GB2255281A

GB2255281A - Articulated micro-endoscope

Info

Publication number: GB2255281A
Application number: GB9104713A
Authority: GB
Inventors: Costas Diamantopoulos
Original assignee: OMEGA UNIVERSAL HOLDINGS; Omega Universal Holdings Ltd
Current assignee: OMEGA UNIVERSAL HOLDINGS; Omega Universal Holdings Ltd
Priority date: 1991-03-06
Filing date: 1991-03-06
Publication date: 1992-11-04
Also published as: GB9104713D0; WO1992015238A1; EP0574460A1

Abstract

A micro-endoscope comprises a flexible outer tube (1) having an insertion length of 90 cm to 1.20 m and made of a material with a low friction coefficient, e.g. polyurethane. Located in the tube (1) is an image bundle of quartz silicon glass fibers (2) each of 2-5 micro-meter diameter which acts as an image lens. Also located in the tube (1) is a light guide tube (3) which houses a bundle of glass fibres (4) through which light is passed to the distal end (5) of the micro-endoscope. A flushing channel (6) extends through the length of the tube (1) enabling a fluid to be flushed to the distal end of tube (1) and an instrument channel (17). The distal end (5) is articulated at (7) to enable the micro-endoscope to be moved through 90 degrees.

Description

AN IMPROVED NI CRO-ENDOS COPE This invention relates to an improved microendoscope and to the use of such a micro-endoscope in applications in urology, gynaecology, cardiovascular disease and ear-nose and throat.

Various types of micro-endoscopes are known which utilise miniaturised glass fiber optics in urologic and gynaecological applications, which permit the passage of medical instruments within an outer flexible tube, such outer flexible tubes having a relatively small outer diameter in the region of 1 to 4mm. These known microendoscopes have a multilayered outer tube of low frictional coefficient materials which are manipulated within the patient's body to carry out examinations or operations. While micro-endoscopes present a great advance in technology on earlier used techniques of endoscopes of larger sizes, the existing micro-endoscopes have the disadvantage that the passive manipulation of the endoscope within the body tract is limited, fiberscopes require skills and, the invasiveness could be traumatic to the patient.Furthermore, the angle of viewing is limited to direct observation forward from the lens and there is no scope of observing other than in the forward direction areas, unless the scope is twisted and manipulated.

An aim of the present invention is to provide an improved micro-endoscope which facilitates active manipulation via articulation of the distal end of the micro-endoscope and overcomes the above mentioned disadvantage, whilst at the same time having a working channel large enough to carry out interventional procedures such as lasers etc.

According to one aspect of the present invention there is provided a micro-endoscope comprising a flexible outer tube within which is located an image bundle of silica fibers, at least one light guide tube, a flushing channel and an instrument channel, wherein the distal end of the flexible outer tube is articulated.

The micro-endoscope may include a wire to control the articulation of the micro-endoscope, one end of the wire being connected to the tip of the distal end of the micro-endoscope and the other end is connected to a handle projecting from the rear end of the micro-endoscope.

Conveniently, the image bundle is of quartz silica glass fibers each of 2 to Spit' diameter.

Preferably, the micro-endoscope includes two light guide fibre bundles.

In a preferred construction the insertion length of the micro-endoscope is 90cm to 1.20m.

According to another aspect of the present invention there is provided a method of hysteroscopy diagnostic procedure to examine the endometrium and fallopian tubes of a patient using the micro-endoscope of the present invention, comprising the steps of administering a local anaesthetic to the patient, passing the endoscope through the Os into the cervical canal to examine the endometrium.

According to a further aspect of the present invention there is provided a method of retrograde ureteroscopy using the micro-endoscope of the present invention, comprising the steps of passing the microendoscope through the working channel of a rigid cystoscope and entering it into the ureteric orifice of a patient, and manipulating it into the ureter while simultaneously flushing through the flushing channel, the articulated distal end of the micro-endoscope assisting manipulation up to the calyx.

Embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings, in which: Figure 1 is a diagrammatic side elevation of a first embodiment of a micro-endoscope; Figure 2 is a cross-section of the micro-endoscope shown in Figure 1; Figure 3 is a diagrammatic side elevation of a second embodiment of a micro-endoscope; Figure 4 is a cross-section of the micro-endoscope shown in Figure 3; Figure 5 is a diagrammatic side elevation of a third embodiment of a micro-endoscope; Figure 6 is a cross-section of the micro-endoscope shown in Figure 5; Figure 7 is a diagrammatic side elevation of a fourth embodiment of a micro-endoscope; Figure 8 is a cross-section of the micro-endoscope shown in Figure 7; Figure 9 is a diagrammatic view of a first combination of a direct viewing system;; Figure 10 is a diagrammatic view of a second combination of a fiberscope viewing system; and Figure 11 is a diagrammatic view of a third combination of a compact viewing system.

