WO2016074894A2 - Laryngoscope d'intubation - Google Patents

Laryngoscope d'intubation Download PDF

Info

Publication number
WO2016074894A2
WO2016074894A2 PCT/EP2015/074432 EP2015074432W WO2016074894A2 WO 2016074894 A2 WO2016074894 A2 WO 2016074894A2 EP 2015074432 W EP2015074432 W EP 2015074432W WO 2016074894 A2 WO2016074894 A2 WO 2016074894A2
Authority
WO
WIPO (PCT)
Prior art keywords
spatula
intubation
handle
guide
laryngoscope according
Prior art date
Application number
PCT/EP2015/074432
Other languages
German (de)
English (en)
Other versions
WO2016074894A3 (fr
Inventor
Markus Weiss
Original Assignee
Universität Zürich
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 Universität Zürich filed Critical Universität Zürich
Publication of WO2016074894A2 publication Critical patent/WO2016074894A2/fr
Publication of WO2016074894A3 publication Critical patent/WO2016074894A3/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
    • A61B1/267—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
    • 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00105—Constructional details of the endoscope body characterised by modular construction
    • 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
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • 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
    • A61B1/00163—Optical arrangements
    • A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
    • 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
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
    • A61B1/0056—Constructional details of insertion parts, e.g. vertebral elements the insertion parts being asymmetric, e.g. for unilateral bending mechanisms
    • 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
    • A61B1/0057—Constructional details of force transmission elements, e.g. control wires

