JPH03231627A - Method and device for observing neck - Google Patents

Abstract

PURPOSE: To improve the rate of discovering a cancer and enable an early treatment by mounting a video camera to one of blades, observing the focused neck and supplying a signal from the camera to a video screen. CONSTITUTION: A neck observing device V has a camera 32 mounted to an underside blade 10 to adjust vertically the camera 32 along a guide member 34 by rotating a worm gear unit 36 and the focus of the camera to a specified region of the neck. An image is projected along a cable 48 on a video controller 50 and a monitor 51 by the camera. A light source 52 such as a xenon light source can project the light through a monochromater 54 and send a light image of selected wavelength neary uniformly to the surface of the neck by a lens system. When the light is converted from one end to the other end of a spectrum by the monochromater, a cancer or troubled part caused by the infection of a virus generates fluorescence with a certain frequency, so that the cancer can be discriminated by a video monitor.

Description

[Detailed Description of the Invention] (Industrial Application Field) This invention relates to a cervical observation mirror, and in particular, it is capable of examining the neck with light of a specially selected wavelength and treating disorders found in the neck. Concerning cervical observation mirrors.

(Prior Art and its Problems) Cervical examinations for cancer and viral diseases are now performed with a device called a colposcope. This device is a binocular microscope that is placed near the patient.

This device provides bright light (white and green light) and the operator looks through the colposcope's eyepieces, much like looking through binoculars. This is done by placing the speculum in the correct location. The device has a camera attachment for taking still photos. The doctor examines the tissue and looks for tissue that turns white after treatment with 3-5% acetic acid. Acetic acid whitens tissues with little mucus, such as cancer cells. Doctors look for lumps or blood vessels that indicate new pathological growth, such as cancer. The effectiveness of colposcopy is only 85%, even when performed by a highly skilled doctor. Also, colposcopes are difficult to use due to their size and weight.

Over the years, various colposcopes have been developed. These include:

U.S. Pat. No. 4,210,133 to Ca5aneda discloses a colposcope having a light source for illumination and equipped with a microscope that can be adjusted vertically for focusing.

Van DerBel U.S. Pat. No. 4,597,383
No. 1, No. 1, No. 1, No. 1, No. 1, No. 1, No. 1, No. 1, 2003, discloses a colposcope fitted with fiber optic illumination means.

US Pat. No. 4,638,792 to Burgin has an adjustable mirror with an integrated light system.

U.S. Pat. No. 4,619,248 to Walsh discloses a light attachment for printing.

U.S. Pat. No. 4,562,832 to Wider et al. shows in FIG. 6 a fiber optic light pipe incorporated into the lower jaw of a colposcope.

US Pat. No. 4,502,468 to Burgin has an adjustable mirror that incorporates a lighting system.

Whitman U.S. Pat. No. 3,789.835
A lighting attachment for a colposcope is disclosed.

US Pat. No. 4,300,570 to 5tafl has a diagnostic method that projects an image of a cervical photograph onto a screen. However, the camera cannot be attached to the speculum.

Hasson, US Pat. No. 3,789,829, discloses a radium applicator that is attached to a speculum.

U.S. Pat. No. 3,037,505 to Walden et al.
A mirror is disclosed having a spray tube supported by mirror jaws.

U.S. Pat. No. 4,461,558 to Tanikawa et al. discloses an endoscopic photographic device and method of use that can be applied to all types of endoscopes.

U.S. Patent No. 4.697.210, issued by Toyota et al.
An endoscope is disclosed for viewing the inside of a cavity within the human body, and the image is displayed on a television screen.・Last 2
The patents in question are representative of many viewing techniques that can be used with endoscopes.

None of these devices contributed to improving the detection rate of cancer or its early treatment.

(Summary of the Invention) The present invention includes a first fixed blade, a second blade attached to the fixed blade so as to be able to approach and move away from the fixed blade, and a second blade that normally biases the blade toward the fixed blade. A cervical observation device including a colposcope having a spring means is provided.

