WO2023194748A1

WO2023194748A1 - Device

Info

Publication number: WO2023194748A1
Application number: PCT/GB2023/050940
Authority: WO
Inventors: Medhat AKER
Original assignee: Aker Health Tech Ltd
Priority date: 2022-04-08
Filing date: 2023-04-06
Publication date: 2023-10-12
Also published as: GB202205253D0; GB2617408A

Abstract

A colonoscope device comprising an articulated elongated body (2) with a head (1), which body (2) comprises a plurality of segments (3) joined at discrete motor (54) driven joints (5), the head (1) providing a plurality of sensors (16, 17) and a light source (12, 14).

Description

DEVICE

Field of the Invention

The present invention relates to a device for moving through a structure comprising a lumen, e.g. a colonoscope device.

Background

Colonoscopy is one of the most commonly utilised investigations in health care. It aims to look for abnormalities in the colon, ranging from simple inflammation, to polyps, to cancer. The bowel cancer screening program (BCSP) perform millions of those procedures per year. Demand is expected to rise by 44% in 5 years.

A colonoscopy is done with a colonoscope and is often done to diagnose causes of bowel symptoms, such as bleeding, anaemia, diarrhoea or constipation, weight loss or inexplicable fatigue.

Lots of people have growths in their bowels, referred to as polyps or adenomas, and sometimes these may need monitoring or removal as they may become cancerous. It is important to check these fully and/or frequently and/or remove tissue samples for biopsies. Those growths or polyps can only be removed by the colonoscope.

A colonoscope comprises a flexible tube, with lighting and a camera mounted at the tip, and gas is put into the bowel to help see all the bowel lining. The colonoscope tube is inserted through the patient’s anus, and is pushed through the tortuous bends of the colon by the endoscopist’s hand from outside. Currently, colonoscopy is one of the most difficult procedures to learn and perform in healthcare, with a learning curve as high as 300 procedures. It is difficult to perform and requires 200+ hours of training to become qualified and able to perform the procedure independently. It also requires 4 staff members per procedure. A single procedure with no interventions can take up to 45-60 minutes to perform. Therefore, a single session (am or pm) can only perform only up to 4 or 5 procedures per session in expert hands. Colonoscopy is uncomfortable for the patient due to excessive air insufflation and due to the pressure and tension from the endoscopist’s hand pushing on the scope. This can also cause significant complications such as perforations and bleeding.

Prior Art

WO 2006 127 874 (GEIGER et al) discloses a method for displaying unseen areas in guided two dimensional (2D) colon screening, comprising: calculating segmentation and colon surface for a colon; calculating a centreline for said colon; designating as a first current focus point a current point of intersection of a first current portion of said centreline and a first current cross-sectional image of a colon in a first current image plane; and extracting a first colon surface portion in a first connected colon component containing said first current focus point marking voxels of said first colon surface portion as a first "seen" area.

US 5337 732 (GRUNDFEST et al) discloses an endoscopic robot utilising an inflatable balloon for progression, comprising: a plurality of segments, including a lead segment and an end segment; a plurality of pivoting joints each positioned in between and connecting adjacent segments; at least one actuator link extending through substantially through each pivoting joint and connecting to an adjacent segment; means for advancing and retracting the actuator links, to move the links together and apart for locomotion of the robot; an inflatable balloon supported around substantially each segment; and means for selectively inflating and deflating the balloons.

DE 3 707 787 (GRUENDLER, 1987) discloses an endoscope with a bendable continuous body of a plurality of successive segments by means of joints connected to each other and of a tubular casing. However only the distal tip is motorized.

The present invention arose in order to overcome problems suffered by existing devices.

Summary of the Invention

According to the present invention there is provided a colonoscope system and device comprising an articulated elongated body with a head, which body comprises a plurality of segments joined at discrete motor driven joints, the head providing a plurality of sensors, cameras, and a light source.

In some embodiments the device as a whole is also pushed or propelled from outside the body, for example with roller propellers motors, for example from an end of the body distal the head, combining with the joints so as to provide an undulating movement through the colon in use.

In some embodiments the sensor comprises high-definition cameras and acoustic or optic sensors adapted to provide data for composition of three-dimensional imaging of the surroundings of the head and lumen information.

In this way the sensors mounted on the head provide a means of identifying the direction of the lumen, insufflate a small amount of air to do so, and as to control movement and to angulate the head in that direction, and passing that angle to the consequent joint. This occurs in the same speed the device is propelled from the outside, therefore maintaining the location of the angle or the bend of the colon.

