HK1238111A1 - Medical devices and methods of placement - Google Patents

Description

Medical device and placement method

Priority declaration

This application claims priority to U.S. patent application No. 14/798,751, filed on 7/14/2015, a continuation-in-part of U.S. patent application No. 14/455,470 filed on 8/2014, the entire disclosure of which is incorporated herein by reference.

Technical Field

The present invention provides various medical devices, each having a camera placed in a camera tube, which allows for continuous visualization (visualization) of each device during and after placement in a patient with one camera. An acoustic device, such as a microphone, is incorporated in many devices and provides continuous monitoring of breath and heart sounds within the patient. The camera and microphone do not contact the patient's tissue and therefore do not need to be sterilized. Continuous visualization and audio monitoring of the patient is real-time and remote monitoring is also achieved. The present invention also provides methods for quickly and accurately placing a medical device within a patient.

Background

There are various devices to stabilize a patient and facilitate their breathing, feeding, and drug delivery. These devices are used in patients who are subjected to surgery following certain trauma, including spinal cord injury, and in patients who suffer from certain medical conditions, including advanced Alzheimer disease. These devices include endotracheal tubes (endotracheal tubes), airway devices (airway devices), feeding tubes (feeding tubes), oral airways (oral air tubes), nasal canulas (nasal canulas), and the like.

Because the human anatomy varies significantly from patient to patient, proper placement of a medical device in the trachea of a patient requires a great deal of skill and is an inherent risk task. The task can become even more complicated as the insertion procedure may have to be performed immediately at the scene of an accident, on a pediatric patient, in a nursing home, in a battlefield or at the scene of a natural disaster where many patients have to be attended at the same time.

The process of placing a breathing tube in a patient is known as intubation (intubation). Devices such as laryngoscopes (laryngoscope), video laryngoscopes (videolaryngoscope), fiberscopes (fiberoptic scopes), and other proprietary video scopes have been developed. These devices provide initial placement accuracy, but do not provide continuous visualization or image mobility after the medical device has been placed within the patient. Newer devices, such as vivariut SL or DL endotracheal tubes, provide continuous visualization, but are costly because they rely on a single use of a disposable camera and the camera cannot be transferred from one medical device to another. The Totaltrack VLM supraglottic airway has a proprietary reusable camera that is used for only one of its devices and cannot be transferred to other medical devices.

Thus, there remains a need for improved devices that can be easily remotely monitored by qualified personnel during and after placement to see if there is an adverse reaction. After the medical device has been placed in the patient, there is still a need to monitor the patient immediately for possible adverse reactions, such as aspiration (aspiration), airway secretion (airway secretion), apnea (apnea), etc.

Disclosure of Invention

At least some of these needs are addressed by the medical device of the present invention which is equipped with a portable universal visualization device in which a camera is placed in a separate camera tube and used to transmit information in real time that can be accessed and monitored remotely and simultaneously from multiple patients.

One embodiment provides a medical visualization device including a camera tube having a distal end and a proximal end. The distal end is sealed by a transparent material and the proximal end has an opening. A camera with wires is placed inside the camera tube. The camera may be placed inside the camera tube, and it may be retracted from the camera tube as desired. The camera can be reused in a variety of devices without the need for sterilization. The camera may wirelessly transmit images to a remote location. In certain embodiments, the camera tube comprises a fiber optic material. The visualization device may be equipped with at least one of the following devices: a light source, a trocar, a bougie, and a sound and temperature monitoring device that can wirelessly transmit information to a remote location. The visualization device may transmit images, sound and other data to any number of remotely located monitoring devices and/or data storage devices. These devices include, but are not limited to, wireless portable devices, smart phones, tablets, watches, mobile phones, handheld wireless devices, computers, remote data servers, radios, televisions, walkie-talkies, and the like.

Another embodiment provides a method of continuously monitoring at least one internal organ of a patient, the method comprising: placing a visualization device having a camera positioned in a sealed camera tube within a patient; causing the camera to instantaneously transmit an image of the internal organ through the transparent material at the distal end of the camera tube; and analyzing the transmitted image. In some embodiments, the image is wirelessly transmitted to at least one remote location.

Various internal organs can be monitored by this method, including the nasopharynx (napharynx), the pharynx (pharynx), the hypopharynx (hypopharynx), the supraglottic structure (supraglottic structure), the airway (airway), the trachea (Trachea), the vocal cords (vocal cord), the stomach (stomach), and the vagina (vagina).

In some embodiments, the length of the camera tube in the visualization device is adjustable, and it can be adjusted to accommodate the length of at least one of the following: endotracheal tubes (endotracheal tubes), supraglottic airways (supraglottic air-guide), airway devices (air-guide), oral airways (oral air-guide), dilators (dillators), tracheostomy devices (tracheostomy), intubated oral airways (intubated oral air-guide), esophageal stethoscopes (esophageal stethoscopes), nasal cannulae (nasal canula), feeding cannulae (feeding tube), suction tubes (suction tube), and endotracheal exchange tubes (endotracheal changing tube).

Other embodiments provide a method for placing a medical device within a patient, wherein the medical device is equipped with the visualization device and a bougie (bougie). The medical device is inserted into a patient and the placement of the device is guided by a bougie under continuous visualization.

A kit for the on-line monitoring of internal organs of a patient is also provided. The kit comprises: a camera tube having an adjustable length and wherein at least one ring is externally attached to the camera tube, wherein the camera tube has a distal end and a proximal end, and wherein the distal end of the camera tube is sealed by a transparent material; and a reusable camera positionable in and removable from the camera tube and wirelessly transmitting images to at least one remote location. Such real-time information obtained by the visualization device may be transmitted or stored to a plurality of remote monitoring sites.

Also provided is a medical device comprising a visualization device sealed to, attached to, or in combination with at least one of: endotracheal tube (endotracheal tube), supraglottic airway device (supraglottic airway device), ventilator adaptive cap (ventilator adaptive cap), dilator (dilator), tracheostomy device (transcutomy device), nasopharyngeal airway (nasal), oral airway (oral airway), stethoscope (esophageal stethoscope), laryngoscope (canalscope), speculum (speculum), nasal cannula (nasal cannula), feeding esophagus (feeding tube), suction tube (suction tube), suction catheter (suction catheter), and endotracheal exchange tube (endotracheal changing tube); and wherein the visualization device comprises a camera tube having a distal end and a proximal end, the distal end being sealed by a transparent material, and a camera placed inside the camera tube through an opening at the proximal end. These medical devices may also be equipped with at least one of the following: bougie (bougie), flexible trocar (flexible stylus), and sound-and-temperature monitoring device (sound-and-temperature-monitoring device). In certain embodiments, the visualization device is externally sealed, attached, or otherwise connected to a second device. In other embodiments, the visualization device may be placed inside the second device. Also encompassed are various endotracheal tubes equipped with the visualization device, including: an endotracheal tube comprising a sleeve through which the visualization device is insertable; an endotracheal tube through which a ventilator adaptive cap is placed with the visualization device internally; and an endotracheal tube externally attached to the visualization device.

Other embodiments provide an oral airway device comprising a tube having a central lumen and a visualization device attached to the tube, wherein the lumen has a diameter such that an endotracheal tube can be placed inside the lumen, and wherein the visualization device comprises a camera tube sealed at a distal end by a transparent material and a camera placed inside the tube through an opening at a proximal end, and wherein the camera tube is positioned along the tube. The visualization device may be attached to the tube internally or externally. The oral airway device may further comprise a detachable handle, which may be connected to the oral airway device by a bracket.

Other embodiments provide an oral airway device having a rotating central passage and made of two half cylinders: a first externally positioned half-cylinder and a second internally positioned half-cylinder, wherein the second half-cylinder fits inside the first half-cylinder and is slidable inside the first half-cylinder along a proximal-distal axis of the first half-cylinder, and wherein the second half-cylinder is also rotatable inside the first half-cylinder and thereby forms a fully enclosed central passage (fully enclosed central passage) or forms an only partially enclosed central passage with a lateral opening (only partially enclosed central passage), and wherein the first half-cylinder and the second half-cylinder are completely separable from each other.

Other embodiments provide a supraglottic ventilation tube with a camera, the supraglottic ventilation tube comprising a ventilation tube having a distal end and a proximal end and equipped with a visualization device, the visualization device comprising a camera tube and a camera, the camera tube attached along the ventilation tube exteriorly, the camera placeable inside the camera tube with an inflatable cuff wrapped over the ventilation tube and the camera tube positioned below the cuff.

Methods for intubating and extubating a patient are also provided, wherein an endotracheal tube or ventilation tube is loaded onto the second half-cylinder of the oral airway device, the second half-cylinder is then assembled with the first half-cylinder of the oral airway device, and the assembly is inserted into the patient under continuous visualization and monitoring.

Another embodiment provides a tubeless intubation device including an ellipsoid attached to a handle and a visualization device attached to the intubation device, wherein the visualization device includes a camera tube and a camera that can be placed in and removed from the camera tube, and wherein the ellipsoid includes a lumen and a channel that opens below the handle.

Other embodiments provide a sliding endotracheal cuff device comprising a tube having a distal end and a proximal end, and a rail attached exteriorly to the tube along a proximal-distal axis, wherein the rail has a groove opening to the interior of the tube, wherein the device further comprises a cuff wrapped exteriorly around the tube at a distal portion of the tube, and wherein the device further comprises a camera tube attached exteriorly to the tube along a proximal-distal axis, and a camera positionable inside and out of the camera tube.

Other embodiments include: an assembly in which an oral airway device is inserted inside a carrier that includes a tube having a lumen and a first balloon covering a distal end of the carrier. The carrier has a lumen opening proximal to the first balloon, and the carrier has a second balloon proximal to the lumen that surrounds a tube of the carrier. The carrier may optionally further comprise a third balloon surrounding the body of the carrier proximal to the second balloon. The balloon is inflatable by an inflation member. Methods of intubation and extubation of a patient via the carrier assembly are also provided.

Drawings

FIGS. 1A, 1B and 1C show side views of an embodiment of the visualization device as shown in FIG. 1A, which may further be equipped with a trocar as shown in FIGS. 1B and 1C;

FIG. 2 shows a side view of an embodiment of an endotracheal device equipped with a visualization device;

FIG. 3 shows a side view of an alternative embodiment of an endotracheal device equipped with a visualization device;

fig. 4A and 4B illustrate two embodiments showing a visualization device attached to a built-in ventilator adaptive cap. FIG. 4A is an embodiment without a light source, while FIG. 4B is an embodiment with a light source;

fig. 5A, 5B and 5C show side views of other embodiments of a visualization device attached to a built-in ventilator adaptive cap and passing through a sliding sleeve (fig. 5A and 5B), wherein the other embodiment shown in fig. 5C includes a bougie or flexible trocar as shown in the inset;

figures 6A and 6B show side views of an embodiment of an endotracheal device equipped with a visualization device passing through a sliding sleeve;

figures 7A and 7B show side views of alternative embodiments of an endotracheal device equipped with a visualization device passing through a sliding sleeve;

FIG. 8 is a side view of an embodiment of an endotracheal device equipped with a bougie;

fig. 9A, 9B, and 9C are side views of a developing device equipped with a plurality of rings. Fig. 9A is a side view of a developing device equipped with two rings. Fig. 9B is a side view of the visualization device as shown in fig. 9A, but also equipped with a bougie. Fig. 9C is a side view of the visualization device as shown in fig. 9A, but further equipped with a light source. Fig. 9D is a cross-sectional view of the visualization device shown in fig. 9A, showing the ring attached to the camera tube. FIG. 9E is a cross-sectional view of the visualization device shown in FIG. 9A, showing an adjustable slide ring having a clasp connected to a camera tube. FIG. 9F is a side view of the endotracheal tube to which the visualization device shown in FIG. 9A is connected by two sliding rings;

figure 10 is a side view of a supraglottic airway device equipped with a visualization device. The endotracheal device shown in fig. 3 is shown as an inset on the left side and the flexible guide trocar is shown as an inset on the right side;

fig. 11A and 11B show side views of an alternative airway device with a visualization device. FIG. 11A is a side view of the airway device, and FIG. 11B is the device as shown in FIG. 11A, but with a ventilator adaptive cap;

fig. 12A, 12B and 12C show an oral airway intubation device with a visualization device. Fig. 12A is a side view of an oral airway device, and fig. 12B and 12C are cross-sectional views of the airway device in its full cylindrical form (fig. 12B) and in its semi-cylindrical form (fig. 12C) in which one semi-cylinder is retracted into the other;

FIG. 13 shows a side view of the dilator with visualization means;

fig. 14A and 14B show side views of a tracheostomy device with a visualization device. Fig. 14A shows an embodiment in which the visualization device is externally attached to the tracheostomy tube, while fig. 14B shows an embodiment in which the visualization device is attached inside the tracheostomy tube;

FIG. 15 shows a side view of the nasopharyngeal airway with an imaging device;

fig. 16A-16C show side views of an oral airway equipped with a visualization device, and fig. 16D shows an intubated oral airway also equipped with a visualization device. Figure 16A shows a visualization device positioned within the airway of an oral cavity. Fig. 16B is the same as fig. 16A, but includes a light source for the visualization device. Fig. 16C is the same as fig. 16A, but includes a whistle. FIG. 16D is an intubated oral airway device having a main lumen in which an endotracheal tube may be placed. FIG. 16E is an intubated/extubated oral airway device having a main lumen as shown in FIG. 16D and in which an endotracheal tube has been placed;