A feature of the invention is that a video camera is attached to one of the blades for viewing the cervix, means are provided for providing light to the cervix, and means are provided for focusing the camera on a selected location on the cervix. , means were provided for feeding signals from the camera to a video screen for viewing the neck and identifying lesions thereon. The focusing means may include a track mounted longitudinally along one of the blades and means for adjusting the camera along the track for focusing. The light supply means may include a light guiding device on the track for supplying light to the cervix. Furthermore, means are provided for selecting the light illuminating the cervix at any one of the optical frequency ranges. This can be light over a wide frequency range, monochromatic light, or laser light for illumination. Particularly useful optical frequencies have been found to be between 200 nm and 1100 nm. A suitable means for selecting from this frequency range is a monochromator. This monochromator converts light from a light source into a single frequency with an exit in the form of a rectangular slit.

A light guiding device is provided having a first end in the form of a rectangular collar that receives the output from the monochromator and has a circular collar at the other end that delivers a round column of light to the neck. Contains a bundle of optical fibers.

A laser guiding device can be provided on the track for delivering a laser beam or laser fiber to vaporize the obstruction on the neck.

A suction pipe may also be provided on the track to remove the smoke produced when the laser vaporizes the obstruction.

The present invention also provides a method for locating and surgically removing the lesion. This method involves selectively illuminating the neck with light of various frequencies, observing the neck while illuminated with each light frequency, and detecting obstruction by fluorescence or reflectance at one of the selected light frequencies. locating the faulty part and removing the located faulty part.

The defect can be removed by vaporizing the defect using a laser, and the laser operation can be stopped in response to the cessation of fluorescence emission at the location of the defect.

Other advantages of the invention will become apparent from the following description read in conjunction with the accompanying drawings.

(Embodiment) According to the present invention, the cervical observation device (1) is attached to a colposcope S as shown in FIG. In use, the speculum is inserted into the vagina as shown. The speculum has a lower fixed blade 10 with a depending handle portion 12. The upper pivoting blade 14 extends generally parallel to the lower blade 10 and has an adjacent depending ear 16 by which the blade 14 is pivotally attached to a support 18. The support 18 has a yoke 20 at its upper end, to which the ears 16 are pivotally mounted.

The lower part of the support 18 has a longitudinal slot 22 which is tightened onto the handle 12 to allow the upper blade 14
and the lower blade 10.
is inserted into the slot 22.

A spring (not shown) is provided at the pivot point between the ear 16 and the yoke 20 to tend to rotate the upper blade 14 counterclockwise toward the fixed blade 10 as shown in FIG. can be provided. However, this movement is limited by the position of the nut 26 on the threaded adjustment rod 28. Conveniently, the rod 28 passes through a lever 30 secured to one of the ears 16 of the upper pivoting blade 14. Thus, when the nut 26 is moved outwardly along the rod, the blade 14 pivots toward the blade 10;
When the nut 26 is moved inwardly along the rod 28, the blade 14 rotates away from the blade 10.

The cervical observation device (1) has a camera 32 attached to the lower blade 10. The longitudinal guide member 34 is fixed to the stationary blade 10, as best seen in FIG. Worm gearing 36 rotating around the bin 38
is installed within the guide member 34 as shown. A rack 40 is attached to the camera and extends longitudinally along the camera. The teeth of this rack are the worm gear device 36
It meshes with the. A control shaft 42 is attached to bin 38 and has a knob 44 for vertically adjusting camera 32 along guide member 34 by rotating worm gearing 36 . This provides a means for focusing the camera on the specific area of the cervix being examined.

The camera is sealed to prevent moisture from entering the electronics, and the camera can be submerged in disinfectant solution between uses on different patients. Typically, during manufacturing, a vacuum chamber is filled with nitrogen after air and moisture are removed. A CCD sensor can be used that picks up the image and sends the signal to a video monitor for processing. The camera case can be made of substantially non-corrosive titanium or other metal or plastic. Cameras can also be disinfected with gases such as nithione oxide.

At the front end of camera 32 is an optical lens system 46 for taking images of the neck. This lens system can have zoom capabilities from 2x to 200x. The camera projects an image along cable 48 to video controller 50 which projects the image onto monitor 51 shown in FIG. 6A. As shown in FIG. 6A, a light source 52, such as a xenon light source, casts light through a monochromator 54.

