Endoscope system

Abstract

An endoscope system includes: an endoscope (10) having a camera (812) at a distal end of a shaft (14) of the endoscope (10); the shaft (14) and the camera (812) can rotate together around a rotation axis (843) of the shaft (14); the camera (812) having a fixed optical axis (841) at a non-zero angle of less than 90 relative to the axis of rotation (843) of the shaft (14); a rotation sensor (704) configured to measure a rotational angular orientation of the shaft (14) and the camera (812) about the rotational axis (843); and a processor (430c) configured to process the image data and the angular orientation from the camera (812) to calculate corrected image data for display, the corrected image data maintaining the angular orientation of the displayed image relative to the measured angular orientation.

Description

[0001] Divisional application

[0002] This application is a divisional application of the Chinese patent application with application number 201980035409.8. The application date of the above application is April 26, 2019, and the name of the invention is "Endoscope with rotatable camera and related methods". Technical Field

[0003] The present disclosure relates to endoscopic instruments for viewing and working in relatively inaccessible spaces; and in some aspects to endoscopic instruments for operating in confined anatomical spaces within the body using an endoscope or arthroscope, for example. Background Art

[0004] The use of endoscopic instruments in medicine (which allows remote observation and operation in inaccessible spaces) is already very mature. These instruments are also useful in automobiles, aviation, plumbing facilities, electronic equipment and many other industries. In the field of medical or veterinary practice, endoscopy or arthroscopy is generally used to observe or treat anatomical areas when minimal incisions are expected or when no incisions are expected, or to avoid interfering with nearby tissues. For example, in orthopedics, one or more arthroscopic instruments introduced into the joint through one or more small skin incisions can be used to obtain the condition of joints such as knees or shoulders. These instruments can also be used to repair various intra-articular tissues. Standard techniques for open surgery to observe and repair these anatomical areas may be more time-consuming (associated with greater risks and trauma to the patient) by comparison, and may be associated with longer recovery times. In addition, anesthesia associated with open surgery may be more complicated, risky and expensive. In order to improve the field of view, the endoscope can be equipped with an active flexible distal segment that can be controlled by the user at the handle end of the instrument. This may not be an effective option when the tip of the instrument is positioned in a confined space that may not allow the range of motion required to flex the distal segment of the endoscope. In medical applications, one such example includes intra-articular surgery. In general, in cases where it is impractical to use an instrument with an active flexible distal segment, it is preferred to use an instrument with a rigid insertion shaft. A non-flexible shaft can provide improved optical or image reproduction, increased space for additional functions within the instrument, and greater durability. However, a rigid endoscope or arthroscope has a limited field of view and may need to be frequently repositioned or rotated to increase the field of view. Some endoscopes or arthroscopes must be removed from the patient's body to replace parts in order to change the field of view. The intubation system can help this method, but it may also increase the complexity of the procedure and the size of the incision. These limitations may reduce operator efficiency, increase surgical time and may increase the risk of iatrogenic injury. In medical and other applications, it would be advantageous to have an endoscope with an increased or variable field of view without using an active flexible distal segment. It is also advantageous to combine functions in a single catheter to reduce the overall diameter of the shaft of the endoscope. Additionally, current instruments are susceptible to degradation in functional and optical quality after repeated use, cleaning and / or sterilization. An endoscope design that is sufficiently inexpensive to manufacture and assemble to make non-reuse economical would also be advantageous. The costs of repeated cleaning or sterilization and repackaging would be eliminated, and it would also be possible to make it easier to standardize sterility, quality, and reliability of disposable devices. Summary of the invention

[0005] In one aspect, an endoscope has a two-part handle, with a distal handle housing capable of rotating relative to a proximal handle housing connected to an endoscope shaft having a distally mounted camera sensor, the proximal handle housing capable of being grasped by a user's hand. The camera sensor can be mounted in an optical housing that positions the camera so that the optical axis of the camera maintains a fixed non-zero angle relative to the axis of rotation of the shaft, the optical housing, and the camera sensor. Rotation of the distal housing causes rotation of the image produced by the camera sensor unless the image rotation is corrected using a signal that tracks the degree of rotation of the distal housing relative to a predetermined horizon. Although such image rotation correction can be performed when both the proximal housing and the distal housing rotate together, it may be more useful to implement the image rotation correction when the distal housing rotates relative to the proximal housing. This can be achieved by mounting a magnet in an inner wall of the proximal housing covering a PCB that is attached to the distal housing, the PCB including a magnetic position sensor, such as a three-axis absolute position sensor. When the distal housing (and the attached camera sensor) rotates, the processor receives input from the position sensor and rotates the image array in the opposite direction by approximately equal amounts so that the displayed image maintains a fixed angular orientation. With this arrangement, when the camera rotates from the starting angular orientation to the second angular orientation around the rotation axis, the displayed image is translated from the first field of view to a different second field of view. The controller can also generate and display a direction pointer at the periphery of the displayed image to inform the observer or user of the actual rotational displacement of the camera sensor relative to the proximal housing of the handle. In an embodiment, the optical axis of the camera can be fixed at an angle between 30 degrees and 70 degrees relative to the rotation axis. The non-zero angle of the optical axis of the camera combined with the angular position signal allows the visual display of the image from the camera to be transformed from a rotating image with a variable field of view to a translating image with a variable field of view. The processor can be configured to smooth the rotation signal from the rotation sensor so that greater smoothing is applied when the camera rotation decelerates than when the camera rotation accelerates.

[0006] The above described system need not be limited to endoscopes or arthroscopes. The system may be adapted for application to any rotatable camera head having an optical axis at a non-zero angle relative to its axis of rotation.

[0007] In another aspect, an optical housing for a distal end of an endoscope shaft may include a molded member configured to partially enclose a camera sensor and a light source to fix the angular position of the camera sensor and the light source relative to the longitudinal axis of the distal end of the endoscope shaft, and to fix the camera sensor and the light source within the distal end of a cylindrical sheath comprising the endoscope shaft. The molded member may have an outer diameter to provide a leak-tight sealing engagement with a portion of the sheath of the shaft, and may include a plurality of channels formed on an outer surface of the molded member to provide one or more fluid flow paths between a fluid channel in the endoscope shaft and an outer surface of the endoscope shaft. The camera may include a lens adjacent to the sensor, and the optical housing may include a lens aperture through which the lens receives light at the distal end of the endoscope shaft. The light source may include a light emitting diode located next to the lens, and the optical housing may include an LED aperture through which the LED projects light to an area outside the distal end of the endoscope shaft. The camera sensor may be mounted on a camera sensor printed circuit board, which is enclosed in the optical housing. The light source may be mounted on a light source printed circuit board that is enclosed in the optical housing. The light source may include a light emitting diode mounted on the light source printed circuit board, and the light source printed circuit board may include an orifice through which a lens adjacent to the camera sensor may protrude. The sheath may terminate at a position near the termination of the optical housing, and one or more channels on the outer surface of the molded member may communicate with one or more lateral orifices between the optical housing and the sheath at the termination of the sheath. The sheath may include a flushing orifice near the termination of the sheath at the distal end of the endoscope shaft, and the flushing orifice may be in fluid communication with the one or more channels of the optical housing. The flow path of the flushing fluid may be formed during the molding of the optical housing. In an embodiment, the top side flow path directs the fluid flow from the distal end of the endoscope shaft in one or more orifices next to the camera sensor lens located adjacent to the camera sensor. The fluid flow from these orifices helps to flush out any bubbles, debris or other materials that may contact the lens surface (thereby interfering with the operation of the camera sensor). In addition, a lateral flow path may be formed in the optical housing to direct some irrigation fluid out of a lateral and inferior aperture of the distal shaft of the endoscope proximate the camera-lens-LED assembly. The sheath and optical housing may be configured to be inserted into a trocar having a distal opening to allow light to reach the camera sensor and to allow the light source to emit light, and the trocar may include a trocar aperture aligned with the irrigation aperture of the sheath.

[0008] The processor may also apply filters to reduce the effects of noise generated in the position sensor signal and any minor position changes in the image caused by the user's unintentional hand movement or tremor. Rotational image stabilization may be achieved through a variety of filtering techniques - either in the analog stage of the position sensor signal, after its digital conversion, or even in the controller software code that mediates the display of the image during rotation. Minor rotational movements with a large number of high-frequency components may be filtered using one of a variety of low-pass filtering techniques. In order to improve the responsiveness of the display controller to the user's rotation input, the controller may determine whether the camera sensor is rotating at a relatively high speed, a relatively high acceleration or deceleration, or whether the rotation signal spectrum is more heavily weighted toward low-frequency components. If so, the controller's low-pass filter coefficients may be adjusted in real time to reduce their effects so that the image rotation correction can be displayed with reduced delay when the rotation is started and maintained. When the user is close to completing the camera rotation, or when the user attempts to maintain the camera sensor in a fixed position, the controller may determine by rotation speed measurement or rotation acceleration measurement, or by spectrum analysis of the signal, that greater filtering should be started on the error-aggravated rotation signal or the high-frequency-aggravated rotation signal.

[0009] In one aspect, the rotation sensor can be configured to measure the rotation angle of the camera around the rotation axis. The processor can be configured to filter the rotation data from the rotation sensor to smooth the rotation of the displayed image. And the filter can be configured to provide greater smoothing when the camera rotation slows down than when the camera rotation speeds up. The filter can be a low pass filter, and the smoothing can have an inverse relationship with the corner frequency of the low pass filter. If the camera rotates at a constant speed, the filter can maintain constant smoothing of the rotation of the displayed image.

[0010] The quality of the displayed image can also be enhanced by selective enhancement of the saturation of the displayed image. In a disposable endoscope, the image quality of a low-cost camera sensor can be improved by selectively emphasizing the saturation of the image without reducing the intensity of white. The saturation of a pixel is enhanced by its saturation factor in a hue, saturation, value (HSV) color space and its brightness factor in a hue, saturation, brightness (HSL) color space. In one aspect, a method of processing an image may include: assigning an HSV value to a pixel of image data in an HSV color space, the saturation of the pixel being within a predefined range of saturation numbers; assigning an HSL value to a pixel of image data in an HSL color space, the brightness of the pixel being within a predefined range of brightness numbers. A processor may calculate a first factor including a score between 0 and 1, the score of the first factor being determined by a probability distribution centered on a number in the lower half of the predefined range of saturation numbers. The processor may calculate a second factor including a score between 0 and 1, the score of the second factor being determined by a probability distribution centered on a number in the middle of the predefined range of brightness numbers. The saturation of a pixel in the HSV color space is adjusted by multiplying the assigned saturation of the pixel in the HSV color space by a value equal to 1 plus the product of a predetermined fixed fraction and a first factor multiplied by a second factor. The processor may then adjust the saturation of the pixel in the HSV color space by multiplying the assigned saturation of the pixel in the HSV color space by a value equal to 1 plus the product of a predetermined fixed fraction and a first factor multiplied by a second factor. The predetermined fixed fraction may be set to 0.5. The probability distribution may be a Gaussian distribution. The probability distribution may be centered around numbers that include approximately 25%-40% of a predefined range of saturation numbers. The probability distribution may also be centered around numbers that include approximately 50% of a predetermined range of brightness numbers.

[0011] The Gaussian function that is biased toward lower saturation values ​​is designed to enhance desaturated pixels without over-amplifying already saturated pixels. The second Gaussian function is used for brightness in the HSL color space in order to reduce the saturation enhancement of near-white and near-black pixels. These factors are used to enhance saturation using the following formula: Enhanced Saturation Value = (Original Saturation Value) x (1 + (Factor 1 x Factor 2 x 0.5)).

[0012] To reduce electromagnetic radiation emitted outward from the endoscope shaft, the rigid or flexible extension circuit board carrying the signal traces between the camera sensor at the distal end of the endoscope and the main PCB in the endoscope handle is preferably constructed as a stripline rather than the more conventional microstrip. The stripline construction includes ground planes below and above the transmission lines (including signal traces) embedded within the rigid or flexible extension circuit board. This creates a consistent ground plane for the entire circuit board, thereby suppressing high-frequency electromagnetic radiation from propagating from the top side of the circuit board.

[0013] An optical coupling arrangement can be implemented to enhance the electrical isolation of the endoscope (and, by extension, the patient) from the digital electronics and chassis ground in the image processing unit external to the endoscope. In an example arrangement, a USB 3.0 power and signal interface is used to provide electrical and electronic connections between the endoscope's PCB and the electronic controls in the image processing unit. The signal interface is configured to operate at frequencies up to about 5 GHz. Thus, optical coupling of the connection between the endoscope cable and the image processing unit can provide an appropriate form of isolation. For example, a USB 3.0 fiber optic extender can be used to provide USB 3.0 signal isolation. The digital communication interface between the local and remote extenders can be optically coupled via a 0.5M fiber optic cable.

[0014] On the other hand, an endoscope assembly may include an endoscope and a trocar. The shaft may include a single catheter configured to carry a flushing fluid between a shaft port at a proximal portion of the shaft and a flushing port at a distal portion of the shaft. The shaft may be configured to be inserted into a trocar having a distal opening to allow the distal end of the shaft to protrude through the opening. The proximal portion of the trocar may be connected to the trocar fluid port, and the distal portion of the trocar may include one or more side ports to allow fluid to enter or leave the trocar space defined by the inner wall of the trocar and the outer wall of the shaft of the endoscope. Thus, the endoscope assembly may be configured to use a trocar space for flushing and a shaft catheter for aspiration, or to use a trocar space for aspiration and a shaft catheter for flushing to perform flushing and aspiration simultaneously. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] These and other aspects will become more apparent from the following detailed description of various embodiments of the present disclosure, with reference to the accompanying drawings, in which:

[0016] Figure 1 is a representative illustration of the two-part handle design of an endoscope;

[0017] Figure 2 Shows Figure 1 Additional features of the illustration;

[0018] Figure 3A An exemplary side view of an endoscope is shown;

[0019] Figure 3B shows an exemplary perspective view of another endoscope;

[0020] Figure 4 shows an exploded view of an example of a handle proximal section of an endoscope;

[0021] Figure 5 shows an exploded view of an alternative example of a handle proximal section of an endoscope;

[0022] Figure 6 shows an exploded view of an alternative example of a handle proximal section of an endoscope;

[0023] Fig. 7A A top perspective view of an example of a handle distal section of an endoscope is shown;

[0024] Figure 7B A side view of an example endoscope is shown with a portion of the handle removed;

[0025] Figure 7C A detailed view of a portion of an example handle distal section of an endoscope is shown;

[0026] Figure 8 An exploded view of an example of a handle distal section and a rotation sensing assembly of an endoscope is shown;

[0027] Fig.9A A partially assembled view of an exemplary endoscope handle is shown;

[0028] Fig. 9B shows a partial cross-sectional view of a handle of an endoscope including an example rotation sensing device;

[0029] Fig. 10A is a representative illustration of a pass-through fluid barrier that allows utility components to pass from a handle of an endoscope to a catheter of an endoscope;

[0030] Fig. 10B A representative illustration of a pass-through barrier having a flexible member is shown;

[0031] Fig.11A An exploded view of an example of an inner jacket mount for use as a pass-through fluid barrier is shown;

[0032] Fig. 11B An example embodiment of a bulkhead or a through-type fluid barrier is shown;

[0033] Fig. 11CAnother example embodiment of a diaphragm or through-type fluid barrier is shown;

[0034] Fig.11D An embodiment of a pass-through barrier through which a plurality of utility components extend is shown;

[0035] Fig.12 An exploded view of an example of a pivot control assembly is shown;

[0036] Fig.13 A perspective view showing an example of a sealing member;

[0037] Fig.14 shows a partially assembled view of an exemplary endoscope having an inner sheath mount, a pivot control structure or assembly, and a sealing member in respective assembled positions;

[0038] Fig.15 Another partially assembled view of an example endoscope having a pass-through barrier, a pivot control structure, and a printed circuit board enclosed in a protective material or housing is shown;

[0039] Fig.16A shows a perspective view of the outer sheath and mounting of an endoscope;

[0040] Fig. 16B yes Fig.16A A rear perspective view of the outer jacket and mounting member;

[0041] Fig.17 shows a perspective view of an outer jacket mounting;

[0042] Fig.18 shows a close-up partial cross-sectional view of the endoscope with the inner sheath mount, inner sheath, and outer sheath in their respective assembled positions;

[0043] Fig.19 An exemplary obturator for insertion into an outer sheath or trocar of an endoscope is shown;

[0044] Fig. 20 An example of a camera assembly mount separated from an inner sheath is shown;

[0045] Fig.21 An alternative example of a camera assembly mount as part of an inner sheath is shown;

[0046] Fig. 22 Depicted in Fig.21 The line 20-20 is intercepted Fig.21 A cross-sectional view of an example camera assembly mount and inner housing;

[0047] Fig.23An example of a camera assembly, a portion of an outer housing, and a portion of a camera assembly mount is shown;

[0048] Fig.24 An alternative example of a camera assembly, a portion of an outer housing, and a portion of a camera assembly mount is shown;

[0049] Fig.25 An alternative example of a camera assembly, a portion of an outer housing, and a portion of a camera assembly mount is shown;

[0050] Fig.26 shows a perspective view of the distal end of an endoscope shaft with a camera assembly mounted at the tip of the shaft without a protective guard, shield or tip structure;

[0051] Fig. 27 Shown is a rotatable camera housing with a pull-wire, and an LED bank at the exposed end of the endoscope shaft (with the surrounding sheath removed);

[0052] Fig.28 and Fig.29 Each half of a spherical rotatable housing for a camera assembly is shown;

[0053] Fig.30 and Fig.31 A pivoting member and a bearing member are shown that allow the housing for the camera assembly to rotate;

[0054] Fig.32 shows a perspective view of a camera assembly;

[0055] Fig.33 shows a side view of a camera assembly and camera assembly mount with walls of the camera assembly mount removed for clarity;

[0056] Fig.34 shows a side view of an alternative exemplary camera assembly and camera assembly mount with walls of the camera assembly mount removed for clarity;

[0057] Fig.35 shows a side view of an alternative exemplary camera assembly and camera assembly mount with walls of the camera assembly mount removed for clarity;

[0058] Figures 36 to 40 depicting some of the possible rotational positions of alternative camera assemblies;

[0059] Fig.41 An example camera assembly is shown;

[0060] Fig.42shows the relationship between the camera assembly and LEDs and their respective power and communication PCB extensions;

[0061] Fig.43 shows the form factor of a PCB for an endoscope with an extension for the endoscope shaft;

[0062] Fig.44 Shows Fig.43 A PCB, wherein one flexible extension is folded over another extension of the PCB;

[0063] Fig.45 shows how the PCB extension is positioned in the endoscope shaft (sheath removed);

[0064] Fig.46 A partially assembled endoscope is shown showing a pass-through fluid barrier or diaphragm and a PCB;

[0065] Fig.47 The relationship between the endoscope PCB and other internal components of the endoscope handle is shown;

[0066] Fig.48 shows a fluid transport lumen and PCB extension within an inner sheath of an endoscope shaft;

[0067] Fig.49 shows the internal fluid pathways within the handle of the endoscope;

[0068] Fig.50 An example camera assembly with attached fiber optic bundle and electronic flex cable is shown;

[0069] Fig.51 shows a top view of an exemplary camera assembly and camera assembly mount;

[0070] Fig.52 A perspective view of a camera assembly and a flexible fiber optic bundle or ribbon is shown;

[0071] Fig.53 shows a perspective view of a camera assembly having a unitary camera housing and light-emitting features;

[0072] Fig.54 Shows Fig.53 A side view of a camera assembly;

[0073] Fig.55 Examples of flexible optical fiber bundles or ribbons are shown;

[0074] Fig.56 Shows Fig.55 A side view of a flexible optical fiber strip;

[0075] Fig.57A perspective view showing one example of a light projection element;

[0076] Fig.58 A perspective view showing another example of a light projection element;

[0077] Fig.59 A perspective view showing another example of a light projection element;

[0078] Fig.60 Shows Fig.59 A bottom perspective view of a light projection element shown in FIG.

[0079] Fig.61 Shows Fig.59 and Fig.60 The light projection element shown in Fig.59 a cross-sectional view taken at line 43-43 of ;

[0080] Fig.62 Shows Fig.59 and Fig.60 The light projection element shown in Fig.59 a cross-sectional view taken at line 44-44 of ;

[0081] Fig.63 Shows Fig.59 and Fig.60 The light projection element shown in Fig.59 a cross-sectional view taken at line 45-45 of ;

[0082] Fig.64 Shows Fig.59 A top perspective view of a camera assembly on which a light projection element is mounted;

[0083] Fig.65 Shown in Fig.32 A cross-sectional view of an example camera assembly taken at line 61-61 of FIG.

[0084] Fig.66 Shown in Fig.50 A cross-sectional view of an example camera assembly taken at line 62-62 of FIG.

[0085] Fig.67 Shown in Fig.50 A cross-sectional view of an example camera assembly taken at line 62-62 of FIG.

[0086] Fig.68 depicts a representative illustration of a camera assembly at a distal tip of an endoscope, in addition to an example sensor and a plurality of example illumination sources;

[0087] Fig.69depicts a top view of an example printed circuit board including an extension for protruding into an endoscope shaft;

[0088] Fig.70 depicts a side view of an example printed circuit board including a protrusion;

[0089] Fig.71 depicts an example flow chart detailing a number of example steps that may be used to control, by a processor, at least one variable light source of an endoscope based on received sensor data;

[0090] Fig.72 shows a side view of a protruding portion of a printed circuit board having an example camera assembly, an example sensor, and a plurality of example light sources mounted thereon;

[0091] Fig.73 Shown include Fig.72 A top view of a distal tip of an example endoscope with an example protrusion of a printed circuit board shown in FIG.

[0092] Fig.74 Shown in Fig.73 a cross-sectional view of the distal tip of the endoscope taken at line 72-72;

[0093] Fig.75 shows a perspective view of the distal end of an endoscope shaft with a light source positioned on the shaft to project light in a direction generally away from the field of view of a camera assembly;

[0094] Fig.76 An example endoscope and an example calibration fixture are depicted;

[0095] Fig.77 depicts a flowchart of multiple example steps including illumination parameter values ​​that may be used to calibrate a variable illumination source of an endoscope;

[0096] Fig.78 shows a partially assembled view of the endoscope with the handle printed circuit board, power / HDMI cable, illumination fiber optics, and irrigation lines in their respective assembled positions;

[0097] Fig.79 shows a block diagram of an example image processing system; and

[0098] Fig.80 depicts an example diagram showing how an image may be righted using input from a rotation sensing assembly;

[0099] Fig.81 shows the relative position of the proximal housing magnet and the rotation sensor on the PCB of the endoscope;

[0100] Fig.82 shows a schematic illustration of the field of view observable by a camera sensor;

[0101] FIG. 83A to FIG. 83D shows the visual effect of the image rotation correction generated by the processor;

[0102] Fig.84 A processor algorithm for varying the filtering of image motion based on the speed of movement or acceleration of movement of a camera sensor is shown;

[0103] Fig.85 A processor algorithm for varying filtering of image rotation based on rotational speed or rotational acceleration of a camera sensor is shown;

[0104] Fig.86 A second processor algorithm for varying filtering of image rotation based on rotational speed or rotational acceleration of a camera sensor is shown;

[0105] Fig.87 A third processor algorithm is shown for varying filtering of image rotation based on rotational speed or rotational acceleration of a camera sensor;

[0106] Fig.88A and Fig.88B Two variations of PCB construction for an elongated PCB component in an endoscope shaft are shown;

[0107] Fig.89 is a block diagram showing the electrical isolation of an endoscope from an image processing unit located externally thereto;

[0108] Fig.90A shows an arrangement of a camera sensor and associated LEDs having a fixed angular position relative to the endoscope axis;

[0109] Fig.90B An alternative arrangement of a camera sensor and associated LEDs having a fixed angular position relative to the endoscope axis is shown;

[0110] Fig.91 A PCB of an endoscope is shown, comprising a handle component and a shaft component, wherein a camera and an LED are fixed at the end of the shaft component;

[0111] Fig.92 Shows the combination Fig.91 An exploded view of the PCB of the endoscope;

[0112] Fig.93 A partial cross-sectional view showing a portion of the PCB of an endoscope shaft that powers an LED next to a camera sensor at the tip of the shaft;

[0113] Fig.94 The placement of an optical housing or mount is shown to enclose the camera and LED at the distal end of the endoscope shaft;

[0114] Fig.95 shows an optical housing into which the camera sensor and LED of FIG. 90 may be embedded;

[0115] Fig.96 Shows Fig.95 Alternative views of the optical housing;

[0116] Fig.97 An optical housing is shown inserted into an inner sheath of an endoscope shaft;

[0117] Fig.98 A fluid flow path for irrigation fluid of an endoscope shaft including an optical housing is shown;

[0118] Fig.99 An outer sheath or trocar is shown surrounding the optical housing and inner sheath of the endoscope shaft;

[0119] Fig.100 An alternative fluid flow path associated with an optical housing is shown;

[0120] Fig.101 Shown with Fig.100 The fluid flow path of the inner sheath is consistent with the fluid orifice of the inner sheath; and

[0121] Fig.102 Shown with Fig.98 and Fig.100 An outer sheath or similar fluid orifice of a trocar that is consistent with the fluid flow path;

[0122] Fig.103 shows a longitudinal cross-sectional view of a schematic representation of an endoscope-trocar combination that allows fluid irrigation and aspiration through separate flow paths;

[0123] Fig.104 An example arrangement of a distal port near the tip of an endoscope shaft for separate fluid irrigation and aspiration is shown;

[0124] Fig.105 Shows the use of Fig.103 An illustration of the arrangement shown in FIG. 1 for simultaneous irrigation and aspiration; and

[0125] Fig.106 A processor-based algorithm for selectively saturating images from a camera sensor is shown. DETAILED DESCRIPTION

[0126] The terms "endoscope" and "arthroscopy" as used herein are intended to be used interchangeably and given their broadest interpretation, with each term referring to an instrument having an elongated section for insertion into a space that is otherwise difficult to access in a minimally invasive manner for the purpose of visual inspection, diagnosis, and / or treatment or repair. In the field of medical or veterinary practice, such a space may include a body cavity or organ cavity, a joint space, a tissue plane, or other body structure. The instrument may also be used in many non-medical (e.g., industrial) applications, such as borescopes, where the diameter of the insertion portion (flexible or rigid) of the visualization instrument needs to be minimized, or where the space within which the rigid borescope must operate is too restricted to allow the use of an active flexible distal segment.

[0127] The two-part handle design of the endoscope 10 is Figure 1 . The example endoscope 10 includes a handle proximal section 16 and a handle distal section 30. The handle proximal section 16 can be a housing. As shown, the handle distal section 30 can extend at least partially into the handle proximal section 16. The handle distal section 30 and the handle proximal section 16 can rotate relative to each other. In some embodiments, the user can hold the handle proximal section 16 still while rotating the handle distal section 30 with a thumb or finger. The endoscope 10 can have many features, such as, but not limited to, a rotation sensing assembly, a fluid conduit, a lighting member (lighting), an imager or camera assembly, a pivot control for an imager, and the like.

[0128] Additional features of endoscope 10 are Figure 2 . The endoscope 10 includes a handle proximal section 16 and a handle distal section 30. In this example, at least a portion of the insertion shaft or section 14 is fixed to the handle distal section 30 and moves with the handle distal section 30. The handle distal section 30 includes a handle protrusion or fin 36 that provides a surface for the user to press against to facilitate rotating the handle distal section 30 relative to the handle proximal section 16. In some embodiments, the user's hand can hold the handle proximal section 16 still while rotating the handle distal section 30 using one of the user's fingers or thumb.

[0129] In some embodiments, one or both of the handle proximal section 16 and the handle distal section 30 may function as a housing or provide support structure for other components of the endoscope 10 . Figure 2The endoscope 10 shown in may include a rotation sensing assembly 150. The rotation sensing assembly 150 can track the rotation of the handle distal segment 30 relative to the handle proximal segment 16. In some embodiments, the rotation sensing assembly 150 may include components that are stationary relative to the handle proximal segment 16 and components that are stationary relative to the handle distal segment 30. For example, the rotation sensing assembly 150 may include a potentiometer and a keyed shaft. The potentiometer may, for example, be mounted to a support member that includes an internal housing of the handle proximal segment 16. Alternatively, the handle distal segment 30 may also include a support member for mounting one or more components of the rotation sensing assembly 150 (see, for example, Figure 8 In either case, the rotational or translational component of the rotational sensing assembly is arranged to move in proportion to the degree of rotation of the handle distal section 30 relative to the handle proximal section 16.

[0130] An exemplary embodiment of an endoscope (or, for example, an arthroscope) 10 is Figure 3A . The endoscope 10 can be used for various endoscopic procedures, including arthroscopy, etc. As shown, the endoscope 10 includes a handle 12 and an insertion section or shaft 14, which may include an elongated hollow shaft, and one or more actuating members, electrical / communication lines, lighting or optical transmission cables and / or fluid channels may be located in the hollow shaft. As shown, in an embodiment, the shape of the handle 12 may be generally cylindrical and rounded. The shape of the insertion section 14 may also be generally cylindrical and extend along the longitudinal axis. In an embodiment, the insertion section 14 may be rigid and relatively straight. In other embodiments, the insertion section 14 may be bent or angled along at least a portion of its length. In other embodiments, the insertion section 14 may include a semi-rigid, ductile material, thereby allowing it to bend and be held in a desired shape. The diameter of the insertion section 14 is significantly smaller than the diameter of the handle 12. In some embodiments, the diameter of the insertion section 14 may be approximately 5.5 mm or less. The insertion section 14 of the endoscope 10 may be approximately the same length as the length of the handle 12. In alternative embodiments, the length and shape of the handle 12 and insertion section 14 may differ significantly.

