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WO2012028843A1 - Appareil de visualisation - Google Patents

Appareil de visualisation Download PDF

Info

Publication number
WO2012028843A1
WO2012028843A1 PCT/GB2011/001270 GB2011001270W WO2012028843A1 WO 2012028843 A1 WO2012028843 A1 WO 2012028843A1 GB 2011001270 W GB2011001270 W GB 2011001270W WO 2012028843 A1 WO2012028843 A1 WO 2012028843A1
Authority
WO
WIPO (PCT)
Prior art keywords
stent
passage
imaging means
endoscope
display
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB2011/001270
Other languages
English (en)
Inventor
Jeremy Colin Russel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Smiths Medical International Ltd
Original Assignee
Smiths Medical International Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Smiths Medical International Ltd filed Critical Smiths Medical International Ltd
Publication of WO2012028843A1 publication Critical patent/WO2012028843A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00082—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles
    • A61B1/00177—Optical arrangements characterised by the viewing angles for 90 degrees side-viewing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles
    • A61B1/00181—Optical arrangements characterised by the viewing angles for multiple fixed viewing angles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00043—Operational features of endoscopes provided with output arrangements
    • A61B1/00045—Display arrangement
    • A61B1/0005—Display arrangement combining images e.g. side-by-side, superimposed or tiled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts

