Compact robotic endoscope with built-in nippers

Abstract

A medical endoscope has a single use section with a built-in surgical instrument, such as nippers, and a physical marker that can clearly display the length of the distal end of the instrument protruding from the distal end of a cannula immediately. The indicia may be three-dimensional indicia that provide a tactile indication in addition to indicating the length of the surgical device protruding from the cannula in a visualized manner.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application is a continuation-in-part application of each of the following patent applications: (a) U.S. patent application No. 17 / 583,095 filed on January 24, 2022 (scheduled to be published as patent No. 11,944,267 on April 2, 2024) and (b) U.S. patent application No. 18 / 083,209 filed on December 12, 2022.

[0003] This application claims the benefit of priority to the following U.S. Provisional Patent Applications: U.S. Provisional Patent Application No. 63 / 454,640 filed on March 25, 2023, U.S. Provisional Patent Application No. 63 / 454,640 filed on March 25, 2023, U.S. Provisional Patent Application No. 63 / 454,953 filed on March 27, 2023, U.S. Provisional Patent Application No. 63 / 458,178 filed on January 11, 2023, U.S. Provisional Patent Application No. 63 / 460,728 filed on April 20, 2023, U.S. Provisional Patent Application No. 63 / 461,939 filed on April 26, 2023, U.S. Provisional Patent Application No. 63 / 462,647 filed on April 28, 2023 U.S. Provisional Patent Application No. 63 / 462,985 filed on April 29, 2023, U.S. Provisional Patent Application No. 63 / 464,571 filed on May 6, 2023, U.S. Provisional Patent Application No. 63 / 466,318 filed on May 14, 2023, U.S. Provisional Patent Application No. 63 / 535,077 filed on August 29, 2023, U.S. Provisional Patent Application No. 63 / 544,645 filed on November 13, 2023, U.S. Provisional Patent Application No. 63 / 544,497 filed on October 17, 2023, U.S. Provisional Patent Application No. 63 / 544,789 filed on October 18, 2023, U.S. Provisional Patent Application No. 63 / 544,963 filed on October 20, 2023, U.S. Provisional Patent Application No. 63 / 554,976 filed on February 17, 2024, U.S. Provisional Patent Application No. 63 / 556,151 filed on February 20, 2024, U.S. Provisional Patent Application No. 63 / 556,712 filed on February 22, 2024, U.S. Provisional Patent Application No. 63 / 599,991 filed on November 21, 2023, U.S. Provisional Patent Application No. 63 / 602,405 filed on November 23, 2023, U.S. Provisional Patent Application No. 63 / 608,316 filed on December 11, 2023, and U.S. Provisional Patent Application No. 63 / 609,317 filed on December 12, 2023 U.S. Provisional Patent Application No. 63 / 613,772 filed on January 14, 2024, U.S. Provisional Patent Application No. 63 / 620,838 filed on January 14, 2024, U.S. Provisional Patent Application No. 63 / 623,236 filed on January 20, 2024, U.S. Provisional Patent Application No. 63 / 623,410 filed on January 22, 2024, U.S. Provisional Patent Application No. 63 / 623,418 filed on January 22, 2024, U.S. Provisional Patent Application No. 63 / 624,086 filed on January 23, 2024, U.S. Provisional Patent Application No. 63 / 554,976 filed on February 17, 2024, U.S. Provisional Patent Application No. 63 / 555,976 filed on February 20, 2024,U.S. Provisional Patent Application No. 552, U.S. Provisional Patent Application No. 63 / 556,151 filed on February 21, 2024, U.S. Provisional Patent Application No. 63 / 556,712 filed on February 22, 2024, U.S. Provisional Patent Application No. 63 / 562,687 filed on March 7, 2024, U.S. Provisional Patent Application No. 63 / 176,307 filed on April 18, 2021, U.S. Provisional Patent Application No. 63 / 285,061 filed on December 1, 2021 Provisional patent application, U.S. Provisional Patent Application No. 63 / 295,913 filed on January 2, 2022, U.S. Provisional Patent Application No. 63 / 299,829 filed on January 14, 2022, U.S. Provisional Patent Application No. 63 / 302,563 filed on January 25, 2022, U.S. Provisional Patent Application No. 63 / 303,690 filed on January 27, 2022, U.S. Provisional Patent Application No. 63 / 310,336 filed on February 15, 2022. ,

[0004] The entire contents of the above-mentioned non-provisional and provisional patent applications are made part of this application by reference, and this application claims the filing date of each application and the benefit of the applications they directly or indirectly incorporate by reference, as well as the benefits they claim, including U.S. provisional applications, U.S. non-provisional applications, and international applications.