In some embodiments the device camera provides a mean of recording and mapping a colon in three dimensions, so as to allow the device to record and provide information about the colon, and how to navigate through it. In particular, the information enables machine learning about the colon, as well as enabling movement to be effective of the head, and subsequently of the shaft/body, whereby the shaft is enabled to move as the head. The recording or map of the colon is then presented on a computer screen enabling to scroll down the colon map for scrutiny and searching for small polyps or lesions by the endoscopist.

In some embodiments each joint is adapted to rotate about an axis which is orthogonal (rotated 90 degrees) to the sequential joint, such that the joints enable the body to move around corners with undulatory movement possible.

In some embodiments the head comprises an air supply, so as to enable the device to provide standard procedures, as known in the art.

In some embodiments the head comprises a water supply, so as to enable the device to provide standard procedures, as known in the art. In some embodiments the head comprises a tool port, enabling passage of a tool such as a wire to remove polyps, as known in the art.

In some embodiments the body includes a silicone covering. Other embodiments may be provided with other materials, so as to comprise a low-friction surface for this may provide a more comfortable and/or less damaging surface to the device within the colon.

In some embodiments the device comprises a displaceable or single-use covering over the body.

In some embodiments the device comprises service line. Such service lines may be wrapped around the body in a helical format so as to limit interference with mobility of the device.

According to a further aspect of the present invention there is provided a method of operating a device substantially as described herein, wherein the device is (1 ) enabled to map the three dimensional surroundings of the head and recorded surroundings and movement of the head, (2) operate the head in accordance with the dimensional surroundings of the head, and (3) sequential segments and joints of the body are operated to replicate movement of the head based upon the information from the sensors, (4) the rollers pushing the device from the outside advance the inserted shaft in a speed equal to but in the opposite direction to the propagation of the wave down the shaft.

According to a still further aspect of the present invention there is provided software for operating the method described herein.

According to some embodiments there is provided a colonoscope device comprising an articulated elongated shaft or body which comprises a plurality of motorized segments joined at discrete motor driven joints, with the head at the distal end of the shaft providing a plurality of cameras, sensors, working ports, and a light source.

According to some embodiments there is provided a colonoscope device wherein acoustic or optic sensors are mounted at the head of the device to gather information on the surroundings of the head, The reaction of the bowel wall to a puff of insufflated air is sensed with the acoustic or optic sensors, then processed, identifying the direction of the lumen and centralising it on the camera.

According to some embodiments there is provided a colonoscope device wherein the sensors comprise cameras adapted to provide data composition of three-dimensional imaging of the surroundings of the head, and to provide a recording or mapping of the whole colon on a 2-dimensional screen.

According to some embodiments there is provided a colonosocpe device wherein the angle of the leading head is automatically propelled down the shaft, in a speed equal to but in the opposite direction of the speed of introduction of the scope.

According to some embodiments there is provided a colonoscope device comprising additional multitude of roller motors placed outside the body to push and advance the scope in the human cavity in a controlled speed and torque, then to pull and retrieve the device after the procedure is done. The whole device can alternatively be rolled inside a disc which can rotate in either direction, expelling the device or winding it in at a controlled speed as above.

According to some embodiments there is provided a colonoscope device wherein each joint is adapted to rotate about an axis orthogonal (at 90 degrees) to the sequential joint. The above characteristics allow the curves of the colon to be maintained at the geographical locations of the bends of the colon automatically, and memorised for the way back out of the body.

According to some embodiments there is provided a colonoscope device wherein the head comprises an air supply channel running through the body.

According to some embodiments there is provided a colonoscope device wherein the head comprises a water supply channel running through the body.

According to some embodiments there is provided a colonoscope device wherein the head comprises at least one tool port running through the body of the device for instrumentation.

According to some embodiments there is provided a colonoscope device comprising a silicone covering. According to some embodiments there is provided a colonoscope device comprising a displaceable covering over the body.

According to some embodiments there is provided a colonoscope device comprising a joint set. The joint set may comprise two joints configured to rotate about orthogonal axes. For example, the angles of the first two joints from the head (which set the head direction) may be passed respectively to the next two joints and so on.

According to some embodiments there is provided a device for moving through a structure comprising a lumen. The device may comprise a plurality of segments. The plurality of segments may comprise a head segment and a plurality of body segments. Each segment may be configured to be connected to an adjacent segment by a respective joint. An angle between each adjacent segment of the plurality of segments may be configured to be adjusted.

According to some embodiments there is provided a device for moving through a structure, wherein the device comprises at least one sensor. The sensor may be configured to obtain data for determining the direction of the lumen relative to the head segment. The device may be configured to automatically adjust an angle of the head segment relative to at least one following first body segment, based on the determined direction of the lumen relative to the head segment. The device may be configured to automatically propagate the adjusted angle of the head segment relative to at least one following first body segment, along the device, as the device moves through the lumen, by correspondingly adjusting the angles between further following body segments.