[0131] At least a portion of the insertion section 14 is removable from the handle 12. In such embodiments, the insertion section 14 or a removable portion of the insertion section 14 can be coupled to the handle 12 in any of a variety of ways, including but not limited to friction fit, snap fit, threaded connection, bayonet mounting, etc. In some embodiments, the insertion section 14 can be a disposable component and the handle 12 can be a reusable component. In embodiments in which the insertion section 14 is disposable, the insertion section 14 can be discarded after use. In other embodiments, the insertion section 14 can be sterilized after use by an autoclave, solution immersion, or other suitable sterilization procedures. In a preferred embodiment, both the handle 12 and the insertion section 14 are disposable and can be discarded after use, thereby eliminating the need and cost of sterilization processes and equipment (except for pre-use sterilization using ethylene oxide, radiation, etc. during, for example, manufacture, assembly, or packaging of the device). Additionally, by making both the handle 12 and the insertion section 14 of the endoscope 10 disposable, there is no degradation in function or reliability due to repeated use and repeated cleaning. There are other benefits to making the entire endoscope 10 disposable, some of which are discussed below.

[0132] Preferably, the disposable endoscope 10 can be equipped with a device to prevent its reuse, especially in cases where sterilizing a used instrument may degrade its function. For example, the endoscope 10 can include a memory chip storing an identification code that can be recognized by an electronic processor in a base unit to which the endoscope 10 must be connected for operability and display of images. The connection can include wired communication between a controller in the base unit and a memory chip in the endoscope 10, or wireless communication using, for example, an RFID device installed in the endoscope 10. (Other types of wireless transmission, such as Bluetooth or Wi-Fi, can also be used). In an embodiment, the base unit can be programmed to encode the memory device on the endoscope 10 when it is used for the first time, and can be programmed to read and identify a code indicating that the endoscope 10 has been previously used whenever the endoscope 10 is subsequently reconnected to any base unit. Once a "used" endoscope 10 is identified, the controller can be programmed to prevent electronic and imaging communications between the endoscope 10 and the base unit. The code and its communication can be encrypted to enhance system security. Alternatively, the endoscope 10 may include a disabling feature in its software that renders the endoscope 10 inoperable after use.

[0133] like Figure 3A As shown in FIG. 1 , the handle 12 of the endoscope 10 may include a number of different features. The handle 12 may include a handle proximal section 16. The handle proximal section 16 may be relatively smooth, such as Figure 3A. The handle proximal section 16 may include one or more hollow sections. The handle proximal section 16 may also be contoured so that it includes many ergonomic attributes. In some embodiments, at least a portion of the handle proximal section 16 may not have a smooth surface and may include a knurled, ribbed, rough, honeycombed, etc. type texture and / or a rubberized or elastomeric surface layer to facilitate gripping the endoscope during operation of the endoscope 10. In an example embodiment, the handle proximal section 16 is formed with a plurality of finger grooves 18. In some embodiments, the handle proximal section 16 may be made of a material having a soft feel or otherwise comfortable to hold (e.g., rubber or other elastomer). In some embodiments, a pistol grip feature (not shown) may be included as part of the handle proximal section 16.

[0134] like Figure 3A As shown in , the handle proximal section 16 can be divided into two separate parts. Figure 3A The handle proximal section 16 in the embodiment includes a handle top section 20 and a handle bottom section 22. The handle top section 20 and the handle bottom section 22 of the handle proximal section 16 can be manufactured as two separate parts and connected together by any suitable means, such as adhesives, screws, snap fits, etc. As shown, the handle top section 20 is smooth and conforms differently from the handle bottom section 22. This can help the user quickly and easily determine the orientation of the endoscope 10 by feel. In some embodiments, the handle top section 20 and the handle bottom section 22 can include surface materials with different feels (e.g., metal material vs. plastic material, metal material vs. elastomeric material, smooth material vs. textured material, etc.).

[0135] The handle 12 of the endoscope 10 may also include a handle distal section 30. Figure 3A As shown in the figure, the handle distal section 30 extends from the handle proximal section 16 toward the insertion section 14. The handle distal section 30 can be smaller in diameter than the handle proximal section 16. As shown, the handle distal section 30 can be longer in length than the handle proximal section 16, but in alternative embodiments, the relative sizes of the handle distal section 30 and the handle proximal section 16 can be different.

[0136] On at least a portion of the handle distal section 30, there may be Figure 3A The grip texture shown in Figure 3AIn the example embodiment shown in FIG. 1 , the gripping texture is a series of spiral ribs 32. In other embodiments, other gripping textures (such as non-spiral ribs, nubs, protrusions, grooves, honeycomb patterns or other forms of knurling or engraving, etc.) may also be used. As shown, the spiral ribs 32 in the example embodiment surround most of the outer diameter of the handle distal segment 30. In some embodiments that include a gripping texture on the handle distal segment 30, the gripping texture may not be formed as a continuous portion of the handle distal segment 30. In such embodiments, the gripping texture may be a "skin" or sleeve applied to the handle distal segment 30. The gripping texture skin may be coupled to the handle distal segment 30 by any suitable means, such as, but not limited to, adhesives, snap fits, various fasteners, overmolding, etc. In some embodiments, the gripping texture skin may be made of a different material than the handle distal segment 30. For example, the gripping texture skin may be a softer elastomeric or rubber material that is more comfortable / less slippery to grip than the material of the handle distal segment 30.

[0137] exist Figure 3A In an example embodiment of the handle distal section 30, the handle distal section 30 includes a handle boss 34 that protrudes from the top of the handle distal section 30. In this example, the handle boss 34 does not protrude sharply upward from the rest of the handle distal section 30. Instead, the handle boss 34 can be configured to bend slightly upward from the rest of the handle distal section 30. In this example, the spiral rib 32 does not extend over the handle boss 34 and onto the top of the handle boss 34. Additional features of the handle boss 34 will be further described below.

[0138] In one aspect, protruding from the bottom of the handle distal section 30 may be a handle fin or paddle 36. In this example, the handle fin 36 may be configured to bend slightly away from the rest of the handle distal section 30 toward the bottom or subordinate position of the endoscope 10. The spiral rib 32 may or may not extend over the handle fin 36 and extend to the bottom of the handle fin 36. In other embodiments, the handle fin 36 may be configured to protrude from the top of the handle distal section 30, and the handle boss 34 may be configured to protrude from the other side of the handle distal section 30. The handle fin 36 may be arranged to correspond to the position of the entry point of various cables, flushing, etc. in the endoscope that the doctor is already familiar with. This may be desirable because such entry points are often used as a surface for pressing against to facilitate rotation and as an orientation mark. Additional features of the handle fin 36 will be further described below.

[0139] An alternative embodiment of the endoscope (or, for example, arthroscope) 10 is Figure 3BAs shown, the endoscope 10 includes a handle 12 and an insertion section or shaft 14, which may include an elongated hollow shaft, and one or more actuating members, electrical / communication lines, lighting or optical transmission cables and / or fluid channels may be located in the hollow shaft. At least a portion of the shaft 14 is capable of being removed from the handle 12. In an example embodiment, the shaft 14 of the endoscope includes an outer sheath, a trocar or cannula 318 attached to a mounting structure 15, which can facilitate attachment and removal of the cannula to the handle 12 in any of a variety of ways, including but not limited to friction fit, snap fit, threaded connection, bayonet mounting, etc.

[0140] like Figure 3B As shown in , the handle 12 of the endoscope 10 may include a handle proximal section 16 that encloses (among other components) a printed circuit board (PCB) for controlling or processing image data detected by a sensor at the distal end of the shaft and / or for providing power to a light source (e.g., an LED) at the end of the shaft. It may also house a fluid conduit for connection to a fluid transport lumen within the shaft 14. The handle proximal section 16 may be divided into two separate parts. Figure 3B The handle proximal section 16 in the embodiment includes a first handle half shell 21 and a second handle half shell 23. The first handle half shell 21 and the second handle half shell 23 of the handle proximal section 16 can be manufactured as two separate parts and connected together by any suitable means (e.g., adhesive, screws, snap fit, etc.) during assembly, and can be symmetrical. For example, the first handle half shell 21 can be ultrasonically welded to the second handle half shell 23 using any ultrasonic welding technology. Additionally, alternatively or optionally, the handle half shells 21, 23 can be manufactured using injection molding techniques known in the art.

[0141] The handle 12 of the endoscope 10 may also include a handle distal section 30. Figure 3B As shown in , the handle distal section 30 extends from the handle proximal section 16 toward the shaft 14. Protruding from the bottom of the handle distal section 30 may be a handle fin or paddle 36. The handle distal section 30 also includes a recess 35 that is sized to accommodate the finger contacts 98 of the pivot control structure 100 (see, e.g., Fig.14 ). An example of a pivot control structure 100 is also described below and is used to rotate a pivotable sensor housing at the distal end of the shaft 14.

[0142] exist Figure 3BAlso shown is a display or camera control button 37. It can be used to capture images produced by the image sensor at the distal end of the shaft 14. In some embodiments, the user can press the button 37 using a predetermined pattern or sequence to, for example, turn on or off video recording of an image on a display showing the field of view of the image sensor at the distal end of the shaft 14, record a snapshot of an image on a display showing the field of view of the image sensor at the distal end of the shaft 14, change the brightness of a light emitting element (e.g., LED) at the end of the endoscope shaft 14, or adjust other characteristics of the sensor or displayed image (e.g., white balance, color saturation, digital magnification, etc.). It is preferred to have the sensor characteristics and LED illumination controlled by a processor associated with a graphical user interface connected to the endoscope, rather than by the endoscope PCB itself, in order to reduce the amount and cost of onboard processing power of the endoscope PCB.

[0143] The button 37 can operate an electromechanical switch on the main PCB located in the distal section 30 of the endoscope handle. In order to ensure maximum moisture resistance of the PCB electronic components, it is preferred to use a magnetic or optical sensor assembly to detect the movement of the button 37. Fig.46 As shown in FIG. 5 (showing the relative positions of some of the components within the handle 12), in one embodiment, the Hall effect sensor on the endoscope PCB 518 can be positioned below and near the shaft 38 connected to the button 37. The button 37 can be spring loaded, and the end of the PCB 518 closest to the shaft 38 can be made to include an embedded magnet. As the button shaft 38 is moved closer to or away from the PCB-based Hall effect sensor, the sensor can generate appropriate signals corresponding to the position of the button shaft 38 and the duration of its stay in this position.

[0144] Figure 4 and Figure 5 Shows Figure 3A 20 and the bottom handle section 22 of the handle proximal section 16 shown in FIG. The handle top section 20 and the handle bottom section 22 are shown in an unconnected or disassembled view. The handle proximal section 16 forms a shell-like structure when assembled. The handle bottom section 22 may include a boss 40 that surrounds the bottom section inner wall 42 at a distance from the top surface 46 of the handle bottom section 22. As shown, there is a curved or U-shaped cutout 44 in the handle bottom section 22 that is arranged at an angle that is approximately perpendicular to the top surface 46 of the handle bottom section 22. Two bolt protrusions 47 may be included near the rear of the handle bottom section 22. The two bolt protrusions 47 may extend slightly above the boss 40 and are approximately at an angle perpendicular to the top surface of the boss 40.

[0145] like Figure 4 and Figure 5As shown in , a portion of the handle top section 20 may be sized so that it may be overlapped by the handle bottom section 22 when the handle proximal section 16 is assembled. Figure 4 and Figure 5 3 , the overlapping section 48 can be stepped inward from the handle top section outer surface 50. The height of the overlapping section 48 can be selected so that it is approximately equal to or slightly greater than the distance between the top of the boss 40 of the handle bottom section 22 and the top surface 46 of the handle bottom section 22. In such an embodiment, when fully assembled, the bottom surface 52 of the handle top section 20 (referring to the orientation when assembled) abuts the top of the boss 40 of the handle bottom section 22. Additionally, in such an embodiment, the handle top section outer surface 50 and the handle bottom section outer surface 54 can be flush with each other and form an almost continuous surface with almost no gap between the two. In some embodiments, there can be a small gap (the small gap shown in Figure 3) between the handle top section outer surface 50 and the handle bottom section outer surface 54.

[0146] As shown, the handle top section 20 may include a plug cutout 59 that is shaped and arranged so that they can receive the plug-like protrusion 47 in the handle bottom section 22. The handle top section 20 may include a curved cutout 58 at the butt or proximal portion of the handle top section 20. As shown, the curved cutout 58 can be recessed into the handle top section 20 at an angle that is substantially perpendicular to the bottom surface 52 of the handle top section 20 (referring to the orientation when assembled). When the handle proximal section 16 is assembled, the curved or U-shaped cutout 44 of the handle bottom section portion 22 and the curved cutout 58 of the handle top section portion 20 can together form a generally circular or oval handle void or opening 60, which will be further described below. It should be understood that the use of the terms "cutout", "cut" and the like herein should not be understood to imply that material must be physically removed by a cutting or material removal process. In some embodiments, the curved or U-shaped cutout 44 and the curved cutout 58 can be formed during manufacturing without physically removing material.

[0147] like Figure 4 As shown in FIG, the handle bottom section 22 may include an axle support member 63. Figure 4 The shaft support member 63 in the embodiment has a curved or semicircular portion which generally corresponds to Figure 5 The shaft support member 63 also includes a pillar. The pillar protrudes vertically from the midpoint of the semicircular portion, leaving a semicircular portion of approximately 90° on both sides of the pillar. Protruding vertically from the top of the pillar of the shaft support member 63 toward the distal end of the handle proximal section 16 is a shaft support section 65. The shaft support section 65 may include a recessed portion, and the sensor gear shaft 120 (see Figure 8) can be seated in the recess. When the handle proximal section 16 is fully assembled, the pillar of the shaft support member 63 can be approximately the length of the radius of the semicircular portion. The shaft support member 63, the tooth-like protrusion 62 and the tooth-like protrusion 64 will be further described below.

[0148] like Figure 5 As shown in FIG. 1 , the handle bottom section 22 may alternatively or optionally include curved tooth-like protrusions 62. The curved tooth-like protrusions 62 are complemented by similar tooth-like protrusions 64 included on the handle top section 20. The tooth-like protrusions 62 and the tooth-like protrusions 64 may be arranged so that when the handle proximal section 16 is fully assembled, they are aligned with each other and form an annular or internal gear ring.

[0149] like Figure 4 and Figure 5 As shown in FIG. 4 , the face of the handle bottom section 22 opposite the curved or U-shaped cutout 44 and the face of the handle distal section 20 opposite the curved cutout 58 may include a semicircular opening or void 70. The curved or U-shaped track 72 may be recessed into the edge of the semicircular void 70 along the entire arc of each semicircular void 70, as shown in FIG. Figure 4 and Figure 5 as shown in .

[0150] Figure 6 Shows Figure 3B 21 and the second handle half shell 23 of the handle proximal section 16 are shown in FIG. The first handle half shell 21 and the second handle half shell 23 are shown in an uncoupled or disassembled view. The handle proximal section 16 forms a shell-like structure when assembled. One of the first handle half shell 21 or the second handle half shell 23 may include a slot 41 sized to mate with a cooperating wall extension 43 in the other of the first handle half shell 21 and the second handle half shell 23 to facilitate assembly. Similar to Figure 4 and 5 , Figure 6 The exemplary embodiment of includes curved cutouts 58. These cutouts 58 allow access to the interior volume of the proximal handle segment 16 when the proximal handle segment 16 is assembled.

[0151] It may be useful to be able to track the rotational orientation of the handle proximal segment 16 relative to the handle distal segment 30, the shaft 14, and a sensor or camera at the distal end of the shaft. In embodiments, this may be accomplished through interaction between a Hall effect sensor and an associated magnet. The Hall sensor may be positioned on the handle proximal segment 16, wherein the magnet is located on an internal component within the handle proximal segment 16, or one or more magnets may be positioned in the handle proximal segment 16, wherein one or more associated Hall effect sensors are mounted on a PCB within the handle proximal segment 16. In some embodiments, one or more magnets 51 may be embedded in or attached to a portion of the handle 12. Figure 6 In the example embodiment shown in FIG. 1 , the proximal handle segment 16 includes two magnets 51 that are generally opposite to each other. In other embodiments, a different number of magnets 51 may be used. As shown in the figure, in this case, each of the first handle half shell 21 and the second handle half shell 23 includes a magnet 51 inserted into the inner wall of each half segment. In the example embodiment, the magnet 51 is coupled to a retaining structure 53, which retains the magnet 51 in place in the proximal handle segment 16. The magnet may optionally be constructed of any suitable rare earth or transition metal or alloy thereof.

[0152] Figure 3A The example handle distal section 30 is Fig. 7A 1 is shown isolated from the rest of the handle 12. Fig. 7A The handle distal section 30 is shown from a generally top perspective view. As shown, the spiral ribs 32 and handle raised section 34 described in detail above are visible on the handle distal section 30. As indicated by the seam extending along the vertical center plane of the handle distal section 30, the handle distal section 30 can be constructed as two or more separate parts (30a and 30b in the example embodiment) coupled together by any suitable means (e.g., snap fit, adhesive and / or screws) or a combination of suitable means.

[0153] Fig. 7A The handle distal section 30 also includes Figure 3A When assembling the endoscope 10, as shown in FIG. Figure 3A As shown in FIG, a portion of the handle distal section 30 may be housed within the handle proximal section 16. For example, the housed handle electronics section 80 protrudes proximally from the outer handle distal section 82 (at Figure 3A and Fig. 7A The accommodated handle electronics section 80 will be described further below.

[0154] Between the housed handle electronics section 80 and the outer handle distal section 82 is a minor diameter span 84. As shown, the minor diameter span 84 may include a rounded groove 86 recessed into the outer surface of the minor diameter span 84. In some embodiments, when fully assembled, the minor diameter span 84 of the handle distal section 30 may be disposed within the semicircular opening 70 of the handle proximal section 16. The rounded groove 86 in the minor diameter span 84 and the curved or U-shaped track 72 in the semicircular opening 70 may be aligned with each other. This may allow the handle distal section 30 and the handle proximal section 16 to rotate relative to each other when the endoscope 10 is in use. Optionally, a ball bearing (not shown) or other type of bearing may roll along the rounded groove 86 in the minor diameter span 84 of the handle distal section 30 and the U-shaped track 72 in the semicircular opening 70 of the handle proximal section 16. In a preferred embodiment, an O-ring (not shown) may be placed in the rounded groove 86 of the minor diameter span 84 of the handle distal section 30. An O-ring (not shown) may function as a dynamic seal between the handle proximal section 16 and the handle distal section 30. In such an embodiment, the handle proximal section 16 and the handle distal section 30 may rotate relative to each other while sealing the interior of the handle proximal section 16 from liquids.

[0155] The handle fin or paddle 36 or other protuberance may be used as an orientation marker for the user as the handle proximal portion 16 and the handle distal section 30 rotate relative to each other. Orientation may be checked visually or by touch. In some embodiments, the grip texture on the handle fin / paddle 36 may be different from the spiral rib 32 on the rest of the handle distal section 30 to aid in orientation checking by feel.

[0156] like Fig. 7A As shown in , the handle raised section 34 may include a button 90. In some embodiments, the handle raised section 34 may include more than one button 90, or may not include a button at all. The button 90 may be located elsewhere on the handle distal section 30 or elsewhere on the handle 12. In some embodiments, the handle raised section 34 may include a button 90, and one or more additional buttons 90 may be located elsewhere on the handle 12. In some embodiments, the button 90 may be a mechanically actuated switch including a depressible member that completes or disconnects a circuit when the depressible member is pressed. The button 90 may include a magnetic or Hall effect-based switch by embedding a magnet in a portion of the button near the Hall effect sensor in the handle distal section 30. Other types of buttons or switches may be used. The button 90 may be assigned multiple functions that may be activated by various user manipulations. In some embodiments, one or more of the buttons 90 may be sealed relative to the outer handle section 82 to prevent liquid penetration.

[0157] Button 90 may be an image capture button. In such an embodiment, pressing button 90 may result in recording a photograph of the displayed image generated by endoscope 10. In some embodiments, the user may double-click button 90, long-press button 90, or hold button 90 to cause a display device connected to endoscope 10 to start recording a video. To stop recording a video, the user may double-click button 90, long-press button 90, or release button 90. In some embodiments, the user may only need to press and release button 90 to stop recording a video. In some embodiments, a single press of button 90 by the user while endoscope 10 is recording a video may result in recording a still image without pausing video recording. In other arrangements, a quick press and release of button 90 may trigger recording of a still image, while a longer press and release or press and hold may trigger recording of a video clip.

[0158] The handle raised section 34 may additionally include a slide button recess 92. Fig. 7A As shown in FIG. 1 , the slide button recess 92 is arranged to allow the slide button or finger contact member 98 to move back and forth (see FIG. Fig.14 ), while limiting lateral movement. In some embodiments, the slide button can be a part of a pivot control or pivot control structure 100 (e.g., see Fig.14 ). In some embodiments, comprising Fig. 7A In the example embodiment shown in FIG. 1 , the slide button recess 92 may be slightly curved to conform to the shape of the portion of the handle within which it resides.

[0159] like Fig. 7A As shown in FIG. 1 , the slide button recess 92 may include a plurality of ridges or stops 94 that may engage with corresponding elements on the slide button to provide a series of discrete positive stops as the user moves the slide button forward and backward. Some embodiments may not include ridges 94. In some embodiments, the portion of the pivot control structure 100 (see FIG. 1 ) with which the user may interface may be Fig.12 ) can be achieved by the pivot control structure recess 96 (see FIG. Fig.14 ) is prominent. Fig. 7A In the exemplary embodiment of the present invention, this portion of the pivot control structure 100 includes a finger contact member 98. As shown, the finger contact member 98 may have an inclined profile for ergonomic reasons. The pivot control structure 100 will be further described below.

[0160] Figure 7B and Figure 7CAn alternative embodiment of a recess 35 is depicted which may be used to accommodate the finger contacts 98 of the pivot control structure 100. For clarity, a portion of the handle proximal section 16 and the handle distal section 30 have been removed. Figure 7C Depicted Figure 7B Detailed view of area 7C. Figure 7C As best shown in FIG. 1 , in some embodiments, the recess 35 includes a ridge 94 for stepwise movement of the pivot control structure, similar to Fig. 7A 96 of the slide button recess shown in FIG. Alternatively, the recess 35 may be generally smooth and may be curved to accommodate the travel path of the pivot control structure 100.

[0161] The interior of the distal handle section 30 may include a shelf 95 located below the recess 35. The shelf 95 may have a surface whose profile mimics the profile of the recess 35. The shelf 95 may include one or more ridges or stops 94 to provide a series of discrete limit stops when the user moves the pivot control structure 100 forward and backward. These ridges 94 can interact with one or more arms 97 extending from the pivot control structure 100. The arms 97 can move freely on the smooth and ridge-free portions of the shelf 95 without ridges or ribs 94. When one of the arms 97 encounters a ridge 94, the ridge can abut the corresponding arm of the arms 97 and prevent further displacement of the pivot control structure 100 until a force sufficient to overcome the mechanical interference presented by the ridge 94 is applied. That is, the ridges 94 can form a force barrier that prevents the finger contact 98 from being actuated out of the rest position. Depending on the embodiment, the ridges 94 can be placed in pairs along the face of the shelf 95. Each rib or ridge 94 in the pair of ridges 94 may be positioned approximately the width of an arm 97 of the pivot control structure 100 apart.

[0162] Figure 8 A more detailed illustration of an exemplary handle distal section 30 is shown without the insertion section 14 attached. Figure 8 1 and 2. An example rotation sensing assembly 150 is also shown in FIG. As shown, the handle distal section 30 is manufactured into two separate parts 30a and 30b. In an example embodiment, the two separate parts 30a and 30b of the handle distal section 30 include a plurality of threaded holes 102, which may be threaded. Screws (not shown) or other suitable fasteners may be used to couple the two separate parts 30a and 30b of the handle distal section 30 together. In some embodiments, the two separate parts 30a and 30b may be coupled together by snap fit, ultrasonic welding, adhesives, etc.

[0163] In some embodiments, one of the two separate parts 30a and 30b of the handle distal section 30 may include a peg-like protrusion 104 that fits into a complementary peg-receiving cavity 106 on the other of the two separate parts 30a and 30b. This may help align and / or couple the two separate parts 30a and 30b together. Figure 8 In the embodiment shown in FIG. 1 , the outer handle distal section 82 may be substantially hollow. In some embodiments, the hollow portion of the outer handle distal section 82 may not be sealed against fluid. Figure 8 In the example embodiment shown in , a drain channel 108 can be included, for example, in the handle fin 36. The drain channel 108 can allow any fluid that enters the hollow portion of the outer handle distal section 82 to easily drain. Alternative embodiments can include additional and / or different drain arrangements.

[0164] The handle distal section 30 may also include a rotation sensor holder 110, such as Figure 8 When the endoscope 10 is fully assembled, the rotation sensor holder 110 can hold the rotation sensing assembly 150. As shown, the rotation sensing assembly 150 can include a forward gear 112. The forward gear 112 is arranged around a forward gear shaft 114. Figure 8 As shown in FIG. 1 , a drive gear 116 is also disposed on the forward gear shaft 114, such that rotation of the forward gear 112 also causes the drive gear 116 to rotate. The drive gear 116 may mesh with a sensor shaft gear 118 disposed on the sensor gear shaft 120. As the forward gear 112 rotates, the sensor shaft gear 118 and the sensor gear shaft 120 will also rotate. The use of a gear assembly may allow the attached potentiometer 122 to be placed off-center from the central axis of rotation of the handle distal section 30, which may advantageously allow for central placement of other internal structures (e.g., irrigation catheters, fiber optic bundles, electronic flex cables, or other electronic components).

[0165] like Figure 8 In the example embodiment of FIG. 1 , the sensor gear shaft 120 may include a spline or keyed (eg, D-shaped) portion. The keyed portion may be operably engaged with one or more rotary potentiometers 122. Figure 8 In the exemplary embodiment of FIG. 1 , there are two rotary potentiometers 122. The potentiometers 122 may be mounted or otherwise attached to a portion of a printed circuit board in a mounting element or handle, as described with reference to FIG. Fig.78The potentiometers 122 each include a keyed (e.g., D-shaped) void into which a corresponding keyed portion of the sensor gear shaft 120 mates. As the sensor gear shaft 120 rotates, the resistance of the potentiometer(s) 122 will change proportionally. Since the resistance will predictably change with the amount of rotation of the sensor gear shaft 120, the measured resistance of the potentiometer(s) 122 can be used to determine the amount of rotation that has occurred between the handle proximal section 16 and the handle distal section 30 (and, by extension, the insertion section 14).

[0166] In some embodiments, the housing of each potentiometer 122 may be mounted to an element of the handle electronics section 80 in which it is housed (or other element attached to the handle distal section 30), and thus fixed relative to the handle distal section 30 (and, by extension, the insertion section 14), while the shaft or rotating hub of the potentiometer 122 is connected to the handle proximal section 16. In other embodiments, the housing of the potentiometer 122 may be fixed relative to the handle proximal section 16, while its shaft or rotating hub may be connected to an element of the handle distal section 30 or the handle electronics section 80.

[0167] Figure 8The example embodiment in includes two rotary potentiometers 122 stacked together and rotationally offset from each other. In alternative embodiments, the potentiometers 122 may be spaced apart from each other but share a common axis of rotation (e.g., such that the brushes of the two potentiometers 122 move through a common axis). This arrangement allows the controller to receive resistance values ​​from the two potentiometers 122 to calculate the degree of rotation of the sensor shaft (and ultimately the degree of rotation of the components at the distal end of the endoscope) through a 360-degree rotation with a desired accuracy, thereby helping to eliminate computational "blind spots" when measuring the rotation of components (e.g., a camera) at the distal shaft of the endoscope. Any blind spots created by the position of the brush of one potentiometer 122 at the end of its range of motion can be compensated by the brush of a second potentiometer 122, where the position of the brush of the second potentiometer is not at the end of its range of motion. In alternative embodiments, more than two rotary offset potentiometers 122 may be used. To simplify calculations, the rotational offset between the potentiometers 122 can be 180 degrees, but other angular offsets can be used to achieve the same result, as long as the rotational offset allows any blind spots generated by one potentiometer 122 to be overlapped by the functional range of another potentiometer 122. In alternative embodiments, the gear ratios between the forward gear 112, the transmission gear 116, and the sensor shaft gear 118 can vary depending on the degree of accuracy desired to measure rotation, the sensitivity of the potentiometer 122, and other factors. In alternative embodiments, the rotation sensing assembly 150 can use a belt instead of one or more gears in the gear assembly. For example, the transmission gear 116 and the sensor shaft gear 118 can be replaced by a belt. Other rotation to rotation arrangements known in the art can also be used. In some embodiments, the forward gear shaft 114 can include a keying feature (e.g., a D-shaped portion) that directly engages the potentiometer 122 in operation. Rotation sensors other than the potentiometer 122 can also be used. Alternative embodiments can include rotation sensors such as rotary encoders, rotary variable differential transformers, or other encoding devices. In embodiments using a rotary encoder, the encoder may be a Gray encoder, a magnetic encoder (see, for example, Fig. 9B ), optical encoders, etc.

[0168] In an embodiment, the sensor gear shaft 120 may not extend to the shaft support of the shaft support member 63. Instead, the rotational sensing assembly 150 may be supported by the rotational sensor holder 110. Among other benefits, this arrangement allows an unlimited degree of rotation of the handle distal section 30 relative to the handle proximal section 16. Additionally, as will be appreciated by those skilled in the art, it allows component a of the rotational sensing assembly 150 to be located in an eccentric position. This can provide benefits during assembly. For example, it can simplify flushing the line 434 (see Fig.78 ), power cable 432 (see Fig.78 ) and other layouts.

[0169] In other embodiments, the shaft support member 63 and the potentiometer 122 can be directly connected via a shaft. A splined or keyed shaft on the distal end can extend from the shaft bearing section of the shaft support member 63 and extend through a corresponding splined or keyed (e.g., D-shaped) gap in the potentiometer 122. Since the shaft support member 63 can be fixed relative to the proximal handle section 16, rotation of the distal handle section 30 relative to the proximal handle section 16 will change the resistance measured by the potentiometer 122. As mentioned above, since the resistance will predictably change with rotation of one handle section relative to the other, the resistance measurement can be used to determine the amount of rotation achieved by the distal handle section and ultimately, for example, by Fig.23 The amount of rotation achieved by the distal end or camera assembly 350 of the endoscope is shown in FIG.

