JP2598603B2 - Endoscope - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope, which is an instrument that allows a physician to see an inaccessible area in a patient's body.

[0002]

2. Description of the Prior Art Conventional endoscopes include, for example, an elongated flexible endoscope body and an endoscope body for viewing the internal body region of a patient. Supported optical components. These optical components include, for example, an illumination fiber for illuminating the area to be viewed, an eyepiece, and an image fiber for transmitting an image proximally to the eyepiece.

[0003] It is also known to provide an endoscope having a distal region that is more flexible than a proximal region. The greater stiffness of the proximal region is due to the reinforcement of the proximal region of the endoscope body, for example, with a wire braid or wire braid.
Obtainable. It is known to provide an endoscope body having a polyimide material. Polyimide constitutes an excellent protector for the optics in the endoscope, but reduces the overall flexibility of the endoscope and is not as smooth as desired.
Although an endoscope body made of polytetrafluoroethylene has a desired lubricity, it is generally difficult to join to other parts.

In order for the endoscope to access the internal body area, it is often necessary or desirable to thread the endoscope through a catheter, and in some situations, the endoscope and the endoscope may be The gap between the passing catheter lumen and the catheter is minimal. This creates a significant surface area for sliding contact between the endoscope and the catheter, which tends to make it difficult to move the endoscope relative to the catheter. Also, it is sometimes necessary or desirable to introduce a liquid, such as a cleaning solution, through the lumen of the catheter and around the endoscope. The very small gap between the endoscope and the catheter makes it difficult to move the endoscope relative to the catheter.

It is sometimes desirable to use an endoscope with an everting catheter. Inversion catheters are typically
An outer catheter having an outer catheter lumen, and an inner catheter capable of longitudinally moving within the outer catheter lumen, the inner catheter being connected to the inner catheter lumen, the outer catheter and the inner catheter. It has an everted element. The everting element can be everted through the distal opening of the outer catheter by applying fluid pressure to the everting element and moving the inner catheter distally within the outer catheter. The everting element may constitute an extension of the inner catheter lumen.

An endoscope is positioned within the inner catheter lumen and an extension of the inner catheter lumen. With the instrument so positioned, pressurizing the everting element causes the everting element to grip a region of the instrument. This gripping of the device by the everting element is useful in that the everting element can be used to draw the device into the desired body area using everting methods. Unfortunately, this gripping action is undesirable as long as the physician wants to move the instrument separately from and relative to the everting element.

[0007] US Patent Application No. 780,871 discloses a method and apparatus by which an instrument can be moved relative to an everting element of an everting catheter system, the method comprising the steps of providing a flushing solution with the everting element gripping the instrument. Where it is introduced between the everting element and the instrument. This releases the instrument from the gripping action of the everting element, so that the instrument can be moved relative to the everting element. For example, a cleaning solution can be introduced into a pre-formed channel, for example, a channel that is present even when the everting element grips the instrument. This allows the cleaning solution to more easily pass between the everting element and the instrument.

[0008]

SUMMARY OF THE INVENTION The present invention provides an endoscope that can be used, if desired, to provide a flow path for a cleaning solution between any surrounding structures. For example, the surrounding structure may be a wall of a catheter lumen that receives the everting element of an endoscope or everting catheter. Also, the endoscope of the present invention reduces the area of contact between the endoscope and any surrounding structures. The endoscope has the feature that it can be reliably driven by the controller and is supported by the endoscope body with additional strength in the area of the endoscope gripped by the controller It is better to prevent damage to the optical components.

[0009] An endoscope constructed in accordance with the teachings of the present invention may have an elongated endoscope body having a proximal end and a distal end. The endoscope body is sized and configured for insertion into an internal body region of a patient. Optical components are supported by the endoscope body so that when the endoscope is in the patient, the internal body region of the patient can be viewed.

One feature of the present invention is that the endoscope body has an outer surface at least partially defining a groove extending in a distal direction of the endoscope body. When the endoscope is in the catheter and / or when the grooved area of the endoscope is gripped by the everting element of the everting catheter, the groove may be used to form a flow path or To be configured. Also, the groove reduces the contact area between the endoscope and any surrounding catheter or body structure, and depending on the shape of the groove,
Form surface irregularities and use this surface irregularity to
Positive drives or interlocks can be advantageously configured with a rotating wheel of the controller that can be used to advance and retract the endoscope.