According to some embodiments there is provided a device for moving through a structure, wherein the device further comprises an air source configured to discharge a volume of air into the lumen of the structure. The device may be configured to determine the direction of the lumen relative to the head segment based on a reaction of a wall of the lumen in response to the discharge of a volume of air from the air source determined based on data from the at least one sensor. According to some embodiments there is provided a device for moving through a structure, wherein the sensor is an acoustic sensor configured to detect an acoustic signal corresponding to a response to the discharge of the volume of air.

According to some embodiments there is provided a device for moving through a structure, wherein the sensor is an optical sensor configured to detect an optical signal corresponding to a response to the discharge of the volume of air.

According to some embodiments there is provided a device for moving through a structure, wherein an optical sensor is configured to obtain an image of the structure.

According to some embodiments there is provided a device for moving through a structure, wherein an at least one following first body segment comprises an immediately following body segment, adjacent the head segment.

According to some embodiments there is provided a device for moving through a structure, wherein an at least one following first body segment further comprises a second following body segment, adjacent the body segment adjacent the head segment.

According to some embodiments there is provided a device for moving through a structure, wherein the angle between the head segment and the immediate following body segment is adjustable about a first axis.

According to some embodiments there is provided a device for moving through a structure, where the angle between the immediate following body segment and the second following body segment is adjustable about a second axis orthogonal to the first axis.

According to some embodiments there is provided a device for moving through a structure, wherein an angle between adjacent segments at each odd numbered joint is adjustable about the first axis and an angle between adjacent segments at each even numbered joint is adjustable about a second axis, orthogonal to the first axis .

According to some embodiments there is provided a device for moving through a structure, wherein the angle between the head segment and the immediate following segment and the angle between the head segment and the second following segment, each propagate down the device every two joints.

Brief Description of Figures

A preferred embodiment of the invention will now be described by way of example only and with reference to the Figures in which:

Figure 1 shows an isometric view of an embodiment of the device according to the present invention;

Figure 2 shows a reverse isometric view of the embodiment of the device shown in Figure 1 ;

Figure 3 shows an isometric view of the embodiment of the device shown in Figure 1 , with covering removed;

Figures 4 show isometric views of the embodiment of the head from the embodiment of the device shown in Figure 1 ;

Figures 5 show isometric views of the embodiment of a segment from the embodiment of the device shown in Figure 1 ;

Figure 6 shows an exploded isometric view of the embodiment of the segment shown in Figures 5; and

Figure 7 shows a stepper motor mounted inside the segments shown in figure 5.

Detailed Description

The present disclosure describes a device for moving through a structure comprising a lumen. The structure may be a human or animal bowel, for example, e.g. a colon. The device may move through the structure to obtain images of the structure, for example. The device may move through the structure to provide access to surgical tools, for example. The device may be used for performing an endoscopy, for example. The device may be for robotic, automated endoscopy, for example.

Details of the device will be described in the context of use for colonoscopy, for convenience. It should be understood that the device may be used differently.

The device comprises a plurality of segments, including a head segment (head) and a plurality of body segments. Each segment is connected by a respective joint. The head is provided at the distal end of the device. The segments may form an articulated elongated body (shaft). An angle between each adjacent segment of the plurality of segments may be configured to be adjusted. The joints may be motor driven for adjusting the angle between segments.

The device may comprise at least one sensor configured to obtain data for determining the direction of the lumen relative to the head segment. The at least one sensor may be provided on the head, e.g. at a distal end thereof.

The head, e.g. at a distal end thereof, may further comprise a camera, an air insufflation channel, a water insufflation channel, a light source and/or a working channel. The head may comprise a plurality of cameras, air insufflation channels, water insufflation channels, light sources and/or working channels.

The one or more sensors may be configured to obtain data for identifying the direction of the lumen of the bowel. The identified direction of the lumen may be used to control the movement of the device. For example, the angle of the head of the device may be automatically adjusted based on the identified direction of the lumen. For example, the angle of the head of the device (i.e. the angle of the head relative to a subsequent segment) may be adjusted such that the head points in a direction that corresponds more closely to the direction of the lumen. For example, an original angle of the head may be such that the head is not pointed in the identified central direction of the lumen. After the adjustment of the angle of the head based on the determined direction of the lumen, the head points in a direction towards the centre of the lumen.

One or more processors may be configured to determine the direction of the lumen based on the data obtained by the one or more sensors. The one or more processors may determine how the angle of the head should be adjusted based on the determined the direction of the lumen, e.g. to correspond with the direction of the lumen, and to control the appropriate joints to adjust the angle of the head. The one or more processors may form part of the device or part of a remote device in communication with the device (e.g. wirelessly).

