WO2022156872A2

WO2022156872A2 - Flexible endoscopes

Info

Publication number: WO2022156872A2
Application number: PCT/EG2021/000002
Authority: WO
Inventors: Ismail Elsaid Amr FATHALLA
Original assignee: Fathalla Ismail Elsaid Amr
Priority date: 2021-01-20
Filing date: 2021-01-20
Publication date: 2022-07-28
Also published as: WO2022156872A3

Abstract

Endoscopy related infections represent an important threat for healthcare systems worldwide. Recent outbreaks of infections with multidrug resistant micro-organisms have highlighted the problems of contaminated endoscopes. Endoscopes at highest risk for contamination have intricate mechanisms, multiple internal channels and narrow lumens that are especially problematic to clean. In light of raised awareness about the necessity for meticulous reprocessing of all types of endoscopes, a call for international collaboration is needed. An overview is presented on current practices for endoscope reprocessing in facilities worldwide.

Description

FLEXIBLE ENDOSCOPES

1- Technical Field

This invention relates to surgical instruments. More specifically, it relates to a device that has been modified for an existing surgical instrument to increase the number of functions the instrument performs.

2- Background art:

FLEXIBLE ENDOSCOPES modern era of The colon and stomach endoscope is designed to perform two closely related functions, that is, to illuminate the site of a surgical procedure and to facilitate the doctor's view of the site. The site is lit by incoherent light carried by optical fibers. An objective lens at the far end of the range focuses the light, and a rod lens transmits the light to the doctor's eye. A separate special instrument is used to deliver the saline solution to the site of the surgical procedure, and another separate instrument continues to empty the irrigation solution and floating debris into it. Separate instruments are also provided to deliver coherent light to it, etc. Thus, multiple incisions are required to bring different tools into the surgical site, or if a single incision is made then multiple entries will be required through the incision as different tools are used. Thus, if a retrofit instrument that would attach to the existing arthroscope and provide it with additional functionality could be developed, the surgeon could perform multiple surgeries without abandoning the two-function colon and gastroscope. However, when looking at prior art as a whole as required by law, it neither knows nor proposes to provide a retrofit tool or how to provide such a tool, endoscopy The colon and stomach endoscope is designed to perform two closely related functions, that is, to illuminate the site of a surgical procedure and to facilitate the doctor's view of the site. The site is lit by incoherent light carried by optical fibers. An objective lens at the far end of the range focuses the light, and a rod lens transmits the light to the doctor's eye... Problems with the previous art:

Overall, endoscopy is very safe; however, the procedure does have a few potential complications, which may include:

• Perforation (tear in the gut wall)

• Reaction to sedation

• Infection

• Bleeding

• Pancreatitis as a result of ERCP

3- Disclosure of Invention

The present invention is presented in the form of a diagnostic tube and control unit which can be securely disassembled into a conventional soft endoscope with high-precision xenon lens and advanced fiber optic means.

• The new tool also includes the addition of 9 levels of illumination to improve the lighting performance

• Add technique of using color charts using Using 9 levels of air to enable accurate and highly controlled inflation for the organ to be examined with the flexible endoscope

• Add a high-precision lens to identify the tiny parts during the examination process

• Using medical technology by adding an early detection device during the examination process

The new tool also includes the provision of a suction port also around the primary organ and it connects the hollow inner portion of the new sheath to a pressure source. Hence, the fluid is easily discharged from the procedure site. Both the irrigation port and the suction orifice are provided with valves so that the doctor can control the rate of fluid flow to the site and the suction rate. The new tool also includes a tube that intercepts the new casing at a predetermined angle. A hole in the jacket that allows optical levels fibers to be in it; The optical planar fibers extend to the far end of the sheath, radially to the outside of the endoscope's outer shell, and thus provide coherent light to the procedure site to vaporize tissue or other materials. Thus it is evident that the primary objective of the present invention is to provide a retrofit tool that can be disassembled by means of a conventional colonoscopy or stomach to increase the versatility of the traditional colonoscopy or stomach. These and other important things, features and advantages of the invention will become apparent as this description continues. Accordingly, the invention includes the features of the construction, the set of elements and the arrangement of the parts to be represented in the construction stipulated hereinafter, and the scope of the invention will be defined in the claims.

