WO2020129076A1

WO2020129076A1 - Portable automated dynamic linearity fibreless video endoscopy devices

Info

Publication number: WO2020129076A1
Application number: PCT/IN2019/050104
Authority: WO
Inventors: Nirav KOTAK; Ashish PATYAL; Atul WALZADE
Original assignee: Kotak Nirav; Patyal Ashish; Walzade Atul
Priority date: 2018-12-17
Filing date: 2019-02-09
Publication date: 2020-06-25

Abstract

The present invention provides an alternative, cost effective, reusable and portable automated dynamic linear fibreless video endoscopy device which is characterized by self extending feature on push of a button along with its distal flexible tip which helps in accurate guidance for intubation under vision for the purpose of adequate ventilation along with a image transmitting system herethrough. It can be used as portable laryngoscope, portable bronchoscope, portablelaproscope, portable G.I scope for multiple purposes like esophagoscopy, gastroscopy, duodenoscopy by virtue of its extention property. Also it can be used in any age group which makes itthe instrument of choice in any, difficult airway situation where the use of other modalities are doubtful.Many other advantages of the invention will be apparent from reading the description which follows in conjunction with the accompanying drawings.

Description

Portable automated dynamic linearity fibreless video endoscopy devices

FIELD OF INVENTION:

This invention relates to a automated portable fibreless endoscopy device which is

characterized by self extending feature on push of a button along with its distal flexible tip which helps in accurate guidance for intubation under vision for the purpose of adequate ventilation along with a image transmitting system herethrough.

BACKGROUND AND PRIOR ART OF INVENTION

The expression“orotracheal tube” generally designates an endotracheal tube that is inserted through the mouth. Orotracheal intubation consists in inserting a tube through the mouth, the laryngeal inlet and into the trachea of a patient. This procedure is commonly performed in medical conditions in patients who are unable to protect their airways, are at risk of pulmonary aspiration and those that require assistance with mechanical ventilation. It is also commonly performed to permit safe general anaesthesia to enable mechanical ventilation during surgery.

A laryngoscope assists with intubation by allowing the clinician to visualise the path of the endotracheal tube as it passes through the glottis towards the trachea. Tracheal intubation can be performed by direct laryngoscopy or indirect laryngoscopy. During direct laryngoscopy, a laryngoscope is used to obtain a direct view of the vocal cords. An orotracheal tube is inserted under direct vision through the vocal cords normally in an unconscious patient. A laryngoscope typically comprises a handle and a blade. There are many types of laryngoscopes designed for direct laryngoscopy. The blade may be curved (e.g. the Macintosh blade), straight (e.g. the Miller blade) or may comprise a moveable hinged blade tip (e.g. McCoy laryngoscope).

The technique of orotracheal intubation begins with the blade inserted into the right corner of the patient’s mouth. The blade is shaped such that a flange will push the tongue to the left side of the oropharynx to create space in the oropharynx through which a view of the larynx will be sought. The epiglottis is visualised. The laryngoscope handle is manipulated so that the blade lifts the epiglottis directly with the straight blade or indirectly with the curved blade thereby exposing the laryngeal inlet in normal patients. The endotracheal tube is then advanced past the vocal cords into the trachea.

Most intubations are straightforward using the direct laryngoscopy procedure described above. However some patients are known to be difficult to intubate under direct laryngoscopy, especially if there are anatomical abnormalities or if the larynx lies particularly anteriorly. Other patients are unexpectedly found during direct laryngoscopy to be difficult to intubate this way. Intubation of these patients may be more successful using indirect laryngoscopy. This can be performed using a videolaryngoscope such as those sold under the trademarks Airtraq and GlideScope and fibreoptic intubating bronchoscope. These videolaryngoscopes have a light source and imaging modality embedded in or inserted near to the distal portion of the blade.

SUBSTITUTE SHEETS (RULE 26) This enables visualization of the laryngeal inlet on a viewer or screen. Fibreoptic intubating laryngoscopes are also used for intubation, particularly if direct laryngoscopy is judged to be difficult or dangerous.