The one or more sensors may comprise one or more acoustic sensors. An acoustic sensor may be configured to sense a sound wave, for example an ultrasonic wave, response from the wall of the bowel. This may be in response to insufflation of air into the lumen or bowel via an air insufflation channel of the device.

One or more air insufflation channels may be provided on the device. An opening of the insufflation channels may be provided at the head of the device, for example. The channels may run along the length of the device and be connected at a proximal end to an air source. The air source may be separate from the device.

For example, air may be discharged from the insufflation channel into the bowel. The discharged air may generate an acoustic wave that is reflected from the bowel wall. Based on the acoustic waves reflected from the bowel wall, the orientation of the head of the device in relation to the bowel wall, and thus the lumen of the bowel, may be determined. For example, based on the magnitude and direction of an acoustic wave reflected from the bowel wall, the orientation of the head of the device in relation to the bowel wall, and thus the lumen of the bowel, can be determined. An acoustic signal of a relatively smaller magnitude may be indicative of the lumen of the bowel. An acoustic signal of a relatively greater magnitude may be indicative of the bowel wall.

Multiple acoustic sensors may be provided at different locations on the device, e.g. around the head, and configured to receive different acoustic signals, e.g. from different locations on the bowel wall. This may allow more accurate determination of the lumen direction.

The one or more sensors may (alternatively or additionally) comprise one or more optical sensors. The optical sensors may be configured to obtain image data of the surroundings of the head. The bowel may be illuminated by a light source of the device. The light source may be provided to the head of the device, for example. The light source may be a white light source, or an infrared light source, for example. The optical sensors may be configured also to image the bowel for other purposes (e.g. for analysis of the bowel for identification of pathologies) or may be provided solely for the purpose of directing the head of the device. The optical sensors may be cameras, for example.

Image analysis of the image data from the optic sensor may be configured to identify regions of the image corresponding to the bowel lumen. The image analysis may identify regions of the image data corresponding to the bowel lumen and thereby identify regions of the data not corresponding to the bowel lumen. Additionally or alternatively, regions of the image data not corresponding to the bowel lumen may be positively identified. For example, a region of the image data may be identified as corresponding to bowel wall. Based on the position of the data identified as corresponding to the bowel lumen, the angle of the head may be adjusted to correspond more closely with the direction of the bowel lumen. Additionally or alternatively, the angle of the head may be adjusted (to correspond more closely with the direction of the bowel lumen) based on the position of the data identified as not corresponding to bowel wall.

The one or more optical sensors may be configured to obtain image data, in response to insufflation of air into the lumen or bowel via an insufflation channel. Air may be discharged into the bowel. The air may be discharged at a force sufficient to cause the bowel wall to move. Based on an image of the bowel in response to the insufflation of air, the position of the head of the device relative to the lumen can be determined. For example, the opening of the lumen may be darker (lower signal) than the surrounding bowel wall (higher signal). For example, according to the direction of the movement from the bowel wall, the orientation of the head of the device in relation to the bowel wall, and thus the lumen of the bowel, can be determined. The bowel may expand radially in response to the insufflation air. The centre of this expansion identified from the image data may be indicative of the lumen direction.

A smaller volume of insufflation air is required for the above methods than for traditional colonoscopy techniques. Traditional colonoscopy techniques utilise insufflation of the bowel for the purpose of improving the field of view of the bowel for the operator of the colonoscope to direct he colonoscope. The volume of discharged air may be such that the diameter of the bowel (i.e. the separation of opposing bowel walls near the head of the device) is not greater than double the width of the device. More preferably, the volume of discharged air may be such that the diameter of the bowel is not greater than the width of the device.

The direction of the head may be adjusted to substantially align with the direction of the lumen, as described above. In a spherical coordinate system, the head may be configured to be adjusted to have any azimuthal angle relative to a neutral position between 0 and 360 degrees (e.g. where all segments aligned). The head may be configured to be adjusted to have a polar angle relative to a neutral position from 0 to 90 degrees, for example.

The head may be configured to be rotated with at least two degrees of freedom, e.g. rotate about two orthogonal axes. These two degrees of freedom may be provided by a single joint between the head and the adjacent body segment. Alternatively, these two degrees of freedom may be provided by a pair of joints, one between the head and the adjacent body segment (first body segment), and one between the adjacent two body segments (first and second body segments).

Advancement of the device along the bowel may be via a propulsion means at a proximal end of the device. The propulsion means may be at an end of the device that is opposite to the head. In some embodiments the device as a whole may be pushed and/or propelled from outside the body. For example, one, or a plurality of rollers may drive the forward movement of the device.