[0170] In other embodiments, the rotation sensing assembly 150 may include a rangefinder, which may be disposed on the received handle electronics section 80 (see Fig. 7A ). The inner wall of the handle proximal section 16 (see Figure 4 ) may include a raised surface of variable thickness or variable height that surrounds most or all of the 360° of the inner wall of the handle proximal section 16 and changes thickness or height in a predetermined manner along its circumferential path. As the handle proximal section 16 and the handle distal section 30 rotate relative to each other, the rangefinder may provide a signal to the controller that varies based on the distance to the varying surface (or its varying thickness or height) read by the rangefinder. The signal may be related to the thickness / height or distance measured by the rangefinder relative to a predetermined reference position, in which the surface has a specific thickness or height, and the signal is related to a specific angular rotation of the handle distal section 30 relative to the handle proximal section 16. This distance may be compared to a previous distance to determine the amount of rotation that has occurred. The rangefinder may be any type of rangefinder (e.g., a mechanical position sensor, an acoustic rangefinder, a laser or other optical rangefinder, etc.

[0171] In yet another alternative embodiment, a sensor arrangement similar to an optical mouse can be used. The sensor can be mounted on one of the contained handle electronics section 80 or handle proximal section 16, and can be configured to track the movement of another of the contained handle electronics section 80 or handle proximal section 16. In such an embodiment, the amount and direction of movement sensed by the sensor can be used to determine the amount and direction of rotational displacement that has occurred. In some embodiments, the surface tracked by the sensor can have a reference grid, a plurality of unique indicators, patterns, markings or other distinguishing features that allow the sensor to determine the rotational orientation at startup. Other types of rotation sensing assemblies 150 known to those skilled in the art can also be used in various embodiments.

[0172] like Figure 8 As shown in , the rotation sensor holder 110 of the handle distal section 30 can be shaped so that when the two separate parts 30a and 30b of the handle distal section 30 are coupled together, the rotation sensing assembly 150 can be captured between the two separate parts 30a and 30b. Each side of the rotation sensor holder 110 can include a forward gear shaft groove 124 and a sensor gear shaft groove 126. When assembled, the forward gear shaft groove 124 and the sensor gear shaft groove 126 can serve as bearing surfaces for the forward gear shaft 114 and the sensor gear shaft 120, respectively. Each side of the rotation sensor holder 110 can also include a holder gap 128. The size and shape of the holder gap 128 can be determined so that when the handle distal section 30 is fully assembled, the drive gear 116, the sensor shaft gear 118 and the potentiometer 122 can fit within the rotation sensor holder 110.

[0173] Fig.9A A partially assembled view of the handle 12 of the endoscope 10 is shown. Fig.9A Only the handle bottom section 22 of the handle proximal section 16 is shown in the figure. As shown in the figure, a part of the handle bottom section 22 of the handle proximal section 16 has been cut away. Fig.9A In the embodiment shown in FIG. 1 , the handle distal section 30 is composed of two separate parts 30a and 30b (see FIG. Figure 8 ). For clarity, Fig.9A One of the halves (30b) of the handle distal section 30 is removed. Fig.9A In the embodiment shown in FIG. 1 , the handle distal section 30 is assembled from two separate components 30 a and 30 b (eg, Figure 8 ). For clarity, Fig.9AOne of the halves (30a) of the handle distal section 30 is removed. The housed handle electronics section 80 may be located inside the handle proximal section 16. The outer handle distal section 82 extends beyond the handle proximal section 16 and is exposed to the environment.

[0174] As described above, the rotation sensing assembly 150 is disposed within the rotation sensor holder 110. As shown in the figure, the forward gear 112 of the rotation sensing assembly 150 can be meshed with the ring gear formed by the toothed protrusion 62 and the toothed protrusion 64 (at Figure 5 16). In such an embodiment, when the handle 12 is fully assembled, any rotation of the handle distal section 30 with respect to the handle proximal section 16 causes the forward gear 112 to rotate because it meshes with the ring gear formed by the toothed protrusions 62 and 64. This rotation can then be translated by the rest of the rotation sensing assembly 150, thereby allowing the rotation to be measured by the rotation sensing assembly 150. In a preferred embodiment, the overall gear ratio can be approximately 1:1.

[0175] Alternatively, something like Figure 4 The handle proximal section 16 of the handle proximal section shown in FIG. 1 may include a keyed shaft or a partially keyed shaft attached to the shaft support section 65 of the shaft support member 63, rather than a gear element. The keyed portion of the shaft may be arranged to mate with the hub of one or more potentiometers 122, which are retained in the rotation sensor holder 110. Thus, when the handle distal section 30 rotates relative to the handle proximal section 16, the brushes of the one or more potentiometers 122 can convert the relative position of the handle distal section 30 and the proximal section 16 into a resistance value that can be used to determine the rotational orientation.

[0176] Reference now Fig. 9B , depicts an alternative embodiment of an example handle 12 of the endoscope 10 including a rotation sensing assembly 150 . Fig. 9B Only the handle first half shell 21 is shown in the figure, so that the interior of the handle 12 is visible. In addition, a part of the handle first half shell 21 has been cut away.

[0177] Fig. 9BAn enclosure 431 for a printed circuit board (PCB) is shown, which includes the following electronic components, which are used to process image data from an image sensor at the distal end of the shaft and optionally to provide power to a light source (e.g., an LED) at the distal end of the shaft of the endoscope. The enclosure 431 is an optional structure, as the PCB may also or additionally be encapsulated in a waterproof material. The waterproof material can be any suitable potting material (e.g., polyparaxylene or other chemical vapor deposited polymers) for coating and protecting the various electronic components mounted on the PCB. A magnet 51 is also shown included in the first half shell 21 of the handle. The printed circuit board within the enclosure 431 may include one or more magnetic position sensors 430g, such as a Hall effect sensor or sensor array. As described above with respect to Figure 6 As mentioned, in some embodiments, each of the handle first half shell 21 and the handle second half shell 23 may include a magnet 51 or multiple magnets 51. In an embodiment, two magnets 51 are positioned relative to each other in each half of the handle 16. When the handle proximal section 16 rotates relative to the handle distal section 30, the (multiple) magnets 51 move relative to the closure 431 and the surrounding printed circuit board. When the magnet moves relative to the printed circuit board, the (multiple) magnetic sensors 430g on the printed circuit board can detect the relative position of the (multiple) magnets 51 by changes in magnetic field strength and position. In an embodiment, a single three-axis position sensor is used to sense the magnet 51. Data from the one or more sensors can be transmitted to a controller or processor for converting the sensor data into a rotational position of the handle proximal portion 16 relative to the handle distal section 30 (and relative to the position of the optical sensor or camera at the distal end of the endoscope shaft). Therefore, the displayed image of the camera's field of view can be rotated to any desired orientation without actually moving the camera at the distal end of the endoscope shaft.

[0178] Reference now Fig. 10AIn an embodiment, the insertion section 14 of the endoscope 10 includes a conduit 157 through which an operation or function can be performed. In industrial or medical applications, this conduit 157 can be used to pass instruments through in order to manipulate objects at the end of the insertion section 14 (such as graspers, clamps, forceps, wire baskets, dilators, knives, scissors, magnetic pickups, etc.). Fluids (gas or liquid) can also be transferred to / from an external source from the space in which the insertion section 14 is placed. In medical applications, such a conduit 157 can insufflate a body cavity with gas, exhaust gas from a body cavity, flush a space with liquid, or extract liquid and / or suspended particles from the space. The conduit 157 can optionally carry practical components such as optical transmission components, information transmission components, power transmission components, and mechanical control components, thereby saving space within the insertion section 14 and helping to reduce the overall diameter of the insertion section 14. The optical transmission components can include, for example, optical fiber bundles, strips, optical conduits, light projection elements, and / or the like. The information transmission component may, for example, include a cable bundle or ribbon that connects the imager or image sensor at the end of the insertion section 14 to an image processing unit in the handle 12 or outside the endoscope 10. Such a cable may also provide power to the image sensor. The mechanical control component may include, for example, a push rod, a pull wire, etc. to control the movement of elements near the end of the insertion section 14. This may, for example, include an active flexible distal segment of the insertion section 14 that can be actively flexed by using (multiple) mechanical control components extending from the handle 12. For example, it may also include a rotatable camera or camera mount at the end of the insertion section 14 that can be actively moved by using (multiple) mechanical control components extending from the handle 12.

[0179] In an embodiment, the fluid transport conduit 157 within the insertion shaft or section 14 is configured to enclose the utility components of the endoscope 10, such as fiber optic bundles, communication cables, and mechanical actuators. In other embodiments, the conduit 157 can be connected to a camera assembly 350 at the distal end of the insertion shaft 14 (e.g., see Fig.23 ) fluid communication. Camera assembly 350 may include a camera sensor or imager connected to a communications cable. In this case, the camera sensor and communications cable connections, as well as the internal components of any associated lens assembly, may be sealed to prevent exposure to liquids present within conduit 157. If at least a portion of endoscope 10 is configured as a disposable device (i.e., disposable after use in a medical procedure), it is feasible to allow camera assembly 350, lens assembly, communications cable, mechanical actuators (e.g., pull wires), and fiber optic cables or bundles to be exposed to a "wet" conduit. Thus, any technical challenges to adequately sterilize components within the conduit are eliminated.

[0180] Some components of the endoscope 10, particularly the electronic components located within the handle section 12, should preferably be kept dry. A partition or barrier element 159 between the conduit 157 of the insertion section 14 and the interior of the handle 12 may allow components from the handle 12 to pass through to the conduit 157 of the insertion section 14 (at Fig. 10A The barrier 159 may include a passage (hole, slit, etc.) through which a through-type component 155 such as the utility component described above can pass from the handle 12 to the catheter 157 of the insertion section 14. The passage may be formed to provide a relatively tight fit around the outer surface of the through-type component 155. In some embodiments, an elastomeric gasket, an O-ring, or other similar element may further help prevent fluid from penetrating into the interior space of the handle 12 from the catheter 157 of the insertion section 14. The barrier 159 may include a wall separating the joint region between the handle 12 and the proximal end of the insertion section 14. The joint region may be near the region where the catheter 157 is connected to a catheter port that provides an external fluid connection for the catheter 157. The block 159 may alternatively comprise a block through which a routing passage connects a utility hole in communication with the conduit 157 on a first side of the block to one or more features (e.g., a conduit port) on a second side opposite the first side of the block or on a third side of the block (which, in some embodiments, may be substantially perpendicular to the first side of the block). A passage for a cable, strap, wire, push rod, or other component from the handle 12 may be formed on the second side of the block opposite the first side of the block and may be aligned with the utility hole of the block. The conduit 157 may be formed by a sheath (such as a sheath) connected or attached to the handle 12 of the instrument. Fig.18 In some embodiments, the through-barrier 159 between the handle 12 and the sheath of the insertion section 14 may include a sheath mount for supporting the sheath of the insertion section 14 proximally near its origin at the handle 12 and attaching or connecting it to the handle 12. In some embodiments, the insertion section 14 may include a cannula within which the sheath may be positioned. The cannula may be mounted to the handle 12 via a disconnect feature, thereby allowing the cannula to remain in place while the endoscope 10 (including the handle 12 and the sheath) may be withdrawn from the site.

[0181] Reference now Fig. 10BIn some embodiments, the barrier 159 may include a flexible or elastomeric member 153. One or more pass-through components 155 may extend through the flexible member 153 of the barrier 159 to the conduit 157 of the insertion section 14. In some embodiments, one or both of the entry point and exit point of the pass-through component 155 in the flexible member 153 may be sealed with a sealing member or sealant 151. The sealing member or sealant 151 may prevent fluid from flowing between the conduit 157 and the handle 12. The sealing member or sealant 151 may also hold the pass-through component 155 so that it is prevented from moving relative to its entry point and / or exit point in the flexible member 153. Any suitable sealing member or sealant 151 may be used, such as glue, epoxy resin or other adhesive. In other embodiments, the pass-through component may be solvent bonded, heat bonded, etc. to the flexible member 153. In other embodiments, the flexible member 153 may be formed in place around the feed-through 155 during manufacturing such that a seal is created between the feed-through 155 and the flexible member 153 .

[0182] As the pass-through component 155 moves (e.g., actuating the pull wire to rotate the camera assembly), the flexible member 153 can stretch or flex because the pass-through components 155 are fixed and prevented from shifting relative to their entry and exit points in the flexible member 153 due to the sealing member or sealant 151. Therefore, the entry or leakage of fluid from the conduit 157 into the handle can be substantially or completely prevented while allowing the pass-through component 155 to move back and forth. The pass-through component 155 that remains in a fixed position and does not shift does not necessarily need to pass through the flexible member 153. Instead, these components can pass through a rigid portion of the barrier 159, which may or may not be coupled to the flexible member 153. The flexible member 153 can be constructed as, for example, an elastomeric member, a flexible membrane, a soft wall, a bellows-like arrangement, a diaphragm, etc.

[0183] about Fig. 10A The blocking member 159 described in Fig.11A 160 and may also be referred to as an inner sheath mount 160. As shown, the inner sheath mount 160 includes a distal segment 161a and a proximal segment 161b, which are Fig.11A 160 to show the interior of the inner sheath mount 160. As shown, the distal segment 161a can include a notch 162 on each side of the distal segment 161a. Fig.11A164. As shown in the example embodiment of FIG. 160, a portion of the inner surface 164 of the distal segment 161a (when assembled) can be recessed. An irrigation or suction route passage 166 can also be recessed into the distal segment 161a of the inner sheath mount 160. As shown, the irrigation route passage 166 is located within the recessed surface 164. The irrigation route passage 166 can be in communication with a utility hole 168 on a first end. In an example embodiment, the utility hole 168 can be located substantially near the center of the distal segment 161a (although in other embodiments, the utility hole 168 need not be centered), within the recessed surface 164.

[0184] The proximal section 161b of the inner sheath mount 160 may also include notches 170 in its right and left sides similar to the notches 162 recessed into the distal section 161a. The notches 170 may extend through the proximal section 161b. The notches 162 and 170 of the inner sheath mount 160 may be sized to receive the protrusions of the handle distal section 30, which may help retain the inner sheath mount 160 in place when the endoscope 10 is fully assembled.

[0185] The proximal section 161b may also include a raised portion 172 on the inner face (when assembled). As shown, the raised portion 172 has an outer dimension similar to the concave surface 164 in the distal section 161a. When assembled, the raised portion 172 may be pressed into the concave surface 164 to couple the distal section 161a and the proximal section 161b together. In some embodiments, glue or other suitable adhesive between the concave surface 164 and the raised portion 172 may be used to bond the proximal section 161b to the distal section 161a. This may also be used to create a hydraulic seal between the two components.

[0186] The proximal section 161b can include many other features. As shown, the proximal section 161b includes an irrigation or suction passage 174. When the proximal section 161b is mated with the distal section 161a, the irrigation or suction passage 174 can be located in alignment with the second end of the irrigation route channel 166. When the endoscope 10 is used, the irrigation or suction fluid can flow between the utility hole 168 and the irrigation passage 174 via the irrigation route channel 166.

[0187] like Fig.11A As shown in the exemplary embodiment of FIG. 1 , the proximal section 161b of the inner sheath mount 160 may include a sheath mount slit 176. As shown, the sheath mount slit 176 may be horizontally oriented (orientation refers to the horizontal orientation of the sheath mount slit 176). Fig.11A 161b) and is located in the proximal section 161b of the inner sheath mount 160, generally aligned with the utility aperture 168. In alternative embodiments, the sheath mount slit 176 may be oriented differently. Fig.11AIn the exemplary embodiment of FIG. 1 , the sheath mount slot 176 extends through the entire proximal section 161 b at an angle that is substantially perpendicular to the plane of the interior face of the proximal section 161 b (when assembled).

[0188] The proximal section 161b of the inner sheath mount 160 may also include a plurality of apertures 178. Fig.11A In the example embodiment of the embodiment of the invention, the orifice 178 is a small diameter hole that extends through the entire proximal section 161b and can be used to allow pulling or pushing of a cable or wire that passes from within the handle to the distal end of the endoscope 10. The proximal section 161b can also include a fiber optic passage 179. In the example embodiment, the orifice 178 and the fiber optic passage 179 are angled perpendicular to the interior face of the proximal section 161b (when assembled). In alternative embodiments, the orifice 178 and the fiber optic passage 179 can be angled differently or can have different diameters. As shown, the orifice 178 is arranged around the sheath mount slit 176. When the inner sheath mount 160 is fully assembled, the sheath mount slit 176 and the orifice 178 are aligned with the utility hole 168 of the distal section 161a.

[0189] In alternative embodiments, the shape, location, size, etc. of some features of the baffle, pass-through barrier, or inner jacket mount 160 may be different. The pass-through barrier or inner jacket mount 160 may include additional features or may omit certain features. In some embodiments, there may be a greater or lesser number of apertures 178. In some embodiments, the apertures 178 may not be spaced in a uniform pattern. Fig.11A There may be more than one flushing passage 174. In some embodiments, the inner sheath mount 160 may be associated with or include a gasket to further prevent fluid penetration into sensitive areas within the handle of the endoscope.

[0190] The handle electronics section 80 (see, e.g., Fig. 7A ) is configured to enclose mechanical and electronic components that are preferably protected from excessive fluid penetration. (Small amounts of liquid or moisture will not necessarily prevent normal mechanical or electrical operation of the endoscope, particularly where the electronic components are coated with a moisture barrier film). The handle distal outer section 82 (pivot control housing) is configured to house the pivot control structure and actuation cables for controlling movement of the camera assembly in the distal end of the endoscope shaft or insertion shaft, and can be exposed to liquids with relatively minimal effect on the operation of the endoscope. Therefore, it is more important to maintain a liquid seal between the handle electronics section 80 and the handle distal outer section 82. Fig.13 and Fig.14The septum or pass-through barrier shown in FIG. 2 (such as seal 210) can be configured to provide a tight seal (e.g., an elastomeric seal) around an electronic flex cable, fiber optic bundle, or other structure that must pass from the distal end of the endoscope to its proximal end before exiting. Fig.11A and Fig.14 The through-type barrier shown in FIG. 1 (such as inner sheath mount 160) may allow for less sealing, particularly as it may be applied to any pull wires or cables that pass from the pivot control structure through the distal end of the endoscope shaft. Any fluid that penetrates the handle distal section 82 may be allowed to pass through one or more drainage holes or passages (e.g., Figure 8 The passage 108 shown in FIG. 1 exits the housing.

[0191] In an alternative embodiment, a pass-through barrier 159 (see FIG. 15A ) between the handle distal section or pivot control housing 82 and the shaft of the endoscope is provided. Fig. 10B ) may include a fully sealed structure that also allows movement of a pull cable or actuation cable extending from the pivot control housing to the distal end of the endoscope shaft. For example, the through-type barrier may include a flexible (or soft) diaphragm, a pleated elastomeric diaphragm, an accordion-structured rubber sleeve, a bellows structure, or an otherwise displaceable diaphragm that is attached to the housing at its periphery, forms a fluid-tight seal around any structure passing through it near its central region, and its central region can freely move back and forth distally and proximally to allow free movement of any pivot control cables passing through it. With a more complete seal at this portion of the endoscope, the need for a secondary seal between the pivot control housing and the handle electronics section 80 can be reduced or eliminated.

[0192] Fig. 11B An alternative embodiment of a septum or pass-through barrier 159 including a flexible member 153 is depicted. As shown, the pass-through barrier 159 includes a rigid structure 167 and a flexible member 153. The rigid portion or structure 167 can act as a frame to which the flexible member 153 is attached or fused. In some embodiments, during manufacturing, a dual molding process can be used to couple the flexible member 153 and the rigid portion or structure 167 together. The rigid structure 167 can include one or more mating features 173 that can be sized to mate with cooperating mating features of the handle distal segment 30 (e.g., see Fig.15 In some embodiments, the interaction of the mating feature(s) 173 with a cooperating portion of the handle distal section 30 (see, e.g., Fig.15 ) can create a seal between the pass-through barrier 159 and the distal section of the handle (see, for example, Fig.15 ).

[0193] Now also refer to Fig. 11C To help create this seal, a gasket member 163 may be included around the perimeter of the pass-through barrier 159. Such a gasket member 163 may be provided along an outer edge 165 ( Fig. 11B ) is placed. Alternatively, during manufacturing, a dual molding process can be used to attach the gasket member 163 to the through-type barrier 159. The gasket member 163 can completely surround the rigid structure 167 and can be formed of a compressible or elastomeric material.

[0194] Still reference Fig. 11B and Fig. 11C , the flexible member 153 includes a plurality of pass-through elements. A plurality of apertures 178 are included in the example flexible member 153. Additionally, the flexible member 153 may include an optional illumination or fiber optic pathway 179. For example, in embodiments where illumination is provided by one or more LEDs at the distal end of the endoscope shaft, such an illumination pathway 179 may not be required. Additionally, a slit or slot 177 may be included in the flexible member 153. In an example embodiment, the slit 177 extends from the flexible member 153 through the rigid structure 167 to the edge of the pass-through barrier 159.

[0195] The through-type elements and passages in the through-type barrier 159 may also be disposed in the rigid frame structure 167 of the through-type barrier 159. For example, it may be desirable that the through-type elements or passages associated with fixed or non-displaced components are disposed in the rigid structure 167 of the through-type barrier 159. In the example embodiment, the rigid structure passage 169 is shown as providing a passage through the rigid structure 167.

[0196] A catheter attachment site or port 256 may also be included on the through-barrier 159. As shown, the catheter attachment port 256 protrudes from the rigid structure 167 and optionally includes a barb fitting to which a flexible tube or catheter may be secured. The catheter attachment site 256 may include an internal lumen extending through the through-barrier 159. Fig. 11B In the example embodiment shown in FIG. 1 , the internal lumen is an irrigation or aspiration passage 174 through which fluid can be transferred from one side of the through-barrier 159 to the other.

[0197] Now also refer to Fig.11D, when assembled, various through-type components 155 can pass through the orifices 178, passages 179 and slits 177 in the through-type barrier 159. Once these through-type components 155 have been located in the through-type barrier 159, a sealing member or sealant 151 can be optionally applied to one or both of the entry points and / or exit points of the through-type components 155 in the through-type barrier 159. In an exemplary embodiment, the sealing member or sealant 151 is a fixing agent such as an adhesive, but any suitable sealing member or sealant can be used in other embodiments. The sealing member or sealant 151 can prevent fluid communication through the through-type elements in the through-type barrier 159. Additionally, when applied to the flexible member 153, it can fix the through-type components 155 so that they will not be displaced relative to their entry points and exit points in the flexible member 153. As a result, in this case, the displacement of the through-type component 155 will cause the flexible member 153 to also move back and forth.

[0198] Fig.12 1 shows an example exploded view of an embodiment of a pivot control structure 100. The pivot control structure 100 can control the pivoting of the structure. The structure can be, for example, in the insertion section 14 (see Figure 3A ) at the distal end of the camera assembly 350 (see Fig.23 ). In alternative embodiments, the pivot control structure 100 may be used to alternatively or additionally control the flexure of the flexible section of the insertion section 14. Some embodiments of the pivot control structure 100 may include transmissions, motors, multi-bar linkages, turntables, etc. that are different from the embodiments disclosed below.

[0199] Fig.12 The example pivot control structure 100 in FIG. 1 is shown in exploded view. The finger contact member 98 described in detail above is shown separated from the pivot control structure 100. As shown, the bottom surface of the finger contact member 98 can optionally include a plurality of latch protrusions 180. Fig.12 In the exemplary embodiment shown in FIG. 1 , there are four peg projections 180 that are generally cylindrical in shape (the number and shape of the peg projections may vary). The finger contact member 98 additionally includes a finger contact member slot 182 located on a lower surface of the finger contact member 98 .

[0200] Below the finger contact member 98, an example embodiment of a pivot portion 184 of the pivot control structure 100 is shown. The top of the pivot member 184 of the pivot control structure 100 may include a slider 186. Protruding from the center of the slider 186 is a finger contact member post 188 that is arranged to mate with the finger contact member slot 182. Optionally, a finger contact member peg hole 190 is on each side of the finger contact member post 188. When the finger contact member 98 is attached to the pivot control structure 100, the finger contact member slot 182 can be slid onto the finger contact member post 188 on the slider 186. Additionally, when assembled, the peg protrusion 180 of the finger contact member 98 (if present) can be seated in the finger contact member peg hole 190 of the slider 186.

[0201] The pivot control structure 100 can interact with one or more features of the endoscope to allow it to be locked or retained in a desired orientation. As shown, the bottom surface of the slide 186 of the pivot member 184 can optionally include one or more grab bars or stop elements 192. In other embodiments, multiple grab bars 192 can be provided along the bottom of the slide 186, arranged to engage with opposing raised features or ridges 94 on the handle 12.

[0202] The catch or stop element 192 can interact with the raised feature or ridge 94 of the slide button recess 92 of the handle boss 32 described above (at Fig. 7A 94). As the pivot control structure 100 is displaced by the user, the space between the ridges 94 can act as a stop into which the grip bar 192 of the slider 186 can be "parked". This helps prevent the pivot control structure 100 from drifting or moving once the user has moved the pivot control structure 100 to the desired position and released it. This also helps ensure that the pivot control structure 100 is not accidentally displaced during use of the instrument. In an alternative embodiment, and as described above with respect to Figure 7C As mentioned, in some embodiments, the pivot control structure 100 may include an arm 97 that acts as a grab bar or stop element 192 .

[0203] As shown, the pivot member 184 of the pivot control structure 100 includes a curved inner shield 194. The inner shield 194 is stacked below the slide 186 and, when assembled, is below the handle housing. The support 196 can span the distance between the top surface of the inner shield 194 and the bottom surface of the slide 186. In some embodiments, the grab bar 192 can be located on the top of the inner shield 194. In such an embodiment, the ridge 94 described above can be located on the inner wall of the housing of the handle distal section 30 so that the ridge 94 can form a stop for the grab bar 192 on the inner shield 194. As described above, this allows the pivot control structure 100 to be "parked" in a desired position.

[0204] Extending from the bottom surface of the inner shield 194 may be a pivot arm 198. In an exemplary embodiment, the pivot arm 198 includes two mechanical cable attachment points or holes 202. One hole 202 is located on one side of the pivot axis 204, while the second hole 202 is located on the other side of the pivot axis 204. In the illustrated embodiment, forward movement of the slider 186 causes the mechanical cable connected to the lower hole 202 to retract proximally, while rearward movement of the slider 186 causes the mechanical cable connected to the upper hole 202 to retract proximally. In order to accommodate relatively unimpeded passage of optical fiber or electrical cables from the proximal end of the handle to the distal end of the handle, the pivot arm 198 may, for example, have a notch on its pivot axis 204 so that the passing cable can freely rest on the pivot axis 204 (or a concentric sleeve or hub around the axis 204). This arrangement will allow passage with minimal lateral or vertical displacement.

[0205] Reference now Fig.12 and Fig.14 Both, the pivot arm 198 is configured to have a lateral displacement section 199 containing a pivot area 200 and a pivot axis 204. Thus, a hub or sleeve containing the pivot axis 204 (when assembled) is shown as a bearing surface on which a passing cable 250 can rest. The lower portion of the pivot arm 198 extends downward from a position below the hub or sleeve of the pivot axis 204. In some embodiments, the lower portion of the pivot arm 198 can optionally be vertically aligned with the upper portion of the pivot arm 198 so that the mechanical cable connected to the point or hole 202 is also vertically aligned. In other embodiments, one or more cables (e.g., cable 250) can travel around (or through) the hub of the pivot axis 204 in various other ways so that its path is minimally obstructed by the pivot arm 198 of the pivot control structure 100.

[0206] Optionally, the auxiliary through-type seal provides additional blocking between the fluid that may penetrate into the housing of the handle distal section 30 and the housing of the handle proximal section 16 (the electronic component section 80 can be contained in the housing). The seal may include an orifice, hole or slit, and components such as but not limited to optical fiber bundles, electronic cables and / or fluid conduit pipes can pass through these orifices, holes or slits. When these components pass through the seal, the size of these holes or slits can be determined to provide a tight fit on these components. In an embodiment, the auxiliary through-type seal is formed by rubber or other elastomeric materials to enhance its fluid sealing properties. In some embodiments, for example, those embodiments including a through-type barrier 159 comprising a flexible member 153 may not include the auxiliary through-type seal. In such an embodiment, the electronic component section 80 and the external handle section 82 can be the same volume or a connected volume.

[0207] Fig.13An example embodiment of an auxiliary seal (ie, sealing member 210) is shown. Fig.13 As shown in , the shape of the sealing member 210 may be substantially rectangular. Fig.13 As shown in , one end of the seal 210 can have a first (e.g., rectangular) shape, while a second end of the seal member 210 can have a second shape (e.g., having rounded edges or being rounded). This can provide advantages during assembly to ensure that the seal member 210 is installed in the correct orientation. The seal 210 may include multiple openings. In an example embodiment, the seal member 210 includes an opening 212 for a fiber bundle (e.g., an illumination fiber), an opening 214 for a flexible cable (i.e., an electronic cable), and an opening 216 for a fluid conduit (e.g., a flushing line). In Fig.13 In the exemplary embodiment shown in FIG. 2 , the illumination fiber orifice 212, the flex cable orifice 214, and the flushing line orifice 216 extend through the entire sealing member 210. The illumination fiber orifice 212 has a relatively small diameter to match the diameter of the fiber bundle or light pipe. The flex cable orifice 214 is a slit that matches the size and shape of the electronic flex cable. The flushing line orifice 216 is cylindrical and has a larger diameter than the illumination fiber orifice 212. The illumination fiber orifice 212, the flex cable orifice 214, and the flushing line orifice 216 are arranged substantially perpendicular to the front face (relative to the front face) of the sealing member 210. Fig.13 ) extends through the sealing member 210 at an angle. In alternative embodiments, the apertures in the sealing member 210 may be different in number, size, or shape. In some embodiments, for example, the sealing member 210 may include additional holes for wiring to the button 90.

[0208] like Fig.13 As shown in the exemplary embodiment of FIG. , the sealing member 210 may also include a plurality of gasket arms 218. Fig.13 In the example embodiment of the embodiment of the present invention, the gasket arm 218 protrudes away from the top and bottom surfaces of the sealing member 210 near the rear edge of the sealing member 210. As shown, there can be two gasket arms 218. In some embodiments, the gasket arm 218 can be straight. In the example embodiment, the gasket arm 218 includes two straight sections connected by an arcuate section, which bends the gasket arm 218 away from the sealing member 210.

