WO1992015238A1 - Micro-endoscope ameliore - Google Patents

Micro-endoscope ameliore Download PDF

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Publication number
WO1992015238A1
WO1992015238A1 PCT/GB1992/000399 GB9200399W WO9215238A1 WO 1992015238 A1 WO1992015238 A1 WO 1992015238A1 GB 9200399 W GB9200399 W GB 9200399W WO 9215238 A1 WO9215238 A1 WO 9215238A1
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
micro
viewing
light guide
tube
Prior art date
Application number
PCT/GB1992/000399
Other languages
English (en)
Inventor
Costas Diamantopoulos
Original Assignee
Omega Universal Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Omega Universal Limited filed Critical Omega Universal Limited
Publication of WO1992015238A1 publication Critical patent/WO1992015238A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/042—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by a proximal camera, e.g. a CCD camera

Definitions

  • This invention relates to an improved micro- endoscope and to the use of such a micro-endoscope in applications in urology, gynaecology, cardiovascular disease and ear-nose and throat.
  • micro-endoscopes which utilise miniaturised glass fiber optics in urologic and gynaecological applications, which permit the passage of medical instruments within an outer flexible tube, such outer flexible tubes having a relatively small outer diameter in the region of 1 to 4mm.
  • These known micro- endoscopes have a multilayered outer tube of low frictional coefficient materials which are manipulated within the patient's body to carry out examinations or operations.
  • micro-endoscopes present a great advance in technology on earlier used techniques of endoscopes of larger sizes
  • the existing micro-endoscopes have the disadvantage that the passive manipulation of the endoscope within the body tract is limited, fiberscopes require skills and, the invasiveness could be traumatic to the patient.
  • the angle of viewing is limited to direct observation forward from the lens and there is no scope of observing other than in the forward direction areas, unless the scope is twisted and manipulated.
  • An aim of the present invention is to provide an improved micro-endoscope which facilitates active manipulation via articulation of the distal end of the micro-endoscope and overcomes the above mentioned disadvantage, whilst at the same time having a working channel large enough to carry out interventional procedures such as lasers etc.
  • a micro-endoscope comprising a flexible outer tube within which is located an image bundle of silica fibers, at least one light guide tube, a flushing channel and an instrument channel, wherein the distal end of the flexible outer tube is articulated.
  • the micro-endoscope may include a wire to control the articulation of the micro-endoscope, one end of the wire being connected to the tip of the distal end of the micro-endoscope and the other end is connected to a handle projecting from the rear end of the micro-endoscope.
  • the image bundle is of quartz silica glass fibers each of 2 to 5nm diameter.
  • the micro-endoscope includes two light guide fibre bundles.
  • the insertion length of the micro-endoscope is 90cm to 1.20m.
  • a method of hysteroscopy diagnostic procedure to examine the endometrium and fallopian tubes of a patient using the micro-endoscope of the present invention comprising the steps of administering a local anaesthetic to the patient, passing the endoscope through the Os into the cervical canal to examine the endometriu .
  • a method of retrograde ureteroscopy using the micro-endoscope of the present invention comprising the steps of passing the micro- endoscope through the working channel of a rigid cystoscope and entering it into the ureteric orifice of a patient, and manipulating it into the ureter while simultaneously flushing through the flushing channel, the articulated distal end of the micro-endoscope assisting manipulation up to the calyx.
  • Figure 1 is a diagrammatic side elevation of a first embodiment of a micro-endoscope
  • Figure 2 is a cross-section of the micro-endoscope shown in Figure 1;
  • Figure 3 is a diagrammatic side elevation of a second embodiment of a micro-endoscope
  • Figure 4 is a cross-section of the micro-endoscope shown in Figure 3;
  • Figure 5 is a diagrammatic side elevation of a third embodiment of a micro-endoscope
  • Figure 6 is a cross-section of the micro-endoscope shown in Figure 5;
  • Figure 7 is a diagrammatic side elevation of a fourth embodiment of a micro-endoscope;
  • Figure 8 is a cross-section of the micro-endoscope shown in Figure 7;
  • Figure 9 is a diagrammatic view of a first combination of a direct viewing system
  • Figure 10 is a diagrammatic view of a second combination of a fiberscope viewing system.
  • Figure 11 is a diagrammatic view of a third combination of a compact viewing system.
  • the first embodiment of a fiberoptic articulated micro-endoscope shown in Figures 1 and 2 comprises a flexible outer tube 1 measuring the insertion length 90 cm to 1.20 m. and made of a low frictional coefficient material such as polyurethane.
  • Located within the tube 1 is an image bundle of quartz silicon glass fibers 2 each of 2-5mm diameter which acts as an image lens.
  • a light guide tube 3 which houses a bundle of glass fibers 4 through which light is passed to the distal end ' 5 of the micro-endoscope.
  • a flushing channel 6 extends the length of the outer tube 1 enabling a fluid to be flushed to the distal end of the tube 1.
  • the distal end 5 of the micro-endoscope is articulated at 7 to enable the micro-endoscope to move through 90 degrees.
  • the control of the articulated end 7 is by means of a thin wire 7a which is connected to a probe 7b at the distal end 5 and passes along the inside of the tube 1 and is connected to a handle 8 which projects from the rear end of the outer tube 1.