Definitions

  • This invention relates to visualisation apparatus of the kind including an elongate support structure.
  • the invention is more particularly, but not exclusively, concerned with visualisation apparatus for medical use.
  • Endoscopes or similar visualisation devices are used for providing an image of a body site to a clinician such as for use in diagnosis, monitoring or surgery.
  • One application for such endoscopes is in the positioning of stents in a body cavity or passage, such as a blood vessel, oesophagus or the like.
  • the endoscope is inserted into the body passage with the stent and the output of the endoscope is monitored to determine when the stent is in the correct position.
  • the stent is then expanded within the body cavity to contact and support the inside of the passage following which the endoscope is removed, leaving the stent in position. This can enable the forward end of the stent to be positioned accurately within the passage.
  • the apparatus includes first and second imaging means supported thereon at different locations spaced from one another along the length the support structure, and that the apparatus includes display means arranged to receive outputs from the imaging means such as to provide a display representation of images from the two different locations along the support structure.
  • the imaging means are preferably directed towards one another at a small angle.
  • the first and second imaging means may include a video chip arranged to provide an electrical image output to the display means.
  • the electrical image output is preferably provided via an electrical cable.
  • the apparatus may include a generally elongate device supported on an external surface of the support structure, the device extending along a region between the first and second imaging means.
  • the generally elongate device is preferably be an expansible stent.
  • endoscope apparatus including an elongate support body and an expansible stent supported on the body close to one end, characterised in that the apparatus includes first and second imaging means supported on the support body at spaced locations at opposite ends of the stent, that the imaging means are arranged to view both the inside of a body passage within which the stent is to be positioned and respective opposite ends of the stent, and that the apparatus includes a display monitor arranged to receive outputs from the two imaging means such as to provide a display representation at the two different locations along the support body.
  • a method of positioning a device within a passage including the steps of mounting the device between two spaced imaging means on visualisation apparatus, viewing on a display images from the imaging means of two different locations along the passage as the apparatus is extended along the passage, determining when the displayed locations indicate a suitable position for the device within the passage, causing the device to be released from the apparatus and locate within the passage between the displayed locations, and subsequently removing the visualisation apparatus to leave the device in position.
  • a method of positioning a stent within a body passage including the steps of mounting the stent between two spaced imaging means on an endoscope, viewing on a display images from the imaging means of two different locations along the body passage as the endoscope is extended along the passage, determining when the displayed locations indicate a suitable position for the stent within the passage, causing the stent to expand off the endoscope so as to be released from the endoscope and locate within the passage between the displayed locations, and subsequently removing the endoscope to leave the stent in position.
  • Figure 1 is a cross-sectional side elevation of the endoscope and stent prior to insertion
  • Figure 2 illustrates a first step in positioning the endoscope within the trachea
  • Figure 3 illustrates a subsequent step where the stent is expanded within the
  • Figure 4 illustrates a further step where the endoscope is removed to leave the stent in position.
  • FIG. 1 With reference first to Figure 1 , there is shown an endoscope 1 supporting an expansible stent 2 and providing an image output to a display 3.
  • the endoscope 1 comprises an elongate support body 10 of a bendable plastics material with a bore 1 1 extending along its length and closed at its forward end 12.
  • the endoscope 1 may be steerable, such as by means of a pull cord (not shown) along one side that is operable to curve the endoscope to one side when pulled.
  • the endoscope could be of a malleable construction (by incorporating a malleable metal element) such that it can be bent to a desired shape, which it retains during insertion.
  • the body could be of a material that can be bent to a desired shape temporarily but will gradually relax to its initial shape over time.
  • the endoscope includes two separate viewing means, one 13 being located close to the patient, forward end 12 and the other 14 being spaced rearwardly from it by a distance of about 20 - 100mm.
  • the viewing means 13 and 14 each comprise a light source, such as an LED 13 A arid 14A, and a video chip and lens unit 13B and 14B.
  • the viewing means 13 and 14 are mounted within the wall of the body 10 to view respective regions of the trachea 40 located radially outwardly of the endoscope 1.
  • the viewing means 13 and 14 are directed at a small angle towards one another, to improve viewing of the stent 2.
  • the endoscope could include additional viewing means if desired, such as one mounted at the forward, patient end and directed to view axially forwardly of the endoscope. This may be useful for preliminary navigation of the endoscope during insertion.
  • the viewing means 13 and 14 are connected by wires 15 extending along the bore 11 to an electrical connector 16 mounted at the rear end of the endoscope 1.
  • a mating connector 17 at one end of a cable 18 is connected with the endoscope connector 16, the cable extending to the display 3.
  • the display 3 may be of any conventional kind and is arranged to represent two separate images 33 and 34 corresponding to the regions viewed by the video chip units 13 and 14 respectively.
  • the display could be mounted directly on the endoscope 1 instead of via the cable 18.
  • the display could be head-mounted, such as on a helmet, goggles or glasses.
  • the display image could be presented in a head-up display manner by projection on a semi- transparent, reflective screen so that the image can be viewed by looking through the screen.
  • the stent 2 may be of any conventional kind, such as of a metal or plastics construction or a combination of both metal and plastics.
  • the stent 2 is expansible in some way, such as by mechanical actuation, by internal pressure, such as exerted by an internal inflatable balloon, or by temperature change (incorporating a shape memory alloy or other phase-change material) caused by warming to body temperature.
  • the stent 2 is a close fit on the body 10, so that it is not displaced axially when the endoscope 1 is inserted in the body, and its length is such that it extends along the region between the two viewing means 13 and 14 without covering them but preferably so that opposite ends of the stent are visible by the viewing means and in the display representations 33 and 34.
  • the stent 2 Prior to insertion, the stent 2 is loaded on the endoscope 1 in its retracted state between the two viewing means 13 and 14, as shown in Figure 1.
  • this shows the endoscope 1 inserted in the trachea 40 to a region 41 of restriction, trauma or the like, where it is desired to position the stent 2.
  • the clinician views the display 3 until the images 33 and 34 show the desired trachea region 41 above and below the edges of the stent 2 so that he knows that the stent is correctly positioned.
  • the clinician now causes the stent 2 to expand radially off the body 10 into contact with the region 41.
  • the stent expands this region 41 slightly to improve patency of the trachea 40 along the region.
  • the clinician observes the image of the stent 2 occupying a greater part of the area of the display representations 33 and 34, as shown in Figure 3.
  • the two images 33 and 34 of opposite ends of the stent 2 enable the clinician to confirm correct placement.
  • two viewing means By employing two viewing means in the above way, one can position a stent or similar device with greater accuracy and confidence. Incorrect placement is immediately apparent.
  • the two viewing means enable the clinician to check that the stent or other device is of the appropriate length or enable the clinician to change the stent before expansion if the size is not correct.
  • the endoscope need not employ video chips but could instead include fibre optic viewing and illumination cables.
  • the signal need not be supplied via a cable but could be supplied instead by wireless means, such as by RF transmission.
  • the invention is not confined to use with tracheal stents but could be used on support structures for various different applications, such as non-medical applications, for example pipe lining equipment.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

La présente invention concerne un endoscope (1) portant une endoprothèse extensible (2) en direction de son extrémité coté patient (12) entre deux puces vidéo (13B et 14B) dirigées l'une vers l'autre avec un petit angle. Les puces vidéo (13B et 14B) sont disposées de sorte à visualiser toutes deux l'intérieur de la trachée (40) ou un autre orifice corporel et des extrémités opposées de l'endoprothèse (2). Un câble (15, 18) s'étend des puces vidéo (13B et 14B) vers un dispositif d'affichage de contrôle (3), les signaux provenant des puces étant fournis par le biais du câble afin de fournir des représentations du champ de visualisation des deux puces sur le dispositif de contrôle. Lorsque les images affichées indiquent que l'endoscope (1) se situe dans la bonne position, l'endoprothèse (2) est étendue et les images affichées sont contrôlées pour s'assurer que l'endoprothèse s'étend au niveau de la région souhaitée de l'orifice (40).
PCT/GB2011/001270 2010-09-01 2011-08-26 Appareil de visualisation Ceased WO2012028843A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1014545.6A GB201014545D0 (en) 2010-09-01 2010-09-01 Visualisation apparatus
GB1014545.6 2010-09-01