Detailed Description;

Primary Components of an Endoscope

The basic components of an endoscope Endoscopy plays a vital role in investigating and diagnosing the causes of many physical problems in patients. Using an endoscope, doctors can examine the digestive tract, identify obstructions, cauterize wounds or perform biopsies. These are complex systems, designed to play an integral role in medical care - but how do they come together? By looking at the main components of an endoscope, we can develop an understanding of how they operate and function. What are the integrated components of an endoscope? Endoscopes have several basic components, however, depending on the tasks they are designed to perform, the specifications may vary. A standard endoscope consists of:

Flexible or rigid tube Tube controller Tower containing a high-resolution screen connected to a personal computer

Liquid bottle

A lens for transmitting an image of the patient's internal system to the operator or viewer (this is generally a relay lens in rigid endoscopes, or multiple optical fibers for fiber endoscopes)

A system for transmitting light to improve the visibility of the area being scanned (the source of this light is usually outside the body, and directed through the optical fibers) Additional channel to accommodate medical instrument manipulators for surgical procedures Ophthalmic (in video endoscopes that lack lenses, images are sent from inside the patient to a screen for viewing and capture) How are the flexible endoscopes put together? Flexible endoscopes feature external components such as: Light guide plug, which connects to the light source: For video binoculars, this will usually be heavier than other types A covert cable (or generic wire), which connects the light guide plug to the endoscope control head The control head itself, which holds the angle control knobs to allow the operator to manage the range performance, as well as any suction or water functions An insertion tube is placed inside the patient's body and, unsurprisingly, becomes heavily contaminated throughout the procedure - the far end is used to house fine video slices, as well as openings for air or water functions, as well as for suction. The curvature section is adjacent to the distal end Endoscopes continue to evolve, becoming more streamlined and technologically advanced; for example, patients can now swallow tiny cameras that take pictures of their internal system before exiting the body. The basic components will likely remain the same, and no changes are usually made to improve performance and patient comfort.

What was invented in detail?

The present invention relates to variable direction of view for flexible endoscopes, in particular, variable direction of view flexible endoscopes incorporating solid state imagers.

Variable direction of view endoscopes allow a user to change the endoscopic viewing direction without having to change the position of the endoscope itself. Such endoscopes are useful when the user wants to see structures which are beside or behind the tip of the endoscope, but cannot easily move the endoscope shaft because of anatomical constraints or constraints imposed by other surgical instruments in the operative field.

Variable direction of view endoscopy is desirable because it affords surgeons greater flexibility in their procedural approach. Increased viewing mobility improves the quality of diagnoses, as in cystoscopy for example, where a typical diagnostic screening involves inspecting the interior surface of the bladder for lesions or tumors. The ability to look laterally and retrograde is important when doing this type of diagnosis because it makes it possible to visually cover the entire bladder surface, including the entrance region near the bladder neck. In ear-nose-throat and neurosurgical procedures, variable viewing is desired because the procedures are delicate, and the entrance ports are small. It is therefore not possible to manipulate the endoscope significantly without injuring the patient. The ability to look sideways and backwards is important however during and after tumor resection when it is necessary to keep track of tumor fragments, which if not caught can nucleate new tumors. Laparoscopy, another surgical discipline, imposes fewer maneuvering constraints but still benefits markedly from variable direction viewing because it allows surgeons to get better observation angles during a procedure and increases diagnostic capabilities. Also, because of the greater viewing versatility, variable direction of view endoscopes can minimize conflicts with other tools and can simplify surgical planning by their ability to achieve standard viewing angles from nonstandard positions, allowing the surgeon to keep the endoscope "off to the side" but still get the desired view.