[0209] Fig.14 An example embodiment of one half (30a) of the handle distal section 30 is shown. As shown, the inner sheath mount 160, the pivot control structure 100, and the seal member 210 are assembled and placed within the illustrated half (30a) of the handle distal section 30. A flexible cable 250 (e.g., a flexible electronic communication / power cable) is also shown. Fig.14In the exemplary embodiment shown in FIG. 1 , the distal section 161a of the inner sheath mount 160 includes a sheath mounting hub 252. The sheath mounting hub 252 extends distally along the same axis as the utility hole 168 (see FIG. 1 ). Fig.11A 160a). In an exemplary embodiment, the sheath mounting hub 252 can be hollow and substantially cylindrical. The inner diameter of the sheath mounting hub 252 can optionally be approximately equal to or slightly larger than the diameter of the utility hole 168. In an exemplary embodiment, a sheath mount mounting tab 254 protrudes upwardly from the outer surface of the sheath mounting hub 252. The sheath mount mounting tab 254 is located beside the face of the insertion side piece 160a from which the sheath mounting hub 252 protrudes. The mounting tab 254 can be used to properly orient the sheath when it is mounted to the sheath mounting hub 252 (e.g., Fig.18 312 ) and may optionally also serve as a locking member to secure the sheath to the sheath mounting hub 252 and the sheath mount 160.

[0210] In other embodiments, the sheath mount tabs 254 may be disposed on an interior surface of the sheath mount hub 252. This may be desirable because it eliminates the need to nest the inner sheath mount hub 252 within the interior of the sheath, thereby eliminating the limitation in the diameter of the conduit of the sheath. Thus, higher flow rates may be obtained through such a conduit. Alternatively, the sheath mount tabs 254 may not be included in some embodiments. The sheath may alternatively be oriented and secured to the sheath mount hub 252 with any suitable fastener (not shown).

[0211] As shown, the flex cable 250 extends through the inner sheath mount 160. The flex cable 250 passes through the sheath mounting hub 252 into the distal section 161a of the inner sheath mount 160. The flex cable 250 is also routed through the sheath mount slot 176 of the proximal section 161b.

[0212] The proximal section 161b of the inner sheath mount 160 includes a fluid conduit attachment site or port 256. The fluid conduit attachment site 256 may be a hollow, generally cylindrical protrusion extending from the proximal section 161b of the inner sheath mount 160 toward the right of the page (relative to the left). Fig.14 ). Flush the pipe of line 434 (see Fig.78 ) can slide on the outer surface of the fluid conduit port 256, which can optionally have barbs to help retain the installed section of the pipe. As shown, the right edge of the fluid conduit port 256 can be chamfered in a manner that also helps to easily install the pipe segment into the port 256. Additionally, as Fig.14As shown in , the proximal end of the fluid conduit port 256 tapers to a slightly larger diameter than the rest of the surface of the port 256. This can act as a barb and help ensure that once attached, the tubing of the flush line 434 (see Fig.78 ) is not easy to fall off. In an alternative embodiment, the catheter port 256 can extend and be fitted into the irrigation line orifice 216 of the sealing member 210. Then, the barb / attachment site of the irrigation line 434 can be placed on the sealing member 210.

[0213] like Fig.14 , the pivot control structure 100 can be pivotally coupled to the handle distal section 30. As shown, the pivot shaft 204 extends through the pivot shaft hole 200 in the pivot arm 198 of the pivot control structure 100. The end of the pivot shaft 204 inserted into the far wall of the handle distal section 30 (or the end of the surrounding hub) can be seated in a pivot bearing 260 protruding from the inner wall of the handle distal section 30. When fully assembled, the opposite end of the pivot shaft 204 can similarly be seated in a pivot bearing 260 protruding from the inner wall of the other half (30b) of the handle distal section 30.

[0214] like Fig.14 , the slider 186 and inner shroud 194 of the pivot control structure 100 may be offset from each other by a distance slightly greater than the thickness of the wall of the handle distal section 30 by a post 196. The post 196 may extend through the pivot control structure recess 96 described above. The curvature of the slider 186 and inner shroud 194 may be selected so that the slider 186 and inner shroud 194 may freely move forward and backward with input from the user without interfering with the wall of the handle distal section 30 housing. The length of the pivot control structure recess 96 may determine the amount of pivot displacement that a user may generate with input to the pivot control structure 100.

[0215] In some embodiments, the walls of the pivot control structure recess 96 can apply friction to the post 196. In such embodiments, the friction can allow the pivot control structure 100 to be "parked" in a certain position. In such embodiments, the walls of the pivot control structure recess 96 can be made of a high friction material, such as rubber or other elastomeric material. In such embodiments, the pivot control structure 100 may not need to include the grab bar 192 or ridge 94 described above.

[0216] The endoscope 10 may also include a mechanical pivot actuator in the form of a pull cable or wire, a belt, or a push rod. The actuator may be any solid, braided, or other elongated member extending from the handle of the endoscope 10 to the movable element at the distal end of the insertion section. The elongated member may be flexible or substantially rigid. The elongated member may be circular (as in the example of a cable), oval, relatively flat, or may have any other shape or cross-section. In some embodiments, the actuator may be a belt.

[0217] In an endoscope having a pannable camera or camera mount at or near the distal end of the shaft or insertion section, the pannable camera or camera mount can be rotated using a pull wire or push rod. In a pull wire embodiment, the panning cable can be attached or connected to the cable attachment hole 202, or looped through the cable attachment hole. In some embodiments, two panning cables can be attached to each cable attachment hole 202. In a preferred embodiment, the two ends of a single panning cable are attached to each cable attachment hole 202, thereby creating a loop. Alternatively, a single cable can be looped through the cable attachment hole 202 at approximately the midpoint of the cable attachment hole, and then the end of the cable is connected to the rotatable camera or camera mount distally. The panning cable can extend from the cable attachment hole 202 in the pivot arm 198 and be routed through one or more apertures 178 in the proximal section 160b of the inner sheath mount 160. The rocking cable may then extend through the utility hole 168 and through the conduit formed by the inner sheath, optionally along the length of the electronic flex cable 250 and / or fiber optic bundle. By pivoting the pivot control structure 100, the rocking cable(s) connected to one of the cable attachment holes 202 will be pulled, while the cable(s) connected to the other attachment hole 202 will relax. The pivot control structure 100 may be used to selectively rotate a distal pivoting object in the insertion section of an endoscope by attaching the rocking cable(s) associated with one cable attachment hole 202 to one side of the pivot point, and attaching the rocking cable(s) associated with the other cable attachment hole 202 to the opposite side of the pivot point. In other embodiments, a similar wiring mechanism may be used to actively flex the flexible distal segment of the insertion section.

[0218] In some embodiments, the pivot arm 198 of the pivot control structure 100 may be pivoted by a transmission. In such embodiments, the finger contact member 98, the finger contact member support 188 (see FIG. Fig.12), slide 186, vertical strut 196 and inner shield 194. At least a portion of the user input gear contained in the handle distal section 30 can protrude from the handle raised section 34. The user input gear can rotate about a pivot axis disposed in the handle distal section 30. This rotation can be initiated by the user, for example, by the user's finger or thumb. The user input gear can mesh with a pivot shaft gear disposed about the pivot axis 204 of the pivot arm 198 of the pivot control structure 100. In such an embodiment, when the user input gear is rotated, the pivot shaft gear and the pivot arm 198 are also caused to rotate, thereby acting on the above-mentioned pivot actuator (e.g., a rocking wire, an actuation wire, or a pull wire). In some embodiments, there can be an intermediate gear or any number of intermediate gears between the user input gear and the pivot shaft gear to provide any desired gear reduction to meet movement accuracy and ergonomic requirements.

[0219] In other embodiments, the pivot arm 198 can be rotated by a motor (e.g., a brushless motor, a stepper motor, etc.). The rotation by the motor can be controlled by one or more user input devices, such as buttons 90. In embodiments including at least one button 90, the button 90 or buttons 90 can control the speed and direction of movement of the pivot arm 198.

[0220] In some embodiments, the pivot shaft 204 can protrude outside of the handle distal section 30. In such embodiments, the pivot shaft 204 (or a covering hub or sleeve) can be directly rotated by the user. In some embodiments, the portion of the pivot shaft 204 that protrudes from the handle distal section 30 can include a knob, dial, crank, etc., so that the user can easily rotate the pivot shaft 204 by grasping and rotating the knob, dial, crank, etc.

[0221] like Fig.14 As shown in the figure, the seal 210 is positioned in the gasket recess 270. The gasket recess 270 may include a gasket arm recess 272. As mentioned above, various components can pass through the seal member 210. As shown, the printed circuit board 430a (e.g., see FIG. 4) connected to the electronic component section 80 housed in the proximal section 16 of the handle is Fig.78 ) can pass through the flex cable aperture 214 of the seal member 210 and extend beyond the seal member 210, through the housing and sheath mount 160 of the handle distal section 30, and ultimately to the distal side in the insertion section of the endoscope. Fig.78 ) and fiber bundles (e.g., illumination fibers 364, see Fig.78) may pass through their respective irrigation line ports 216 and fiber bundle ports 212 and extend through the housing of the handle distal section 30 similar to the flex cable 250. In some embodiments, the sealing member 210 may not be included. Conversely, the electronics section 80 may not be separate from the rest of the handle 12. In such embodiments, the enclosed printed circuit board 431 (e.g., see Fig.15 ) can be coated or encapsulated with a protective coating or layer, such as potting. In embodiments including seal 210, a printed circuit board (e.g., see Fig.15 ) can still be encapsulated with a protective coating or layer. Additionally or alternatively, the inner sheath mount 160 may include a similar FIG. 11B to FIG. 11C 153 of the flexible member shown in the figure forms a seal around any pass-through component (e.g., flexible cable 250, actuator / cable, lighting fiber optic, etc.) that passes through the inner sheath mount 160 and shifts when any pass-through component that passes through the inner sheath mount 160 is displaced.

[0222] Fig.14 Only one half of the gasket recess 270 is shown in FIG. The other half of the gasket recess 270 may be located on another half of the handle distal section 30 (eg, 30b, see FIG. Figure 8 ). When fully assembled, the sealing member 210 is captured between the two halves of the gasket recess 270. When fully assembled, the sealing member 210 can ensure that fluids that may be present in the handle distal section 30 can be prevented from penetrating into the handle proximal section 16, which contains electronic components including the electronic component section 80. The sealing member 210 can be made of a suitable compliant material (e.g., an elastomer) or other suitable gasket material, and can be pressed into the gasket recess 270 to ensure a tight seal. In some embodiments, the sealing member 210 can be held in place using an adhesive.

[0223] Fig.15 Another example embodiment of one half (30a) of the handle distal section 30 is shown. As shown, the through-blocking member 159 and the pivot control structure 100 are assembled and placed in the illustrated half (30a) of the handle distal section 30. The enclosure 431 of the printed circuit board that has been encapsulated with the protective material 752 is also shown in place within the portion 30a of the handle distal section 30. In some embodiments, the protrusion 430h can be a ribbon or flexible cable 250 (e.g., see Fig.14). The printed circuit board can be connected to the components at the distal end of the shaft 14 by one or more strip cables passing through the bulkhead or through-block 159. These cables may or may not need to slide back and forth slightly through the bulkhead to accommodate rotational movement of the sensor or camera housing at the distal end of the endoscope shaft, or if the shaft 14 is a flexible shaft, to accommodate flexure and extension of the shaft. Alternatively, the PCB may include an extension 430h of the PCB itself that extends through the through-block 159 into the shaft or insertion section 14. In some embodiments, the printed circuit board and its extension 430h can be similar to those described with respect to Fig.43 and Fig.44 or Fig.69 The sealant 151 is shown in place around the protrusion 430h. In some embodiments, the pass-through barrier 159 may include a peripheral gasket 163 (e.g., see Fig.11D ). The through-blocker 159 can be coupled to the handle distal section 30 in a variety of ways, including but not limited to adhesives, epoxies, glues, solvent bonding, press fits, and the like.

[0224] Fig.15 The pivot control structure 100 is similar to Fig.12 and Fig.14 However, the pivot control structure 100 may include an arm 97 that is similar to the pivot control structure shown in FIG. Figure 7C Additionally, in this particular embodiment, the pivot arm 198 of the pivot control structure 100 does not include a pull wire attachment hole 202 (see, e.g., Fig.14 ). Instead, a fastener 203 or similar structure including an eyelet 201 can be attached to or as part of the pivot arm 198. A pull wire can be attached to the pivot arm through the eyelet 201, and the pivot control structure 100 can be used to actuate the pull wire, for example, to bend the flexible shaft or the insertion section 14, or to rotate a camera assembly in the insertion section 14. The pull wire can pass through the flexible member 153 of the pass-through barrier 159 to actuate components in the insertion section 14.

[0225] like Fig.15 As shown in , the pass-through barrier 159 may be the only barrier separating the insertion section 14 from the electronic components housed in the handle distal section 30 and the proximal section 16. The sealing member 210 may not be included (e.g., see Fig.14 ). In some embodiments, the electronics section 80 may not be separate or fluidically isolated from the rest of the handle 12. Fig. 11C As mentioned, in some embodiments, the pass-through barrier 159 may include a peripheral gasket member 163 to provide additional sealing.

[0226] Fig.17 An example embodiment of an outer sheath, trocar, or cannula mount 300 is shown. Fig.16A and Fig. 16B As shown in , an outer sheath, trocar or cannula 318 may be employed to provide additional protection for components in the distal end of the insertion section, or to allow a user to withdraw the insertion section of the endoscope while leaving the cannula 318 in place to allow the insertion section of the endoscope to be reinserted later. As shown, the cannula mount 300 may have a frustoconical shape, with a larger diameter section formed proximally for mounting the trocar or cannula 318 on the inner sheath 312 (e.g., see Fig.18 ) connector (e.g., a bayonet mount). The cannula mount hole 302 can extend through the cannula mount 300 to merge with the cannula channel. The cannula or outer sheath mount hole 302 can be configured to receive and retain a cannula 318. The cannula 318 can be configured to act as a sleeve on the inner sheath 312 of the insertion section, wherein the inner sheath defines the axis of the endoscope or arthroscope.

[0227] As shown, the female bayonet mount 304 includes two slots 306. The two slots 306 can optionally have different sizes to ensure the correct orientation of the cannula 318 relative to the mating (male) connector on the distal portion of the handle distal section 30. In some embodiments, the slots 306 of the female bayonet mount 304 can include a serif into which the male bayonet mount 308 can be spring loaded using, for example, a Belleville washer. In such an embodiment, the spring-loaded connection can help ensure that the two pieces (cannula 318 and handle distal section 30) are more securely locked together.

[0228] In some embodiments, the cannula mount 300 may include alignment features thereon so that the cannula 318 is properly oriented with the cannula mount 300 during assembly and, when installed on the inner sheath 312 of the insertion section, ultimately aligns with the inner sheath 312 (e.g., see Fig.18 ) is correctly oriented. Fig.17 In the example embodiment of the embodiment of the present invention, the outer sheath or trocar mount tab 310 can protrude from the inner wall of the outer sheath mount hole 302. The outer sheath mount tab 310 can extend from the distal side of the concave bayonet mount portion 304, which can then be used to align the bayonet mount 300 with the cannula 318 having a matching slot during assembly. Alternatively, the need for such a feature can be eliminated by coupling the outer sheath or cannula 318 and the cannula mount 300 with a suitable fixture.

[0229] Fig.18A partial cross-sectional view of an example embodiment of a distal side of the handle distal section 30 is shown. An inner sheath 312 is mounted on the sheath mounting hub 252 of the inner sheath mount 160. The inner sheath 312 includes a sheath mount recess 314. The inner sheath mount recess 314 can be sized to receive the sheath mount tab 254 on the sheath mounting hub 252. In such an embodiment, the sheath mount tab 254 and the inner sheath mount recess 314 can ensure that the inner sheath 312 is properly oriented on the endoscope 10.

[0230] Inner sheath 312 (and / or outer sheath, trocar or cannula 318, see Fig.17 ) can be made of any of steel, a variety of hardened plastics, or other rigid durable materials. Alternatively, the inner sheath 312 or a portion thereof can be flexible, thereby allowing the insertion section of the endoscope to be bent as needed to be inserted into a non-site line target area. In these embodiments, the user can forgo the use of an outer sheath or cannula 318, or the cannula 318 itself can also be made of similar flexible materials.

[0231] exist Fig.18 In the example embodiment shown in FIG. 1 , the male bayonet mount 308 is also visible. The male bayonet mount 308 may include two prongs 316. The prongs 316 may be sized to fit within the legs of the L-shaped slot 306 of the female bayonet mount 304, also now referred to as Fig.17 The outer sheath 318 and cannula mount 300 can be coupled to the handle distal section 30 by aligning the detents 316 with the slots 306, pressing the bayonet mount over the detents 316, and then rotating the bayonet mount to lock it into place. As shown, the two detents 316 are optionally sized differently so that the outer sheath or trocar mount 300 can have only one possible orientation when coupled to the handle distal section 30.

[0232] Now still referring to Figures 16 to Fig.17 In addition, an outer sheath, trocar or cannula 318 can be slid over the inner sheath 312 to form a cannula. The inner diameter of the outer sheath 318 can be only slightly larger than the outer diameter of the inner sheath 312 to ensure a tight fit. The outer sheath 318 can include an outer sheath recess 320. When the endoscope 10 is fully assembled, the outer sheath recess 320 can be sized to receive the outer sheath mount tab 310. In some embodiments, the outer sheath 318 can be friction fit, glued or otherwise fused or attached to the wall surrounding the outer sheath mount hole 302. When the endoscope 10 is fully assembled, the outer sheath mount tab 310 can help ensure the correct orientation of the outer sheath 318.

[0233] When the shaft or insertion section 14 (see FIG. 3 ) of the endoscope 10 is inserted into the target area, the outer sheath 318 and outer sheath mount 300 can be detached from the rest of the endoscope 10 as mentioned above. This can allow the outer sheath 318 to act as a cannula, remaining in place to allow the endoscope 10 to be reintroduced into the target area.

[0234] Fig.19 318 is an obturator 319 suitable for use with an outer sheath 318. During the introduction of the endoscope into the surgical field, the obturator can be inserted into the outer sheath or trocar 318 to assist in the passage of the outer sheath 318 into the desired position, after which the trocar can be withdrawn and the inner sheath 312 of the shaft 14 can be inserted. If the shaft 14 needs to be substantially repositioned within the surgical field during operation, the endoscope shaft 14 can be withdrawn from the patient while the outer sheath 318 is held in place, the obturator can be introduced into the outer sheath 318, and the obturator / trocar assembly can be repositioned as needed. Once in the proper position, the obturator can be withdrawn from the outer sheath or trocar 318, and then the endoscope shaft with the inner sheath 312 can be reinserted into the outer sheath or trocar 318. In the example shown, the obturator 319 includes a solid shaft portion 321 with a pointed or blunt end 323, and a base 325. The base 325 is optionally equipped with a locking mount that mates with the locking mount of the distal handle section 30 of the endoscope handle so that the obturator can be secured to the outer sheath / trocar 318 when in use. If desired, the outer sheath, trocar or cannula 318 can be used as a conduit through which other instruments can be introduced into the target area. The outer sheath or trocar 318 can also function as a conduit through which fluids can be introduced into or withdrawn from the target area.

[0235] Fig. 20 310 is a perspective view of a camera assembly housing 330 or distal working section that is separate from the distal end of the inner sheath 312. In this embodiment, the distal working section of the insertion section of the endoscope can be constructed separately from the inner sheath 312 and then mated with the distal end of the inner sheath 312 during assembly. In other embodiments, the inner sheath 312 can be constructed as a single piece, including the distal working section. In embodiments where the distal working section is constructed separately, the distal working section can be made of a material that is different from the material of the inner sheath 312. Additionally, it can be constructed of many assembled parts.

[0236] exist Fig. 20In an exemplary embodiment of the embodiment of the present invention, the distal edge of the inner sheath 312 includes an inner sheath distal recess 322. The camera assembly housing 330 may include a nesting segment 332 that is shaped and has an outer diameter suitable for insertion into the distal end of the inner sheath 312 during assembly of the endoscope 10. The nesting segment 332 may include a nesting segment tab 334 or other alignment feature. The size of the nesting segment tab 334 can be determined so that it can mate with the inner sheath distal recess 322 when the endoscope 10 is assembled. The nesting segment tab 334 and the inner sheath distal recess 322 can help ensure that the camera assembly housing 330 is properly oriented and aligned when the endoscope 10 is assembled.

[0237] The camera assembly housing 330 may additionally include a working segment 336. As shown, Fig. 20 The working segment 336 in the camera assembly mount 330 may include a top void 338, with or without a bottom void 340. The top void 338 and the bottom void 340 may extend along a majority of the working segment 336 of the camera assembly mount 330. A rounded tip 342 may be included at the distal end of the working segment 336 of the camera assembly mount 330. As shown, the rounded tip 342 may optionally include an embrasured opening 344. The edges of the embrasured opening 344 may be beveled, chamfered, or rounded. In an example embodiment, the embrasured opening 344 is continuous with the top void 338. In some embodiments, the top void 338 and the bottom void 340 may be similarly embrasured.

[0238] Rounded end 342 (such as Fig. 20 The chamfered tip 342 shown in Figure 34 can provide many benefits. The chamfered tip 342 can help insert the insertion section 14 into the target area of ​​the patient. In some cases, this can eliminate the need for an obturator. In arthroscopic applications, the profile of the chamfered tip 342 allows the endoscope 10 to be maneuvered into the compact space within the joint. The chamfered tip 342 can additionally allow the surgeon to apply pressure atraumatically on the tissue within the target area. The chamfered tip 342 can also be used as a protective feature for the camera assembly 350.

[0239] like Fig. 20 As shown in FIG, the inner wall of the working section 336 of the camera assembly housing 330 includes two camera mount pivot bearings 346. Fig. 20 In the example embodiment shown in , the camera pivot bearing 346 protrudes substantially vertically from the inner side wall of the camera assembly mount 330. The camera assembly housing 330 can be made of steel, any number of hardened plastics, or any other suitably strong rigid material.

[0240] exist Fig. 20In the example embodiment shown in FIG. 1 , the inner wall of the working section 336 of the camera assembly housing 330 includes a plurality of cable guide holes 348. In a preferred embodiment, there may be only two cable guide holes 348. One cable guide hole 348 may be located on one side wall, while the other cable guide hole 348 may be located on the opposite side wall. Preferably, the cable guide holes 348 may be disposed below the camera mount pivot bearing 346 so that the distal end of the control cable may be moved relative to the camera, camera mount, or camera assembly 350 to which it is connected (e.g., see FIG. 1 ). Fig.25 ) forms an angle. The camera assembly housing 330 may also include one or more constraint features. Fig.17 In the example embodiment shown in FIG. 3 , there are two limiting notches 349. One limiting notch 349 is located on one side wall, and the other limiting notch 349 is located on the opposite side wall. Fig.17 As shown in FIG, the limiting notch 349 is generally aligned with the cable guide hole 348. The cable guide hole 348 and the limiting notch 349 will be further described below.

[0241] Fig.21 An embodiment of the distal working section or camera assembly housing 330 and inner sheath 312 constructed as a single part is depicted. Fig. 22 , showing that in Fig.21 20-20. In embodiments where the distal working section or camera assembly housing 330 and inner sheath 312 are constructed as a single part, they may be made of steel. In this case, the tip shape of the inner sheath 312 and camera assembly housing 330 may be produced by a rolling process. Various voids, openings, and other features, such as those described above, may then be post-machined into the part. Fig.21 In the exemplary embodiment, the camera assembly housing 330 includes only the camera mount pivot bearing 346 .

[0242] It may be advantageous to produce the inner sheath 312 and the camera assembly housing 330 as a single part. Among these advantages, the part may be stronger. Another advantage is that the need for a nesting portion is removed. Therefore, a "bottleneck" in the cross-sectional area at the joint of the inner sheath 312 and the camera assembly housing 330 is removed. This may provide many benefits. Removing such a bottleneck allows more space for various components (such as utility components within the inner sheath 312 and the camera assembly housing 330). In addition, removing such a bottleneck allows increased flushing fluid flow within the inner sheath 312 and the camera assembly housing 330. Alternatively or additionally, the overall diameter of the inner sheath 312 and the camera assembly housing 330 can be reduced. The inner sheath 312 and the camera assembly housing 330 can also be thickened. This helps to strengthen the part. Because the thickening will strengthen the part, it can also allow the outer sheath or cannula 318 to be made thinner. A thinner outer sheath or cannula 318 can in turn allow for a larger diameter inner sheath 312 and camera assembly housing 330. That is, the cross-sectional area of ​​the conduit within the insertion section 14 can be made larger without increasing the overall diameter of the insertion section 14 (composed of the outer sheath 318, the inner sheath 312, and the camera assembly housing 330). The thickening also enables the camera mount pivot bearing 346 to have a larger bearing surface, thereby allowing the pressure exerted on the bearing to be distributed over a larger area.

[0243] Fig.23 The insertion section 14 is shown (in Figure 3A An assembled view of the end cap (best shown in FIG. Fig.23 318. The camera assembly housing 330, camera assembly 350 and outer sheath or cannula 318 can be seen in the figure. As shown, the rounded end 342 of the camera assembly housing 330 protrudes past the distal end of the outer sheath or cannula 318. The viewing notch 352 is recessed into the top of the outer sheath 318. The camera assembly 350 is able to be rocked throughout the entire observable range defined by the opening created by the combination of the porthole opening 344 and the viewing notch 352. In some embodiments, the rockable range can be approximately 180°. When rocked, the camera assembly 350 can pivot on the camera pivot bearing 346 (e.g., see Fig. 20 ). Shake actuation will be described further below.

[0244] In some embodiments, when the insertion section 14 (see FIG. 3 ) of the endoscope 10 is inserted into the target area, the outer sheath 318 can be rotated to an insertion position (not shown). In the insertion position, the viewing notch 352 may not be aligned with the blasthole opening 344 and the top gap 338. This can help protect the camera assembly 350 during insertion and can reduce the risk of damage to tissue during insertion of the insertion section 14 in medical applications. After insertion, the outer sheath 318 can be rotated back to a position where the viewing notch 352 is aligned with the blasthole opening 344 and the top gap 338 so that the full observable range is available again.

[0245] In some embodiments, a cap or window material may cover or be placed in the opening defining the viewing notch 352 and the blasthole opening 344 to protect the camera assembly 350. In some embodiments, the distal edge of the outer sheath 318 and the viewing notch 352 may be blasthole-shaped, rounded, beveled, etc. to help prevent damage that may result from having sharp edges.

[0246] In an exemplary embodiment, no cap or window is used. This arrangement provides a number of benefits. For example, by not using a cap or window at the end of the insertion section 14, the cost of the endoscope can be reduced because expensive scratch and wear resistant materials such as sapphire, specialty glass, etc. are not used. The absence of a cap or window can also eliminate any undesirable reflections from the surface of the cap or window (which would otherwise affect the clarity of any image captured by the camera). Moreover, by not using a cap or window, the inner sheath 312 (see FIG. 1 ) of the endoscope 10 can be used to view the endoscope 10. Fig.15 ) catheter to perform irrigation of the target area. This allows the overall diameter of the insertion section 14 to remain small while maintaining irrigation capabilities. Additionally, the irrigation flow within the inner sheath 312 can help to clear / clean out any debris or material from the camera assembly 350 and any associated one or more lenses. In one example, the user is able to effectively rinse the camera assembly 350 by shaking the camera assembly 350 during irrigation so that the irrigation flow washes the lens assembly 354 of the camera assembly 350 (see, e.g., FIG. 1 ). Fig.32 ) and carry away debris or unwanted materials. As an added benefit, the flushing flow can also help cool the image sensor 380 associated with the camera assembly 350 (see, for example, Fig.65 ).

[0247] As shown, the blasthole opening 344 and viewing recess 352 may be sized to protect the camera assembly 350 without requiring a cap or window. Fig.23In an exemplary embodiment of the present invention, the porthole opening 344 and the viewing recess 352 partially enclose the camera assembly 350, which is recessed from the outer surface formed by the porthole opening 344 and the viewing recess 352. Thus, the porthole opening 344 and the viewing recess 352 define the edge of a shield for the camera assembly 350. This partial encapsulation helps protect the movable components of the camera assembly 350 and any associated components (e.g., control cables, electrical cables, information cables, etc.) from contact with foreign objects during insertion of the insertion section into the target area, or during use of the instrument while in the target area. The porthole opening 344 and the viewing recess 352 provide an unrestricted field of view for the camera assembly 350 while exposing only a small portion of the camera assembly 350 to damage from objects external to the insertion section (e.g., medical instruments such as a razor). This helps ensure that the camera assembly 350 is not damaged during insertion or during the surgical procedure.

[0248] As the camera assembly 350 rotates, the distance between the camera assembly 350 and the outer jacket 318 will change. As a result, the amount of the outer jacket 318 that falls into the field of view of the camera assembly 350 will also change. The greater the distance from the camera assembly 350 to the inner jacket 318, the greater the amount of the outer jacket 318 that is in the field of view of the camera assembly 350. Thus, by varying the width of the viewing notch 352, an optimal amount of protection can be achieved while still providing the camera assembly 350 and an unrestricted field of view.

[0249] Fig.24 The insertion section 14 is depicted (in Figure 3A 318 ) in which the viewing notch 352 has a varying width. The varying width of the viewing notch 352 allows the viewing notch 352 to be just outside the field of view of the camera assembly 350 at any angular orientation of the camera assembly 350. This allows the camera assembly 350 to be more fully encased by the outer sheath 318.

[0250] Fig.25 The insertion section 14 is depicted (in Figure 3A Another alternative embodiment of the end of the invention (best shown in FIG. 1 ) includes a plurality of openings 353 separated by rods 351 instead of the openings 353 of FIG. Fig. 22 350. This arrangement can provide additional protection for the camera assembly 350. In order to minimize the amount that the rod 351 obscures the field of view of the camera assembly 350, the rod 351 can be made of a transparent material. In other embodiments, the rod 351 can be made of an opaque material, for example, the same material as the outer sheath 318.

