US20120178996A1

US20120178996A1 - System and method for viewing oropharyngeal area

Info

Publication number: US20120178996A1
Application number: US13/373,869
Authority: US
Inventors: Jay (Jason) Tydlaska; Amy Sheppard
Original assignee: Individual
Current assignee: MAGAW LLC
Priority date: 2009-03-31
Filing date: 2011-12-05
Publication date: 2012-07-12
Also published as: CA2756698A1; ES2899623T3; US8864657B2; US20120169481A1; US9351633B2; US20100249513A1; US20120178997A1; EP2414015B1; HRP20211849T1; DK2414015T3; MX2011010133A; PT2414015T; EP2414015A4; HUE056824T2; PL2414015T3; US8663099B2; EP2414015A1; SMT202200018T1; CA2756698C; PL2414015T4

Abstract

The present invention generally provides a system and method for viewing the oropharyngeal and laryngeal area utilizing a laryngoscope capable of being connected to a monitor and power source, said laryngoscope being comprised of a handle, an arm, a camera, a light, and a disposable sheath, wherein the sheath is slideably and removably coupled to the arm; the sheath being further comprised of a canal capable of being threaded with a bougie; the handle being further comprised of a remote ejection element mechanically connected to a spring element capable of ejecting the sheath from the arm; the arm being removably coupled to the handle. The system is further comprised of a display device, and an IV pole attachment and an LED imaging device. The sheath may be remotely ejected by depressing a thumb ejector switch on the handle which releases a clasp at the coupling point and further releases a spring element held in compression which, upon release, forcibly moves the sheath along the length of the arm, such that the sheath becomes detached from the arm. The sheath is further comprised of a small canal at least partially running along the outside length that serves as a guide for the bougie. The IV pole attachment is comprised of an attachment receiver that allows the user to quickly attach and separate the display unit from the IV Pole attachment, the laryngoscope is comprised of a heating element. In one aspect of the present invention, the laryngoscope is capable of being motion activated such that the laryngoscope is powered on upon movement or such that the laryngoscope is powered off when no movement is detected for a predetermined time. In another aspect, the system is capable of wirelessly communicating with the screen.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional which claims the benefit of U.S. Published Application U.S. 2010/0249513 A1 filed on Mar. 31, 2010, which claims the benefit of PPA No. 61/165,091, filed on Mar. 31, 2009 referenced by incorporation herein which claims the benefit of PPA 61/419,880 filed Dec. 6, 2010 by the present inventor.

