WO2015038290A1 - Appareil d'examen médical assisté - Google Patents

Appareil d'examen médical assisté Download PDF

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Publication number
WO2015038290A1
WO2015038290A1 PCT/US2014/051552 US2014051552W WO2015038290A1 WO 2015038290 A1 WO2015038290 A1 WO 2015038290A1 US 2014051552 W US2014051552 W US 2014051552W WO 2015038290 A1 WO2015038290 A1 WO 2015038290A1
Authority
WO
WIPO (PCT)
Prior art keywords
scope
power
control device
assisted medical
proximal end
Prior art date
Application number
PCT/US2014/051552
Other languages
English (en)
Inventor
David Lodin
Robert A. Ganz
Original Assignee
Endocon, Inc.
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 Endocon, Inc. filed Critical Endocon, Inc.
Publication of WO2015038290A1 publication Critical patent/WO2015038290A1/fr

Links

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
    • A61B1/012—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 characterised by internal passages or accessories therefor
    • A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments
    • 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
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00039—Operational features of endoscopes provided with input arrangements for the user
    • A61B1/00042—Operational features of endoscopes provided with input arrangements for the user for mechanical operation
    • 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
    • A61B1/00112—Connection or coupling means
    • A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
    • A61B1/00128—Connectors, fasteners and adapters, e.g. on the endoscope handle mechanical, e.g. for tubes or pipes
    • 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
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00133—Drive units for endoscopic tools inserted through or with the endoscope

