Handle for Multifunction Endoscope
A multifunction endoscope handle comprises a body cover, a first body cover extension and a second body cover extension. The body cover comprises distal and proximal ends with a waist of therebetween. The proximal and distal end circumferences part each larger than the waist circumference. The body cover also comprises an outer surface tapering from the distal and proximal ends to the waist. Both of the first and second body cover extensions extend radially outwardly directions from the outer surface of the body cover. In some embodiments the proximal circumference is larger than the distal circumference. The outer surface is preferably a smoothly tapering outer surface. The body cover may comprise a plurality of ports at a proximal portion thereof.
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This application claims the benefit of Provisional Patent Application No. 60/747,780 filed 19 May 2006, entitled Endoscope for Fiber Optic Procedures, Attorney Docket LSCP 1026-1.
BACKGROUND OF THE INVENTION1. Field of the Invention
The present invention relates generally to endoscopes, and in particular the configuration of a handle used for a multifunction endoscope.
2. Description of Related Art
An endoscope is an illuminated medical device used look inside the body and examine organs. An endoscope can be rigid or flexible. Endoscopes designed for particular procedures often have specialized names, such as cystoscope (bladder), nephroscope (kidney), bronchoscope (bronchi), laryngoscope (larynx), otoscope (ear), arthroscope (joint) and laparoscope (abdomen). In addition to being used for viewing and examination, endoscopes are often used with various types of medical instruments for diagnostic and therapeutic procedures. An example of these medical instruments includes a medical laser device using fiber optics to deliver the laser energy to, typically, the distal end of the endoscope. Other medical instruments that can be used with endoscopes include grasping, cutting, tissue sampling and suturing medical instruments as well as medical instruments designed to provide energy other than laser energy such as RF and ultrasonic energy.
Endoscopic removal of tissue by means of lasers has been realized in procedures such as photoselective vaporization of prostate (PVP) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Lasers in the visible and invisible spectral range have been utilized for endoscopic procedure of tissue removal. Tissue removal is typically carried out under endoscopic visualization of the operating field through a telescope. Laser light is guided to the operating field by an optical light guide (laser fiber). To steer the light guide to the target tissue an endoscope is often utilized. In some implementations the telescope can be embodied in the endoscope as a fixed or modular component.
Performing a surgical laser procedure through an endoscope creates several challenges. Vaporization of tissue in a body cavity filled with an irrigant creates vapor bubbles and tissue particles that get released into the irrigant and that can obscure the view of the surgeon.
Controlling the surgical effect the laser has on tissue requires the surgeon to position the laser fiber with high precision. The surgeon has to consider the characteristics of the laser beam such as its divergence coming out of the laser fiber and control the distance between laser fiber and tissue to achieve the desired effect. In some instances the laser effect can change its nature dependent on the distance between laser fiber and tissue. In some cases vaporization will occur when the fiber is close to tissue but coagulation without vaporization will occur when the fiber is further away from tissue.
The surgeon has to control the position of the distal tip of the laser fiber relative the distal tip of the endoscope to avoid damage to the endoscope by unintentional exposure of the endoscope to laser light.
Thus, in some high power laser applications, it is possible to damage an endoscope by inadvertently directing laser radiation into the structure. In addition, it is necessary to provide for an effective irrigation flow in such systems. Finally, is desirable to provide a structural design which is comfortable to hold and utilize by surgeons. An endoscope is described herein that allows surgeons to safely and effectively perform laser surgery, including transurethral laser vaporization of prostate tissue.
SUMMARY OF THE INVENTIONA simple endoscope used for examination of an organ may have only two ports, one for the light source and one for the optical image. However, endoscopes used for medical procedures such as ablation of tissue using laser energy will typically have many more ports and therefore make the design of the proximal portion of the endoscope more complicated. The increased complexity includes the presence of tubes, lines, wires and other things extending from the proximal portion of the endoscope. One aspect of the invention is the recognition that different individuals using the same endoscope will often hold and manipulate the endoscope by its proximal portion in different ways. This is particularly true for multifunction endoscopes used for both of viewing and for treatment, at least in part because of the increased complexity of the procedure and the number of things extending from the proximal portion, as well as the personal preferences of the operator.
A handle for a multifunction endoscope comprises a body cover, a first body cover extension and a second body cover extension. The body cover comprises distal and proximal ends with an axis extending therebetween with a waist between the distal and proximal ends. The distal and proximal ends and the waist have distal and proximal circumferences and a waist circumference, respectively. The proximal circumference is larger than the waist circumference and the distal circumference is larger than the waist circumference. The body cover also comprises an outer surface, the outer surface tapering from the distal end to the waist and from the proximal end to the waist. The first body cover extension extends in a first radial direction from the outer surface of the body cover between the proximal end and the waist. The second body cover extension extends in a second radial direction from the outer surface of the body cover between the proximal end and the waist.
