WO1995024149A1 - Procede et appareil permettant des explorations hysteroscopiques et falloscopiques - Google Patents

Procede et appareil permettant des explorations hysteroscopiques et falloscopiques Download PDF

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Publication number
WO1995024149A1
WO1995024149A1 PCT/US1995/002874 US9502874W WO9524149A1 WO 1995024149 A1 WO1995024149 A1 WO 1995024149A1 US 9502874 W US9502874 W US 9502874W WO 9524149 A1 WO9524149 A1 WO 9524149A1
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WO
WIPO (PCT)
Prior art keywords
catheter
imaging element
lumen
access
distal
Prior art date
Application number
PCT/US1995/002874
Other languages
English (en)
Inventor
Julian N. Nikolchev
Michelle M. Arney
James Doty
Original Assignee
Conceptus, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Conceptus, Inc. filed Critical Conceptus, Inc.
Priority to EP95912793A priority Critical patent/EP0751738A4/fr
Priority to AU19836/95A priority patent/AU1983695A/en
Priority to JP7523613A priority patent/JPH10500034A/ja
Publication of WO1995024149A1 publication Critical patent/WO1995024149A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00149—Holding or positioning arrangements using articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/0125—Endoscope within endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres

Definitions

  • the present invention relates generally to endoscopic surgical methods and apparatus. More particularly, the present invention relates to an improved method and system for performing hysteroscopic and falloposcopic examination of the fallopian tubes and other elongate body ducts.
  • Such falloposcopic access and imaging techniques are generally performed as follows.
  • a hysteroscope is introduced into the uterus and an irrigating solution introduced to distend the uterus and permit video monitoring.
  • a very small guidewire is then introduced through the hysteroscope and advanced past the os into the fallopian tube. The guidewire will continue to be advanced until it approaches the distal fimbria.
  • a small access catheter may then be advanced through the hysteroscope and over the guidewire into the fallopian tube, again preferably reaching the distal fimbria.
  • the falloposcope a small diameter fiberoptic bundle including both imaging and illumination fibers, is advanced until its distal end reaches the distal end of the access catheter.
  • Imaging may then be performed in a retrograde manner with the falloposcope and access catheter being drawn outwardly through the fallopian tube while producing an image on the associated video monitor.
  • the access catheter also provides an access lumen for devices, such as drug delivery catheters, small instruments, and the like, for treatment of tubal lumen disease.
  • falloposcopic techniques represent a significant advantage, they still suffer from certain limitations.
  • the techniques require simultaneous manipulation and coordination of the hysteroscope, access catheter, and falloposcope in order to introduce the falloposcope to the fallopian tube and withdraw the catheter and falloposcope for imaging.
  • Such manipulation must be performed while the treating physician is viewing two separate images from the hysteroscope and falloposcope.
  • falloposcopic procedures have usually required at least one assistant to hold and manipulate the hysteroscope at the desired location throughout the procedure.
  • the primary treating physician can then manipulate both the access catheter and falloposcope in order to produce images of the desired region.
  • Manipulation of the catheter and falloposcope by themselves, however, can be problematic.
  • a particular problem that can arise results from elongation associated with stretching of the access catheter as the catheter and falloposcope are drawn through the fallopian tube in a retrograde manner. Because of resistance to passage of the catheter through the fallopian tube, the catheter can be stretched so that its distal end elongates past the distal end of the falloposcope. Optimal imaging occurs when the distal end of the falloposcope is substantially aligned with the distal end of the access catheter. Thus, it may become necessary for the physician to periodically stop the procedure, unattach the falloposcope from the access catheter, and reposition the falloposcope relative to the catheter so that image sharpness is restored.
  • Hysteroscopes and falloposcopes are described generally in U.S.
  • the present invention provides simplified apparatus and procedures for introducing and manipulating hysteroscopes, access catheters, falloposcopes, and other instruments for use in imaging and treatment of fallopian tubes.
  • the apparatus and procedures of the present invention further provide for improved image quality when the fallopian tube is imaged using a catheter and falloposcope passed through the tube in a retrograde manner.
  • an access catheter is introduced to the fallopian tube through a viewing scope, typically a hysteroscope, which provides a primary access lumen.