Definitions

  • the present invention relates to an intubation laryngoscope comprising an intubation spatula and a handle.
  • Endotracheal intubation ie the introduction of a ventilation tube into the trachea of a patient, is usually carried out in anesthesia, intensive care or emergency medicine by means of a direct laryngoscopy.
  • a direct laryngoscopy by means of a conventional intubation laryngoscope, for example, Miller or Macintosh (US2354471) a direct view through the mouth on the vocal cords is set so that the breathing tube can be inserted into the trachea under direct view of the larynx between the two vocal cords.
  • the endoscopic transmission of the view from the laryngoscope tip to a screen during endotracheal intubation is likewise advantageous for training, demonstration, monitoring and, if appropriate recording, also for documentation purposes (Weiss, M. et al., Anesthesiology 1998, V89, No 3A: SSE9).
  • a normally shaped intubation spatula with an endoscopic transmission of the view from the spatula tip provides an improvement in viewing angle of 40 ° to 50 ° over the direct laryngoscopic view.
  • the introduction of angled or excessively curved spatulas has made insertion of the tube difficult and hence additional aids such as curved or bendable or controllable intubation stylets in the breathing tube have become necessary.
  • injuries to the oracular structures have been described using highly angled endoscopic laryngoscopes.
  • Angled video laryngoscopes or highly curved video laryngoscopes may be beneficial for a better view of the vocal cords in known anatomically difficult intubation conditions, but may complicate intubation in routine intubation of the normally intubated patient.
  • an endoscopic intubation laryngoscope is desirable in which the curvature or angle of the intubation spatula would be adaptable to the situation. This would allow to intubate the patient without guide aids in normal intubation conditions or with only slight visual limitations with normal shaped Intubationsspateln and adjust the curvature or the angle of the intubation spatula as necessary in difficult conditions.
  • Laryngoscopes with a mobile intubation spatula are known.
  • US4573451 shows an intubation spatula which has a joint in the area of the tip.
  • the tip of the intubation spatula can be adjusted by means of a flexible or flexible pressure element and fixed by means of engaging ratchet parts.
  • US4573451 only the tip is movable and when bending back the tip there is a risk of pinching epithelial layers of the patient in the joint site.
  • WO9311700 shows a laryngoscope, in which a lower tongue of the intubation spatula is divided into several sections and can be deformed accordingly.
  • the mechanics used here have a complicated multipart construction and are therefore not suitable for a disposable laryngoscope.
  • EP2679144 shows a laryngoscope with a plurality of slidable cylindrical elements which push a flexible lower blade of an intubation spatula away by advancing the elements away from an upper blade to increase the curvature of the lower blade. The curvature of the upper leaf remains unchanged.
  • WO10079521 shows a laryngoscope in which the intubation spatula is provided with magnets and is influenced by counter-magnets partly outside the patient.
  • FR2821736 provides a Intubationsspatel, consisting of several pivotally interconnected links, which are pivotally actuated via a tension element. The tension element is anchored in a carriage on the side in the handle. The intubation spatula is preloaded with the strongest curvature.
  • No. 6,174,281 shows a laryngoscope with an intubation spatula made up of a plurality of links which are flexibly connected to one another on the underside by means of hinged connections.
  • the intubation spatula can be actively deformed by means of a tension element which runs along the upper edge of the intubation spatula.
  • the actuation takes place here by means of a hand lever which is articulated rotatably at the upper end of the handle.
  • Disposable laryngoscopes desired to avoid costly and expensive cleaning, disinfecting or even sterilizing the devices. Since the optoelectronic elements of the endoscopic laryngoscopes or video laryngoscopes usually represent the most expensive elements of the laryngoscope, there is a need, however, to design them as reusable elements. From WO9944490, US2014107422, WO11023930 and For example, WO10120950 discloses laryngoscopes comprising an image pick-up device and a disposable spatula. In this case, the disposable spatula is placed over an image guide of the image recording device with an optically transparent window.
  • Disposable spatula and image recording device are each designed such that the tip of the image recording device is applied to the optical window.
  • slight movements of the disposable spatula such as may occur during insertion of the laryngoscope, affect the rest contact against the window and may affect the quality of imaging.
  • adjusting the radius of curvature of the spatula is not possible.
  • the problem of contact contact is even more pronounced.
  • Another object is to provide a partially disposable intubation laryngoscope, the reusable opto-electronic elements easily and reliably in the disposable part of the intubation laryngoscope, which come into contact with body fluids of the patient.
  • the aim is to ensure optimum image quality in every situation.
  • the intubation laryngoscope is preferably made of plastic and comprises a handle, an intubation spatula with a plurality of joint portions and an actuator for adjusting the blade curvature.
  • the Intubationsspatel comprises a bendable spatula body with a cavity and a gapless top, on the underside of a guide is formed.
  • the intubation spatula further comprises a bendable spatula tongue, which is movably guided along the guide in the longitudinal direction of the intubation spatula and forms a gap-free underside of the intubation spatula.
  • the upper side of the intubation spatula (that is to say the convex or the side facing away from the handle) can be designed with a uniform surface which has no incisions, gaps, hinges or other irregularities which, for. B. would represent a risk of injury to the patient at a change in curvature.
  • the underside ie the concave or the handle-facing side
  • the top resp. Underside for example, has no joint incisions, which can close depending on the blade curvature and thus could pinch tissue of the patient.
  • the deflectable spatula body comprises a first spatula half shell and a second spatula half shell, which are joined together to form the cavity and the gap-free top and which form the leadership for the spatula tongue on the underside thereof.
  • Term half-shell should not be understood that the two half-shells must be mirror-symmetrical.
  • the intubation spatula may be in its relaxed, d .h. be formed in the least or not curved or angled shape, straight, slightly curved or slightly angled.
  • a non-adjustable shape of the spatula body can be easily manufactured as a one-piece injection molded part without half shells.
  • the deflectable spatula tongue forms the tension member by being connected at its proximal end to the actuator and transmitting a force generated by the actuator directly to the spatula tip.
  • the pulling element may further comprise a pull rope which either connects the proximal end of the spatula tongue to the actuator, or the pull rope is guided in the cavity and secured to the spatula tip.
  • the spatula tongue would be held displaceably at the proximal end of the intubation spatula and shifts in the proximal direction with increasing spatula curvature relative to the two spatula half shells.
  • the joint sections of the intubation spatula can be formed by notches, preferably V-shaped notches, which are open towards the underside, in side walls of the spatula body adjoining the cavity.
  • the bendable spatula tongue resp.
  • the tension element then covers these incisions as seen from the underside, so that a gap-free underside of the intubation spatula is formed.
  • the spatula tongue preferably at least the width of the underside of the spatula body resp. of the assembled spatula shells. It can also be wider, so that it protrudes on one or both sides over the underside of the spatula body.
  • the shape of the incisions determines the shape of the spatula in the maximum bend / curvature.
  • different forms resulting in maximum tension be effected.
  • only one incision would be conceivable, which would lead to a simple buckling of Intubationsspatels.
  • the bendable spatula tongue can with its distal end in the region of the spatula tip with the spatula body resp. be connected to the first and the second spatula half shell.
  • a translatory movement of the spatula tongue causes the spatula tip to be pulled or pushed away relative to the handle, thus resulting in a change in the curvature of the blade or bending.