Alternatively, the device may be coiled inside a rotatable disc. The disc may be configured to rotate to expel the device out of the disc, such that the shaft may be driven forwards. The disc may rotate to draw the device into the disc, such that the shaft may be driven backwards. Rotation of the disc in a first direction may provide forwards movement of the device. Rotation of the disc in a second direction may provide backwards movement of the device. The second direction may be opposite to the first direction. The disc may be configured to contain the entirety of the length of the device coiled inside.

As the device is advanced (forwards or backwards) along the bowel, the angle between on pair of segments may be passed to a subsequent pair of segments. For example, the angle of one joint may be passed along the device to become the new angle of a subsequent joint. This may occur at the same speed, and in an opposite direction to the direction of travel of the device. In this way, as the device is propelled, a bend in the device is maintained at the same position relative to the bowel. The relative position of an angle of the shaft of the device and a bend of the bowel is therefore maintained. In this way, the device may be configured such that the direction of a portion of the shaft of the device automatically follows the direction of the lumen of the bowel during the advancement (forwards or backwards) of the device.

This may provide an undulating movement through the colon, allowing the shaft to follow the bends and curves of the flexures of the colon.

The angle of the head of the device may be passed along the shaft of the device, as the device is advanced along the bowel, as described above. As described above the direction of the head may be adjusted by adjusting one or more joints. These one or more joints may form a join set. The angles of joints in each joint set may be propagated to the next joint set, as the device moves.

Where the joint set comprises only a single joint, the angle may be passed from joint to joint directly. The angle of the joint of the head segment may be passed to the subsequent (proximal) joint as the device is advanced along the bowel. The angle of the head segment relative to the first (body) segment thus becomes the angle of the first (body) segment relative to the subsequent (second) body segment. The angle of the head joint thus becomes the angle of the (proximal) joint of the subsequent segment.

An angle of a body segment of the device (for example, an angle of a segment of the device corresponding to the angle to the head of the device at that position) may be passed to a subsequent segment, as the device is advanced or retracted along the bowel. The angle of the (proximal) joint of a first (distal) segment may become the angle of the (proximal) joint of a second (proximal) segment as the device is advanced along the bowel. The angle of the (proximal) joint of the n segment may become the angle of the (proximal) joint of the (n+1 ) segment.

An angle of the head that has been determined by the automated process described above, may thus be transferred to subsequent (body) segments. Thus, subsequent segments may automatically be positioned to the angle of the head segment determined at the corresponding position in the bowel. In a similar way, the angle of a joint may be passed to the previous (distal) joint as the device is retracted along the bowel. The angle of the (proximal) joint of a first (proximal) segment may become the angle of the (proximal) joint of a second (distal) segment, as the device is retracted along the bowel. The angle of the (proximal) joint of the n segment may become the angle of the (proximal) joint of the (n-1 ) segment.

The joint set may comprise two joints configured to rotate about orthogonal axes. In this case, the angles of the first two joints from the head (which set the head direction) may be passed respectively to the next two joints and so on. In other words, the angle of a joint may be passed between alternate joints, i.e. passed along every second joint, as the device is advanced along the bowel.

An angle of the head (that has been determined by the automated process described above) may be transferred to a subsequent pair of (body) segments. Thus, subsequent pairs of segments may automatically be positioned to the angle of the head segment determined at the corresponding position in the bowel. The angle of the joint of the head segment may be passed to the second joint in the proximal direction as the device is advanced along the bowel. The angle of the head segment relative to the first (body) segment (in the proximal direction) thus becomes the angle of the second (body) segment (in the proximal direction) relative to the subsequent (third) body segment (in the proximal direction). The angle of the head joint thus becomes the angle of the (proximal) joint of the subsequent pair of segments. The angle of the head joint thus becomes the angle of the (proximal) joint of the second segment.

In a similar way, an angle of a body segment of the device may be passed between alternate body segments, i.e. every second body segment, as the device is advanced or retracted along the bowel.

The angle of the (proximal) joint of a first segment may become the angle of the (proximal) joint of a third segment (in the proximal direction), as the device is advanced along the bowel. The angle of the (proximal) joint of the n segment may become the angle of the (proximal) joint of the (n+2) segment, as the device is advanced along the bowel. The angle of the (proximal) joint of a first segment may become the angle of the (proximal) joint of a third segment (in the distal direction), as the device is retracted along the bowel. The angle of the (proximal) joint of the n segment may become the angle of the (proximal) joint of the (n-2) segment, as the device is advanced along the bowel.