[0251] Alternatively, the viewing recess 352 is partially covered (see Fig.24) or one or more openings 353 (see Fig.25 ) can be mounted to the distal end of the shaft or insertion section 14 (see, for example, Figure 1 ). Such a covering member may be, for example, a cage that allows a substantially clear field of view for the camera assembly 350 while providing additional protection for the camera assembly 350. In some embodiments, the covering member may include an optically transparent partial cover.

[0252] In another embodiment, the camera assembly can be mounted at the distal end of the endoscope shaft without the protective tip structure 342. While the tip structure 342 can provide some protection for the camera assembly, it can also inhibit the full field of view of the camera at all positions within its range of motion. Fig.26 An example of an alternative arrangement is shown in . In this example, the sensor or camera housing 500 itself is constructed to provide adequate protection to the enclosed camera assembly (e.g., lens and sensor assembly). For example, the camera housing 500 can be at least partially constructed of steel or a similarly strong material; at least one outer shell of the housing can be constructed to resist physical damage when the insertion end of the endoscope is introduced or repositioned. The exposed portion of the housing 500 preferably has an outer spherical, ellipsoidal (oblate spheroid or prolate, etc.) or dome-like shape - or other rounded shapes that provide rounded edges to help prevent damage to tissue when the endoscope shaft is inserted or moved within the operating area. Placing the camera assembly in the reinforced and at least partially rounded housing 500 at the distal end or distal tip 550 of the endoscope shaft 14 provides an unobstructed view of a larger portion of the surgical field without placing the camera assembly or nearby tissue at risk of injury. In this example, a pull wire 502, cable, or ribbon may be used to rotate the sensor or camera housing 500 about an axis 504 so that the optical axis of the camera assembly (lens and sensor assembly) can be aimed from less than zero degrees to greater than ninety degrees relative to the long axis of the distal end 550 of the endoscope shaft 14. If the sensor or camera assembly is arranged to have a wide field of view, the range of motion of the camera housing may be arranged to provide an optical axis range of motion of between about 35 degrees and about 115 degrees at the distal or insertion end of the endoscope shaft relative to the long axis of the endoscope shaft. In this arrangement, the operator can still directly observe the operating area opposite the distal end of the endoscope shaft and can also observe the area of ​​the surgical field behind the end of the endoscope. This arrangement may also allow the operator to rinse the surface of the camera assembly by rotating the camera assembly to a position equal to or greater than 90 degrees to remove any accumulated surface debris.

[0253] exist Fig.32 The camera assembly 350 is shown separately in FIG. This arrangement is more suitable for Fig.25 The insertion section or shaft shown in Figures 18 to 23 10. The endoscope 10 of the embodiment of the present invention is provided with a rounded tip 342 at the working end of the distal endoscope shaft shown in FIG. As shown, a ribbon or flexible cable 250 is coupled to the camera assembly 350 and can provide a power and data communication path to and from the camera assembly 350. The camera assembly 350 can be any suitable structure configured to support the camera of the endoscope 10. In embodiments where the camera assembly 350 can be rocked, the camera assembly 350 can include a pivot actuator attachment feature.

[0254] As shown, the camera assembly 350 may include a lens assembly 354. As shown, the lens assembly 354 may be held in place between a camera housing top 356 and a camera housing bottom 358. When assembled, the camera housing top 356 and the camera housing bottom 358 may be coupled together by any suitable means, such as, but not limited to, glue, adhesives, ultrasonic welding, press fit of cooperating features, etc. Fig.32 In the example embodiment of the embodiment, the lens assembly 354 protrudes through the lens opening 360 in the camera housing top 356 so that the lens assembly 354 can have a clear view of the target anatomical area. In some embodiments, at least a portion of the lens assembly 354 can protrude from the camera housing top 356.

[0255] The camera housing top 356 may include many other voids. Fig.32 In the exemplary embodiment shown in FIG. 1 , the camera housing top 356 includes a right side and a left side (relative to the left side) of the lens opening 360. Fig.32 ) side, the voids 362 being designed to accommodate the end elements of optical fibers (or optionally other light sources, such as LEDs) to project light onto a target area consistent with the direction in which the camera lens or lens assembly 354 can be aimed. In the example shown, the shape of the right elongated void 362 is trapezoidal, while the shape of the left elongated void 362 is diamond-shaped. In alternative embodiments, the shapes of the voids 362 can be different, for example, both can be oval. In alternative embodiments, there can be additional voids 362. For example, in some embodiments, there can be three voids 362 arranged in a triangular configuration around the lens opening 360. In some embodiments, there can be four voids 362 arranged in a rectangular, square, circular, or oval configuration around the lens opening 360.

[0256] One or more illumination sources of endoscope 10 may be at least partially included within endoscope 10. The one or more illumination sources may illuminate the field of view of the camera of camera assembly 350 regardless of its panning position. In some embodiments, the illumination source may be in camera assembly 350. Fig.32In an exemplary embodiment, the illumination source is a plurality of optical fibers (e.g., fiberoptic fibers) 364 that can transmit light from an illumination element (not shown) external to the endoscope 10. The optical fibers 364 can be routed and connected to a void 362 in the top 356 of the camera housing. In an exemplary embodiment, 28 optical fibers 364 are routed into the void 362 of the top 356 of the camera housing. In alternative embodiments, the number of optical fibers 364 can be different. The light emitting end of the optical fiber 364 can be roughly flush with the top surface of the top 356 of the camera housing. In some embodiments, other illumination sources, such as LEDs, can be used. The optical fibers 364 or other illumination sources can be configured to provide light of any desired color or intensity at a predetermined light projection angle.

[0257] like Fig.32 As shown in the example embodiment of FIG. 3 , the camera assembly 350 may include a pivot pin 366. The pivot pin 366 may be pivotally coupled to a pivot pin bearing 346 in the camera assembly housing 330 (see FIG. 3 ). Fig. 20 ). The pivot pin 366 can protrude substantially perpendicularly from the long axis of the insertion section. The pivot pin 366 can allow the camera assembly 350 and the optical fiber 364 (or other illumination source) to pivot in tandem with each other.

[0258] The camera assembly 350 may also include a pivot actuator attachment feature as mentioned above. Fig.32 In the example embodiment of FIG. 3 , camera assembly 350 includes a top cable attachment feature or anchor point 372 and a bottom cable attachment feature or anchor point 374. Top cable attachment feature 372 and bottom cable attachment feature 374 will be discussed further below.

[0259] As mentioned above, the endoscope 10 may also include one or more pivot actuators. The pivot actuator may be an elongated member for pulling or pushing the camera assembly 350 via a pivot attachment feature. In the examples shown, the pivot actuator is primarily a pull cable or wire, but these examples should not be construed as strictly limiting the pivot actuator to a cable-like structure. The elongated member may be flexible or substantially rigid. The elongated member may be round (as in the example of a cable), flat, or may have any other shape or cross-section. In some embodiments, the pivot actuator may be a band that is arranged around a cooperating attachment feature, wherein the attachment feature frictionally engages or otherwise meshes with a feature on the inner circumference of the band. In a preferred embodiment, the pivot actuator may be used to supply only a pulling force. This arrangement allows for smaller diameter insertion segments 14 (see Figure 3A), because the pivot actuator does not have to be thick or cross-sectionally reinforced, or confined within the support rail, to prevent significant lateral displacement within the insertion section 14 in response to a push on the pivot actuator. The pull-wire or cable arrangement also allows a wider variety of materials to be used in constructing the pivot actuator, because the material only needs to have tensile strength, not compressive stiffness.

[0260] like Fig.33 As shown in , the pan cables can be attached to the camera assembly 350 above and below the pivot pin 366. In the example embodiment, for ease of illustration, the pan cables are shown as being relatively slack. In operation, one or more pan cables on one side of the pivot pin 366 will be in tension, while one or more pan cables on the other side of the pivot pin 366 will be slack. As detailed above and now also with reference to Fig.14 The rocking cable can be proximally attached to the cable attachment hole 202 of the pivot control structure 100 (see Fig.14 ). In some embodiments, two rocking cables can be attached to each cable attachment hole 202. The rocking cables can extend from the cable attachment holes 202 in the pivot arm 198 and be routed through one or more apertures 178 in the proximal section 161b of the inner sheath mount 160 (see Fig.11A ). The pan cable can then extend through the utility hole 168 next to the flexible cable 250. Because the cable attachment holes 202 are located on opposite sides of the pivot point of the pivot arm 198, pivoting the pivot control structure 100 can cause the pan cable attached to one of the cable attachment holes 202 to become slack while the pan cable attached to the other cable attachment hole becomes taut. By attaching the pan cable associated with one cable attachment hole 202 to the camera assembly 350 on one side of the pivot pin 366 and attaching the pan cable associated with the other cable attachment hole 202 to the opposite side of the pivot pin 366, the pivot control structure 100 can be used to selectively rotate the camera assembly 350. In some embodiments, pushing the pivot control structure 100 forward can pan the camera assembly 350 forward, while pulling the pivot control structure 100 rearward can pan the camera assembly 350 rearward. In some embodiments, all of the pan cables may be under tension when assembled.

[0261] In the preferred embodiment, only a single pan cable may be attached to each cable attachment hole 202 (see FIG. Fig.14). In such an embodiment, there may be a top shake cable 368 and a bottom shake cable 370. The top shake cable 368 and the bottom shake cable 370 may extend to the camera assembly 350 as described above. The top shake cable 368 may be wrapped around a top cable attachment feature 372 on the camera assembly 350 and return to the same cable attachment hole 202 on the pivot arm 198 from which it originated. The bottom shake cable 370 may be wrapped around a bottom cable attachment feature 374 on the camera assembly 350 and return to the same cable attachment hole 202 from which it originated. Alternatively, the shake cables may be looped through the attachment hole 202 with both ends of the cables terminating distally at the cable attachment features.

[0262] In the exemplary embodiment, the top cable attachment feature 372 (at Fig.32 356) includes two holes in the camera housing top 356. The top cable attachment feature 372 additionally includes a recess connecting the two holes. The top pan cable 368 can enter one of the holes, follow the recess, and exit the other of the two holes to return to the cable attachment hole 202 in the handle (see FIG. Fig.14 ). Bottom cable attachment feature 374 (at Fig.32 358) includes two attachment points or hooks protruding from opposite sides of the camera housing bottom 358. The bottom cable attachment feature 374 is on the opposite side of the pivot pin 366 than the top cable attachment feature 372. The bottom pan cable 370 can be wrapped around one attachment point or hook of the bottom cable attachment feature 374, strung over to a second attachment point or hook of the bottom cable attachment feature 374, and from there back to its cable attachment hole 202 on the pivot arm 198 of the handle. In alternative embodiments, the top cable attachment feature 372 and / or the bottom cable attachment feature 374 can include, for example, an eyelet, a claw, a peg, etc.

[0263] The top and bottom rocking cables 368, 370 may be made of any suitable cable or wire material (either metal or synthetic polymer, or braided or monofilament). The top and bottom rocking cables 368, 370 may be, for example, laterally flexible metal or plastic strips or ribbons. In a preferred embodiment, the top and bottom rocking cables 368, 370 are made of a material that resists stretching under tension. A single rocking cable is attached to the pivot arm 198 (see FIG. 1 ). Fig.14) around a pivot actuator attachment feature on the camera assembly 350 as this ensures that the side of the pan cable traveling to the camera assembly 350 is under the same tension as the side of the pan cable returning from the camera assembly 350; any stretching of certain portions of the cable over time or with use will have the same effect on both halves of the cable.

[0264] In a preferred embodiment, the top rocker cable 368 can be routed through one of the cable guide holes 348 on each inner wall of the camera assembly mount 330. Fig.33 , the top rocking cable 368 passes through one of the cable guide holes 348 and continues along the exterior of the camera assembly housing 330 toward the camera assembly 350. In some embodiments, along the path taken by the top rocking cable 368, there may be a recess or groove recessed into the exterior of the camera assembly housing 330. In such embodiments, the recess or groove may serve as a guide. The recess or groove may also help ensure that the top rocking cable 368 is approximately flush with the outer surface of the camera assembly housing 330. This may help ensure that the outer sheath 318 (see Fig.23 ) will not impact on the top rocker cable 368 and impair the movement of the top rocker cable during use of the fully assembled endoscope 10.

[0265] like Fig.33 As shown in FIG. 3 , the top rocking cable 368 is threaded through the restraining notch 349 as it reenters the interior of the camera assembly housing 330. The top rocking cable 368 then travels to the top cable attachment feature 372 as described above. Returning to the cable attachment hole 202 (see FIG. 3 ), the top rocking cable 368 is threaded through the restraining notch 349. Fig.14 ), the top rocking cable 368 travels from the top cable attachment feature 372 to the opposite wall of the camera assembly housing 330 (see Fig. 20 ). The top rocking cable 368 then travels along the outer surface of the front wall of the camera assembly housing 330, and optionally along a recess or groove in the wall. The top rocking cable 368 then re-enters the interior volume of the camera assembly housing 330 and travels back to the cable attachment hole 202 in the handle as previously described.

[0266] The end segment of a pivot actuator (such as a wire or cable) near its connection to the pivot assembly at the distal end of the insertion section can be constrained at a fulcrum or support point to redirect the actuator so as to form an angle relative to the long axis of the insertion section or shaft. For example, an increased pivot range of the pivot camera assembly 350 can be achieved by routing the top rocking cable 368 through the cable guide hole 348 and the constraining or redirecting notch 349, and then angling it upward to the top cable attachment feature 372 on the other side of the pivot pin 366. Thus, an image sensor having a predetermined or fixed angle field of view can be rotated to allow a rotatable field of view so that the observable area can be increased to a range of up to 180 degrees. In other embodiments, the image sensor can be rotated so as to achieve an observable area of ​​more than 180 degrees. As Fig.33 As shown in , routing the cables as described enables the cables to be attached relative to and therefore allows for a greater degree of reverse rotation of the camera assembly 350 .

[0267] In some embodiments, and now also with reference to Fig.34 The camera assembly 350 is able to rotate a full 180 degrees or more due to the presence of two sets of cable guide holes 348: a lower set of guide holes 348 for controlling the top section of the camera housing, and an upper set of guide holes 348 for controlling the bottom section of the camera housing. The degree to which the camera assembly 350 can be rotated is a function of the angle formed by the distal end of the rocking cable relative to the proximal portion of the rocking cable or the longitudinal axis of the insertion section (or endoscope shaft) 14 (see Figure 1 ). The greater the angle formed by the distal end of the rocking cable relative to the longitudinal axis of the insertion section 14 as it re-enters the exterior of the camera assembly housing 330, the greater the range of motion it induces in the camera assembly 350. In a preferred embodiment, the re-entry surface or redirecting guide of the camera assembly housing 330 is positioned to provide an angle of the distal end of the rocking cable relative to the long axis of the insertion section 14 in the range of approximately 30 degrees to 90 degrees. In other embodiments, the range of rotational motion of the camera assembly 350 can be improved while limiting the frictional resistance of the rocking cable by positioning the cable re-entry surface or guide to achieve an angle of the distal end of the rocking cable in the range of approximately 45 degrees to 80 degrees. As described above, such an embodiment only requires tension on either cable of a pair of complementary cables 368, 370 (one cable angled upward at a distal or distal position in the insertion section 14 to attach to a top cable attachment feature 372, and one cable angled downward at a distal or distal position in the insertion section 14 to a corresponding bottom cable attachment feature 374). With this arrangement, no lateral or transverse movement of the actuation cable is required over a majority of the length of the insertion section 14, which allows the interior space within the insertion section 14 to be narrower, thereby helping to minimize its overall diameter.

[0268] In some embodiments, the constraint or redirection notch 349 may not be used. Some embodiments may use different types of constraint or redirection elements incorporated into the wall at the distal end of the insertion section. In some embodiments, a pulley or eyelet may be used as a constraint. Pins, bolts, struts, etc. may also be used as constraint or redirection elements. In some embodiments, a curved finger or claw may be formed in the side wall of the camera assembly housing 330. The curved finger may extend into the interior volume of the camera assembly housing 330 so that there is a space between the inner wall of the camera assembly housing 330 and the curved finger. The top shaking cable 368 may travel through this space so that it is constrained by the curved finger. In most embodiments, it may be desirable that the contact point between the constraint and the cable has such a smoothness or radius of curvature that is sufficient to minimize the possibility of friction damage to the shaking cable during endoscopic operation. In some cases, the constraint may be coated with a material having a low coefficient of friction, such as Teflon.

[0269] In some embodiments, the bottom pan cable 370, rather than the top pan cable 368, may be constrained similar to the previous description to enable the camera assembly 350 to have a greater pivot range in one rotational direction than in another rotational direction. Fig.34 As shown in , in some embodiments, both the bottom crank cable 370 and the top crank cable 368 can be constrained or redirected, allowing a much greater pivot range.

[0270] exist Fig.34 , outer sheath 318, camera assembly housing 330, and camera assembly 350 are shown. There are two sets of cable guide holes 348. One set of cable guide holes is above the longitudinal axis of camera assembly housing 330, and the other set of cable guide holes is below the longitudinal axis of camera assembly housing 330. There are also two restraining notches 349. One of the restraining notches 349 is above the longitudinal axis of camera assembly housing 330, and the other restraining notch is below the longitudinal axis of camera assembly housing 330.

[0271] Improved mechanical advantage of the shake cable is achieved by positioning a redirecting element (e.g., a notch) on one side of the pivot axis of the camera assembly 350 (e.g., below) while attaching the terminal end of the shake cable to a point on the camera assembly 350 that is on the opposite side of the pivot axis of the camera assembly 350 (e.g., above).

[0272] As shown, the top rocking cable 368 travels through one of the cable guide holes 348 below the longitudinal axis and re-enters the camera assembly housing 330 at the restraining notch 349 below the longitudinal axis. The top rocking cable 368 is then redirected upward to the top cable attachment feature 372 on the camera assembly 350. Fig.34 , the bottom rock cable 370 travels through the cable guide hole 348 above the longitudinal axis of the camera assembly housing 330. The bottom rock cable 370 then re-enters the camera assembly housing 330 through the restraining notch 349 above the longitudinal axis of the camera assembly housing 330. The bottom rock cable 370 is then redirected downward to the bottom cable attachment feature 374. The top rock cable 368 and the bottom rock cable 370 can be wrapped around a portion of the camera assembly 350, depending on where the camera assembly 350 has been pivoted. Fig.34 , the bottom rocker cable 370 is shown wrapped around a portion of the camera assembly 350.

[0273] Some embodiments may utilize strap 384 as a pivot actuator. Fig.35 3 shows an embodiment that includes a strap 384 as a pivot actuator. As shown, the strap 384 is wrapped around one of the pivot pins 366 of the camera assembly 350. In some embodiments, the pivot pins 366 can be elongated so that a portion of at least one of the pivot pins 366 protrudes from the pivot bearing 346. In such an embodiment, the strap 384 can be wrapped around this portion of the pivot pin 366, such as Fig.35 . In some embodiments, the shape of camera assembly 350 can be different so that strap 384 can be wrapped around camera assembly 350. For example, camera assembly 350 can be generally cylindrical in shape. The generally cylindrical shape of camera assembly 350 can be coaxial with pivot pin 366. In such an embodiment, strap 384 can be wrapped around the circumference of camera assembly 350.

[0274] In some embodiments, the surface on which the belt 384 is wrapped can be concave (e.g., V-shaped) relative to the surfaces on its sides. This can help keep the belt 384 in place during operation. In other embodiments, any other type of guide can be used. For example, the surface on which the belt 384 is wrapped can be flanked by two walls that keep the belt 384 in place during operation.

[0275] The strap 384 may be made of a high friction material so that the strap 384 does not slip across the surface around which it is wrapped when the strap 384 is driven. In some embodiments, the strap 384 may have a rough surface, or may be toothed, to aid in its ability to grip or form engage the camera assembly pivot pin 366 (which may be geared). The use of the strap 384 may allow for a wider range of pivoting of the camera assembly 350 without requiring the pull cable pivot actuator to redirect laterally within the insertion section 14 to achieve an equivalent range of motion of the camera assembly 350. This allows the insertion section 14 to be made with a smaller diameter.

[0276] In embodiments using strap 384, strap 384 may be configured to be pivoted by pivot control structure 100 (see Fig.14 ). In some embodiments, the opposite end of the belt 384 from the belt wrapped around the camera assembly 350 or the pivot pin 366 can be wrapped around the pivot shaft 204 of the pivot control structure 100. In such an embodiment, the rotation of the pivot shaft 204 can drive the belt 384. The portion of the pivot shaft 204 around which the belt 384 is wrapped can have a relatively large diameter. This may be desirable so that only a small pivot displacement of the pivot shaft 204 is required to drive a relatively large amount of the belt 384. In an embodiment where the belt 384 includes teeth, the teeth of the belt 384 can be interlaced with the gears located on the pivot shaft 204 of the pivot control structure 100. In such an embodiment, the rotation of the pivot shaft 204 and the rotation of the gears on the pivot shaft 204 can drive the belt 384. When the belt 384 is driven, the movement of the belt 384 will exert a driving force on the camera assembly 350, thereby causing the camera assembly 350 to pivot.

[0277] In other embodiments, the pivot actuator may be a rack of a rack and pinion arrangement. In such an embodiment, the pivot pin 366 of the camera assembly 350 may include a toothed portion. The toothed portion of the pivot pin 366 may be a pinion that is interlaced with the rack of the pivot actuator. When the rack is longitudinally displaced within the insertion section 14, this movement is converted into a rotation of the camera assembly 350 by the toothed pinion portion of the pivot pin 366. Although such an embodiment does not rely solely on pulling force to rotate the camera assembly 350, the pivot actuator still does not require lateral displacement of the actuator within the insertion section 14. In some specific embodiments, the push-pull rack type actuator may still require features (e.g., stiffness, thickness) or may be constrained within a track to prevent lateral or left-right deflection during the application of compressive force on the rack.

[0278] In yet another arrangement using one or more rocking cables, a similar range of pivoting can be achieved without requiring any routing of the rocking cables through the various features included in the camera assembly mount 330. This may be desirable because it may allow the insertion section 14 (see Figure 1 ) is made smaller in diameter. Additionally, the camera assembly mount 330 for this embodiment does not require any fenestrations (e.g., Fig. 20 cable guide holes 348) or redirecting elements / constraints (e.g., Fig. 20 The restraining notch 349) simplifies the manufacture of the camera assembly mounting. Such an embodiment can be used, for example, Fig.21 The camera assembly mount 330 and inner housing 312 are shown in the exemplary embodiment of FIG.

[0279] In such an embodiment, the camera assembly 350 may include one or more winding features or surfaces 1400. The winding feature is configured to at least partially wind the terminal end of the shaking cable around the housing of the camera assembly 350. The connection point or attachment point of the terminal end of the shaking cable can be located on the camera assembly housing far side of the winding feature. The winding feature preferably has a curved, slightly concave surface that can be partially or completely wrapped around a portion of the camera assembly housing. Therefore, in various embodiments, the shaking cable can be only partially wound around the housing, or wound around the housing in one or more complete loops. Longer winding features provide a wider rotation range of the camera assembly. During actuation, the associated shaking cable can be wound or unwound from the winding feature 1400. The winding feature 1400 can increase the pivot range of the camera assembly 350. The winding feature 1400 can allow a more consistent torque to be applied to the camera assembly 350 during rotation. The winding feature 1400 can be configured to produce a moment arm of desired or varying length. Additionally, positioning the winding feature 1400 radially separated from the rotational axis of the camera assembly can help the pan cable more efficiently generate rotational torque.

[0280] Figures 36 to 40The process conceptually illustrates a camera assembly 350 including a wrap-around feature 1400 in multiple rotational positions. As shown, the wrap-around feature 1400 can include an arcuate portion and a straight portion. The arcuate portion is shaped so that it has a radius of curvature extending from the pivot axis of the camera assembly 350. The straight portion of the wrap-around feature 1400 is angled so that it functions as a torque increasing feature. Additionally, the straight portion of the wrap-around feature 1400 allows the camera housing 355 to be made with more material that would otherwise need to be removed to continue the arcuate section, and thereby increases the structural integrity of the camera housing 355. This may be particularly important in embodiments where the camera assembly 350 is designed to fit in a very small space and therefore must be manufactured in a very small form factor.

[0281] like Fig.36 , the top rocking cable 368 can be wound around the winding feature 1400. The tension applied by the top rocking cable 368 will generate a torque about the pivot axis of the camera assembly 350, thereby causing the camera assembly 350 to rotate in a clockwise direction. Additionally, the straight portion of the winding feature 1400 creates a longer moment arm, thereby increasing the torque generated for a given amount of tension.

[0282] The camera assembly 350 is rotated to Fig.37 , the top rocking cable 368 begins to unwind from the winding feature 1400. As force continues to be applied and the camera assembly continues to rotate, the top rocking cable 368 will continue to unwind from the winding feature, such as Fig.38 When fully deployed, the point at which the top rocking cable 368 leaves the winding feature 1400 will be located on the arcuate section of the winding feature 1400 (as shown in FIG. Fig.37 and Fig.38 1400). In an embodiment, all points on the arcuate segment of the winding feature 1400 may be located an equal distance from the pivot axis.

[0283] In an exemplary embodiment, as tension continues to be applied by the top rocking cable 368, the camera assembly 350 will continue to rotate until the top rocking cable 368 no longer contacts the surface of the winding feature 1400, as shown in FIG. Fig.39 The camera assembly 350 can then continue to rotate until the tension of the top rocking cable 368 is close to being aligned with the axis of rotation of the camera assembly 350. This position is Fig.401400. As will be appreciated by those skilled in the art, the rocking cable 368 may be wrapped around the winding feature 1400 one or more times to increase the amount of rotation that can be produced using the rocking cable 368. The extent to which the rocking cable 368 is wrapped around the contact surface on the camera assembly 350 allows for a rotation range of more than 90 degrees of the camera assembly 350. The extent of rotation of the camera assembly 350 will be limited only by the amount of slack and the flexibility of the attached electronic flex cable and / or fiber optic bundle.

[0284] In an embodiment, the rocking cable and winding surface are arranged to allow the camera assembly 350 to be rotated to a position between about 90 degrees and about 120 degrees of the long axis of the distal endoscope shaft, orienting the lens surface of the camera assembly at least partially in the direction of the proximal end of the endoscope shaft. In this position, any debris or other contaminants on the lens surface can be washed away by the irrigation fluid traveling distally in the endoscope shaft.

[0285] To remove the camera assembly 350 from Fig.40 Rotate the position to Fig.38 In the position shown in FIG. 3 , a pulling force can be applied via the bottom shaking cable 370. In some embodiments, the bottom shaking cable 370 can also be associated with a winding feature. For example, the corners or edges of the camera assembly 350 that can be wrapped around by the bottom shaking cable 370 can be rounded.

[0286] Fig.41 A top perspective view of a particular example embodiment of a camera assembly 350 including a wrap-around feature 1400 is depicted. The camera assembly 350 includes a lens assembly 354. The lens assembly 354 is disposed within an interior of a camera housing 355. As shown, the wrap-around feature 1400 can be recessed into one side of the camera housing 355. The wrap-around feature 1400 in the example embodiment includes an arcuate portion and a straight portion. The arcuate portion of the wrap-around feature 1400 is shaped such that it has a radius of curvature extending from the center or pivot axis of the pivot pin 366.

[0287] like Fig.41 As best shown in FIG. 1 , the wall into which the wrap feature 1400 is recessed can include a first void 1402. The camera housing 355 can also include a second void 1404. The second void 1404 can pass through the top surface of the camera housing 355 to the bottom surface of the camera housing 355.

[0288] As shown, only a single shaking cable 1406 may be used. The shaking cable 1406 may extend through both the first void 1402 and the second void 1404 in the camera housing 355. One end of the shaking cable 1406 may be attached to the cable attachment hole 202 on the pivot arm 198 (see Fig.14). The other end of the shaking cable 1406 can be attached to another cable attachment hole 202 on the pivot arm 198. In some embodiments, the shaking cable 1406 can be fixedly attached to the camera housing 355 at one or more points. For example, a glue adhesive can be placed into one of the gaps 1402 or 1404. This can ensure that the shaking cable 1406 does not slide or move on the surface of the camera housing 355 during actuation. Additionally, in some embodiments, the shaking cable 1406 can be knotted at one or more locations. For example, the shaking cable 1406 can be fed through one of the gaps 1402 or 1404, knotted, and then fed through the other gap in the gaps 1402 or 1404. Preferably, the width of the knot can be wide enough so as not to fit through any of the gaps 1402 or 1404. This knot can again help prevent the shaking cable 1406 from sliding or moving on the surface of the camera housing 355 during actuation.

[0289] As will be appreciated by those skilled in the art, Figure 41 to Figure 34 The embodiment shown in FIG. 1404 can be easily modified to use two shake cables. One shake cable can terminate in or at the first void 1402 and fixedly attached to the camera housing 355. The second shake cable can terminate in or at the second void 1404 and fixedly attached to the camera housing 355.

[0290] In an alternative example, Fig. 27 It is shown how a pull wire 502 operated by a pivot control structure 100 is wrapped around and / or attached to a rounded or domed sensor or camera housing 500 at the distal end of the endoscope shaft 14. For clarity, the inner sheath 312 has been removed. In this example, the camera housing 500 includes a slot 501 that is offset to one side of the housing 500 and is approximately circumferential so as not to interfere with the lens / camera assembly contained within the housing 500 (which is preferably positioned approximately in the center of the two assembled halves of the housing). The pull wire 502 is retained within the slot 501 and can be secured to the housing 500 at a recess 503. A knot placed in the pull wire 502 can be embedded in the recess 503 to act as an attachment point that causes the housing 500 to rotate as the pull wire 502 moves back and forth along the endoscope shaft. Optionally, a small amount of adhesive can be used during assembly of the endoscope to provide added attachment security. In a preferred embodiment, the pull wire 502 comprises a Kevlar wire, which provides considerable longitudinal strength and stretch resistance. Other wire types may include steel (braided or single strand), nylon, or other materials with appropriate strength and stretch resistance.