  • the adjacent to the cavity side walls of the spatula body resp. the first and second spatula half-shells may have at right angles bent guide legs, which form the guide for the spatula tongue. These are preferably directed to the cavity, but could also be directed to the outside.
  • the guide legs are in Spatellhurscardi in the region of the joint sections resp. interrupted incisions so that they do not preclude a change in curvature of the intubation spatula.
  • the bendable spatula tongue may have on its upper side one or more guide carriages with which the spatula tongue is movably guided in the guide of the spatula body or the two spatula half shells.
  • the guide carriages can have, for example, a T or L profile.
  • the guide carriages can be arranged at such a distance that they respectively engage in sections of the interrupted guide legs and also by the movement of the spatula tongue relative to the spatula body, respectively. to the spatula half shells do not reach into the interruptions of the guide legs.
  • the actuator for adjusting the blade curvature can be arranged in the proximal extension of the intubation spatula.
  • the actuator for adjusting the spatula curvature comprises an adjusting screw, which is rotatably connected to the proximal end of the spatula tongue, so that a rotation of the adjusting screw leads to a translational displacement of the spatula tongue and thus to a change in the blade curvature.
  • the curvature of the intubation spatula is infinitely adjustable.
  • the adjusting screw can be formed in two halves with a central receptacle for a fastening element of the spatula tongue, which can also be easily manufactured as an injection molded part.
  • the actuating device may be partially formed on the spatula body or on the handle (for example, a socket for the adjusting screw), or designed as a unit attached to the spatula body or the handle (for example, with a motor).
  • the cavity in the intubation spatula can form a guide channel or guide tube for receiving at least one optical and / or electrical conductor, which has a distal outlet opening.
  • One or more light sources eg a light guide, a lamp or an LED
  • an image recording means eg a CCD chip or an endoscope
  • the handle may comprise a first handle half-shell and a second handle half-shell which are interconnected to form a cavity for receiving the at least one optical and / or electrical conductor.
  • the first handle half shell and the first spatula half shell respectively the second handle half shell and the second spatula half shell can be formed in one piece.
  • the cavity of the intubation spatula and the cavity of the handle may be interconnected via a passage which passes the proximal end of the spatula tongue and the set screw.
  • the fastening element of the spatula tongue is preferably designed as a rod-shaped extension, so that there is sufficient distance between the adjusting screw and the proximal end of the spatula tongue.
  • the various shells and the spatula tongue can be inexpensively manufactured as injection molded parts, making the intubation laryngoscope a disposable intubation laryngoscope.
  • the optical resp. electrical conductors may be fixed or detachable in the intubation laryngoscope and terminate with a plug connection on the bottom or side of the handle.
  • the power supply as well as the optoelectronic conversion of the image can take place inside or outside the video laryngoscope, in the latter case either on a small monitor plugged into the laryngoscope, which for example contains both power supply and optoelectronic image conversion, or by means of a cable connection to a bedside mounted monitor which includes, for example, both power supply and optoelectronic image conversion, or by means of an attachable wireless connection adapter which includes, for example, both power supply and optoelectronic image conversion.
  • Handle and Intubationsspatel can also be releasably connected to each other.
  • the handle is preferably designed to be reusable and may include the power supply and / or the optoelectronic image conversion and / or a permanently mounted screen.
  • the Intubationsspatel with the actuator can be placed as a touch-mounted on the handle disposable intubation spatula z. B. be designed with integrated optoelectronic image guide and lighting.
  • Opto-electronic image conversion and / or current supply can also be introduced as a piston-like insert into the laryngoscope handle and can make contact with the optical / electrical conductors inside the laryngoscope handle.
  • This insert may have a screen attached or permanently mounted and / or a plug-in contact for a wireless connection or a cable connection to a display unit screen).
  • the handle can have a motor drive, which resp. Activate adjusting screw for adjustment of the blade curvature.
  • appropriate switches can be attached to the handle, so that the user can adjust the radius of curvature by pressing a button.
  • an attachable from the outside motor drive can be attached, which the actuator respectively.
  • Adjusting screw for adjusting the Spatula curvature can activate.
  • appropriate switches can be attached to the handle approach, so that the user can adjust the radius of curvature by pressing a button.
  • the intubation laryngoscope may have a channel or tube which extends from the handle to the exit opening of the cavity in the intubation spatula and is hermetically sealed at the distal end by means of a light / image transmissive lens.
  • an endoscope with image-light transmission can be advanced to the tip of the intubation spatula.
  • the intubation laryngoscope has a fastening and tensioning mechanism at the endoscope entry point into the handle, which can fix the thin endoscope or press it towards the spatula tip towards the lens. This allows a reuse of the opto-electronic components (endoscope with image-light transmission) of the laryngoscope, without having to clean them consuming.
  • the handle and / or intubation spatula may be made of plastic and / or metal.
  • An intubation laryngoscope comprising a handle and an intubation spatula with a guide channel or guide tube, in particular but not exclusively an intubation spatula with an adjustable radius of curvature, may further comprise an image recording device; wherein the guide channel or guide tube has an optically transparent window in the region of a distal spatula tip; and wherein the image pickup device has a flexible image guide with a distal optical tip.
  • the image recording device is designed as a reusable unit whose image guide and optical tip are releasably inserted into the Intubationsspatel. For optimal image acquisition, the distal optic tip is in the installed state, ie.
  • An image pickup device with a force applied optical tip can be considered as an independent invention or in combination with all embodiments described above.
  • the intubation laryngoscope with handle, intubation spatula and reusable image acquisition unit may have the features of the previously described embodiments of a bendable intubation laryngoscope, some of which are also transferable to intubation laryngoscopes with a fixed intubation spatula.
  • the handle of the intubation laryngoscope has a cavity in which the image recording device is partially accommodated.
  • the flexible image guide may be resiliently supported relative to the handle so that the optic tip, when installed, is acted upon by a force in the direction of the window which presses the optic tip against the optically transparent window.
  • a spring-mounted image guide allows slight movements of the image guide in the longitudinal direction, which always allows optimal image quality especially in a bendable spatula by thereby the optical tip is not detached from the optically transparent window even when bending the spatula. It is also possible to compensate for differently sized intubation spatula or for guide channels or guide tubes of different lengths (see below).
  • the image pickup device an electronics housing with a distal optical mount resp.
  • optical insertion which are arranged in a cavity of the handle, wherein the image conductor at the proximal end with the optical mount resp. Optics introduction is connected.
  • the electronics housing may be at least partially insertable or insertable into a cavity of the handle and spring biased relative to the handle so that the distal optic tip is loaded with a force in the direction of the window when installed against the optically transparent window suppressed.
  • a spring can be arranged between the electronics housing and a proximal bottom or intermediate bottom of the handle. The electronics housing is so slidably held in the handle in the longitudinal direction.
  • the power supply, the control of the image recording device and the image transmission can be done via a cable with a connector at the proximal end of the handle.
  • control of the image recording device and the image transmission to an external monitor can also be wireless (eg Bluetooth, WLAN, radio), since the electronics housing is displaceably mounted in the longitudinal direction of the handle. In this way, insertion is even easier.