[0005] Each of the following U.S. patents and U.S. and International (PCT) patent applications is incorporated by reference into this patent application:

[0006] Patent application No. 16 / 972,989, filed on December 7, 2020;

[0007] Patent application No. PCT / US21 / 50095 filed on September 13, 2021;

[0008] Patent application No. PCT / US2017 / 053171 filed on September 25, 2017;

[0009] Patent application No. 17 / 835,624 filed on June 8, 2022;

[0010] Patent application No. 16 / 363,209 filed on September 25, 2017, now patent No. 11,832,797;

[0011] Patent application No. 17 / 843,217 filed on June 17, 2022;

[0012] Patent application No. PCT / US16 / 18670 filed on February 19, 2016;

[0013] Patent application No. 14 / 913,867 filed on February 23, 2016, now patent No. 10,874,287;

[0014] Patent application No. PCT / US16 / 65396 filed on December 7, 2016;

[0015] Patent application No. 15 / 371,858 filed on February 20, 2018, now patent No. 9,895,048;

[0016] Patent application No. 15 / 462,331 filed on March 17, 2017, now patent No. 10,524,636;

[0017] Patent application No. 15 / 651,526 filed on July 17, 2017, now patent No. 10,278,563;

[0018] Patent application No. 15 / 855,532 filed on December 27, 2017, now patent No. 10,292,571;

[0019] Patent application No. PCT / US18 / 14880 filed on January 23, 2018;

[0020] Patent application No. 16 / 407,028 filed May 8, 2019, now patent No. 11,253,141;

[0021] Patent application No. 16 / 413,160 filed May 15, 2019, now patent No. 10,869,592;

[0022] Patent application No. 16 / 447,251, filed on June 20, 2019, now patent No. 11,013,141;

[0023] Patent application No. PCT / US20 / 38349 filed on June 18, 2020;

[0024] Patent application No. PCT / US20 / 46018 filed on August 12, 2020;

[0025] Patent application No. 17 / 122,282 filed on December 15, 2020;

[0026] Patent application No. 17 / 145,466 filed on January 11, 2021, now patent No. 11,395,579;

[0027] Patent application No. 17 / 370,575 filed on July 8, 2021;

[0028] Patent application No. 17 / 349,674 filed on June 16, 2021;

[0029] Patent application No. 17 / 573,095 filed on January 24, 2022;

[0030] Patent application No. PCT / US2017 / 053171 filed on September 25, 2017;

[0031] Patent application No. 17 / 835,624 filed on June 8, 2022;

[0032] Patent application No. 16 / 363,209 filed on September 25, 2017, now patent No. 11,832,797;

[0033] Patent application No. 17 / 843,217 filed on June 17, 2022;

[0034] Patent application No. 17 / 362,043, filed on June 29, 2021, now patent No. 11,350,816;

[0035] Patent application No. 17 / 473,587, filed on September 13, 2021, now patent No. 11,330,973;

[0036] Patent application No. 17 / 745,526 filed on May 16, 2022;

[0037] Patent application No. 17 / 521,397, filed on November 8, 2021;

[0038] Patent application No. 17 / 720,143 filed on April 13, 2022;

[0039] Patent application No. 18 / 212,621 filed on June 21, 2023;

[0040] Patent application No. 17 / 941,884 filed on September 9, 2022;

[0041] Patent application No. 17 / 835,624 filed on June 8, 2022, now patent No. 11,684,248;

[0042] Patent application No. 18 / 083,209 filed on December 16, 2022;

[0043] Patent application No. 18 / 113,395 filed on February 23, 2023;

[0044] Patent application No. 18 / 211,486 filed on June 19, 2023;

[0045] Patent application No. 18 / 233,282 filed on August 11, 2023;

[0046] Patent application No. 18 / 374,740 filed on September 29, 2023;

[0047] Patent application No. 14 / 913,867 filed on February 23, 2016, now patent No. 10,874,287;

[0048] Patent application No. 16 / 407,028 filed May 18, 2019, now patent No. 11,253,141;

[0049] Patent application No. 16 / 413,160 filed May 15, 2019, now patent No. 10,869,592;

[0050] Patent application No. 17 / 122,282 filed on December 15, 2020, now patent No. 11,844,498;

[0051] Patent application No. 15 / 371,858 filed on December 7, 2016, now patent No. 9,895,048;

[0052] Patent application No. 13 / 094,415 filed April 26, 2011, now patent No. 9,649,014;

[0053] Patent application No. 15 / 462,331 filed on March 17, 2017, now patent No. 10,524,636;

[0054] Patent application No. 15 / 651,526 filed on July 17, 2017, now patent No. 10,278,563;

[0055] Patent application No. 15 / 855,532 filed on December 27, 2017, now patent No. 10,292,571;

[0056] Patent application No. 15 / 484,953 filed on April 11, 2017, now patent No. 10,426,320;

[0057] Patent application No. PCT / US2020 / 038349 filed on June 18, 2020, now Patent No. 11,013,396;

[0058] Patent application No. 17 / 370,575 filed on July 8, 2021;

[0059] Patent application No. 18 / 209,947 filed on June 14, 2023;