DESCRIPTION OF PRIOR ART

To clearly view the oropharyngeal area intubation is generally performed, with a device commonly referred to as a laryngoscope. Advances in recent years have added other capabilities, but a lack of realization of the problems faced by practitioners has resulted in laryngoscopes little changed from the laryngoscopes of 40 years ago. Laryngoscopes need to be developed that can handle even the most challenging intubations, those requiring a bougie to pull in an even larger endotracheal tube.
Over 20 million intubation procedures are performed each year in the United States either as a routine part of surgery or in emergency situations resulting from trauma, cardiopulmonary arrest or other disease processes. In an intubation procedure, it is necessary to insert an endotracheal tube (ET tube) in order to maintain a patient's respiratory function. The tube is inserted into a patient's trachea via either the mouth or nasal tract so that the airway remains open and oxygen reaches the patient's lungs.
Practitioners use an instrument known as a laryngoscope to help in the placement of the ET tube. This instrument typically comprises a handle, a blade, and a light. The practitioner uses the device to move the tongue to the left and epiglottis anteriorly so that the airway may be properly identified. Once the airway is properly identified, the practitioner inserts the tube with one hand while holding the laryngoscope with the other. In a small percentage of patients, the airway cannot be identified with the laryngoscope alone. With these patients, practitioners sometimes use a device known as a “bougie”. This bougie is a small diameter flexible cylinder of metal, plastic or other material that may serve as a guide for placement of a larger ET tube.
The laryngoscope predominantly used today to accomplish this task was developed in the 1940's. When performed by an experienced practitioner, the procedure is usually quick and uneventful. However, even in the hands of well skilled individuals, there is still an unacceptable number of occurrences in which placement of the endotracheal tube is difficult or impossible resulting in an inability to provide the patient with oxygen leading to death or injury. Difficulty in placing the endotracheal tube may be due to trauma, abnormal anatomy, disease processes or for unknown and unpredictable reasons.
More recently due to advances in miniaturization of technology, devices have been developed known as video laryngoscopes that greatly improve the ability to adequately locate the vocal cords and appropriately place the endotracheal tube. These devices are generally constructed with a small camera placed at the distal end of the laryngoscope and the image obtained by that camera is viewed on a remote monitor.
What is needed is an inexpensive, sanitary, easy to use laryngoscope system that may be used in all situations, including the most difficult intubations in the most challenging environments.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide an inexpensive, sanitary, easy to use system and method for viewing the oropharyngeal and laryngeal area that may be used in all situations, including most difficult intubations in most challenging environments
In accordance with the present invention there is provided a laryngoscope capable of being connected to a monitor and power source, said laryngoscope being comprised of a handle, an arm, a camera, a light, and a disposable sheath; wherein the sheath is slideably and removably coupled to the arm; the sheath being further comprised of a canal capable of being threaded with a bougie; the handle being further comprised of a remote ejection element mechanically connected to a spring element capable of ejecting the sheath from the arm; the arm being removably coupled to the handle. The system is further comprised of a display device, and an IV pole attachment. The sheath may be remotely ejected by depressing a thumb ejector switch on the handle which releases a clasp at the coupling point and further releases a spring element held in compression which, upon release, forcibly moves the sheath along the length of the arm, such that the sheath becomes detached from the arm. The sheath is further comprised of a small canal at least partially running along the outside length that serves as a guide for the bougie. With the laryngoscope properly placed, the practitioner may thread a bougie through the sheath's bougie canal into the airway and use this bougie as a guide for the ET tube.
The laryngoscope is further comprised of a light and a camera. The lens of this camera is located at the distal end of the arm and the signal is transmitted either wirelessly or through a cord to the display device. The light is also located at the distal end of the arm. The cord further transmits power from a power source to the light and camera. In one embodiment of the present invention, the camera is located in the arm of the camera with the lens positioned near the body of the camera. In another embodiment, the body of the camera is located in the handle and communicates with the lens through a cable. In still another embodiment of the present invention, the image collected by the lens is reflected on a mirror or prism.
The display unit is comprised of a container, a screen, and a battery. The container is configured such that it may be removably coupled to an IV pole attachment or sit upright when not attached to the IV pole attachment.
The IV pole is conventional and commercially available. The IV pole attachment is comprised of an attachment receiver that allows the user to quickly attach and separate the display unit from the IV Pole attachment an IV clamp with a “C” shaped opening, and a laryngoscope storage, receptacle. In one aspect of the present invention, the laryngoscope is comprised of a heating element.
In one aspect of the present invention, the laryngoscope is capable of being motion activated such that the laryngoscope is powered on upon movement.
In another aspect of the present invention, the laryngoscope is capable of being motion activated such that the laryngoscope is powered off when no movement is detected for a predetermined period of time.
In one aspect of the present invention, the screen is capable of being motion activated such that the screen is powered on upon movement.
In another aspect of the present invention, the screen is capable of being motion activated such that the screen is powered off when no movement is detected for a predetermined period of time.
In another aspect of the present invention, the arm is removably coupled to the handle.
In another aspect of the present invention, a user using the ejection element may eject the sheath without touching the sheath.
In another aspect of the present invention, the display unit is comprised of a stand such that said unit is capable of standing upright.
In another aspect of the present invention, the laryngoscope is capable of wirelessly communicating with the screen.

BRIEF DESCRIPTION OF THE DRAWINGS

A complete understanding of the present invention may be obtained by reference to the accompanying drawings, when considered in conjunction with the subsequent, detailed description, in which:
For purposes of clarity and brevity, like elements and components will bear the same designations and numbering throughout the Figures.

DESCRIPTION OF AT LEAST ONE EMBODIMENT

FIG. 1 is a side perspective view of the laryngoscope system in accordance with a preferred embodiment.

FIG. 2A is an isometric cut-away right side view of the laryngoscope in the open position with the arm 14 and sheath 10 attached in accordance with a preferred embodiment.

FIG. 2B is an isometric cut-away right side view of the laryngoscope of FIG. 2A with the thumb ejector 20 switch in the extended position.

FIG. 3 is an isometric, rear, and side view of the laryngoscope arm 14 and a partial view of the laryngoscope handle, in accordance with a preferred embodiment.