  • the power supply then takes place via a battery arranged in the electronics housing. It is also a rechargeable battery possible, which wireless, z. B. inductively charged in a corresponding holder.
  • the handle may have a cover at the proximal end, such that the image capture device may be inserted from the proximal end into the lumen of the handle.
  • the image recording device is supported with a spring relative to the lid.
  • the electronics housing of the image capture device may be formed by a proximal part of the handle, preferably by a respective proximal part of a first and a second handle half shell, the optics mount opposite the electronics housing is resiliently mounted, so that the distal optical tip is acted upon in the installed state with a force in the direction of the window.
  • the optical mount in the longitudinal direction displaceable on a spring, which respectively on the side wall of the electronics housing. the handle is supported, be stored.
  • a disposable or disposable part of the intubation laryngoscope may respectively comprise the intubation spatula and at least the distal end of the handle, respectively.
  • the distal handle approach which is preferably firmly connected to the Intubationsspatel include. In this way, the distal part of the handle, which comes into contact with the mouth opening of the patient during intubation and thus contaminated, is discarded after a single use.
  • the dividing line between the disposable distal region of the handle and the reusable proximal region may vary between far distal (small portion of the handle being disposable) and far proximal (small portion of the handle being reusable).
  • the image conductor may comprise at least one optical and / or at least one electrical conductor, which supply the optical tip with light and transmit the images taken at the optical tip.
  • the supply of light can be done, for example, fiber optically by means of a light source in the electronics housing of the image pickup device and a light guide to the optical tip or electrically by means of a lamp or a LED.
  • the image transmission can also be made fiber optically to a camera (chip camera) in the electronics housing of the image recording device or electrically with a chip camera installed in the optical tip (eg CCD or CMOS sensor).
  • the flexible image conductor or the optical and / or electrical conductors alone are led into the electronics housing.
  • the transmission of the video signal or the video camera raw signal can be made via cable to an external monitor or on a plug-in monitor on the handle. This can be done with a handle Be provided plug connection.
  • the transmission can also be done wirelessly to an external or attachable monitor.
  • the image recording unit may be provided with a battery, which is preferably housed in the electronics housing.
  • the power supply and the opto-electronic conversion of the image can take place outside the video laryngoscope - either on a small monitor plugged into the laryngoscope, which contains, for example, both power supply and optoelectronic image conversion, or by means of a cable connection to a bedside monitor. which includes, for example, both power supply and opto-electronic image conversion, or by means of an attachable wireless connection adapter which includes, for example, both power supply and opto-electronic image conversion.
  • the intubation spatula can have a cavity for receiving the flexible image conductor, which is designed as a guide channel and / or in which a guide tube is arranged.
  • the guide channel resp. can be a molded-on component of an intubation laryngoscope, or can be designed as a separate part, which can be inserted into the cavity.
  • the guide channel resp. the guide tube in approximately the cross section of the image guide resp. the optical tip and can be tapered towards the distal end.
  • the cross section of the image conductor or at least the optical tip or the guide tube / guide channel is designed (eg rectangular), that a rotation of the image guide, respectively. the optical tip in the guide tube / guide channel is prevented.
  • the optically transparent window at the distal end of the guide channel or the guide tube may be formed as a lens.
  • the guide tube may extend from the distal portion of the handle to the area of the distal spatula tip. Preferably, it extends along the disposable part of the Intubationslaryngoskops. It is also possible for an inserted guide tube to extend from the hollow space of the handle into the proximal region of the intubation spatula, where it merges into a guide channel.
  • the guide tube or guide channel can be sealed at the distal end with the optically transparent window and / or be designed to be flexible.
  • the guide channel or guide tube may have a funnel-shaped opening at the proximal end to facilitate initial insertion of the optic tip / image conductor.
  • Both the bendable intubation spatula and the replaceable image recording device with a spring-loaded image guide can each be regarded as a separate invention, wherein the described reusable image recording device can be combined both with a bendable laryngoscope spatula and with a fixed spatula-shaped laryngoscope (straight / crooked / angled).
  • Fig. 1 is a side view of a intubation laryngoscope with relaxed
  • Fig. 2 is a side view of the intubation laryngoscope with curved
  • FIG. 3 is an enlarged sectional view through the Intubationsspatel. 4 is an exploded view of the intubation laryngoscope;
  • Fig. 5 is a perspective view of the intubation laryngoscope
  • Fig. 6 is a perspective view of the intubation laryngoscope without first
  • Half shell; 7 shows a perspective view of an intubation laryngoscope with a reusable image recording device
  • FIG. 8 is a perspective view of a guide tube
  • FIG. 9 is a perspective view of a reusable
  • Image recording device with flexible image guide
  • FIG. 10 shows a side view of an intubation laryngoscope with reusable image recording device
  • FIG. 11 shows a perspective view of an intubation laryngoscope with a reusable image recording device during insertion of the image recording device
  • Fig. 12 is a side view of a intubation laryngoscope with a rigid
  • FIG. 1 and Fig. 2 show the functional principle of the intubation laryngoscope.
  • 1 shows a side view of an intubation laryngoscope with a relaxed intubation spatula, that is to say the Intubationsspatel is shown in contrast to Figure 2 with the least curvature.
  • Figure 2 shows the intubation laryngoscope with curved intubation spatula, i. with the strongest possible curvature.
  • the intubation laryngoscope comprises a handle 1 and a curved Intubationsspatel 2. Furthermore, the laryngoscope shown in the proximal extension of the Intubationsspatels 2 with an actuator 4, here in the form of an adjusting screw 14, provided with which the blade curvature can be adjusted continuously.
  • the Intubationsspatel 2 has at its bottom, d .h. the concave side facing the handle 1, as a pulling element a spatula tongue 6, which is fixed with its distal end in the region of the spatula tip 3.
  • the intubation spatula 2 has a plurality of joint sections in the form of incisions 5.
  • the spatula tongue 6 is held displaceably.
  • a proximal end of the spatula tongue 6 (not visible in FIGS. 1 and 2) is operatively connected to the adjusting screw 14 of the actuating device 4, so that a rotation of the adjusting screw 14 leads to a translatory movement of the spatula tongue 6 in the longitudinal direction of the intubation spatula.
  • the spatula tip 3 can be pulled in the direction of the handle 1, whereby the incisions 5 in the intubation spatula 2 close continuously and the intubation spatula is guided to the position with the strongest curvature (FIG. 2).
  • FIG. 3 to 5 illustrate the structure of the laryngoscope.
  • FIG. 3 shows an enlarged sectional representation (FIG. 1: section A-A) through the intubation spatula 2.
  • 4 shows an exploded view of the intubation laryngoscope with the various parts.
  • FIGS. 5 and 6 each show a perspective view of the intubation laryngoscope, respectively. of the partially open intubation laryngoscope.
  • no optical and / or electrical conductors or guide elements for receiving and guiding electrical / optical elements are shown.
  • the intubation spatula 2 comprises a bendable spatula body comprising a first spatula half shell 2a and a second spatula half shell 2b.
  • the handle 1 comprises a first handle half-shell 1a and a second handle half-shell 1b.
  • the first handle half shell 1a and the first spatula half shell 2a respectively the second handle half shell 1b and the second spatula half shell 2b are integrally formed.
  • the two spatula half shells 2a, 2b are connected to form a cavity 7 and a closed, gap-free top 8 with each other.
  • the cavity 7 of the intubation spatula 2 forms a guide channel for receiving at least one optical and / or electrical conductor, which has a distal outlet opening 15 in the region of the spatula tip 3.
