JPH06217937A - Endoscope - Google Patents

Abstract

PURPOSE: To obtain an endoscope which can be used for arranging a passage for a washing solution between optional surrounding structures by including an outer surface to constitute a channel in an endoscopic body and structuring the channel in such a way that at least one part of the channel extends in a distal direction of the endoscopic body. CONSTITUTION: An endoscope 11 is equipped with an illuminating fiber 17, a visualizing fiber 19 and an endoscopic body 13. The endoscopic body is flexible and has a proximal end part 21 and a distal end part 23. The endoscopic body 13 has an outer surface 45 to constitute a channel 47. One part of the channel 47 extends in a distal direction of the endoscopic body 13. The channel 47 is structured from a spiral rib 49. An outer surface 45 of the endoscopic body 13 projects outward along the length of a wire constituting a coil 43 to structure the spiral rib 49 and reinforce a proximal area 35. The proximal area 35 has a cylindrical passage 51 in an axial direction. The illuminating fiber 17 and the image fiber 19 extend through the passage 51. A distal area 37 constitutes a passage 63 and has a polymer tube 65 made of polyimide and a layer 67 of a slipping material.

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 for allowing a doctor to see an inaccessible region in a patient's body.

[0002]

BACKGROUND OF THE INVENTION Conventional endoscopes, for example, include an elongated flexible endoscope body and an endoscope body so that the internal body region of the patient can be seen. Supported optics. These optical components include, for example, an illuminating fiber for illuminating the area to be viewed, an eyepiece, and an image fiber for transmitting the image proximally to the eyepiece.

It is also known to provide endoscopes having a distal region that is more flexible than the proximal region. The greater rigidity of the proximal region results from the reinforcement of the proximal region of the endoscope body with, for example, wire braid or wire braid,
Obtainable. It is known to provide an endoscope body having a polyimide material. Polyimide constitutes an excellent protector for optical components within an endoscope, but reduces the overall flexibility of the endoscope and is not as lubricious as desired.
Endoscope bodies made of polytetrafluoroethylene have the desired lubricity, but are generally difficult to bond to other parts.

It is often necessary or desirable to thread an endoscope through a catheter in order for the endoscope to access internal body regions, and in some situations, the endoscope and the endoscope may be There is minimal clearance between the lumen of the threading catheter. 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 wash solution, through the lumen of the catheter and around the endoscope. The presence of a very small gap between the endoscope and the catheter makes it difficult to move the endoscope with respect to the catheter.

It is sometimes desirable to use an endoscope with an everting catheter. The everting catheter is typically
An outer catheter having an outer catheter lumen and an inner catheter capable of longitudinal movement within the outer catheter lumen, the inner catheter being coupled to the inner catheter lumen and the outer and inner catheters. And an aversion element. The everting element can be everted through the distal opening of the outer catheter by applying fluid pressure to the everting element and by moving the inner catheter distally within the outer catheter. This everting element may comprise 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, pressing the everting element causes the everting element to grip a region of the instrument. This grasping of the instrument by the everting element is useful in that the everting element can be used to draw the instrument into a desired body region. Unfortunately, this gripping action is undesirable as long as the physician wants to move the instrument separately from and with respect 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 the everting element of an everting catheter system, in which washing solution is grasped by the everting element. Introduce it 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, the wash solution can be introduced into a preformed channel, eg, a channel that is present even when the everting element grips the instrument. This allows the wash 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 to provide a flow path for a cleaning solution with any surrounding structure, if desired. For example, the surrounding structure may be the wall of a catheter lumen that receives the everting element of an endoscope or everting catheter. The endoscope of the present invention also reduces the contact area between it and any surrounding structures. This endoscope has a feature that it can be reliably driven by the controller, and is supported by the endoscope body with additional strength in the region of the endoscope gripped by the controller. It is good to prevent damage to the optics.

An endoscope constructed according to the techniques 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. The optics are carried by the endoscope body so that the interior body area of the patient can be viewed when the endoscope is inside the patient.

