Abstract: A miniature ultrasound imaging probe that may be delivered through the biopsy channel of an endoscope. The probe includes a probe tip mounted at the distal end of a flexible catheter. The probe tip includes a transducer body mounted on the distal end of a distal actuating rod with the transducer body carrying an ultrasound transducer. The distal actuating rod is mounted on the distal end of a plurality of concentric, springs wound in opposite directions extending concentrically through the catheter and terminating in a proximal actuating rod. A flexible bag filled with an acoustic coupling fluid is mounted at the distal end of the catheter. The bag surrounds the transducer body to isolate it from the external environment and retain the acoustic coupling fluid. When the probe is to be inserted through a narrow passage, the proximal actuating rod is advanced into the catheter to extend the transducer body against the flexible bag. As a result, the bag elongates and its width is reduced.

Abstract: An apparatus and method for providing an endoscope with a plurality of potential channels is disclosed. A tubing having a radially flexible wall is positioned adjacent the endoscope insertion tube. The tubing is collapsed prior to inserting the insertion tube into the patient's body. After the insertion tube is within the patient's body, the tubing is expanded to create a channel. A medical apparatus may pass through the channel for performing a medical procedure. The tubing is expanded by placing a tapered rod therethrough, by placing a fluid under pressure within the tubing, or by elevating a flat coiled wire into a cylindrical coil. A radially rigid tubing is placed within the expanded flexible tubing to permit medical devices to extend from a position outside of the patient's body to the distal end of the insertion tube.

Abstract: A device and method for preventing accidental needle sticks. A sleeve having an annular shaft is slidably connected to a needle. A cord is rigidly affixed to the hub of the needle at one end thereof and to a blocking member at the other end thereof is also slidably coupled to the sleeve. After the needle has been used and is being removed from the patient's body, the sleeve is slid along the needle shaft to cover the tip and pulls the blocking member into position over the sharp tip of the needle. This positively covers the sharp tip of a needle with a puncture-proof blocking member to prevent accidental needle sticks. In alternative embodiments, a resilient member is pressed to align a hole through which the needle is projecting with a hole in a puncture-proof member which is covering the sharp tip of the needle to permit the needle protective device to be slid down the shaft of the needle and the needle to be used. A recessed needle assembly to be used in tandem with a needle assembly, is also disclosed.

Abstract: A system for packaging disposable endoscope sheaths so that they do not become contaminated prior to use during shipment, storage and installation on an endoscope. The packaging system also prevents the spread of contamination after use while the sheath is being removed from the endoscope and then discarded. The sheath is shipped in an elongated, flexible bag having a length substantially equal to the length of the insertion tube of the endoscope and a diameter substantially larger than the diameter of the insertion tube. The sheath and bag may be shipped in a sterile tray having a spiral recess containing the sheath, bag and funnel-like container or bag holding the tubing of the air, water, and suction channels. Installation of the sheath on the endoscope is accomplished by inflating the sheath while it is in the bag so that the sheath expands until it contacts the wall of the bag.

Abstract: Various methods and mechanical devices for providing manipulation and steering of the bending section of an endoscope having a sheath thereon is disclosed. In one embodiment, the longitudinal center axis of a biopsy type is aligned with the longitudinal center of the insertion tube, both being in common with the instantaneous bending center of the insertion tube. The insertion tube is capable of only right and left movement through steering but is also rotatable with respect to the handle to permit the tip to be positioned in any desired location. In an alternative embodiment, the instantaneous bending center is radially offset from the longitudinal center of the insertion tube. The hinges are positioned in the bending section of the insertion tube for locating the instantaneous center of bending at a desired location in a groove. Four, or in an alternative embodiment, three cables are provided for controlling the movement and steering of the bending section.

Abstract: A system for packaging disposable endoscope sheaths so that they do not become contaminated prior to use during shipment, storage and installation on an endoscope. The packaging system also prevents the spread of contamination after use while the sheath is being removed from the endoscope and then discarded. The sheath is shipped in an elongated, flexible bag having a length substantially equal to the length of the insertion tube of the endoscope and a diameter substantially larger than the diameter of the insertion tube. The sheath and bag may be shipped in a sterile tray having a spiral recess containing the sheath, bag and funnel-like container or bag holding the tubing of the air, water, and suction channels. Installation of the sheath on the endoscope is accomplished by inflating the sheath while it is in the bag so that the sheath expands until it contacts the wall of the bag.

Abstract: An endoscope specially adapted for use with a disposable sheath having an outer casing and one or more internal channels. The endoscope includes a tip portion connected to a control handle through a flexible insertion tube. The insertion tube is formed by a braided wire tube covered by a flexible waterproof coating and surrounding a resilient D-shaped tube through which optical components for the endoscope extend. A longitudinally extending groove is formed in the braided tube to receive the channel(s). The groove extends perpendicular to, and makes contact with, a generally planar portion of the D-shaped tube so that the D-shaped tube can restrict deformation of the groove as the insertion tube bends. Longitudinal channels are formed on opposite sides of the groove to house control cables extending from the control handle to the tip portion. The cables are surrounded by tubes that collectively occupy the entire channel so that the tubes prevent the channel, and hence the groove, from collapsing.

