interface 176, and / or a console. 170 other components can be used to orient in the camera assembly 179 so that when the handpiece 177 is coupled to the camera 179, manual image orientation is not required and the user can move the handpiece 177 By manipulating, the probe 175 can be rotated relative to the camera assembly 179 without disturbing the image output.

  Although the invention has been shown and described with reference to specific exemplary embodiments thereof, various changes in form and detail may be made without departing from the spirit and scope of the invention and the claims. Those skilled in the art will understand that this can be done.

Claims (30)

A surgical endoscope,
A handpiece comprising a cavity, a distal surface, a first surface including a first opening to the cavity, and a second surface including a second opening to the cavity;
A probe extending distally from the distal surface of the handpiece, comprising a proximal end in communication with the cavity at the distal surface of the handpiece;
Extends from the distal end of the probe to the proximal end of the probe, extends from the proximal end of the probe into the cavity and through the cavity to the first opening of the handpiece. An illumination guide extending, the illumination guide comprising an illumination guide distal end terminating at a distal end of the probe;
Extends from the distal end of the probe to the proximal end of the probe, extends from the proximal end of the probe into the cavity and through the cavity to the first opening of the handpiece. A laser guide extending, the laser guide comprising a laser guide distal end terminating in the distal end of the probe;
Extends from the distal end of the probe to the proximal end of the probe, extends from the proximal end of the probe into the cavity and through the cavity to the second opening of the handpiece. An image guide comprising an image guide distal end that terminates at the distal end of the probe and an image guide proximal end that terminates at the second surface of the handpiece. Prepared,
The handpiece is removably coupled to a camera assembly at the second surface of the handpiece to optically couple the image guide proximal end to the camera assembly;
A surgical endoscope in which the first surface and the second surface do not overlap. A laser and illumination first channel in the handpiece extending from the first opening;
An image second channel in the handpiece extending from the second opening;
A laser and illumination and image third channel in the handpiece extending proximally from the distal surface;
Further comprising
The probe extends distally from the third channel at the distal surface of the handpiece, the probe including the illumination guide, the laser guide, and the image guide;
The illumination guide, the laser guide, and the image guide extend from the proximal end of the probe into the third channel;
The first channel comprises a first axis;
The second channel comprises a second axis;
The third channel comprises a third axis;
The second axis and the third axis are substantially coaxial;
The endoscope according to claim 1, wherein the first axis has a non-zero angular relationship with respect to the second axis and the third axis. The handpiece includes a proximally extending nose for engaging the camera assembly;
The second channel extends through the nose;
The endoscope according to claim 2, wherein the second proximal surface constitutes an end of the nose.   The endoscope according to claim 1, wherein the image guide is configured by an optical fiber.   The endoscope according to claim 1, wherein the illumination guide includes a set of optical fibers arranged in a nested manner around the laser guide and the image guide in the probe to fill a space in the probe.   The endoscope of claim 1, wherein the camera assembly comprises a latch adapted to removably attach the camera assembly to the handpiece.   The endoscope of claim 1, wherein the camera assembly is directly attached to the handpiece, and the output of the camera assembly is adapted to be coupled to a remote display by an electrical cable. The probe is
A distal portion extending proximally from the distal end of the probe;
A proximal portion extending distally from the proximal end of the probe;
The distal portion of the probe has an outer diameter of about 25 mils (0.64 mm), a sidewall that is at least about 2 mils (0.05 mm) thick, and a length of about 710 mils (18 mm);
The proximal portion of the probe has an outer diameter of at least about 35 mils (0.89 mm) and a sidewall of at least about 5 mils (0.13 mm);
The laser guide comprises a fiber having a first surface with a cross section of a diameter of about 100 micrometers;
The image comprises a fiber forming a second surface of an essentially continuous cross section with a diameter of about 14 mils (0.36 mm);
The endoscope of claim 1, wherein the first surface and the second surface do not overlap and the probe is adapted to pass through a 23 gauge (0.635 mm) sleeve.   The endoscope according to claim 8, wherein the side wall of the probe is made of metal.   The endoscope according to claim 8, wherein the imaging component comprises an optical fiber bundle having about 6000 fibers 7 forming a second surface of the essentially continuous cross section.   The endoscope of claim 8, wherein the illumination fiber optic bundle comprises about 70 fibers that essentially surround the laser guide fiber and the imaging component. The laser fiber is adapted to transmit laser energy of about 532 nanometers;
A camera is coupled to the imaging component;