In some embodiments each joint is adapted to rotate about an axis which is orthogonal (rotated 90 degrees) to the sequential joint. In this way, a distal end of a pair of adjacent segments (comprising two orthogonally arranged joints) may be angled to have an azimuthal angle between 0 and 360 degrees relative to a segment preceding the pair of segments. A sequence of sequential orthogonally arranged joints enable the body to move around corners in three dimensional space. Each pair of orthogonally connected consecutive segments may have 7 degrees of freedom, e.g. including three corresponding to rotational movement around the x, y, and z axes, and three corresponding to translational movement along the x, y, and z axes.

The device may a comprise, e.g. arranged at the head of the device. The camera may provide a means of viewing a region of the bowel at the head of the device. A camera image and/or video may be recorded for viewing at a later time, e.g. to identify pathologies.

A plurality of cameras may be provided at the head of the device. For example, the head may comprises two cameras. The two cameras may allow three-dimensional image and/or video capture. In other words, the use of two cameras at the head of the device may allow the viewing of a region of the bowel in three dimensions.

Image and/or video data recorded from the one or more cameras provides for the mapping of the colon. In other words, the device and mapping a colon in three dimensions, so as to allow the device to record and provide information about the colon, and how to navigate through it. In particular, the information enables machine learning about the colon, as well as enabling movement to be effective of the head, and subsequently of the shaft/body, whereby the shaft is enabled to move as the head in a follow the leader fashion. The recording or map of the colon is then presented on a computer screen enabling to scroll down the colon map for scrutiny and searching for small polyps or lesions by the endoscopist. The device may comprise a covering. The covering may shield the components of the device from the internal surface of the colon i.e. the mucosal surface. The covering may provide a low-friction surface, to reduce friction between the device and the surface of the colon as the device is advanced though the colon, for example during a colonoscopy process. In this way, the risk of damage to the colon during a colonoscopy process may be reduced. The cover may improve patient comfort during a colonoscopy process. In some embodiments the body includes a silicone covering. Other embodiments may be provided with other materials, so as to comprise a low- friction surface for this may provide a more comfortable and/or less damaging surface to the device within the colon. In some embodiments the device comprises a displaceable or single-use covering over the body.

In some embodiments the head comprises a water supply, so as to enable the device to provide standard procedures, as known in the art.

In some embodiments the head comprises a working tool port, enabling passage of a tool such as a wire to remove polyps, or biopsy forceps, as known in the art.

In some embodiments the device comprises service line. Such service lines may be wrapped around the body in a helical format inside the outer covering so as to limit interference with mobility of the device.

The device may be configured to be operated in automatic mode and/or manual takeover mode. In manual takeover mode the device may be operated manually by an operator i.e. the direction of the device in controlled by the operator.

The device may have a complete manual take over option in which the device will be slack and be operated manually from outside the body similar to the current art. Or also the option of joystick type control of the device is provided, operating the device as described herein, wherein the device is (1 ) enabled to map the three dimensional surroundings of the head and recorded surroundings and movement of the head, (2) operate the head in accordance with the dimensional surroundings of the head, upon the information from the sensors and (3) sequential segments and joints of the body are operated to replicate movement of the head in a follow the leader fashion (4) the rollers or disc pushing the device from the outside advance the inserted shaft in a speed equal to but in the opposite direction to the propagation of the wave down the shaft.

An angle of the head that has been provided by a manual operation process may be transferred to subsequent (body) segments, in the same way as described above for the angle of the head determined by automated processes. Thus, subsequent segments may automatically be positioned to the angle of the head segment provided at the corresponding position in the bowel.

Figures 1-3 show exemplary colonoscope devices comprising an articulated elongated body (shaft) 2 and a head 1 . The body may comprise a plurality of segments 3 joined at joints 5.

Figures 1-3 depict colonoscope devices comprising a head 1. When in use, the head may be configured to be at the leading end of the colonoscope device. The head may comprise features that provide various functionalities to the device. For example, the head may comprise a sensor, a plurality of sensors, a light source (12, 14) and/or a plurality of light sources.

With reference to the figures there is generally shown an embodiment of an endoscope device for colonoscopy generally comprising an articulated elongated body 2 with a head 1 , which body comprises a plurality of segments 3 joined at joints 5, the head 1 providing a plurality of sensors and a light source.

Figures 1-3 depict colonoscope devices comprising a multi-segment body. The multisegment body may comprise a plurality of rigid segments 3. Each segment may comprise a spur part 19 and a receiving part 91 (shown in Figures 4a-b and 5a-b). The head may comprise a spur part 19 and not comprise a receiving part 91 (shown in Figures 4a-4b). A spur part on one segment may be joined with a receiving part of an adjacent segment to form a joint. A receiving part 91 may comprise a pivot pin 53. The pivot pin 53 may be configured to fit into a receiving hole 18 in the spur part 19 of an adjacent segment. The pivot pin may secure the joint parts whilst allowing the relative pivoting of the parts. The parts may extend to either end of a tubular torso, wherein the two parts may interconnect at a pin 53.

