WO2012007633A1 - Device for automatically guiding the distal end of a fibrobronchoscope/videobronchoscope - Google Patents

Device for automatically guiding the distal end of a fibrobronchoscope/videobronchoscope Download PDF

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Publication number
WO2012007633A1
WO2012007633A1 PCT/ES2011/070526 ES2011070526W WO2012007633A1 WO 2012007633 A1 WO2012007633 A1 WO 2012007633A1 ES 2011070526 W ES2011070526 W ES 2011070526W WO 2012007633 A1 WO2012007633 A1 WO 2012007633A1
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WIPO (PCT)
Prior art keywords
distal end
flexible tube
servomotor
airway
fibrobronchoscope
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PCT/ES2011/070526
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Spanish (es)
French (fr)
Inventor
Juan Carlos RIVERA GARCÍA
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Rivera Garcia Juan Carlos
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Publication of WO2012007633A1 publication Critical patent/WO2012007633A1/en

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    • 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
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0052—Constructional details of control elements, e.g. handles
    • 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
    • A61B1/05—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 the image sensor, e.g. camera, being in the distal end portion
    • 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
    • A61B1/267—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 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A61B1/2676—Bronchoscopes

Definitions

  • the present invention refers to a device for guiding the distal end of a fibrobronchoscope / videobronchoscope, which is intended to allow such guidance to be performed automatically facilitating considerably the work of the specialist that the fiberoptic bronchoscope / videobronchoscope tube must be inserted along the airway of a patient.
  • fibrobronchoscopes comprising a flexible tube at whose distal end incorporates an image capture element that communicates with a viewfinder, provided at the proximal end of the fibrobronchoscope, for visualization of the captured images. It also incorporates a fiber optic beam that runs along the flexible tube through which the illumination of the distal end of the bronchoscope is performed and allows images to be captured.
  • an image capture element can be constituted by a lens that, through a fiber optic beam, which runs along the flexible tube, sends the captured image to the viewfinder provided at the proximal end of the fibrobronchoscope.
  • video bronchoscopes are used in which it replaces the optical fiber of image capture with a CCD (charge couped device) system, which comprises a chip placed on the tip of the video bronchoscope, next to the lens, which acts as a a miniature television camera, and transmits the image to a video processor, and then sends it to a television monitor.
  • a video converter is used, which is connected to the CCD, which goes from the viewfinder to the video processor, and is in turn connected to the television monitor.
  • the fibrobronchoscope / videobronchoscope is equipped with a working channel that runs along the flexible tube, which allows the aspiration of secretions, drug installation, catheter passage, tweezers, brushes, etc.
  • At least two metal wires are incorporated that are connected to a mechanism, provided in the viewfinder area, to act on the metal wires, and govern the angulation of the distal end, to orient it in the direction of the airway of a patient, which allows its introduction along the same by a specialist.
  • the government of the distal end angulation is performed manually acting on the mechanism provided in the viewfinder area, which determines that the intubation requires great skill by the medical professional (anesthetist), for the introduction of the flexible tube through the respiratory tract, especially on critical occasions where the patient may not even be sedated in a state of "no rest", in an urgent situation, and even where your life may depend on the correct placement of the fibrobronchoscope.
  • the invention solves these drawbacks by means of a new device that automatically guides the distal end of the fibrobronchoscopes and videobronchoscopes. DESCRIPTION OF THE INVENTION
  • the invention has developed a new device for guiding the distal end of a fibrobronchoscope and a videobronchoscope, which, like those provided in the prior art, are provided, among other elements, with a flexible tube whose distal end includes an image pickup element that communicates with a viewer provided at its proximal end, to display the images captured by the distal end.
  • the flexible tube is provided longitudinally with a pair of metallic threads whose action produces the angular displacement of the distal end of the flexible tube to orient it in the direction of the airway of a patient, and presents the novelty that it also comprises a first servomotor which is related to a coil in which the metallic threads are wound in different winding directions, to perform the longitudinal displacement of the metallic threads in different directions and thus govern the angular displacement of the distal end of the flexible tube.
  • the fibrobronchoscope is provided with a second servomotor, which is related to a solidary coil of the flexible tube, to cause torsion thereof, and thus govern the angulation of the distal end of the flexible tube in any direction in combination with the movement of the first servomotor.
  • the guiding device of the invention comprises an image processor to which the captured images are applied for processing, so that said processor comprises means for detecting the direction of the airway from the processor of the captured image, and also comprises actuation means of the first and second servomotor so that they perform the action of the distal end of the flexible tube in the airway direction detected in the image.
  • the device is also provided with a signaling element when the distal end is oriented according to the direction of the airway, to indicate the user of the fibrobronchoscope / videobronchoscope when the flexible tube can be inserted.
  • the control of the angulation of the distal end of the fibrobronchoscope / videobronchoscope is performed automatically, at the same time that it is signaled when the correct orientation in the airway has been performed to allow the introduction of the tube flexible, which simplifies and considerably facilitates the intubation process that conventionally presents the problems already mentioned in the previous section.