One feature of the present invention is that the endoscope body has an outer surface, at least a part of which constitutes a groove extending in the distal direction of the endoscope body. When the endoscope is inside the catheter, and / or when the grooved region of the endoscope is gripped by the everting element of the everting catheter, this groove is used to create a flow path or partially To configure. 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,
Forming surface irregularities and using this surface irregularity,
The positive drive or interlock can be advantageously configured with a rotating wheel of the controller that can be used to advance and retract the endoscope.

The groove is of any shape capable of producing one or more of these functions. For example, at least a portion of the groove should extend distally in order to use the groove to construct the flow path. In the preferred shape, the groove is generally helical and thus extends distally of the endoscope as it extends around the endoscope body. The spiral shape also facilitates gripping the endoscope by the controller and reduces the contact area between the endoscope and any surrounding catheter structures. There are also advantages to constructing this type of structure, as will be described more fully below.

Alternatively, the groove may extend generally 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 to flexible endoscopes. The optical components are of any type commonly used in endoscopes, such as illuminating fibers and visualization fibers.

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

If the groove constitutes a flow path for the irrigation solution between the everting element of the everting catheter and the endoscope, the groove is preferably in the part of the endoscope grasped by the everting element. Both proximal and distal regions of the endoscope may be grasped by the everting element, but more commonly it is the distal region that is grasped. In this latter case, it is desirable to provide a groove in the distal region of the endoscope.

Another feature of the invention is, inter alia, that of a controller, eg, common assignee pending US application 788,33.
When grasping the proximal region by the controller shown in No. 8 (filed on November 6, 1991), reinforcing the proximal region to protect the optical components housed in that part of the endoscope body. Is. In a preferred configuration, the proximal region has a polymer matrix and an elongated generally helical reinforcement member embedded in the polymer matrix. This not only reinforces the proximal region of the endoscope body, but also provides an advantageous way to provide a groove on the outer surface of the proximal region of the endoscope body. More specifically, the helical stiffening member allows the polymeric material to be provided with helical ribs that bulge outward along the length of the helical stiffening member to form at least a portion of the groove.

The spiral stiffening member preferably comprises a metal coil. The helical reinforcement member is preferably in the form of a metal wire of oval cross section. By orienting the major axis of the oval cross section approximately in the longitudinal direction of the endoscope body,
Good resistance to bending loads is obtained without unduly thickening the walls of the endoscope body. The distal region preferably has a polymer tube coated with a polymer layer that provides lubricity. The polymer layer that imparts lubricity is preferably fluorinated ethylene propylene, polytetrafluoroethylene, or the like. The polymer tube provides strength to protect the optics supported within the distal region, even in the thin walled configuration. The preferred polymeric material for this tube is polyimide. Polyimide is also a suitable polymer for the proximal region matrix.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT FIG. 1 generally illustrates an endoscope body 13 and hub 1.
5 shows an endoscope 11 with 5. In addition, the endoscope 11
Has one or more illumination fibers 17 (four shown in FIG. 6) and an image or visualization fiber 19. The endoscope body 13 is flexible and has a proximal end 21 and a distal end 23. The proximal end 21 is received in the axial passage 25 of the hub 15. A strain relief tube 27 receives the region of the endoscope body 13 adjacent the proximal end 21, which strain relief tube 27 is also received in the passage 25. An adhesive 28, such as a urethane adhesive, is used to pipe 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, such as urethane adhesive 30.

The illuminating fiber 17 extends from the distal end 23 through the endoscope body 13 and into the passage 25, and also through the leg 29 of the hub 15 or the illuminating connector. The part 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. Fiber 17,1 using a suitable adhesive such as an epoxy adhesive
The ends of 9 are preferably joined to the legs 29, 31 respectively. The legs 31 can be adapted to be coupled 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 designed to be connected to. The hub 15 can be constructed of any rigid material, but a polymeric material such as ABS is preferred.

The optics of endoscope 11 may be of a type that allows the internal body area 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) long and the distal region 37 is approximately 35.56 cm (14 inches) long. The proximal region 35 is received in and coupled to the hub 15, and the length of the proximal region adjacent the hub is received in the tube 27.