FIGS. 16F and 16G are examples showing a portion of an intubated/extubated oral airway device having a detachable handle attachable to a receptacle on the intubated/extubated oral airway device;

fig. 16H and 16J-16P illustrate an intubating/extubating oral airway device with a rotating central channel. Fig. 16H and 16J illustrate the ability of an intubating/extubating oral airway device with a rotating central channel to extend distally. The embodiment shown in fig. 16H and 16J has a camera tube with a camera externally placed over the intubated/extubated oral airway, while the embodiment shown in fig. 16K provides an intubated/extubated oral airway in which the camera tube is placed inside the rotating central channel. Fig. 16L-16N further demonstrate how the inner half cylinder can be rotated in the intubating/extubating oral airway to form a fully enclosed central channel. FIGS. 16O-16P illustrate insertion of an endotracheal tube inside the rotating central channel of an intubated/extubated oral airway;

FIGS. 17A and 17B show side views of a supraglottic airway device equipped with a visualization device and a working tube and a sound tube;

fig. 18A to 18B show side views of a one-piece laryngoscope having an imaging device. FIG. 18A shows a laryngoscope with a visualization device and FIG. 18B is the same laryngoscope except that it is also equipped with a bougie and the visualization device is equipped with a light source;

figure 19 shows a side view of a speculum with a visualization means;

fig. 20A to 20F show a nasal cannula with a visualization device. Fig. 20A shows the positioning of the cannula on the head of a patient, and fig. 20B is the same as that shown in fig. 20A, except that the visualization device is equipped with a light source. Fig. 20C is a side view of the cannula shown in fig. 20A, and fig. 20D is a side view of the cannula shown in fig. 20B. Fig. 20E is a cross-sectional view of the head of a patient with the cannula of fig. 20A inserted therein. FIG. 20F is another embodiment in which the nasal cannula with visualization device as shown in FIG. 20A is further combined with an external stethoscope;

FIG. 21 is a feeding tube equipped with a visualization device;

figures 22A, 22B, 22C illustrate various embodiments of suction tubes equipped with visualization devices. Fig. 22A shows the visualization device positioned inside the suction tube. FIG. 22B is the same as that shown in FIG. 22A but also equipped with a bougie, and FIG. 22C is the same as FIG. 22B but showing the bougie protruding from the distal end of the aspiration tube;

figure 23 shows a suction catheter equipped with a visualization device;

FIG. 24 shows an endotracheal tube equipped with a visualization device;

fig. 25A to 25D show a supraglottic ventilation tube with a camera. Fig. 25A is a side view of a supraglottic ventilation tube with a camera. Figure 25B is an enlarged view of the distal tip of the supraglottic ventilation tube with cuff. FIGS. 25C and 25D illustrate insertion of a supraglottic ventilation tube into an intubating/extubating oral airway;

fig. 26A to 26J show a tubeless cannula device. Figure 26A shows the upper surface of a tubeless intubation device. Figure 26B shows the bottom surface of a tubeless intubation device. Fig. 26C-26F illustrate loading of a tubeless intubation device with an endotracheal tube for insertion into a patient. Figure 26G shows the upper surface of the tubeless intubation device without the cuff and figure 26H shows the bottom surface of the tubeless intubation device shown in figure 26G. FIGS. 26I and 26J illustrate loading of the device of FIG. 26G with a supraglottic airway;

FIGS. 27A-27G show a sliding endotracheal tube cuff (FIGS. 27A, 27C-27G) and loading of the endotracheal tube into the sliding cuff (FIG. 27B);

figures 28A-28B illustrate an endotracheal tube having a visualization device that is slidable along and detachable from the endotracheal tube;

fig. 29A-29C show a sliding camera tube with rails and placement of the camera tube into a laryngoscope;

FIGS. 30A-30B show a supraglottic airway device with an in-built endoscope guide (FIG. 30A), and insertion of the device into a patient (FIG. 30B);

FIGS. 31A and 31B illustrate an assembly formed by a nasogastric tube and a visualization device;

FIG. 32 shows an oral airway embodiment;

fig. 33A-33C illustrate other embodiments of an endotracheal tube with an externally attached camera tube. FIG. 33A shows an embodiment with a suction tube, FIG. 33B shows an embodiment with a drug dispensing device, and FIG. 33C shows an embodiment with biopsy forceps;

fig. 34A-34H illustrate various embodiments of oral airway devices. Figure 34A shows an embodiment with a separate lumen for an esophageal obturator. Also shown is an endotracheal tube that can be placed into the oral airway device. Fig. 34 is the same embodiment as that shown in fig. 34A, but with a ventilator cap instead of an endotracheal tube. Fig. 34C is an oral airway device without a balloon, also showing an endotracheal tube. Fig. 34D is the same embodiment as that shown in fig. 34C, but with a ventilator cap instead of an endotracheal tube. Fig. 34E-34H show an expandable oral airway device with a carrier. Fig. 34E shows placement of the oral airway device into the carrier. Fig. 34F is an enlarged view of the carrier shown in fig. 34E. Fig. 34G and 34H show the oral airway device positioned inside the carrier, with fig. 34G showing the oral airway device fully positioned inside the carrier and fig. 34H showing the oral airway device expanded from the carrier;

fig. 35A-35B illustrate other embodiments of oral airway devices. FIG. 35A shows an oral airway device positioned in a patient, while FIG. 35B provides an embodiment of an oral airway device with a side-port; and

fig. 36A, 36B, 36C show nasopharyngeal airway devices. Fig. 36A is an embodiment with two air bags, while fig. 36B is an embodiment with three air bags. FIG. 36C shows the positioning of a three-balloon nasopharyngeal airway device in a patient.

Detailed Description

The present invention provides improved medical devices equipped with visualization devices for intubation, ventilation, feeding and monitoring of patients. The present invention also provides a method for rapid and accurate placement of a medical device within a patient and for continuous, remote, on-the-fly monitoring of the patient after placement.

These medical devices are equipped with a visualization device in which the camera is placed in a separate sealed camera tube. Because the camera is not in contact with the patient, there is no need to sterilize the camera, and the same camera can be reused in many applications. Thus, the same camera may be switched between different medical devices for monitoring various internal organs (e.g., medical devices placed in the patient's airway, larynx, gastrointestinal tract, chest cavity, or vaginal cavity). In certain embodiments, the camera is disposable.

One embodiment provides a developing device as shown in fig. 1A and other embodiments thereof as shown in fig. 1B and 1C. In fig. 1A, a visualization device, generally 10, includes a camera tube 12 having a distal end 14 and a proximal end 16. The camera tube 12 may be a plastic tube. In certain embodiments, the camera tube 12 may comprise a fiber optic material. The camera tube 12 is sealed at the distal end 14 by a transparent material 17. The diameter of the camera tube 12 is designed such that a camera 18 having a guidewire 20 can be inserted inside the camera tube 12 through an opening at the proximal end 16 and moved down the camera tube 12 toward the distal end 14 such that the camera 18 continuously transmits images obtained through the transparent material 17. The length of the camera tube 12 may vary and may be adjusted according to the length of the medical device with which the visualization device is to be used. For example, the length of the camera tube 12 may be longer when the visualization device 10 is used with a feeding tube than when the visualization device 10 is used with an endotracheal tube. In some embodiments, the visualization device obtains the image and wirelessly transmits, broadcasts, or records this information to at least one device located at a remote location.

Because the camera tube 12 is sealed at the distal end 14 by the transparent material 17, the camera 18 does not come into contact with the patient's tissue or bodily fluids, and thus the camera 18 does not have to be sterilized or disposable, and it can be reused in other applications. However, in some applications, the camera 18 may be disposable. The camera 18 may be loaded with a wafer and equipped to obtain and transmit digital images in real time. The camera 18 is also connected by a wire 20 to an image receiving and processing device (not shown), such as a computer equipped with a monitor, or a computer network. The camera 18 may also communicate wirelessly with image receiving devices located at any location, including multiple locations and remote locations. Because the length and diameter of the camera tube 12 can be adjusted based on the needs of the patient, the visualization device 10 is suitable for a wide variety of patients, including pediatric patients and adult patients with abnormal anatomy or trauma.

Because the visualization device 10 is bendable and flexible, the visualization device 10 is easily inserted into and removed from the patient. The camera 18 may have its own light source. Because the visualization device 10 delivers images from within the patient's body on the fly, it can be used to guide the medical device for proper placement. Accordingly, certain embodiments relate to a method for rapid and accurate placement of a medical device within a patient, including a method for guided and rapid placement under continuous visualization into the airway, larynx, gastrointestinal tract, chest cavity, or vaginal cavity of a patient.

As shown in the embodiment of fig. 1B, the visualization device 10 may also be equipped with a trocar 22, which trocar 22 may be externally sealed to the camera tube 12 or otherwise attached to the camera tube 12 on at least one side of the camera tube 12 along the proximal-distal (16-14) axis of the camera tube 12. The trocar 22 may be made of wire or some other sturdy material in order to retain the originally flexible visualization device 10 in a particular shape. In certain embodiments, the trocar 22 may have the same length as the camera tube 12. In other embodiments, the trocar 22 is shorter than the camera tube 12 such that at least a portion of the camera tube 12 on the proximal end 16 or the distal end 14 or on both ends 16 and 14 is not in contact with the trocar 22. As shown in fig. 1C, the trocar 22 may be bent into various shapes and it retains the shape it has been bent into, which allows the visualization device 10, which is otherwise flexible, to retain a particular shape.

In an alternative embodiment, the visualization device 10 may be equipped with a bougie (bougie) that may be externally attached to the camera tube 12 on at least one side of the camera lumen 12 along a proximal-distal (16-14) axis of the visualization device 10.

The bougie may be made of a variety of materials, including flexible plastic materials. Because the bougie is bendable, yet retains its bent shape, the bougie is suitable for guiding the imaging device 10 within a patient. In certain embodiments, the bougie may have the same length as the camera tube 12. In other embodiments, the bougie may be made shorter or longer than the camera tube 12, such that only a portion of the camera tube 12 is in contact with the bougie. In some embodiments, the bougie protrudes on at least the distal end 14.

The visualization device 10 may also be equipped with a portable light source (not shown) that may be built into the camera 18, or it may be built into the camera tube 12. In the alternative, the light source may remain on the proximal end 16 outside the camera tube 12, but still be positioned such that the light source emits light into the interior of the camera tube 12.

In the embodiment shown in fig. 1A-1C, the camera tube 12 may be disposable, and the camera 18 may be reused without sterilization. However, in at least some embodiments, the camera 18 may also be disposable.

During placement within the patient, the visualization device 10 is positioned, either alone or in combination with another medical device, under continuous visualization with the camera 18 such that the distal end 14 of the visualization device 10 is inserted within the patient.

Any of the visualization devices 10 described above may be attached, sealed, or otherwise connected externally or internally to a disposable or non-disposable medical device as described in more detail below. Various medical devices for pediatric and adult patients may be constructed during manufacture such that the camera device tube 12 is sealed or attached to the medical device. In certain embodiments, the visualization device 10 may slide or glide along a medical device to which the visualization device 10 is attached. For example, the camera tube 12 of the visualization device 10 may be equipped with a set of rings, a rail, or a half cylinder that will allow the camera tube 12 to slide or glide along the medical device to which the visualization device 10 is attached.

In other embodiments, the visualization device 10 may be sold as a kit that can be attached by a medical practitioner to pre-manufactured medical devices for pediatric and adult patients based on the individual needs of a particular patient. The length of the camera tube 12 may be varied such that the camera tube 12 has the same or similar length as the medical device to which the visualization device 10 is sealed, attached, or otherwise connected.

Having the ability to verify placement of medical devices on the fly enables multiple experts to assist in the placement operation and verify it. This is achieved by equipping the medical device with a visualization device 10. In certain embodiments, a method is provided in which a visualization device 10 is used to place a medical device in an ambulance, in a battlefield, or in a nursing home or hospital. The visualization device 10 provides the ability to monitor the patient on-the-fly. Since visualization device 10 can interact with many devices of the disposable and other types, the use of device 10 on a variety of medical devices provides a way for the medical practitioner to customize the appropriate device for each patient or situation. Enabling the same camera apparatus to interact with a variety of medical devices provides economies of scale (economy of scale) such that even minimal organizations may have all the appropriate alertness and skills.

In at least some embodiments, the visualization device 10 can be used in assembly with at least one medical device as described in more detail below. A method in which visualization device 10 is used on an airway device allows for the immediate continuous visualization of any of the following in a patient during normal and abnormal ventilation: nasopharynx, pharynx/hypopharynx, supraglottic structures, airway, visceral anatomy, vocal cords. This method also enables detection of anatomical abnormalities and vocal cord movement abnormalities.