  • the device is further provided with a second signaling element that indicates when the distal end has lost the orientation of the airway direction, so that the user knows that he has to stop the introduction of the flexible tube because the correct orientation of the airway has been lost.
  • the first and second signaling elements are determined by optical, acoustic or both elements, such as by means of LEDs that perform the optical signaling when the correct and incorrect orientation of the distal end of the fibrobronchoscope / videobronchoscope occurs in the airway of the patient, and as for example it can be the incorporation of a loudspeaker whose sounds indicate said correct and incorrect orientation.
  • the first and second servomotor are determined by microservomotors that are arranged in the area of the viewfinder of the fibrobronchoscope / videobronchoscope acting on the coils in the manner already mentioned, but the possibility is also provided that the first and second servomotor are arranged in a support in which the fibrobronchoscope / videobronchoscope is fixed, as for example the use of a box-like frame in which they are fixed both the first and second servomotor and the fibrobronchoscope / videobronchoscope, so that the flexible tube goes outside through one of the walls of the support.
  • the described configuration allows, in situations where the patient presents an anatomical pattern outside of normality, to take a photo that the image processor converts into the objective image where the tip will have to be directed, which gives great versatility.
  • Figure 1. Shows a view of a conventional fibrobronchoscope inserted in the airways of a patient.
  • Figure 2. Shows a detail of the distal end of the flexible tube and the possible angulation that it can adopt.
  • Figure 3. Shows a possible embodiment of the device of the invention.
  • Figure 4.- Shows another possible embodiment of the device of the invention.
  • a conventional fibrobronchoscope comprises a flexible tube 2 at whose distal end 7 comprises an image acquisition lens that communicates with a viewfinder 3 provided at its proximal end for Display of captured images.
  • two metallic threads 6 are provided to govern the angulation of the distal tip 7 of the flexible tube 2 by means of an actuation mechanism 8 that divides said metallic threads 6 and also allows the rotation of the flexible tube 2 to manage to govern the angulation of the distal end of the flexible tube 2 in any direction.
  • the novelty of the invention resides in the incorporation of a first servo motor 8 whose action causes the longitudinal displacement of the metallic threads 6 in different directions, and includes a second servo motor 9 that causes the angular displacement of the flexible tube 2, so that combining the actuation of the first 8 and second servomotor 9 governs the angular displacement of the distal end 7 of the flexible tube 2 in any direction.
  • Each of the servomotors is connected to an image processor 10, such as a personal computer, in which the images captured by the distal end 7 of the fibrobronchoscope 1 are received.
  • the image processor 10 performs the processing of the captured image, and includes means for detecting the direction of the airway from the processing of said captured image, so that once the detection of said direction, calculates the action to be performed on the first 8 and second servomotor 9 to cause angular control of the distal end 7, so that it is oriented in the direction of the airway detected in the image.
  • Image capture has been schematically represented by dashed line 17.
  • the processor 10 governs the operation of the first 8 and second servomotor 9 depending on the processing performed of the captured image to establish the appropriate angular orientation of the distal end 7, in accordance with the direction of the patient's airways 11.
  • the first servomotor 8 is constituted by a microservomotor which, by means of a reduction gear 12, is related to a coil 13 in which the metallic threads 6 are wound in opposite directions, in different areas thereof. , so that the rotation of the coil 13 produces the longitudinal displacement of the metallic cables 6 in different directions.
  • the metallic threads 6 are constituted by a single metallic thread 6 wound on the bobbin 13, producing the same effect mentioned above.
  • the second servomotor 9 is constituted by a microservomotor which, by means of a reduction gear 14, meshes with a coil 15 integral with the flexible tube 2 to produce its rotation.
  • the reduction gears 12 and 14 allow to govern the angular displacement of the distal end 7 of the flexible tube 2 with great precision.
  • the fiberoptic bronchoscope 1 is located in a support 16, which is determined by a box-like frame, in which the first 8 and second servomotor 9 are fixed, to perform the functionality described in an equivalent manner to the example of the embodiment of figure 3, that is, by means of reduction gears and coils equivalent to those described for said embodiment of figure 3.
  • the processor 10 is connected to a first signaling element 18, such as a green light, and a second signaling element 19, such as a red light, so when the processor 10 detects the correct orientation of the distal end 7 on the airways of the patient 11, activates the green light 18, which indicates to the operator that he can advance in the introduction of the flexible tube 2 over the patient's airway 11. If during the advance it it loses the location of the airway direction, activates the red light 19 indicating the operator to stop, so that the processor 10 redirects again the correct position of the distal end 7 of the flexible tube 2, again activating the green light 18 at Get the reorientation.
