FR2723527A1 - Variable-shape endoscope - Google Patents

Abstract

The endoscope consists of a tube (1) containing optical light guides (3, 4). At least part, and preferably the whole of the tube's length is made from a semi-rigid material which can be bent by hand so that the endoscope can be bent into the required shape. The semi-rigid material is a metal or metal alloy, such as soft steel, aluminium or aluminium alloy. The semi-rigid tube is covered by a supple sleeve, e.g. of silicone or PVC, with an inner diameter 2 - 3 mm greater than that of the semi-rigid tube, which acts as a guide for the supple tube. When necessary the semi-rigid tube can be withdrawn, leaving the supple one in place.

Description

Shapeable endoscope, and method and device for placing a pipe in a cavity, using this endoscope.

 The present invention relates to a moldable endoscope.

It also relates to a method and a device applying this moldable endoscope, for the installation of a flexible pipe, through a curved or sinuous passage.

According to a particularly advantageous application, the moldable endoscope according to the invention is intended to facilitate intubation of the trachea. However, this very interesting application is not limiting,
The endoscope according to the invention can, for example, be advantageously used in urology for the placement of probes, in pneumology for the placement of drains, or even in industry, in very diverse fields (automotive industry, etc.), in order to allow the examination of various cavities or the introduction of flexible tubes into these cavities through a non-rectilinear passage devoid of specific guide members.

 More specifically described below, by way of example, an application of the invention to the intubation of the trachea.

 Intubation of the trachea is a maneuver widely used in emergency medicine or during surgical procedures, to ensure the passage of air in the lungs or to evacuate secretions that clog up the respiratory tract.

 It is understood that the introduction of a tube, me-flexible me, in the larynx and the trachea is a delicate intervention, because it is essential that this introduction is carried out without creating trauma in the aforementioned organs which present important anatomical variations from one subject to another. It therefore requires great skill and a lot of experience.

 To facilitate the placement of endotracheal tubes, practitioners use laryngoscopes which highlight the larynx and thus allow the placement of the probe under direct sight control. Some researchers have recommended modifying this technique by proposing intubation endoscopes comprising a rigid (FR-A-2,562,413) or flexible (US-A-4,742,819) tube containing the laryngoscopic optic and serving as a guide mandrel. On which we drag the intubation probe. Rigid endoscopes (FR-A-2,562,413) are solid, but very difficult to handle, except by very experienced specialists. On the other hand, flexible endoscopes (US-A-4,742,819) are easier to handle, but are very fragile. They are also relatively complex, because they are generally equipped with a so-called "bending device" making it possible to modify the orientation of their distal end.

 Resuscitators and anesthesiologists also use, when possible, a conventional endoscope whose flexible rod containing the endoscopic optic is used as a guide mandrel for the intubation probe arranged around said rod.

 However, current endoscopes are also very fragile, expensive, soft devices, complicated to use for this purpose. They can be easily damaged by teeth.

 In general, the invention aims to obtain an endoscope whose rod containing the light guides can be easily and quickly shaped, so that it can be safely directed into natural cavities of the human body or into cavities or passages not straight without guide means, machines or apparatus, according to the destinations of this endoscope.

 Another object of the invention is the production of a device and a method of intubation making it possible to install, easily and quickly, a flexible tube in a cavity of the human body or in a curved passage devoid of means of specific guidance, of a machine or apparatus, depending on the destination of this device.

 In the aforementioned object, a particular object of the invention is therefore to remedy the drawbacks of the current devices and methods of tracheal intubation.

 According to the invention, these objectives are achieved by means of an endoscope whose rod containing in particular the light or endoscopic optical guides, is modifiable, this rod comprising, over at least a portion of its length and, preferably, over the whole of its length, a reinforcing element executed in a semi-rigid material malleable by hand, allowing the said endoscopic rod to be shaped to the desired shape.

Of preferred and very advantageous naniere, this moldable reinforcing element is constituted by a tube containing
The light guides and any other internal components of the endoscopic rod, this tube being executed in a semi-rigid material malleable by hand, allowing it to be shaped to the desired shape.

 On the other hand, according to the device and the method of the invention, the flexible tube is placed around the rod or tube of the moldable endoscope to which a conformation is given corresponding to that of the curved or sinuous passage into which must be introduced. said flexible hose, the endoscopic rod / flexible hose assembly being then engaged in said passage, under endoscopic control, the flexible hose is then pushed along the endoscope tube or rod until it comes to occupy the position desired.

In application to tracheal intubation, the intubation probe is placed around the malleable semi-rigid tubular rod of the endoscope. The practitioner adapts the endoscope tube to the patient's anatomical shape and places it in the laryngo-tracheal cavity. The intubation probe is then pushed along the endoscope tube which serves as its guide mandrel, until
The desired location, in the trachea.