[0060] Patent application No. 17 / 145,466 filed on January 11, 2021, now patent No. 11,395,579;

[0061] Patent application No. 16 / 664,082 filed on October 25, 2019, now patent No. 11,071,442;

[0062] Patent application No. 17 / 349,674 filed on June 16, 2021;

[0063] Patent application No. PCT / US2020 / 046018 filed on August 12, 2020;

[0064] Patent application No. 17 / 583,095 filed on January 24, 2022;

[0065] Patent application No. 13 / 276,839, filed on October 19, 2011, now Patent No. 8,702,594;

[0066] Patent application No. 13 / 094,415, April 26, 2011, now patent No. 9,649,014. Technical Field

[0067] The present patent specification relates to an endoscope and an endoscope method. Some embodiments relate to a portable endoscope, the endoscope comprising a reusable portion and a releasable fixed single-use portion, and some embodiments relate to an endoscope comprising a grasping forceps or another surgical instrument. Background Art

[0068] Practitioners such as urologists and gynecologists have long relied on the use of endoscopes for the observation and treatment of internal tissues. For both rigid and flexible conventional endoscopes, their optical systems and related components are relatively expensive and need to be reused many times. After each use, they need to undergo rigorous decontamination and disinfection procedures, which adds a lot of equipment and labor costs. In recent years, disposable or partial endoscopes have been developed and improved. They generally include a single-use portion, which includes a cannula, and an imaging module is installed at the distal end of the cannula. The single-use portion is releasably fixed to a reusable portion, which includes image processing electronics and a display. Alternatively, the reusable portion may have only limited electronics, or no electronics, and may not have a display. In this case, the imaging module at the tip of the cannula is coupled to a remote processing unit and / or a remote display, which is operably coupled to the imaging module wirelessly or by cable. Disposable or single-use endoscopes greatly reduce the risk of cross-contamination and hospital-acquired diseases, and save the cost and time of decontamination and disinfection. Disposable endoscopes may be used in medical procedures such as imaging and treatment of the male and female urinary systems, the female reproductive system, and other internal organs.Examples of disposable or single use endoscopes are discussed in the patents and applications cited herein.

[0069] When it is necessary to pass a surgical instrument, such as a grasper, through a lumen or working channel in an endoscope, two physicians or clinicians are traditionally involved - one to hold and manipulate the endoscope and the other to pass the surgical instrument through a proximal port in the endoscope. Original application No. 17 / 583,095 (issued as patent No. 11,944,267) describes an improvement in which a surgical instrument, such as a grasper, can be built into an endoscope so that a single physician can manipulate both the endoscope and the surgical instrument. This patent application is intended to achieve further improvements related to the use of surgical instruments passed through the lumen of an endoscope, particularly a portable endoscope with a single-use cannula and related components.

[0070] The subject matter described or claimed in this patent specification is not limited to embodiments that solve any specific disadvantages or operate only in the above environment. On the contrary, the above background is provided only to illustrate an exemplary technical field in which certain embodiments described in this patent specification can be implemented. Summary of the invention

[0071] As originally claimed (but as may be amended at the time of filing this patent application), according to certain embodiments, a compact robotic endoscope comprises a reusable portion; a single-use portion comprising (a) a proximal portion releasably coupled to the reusable portion to form the endoscope, (b) a hub extending distally from the proximal portion along a cannula axis and having a hub port, (c) a cannula extending distally from the hub and having an imaging module and a distal port at its distal end, and (d) an inner lumen extending from the hub port to the distal port; a surgical instrument comprising a push-pull assembly comprising a finger grip, a push-pull button movable distally and proximally relative to the finger grip, and a cable having a surgical device fixed at the distal end; wherein the proximal end of the cable is a proximal end of the cannula; and The end is fixed to the push-pull button, the cable extends from here to the hub port and the lumen, and extends to the surgical device through the hub port and the lumen, and can move the surgical device distally and proximally relative to the cannula as the push-pull button moves relative to the finger grip; a locking knob is fixed to the middle part of the cable, can move distally and proximally with the cable relative to the hub, and can selectively lock the cable on the hub, thereby locking the surgical device in a selected position relative to the cannula; an easily identifiable marking structure on the hub and / or the push-pull button can indicate the axial position of the locking knob relative to the hub and / or the push-pull button relative to the finger grip, thereby indicating the axial position of the surgical device relative to the cannula.

[0072] According to certain embodiments, the endoscope further includes one or more of the following components: (a) the cannula is rotatable about the cannula axis relative to the reusable portion, the motor is operably coupled to the cannula to rotate the cannula about the cannula axis through a selected angle relative to the reusable portion, and the manual controller is operably coupled to the motor to selectively cause the motor to drive the cannula to rotate through the angle; (b) the surgical device fixed to the distal end of the cable includes a grasping forceps, which are movable between a retracted position in the cannula and an extended position in which the grasping forceps protrude distally from the cannula; (c) the grasping forceps are spring-biased grasping forceps, which can be opened when performing distal axial movement relative to the cannula and can be closed when performing proximal axial movement relative to the cannula; (d) the distal end of the cannula is configured to be angled, and the reusable portion includes a manual controller to angle the cannula through a selected angle relative to the long dimension of the cannula; (e) (i) the single-use portion is configured to be shipped to an end user in a sterile package together with the surgical instrument; and (j) the surgical instrument is permanently built into the single-use portion.