  • the spatula tip 3 is formed by one of the two spatula half shells 2a, 2b. In the embodiment shown, it is the second spatula half shell 2b.
  • one side wall 12a, 12b of the spatula half shells 2a, 2b are provided with a plurality of V-shaped notches 5 which are open towards the lower side 10 and which form the joint sections of the intubation spatula 2.
  • the two spatula halves 2a, 2b form a guide 11, in which the spatula tongue 6 is held movably.
  • This guide 11 is formed in the illustrated embodiment by right-angled inwardly bent guide legs 12a, 12b, which are arranged on the underside of the side walls 12a, 12b. In the area of the cuts 5, the guide legs 12a, 12b are interrupted.
  • this has a plurality of arranged on the top guide carriage 13, which in the embodiment shown have a T-profile.
  • the spatula tongue 6 is in the embodiment shown a flexible, elongated plate, which completely covers the incisions 5 seen in the composite Intubationsspatel 2 from the bottom, thus forming a closed, gap-free bottom 9 of the Intubationsspatels 2. In this way, there is no risk of injury to a patient by pinching tissue in the incisions 5 of the intubation spatula 2.
  • the spatula tongue 6 is wider than the underside 10 of the spatula half shells 2a, 2b, so that it protrudes on one side and a guide surface 16th forms for a tube, which is formed in the spatula tip 3, and is formed there by second spatula half shells 2b.
  • the spatula tongue 6 has a fastening element 17, here in the form of a rod with an attached plate 18.
  • the fastening element 17 is rotatably held in the adjusting screw 14.
  • the adjusting screw 14 consists of two halves 14a, 14b which form an external thread and an actuating knob 19.
  • the adjusting screw 14 is held in a corresponding holder 20 with internal thread at the proximal end of the Intubationsspatels 2 in the upper region of the handle 1.
  • the guide carriages 13 are asymmetrical, i. E. laterally offset at the top of the elongated plate of the spatula tongue 6 arranged.
  • the fastening element 17 and thus also the actuating device 4 are also arranged offset laterally in order to exert an optimal power transmission to the spatula tongue 6.
  • the handle 1 is hollow and can also serve as a guide channel or receptacle for optical and / or electrical conductors.
  • a passage is present between the cavity 7 of the intubation spatula 2 and the cavity of the handle 1, which passes between the proximal end of the spatula tongue 6 and the adjusting screw 14 on the fastening element 17.
  • the rod-shaped fastening element 17 is formed sufficiently long that a passage between the proximal end of the elongated plate of the spatula tongue 6 and the adjusting screw 14 is present.
  • FIGS. 7, 10 and 11 each show an intubation laryngoscope with a reusable image recording device 30.
  • a first spatula half shell is not shown in order to better illustrate the internal elements.
  • a first spatula half shell and a first handle half shell is not shown.
  • Fig. 11 is a part of a first handle half-shell not shown.
  • the intubation laryngoscopes of FIGS. 10 and 11 differ in their construction of the image recording device 30.
  • the handle 1 resp. a proximal portion of the handle 1 releasably connected to the Intubationsspatel 2.
  • Handle part z. B. be formed of plastic.
  • the proximal region of the handle 1 partially contains the reusable image recording device 30, which is arranged in a cavity 41 of the handle 1.
  • the dividing line in the handle 1 may also be arranged differently than in the embodiments shown further in the proximal region.
  • the handle 1 has a cavity 41, in which a substantial part of the image pickup device 30 (electronics housing 37 and optics holder / optical inlet 36) is arranged.
  • a flexible guide tube 34 is inserted, which is sealed at the distal end with an optically transparent window 33.
  • the window 33 can also be designed as a lens.
  • the optically transparent window 33 comes to rest in an outlet opening 15 of the intubation spatula 2.
  • At the proximal end of the guide tube 34 has a funnel-shaped opening 35 for facilitated insertion of an elongated, flexible image conductor 31 of the image pickup device 30. Because of the guide tube 34 sealingly sealed off at the distal end, the flexible image conductor 31 of the reusable image recording device 30 does not come into contact with body fluids of the patient, which makes cleaning considerably easier or even unnecessary during reuse.
  • Fig. 8 shows a perspective view of such a guide tube 34.
  • the guide tube 34 extends between the fastening element 17 of the spatula tongue 6 and the second spatula half shell 2 b during the transition from the handle 1 to the intubation spatula 2.
  • the image recording device 30 in the form shown, has an electronics housing 37 with a distal optical mount 36.
  • the electronic housing 37 in particular the electronic elements of the image pickup device 30, such as the power supply (battery), image processing means, an electronic control, connections, etc. are included (not shown).
  • the image recording device can be used with the electronics housing 37 in the cavity 41 of the handle 1.
  • Optical introduction 36 is the flexible image conductor 31 in the electronics housing introduced and kept.
  • the distal end of the image guide 31 is provided with an optical tip 32, which has a lighting means and an image pickup means.
  • the flexible image conductor 31 comprises at least one optical and / or at least one electrical conductor for image transmission, respectively. to the light supply.
  • FIG 11 shows a perspective view of the intubation laryngoscope during insertion of the flexible image conductor 31 of the image recording device 30 into the disposable part of the intubation laryngoscope.
  • the flexible image conductor 31 When inserting the image recording device 30 into the disposable part of the intubation laryngoscope, the flexible image conductor 31 is inserted with its optical tip 32 into the funnel-shaped opening 35 of the guide tube 34 until the optical tip 32 rests on the optically transparent window 33 at the distal end of the guide tube 34.
  • the guide tube 34 for example, a rectangular inner cross-section and the flexible image conductor 31, for example, have a rectangular outer cross-section to prevent rotation of the two parts to each other.
  • the optical tip 32 is acted upon in the installed state with a force which presses the optical tip 32 in a so-called "closed-contact” against the optically transparent window 33
  • Spatula curvature ensures that the "closed-contact" is always present.
  • the image recording device 30 is mounted with the electronics housing 37 at the proximal end on a spring 40 which is supported against a proximal bottom or intermediate bottom of the handle 1, as shown in Fig. 11.
  • the electronics housing 37 is held in the cavity 41 of the handle in the longitudinal direction displaceable.
  • the spring 40 can be arranged between the distal optics holder 36 and the electronics housing 37, in which case the electronics housing 37 is opposite a proximal bottom or intermediate bottom of the handle 1 is supported, as shown in Fig. 10. In this case, only the optical holder 36 is slidably held in the cavity 41 of the handle 1 in the longitudinal direction.
  • the length of the flexible image guide 31 has a slight excess in relation to the distance between the optical mount 36 and window 33, so that when inserted image pickup device 30, the spring force of the spring 40 acts on the image conductor 31 to the optical tip 32 while the optical tip 32 on the Window 33 is pressed. In the inserted state, therefore, a gap 39 between the optics holder 36 and the funnel-shaped opening 35 of the guide tube 34 is present.
  • a cable 38 between the electronics housing 37 and a connector at the proximal end of the handle 1 is provided.
  • the image transmission can also be wireless.
  • the distal end of the handle 1 is designed such that it can be inserted into the disposable part of the laryngoscope.
  • locking means 42 are present.
  • FIG. 12 shows a side view of an intubation laryngoscope which, in contrast to the other laryngoscopes shown, has a rigid, non-bendable intubation spatula 2.
  • the intubation spatula 2 and the handle 1 are likewise each formed with two half-shells, wherein the first spatula half-shell is not shown.
  • the handle 1 has a cavity 41, in which the reusable image pickup device 30 with its electronics housing 37 can be inserted. As already described above, this is resiliently mounted on a spring (not recognizable), so that in the inserted state the optical tip 32 is pressed onto the optically transparent window 33 in the region of the spatula tip 3.
  • the cavity 7 in Intubationsspatel 2 as a guide channel for the optical tip 32, respectively. formed the image conductor 31.
  • a guide tube 34 is inserted, which optical tip 32, respectively. guides the image conductor 31 from the distal region of the cavity 41 of the handle 1 around a corner into the intubation spatula 2.
  • the funnel-shaped opening 35 is formed at the proximal end of the guide tube 34.