Referring to fig. 2, this embodiment provides an endotracheal device (generally 30). Endotracheal device 30 includes an endotracheal tube 32 having a distal end 32A and a proximal end 32B. The visualization device 10 is externally sealed or otherwise attached to at least one side of the endotracheal tube 32 along the proximal-distal (32B-32A) axis of the endotracheal tube 32. The visualization device 10 is essentially made up of all the elements shown in fig. 1A, wherein a camera 18 is inserted inside the camera tube 12 through an opening at the proximal end 16 of the camera tube 12, down to the distal end 14, and the opening of the distal end 14 is sealed by a transparent material 17. Because the camera 18 is positioned inside the sealed camera tube 12, the camera 18 does not come into contact with the patient, and the camera 18 does not need to be sterilized for reuse in multiple applications. Thus, the camera 12 need not be disposable or sterilized prior to other use. However, in at least some applications, the camera 18 may be disposable.

Because the camera 18 is disposed inside the separate camera tube 12, and the camera tube 12 is externally positioned on the endotracheal tube 32, the diameter of the camera tube 12 is not limited by the diameter of the endotracheal tube 32. Thus, the diameter of the camera tube 12 may be larger or smaller than the diameter of the endotracheal tube 32.

Thus, the visualization device 10 may be used on endotracheal devices for pediatric and adult patients with anatomical abnormalities. In certain embodiments, the diameter of visualization device 10 is greater than the diameter of endotracheal tube 32.

The camera 18 is connected to external devices such as a computer and a monitor (not shown) through a wire 20. In at least some embodiments, the visualization device 10 is also equipped with a light source 21. The light source 21 may be held outside the camera tube 12, but near the proximal end 16 of the tube 12, so that the light source 21 emits light into the camera tube 12. In alternative embodiments, the light source 21 may be built into the camera tube 12, or in other embodiments, the light source 21 may be built into the camera 18.

In at least some applications, the camera 18 is a digital camera equipped with a wafer, and which continuously collects and transmits images. The camera 18 may be connected wirelessly or by hard-wired connection to a computer network (not shown) that collects and analyzes images acquired by the camera 18. This configuration allows for distal, continuous, and real-time monitoring of endotracheal device 30 during and after in vivo placement in a patient. Thus, accurate and rapid placement of endotracheal device 30 can be achieved. In addition and because the visualization device 10 continues to acquire images after the endotracheal device 30 is placed within the patient, the patient can be immediately monitored for adverse reactions, such as bleeding, airway obstruction, dislodgement or malfunction of the endotracheal device 30, and other reactions. Endotracheal device 30 continues to transmit images and information as long as it remains within the patient.

In some embodiments, endotracheal tube 32 is also fitted with a cuff 34 at its distal end 32A. In other embodiments, endotracheal tube 32 is not fitted with cuff 34. Cuff 34 may be inflated by device 36 after placement of endotracheal device 30 in a patient and verification that endotracheal device 30 is properly positioned in the patient by images obtained with visualization device 10.

The endotracheal device 30 may also be equipped with a sound monitoring device 38, the sound monitoring device 38 being externally sealed to or otherwise attached to one side of the endotracheal tube 32 along the proximal-distal axis (32B-32A) of the endotracheal tube 32. The sound monitoring device 38 may be a microphone placed inside the plastic tube 40. The sound monitoring device 38 monitors heart beat and breath sounds and may be connected by wire or wirelessly to a remote device that collects and monitors vital signals of the patient. In the embodiment shown in FIG. 2, visualization device 10 is placed proximal to cuff 34 and outside of endotracheal tube 32. It will be appreciated that endotracheal device 30 may be constructed with any endotracheal tube 32, including single and double lumen tubes. Endotracheal device 30 may be used with pediatric patients or adult patients. Endotracheal device 30 can be made in a variety of sizes.

In another embodiment and as shown in fig. 3, an endotracheal device (generally 50) includes an endotracheal tube 52 and a visualization device 10, the endotracheal tube 52 having a distal end 52A and a proximal end 52B, the visualization device 10 being placed inside the endotracheal tube 52 through an opening in the proximal end 52B. In this embodiment, the visualization device 10 is attached to a built-in ventilator-adaptable cap 68, which built-in ventilator-adaptable cap 68 connects the endotracheal device 50 to a ventilator (not shown) through an outlet 70. The built-in ventilator adaptable cap 68 includes an opening 72 through the cap 68. Visualization device 10 is placed through opening 72 and inside endotracheal tube 52. The built-in ventilator adaptable cap 68 is then connected to the endotracheal tube 52 at the proximal end 52B of the endotracheal tube 52.

The visualization device 10 is the same as the visualization device 10 shown in fig. 1A, and it includes a camera tube 12 having a sealed distal end 14 and an open proximal end 16. A camera 18 is placed inside the camera tube 12 through the proximal end 16 of the camera tube 12. The camera 18 is connected to an image monitoring device (not shown) by a wire 20. In some embodiments, the camera 18 is wirelessly connected to an image monitoring device (not shown). The camera 18 continuously and instantaneously collects images through the transparent material 17, and the distal end 14 of the camera tube 12 is sealed by the transparent material 17. The image may be transmitted to a remote location.

Endotracheal tube 52 may optionally be equipped with a cuff 64 at distal end 52A such that cuff 64 wraps around endotracheal tube 52 and cuff 64 may be inflated by device 65 once endotracheal device 50 is properly placed inside the patient's airway. As can be seen from fig. 3, distal end 14 of visualization device 10 extends distally relative to distal end 52A of endotracheal tube 52 and under cuff 64 so that visualization device 10 can still record images within the patient and under cuff 64 even when cuff 64 is inflated by device 65 after placement within the patient. Further, endotracheal device 50 may have an elliptical opening 67 at distal end 52A, and visualization device 10 may be positioned inside endotracheal tube 52 such that distal end 14 of visualization device 10 is aligned with or in close proximity to elliptical opening 67 of endotracheal tube 52.

Referring to fig. 4A and 4B, other embodiments provide the visualization device 10 assembled with a built-in ventilator-adaptable cap 68, the built-in ventilator-adaptable cap 68 being connected to a ventilator (not shown) through an outlet 70. The visualization device 10 is inserted through an opening 72 in the built-in ventilator adaptable cap 68 as shown in fig. 4A and 4B. As shown in fig. 4B, the visualization device 10 may also be equipped with a light source 74, which light source 74 may be part of the camera tube 12, or it may be built into the camera 18, or it may remain outside the built-in ventilator adaptable cap 68. The visualization device 10 is assembled with a built-in ventilator-adaptable cap 68 as shown in fig. 4A and 4B, and may then be used in an endotracheal tube as described in connection with fig. 3, or in a supraglottic device, or with a laryngeal mask, or with any other medical device to which the built-in ventilator-adaptable cap 68 may be attached. As shown in fig. 4A and 4B, the camera tube 12 has a distal end 14 and a proximal end 16. The camera 18 is placed inside the tube 12 through an opening in the proximal end 16 and moved down to the distal end 14 sealed by the transparent material 17. The camera 18 collects images through the transparent material 17 and transmits them in real time to a monitoring device that may be located remotely.

Other embodiments of a built-in ventilator adaptive cap 68 equipped with the visualization device 10 are shown in fig. 5A, 5B and 5C. As can be appreciated from fig. 5A, the visualization device 10 includes a camera 18 located inside the camera tube 12. The visualization device 10 is inserted through the ventilator adaptable cap 68. As shown in the embodiment of fig. 5A, a plastic transparent sleeve 76 may be attached over the adaptable cap 68 such that the sleeve 76 may slide up and down in the proximal-distal direction as shown in fig. 5A and 5B, which allows the visualization device 10 to remain sterile during insertion and removal. Because visualization device 10 is inserted and removed through sleeve 76, visualization device 10 remains sterile and free of contamination. The sleeve 76 is long enough to maintain the entire imaging device 10 outside the ventilation cap and sterile. Another embodiment is shown in FIG. 5C, in which visualization device 10 is inserted through sleeve 76 as shown in FIGS. 5A and 5B, except that bougie 78 is added through bougie tube 80.

The bougie 78 may be replaced by a flexible guiding trocar 82 as shown in the inset of fig. 5C, the flexible guiding trocar 82 serving to rotate and guide the trocar within the patient, the trocar being protected from contact with the patient's tissue. If the tube 80 is used with a trocar, the tube 80 must be sealed at the distal end. Other tubes may be attached and placed through the sleeve 76. These tubes include, but are not limited to, suction tubes and tool tubes that can be used to deliver biopsy forceps (biopsy procedures) and other tools. The assembly formed by the built-in ventilator adaptable cap 68 and the visualization device 10 and the sleeve 76 may be used with any medical device to which the built-in ventilator adaptable cap may be attached, including an endotracheal tube, a supraglottic device, or a laryngeal mask airway as described in connection with fig. 3. If the embodiment with the bougie or trocar is used as described in connection with fig. 5C, the bougie 78 may protrude distally relative to the medical device or slide independently of the medical device and serve to guide movement of the medical device within the patient under visualization achieved with the visualization device 10 during placement.

Other embodiments of an endotracheal device (generally 84) equipped with a visualization device are shown in fig. 6A and 6B. As can be appreciated from fig. 6A, visualization device 10, including camera 18 located inside camera tube 12, may be inserted inside endotracheal tube 86 through opening 87 on one side of endotracheal tube 86. As shown in the embodiment of fig. 6A, a plastic sleeve 92 may be attached over opening 87 such that sleeve 92 may slide up and down as shown in fig. 6A and 6B, which is advantageous to maintain sterility of visualization device 10 as it moves into and out of endotracheal tube 86. Because visualization device 10 is inserted into and removed from endotracheal tube 86 through sleeve 92, visualization device 10 remains sterile and free of contamination. The visualization device 10 may be removed entirely from the endotracheal tube 86 through the sleeve 92 and maintained sterile. The endotracheal tube 86 may be equipped with a cuff 88 positioned near the distal end 86A. Visualization device 10 may be moved along the proximal-distal (86B-86A) axis inside endotracheal tube 86 such that visualization device 10 is distal to cuff 88, or visualization device 10 may protrude distally outside endotracheal tube 86 as shown in fig. 6B. This allows images to be obtained from within the patient with visualization device 10 after cuff 88 is inflated by device 90 and allows images to be obtained from the region of the patient's body distal to cuff 88. After cuff 88 is inflated, this region distal to cuff 88 is available for monitoring by imaging device 10, in which device 10 camera 18 collects images through transparent material 17 at distal end 14.

In this embodiment, the visualization device can slide up and down inside the endotracheal tube, which allows the camera tube 12 to be advanced and retracted while maintaining sterility of the endotracheal tube into which the visualization device 10 can be inserted, as described above. The camera 18 can be easily advanced inside the camera tube 12 and provides inspection of the endotracheal tube (throughout its length) and distal to the tip of the endotracheal tube.

Fig. 7A and 7B show another embodiment of an endotracheal device (generally 100) equipped with visualization device 10. Other tubes may also be attached to the tube 10 or placed adjacent to the tube 10. These tubes include, but are not limited to, aspiration tubes, tubes for delivery instruments (e.g., forceps, bougies, or flexible trocars). As can be appreciated from fig. 7A, the visualization device 10 includes a camera 18 located inside a camera tube 12, the camera tube 12 being externally positioned on the endotracheal tube 102 along a proximal-distal (102B-102A) axis. As shown in the embodiment of fig. 7A, the plastic sleeve 108 may be attached to the endotracheal tube 102 such that the sleeve 108 may slide up and down the exterior of the endotracheal tube 102 as shown in fig. 7A and 7B, which facilitates movement of the visualization device 10 along the proximal-distal (102B-102A) axis of the endotracheal tube 102. Because visualization device 10 is inserted and removed through sleeve 108, visualization device 10 remains sterile and free of contamination. The endotracheal tube 102 may be equipped with a cuff 104 wrapped around the endotracheal tube 102 near its distal end 102A. The visualization device 10 is moved along the proximal-distal axis 102B-102A outside the endotracheal tube 102 so that the visualization device 10 can be positioned proximal to the cuff 104. This also allows images to be obtained from the patient with visualization device 10 after cuff 88 is inflated by device 106. The camera tube 12 may be slid to the proximal or distal side of the cuff 104. Thus, at least in certain embodiments, the camera tube 12 will become a sealed tunnel.

Figure 8 shows another embodiment of an endotracheal device, generally 110. The device 110 may be equipped with a visualization device 10 and a sound tube 40 (not shown) as described in connection with fig. 2. The endotracheal device is also equipped with a bougie 116, the bougie 116 being slidable up and down along a proximal-distal (116B-116A) axis inside a tube 118, the tube 118 being externally attached to the endotracheal tube 111. The endotracheal tube 111 is equipped with a cuff 112, the cuff 112 being located near the distal end 110A of the tube. After the endotracheal device 110 is placed in the patient, the cuff 112 may be inflated by the device 114. Visualization device 10 may be sealed or attached to the exterior or interior of endotracheal tube 111 as described above in connection with the embodiments provided by fig. 2, fig. 3, fig. 4A, fig. 4B, fig. 5A, fig. 5B, fig. 6A, fig. 6B, fig. 7A, and fig. 7B. The bougie 116 guides movement of the endotracheal device 111 under visualization by the visualization device 10 during placement within the patient and allows guided sliding of the medical device through the bougie 116 inside the patient's airway.