[0073] According to certain embodiments, an endoscope comprises: a reusable portion and a single-use portion releasably fixed to the reusable portion; wherein the single-use portion comprises a proximal portion that can be releasably coupled to the reusable portion to form the endoscope, a hub extending from the proximal portion to the distal end along the cannula axis, a cannula extending from the hub to the distal end, and an inner lumen; wherein: the cannula has an imaging module located at its distal end and a distal port communicating with the lumen; the hub has a hub port communicating with the lumen; the single-use portion further The surgical instrument comprises a manually-operated control assembly fixed to a hub port, a cable passing through the hub port and a lumen, and a surgical device at the distal end of the cable, wherein the surgical device can move relative to a cannula between a distal position and a retracted position in response to manual operation of the control assembly; a physical marker on at least one of the hub and the control assembly moves relative to the hub and / or the control assembly, and its movement matches the movement of the surgical device relative to the cannula, and can provide an instantaneous position indication of the surgical device relative to the cannula.

[0074] According to certain embodiments, the endoscope described in the previous paragraph further includes one or more of the following components: (a) the endoscope further includes a locking mechanism fixed to at least one of the cable and the control assembly, and the locking mechanism can selectively lock the surgical device in a selected position relative to the cannula; (b) the marking includes a ridge indentation on the hub, and the locking mechanism includes a knob fixed to the cable, and the knob can move with the cable relative to the indentation, thereby instantaneously indicating the position of the surgical device relative to the cannula; (c) the manually operated control assembly includes a finger grip and a push-pull member, the finger grip can maintain a set distance from the hub port, the push-pull member is coupled to the proximal end of the cable and can move relative to the finger grip, and the marking includes a ridge indentation on the movable member, and the movable member moves relative to the finger grip to indicate the position of the surgical device relative to the cannula.

[0075] According to certain embodiments, an endoscopic inspection method includes: inserting a cannula portion of a single-use portion of an endoscope into an internal space of a human body; using an imaging module at the tip of the cannula to capture an image of the internal space; manually operating a built-in control component in the single-use portion to selectively move a cable, wherein the cable originates from the control component, passes through a proximal port of the single-use portion and a lumen therein, and terminates distally in a surgical device, wherein the surgical device moves between a distal position in which at least a portion of the surgical device protrudes from the cannula and a retracted position in the cannula; detecting the position of the surgical device relative to the cannula by detecting visible displacement of the cable or a component fixed to the cable relative to a physical marker on the single-use portion and located proximal to the cannula.

[0076] According to certain embodiments, the endoscopic inspection method further includes: (a) the step of manually operating the control component includes: selectively moving the push-pull button relative to the finger grip portion, thereby axially pushing or pulling the cable along the length direction of the lumen, thereby moving the surgical device distally or proximally relative to the distal end of the cannula; (b) the step of moving the surgical device relative to the cannula includes: moving the grasping forceps, the grasping forceps having offset distal jaws that are away from each other, when the grasping forceps move distally relative to the cannula, the distal jaws can move away from each other, when the grasping forceps move proximally relative to the cannula, the distal jaws can move toward each other; (c) using a locking knob coupled to the cable and capable of selectively locking the cable to the cannula, the surgical device is selectively locked in a selected position relative to the cannula; (d) the step of detecting the position of the surgical device relative to the cannula includes: detecting the position of the locking knob relative to the mark on the single-use portion. BRIEF DESCRIPTION OF THE DRAWINGS

[0077] In order to further illustrate the above and other advantages and features of the subject matter of this patent specification, specific examples of embodiments of this patent specification are shown in the accompanying drawings. It should be understood that these drawings only describe illustrative embodiments and should not be considered as limiting the scope of this patent specification or the appended claims. The subject matter of this patent specification will be described and explained in additional detail using the accompanying drawings, in which:

[0078] Figure 1 is a perspective view of an assembled endoscope with integrated surgical instruments according to certain embodiments.

[0079] Figure 2 is a perspective view of a single-use portion of an endoscope viewed from a right side perspective according to certain embodiments.

[0080] Figure 3 is a perspective view of a single-use portion of an endoscope viewed from another right side perspective according to certain embodiments.

[0081] Figure 4 is a perspective view of a single-use portion of an endoscope viewed from a top side perspective according to certain embodiments.

[0082] Figures 5A-5D is a partial cross-sectional view and a partial side elevation view of a distal portion of a cannula according to certain embodiments, with graspers on the cannula in different positions relative to the cannula.