In some embodiments the proximal circumference is larger than the distal circumference. The outer surface is preferably a smoothly tapering outer surface. The body cover may comprise a plurality of ports at a proximal portion thereof. The handle may also comprise a second body cover positioned distally of the distal end of the body cover. The second body cover may comprise additional ports therein.
A method for manipulating an endoscope comprises selecting an endoscope, the endoscope comprising a handle, an external cannula extending from the handle, and an optical fiber. The optical fiber extends through the handle and through the external cannula with a proximal portion of the optical fiber extending proximally from a port at the second body cover extension. The body cover of the handle is grasped with a first hand using a chosen gripping technique. A user-manipulable knob mounted to the proximal portion of the optical fiber is grasped with a second hand. The optical fiber is selectively moved within the external cannula by at least one of rotating the optical fiber around its own axis and longitudinally sliding the optical fiber through the external cannula using the user-manipulable knob.
Other features, aspects and advantages of the present invention can be seen on review the Figs., the detailed description, and the claims which follow.
Individual lumens may be used for a single purpose, such as delivery of irrigation liquid, or for two or more purposes, such as housing the telescope and a optical fiber.
As suggested in
In a preferred embodiment the longitudinal motion of optical fiber 16 is directed axially along axis 28 (illustrated in
Body cover 22 has a smoothly tapering outer surface 48 that tapers radially inwardly from distal and proximal ends 24, 26 towards a central or waist portion 42. The circumference of proximal end 26 is larger than the circumference of distal end 24, which is larger than the circumference of waist portion 42. Outer surface 48 has a generally circular, slightly oval cross-sectional shape along axis 28 with a diameter in a range of about 1.5 to 2 cm, for example. Outer surface 48 may have other, preferably smoothly curving, shapes, such as egg-shaped, at various positions along axis 28 or along the entire length of axis 28.
Handle 12 also has first and second body cover extensions 44, 46 extending radially outwardly from the outer surface 48 of body cover 22 adapted to comfortably shield the surgeon's hand from fittings for the telescope and the fiber 16. Extensions 44, 46 are positioned between proximal end 26 and waist portion 42. Extensions 44, 46 have smoothly curving, distally-facing outer surfaces 50, 52 to provide a smooth transition between outer surface of 48 of body cover 22 and extensions 44, 46. As seen in
As shown in
Endoscope 10 also includes a telescope 64 extending through a telescope port 65 at proximal end of 26 and aligned with axis 28. Telescope 64 includes a camera fitting 66 to permit images of the working region 68 in the vicinity of laser beam 20 captured by the telescope at distal tip 18 to be recorded and/or monitored during use. Illumination port 56 is coupled to the interior of telescope 64 so the light from the illumination source passes distally along the telescope to illuminate working region 68.
In a preferred embodiment the motion of optical fiber 16 is both axially along axis 28 and also rotationally about its own axis to permit laser beam 20 to be directed proximally and distally as optical fiber 16 moves generally along axis 28 as well as being swept side to side as optical fiber 16 rotates about its own axis. Distal tip 18 of external cannula 14 is beveled to permit this range of movement of laser beam 20 while providing for proper viewing of working region 68. This manipulation of optical fiber 16, see
The structure of the travel limiter 300 (in the form of a cam in this embodiment) is illustrated in
Although not shown in
As illustrated in
The above descriptions may have used terms such as above, below, top, bottom, over, under, et cetera. These terms are used to aid understanding of the invention are not used in a limiting sense.
While the present invention is disclosed by reference to the preferred embodiments and examples detailed above, it is to be understood that these examples are intended in an illustrative rather than in a limiting sense. It is contemplated that modifications and combinations will occur to those skilled in the art, which modifications and combinations will be within the spirit of the invention and the scope of the following claims.
Any and all patents, patent applications and printed publications referred to above are incorporated by reference.
Claims
1. A handle for a multifunction endoscope comprising:
- a body cover comprising: distal and proximal ends with an axis extending therebetween; a waist between the distal and proximal ends; the distal and proximal ends and the waist having distal and proximal circumferences and a waist circumference, respectively; the proximal circumference being larger than the waist circumference and the distal circumference being larger than the waist circumference; and an outer surface, the outer surface tapering from the distal end to the waist and from the proximal end to the waist;
- a first body cover extension extending in a first radial direction from the outer surface of the body cover between the proximal end and the waist; and
- a second body cover extension extending in a second radial direction from the outer surface of the body cover between the proximal end and the waist.