  • the surgeon can manipulate the articulated end of the micro-endoscope by pulling or pushing on the handle 8 to bend the distal end of the tube 1 and probe 7b through an angle of 90 degrees.
  • the various tubes carrying the fiberoptics and the flushing and instrument tubes are sealed in the flexible outer tube 1 by an epoxy adhesive 10.
  • FIG. 3 and 4 like parts have the same reference numerals as in Figures 1 and 2, except that a second light guide tube 3a is included to facilitate the use of the micro-endoscope with a fiberscope system using a CCD-camera, video monitor, video recorder and video printer (see Figures 10 and 11).
  • the outside diameter of the micro-endoscope is 2.2 mm.
  • Figures 5 and 6 show a third embodiment of the micro-endoscope of the present invention, comprising an outer flexible polyurethane tube 11, the upper half of which houses an image guide 12 with a lens comprising a bundle of quartz silca glass fibers 13.
  • a second tube 14 comprises a bundle of glass fibers 15 through which light is passed to the distal end 16 of the micro-endoscope.
  • the tubes 12 and 14 are sealed in the tube 11 by an epoxy adhesive.
  • the lower half of the tube 11 has a flushing channel 17 which is semi-circular in cross-section and can also be used as a working channel for the insertion of instruments.
  • the controls and connections for the components 12, 13, 14, 15 and 17 extend from the rear end of the flexible tube 11 via a branch connection 18.
  • a fourth embodiment of the micro-endoscope according to the invention is shown in Figures 7 and 8 and is similar in construction to that shown in Figures 5 and 6, where like parts have the same reference numerals.
  • the difference between the third and fourth embodiments is that the polyurethane flexible tube 11 is housed in an outer SUS pipe 19 and the light guide fibers 20 surround the image guide 21.
  • the fibers 20 and image guide 21 are secured in position within the tube 11 by an epoxy adhesive.
  • the distal end 22 of the outer SUS pipe 19 may be connected to an end probe 23.
  • micro-endoscope may be used with three possible combinations of direct viewing or recording systems shown in Figures 9 to 11.
  • Figure 9 illustrates a direct viewing system which includes an eyepiece 24 conected to the end of an image bundle of quartz silicia glass fibers 25.
  • a light source 26 is connected to a light guide tube 27 so that the surgeon may view the operative area by looking into the eyepiece 24.
  • the eyepiece 24 of Figure 9 is replaced by an eyepiece 28 of CCD-camera (not shown) which is connected to a TV monitor 29 and a multi-system video recorder 30.
  • the CCD - camera focuses on the operation which is transmitted to the TV monitor 29 and may be recorded on the video recorder 30.
  • a group of medical students may view the operation while it is being performed, or the video recording of the operation at a later time and different place, whilst a video printer can also be utilised to print recordings of interest.
  • the eyepiece 31 of the CCD-camera 32, light source 33 (halogen or Xenon) and a six-inch monitor 34 are mounted in a housing 35 and are connected to the micro-endoscope via a branch connection 36.
  • This construction allows for more than 7000 pixels fiberscope resulting in an improved resolution.
  • micro-endoscope The method of use of improved micro-endoscope will now be described using hysteroscopy diagnostic procedure to examine the endometrium and fallopian tubes of a patient.
  • a local anaesthetic is first administered to the patient and the distal end of the micro-endoscope, carrying the probe, is passed through the Os and into the cervical canal to examine the endometrium, the micro- endoscope is manipulated and passed through the tubal ostrium opening into the fallopian duct where the surgeon can carry out an examination by using a direct view system or the fiberscope viewing system.
  • the micro-endoscope of the present invention may also be used to carry out a retrograde ureteroscopy comprising the steps of passing the micro-endoscope through the working channel of a rigid cystoscope and entering the ureteric orifice of the patient. The surgeon then manipulates the distal end of the micro-endoscope into the ureter while simultaneously flushing a fluid through the flushing channel of the micro-endoscope and the micro-endoscope is then further manipulated up to the patient's calyx.
  • micro-endoscope and its end articulation allows for a more accurate and a less traumatic examination procedure to be carried out.
  • the steering mechanisms and articulation of the distal tip measuring 2 to 3 cms allow for an excursion of 90 degrees.
  • the various modifications of the micro-endoscope enable a urologist and a gynaecologist to undertake procedures under direct vision and or remote viewing and recording facilities.
  • the use of quartz silica glass fibers in the image bundle provides a high quality of image relative to its size. These fibers have an excellent mechanical strength, heat and radiation resistance thus having many applications.
  • the micro-endoscope is not only a diagnostic instrument but due to its steerability and the relatively large size working channels, will allow a wide range of accessories such as grasping forceps and stone extractors to be used.
  • the articulation mechanism enables the tip of the distal end to move 90 degrees in one direction, thus allowing the surgeon to scan and observe an object through an angle of 90 degrees while the viewing angle of the lens is maintained at 70 degrees.
  • the improved micro- endoscope thus enables gall-stones to be observed or destroyed with a laser, by reducing manipulation of the micro-endoscope to a minimum and reducing the invasiveness of the patient.
  • the micro-endoscope of the present invention may be made to the micro-endoscope of the present invention.
  • the outside diameter may be reduced to 0.35 mm so that it can be used for viewing coronory arteries with reduced danger of perforating the arterial wails.