Abstract

L'invention concerne un laryngoscope d'intubation comprenant une poignée (1), une spatule d'intubation (2) présentant un canal de guidage ou un flexible de guidage (34) et un dispositif d'enregistrement d'image (30) ; le canal de guidage ou le flexible de guidage (34) présentant une fenêtre optiquement transparente (33) au niveau d'une point de spatule distale (3) ; et le dispositif d'enregistrement d'image (30) présentant un conducteur d'image flexible (31) pourvu d'une pointe d'optique distale (32). Selon l'invention, le dispositif d'enregistrement d'image (30) est conçu comme unité réutilisable dont le conducteur d'image (31) et la pointe d'optique (32) peuvent être introduits de façon amovible dans la spatule d'intubation (2), et pour un enregistrement d'image optimal, la pointe d'optique distale (32) est soumise, à l'état monté, à une force en direction de la fenêtre (33) de telle manière que la pointe est comprimée contre la fenêtre optiquement transparente (33).
PCT/EP2015/074432 2014-11-12 2015-10-22 Laryngoscope d'intubation WO2016074894A2 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CH1755/14 2014-11-12
CH01755/14A CH710358A1 (de) 2014-11-12 2014-11-12 Biegsames Intubationslaryngoskop.
CH760/15 2015-05-28
CH00760/15A CH710367A2 (de) 2014-11-12 2015-05-28 Biegsames Intubationslaryngoskop mit wiederverwendbarer Bildaufnahmeeinrichtung.

