Abstract: The fiberscope (referred to as an “endoscopic stylet” by the inventor) has a largely semi-rigid insertion cord which permits a user to pre-form the endoscopic stylet to follow the anticipated contours of the airway leading to the trachea and to insure that it reliably shepherds the associated endotracheal tube to the intended tracheal position. By visually tracking the progress of the endoscopic stylet through the airway, specifically through the vocal cords and into the trachea, placed at the proper distance above the carina, as permitted by the fiberoptic portions of the endoscopic stylet, proper positioning of the endotracheal tube is virtually assured, and post-intubation verification would be unnecessary in most instances since intubation is itself verification of proper endotracheal tube placement.

Abstract: An enhanced endotracheal tube utilizing a fiber optic bundle positioned in its wall section to transmit light and a reflectively coated bore to transmit images is disclosed. Additional passages formed in the wall of the endotracheal tube are adapted to receive a stylette and to act as an air passage for inflating an inflatable cuff formed on the inner end of the endotracheal tube. The light transmitted through the fiber optic bundle aids in illuminating the patient's laryngeal area and the image is reflected along the reflectively coated bore to aid the physician in intubating the patient. Alternative embodiments using a bore with a sleeve having a different refractive index from that of the tube material and an enhanced endotracheal tube for use with children are shown.

Abstract: The invention relates to a device for introducing an intubation tube into the trachea. The inventive device comprises a shaft, a receiving element arranged at the distal end of said shaft to which a proximal end of an intubation tube can be mounted and a coupling arranged at the proximal end of the shaft for coupling an endoscope thereto.

Abstract: An apparatus and method for coupling a gastroscope (30) to a gastrostomy feeding tube apparatus (10) such that both can be introduced together into the alimentary tract, thereby eliminating the need to separately introduce the gastroscope afterward in order to verify that the gastrostomy feeding tube (11) has been correctly placed within the stomach of the patient. The gastrostomy feeding tube includes a coupling member (12), such as an elongate tract or thread, that is accessible about the second end (26) thereof. The elongate tract is drawn through the working channel (31) of the gastroscope by an engagement member (29), such as snare, which then allows the distal end (33) of the gastroscope to be advanced into the end cap (18) of the feeding tube so that the two can be pulled together into the stomach. In another embodiment, the coupling member comprises an integrated attachment member (39), such as hook, to which the engaging member can attach.

Abstract: The subject invention pertains to a system for imaging the human airway having highly advantageous optical, mechanical, ergonomical and physical characteristics. In a specific embodiment, the human airway can be imaged during the intubation procedure. The subject imaging scopes can incorporate a malleable stylet which retains its shape when bent, in order to facilitate intubation of a patient. In a preferred embodiment, a solid metal stylet, for example, a conventional endotracheal tube stylet, can be utilized. In a specific embodiment the subject intubation scope allows for a user to utilize conventional techniques for the insertion of an endotracheal tube, reducing the training needed for use of the subject intubation scope. Preferably, the subject imaging scopes also incorporate at least one illumination fiber to convey light to the distal tip of the subject imaging scopes, for illumination of the objects to be imaged.

Abstract: An endoscope for intubating an endotracheal tube includes an elongated insertion portion including at least an image transmitting optical fiber bundle, an illumination light transmitting optical fiber bundle, and a bendable element, an operation portion connected to the proximal end portion of the insertion portion, a bending operation mechanism provided in the operation portion, an endotracheal tube connection section provided in the vicinity of a joint between the insertion portion and the operation portion; and a bendable element for bending the insertion portion provided so as to extend from the inside of the insertion portion to the bending operation mechanism.

Abstract: An apparatus and method for accomplishing simultaneous bronchoscopy and airway instrumentation and securing the instrument in place using an adjustable threaded gastight seal. The apparatus consisting of a hollow elongated manifold for simultaneous fiberoptic bronchoscopy through a fiberoptic port (4) and introduction a secondary tubular instrument (2) through a threaded secondary instrument port (5) while maintaining mechanical ventilation of a intubated patient using a ventilation port (7) and endotracheal tube connection port (6). The secondary instrument port (5) is constructed in a manner to allow introduction of a tubular instrument into the airway and form an adjustable gastight seal.

Abstract: An eyepiece optical system, an illuminating lamp, and a battery 2 are housed in an operation unit 2. An insertion unit in which an image transmitting optical fiber bundle and an illumination light transmitting optical fiber bundle are incorporated is detachably coupled with the operation unit through a coupling unit. The insertion unit is bent using a bending wire attached to the distal end thereof and coupled to the operation unit by a wire operating mechanism. An anti-clouding material can be disposed on a surface of the distal end of the insertion unit to protect it against clouding.

