RU2806722C1 - Videorectoscope - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: videorectoscope contains a body with a handle and a rigid barrel detachably connected to it with two longitudinal channels, one of which is instrumental and serves to place a medical probe with forceps for taking a biopsy, forming the head of the probe, and in the other, at the distal end of the barrel, a video camera is installed, the cable of which brought out through the housing and configured to connect to a display device. The distal end of the barrel is made elongated in the part corresponding to the location of the instrumental channel, which in this section of the extension is bent along a line that ensures rotation of the head of the medical probe in the direction to the optical axis of the video camera. The head of the medical probe at the exit from the canal is oriented at an angle of 20±7° to the optical axis of the video camera.

EFFECT: increasing the safety of the medical device and eliminating the possibility of damage to the patient's mucous membrane by the surgical instrument by creating conditions for safe insertion of the surgical instrument for the patient and placing its working area in the line of sight of the video camera.

7 cl, 7 dwg

Description

Field of technology to which the invention relates

The invention relates to the field of medicine, more specifically to devices intended for intracavitary examination of the mucous membrane of the rectum and sigmoid colon and taking a biopsy.

State of the art

An operational electronic video endoscope is known (see patent WO 9325137, IPC: A61B 1/018, publ. 12/23/1993), including an elongated tubular barrel having a distal working end and a proximal end to which a pistol grip is attached. Inside the barrel there is a bundle of light-conducting fibers, between which there is a direct channel for a surgical instrument and a means for forming an electronic image, the electronic cable of which exits through the pistol grip and is connected to the electronic processor unit.

The disadvantages of this design include high requirements for the skills and qualifications of the doctor conducting the study, otherwise there is a high probability of damage to the intestinal mucosa by the surgical instrument coming out of the end of the barrel, which is fraught with serious consequences for the patient.

Known rectoscope, patent CN 207940885, IPC: A61B 1/04, A61B 1/31, publ. 10/09/2018, containing a steel barrel, one end of which, the proximal one, is connected to the control handle, and at the other, distal end, a streamlined tip with a side cutout is attached, forming an open hollow volume, inside of which the head of a video camera, an LED lamp and surgical forceps for taking a sample (bipsy). This design ensures high safety and eliminates the possibility of accidental damage to the intestinal walls during manipulation. The disadvantages of this solution include poor visibility, because At any given time, only a small section of the intestinal wall, located in the area of the cut-out window, is available for viewing, which makes the study difficult.

A video rectoscope is known, see patent US 6447444 (B1), IPC: A61B 1/00, A61B 1/31, publ. 09.10.2002, containing a rigid elongated insert element - a barrel having distal and proximal ends, a video camera head mounted on the distal end of the barrel, and a cover put on the barrel. The distal part of the cover is made transparent, which allows the operation of a video camera, and has a tapered end, which facilitates insertion of the device through the anus, while the tapered end is formed by a pair or more petals that close during insertion through the anus and expand after insertion, providing support mucosal walls and the ability to operate a surgical instrument.

The disadvantages of the mentioned technical solution include the excessive complexity of the design, which is due to the presence of a protective cover with movable petals, a special design of the video camera made with the lens turned at an angle to the longitudinal axis of the channel, and the use of a mirror placed on the protrusion of the cover in the field of view of the video camera to ensure good overview of the operating area of surgical forceps.

Today, there are many different medical devices for endoscopic examinations, the design of which provides for the possibility of video recording of the examination process, for example, see patents: CN 106725262 (A), publ. 05/31/2017; CN 208837905(U), 05/10/2019; CN 213665171(U), 07/13/2021; CN215128388(U), 12/14/2021; CN 103622662(A), 03/12/2014; RU 2622032(C1), 06/08/2017; CN 201641961(U), 11/24/2010; KR 20010031806(A), 04/16/2001; RU 2420222 (CI), CN 105287001 and others.