Reference can be made to the work of George berci , United states patent number

(US4846153 A) who made an endoscope which includes an elongated sheath member, with a selectively controllable bendable section which houses an image forming optical system. A generally rigid section includes a control housing. An image transmitting optical system extends throughout the length of the sheath member and terminates behind and adjacent the image- forming system. A light transmitting system also extends throughout the length of the sheath member to the image forming optical system, the rearward end of which is adapted to be operatively connected to a light source. A channel, extending throughout the length of the sheath member, provides a flow of pressurized gas is directed across the image forming optical system to keep the image forming optical system operationally clear.

DISADVANTAGES OF THE ABOVE MENTIONED DEVICES:

Various laryngoscopes are available today but the greatest disadvantage of all is that their blades are anatomically curved and are rigid hence their use in difficult airway situation where each individual airway anatomy varies, is problematic. Also the hyperdynamic response during intubation because of lifting of epiglottis preclude its use in hypertensive and heart disease patients. This same problem also occurs with the video laryngoscopes.

While using an videolaryngoscope when the user attempts to insert an endotracheal tube, it is common however to have a good laryngoscopic view on the screen to be achieved but for the user to have difficulty directing the endotracheal tube into the laryngeal inlet. Most problematic is the endotracheal tube tip directing too posteriorly. A stiff introducer or bougie can be inserted into the endotracheal tube to try to overcome this difficulty but this adds complexity and risk to the procedure. Some videolaryngoscopes, for example the Airtraq® , have an insertion technique completely different to that used in direct laryngoscopy and have an open sided rigid channel to help guide the tube. A disadvantage of these rigid open sided channels is that the endotracheal tube is not placed with a technique similar to direct laryngoscopy which is familiar to all anesthesiologists. Another disadvantage is that depending upon tube diameter used, the tube tip is not always gripped sufficiently to direct it along the blade in a sufficiently anterior direction. Another disadvantage is that the rigidity of the guiding channel can impede the removal of the laryngoscope over the endotracheal tube when intubation has been achieved and the laryngoscope needs to be removed.

The use of fibreoptic for intubation also have many disadvantages. Firstly they are very costly and not easily available in all hospitals. Also its use requires a long learning curve. Since it is

SUBSTITUTE SHEETS (RULE 26) made up fibreoptic bundles which are very fine and any break in the bundle due to biting by the patient teeth during the procedure can damage it.

Also since all fibreoptic scopes or fibreless scopes have to be of a length twice of the endotracheal tube ( around 60 cms in case of adults), and also because they have to reach the bronchus, they require to be carried around mostly in specially constructed bags, carriers and which are quiet huge to carry around.

Also in the case of oesophagoscopes, gastroscopes, duodunoscopes the same applies.

ADVANTAGES OF THIS INVENTION :

1 . Because of its portable property and its cost effectiveness it can be carried any where, just as a pen kept in pocket.

2. The flexible tip is incorporated with HD camera with antifogging mechanism which helps in situation where the laryngeal inlet is either anterior or posterior so by just adjusting the tip we can have a clearer vision of the laryngeal inlet and better alignment for the passage of the tube.

3. The flexible tip is also incorporated with suction and oxygen channel. Suction channel helps in aspirating any secretions in the form of blood, saliva, or gastric content, hindering the camera view, while the oxygen channel provides continuous source of oxygen during the intubation procedure and also help in antifogging.

4. Its alternate use can be as portable laryngoscope, portable bronchoscope, portable G.l scope, and portable laproscopic device.

5. As a portable G.l scope it can be used for multiple purposes like

oesophagoscopy, gastroscopy, duodenoscopy just by extending it.

6. Can be used with multiple handy screen like mobile, tabet, laptop or surgeon laproscopy screen.

7. It also incorporate a specialized mechanism to flex the Flexitip camera at any desired extension.

OBJECTS OF THE INVENTION :

The main object of this invention is to give a Portable automated dynamic linearity fibreless video endoscopy devices which is cost effective and can serve the purpose of other endoscopes along with the main purpose of intubation under vision.

DETAILED DESCRIPTION OF INVENTION:

Figure 1 is a longitudinal section of a Portable automated dynamic linearity fibreless video endoscopy. It shows the different components of the apparatus which consists of flexi tip controller(l ), USB connection to either mobile, tablet, laptop, laproscopic monitor, etc (2), power source for bidirectional motor (3), cap for endoscope (4), camera with lights and

SUBSTITUTE SHEETS (RULE 26) antifogging mechanism (5), bidirectional motor switch (6), endoscope holder/ head (7), endoscope body with extendable scopes .