Abstract: For fiberoptic endotracheal intubation, a method is disclosed that uses a device having a cannula with a first, distal end for placement within the pharynx of a patient, a second, proximal end for being disposed outside of the patient's oral cavity, and a flow passage between the first and second ends. The cannula has a length such that, when the distal end is placed within the pharynx, it terminates distally at a point near the patient's epiglottis. The device includes an inflatable cuff structure for forming a seal between a wall of the cannula and the patient's pharynx. The cuff is positioned adjacent to the distal end of the device and defines, on inflation, a ventral/anterior portion and a posterior portion. The method involves a step of inserting the device, with cuff deflated, into a patient's mouth so that the distal end of the device is disposed at a point near the patient's epiglottis to establish an airway column down the core of the device.

Abstract: Apparatus and method for selectively blocking respiratory airflow to a pediatric lung or a single lobe thereof. The apparatus comprises an endotracheal tube adapted for passage of a bronchoscope therethrough and a second flexible tube which is parallel with and fixedly contacting said endotracheal tube. A bronchial blocker assembly, having a pair of axial passageways therethrough, is provided which is insertable into and movable along the length of said second flexible tube. One of said axial passageways receives a stylet, said stylet being movable along the length of and rotatable within said axial passageway. Said stylet being sufficiently flexible to guide said endotracheal tube and said bronchial blocker assembly along a pediatric patient's windpipe. Means are provided for fixing said bronchial blocker assembly relative to said second axial passageway when said bronchial blocker assembly is resident therewithin.

Abstract: A viewing system for use with a breathing tube such as an endotracheal intubation tube or a tracheostomy tube and a viewing assembly having a viewing conduit for indirectly viewing the tracheal area of a patient into which the breathing tube is being inserted and for guiding the tube into place within the patient's trachea is disclosed. The viewing system also incorporates an adapter handle which allows the viewing assembly to be used with breathing tubes of varied lengths.

Abstract: A hand-held viewing system for use during medical procedures including endotracheal intubations or tracheostomies is disclosed. The viewing system includes an endoscope assembly having a fiber optic bundle for indirectly viewing the tracheal area of a patient into which the breathing tube is being inserted and a malleable sheath on the endoscope assembly for guiding the tube into place within the patient's trachea. The viewing system also incorporates an adapter stop which allows the endoscope assembly to be used with breathing tubes of varied lengths. A handle is included to which the endoscope assembly and a viewing means are removably connected.

Abstract: An intubation device comprises an imaging conduit including an illumination conduit for delivering illumination to a distal end of the device and an image-receiving conduit for communicating images from the distal end of the device to the proximal end of the device. The device also comprises a flushing conduit for delivery of fluids and/or gases to the distal end of the device. The image conduit and the flushing conduit are attached at the distal end of the device. The distal end of the device can be manipulated by advancing the imaging conduit in an axial direction while maintaining the flushing conduit fixed in place. Furthermore, a length adjustment member is provided for adjusting the extent to which the distal end of the device extends beyond a distal end of an endotracheal tube which is inserted over the imaging and flushing conduits. The illuminating conduit and the image-receiving conduit terminate in separate ports at the distal end of the device.

Abstract: A balloon-tipped, wire-guided double lumen, endobronchial blocker catheter (6) is provided for insertion into the tracheal bronchial tree using a fiberoptic bronchoscope (2). The catheter incorporates a removable wire guide (14), which runs the entire length of the catheter exiting the tip as a small unencased wire loop (12). The small unencased wire loop is positioned around the circumference of a fiberoptic bronchoscope and when advanced along the fiberoptic bronchoscope thereby allows the catheter to navigate the airway using the fiberoptic bronchoscope as a guide or stint allowing the catheter to reach portions of the lung where access is difficult due to sharp bends in the tracheal bronchial tree. A balloon (8) thereof is inflated to provide obstruction of a portion of the lung from ventilation. The long wire guide loop is removable allowing communication of the blocked segment with the proximal end of the catheter.

Abstract: An esophageal overtube for use with an endoscope in which the overtube has a conduit for evacuation of laser smoke and burnt tissue which is created during esophageal tumor ablation with laser therapy. A vacuum port on the esophageal overtube facilitates connection to a vacuum source which evacuates the laser smoke and burnt tissue to a site remote from the operating environment. An embodiment of the esophageal overtube has a bite block which can be either reusable or detachable from the overtube in a disposable version. Another embodiment of the esophageal overtube has a seal which seals the esophagus from the operating environment. Also disclosed are methods for using the various esophageal overtubes.

Abstract: A flexible fiber-optic endoscope having a plurality of independently removable modules wherein such modules contain components including a hollow body assembly with a steerable articulation section having a control means for remote manipulation, a tubular fiber-optic assembly incorporating an objective lens and an optic image guide and an optical eyepiece for viewing images carried by the image guide, and a disposable cover assembly for covering the steerable articulation section.