Definitions

  • the present invention pertains to an endoscope having power-assisted steering controls allowing greater ease of use.
  • the invention addresses the aforementioned concerns by providing a scope control system that can be advanced and controlled using a single hand.
  • One aspect of the invention is a scope system that incorporates servo-motors to facilitate single-handed operation.
  • Another aspect of the invention provides a scope system that may be controlled by a right hand or a left hand without requiring reconfiguration.
  • Another aspect of the invention incorporates steering controls that will not fatigue the user's hand.
  • Another aspect of the invention provides a scope system that provides physically easier steering while still providing direct manual control and feedback.
  • Another aspect of the invention provides a power-assisted steering scope system that is cost-effective.
  • Figure 1 is a plan view of an embodiment of a scope of the invention.
  • Figure 2 is a perspective view of a controller of the invention being inserted into an optional sleeve of the invention
  • Figure 3 is a plan view of a controller inserted into a sleeve and attached to a scope body of the invention
  • Figure 4 is a perspective view of an embodiment of a controller of the invention.
  • Figure 5 is a plan view of an embodiment of a scope of the invention.
  • Figure 6 is a perspective view of an embodiment of a scope body of the invention
  • Figure 7 is a perspective view of an embodiment of a scope body of the invention
  • Figure 8a is an elevation of a controller of the invention attached to a scope body
  • Figure 8b is a front view of the controller of Figure 8a;
  • Figure 9 is an elevation of a closeable auxiliary port of the invention.
  • Figure 10 is a plan view of the closeable auxiliary port of Figure 9;
  • Figure 1 1 is a plan view of a closeable auxiliary port of the invention
  • Figure 12 is a cutaway view of an embodiment of an actuator of the invention.
  • Figure 13 is a cutaway view of an embodiment of an actuator of the invention.
  • FIG. 1 shows one embodiment of a scope 100 of the invention.
  • the scope 100 generally includes a scope body 102, scope head 101 , interface conduit 103, and tool access port, 104.
  • Attached to the scope head 101 is a servo control box 105.
  • the servo control box 105 may include a stand 106, useable to hold the scope 100 in a desired orientation when not being held by an operator.
  • the stand 106 may be stationed on the floor or attached to the patient bed. Positioning and mounting is dependent on the size of the scope 100, and facilitating easy access to the tool port 104.
  • actuators are connected to the steering control wires within the scope, 100, via the interface, 107. In one preferred embodiment, these actuators are DC stepper motors, which enable absolute positioning when properly calibrated.
  • the details of the control box 105 is described in more detail below, making reference to Figures 12 and 13.
  • FIG. 2 depicts an embodiment of a control device 200 of the invention.
  • the control device is used to operate the actuators described above.
  • the control device generally includes a head 201 and tail 204.
  • the head 201 houses includes user input controls, such as, by way of non-limiting example, a switch 202 that directs the steering actuators described above.
  • An x-y switch is depicted but switch 202 may also be a roller ball, touch pad, membrane switch, joystick, or other control.
  • the head 201 may include other input controls as well. Non-limiting examples of other functions include irrigation, suction, and imaging, to name a few. These controls are depicted by buttons 203.
  • Manipulation of the user input controls causes a signal to be sent to the servo control box, preferably wirelessly but alternatively physically.
  • the control device 200 is preferably sealed to allow use of cold sterilants currently used for endoscopic devices.
  • the control device tail 204 acts as a handle.
  • a wipe 205 is provided with a sleeve or pocket 206 sized to accommodate the tail 204.
  • Wipe 205 may be simple cotton gauze and is preferably disposable, or may be made of cloth and be washable. It is common to use disposable gauze to hold a slippery scope for control purposes and wipe 205 allows the user to handle the scope in a manner s/he is accustomed to, while simplifying the steering aspect of scope use.
  • Figure 3 shows a typical configuration for the utilization of the control device 200, with the tail 204 inserted into the pocket 206 of the wipe 205.
  • the wipe is wrapped around at least a portion of the scope.
  • the wipe 205 is used in a typical fashion to aid manual control of the scope forward and backward, while keeping all other functional controls within easy access.
  • Figure 4 depicts an example of a control device 200 having true-position sliding switches 206 rather than an x-y switch. Additionally provided is a contoured base 207 shaped to ride on the scope body 102. The contoured base 207 may also include a non-slip coating 208 that increases friction between the control device 200 and the scope body 102 to make manipulations easier. The coating 208 may obviate the need for the gauze wipe 205.
  • Figure 5 illustrates an embodiment of a scope 120 in which a control box 300 is integrated into the scope head rather than attached to it. In this configuration, all functional capabilities of the scope can be activated from the control device 200 ( Figure 2).
  • the scope head/control box 300 includes all servos, electric valves and mechanical actuators (not shown).
  • scope 120 includes a scope body 102, an optional stand 106, and an interface conduit 103 that interconnects to all supply elements utilized by the scope, e.g. water, vacuum, imaging.
  • FIG. 6 One aspect of the invention, shown in Figure 6, is a scope body 102 featuring a plurality of access ports 108 along a section thereof. Access ports 108 lead to a tool lumen 1 1 1 , best shown in Figure 7.
  • the access ports 108 may be instead of, or in addition to, tool access port 104 of the scope.
  • Access ports 108 provide alternative, more distal entrances to the tool lumen 1 1 1 , thus increasing tool controllability when the scope body is partially withdrawn from the patient. Increase tool controllability is achieved due to the shortened effective length of the tool lumen 1 1 1 when using the more distal access ports 108.