In particular reference to the pictured embodiment the embodiment comprises a multisegment body comprised of a plurality of rigid segments 3, each segment comprising a spur part 19 and a receiving part 91 , the two parts joined to form a joint at a pivot pin 53 fitting into a receiving hole 18 in the spur part 19.

The pivot pin may drive the relative pivoting of adjacent segments. The pin may be configured to be driven by motor 54, as shown in Figure 7. The pin motor 54 may comprise intermediate gearing. Each torso may contain a dedicated motor to drive the corresponding pivot pin. The dedicated pin motor may be a two-phase stepper motor 54, which controls the pin 53. It may be envisaged that other types of motor are possible. In the embodiment shown, the parts extend to either end of a tubular torso, wherein the two parts interconnect at a pin 53. In the embodiment shown, the pin is driven by a dedicated motor 54, as shown in Figure 7 with intermediate gearing. Each torso contains a 2 phase stepper motor 54 which controls the pin 53. It may be envisaged that other types of motor are possible.

The two parts of a joint (spur part 19 and receiving part 91 ) may face in orthogonal directions. The parts may extend sufficiently from the torso so as to allow movement about the pin through 90 degrees. The parts may extend sufficiently from the torso so as to allow movement about the pin through 180 degrees of movement. The arrangement of sequential segments may form sequential orthogonally arranged joints to enable full movement of the body. A sequential pair of joints, may comprises orthogonally arranged segments. A sequential pair of joints may be configured to provide a full range of movements.

In the embodiment shown, the two parts face in orthogonal directions and the parts extend sufficiently from the torso so as to allow movement about the pin through 90 degrees, where other embodiments may envisage 180 degrees of movement. As a result sequential segments form sequential orthogonally arranged joints, enabling full movement of the body in totality as the embodiment moves through the colon. In the embodiment shown, supply lines for the electrical connection between the motors run alongside the body 2 up to the head. The supply lines at the head are passed through flexible channels 51.

In the embodiment shown, the body is covered with a silicone covering 4. The covering 4 may shield the components of the device from the internal surface of the colon i.e. the mucosal surface. The covering 4 may provide a low-friction surface, to reduce friction between the device and the surface of the colon as the device is advanced though the colon, for example during a colonoscopy process. The covering 4 may be a silicone covering. The covering 4 may comprise silicone and/or other materials providing a low-friction surface.

In the embodiment shown, the head includes a flat circular cylindrical end 20. In the embodiment shown, the head includes a right camera 16 and a left camera 17, located close to one spaced circumferentially. In the embodiment shown, the cameras are capable of wide angle 235 degree capture. This enables the device two perspectives so as to effectively enable mapping of the head surroundings in the colon, and identify its pathway.

In the embodiment shown, the head also includes two light sources provided by light emitting diodes (LEDs) 12,14. The LEDs and dual cameras allow 3D mapping of the colon to greatly improve analysis of the colon.

The device may be configured to store the 'path memory'. The path of the device (for example comprising the location and angle of one or more segments of the device) may be stored in a memory associated with the device. For example, a route manually articulated by an operator (surgeon) may be saved and/or a route automatically determined by the device may be saved. A stored path may be displayed, for example on a screen. In some embodiments a stored path may be displayed in 3D. A stored path may comprise data from one or more of the components of the device. Information from sensors mounted at the head of the device may be stored and/or data from each motor within the device and/or image data (for example image data facilitating automated recognition of where the device sits within the colon). Position data, providing a guide as to the location of the head of the device, may be used to determine the location of an identified lesion. This means the device may be configured to articulate through the colon with greater ease and much less discomfort to the patient.

The device shown has a 'path memory' where the route the surgeon articulates the device is memorised and even displayed visually in 3D. This will use a combination of information from sensors mounted at the head and from each motor within the device as well as image recognition of where the device sits within the colon. This means the device can articulate through the colon with greater ease and much less discomfort to the patient.

The head may comprise water supply port 16, for example for cleaning, air supply port 17, for example for insufflation. The water supply port 16 and air supply port 17 may be located proximate to one another and circumferentially spaced. The head may comprise a tool port 14, for example for the introduction of biopsy equipment and/or the passage of biopsy tissue and/or the introduction of other tools know in the art, located distally on the circumference. In the embodiment shown, the head includes standard ports known in the art, namely water supply 16, for cleaning purposes, air supply 17, for insufflation purposes, located close together circumferentially, and tool port 14, for biopsies and tools, located distally on the circumference.