  • a first signaling element 18, such as a green light and a second signaling element 19, such as a red light

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Abstract

The fibrobronchoscope/videobronchoscope (1) comprises a flexible tube (2) with, at the distal end (7) thereof, an image-capturing means that communicates with a viewfinder (3), and includes longitudinally a pair of metal wires (6) which, when actuated, move the distal end (7) angularly to orient it in a desired angular direction. The device is characterized in that it includes a first servomotor (8) linked to the metal wires (6), a second servomotor (9) linked to the flexible tube (2) and an image processor (10) for processing the captured image which, on the basis of the processing of the captured image, actuates the first servomotor (8) and second servomotor (9) to orient the distal end (7) of the flexible tube (2) in the direction of the respiratory tract of the patient (11). It also signals when the distal end is oriented correctly for insertion.

Description

DISPOSITIVO DE GUIADO AUTOMÁTICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO  AUTOMATIC GUIDE DEVICE OF THE DISTAL END OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE
OBJETO DE LA INVENCIÓN  OBJECT OF THE INVENTION
La presente invención, tal y como se expresa en el enunciado de esta memoria descriptiva, se refiere a un dispositivo de guiado del extremo distal de un fibrobroncoscopio/videobroncoscopio, que tiene por objeto permitir realizar dicho guiado de forma automática facilitando considerablemente la labor del especialista que ha de introducir el tubo flexible del fibrobroncoscopio/videobroncoscopio a lo largo de la via respiratoria de un paciente.  The present invention, as expressed in the statement of this specification, refers to a device for guiding the distal end of a fibrobronchoscope / videobronchoscope, which is intended to allow such guidance to be performed automatically facilitating considerably the work of the specialist that the fiberoptic bronchoscope / videobronchoscope tube must be inserted along the airway of a patient.
ANTECEDENTES DE LA INVENCIÓN  BACKGROUND OF THE INVENTION
En la actualidad es conocido el uso de fibrobroncoscopios que comprenden un tubo flexible en cuyo extremo distal incorpora un elemento de captación de imágenes que comunica con un visor, previsto en el extremo proximal del fibrobroncoscopio, para visualización de las imágenes captadas. Además incorpora un haz de fibra óptica que discurre a lo largo del tubo flexible mediante el cual se realiza la iluminación del extremo distal del fibrobroncoscopio y permitir captar imágenes. Asi, un elemento de captación de imágenes puede estar constituido por un objetivo que mediante un haz de fibra óptica, que discurre a lo largo del tubo flexible, envia la imagen captada hasta el visor previsto en el extremo proximal del fibrobroncoscopio . En otras realizaciones se utilizan videobroncoscopios en los que reemplaza la fibra óptica de captación de la imagen por un sistema CCD (charge couped device) , que comprende un chip colocado en la punta del videobroncoscopio, a continuación de la lente, que hace las veces de una cámara de televisión en miniatura, y transmite la imagen hasta un video procesador, para posteriormente remitirla a un monitor de televisión. En este caso se utiliza un video convertidor, que está conectado con el CCD, que va desde el visor hasta el vídeo procesador, y está conectado a su vez al monitor de televisión. At present, the use of fibrobronchoscopes comprising a flexible tube at whose distal end incorporates an image capture element that communicates with a viewfinder, provided at the proximal end of the fibrobronchoscope, for visualization of the captured images is known. It also incorporates a fiber optic beam that runs along the flexible tube through which the illumination of the distal end of the bronchoscope is performed and allows images to be captured. Thus, an image capture element can be constituted by a lens that, through a fiber optic beam, which runs along the flexible tube, sends the captured image to the viewfinder provided at the proximal end of the fibrobronchoscope. In other embodiments, video bronchoscopes are used in which it replaces the optical fiber of image capture with a CCD (charge couped device) system, which comprises a chip placed on the tip of the video bronchoscope, next to the lens, which acts as a a miniature television camera, and transmits the image to a video processor, and then sends it to a television monitor. In this case a video converter is used, which is connected to the CCD, which goes from the viewfinder to the video processor, and is in turn connected to the television monitor.
Además el fibrobroncoscopio/videobroncoscopio está dotado de un canal de trabajo que discurre a lo largo del tubo flexible, que permite la aspiración de secreciones, instalación de fármacos, paso de catéteres, pinzas, cepillos, etc.  In addition, the fibrobronchoscope / videobronchoscope is equipped with a working channel that runs along the flexible tube, which allows the aspiration of secretions, drug installation, catheter passage, tweezers, brushes, etc.
También cabe señalar que a lo largo del tubo flexible se incorporan al menos dos hilos metálicos que están conectados a un mecanismo, previsto en la zona del visor, para actuar sobre los hilos metálicos, y gobernar la angulacion del extremo distal, para orientarlo en la dirección de la vía respiratoria de un paciente, lo que permite realizar su introducción a lo largo de la misma por parte de un especialista.  It should also be noted that along the flexible tube at least two metal wires are incorporated that are connected to a mechanism, provided in the viewfinder area, to act on the metal wires, and govern the angulation of the distal end, to orient it in the direction of the airway of a patient, which allows its introduction along the same by a specialist.