[0083] Figure 6 is a perspective exploded view of an endoscope according to certain embodiments, showing a reusable portion of the endoscope and how a single-use portion is mounted to the endoscope. DETAILED DESCRIPTION

[0084] Examples of preferred embodiments are described in detail below. Although this patent specification only describes a few embodiments, the new subject matter described in this patent specification is not limited to any one embodiment or combination of embodiments described in this patent specification, but includes a large number of alternatives, modifications and equivalents. In addition, although a large number of specific details are set forth in the following description in order to provide a comprehensive understanding, some embodiments may be implemented without setting forth some or all of the details. In addition, for the sake of clarity, this patent specification does not describe in detail certain technical materials known in the related art to avoid unnecessary confusion about the new subject matter described in this patent specification. It should be clear that individual features of one or more specific embodiments described in this patent specification may be used in combination with features of other described embodiments or with other features.

[0085] In the various drawings, similar reference numerals and designations denote similar components. Further, reference numerals for components that are similar in structure and function have the same second and third digits. For the sake of brevity, components having the same reference numeral and the same last two digits of the reference numeral will be described only in conjunction with the drawing that first mentions them, and will not be repeated in conjunction with the drawings discussed subsequently.

[0086] When a surgical instrument, such as a grasper, is passed into a patient's body through a lumen or working channel in an endoscope, the practitioner performing the medical procedure typically relies on visualizing the distal end of the instrument in an image from an imaging module at the tip of the cannula. However, the view may not be clear enough, or the physician may not be looking at the display of the view at the time. In such cases, the physician may also rely on experience and feel to assess the length of the surgical instrument protruding distally from the cannula. In some cases, another method, such as ultrasound or x-ray imaging or another imaging method, may be used to visualize the cannula tip and the surgical instrument tip, but this practice may not be feasible in many cases.

[0087] In addition to visually indicating the length of a surgical device such as a grasper protruding from the cannula, or the degree to which the grasper, as described below, is open or closed, the physical markings may be made sufficiently prominent to provide a tactile indication. For example, the markings may be ridges that are large enough to be felt by touch even with a gloved finger, allowing the physician to determine by touch how far the surgical device extends distally from the cannula and / or how open or closed the grasper is.

[0088] As described in detail below, the present patent application discloses a particularly convenient and effective method for improving the combined use of surgical instruments (such as graspers) and endoscopes (especially endoscopes with single-use cannulas and related components).

[0089] Figure 11 is a perspective view of an assembled endoscope 100 with an integrated surgical instrument from a right side perspective according to some embodiments. As shown, the endoscope 100 is in an assembled state, with the single-use portion 102 releasably secured to the reusable portion 104 and the surgical instrument 106 secured to the single-use portion 102.

[0090] The single-use portion 102 includes: (a) a proximal portion 102a, which is releasably coupled to the reusable portion 104; (b) a hub 102b, which extends distally from the proximal portion 102a along the cannula axis A and has a fluid port 112 and a surgical instrument port 114; (c) a cannula 108, which extends distally from the hub 102b along the cannula axis A and has a flexible distal portion 102c with an imaging module 330 and a distal port 102d ( Figure 5A ), and further having at least one internal passage or lumen 110 extending from ports 112 and 114 to distal port 102d. Ports 114 and 112 may be connected to the same internal lumen 110 or to different internal lumens of each.

[0091] The surgical instrument 106 includes a manually operable control assembly in the form of a push-pull assembly 106a ( Figure 1 and Figure 2 ) and a cable 106b, which extends from the component 106a through the port 114 and the lumen 110 to or through the distal port 102d and terminates at a device such as a grasper 118 at the distal end. The component 106a includes a push-pull button 106c, to which the proximal end of the cable 106b is fixed; a finger grip 106d, in which the distal end of the push-pull button 106c can slide distally and proximally; and a hollow catheter or cannula 106e, in which the portion of the cable 106b between the push-pull button 106c and the port 114 can slide distally and proximally. In some embodiments, the catheter 106e can be omitted, and the distal end of the finger grip 106d or an extension thereof can be directly fixed to the port 114. The catheter 106e has a distal end, which is fixed to the port 114 by a Luer coupling. If the conduit 106e is omitted, the distal end of the finger grip 106d or an extension thereof may also be coupled to the port 114. Alternatively, a different coupling method may be used to secure the conduit 106e or the finger grip 106d to the port 114. A backflow prevention valve (not shown) may be used at the port 114 to prevent fluid from being discharged from the port 114.

[0092] During operation, when the cannula 108 is inserted into the patient's body, the push-pull button 106c is retracted proximally relative to the finger grip 106d, so that the distal end of the surgical instrument 106 (such as the grasping forceps 118) is retracted or mostly retracted into the cannula 102. During the medical procedure in which the cannula 102 is inserted into the patient's body, when necessary, the physician moves the push-pull button 106c distally relative to the finger grip 106d to push the grasping forceps 118 distally out of the cannula 108. When necessary, the physician pulls the push-pull button 106c proximally relative to the finger grip 106d to retract the grasping forceps 118 toward or into the cannula 108. As further described below, the movement of the grasping forceps 118 relative to the cannula 108 causes the jaws of the grasping forceps to open or close accordingly.