Fig. 9A to 9C show other embodiments of the developing device (120 as a whole). As shown in fig. 9A, the camera tube 12 may be equipped with at least one, and preferably two, outer rings 122, the outer rings 122 being sealed or otherwise connected to the camera tube 12 by members 124. In some embodiments, one loop 122 is positioned at 1/3 about the length of the camera tube from the proximal end 16, and the other loop is positioned at 2/3 about the length of the camera tube from the proximal end. Although in the embodiment shown in fig. 9A, the camera tube 12 is equipped with two rings 122, other embodiments include camera tubes in which more than 2 rings or only 1 ring is used. The positioning of the rings along the proximal-distal (16-14) axis of the camera tube 12 may also vary. Other configurations include clips or plastic bands for holding the camera tube 12.

As in all other embodiments, the camera tube 12 has a distal end 14 and a proximal end 16, the distal end 14 being sealed by a transparent material 17, the proximal end 16 having an opening through which the camera 18 is inserted into the camera tube 12. As shown in fig. 9B, the visualization device 120 may also be equipped with a tube 118 externally sealed or otherwise attached along the proximal-distal (16-14) axis of the camera tube 12. The bougie 116 is placed inside the tube 118 such that the distal end 116A of the bougie 116 protrudes distally on the camera tube 12, while the proximal end 116B of the bougie 116 extends proximally outside the visualization device 120 and can be used by a medical provider to rotate the distal end 116A and thus guide the movement of the visualization device 120 along with the medical device to which the visualization device 120 is attached.

As shown in fig. 9C, the visualization device 120 may also be equipped with a light source 21, and the light source 21 may be built into the camera tube 12, built into the camera 18, or it may be held outside the visualization device 120 and outside the patient's body. The visualization device 120 is attached to the medical device by a ring 122, and this allows customization of the positioning of the visualization device 120, as the visualization device 120 can slide up and down along the proximal-distal axis of the medical device.

As shown in the cross-sectional view of FIG. 9D, the ring 122 may have any diameter suitable for fitting over a selected medical device. As further shown in fig. 9E, in at least some embodiments, the ring 122 can have a clasp 126 such that the diameter of the ring 122 can be adjusted according to the diameter of the medical device to which the visualization device 120 is attached by the ring 122.

The embodiment shown in fig. 9F provides an assembly (generally 128) in which visualization device 120 is attached to endotracheal tube 52 by ring 122. The ring 122 is slidable up and down along the proximal-distal (52B-52A) axis of the endotracheal tube 52, and as such, the position of the visualization device 120 can be adjusted relative to the endotracheal tube 52. In addition, the ring 122 may rotate about the endotracheal tube 52, which allows for varying positioning of the camera device 120 as images from different areas within the patient are required.

Because the ring 122 may be adjustable, the visualization device 120 may be used with endotracheal tubes having any size, including endotracheal tubes for pediatric patients. Furthermore, the visualization device 120 having at least two rings externally connected to the camera tube 12 may be provided as a kit and may be assembled by the medical practitioner with any conventional endotracheal tube or any other conventional medical device that requires visualization and monitoring at the time of treatment.

Other embodiments provide an intubation method in which an endotracheal tube (including any of the endotracheal tubes described above and equipped with an imaging device as described above) is placed in the patient's airway and positioned below the patient's vocal cords under a constant visualization achieved by the imaging device 10.

Referring to figure 10, there is shown a side view of the supraglottic airway device, generally 130. Any standard endotracheal tube known in the art and the endotracheal device shown in fig. 3 in the inset on the left side of fig. 10 may be used in combination with the supraglottic airway device 130.

The supraglottic airway device 130 includes a supraglottic tube 131, the supraglottic tube 131 having a distal end 131A and a proximal end 131B and a lumen 146. Supraglottic airway device 130 includes a designated cannula 133 inserted into lumen 146, and endotracheal device 50 may be placed into cannula 133, as shown in fig. 10. The distal end 133A of cannula 133 terminates in an oval shaped opening 140 located distally relative to cuff 132, cuff 132 being inflatable by device 134. The sleeve 133 has a plurality of holes 148 distributed throughout its body to allow ventilation through the tube 131 from the outlet 144.

While standard endotracheal devices (including endotracheal device 50) may be equipped with a visualization device, supraglottic airway device 130 includes its own visualization device 10 disposed in lumen 146. The visualization device 10 includes a camera tube 12 having a distal end 14 and a proximal end 16. Distal end 14 is sealed by a transparent material 17. The camera tube 12 is externally sealed or otherwise attached to the cannula tube 133 along the proximal-distal (131B-131A) axis. The supraglottic device 130 may also be equipped with a bougie 116 located inside the tube 118. The tube 118 is placed inside the lumen 146 such that the distal end 116A of the bougie 116 protrudes from the tube 118 through the elliptical opening 142 to the exterior of the supraglottic body 131, the elliptical opening 142 being slightly proximal to the distal end 131A on the supraglottic body 131. The elliptical opening 142 of the supraglottic body 131 partially overlaps the elliptical opening 140 of the cannula 133. The probe tube has its own opening to 140.

At the distal end 131A, the tube 131 is covered by a balloon 136, and the balloon 136 is inflatable by a device 138. In certain embodiments, the bougie 116 may be replaced by a flexible guiding trocar 82 shown on the right side of FIG. 10.

In addition to the visualization device 10, the supraglottic device 130 may also be equipped with the sound and temperature monitoring device 38 located inside the tube 40, with the tube 40 externally sealed or otherwise attached to the tube body 131 along the proximal-distal (131B-131A) axis. After the supraglottic device 130 is placed in the patient, the sound device 38 may monitor the patient's heart beat and breathing. The tube 131 is connectable at its proximal end 131B to a ventilator (not shown) via an outlet 144. Since the supraglottic device 130 can be ventilated in a closed loop through the tube 131, the endotracheal tube 50 can be placed inside the cannula 133 without stopping the ventilation, and thus, the supraglottic device 130 provides continuous ventilation, provides continuous visualization on the fly through the visualization device 10, and provides continuous sound and temperature monitoring through the sound monitoring device 38 with the temperature probe. Such real-time information may be communicated or stored to a plurality of remote monitoring sites.

Other advantages of supraglottic airway devices include the ability to intubate under continuous ventilation, extubate and easily reinsert when needed, and the ability to continuously visualize the vocal cords and supraglottic structures. The device 130 is suitable for use with children and adults. In addition, the device 130 is equipped with a cuff 132 for occluding the pharynx after the device 130 is placed in the patient and a balloon 136 for occluding the esophagus after the device 130 is placed in the patient. Further, an endotracheal tube may be placed in tube 133 just proximal to the vocal cords. This allows for ventilation through 144 and tube 131 without interruption.

Referring to fig. 11A and 11B, an alternative embodiment of an airway device, generally 150, is provided. This device can be used for pediatric patients as well as adult patients, as it can be adopted in different sizes. It provides continuous visualization of supraglottic structures and it can be advanced, retracted or rotated left or right to provide direct visualization of the vocal cords. As can be appreciated from fig. 11A and 11B, the airway device 150 includes a tube 152, the tube 152 having a distal end 152A and a proximal end 152B and a lumen 153. The tube 152 may be connected to a ventilator via an outlet 154. Visualization device 10 is sealed or otherwise attached inside tube 152 on at least one side of tube 152 along a proximal-distal (152B-152A) axis. The visualization device 10 includes a camera tube 12 having a distal end 14 and a proximal end 16. The camera tube 12 is sealed at the distal end 14 by a transparent material 17. The proximal end 16 of the camera tube 12 remains open and the camera 18 is inserted into the camera tube 12 through the proximal end 16. The camera 18 does not come into contact with the patient's body and it need not be sterile and disposable, however, in at least some applications it may be disposable. The visualization device 10 may also be equipped with a light source, which may be built into the camera tube 12 or may be part of the camera 18. In the alternative, the light source may remain outside the camera tube 12, but still emit light into the camera tube 12 sufficient for the camera 18 to obtain images within the patient.

The cannula 156 is disposed within the lumen 153 of the body 152 along a proximal-distal (152B-152A) axis. The cannula 156 shares a lumen 119 with the bougie 116, the bougie 116 is inserted inside the lumen 119 along a proximal-distal (152B-152A) axis such that the distal end 116A of the bougie 116 can protrude outside of the tube 152 at the distal end 152A, and the proximal end 116B can protrude outside of the tube 152, and the proximal end 152B can be used by a practitioner to guide movement of the airway device 150 through the bougie 116 during placement in a patient, including advancing the bougie 116 through the patient's vocal cords under direct visualization by the camera 18. The sleeve 156 has a plurality of holes 157 distributed along the sleeve 156.

In at least some embodiments, airway device 150 is further equipped with an acoustic and temperature monitoring device 38 insertable into tube 40, tube 40 being sealable or otherwise attachable along a proximal-distal (152B-152A) axis inside tube body 152 such that the distal end of acoustic monitoring device 38 is positioned at or near distal end 152A of tube body 152, tube body 152 also being equipped with a cuff 158 at distal end 152A along the circumference of tube body 152. The cannula 156 is designed such that, in at least some embodiments, the cannula 156 has a ramp 160 at the distal end 152A of the airway device 150. A standard endotracheal tube, including those described above in various embodiments, can be placed inside the lumen 119 in the cannulated tube 156 for positioning within the patient.

As shown in fig. 11B, a ventilator-adaptable cap 68 and a cover 69 are attached to the tube body 152 at the proximal end 152B. An endotracheal tube is inserted through cap 68 into device 150. When ventilation is achieved through outlet 154, it is preferable to use a cap 68 with a cover 69 over airway device 150.

As shown in fig. 12A, 12B and 12C, yet another embodiment of an oral airway device (generally 170) is provided. As can be appreciated from fig. 12A, the airway device 170 includes a tube 172 having a distal end 172A and a proximal end 172B. The tube 172 terminates at a distal end 172B with two ramps 174 and 176. As can be appreciated from the side view of the tube 172 shown in fig. 12A and the cross-sectional views of fig. 12B and 12C, the tube 172 is made of two half cylinders 178 and 180. Semi-cylindrical body 178 is slightly smaller in diameter than semi-cylindrical body 180. Tube 172 may exist in two forms: as a full cylinder as shown in fig. 12B or as a half cylinder as shown in fig. 12C. Semi-cylindrical bodies 178 and 180 are connected by means such that semi-cylindrical bodies 178 are rotatable and retractable into semi-cylindrical bodies 180. The semi-cylindrical form shown in fig. 12C is achieved by: cylinder 178 is rotated approximately 180 degrees and aligned with cylinder 180 such that cylinder 178 is inside cylinder 180 as shown in figure 12C.

The visualization device (generally 10) is externally sealed or otherwise attached to half-cylinder 180 along the proximal-distal (172B-172A) axis. The visualization device 10 includes a camera tube 12 having a distal end 14 and a proximal end 16. Distal end 14 is sealed by a transparent material 17. The camera 18 is placed into the camera tube 12 through an opening at the proximal end 16 and moved inside the camera tube 12 to the distal end 14. Like all other embodiments, the camera 18 does not come into contact with the patient's body, and it need not be disposable, need not be sterilized, and it can be reused in multiple devices. The camera 18 is connected to at least one monitoring device by a wire 20 and transmits images instantaneously. The camera 18 may be wirelessly connected to at least one monitoring device positionable at some remote location. The light source may be added as described in connection with the visualization device in other applications.

Half cylinder 180 terminates at distal end 172A with two ramps 174 and 176. Ramp 174 is smaller in size than ramp 176 and the two ramps are superimposed on top of each other such that the smaller ramp 174 is proximal to the lumen 182 formed by half cylinders 178 and 180 when they are in the form of a full cylinder as shown in fig. 12B, while ramp 176 is distal to lumen 182. The ramps 174 and 176 are flexible and absorb shocks resulting from the sliding and release of an endotracheal tube that can be delivered to the patient through the oral airway device 170. The ramp also facilitates removal of the oral airway device 170 after the endotracheal tube is placed in the patient.

As shown in fig. 12A, the oral airway intubation device 170 may also be equipped with a bougie 160, and the bougie 160 may be inserted into the tube 118 along a proximal-distal (172B-172A) axis such that the distal end 116A of the bougie 116 projects distally relative to the oral airway device 170, and the proximal end 116B projects proximally out of the oral airway device and may be used to manipulate the distal end 116A of the bougie 116 to guide movement of the airway device 170 during placement of the bougie 116 within the patient. The probe tube 118 is positioned on the smaller half cylinder 178 and shares a lumen 182 with the body 172.

Another embodiment provides a dilator (generally 190 in fig. 13) with an imaging device. As can be appreciated from fig. 13, the dilator 190 includes a tube 192 having a proximal end 192B and a distal end 192A. Some distal portion of the tube 192 is tapered into a conical shape 192C so that the opening at the distal end 192A of the tube 192 is significantly smaller in diameter than the opening at the proximal end 192B. Visualization device 10 is positioned within lumen 195 of tube 192 along a proximal-distal (192B-192A) axis. The visualization device 10 may be sealed or otherwise attached inside the tube 192. The visualization device 10 is substantially the same as the device shown in fig. 1A and includes a camera tube 12 having a proximal end 16 and a distal end 14. The distal end 14 of the camera tube 12 is in close proximity to the distal end 192A of the tube body 192. A camera 18, which may be disposable or reusable, is placed inside the camera tube 12 through an opening at the proximal end 16 and down to the distal end 14 of the camera tube 12, the distal end 14 being sealed by a transparent material 17. As with the other embodiments, visualization device 10 may be equipped with a light source located outside of dilator 194 or built into camera tube 12. In some embodiments, the light source may be built into the camera 18.