En este sentido puede citarse la patente de invención US 5846183, en la que se realiza el gobierno de la angulacion del extremo distal mediante un mando previsto en la zona del visor.  In this sense, the invention patent US 5846183 can be cited, in which the government of the angulation of the distal end is carried out by means of a control provided in the viewfinder area.
Tanto en el fibrobroncoscopio indicado del documento anterior, como en cualquiera de los previstos en el estado de técnica, el gobierno de la angulacion del extremo distal se realiza de forma manual actuando sobre el mecanismo previsto en la zona del visor, lo que determina que la intubación requiera de gran habilidad por parte del profesional médico (anestesista) , para la introducción del tubo flexible a través de la vía respiratoria, especialmente en ocasiones críticas donde incluso puede que el paciente no se encuentre sedado en estado de "no reposo", en una situación de urgencia, e incluso donde su vida pueda depender de la correcta colocación del fibrobroncoscopio .  Both in the indicated fibro bronchoscope of the previous document, as in any of those provided in the state of the art, the government of the distal end angulation is performed manually acting on the mechanism provided in the viewfinder area, which determines that the intubation requires great skill by the medical professional (anesthetist), for the introduction of the flexible tube through the respiratory tract, especially on critical occasions where the patient may not even be sedated in a state of "no rest", in an urgent situation, and even where your life may depend on the correct placement of the fibrobronchoscope.
La invención resuelve estos inconvenientes mediante un nuevo dispositivo que realiza el guiado del extremo distal de los fibrobroncoscopios y de los videobroncosopios de forma automática. DESCRIPCIÓN DE LA INVENCIÓN The invention solves these drawbacks by means of a new device that automatically guides the distal end of the fibrobronchoscopes and videobronchoscopes. DESCRIPTION OF THE INVENTION
Para conseguir los objetivos y resolver los inconvenientes anteriormente indicado, la invención ha desarrollado un nuevo dispositivo de guiado del extremo distal de un fibrobroncoscopio y de un videobroncoscopio, que al igual que los previstos en el estado de la técnica están dotados entre otros elementos, de un tubo flexible cuyo extremo distal incluye un elemento de captación de imágenes que comunica con un visor previsto en su extremo proximal, para realizar la visualización de las imágenes captadas por el extremo distal. Además, el tubo flexible está dotado longitudinalmente de un par de hilos metálicos cuya actuación produce el desplazamiento angular del extremo distal del tubo flexible para orientarlo en la dirección de la via respiratoria de un paciente, y presenta la novedad de que además comprende un primer servomotor que está relacionado con una bobina en la que se encuentran enrollados los hilos metálicos en diferentes sentidos de enrollado, para realizar el desplazamiento longitudinal de los hilos metálicos en diferentes sentidos y asi gobernar el desplazamiento angular del extremo distal del tubo flexible .  In order to achieve the objectives and solve the aforementioned drawbacks, the invention has developed a new device for guiding the distal end of a fibrobronchoscope and a videobronchoscope, which, like those provided in the prior art, are provided, among other elements, with a flexible tube whose distal end includes an image pickup element that communicates with a viewer provided at its proximal end, to display the images captured by the distal end. In addition, the flexible tube is provided longitudinally with a pair of metallic threads whose action produces the angular displacement of the distal end of the flexible tube to orient it in the direction of the airway of a patient, and presents the novelty that it also comprises a first servomotor which is related to a coil in which the metallic threads are wound in different winding directions, to perform the longitudinal displacement of the metallic threads in different directions and thus govern the angular displacement of the distal end of the flexible tube.
Además, el fibrobroncoscopio está dotado de un segundo servomotor, que está relacionado con una bobina solidaria del tubo flexible, para provocar la torsión del mismo, y asi gobernar la angulación del extremo distal del tubo flexible en cualquier dirección en combinación con el movimiento del primer servomotor.  In addition, the fibrobronchoscope is provided with a second servomotor, which is related to a solidary coil of the flexible tube, to cause torsion thereof, and thus govern the angulation of the distal end of the flexible tube in any direction in combination with the movement of the first servomotor.
Además el dispositivo de guiado de la invención comprende un procesador de imágenes al que se aplican las imágenes captadas para realizar su procesado, de modo que dicho procesador comprende medios de detección de la dirección de la via respiratoria a partir del procesador de la imagen captada, y también comprende medios de actuación del primer y segundo servomotor de modo que realizan la actuación del extremo distal del tubo flexible en la dirección de la via respiratoria detectada en la imagen. El dispositivo además está dotado de un elemento de señalización de cuando el extremo distal está orientado según la dirección de la via respiratoria, para indicar al usuario del fibrobroncoscopio/videobroncoscopio cuando puede realizar la introducción del tubo flexible. Furthermore, the guiding device of the invention comprises an image processor to which the captured images are applied for processing, so that said processor comprises means for detecting the direction of the airway from the processor of the captured image, and also comprises actuation means of the first and second servomotor so that they perform the action of the distal end of the flexible tube in the airway direction detected in the image. The device is also provided with a signaling element when the distal end is oriented according to the direction of the airway, to indicate the user of the fibrobronchoscope / videobronchoscope when the flexible tube can be inserted.