[0291] Fig.26 and Fig.23The rounded sensor housing 500 shown in .2 can enclose a lens 510 and image sensor 512 of simpler construction, and the light source for illuminating the operating area can be located near the sensor / camera housing 500 rather than being mounted to the housing itself. Fig.28 and Fig.29 It is shown how the rounded or dome-shaped sensor / camera housing 500 is composed of two sections 500a and 500b. Each of these sections can be molded or machined to have internal cutouts for placing a PCB extension 514 or the distal end of a flex cable, its associated sensor 512 (e.g., CMOS or CDD), and a suitable lens 510. The two sections 500a and 500b can be connected to these components by a variety of methods. In the example shown, one or more pins 500c of section 500b can be mated with a corresponding arrangement of matching recesses 500d of section 500a. As shown in FIG. Fig.30 As shown in , the pivot shaft 505 on the outside of each segment can be inserted into a corresponding hole, bearing or bushing 507 (which can be resiliently flexible to allow assembly) at the distal end of the inner sheath 312 of the endoscope shaft. The assembled housing 500 can be pressed into or snap-fit ​​into place within the hole 507, which can help keep the two segments 500a and 500b connected together. Optionally, an adhesive can also be used to securely connect the pins 500c to their corresponding recesses 500d. Although the illustrated sensor / camera housing 500 does not include a light source, this is an option; an LED or set of LEDs of appropriate size can be included around the periphery of the lens, or the ends of the fiber optic cables can be mounted in a similar arrangement, as discussed below.

[0292] In an exemplary arrangement, one or more LEDs 508 may be positioned along the open portion 506 of the inner sheath 312 of the endoscope shaft 14 . Fig.42The sensor 512 and lens 510 assembly within the sensor housing 500 is shown (half of the housing has been removed for clarity). Both the lens 510 and the sensor 512 (e.g., a CMOS or CCD sensor) are appropriately sealed to prevent liquid from entering between them. The sensor 512 can be connected to a strip or flexible cable that runs through the endoscope shaft to a PCB in the endoscope handle. Similarly, the light source / LED can be connected to the strip or flexible cable to receive power, or can be connected to a separate strip or flexible cable adjacent to the sensor communication cable. In an alternative example, the main PCB in the endoscope handle can be manufactured to have an elongated extension that is arranged to extend through the endoscope shaft to one or more components at the distal end of the shaft. The PCB can be constructed to have a flexible component that is clamped together with a rigid component. The flexible component can be exposed from the main PCB to form a PCB extension of the endoscope shaft. The rigid component can similarly be exposed from the main PCB to form a PCB extension of the endoscope shaft. Either or both of these extensions may alternatively be combined with a strip or flexible cable from the main PCB to provide power or communications to components at the distal end of the endoscope shaft. For example, the sensor 512 may be mounted from the main PCB in the endoscope handle 12 to the distal end of the flexible PCB extension 514. The sensor PCB extension 514 is flexible and has sufficient slack to allow the sensor 512 and lens 510 to rotate as the sensor housing 500 rotates. Moreover, the light source in this example includes one or more LEDs 508 mounted to either sensor PCB extension (or preferably to a separate light source PCB extension 516). Due to the power requirements of the light source, mounting the power cord on a separate flexible cable or PCB extension 516 can increase the reliability of the endoscope. Moreover, if the endoscope shaft 14 is rigid (e.g., as is the case with most arthroscopes), the light source power cord can be mounted to the rigid PCB extension, further enhancing the overall robustness of the endoscope. In Fig.42 In the example shown in , the flexible sensor PCB extension 514 is folded at its base and placed against the rigid light source PCB extension 516, with the two extensions incorporated into the main PCB within the handle 12 of the endoscope (see below).

[0293] Fig.26 and Fig.42 The form factor of the printed circuit board (PCB) of the embodiment shown in Fig.43 Note that Fig.43 and Fig.44The form factors shown in can also be used to represent how a ribbon or flex cable can be folded to run adjacent to a companion ribbon or flex cable, or adjacent to a companion PCB extension of a connected component that passes through a bulkhead and along the endoscope shaft to the distal end of the shaft. In one example, a rigid main PCB 518 (on which multiple electronic processing components are mounted) includes a composite of rigid and flexible components that are clamped together, and the main PCB 518 is located within the endoscope handle. The flexible PCB extension portion 514 emerges from the composite main PCB 518 at a certain angle to the direction of the rigid extension portion 516 so that the proximal leg 514a of the flexible extension portion 514 can be folded at point 520 ( Fig.44 ) to move adjacent to the rigid portion 516, such as Fig.44 In the example shown, the proximal leg 514a of the flexible plate extension is at an angle of approximately 90 degrees relative to the rigid plate extension. In some embodiments, the angle may be less than or greater than 90 degrees due to the flexibility of the flexible plate extension allowing the proximal leg 514a to accommodate folding that is not perfectly aligned. Fig.45 , the flexible PCB extension 514 is shown extending along the endoscope axis adjacent to the rigid PCB extension 516 (the inner sheath, sensor housing, and lens are removed for clarity). In this way, the two PCB extensions can pass through elastomeric slots in a diaphragm or fluid barrier, such as Fig. 11B or Fig. 11C The narrow slot 177 is shown in FIG.

[0294] Fig.46 A cross-sectional view of an exemplary endoscope is shown. The main PCB 518 is shown associated with the handle proximal section 16, the camera control button 37, the septum or pass-through block 159, and the pivot control structure 100. The rotational position sensor magnet 51 is shown associated with both the handle proximal section 16 and the main PCB 518. An exemplary fluid conduit 434 (for irrigation or aspiration) is shown proximal to the septum 159. It can be connected by means of a Fig.47 154, or connected to the bulkhead 159 by any other suitable fixed connection means. In this case, the inner sheath 312 has been removed for clarity of description.

[0295] Fig.47The PCB of the endoscope is shown without the handle, inner sheath, pivot control structure and fluid conduit when the extension of the PCB of the endoscope passes through the partition or pass-through barrier 159. In addition, the rotational position sensing magnet 51 and the camera control button 37 and shaft 38 (with embedded magnets) are shown as being associated with the main PCB 518 to provide an indication of where the corresponding Hall effect sensors for these magnets can be located on the PCB 518. As shown, the fold point 520 of the flexible PCB extension is located near the partition 159 so that the combined adjacent flexible and rigid PCB extension can pass through the partition at the slot 177. The slot can be securely sealed to prevent fluid penetration in this case because a sufficient amount of slack in the flexible PCB extension 514 can be provided distally at the sensor 512 near its end.

[0296] like Fig.48 , a fluid or air delivery lumen 157 shares space within the endoscope shaft 14 with PCB extensions 514, 516 (or alternatively with one or two ribbon or flexible cables) that supply power to a light source and communicate with a sensor / camera located at the distal end of the endoscope shaft 14. For clarity, the sensor / camera housing has been removed. Note that the inner sheath 312 of the shaft 14 has cutouts or openings proximate to the sensor / camera housing, above to provide illumination by a light source or LED, and optionally below to improve fluid flow around the sensor / camera housing. This is for example Fig.26 and Fig.72 .6 is shown.

[0297] Fig.49 A cross-sectional view of the interior of the handle distal section 30 of the above-described endoscope is shown. A partition or fluid barrier 159 separates the relatively dry area (where the pivot control structure, camera control buttons, and the distal end of the main PCB are located) from the wet section 30a. A fluid or air conduit 434 travels from the exterior of the endoscope handle, through the handle proximal section 16, and connects to the port 256 of the partition 159. In this example, the fluid passing through the conduit 434 and the port 256 communicates with the lumen 157 of the endoscope shaft 14 via the space occupied by the wet section 30a. Appropriate seals can be used to contain this fluid so that fluid or air does not leak between the distal section housing and the proximal end of the endoscope inner sheath 312.

[0298] Now return to reference Figure 7C and Fig.14, the pivot control structure 100 can be "parked" in a stop defined by a ridge 94 in the slide button recess 92 of the handle boss 34 or in another portion of the handle 12. In some embodiments, the ridges 94 can be spaced apart so that the stops formed by the ridges 94 can correspond to a specific angular orientation of the camera assembly 350. In some embodiments, the stops formed by the ridges 94 can be spaced apart so that their positions correspond to specific angular increments (e.g., 30°) of the camera assembly 350.

[0299] As mentioned above (see Fig. 7A ), the handle distal section 30 can be rotated relative to the handle proximal section 16. Such rotation will also cause the longitudinal axis of the insertion section 14 to rotate. In turn, the camera assembly 350 can rotate with the insertion section 14. This can allow the user to obtain a near-global view of the anatomical region in question with minimal or even no angular repositioning of the endoscope 10. The user may only need to shake the camera assembly 350 and rotate the handle distal section 30 relative to the handle proximal section 16 to obtain the desired field of view within the anatomical region.

[0300] Repeated twisting and bending of optical fibers, such as optical fiber 364, may result in one or more optical fibers breaking or failing. In the case of optical fiber 364, this results in a loss of light and illumination that increases as more optical fibers 364 are damaged. Such bending may occur if optical fiber 364 is terminated as described above and attached or fused to a portion of pivoting camera assembly 350. If endoscope 10 is designed to be disposable, any degradation in the integrity or performance of optical fiber 364 may be within acceptable limits relative to the expected life of the instrument. Therefore, in some embodiments, optical fiber 364 may be attached or fused to pivoting camera assembly 350 with minimal issues of optical fiber 364 breaking and resulting loss of light. In some embodiments, an end illuminator, light projection element, or light emitter associated with optical fiber 364 may be advantageously mounted to camera assembly 350 so as to project light at any target or field of view to which lens assembly 354 of camera assembly 350 has been rotated or panned. This arrangement helps to ensure that the field of view of lens assembly 354 (at Figure 25 to Figure 27 364) is always illuminated by optical fiber 364, regardless of where in the pannable range of camera assembly 350 the camera assembly 350 has been rotated.

[0301] In some embodiments, the illumination system may include a light guide or light pipe 375. In some embodiments, the optical fiber 364 may include a light guide or light pipe 375 along at least a portion of the path of the illumination system (see, e.g., Fig.51). The terms "light guide" and "light duct" may be used interchangeably herein. When the optical fiber is relatively straight, light loss is relatively small because the angle of incidence of the light within the optical fiber is shallow enough to facilitate near-total reflection within the optical fiber. However, bending the optical fiber may change the angle of incidence to the extent that some light transmission out of the optical fiber is possible. However, the bending of the light duct or light guide can be controlled. To this end, the use of light guide 375, where feasible, can help minimize light loss in an illumination system that includes optical fiber 364, or can completely replace the optical fiber. Light guide 375 can also provide many other benefits. For example, light guide 375 can facilitate assembly and reduce assembly time of the device. Light guide 375 can be of the type described herein, or can be any suitable type of light guide known to those skilled in the art.

[0302] Fig.51 An example embodiment of an endoscope 10 utilizing a light conduit 375 is shown. The two larger diameter light conduits 375 may be provided along one or more sections of the wall of the inner sheath 312 (see Fig. 20 ) extends into the camera assembly housing 330 and then bends or curves into one of the camera assembly pivot bearings 346. The curved section of each light conduit 375 can be coated with a highly reflective material 376 to minimize the loss of light exiting the light conduit as the light conduit 375 changes direction. Any suitable highly reflective material 376 known to those skilled in the art can be used. In such an embodiment, the camera assembly 350 can also have built-in camera assembly light conduits 377 formed at the pivot bearing 346 at the joint with the light conduit 375. Light carried by the light conduit 375 can be transferred to the camera assembly light conduit 377 at the joint. The camera assembly light conduit 377 can extend from each of the pivot pins 366 into the camera assembly 350. The camera assembly light conduit 377 terminates in the light projection gap 362 so that the field of view of the camera assembly 350 will be illuminated regardless of the rotational position of the camera and lens assembly. In such an embodiment, any bends provided by the camera assembly light duct 377 may be coated with a highly reflective material 376 as described above. In some embodiments, highly reflective material 376 may be included on other portions of the light duct 375 and camera assembly light duct 377 in addition to the bends of the light duct 375 and camera assembly light duct 377.

[0303] Creating an optical conduit joint that coincides with the pivot region of the camera assembly 350 may be desirable because it avoids bending or twisting of the optical fiber 364 when the camera assembly 350 is rotated, thereby eliminating the risk of damage to the optical fiber 364. This design may be suitable for use in a reusable or disposable endoscope 10. This arrangement may also reduce the manufacturing or assembly costs of the endoscope 10.

[0304] In another example embodiment (not shown) using a light tube 375, a larger diameter light tube 375 can extend substantially along the path of the flex cable 250. The end of the light tube 375 closest to the inner sheath mount 160 can be spliced ​​with the optical fiber 364, or arranged to introduce light from another illumination source. The end of the light tube 375 closest to the camera assembly 350 can also be spliced ​​with the illumination optical fiber 364 extending to the camera assembly 350.

[0305] In some embodiments, the optical fibers 364 to the camera assembly 350 can be arranged to form a flexible strip 1000, thereby creating a linear optical fiber array that can bend with minimal bending or with bending in only one dimension (e.g., see Fig.52 ) terminates into a light projection element. Alternatively, the flexible strip 1000 need not be a linear array of optical fibers, but instead in some embodiments may be a single strip-shaped piece of flexible light-guiding material. In some embodiments, there may be two flexible strips 1000, each extending into one of the light projection voids 362 in the camera assembly 350. In some embodiments, the flexible strip 1000 may be coated with a reflective material 376 to maximize the amount of light at the camera assembly 350. In some embodiments, the flexible strip 1000 may form a joint with a light duct.

[0306] In some embodiments, the camera housing top 356 may include a light ducting material to act as a light projection element or illuminator. In this case, light may be emitted from a majority of the camera housing top 356 and into the field of view of the camera assembly 350. In some embodiments, some areas of the camera housing top 356 may be blacked out or masked so that light is emitted only from one or more desired areas of the camera housing top 356. In some embodiments, some areas of the camera housing top 356 may be coated with a highly reflective material 376 to prevent unwanted light emission from these areas.

[0307] Fig.52An embodiment is shown in which the optical fiber 364 is incorporated into a flexible strip 1000, which can optionally be coated with a highly reflective material 376. As shown, the flexible strip 1000 extends to the camera assembly 350. The flexible strip 1000 can be overmolded, potted, fused, or otherwise coupled to the camera assembly 350.

[0308] exist Fig.52 In the exemplary embodiment, the camera assembly 350 includes an integral camera housing 1002. Fig.53 1002 without the attached flexible strip 1000 is shown in more detail in FIG. In an example embodiment, the integral camera housing 1002 is made of a light conduit or transmission material and functions as a light projection element. The integral camera housing 1002 in an example embodiment can be almost completely coated with a highly reflective material 376 to maximize the light output from the uncoated or unmasked areas of the integral camera housing 1002. A light projection or illumination surface 1004 having a shape suitable for placement adjacent to the lens and image sensor assembly on the integral camera housing 1002 can be constructed by masking the area during application of the highly reflective material 376 (or alternatively a simple dark mask). In an example embodiment, the light projection surface 1004 has the shape of a ring. In other embodiments, the light projection surface 1004 can be a crescent, a semicircle, or can have any other desired shape. Light can be emitted from the light projection surface 1004 of the integral camera housing 1002 to illuminate the field of view of the lens assembly 354. As in the above-described embodiments, the field of illumination preferably pivots with the camera assembly 350, thereby ensuring that the field of view of the lens assembly 354 is always illuminated.

[0309] Fig.54 Another example embodiment of an integral camera housing 1002 is shown. As shown in outline form, the integral camera housing 1002 includes a coupling recess 1006. The coupling recess 1006 can allow the flexible strip 1000 to be properly coupled to the integral camera housing 1002. In some embodiments, the coupling recess 1006 can allow the flexible strip 1000 to be coupled to the integral camera assembly 1002, such as by a snap fit. In some embodiments, the coupling recess 1006 can accommodate optical fibers 364 that are not formed in the flexible strip 1000. Similar to Fig.53 ,exist Fig.54 In the embodiment, the integrated camera housing 1002 can be used as a light projection element. The integrated camera housing 1002 can also be similarly as described with respect to Fig.53 The integral camera housing 1002 is depicted as being coated and / or masked.

[0310] Fig.55 and Fig.56An embodiment is shown in which a light projection element 1005 is incorporated into the end of the flexible strip 1000. The light projection element 1005 can be formed of a light conduit material, which in some embodiments can be a group of fibers fused into a shape suitable for projecting light from the fiber optic bundle or flexible strip 1000 in a desired manner. In some embodiments, the light projection element 1005 and the flexible strip 1000 can be two separate parts fused together (e.g., by heating or by chemical means). In other embodiments, the light projection element 1005 and the flexible fiber optic strip 1000 can be a single molded part. In some embodiments, the light projection element 1005 can be as described with respect to Figures 49 to 62 Produced as described.

[0311] Still reference Fig.55 and Fig.56 , the flexible strip 1000 can be coated with a highly reflective material 376. The bottom and sidewalls of the light projection element 1005 can also be coated with a highly reflective material 376. This can ensure that light is only emitted from the uncoated top of the light projection element 1005 and enters the field of view of the lens assembly 354. Fig.56 As shown in FIG. 1 , the light projection element 1005 or the flexible strip 1000 may include a coupling feature 1008. The coupling feature 1008 may allow the light projection element 1005 and the flexible strip 1000 to be coupled to or into the camera assembly 350. The coupling feature 1008 may be an integral part of the light projection element 1005.

[0312] Fig.57 and Fig.58 Two example embodiments of a flexible strip 1000 including a light projection element 1005 that may be formed from a light piping material are depicted. Fig.57 The light projection element 1005 in the embodiment has a generally annular shape, and Fig.58 The light projection element 1005 in FIG. 1 is generally crescent-shaped, but other shapes may be selected as required. Fig.57 and Fig.58 In the example embodiment of FIG. 1 , only the top surface of the light projection element 1005 is not coated with the highly reflective material 376 .

[0313] The light projection element 1005 may include one or more textures 1010 that help guide light emitted from the light projection element 1005. In some embodiments, the one or more textures 1010 may be included to promote light to be emitted in a diffuse manner. The one or more textures 1010 may be created, for example, during molding of the light projection element 1005, or alternatively, the light duct material forming the light projection element 1005 may include a filler material that promotes light to be emitted from the light projection element 1005 in a diffuse manner.

[0314] Fig.59 and Fig.60 1005 are top and bottom perspective views, respectively, of another exemplary embodiment of a light projection element 1005. As shown, the shape of the light projection element 1005 is annular. The light projection element 1005 also includes a coupling feature 1008, such as Fig.60 As shown in the bottom perspective view. Fig.60 The coupling feature 1008 in is an integral part of the light projection element 1005. In an example embodiment, the coupling feature 1008 is a boss or bracket. The boss coupling feature 1008 can help position and / or align the light projection element 1005 on another component (such as the camera assembly 350). Additionally, in some embodiments, an adhesive or glue can be placed along the boss coupling feature 1008 to secure the light projection element 1005 to another component (such as the camera assembly 350). Fig.64 , the light projection element 1005 is shown attached to the example camera assembly 350.

[0315] Figure 59 to Figure 60 The light projection element 1005 shown in FIG. 1 does not include a highly reflective coating or material 376 (see, for example, Fig.55 ). The need for such a highly reflective coating or material 376 may be minimized by sizing the light projection element 1005 so as to increase or maximize the total internal reflection of light entering and within the light projection element 1005, where emission of light is undesirable. This may be achieved by ensuring that any one or more bends have a large radius in the area of ​​the light projection element 1005 where emission of light is undesirable. Additionally, this may be achieved by sizing the light projection element 1005 so that variations in thickness across the light projection element 1005 do not introduce variations in the angle of incidence of light within the light projection element 1005, which would cause the angle of incidence to be less than the critical angle. It may be desirable that the thickness of the light projection element 1005 does not decrease to less than the thickness of the optical fiber or flexible strip to which the light projection element 1005 is attached. It may also be desirable that the surface of the light projection element 1005 is smooth in the area where emission of light is undesirable.

[0316] Fig.61 , Fig.62 and Fig.63 Depicted Figure 59 to Figure 60 FIG. 1 is a diagram showing a plurality of cross sections of the light projection element 1005 depicted in FIG. Fig.59 As shown in the figure, the light entering the light projection element 1005 must pass through the first curved portion 1300 and the second curved portion 1302 before being emitted out of the top surface of the light projection element 1005. Figure 61 to Figure 63As shown in , the light projection element 1005 can be shaped so that the radius of these bends varies depending on the plane of the light projection element 1005. The radius of each of these bends 1300 and 1302 can be selected so as to be as gradual as possible in the available space in a given plane. Also as shown, the thickness of the light projection element 1005 remains approximately constant. This ensures that changes in the angle of incidence due to thickness changes are minimized.

[0317] about Figure 59 to Figure 63 The light projection element 1005 is shown and described as being attached to Fig.64 350. As shown, the light projection element 1005 is arranged so that it projects light into a main illumination field that is substantially consistent with the field of view of the lens assembly 354 (the surrounding area around the main illumination field may also be illuminated due to diffusion and reflection of the emitted light).

[0318] Exemplary methods for constructing fiber optic light delivery elements are disclosed in US Patent Application Serial No. 14 / 170,080 (US Application Publication No. 2014 / 0221749), filed on January 31, 2014, which is hereby incorporated by reference in its entirety.

[0319] Fig.65 Shown in Fig.32 A cross-sectional view of an exemplary camera assembly including lens assembly 354 taken at the cross-sectional plane represented by line 61-61. Fig.32 As shown in the figure, the lens assembly 354 is shown as being housed between the top 356 of the camera housing and the bottom 358 of the camera housing. As shown, the lens assembly 354 is positioned to project an image onto the plane of the image sensor 380. The type of image sensor 380 may include, for example, a CCD image sensor, a CMOS image sensor, etc. Preferably, the image sensor 380 can be housed in a sealed section of the camera assembly 350 to protect against fluid exposure. In a disposable endoscope, a lower cost process can be used to seal the image sensor to prevent fluid exposure (e.g., using a transparent epoxy compound) because the component cannot be designed to withstand the rigors of sterilization and reuse.

[0320] like Fig.65As shown in , the image sensor 380 can be electrically coupled to the flex plate 381 of the flex cable 250. In some embodiments, a conformal coating material can be used to provide added moisture protection, and optionally can be configured to support a ball grid array mounted connector for the image sensor 380. The flex cable 250 can provide power to the image sensor 380 and to a device that transmits data and / or commands to or from the image sensor 380. In some embodiments, a reinforcement member 382 can be included in the camera assembly 350. Fig.65 In the example embodiment shown in FIG, stiffener 382 is positioned to reinforce the structure on which image sensor 380 is supported, which can help protect the physical integrity of image sensor 380. Stiffener 382 may include, for example, a thin aluminum backing member (which may be approximately 0.002 inches thick in an exemplary embodiment).

[0321] The camera assembly 350 may also include one or more fiber guides 384. Fig.65 In the example shown in FIG. 3 , the fiber guide 384 is coupled to the bottom surface of the camera housing bottom 358. The example fiber guide 384 includes a guide groove 386. Fig.65 In FIG. 3 , it can be seen that the back wall of the guide groove 386 of the fiber guide 384 protrudes toward the bottom of the page. The fiber guide 384 may also be or include a plurality of guide recesses or channels 388, Fig.65 In the example fiber guide 384 shown in FIG. 1 , the plurality of guide notches or channels are recessed into the back wall of the guide groove 386. In some embodiments, including Fig.65 In an exemplary embodiment of the present invention, a guide recess or channel 388 can be formed in one or both of the camera housing top 356 and the camera housing bottom 358. The fiber guide 384 can help route the illumination fiber 364 during assembly of the endoscope 10. The fiber guide 384 can also be used to hold the illumination fiber 364 in place during operation of the endoscope 10. The location, shape, number, size, etc. of the fiber guides 384 can vary depending on the specific configuration of the endoscope 10. In some embodiments, in addition to the fiber guide 384, glue, epoxy, or another suitable adhesive or agent can be used to help hold the illumination fiber 364 in a desired position. In embodiments where, for example, a light guide or light projection element (e.g., such as Figure 51 to Figure 58 As shown in or Fig.66 In some cases (as shown in ), the fiber guide 384 may not be used in the assembly.

[0322] Fig.66 Depicted in Fig.50 The line 62-62 of Fig.50. As shown, the lens assembly 354 is shown in an appropriate position in the camera housing 355. The image sensor 380 is also shown in an appropriate position within the camera housing 355. The lens assembly is positioned to project an image to the image sensor 380. As described above, the image sensor 380 can be any type of image sensor (e.g., CCD, CMOS, etc.) and can be sealed to prevent fluid exposure. Also as described above, the image sensor 380 is connected to a flexible board 381 attached to the flexible cable 250. Fig.66 The camera assembly 350 shown in FIG. 1 does not include the fiber guide 384 (see FIG. Fig.65 ). On the contrary, Fig.66 , the light projection element or light emitter 2005 is in an appropriate position on the camera assembly 350.

[0323] As shown, in an exemplary embodiment, the flex cable 250 is folded back in half. This can be accomplished by bending the flex cable 250 and then maintaining the bend by applying glue or another fixative to the affected area of ​​the flex cable 250. In embodiments where the camera assembly 350 is enclosed in a confined space, it may be advantageous to double loop the flex cable 250 under the camera assembly 350. For example, Fig.24 The space shown confining the camera assembly 350 within the inner sheath 312 can limit the amount of flexible cable 250 available for bending. The flexible cable 250 may then have to bend to an undesirably small radius at certain rotational positions of the camera assembly 350. Such a small bend radius can be detrimental to the flexible cable 250, especially if it occurs repeatedly. This problem becomes more severe as the diameter of the inner sheath 312 decreases. However, by arranging the flexible cable 250 to be folded back in half, a greater length of the flexible cable 250 can be used for repeated bending as the camera assembly 350 rotates, and a larger minimum bend radius can be obtained. Therefore, this can allow the inner sheath 312 to be manufactured with a smaller diameter without the integrity issues of the flexible cable 250 caused by repeated bending and straightening at a small radius.

[0324] Both the flexible cable 250 and the optical fiber 364 guiding the light projection element 2005 exhibit a certain resistance to bending. Additionally, both can exert a restoring elastic force when bent. This resistance to bending may increase the resistance of the camera assembly 350 to rotation. Fig.67 As shown in FIG, the flex cable 250 and the optical fiber 364 can be angled toward each other. This arrangement can take advantage of the stiffness of the flex cable 250 relative to the optical fiber 364 (or vice versa) to facilitate rotating the camera assembly 350. To best illustrate this concept, in FIG. Fig.67 In the embodiment of the present invention, the flexible cable 250 is not folded back.

[0325] In some embodiments, at least one illumination source for camera assembly 350 may be positioned to project light in a direction other than into the field of view of camera assembly 350. That is, the direct illumination field of the illumination source may be oriented so that it is outside or not consistent with the field of view of the camera assembly. Such an illumination source may be referred to as an indirect light source, while an illumination source that projects light directly into the field of view of camera assembly 350 may be referred to as a direct light source. An indirect light source may, for example, be oriented so that it emits light behind camera assembly 350 or in a direction substantially opposite to the direction of the field of view of camera assembly 350. For example, instead of or in addition to a light projection element 2005 coupled around lens assembly 354 or a lens and projects light into the field of view of lens assembly 354 or a lens, light projection element 2005 may be attached to a portion of camera assembly 350 opposite lens assembly 354 or a lens.

[0326] Although counter-intuitive, projecting light outside of the field of view of the camera assembly 350 (e.g., behind the camera assembly 350 in a direction opposite to the field of view) provides increased image quality and reduces the need for image processing. For example, such an illumination arrangement can help provide greater depth perception during an endoscopic procedure because shading of areas that would otherwise be directly illuminated can be maintained. By emitting light from the light projection element 2005 or other illumination source to points outside of the field of view of the camera assembly 350, hot spots or areas that appear washed out and dark spots or areas that appear underexposed can be mitigated. Such an illumination arrangement can help provide more uniform illumination within the field of view of the camera assembly 350.

[0327] Fig.68 , a representative embodiment of an illumination arrangement in which light can be emitted from a plurality of light sources 702a-702d to areas inside and outside of the field of view 700 of the camera assembly 350 is shown. As shown, an extension 430h of a printed circuit board in the endoscope handle is shown extending to the camera assembly 350. The printed circuit board extension 430h can provide power and data communication paths to various components in the insertion section 14. In some embodiments, a ribbon or flexible cable 250 (e.g., Fig.14 ) may be used in place of the printed circuit board extension 430h. A plurality of components are mounted on the printed circuit board extension 430h. These components may be any or a variety of different components, such as sensors, light emitters, etc. In the example embodiment, the components are described as light sources 702a to 702d. The light sources 702a to 702d may be any suitable light source, such as, but not limited to, fiber optic cables, light projection elements 2005 (see, e.g., Fig.62 ), LED or LED array.

[0328] For various reasons, it may be desirable to use LEDs in some specific embodiments. For example, in some specific embodiments, the use of LEDs can eliminate the need for illumination fiber bundles / strips. Some optical fibers may degrade during use when subjected to long periods of bending, and may be susceptible to light loss when bent. LEDs have a long life and do not require longer fiber bundles that are subjected to bending. The use of LEDs can also minimize the number of pass-through elements between the dry section of the endoscope (e.g., handle 12) and the wet section of the endoscope (e.g., insertion section 14). Additionally, by omitting optical fibers, less of the cross-sectional area of ​​the fluid conduit in the insertion section 14 may be blocked or filled. This can allow for an increased flushing fluid flow rate through the insertion section 14. LEDs also help to simplify manufacturing, or increase the ease of manufacturing.

[0329] As shown, the first light source 702a is arranged so that it can project light generally toward the field of view 700 of the camera assembly 350. Such a light source 702a can generally provide direct illumination of the field of view 700. In some embodiments, the direct light source 702a can be omitted, or the direct light source can be accompanied by one or more other indirect light sources, such as any one or a combination of light sources 702b to 702d. In an embodiment including a direct light source 702a combined with one or more indirect light sources, the direct light source 702a can provide light at a lower intensity than one or more of the indirect light sources. In some embodiments, the direct light source 702a can provide light that is not in the same spectrum or spectral subset as the light emitted by the (multiple) indirect light sources. For example, the direct light source 702a can be an RBG LED array, and the indirect light source can emit white light.