  • a viewing scope typically a hysteroscope
  • the proximal end of the viewing scope is fixed onto a support surface, and the access catheter introduced through the working lumen of the viewing scope (typically over a guidewire) while the viewing scope remains immobilized.
  • the treating physician is free to use his or her hands to perform introduction of the access catheter and other tasks required for imaging or treatment.
  • Immobilization of the viewing scope may be accomplished using a support structure, such as an articulated arm, which is attached to the support surface at one end and to the proximal end of the viewing scope at its other end.
  • a support structure for the viewing scope comprises an arm structure having a first end and a second end with a plurality of articulated segments therebetween.
  • a clamp or other attachment device is provided at a first end of the support structure for mounting the arm on a fixed surface, and an attachment member is provided on the other end of the arm for detachably securing a proximal handle of a viewing scope.
  • Means are further provided for selectively immobilizing the articulated segments so that the distal end of the arm structure may be locked relative to the proximal end to hold the viewing scope in the desired orientation.
  • a preferred clamp for the viewing scope comprises an elongated base having an axial slit with a pair of opposed retaining elements disposed on either side of the slit. The slit may then be tightened to clamp the proximal handle of the hysteroscope therebetween.
  • an access catheter is introduced to a patient's fallopian tube by introducing the shaft of the viewing scope in the uterus. A distal portion of the shaft having a length from 1 cm to 4 cm is then deflected toward the os of the fallopian tube which is desired to be entered. The remainder of the shaft of the viewing scope remains substantially rigid while the guidewire is first introduced through the os and into the fallopian tube. The access lumen is then advanced over the guidewire while the rigid portion of the shaft provides support to assist advancement of the catheter into the fallopian tube.
  • an improved hysteroscope comprises a handle and deflectable working shaft having an access lumen and fiberoptic imaging elements therein.
  • the improvement comprises a working shaft which is substantially rigid over its proximal length and selectively deflectable over from 1 cm to 4 cm of its distal length.
  • the improved hysteroscope can be used for introducing a guidewire and access catheter into the fallopian tubes as described above.
  • the improved hysteroscope may further comprise an enlarged diameter shoulder on the working shaft which is located from 3 cm to 12 cm proximally of the distal end of the shaft.
  • the diameter of the working shaft is preferably 4 mm or less, to facilitate introduction through the cervical os into the uterus.
  • the shoulder preferably has a diameter from 4 mm to 5 mm to enhance sealing against the cervical os to prevent the loss of fluid when the uterus is distended with a clear irrigation solution for viewing.
  • an improved method for retrograde imaging of an elongate body duct comprises withdrawing a fiberoptic imaging element disposed within an access catheter through the lumen.
  • the improvement comprises adjusting the position of the imaging element within the access catheter as the element is withdrawn in order to maintain alignment of the distal end of the imaging element with the distal end of the access catheter.
  • the elongation of the access catheter which may occur during withdrawal of the catheter and imaging element can be offset and image quality can be enhanced.
  • the relative position of the imaging element in the access catheter will be adjusted manually, where the user manually grasps the proximal ends of both the access catheter and the imaging element. The user may thus continuously adjust the relative positions of the imaging element and access catheter in order to maintain the desired image quality.
  • a system for imaging a tubular duct comprises a remote access catheter having a hub at its proximal end.
  • a fiberoptic imaging element is receivable through a port in the hub and within a central lumen of the access catheter.
  • the imaging element has a length which is greater than that of the catheter lumen and includes a sleeve formed thereover and positioned so that the sleeve will be disposed within the first hub port when the distal end of the imaging element is aligned with the distal end of the catheter.
  • the hub port and sleeve are adapted so that the port may be closed over the sleeve with sufficient tightness to prevent leakage of fluid as the duct is being distended with pressurized fluid while still allowing the fiberoptic element to be axially translated within the access catheter.
  • the access catheter has a reduced diameter over a distal portion thereof, usually having a distal portion with a length in the range from 4 cm to 20 cm and an inner diameter in the range from 0.4 mm to 0.6 mm and a proximal portion with a length greater than or equal to 25 cm and an inner diameter in the range from 0.6 mm to 1 mm.