 In the advantageous application to tracheal intubation, the endoscope according to the invention provides the important advantage of great ease of use. Anesthesiologists can use it easily and without changing their habits.

 The absence of crutch means greatly simplifies its manufacture and use. It is also very robust, because unlike conventional endoscopes or similar devices comprising a flexible tube, its endoscopic rod is provided with a solid tubular frame protecting its internal components from the destructive effects of possible teeth bumps.

The aims, characteristics and advantages above and others still will emerge more clearly from the description which follows and from the appended drawings in which
Figure 1 is a simplified view of an endoscope to which the invention can be applied, the dashed line illustrating an example of conformation that it is possible to give to this endoscope.

 Figure 2 is a cross-sectional view on a larger scale of the tube or rod including the light guides of this endoscope.

 Figure 3 is a simplified view of a device for the establishment of a flexible pipe in a cavity, applying the moldable endoscope according to the invention.

 Figure 4 is a sectional view along line 4-4 of Figure 3.

 Figures 5 to 7 are schematic views ilLustrant the establishment of an intubation probe in the trachea of a patient.

Reference is made to the said drawings to describe an interesting, although in no way limiting, embodiment example of
The endoscope moldable according to the invention and devices and method for placing a flexible tube in a cavity, applying this endoscope.

 This endoscope may comprise, in a manner known per se, an insertion tube or rod 1 containing the endoscopic optic and which, in the application to tracheal intubation, may have a length of the order of 270 mm to 600 mm and a diameter of the order of 2.7 mm to 6.5 mm.

 This rod is connected to a vision device 2 which can be an eyepiece, a camera or cinematographic camera lens, a videoendoscope screen, etc.

 The endoscopic optic is formed of light guides comprising, for example, one or more lighting optical fibers 3 capable of receiving the light emitted by a lighting source E and of routing it to the distal end of the endoscopic rod 1, and an optical fiber for image transmission 4, the distal end of which constitutes a lenticular objective and the proximal end of which is connected to the vision device 2.

 The insertion tube or rod 1 can also include one or more working channels 5 which can be used for various purposes.

According to a characteristic arrangement of the invention,
The rod 1 containing the endoscopic optics 3-4, is moldable, this rod comprising over at least a portion of its length and, preferably, over its entire length, a reinforcement element executed in a semi-rigid material malleable by hand, allowing said endoscopic rod to be shaped to the desired shape.

 Preferably and advantageously, this moldable reinforcing element is constituted by a tube 6 containing the light guides and other possible internal components of the endoscopic rod, this tube being executed in a semi-rigid material which is malleable by hand. In other words, the endoscopic tube 6 or other moldable reinforcing element, is executed in a material which can be molded manually and which retains the shape which is given to it by this modeling.

 Advantageously, the moldable tube 6 or other moldable reinforcing element is made of a malleable metal by hand such as, for example mild steel, aluminum or aluminum alloy.

 The moldable reinforcing element could also consist of one or more semi-rigid metallic wires malleable by hand and embedded in a flexible sheath containing the usual constituent elements of the endoscopic rod 1.

 According to another characteristic arrangement of the invention, the moldable tube 6 executed in semi-rigid metal malleable by hand, is housed in a flexible sheath 7 having a smooth outer surface and which can be, for example, executed in silicone, poly (vinyl chloride) or PVC, or others.

 The hand-malleable semi-rigid tube 6 can have a thickness of the order of 0.5 mm, while the flexible sheath 7 can have a thickness of the order of 0.2 mm.

 Thanks to this flexible sheath 7, the endoscopic rod 1 never forms an angle when it is bent, but always takes a curved conformation.

 It is understood that one can give the desired shape to the endoscopic tube without affecting the efficiency of the interior arrangement of said tube and, of course, without damaging its internal components. It can also be seen that the moldable tube constitutes a relatively hard and resistant protective sheath making it possible to effectively protect the internal components of the endoscopic rod.

 The device for placing a tube in a curved or sinuous cavity also comprises a pipe 8 executed in a flexible material such as, for example, poly (vinyl chloride) or flexible PVC, and whose internal diameter is much greater to the external diameter of the endoscopic rod, so that it can slide easily on the latter, for example under a simple nano push. The difference between the external diameter of the endoscopic rod 1 and the internal diameter of the pipe 8 is, for example, of the order of 2 to 3 mm. Preferably, the pipe 8 has a length less than that of the endoscopic rod 1 around which it is intended to be placed.

 In industrial applications, the flexible pipe 8 can be constituted by a conduit intended to establish communication between a cavity of a machine and an external device, through a non-straight passage passage and, devoid of guide members.

 In medical applications, the flexible tube 8 can be constituted by an intubation probe, by a drain or other tube intended to establish communication between a cavity of the human body and the outside or an external device, through an anatomical passage. narrow.