Por lo tanto mediante la configuración descrita, se realiza el control de la angulación del extremo distal del fibrobroncoscopio/videobroncoscopio de forma automática, al mismo tiempo que se señaliza cuando se ha realizado la orientación correcta en la via respiratoria para permitir efectuar la introducción del tubo flexible, lo que simplifica y facilita considerablemente el proceso de intubación que convencionalmente presenta los problemas ya comentados en el apartado anterior.  Therefore, by means of the described configuration, the control of the angulation of the distal end of the fibrobronchoscope / videobronchoscope is performed automatically, at the same time that it is signaled when the correct orientation in the airway has been performed to allow the introduction of the tube flexible, which simplifies and considerably facilitates the intubation process that conventionally presents the problems already mentioned in the previous section.
En una realización de la invención, se prevé que el dispositivo además esté dotado de un segundo elemento de señalización que indica cuando el extremo distal ha perdido la orientación de la dirección de la via respiratoria, de forma que el usuario sabe que ha de detener la introducción del tubo flexible por haberse perdido la orientación correcta de la via respiratoria.  In one embodiment of the invention, it is envisioned that the device is further provided with a second signaling element that indicates when the distal end has lost the orientation of the airway direction, so that the user knows that he has to stop the introduction of the flexible tube because the correct orientation of the airway has been lost.
El primer y segundo elemento de señalización están determinados por elementos ópticos, acústicos o ambos, como por ejemplo puede ser mediante diodos led que realizan la señalización óptica de cuando se produce la correcta e incorrecta orientación del extremo distal del fibrobroncoscopio/videobroncoscopio en la via respiratoria del paciente, y como por ejemplo puede ser la incorporación de un altavoz cuyos sonidos indican dicha correcta e incorrecta orientación.  The first and second signaling elements are determined by optical, acoustic or both elements, such as by means of LEDs that perform the optical signaling when the correct and incorrect orientation of the distal end of the fibrobronchoscope / videobronchoscope occurs in the airway of the patient, and as for example it can be the incorporation of a loudspeaker whose sounds indicate said correct and incorrect orientation.
Cabe señalar que, de acuerdo con una realización de la invención, el primer y segundo servomotor están determinados por microservomotores que están dispuestos en la zona del visor del fibrobroncoscopio/videobroncoscopio actuando sobre las bobinas de la forma ya comentadas, pero también se prevé la posibilidad de que el primer y segundo servomotor queden dispuestos en un soporte en el que a su vez se fija el fibrobroncoscopio/videobroncoscopio, como por ejemplo puede ser el empleo de un bastidor a modo de caja en el que se encuentran fijados tanto el primer y segundo servomotor como el fibrobroncoscopio/videobroncoscopio, de forma que el tubo flexible sale al exterior a través de una de las paredes del soporte. It should be noted that, according to an embodiment of the invention, the first and second servomotor are determined by microservomotors that are arranged in the area of the viewfinder of the fibrobronchoscope / videobronchoscope acting on the coils in the manner already mentioned, but the possibility is also provided that the first and second servomotor are arranged in a support in which the fibrobronchoscope / videobronchoscope is fixed, as for example the use of a box-like frame in which they are fixed both the first and second servomotor and the fibrobronchoscope / videobronchoscope, so that the flexible tube goes outside through one of the walls of the support.
La configuración descrita permite, en situaciones en las que el paciente presente un patrón anatómico fuera de la normalidad, sacar una foto que el procesador de imágenes la convierte en la imagen objetivo hacia donde se tendrá que dirigir la punta, lo que otorga gran versatilidad.  The described configuration allows, in situations where the patient presents an anatomical pattern outside of normality, to take a photo that the image processor converts into the objective image where the tip will have to be directed, which gives great versatility.
A continuación para facilitar una mejor comprensión de esta memoria descriptiva, y formando parte integrante de la misma, se acompañan una serie de figuras en las que con carácter ilustrativo y no limitativo se ha representado el objeto de la invención.  In order to facilitate a better understanding of this descriptive report, and being an integral part thereof, a series of figures are attached in which the object of the invention has been shown as an illustrative and non-limiting nature.
BREVE ENUNCIADO DE LAS FIGURAS  BRIEF STATEMENT OF THE FIGURES
Figura 1.- Muestra una vista de un fibrobroncoscopio convencional introducido en las vias respiratorias de un paciente .  Figure 1.- Shows a view of a conventional fibrobronchoscope inserted in the airways of a patient.
Figura 2.- Muestra un detalle del extremo distal del tubo flexible y de la posible angulación que éste puede adoptar .  Figure 2.- Shows a detail of the distal end of the flexible tube and the possible angulation that it can adopt.
Figura 3.- Muestra un posible ejemplo de realización del dispositivo de la invención.  Figure 3.- Shows a possible embodiment of the device of the invention.