As shown in fig. 13, the camera 18 is connected to a monitoring device (not shown) by a wire 20. In some embodiments, the camera 18 may communicate with the monitoring device wirelessly. The guidewire is positioned inside the lumen 195 of the tube 192 at the proximal end 194A. The proximal end 194B of the guidewire 194 protrudes outside the tube 192 at the proximal end 192B. The visualization device 10 is used to verify proper placement of the dilator device 190 and to allow for continuous visualization movement as dilation proceeds. The dilator device 190 is particularly suitable for use with the Seldinger technique.

Other embodiments provide various tracheostomy tubes equipped with a visualization device. Figure 14A shows a side view of an embodiment of a tracheostomy device, generally 200. The device 200 includes a tubular body 202 having a distal end 202A and a proximal end 202B. The inflatable cuff 204 is wound around the tube 200 somewhat near the distal end 202A, but never just at the distal end 202A. After the device 200 is properly placed in the patient, the cuff 204 may be inflated by the device 206. At the proximal end 202B, the tube 202 protrudes through the plastic plate 208 such that some portion of the tube 202 is proximal to the plastic plate and will remain outside the patient's neck after the device 202 is positioned within the patient. The plastic plate 208 may be oval in shape, with the tube 202 protruding from the oval plastic plate 208 at the middle of the plate. The plastic plate 208 may have two openings 209 (one on each side of the plate) to secure the device 200 around the patient's neck with some sort of bandage, as follows: the device 200 is strapped (tying) around the patient's neck through the opening 209.

In the embodiment shown in fig. 14A, the visualization device 10 is externally sealed or otherwise attached to the tube 202. The visualization device 10 includes a camera tube 12, the camera tube 12 externally sealed or otherwise attached to a tube body 202 along a proximal-distal (202B-202A) axis. The camera tube 12 is placed under the cuff 204 such that the cuff 204 wraps around the camera tube 12 and the distal end 14 of the camera tube 12 is distal to the cuff 204. Distal end 14 is sealed by a transparent material 17. The proximal end 16 of the camera tube 12 protrudes through the plastic plate 208 and is held outside the patient's neck. The camera 18 may be placed inside the camera tube 12 through an opening in the proximal end 16. The camera 18 is not disposable, need not be sterilized, and can be easily removed from the camera tube 12. The camera 18 is connected to the monitoring device by a wire 20. In other embodiments, the camera 18 may communicate with the monitoring device wirelessly. A light source may be added to the visualization device 10 as described above in other embodiments.

Figure 14B shows another embodiment of a tracheostomy device, generally 210. In this embodiment, the device 210 includes the same tube 202, cuff 204, plate 208, and other components as described in connection with device 200. However, unlike device 200, visualization device 10 is placed inside lumen 203 of tube 202. The visualization device 10 includes a camera tube 12 having a distal end 14 and a proximal end 16. The camera tube 12 may be sealed or otherwise attached to the tube body 202 inline along the proximal-distal (202B-202A) axis so that the distal end 14 of the camera tube 12 is in close proximity to the distal end 202A of the tube body 202. Distal end 14 is sealed by a transparent material 17. The camera 18 is placed inside the camera tube 12 through an opening at the proximal end 16, and the proximal end 16 remains outside the patient's neck after the device 210 is placed inside the patient. The camera 18 is connected to the monitoring device by a wire 20. In other embodiments, the camera 18 communicates with the monitoring device wirelessly. In certain embodiments, visualization device 10 includes a light source.

Another embodiment provides the nasopharyngeal airway (generally 220 in fig. 15) with a visualization device. Airway 220 includes a tube 222 having a proximal end 222B and a distal end 222A. Two fasteners 224 are attached at the proximal end 222B of the tube 222. After placement of airway 220 within the patient, the proximal portion of tube 222 with fastener 224 remains outside the patient, and fastener 224 may be used to secure airway 220 around the head of the patient.

The visualization device 10 is externally sealed or otherwise attached to the tube 222 along the proximal-distal (222B-222A) axis. Visualization device 10 includes a camera tube 12 having a proximal end 16 and a distal end 14. The distal end is in close proximity to the distal end 222A of the tube 222. Distal end 14 is sealed by a transparent material 17. A camera 18 is placed inside the camera tube 12 through an opening at the proximal end 16. The camera 18 moves all the way to the distal end 14 and images are collected in the patient's body on the fly during placement of the device 220 and after the device 220 has been properly placed and secured. As in other embodiments, the camera 18 does not come into contact with the patient's body, does not have to be sterilized, and can be reused in multiple devices or in different patients. The camera 18 communicates with a monitoring device (not shown) via a wire 20, either wirelessly or both.

Other embodiments provide various oral airways as shown in fig. 16A, 16B, 16C, and 16D. Referring to fig. 16A, an oral airway (generally 230) with a visualization device includes a tube 232 having a lumen 233. The tube body is slightly curved in a hook-like shape along a proximal-distal (232B-232A) axis. The visualization device 10 is placed inside the lumen 233 of the tube 232. The visualization device 10 includes a camera tube 12 and a camera 18. The camera tube 12 may be sealed or otherwise attached to the tube body 232 internally within the lumen 233 and along the proximal-distal (232B-232A) axis. The camera tube 12 has a proximal end 16 and a distal end 14. The distal end 14 is in close proximity to the distal end 232A of the body 232. Distal end 14 is sealed by a transparent material 17.

The camera tube 12 has an opening at the proximal end 16 through which the camera 18 is inserted into the camera tube 12 all the way to the distal end 14. The camera 18 communicates with the monitoring device wirelessly or through a wire 20. The embodiment shown in fig. 16B is the same as that shown in fig. 16A, except that a light source 21 is added to the visualization device 10. The light source 21 may be held outside the camera tube 12, or it may be built into the camera tube 12, or it may be part of the camera 18.

The embodiment shown in fig. 16C is the same as that shown in fig. 16A, except that two whistles (whistles) 234A and 234B are added to the interior of the lumen 233 of the tube 232. The whistle 234B is located at the proximal end of the tube 232 and it produces a sound when the patient inhales. The whistle 234A is located at the distal end of the tube 232 and it produces a sound when the patient exhales.

Other embodiments include an oral airway as shown in fig. 16A-16C, but also equipped with sound and temperature monitoring devices that are also placed inside lumen 233 and transmit information to a monitoring device that can be positioned at a distal location.

Figure 16D shows an embodiment of an intubated airway device (generally 230) with a visualization device. Intubation airway device 230 includes a tube body 232, tube body 232 having a lumen 233 in which an endotracheal tube may be placed. The visualization device 10 includes a camera tube 12 having a distal end 14 and a proximal end 16. Distal end 14 is sealed by a transparent material 17. A camera 18 is placed inside the camera tube 12 through an opening at the proximal end 16. The camera tube 12 is placed inside the lumen 233 of the tube body 232.

The bougie 116 is added inside the tube body 232 such that the bougie 116 is inserted into the tube 118 along the proximal-distal (232B-232A) axis, the tube 118 sharing a lumen with the lumen 233. A portion 116A of the bougie 116 projects outside the distal end 232A of the tube 232. A portion 116B of the bougie 116 protrudes from the proximal end 232B and above the vocal cords to the exterior of the tube 232. The endotracheal tube can be positioned inside the lumen 233 and the bougie 116 used to guide the movement of the endotracheal tube through the patient's vocal cords under constant visualization by the camera 10. The distal end 14 of the camera tube 12 is close to the distal portion 116A of the bougie 116 and, therefore, guided placement is performed under constant visualization.

Fig. 16E shows an intubation airway device 230 with a visualization device similar to that of fig. 16D, but with an endotracheal tube 234 inserted within lumen 233 of tube 232 of intubation airway device 230. As can be appreciated from fig. 16E, any endotracheal device can be easily inserted and removed by sliding through lumen 233. Thus, intubation, extubation, and re-intubation may be performed using the intubation airway device 230 under continuous visualization. The device provides continuous visualization during intubation and extubation as well as during ventilation by means of a camera 18 in the camera tube 12. Thus, the device 230 may be used for intubation and extubation without lifting the mandible, tongue, or soft tissue of the patient's oral airway, and such a method is one of the embodiments described.

Fig. 16F and 16G provide another embodiment of an oral airway intubation/extubation device. As can be seen from the figures, a handle 236 may be attached to the proximal end 232B of the oral airway tube intubation/extraction device 230. The handle 236 may be made of any suitable strong material (e.g., plastic, wood, or metal). The handle 236 may have any shape and size that will provide sufficient grip with one hand of a healthcare provider. In some embodiments, the handle 236 is a cylinder. In other embodiments, the handle 236 may be made in any other shape suitable for gripping by one hand. On one end, handle 236 has means 237 for attachment to a socket 238, socket 238 being connected to proximal surface 232C of oral airway tube intubation/extubation device 230, as shown in fig. 16G. Member 237 may be made in any shape suitable for attachment to bracket 238. In certain embodiments, the member 237 may be in the shape of a cylinder as shown in fig. 16F. In some embodiments, as shown in fig. 16F, bracket 238 can be in the shape of a semi-cylinder slightly larger in diameter than member 237 such that member 237 fits snugly inside bracket 238.

When handle 236 is connected to bracket 238, the medical services provider may use handle 236 to lift the patient's mandible and tongue. Thus, intubation/extubation can be easily accomplished by any healthcare provider (including healthcare providers with small build) on any patient (including unconscious patients). Because handle 236 is disconnectable from bracket 238, handle 236 may be removed after it is no longer in use. Handle 236 may then be re-attached to bracket 238 as needed for further manipulation of the patient's mandible and/or tongue.

Fig. 16H and 16J through 16P provide another embodiment of an oral airway tube intubation/extraction device (generally 350) with a rotating central channel. The oral airway tube intubation/extubation device with a rotary central channel comprises two half cylinders: inner cylinder 351 and outer cylinder 352. Semi-cylinders 351 are smaller in diameter and fit inside larger semi-cylinders 352 so that inner semi-cylinders 351 can slide proximally and distally inside outer semi-cylinders 352, as shown in figure 16J. In at least some applications, inner half cylinder 351 may be completely removed from device 350 so that only outer half cylinder 352 remains inserted in the patient, as shown in FIG. 16H.

As can be appreciated from fig. 16J, inner cylinder 351 can be longer than outer cylinder 352, and inner cylinder 351 can slide distally and proximally within outer cylinder 352. As can be appreciated from fig. 16H and 16J, in certain embodiments, the camera tube 12 may be externally attached along the outer half cylinder 352, and the camera 18 may be placed inside the camera tube 12 and provide continuous visualization during intubation and extubation.

In other embodiments, as shown in fig. 16K, the camera tube 12 may be positioned inside the inner half cylinder 351 so that the camera 18 provides continuous visualization during intubation and extubation.

As can be appreciated from fig. 16L-16N, inner half cylinder 351 can be rotated inside outer half cylinder 352 so that both half cylinders can form a fully enclosed channel as shown in fig. 16N, or the half cylinders can form a channel that is not fully enclosed and remains open on at least one side as shown in fig. 16L. In some embodiments, inner cylinder 351 may have at least one retractable extension 353 that, when extended out of cylinder 351, locks cylinder 351 in a position on cylinder 352 and prevents cylinder 351 from sliding further distally along outer cylinder 352.

Fig. 16O and 16P illustrate two different ways of inserting an endotracheal tube 354 inside an oral airway tube/tube drawing device 350 having a rotating central channel. The endotracheal tube 354 may be conveniently placed inside the rotating central channel of the oral airway intubation/extubation device 350, as shown in fig. 16O. In the alternative and as shown in fig. 16P, the endotracheal tube 354 may be first placed inside the inner semi-cylinder 351, followed by insertion of the inner semi-cylinder 351 inside the outer cylinder 352. This form of assembly allows flexibility in inserting endotracheal tubes of various sizes, including pediatric endotracheal tubes, and allows insertion to be very accurate and performed under constant visualization by the camera. Furthermore and because inner semi-cylinder 351 is slidable along the proximal-distal axis, the intubation procedure can be accurate and can be customized to the particular patient to suit the patient's size and anatomy. Alternatively, the device 250 may be placed on an endotracheal tube 354 already in place in the patient to provide constant visualization and to provide a conduit for intubation and possibly re-intubation.

Other embodiments provide supraglottic airway devices with visualization means. Referring to fig. 17A, a supraglottic airway device (generally 240) with a visualization device is shown. The supraglottic airway device includes a body 242, the body 242 having a lumen 243 in which a sound monitoring device 246 is placed. The body 242 may have a tapered cylindrical shape at the distal end, and wherein the distal end of the body 242 projects with a tongue-shaped tip 248. At least a portion of the surface of body 242 curves slightly toward lumen 243 and forms surface 249. The visualization device, generally 10, includes a camera tube 12, the camera tube 12 having a distal end 14 sealed by a transparent material 17, and a camera 18 placed inside the camera tube 12 through an opening at the proximal end of the camera tube 12. The camera tube is positioned exteriorly on surface 249 along the distal-proximal axis of body 242. Camera tube 12 is connected to surface 249 by sliding member 245 so that camera tube 12 can slide on surface 249 along axes 242A-242B.