Publications (2)

Publication Number Publication Date
WO2016074894A2 true WO2016074894A2 (fr) 2016-05-19
WO2016074894A3 WO2016074894A3 (fr) 2016-07-07

Family

ID=52577575

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2015/074432 WO2016074894A2 (fr) 2014-11-12 2015-10-22 Laryngoscope d'intubation

Country Status (2)

Country Link
CH (2) CH710358A1 (fr)
WO (1) WO2016074894A2 (fr)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3202307A1 (fr) * 2016-02-05 2017-08-09 Karl Storz GmbH & Co. KG Laryngoscope
EP3266366A1 (fr) * 2016-07-06 2018-01-10 Karl Storz SE & Co. KG Laryngoscope adaptatif et spatule adaptative pour un laryngoscope
EP3357408A1 (fr) * 2017-02-02 2018-08-08 Karl Storz SE & Co. KG Laryngoscope adaptatif et spatule adaptative pour un laryngoscope
CN109645946A (zh) * 2018-12-29 2019-04-19 上海交通大学医学院附属第九人民医院 一种咽喉部内镜手术装置
WO2019075588A1 (fr) * 2017-10-20 2019-04-25 Bordones Cartagena Judith Dispositif à usage médical pour réaliser une intubation endotrachéale de personnes et procédé pour sa fabrication
FR3114955A1 (fr) * 2020-10-12 2022-04-15 Vital Technics Lame de laryngoscope ou laryngoscope integrant cette lame avec des formes specifiques de guidage de la sonde endotracheale et methode associee
EP4108158A1 (fr) * 2021-06-23 2022-12-28 Heine Optotechnik GmbH & Co KG Module rapporté, ainsi que système de vidéo-laryngoscope
CN117378992A (zh) * 2023-11-30 2024-01-12 广东埃纳生医学科技有限公司 一种医用喉镜可调节插入管

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN210520942U (zh) 2017-12-28 2020-05-15 太平洋医疗耗材实业有限公司 喉镜系统和窥视片组件

Citations (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2354471A (en) 1943-08-18 1944-07-25 Foregger Company Inc Laryngoscope
US4573451A (en) 1984-11-08 1986-03-04 Jack Bauman Laryngoscope blade with a bendable tip
CN2046364U (zh) 1989-01-17 1989-10-25 中国人民解放军第一二三医院 多用可调式麻醉咽喉镜
WO1993011700A1 (fr) 1991-12-13 1993-06-24 Elio Valenti Laryngoscope pivotant possedant une spatule mecanique courbee et servant a l'intubation des malades sous anesthesie ou en cours de reanimation
US5800344A (en) 1996-10-23 1998-09-01 Welch Allyn, Inc. Video laryngoscope
US5827178A (en) 1997-01-02 1998-10-27 Berall; Jonathan Laryngoscope for use in trachea intubation
WO1999044490A1 (fr) 1998-03-01 1999-09-10 Volpi Ag Laryngoscope
US6174281B1 (en) 1996-02-23 2001-01-16 Arcomedic Ltd. Laryngoscope
FR2821736A1 (fr) 2001-03-07 2002-09-13 Messaoud Tounsi Laryngoscope a lame a courbure reglable et application
WO2010079521A1 (fr) 2009-01-12 2010-07-15 Andrea De Domenico Laryngoscope amélioré, comprenant un ensemble d'éléments magnétiques
WO2010120950A1 (fr) 2009-04-14 2010-10-21 Verathon Inc. Système et dispositifs de vidéo-laryngoscopie
WO2011023930A1 (fr) 2009-08-28 2011-03-03 Indian Ocean Medical Inc. Laryngoscope
US20130057667A1 (en) 2010-05-13 2013-03-07 Aircraft Medical Limited Video laryngoscope
EP2679144A1 (fr) 2012-06-27 2014-01-01 De Domenico, Andrea Lame d'un laryngoscope ou de dispositifs semblables, avec un mécanisme d'écartement progressif.
US20140107422A1 (en) 2012-10-12 2014-04-17 Dieter Huels Video Laryngoscope With Disposable Blade

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004005709A1 (de) * 2004-02-05 2005-08-25 Polydiagnost Gmbh Endoskop mit einer flexiblen Sonde
GB2431539B (en) * 2005-10-24 2011-06-15 Pentax Corp Intubation assistance apparatus and intubation assistance used in the apparatus
US20090247833A1 (en) * 2008-04-01 2009-10-01 Tanaka David T Adapter for removably coupling a camera to a laryngoscope and laryngoscope and system using same
US8468637B2 (en) * 2009-02-06 2013-06-25 Endoclear Llc Mechanically-actuated endotracheal tube cleaning device
US20110196204A1 (en) * 2010-02-11 2011-08-11 Al Medical Devices, Inc. Shape-conforming intubation device
US8414481B2 (en) * 2010-06-24 2013-04-09 General Electric Company Laryngoscope

Patent Citations (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2354471A (en) 1943-08-18 1944-07-25 Foregger Company Inc Laryngoscope
US4573451A (en) 1984-11-08 1986-03-04 Jack Bauman Laryngoscope blade with a bendable tip
CN2046364U (zh) 1989-01-17 1989-10-25 中国人民解放军第一二三医院 多用可调式麻醉咽喉镜
WO1993011700A1 (fr) 1991-12-13 1993-06-24 Elio Valenti Laryngoscope pivotant possedant une spatule mecanique courbee et servant a l'intubation des malades sous anesthesie ou en cours de reanimation
US6174281B1 (en) 1996-02-23 2001-01-16 Arcomedic Ltd. Laryngoscope
US5800344A (en) 1996-10-23 1998-09-01 Welch Allyn, Inc. Video laryngoscope
US5827178A (en) 1997-01-02 1998-10-27 Berall; Jonathan Laryngoscope for use in trachea intubation
WO1999044490A1 (fr) 1998-03-01 1999-09-10 Volpi Ag Laryngoscope
FR2821736A1 (fr) 2001-03-07 2002-09-13 Messaoud Tounsi Laryngoscope a lame a courbure reglable et application
WO2010079521A1 (fr) 2009-01-12 2010-07-15 Andrea De Domenico Laryngoscope amélioré, comprenant un ensemble d'éléments magnétiques
WO2010120950A1 (fr) 2009-04-14 2010-10-21 Verathon Inc. Système et dispositifs de vidéo-laryngoscopie
WO2011023930A1 (fr) 2009-08-28 2011-03-03 Indian Ocean Medical Inc. Laryngoscope
US20130057667A1 (en) 2010-05-13 2013-03-07 Aircraft Medical Limited Video laryngoscope
EP2679144A1 (fr) 2012-06-27 2014-01-01 De Domenico, Andrea Lame d'un laryngoscope ou de dispositifs semblables, avec un mécanisme d'écartement progressif.
US20140107422A1 (en) 2012-10-12 2014-04-17 Dieter Huels Video Laryngoscope With Disposable Blade