As shown in FIG. 3, the proximal region 35 includes a polymer matrix 41 and a polymer matrix 41.
And a coil-shaped elongated generally helical reinforcement member embedded therein. The polymer matrix 41 can be composed of a variety of materials, but preferably the polymer material is polyimide. Similarly, coil 43 may be constructed of a variety of materials, but is preferably constructed 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 the distal direction of the endoscope body. The groove 47 may have a variety of different shapes, but in the embodiment of FIGS.
Is a spiral shape. The groove 47 may extend for various distances along the outer surface 45, but preferably extends for most of the length of the proximal region 35, and in this embodiment extends the entire length of the proximal region 35.

The groove 47 is constituted by a spiral rib 49. As an example, the outer diameter of the endoscope body when 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 when measured at the bottom of the groove 47 is, for example, about It is 0.0724 cm (0.0285 inches), which results in a rib height of approximately 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, 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 0.00254 cm (0.001 inch) x 0.00762 cm (0.003 inch). As shown in FIG. 3, the outer surface 45 of the endoscope body 13 bulges 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 help define 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 wall thickness, after which the coil 43
Are placed or wrapped around the preformed portion of the matrix 41. Finally, the dipping process is repeated to form the proximal region 35 substantially as shown in FIG.

Proximal region 35 is elongated, 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 is generally cylindrical, having grooves 47 and ribs as described above.
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 carried by the image fiber 19. The coil 43 also resists any tendency of the 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 includes the passage 6
3, comprising a flexible, cylindrical polymer tube 65, preferably made of polyimide, and a coating or layer 67 of a lubricious material, with polytetrafluoroethylene or fluorinated ethylene propylene being preferred. . 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 a dip process and have a thickness of about 0.047 cm (0.0185 cm).
Inch) diameter. Layer 67 is, for example, about 0.050.
8 cm (0.020 inch) diameter and 0.0019 cm (0.00075)
Inch).

Proximal region 35 and distal region 37 may be joined at transition 39 in any suitable manner, but FIG.
The configuration shown in is preferable. As shown in FIG. 4, a length of distal region 37 with layer 67 removed and proximal region 35.
Area 37 and join the area 37 to the area 35 using an adhesive 69 such as cyanoacrylate. The adhesive 69 has a tubular portion 71 within the passageway 51 and a tapering or conical portion 73 of decreasing diameter such that it extends distally to blend 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 retained within the lens bushing 75 by a suitable adhesive, such as an epoxy adhesive. Lens bush 75 is constructed of a suitable metal such as stainless steel. Lens 33 is positively coupled to distal end 77 of image fiber 19 by a suitable adhesive, which may be a UV curable adhesive. The lens bushing 75 and the illuminating fiber 17 are retained in the passage 63 by a suitable adhesive such as an epoxy adhesive.

The endoscope 11, which is adapted to view various internal body regions, is, in this embodiment, a fallopian tube endoscope, which is sized 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 lighting fiber 17 is in place,
The light is connected distally through the distal end 23 and the image fiber 19 directs the image proximally for visualization through the eyepiece or by a camera and monitor. The groove 47 forms or partially forms a flow path for a liquid, such as an irrigation solution, when the proximal region 35 is within the lumen of a catheter (not shown), and the reinforced proximal region 35 is Protect the fibers 17, 19 from the compressive forces of any controller used to advance and retract the endoscope.

FIG. 7 is an endoscope 1 which is identical to endoscope 11 in all respects not shown or described herein.
1a is shown. Parts of the endoscope 11a that correspond 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 is tightly wound by the spiral rib 49, thereby forming a spirally extending groove having a twist angle different from the twist angle of the groove 47. The point is that the spiral rib 49a has a spiral rib 49a. The outer surface 45a is also shaped somewhat differently in that the bottom of the groove 47a is not as smoothly curved as in the endoscope 11. As in the case of the endoscope 11, the spiral groove 47a and the spiral rib 49a extend over all or part of the proximal region and / or the distal region.

FIG. 7 also shows the endoscope 11a in a tubular structure 81 which is, for example, a catheter or an everting element of an everting catheter. Regardless of the particular nature of the tubular structure 81, the outer surface 45a of the endoscope 11a and this outer surface 4a
The inner surface 85 of the tubular structure 81 facing 5a constitutes a spiral flow path 83. This flow path 83 completely supplies the cleaning solution or other liquid around the endoscope 11a and extends the entire length of the endoscope having the spiral groove 47a. When the tubular structure 81 is the everting element of an everting catheter, preferably the helical rib 49a and the helical groove 47a extend at least over a majority of the proximal region of the endoscope 11a.