[0011] The grooves are of any shape that can provide one or more of these functions. For example, at least a portion of the groove should extend in a distal direction in order to use the groove to configure the flow path. In a preferred shape, the groove is generally helical, and thus extends distally of the endoscope as it extends around the endoscope body. The helical shape also makes it easier for the controller to grip the endoscope and reduces the area of contact between the endoscope and any surrounding catheter structures. Also, as will be explained more fully below, there is an advantage in constructing such a structure.

As a variant, the groove may extend substantially axially. In a preferred configuration, a plurality of splines are provided on the outer surface of the endoscope body defining a plurality of generally axially extending grooves. The invention is applicable to rigid or flexible endoscopes, but is particularly adapted for flexible endoscopes. The optical components are of any type commonly used in endoscopes, such as illumination fibers and visualization fibers.

The endoscope body preferably has a distal region including a distal end and a proximal region having a greater cross section than the distal region. According to this configuration, the distal region of the endoscope body can be easily screwed through the opening of the controller, and the distal region having a larger cross-sectional area can be grasped and driven by the controller. The length and position of the groove may be selected according to the desired function. For example, the groove may extend through all or a portion of the proximal and / or distal regions. One advantage of having a groove in the proximal region is that the proximal region is the region that is gripped by the controller. Therefore, by providing the groove in the proximal region, more reliable driving can be achieved between the controller and the endoscope. Another advantage of positioning the groove in the proximal region is that a flow path can be provided between the proximal region and a catheter or other tubular structure from which the proximal region extends.

If the groove constitutes a flow path for the cleaning solution between the everting element of the everting catheter and the endoscope, the groove is preferably in the part of the endoscope which is gripped by the everting element. Although both the proximal and distal regions of the endoscope may be grasped by everting elements, more typically the distal region is grasped. In this latter case, it is desirable to provide a groove in the distal region of the endoscope.

[0015] Other features of the invention include, among others, a controller, such as a common assignee's co-pending US Application No. 788,33.
When grasping the proximal region with the controller shown in No. 8 (filed November 6, 1991), the proximal region is reinforced to protect the optical components housed in that part of the endoscope body. It is. In a preferred configuration, the proximal region has a polymer matrix and an elongated generally helical reinforcing member embedded in the polymer matrix. This not only reinforces the proximal region of the endoscope body, but also provides an advantageous method for providing grooves on the outer surface of the proximal region of the endoscope body. More specifically, the helical reinforcement member allows the polymeric material to have helical ribs that rise outwardly along the length of the helical reinforcement member to form at least a portion of the groove.

The helical reinforcing member preferably comprises a metal coil. The helical reinforcement is advantageously in the form of a metal wire having an oblong cross section. By orienting the long axis of the oval cross section generally in the longitudinal direction of the endoscope body,
Good resistance to bending loads is obtained without unduly thickening the wall of the endoscope body. The distal region preferably has a polymer tube coated with a lubricating polymer layer. The lubricating polymer layer is preferably fluorinated ethylene propylene, polytetrafluoroethylene, or the like. The polymer tubing provides strength to protect the optics supported in the distal region, even in a thin-walled configuration. The preferred polymer material for this tube is polyimide. Polyimide is also a suitable polymer for the proximal region matrix.

[0017]

FIG. 1 shows generally an endoscope body 13 and a hub 1.
5 shows an endoscope 11 having the same. In addition, the endoscope 11
Has one or more illumination fibers 17 (four are shown in FIG. 6) and an image fiber or visualization fiber 19. Endoscope body 13 is flexible and has a proximal end 21 and a distal end 23. Proximal end 21 is received in axial passage 25 of hub 15. A strain relief tube 27 receives an area of the endoscope body 13 adjacent the proximal end 21, and the strain relief tube 27 is also received in the passage 25. An adhesive 28, such as a urethane adhesive, attaches the endoscope body 13 to the tube 27.
Is joined to. Endoscope body 13 and tube 27 are attached to hub 15 by any suitable method, for example, urethane adhesive 30.

The illumination fiber 17 extends from the distal end 23 through the endoscope body 13 into the passage 25 and extends through the leg 29 of the hub 15 or the illumination connector. Portion 29 is adapted to be coupled to a light source (not shown). Similarly, the image fiber 19 extends from the distal end 23 through the entire length of the endoscope body 13 into the passage 25 and into the leg 31 of the hub 15. Using a suitable adhesive such as an epoxy adhesive, the fibers 17, 1
9 are preferably joined to the legs 29, 31 respectively. The legs 31 can be connected to an eyepiece (not shown) for direct visualization, in this embodiment a camera (not shown) so that the image can be viewed on a monitor. It is to be connected to. Hub 15 may be comprised of any rigid material, but is preferably a polymeric material such as ABS.