Abstract: A nasal intubation apparatus comprises a curved rigid body having a distal end and a proximal end joined by a curved section which approximates the curvature of the transition of the normal human nasopharynx to the oropharynx. The body has provided in it fiberoptic viewing and illumination channels. A working channel is provided to permit use of a flexible guide member to act as a guide for positioning of an endotracheal tube fitted over the intubation apparatus body. A controllable tip section at the distal end of the body is provided.

Abstract: An endoscopic instrument for controlled introduction of tubular members in the body includes a blade assembly having a blade for being introduced in the body to retract or manipulate anatomical tissue for introduction of a tubular member at a site in the body, a tubular member assembly having a tubular member with a distal end for being introduced at the site in the body and a remote viewing assembly having a distal end for being positioned in the body to permit introduction of the tubular member at the site in the body to be confirmed visually at a location remote from the site in the body. The distal end of the tubular member and the distal end of the remote viewing device are movable along the blade to introduce the tubular member distal end at the site in the body.

Abstract: The invention is of an intubation system which is based on a specially designed fiberscopic instrument of a new design to address the unique requirements for intubation. The fiberscope (referred to as an "endoscopic stylet" by the inventor) has a largely semi-rigid insertion cord which permits a user to pre-form the endoscopic stylet to follow the anticipated contours of the airway leading to the trachea and to insure that it reliably shepherds the associated endotracheal tube to the intended tracheal position. By visually tracking the progress of the endoscopic stylet through the airway, specifically through the vocal cords and into the trachea, placed at the proper distance above the carina, as permitted by the fiberoptic portions of the endoscopic stylet, proper positioning of the endotracheal tube is virtually assured, and post-intubation verification would be unnecessary in most instances since intubation is itself verification of proper endotracheal tube placement.

Abstract: An endoscopic instrument for controlled introduction of tubular members in the body includes a blade assembly having a blade for being introduced in the body to retract or manipulate anatomical tissue for introduction of a tubular member at a site in the body, a tubular member assembly having a tubular member with a distal end for being introduced at the site in the body and a remote viewing assembly having a distal end for being positioned in the body to permit introduction of the tubular member at the site in the body to be confirmed visually at a location remote from the site in the body. The distal end of the tubular member and the distal end of the remote viewing device are movable along the blade to introduce the tubular member distal end at the site in the body.

Abstract: An intubator includes a housing and a memory cylinder connected for axial movement relative to the housing. A flexible scope tube attached to the housing extends within and through the memory cylinder such that the scope tube can be retracted within or caused to extend beyond the distal end of the memory cylinder by the relative axial movement between the housing and memory cylinder. The scope tube is angularly adjustable and includes a light transmitting fiber optic cable, a visual transmission fiberoptic cable, and a fluid conduit. In use, an endotracheal tube is mounted on the memory cylinder such that the endotracheal tube, memory cylinder and scope tube have their distal ends flush. The intubator is then inserted through the patient's mouth to the larynx opening. Collapsing the memory cylinder within the handle causes the scope tube to be extended from the memory cylinder for positioning within the trachea.

Abstract: An improved endoscope has been provided which includes an elongated cylindrical shell housing with a transparent window at the distal end thereof. A removable core has an objective endoscope lens or optics at the distal end thereof and an image sensor mounted within the distal end of the core. A transmitting electronic cable with multiple conductors each has a distal end connected to the image sensor circuit board and a proximal end connected to a video control unit. Signals are transmitted from the control unit to the video monitor which displays the image. A sterile separable channel section, removably receives the core in a defined relationship and has at least one longitudinal channel for transmitting fluids or for receiving an operative instrument or carrying light transmitting fiber. A flexible tube is connected to the proximal end of the channel for supplying fluid or for manipulating the operative instrument from a remote location. The separable channel section is disposable after use on a patient.

Abstract: An endotracheal tube insertion system includes a formable shaft having sufficient stiffness to hold a formed shape and having a plurality of longitudinally extending passageways defined therethrough. The instrument further includes a housing connected to the first end of the formable shaft. An image guide cable is disposed in a first longitudinally extending passageway and is optically connected to an eyepiece which is affixed to the first end of the housing. A light source is attached to the second end of the formable shaft proximate the second end of the image guide cable. A baffle member is attached to the second end of the formable shaft proximate to a second longitudinally extending passageway and has an opening directed toward the first longitudinally extending passageway. A fluid port is in fluid communication with the second passageway. A suction port is also provided in fluid communication with a third longitudinally extending passageway.

Abstract: A multifunctional intubating stylet and laryngoscope, and a method of intubating a patient, comprise a laryngoscope body, and a hollow tubular intubating stylet affixed to and extending generally parallel to the laryngoscope body. An endotracheal tube is mounted on the exterior of the stylet. A guide member is passed through the interior of the stylet and advanced through the patient's vocal cords into the trachea. The endotracheal tube is then advanced along the guide member until it is established in a desired location in the patient's trachea to permit ventilation of the patient.