  • the hub includes a valve for selectively tightening over the sleeve.
  • FIG. 1 is a side elevational view of a hysteroscope constructed in accordance with the principles of the present invention.
  • Fig. 2 is a top view of the hysteroscope of Fig. 1.
  • Fig. 3 is an enlarged end view of the working shaft of the hysteroscope of Fig. 1, taken at line 3-3.
  • Fig. 4 is a perspective view of the combination of an access catheter and falloposcope constructed in accordance with the principals of the present invention.
  • Fig. 5 is an elevational view of the falloposcope of Fig. 4, illustrating the entire assembly.
  • Fig. 6 is an enlarged end view of the falloposcope of Fig. 5, taken at line 6-6.
  • Fig. 7 illustrates the combination of hysteroscope, access catheter, and falloposcope used in imaging a fallopian tube through the uterus.
  • Fig. 8 is a detailed view of a proximal hub on the access catheter showing the position of a control sleeve on the falloposcope within a port on the hub.
  • Fig. 9 illustrates the preferred method for holding the proximal end of the hysteroscope in the method of the present invention, where the proximal end is immobilized and a support structure attached to a table.
  • Figs. 10-13 illustrate the use of the access catheter and falloposcope in imaging a fallopian tube in greater detail.
  • the present invention utilizes a viewing scope to provide a primary access lumen into a patient's body cavity, typically the uterus.
  • the viewing scope will have viewing capabilities, typically in the form of a fiberoptic bundle running through its working shaft.
  • the working shaft will also provide the access lumen, and the scope will typically include a proximal handle which provides a port which opens into the access lumen and the necessary interface between the fiberoptic bundle and the external video imaging equipment.
  • the viewing scope will be a hysteroscope having a substantially rigid working shaft with a deflectable distal tip, as described in more detail hereinafter. It will be appreciated, of course, that the term hysteroscope is used for convenience only, and the present invention can utilize any viewing scope having the requisite capabilities just described.
  • a viewing scope 10 comprises a working shaft 12 having a proximal end 14 and distal end 16 and a handle 18 attached at its proximal end.
  • An access or working lumen 20 extends from the proximal end 14 to the distal end 16 of shaft 12 and is accessible through a connector port 22 disposed on the handle 18.
  • the working shaft 12 further includes a fiberoptic bundle 24 (Fig. 3) and a plurality of illuminating optical fibers 26 which may be interfaced with conventional video monitoring equipment through connecting cables 28 and 30.
  • the construction of the viewing scope is generally conventional and typical of a variety of commercially available hysteroscopes such as those available from Olympus Optical Company, Intramed Laboratories, Inc., and others, and described in U.S. Patent Nos. 4,911,148; 4,836,189; 4,779,612; 4,641,634; and 4,503,843, the full disclosures of which are incorporated herein by reference.
  • the present invention provides improved viewing scopes, particularly in the form of improved hysteroscopes, where the working shaft is modified in two respects to enhance and facilitate the introduction of guidewires, access catheters, and secondary fiberoptic imaging elements (e.g.
  • the first improvement comprises forming the working shaft as a substantially rigid structure from the proximal end 14 to a transition point 30.
  • the remainder of the working shaft 12 will be deflectable from the transition point 30 to the distal tip 16.
  • the tip can be deflected in a right direction or left direction, as illustrated in broken line in Fig. 2, using knob 32 on handle 18.
  • the length of the deflectable portion of shaft 12 will be in the range from 1 cm to 4 cm, preferably being from 2 cm to 3 cm.
  • Total length of the working shaft 12 will be in the range from 15 cm to 25 cm, preferably from 17.5 cm to 18.5 cm.
  • the second improvement in working shaft 12 is the provision of a tapered shoulder 34 at a location between the proximal end 14 and distal end 16.
  • the tapered shoulder 34 is intended to engage and seal the cervical os OS, as illustrated in Fig. 7, when the working shaft 12 is introduced to the uterus.
  • the shoulder will be located by distance in the range from 3 cm to 12 cm, preferably from 10 cm to 12 cm, from the distal end 16 of the shaft.
  • the diameter Dl of the shaft distal to the shoulder 34 will usually be below 4 mm, preferably being in the range from 3.5 to 3.6 mm.
  • the diameter D2 of the proximal of the shaft is less critical, typically being in the range from 4 mm to 5 mm.
  • the access lumen 20 through the working shaft 12 may also have a stepped diameter corresponding to the outer diameter but this is not necessary.