FIG. 8 is an endoscope 1 which is identical to endoscope 11 in all respects not shown or described herein.
1b is shown. Parts of the endoscope 11b that correspond 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 a plurality of axially extending splines or ribs 49b forming a plurality of axially extending grooves 47b on its outer surface 45b. Is. In this embodiment, the grooves 47b and ribs 49b are generally triangular in cross section.

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

FIG. 9 is an endoscope 1 identical to endoscope 11 in all respects not shown or described herein.
1c is shown. Parts of the endoscope 11c that correspond to parts of the endoscope 11 are indicated by corresponding reference numerals with the symbol c. The endoscope 11c has a rib 49
It is the same as the endoscope 11b except for the shape of c and the shape of the groove 47c. The rib 49c and the groove 47c are substantially rectangular. Similar to the endoscope body of the endoscope 11b, the endoscope body 13c may be extruded and the ribs 49c may be located in all or part of the proximal and / or distal region of the endoscope body. It is provided.

While exemplary embodiments of the present invention have been shown and described, those skilled in the art will appreciate that many variations, modifications and substitutions may be made without necessarily departing from the spirit and scope of the invention. It can be carried out.

[Brief description of drawings]

FIG. 1 is a partial cross-sectional side elevational 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 the distal region of the endoscope with the optical fiber removed.

FIG. 3 is a partial axial cross-sectional view along a portion of the 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 fiber removed.

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

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

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

Figure 8: Endoscope (not shown internal details of its construction)
FIG. 7A is a radial cross-sectional view of a third form proximal or distal region 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 fiber removed.

[Explanation of symbols]

 11 Endoscope 13 Endoscope Body 15 Hub 17 Illuminating 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 Position region 37 Distal region 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

Front Page Continuation (72) Inventor Gary M Walker United States California 92029 Escondido Julinda Way 2845 (72) Inventor Robert John Ericker United States California 90631 La Habra North Dexter Street 600

Claims (10)

[Claims] 1. An elongated endoscopic body having a proximal end and a distal end and sized and configured for insertion into an internal body region of a patient; and an endoscope within the patient. And an optical component carried by the endoscope body so that the interior body region of the patient can be seen, the endoscope body having an outer surface defining a groove, wherein at least one of the grooves is provided. An endoscope characterized in that a part thereof extends in the distal direction of the endoscope body. 2. The endoscope according to claim 1, wherein the part of the groove has a substantially spiral shape. 3. The endoscope according to claim 1, wherein the part of the groove is substantially in the axial direction. 4. The endoscope of claim 1, wherein the endoscope is flexible and the optics include an illumination fiber and a visualization fiber. 5. The endoscope body has a distal region including the distal end, a proximal region having a larger cross section than the distal region, and the groove is in the proximal region. The endoscope according to claim 1 or 2, characterized in that. 6. The proximal region comprises a polymer matrix,
The endoscope according to claim 5, further comprising an elongated generally helical reinforcing member embedded in the polymer matrix. 7. The length of the helical stiffening member to provide a helical rib that defines the outer surface of at least a portion of the proximal region of the endoscope body and that defines the portion of the groove. The endoscope according to claim 6, wherein the endoscope is bulged outward along the direction. 8. The endoscope body has a distal region including the distal end and a proximal region having a larger cross-section than the distal region, the distal region being smooth. The endoscope according to claim 6, comprising a polyimide tube covered with a polymer layer. 9. A hub adapted to be coupled to an illumination source and a camera, the hub being coupled to the 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 8, further comprising a strain relief tube that receives the strain. 10. An elongated endoscopic body having a proximal end and a distal end and sized and configured for insertion into an internal body region of a patient, and an endoscope within the patient. Optics carried by the endoscope body to allow viewing of an internal body region of the patient, the endoscope body including a distal region including the distal end,
A proximal region of greater cross-section than the distal region, the proximal region having a polymer matrix and an elongated generally helical reinforcement member embedded in the polymer matrix; An endoscope characterized in that the proximal region has a polyimide tube covered with a smooth polymer layer.