Abstract: An endoscopic instrument for controlled introduction of tubular members in the body includes a blade assembly having a blade for being introduced in the body to retract or manipulate anatomical tissue for introduction of a tubular member at a site in the body, a tubular member assembly having a tubular member with a distal end for being introduced at the site in the body and a remote viewing assembly having a distal end for being positioned in the body to permit introduction of the tubular member at the site in the body to be confirmed visually at a location remote from the site in the body. The distal end of the tubular member and the distal end of the remote viewing device are movable along the blade to introduce the tubular member distal end at the site in the body.

Abstract: A guide tube comprising a tube body having a throughhole penetrated therethrough in the axial direction and a mouthpiece provided at the rearward end of the tube body, or comprising a tube body having a throughhole penetrated therethrough in the axial direction, a connector provided at the rearward end of the tube body and a mouthpiece engageable with and detachable from the connector, the tube body being embedded with a coil spring in the tube wall and cut slantly to the axial direction at the forward end, and the mouthpiece having a circular or elliptical cross-sectional shape, a rib at the forward end and a flange at the rearward end, and the connector being in a structure engageable with and detachable from the mouthpiece and having at the rearward end a sealing film member with a slit or a perforation at the center facilitates passage of an endoscope through the phalynx to the esophagus, simplifies washing of or aspiration from the esophagus or stomach and shortens the treating time and reduces a painful

Abstract: The present invention is an endoscopic over-tube for receiving and guiding medical instrumentation into the upper alimentary canal of a patient. The endoscopic over-tube has a bite block for insertion and retention in the mouth of the patient. The endoscopic over-tube also has a flexible protective sheath engaging the bite block and adapted for insertion into the upper alimentary canal of the patient. The sheath includes a stiffened region that insulates the posterior wall of the patient's pharynx from medical instrumentation as the medical instrumentation is intubated through the sheath and into the patient's alimentary canal.

Abstract: A malleable fiberoptic intubating apparatus has an elongate arcuate thin-walled tubular stylet which removably carries an endotracheal tube around it and the fiberoptic bundle of a flexible fiberoptic bronchoscope within it, a handle at the rearward end of the stylet, and a telescoping bronchoscope support arm that releasably receives and carries a bronchoscope and moves relative to the handle. An adjustable endotracheal tube positioning element engages the proximal end of the endotracheal tube and positions it on the stylet. An adjustable fiberoptic bundle positioning element engages the flexible fiberoptic bundle of the bronchoscope and positions it within the stylet. The instrument is placed in the mouth, the larynx is identified, and the instrument is advanced as a unit into the trachea. Then the fiberoptic bronchoscope and stylet are removed from the mouth, leaving the endotracheal tube in the proper part of the trachea.

Abstract: A multifunctional intubating stylet and laryngoscope, and a method of intubating a patient, comprise a laryngoscope body, and a hollow tubular intubating stylet affixed to and extending generally parallel to the laryngoscope body. An endotracheal tube is mounted on the exterior of the stylet. A guide member is passed through the interior of the stylet and advanced through the patient's vocal cords into the trachea. The endotracheal tube is then advanced along the guide member until it is established in a desired location in the patient's trachea to permit ventilation of the patient.

Abstract: An endotracheal intubating instrument has an elongate curvilinear blade member releasably attachable to a handle and a central channel sized to removably receive and slidably engage an endotracheal tube therein, an elongate tubular housing removably connected at its forward end to the rearward end of the endotracheal tube which removably receives a fiberoptic scope having an eyepiece at a rearward end and a fiberoptic bundle extending forwardly within the endotracheal tube, and an adjustable positioning element through which the forwardly extending fiberoptic bundle passes for adjustably positioning and maintaining the tip end of the fiberoptic bundle relative to the forward end of the endotracheal tube. The apparatus is placed in the mouth, the larynx is identified, and the endotracheal tube, housing, and fiberoptic scope are advanced as a unit into the trachea as the blade is removed. Then the fiberoptic scope and housing are withdrawn, leaving the endotracheal tube in the desired part of the trachea.

Abstract: An image recording apparatus for recording an image on a recording medium by employing a transfer recording medium having a transfer recording layer whose transfer characteristics change upon application of heat energy and light energy thereto comprises: a recording section including a thermal head for applying heat energy to the transfer recording medium disposed along a conveying route of the transfer recording medium and a light source for applying light energy to the transfer recording medium; a transfer section for transferring onto the recording medium an image formed on the transfer recording medium in the recording section; and a device disposed upstream of the transfer section in the advancing direction of the transfer recording medium and adapted to make portions of the transfer recording layer other than an image-forming area non-transferrable.