  • access ports 108 may alternatively take the form of an access slot 109.
  • the control device 200 may include a feature 307 that allows the device 200 to be attached to the scope body 102.
  • the feature 307 includes an internal lumen that communicates with tool lumen 1 1 1 , when the feature 307 is attached to an access port 108 or slot 109.
  • Feature 307 thus allows a physician a more distal control station for operating the control device and any tools s/he may be using in the event that the scope is partially withdrawn from the patient.
  • the access ports 108 may be optionally angled toward the distal end of the scope body 102. This design allows simplification of the scope configuration, allowing for a single, straight segment as depicted in Figures 5 and 6. The cumbersome right angle of heavy cabling is no longer needed as all the servo controls described earlier can be incorporated into the primary control box currently used with all scopes.
  • FIG. 8-b One aspect of the invention also shown in Figures 8-b is that more than one tool lumen 1 1 1 may be provided. Multiple tool lumens may allow the passage of multiple devices. Another reason would be to ensure the easiest access for insertion of a tool, such as a biopsy tool, by keeping at least some of the access ports, 108, in the event that the scope is twisted during the procedure.
  • a tool such as a biopsy tool
  • Figures 9-1 1 there are shown mechanisms for sealing or closing access ports 108 when they are not in use to prevent contaminating lumen(s) 1 1 1 .
  • Figures 9 and 10 show a sliding internal tube 1 12 that resides within lumen 1 1 1 and is slidable via thumb slide 1 13 from a first position to a second position.
  • the tube 1 12 has a hole 1 15 formed therein that aligns with the port 108 when the tube 1 12 is in the first position, shown in Figure 9-10.
  • the hole 1 15 is taken out of alignment with the port 108, thereby blocking communication between the port 108 and the tool lumen 1 1 1 .
  • the groove 1 14 may have a rubber or polymer insert that deforms itself around slide 1 13 to provide additional sealing.
  • Figure 1 1 shows an alternative mechanism, comprising a permanent, semipermeable plug 1 16.
  • the plug 1 16 is penetrable by a tool but reseals when the tool is removed. When sealed, the plug 1 16 is able to withstand a predictable amount of suction through the lumen 1 1 1 without allowing ambient air from being drawn into the lumen 1 1 1 through the port 108.
  • Figures 1 and 5 discussed servo control boxes 105 and 300, respectively.
  • Servo control box 105 of Figure 1 interacts with the scope head 101 via an interface 107, while servo control box 300 is integrated into the scope head.
  • servo control box 300 is integrated into the scope head.
  • Figure 12 depicts a control box 105 connected to a scope 100 via an interface 107.
  • the interface 107 includes a first connector 400 attached to the control box 105, and a second connector 402 attached to the scope head 101 of the scope 100.
  • the first and second connectors 400 and 402 are constructed and arranged for easy alignnnent and mating. When mated, the connectors 400 and 402 align in order to bring internal components in working relationship with each other.
  • the first connector 400 surrounds a drive shaft 404 that extends into the control box 105 and is operably connected to a servo motor.
  • the drive shaft 404 is slidable axially such that connection may be easily made with a corresponding secondary shaft 406 contained in the second connector 402. Interacting ends of the drive shaft 404 and secondary shaft 406 are fitted with locking components 408 and 410.
  • Springs 412 and 414 act on the shafts 404 and 406 in order to maintain the components 408 and 410 in tight contact with each other. The constant tension effected by the components 408 and 410 and the springs 412 and 414 reduces system hysteresis.
  • interface 507 includes a first connector 500 attached to the control box 105 and a second connector 502 attached to the scope head 101 of scope 100.
  • the first and second connectors 500 and 502 are constructed and arranged for easy alignment and mating. When mated, the connectors 500 and 502 align in order to bring internal components in working relationship with each other.
  • the first connector 500 surrounds a first gear 504, which is driven by servo motor 506 via a belt 508.
  • belt 508 may be substituted for a chain, worm drive, or other acceptable drive mechanism.
  • Second connector 502 contains a secondary gear 510 that meshes with first gear 504 when the first connector 500 is mated with the second connector 502.
  • the secondary gear 510 is operably attached to a control wire 512 or similar control mechanism used for controlling scope 100.
  • control box In a similar fashion is the connection between the control box and scope elements for the additional functions, such as, but not limited to, imaging, water, and suction. These functions maybe incorporated into the same connector as the power transmission, or may be housed in a separate connector, creating a split-tail at the proximal end of the scope.
  • the scope, 101 has a distal, working end, 102. This is the end to be handled by the user and inserted into the patient. There is also a proximal end, 103, which serve as a service length connecting the working end to the control box, 104, via a connector, 105, or connectors.
  • section 106 Between the proximal and distal ends of the scope is a section, 106, which enables some rotation of the scope. Within section 106, there is a break in the continuity of the length of the torsionally-rigid scope jacket. In this section, features allow for partial rotation. This partial rotation must be at least 90 degrees in both directions, and could be as much as 160 degrees in either direction or more. A feature limiting rotation provides tactile feedback to the user that full rotation has been reached.
  • a tough, flexible jacket covers section 106 and is hermetically attached to proximal and distal portions of the scope.
  • a typical diameter for an endoscope is 0.50 inches.
  • a feature such as an imaging conduit or actuation cable can be assumed to rotate about a 0.125 inch radius. Again, assuming a maximum rotation of + 160 degrees over a length of 12.0 inches, the strain induced on any element is approximately 0.04%, far lower than any hysteresis that may be fabricated into a device like an endoscope.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Endoscopes (AREA)