Abstract

Micro-endoscope amélioré comprenant un tube externe souple (1) d'une longueur d'insertion de 90 cm à 1,20 m, par exemple du polyuréthane. Dans le tube (1) se trouve un faisceau d'imagerie de fibres de verre au quartz et au silicium (2) ayant chacune un diamètre de 2 à 5 mm, qui agit à la manière d'une lentille d'imagerie. Dans le tube (1) se trouve également un tube de guidage de la lumière (3) abritant un faisceau de fibres de verre (4) à travers lesquelles de la lumière est envoyée vers l'extrémité distale (5) du micro-endoscope. Un canal d'arrivée de liquide (6) s'étend le long du tube (1), ce qui permet d'envoyer un liquide vers l'extrémité distale du tube (1), ainsi qu'un canal destiné aux instruments (17). L'extrémité distale (5) est articulée en (7) pour permettre au micro-endoscope d'effectuer un mouvement d'une amplitude de 90 degrés.
PCT/GB1992/000399 1991-03-06 1992-03-06 Micro-endoscope ameliore WO1992015238A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9104713.4 1991-03-06
GB9104713A GB2255281A (en) 1991-03-06 1991-03-06 Articulated micro-endoscope

Publications (1)

Publication Number Publication Date
WO1992015238A1 true WO1992015238A1 (fr) 1992-09-17

Family

ID=10691079

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1992/000399 WO1992015238A1 (fr) 1991-03-06 1992-03-06 Micro-endoscope ameliore

Country Status (3)