The optics of the endoscope 11 are preferably of a type that allows the internal body region of the patient to be viewed when the endoscope is inside the patient. In the embodiment shown in FIGS. 1 to 6, these optical components are an illumination fiber 17, an image fiber 19, and a GRIN lens 3 functioning as an objective lens.
3 (FIGS. 5 and 6). The endoscope body 13 has a proximal region 35 and a distal region 37. Proximal region 3
5 extends from the proximal end 21 to the transition 39 and the distal region 37 extends from the transition 39 to the distal end 23. For example, the proximal region is approximately 152.4 cm (60 inches) in length and the distal region 37 is approximately 35.56 cm (14 inches) in length. Proximal region 35 is received and connected to hub 15, and the length of the proximal region adjacent the hub is received in tube 27.

As shown in FIG. 3, the proximal region 35 comprises a polymer matrix 41 and the polymer matrix 41.
And an elongated generally helical reinforcing member in the form of a coil embedded therein. The polymer matrix 41 can be composed of various materials, but preferably, the polymer material is polyimide. Similarly, the coil 43 can be made of various materials, but is preferably made of a metal such as stainless steel.

The endoscope body 13 has an outer surface 45 forming a groove 47, and a part of the groove 47 extends in a distal direction of the endoscope body. The grooves 47 may be of various different shapes, but in the embodiment of FIGS.
Is a spiral. The groove 47 may extend for various distances along the outer surface 45, but preferably extends over most of the length of the proximal region 35, and in this embodiment extends over the entire length of the proximal region 35.

The groove 47 is formed by a spiral rib 49. As an example, the outer diameter of the endoscope body measured at the apex of the rib 49 is, for example, about 0.08 cm (0.0315 inch), and the outer diameter of the endoscope body measured at the bottom of the groove 47 is, for example, about 0.08 cm (0.0315 inch). 0.0285 cm (0.0285 inches), which results in a rib height of about 0.038 cm (0.285 inches). Of course, these dimensions are purely exemplary.

The coil 43 is made of a stainless steel wire having an oval cross section, and the long axis of the cross section extends substantially in the axial direction, that is, in the length direction of the endoscope body 13. More specifically, in this embodiment, the wire has a rectangular cross-section that is, for example, about 0.001 inch by 0.003 inch. As shown in FIG. 3, the outer surface 45 of the endoscope body 13 protrudes outward along the length of the wire forming the coil 43 to form a spiral rib 49. Thus, the coil 43 can be used not only to reinforce the proximal region 35, but also to assist in forming the groove 47. For example, the proximal region 35 can be constructed by dipping an elongated mandrel (not shown) in liquid polyimide and then curing the polyimide. This dipping process is repeated until the proximal region 35 reaches the desired thickness, and then the coil 43
Is placed or wrapped around the preformed portion of the matrix 41. Finally, the above immersion step is repeated to form the proximal region 35 substantially as shown in FIG.

The proximal region 35 is elongate, tubular and flexible, and has a cylindrical axial passage 51, which is generally cylindrical. Although not shown in FIG. 3, the illumination fiber 17 and the image fiber 19 extend through the passage 51. Outer surface 45 has grooves 47 and ribs as described above, but is generally cylindrical.
The coil 43 reinforces the proximal region 35 against compressive forces that may damage the fibers 17, 19 and / or cause signal distortion of the image transported by the image fiber 19. Also, coil 43 resists any tendency of proximal region 35 to twist.

The distal region 37 (FIG. 2) is elongated and flexible, and has a generally cylindrical outer surface 61 and a generally cylindrical axial passage 63. Although not shown in FIG. 2, the fibers 17, 19 extend through the passage 63. The distal region 37 is more flexible and of smaller diameter than the proximal region 35 (FIG. 4). The distal region 37 is
3 comprising a flexible, cylindrical polymer tube 65, preferably made of polyimide, and a coating or layer 67 of a slippery material, preferably polytetrafluoroethylene or fluorinated ethylene propylene. . The polyimide tube 65 may have a very thin wall thickness, for example, about 0.00254 cm. For example, the tube 65 may be extruded or formed by dipping and may be about 0.047 cm (0.0185 cm).
Inches) in diameter. Layer 67 may be, for example, about 0.050
8 cm (0.020 inch) diameter and 0.0019 cm (0.00075)
Inches).