The camera 18 is placed inside the camera tube 12 and because the camera tube 12 is sealed at the distal end 14, the camera 18 does not come into contact with the patient and the camera 18 does not need to be sterilized for reuse in other applications. The camera 18 is connected to the monitoring device by a wire 20 or wirelessly. The camera 18 is not disposable and may be reused in other applications.

The device 240 is also equipped with a bougie 244, the bougie 244 also being located on a surface 249 and connected to the surface 249 by a sliding member 245 so that the bougie 244 can slide along the 242A-242B axes. Fig. 17B provides an alternative embodiment of the device 240 in which the sound and temperature monitoring device 246 may protrude through an opening at the tip 248.

Another embodiment provides a one-piece video laryngoscope (generally 250) with a visualization device, as shown in fig. 18A and 18B. The video laryngoscope 250 includes a barrel 252 having a proximal end 252B and a distal end 252A. The body 252 extends at a distal end 252A with a scoop 254. Scoop 254 is bent horizontally such that a distal end 254A of scoop 254 is nearly parallel to a proximal end 254B of the scoop. The body 252 has an opening 256 near its distal end 252A. The visualization device 10, including the camera 18 placed inside the camera tube 12, is placed through the opening 256 such that the distal end 14 of the camera tube 12 may be proximate to the proximal end 254A of the scoop 254. The device can be easily inserted into the upper esophagus and the vocal cords visualized.

However, the position of the distal end 14 may be adjusted as desired by sliding the camera tube 12 through the opening 256. The distal end 14 is sealed with a transparent material 17 so that the camera 18 does not come into contact with the patient's body, and therefore, the camera 18 does not need to be sterilized for reuse in multiple applications. The camera 18 is inserted into the camera tube 12 through an opening at the proximal end 16. The camera 18 is connected to at least one monitoring device by a wire 20 or wirelessly.

The embodiment of FIG. 18B is the same as the embodiment of FIG. 18A, except that a light source 21 is added to the visualization device 10 as described above in connection with the light source 21 in the other medical devices. The bougie 116 in the tube 118 is also added through the opening 256 and the distal end 116A can be manipulated at the proximal end 116B of the bougie 116 to guide placement of the device 250 under continuous visualization with the camera 18.

Another embodiment includes a vaginal speculum (generally 260) with a visualization device, as shown in fig. 19. Any speculum 261, including disposable specula, that is well known and used for trabecular examination may be equipped with a visualization device, typically 10, that includes a camera 18 placed inside a camera tube 12. The camera tube 12 may be attached to the speculum 261 or some other implement. The camera 18 is placed in the camera tube 12 through an opening at the proximal end 16 and moved all the way towards the distal end 14, the distal end 14 being sealed by a transparent material 17. The camera 18 is connected to at least one monitoring device by a wire 20, or the camera 18 may be connected wirelessly.

Other embodiments pertain to various tubes equipped with the visualization device shown in fig. 1A and described in more detail below.

Fig. 20A-20F relate to various embodiments of a nasal cannula (generally 270) with a visualization device. Fig. 20A shows the positioning of the nasal cannula 272 on the patient's head with the imaging device 10 added to one of the two nostril tubes. Nasal cannula 272 can be any nasal cannula known in the art and used by practitioners. The visualization device 10 is as described in connection with fig. 1A and includes a camera 18 inserted inside the camera tube 12. The camera tube 12 is externally sealed or otherwise attached along at least one nostril tube 274 of the nasal cannula 272, as shown in more detail in fig. 20C. Such a nasal cannula with visualization device 10 provides continuous visualization of the vocal cords and the upper segment of the esophagus. The cannula may be used to determine whether the vocal cords are moving correctly, whether there are any abnormal anatomical structures, and the color of the patient's tissue.

As shown in fig. 20E, the nasal cannula with the visualization device may be properly positioned through the patient's nostrils as the positioning is guided and constantly visualized by the camera device 10. The distal end 14 of the camera tube 12 is aligned with the distal end of the at least one nostril tube 274. As shown in fig. 20F, the nasal cannula with visualization device may also be equipped with an external stethoscope 275, the external stethoscope 275 may be placed externally on the chest of the patient and used to monitor respiratory and cardiac sounds.

Fig. 20B and 20D show the same embodiment as that shown in fig. 20A and 20C except that the developing device 10 is equipped with a light source 21 as described in connection with the light source 21 in the other embodiments.

Another embodiment includes an esophagus (generally 280) with an imaging device, as shown in fig. 21. The visualization device (generally 10) is externally sealed or otherwise attached along the proximal-distal (282A-282B) axis of the esophagus 282. The visualization device 10 is substantially the same as described above in connection with fig. 1A and other embodiments. Visualization device 10 includes a camera tube 12 having a proximal end 16 and a distal end 14. A camera 18 with a guidewire 20 is inserted into the camera tube 12 through an opening at the proximal end 16 and slid all the way to the distal end 14, which is sealed by a transparent material 17. The camera 18 does not come into contact with the patient's body and can be reused in multiple devices. In this embodiment, any feeding tube known in the art may be used, including a feeding tube with a trocar 284 as shown in fig. 21. The esophagus 282 may be equipped with a coupler 283 at the proximal end 282A. The food intake shaft 282 may further include a plurality of apertures 285 at the distal end 282B for food dispensing.

Other embodiments provide various suction tubes (generally 290) equipped with visualization devices, as shown in fig. 22A, 22B, and 22C. Any suction tube may be used, including but not limited to nasogastric tubes as known in the art, and in general, a suction tube 292 with a coupler 293 at the proximal end 292B is suitable, as shown in fig. 22A. The visualization device, generally 10, includes a camera tube 12 and a camera 18 having a lead 20. The camera 18 is inserted into the camera tube 12 through an opening at the proximal end 16 and slid all the way to the distal end 14 of the camera tube 12. Distal end 14 is sealed by a transparent material 17. The camera 18 may transmit information to a remote location.

The camera tube 12 is placed inside the suction tube 292 through an opening 294 at the proximal end 292B of the suction tube 292. The camera tube 12 is then aligned with the length of the suction tube 292 such that the distal end 14 of the camera tube 12 is in close proximity to the distal end 292A of the suction tube 292.

Figures 22B and 22C show another embodiment of a suction tube (generally 290) with a visualization device as shown in figure 22A, but which is also equipped with a bougie 116 placed inside the tube 118, the tube 118 being placed inside the suction tube 292 through an opening 295. The distal end 116A of the bougie 116 may protrude outside the distal end 292A of the suction tube 292 and may be manipulated by a medical practitioner with the proximal end 116B protruding outside the patient to guide placement of the suction tube 292 under constant visualization with the camera 18 through the distal end 14 of the camera tube 12. The bougie 116 allows for rapid and accurate placement of the device 290 within the patient under constant visualization by the camera 12. The bougie 116 may be used to guide the placement of the device 290 and move the device 290 to the left or right in the trachea.

Referring to fig. 23, this embodiment provides an aspiration catheter (generally 300) with a visualization device. The aspiration conduit 302 is not flexible and may be any aspiration conduit known in the art. The visualization device (generally 10) is positioned inside the aspiration catheter 302 through the opening 303, the opening 303 being in close proximity to the proximal end 302B of the aspiration catheter 302. The visualization device 10 includes a camera 18 having a guidewire 20, the camera 18 being placed inside the camera tube 12 through an opening at the proximal end 16 of the camera tube 12, and then the camera 18 is slid to the distal end 14 sealed by the transparent material 17. The distal end 14 of the camera tube 12 is aligned with the distal end 302A of the suction catheter 302, while the proximal end 16 of the camera tube 12 protrudes outside the patient's body to allow the camera 18 to be pulled out of the camera tube 12 as needed. In other embodiments, the suction tube is placed externally, and such a combination may work in conjunction with a suction cap.

Referring to fig. 24, this embodiment provides an endotracheal exchange tube (generally 310) having a visualization device. The endotracheal tube may be any endotracheal tube known in the art. The visualization device, generally 10, includes a camera 18 having a guidewire 20, the camera 18 being placed inside the camera tube 12 through an opening at the proximal end 16 of the camera tube 12 and slid all the way to the distal end 14 of the camera tube 12. Distal end 14 is sealed by a transparent material 17. The visualization device 10 is placed inside the endotracheal exchange tube 312 through an opening 313 in the exchange tube 312 such that the camera tube 12 is aligned with the exchange tube 312 along the proximal-distal (312B-312A) axis and the distal end 14 of the camera tube 12 is in close proximity to the distal end 312A of the exchange tube 312. In other embodiments, the camera tube 12 may be placed outside the endotracheal changing tube, or it may be externally fitted over the endotracheal changing tube as is known in the art.

Other embodiments include a supraglottic ventilation tube (generally 360) with a camera, as shown in fig. 25A-25D. As can be appreciated from fig. 25A, the device 360 includes a tube 361 having a distal end 361A and a proximal end 361B. The device 360 is equipped with a visualization device 10 as described in connection with fig. 1A, 1B and 1C, and the visualization device 10 comprises a camera tube 12 externally attached to the device 360. The disposable camera 18 may be inserted into the camera tube 12 along with the light source 362. Near the distal end 361A, the device 360 includes an inflatable cuff 364 wrapped around the tube 361. The cuff 364 may be inflated by the member 366 after the esophageal camera tube is positioned within the patient.

As can be appreciated from fig. 25B, the camera tube 18 is positioned below the cuff 364 such that the cuff 364 wraps around the camera tube 12. The camera tube 12 is slidable along the tube 361 so that after the cuff 364 is inflated in the patient, images can be taken by the camera 18 from either the proximal or distal side of the cuff 364.

As shown in fig. 25C and 25D, the device 360 may be placed inside an intubated/extubated oral airway device 350 (including the intubated/extubated oral airway device 350 shown in fig. 16H-16K). As can be appreciated from fig. 25D, the device 360 can be easily inserted into a patient with the aid of the intubating/extubating oral airway device 350. Supraglottic ventilation tubes can be positioned under direct and continuous visualization into the patient's hypopharynx. After insertion is complete, the device 350 may be removed.

Other embodiments provide a tubeless intubation device (generally 370) shown in fig. 26A-26J. The tubeless cannula device 370 has an upper surface shown in fig. 26A and a bottom surface shown in fig. 26B. The tubeless intubation device 370 includes an ellipsoid 372 having an elliptical upper surface 373, the elliptical upper surface 373 of the ellipsoid 372 having a lumen opening 374A therein, as shown in fig. 26A. The elliptical upper surface 373 is connected to the semi-ellipsoidal bottom surface 378 as shown in fig. 26A and 26B such that the distal end 376 of the ellipsoid 372 is tapered because the semi-ellipsoidal bottom surface 378 is tapered at the distal end 376. The ellipsoid 372 encloses a lumen 374, the lumen 374 opening onto the elliptical upper surface 373 with a lumen opening 374A. Lumen 374 is open on a proximal side of semi-ellipsoidal bottom surface 378 with a trench (canal)379, trench 379 connecting to semi-ellipsoidal bottom surface 378 and extending below semi-ellipsoidal bottom surface 378. A semi-ellipsoidal bottom surface 378 is also connected to the handle 380.

The handle 380 includes three portions connected together: a proximal portion 380A, an intermediate portion 380B, and a distal portion 380C. The proximal portion 380A may be made in a flat rectangular shape with an annular socket 382 attached to the bottom surface of the proximal portion 380A. The portion 380A curves downward at an approximately 90 degree included angle at its distal portion where it connects to the middle portion 380B. The middle portion 380B also has a flat rectangular shape and may vary in length. As can be seen from fig. 26B, the trench 379 connects to the bottom surface of the middle portion 380B at a distal portion of the middle portion 380B. The middle portion 380B is connected at its distal end to the distal portion 380C. The middle portion 380B curves upward at the distal portion at an approximately 90 degree included angle and connects to the distal portion 380C. The distal portion 380C is connected by its distal end to an elliptical upper surface 373 of the ellipsoid body 372.

A visualization device (generally 10) comprising a camera tube 12 and a camera 18 insertable into the camera tube 12 is attached to the handle 380 on an upper surface of the handle 380 such that the visualization device 10 extends from a proximal end 380A of the handle 380 along the handle 380, with the camera 18 inserted inside the camera tube 12 at the proximal end 380A and all the way into the distal portion 380C. As in the other embodiments, the camera tube 12 is sealed at its distal end by a transparent material 17 so that the camera 18 does not come into direct contact with the patient's body and can be reused. As in other embodiments, the camera tube 18 may slide along the proximal-distal axis of the handle 380. The visualization device 10 may further include a light source 384 that may be inserted into the camera tube 12 along with the camera 18. In certain embodiments, the ellipsoid 372 may include an inflatable cuff 385 that may be inflated by the member 386.

In some embodiments, the handle 380 may be made of a flexible material. In other embodiments, tubeless intubation device 370 may be designed without cuff 385. In certain embodiments, the camera tube 12 is secured to the handle 380. In certain embodiments, the camera tube 12 includes a light source. In other embodiments, the camera tube 12 has no other light source.