  • the diameter of lumen 20 will typically be in the range from 1 mm to 2 mm, preferably from 1.5 mm to 1.7 mm
  • Access to the target body lumen typically a fallopian tube
  • a fallopian tube will be provided through the working lumen 20 of the viewing scope 10 using a small-diameter access catheter
  • the length of the catheter will be sufficient to permit introduction through the viewing scope and into the target lumen.
  • the length of the body of the access catheter will typically be from 40 cm to 60 cm, usually being about 50 cm.
  • Suitable catheters may be constructed in accordance with the teachings of U.S. Patent 4,739,768, the full disclosure of which is incorporated herewith by reference.
  • the catheter 40 includes a catheter body 42 having a distal portion 44, a distal port 45, and a proximal end 46.
  • the distal portion 44 will preferably have a reduced diameter compared to the proximal portion.
  • the distal portion will have an inner diameter in the range from 0.4 mm to 0.6 mm, preferably from 0.5 mm to 0.6 mm, usually being about 0.55 mm.
  • the proximal portion will have an inner diameter in the range from 0.6 mm to 1 mm, preferably from 0.6 mm to 0.75 mm, usually being about 0.68.
  • the length of the reduced-diameter distal portion 44 will typically be from 4 cm to 20 cm, preferably from 15 cm to 20 cm, more usually being about 17 to 18 cm.
  • Catheter 40 further includes a proximal connector 50 which includes an axially aligned port 52 and a side port 54.
  • the axially aligned port 52 receives a fiberoptic imaging element 60 (illustrated in isolation in Figs. 5 and 6) , while the side port 54 remains available for introducing irrigation fluid through the lumen of catheter body 42 into the fallopian tube, as described hereinafter.
  • Fiberoptic imaging elements 60 is typically in the form of a falloposcope comprising flexible shaft 62 a small diameter, typically in the range in the range from 0.3 mm to 0.6 mm, usually about 0.5 mm.
  • the shaft 67 carries a fiberoptic bundle 64 and a plurality of light transmitting optical fibers 66 at the distal end 68 for imaging and illuminating, respectively (Fig. 6) .
  • the fiberoptic imaging element 60 further includes a pair of connectors 70 and 72 attached to proximal end 74 by a flexible cable 76. Connectors 70 and 72 allow interconnection with conventional video monitoring equipment, where one connector provides the visual image and the other connector provides the illumination.
  • the fiberoptic imaging element 60 is configured to mate with the access catheter 40 in a way that facilitates manipulating both the imaging element and catheter during imaging of the fallopian tube.
  • the length of the flexible shaft 62 (including a control sleeve section 80 described below) will be slightly longer than the total length of the access catheter 40 from its distal tip to the axially aligned port 52.
  • flexible shaft will be from 1 cm to 10 cm longer than the catheter 40, having a total length from 55 cm to 65 cm.
  • the fiberoptic imaging element 60 further includes a control sleeve 80, typically in the form of a polymeric sheath, formed over a proximal portion of the flexible shaft 62.
  • the control sleeve 80 will be sized to be received within axially aligned port 52, more particularly to be received within a compression-seal valve 82 disposed in the port.
  • the control sleeve will have a diameter in the range from 1.5 mm to 2 mm, preferably from 1.6 mm to 1.7 mm.
  • the compression seal valve 82 will typically be a Touhy-Borst valve or equivalent which permits the physician to selectively tighten an O-ring 82 on the exterior of the control sleeve 80.
  • the enlarged diameter of the control sleeve 80 relative to the shaft 62 greatly facilitates forming a compression seal (i.e., it is very difficult to seal around the shaft 62 of the imaging element 60 which typically has a diameter of about 0.5 mm.
  • the control sleeve also provides strain relief which helps protect the delicate imaging element. By tightening the valve in an appropriate amount, leak-back of irrigation fluid introduced through side port 54 is prevented without significantly inhibiting axial translation of the sleeve within the valve. This is an important feature since it allows the physician to adjust the relative position of the fiberoptic imaging element 60 within the catheter 40 in order to maintain alignment of their respective distal ends in order to enhance imaging with interrupting imaging of the fallopian tube.
  • a connector 88 is provided on the imaging element 60 on the proximal side of control sleeve 60.
  • Connector 88 allows the physician to grasp and manipulate the imaging element 60 by holding both the connector 88 and the proximal connector 50 on the catheter 40 and pushing or pulling as appropriate. The physician may use either two hands or a single hand to perform such manipulations.
  • Figs. 7 and 10-13 use of the viewing scope 10, access catheter 40, and fiberoptic imaging element 60 in the imaging of a fallopian tube F will be described.