The proximal region 35 and the distal region 37 may be joined at the transition 39 in any suitable manner.
Is preferable. As shown in FIG. 4, a length of the distal region 37 with the layer 67 removed is replaced with a proximal region 35.
And the region 37 is joined to the region 35 using an adhesive 69 such as cyanoacrylate. The adhesive 69 includes a tubular portion 71 in the passageway 51 and a tapered or conical portion 73 of decreasing diameter such that it extends distally to hybridize the outer surface of the proximal region 35 and the outer surface of the distal region 37. have.

Referring to FIGS. 5 and 6, the lens 33 and the distal region of the image fiber 19 are held in the lens bush 75 by a suitable adhesive, such as an epoxy adhesive. The lens bush 75 is made of a suitable metal such as stainless steel. The lens 33 is securely connected to the distal end 77 of the image fiber 19 by a suitable adhesive, which may be a UV curable adhesive. The lens bush 75 and the illumination fiber 17 are held in the passage 63 by a suitable adhesive such as an epoxy adhesive.

Although endoscope 11 is adapted to view various internal body areas, in this embodiment, it is a fallopian tube endoscope, dimensioned and configured for vaginal insertion into the fallopian tube. ing. This can be accomplished utilizing a catheter, such as an everting catheter, as shown by way of example in the parent patent application. When the illumination fiber 17 is in place,
Light is connected distally through the distal end 23 and the image fiber 19 directs the image proximally for visualization through an eyepiece or by a camera and monitor. Groove 47 defines or partially defines a flow path for a liquid, such as a cleaning solution, when proximal region 35 is within the lumen of a catheter (not shown). Protect the fibers 17, 19 from the compressive force of any controller used to advance or retract the endoscope.

FIG. 7 shows an endoscope 1 which is identical to the endoscope 11 in every respect not shown or described.
1a is shown. Parts of the endoscope 11a corresponding to parts of the endoscope 11 are indicated by corresponding reference numerals with the symbol a. The main difference between the endoscopes 11 and 11a is that the endoscope 11a forms a spirally extending groove having a torsion angle different from that of the groove 47 by being tightly wound by the spiral rib 49. In that it has a spiral rib 49a. Also, the outer surface 45a is shaped somewhat differently in that the bottom of the groove 47a is not as smoothly curved as in the endoscope 11. As in endoscope 11, helical groove 47a and helical rib 49a extend over all or a portion of the proximal and / or distal regions.

FIG. 7 shows an endoscope 11a in a tubular structure 81 which is, for example, an everting element of a catheter or everting catheter. Regardless of the particular properties of the tubular structure 81, the outer surface 45a of the endoscope 11a and its outer surface 4a
A spiral flow path 83 is formed by the inner surface 85 of the tubular structure 81 facing 5a. With this flow channel 83, a cleaning solution or other liquid is completely supplied around the endoscope 11a and extends over the entire length of the endoscope having the spiral groove 47a. If the tubular structure 81 is the everting element of an everting catheter, preferably the helical rib 49a and the helical groove 47a extend over at least a majority of the proximal region of the endoscope 11a.

FIG. 8 shows an endoscope 1 which is identical to the endoscope 11 in every respect not shown or described.
1b. Parts of the endoscope 11b corresponding to parts of the endoscope 11 are indicated by corresponding reference numerals with the symbol b. The main difference between the endoscopes 11b, 11 is that the endoscope 11b has on its outer surface 45b a plurality of axially extending splines or ribs 49b forming a plurality of axially extending grooves 47b. It is. In this embodiment, the grooves 47b and the ribs 49b have a substantially triangular cross section.

Like the endoscope 11a, the endoscope 11b is
Shown is in a tubular structure 81b having an inner surface 85b facing its outer surface 45b. Therefore,
Like the channel 83, the channel 83b is formed by the endoscope and the matching surface of the tubular structure. In detail, in FIG. 8, the channel 83b is constituted by the groove 47b of the outer surface 45b and the inner surface 85b of the tubular structure 81b. The channel 83b extends substantially in the axial direction. The groove 47b and the rib 49b extend along all or a part of the proximal region and / or the distal region of the endoscope 11b.

