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
  • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
  • A61B1/015—Control of fluid supply or evacuation
• • 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
  • A61B1/00103—Constructional details of the endoscope body designed for single use
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
  • A61B1/0125—Endoscope within endoscope
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
  • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments

Definitions

• the invention relates to an endoscopic multifunction device for medical therapy according to the preamble of claim 1 .
• An endoscopic multifunction device of this kind comprises a shaft having a front end and a far end, at least one channel defined by a bore extending from the front end to the far end of the shaft, and an optical system arranged on the shaft for optically imaging a region at the far end of the shaft.
• An endoscopic multifunction device of this kind can for example be used for minimal- invasive endoscopic surgery, for example for treating a herniated vertebral disc of a patient.
• a medical instrument such as medical pliers may be guided through an endoscopic device to access a spinal disc in order to remove disc tissue, to treat pain receptors at the spinal disc or to stabilize tissue, in particular fibrous tissue, at the spinal disc.
• an optical system is used to obtain images of the operation site, wherein a camera may be arranged at the far end (also denoted as the "tip") of the shaft or an optical lens system may be integrated into the shaft for guiding light from the operation site to an external camera system connected to the shaft.
• MRI magnetic resonance imaging
• the endoscopic multifunction device is autoclavable, i.e. it can be sterilized by means of an autoclave in which the device is subjected to water vapour in a pressure container.
• an optical system in particular a camera system and a lighting system
• endoscopic devices having an integrated optical system such as a camera and a lighting system allowing for a sterilization by means of an autoclave are in general expensive. This is due to high temperatures occurring in an autoclave, which affect the components of the endoscopic device and their connections within the device such as the connections of light guiding means, the adhesion of lenses to the shaft and the attachment of other components.
• Endoscopic devices which are compatible with magnetic resonance imaging are for example known from EP 0 850 595 B1 and US 5,876,338 A which describe endoscopic devices having integrated magnetic resonance receive coil elements.
• an endoscopic multifunction device having the features of claim 1 . Accordingly, within such endoscopic multifunction device the optical system is arranged on an endoscope element releasably arranged in the at least one channel of the shaft.
• the instant invention makes use of the idea to, on the one hand, provide a shaft of an endoscopic multifunction device having one or multiple channels defined by one or multiple bores extending through the shaft and allowing for example to guide medical instruments such as medical pliers or other minimal-invasive medical instruments through the shaft towards an operation site.
• the shaft is fabricated such that it can be used multiple times and can easily be sterilized.
• the shaft may be fabricated as a rigid element not comprising any electric or electronic components such that it can easily be sterilized by means of an autoclave.
• the optical system of the endoscopic multifunction device is arranged on an endoscope element which, in a functional state of the endoscopic multifunction device, is received in a channel of the shaft and is releasably held within such channel.
• the endoscope element carrying the optical system such as a camera chip and/or a lighting system can be released from the shaft and is produced in a modular fashion as a modular element, it can easily be replaced by another endoscope element after a surgery such that the endoscope element may be produced as a single-use element which is not reused for multiple surgeries.
• the endoscope element itself may be fabricated such that it also can be sterilized using an autoclave. Because within a single-use element a cross infection between multiple patients is not possible, this is however not absolutely necessary.
• the optical system may for example comprise a camera chip and/or a lighting element such as a light emitting diode (LED) which preferably are arranged on the endoscope element in proximity to the far end of the shaft (at the "tip" of the endoscope element).
• LED light emitting diode
• the shaft is preferably made as a rigid element which can be used to access an operation site within a patient.
• the endoscope element in contrast, can be made flexible and does not require any particular stability, because it is received within the channel of the shaft and hence is held and stabilized by the shaft.
• the endoscope element may be arranged in the associated channel in the shaft such that it is movable during surgery within the channel of the shaft such that its position can be varied depending on the needs of optical inspection of the operation site during surgery.