[0093] Importantly, the push-pull assembly 106a allows the physician to immediately and clearly know the position of the grasper 118 relative to the cannula 108. To this end, the hub 102b has a marking structure, such as several ridge indentations, only two of which are located at the Figure 2 The markings are numbered as marks 102b1 and 102b2. The markings are spaced apart along the cannula axis A, and a locking mechanism (e.g., a locking mechanism in the form of a knob 116) is fixed to a portion of the cable 106b inside the hub 102b so as to move with the cable 106b along the cannula axis A. Therefore, the axial position of the knob 116 relative to the markings 102b1 and 102b2 corresponds to the axial position of the grasper 118 relative to the cannula 102. The markings 102b1 and 102b2 are spaced apart axially and correspond to the displacement of the grasper 118 relative to the cannula 102 in some distance measurement (e.g., millimeters or a portion of the axial length of the grasper 118). Alternatively, or in addition, there are several comparable marking structures 102c1 ( Figure 2 ), which is used to indicate the axial position of the button 106c relative to the finger grip portion 102d, thereby indicating the position of the forceps 118 relative to the distal end 102c of the cannula 102.

[0094] As discussed above, the markings may be made large enough to provide a tactile indication in addition to a visual indication, for example, the indicator grooves or ridges may be made large enough to be felt with a finger (even a gloved finger).

[0095] Examples of grasping forceps (such as grasping forceps 118) are described in detail in the original application No. 17 / 583,095, which is scheduled to be issued as patent No. 11,944,267 and is made a part of this application by reference. Except that the figure numbers and certain reference numerals are consistent with the terminology used in this patent specification, the present invention Figures 5A-5D Respectively with the original application Figure 6 Similar to the A-6D.

[0096] Figures 5A-5D 1 is a partial cross-sectional view and a partial side elevation view of the distal end portion 102c of the cannula 102 according to certain embodiments, with the grasper 118 on the cannula in different positions relative to the cannula. Figure 5A The grasper 118, grasper jaw portions 162 and 164, and claw portions 172 and 174 are shown in an open position. In this position, the arched portions 182 and 184 of the grasper 118 protrude distally from the distal port 102d located at the distal end 102c of the cannula 102. The grasper 118 is a spring-biased grasper that keeps its jaws 172 and 174 apart. Figure 5A As shown, when the grasper 118 is in a position protruding distally from the distal port 102d of the cannula 102, the jaw portions 162 and 164 and the claw portions 172 and 174 are separated from each other.

[0097] Figure 5B The grasper 118 is shown after the cable 106b has pulled it proximally to a distance relative to the cannula 102. The grasper 118 has now moved proximally relative to the distal port 102d over a portion of its axial length in the direction indicated by the dashed arrow 620. The physician accomplishes this by manually pulling the push-pull button 106c distally relative to the finger grip 106d. Figure 5B In the position shown, the proximal ends of the arched portions 182 and 184 have just begun to engage the distal edge of the distal port 102d. Figure 5B As shown by dashed arrow 622, the engagement causes jaws 172 and 174 to move toward each other. Since the distance d between distal port 102d and jaws 172 and 174 is d, wide field of view camera module 330 (shown by dashed line 730) should be able to have a good view of jaws 172 and 174 and any tissue or object (not shown) that the jaws may be holding or targeting.

[0098] Figure 5C The grasper 118 is shown after it has been moved further proximally relative to the cannula distal end port 102d of the cannula 102 and the grasper jaws 172 and 174 have been clamped together. Figure 5C As shown, the arched portions 182 and 184 are retracted proximally of the distal port 102d and are pressed against each other by contact with the internal structure of the proximal lumen 110 of the distal port 102d. This pressing of the arched portions 182 and 184 against each other, in turn, places the claws 172 and 174 in a closed position to clamp any tissue or other object (not shown) that may be caught by the claws.

[0099] Figure 5D Shows the Figure 5C The grasping forceps 118 are further retracted proximally. Figure 5DIn the embodiment shown in FIG. 1 , the claws 182 and 184 are almost flush with the distal surface of the distal port 102d.

[0100] Return to reference Figure 1-3 , as the physician manually moves the push-pull button 106c relative to the finger grip 106d, the grasper 118 moves relative to the distal end 102c of the cannula 102. As the grasper 118 moves relative to the distal port 102d, the locking knob 116 correspondingly moves axially relative to the hub 102b and the marking structures (such as indentations or ridges 102b1, 102b2, etc.) on the hub 102b. Accordingly, the push-pull button 106c moves axially relative to the finger grip 106d, so that several marking structures 106C1 (if used in the example of the endoscope 100) also show the axial position of the grasper 118 relative to the distal end port 102d of the cannula 102. In this way, even if the view of the grasper 118 in the image from the imaging module 330 is not completely clear or easy to interpret, the physician can immediately know the position of the grasper 118 relative to the cannula 102 and the position of the grasper jaws 172 and 174 relative to each other, even if the physician is not viewing the image from the imaging module 330 at the time.