The tubeless intubation device 370 may be used to insert an endotracheal tube of any size into a patient under continuous visualization by the camera 18. The tubeless intubation device 370 may also be used to withdraw and re-intubate a patient. Tubeless intubation device 370 may also be used as a supraglottic device with an endotracheal tube inflated through cuff 385.

As shown in fig. 26C, the endotracheal tube 388 may be loaded onto the tubeless intubation device 370 such that the proximal end of the endotracheal tube 388 is secured to the tubeless intubation device 370 by the annular bracket 382. It will be appreciated that any endotracheal tube may be loaded into the device 370 and inserted into the patient. As can be seen in fig. 26C, the endotracheal tube 388 in this embodiment is equipped with a cuff 390. The cuff 390 of the endotracheal tube can be inflated after the endotracheal tube is loaded into the device 370 and held in place by the annular bracket 382. It will be appreciated that the embodiment of the device 370 shown in figures 26A to 26C is equipped with a cuff 385 and that the cuff 385 of the structure may be inflated in the hypopharynx.

The distal end of the endotracheal tube 388 is then passed through the channel 379 and through the lumen 374 such that the distal end of the endotracheal tube 388 protrudes from the lumen opening 374A on the elliptical upper surface of the ellipsoid 372, as shown in fig. 26D and 26E. The endotracheal tube 388 is slidable along the proximal-dorsal axis of the tubeless intubation device 370 such that a longer or shorter portion of the endotracheal tube 388 protrudes from the lumen opening 374A.

As can also be appreciated from fig. 26F, after the endotracheal tube 388 is delivered through the tubeless intubation device 370 under direct and continuous visualization and assists in placing the endotracheal tube 388 within the patient, the tubeless intubation device 370 can be easily removed from the patient while the endotracheal tube 388 remains safely in place under continued visualization. Accordingly, the tubeless device 370 may be used with standard endotracheal tubes to intubate and extubate a patient. The device 370 may also be used as a supraglottic device.

Other embodiments of a tubeless intubation device 370 are shown in fig. 26G through 26J. As shown in fig. 26G, and as can be appreciated particularly from fig. 26H, the tubeless intubation device 370 in these embodiments does not include a cuff. However, and as with the tubeless intubation device 370 of FIG. 26A, the device 370 of FIG. 26G has an upper surface as shown in FIG. 26G and a bottom surface as shown in FIG. 26H. The tubeless intubation device 370 includes an ellipsoid 372 having an elliptical upper surface 373, the elliptical upper surface 373 of the ellipsoid 372 having a lumen opening 374A therein, as shown in fig. 26G. The elliptical upper surface 373 is connected to the semi-ellipsoidal bottom surface 378 as shown in fig. 26G and 26H such that the distal end 376 of the ellipsoid 372 is tapered because the semi-ellipsoidal bottom surface 378 is tapered at the distal end 376. The ellipsoid 372 encloses a lumen 374, the lumen 374 opening onto the elliptical upper surface 373 with a lumen opening 374A. Lumen 374 is open on a proximal side of semi-ellipsoidal bottom surface 378 as shown in fig. 26H. A semi-ellipsoidal bottom surface 378 is also connected to the handle 380. This embodiment of the device 370 does not include trenches.

The handle 380 includes three portions connected together: a proximal portion 380A, an intermediate portion 380B, and a distal portion 380C. The proximal portion 380A may be made in a flat rectangular shape with an annular socket 382 attached to the bottom surface of the proximal portion 380A. The portion 380A curves downward at an approximately 90 degree included angle at its distal portion where it connects to the middle portion 380B. The middle portion 380B also has a flat rectangular shape and may vary in length. As can be seen from fig. 26B, the trench 379 connects to the bottom surface of the middle portion 380B at a distal portion of the middle portion 380B. The middle portion 380B is connected at its distal end to the distal portion 380C. The middle portion 380B curves upward at the distal portion at an approximately 90 degree included angle and connects to the distal portion 380C. The distal portion 380C is connected by its distal end to an elliptical upper surface 373 of the ellipsoid body 372.

A visualization device (generally 10) comprising a camera tube 12 and a camera 18 insertable into the camera tube 12 is attached to the handle 380 on an upper surface of the handle 380 such that the visualization device 10 extends from a proximal end 380A of the handle 380 along the handle 380, with the camera 18 inserted inside the camera tube 12 at the proximal end 380A and all the way into the distal portion 380C. As in the other embodiments, the camera tube 12 is sealed at its distal end by a transparent material 17 so that the camera 18 does not come into direct contact with the patient's body and can be reused. As in other embodiments, the camera tube 12 may slide along the proximal-distal axis of the handle 380. The visualization device 10 may further include a light source 384, and the light source 384 may be inserted into the camera tube 12 along with the camera 18.

As shown in fig. 26I and 26J, the device 370 may be used to insert and remove a supraglottic airway (generally 392 in fig. 26I and 26J) for a patient. The device 370 may also be used to place a laryngeal mask airway. As shown in fig. 26J, the supraglottic airway 392 is secured in the device 370 by the ring holder 382 such that the distal end of the device 392 is aligned with the distal end of the device 370 and the lumen 394 of the device 392 is aligned with and secured to the lumen 374 of the device 370. Since the assembly formed by the devices 370 and 392 is equipped with the camera device 10, the camera device 10 provides continuous visualization of the patient's supraglottic structures during placement.

Other embodiments provide a sliding endotracheal cuff device (generally 400) as shown in fig. 27A-27G. As can be appreciated from fig. 27A and 27B, the endotracheal tube 410 comprises a tube 412 having a proximal end 412A and a distal end 412B, wherein a rail 414 is designed along the proximal-distal axis (412A-412B) such that the endotracheal tube 410 fits inside the device 400 and the rail 414 fits into the rail 404 of the device 400. The device 400 may then be slid over the endotracheal tube 410 along the proximal-distal axes 412A-412B, as shown in fig. 27B. Design details of the apparatus 400 will be further explained in conjunction with fig. 27C to 27F. As can be appreciated from fig. 27C, the rail 404 has a groove 405 facing the interior of the tube 402. The groove 405 is designed such that the rail 414 of the endotracheal tube 410 fits inside the groove 405 and is slidable along the rail 404. The rail design allows for easy removal of the endotracheal tube 410 from the device 400 while keeping the device 400 in place in the patient. In the alternative, the device 400 may be removed while the endotracheal tube 410 is held in place within the patient. With the device 400 held in place, the change from one endotracheal tube 410 to another may be easily accomplished. Furthermore, since the cuff 406 is present on a separate device, the endotracheal component can be held in place if the only cuff that needs to be replaced. Although in the drawing of FIG. 27, the device 400 is shown as a cylinder, in other embodiments, the device may be semi-cylindrical.

As can also be appreciated from fig. 27D, certain embodiments of the device 400 include other tubes 416, the tubes 416 may be used to deliver drugs, suction, and tools such as forceps and bougies. Other embodiments of the device 400 include the embodiment shown in figure 27E in which the cuff 406 is movable along the rails 404. Still other embodiments of device 400 include the embodiment shown in fig. 27F, wherein distal portion 402A of tube 402 includes mesh 418. As can also be appreciated from fig. 27F, the cuff 406 may be inflated through the mesh 418.

As can be appreciated from fig. 27G, the camera tube 12 may be fixed along the body 402, or it may slide proximally and distally along the body 402. In summary, the device 400 prevents the problem of breaking the seal after the device has been in place in the patient for a period of time.

Other embodiments provide an endotracheal tube (generally 430) as shown in fig. 28A and 28B. Device 430 includes a tube 432 having a proximal end 432A and a distal end 432B. Visualization device 10 is positioned along a proximal-distal axis (432A-432B) of tube 432. As can be appreciated from fig. 28B, the visualization device 10 comprises a camera tube 12 sealed at a distal end by a transparent material 17. The camera 18 may be placed inside the camera tube 12. The camera tube 12 includes a rail 434 that extends along the camera tube 12. The tube 12 also includes a half cylinder 436, the half cylinder 436 being attached to the tube 12 on the side opposite the side to which the rail 434 is attached. The diameter of the semi-cylindrical body 436 is such that the visualization device 10 can be easily snapped onto the tube 432 of the endotracheal tube 430 by means of the semi-cylindrical body 436. Therefore, the imaging device 10 of this embodiment can be easily assembled with any endotracheal tube, and the imaging device 10 can be easily removed from the endotracheal tube when imaging is no longer required. Importantly, the camera tube can be detached at any time. Thus, the device is similar to a laryngoscope, but the camera tube can be removed when it is no longer needed. Thus, one of the advantages of this device is a rail that allows sliding along any other tubular device.

Other embodiments provide a sliding camera tube (generally 440) with a rail, as shown in fig. 29A-29C. As can be appreciated from fig. 29A, the camera tube 440 includes a tube into which the camera 18 can be inserted. The tube 12 is sealed at the distal end by a transparent material 17. The rails 442 extend along the tube 12. Tube 12 is attached to semi-cylindrical body 444, semi-cylindrical body 444 having a diameter such that camera tube 440 can be easily assembled with and slid along an endotracheal tube or any other tube. As can be appreciated from fig. 29A, the camera tube 440 can easily slide into a laryngoscope equipped with a rail 448, along which rail 448 the camera tube 440 can slide. As can be appreciated from fig. 29B, the camera 18 may be inserted into the tube 12 after the camera tube 440 is positioned on the laryngoscope.

As can also be appreciated from fig. 29C, the camera tube 440 can be easily detached from the laryngoscope and assembled with any other device. For example, as described in connection with fig. 28, the camera tube 440 may be placed on an endotracheal tube. Thus, the device enables intubation during laryngoscopy and after device 440 is removed from device 448.

Other embodiments provide a supraglottic airway device (generally 450) with an in-built endoscope guide, as shown in fig. 30A and 30B. As can be appreciated from fig. 30A, the device 450 includes a camera tube 12 positioned exteriorly along the body of the device 450. The device 450 is also equipped with a semi-cylindrical endoscope guide 452, the semi-cylindrical endoscope guide 452 running along the body 451 of the device 450 exteriorly below the cuff 454 and forming a semi-lumen. The device 450 may be used to place the supraglottic airway with the endoscope in place. The device 450 can accommodate endoscopes of all sizes. The device 450 may be placed after the endoscope has been inserted into the patient. The device 450 is capable of ventilating a patient under continuous visualization during the performance of an endoscopic examination. As can also be appreciated from fig. 30B, the device 450 can be positioned in the patient's mouth 456, and the device 450 can then be easily detached from the endoscope half-lumen 452.

Fig. 31A and 31B provide other embodiments of an assembly (generally 460) having a nasogastric tube and imaging device 10. The visualization device 10 includes a camera tube 12 and a camera 18 that can be inserted inside the camera tube 12. Nasogastric tube 461 includes valve 462. The assembly 460 also includes an oxygen tube 464 having a plurality of perforations, the oxygen tube 464 being connectable to an oxygen source 468. As can be appreciated from fig. 31A and 31B, the perforation 466 is located at the distal end of the tube 464, and this allows the perforation to be located in the midsharynx for delivery of oxygen to the patient, as shown in fig. 31A. The lengths of camera tube 12, oxygen tube 462 and nasogastric tube 461 are calculated so that the assembly has flexibility and camera tube 12 can be located in the midsagittal. However, the camera tube 12 can be slid over the gastric tube 461 to travel distally of the gastric tube 461, thereby providing a continuous visualization of the patient's gastric organ. Those skilled in the art will appreciate that in some embodiments, assembly 460 comprises nasogastric tube 461 as shown in fig. 31A, while in other embodiments, assembly 460 comprises esophagus 470 instead of nasogastric tube 461.

Figure 32 is another embodiment of an oral airway (generally 480) with camera means. The oral airway includes a tube 482 having a lumen 484, the tube 482 being similar to the tubes of other oral airways described in the present invention. The camera device 10 comprises a camera tube 12, the camera tube 12 being sealed at its distal end by a transparent material 17, and a camera 18 being placeable in the camera tube 12.

The camera device 10 is placed inside the lumen 484. The oral airway device 480 may provide continuous visualization of the patient's supraglottic structures, including the patient with positive ventilation pressure and the patient's vocal cords that are autonomously ventilated. The oral intubation device 480 may be used to place an endotracheal tube through the vocal cords without lifting the mandible. As in the previous embodiments, the device 480 provides continuous visualization after the endotracheal tube is placed and during extubation. It should be understood that this camera tube may slide proximal and distal to the tip of the device 480. The bougie 486 is also disposed within the lumen 484 and is movable along a proximal-distal axis and guides the positioning of the camera device 10, which is also movable along the proximal-distal axis. The device 480 also includes an aspiration catheter 488, the aspiration catheter 488 also being disposed within the lumen 484 and being movable along a proximal-distal axis within the lumen 484. As will be appreciated by those skilled in the art, an endotracheal tube may be placed inside the lumen 484 to intubate the patient.