The disadvantages of all the above-mentioned analogues include the fact that the area of exit and operation of the surgical instrument is located in the peripheral area, outside the line of sight of the video camera and close to one of the intestinal walls. In such conditions, it is impossible to do without an air injection system, which allows you to straighten and expand the intestinal walls before inserting the instrument. Otherwise, the possibility of injury to the intestinal mucosa by a surgical instrument cannot be ruled out, which can lead to serious consequences.

As the closest analogue for the proposed device, the design of the video rectoscope is adopted, disclosed in the patent CN 105725955, IPC: A61B 1/00, publication date 07/06/2016.

Like the claimed device, the video rectoscope according to patent CN 105725955 contains a housing with a handle and a rigid barrel detachably connected to it with two longitudinal channels, in one of which, the instrumental one, a medical probe is placed, and in the other, at the distal end of the barrel, a video camera is installed, the cable of which is brought out through the housing to the outside and is configured to connect to a mobile display device.

The disadvantages of the closest analogue include all of the above, namely: low safety of the device and the possibility of damage to the intestinal mucosa with a surgical instrument.

The claimed invention is aimed at creating a simple and safe design of a video rectoscope, which eliminates the possibility of damage to the intestinal mucosa during use.

The achieved technical result consists in creating conditions for safe insertion of a surgical instrument into the cavity under study with placement in the line of sight of a video camera, which improves the safety of using the proctoscope and eliminates the possibility of injury to the patient's mucosa.

Disclosure of the invention

The essence of the invention as a technical solution lies in the fact that in the design of a video rectoscope containing a body with a handle and a rigid barrel detachably connected to it with two longitudinal channels, one of which is instrumental, serves to place a medical probe with forceps for taking a biopsy, forming the head of the probe , and in the other, at the distal end of the barrel, a video camera is installed, the cable of which is routed out through the housing and is configured to connect to a display device, according to the claimed invention, the distal end of the barrel is made elongated in the part corresponding to the location of the instrumental channel, which in this section of the extension is bent along line ensuring rotation of the medical probe head in the direction to the optical axis of the video camera. The bend of the instrumental channel is preferably made in an arc and in such a way that the head of the medical probe at the exit from the channel is oriented at an angle of (20±7)° to the optical axis of the video camera. A medical probe is a special instrument for carrying out diagnostic and therapeutic procedures in various cavities and channels of the human body; it is an instrument in the form of a thin flexible tube or flexible rod with a working body at the end. A proctoscope typically uses a medical probe with biopsy forceps that form the head of the probe. Unlike the closest and other known analogues, the proposed device has an original design of the distal end of the barrel. If in the nearest and other known analogues the surgical instrument passes through a straight channel and exits from the distal end of the trunk into an open cavity in the immediate vicinity of the intestinal wall, which is not supported by anything outside the trunk, then in the proposed design the surgical instrument emerging from the trunk of the rectoscope is turned away from the nearby wall intestines and is directed towards the center of the cavity and at the same time towards the optical axis of the video camera. In this case, the exit of the instrumental channel is located under a protruding section of the trunk, which forms a kind of canopy over the exit and holds the mucosal wall located above the surgical instrument at that moment, preventing it from sagging in this area.

In this case, the surgical instrument, starting from the exit from the instrumental channel, and subsequently during operation, is in the line of sight of the video camera, which ensures the best quality and clarity of the image obtained on the screen. As a result, visual control of manipulations with the instrument is facilitated and the safety of the procedure is further increased.

All this together makes it possible to increase the safety of the study and eliminate the possibility of accidental damage to the intestinal mucosa.

Due to the high safety of the proposed design, the requirements for the qualifications of the doctor conducting the examination are reduced, and the possibility of using the proctoscope in the conditions of simple clinics, first aid stations, etc. is ensured.

Moreover, the proposed device is characterized by simplicity of design and manufacturability.