• the endoscope element may extend with its tip beyond the far end of the shaft and may comprise means for moving the tip such that the orientation and position of the tip can be varied, hence allowing for an adjustment of the viewing region visible through the optical system.
• the endoscope element arranged in the associated channel of the shaft may fill the channel such that it tightly seals the channel and hence prevents a fluid flow through the channel. This may be of importance if the operation site shall be flushed during surgery using a medical fluid, the tight sealing of the endoscope element in the channel preventing a fluid flow through the channel to avoid leakage of fluid through the channel.
• the shaft advantageously comprises multiple channels.
• a medical instrument such as medical pliers may be received, and in a second channel the endoscope element is arranged.
• further channels may be present, for example to allow for a fluid flow towards and from an operation site for the purpose of flushing the operation site.
• the endoscopic multifunction device preferably is fabricated such that it is compatible with magnetic resonance imaging and in particular does not produce any artefacts (such as image distortions due to magnetic materials exceeding the actual shape of the device) when using magnetic resonance imaging.
• the shaft and the endoscope element as well as their components are made of a non-magnetic material (a material having a small magnetic susceptibility) such that artefacts caused by the multifunction device within a magnetic resonance image are reduced to a minimal.
• the shaft may for example be made of titanium, hence yielding a non-magnetic rigid element providing a guide for both the endoscope element and a medical instrument inserted into an appropriate channel of the shaft.
• the endoscope element may for example be made of a plastic material, such as PEEK, or it also may be made of a non- magnetic metallic alloy such as a nickel-titanium alloy.
• components of the shaft or the endoscope element are preferably made of a non-magnetic material.
• Lenses and prisms for example may be made of glass.
• Windows may be made of sapphire.
• Further shafts, pipes, connectors or buttons may be made of nickel, titanium, brass or plastic such as PEEK.
• the endoscope element extends through the associated channel of the shaft such that, in a functional state of the multifunction device, a tip of the endoscope element is positioned in proximity of the far end of the shaft and, by means of the shaft, hence may be brought and guided towards an operation site of a patient.
• the endoscope element at a location removed from the tip, may further comprise a control device which may be constituted to control the optical system and its settings, for example a zoom setting and a focus setting. For this, the imaging characteristics of a camera chip may be controlled electronically.
• the camera chip and/or a lens in a movable fashion on the tip of the endoscope element such that via the control device the position of the camera chip and/or the lens may be adjusted for adjusting the setting or viewing region of the optical system.
• the endoscope element may furthermore comprise a connector allowing for an electrical connection of the optical system to an external control and display unit.
• a connector allowing for an electrical connection of the optical system to an external control and display unit.
• Such connector may for example be constituted as a USB connector allowing for a connection to a standardized USB interface of the external control and display unit.
• the endoscope element by means of its connector is connected to the control and display unit, wherein the endoscope element and its electrical components are also supplied with electrical power via the control and display unit.
• Fig. 1 shows a schematic view of a shaft of an endoscopic multifunction device
• Fig. 2 shows a schematic view of a different embodiment of an endoscopic multifunction device comprising multiple shafts
• Fig. 3 shows a front view of a far end of a shaft of a multifunction device
• Fig. 4 shows a schematic view of an endoscope element arranged in a channel of a shaft of an endoscopic multifunction device
• Fig. 5 shows a tip of an endoscope element comprising a camera chip and a lighting element of an optical system
• Fig. 6 shows a schematic view of an embodiment of an endoscope element.
• Fig. 1 shows a first embodiment of an endoscopic multifunction device 1 comprising a single shaft 10 having a far end 103 and a front end 104 carrying a connection interface 100.
• a second embodiment of an endoscopic multifunction device comprising a first shaft 10 and a second shaft 1 1 is shown in Fig. 2.
• the multifunction device of Fig. 2 comprises multiple connection interfaces 100, 101 , 102, 1 10 for connecting tubes or inserting medical instruments or other equipment to be used during medical surgery in connection with the endoscopic multifunction device 1 .
• the endoscopic multifunction device 1 in its simple embodiment of Fig. 1 or its more complicated embodiment of Fig. 2, serves to perform a minimal-invasive surgery on a patient by accessing an operation site through guiding the shaft 10 with its far end 103 towards an operation site.