Light sources such as halogens, mercury fumes, mercury arcs, incandescent lights, and lasers can also be used. A monochromator has the ability to emit light from a light source 52 at a single wavelength that can be varied in steps. The monochromator should have a high output power in the frequency range of 200 nm to 1100 nm. With this method, the doctor watches a video monitor while changing the light frequency in steps, looking for fluorescent lesions in the neck.

It is known that various lesions emit fluorescence in response to various optical frequencies.

Light exits the monochromator 54 through a slit 56 shown in FIG. 6B and enters one end of a bundle of optical fibers 58. One end of fiber optic bundle 58 is mounted within a rectangular collar 60 that is joined to the end of monochromator 54 to receive light from slit 56.

The other end of fiber optic bundle 58 has a circular collar 62 .

Collar 62 and cable 48 of video control device 50 connect to a cable or light guiding device 64 in which individual optical fibers 64 are located around the outside of lens system 46, as best seen in FIG. ing. Therefore, an optical image of the selected wavelength can be sent almost uniformly to the surface of the cervical region. As the light is shifted from one end of the spectrum to the other by a monochromator, lesions caused by cancer or viral infection fluoresce at certain frequencies and can be identified on a video monitor.

A laser beam can then be used to destroy the obstruction. This destruction is accomplished by sending a laser beam along an optical fiber 66 that extends through a channel 68 attached to guide member 34. A steering cable (not shown) can be provided in the optical fiber 66 to direct the laser to the location of the defect. KPT-532 lasers, carbon dioxide lasers or YAG lasers have been found to be satisfactory. A suction channel 70 can be provided next to the laser channel 68 to remove smoke resulting from the destruction of the obstruction. This channel is connected to a vacuum hose 72, as shown in FIG.

An alternative configuration is shown in FIG. A removable bandpass filter 74 is provided between the light source 52 and the fiber optic bundle 58 to provide selected wavelengths of light to the neck. Bandpass filters are useful when a patient undergoes a procedure that uses a substance that accumulates in the lesion and fluoresces at a known wavelength of light. In such cases, a bandpass filter can be selected that transmits only the desired wavelength or frequency. A suitable substance is hematoporphyrin (
HPD), dehematovorphyline ether (D
HE), corins, pheophorbides and coumerins. Additionally, rhodamine 123 can be sprayed or applied to the neck. Finally, the lesion can be marked with a monoclonal antibody.

In another embodiment shown in FIG. 8, light source 52 is coupled directly to fiber optic bundle 58.

This embodiment can be used when the cervical obstruction object fluoresces over a wide frequency range of identification light -0 An addition to the above device can be made. For example, a character generator for the patient's name, age, etc., a video recorder,
A video printer, suitable image processing equipment, etc. can be added.

From the above, the advantages of the present invention are clear. A simple and highly useful neck viewing device has been provided that can be easily used by physicians to look for cancer and other lesions in the neck. Also, because the camera is small, there is sufficient space between the camera and the mirror blade to insert any necessary forceps or other instruments.

Using a neck viewing device in conjunction with a monochromator, doctors step-by-step change the wavelength of light from one end of the spectrum to the other until fluorescence, a signature of abnormal cells, is observed. I can do it. A laser beam can be used to destroy the abnormal cells. Once it is determined that abnormal fluorescence is no longer occurring, the obstruction has been eradicated, and the laser can be discontinued. It is also possible to provide channels to suck up the smoke resulting from the destruction of the obstruction. Finally, the camera can be adjusted and focused along the guiding member on the fixed blade of the mirror.

It should also be noted that the device can be removed from the speculum and used with a sophisticated light source to look for similar obstructions in the rectum or other body surfaces.

Although the invention has been described in detail with reference to specific embodiments, it will be understood that various other modifications may be made within the scope of the invention.