The deflection of the medical probe at the outlet at an angle of (20±7)° is the most optimal. A smaller deviation of the instrument, less than 13°, will lead to excessive removal of the operating area of the surgical instrument from the video camera lens, a decrease in the quality of the resulting image and inconvenience for the doctor. A steeper bend of the channel, providing a probe deflection of more than 27°, will significantly complicate the exit of the instrument from the channel.

The arcuate bend of the tool channel, made along the radius, helps to increase the smoothness of the tool exit.

The distal end of the barrel is preferably made with radial thickening of the walls and a narrowing of the extension section towards the longitudinal axis of the barrel, which further improves the safety of the device and facilitates its insertion into the cavity under study.

An industrially produced endoscope camera with a built-in LED light source in the form of a matrix of LEDs placed in a circle around the camera lens and a flexible probe cable with a USB connector for connecting to a display device can be used as a video camera.

The camera is fixed at the distal end of the barrel using an elastic sleeve.

A mobile phone (smartphone), tablet, laptop or other computer can be used as a display device.

The proximal end of the barrel may be connected to the body via a bayonet connection.

The barrel can be formed entirely from transparent plastic.

Brief description of drawings

The essence of the proposed technical solution and the achieved result are illustrated by the following examples of implementation and the accompanying drawings, which show:

in fig. 1 - proposed device, general view;

in fig. 2 - view A from Fig. 1;

in fig. 3 - view B from Fig. 1;

in fig. 4 - video rectoscope, longitudinal section;

in fig. 5 - fragment I from Fig. 4, enlarged;

in fig. 6 - cross section of the distal end of the trunk;

in fig. 7 - video camera, a possible example of execution.

Carrying out the invention

The video rectoscope contains (see Fig. 1-3) a body 1 with a handle 2 and a rigid shaft 3 detachably connected to it at the proximal end with two longitudinal channels 4 and 5 for placing, respectively, a video camera 6 and a surgical instrument - a medical probe 7 with forceps 8 to take a biopsy (Fig. 4-6).

The connection of the housing 1 with the barrel 3 can be made using a bayonet connection 9. In the assembled state, the internal cavities of the housing 1 form continuations of the channels 4 and 5 of the barrel 3. The valve 10 with a sealing membrane serves as the input port for the medical probe 7.

The rectoscope can be equipped with a one-way valve to prevent the reverse flow of liquid and air, a scale applied to the outer surface of the barrel 3, and, if necessary, means of air injection. However, all these elements are known and are not discussed in detail in this application.

The barrel 3 is entirely made of transparent plastic or, at a minimum, has an optically transparent window 11 at the distal end (see Fig. 4-5), behind which a video camera 6 is installed and fixed, for example, by means of an elastic sleeve 12. The cable 13 of the video camera 6 is brought out through the opening of the housing 1 outwards. To connect to a display device 14, such as a smartphone, tablet, laptop or other computer, there is a USB connector 15 at the end of the cable 13.

The distal end 16 of the barrel 3 on the part of the diameter corresponding to the location of the instrumental channel 5 is made elongated and protrudes beyond the transparent window 11 (see Fig. 5). In the extension section, the instrumental channel 5 is bent to ensure rotation of the medical probe 7 in the direction to the optical axis O of the video camera 6.

An arcuate (radius) bend of the channel 5 is preferable, since it facilitates the smoothest exit of the head 8 of the probe 7 from the channel, but this does not limit the possibilities of other designs.

At the exit from channel 5, the head 8 of the medical probe 7 is oriented to the optical axis O of the video camera at an angle α, the value of which corresponds to (20±7)°. A deviation of the instrument at the output of less than 13° is undesirable, since it leads to a removal of the working area of the surgical instrument from the video camera lens and a decrease in the quality of the resulting image. A bend of more than 27° significantly complicates the exit of head 8 from the channel.