The first embodiment of a fiberoptic articulated micro-endoscope shown in Figures 1 and 2 comprises a flexible outer tube 1 measuring the insertion length 90 cm to 1.20 m. and made of a low frictional coefficient material such as polyurethane. Located within the tube 1 is an image bundle of quartz silicon glass fibers 2 each of 2-5mm diameter which acts as an image lens. Also located within the tube 1 is a light guide tube 3 which houses a bundle of glass fibers 4 through which light is passed to the distal end 5 of the micro-endoscope. A flushing channel 6 extends the length of the outer tube 1 enabling a fluid to be flushed to the distal end of the tube 1.

The distal end 5 of the micro-endoscope is articulated at 7 to enable the micro-endoscope to move through 90 degrees. -The control of the articulated end 7 is by means of a thin wire 7a which is connected to a probe 7b at the distal end 5 and passes along the inside of the tube 1 and is connected to a handle 8 which projects from the rear end of the outer tube 1. In operation the surgeon can manipulate the articulated end of the micro-endoscope by pulling or pushing on the handle 8 to bend the distal end of the tube 1 and probe 7b through an angle of 90 degrees. The various tubes carrying the fiberoptics and the flushing and instrument tubes are sealed in the flexible outer tube 1 by an epoxy adhesive 10.

In the second embodiment of the micro-endoscope illustrated in Figures 3 and 4 like parts have the same reference numerals as in Figures 1 and 2, except that a second light guide tube 3a is included to facilitate the use of the micro-endoscope with a fiberscope system using a CCD-camera, video monitor, video recorder and video printer (see Figures 10 and 11). The outside diameter of the micro-endoscope is 2.2 mm.

Figures 5 and 6 show a third embodiment of the micro-endoscope of the present invention, comprising an outer flexible polyurethane tube 11, the upper half of which houses an image guide 12 with a lens comprising a bundle of quartz silca glass fibers 13. A second tube 14 comprises a bundle of glass fibers 15 through which light is passed to the distal end 16 of the micro-endoscope.

The tubes 12 and 14 are sealed in the tube 11 by an epoxy adhesive.

The lower half of the tube 11 has a flushing channel 17 which is semi-circular in cross-section and can also be used as a working channel for the insertion of instruments. The controls and connections for the components 12, 13, 14, 15 and 17 extend from the rear end of the flexible tube 11 via a branch connection 18.

A fourth embodiment of the micro-endoscope according to the invention is shown in Figures 7 and 8 and is similar in construction to that shown in Figures 5 and 6, where like parts have the same reference numerals. The difference between the third and fourth embodiments is that the polyurethane flexible tube 11 is housed in an outer SUS pipe 19 and the light guide fibers 20 surround the image guide 21. The fibers 20 and image guide 21 are secured in position within the tube 11 by an epoxy adhesive. The distal end 22 of the outer SUS pipe 19 may be connected to an end probe 23.

The various embodiments of the micro-endoscope described above may be used with three possible combinations of direct viewing or recording systems shown in Figures 9 to 11.

Figure 9 illustrates a direct viewing system which includes an eyepiece 24 conected to the end of an image bundle of quartz silicia glass fibers 25. A light source 26 is connected to a light guide tube 27 so that the surgeon may view the operative area by looking into the eyepiece 24.

In the system illustrated in Figure 10 the eyepiece 24 of Figure 9 is replaced by an eyepiece 28 of CCD-camera (not shown) which is connected to a TV monitor 29 and a multi-system video recorder 30. Instead of viewing the operative area directly the CCD - camera focuses on the operation which is transmitted to the TV monitor 29 and may be recorded on the video recorder 30. Thus a group of medical students may view the operation while it is being performed, or the video recording of the operation at a later time and different place, whilst a video printer can also be utilised to print recordings of interest.

In the compact system illustrated in Figure 11, the eyepiece 31 of the CCD-camera 32, light source 33 (halogen or Xenon) and a six-inch monitor 34 are mounted in a housing 35 and are connected to the micro-endoscope via a branch connection 36. This construction allows for more than 7000 pixels fiberscope resulting in an improved resolution.

The method of use of improved micro-endoscope will now be described using hysteroscopy diagnostic procedure to examine the endometrium and fallopian tubes of a patient. A local anaesthetic is first administered to the patient and the distal end of the micro-endoscope, carrying the probe, is passed through the Os and into the cervical canal to examine the endometrium, the microendoscope is manipulated and passed through the tubal ostrium opening into the fallopian duct where the surgeon can carry out an examination by using a direct view system or the fiberscope viewing system.