Publications (1)

Publication Number Publication Date
WO2012028843A1 true WO2012028843A1 (fr) 2012-03-08

Family

ID=43013537

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2011/001270 Ceased WO2012028843A1 (fr) 2010-09-01 2011-08-26 Appareil de visualisation

Country Status (2)

Country Link
GB (1) GB201014545D0 (fr)
WO (1) WO2012028843A1 (fr)

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013093391A1 (fr) 2011-12-20 2013-06-27 Smiths Medical International Limited Dispositif d'imagerie et d'éclairage
EP3102085A1 (fr) * 2014-02-06 2016-12-14 Dentsply Sirona Inc. Contrôle de racines dentaires et de l'espace de la cavité endodontique à l'intérieur de celles-ci
CN107174190A (zh) * 2017-05-12 2017-09-19 崔朝阳 一种耳鼻喉电子检查装置
US11801041B2 (en) 2020-08-03 2023-10-31 Teleflex Life Sciences Limited Handle and cartridge system for medical interventions
US11850140B2 (en) 2013-03-14 2023-12-26 Teleflex Life Sciences Limited Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US12121228B2 (en) 2017-12-23 2024-10-22 Teleflex Life Sciences Llc Expandable tissue engagement apparatus and method
US12201283B2 (en) 2005-05-20 2025-01-21 Teleflex Life Sciences Llc Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US12213842B2 (en) 2020-02-21 2025-02-04 Teleflex Life Sciences Llc Apparatus for preventing device deployment failure
US12324576B2 (en) 2012-06-29 2025-06-10 Teleflex Life Sciences Llc Flexible system for delivering an anchor
US12440301B2 (en) 2018-11-07 2025-10-14 Teleflex Life Sciences Llc System for delivery of a fiducial marker
US12458337B2 (en) 2013-03-15 2025-11-04 Teleflex Life Sciences Llc Anchor delivery system

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6261226B1 (en) * 1994-03-30 2001-07-17 Medical Media Systems Electronically Steerable Endoscope
US20050192496A1 (en) * 2004-01-09 2005-09-01 Michael Maschke Catheter for inserting into a vessel
US20060287595A1 (en) * 2005-06-16 2006-12-21 Michael Maschke Medical system for inserting a catheter into a vessel

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6261226B1 (en) * 1994-03-30 2001-07-17 Medical Media Systems Electronically Steerable Endoscope
US20050192496A1 (en) * 2004-01-09 2005-09-01 Michael Maschke Catheter for inserting into a vessel
US20060287595A1 (en) * 2005-06-16 2006-12-21 Michael Maschke Medical system for inserting a catheter into a vessel

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12201283B2 (en) 2005-05-20 2025-01-21 Teleflex Life Sciences Llc Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
WO2013093391A1 (fr) 2011-12-20 2013-06-27 Smiths Medical International Limited Dispositif d'imagerie et d'éclairage
US12376842B2 (en) 2012-06-29 2025-08-05 Teleflex Life Sciences Llc Flexible system for delivering an anchor
US12324576B2 (en) 2012-06-29 2025-06-10 Teleflex Life Sciences Llc Flexible system for delivering an anchor
US11850140B2 (en) 2013-03-14 2023-12-26 Teleflex Life Sciences Limited Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US12042372B2 (en) 2013-03-14 2024-07-23 Teleflex Life Sciences Llc Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US12458337B2 (en) 2013-03-15 2025-11-04 Teleflex Life Sciences Llc Anchor delivery system
EP3102085A1 (fr) * 2014-02-06 2016-12-14 Dentsply Sirona Inc. Contrôle de racines dentaires et de l'espace de la cavité endodontique à l'intérieur de celles-ci
CN107174190A (zh) * 2017-05-12 2017-09-19 崔朝阳 一种耳鼻喉电子检查装置
US12121228B2 (en) 2017-12-23 2024-10-22 Teleflex Life Sciences Llc Expandable tissue engagement apparatus and method
US12440301B2 (en) 2018-11-07 2025-10-14 Teleflex Life Sciences Llc System for delivery of a fiducial marker
US12213842B2 (en) 2020-02-21 2025-02-04 Teleflex Life Sciences Llc Apparatus for preventing device deployment failure
US12167842B2 (en) 2020-08-03 2024-12-17 Teleflex Life Sciences Llc Handle and cartridge system for medical interventions
US11801041B2 (en) 2020-08-03 2023-10-31 Teleflex Life Sciences Limited Handle and cartridge system for medical interventions

Also Published As

Publication number Publication date
GB201014545D0 (en) 2010-10-13

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