At the distal end 16 of the trunk 3, a radial (annular) thickening 17 of the walls and a narrowing 18 of the elongated section can be formed (see Fig. 1-2)

As a video camera 6, for example, an industrially produced endoscope video camera SME 11 0.3 MP LED USB (https://vizit-nt.ru/videokamera-endoskop-led-usb) can be used, which has a built-in light source with adjustable backlight on six super-bright LEDs 19 placed in a circle around the lens 20 of camera 6 (see Fig. 7). To output digital signals, use a flexible electrical cable with a USB connector and a mechanical backlight adjustment unit.

The video rectoscope is used in a known manner.

Before the patient is examined, the device is assembled, while the bayonet connection ensures simplicity and efficiency of assembly.

The barrel 3 of the rectoscope is inserted into the anus, while the streamlined shape of its distal end, formed by thickenings 17 and narrowing 18, facilitates insertion of the device and ensures safety for the patient.

When the barrel 3 of the rectoscope is moved longitudinally along the rectum and lower part of the sigmoid colon, the video camera 6, through a transparent window 11, illuminates the cavity and video records it with real-time image transmission to the display device 14, which allows the doctor to examine the intestinal mucosa.

Due to the fact that any mobile phone, tablet or other personal computer can be connected to the device as a display device 14, on which it is enough to install the appropriate software application, usually included with the endoscope camera, the possibilities of using the device are significantly expanded.

To take a biopsy, the medical probe 7 is pushed through port 10 until the head 8 exits channel 5. In this case, the doctor controls the exit of the instrument, having a clear image of the exit located in the line of sight of the video camera, almost on the optical axis, and can quickly adjust his actions.

The head 8 of the probe 7 emerging from the instrumental channel 5 is directed to the center of the intestinal lumen, supported by the elongated section of the distal end 16 of the barrel 3 hanging over the exit 21 (see Fig. 5), which eliminates the possibility of accidental damage to the mucosa with forceps during the movement of the instrument.

The working area of the forceps 8, in which the biopsy is taken, is located at the intestinal wall opposite the exit 21 of the instrumental channel 5, i.e. is located in the line of sight of the video camera 6, which ensures the clarity and quality of the resulting image and guarantees the safety of the procedure.

Video camera 6 allows you to record the inspection session and take pictures of individual areas.

Upon completion of the study, the medical probe 7 is removed through port 10, the barrel 3 is disconnected from the body 1 and the video camera 6 and undergoes mandatory sanitization, disinfection and sterilization, according to the instructions of the Ministry of Health of the Russian Federation. Disposable use of barrel 3 is allowed, but is not advisable.

The proposed device is characterized by simplicity of design and high safety of use, due to which the device can have a wide range of applications: in any medical institutions, clinics, first aid stations, offices, etc.

Claims (7)

1. A video rectoscope containing a body with a handle and a rigid barrel detachably connected to it with two longitudinal channels, one of which is instrumental, serves to place a medical probe with forceps for taking a biopsy, forming the head of the probe, and in the other, a video camera is installed at the distal end of the barrel , the cable of which is brought out through the housing and is configured to connect to a display device, characterized in that the distal end of the barrel is made elongated in the part corresponding to the location of the instrumental channel, which in this section of the extension is bent along a line ensuring rotation of the head of the medical probe in the direction to optical axis of the video camera, while the head of the medical probe at the exit from the channel is oriented at an angle of 20±7° to the optical axis of the video camera. 2. Video rectoscope according to claim 1, characterized in that the instrumental canal is bent in an arc. 3. Video rectoscope according to claim 1, characterized in that the distal end of the barrel is made with radial thickening of the walls and a smooth narrowing of the elongated section. 4. Video rectoscope according to claim 1, characterized in that the video camera is an endoscope camera with a built-in LED light source in the form of a matrix of LEDs placed in a circle around the camera lens, and with a flexible cable equipped with a USB connector for connecting to a display device. 5. Video rectoscope according to claim 1, characterized in that a mobile phone is used as a display device. 6. Video rectoscope according to claim 1, characterized in that the barrel is connected to the body via a bayonet connection. 7. Video rectoscope according to claim 1, characterized in that the barrel is formed from transparent plastic.