[Brief explanation of drawings]

FIG. 1 is a side view of a cervical observation device constructed and used in accordance with the present invention. FIG. 2 is an enlarged rear view of the cervical observation device of FIG. 1. FIG. 3 is a longitudinal cross-sectional view taken along line 3--3 of FIG. 2, detailing the video camera and its associated laser and suction tubes. FIG. 4 is a longitudinal cross-sectional view taken along line 4--4 of FIG. 2, detailing the track mounting for the video camera. FIG. 5 is an enlarged cross-sectional view taken along line 5-5 of FIG.
The video camera and track mechanism are shown in detail. FIG. 6A is a schematic diagram of a video camera used in conjunction with a monochromator. 6A details the luminous flux connector of FIG. 6A for converting; FIG. FIG. 7 is a schematic diagram showing a video camera used with a bandpass filter providing monochromatic light. FIG. 8 is a schematic diagram showing a light source and a camera used directly. ■...Cervical observation device, S...Colposcope 32...Camera, 46...Optical lens system 50...Video control device, 51...Monitor 52...Light source,
54... Monochromator 58... Optical fiber bundle, 64... Optical fiber 74... Engraving of band pass filter drawing (no change in content) Procedural amendment (method) % formula % 1. Display of incident Heisei 2 Patent Application No. 24321 2, Title of Invention Method and Apparatus for Head Observation 3, Relationship with Amendment Case

Claims (17)

[Claims] (1) A first fixed blade, a second blade mounted so as to be able to approach and separate from the fixed blade, and a spring means that normally biases the second blade toward the fixed blade. a cervical speculum having: a video camera attached to one of said blades for viewing the cervix; means for providing light to the cervix; and a video camera mounted at a selected location on the cervix. Cervical viewing device comprising means for focusing and means for providing signals from said camera to a video monitor for viewing the neck and identifying lesions thereon. (2) said focusing means includes: a track mounted longitudinally along one of said blades; and means for adjustably positioning said camera along said track for focusing. The device according to claim 1, characterized in that: (3) The device according to claim 2, wherein the means for supplying light includes a light guiding device on the track for supplying light to the neck. 4. The device of claim 3, wherein the light guiding device surrounds the camera focusing means and provides light to illuminate the neck. 5. The apparatus of claim 4, wherein the means for providing light includes means for selecting a frequency of light for illuminating the cervix at any frequency within the optical frequencies. (6) Claim 5 characterized in that the light is supplied at any frequency within the range of 200 nm to 1100 nm.
The device described in. 7. The apparatus of claim 5, wherein the means for selecting includes means for sequentially selecting all available frequencies. (8) The apparatus of claim 5, wherein the means for selecting includes a selected bandpass filter. 9. The apparatus of claim 5, wherein the means for selecting includes a laser illumination device of the selected frequency. (10) The means for selecting in said order comprises: a monochromator converting light from a light source to a single frequency at an exit in the form of a rectangular slit; and means for coupling said slit to said light guide device. 8. The device according to claim 7, characterized in that: (11) The light guide device includes: an optical fiber bundle having a first end and a second end; a rectangular collar that receives and holds the first end of the fiber bundle in a rectangular shape; and the first end of the fiber bundle. 11. The device of claim 10, further comprising a circular collar receiving two ends to hold the slit in a circular shape and converting the light from the slit into a columnar shape to be transmitted to the light guiding device. 12. The apparatus of claim 2, further comprising a laser channel disposed on the track to deliver a laser beam that vaporizes a lesion on the neck seen by the camera. 13. The apparatus of claim 12, further comprising a suction tube disposed on the track to remove smoke as the obstruction is evaporated. (14) The track and adjustment means include: a guide member attached to the fixed blade and extending longitudinally along the fixed blade; a worm gear device rotatably attached to the guide member; and a worm gear device attached to the camera. a rack extending longitudinally of the camera and meshing with the worm gear; adjusting the position of the camera along the fixed blade by rotating the worm gear to position the camera at a selected location on the neck; Claim 2, further comprising a rotatable control shaft for focusing the portion.
The device described in. (15) Selectively illuminate the neck with light of various frequencies, observe the neck illuminated with each light frequency, and determine the fluorescence emission or reflectance of the affected area at one of the selected light frequencies. A method for locating and removing an obstruction in the neck, characterized in that the method comprises the steps of locating the obstruction and removing the located obstruction. The method of claim 15, further comprising: (16) removing the obstruction by vaporizing the obstruction using a laser. 17. The method of claim 16, further comprising: (17) ceasing use of the laser for each defective portion in response to cessation of fluorescence emission at the location of the defective portion.