  • the working shaft 12 of the hysteroscope 10 is first introduced to the uterus U in a conventional manner or using an adjustable support system as described hereinafter.
  • the deflectable distal end 16 of the shaft 12 is directed toward the os OS and a guidewire (not illustrated) introduced through a Y-connector 90 affixed to the connector 22 on the scope 10.
  • the uterus will be distended by introducing irrigation fluid through side port 92 on connector 90 so that the guidewire may be introduced under direct visualization through the scope.
  • the physician may also view the procedure fluoroscopically.
  • Suitable guidewires are available from commercial suppliers, such as Target Therapeutics, Fremont, California, and others.
  • the guidewire will be introduced at least 1 cm beyond the tubal os, and preferably to near the distal fimbria F. After the guidewire has been properly located, access catheter 40 will be introduced over the guidewire, again in the conventional manner.
  • the catheter 40 will preferably be introduced until its distal end 44 approaches the fimbria F, as illustrated in Fig. 7.
  • the guidewire may then be withdrawn and exchanged for the fiberoptic imaging element 60, which will be introduced so that distal end 68 becomes aligned within distal port 45 end of the catheter 40.
  • a clear irrigation fluid is introduced through the side connector 54 on hub 50. Because of leakage through the fimbria, it is necessary to introduce the fluid at a rate from about 5 ml/min to 10 ml/min.
  • Use of the catheter 40 having an enlarged proximal portion has been found to significantly reduce the pressure required to introduce fluid at such rates. While a catheter having a uniform diameter (size so that its distal portion may pass through the fallopian tube) may require a pressure up to 10 atm or higher, use of an enlarged proximal diameter (as described above) can reduce the pressure below 5 atm, of 3 to 5 atm. Such reduced pressure are easier to handle and decrease the likelihood of accidents.
  • the imaging element 60 and catheter 40 are withdrawn simultaneously in a retrograde manner to provide imaging along the length of the fallopian tube.
  • the catheter body 42 will have tendency to elongate so that its distal end 45 extends beyond distal end 68 of the imaging element, as illustrated in Fig. 11. As described above, such a situation degrades the image quality being provided.
  • image quality can readily be restored by adjusting the axial position of the imaging element 60 within the catheter 40 by translating control sleeve 80 within the axial port 52 of connector 50.
  • the physician can continuously move the connector 88 relative to connector 50 while viewing the image on the associated video monitor in order to obtain the clearest image possible as the catheter is being withdrawn through the fallopian tube.
  • support structure 100 includes a plurality of arms 102 and joints 104 which are designed to freely articulate so that a support base 106 at a distal end of the structure 100 can be moved freely in space (until locked in position using the central knob 105) .
  • the support structure 100 may be firmly secured to a table leg L using a clamp 110 and attachment structure 112.
  • Such systems are commercially available from suppliers, such as Lino Manfrotto & Company.
  • the present invention provides a unique support base 106 and scope attachment member 120.
  • the base 106 is attached to the support structure and may be locked in position together with all remaining components of the support structure.
  • the scope attachment member 120 may be mounted on the support 106 using a quick interconnect mechanism 122.
  • the attachment member comprises a pair of opposed retaining elements 130 which are separated by an axial slit 132.
  • a threaded shaft 134 or other tightening mechanism is provided so that the retaining elements may be secured on opposite sides of the handle 18 of the viewing scope 10. In this way, attachment member 120 may be secured to the handle 18 prior to the mounting of the attachment member and handle onto the support structure 100 using the disconnect 122.
  • fallopian tube imaging procedures can be easily performed by a single physician.
  • the physician can first introduce the viewing scope 10 into the uterus and identify the target fallopian tube ostium.
  • the scope 10 can then be attached to the support structure 100 and the support structure locked in position (immobilized) when the scope is in its desired position.
  • the physician can then introduce the catheter 40 and imaging element 60 using the guidewire procedure described above while the viewing scope 10 remains locked in position on the support structure 100.
  • the catheter and imaging element 60 may be withdrawn in a retrograde manner through the fallopian tube to perform the imaging, as described above.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gynecology & Obstetrics (AREA)
  • Reproductive Health (AREA)
  • Endoscopes (AREA)
  • Surgical Instruments (AREA)
  • Mechanical Treatment Of Semiconductor (AREA)