FIG. 4 is an isometric right side view of the laryngoscope with the arm 14 in the closed position in accordance with a preferred embodiment.

FIG. 5 is an isometric right side and rear view of the laryngoscope with the arm 14 in the closed position without the sheath 10 attached in accordance with a preferred embodiment.

FIG. 6 is an isometric right side, top view of the sheath 10, in accordance with a preferred embodiment.

FIG. 7 is a top, front, and left side isometric view of the display unit with the stand in the open position.

FIG. 8 is rear elevation view of the display unit with the stand in the open position.

FIG. 9 is a right side isometric view of the display unit with the stand in the open position.

FIG. 10 is a rear isometric view of the IV pole attachment.

FIG. 11 is a front view of the IV pole attachment.

FIG. 12 is a block diagram depicting the camera 16 unit.

FIG. 13 is a block diagram depicting the laryngoscope motion sensor system.

FIG. 14 is a block diagram depicting the display unit motion sensor system.

FIG. 15 is a block diagram depicting the laryngoscope and display unit wireless communication system.

Referring to FIGS. 1-15 there is shown a laryngoscope system 12 of the present invention. This laryngoscope system 12 is generally comprised of a laryngoscope 14, a display unit 72, and an IV pole attachment 98 capable of being coupled to an IV pole 128.
Referring to FIGS. 1-6, the laryngoscope 14 of the present invention comprises a handle 16, a curved blade or arm 14 18, a light 20, a camera 16 22, and a disposable sheath 10 24. The handle 16 of the laryngoscope 14 has a curved arm 14 18 attached. In one aspect of the present invention, the arm 14 18 is removably coupled to the handle 16. Slideably coupled to the arm 14 18 is a sheath 10 24 which snaps into place at a coupling point 68 (FIG. 3). In the preferred embodiment, this sheath 10 24 is formed from plastic and is at least partially clear so as to allow light emitted from the light 20 to pass through it. Referring to FIG. 6, in the preferred embodiment, the sheath 10 24 is comprised of a transparent window 28. The sheath 10 24 has one or more clasps 30 on its proximal end (FIG. 6) which may be removably coupled to the arm 14 18 at the coupling point 68 (FIG. 3). In one aspect of the present invention, a user, using the thumb ejector 20 switch 34, may eject the sheath 10 24 without physically touching the sheath 10 24. Referring to FIGS. 2A, 2B and FIG. 5, the thumb ejector 20 switch 34 is located at the upper end of the handle 16. The thumb ejector 20 switch 34 is comprised of a plunger block 36, an ejection rod 38, and a protrusion 40. The thumb ejector 20 switch 34 is coupled to the ejection rod 38 which is coupled at the top end with the plunger block 36. The plunger block 36 is comprised of the protrusion 40. A return spring 42 is coupled to the thumb ejector 20 switch 34. This return spring 42 maintains the ejection rod 38 in a retracted position as a rest state (FIG. 2A). Above the plunger block 36 is a retaining receptacle 44. This retaining receptacle 44 is structured and arranged such that it is capable of nesting the protrusion 40 and maintains the thumb ejector 20 switch 34 in a rest position and prevents accidental deployment of the ejection rod 38.
Referring to FIGS. 2B, 3, 5 and 6, the sheath 10 24 may be remotely ejected by depressing the thumb ejector 20 switch 34 (FIG. 2B) on the handle 16 which releases the clasp 30 at a sheath 10 connection ridge 58 located on the arm 14 18 at the coupling point 68. The thumb injector switch 34, when depressed, travels down a switch channel 31 (FIG. 5). In one embodiment, thumb ejector 20 switch 34 further releases a spring element 60 (FIG. 3) held in compression which, upon release, forcibly moves the sheath 10 24 along the length of the arm 14 18, such that the sheath 10 24 becomes detached from the arm 14 18. Referring to FIG. 6, in one aspect of a preferred embodiment, the clasp 30 has a score line 32 or thinner layer of material. This score line 32 creates a weakened area in the clasp 30 so that when depressed by the ejection, rod 38, the clasp 30 is deformed at the score line 32. In one aspect of the present invention, the clasp 30, after ejection, cannot be returned to its original un-deformed configuration without breaking at the score line 32. Such breaking prevents the sheath 10 24 from being reused and thus, helps prevent contamination.