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
M. WEISS ET AL., ANESTHESIOLOGY, vol. V89, no. 3A:SSE, 1998

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10368730B2 (en) 2016-02-05 2019-08-06 Karl Storz Se & Co. Kg Laryngoscope
EP3202307A1 (fr) * 2016-02-05 2017-08-09 Karl Storz GmbH & Co. KG Laryngoscope
EP3266366A1 (fr) * 2016-07-06 2018-01-10 Karl Storz SE & Co. KG Laryngoscope adaptatif et spatule adaptative pour un laryngoscope
US20180020906A1 (en) * 2016-07-06 2018-01-25 Karl Storz Gmbh & Co. Kg Adaptive laryngoscope and adaptive blade for a laryngoscope
US10646112B2 (en) * 2016-07-06 2020-05-12 Karl Storz Se & Co. Kg Adaptive laryngoscope and adaptive blade for a laryngoscope
US10791912B2 (en) 2017-02-02 2020-10-06 Karl Storz Se & Co. Kg Laryngoscope and adaptive blade for a laryngoscope
US20180235447A1 (en) * 2017-02-02 2018-08-23 Karl Storz Se & Co. Kg Laryngoscope and adaptive blade for a laryngoscope
EP3357408A1 (fr) * 2017-02-02 2018-08-08 Karl Storz SE & Co. KG Laryngoscope adaptatif et spatule adaptative pour un laryngoscope
WO2019075588A1 (fr) * 2017-10-20 2019-04-25 Bordones Cartagena Judith Dispositif à usage médical pour réaliser une intubation endotrachéale de personnes et procédé pour sa fabrication
CN109645946A (zh) * 2018-12-29 2019-04-19 上海交通大学医学院附属第九人民医院 一种咽喉部内镜手术装置
FR3114955A1 (fr) * 2020-10-12 2022-04-15 Vital Technics Lame de laryngoscope ou laryngoscope integrant cette lame avec des formes specifiques de guidage de la sonde endotracheale et methode associee
EP4108158A1 (fr) * 2021-06-23 2022-12-28 Heine Optotechnik GmbH & Co KG Module rapporté, ainsi que système de vidéo-laryngoscope
CN117378992A (zh) * 2023-11-30 2024-01-12 广东埃纳生医学科技有限公司 一种医用喉镜可调节插入管
CN117378992B (zh) * 2023-11-30 2024-02-27 广东埃纳生医学科技有限公司 一种医用喉镜可调节插入管

Also Published As

Publication number Publication date
WO2016074894A3 (fr) 2016-07-07
CH710367A2 (de) 2016-05-13
CH710358A1 (de) 2016-05-13

Similar Documents

Publication Publication Date Title
WO2016074894A2 (fr) Laryngoscope d'intubation
EP2139376B1 (fr) Camera de diagnostic et element rapporte pour la realisation d'une telle camera
DE19715507C1 (de) Medizinisches Instrument mit einem tubusartigen Element und einem dazu abgewinkelten Griff, insbesondere Mediastinoskop, Laryngoskop, Divertikuloskop
DE60111057T3 (de) Intubationsinstrument
DE102004054748B4 (de) Mundtubus und Hilfsvorrichtung zur Notfallbeatmung
EP1179988B1 (fr) Laryngoscope
DE60308399T2 (de) Vaginaspekulum
DE102006050076A1 (de) Intubationshilfsgerät
DE102006050074A1 (de) Intubationshilfsgerät
DE2326786A1 (de) Verfahren und vorrichtung zur optischen untersuchung von hohlraeumen
DE19947811C2 (de) Endoskop mit elektrischer Einrichtung und Lichtleiter
WO1991000049A1 (fr) Endoscope avec dispositif video agence a son extremite distale
DE19734591C1 (de) Laryngoskop
DE102006057809A1 (de) Intubationsschlauch
DE112017005780T5 (de) Dreh-Fixiermechanismuseinheit einer Endoskopvorrichtung und Endoskopvorrichtung
DE102009028083A1 (de) Intubationsinstrument
WO1999044490A1 (fr) Laryngoscope
DE102007049191B4 (de) Intubiervorrichtung
DE2402886B2 (de) Am distalen Ende gelenkiges Fiberendoskop mit durch Ringe gefädelten Betätigungsdrähten
DE2454370C3 (de) Transnasales Endoskop
DE102008046463B4 (de) Laparoskop mit starrem Schaft und laparoskopisches System
DE2949422C2 (fr)
DE19808419B4 (de) Instrument zur Inspektion des Mund- und Rachenraumes
WO2018162112A1 (fr) Adaptateur pour une caméra ainsi que dispositif et procédé pour prendre des clichés lors d'un traitement dentaire dans une cavité buccale d'un patient, en particulier lors d'une endodontie
DE3934804A1 (de) Laryngoskop

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 15784359

Country of ref document: EP

Kind code of ref document: A2

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: FESTSTELLUNG EINES RECHTSVERLUSTS NACH REGEL 112(1) EPUE (EPA FORM 1205 VOM 17.10.2017)

122 Ep: pct application non-entry in european phase

Ref document number: 15784359

Country of ref document: EP

Kind code of ref document: A2