In the embodiment shown, the supply lines for the electrical connection of the motors, and the water supply and the air supply are provided in two polyvinyl chloride (PVC) tubes that are arranged to the exterior of the body, between the body and covering.

In other embodiments it may be envisaged that the supply lines of electrical and tool connection are inline. One or more of the supply lines may pass through a central region of the device, i.e. one or more of the supply lines may be contained within the device.

The invention has been described by way of examples only and it will be appreciated that variation may be made to the above-mentioned embodiments without departing from the scope of protection as defined by the claims.

Claims

1. A colonoscope device comprising an articulated elongated body with a head, which body comprises a plurality of segments joined at discrete motor driven joints, the head providing a plurality of sensors and a light source.

2. A colonoscope device according to claim 1 wherein the sensors comprise cameras adapted to provide data composition of three-dimensional imaging of the surroundings of the head, and to provide a recording or mapping of the whole colon on a 2 dimensional screen.

3. A colonoscope device according to claim 1 and 2 wherein acoustic or optic sensors are mounted at the head of the device to gather information on the surroundings of the head, in order to identify the lumen by automatically insufflating a small amount of air to identify the lumen, and automatically point the head in the that direction.

4. A colonoscope device according to claims 1 or 2, or 3 wherein each joint is adapted to rotate about an axis orthogonal (at 90 degrees) to the sequential joint.

5. A colonoscope device according to claim 1 , 2 or 3 or 4 wherein the head comprises an air supply channel running through the body.

6. A colonoscope device according to any preceding claim wherein the head comprises a water supply channel running through the body.

7. A colonoscope device according to any preceding claim wherein the head comprises at least one tool port running through the body of the device for instrumentation.

8. A colonoscope device according to any preceding claim comprising a silicone covering.

9. A colonoscope device according to any preceding claim comprising a displaceable covering over the body.

. A colonoscope device according to any preceding claim comprising an additional roller motors placed outside the body to push and advance the scope in the human cavity in a controlled speed and torque, then to pull and retrieve the device after the procedure is done. . Method of providing an examination of a colon comprising a device according to any of the preceding claims. . Software for a device according to any of claims 1 to 7 or methods thereof. . The system of automatically double controlled (outside propellers and retrievers in addition to the individualised motors inside the body). Which aim to move the colonoscope inside the colon in an undulatory movement in order to advance through the colon. . The system by which the map of the colon is presented after the procedure on a 2 dimensional screen to be scrolled down by the endoscopist for scrutiny. . A device for moving through a structure comprising a lumen, the device comprising: a plurality of segments, including a head segment and a plurality of body segments, each segment connected to an adjacent segment by a respective joint, wherein an angle between each adjacent segment of the plurality of segments is configured to be adjusted; at least one sensor configured to obtain data for determining the direction of the lumen relative to the head segment, wherein: the device is configured to automatically adjust an angle of the head segment relative to at least one following first body segment, based on the determined direction of the lumen relative to the head segment; and the device is configured to automatically propagate the adjusted angle of the head segment relative to at least one following first body segment, along the device, as the device moves through the lumen, by correspondingly adjusting the angles between further following body segments. . The device of claim 15, wherein the device further comprises an air source configured to discharge a volume of air into the lumen of the structure, and the device is configured to determine the direction of the lumen relative to the head segment based on a reaction of a wall of the lumen in response to the discharge of a volume of air from the air source determined based on data from the at least one sensor.

17. The device of claim 16, wherein the sensor is an acoustic sensor configured to detect an acoustic signal corresponding to a response to the discharge of the volume of air.

18. The device of claim 16, wherein the sensor is an optical sensor configured to detect an optical signal corresponding to a response to the discharge of the volume of air.

19. The device of claim 18, wherein the optical sensor obtains an image of the structure.

20. The device of any of claims 15-19, wherein the at least one following first body segment comprises an immediately following body segment, adjacent the head segment.

21. The device of any of claims 20, wherein the at least one following first body segment further comprises a second following body segment, adjacent the body segment adjacent the head segment.

22. The device of claim 21 , wherein the angle between the head segment and the immediate following body segment is adjustable about a first axis.

23. The device of claim 22, where the angle between the immediate following body segment and the second following body segment is adjustable about a second axis orthogonal to the first axis.

24. The device of claim 23, wherein an angle between adjacent segments at each odd numbered joint is adjustable about the first axis, and an angle between adjacent segments at each even numbered joint is adjustable about a second axis, orthogonal to the first axis . The device of claim 24, wherein the angle between the head segment and the immediate following segment and the angle between the head segment and the second following segment, each propagate down the device every two joints.