[0330] exist Fig.68702a to 702d. For illustrative purposes, these light sources are shown together and need not all appear in any given embodiment. Any number of light sources 702a to 702d may be included in various embodiments. In various embodiments, some of the light sources 702a to 702d may be omitted. Each of the light sources 702b to 702d is an indirect light source arranged so that they do not directly emit light into the field of view 700 of the camera assembly 350. The light sources 702b to 702d are arranged to emit light in a direction substantially opposite to the field of view 700 of the camera assembly 350. The light source 702d may be attached to the camera assembly 350 and may be arranged to emit light from the side of the camera assembly 350. In a preferred embodiment, the backlight provides the only source of illumination for the surgical field. In this case, for example, the illumination source for the distal end of the endoscope may include only one or more LEDs located at position 702b; that is, light is projected from the side of the endoscope shaft away from the side from which the majority of the field of view of the camera assembly is directed. The light thus provided more indirectly and diffusely illuminates the space viewed by the camera assembly, thereby preventing bright reflections of light aimed directly at the camera or reducing the casting of shadows and improving the operator's field of view. On the other hand, placing the LED at position 702a can improve the illumination of the area of ​​the surgical field toward which the camera field of view 700 is pointed.

[0331] The camera assembly 350 may include one or more filters to selectively use wavelengths emitted from one or more light sources 702a to 702d. For example, a polarizing filter or a bandgap filter may be used to enhance the imaging performed by the camera assembly 350.

[0332] Depending on the embodiment, the camera assembly 350 can be rotated within the insertion section 14. In such an embodiment, the light sources 702a-702d can remain stationary while the camera assembly 350 rotates. Alternatively, one or more light sources 702a-702d can rotate with the camera assembly 350 (e.g., the light sources 702a-702d can be attached to the camera assembly 350 and thus rotate with the camera assembly 350). The light sources 702a-702d are positioned so that they do not emit light directly into the field of view 700 in any or a large percentage (e.g., from about 70% to 100%) of the possible rotational positions of the camera assembly 350. In some embodiments, the entire distal end of the shaft or insertion section 14 (or the entire insertion section 14) can be transparent so that the camera assembly 350 can be rotated therein to obtain multiple viewing angles through the one or more transparent portions; in this particular embodiment, the distal portion of the insertion section 14 can optionally be fluidly sealed from the surrounding space, and the camera and light sources rely on the transparency of the distal end of the shaft.

[0333] Additionally, in some embodiments, a controller that monitors the rotational position of camera assembly 350 can increase or decrease the intensity of light emitted by various light sources 702a-702d depending on the position of field of view 700. For example, the controller can detect the position of the camera assembly 350 by a sensor such as a rotary potentiometer attached to pivot shaft 204 (e.g., see FIG. Fig.14 )) to monitor the displacement of the pivot control structure 100 (see, for example, Fig.14 ). Based on the data collected from the sensor, the controller can determine whether the light source 702a to 702d has been transferred from a direct light source to an indirect light source, or vice versa. The controller can then adjust the intensity of the light generated by the light sources 702a to 702d accordingly. Based on the sensor readings, the controller can, for example, determine which light sources 702a to 702d are emitting light into the field of view 700 of the camera assembly 350, and reduce the intensity of the light generated by these light sources 702a to 702d. The controller can use the sensor readings to determine whether the camera assembly 350 has been rotated so that the light sources 702a to 702d that previously emitted light directly into the field of view 700 now act as indirect light sources. When it is determined that the light source 702a to 702d has been transferred from a direct light source to an indirect light source, the intensity of the light generated by this light source 702a to 702d can be increased. The adjustment of the emitted light can be performed in a continuous, gradual manner, a step-by-step manner, or a binary manner (e.g., switching between a preset direct intensity level and an indirect intensity level).

[0334] exist Figures 69 to 70 An example of a PCB 430a is shown in FIG. 4 that includes a plurality of LED light sources 750 and a sensor 754 on an extension 430h of the PCB 430a. A sensor or camera assembly 350 is also shown at the end of the PCB extension 430h. Fig.69 A top view of a printed circuit board 430a is depicted, and Fig.70 A side view of printed circuit board 430a is depicted.

[0335] The printed circuit board 430a may include a main portion 430L from which the shaft portion 430H extends. The main portion 430l of the printed circuit board 430a may be housed in the handle 12 of the endoscope 10 (see, for example, Figure 3A or Figure 3B ).exist Figures 69 to 70 In the example embodiment shown in , for simplicity, the main portion 4301 is not shown as being filled with electronic components. Fig.78 An example printed circuit board 430a populated with example components 430b to 430f is depicted in FIG. Fig.70As shown in , at least a portion of the main portion 430L of the printed circuit board 430a can be coated or encapsulated with a protective coating or material layer. The protective material can be any of a variety of potting materials or conformal coating materials. Acrylic resins, epoxy resins, polyurethanes, silicone resins, polyparaxylene, thermosetting plastics, rubber or any other potting materials or conformal coating materials can be used. Preferably, the protective material is biocompatible and provides waterproof properties. A transparent protective coating can also be placed on the LED 750 and sensor 754 on the protrusion 430h.

[0336] PCB extension (or optional ribbon cable) 430h may extend through pass-through barrier 159 (see, e.g., Fig.15 ) and along the axis of the insertion section 14 of the endoscope 10 (see, for example, Fig.15 ). The protrusion 430h can provide power and data communication paths to various components (e.g., camera assembly 350 and / or LED 750) within the insertion section 14 (e.g., see Fig.15 ). The protrusion 430h can be divided into multiple different parts. In the example shown, the protrusion 430h includes a first part 430i, a second part 430j, and a third part 430k. (In other embodiments, the protrusion 430h can be divided into a different number of parts). Each part of the protrusion 430h can have different characteristics. For example, each part of the protrusion 430h can have a different level of flexibility. Some parts may be rigid circuit boards, while other parts are flexible cables. Additionally, each part of the circuit board can have a different number of layers, different widths, a different number of traces on each layer, etc. It may be desirable that at least a portion of the protrusion 430h of the printed circuit board 430a is a flexible cable or is otherwise flexible. This can help facilitate rotation of the camera assembly 350.

[0337] In some embodiments, the first section 430i can be a six-layer rigid circuit board. The second section 430j can be a two-layer flex cable. The third section 430k can be a four-layer rigid circuit board. Each section can transition into the next section, or connectors can be used between one or more sections of the protrusion 430h. To simplify manufacturing and reduce costs, it is preferred that the communication and power lines in the endoscope shaft include flexible and / or rigid extensions of the main PCB located in the endoscope handle. The entire PCB with (multiple) extensions can be as shown. Fig.43 as shown, and any flexible PCB extensions can be Fig.44 The fold shown is to run adjacent to a mating PCB extension (rigid or flexible) during assembly of the endoscope.

[0338] Sensor 754 can be any of a variety of sensors. In some embodiments, sensor 754 can be a temperature sensor, such as a thermistor, a thermocouple, or a resistance temperature detector. In some specific embodiments, sensor 754 can be a thermistor. Temperature sensor 754 can be used to monitor the temperature of the environment near LED 750 or at these LEDs.

[0339] During an endoscopic procedure, an irrigation fluid may flow through the LED 750. The fluid may help cool the LED 750, thereby maintaining the temperature of the LED 750 within a desired temperature range. In the case where the endoscope 10 is outside the patient's body and the irrigation fluid is not traveling, the controller may monitor data from the sensor 754 to determine whether the environment near the LED 750 becomes hotter than the desired temperature range. In the event that the temperature exceeds the temperature range, the controller may command the current flow to the LED 750 to be reduced, or the controller may command the LED 750 to be turned off. The temperature sensor may also be used as an irrigation fluid flow sensor. During an endoscopic procedure, the flow rate of the irrigation fluid may be sufficient to dissipate the heat generated by the LED 750 by convection, so that the area around the LED 750 is within the desired temperature range. In the event that the flow rate is reduced by more than a certain amount, the temperature in the area near the LED 750 may increase. In some embodiments, this increase may be interpreted by the controller as a reduction in the flow rate of the irrigation fluid. In response, the controller may generate a notification to the user for this effect.

[0340] Fig.71 A flowchart detailing a number of example steps that a controller may use to control an LED in an insertion section 14 based on a sensed temperature is depicted. At step 756, the controller receives a data sample from a temperature sensor proximate to the LED. The controller then analyzes the data sample at step 758. If 760 the temperature is not outside a first predefined range, step 756 may be repeated. If 760 the temperature is outside the first predefined range, then at step 762, the controller may transition one or more LEDs from a first state to a second state. The temperature range may have an upper limit between 40 degrees Celsius and 50 degrees Celsius (e.g., 50 degrees Celsius). The first state may be a high light output intensity on state, and the second state may be an off state. In the example flowchart, the second state is a dark state or an off state. The controller receives a data sample from a temperature sensor at step 764, and analyzes the data sample at step 766. If 768 the data sample indicates that the temperature is outside a second predefined range, step 764 may be repeated. If 768 the data sample indicates that the temperature is within the second predefined range, then at step 770, at least one LED may be turned on or commanded to increase the intensity of the light it produces.

[0341] The first predefined range and the second predefined range may be the same, or the first predefined range and the second predefined range may be different, wherein the second predefined range is smaller than the first predefined range. This can ensure that the controller does not quickly cycle between turning on / off or dimming and increasing the intensity of the light from the LED. In some embodiments, after reaching step 762, a timer can be started. The timer can be a minimum dimming or off time timer for at least one LED whose brightness has been modified. In the event that the minimum off or dimming timer does not expire, the at least one LED will not be adjusted back or commanded to increase the light output intensity even if the temperature is within the second predefined range. This can also help prevent rapid cycling between LED states.

[0342] Fig.72 A close-up side view of an example of an end of a protrusion 430h of a printed circuit board 430a is depicted. As shown, the protrusion 430h includes a first portion 430i, a second portion 430j, and a third portion 430k. The camera assembly 350 is attached to the third portion 430k. A sensor 754 is mounted on the first portion 430i near the plurality of LEDs 750a to 750d. The sensor 754 can be a temperature sensor (such as a thermistor) and can be used to help control the LEDs 750a to 750d. Sensors for detecting fluid environment characteristics other than temperature (e.g., conductivity, pH, etc.) can also be used.

[0343] LED 750a can be a direct light source and generally projects light into the field of view 700 of camera assembly 350. LED 750a is mounted to a first side 430m of a first portion 430i of protrusion 430h. LEDs 750b to 750d are mounted on a second side 430n of the first portion 430i opposite the first side 430m. These LEDs 750b to 750d can be indirect light sources and, in some embodiments, may not project light directly into the field of view 700 of camera assembly 350 at any rotational orientation of camera assembly 350. In some embodiments, LED 750a can be an RBG LED array. LED 750a can be adjusted to provide light at a spectrum that can help modify the color of an image produced by an image sensor of camera assembly 350 in a desired manner. For example, LED 750a can be adjusted to correct for color deviations of the image sensor of camera assembly 750a. LEDs 750b to 750d can be white light LEDs. As shown, the first portion 430i of the protrusion 430h can be a thicker portion of the printed circuit board relative to the other portions 430j, 430k of the protrusion 430h. This can allow the power requirements of the LEDs 750a to 750d to be easily accommodated.

[0344] The first portion 430i can transition to a second portion 430j of the protrusion 430h. The second portion 430j can be a relatively thin flexible cable. The second portion 430j can facilitate rotation of the camera assembly 350 around the axis of the pivot pin 366 of the camera assembly 350. As shown, the second portion 430j can have a certain length so that when the first portion 430i and the third portion 430k are parallel to each other, the second portion 430j is bent or arched. This can help allow an increased range of motion for the camera assembly 350.

[0345] Fig.73 An example embodiment of a camera assembly housing 330 for insertion section 14 is depicted. Fig.74 Depicted in Fig.73 72-72 of the camera assembly housing 330. The camera assembly housing 330 is continuous with the inner sheath 312, and the two can be formed as a single part. Figure 73 to Figure 74 As shown in FIG. 4 , the protrusion 430h of the printed circuit board 430a (see, for example, Fig.70 ) is shown within the camera assembly housing 330. The protrusion 430h is similar to Fig.72 , and includes a camera assembly 350, a plurality of LEDs 750a to 750d, and an optional sensor 754. As shown, the LEDs 750a to 750d are arranged so that they can emit light from the top opening 338 and the bottom opening 340 of the camera assembly housing 330. The camera assembly 350 can be rocked so that its field of view can sweep from the blasthole-shaped opening 344 at the rounded end 342 through the opening provided by the top void 338. When fully assembled, the outer sheath 318 (e.g., see Fig.24 ) can be placed over the camera assembly housing 330 and inner jacket 312 to protect the camera assembly 350 while still providing an unobstructed field of view.

[0346] Fig.26 A perspective view of the distal end of the shaft of an endoscope (or arthroscope) 14 is shown, wherein a sensor or camera housing 500 is positioned at the end of the shaft. In this case, the inner sheath 312 is devoid of a distal-most protective shield, shroud, or tip structure. At least a portion (i.e., the distal-most portion) of the rotatable sensor or camera housing 500 forms the distal-most element of the insertion end of the endoscope. Thus, the sensor housing 500 is preferably configured to withstand repeated contact with anatomical structures including soft tissue, bone, cartilage, or joint surfaces. In an embodiment, as described above with respect to the camera housing 350, the rounded or dome-shaped camera housing 500 may also include a light source that is capable of moving with the rotatable camera housing and continuously directed toward the field of view of the camera housing 500. The light source may include, for example, one or more LEDs, or the end of a fiber optic bundle. In Fig.26 In the example shown in , the light source 508 (in this case a LED bank) is positioned on one side of the shaft just proximate to the location of the rotatable sensor or camera housing 500. In the illustration, the light source 508 is on the side that directs illumination toward the overall field of view of the camera / lens assembly 500 when rotated approximately 90 degrees relative to the long axis of the endoscope shaft 14. (Alternatively, the light source can be arranged opposite the side on which the camera assembly (lens and sensor) can be oriented). In the arrangement shown, the optical axis of the camera assembly can be generally pointed in the direction of light projected from a first side of the insertion end of the endoscope. In other arrangements, the light source is positioned on a second, opposite side of the insertion end, projecting light away from the second side of the insertion end of the endoscope, while the optical axis of the camera assembly can be generally pointed toward the field of view opposite the first side of the insertion end of the endoscope. Fig.75 A perspective view of the latter arrangement is shown, in which light emitted by a light source 508 (an LED in this example) is directed to an area generally away from the field of view of the sensor and lens 512. An alternative second arrangement is intended to provide indirect illumination (or backlighting) of the field of view of the camera assembly by relying on ambient light generated by an illumination source in the operating area of ​​the endoscope. The illumination source or LED is mounted flush with or recessed from the outer surface of the inner sheath or shaft of the insertion end. If recessed, there is less likelihood that the heat generated by the LED will directly touch or injure nearby tissue in the operating area.

[0347] Selective saturation enhancement

[0348] The quality of displayed images generated by low-cost image sensors (such as those found in disposable endoscopes) can also be enhanced by selective enhancement of the saturation of the displayed images. In clinical environments using endoscopes or arthroscopy, it has been found that red and white tones are particularly important in generating satisfactory images. Therefore, the image quality from the camera sensor can be improved by selectively emphasizing the saturation of the image without reducing the intensity of unsaturated pixels. Each pixel is analyzed according to its hue, saturation and value or brightness. The saturation of a pixel is enhanced by its saturation factor in the HSV (hue, saturation, value) color space and its brightness factor in the HSL (hue, saturation, brightness) color space. In this example, a Gaussian function that shifts toward a lower saturation value is designed to enhance desaturated pixels without over-amplifying already saturated pixels. Similarly, a second Gaussian function is used for brightness in the HSL color space to reduce the saturation enhancement of near-white and near-black pixels. Distributions other than Gaussian functions (i.e., other types of probability distributions) can be used, and the selective enhancement process itself does not particularly rely on the use of Gaussian functions.

[0349] like Fig.106As shown in, in one example, if a pixel 1050 is in the red range of medium saturation, the processor assigns a value ("factor 1") 1052 in the range of 0 to 1, and may be based on a probability distribution 1054 (e.g., a Gaussian distribution) such that saturation values ​​in the HSV color space 1056 in the lower / middle portion of the saturation range are assigned a value of 1. The centering 1058 of the probability distribution may be anywhere in the lower half of the saturation range; and in an example, the probability distribution can be centered around values ​​approximately 25%-40% of the saturation range. This provides a weighting factor for the saturation of pixels that is skewed toward pixels with relatively low saturation, and leaves pixels with relatively high saturation relatively unchanged. A second value ("factor 2") is then calculated 1060, and this second value may also be based on a probability distribution 1062 (e.g., a Gaussian distribution) of the brightness of the pixel in the HSL color space 1064. The probability distribution can be centered 1066 around brightness values ​​that are approximately 50% of the range, such that values ​​toward each end of the spectrum are assigned values ​​close to zero. If the pixel is close to white, the second factor will greatly suppress the enhancement in the final calculation. The saturation of a pixel can be enhanced by the following formula:

[0350] Enhanced saturation value = (original saturation value) x (1 + (factor 1 x factor 2 x 0.5)) Formula 0003

[0351] In this example, the fixed fraction of 0.5 (which is multiplied by the product of the first factor and the second factor) may be an arbitrary number and may be adjusted empirically by observing the effect of the enhancement process on the displayed image.

[0352] Reference now Fig.76 In embodiments including at least one variable illumination source capable of producing light at different intensities and / or spectra, the endoscope 10 may be placed in a calibration fixture 780 to facilitate setting various illumination parameters. Embodiments having one or more white LEDs and one or more colored LEDs (e.g., an RBG LED array) may be placed in a calibration fixture, for example, prior to use, to adjust the intensity of the light output of its LEDs and to adjust the color output of the one or more colored LEDs. This may help ensure more uniform image quality and minimize differences between endoscopes 10 that can be attributed to differences between their LEDs and / or image sensors.

[0353] The calibration fixture 780 may be a light-tight box or other volume that includes an opening 782 sized to fit the insertion section 14 of the endoscope 10. This opening 782 may be gasketed so that when the endoscope 10 is mounted in the calibration fixture 780, a light-tight seal is formed against the insertion section 14 of the endoscope 10. The interior of the calibration fixture 780 may include a camera assembly 350 (e.g., see FIG. 1 ) placed in the endoscope 10. Fig.73 ) within the field of view of the calibration fixture 780. For example, a target with known color characteristics can be placed within the calibration fixture 780.

[0354] The controller can monitor the characteristics of the one or more targets in the image captured by the image sensor of the camera assembly 350. Because the characteristics of the targets (e.g., color) are known, the controller can adjust the illumination provided by the (multiple) variable light sources until the characteristics of the (multiple) targets in the captured image match or are within the range of known characteristics of the one or more targets. For example, the intensity of light and / or the spectrum of light generated by the plurality of LEDs 750a to 750d included in the insertion section 14 can be adjusted (e.g., see Fig.72 ).

[0355] Fig.77A flowchart detailing a number of example steps that may be used to calibrate one or more illumination parameters of at least one variable light source included in an endoscope is depicted. At step 784, a portion of an insertion section of an endoscope including a camera assembly may be placed in a calibration fixture. Once inserted, at step 786, a controller may command a variable illumination source in the endoscope to emit light. The light may be emitted based on default parameters (e.g., light intensity and color parameters). At step 788, the controller may receive image data from an image sensor of the camera assembly of the endoscope. At step 790, this data may be analyzed by the controller. For example, the image data may be analyzed to determine one or more characteristics of interest of one or more targets in a captured image. At step 792, these characteristics may be compared to known or expected characteristics of the one or more targets that have been imaged. If the characteristics of the target in the captured image are within a range of known or expected characteristics 794, then at step 796, the calibration may be considered complete. If the characteristics of the one or more targets in the captured image are not within a range of known or expected characteristics 794, then at step 798, the controller may adjust one or more illumination parameters of at least one variable illumination source of the endoscope. In an example embodiment, at step 798, the intensity and / or spectrum of light produced by at least one variable light source is adjusted. Step 788 may be repeated after the adjustment. The images may continue to be compared and analyzed, and the illumination parameters may be adjusted until the characteristics of the target in the captured image are within a range of their known or expected values. Various methods may be used in the construction and assembly of the lens or lens group to focus the image onto the sensor or camera at the distal end of the endoscope shaft. Examples of these methods and techniques are disclosed in U.S. patent application serial number 14 / 170,080 filed on January 31, 2014 (U.S. application publication number 2014 / 0221749), which is incorporated herein by reference in its entirety.

[0356] Fig.78 Another exemplary embodiment of the endoscope 10 is shown. The outer sheath 318 is Fig.78 16 and 17. The endoscope 10 is shown mounted on the endoscope. Additionally, for clarity of description, only the lower half shell 22 of the handle proximal section 16 and the half (30a) of the handle distal section 30 are visible. As shown, the endoscope 10 includes a printed circuit board 430a (also referred to herein as a handle or main PCB 430a) surrounded by the handle. An electronic cable (e.g., a power / HDMI cable) 432, an optical fiber 364, and a flushing / suction line 434 are also shown. Fig.78An example routing path for the power / HDMI cable 432, the optical fiber 364, and the irrigation line 434 is shown. As shown, the electronic cable 432, the optical fiber 364, and the irrigation line 434 enter the endoscope 10 through the opening 60 at the rear end or docking end of the handle proximal section 16. This entry point may be more advantageous than the handle side entry point because it reduces the possibility of tangling of various cords and cables when the insertion section is rotated relative to the handle proximal section 16.

[0357] In some embodiments, the electronics cable 432, optical fiber 364 (if present), and irrigation line 434 may enter the endoscope 10 at an angle relative to the rear handle opening 60. This arrangement provides ergonomic benefits to the user by allowing the user to grip a larger portion of the rear of the handle proximal section 16.

[0358] As shown, the electronic cable 432, the optical fiber 364 (if implemented in the endoscope) and the flushing line 434 extend on a portion of the handle PCB 430a after entering the handle proximal section 16. The electronic cable 432 is inserted into the connector 430b (e.g., power / HDMI connector) of the handle PCB 430a. The electronic cable 432 can provide power to the endoscope 10. The image data can be transferred to the handle PCB 430a via the flexible cable 250. The electronic cable 432 can transmit the visual data collected by the endoscope 10 to an external graphical user interface display (not shown). The optical fiber 364 (if implemented in the endoscope) and the flushing line 434 extend below the handle PCB 430a and follow the path described above. In the embodiment where the endoscope 10 is disposable, the electronic cable 432, the optical fiber 364 and the flushing line 434 can all be included as disposable components to ensure sterility each time the endoscope is used, or to save the cost of sterilization and packaging for reuse.

[0359] In this example, the control line 91 of the button 90 is also shown. Fig.78 As shown, the control line 91 passes through the orifice in the sealing member 210. The control line 91 is in communication with the handle PCB 430a. Fig.78 As shown in FIG. 4 , the handle PCB 430a includes a handle PCB flex cable 430e. The handle PCB flex cable 430e is connected to the handle PCB portion 430f, thereby allowing the PCB portion 430f to be oriented at a certain angle (e.g., vertically) relative to the rest of the handle PCB 430a. When assembled, the flexibly attached handle PCB portion 430f can be disposed between the two potentiometers 122 of the example rotation sensing assembly 150 (see FIG. 4 ). Figure 8 ).

[0360] In some embodiments, the handle PCB 430a may include an image or graphics processing unit 430c. However, preferably, the image processing unit 430c is located outside the endoscope 10. The image processing unit 430b may be used as an electronic correction mechanism for the endoscope 10. The image processing unit 430c may receive an image captured by the image sensor 380, which is sent from the image sensor 380 to the handle PCB 430a via the flexible cable 250. In a preferred embodiment, the image captured by the image sensor 380 is then transmitted to the image processing unit 430c outside the endoscope 10 via the electronic cable 432. The image processing unit 430c may also receive a signal from the rotation sensing assembly 150. In some embodiments, an analog-to-digital converter 430d may be included on the handle PCB 430a to convert the signal from the rotation sensing assembly 150. The image processing unit 430c may use the signal from the rotation sensing assembly 150 to electronically "correct" the image to the desired orientation. In some embodiments, the image may be rotated by the image processing unit 430c so that the image is displayed as if it were captured from the user's perspective. In some embodiments, the image processing unit 430c may also correct for the effects of lens distortion.

[0361] Unless the orientation of the image displayed on the graphical user interface is first corrected, the displayed image may be confusing to the user.By defining the direction according to the user's perspective, the image processing unit 430c can use the data from the rotation sensing component 150 to automatically rotate the image so that the image corresponds to the user's perspective.

[0362] Fig.79 An example block diagram of an imaging system is shown. As shown, the imaging system includes an image sensor 380 that captures an image. The image captured by the image sensor 380 can be passed to an image processing unit 452 via a camera serial interface 450 (e.g., a MIPI (Mobile Industry Processor Interface) camera serial interface). The image processing unit 452 (IPU) can then move the image frame to other hardware components in the imaging system. Other hardware components may include, but are not limited to, a memory device and a graphics processing unit 430c (graphical processing unit, GPU). The graphics processing unit 430c can correct any distortion caused by the lens assembly 354.

[0363] In some embodiments, the graphics processing unit 430c can correct for such distortion by representing the image as a texture on a surface that has been loaded into the graphics processing unit 430c. This can cause the image to be adjusted or stretched in a manner that corrects and / or eliminates the distortion introduced by the lens assembly 354. In embodiments where the image is corrected, the graphics processing unit 430c can then rotate the corrected image via input from the rotation sensing assembly 150 (e.g., see Figure 8 For example, the measurement value from the rotation sensing assembly 150 may be transmitted to the graphics processing unit 430c via the analog-to-digital converter 430d (see, for example, Fig.78 ). The signal from analog-to-digital converter 430d can then be used to rotate the image to its corrected orientation. In some embodiments, the user may be able to toggle image correction, distortion correction, and / or various other image manipulations that can be turned on or off. Image correction will be discussed later in the specification. Fig.80 Further description.

[0364] The processed images from the image processing unit 430c can be displayed on a graphical user interface or display 454. In some embodiments, the processed images from the image processing unit 430c can be stored in a memory. In such an embodiment, for example, a user can capture an image to be stored in a memory for later recall by triggering button 90. Some embodiments may include a video processing unit 456 that can encode frames from the image sensor 380 into a recordable video format. In such an embodiment, the encoded video can then be stored in a memory. As described above, a user can command the endoscope to initiate and stop video capture by interacting with a button (such as button 90).

[0365] In some embodiments, the image processing unit 430c may also perform exposure feedback analysis on the captured image. In certain embodiments, an image histogram may be generated from all pixels of the image. The image histogram may then be used to tune the image or to tune the exposure of subsequent images received by the image chip or sensor 380. Such further processing by the image processing unit 430c may help reduce overexposed white areas of the image or underexposed dark areas of the image. Other means of tuning one or more images, such as tone mapping, etc., may also be used.

[0366] Fig.80 Depicted are example diagrams showing how input from the rotation sensing assembly 150 may be used to rectify an image (eg, see Fig.80). As shown, a first block 2100 and a second block 2102 are depicted. Within each block 2100, 2102, an endoscope 10 having a field of view 2104 is depicted. The field of view 2104 of the endoscope 10 in the first block 2100 is oriented approximately 180 degrees from the endoscope 10 in the second block 2102. This can be achieved by rotating the distal end of the endoscope 10 relative to the proximal end of the endoscope 10. In a conventional endoscope 10, during the rotation of the distal section relative to the proximal section, the image sensor does not rotate because the image sensor is housed in the proximal section. Therefore, both the endoscopes 10 shown in the first block 2100 and the second block will capture an image 2106.

[0367] In some embodiments described herein where the image sensor 380 rotates with the distal end of the endoscope 2106, this is not the case. The endoscope 10 shown in the first block 2100 will capture the image 2106, while the same endoscope 10 rotated to the position shown in the second block 2102 will capture the image 2108. As the image sensor rotates with the distal end of the endoscope 10, the image sensor will invert the image. In this position, for example, the top of the image sensor will pick up what people accustomed to conventional endoscopes 10 would expect to be the bottom of the image.

[0368] Alternatively, the image may rotate in proportion to the degree of rotation of the distal end of the endoscope 10. Thus, the image can always be displayed in a manner that is expected by a user accustomed to a conventional endoscope 10. This may help alleviate problems associated with rotating image sensors.

[0369] Image rotation correction

[0370] exist Fig.81 , the magnets 51 are shown in relative positions. Although actually mounted on the interior surface of the proximal housing of the endoscope handle, in this illustration, both the proximal and distal handle housings have been removed for clarity. The rotation sensor 704 is shown as being mounted on the handle PCB, positioned to respond to the position of the magnet 51 in a rotational plane that includes the sensor 704. Note that, optionally, only one magnet 51 may be used to perform the function of providing sensor 704 position data of the magnet (and therefore the proximal housing) relative to the sensor (and therefore the PCB and distal housing to which it is attached). The relative rotation data is provided to the controller so that the displayed image orientation can be kept stationary while the distal housing and shaft rotate relative to the proximal housing.

[0371] The "correction mechanism" provided by a controller on the PCB (or, more remotely, on an image processing unit external to the endoscope) is designed to emulate the image orientation of a conventional rod-lens endoscope, in which an image sensor (camera) near the axis of the endoscope is held in a fixed position, and the angle of a beveled lens at the end of the rod rotates as the rod and axis rotate. (The angled or beveled lens at the end of the rod acts as a prism so that the image on the camera remains upright as different segments of the peripheral image move in and out of the camera's field of view during rotation of the rod lens). In the present case, the camera is located at the tip of the rotating endoscope axis, with the camera mounted at an angle of less than 90 degrees relative to the endoscope axis. A controller in the endoscope or image processing unit tracks the rotational position of the "rod" (or in this case, camera) portion relative to the proximal handle portion of the endoscope, and the controller counter-rotates the displayed image to keep it appearing upright. The end result is a non-rotated displayed image that remains upright, in which the field of view appears to change by translation rather than rotation.