Next figures show the working of the apparatus as a whole

Further diagrams explain each component of a Portable automated dynamic linearity fibreless video endoscopy device in detail.

Figure 2 shows endotracheal tube (9), extendable endoscopes(1 1 ), Flexitip camera with lights (5), Flexitip controller in pulled up position (1 ), bidirectional motor switch in down press position (10).

The bidirectional motor switch (6) when pushed in downward direction helps in extension of the extendable endoscopes and when pushed in upward direction helps in retracting to its original position. In this way various length of extension can be achieved depending on the requirement for intubation or any procedure like endoscopy. It also shows the working mechanism of the the flexi tip controller(l ), which when pulled in upward direction helps in the anterior movement of the Flexi tip Camera with lights( 5) to various degrees.

Figure 3 shows the small pulley for cord controlling endoscopic extension (12), bigger pulley for cord / camera cord controlling endoscope retraction (13), camera cord (14), cord controlling endoscope extension (15), Flexitip controlling cord (16), bidirectional motor (18), Suction channel /02 supply (17), Suction/02 port (19).

Figure 4 shows a specialized mechanism to flex the Flexitip camera at any desired extention. Here in diagram A the Flexitip controller(l ) is in neutral position, hence the Flexitip cord clamper is in open position (20), and the Flexitip controlling cord (16) is not controlling or flexing the Flexitip camera. Whereas in diagram B the Flexitip controller (1 ) is in pulled up position, hence the Flexitip cord clamper is in clamped position (21 ), and the Flexitip controlling cord (16) is clamped and pulled up and can control or flex the Flexitip camera if Flexitip controller is further pulled up.

A single embodiment of the invention has been described herein. Many variations could be made without departing from the spirit of invention.

All sizes are available which can be used in patients of variable age.

It can be of any material which is rigid but at the same time flexible.

SUBSTITUTE SHEETS (RULE 26)

Claims

1 . it’s a portable automated dynamic linearity fibreless video endoscopy device which has property of self extention along with distal flexible tip with high definition camera, light source and antifogging mechanism.

2. A portable automated dynamic linearity fibreless video endoscopy device as set forth in claim 1 which act as a fibreoptic and can be used as a bridge to intubation

3. A portable automated dynamic linearity fibreless video endoscopy device as set forth in claim 1 in which the bidirectional motor switch when pushed in downward position helps in extension of the fibreless video endoscopy device to various lengths as required .

4. A portable automated dynamic linearity fibreless video endoscopy device as set forth in claim 1 in which the flexitip controller when pulled up position helps in the flexion of the distal flexitip camera with lights. Alternative Flexitip controller which can both flex the distal tip in both directions is especially useful in Gl scopy devices.

5. A portable automated dynamic linearity fibreless video endoscopy device as set forth in claim 1 in which the holder/head contains a channel to which an USB or multiple handy screens like mobile, tablet, laptop or a surgeon laproscopy screen can be attached to visualize or record the area of interest .

6. A portable automated dynamic linearity fibreless video endoscopy device as set forth in claim 1 in which the head/ holder contains a bidirectional motor switch which helps in rotating the small and bigger pulley for the extention and for the retraction of the fibreless video endoscopy device respectively .

7. A portable automated dynamic linear fibreless video endoscopy device as in claim 1 , can be used as portable laryngoscope, portable bronchoscope, portable laproscope, portable G.l scope for multiple purposes like esophagoscopy, gastroscopy, duodenoscopy by virtue of its extention property.

8. Because of its portable property and its cost effectiveness it can be carried any where, just as a pen kept in pocket.

9. The flexible tip is incorporated with HD camera with antifogging mechanism which helps in situation where the laryngeal inlet is either anterior or posterior so by just adjusting the tip we can have a clearer vision of the laryngeal inlet and better alignment for the passage of the tube.

SUBSTITUTE SHEETS (RULE 26)

10. The flexible tip is also incorporated with suction and oxygen channel. Suction channel helps in aspirating any secretions in the form of blood, saliva, or gastric content, hindering the camera view, while the oxygen channel provides continuous source of oxygen during the intubation procedure .

1 1 . There comes along a specialized mechanism to flex the Flexitip camera at any desired extention.

SUBSTITUTE SHEETS (RULE 26)