2. The handle according to claim 1 wherein the proximal circumference is larger than the distal circumference.
3. The handle according to claim 1 wherein the outer surface is a smoothly tapering outer surface.
4. The handle according to claim 1 wherein the distance between the distal and proximal ends is 8 to 15 cm.
5. The handle according to claim 1 wherein the distance between the distal and proximal ends is 9 to 12 cm.
6. The handle according to claim 1 wherein the first and second body cover extensions comprise forward-facing surfaces, said outer surface and said forward facing surfaces creating a smoothly curving user-grasping surface.
7. The handle according to claim 1 wherein the second radial direction extends both radially outwardly away from the axis and axially towards the distal end.
8. The handle according to claim 1 wherein the body cover comprises a proximal portion, the proximal portion comprising a plurality of ports.
9. The handle according to claim 1 further comprising a first port at the first body cover extension, a second port at the second body cover extension and a third port at the proximal end and along the axis.
10. The handle according to claim 9 further comprising an illumination fitting at the first port, an optical fiber fitting at the second port and a camera fitting at the third port.
11. The handle according to claim 10 further comprising a valve at the second body extension associated with the second port.
12. The handle according to claim 1 further comprising a second body cover positioned distally of the distal end of the body cover.
13. The handle according to claim 12 farther comprising fourth and fifth ports in the second body cover.
14. The handle according to claim 13 for the comprising an inflow fitting at the fourth port and an outflow fitting at the fifth port.
15. The handle according to claim 12 further comprising a coupler between the second body cover and the body cover.
16. A multifunction endoscope comprising:
- a handle made according to claim 1;
- an external cannula extending from the handle;
- a port at the second body cover extension;
- an optical fiber extending through the handle and external cannula with a proximal portion of the optical fiber extending proximally from the port;
- a user-manipulable knob mounted to the proximal portion of the optical fiber, so that a user may grasp the body cover of the handle with one hand and manipulate the optical fiber through the user-manipulable knob with the other hand.
17. A method for manipulating an endoscope comprising:
- selecting an endoscope comprising a handle made according to claim 1, an external cannula extending from the handle, and an optical fiber extending through the handle and through the external cannula with a proximal portion of the optical fiber extending proximally from a port at the second body cover extension;
- grasping the body cover of the handle with a first hand using a chosen gripping technique;
- grasping a user-manipulable knob mounted to the proximal portion of the optical fiber with a second hand; and
- selectively moving the optical fiber within the external cannula by at least one of rotating the optical fiber around its own axis and longitudinally sliding the optical fiber through the external cannula using the user-manipulable knob.
18. A handle for a multifunction endoscope comprising:
- a body cover comprising: distal and proximal ends with an axis extending therebetween; a waist between the distal and proximal ends; the distal and proximal ends and the waist having distal and proximal circumferences and a waist circumference, respectively; the proximal circumference being larger than the distal circumference and the distal circumference being larger than the waist circumference; and an outer surface, the outer surface smoothly tapering from the distal end to the waist and from the proximal end to the waist;
- a first body cover extension extending in a first radial direction from the outer surface of the body cover between the proximal end and the waist;
- a second body cover extension extending in a second radial direction from the outer surface of the body cover between the proximal end and the waist;
- the first and second body cover extensions comprising forward-facing surfaces, said outer surface and said forward facing surfaces creating a smoothly curving user-grasping surface;
- a first port at the first body cover extension, a second port at the second body cover extension and a third port at the proximal end and along the axis;
- a second body cover positioned distally of the distal end of the body cover;
- fourth and fifth ports at the second body cover.
19. The handle according to claim 18 wherein the second radial direction extends both radially outwardly away from the axis and axially towards the distal end,
20. The handle according to claim 18 further comprising:
- an illumination fitting at the first port;
- an optical fiber fitting at the second port;
- a camera fitting at the third port;
- a valve at the second body extension associated with the second port;
- an inflow fitting at the fourth port; and
- an outflow fitting at the fifth port.
Type: Application
Filed: Jan 31, 2007
Publication Date: Nov 22, 2007
Applicant: AMS Research Corporation (Minnetonka, MN)
Inventors: Kester Nahen (Heildeberg), Ken Arnold (Soquel, CA), Douglas G. Stinson (Fremont, CA), Eduardo Asturias (San Francisco, CA), Victor Lazzaro (Discovery Bay, CA), James Raymond Kermode (Los Altos, CA)
Application Number: 11/669,633
International Classification: A61B 1/00 (20060101);