[0372] Fig.82 The region of the image received by the camera sensor mounted at an angle at the end of the shaft of the endoscope is schematically shown. The central feature 904 (and any central elements it represents) is shown in an upright position. Fig.99 As shown in , the camera sensor is angled upward relative to the long axis of the distal end of the endoscope shaft. The optical axis of the camera sensor and lens 841 (meaning the line about which the camera and lens exhibit rotational symmetry) is at a non-zero angle Φ relative to the rotation axis 843 of the distal end of the endoscope and camera sensor 812. Fig.82 900. The upper peripheral field of view is represented by region 906. The right peripheral field of view is represented by region 908. The lower peripheral field of view is represented by region 910. The left peripheral field of view is represented by region 912. Because the camera sensor and its mounting are angled upward from the long axis of the distal endoscope shaft, an observer of the image processed by the camera sensor array, as represented by image boundary 902, primarily sees the central element 904 and the upper field of view 906. As the endoscope shaft and associated camera sensor and mounting rotate, other peripheral fields enter the primary field of view in a non-rotating manner. Due to the image rotation correction performed by the processor, the angle of the camera sensor translates the various fields of view into the displayed image.

[0373] FIG. 83A to FIG. 83D900 shows the effect generated by the image rotation correction processor. Arrow 900 shows the position of the camera sensor mount (and camera sensor) with its beveled end angled toward the arrow so that the optical axis of the camera sensor 802 is angled from the rotational axis of the endoscope shaft in the direction of the arrow. The angle itself is arbitrary and can be any angle relative to the longitudinal axis of the distal end of the shaft, but in this case, the optical axis can be a non-zero angle; for example, approximately 30 degrees from the horizontal (i.e., relative to the long axis of the distal end of the endoscope shaft). To assist the operator, arrow 900 or a similar graphical indicator can be projected onto the operator's visual display so that the operator is constantly aware of the orientation of the camera sensor 802. As the endoscope shaft or insertion section is rotated relative to the proximal handle, the camera orientation rotates about a central region 904, with the camera rotating from the proximal end of the endoscope shaft to the distal end of the endoscope shaft. Fig.83A Rotate to Fig.83D During this time, the central area remains in a fixed position. For example, in the first position, the visible field 906 above the central object 904 is brought into view ( Fig.83A ). In the second position, the visible field 908 to the right of the central object 904 is brought into view ( Fig.83B ). In the third position, the visible field 910 below the central object 904 is brought into view ( Fig.83C In the fourth position, the visible field 912 to the left of the central object 904 is brought into view ( Fig.83D ). Note that the image correction or image rotation correction controller can project a continuously changing target visible field between these positions, with the peripheral field moving in and out of the field of view in a translational manner rather than a rotational manner. Without this feature, the image projected on the display screen would rotate with the axis of the endoscope, so that, for example, Fig.83A The central object 904 in an upright position in the image (along with the rest of the field of view) will rotate with the camera sensor 802, thereby displaying a corresponding rotation of the object 914 (and the associated field of view), rather than remaining a stationary object 904 and a translating field. Thus, the image rotation correction controller simulates the visual effect of a fixed camera sensor receiving images from a rotating rod lens.

[0374] In one embodiment, the rotation correction system can employ a "three-axis" absolute magnetic position sensor mounted on a PCB and capable of measuring magnetic flux density on the x, y, and z axes in a space associated with one, two, or more magnets mounted on the interior surface of a proximal handle housing that covers the sensor on the PCB. (Example sensors include the MLX90365 three-axis position sensor from Melexis). The onboard magnetic sensor is fixed relative to the PCB, distal housing, and axis of the endoscope. It rotates with the distal housing and is configured to rotate about its z-axis with small or minimal x and y offsets. The magnet is oriented in the proximal housing so that it maintains constant field uniformity at the sensor throughout a full 360 degree rotation and rotates about the sensor's z-axis through its xy plane. In a more robust embodiment, two magnets in opposing positions in the proximal housing are used (however, in practice one magnet is sufficient for system operation).

[0375] The magnetic sensor is configured to provide a linear output corresponding to the angle of the xy vector component of the magnetic flux density passing through it. The angle can be calculated using the following formula:

[0376] Where α is the magnetic angle, βx and βy are the x and y components of the magnetic flux density, Vx and Vy are the measured Hall signals for βx and βy, and k is a programmable scaling factor that defines the sensor's sensitivity mismatch between βx and βy. The position sensor itself performs calculations internally to linearize the output. The end result is a linear voltage output between 0V and +5V that is related to the angular position using the following formula:

[0377] The output of the sensor is The resistor divider steps down and is then sampled by a 12-bit analog-to-digital converter (ADC). The ADC value is then read by the onboard microcontroller. The output of the sensor is proportional to its supply voltage, so the supply voltage is also read by the ADC in order to scale the output appropriately.

[0378] In an embodiment, the rotation value read from the ADC is sent from the endoscope's PCB to an external image processing unit (IPU) via a USB link when requested by the controller. The value is received by the application via a dynamic link library (DLL), which acts as an interface between the hardware and the controller application. The rotation value measured by the ADC can be converted from counts to rotation angles in the firmware, DLL, or application itself running on the endoscope. In the example architecture, the conversion is done in the DLL.

[0379] Through the calibration process, in an example arrangement, the minimum and maximum values ​​seen at the intersection of the sensor from 360° to 0° are measured and stored in an onboard EEPROM (Electrically Erasable Programmable Read Only Memory) (or other suitable memory chip) of the endoscope's PCB. These minimum and maximum output values ​​are scaled according to the supply voltage before being stored. This scaled value is read when the mirror is connected to a controller application and used to determine the rotation value. For example, the formula for converting the current scaled ADC value to the appropriate angle may be:

[0380] in, is the rotation angle, Vadc is the current scaled ADC value, and Vmin and Vmax are the minimum and maximum scaled ADC values ​​measured during calibration.

[0381] After receiving the scaled rotation value, the image processed by the application is rotated an equal amount in the opposite direction before being displayed on the screen. In addition, the controller can optionally generate and display a pointer at the periphery of the displayed image that rotates around the displayed image to indicate to the end user the current rotational position relative to the 0 degree point. To ensure that there is no jitter in the displayed image or pointer, a filter can be applied to the position value of each component to eliminate any subtle adjustments that would otherwise be caused by jitter in the raw ADC values ​​read by the electronic system. The resulting effect seen by the end user is a stable image (which remains in an upright position no matter which direction the sensor is facing) and a projected field of view that rotates around the sensor's axis of rotation.

[0382] Image motion smoothing

[0383] The act of moving a camera lens from a starting position to an ending position may be associated with undesirable visual effects when viewed on a monitor. This is particularly true if the camera movement is performed manually by an operator. If the visual effects of the suddenness of the movement are not adjusted and / or filtered, the image display from the camera sensor may exhibit jitter, overshoot, or back-and-forth motion artifacts caused by small unintended movements of the camera while it is being moved or when it is about to stop. There are a variety of methods to filter the image rotation or translation signal to reduce the visual effects of motion artifacts, signal noise, and even hand tremors before, during, or after the rotation or translation of the camera. The actual measured translation position or rotation angle position of the camera can be filtered. It has been found that the visual display of the rotated or translated image can be improved by applying a low-pass filter with one or more variable filter coefficients; wherein the processor selects the coefficients based on whether the camera movement is starting or ending, or whether the camera is moving quickly or slowly. When applied to a camera movement intended to follow a moving object or pan a scene, the degree of filtering may be reduced during fast movements and increased during slow movements. When applied to a camera movement that is intended to move to a new field of view, the degree of filtering of the rotational or translational position of the camera can be reduced at the beginning of the camera movement, and the degree of filtering of the rotational or translational position of the camera can be increased as the camera approaches a visual target. (The beginning of a camera movement is typically associated with an acceleration of the camera, and the end of a camera movement is typically associated with a deceleration of the camera.) This creates a "soft landing" visual effect on the image near the endpoint of the rotation or translation, while allowing the displayed image to quickly transition to a point near the intended target image. If the image rotation is being corrected by the processor to maintain an upright orientation of the viewable field, a "soft landing" effect is observed as the viewed image translates to its endpoint.

[0384] Typically, the low pass filter used in smoothing can be constructed or programmed to have a variable corner frequency, such that the corner frequency varies based on rotational or translational data generated by a motion or position sensor linked to the camera. For example, Fig.81 The position sensor 704 shown in FIG. 7 can be used to detect the angular position of the camera relative to the proximal endoscope handle (which holds the magnet 51). Alternatively, the position sensor can be coupled to Fig. 27 The pull wire 502 of the pivotable camera housing 500 shown in FIG. Fig.12A handle-based mechanism shown in FIG. 1 , which involves moving a pull wire or cable to rotate the camera housing. The position data can be related to a rotational or translational velocity or a rotational or translational acceleration. In addition, filtering or smoothing can be varied differently depending on whether the position signal or data indicates that the camera is accelerating or decelerating. As used herein, a low-pass filter is defined as one that produces greater filtering or smoothing when its corner frequency or cutoff frequency is reduced. In digital terms, this can be achieved by biasing or correcting the actual current position data more strongly toward the immediately preceding filtered or unfiltered position data. There are a variety of methods for constructing or programming filters, but the end result is usually that the processor automatically adjusts one or more filter coefficients of the low-pass filter in real time according to the nature of the camera rotation or translation detected by the sensor. An example implementation of this feature can be provided by an endoscope having a camera at the end of a rotatable endoscope shaft. In this example, the rotation data generated by the sensor in the endoscope handle can be filtered without image rotation correction or before or after image rotation correction processing has occurred.

[0385] Fig.84 A processor flow chart is shown that implements a smoothing algorithm based on camera acceleration, which causes the displayed image to respond quickly to the start of camera movement, or to reach the target image position more slowly if the operator slows the camera movement before reaching a visible target. The time step increment is assumed to be constant. The position sensor detects the position of the camera 920. This position is compared to the position at the previous time step, and the processor determines whether the position change indicates that the camera is accelerating 922, decelerating 924, or maintaining a constant speed 926. If accelerating, the processor adjusts the digital filter to reduce smoothing of the position data 928. If decelerating, the processor adjusts the digital filter to increase smoothing of the position data 930. If at a constant speed, the processor maintains the previous filter smoothing 932. A low pass filter is applied to the camera position data 934 using the selected filter characteristic, and the processor time step is incremented 936.

[0386] Fig.85A processor flow chart is shown that implements a camera rotation based smoothing algorithm that causes the displayed image to respond quickly to the start of camera rotation, or to reach a target image position more slowly if the operator slows down camera rotation before reaching a visible target. The time step increment is assumed to be constant. The position sensor detects the position of the camera 940. This position is compared to the position at the previous time step, and the processor determines whether the position change indicates that the camera is accelerating 942, decelerating 944, or maintaining a constant speed 946. If accelerating, the processor adjusts the digital filter to reduce smoothing of the position data 948. If decelerating, the processor adjusts the digital filter to increase smoothing of the position data 950. If at a constant speed, the processor maintains the previous filter smoothing 952. A low pass filter is applied to the camera position data 954 using the selected filter characteristic, and the processor time step is incremented 956.

[0387] Suitable low-pass filters may include, for example, infinite impulse response (IIR) filters (such as single-pole filters, exponentially weighted moving average filters, second-order Butterworth filters) or finite impulse response (FIR) filters (such as running average filters, moving window function filters, etc.). In one example, one may use a discrete, infinite impulse response (IIR), single-pole, low-pass filter on the measured translation or angular position. The low-pass filter may have variable filter coefficients that affect filter smoothing based on angular velocity and affect slew rate based on the sign of angular acceleration.

[0388] An example of an IIR response filter is: Formula A

[0389] Among them, α i is the filter coefficient at time i, B i is the value measured at time i, A f,i-1 is the previous filtered value, and A f,i is the filtered value at time i. Filter coefficient α i The smoothing effect associated with the filter coefficients is related to the corner frequency (f C )Related: Formula B

[0390] where Δt is the sampling frequency. Thus, the corner frequency of the filter can vary with the rate or acceleration of rotation of the camera relative to the handle. It is more convenient to describe the filter as having variable filter coefficients, but it should be understood that the smoothing effect associated with the filter coefficients is related to the corner frequency or cutoff frequency of any given low-pass filter.

[0391] Fig.86 960 shows a processor flow chart implementing an IIR low pass filter algorithm to filter the rotation signal of a rotating camera. The low pass filter can have variable filter coefficients based on the angular velocity and based on the sign of the angular acceleration. The algorithm receives the current angle of the camera at step 962. i At step 964, the algorithm determines the filtered angular velocity ' f i , where the filtered angular velocity is based on the current angle i and previous camera angles i-1 Angular velocity Equal to a fixed time step (Δt) At step 966, the algorithm determines the filtered angular acceleration '' f i , where the filtered angular acceleration is based on the current angular velocity of the camera ' f i and the previous angular velocity ' f i-1 Angular velocity Equal to a fixed time step (Δt) Note that for the rate of change factor (i.e., etc.), the Δt portion of the formula is either implicitly linked to the coefficients in the equation (i.e., the velocity terms) or is ignored because they are not needed (e.g., in one embodiment, only the acceleration term can be calculated to determine the sign).

[0392] In step 1000, the variable filter coefficient β is determined. i , characterized in that the smoothing effect is reduced (the turning frequency is increased) when the angular acceleration is positive, the smoothing effect is kept constant when the acceleration is zero, and the smoothing effect is increased (the turning frequency is reduced) when the angular acceleration is negative. In the example, the filter coefficient β i The change in can be described mathematically as: Formula C

[0393] in, is the angular velocity of the camera position, is the angular acceleration of the camera position, and is the variable part of the filter coefficient at the previous time step. The terms 2 and 0.1 in formula C are arbitrary, can be other constant values, and can be determined empirically by testing and finding the most visually appealing effect of filtering with image rotation.

[0394] In step 1010, a discrete, infinite impulse response, single-pole low-pass filter is implemented, wherein the current angle signal i Part of α i is added to the angle signal i-1 The second part of the previous filtered value (1-α i ). This filtering step can be described by equations D and E: Formula D Formula E

[0395] in, is the time step The filtered angular position at is the time step The filter coefficients of the filter at is the time step The measured angular position at is the time step The filtered angular position at , A is a constant factor, and is the time step The variable part of the filter coefficient at .

[0396] In step 1010, the filter described by equations C through E can be implemented in a variety of codes, including but not limited to C++, Python, machine language, etc. The choice of code is arbitrary. In step 1012, the filtered angle The image may be output to a processor that rotates the image, or alternatively to a processor that corrects the rotated image to maintain an upright orientation of the displayed field of view when the camera is rotated.

[0397] In the example, Fig.84 The IIR method described in can be applied more generally to translational movements of camera sensors. In addition to using the position X i , speed X' i and acceleration X" i Replace the rotation position , rotation speed and rotational acceleration Other than that, the approach remains unchanged.

[0398] An implementation of a discrete, infinite impulse response, single-pole low-pass filter for translational motion is given by: Formula F Formula G

[0399] in, is the time step The filtered position at is the time step The filter coefficients of the filter at is the time step The measured position at is the time step The filtered position at , A is a constant factor, and is the time step The variable part of the filter coefficient at .

[0400] Variable filter coefficient β i Can be velocity-based and acceleration-based sign: Formula H

[0401] in, is the velocity of the camera position, is the acceleration of the camera position, and is the variable part of the filter coefficient at the previous time step. The variables C1 and C2 are constants and can be determined empirically. In one example, C1 is 2 and C2 is 0.1. Speed Equal to a fixed time step (Δt) ,in is the current measured position, and is the previous filtered position. Similarly, acceleration is equivalent to a fixed time step (Δt) ,in are the velocities at the current and previous time steps.

[0402] Fig.87 Another example of a processor algorithm 1020 is shown, which is arranged to improve the displayed image by filtering the image rotation angle based on the angular acceleration of the camera rotation. Algorithm 1020 includes the steps of modifying the received camera angle and limiting the intermediate values ​​to improve the stability of the algorithm. In step 1022, the processor receives the current camera angular position θ i In step 1024, the processor corrects the angle for winding, for example, if the angle value exceeds 360° or is less than 0°, the angle value is corrected to an equivalent angle between 0° and 360°. If the angle sensor is configured to report only angles within a single rotation (e.g., 0o To 360 o ), you do not need to include this step.

[0403] At step 1026, the algorithm determines the current angular position θ i.c and the previous filtered angular position θ f i-1 The minimum angle Δθ between i, Note that between any two angular positions on the circle, there are two angles between them: a minimum angle with a magnitude less than 180° and a second angle with a magnitude greater than 180°. Algorithm 1020 selects the minimum angle Δθ i , to improve the stability in subsequent calculations and the stability of the algorithm. Note that for a fixed time step, the minimum angle can be regarded as the angular velocity.

[0404] In step 1028, the angular acceleration factor dm i According to the minimum angle Δθ normalized by 180 i and the previous filter coefficient β i-1 Calculate the angular acceleration factor dm i is actually the normalized acceleration which is equal to the change in normalized angular velocity. In step 1028, the resulting angular acceleration factor is limited to be no less than a minimum value dm MIN , and not greater than the maximum value dm MAX In some examples, dm MIN Set to -1, and you can set dm MAX is set to 1.0. As mentioned above, Δθ i is the angular velocity, and dividing it by 180 normalizes the angle to a fraction of the maximum possible angular difference. As explained below, the filter coefficient β i can be considered as the normalized angular velocity, since β i Equal to β i-1 Add the normalized acceleration.

[0405] In step 1030, based on the acceleration factor dm i Determine the filter coefficient β i When the acceleration factor is greater than zero, the smoothing effect is reduced (the filter corner frequency increases). If the acceleration factor is less than zero, the smoothing effect is increased (the filter corner frequency decreases). If the acceleration factor is zero, the smoothing effect remains unchanged. Next, step 1030 converts the obtained filter coefficient β i Restricted to be no less than the minimum value dβ MIN , and is not greater than the maximum value dβ MAX In some examples, dβ can be MIN Set to -1, and dβMIAX Set to 1.0.

[0406] The filter implemented in step 1040 is in the form of a discrete, infinite impulse response, single-pole low-pass filter. In step 1040, the angle difference Δθ i A portion of is added to the rotation position θ f i-1 , to define the new filtered rotational position θ f i The factor C3 is a constant that can be set to 0.95 in one example, but can be set to another fraction based on empirical observations of the visual effects of filtering. As described above, the filter coefficients are determined in step 1030. In other examples, the filter identified in step 1040 can be a different type of filter, such as a Butterworth filter (where the corner frequency is related to the smoothing effect) or a finite impulse response filter (such as a moving window filter (where the width of the window is proportional to the smoothing effect)).

[0407] In step 1042, the new filtered rotational position or angle θ f i can optionally be expressed as a fraction of a full rotation, and can be constrained to be no less than θ MIN and is not greater than θ MAX In this case, θ MIN is set to 0, and θ MAX is set to 1. In this way, the fractional angular position can be kept within a range of fractions less than 1 (which represents a full 360 degree rotation). Finally, at step 1044, the filtered and constrained new rotation angle can be output to a processor that rotates the image, or alternatively to a processor that corrects the rotated image to maintain an upright orientation of the displayed field of view when the camera is rotated.

[0408] If used with image rotation correction, an observer of the displayed image will perceive the image rotation correction as occurring quickly with little delay during the initial rotation of the camera sensor, and the image rotation delay before reaching the target position increases as the operator decelerates the camera rotation when reaching the target rotation position. The image rotation delay may also increase as the controller generates corrections for overshooting the target rotation position. The visual effect may be similar to the image rotation appearing to perform a "soft landing" at the target rotation position.

[0409] Reducing electromagnetic emissions

[0410] Fig.88AA schematic representation of a typical arrangement of signal, communication, and clock traces 706 embedded in a printed circuit board 708 having a microstrip configuration is shown. This type of construction is standard and generally acceptable for most applications. But in a PCB (rigid or flexible) that extends along the shaft of an endoscope, high frequency transmissions (which can reach into the gigahertz range) can result in excessive electromagnetic emissions from the circuit board and shaft. A single uniform ground plane 710 of a microstrip configuration may not be sufficient to prevent these emissions from propagating from the top side of the board. Fig.88B A schematic representation of an embodiment of a stripline board 712 configuration is shown. In this case, a ground plane 710 is located below the signal traces embedded in the board, and a second ground plane 714 is located above the signal traces. The ground planes 710 and 714 are interconnected by a ground plane VIA (vertical interconnect access) 716. It has been found that the addition of a top ground plane 714 and a bottom ground plane 710 greatly reduces electromagnetic emissions from an elongated board extending through the length of the endoscope shaft.

[0411] Electrical isolation of endoscope and image processing unit

[0412] Fig.89 A block diagram showing how an endoscope can be electrically isolated from an external image processing unit is shown. In this example, an optical coupling arrangement can be implemented to enhance the electrical isolation of the endoscope (and, by extension, the patient) from the digital electronic components and the backplane ground in the image processing unit external to the endoscope. In the example arrangement, a USB 3.0 power and signal interface is used to provide electrical and electronic connections between the PCB of the endoscope 720 and the electronic controls in the image processing unit 722. The signal interface is configured to operate at frequencies up to about 5 GHz (gigahertz). Therefore, the optical coupling 724, 726 of the connection between the endoscope cable and the image processing unit can provide an appropriate form of isolation. For example, a USB 3.0 fiber optic extender can be used to provide USB 3.0 signal isolation. The digital communication interface between the local extender 726 and the remote extender 724 can be optically coupled via a 0.5M fiber optic cable. Examples are the Icron Spectra 3022, Intellix DIGI-FO-USB3.0 or the Newnex FIreNEXTM -5000H board set, among other options.

[0413] Fixed-angle camera sensor and LED housing assembly

[0414] In an embodiment, the camera sensor and the LED light can be fixed at a predetermined angle, such as Fig.90A , Fig.90B and Fig.99 In this example, Fig.90A, Fig.90B and Fig.91 , a rigid printed circuit board 800 holds a camera sensor 802. The circuit board 800 (in this case a flexible / rigid hybrid) extends proximally into a flex board 804 that has been bent to place the optical axis of the camera sensor 802 at a desired angle relative to the long axis of the distal end of the endoscope shaft (in this case it may be approximately 30 degrees). A second board 800B (flexible or rigid) that carries power to an LED 806 extends proximally as a flex board 808 or cable. The board 804 has an aperture 810 through which a lens 812 protrudes to focus a target image onto the camera sensor 802.

[0415] like Fig.90B As shown in FIG, in an alternative configuration, a flexible board or cable 808 may extend from a lower portion or end of the circuit board 800 to provide a mounting surface for supporting the LED 806. In such an arrangement, it may not be necessary to extend the LED board 804 past the camera lens 812, thereby eliminating the need to construct an aperture in the LED board through which the lens 812 protrudes.

[0416] Fig.91 A fixed angle camera assembly including a handle portion PCB 518 and a shaft portion PCB 804 (flexible, rigid, flexible-rigid hybrid, or a combination thereof) is shown. The tip 800 of the shaft portion PCB 804 may be rigid to accommodate the mounting of a camera / lens assembly 812 or an LED 806. A flexible board may be adapted to form an angled portion 808 for the optical components. And a flexible board, a rigid board, or a combination of the two may be used for the portion 804 that travels in the endoscope shaft. As shown, the shaft portion PCB 804 may form a permanent connection to the handle portion PCB 518 so that the combined electronic components form an integral, inseparable structure. In some cases, the shaft portion PCB may be merely an extension of the handle portion PCB. In other cases, it may be convenient to form a permanent attachment or connection 805 of the shaft portion PCB 804 to the handle portion PCB 518 after the initial assembly of the endoscope (e.g., inserting the shaft portion PCB and the optical housing into the inner sheath). A permanent connection may then be made on the handle portion PCB 518. The entire assembly can be coated as a unit to prevent liquid penetration (eg, using parylene coating of electronic components) since the two PCB components are inseparable after assembly.

[0417] Fig.92An exploded view of an example endoscope with a fixed angle camera and LED at the end of the shaft is shown. The hybrid flexible / rigid board in the inner sheath 312 terminates at the end with the camera sensor / LED assembly in the optical mount 820. The distal housing or handle section 30 is partially surrounded by the proximal handle assembly 21, 23. In this example, the handle PCB is located in an enclosure 431 connected to the distal handle section 30. The flushing line 434 is connected to the catheter in the inner sheath 312 and in this example comes out of the rear end of the endoscope handle 21, 23.

[0418] Fig.93 A partial cutaway view of a flex / rigid board 808 is shown with an LED 806 positioned above a corresponding board of a camera sensor 802. In this example, an aperture is constructed in the LED board 808 to accommodate the protrusion of a camera lens 812. Fig.94 An optical housing or mount 820 is shown in which the camera sensor and LED are mounted or housed. The optical housing 820 extends distally from the distal end of an inner sheath 826 of the endoscope. When the endoscope is in use, the distal end of the optical housing and associated camera lens and LED are substantially covered and protected by an outer sheath or trocar 840 (in the embodiment of FIG. Fig.99 ).

[0419] Fig.95 A top perspective view of an optical housing or mount 820 is shown. The distal end of an endoscope shaft flex plate or cable, camera sensor, and associated LEDs can be mounted at a fixed angle relative to the long axis of the endoscope shaft by encapsulating the optical elements, the plate on which the optical elements are mounted, and the distal portion of one or more flex plates in the optical housing 820. This can be a molded plastic part in which a mold is formed (e.g., injection molded) around the distal optical components of the endoscope and (multiple) flex plates. This is used to fix the optical and lighting elements (camera sensor, LED) and their respective flex plates in place and seal the components to avoid exposure to liquids. Once formed and cured, the assembly (optical housing 820 plus encapsulated optical and lighting components) can be inserted into an endoscope shaft inner sheath (by press fit, or, for example, by using an adhesive). Any angle can be selected, but in some examples, the optical axis of the camera sensor and / or LED can be fixed at a non-zero angle (such as an angle between about 30 degrees and about 70 degrees relative to the long axis of the distal end of the endoscope shaft).

[0420] Fig.96 A bottom perspective view of optical housing 820 is shown. Molded apertures 822 for the LEDs and molded apertures 824 for the camera lens are shown, as well as surface channels configured to direct flushing fluid in different directions on the exterior surface of housing 820.

[0421] Fig.97 The optical housing 820 is shown after it has been inserted into the distal end of the inner sheath 826 of the endoscope shaft. At the top, the distal end 828 of the inner sheath 826 butts up against the raised section 830 of the optical housing 820, thereby forming a liquid seal with the housing, except for the flow channel formed on the outer surface of the housing 820. The upper flow channel 832 is shown as communicating with the lateral aperture 834 between the distal lateral side 836 of the inner sheath 826 and the lateral side 838 of the housing 820. In this example, the lateral apertures 834 are present on both sides of the housing 820, and each lateral aperture provides a liquid outflow path from the central liquid channel within the endoscope shaft to the area covering the camera lens 812 and the LED 806. In this manner, the flow of liquid through these lateral apertures can help wash away bubbles, debris, or other materials that may contact the lens or LED surfaces during use of the endoscope. Optionally,...

Claims

1. An endoscope (10) system, comprising: an endoscope (10) having a camera (812) located at a distal end of a shaft (14) of the endoscope (10); The shaft (14) and the camera (812) are capable of rotating together around a rotation axis (843) of the shaft (14); The camera (812) has an axis of rotation (843) at a position less than 90 degrees relative to the shaft (14). 0 A fixed optical axis (841) having a non-zero angle; a rotation sensor (704) configured to measure a rotational angular orientation of the shaft (14) and the camera (812) about the rotation axis (843); A processor (430c) configured to process image data and the angular orientation from the camera (812) to calculate corrected image data for display that maintains the angular orientation of the displayed image relative to the measured angular orientation.

2. The endoscope (10) system according to claim 1, wherein: When the camera (812) rotates about the rotation axis (843) from a first angular orientation to a second angular orientation, the displayed image shifts from a first field of view to a different second field of view.

3. The endoscope (10) system according to claim 1, wherein: As the field of view translates from the first angular orientation to the second angular orientation, an object (904) visible on the centerline rotational axis (843) remains a stationary object (904).

4. The endoscope (10) system according to claim 1, wherein: The optical axis (841) of the camera (812) is fixed at an angle between 30 degrees and 70 degrees relative to the rotation axis (843).

5. The endoscope (10) system according to claim 1, wherein: The processor (430c) is configured to smooth the rotation signal from the rotation sensor (704) such that greater smoothing is applied when the rotation of the camera is decelerating than when the rotation of the camera is accelerating.

6. The endoscope (10) system according to claim 1, wherein: The shaft (14) is connected to a distal housing (30) of a handle (12) of the endoscope (10).

7. The endoscope (10) system according to claim 6, wherein: A PCB (800) is connected to the distal housing (30) and includes a magnetic position sensor (430g).

8. The endoscope (10) system according to claim 7, wherein: The proximal housing of the handle (12) encloses the PCB (800).

9. The endoscope (10) system according to claim 8, wherein: The distal housing (30), the shaft (14), and the camera (812) are rotatable together relative to the proximal housing.

10. The endoscope (10) system according to claim 8, wherein: The proximal housing includes one or more magnets (51) positioned opposite a position sensor (430g) on ​​the PCB (800).

11. The endoscope (10) system according to claim 10, wherein: The position sensor (430g) rotates relative to the one or more magnets (51) and generates an angular position signal indicative of an angle of rotation of the distal housing (30), the shaft (14), and the camera (812) relative to the proximal housing.

12. The endoscope (10) system according to claim 1, wherein: The non-zero angle of the optical axis (841) of the camera (812) in combination with the angular position signal allows the visual display of the image from the camera (812) to be converted from a rotational image with a variable field of view to a translational image with the variable field of view.

13. The endoscope (10) system according to claim 3, wherein: The processor (430c) is configured to reverse rotate the image received by the camera (812) to maintain an upright display of a central feature.

14. The endoscope (10) system according to claim 1, wherein: The processor (430c) is configured to reverse rotate the image received by the camera (812) to simulate the visual effect of a fixed camera sensor (802) receiving the image from a rotating rod lens.

15. The endoscope (10) system of claim 4, further comprising a processor, and wherein: The processor (430c) projects an indicator (900) on the displayed image, the indicator informing a user of the orientation of the camera.

16. The endoscope (10) system according to claim 15, wherein: The indicator (900) is an arrow.

17. The endoscope (10) system of claim 1, further comprising a processor, and wherein: The processor (430c) is configured to reversely rotate the image received by the camera (812) to maintain an upright display of the central feature.

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