Abstract: An endoscope and valve system specially adapted for use with a disposable sheath having a plurality of channels and respective resilient tubes extending therefrom. In one embodiment, the resilient tubes extend along grooves formed in the side of an endoscope control handle and are captured behind a pivotably mounted access door. The valve system pinches the tubes against the door. The pinching mechanism selectively releases the tubes by pressing respective valve-actuating buttons on the control handle. In another embodiment, the tubes are placed in external pinch valves which are selectively actuated by actuating switches mounted on the control handle.

Abstract: A contamination system for endoscopes having a handle, an insertion tube projecting from the handle, and control knobs detachably mounted on control shafts projecting from the handle to control the angular orientation of distal end of the insertion tube. The handle is placed in a liquid-impermeable bag, with the control shafts projecting through an aperture in the bag. The control knobs are then attached to the shafts prior to performing an endoscopic procedure. After the procedure has been completed, the control knobs are removed from the shafts and decontaminated, the handle is removed from the bag, and the bag is discarded.

Abstract: An endoscopically deliverable ultrasound imaging system having an ultrasound probe mounted at the end of an endoscopically deliverable catheter. The catheter connects the probe to an ultrasound imaging system. The axial or radial position of the ultrasound probe is measured by a position transducer mounted on the endocscope adjacent the biopsy port from which the catheter extends. The output of the position measuring transducer is applied to the ultrasound imaging system so that the imaging system provides an image of the tissue depth as a function of the position of the ultrasound probe.

Abstract: A system for endoscopic detection of blood flow is disclosed. A catheter is sized to pass through the biopsy channel of an endoscope and includes an elongated catheter tube of flexible material and an ultrasonic probe carried by the catheter tube adjacent its tip. Depending on the application, the ultrasonic field provided by the ultrasonic probe may be either transverse or parallel to the longitudinal axis of the catheter tube and may be either highly directional, omnidirectional, or sectorial. The ultrasonic probe is coupled to a pulsed Doppler circuit (FIG. 16) by an isolation circuit (FIG. 20) that provides electrical isolation and RFI suppression. The Doppler circuit is designed to enhance close proximity detection of blood flow, to limit the range of the probe's ultrasonic field, and to distinguish between arterial blood flow, venous blood flow, and vessel wall motion.

Abstract: An endoscope sheath having a flexible tube surrounding the elongated core of an endoscope. The flexible tube has a transparent window near its distal end positioned in front of the viewing window of the endoscope. Channels for taking biopsies, injecting air or injecting water to wash the window of the sheath may extend along the endoscope, either inside or outside the sheath. Where the channels are positioned inside the sheath, they may be inserted in a longitudinal groove formed in the endoscope core. The protective sheath may be used with either end-viewing endoscopes or side-viewing endoscopes. In the latter case, the channel for taking biopsies extends through an elongated elastomeric membrane so that a catheter through the biopsy channel may be moved longitudinally by manipulation of an elevator. The protective sheath may be installed by rolling the elastomeric tube into an annular configuration and then unrolling the tube over the core of the endoscope.

Abstract: Various forms of a catheter that is sized to pass through the biopsy channel of an endoscope include an elongated catheter tube of flexible material and an ultrasonic probe carried by the catheter tube adjacent its tip. The forms include: a papillotome catheter (FIGS. 1 and 3); catheters for general endoscopic and nonendoscopic applications (FIGS. 4, 7A through 7C, 8A through 8B, 10A through 10B, and 11); and, a sclerosing catheter (FIGS. 13 through 15). These catheters may be used to determine the location of the retroduodenal artery in endoscopic papillotomy (FIGS. 2, 5, and 6), to evaluate and treat esophageal varices (FIGS. 9 and 12), or generally to detect blood flow in a biological structure within the body. Depending on the application, the ultrasonic field provided by the ultrasonic probe may be either transverse or parallel to the longitudinal axis of the catheter tube and may be either highly directional, omnidirectional, or sectorial.

Abstract: The invention is a fiber-optic endoscope which has an elongated ultrasonic array, such as a linear array or a phased array. The array is mounted on either the distal portion of the bending section (not under operator control) portion of the endoscopic tube or on the proximal portion of bendable portion of the tube. Thus, the present invention includes both a fiber-optic endoscope and an ultrasonic transducer. Yet, the presence of the ultrasonic transducer does not interfere with the operation of the placement of the fiber-optic probe.

Abstract: An endoscope specially adapted for use with a disposable sheath having an outer casing and one or more internal channels. The endoscope includes a tip portion connected to a control handle through a flexible insertion tube. The insertion tube is formed by a braided wire tube covered by a flexible waterproof coating and surrounding a resilient D-shaped tube through which optical components for the endoscope extend. A longitudinally extending groove is formed in the braided tube to receive and channel(s). The groove extends perpendicular to, and makes contact with, a generally planar portion of the D-shaped tube so that the D-shaped tube can restrict deformation of the groove as the insertion tube bends. Longitudinal channels are formed on opposite sides of the groove to house control cables extending from the control handle to the tip portion. The cables are surrounded by tubes that collectively occupy the entire channel so that the tubes prevent the channel, and hence the groove, from collapsing.