In one embodiment of the invention, and as shown in FIG. 6, the sheath 10 is further comprised of a small canal 12 running at least partially along the outside length that serves as a guide for a bougie 70. With the laryngoscope 14 properly placed, the practitioner may thread the bougie 70 through the sheath's bougie canal 12 into the airway and use this bougie 70 as a guide for an ET tube (not shown). As shown in the FIG. 6, in the preferred embodiment, this canal 12 is open on one side 27 such that the bougie 70 may be inserted and removed through this open side 27. This open side 27 permits the user to maintain the laryngoscope 14 in the airway while threading the ET tube over the bougie 70. In this embodiment, the bougie 70 is forced out of the canal 12 through the side opening 27 by the ET tube. In the preferred embodiment, this canal 12 with its open side 27 is “C” shaped. This “C” shape helps maintain the bougie 70 within the canal 12 while still allowing the bougie 70 to be removed through the open side 27.
Although the canal 12 of the preferred embodiment is open and forms a “C” shape, the canal 12 need not be open and need not be “C” shaped. Rather, the canal 12 can be dosed on the sides so as to completely surround the bougie 70 along its length and can be circular or any other suitable shape.
As best shown in FIG. 5, the laryngoscope 14 also has a light 20 and a camera 16 positioned at the distal end of arm 14 and confined within arm 14 walls 10 beneath a transparent cap 66. This cap 66 is clear and allows light to reach the lens 56 and light generated from the light 20 to exit the arm 14. A lens 56 for this camera 16 is located in the arm 14 18 and the signal is transmitted through a cord 96 to a display unit 72. While in the preferred embodiment the camera 16 is solid state and does not rely upon mirrors or prisms, the camera 16 may be comprised of a lens 56 that focuses light as an image on a prism. The image may then reflected by the prism to the camera 16 22.
Referring to FIGS. 5 & 12, the lens 56 of the camera 16 is also located at the distal end of the arm 14. In another embodiment, the main portion of the camera 16 is located in the handle 16 and communicates with the lens 56 through a fiber optic cable. In one embodiment, the camera 16 transmits the signal directly to the display unit 72 without the use of mirrors and prisms. In the preferred embodiment, the camera 16 is a complementary metal-oxide-semiconductor (CMOS) camera 16. However, other cameras 22 may be used including those incorporating charge-coupled device (CCD) technology.
In the preferred embodiment, the camera 16 transmits video images to the display unit 72. Referring to FIG. 12, the camera 16 is comprised of a lens 56, a shutter 51, an image sensor 57, a processor or CPU 59, and a flex circuit 61. Images collected by the camera 16 are displayed on the screen 88 of the display unit 72. Although the camera 16 of the preferred embodiment produces video images, it can also generate still images which may also be displayed on the screen 88 of the display unit 72.
Referring to FIG. 5, in the preferred embodiment, the arm 14 is comprised of a heating unit 21. This heating unit 21 heats the light 20 and camera 16 area and prevents the light 20 and camera 16 from developing moisture which may obscure the images gathered by the camera 16. The heating unit 21 is comprised of a thermistor 23 which monitors the temperature of the heating unit 21 and shuts the unit 21 off when a predetermined temperature is reached.
In the preferred embodiment, such temperature is approximately 120 degrees Fahrenheit. The arm 14 is further comprised of a flex circuit 61 (FIG. 5). This circuit 61 is capable of supplying power to the camera 16 light 20 and heating unit 21 as well as transmitting information (including images) between the camera 16 and display unit 72. The handle 16 and arm 14 are each further comprised of heater switch 53 and 55. When the laryngoscope 14 is in the folded position, the heater switch 53 and 55 is in the open position and no power to the heater unit 21 is transferred. In this folded position, connectors 52 are also open such that power is not transferred to the light 20, camera 16, and heating unit 21.
As shown in FIGS. 3 & 4, in alternative embodiments, a sheath 10 switch 25 is located on the arm 14. When the sheath 10 is in place and the arm 14 is in the working/engaged position as shown in FIGS. 2A and 2B, power is supplied to the heating unit 21. However, when the sheath 10 24 is not present, as shown in FIG. 3, or the arm 14 is in the folded/disengaged position depicted in FIG. 4, the heater switch 53, 55 is open, and no power is supplied to the heater unit 21. The sheath 10 switch 25 interrupts power to the handle portion 53 of heater switch 53, 55.
The cord 96 further transmits power from a power source to the light 20 camera 16 and heating unit 21. Referring to FIG. 13, in one aspect of the present invention the laryngoscope 14 is comprised of a motion sensor 134 and processor 136 that allow the laryngoscope 14 to be motion activated such that the laryngoscope 14 is powered on upon a predetermined threshold of movement. In another aspect of the present invention, the laryngoscope 14 is capable of being motion activated such that the laryngoscope 14 is powered off when no movement is detected for a predetermined period of time.