 According to the method of the invention, the flexible pipe 8 is placed around the endoscopic rod 1 to which a conformation is given which is a function of the conformation of the cavity or passage in which must be introduced and left said flexible pipe. The endoscopic rod 1 / flexible pipe 8 assembly, shaped to the desired shape, is then engaged in said passage under control of the endoscopic optics, the flexible pipe 8 is then pushed along the endoscopic rod 1 on which it slides easily. following the curves given to the latter, until it comes to occupy the desired position, the endoscopic rod then being removed, leaving the flexible hose in place.

 The device for placing an intubation probe in the trachea, comprises an intubation probe 8 executed in a flexible material such as poly (vinyl chloride) or flexible PVC whose internal diameter is clearly greater than the external diameter endoscopic tube 1, as indicated above, so that it can slide easily on the latter, under a simple manual push.

 Preferably, the intubation probe 8 has a length less than that of the endoscopic rod 1 around which it is intended to be placed for the intubation maneuver of the trachea.

 According to the method of intubation of the trachea according to the invention, the flexible intubation probe 8 is placed around the endoscopic rod 1 which is given a conformation adapted to the anatomical shape of the upper respiratory tract of the patient. The set of intubation probe 8 / endoscopic rod 1, shaped to the desired shape, is then engaged in the larynx L.

 The passage of the vocal cords is done under endoscopic control. The assembly is then slightly tilted (traced in broken lines in FIG. 5) to bring its distal end facing the entrance to the trachea T and then engaged in the upper part of the latter. The intubation probe 8 is then pushed along the endoscopic rod 1 on which it slides easily by following the curvatures of the latter, until it comes to occupy the desirable position, in the trachea T (FIG. 6) , said endoscopic rod then being removed leaving the intubation probe in place (Figure 7).

Claims (10)

1. - Endoscope comprising an endoscopic rod or tube (1) containing in particular the light guides (3, 4) of the endoscopic optic, characterized in that this rod (1) is moldable, said rod comprising, on at least one part of its length and, preferably, over its entire length, a reinforcing element (6) executed in a semi-rigid material malleable by hand, making it possible to model said endoscopic rod (1) to the desired shape. 2. - moldable endoscope according to claim 1, characterized in that the moldable reinforcement element consists of a tube (6) containing the usual components (3, 4, 5) of the endoscopic rod (1), this tube modelable (6) being executed in a semi-rigid material malleable by hand, making it possible to model it to the desired shape. 3. - moldable endoscope according to one of claims 1 or 2, characterized in that the moldable reinforcing element (6) constituting the endoscopic rod (1) is executed in a metal or semi-rigid metallic alloy malleable to hand. 4. - Modelable endoscope according to claim 3, characterized in that the malleable tube (6) is made of mild steel, aluminum, or aluminum alloy. 5. - Modelable endoscope according to any one of claims 1 to 4, characterized in that the semi-rigid tube malleable by hand (6) is housed in a flexible sheath (7), for example made of silicone or poly (vinyl chloride) or flexible PVC. 6. - Device for fitting a flexible pipe into a cavity, through a non-rectilinear passage and devoid of guide means, characterized in that it comprises a moldable endoscope executed according to any one of claims 1 to 5, and a flexible pipe (8) sized to be able to be arranged around said endoscope and to slide easily along the latter. 7. - Device according to claim 6, characterized in that the internal diameter of the flexible pipe (8) is significantly greater than the external diameter of the endoscopic rod (1), the diametral difference being, for example, of the order of 2 to 3 mm. 8. - Procedure for placing a flexible pipe in a cavity, through a curved or sinuous passage, characterized in that the flexible pipe (8) is arranged around a rod or endoscopic tube (1) executed according to any one of claims 1 to 5, in that said endoscopic rod (1) is given a conformation adapted to that of said passage, the flexible hose (8) / endoscopic rod (1) assembly then being engaged in said passage, under optical control, the flexible pipe (8) is then pushed along the rod of the endoscope (1) until it comes to occupy the desired position, the endoscope being finally withdrawn leaving the flexible hose in place. 9. - Tracheal intubation device, characterized in that it comprises a moldable endoscope, executed according to any one of claims 1 to 5, and a flexible intubation probe (8) sized to be able to be disposed around the endoscopic rod (1) of said endoscope and slide easily along the latter. 10. - Tracheal intubation method, characterized in that the intubation probe (8) is arranged around an endoscopic tube or rod (1) executed according to any one of claims 1 to 5, in that that said endoscopic tube (1) is given a conformation adapted to the anatomy of the patient's upper respiratory tract, the intubation probe (8) / endoscopic tube (1) assembly then being engaged in the larynx and trachea , the intubation probe (8) is then pushed along the endoscopic tube (1), under endoscopic control, until it comes to occupy the desirable position in the trachea, said endoscopic tube (1) being finally withdrawn , leaving the intubation probe (8) in place.