Flexible endoscopes are a type of variable direction of view endoscopes that can typically adapt to anatomy better than rigid endoscopes and therefore can be less invasive and less traumatic to the patient. For example in gastroscopy, a flexible endoscope can be inserted through a natural orifice and accommodate the tortuous shape of the intestine, while gastroscopy with a rigid endoscope would likely require surgical incisions and cause the patient unnecessary pain. Moreover, flexible endoscopes can also change their viewing direction, which can be a significant advantage in many cases. Through articulation knobs, the operator can adjust the direction of the endoscope tip to "look" sideways and backwards. Such tip articulation requires room for the tip to flex, however, so if the specific anatomy is too confining, articulation may not be possible. For example, when investigating small spaces such as the ventricles of the brain, there is not much "wiggle room," and the bending radius of even the smallest flexible endoscope would be too large to allow any useful change of viewing direction. Attempting to articulate the scope tip in such situations would simply run the tip into the surrounding anatomy without improving the viewing range and may possibly injure the patient.

A fundamental feature of variable direction endoscopy is that it generally makes it possible for surgeons to eliminate "blind movements." A blind movement is the process of moving an instrument inside a patient without being able to see where the instrument is heading. This can occur when it is necessary to advance a fixed-angle side viewing endoscope in its length direction without being able to see what is ahead of the scope, or when a surgical tool has to be manipulated at the boundary of the endoscopic field of view.

Many known variable direction of view endoscopes also have drawbacks. First, these scopes use a movable image sensor or optical element at the tip of the scope to vary the viewing direction. Because of these moving parts, fabricating variable direction of view scopes is complicated and costly, and such scopes are less robust than traditional fixed-angle scopes. Also, they often deliver inferior illumination and image quality.

These scopes, both rigid and flexible tip endoscopes, also subject the user to disorientation. As the endoscopic line of sight is changed, the user faces two difficulties. The first is keeping track of where the endoscope is "looking." With a rigid fixed-angle endoscope it is relatively easy for the user to extrapolate the endoscopic viewing direction from the position of the endoscope shaft. This is not the case when the viewing direction is regularly changed

Exploitation method:

The flexible endoscope was invented to be placed in all places that provide medical services, such as hospitals, clinics, surgical operating rooms, and equipped ambulances, and it has also become an alternative to the old traditional methods of diagnosing the stomach or colon, opening places for operations, as well as early exploration and diagnosis. All these features are now summarized in this. A device that can do all these diagnostic processes simultaneously

New items to be protected:

• Common areas of medical uses include: bronchoscopy, colonoscopy and viewing of the upper gastroenterological systems. Endoscopies are commonly used for the diagnosis of cancer. Recent video-endoscopes with high costs can only be used in the department of endoscopy and the patients from CCU or ICU that need endoscopy should be transported there.

The main components of portable and digital video endoscope are:

A flexible tube.

A light that illuminates what the doctor wants to examine. The light is delivered via an optical fiber system.

A high quality CCD system that transmits an image to the viewer from the fiberscope. Another channel to allow the entry of medical instruments or manipulators.

Hand touch monitor and control center

The device consists of a flexible endoscope tube with an integrated video chip (CCD) which is located in the endoscope tip as well as a video controller-monitor. The hand touch monitor allows us to freeze, mark and save high quality taken pictures. The endoscope is very easy to control.

Preliminary results

Portable capabilities

Low costs of production

Brighter and more powerful Narrow Band Imaging

Ground-breaking Dual Focus for advanced diagnostics

Outstanding, true-to-life HD image quality

Advancing visualization

Advancing maneuverability

Superior image quality in a super-slim design

Wider possibilities for therapeutic intervention

Fully waterproof endoscope and hand-touch monitor and controlling

Differentiating diseased mucosa

Enhancing observation

Up to 100X zoom

Excellent device handling

High-resolution, high definition images

Wide angulation range'

Slim design • Conclusions/Future directions

Low costs of industrial production, portable capabilities and easy handling of this invention as well as high quality pictures and many practical options had led to be considered as a new hope for massive production and use in CCU, ICU and other departments of the hospitals.

Capsule endoscopy is one of the new procedures that involve the use of a very small wireless camera to take pictures in the digestive system.