Figura 4.- Muestra otro posible ejemplo de realización del dispositivo de la invención.  Figure 4.- Shows another possible embodiment of the device of the invention.
DESCRIPCIÓN DE LA FORMA DE REALIZACIÓN PREFERIDA  DESCRIPTION OF THE PREFERRED EMBODIMENT
A continuación se realiza una descripción de la invención basada en las figuras anteriormente comentadas.  Below is a description of the invention based on the figures mentioned above.
Con ayuda de las figuras 1 y 2 se describe de forma somera la estructura de un fibrobroncoscopio 1 convencional para permitir su introducción en las vias respiratorias de un paciente. With the aid of Figures 1 and 2, the structure of a conventional fibrobronchoscope 1 is briefly described to allow its introduction into the airways of a patient.
Asi, tal y como ya fue comentado en el apartado de antecedentes de la invención, un fibrobroncoscopio convencional comprende un tubo flexible 2 en cuyo extremo distal 7 comprende una lente de captación de imágenes que comunica con un visor 3 previsto en su extremo proximal para la visualización de las imágenes captadas.  Thus, as already mentioned in the background section of the invention, a conventional fibrobronchoscope comprises a flexible tube 2 at whose distal end 7 comprises an image acquisition lens that communicates with a viewfinder 3 provided at its proximal end for Display of captured images.
Además en el extremo distal incluye una entrada 4 a un canal de trabajo 5 que discurre a lo largo del tubo flexible 2, y que permite la aspiración de secreciones, instalación de fármacos, el paso de catéteres, pinzas, etc.  Furthermore, at the distal end it includes an inlet 4 to a working channel 5 that runs along the flexible tube 2, and which allows the aspiration of secretions, drug installation, the passage of catheters, tweezers, etc.
Además a lo largo del tubo flexible se prevén dos hilos metálicos 6 previstos para gobernar la angulación de la punta distal 7 del tubo flexible 2 mediante un mecanismo de actuación 8 que fracciona de dichos hilos metálicos 6 y permite además realizar el giro del tubo flexible 2 para conseguir gobernar la angulación del extremo distal del tubo flexible 2 en cualquier dirección.  Furthermore, along the flexible tube, two metallic threads 6 are provided to govern the angulation of the distal tip 7 of the flexible tube 2 by means of an actuation mechanism 8 that divides said metallic threads 6 and also allows the rotation of the flexible tube 2 to manage to govern the angulation of the distal end of the flexible tube 2 in any direction.
Para permitir realizar la captación de imágenes en el extremo distal 7 del tubo flexible 2, también se prevé la incorporación de haces de fibra óptica (no representados) que iluminan dicho extremo distal.  To allow imaging at the distal end 7 of the flexible tube 2, the incorporation of fiber optic beams (not shown) that illuminate said distal end is also provided.
La novedad de la invención reside en la incorporación de un primer servomotor 8 cuya actuación provoca el desplazamiento longitudinal de los hilos metálicos 6 en diferentes sentidos, e incluye un segundo servomotor 9 que provoca el desplazamiento angular del tubo flexible 2, de forma que combinando la actuación del primer 8 y segundo servomotor 9 se gobierna el desplazamiento angular del extremo distal 7 del tubo flexible 2 en cualquier dirección .  The novelty of the invention resides in the incorporation of a first servo motor 8 whose action causes the longitudinal displacement of the metallic threads 6 in different directions, and includes a second servo motor 9 that causes the angular displacement of the flexible tube 2, so that combining the actuation of the first 8 and second servomotor 9 governs the angular displacement of the distal end 7 of the flexible tube 2 in any direction.
Cada uno de los servomotores está conectado a un procesador de imágenes 10, como por ejemplo puede ser un ordenador personal, en el que se reciben las imágenes captadas por el extremo distal 7 del fibrobroncoscopio 1. De esta forma, el procesador de imágenes 10 realiza el procesado de la imagen captada, e incluye medios para realizar la detección de la dirección de la via respiratoria a partir del procesado de dicha imagen captada, de modo que una vez realizada la detección de dicha dirección, calcula la actuación a realizar sobre el primer 8 y segundo servomotor 9 para provocar el control angular del extremo distal 7, de forma que éste se oriente en la dirección de la via respiratoria detectada en la imagen. La captación de imagen se ha representado esquemáticamente mediante la linea de trazos 17. Each of the servomotors is connected to an image processor 10, such as a personal computer, in which the images captured by the distal end 7 of the fibrobronchoscope 1 are received. In this way, the image processor 10 performs the processing of the captured image, and includes means for detecting the direction of the airway from the processing of said captured image, so that once the detection of said direction, calculates the action to be performed on the first 8 and second servomotor 9 to cause angular control of the distal end 7, so that it is oriented in the direction of the airway detected in the image. Image capture has been schematically represented by dashed line 17.