The endoscope according to claim 8, wherein a blocking filter is between the imaging component and the camera to block the wavelength of the laser energy, and the filter is transmissive to other visible light. The laser fiber is adapted to transmit laser energy of about 532 nanometers;
A camera is coupled to the imaging component;
The endoscope of claim 10, wherein a blocking filter is between the imaging component and the camera to block the wavelength of the laser energy, and the filter is transparent to other visible light.   The endoscope according to claim 12, wherein the probe is a metal.   The endoscope according to claim 13, wherein the probe is a metal. A laser video endoscope for ophthalmic surgery with a handpiece, comprising:
A hollow rigid probe extending distally of the handpiece;
The probe has a distal portion and a proximal portion;
The distal portion of the probe has an outer diameter of about 25 mils (0.64 mm) and sidewalls of about 2 mils (0.05 mm) thick and has a length of about 710 mils (18 mm);
The proximal portion of the probe has an outer diameter of at least about 35 mils (0.89 mm) and a sidewall of at least about 5 mils (0.13 mm);
The probe includes a laser guide fiber having a cross-section first surface, an imaging component having an essentially continuous cross-section second surface, and an illumination fiber bundle;
The laser video endoscope, wherein the first surface and the second surface do not overlap and the probe is adapted to pass through a 23 gauge (0.635 mm) sleeve. The laser guide fiber has a diameter of about 100 micrometers;
The endoscope of claim 16, wherein the imaging component has a diameter of about 14 mils (0.36 mm). The laser fiber is adapted to transmit laser energy of about 532 nanometers;
A camera is coupled to the imaging component;
The endoscope of claim 17, wherein a blocking filter is between the imaging component and the camera to block the wavelength of the laser energy and the filter is transmissive to other visible light. A laser video endoscope for ophthalmology,
With handpieces,
A hollow rigid probe extending in the distal direction of the handpiece,
The probe has a distal portion and a proximal portion;
The distal portion of the probe has an outer diameter of about 25 mils (0.64 mm) and a sidewall that is about 2 mils (0.05 mm) thick;
The probe includes a laser guide fiber, an imaging component, and an illumination fiber bundle;
The laser guide fiber has a first surface with a cross section of a diameter of about 100 micrometers;
The imaging component has an essentially continuous cross-section second surface having a diameter of about 14 mils (0.36 mm);
The laser video endoscope, wherein the first surface and the second surface do not overlap and the probe is adapted to pass through a 23 gauge (0.635 mm) sleeve. The laser fiber is adapted to transmit laser energy of about 532 nanometers;
A camera is coupled to the imaging component;
The endoscope according to claim 19, wherein a blocking filter is between the imaging component and the camera and blocks a wavelength of the laser energy, the filter being transparent to other visible light. A laser video endoscope for ophthalmic surgery,
With handpieces,
A hollow rigid probe extending in the distal direction of the handpiece,
The probe has a distal portion and a proximal portion;
The distal portion of the probe has an outer diameter of about 25 mils (0.64 mm) and a sidewall that is at least about 2 mils (0.05 mm) thick;
The proximal portion of the probe has an outer diameter of at least about 35 mils (0.89 mm) and a sidewall of at least about 5 mils (0.13 mm);
The probe includes a laser guide fiber, an imaging component, and an illumination fiber bundle;
The laser guide fiber has a first surface with a cross section of a diameter of about 100 micrometers;
The imaging component has an essentially continuous cross-section second surface having a diameter of about 14 mils (0.36 mm);
The laser video endoscope, wherein the first surface and the second surface do not overlap and the probe is adapted to pass through a 23 gauge (0.635 mm) sleeve.   The endoscope according to claim 8, wherein the proximal portion of the probe has a length of 120 mils (3 mm).   The endoscope of claim 16, wherein the proximal portion of the probe has a length of 120 mils (3 mm).   The endoscope of claim 19, wherein the proximal portion of the probe has a length of 120 mils (3 mm).   The endoscope of claim 21, wherein the proximal portion of the probe has a length of 120 mils (3 mm). The handpiece has a first section and a second section;
The first section and the second section, the body from at least a portion of the body of the handpiece when the first section is attached to the second section, the body comprises the cavity. The endoscope according to 1.   The endoscope according to claim 1, further comprising a connecting portion for removably attaching the handpiece to the camera assembly.   The connecting portion locks the handpiece and the camera assembly, and allows an axial rotational movement of the probe relative to the camera assembly while maintaining the optical coupling of the image guide proximal end and the camera assembly. The endoscope according to claim 27, wherein the endoscope is enabled.   29. The endoscope of claim 28, wherein the orientation of image output from the camera assembly is independent of the rotational movement of the probe relative to the camera assembly.   The endoscope according to claim 1, wherein at least one of the first surface and the second surface includes a proximal surface of the handpiece.

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