Abstract

On obtient des images des trompes de Fallope (F) avec un système coaxial comprenant un hystéroscope (10) un cathéter (40) d'accès et un falloscope (60), ces deux derniers étant conçus pour permettre un alignement approprié entre leurs extrémités (45) distales respectives pour améliorer la qualité d'image. On décrit un système de support d'hystéroscope (10) qui évite de devoir utiliser ce dernier manuellement pendant l'exploration.
PCT/US1995/002874 1994-03-07 1995-03-06 Procede et appareil permettant des explorations hysteroscopiques et falloscopiques WO1995024149A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP95912793A EP0751738A4 (fr) 1994-03-07 1995-03-06 Procede et appareil permettant des explorations hysteroscopiques et falloscopiques
AU19836/95A AU1983695A (en) 1994-03-07 1995-03-06 Method and apparatus for performing hysteroscopic and falloposcopic procedures
JP7523613A JPH10500034A (ja) 1994-03-07 1995-03-06 子宮鏡及び卵管鏡処置を行なう方法及び装置

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US20747594A 1994-03-07 1994-03-07
US08/207,475 1994-03-07

Publications (1)

Publication Number Publication Date
WO1995024149A1 true WO1995024149A1 (fr) 1995-09-14

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EP (1) EP0751738A4 (fr)
JP (1) JPH10500034A (fr)
AU (1) AU1983695A (fr)
WO (1) WO1995024149A1 (fr)

Cited By (6)

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EP1292214A2 (fr) * 2000-05-19 2003-03-19 C.R. Bard, Inc. Fil de guidage avec fonction de visualisation
WO2006003836A1 (fr) 2004-07-01 2006-01-12 Olympus Corporation Partie d’insertion d’endoscope, endoscope, et système d’endoscope
EP2494910A1 (fr) * 2011-03-01 2012-09-05 Sanovas, Inc. Cathéter orientable
CN105749405A (zh) * 2014-12-19 2016-07-13 谷村哲明 包含输卵管镜的导管***及该***的组合方法
US10349821B2 (en) 2011-03-01 2019-07-16 Sanovas Intellectual Property, Llc Cleaning system for medical imaging device
WO2020196998A1 (fr) * 2019-03-27 2020-10-01 주식회사 엠케어코리아 Implant pour le dépistage du cancer des ovaires, kit de test de dépistage le comprenant et procédé de test de dépistage du cancer des ovaires l'utilisant

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JP2006055218A (ja) * 2004-08-17 2006-03-02 Kitazato Supply:Co Ltd 軟性子宮鏡用卵管内生殖材料移植用器具
JP6164207B2 (ja) * 2012-03-16 2017-07-19 コニカミノルタ株式会社 ファイバースコープ及びその挿入部並びに内視鏡システム
JP6139759B1 (ja) * 2016-07-09 2017-05-31 アイハート・メディカル株式会社 細胞採取用器具

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EP1292214A2 (fr) * 2000-05-19 2003-03-19 C.R. Bard, Inc. Fil de guidage avec fonction de visualisation
EP1292214A4 (fr) * 2000-05-19 2007-07-04 Bard Inc C R Fil de guidage avec fonction de visualisation
WO2006003836A1 (fr) 2004-07-01 2006-01-12 Olympus Corporation Partie d’insertion d’endoscope, endoscope, et système d’endoscope
EP1769717A1 (fr) * 2004-07-01 2007-04-04 Olympus Corporation Partie d'insertion d'endoscope, endoscope, et système d'endoscope
EP1769717A4 (fr) * 2004-07-01 2009-08-12 Olympus Corp Partie d'insertion d'endoscope, endoscope, et système d'endoscope
US8465419B2 (en) 2004-07-01 2013-06-18 Olympus Corporation Endoscope insertion unit, endoscope and endoscope system
EP2494910A1 (fr) * 2011-03-01 2012-09-05 Sanovas, Inc. Cathéter orientable
US10058235B2 (en) 2011-03-01 2018-08-28 Sanovas Intellectual Property, Llc Steerable catheter
US10349821B2 (en) 2011-03-01 2019-07-16 Sanovas Intellectual Property, Llc Cleaning system for medical imaging device
CN105749405A (zh) * 2014-12-19 2016-07-13 谷村哲明 包含输卵管镜的导管***及该***的组合方法
WO2020196998A1 (fr) * 2019-03-27 2020-10-01 주식회사 엠케어코리아 Implant pour le dépistage du cancer des ovaires, kit de test de dépistage le comprenant et procédé de test de dépistage du cancer des ovaires l'utilisant

Also Published As

Publication number Publication date
EP0751738A1 (fr) 1997-01-08
AU1983695A (en) 1995-09-25
EP0751738A4 (fr) 1998-11-11
JPH10500034A (ja) 1998-01-06

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