Fig. 33A-33C are other embodiments of an endotracheal tube 490, the endotracheal tube 490 having a camera tube 12 externally attached and a suction tube 492 also externally attached to the endotracheal tube 490, the camera tube 12 having a camera 18 disposed therein, as shown in fig. 33A. As shown in fig. 33B and 33C, other devices (e.g., drug dispensing device 494 shown in fig. 33B and biopsy forceps 496 shown in fig. 33C) may be externally attached to endotracheal tube 460. Additionally, ventilation tubes may be placed (added) in the assembly. Additional balloons may be added circumferentially around the camera tube to provide ventilation. This system can also be used to separate ventilation functions between the left and right bronchi. Since the camera tube 12 and the suction tube 492 are fixed to the endotracheal tube 490 by a set of rings, the attachment form is flexible and each of the camera tube 12 and the suction tube 492 can be rotated 360 degrees around the endotracheal tube 490. In addition to being able to rotate about the endotracheal tube 490, the camera tube 12 and the suction tube 492 are also slidable along the proximal-distal axis of the endotracheal tube. The camera tube 12 is sealed at the distal end by a transparent material 17 and this allows the camera 18 to visualize external structures in the airway, including but not limited to the vocal cords.

Fig. 34A to 34H are further embodiments of oral airway devices (500 as a whole) that allow for continuous visualization of a patient's vocal cords. As shown in fig. 34A, the device includes a tube 502 having a lumen 504 into which an endotracheal tube 506 or any other similar device may be inserted. The tube 502 has a proximal end 502A and a distal end 502B. The visualization device 10 is located externally along the tube 502 and it comprises a camera tube 12 and a camera 18, the camera tube 12 being sealed at the distal end by a transparent material 17, the camera 18 being usable in a number of applications since it is not in direct contact with the patient's body. Positioning the camera device provides a continuous visualization of the front of the lumen. Attached along the proximal-distal axis of the tube 502 is another tube having a lumen 508. This other tube 508 may be used to position the esophageal obturator 510, which may then be placed in the patient's esophagus under direct visualization with the visualization device 10. The esophageal obturator 510 is equipped with a balloon 512 at the distal end. Balloon 512 is inflatable by member 514 and is used to seal the upper esophageal segment of the patient. In addition, device 500 is equipped with a second balloon 516, second balloon 516 extending circumferentially and around bodies 502 and 508 and proximal to balloon 512. Balloon 516 may be used to be inflated by member 518 and to seal the upper pharynx. Thus, with the endotracheal tube 506 pulled proximally back in the device 500 and the endotracheal tube 506 inflated, the device 500 may act as a supraglottic airway.

Alternatively and as shown in fig. 34B, the endotracheal tube 506 can be removed and a ventilator cap 520 can be placed proximally in the central oral airway lumen to ventilate the patient as a supraglottic device. With continuous and direct visualization by visualization device 10, device 500 may be capable of ventilation as a supraglottic airway. Under direct visualization, the device may also be returned to use for placement of the endotracheal tube.

Fig. 34C and 34D provide another embodiment of an oral airway device (generally 500), but in which visualization device 10 is positioned internally within lumen 504. Fig. 34C includes an endotracheal tube 506 that can be placed inside the lumen 504, as described in connection with fig. 34A. In addition and as shown in fig. 34D, the device 500 may also be used with a ventilation cap 520.

One of the significant differences between the oral airway device 500 implemented in fig. 34C and 34D and the embodiment shown in fig. 34A and 34B is that the device 500 shown in fig. 34C and 34D does not include a balloon. However, body 502 of device 500 includes at least one retractable extension 522.

As shown in fig. 34E, the oral airway device 500 shown in fig. 34C and 34D may be used in combination with a carrier device 540. As shown in fig. 34E and 34F, carrier device 540 includes a tube 542 having a lumen 544. The two bladders are sealed to the carrier body 542. The first bladder 548 covers the distal end of the carrier body 542. The first bladder 548 may be inflated by the member 549. The second balloon 550 is located proximal to the first balloon 548 and is circular around the carrier body 542. The second balloon 550 may be inflated by member 551.

Carrier body 542 includes an opening 546, opening 546 being located on carrier body 542 between first and second balloons 548, 550. Thus, the lumen 544 is open at the carrier body 542 with an opening 546. The carrier body 542 is equipped with a slide rail 552 that extends along at least a portion of the carrier body 542. The carrier body 542 is also equipped with a handle 554 to allow the carrier device 540 to be pushed, pulled, and/or rotated side-to-side.

As can be appreciated from fig. 34E, the oral airway device 500 may be inserted into the lumen 544 of the carrier device 540. The extension 522 of the body 502 may slide along the slide rail 552 until the device 500 is positioned inside the lumen 544. As can be appreciated from fig. 34G and 34H, the device 500 can slide up and down inside the carrier 540, which allows an endotracheal tube to be placed proximally in the central lumen 544 of the carrier 540.

As shown in the previous embodiments, the device 500 can be advanced distally or brought proximally as a whole to align the central lumen between the two balloons 548 and 550 to visualize the vocal cords. Thus, the endotracheal tube can be advanced under direct and continuous visualization by the camera device 10. If desired, the endotracheal tube can be withdrawn from the trachea, either completely or partially, into the proximal side of the lumen 504 (with the balloon on the endotracheal tube inflated) to convert to a supraglottic device.

Balloons 548 and 550 may be inflated and thus occlude the upper esophageal segment distally and the pharynx proximally. This can be accomplished under direct and continuous visualization of the vocal cords, glottic structures, and the upper esophageal segment and hypopharynx by visualization device 10. If an endotracheal tube is not present, a ventilation cap 520 may be placed proximal to the central lumen 504.

Fig. 35A shows an oral airway device 560 with a camera tube 12 positioned in a patient's mouth. The camera tube 12 has a sealed distal end and an open proximal end as in the previous embodiment. The oral airway device 560 has a central lumen 564 to allow the endotracheal tube 562 to enter and slide distally down. Oral airway device 560 has a curvature and length that allows oral airway device 560 to pass under the epiglottis and actually touch the patient's vocal cords. Thus, there is no need to lift the mandible or tissue. This novel intubation method is easier to master and requires less skill than all other intubation formats, such as laryngoscopy, video laryngoscopy, or fiber optic intubation.

Once the distal end of oral airway device 650 touches or is just proximal to the patient's vocal cords, endotracheal tube 562 can be slid proximally and distally through the vocal cords in central lumen 564 under direct and continuous visualization by camera 18. The oral airway device 560 still maintains a direct and continuous visualization of the endotracheal tube 562 and the patient's vocal cords while the endotracheal tube 562 is placed and secured.

Additional details of the oral airway device 560 can be appreciated from fig. 35B, which shows that the sides 566 of the oral airway device 560 are open to allow the endotracheal tube 562 to be laterally removed from the central lumen 564 of the oral airway device 560 when desired. As can also be appreciated from fig. 35B, the device 560 may also be equipped with a cap 568, the cap 568 may be designed in a variety of different sizes and may be placed or removed to lengthen or shorten the oral airway device 560 to properly accommodate patients of different sizes. As shown in fig. 35B, the cap 568 has still one side 570 removed to allow the endotracheal tube to be moved laterally out of the central portion of the oral airway device 560. Additionally, the cap 568 may be removed and rotated 180 degrees to help hold the endotracheal tube in place.

Fig. 36A, 36B and 36C show a nasopharyngeal airway device (generally 580). The apparatus includes a tube body 582 within which the camera tube 12 is positioned. The distal end of the camera tube 12 is sealed by a transparent material 17. The camera 18 is placed inside the camera tube 12. The tube body 582 has a closed distal end with an occlusion soft balloon 584 just proximal to the tip of the body 582. The balloon 584 may be inflated by the member 585. Located on the proximal side of the distal balloon 584 is an open lumen (vocal cord visualization lumen) 586, which open lumen 586 allows the distal side of the camera tube 12 to be disposed forward toward the vocal cords for viewing. The vocal cord visualization lumen 586 is proximal to the main lumen 588 in the nasopharyngeal airway tube 582. The lumen 588 extends proximally to distally to merge into a visualization opening 586 that receives the camera tube 12.

A larger balloon 590 may be placed proximal to the vocal cord visualization camera lumen 586. The balloon 590 may be inflated by a member 591. Balloon 590 may occlude the posterior pharynx. Additionally, another balloon 592 may be located proximal to the pharyngeal cuff balloon 590, as shown in FIG. 36B. The balloon 592 may be inflated by the member 593.

Ideally, these balloons occlude the upper esophageal segment (hypopharynx), pharynx, and septum. These balloons may have multiple individual adjustment cuffs (pilot cuff), or one or more balloons may share a single adjustment cuff. A standard 15 mm cap (not shown) may be attached to the proximal portion of the nasopharynx device to provide positive pressure ventilation with the hypopharynx and pharynx sealed and the balloon in place and inflated.

As shown in fig. 36C, the device 580 is placed in the patient, and the balloon is inflated in the septum, pharynx, and hypopharynx. In direct and continuous visualization, the visualization camera lumen 586 can be easily aligned with the vocal cords being visualized from the front. A ventilator cap may be placed proximally to provide positive pressure ventilation. This device may be a rescue device to provide a continuous visualization of the vocal cords while maintaining a closed system.

Claims (10)

1. A medical device comprising a visualization device sealed to, attached to, or otherwise combined with at least one of: oral cavity air duct, supraglottic air duct device, endotracheal tube, pipeless intubation device, sliding endotracheal cuff device, ventilator adaptive cap, dilator, tracheostomy device, nasopharynx air duct, esophagus stethoscope, laryngoscope, trocar, bougie, speculum, nose sleeve, esophagus, suction tube, suction catheter, and endotracheal exchange tube; and wherein the visualization device comprises a camera tube having a distal end and a proximal end, the distal end being sealed by a transparent material, and a camera placed inside the camera tube through an opening at the proximal end, and wherein the camera is disposable or reusable.

2. The medical device of claim 1, wherein the second device has a proximal end and a distal end, wherein the camera tube is attached to the second device either internally or externally along a proximal-distal axis, and the camera tube is slidable internally or externally along the proximal-distal axis of the second device.

3. The medical device of claim 1, wherein the second device is the oral airway tube comprising a tube forming a rotational central channel and made of two half cylinders: a first externally disposed half-cylinder and a second internally disposed half-cylinder, wherein the second internally disposed half-cylinder fits inside the first externally disposed half-cylinder and can slide inside the first externally disposed half-cylinder along a proximal-distal axis of the first externally disposed half-cylinder, and wherein the second internally disposed half-cylinder can also rotate inside the first externally disposed half-cylinder and thereby form a completely enclosed central passageway or form a only partially enclosed central passageway with lateral openings, and wherein the first externally disposed half-cylinder and the second internally disposed half-cylinder can be separated from each other; and wherein the camera tube is attached to the oral airway either externally along the first externally disposed semi-cylindrical body or internally along the second internally disposed semi-cylindrical body.

4. The medical device of claim 3, wherein the second inner half-cylinder has at least one retractable extension on a body of the second inner half-cylinder that, when extended out of the body of the second inner half-cylinder, secures a positioning of the second inner half-cylinder on the first outer half-cylinder such that a portion of the second inner half-cylinder protrudes out of the first outer half-cylinder and the retractable extension prevents the second inner half-cylinder from sliding further distally within the first outer half-cylinder.

5. The medical device of claim 1, wherein the second device is the oral airway device, the oral airway device comprising a tube, and wherein the oral airway device is assembled with a carrier, wherein the carrier comprises a tube having a lumen in which the oral airway device can be placed, wherein a first balloon covers a distal end of the carrier, wherein the carrier has a lumen opening proximal to the first balloon, wherein the carrier has a second balloon surrounding the tube of the carrier proximal to the lumen, wherein the carrier further comprises a third balloon surrounding a body of the carrier, as needed, proximal to the second balloon, and wherein the balloon is inflatable by an inflation means.

6. The medical device of claim 1, wherein the second device is the tubeless intubation device, the tubeless intubation device including an ellipsoid attached to a handle and the camera tube attached to the tubeless intubation device, and wherein the ellipsoid includes a lumen with one opening on an upper surface of the ellipsoid and another opening on a bottom surface of the ellipsoid, and wherein a proximal end of the handle is equipped with an annular receptacle adapted to hold at least one of: an endotracheal tube, a supraglottic airway, and a laryngeal mask airway; and wherein the ellipsoid may optionally be equipped with a cuff.

7. The medical device of claim 1, wherein the second device is the supraglottic ventilation device, the supraglottic ventilation device comprises a ventilation tube having a distal end and a proximal end, and the camera tube is attached along the ventilation tube exteriorly, wherein an inflatable cuff is wrapped around the ventilation tube, and the camera tube is positioned below the cuff and is slidable distally under the cuff; and wherein the supraglottic ventilation tube optionally further comprises an in-built endoscope guide.

8. The medical device of claim 1, wherein the second device is the sliding endotracheal cuff device comprising a tube having a distal end and a proximal end, optionally a rail attached externally to the tube along a proximal-distal axis, wherein the rail has a groove that is open to the interior of the tube, wherein the second device further comprises a cuff that is externally wrapped around the tube at a distal portion of the tube, and wherein the second device further comprises the camera tube attached externally to the tube along the proximal-distal axis.

9. Use of any one of the devices of claims 1-8 for intubation and extubation of a patient.

10. Use of a medical device as claimed in claim 6 wherein at least one of the following is carried on a tubeless intubation device as claimed in claim 6 and secured thereto by the annular holder: an endotracheal tube, a supraglottic airway, and a laryngeal mask airway.