In FIG. 3, there is shown the connection assembly between the handle 16 and arm 14. At the base of the handle 16 there is a pin 46 and ball spring receptacles 48. The arm 14 is comprised of ball springs 62. To couple the arm 14 to the handle 16, the pin 46 is inserted in arm 14 opening 47. The ball springs 62 slide into ball spring receptacles 48. This connection aligns arm 14 plate 64 with handle plate 50 within the walls 54 of handle plate 50 such that an electrical connection is made with connectors 52.
Referring to FIGS. 1 and 7-9, the display unit 72 is comprised of a thin container 74, a screen 88, a DC Jack 94, a battery management board and a battery. The container 74 is comprised of an IV pole attachment connector 90 such that it may be removably coupled to an IV pole attachment receiver 100 (FIG. 11) or, as shown in FIGS. 7 & 9, sit upright on a stand 92 when not attached to the IV pole attachment receiver 100. Referring to FIGS. 7-9, the container 74 of the preferred embodiment is generally rectangular and is comprised of a face 76, a back 78, and sides 80. The face. 76 of the container 74 partially surrounds the screen 88 so that the screen 88 may be viewed. In the preferred embodiment, the stand 92 is pivotally coupled to the back 78 and is structured and arranged such that it extends generally rearward from the back 78 when in use and folds flat against the back 78 in a recess 86 when in the stored position. In the preferred embodiment, said recess 86 is contoured to the shape of the stand 92.
Referring to FIG. 14, in one aspect of the present invention the display unit 72 is comprised of a motion sensor 138 and processor 140 that allow the screen 88 to be motion activated such that the screen 88 is powered on upon a predetermined threshold movement. In another aspect of the present invention, the screen 88 is capable of being motion activated such that the screen 88 is powered off when no movement is detected for a predetermined period of time.
Referring again to FIGS. 7-9, in one aspect of the present invention, the face 76 has a battery status indicator 84. This indicator 84 is comprised of a plurality of LED 18 lights. In the preferred embodiment, two green lights showing indicate to the user that the battery is fully charged and the system 12 is operable. An amber light indicates the battery is depleted and will need to be charged soon. A red light indicates the battery lacks sufficient charge to operate the screen 88, camera 16, and light 20. In the preferred embodiment, the indicator 84 is positioned at the lower portion of the face 76 near the center and beneath the screen 88.
The back 78, on the inside, has pegs and receptacles which act as coupling devices. The central pegs of the back correspond with receptacles located on the reverse side of the screen 88. The perimeter receptacles correspond with pegs located on the inside side of the face 76.
The screen 88 and battery are mounted on the inside portion of the back 78 of the container 74. The battery of the preferred embodiment is a rechargeable lithium battery and is capable of illuminating the screen 88. The screen 88 of the preferred embodiment is a 3.5 inch (Diagonal) Liquid Crystal Display (LCD). The screen 88 displays the image captured by the camera 16. In one aspect of the present invention, the screen 88 also displays other information such as the battery charge level, time, date, and the like.
The display unit 72 is further comprised of a DC input jack 94 and charge indicator 130. This jack 94 accepts the barrel portion of a charging cable. This jack 94 connects with and is used to recharge the battery. The charge indicator 130 is an LED 18 light that, when lit, alerts the user that the battery is being charged. In one aspect of the present invention, the unit 72 may not be operated while the charge cable is inserted into the jack 94
The cable 62 is capable of communicating images received from the camera 16 to the screen 88 through the communication jack 132. Referring to FIG. 15, in one aspect of the present invention, the laryngoscope 14 is capable of wirelessly communicating with the display unit 72. In this embodiment, the laryngoscope 14 is further comprised of a transmitter 148, a processor or CPU 152 and an antenna 150. The display unit 72 is further comprised of a receiver 142, a processor or CPU 146 and an antenna 144. Images captured by the camera 16 are processed by the CPU 152 and transmitted wirelessly to the display unit 72 receiver 142 such that the images are displayed on screen 88.
The communication cable 96 is also capable of transmitting power generated by the battery to the light 20 and camera 16. The battery management board is a conventional and commercially available circuit board and is capable of maintaining an appropriate charge level in the battery.