[0101] The locking knob 116 can lock the cable 106b in position relative to the hub, thereby locking the grasper 118 in a selected position relative to the cannula 102. The knob 116 can be rotated on a threaded mount (not shown) so that manually turning the knob 116 one-way can pull or push the cable 106d against the inner wall of the hub 102b and lock it in position relative to the hub 102b and the cannula 102, thereby preventing the cable 106b and grasper 118 from axial movement relative to the cannula 102. The cable 106b and grasper 118 are released for axial movement relative to the cannula 102 by turning the knob 116 in the other direction.

[0102] When the cannula 102 is inserted into the patient, the grasping forceps 118 are generally in Figure 5D The retracted position shown in FIG. 106 is generally maintained in this position until the physician decides to grasp the tissue or object. The physician then pushes the push-pull button 106c to move the grasping forceps distally from the distal port 102d, and the grasping forceps jaws 172 and 174 are partially opened to Figure 5A and 5B Relative position between the positions shown, or open to Figure 5A After performing the desired medical procedure using grasper 118, the physician will typically retract grasper 118 and any tissue or object grasped by grasper 118 back into lumen 110, i.e., back into position. Figure 5D The cannula 102 may be retracted proximally to the position shown, or retracted proximally to an even more proximal position and the cannula 102 may be removed from the patient.

[0103] According to some embodiments, the cannula 108 can be rotated relative to the hub 102b about the axis A, and thus relative to the reusable position 104, such as Figure 1-3 The physician may manually control the rotation by grasping the cannula 108 and / or the proximal port 112 and turning it relative to the hub 102b, or by a manual lever or wheel mounted on the hub 102b or the reusable portion 104, or by using a motor in the reusable portion 104 or the hub 102b controlled by a switch or joystick on the reusable portion 104. The rotation angle may be plus or minus 180 degrees or some other desired angle to visualize the internal organs from some or all possible viewing angles. The cannula rotation mechanism will be described in more detail below.

[0104] According to certain embodiments, the distal end portion 102c of the cannula 102 is configured to be offset from the axis A or to be at an angle to the axis A, and the angle may be up to 270 degrees or other desired angle ranges. Figure 1-4 Such angulation is shown, with an angle of approximately 270 degrees. Angulations of other angles (including no angulation) are not shown, but should be understood to be included in the operation of the endoscope 100. The physician may fully manually control the angulation via a lever or wheel on the reusable portion 104, or using a motor and a switch or joystick in the reusable portion 104 or the hub 102b, as will be described in more detail below.

[0105] like Figure 6 As shown, the single-use portion 102 is releasably secured to the reusable portion 104 as described in more detail in the original application Ser. No. 18 / 083,209; the original application Ser. No. 18 / 083,209 is incorporated herein by reference. In order to conform to the terminology used in this application, in addition to renumbering the drawings and some reference numerals, Figure 6 In the original application Figure 1 Part of B is similar.

[0106] Figure 6 1 is an exploded perspective view of the reusable portion 104 and the proximal portion 102a of the cannula 102, showing an example in which the motor rotates the cannula 102 about the cannula axis A relative to the reusable portion 104 in response to instructions from a physician manually operating an electrical switch. Similar motor control may also be employed when controlling the angulation of the distal portion 102c of the cannula 102.

[0107] The reusable portion 104 includes a grip handle 606 that extends transversely to the cannula axis A along the handle axis D and is configured as a handheld handle. The reusable portion 104 has an elongated slot 608 that has an open side facing right and extends along the cannula axis A. The proximal portion 102a of the single-use portion 102 is releasably fixed to the reusable portion 104 at the slot 108. The reusable portion 104 includes an internal power source 619 (such as a battery) and an internal motor 611 as shown in the schematic diagram. The gear shaft 613 extends into the slot 608 along an axis C perpendicular to the cannula axis A and the handle axis D, and is coupled to the motor 611 so as to selectively rotate clockwise and counterclockwise around the axis C at a selected rotation angle as needed. The motor 611 can be a stepper motor and can be located directly behind the gear shaft 613 so that the motor shaft rotates around an axis parallel to the axis C. The gear shaft 613 can be engaged and drive the shaft (not shown) to extend rightward in the proximal portion 102a of the single-use portion 102 when the endoscope 100 is assembled. The distal surface of the handle 606 has buttons 615 and 617 for selectively coupling the power supply 609 with the motor 611 to rotate the gear shaft 613 at a selected angle in a selected angular direction like a robot. For example, when the button 613 is pressed, the cannula 102 rotates counterclockwise relative to the reusable portion 104, and when the button 617 is pressed, the cannula 102 rotates clockwise. The buttons 615 and 617 are preferably arranged at a position where the user grasps the handle 606 with the index finger and / or middle finger for operation.