FIG. 9 shows an endoscope 1 which is identical to the endoscope 11 in every respect not shown or described.
1c is shown. Parts of the endoscope 11c corresponding to parts of the endoscope 11 are indicated by corresponding reference numerals with the symbol c. The endoscope 11c has a rib 49
Except for the shape of c and the shape of the groove 47c, it is the same as the endoscope 11b. The rib 49c and the groove 47c are substantially rectangular. As with the endoscope body of endoscope 11b, endoscope body 13c may be extruded and ribs 49c may be provided on all or a portion of the proximal and / or distal regions of the endoscope body. Provided.

While preferred embodiments of the present invention have been shown and described, many modifications, changes and substitutions may be made by those skilled in the art without departing from the spirit and scope of the invention. It can be carried out.

[Brief description of the drawings]

FIG. 1 is a partial cross-sectional side elevation view of one form of an endoscope constructed in accordance with the teachings of the present invention.

FIG. 2 is a partial axial cross-sectional view along a portion of a distal region of the endoscope with the optical fibers removed.

FIG. 3 is a partial axial cross-sectional view along a portion of a proximal region of the endoscope with the optical fiber removed.

FIG. 4 is a partial axial cross-sectional view along the transition between the proximal and distal regions of the endoscope with the optical fibers removed.

FIG. 5 is a partial axial cross-sectional view along a portion of a distal region including a distal end of an endoscope.

FIG. 6 is an end elevational view of the endoscope.

FIG. 7 is a partial elevational view of a second form of the endoscope shown in a tubular structure, such as a catheter or other body, which is shown in an axial cross-section.

FIG. 8 shows an endoscope (the internal details of its configuration are not shown)
FIG. 4 is a radial cross-sectional view of a third or proximal region or distal region and a tubular structure of FIG.

FIG. 9 is a radial cross-sectional view of the proximal or distal region of the fourth form of the endoscope with the optical fibers removed.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 11 Endoscope 13 Endoscope body 15 Hub 17 Illumination fiber 19 Image fiber 21 Proximal end 23 Distal end 25 Axial passage 27 Strain relief tube 28, 30 Adhesive 29, 31 Leg 33 Lens 35 Near Positioning area 37 Distal area 41 Polymer matrix 43 Coil 45 Outer surface 47 Groove 49 Rib 51 Axial passage 65 Polymer tube 67 Coating or layer 69 Adhesive 75 Lens bush

 ────────────────────────────────────────────────── ─── Continuation of the front page (72) Robert John Ericker, Inventor, California 90631 La Habra North Dexter Street 600 (56) References JP-A-53-139390 (JP, A) JP-A-62-258675 (JP) JP-A-2-246922 (JP, A) JP-A-62-289014 (JP, A) JP-A-4-47402 (JP, U) JP-A-1-155403 (JP, U)

Claims (7)

(57) [Claims] 1. An elongated endoscope body having a proximal end and a distal end, sized and configured for insertion into an internal body region of a patient; An optical component supported by the endoscope body so that the internal body region of the patient can be seen, wherein the endoscope body has an outer surface defining a spiral groove, and At least a portion of the shaped groove extends distally of the endoscope body, the endoscope body including a distal region including the distal end, and a proximal region, the helical groove being An endoscope in the proximal region and terminating proximally of the distal end. 2. The endoscope according to claim 1, wherein the endoscope is flexible, and the optical components include an illumination fiber and a visualization fiber. 3. The endoscope according to claim 1, wherein the proximal end has a greater cross-section than the distal region. 4. The proximal region includes a polymer matrix,
The endoscope according to claim 3, further comprising an elongated spiral reinforcing member embedded in the polymer matrix. 5. The length of the helical reinforcement member so as to form an outer surface of at least a portion of the proximal region of the endoscope body and to provide a helical rib forming the portion of the groove. The endoscope according to claim 4, wherein the endoscope protrudes outward along the line. 6. The endoscope body has a distal region including the distal end and a proximal region having a greater cross section than the distal region, wherein the distal region is smooth. The endoscope according to claim 4, comprising a polyimide tube covered with a polymer layer. 7. A hub adapted to be coupled to an illumination source and a camera, wherein the hub is coupled to a proximal region, and the length of the proximal region coupled to and adjacent to the hub. The endoscope according to any one of claims 1 to 6, further comprising a strain removing tube that receives the strain.