De esta forma, el procesador 10 gobierna el funcionamiento del primer 8 y segundo servomotor 9 en función del procesado realizado de la imagen captada para establecer la orientación angular adecuada del extremo distal 7, de acuerdo con la dirección de las vias respiratorias del paciente 11.  In this way, the processor 10 governs the operation of the first 8 and second servomotor 9 depending on the processing performed of the captured image to establish the appropriate angular orientation of the distal end 7, in accordance with the direction of the patient's airways 11.
En el ejemplo de realización de la figura 3, el primer servomotor 8 está constituido por un microservomotor que mediante un engranaje reductor 12 se relaciona con una bobina 13 en la que están enrollados los hilos metálicos 6 en sentidos opuestos, en zonas diferentes de la misma, de modo que el giro de la bobina 13 produce el desplazamiento longitudinal de los cables metálicos 6 en diferentes sentidos. Igualmente, cabe la posibilidad de que los hilos metálicos 6 estén constituidos por un único hilo metálico 6 enrollado sobre la bobina 13, produciendo el mismo efecto comentado anteriormente.  In the exemplary embodiment of Figure 3, the first servomotor 8 is constituted by a microservomotor which, by means of a reduction gear 12, is related to a coil 13 in which the metallic threads 6 are wound in opposite directions, in different areas thereof. , so that the rotation of the coil 13 produces the longitudinal displacement of the metallic cables 6 in different directions. Likewise, it is possible that the metallic threads 6 are constituted by a single metallic thread 6 wound on the bobbin 13, producing the same effect mentioned above.
Además, en el ejemplo de la figura 3, el segundo servomotor 9 está constituido por un microservomotor que mediante un engranaje reductor 14 engrana con una bobina 15 solidaria del tubo flexible 2 para producir el giro de la misma .  In addition, in the example of Figure 3, the second servomotor 9 is constituted by a microservomotor which, by means of a reduction gear 14, meshes with a coil 15 integral with the flexible tube 2 to produce its rotation.
Los engranajes reductores 12 y 14 permiten gobernar el desplazamiento angular del extremo distal 7 del tubo flexible 2 con gran precisión. En el ejemplo de realización de la figura 4 el fibrobroncoscopio 1 se encuentra situado en un soporte 16, que está determinado por un bastidor a modo de caja, en el que a su vez se encuentran fijados el primer 8 y segundo servomotor 9, para realizar la funcionalidad descrita de forma equivalente al ejemplo de la realización de la figura 3, es decir, mediante engranajes reductores y bobinas equivalentes a los descritos para dicho ejemplo de realización de la figura 3. The reduction gears 12 and 14 allow to govern the angular displacement of the distal end 7 of the flexible tube 2 with great precision. In the exemplary embodiment of Figure 4, the fiberoptic bronchoscope 1 is located in a support 16, which is determined by a box-like frame, in which the first 8 and second servomotor 9 are fixed, to perform the functionality described in an equivalent manner to the example of the embodiment of figure 3, that is, by means of reduction gears and coils equivalent to those described for said embodiment of figure 3.
Por último señalar, que el procesador 10 está conectado a un primer elemento de señalización 18, como por ejemplo puede ser una luz verde, y a un segundo elemento de señalización 19, como por ejemplo puede ser una luz roja, de modo que cuando el procesador 10 detecta la correcta orientación del extremo distal 7 sobre las vias respiratorias del paciente 11, activa la luz verde 18, que indica al operador que puede avanzar en la introducción del tubo flexible 2 sobre la via respiratoria del paciente 11. Si durante el avance se pierde la localización de la dirección de la via respiratoria, activa la luz roja 19 indicando al operador que debe detenerse, para que el procesador 10 reoriente de nuevo la posición correcta del extremo distal 7 del tubo flexible 2, activando nuevamente la luz verde 18 al conseguir la reorientación.  Finally, it should be noted that the processor 10 is connected to a first signaling element 18, such as a green light, and a second signaling element 19, such as a red light, so when the processor 10 detects the correct orientation of the distal end 7 on the airways of the patient 11, activates the green light 18, which indicates to the operator that he can advance in the introduction of the flexible tube 2 over the patient's airway 11. If during the advance it it loses the location of the airway direction, activates the red light 19 indicating the operator to stop, so that the processor 10 redirects again the correct position of the distal end 7 of the flexible tube 2, again activating the green light 18 at Get the reorientation.
Cabe señalar que las diferentes imágenes se muestran en la pantalla del ordenador 10, para facilitar en mayor medida la intubación del tubo flexible 2 en la via respiratoria del paciente 11.  It should be noted that the different images are shown on the computer screen 10, to facilitate the intubation of the flexible tube 2 in the airway of the patient 11.