For this procedure, one swallows a capsule the size of vitamin-sided capsule or a large pill. The technology involves the use of a wireless miniature encapsulated camera that takes pictures as the capsule travels through the digestive system.

As it travels down the digestive system, the capsule wirelessly transmit the images it captures which can then be used to detect any issues in the digestive tract. The images (it can take thousands of images) are then transmitted to a recorder from which they can be retrieved. Like ingested food, the capsule travels through the digestive system and ultimately leaves the body when the individual passes stool.

The main components of capsule endoscopy include:

• Sensor array (electrodes) - The patient wears this around the abdomen area like a sensor belt

• Data recorder worn by the patient and connected to the electrodes

• The capsule that is 26mm by 11mm in size - Some of the components of the capsule include; a lens, diodes (that emit light) a semi- conductor, an antenna as well as a transmitter.

Since its approval by the FDA in 2001, capsule endoscopy has been shown to be an effective procedure with a number of advantages that include:

• Painless

• disposable

• non-invasive Confocal Laser Endomicroscopy and Endocytoscopy

These are some of the new procedures aimed at enhanced high resolution in the assessment of gastrointestinal mucosal histology at both the cellular and sub-cellular level.

Basically, the technique is based on the principle of illuminating the tissue of interest with low power laser which in turn allows for the detection of fluorescent light that is reflected from the tissue.

With this procedure, it becomes possible to carry out in vivo examinations with images being displayed in real-time. It has been shown to be particularly beneficial in the detection of abnormal growth of tissue in conditions like ulcerative colitis.

4- Brief description of drawing figures:

An engineering drawing of the binoculars externally Full view of the binoculars View a diagram of the console manually directing the tip of the flexible endoscope to travel through the intraluminal pathway is dependent on the skill and experience of the physician. In this paper, we present the investigation of a flexible automatic endoscope guidance system that uses endoscopic images to control the orientation of the limb towards the direction of the lumen. Two image control algorithms are investigated, one dependent on optical flux and the other dependent on image intensity. Both are evaluated using simulations in which the endoscope is guided through the lumen. The RMS distance to the center of the lumen was less than 25% of the lumen width. An experimental setup was created with a standard flexible endoscope, and image-based control algorithms were used to operate the wheels of the endoscope to guide the tip. Experiments were performed in an anatomical model to simulate gastroscopy. The image intensity based algorithm was able to accurately guide the tip of the endoscope via an intraluminal pathway from the mouth to the duodenum. Compared with manual control, the robotic viewfinder performed 68% better in terms of preserving luminosity in the center of the image.

Claims

5- Claims Common areas of medical uses include: bronchoscopy, colonoscopy and viewing of the upper gastroenterological systems. Endoscopies are commonly used for the diagnosis of cancer. Recent video-endoscopes with high costs can only be used in the department of endoscopy and the patients from CCU or ICU that need endoscopy should be transported there.

1. The main components of portable and digital video endoscope are:

2. A flexible tube.

3. A light that illuminates what the doctor wants to examine. The light is delivered via an optical fiber system.

4. A high quality CCD system that transmits an image to the viewer from the fiberscope.

5. Another channel to allow the entry of medical instruments or manipulators.

6. Hand touch monitor and control center

7. The device consists of a flexible endoscope tube with an integrated video chip (CCD) which is located in the endoscope tip as well as a video controller-monitor. The hand touch monitor allows us to freeze, mark and save high quality taken pictures. The endoscope is very easy to control.

8. Preliminary results

9. Portable capabilities

10. Low costs of production

11. Brighter and more powerful Narrow Band Imaging

12. Ground-breaking Dual Focus for advanced diagnostics

13. Outstanding, true-to-life FID image quality

14. Advancing visualization

15. Advancing maneuverability

16. Superior image quality in a super-slim design

17. Wider possibilities for therapeutic intervention

18. Fully waterproof endoscope and hand-touch monitor and controlling

19. Differentiating diseased mucosa

20. Enhancing observation

21 . Up to 100X zoom

22. Excellent device handling

23. High-resolution, high definition images

24. Wide angulation range

25. Slim design