Country Link
EP (1) EP0574460A1 (fr)
GB (1) GB2255281A (fr)
WO (1) WO1992015238A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5419312A (en) * 1993-04-20 1995-05-30 Wildflower Communications, Inc. Multi-function endoscope apparatus
WO2021050537A1 (fr) * 2019-09-09 2021-03-18 Arizona Board Of Regents On Behalf Of The University Of Arizona Falloscope collecteur de cellules et procédé de détection du cancer de l'ovaire

Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL9401180A (nl) 1994-07-18 1996-03-01 Draeger Med Electronics Bv Catheter met meerdere sensoren op afstand van elkaar.
GB2363334B (en) * 2000-06-14 2002-12-31 Ismail Khan A cystoscope
GB0130608D0 (en) 2001-12-21 2002-02-06 Psimedica Ltd Medical fibres and fabrics
DE10358817B3 (de) * 2003-12-16 2005-04-14 Olympus Winter & Ibe Gmbh Endoskop
DE202009017097U1 (de) * 2009-12-18 2011-02-24 Joimax Gmbh Endkoskop insbesondere für die minimal-invasive Chirurgie an der Wirbelsäule
CN103327878B (zh) * 2011-01-25 2017-03-15 英伟森医疗公司 用于维持狭窄体腔的系统
CN105769304B (zh) * 2014-12-22 2018-02-02 中国科学院沈阳自动化研究所 一种面向子宫内膜修复的内窥镜手术系统及其应用
US11647899B2 (en) * 2018-06-14 2023-05-16 Boston Scientific Scimed, Inc. Devices, systems and methods for accessing a body lumen

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4327738A (en) * 1979-10-19 1982-05-04 Green Philip S Endoscopic method & apparatus including ultrasonic B-scan imaging
US4736733A (en) * 1987-02-25 1988-04-12 Medical Dynamics, Inc. Endoscope with removable eyepiece
EP0280397A2 (fr) * 1987-02-25 1988-08-31 Edwin L. Adair Endoscope
EP0281161A2 (fr) * 1984-01-03 1988-09-07 Medical Dynamics, Inc. Assemblage d'un câble pour un endoscope à laser
DE3920706A1 (de) * 1989-06-24 1991-01-10 Foerster Ernst Kathetervorrichtung zur biopsie

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0221041Y2 (fr) * 1983-11-08 1990-06-07
US4589404A (en) * 1984-01-03 1986-05-20 Medical Dynamics, Inc. Laser endoscope
DE3443337A1 (de) * 1984-11-28 1986-05-28 Richard Wolf Gmbh, 7134 Knittlingen Instrument zur untersuchung und behandlung von koerperkanaelen
US4836189A (en) * 1988-07-27 1989-06-06 Welch Allyn, Inc. Video hysteroscope
US4899732A (en) * 1988-09-02 1990-02-13 Baxter International, Inc. Miniscope
US4911148A (en) * 1989-03-14 1990-03-27 Intramed Laboratories, Inc. Deflectable-end endoscope with detachable flexible shaft assembly
US4994910A (en) * 1989-07-06 1991-02-19 Acuimage Corporation Modular endoscopic apparatus with probe

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4327738A (en) * 1979-10-19 1982-05-04 Green Philip S Endoscopic method & apparatus including ultrasonic B-scan imaging
EP0281161A2 (fr) * 1984-01-03 1988-09-07 Medical Dynamics, Inc. Assemblage d'un câble pour un endoscope à laser
US4736733A (en) * 1987-02-25 1988-04-12 Medical Dynamics, Inc. Endoscope with removable eyepiece
EP0280397A2 (fr) * 1987-02-25 1988-08-31 Edwin L. Adair Endoscope
DE3920706A1 (de) * 1989-06-24 1991-01-10 Foerster Ernst Kathetervorrichtung zur biopsie

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5419312A (en) * 1993-04-20 1995-05-30 Wildflower Communications, Inc. Multi-function endoscope apparatus
WO2021050537A1 (fr) * 2019-09-09 2021-03-18 Arizona Board Of Regents On Behalf Of The University Of Arizona Falloscope collecteur de cellules et procédé de détection du cancer de l'ovaire

Also Published As

Publication number Publication date
GB2255281A (en) 1992-11-04
EP0574460A1 (fr) 1993-12-22
GB9104713D0 (en) 1991-04-17

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