Claims

REIVINDICACIONES
1. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , comprendiendo dicho fibrobroncoscopio/videobroncoscopio (1) un tubo flexible (2) cuyo extremo distal (7) incluye un elemento de captación de imágenes que comunica con un visor 1. - AUTOMATIC GUIDING DEVICE OF THE DISTAL END OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, said fibrobronchoscope / videobronchoscope (1) comprising a flexible tube (2) whose distal end (7) includes an image capture element that communicates with a viewfinder
(3) previsto en su extremo proximal, de visualización de las imágenes captadas, incluyendo el tubo flexible (2) longitudinalmente un par de hilos metálicos (6) cuya actuación produce el desplazamiento angular del extremo distal (7) del tubo flexible (2) para orientarlo en la dirección de la via respiratoria de un paciente (11) y permitir su introducción a lo largo de la misma, caracterizado porque comprende: (3) provided at its proximal end, for displaying the captured images, including the flexible tube (2) longitudinally a pair of metal wires (6) whose action produces the angular displacement of the distal end (7) of the flexible tube (2) to guide it in the direction of the airway of a patient (11) and allow its introduction along it, characterized in that it comprises:
- Un primer servomotor (8), relacionado con una bobina - A first servomotor (8), related to a coil
(13) alrededor de la cual están dispuestos los hilos metálicos (6) en diferentes sentidos de enrollado; (13) around which the metallic threads (6) are arranged in different winding directions;
un segundo servomotor (9), relacionado con una bobina (15) solidaria del tubo flexible (2);  a second servomotor (9), related to a coil (15) integral with the flexible tube (2);
- un procesador de imágenes (10) de procesado de la imagen captada y que está dotado de medios de detección de la dirección de la via respiratoria y de medios de actuación del primer (8) y segundo servomotor (9) para orientar el extremo distal (7) del tubo flexible (2) en la dirección de la via respiratoria detectada en la imagen;  - an image processor (10) for processing the captured image and which is provided with means for detecting the direction of the airway and actuation means of the first (8) and second servomotor (9) to orient the distal end (7) of the flexible tube (2) in the direction of the airway detected in the image;
un primer elemento de señalización (18) de cuando el extremo distal (7) está orientado según la dirección de la via respiratoria, para indicar al usuario del fibrobroncoscopio/videobroncoscopio (1) cuando puede realizar la introducción del tubo flexible (2) .  a first signaling element (18) of when the distal end (7) is oriented according to the direction of the airway, to indicate the user of the fibrobronchoscope / videobronchoscope (1) when he can introduce the flexible tube (2).
2. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , según reivindicación 1, caracterizado porque comprende un segundo elemento de señalización (19) del momento en que el extremo distal (17) ha perdido la orientación de la dirección de la vía respiratoria, para indicar que se ha de detener la introducción del tubo flexible (2) . 2. - AUTOMATIC GUIDING DEVICE OF THE DISTAL EXTREME OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, according to claim 1, characterized in that it comprises a second signaling element (19) from the moment at which the distal end (17) has lost the direction orientation of the airway, to indicate that the introduction of the flexible tube (2) has to be stopped.
3. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , según reivindicaciones 1 y 2, caracterizado porque el primer (18) y segundo elemento de señalización (19), están seleccionados entre elementos ópticos, acústicos y combinación de ambos.  3. - AUTOMATIC GUIDE DEVICE OF THE DISTAL EXTREME OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, according to claims 1 and 2, characterized in that the first (18) and second signaling element (19), are selected from optical, acoustic elements and combination of both.
4. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , según reivindicación 1, caracterizado porque el primer (8) y segundo servomotor (9), están determinados por microservomotores dispuestos en la zona del visor (3) del fibrobroncoscopio/videobroncoscopio (1) .  4. - AUTOMATIC GUIDE DEVICE OF THE DISTAL END OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, according to claim 1, characterized in that the first (8) and second servomotor (9) are determined by microservomotors arranged in the viewfinder area (3) of the fibrobronchoscope / video bronchoscope (1).
5. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , según reivindicación 1, caracterizado porque el primer (8) y segundo servomotor (9), y el fibrobroncoscopio/videobroncoscopio (1) están dispuestos en un soporte (16).  5. - AUTOMATIC GUIDE DEVICE OF THE DISTAL EXTREME OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, according to claim 1, characterized in that the first (8) and second servo motor (9), and the fibrobronoscope / video bronchoscope (1) are arranged on a support (16) .
6. - DISPOSITIVO DE GUIADO AUTOMATICO DEL EXTREMO DISTAL DE UN FIBROBRONCOSCOPIO/VIDEOBRONCOSCOPIO , , según reivindicación 5, caracterizado porque el soporte (16) es un bastidor a modo de caja.  6. - AUTOMATIC GUIDING DEVICE OF THE DISTAL END OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE, according to claim 5, characterized in that the support (16) is a box-like frame.
PCT/ES2011/070526 2010-07-16 2011-07-15 Device for automatically guiding the distal end of a fibrobronchoscope/videobronchoscope WO2012007633A1 (en)

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ES201031084A ES2374904B1 (en) 2010-07-16 2010-07-16 AUTOMATIC GUIDE DEVICE OF THE DISTAL END OF A FIBROBRONCOSCOPE / VIDEOBRONCOSCOPE.
ESP201031084 2010-07-16

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ES2374904A1 (en) 2012-02-23

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