• the shaft 10 may be guided to an operation site through a small cut in a dorsolateral back region of the patient, and by means of the endoscopic multifunction device 1 tissue of a spinal disc may be removed, pain receptors may be destroyed or regions of the spinal disc may be stabilized.
• a channel 20 defined by a longitudinal bore extending from the front end 104 to the far end 103 of the shaft 10 (or through the shaft 1 1 and the shaft 10 within the embodiment of Fig. 2) is provided which allows inserting a medical instrument into the shaft 10 and guiding the medical instrument through the shaft 10 towards the operation site. This is visible in Fig. 3 and 4.
• an endoscope element 3 is inserted into another channel 21 of the shaft 10 and extends through the channel 21 , as shown in Fig. 4, towards the far end 103 of the shaft 10.
• the endoscope element 3 carries, as visible in Fig. 5, components of an optical system, such as a camera chip 31 and a lighting element 32, for example an LED, which are arranged on a tip 30 of the endoscope element 3 and are electrically connected by appropriate cables to for example an external control and display unit 5, as shown in Fig. 6.
• the camera chip 31 is arranged on the tip 30 of the endoscope element 3 in connection with a lens 310 for optically guiding light towards the camera chip 31 .
• the camera chip 31 may for example be a CCD chip.
• the endoscope element 3 is fabricated as a single-use element which releasably is arranged in the channel 21 of the shaft 10. The endoscope element 3 hence can be replaced after a surgery such that a cross-infection between different patients can be avoided.
• the multifunction device 1 without the endoscope element 3 can easily be sterilized by means of an autoclave without particular modifications to the multifunction device 1 and hence can be reused.
• no electric or electronic elements are arranged on the shaft 10 or the shaft 1 1 such that, after removing the endoscope element 3, the multifunction device 1 can easily be sterilized.
• the endoscope element 3 in its functional state in which it is arranged in the associated channel 21 of the shaft as shown in Fig. 4, can be constituted to tightly seal the channel 21 such that no fluid can pass through the channel 21 once the endoscope element 3 has been inserted into the channel 21 .
• This is beneficial if a flushing of an operation site by means of further channels 22, 23 (see Fig. 3) shall be carried out, hence preventing a leakage of fluid through the channel 21 out of the operation site.
• One of the channels 22, 23 is provided for providing a medical flushing fluid towards an operation site and the other channel 22, 23 is used to remove the flushing fluid from the operation site such that the fluid is flushingly moved through the operation site.
• the endoscopic multifunction device 1 is compatible with magnetic resonance imaging in that its components are made from non-magnetic materials, hence materials exhibiting a low magnetic susceptibility and producing no or only little artefacts within magnetic resonance images.
• the shaft 10 and the shaft 1 1 may be made of titanium and are preferably rigid.
• the endoscope element 3 may be provided in the shape of a tube being made of a plastic material such as PEEK.
• the components of the optical system, namely the camera chip 31 , the lens 310 and the lighting element 32, are as well made of non-magnetic materials.
• the endoscope element 3 comprises a first section 3A which may be formed in a flexible manner.
• the section 3A is to be inserted into the associated channel 21 of the shaft 10 and, hence, is guided within the channel 21 such that it is supported by the shaft 10.
• a control device 33 having control buttons 330, 331 for controlling the settings of the optical system 31 , 32, for example for controlling a zoom setting, a focus setting and/or a brightness setting of the optical system 31 , 32.
• the control device 33 is connected via a cable 3B to a connector 34 being constituted as a USB connector, which can be plugged into a standardized USB connection interface of the control and display unit 5.
• the control and display unit 5 comprises a monitor 50 for displaying images acquired via the optical system 31 , 32 of the endoscope element 3 and may be placed within a surgery room such that a surgeon during surgery may directly inspect the operation site by means of the monitor 50.
• an endoscopic multifunction device of this kind with a replaceable endoscope element carrying an optical system can also be used in connection with other imaging modalities and not necessarily must be constituted in a fashion compatible with magnetic resonance imaging.
• an endoscopic multifunction device may not only be used for treatment of a herniated vertebral disc but can also be employed for other minimal-invasive surgeries on a patient.

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• Health & Medical Sciences (AREA)
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Cited By (32)

Citations (6)

• 2012
  • 2012-03-09 DE DE112012005999.9T patent/DE112012005999T5/de not_active Withdrawn
  • 2012-03-09 WO PCT/EP2012/054093 patent/WO2013131578A1/fr not_active Ceased

Patent Citations (7)

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