Abstract

L'invention concerne un appareil d'examen médical et un procédé conférant une facilité d'utilisation accrue, qui comprennent un mécanisme de direction assistée, des commandes pouvant être actionnées à l'aide d'un seul doigt et un organe de commande détachable pouvant être placé distalement, à proximité d'un orifice de canal de travail auxiliaire, pour une maîtrise accrue quand l'appareil d'examen médical n'est pas complètement inséré dans le corps d'un patient.
PCT/US2014/051552 2013-09-12 2014-08-18 Appareil d'examen médical assisté WO2015038290A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201361960214P 2013-09-12 2013-09-12
US61/960,214 2013-09-12
US201361960438P 2013-09-18 2013-09-18
US61/960,438 2013-09-18

Publications (1)

Publication Number Publication Date
WO2015038290A1 true WO2015038290A1 (fr) 2015-03-19

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PCT/US2014/051552 WO2015038290A1 (fr) 2013-09-12 2014-08-18 Appareil d'examen médical assisté

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017025969A1 (fr) * 2015-08-11 2017-02-16 Human Extensions Ltd. Unité de commande pour endoscope flexible

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4207873A (en) * 1977-05-16 1980-06-17 American Cystoscope Makers, Inc. Endoscope deflection control
US20050075538A1 (en) * 2003-04-01 2005-04-07 Banik Michael S. Single use endoscopic imaging system
US20090264759A1 (en) * 2008-04-22 2009-10-22 Ep Medsystems, Inc. Ultrasound Imaging Catheter With Pivoting Head
US20100191050A1 (en) * 2009-01-23 2010-07-29 Ethicon Endo-Surgery, Inc. Variable length accessory for guiding a flexible endoscopic tool
US20110213300A1 (en) * 2004-03-23 2011-09-01 Boston Scientific Scimed, Inc. In-vivo visualization system
US20120271109A1 (en) * 2000-04-03 2012-10-25 Intuitive Surgical Operations, Inc. Steerable endoscope and improved method of insertion

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4207873A (en) * 1977-05-16 1980-06-17 American Cystoscope Makers, Inc. Endoscope deflection control
US20120271109A1 (en) * 2000-04-03 2012-10-25 Intuitive Surgical Operations, Inc. Steerable endoscope and improved method of insertion
US20050075538A1 (en) * 2003-04-01 2005-04-07 Banik Michael S. Single use endoscopic imaging system
US20110213300A1 (en) * 2004-03-23 2011-09-01 Boston Scientific Scimed, Inc. In-vivo visualization system
US20090264759A1 (en) * 2008-04-22 2009-10-22 Ep Medsystems, Inc. Ultrasound Imaging Catheter With Pivoting Head
US20100191050A1 (en) * 2009-01-23 2010-07-29 Ethicon Endo-Surgery, Inc. Variable length accessory for guiding a flexible endoscopic tool

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017025969A1 (fr) * 2015-08-11 2017-02-16 Human Extensions Ltd. Unité de commande pour endoscope flexible
CN107847105A (zh) * 2015-08-11 2018-03-27 人类扩展有限公司 用于柔性内窥镜的控制单元
US10835108B2 (en) 2015-08-11 2020-11-17 Human Xtensions Ltd. Control unit for a flexible endoscope

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