The micro-endoscope of the present invention may also be used to carry out a retrograde ureteroscopy comprising the steps of passing the micro-endoscope throu#gh the working channel of a rigid cystoscope and entering the ureteric orifice of the patient. The surgeon then manipulates the distal end of the micro-endoscope into the ureter while simultaneously flushing a fluid through the flushing channel of the micro-endoscope and the micro-endoscope is then further manipulated up to the patient's calyx.

The improved micro-endoscope of the invention has the following advantages over known micro-endoscopes: The flexibility of the micro-endoscope and its end articulation allows for a more accurate and a less traumatic examination procedure to be carried out. The steering mechanisms and articulation of the distal tip measuring 2 to 3 cms allow for an excursion of 90 degrees.

The various modifications of the micro-endoscope enable a urologist and a gynaecologist to undertake procedures under direct vision and or remote viewing and recording facilities.

The use of quartz silica glass fibers in the image bundle provides a high quality of image relative to its size. These fibers have an excellent mechanical strength, heat and radiation resistance thus having many applications.

The micro-endoscope is not only a diagnostic instrument but due to its steerability and the relatively large size working channels, will allow a wide range of accessories such as grasping forceps and stone extractors to be used.

The articulation mechanism enables the tip of the distal end to move 90 degrees in one direction, thus allowing the surgeon to scan and observe an object through an angle of 90 degrees while the viewing angle of the lens is maintained at 70 degrees. The improved microendoscope thus enables gall-stones to be observed or destroyed with a laser, by reducing manipulation of the micro-endoscope to a minimum and reducing the invasiveness of the patient.

Various other modifications may be made to the micro-endoscope of the present invention. For example, the outside diameter may be reduced to 0.35 mm so that it can be used for viewing coronory arteries with reduced danger of perforating the arterial walls.

Claims

CLAIMS:

1. An micro-endoscope comprising a flexible outer tube within which is located an image bundle of silica fibers, at least one light guide tube, a flushing channel and instrument channel, wherein the distal end of the flexible outer tube is articulated.

2. A micro-endoscope as claimed in Claim 1, wherein articulation of the outer tube is controlled by a wire connected at one end to the tip of the distal end of the micro-endoscope and the other end is connected to a handle projecting from the rear end of the micro-endoscope

3. An micro-endoscope as claimed in Claims 1 or 2, wherein the image bundle is of quartz silica glass fibers each of 2 to 5Fm diameter.

4. An micro-endoscope as claimed in any preceding claim wherein there are two light guide fiber bundles.

5. An micro-endoscope as claimed in any preceding claim, wherein the length of the endocope is 90 cm to 1.20 m.

6. An micro-endoscope as claimed in any preceding claim, wherein the outer tube is made of a flexible polyurethane.

7. An micro-endoscope as claimed in any preceding claim, wherein the image bundle light guide tube, flushing channel and instrument channel are sealed within the outer tube by an epoxy adhesive.

8. A viewing system for use with the micro-endoscope as claimed in the preceding claims, comprising a removable lens eyepiece which is connected to the image bundle of glass fibers and a light source connected to the light guide tube for direct viewing.

9. A viewing system for use with the micro-endoscope as claimed in any of claims 1 to 7, comprising a lens eyepiece which is connected to the image bundle of glass fibers, the viewing end of the eyepiece being connected to a television monitor and a multi-system video recorder, and a light source connected to the light guide tube forming a fiberscope system for simultaneous, remote or delayed viewing and recording for subsequent viewing.

10. A viewing system for use with the micro-endoscope as claimed in any of claims 1 to 7, comprising a compact system including a light source, a video display monitor and a CCD-camera located in a housing, the CCD-camera being connected to a lens eyepiece, wherein the eyepiece is connectable to the image bundle of glass fibers and the light source is connectable with the light guide tube.

11. A method of hysteroscopy diagnostic procedure to examine the endometrium and fallopian tubes of a patient using the micro-endoscope as claimed in any of claims 1 to 7, comprising the steps of administering a local anaesthetic to the patient, passing the micro-endoscope through the Os into the cervical canal to examine the endometrium, the micro-endoscope then being passed through the tubal ostium opening into the fallopian duct.

12. A method of retrograde ureteroscopy using the micro-endoscope as claimed in any of claims 1 to 7, comprising the steps of passing the micro-endoscope through the working channel of a rigid cystoscope and entering it into the ureteric orifice of a patient, and manipulating it into the ureter while simultaneously flushing through the flushing channel, the articulated distal end of the micro-endoscope assisting manipulation up to the calyx.

13. A micro-endoscope substantially as hereinbefore described with reference to and as shown in Figures 1 to 8 of the accompanying drawings.

14. A viewing system substantially as hereinbefore described with reference to and as shown in Figures 9 to 11 of the accompanying drawings.

14. A method of retrograde ureterosocpe substantially as hereinbefore decribed with reference to the accompanying drawings.

15. A method of hysteroscopy diagnostic procedure substantially as hereinbefore described with reference to the accompanying drawings.