The IV pole 128 is conventional and commercially available. As may be seen in FIGS. 1 and 10-11, the IV pole attachment 98 is comprised of an attachment receiver 100, an IV pole clamp 108 with a C shaped opening, a tightening screw 110 with wing knob 112, and a laryngoscope receptacle 114. The attachment receiver 100 allows the user to quickly attach and separate the display unit 72 from IV pole attachment 98 and is comprised of a bracket 102, and a quick release button 104. The attachment connector 90 of the display unit 72 may be slideably attached to the attachment receiver 100. The user may detach the display unit 72 from the attachment receiver 100 by depressing the release button 104 which activates a lever 106 that disengages the display unit 72 from the attachment receiver 100. The IV pole attachment 98 may be secured to an IV pole 128 by inserting the pole 128 in the IV clamp's 108 C shape opening and tightening the tightening screw 110 with the wing knob 112.
Referring to FIGS. 10-11, the laryngoscope receptacle 114 is comprised of a contoured holder 116 and an extension portion 118. The extension portion 118 is comprised of a first member 124 and a second member 126. In the preferred embodiment, the first member 124 is structured and arranged such that it can rotate 360 degrees around an imaginary axis 120 that extends from a longitudinal axis of the extension portion 118. The second member 126 is structured and arranged such that it can rotate up to 360 degrees around an axis 122 perpendicular to the axis 120 around which the first member 124 rotates. Therefore, as may be seen in FIGS. 10 and 11, the receptacle 114, without the need for the user detaching the IV pole attachment 98 from the IV pole 128, can be positioned on either side of an IV pole 128 and oriented such that the contoured holder 116 remains in an upright position and capable of receiving the laryngoscope 14.
The contoured holder 116 is shaped to accommodate the laryngoscope 14 in the folded position as shown in FIG. 4.
In the preferred embodiment the arm 14 is made from stainless steel. The handle 16 and container 74 are made from Acrylonitrile butadiene styrene (ABS). Although the handle 16 and container 74 of the preferred embodiment are formed from ABS, they need not be. For instance, the handle 16 and container 74 may be formed of any conventional material such as metal or plastic.
While there has been illustrated and described what is, at present, considered to be a preferred embodiment of the present invention, it will be understood by those skilled in the art that various changes and modifications may be made, and equivalents may be substituted for elements thereof without departing from the true scope of the invention. Therefore, it is intended that this invention not be limited to the particular embodiment disclosed as the best mode contemplated for carrying out the invention, but that the invention will include all embodiments falling within the scope of this disclosure.
Since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art, the invention is not considered limited to the example chosen for purposes of disclosure, and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention.
Having thus described the invention, what is desired to be protected by Letters Patent is presented in the subsequently appended claims.

Claims

1. A method viewing the oropharyngeal and laryngeal area, comprising:

means for covering;

means for threading, rigidly molded to said means for covering;

means for connecting, ejectably connected to said means for covering;

means for viewing;

means for lighting, optically connected to said means for viewing, and optically connected to said means for threading; and

means for removing sheath, closely coupled to said means for covering.

2. The method in claim 1, wherein said means for covering comprises an ejectable sheath.

3. The method in claim 1, wherein said means for threading comprises a canal.

4. The method in accordance with claim 1, wherein said means for connecting comprises an arm.

5. The method in accordance with claim 1, wherein said means for viewing comprises a camera.

6. A method viewing the oropharyngeal and laryngeal area, comprising:

an ejectable sheath, for covering;

a canal, for threading, rigidly molded to said sheath;

an arm, for connecting, ejectably connected to said sheath;

a camera, for viewing;

an LED, for lighting, optically connected to said camera, and optically connected to said canal; and

a tab ejector, for removing sheath, closely coupled to said sheath.

7. The method in accordance with claim 6, wherein lighting comprises an LED.

8. The method in accordance with claim 6, wherein said means for removing sheath comprises a tab ejector.