[0108] The reusable portion 104 preferably includes a display 642 mounted thereon, and the display 642 is operably coupled to the imaging module 330. Both are preferably powered by a power source 619. In addition, the proximal end of the reusable portion 104 has a button 644, which is positioned so that the user can operate it with the thumb when grasping the handle 606. The button 644 is operably coupled to the imaging module 330 at the distal end of the cannula 102 to control the operation of the imaging module 330 (e.g., imaging functions), and can be coupled to the display 642 to control display functions. The button 644 may include two or more buttons or another suitable interface to control the respective functions of the imaging module 330 and / or the display 642. The reusable portion 104 further includes a pivot latch 646, Figure 1 6 shows the pivoting latch 646 pivoted downward to a closed position, and latched to the reusable portion 104 in this position, combining the reusable portion 104 and the single-use portion 102. When pivoted upward to an open position, the latch 646 can snap the single-use portion 102 into the slot 608 of the reusable portion 104.

[0109] As described in Original Application No. 18 / 083,209 Figure 1 As shown in Figures 2C and 2E, the power transmission mechanism can be used to convert the rotation of the shaft 613 driven by the motor 644 into the rotation of the cannula 102.

[0110] In addition to or in lieu of rotating the cannula 108 relative to the reusable portion 104 as described above, the reusable portion of the endoscope 100 (see also the original patent Figure 1 ) on the Internet, use the doctor's Figure 6 The motors may be controlled by a touch pad or joystick, or by a physician using a thumbstick (see original patent application Ser. No. 17 / 835,624) Figure 1 B) or a mechanical linkage 146 controlled by using a wheel instead of the rod 146 ( Figure 6 ), the endoscope 100 may also angle the distal end 102c of the single-use portion 102, as described in the aforementioned patent application Ser. No. 17 / 941,884, which is incorporated herein by reference and becomes a part of this patent application.

[0111] In embodiments where a motor is used for cannula angulation, an additional fail-safe control may be added to restore the cannula to no angulation or to some very low or minimum degree of angulation if the cannula 102 is unable to return to this state due to a power outage or electronic pulse, etc. This control may be achieved by spring biasing the distal end 102c to the no angulation state with a force sufficient to restore the cannula to the no angulation state, but the motor is able to overcome the biasing force when the physician engages the motor to angulate the cannula. One benefit of this control is that the cannula can always be restored to no angulation or to some degree of low angulation if the physician wishes to remove the cannula from the patient and the motor control of the angulation fails or is otherwise ineffective.

[0112] The patent application No. 15 / 855,532 discloses an alternative method for coupling a single-use portion with a reusable portion to assemble an endoscope, which method can be used to couple a reusable portion (such as portion 104 described above) with portion 102 described above to assemble an endoscope 100; the patent application No. 15 / 855,532 becomes a part of the present invention through reference in the present invention.

[0113] In certain embodiments, the endoscope 100 may be operably coupled to an external processor and display unit 652 via a cable 650 or wireless connection 654, as further described in the patent application; the patent application is incorporated herein by reference. In this case, the endoscope 100 may omit the display 642 and some or all of the image processing electronics in the reusable portion 104, and use the image processing electronics and display in the unit 652. Alternatively, the image from the module 330 may be displayed on the display 642 and the unit 652 simultaneously, and the display 642 and the unit 652 may each send commands to the module 330 and manipulate the displayed image using a touch screen and / or other interface facilities.

[0114] Preferably, the single-use portion 102 is sealed and shipped to the end user in a sterile bag together with the surgical instrument 106. Both can be packed in the same sterile bag, and the instrument 106 is assembled into the single-use portion, or both can be shipped in separate sterile envelopes and assembled when required for a medical procedure by passing the cable 106b and its distal grasper or other medical device through the port 114 and fixing the housing 106e to the port 114 (when the housing 106e is not used).

[0115] Although the foregoing description has been described in some detail for the sake of clarity, it is apparent that certain changes and modifications may be made without departing from the principles of this patent specification. There are many alternative ways to implement the processes and devices described in this patent specification. Therefore, the present embodiments may be viewed as illustrative rather than restrictive, and the body of work described in this patent specification is not limited to the details provided in this patent specification, but may be modified within the scope and equivalents of the appended claims.

Claims

1. A compact robotic endoscope comprising: Reusable part; The single-use portion comprises: (a) a proximal portion, which is releasably coupled to the reusable portion to form the endoscope; (b) a hub, which extends from the proximal portion to the distal end along the cannula axis and has a hub port; (c) a cannula, which extends from the hub to the distal end along the cannula axis and has an imaging module and a distal port located at its distal end; (d) an inner lumen extending from the hub port to the distal port; A surgical instrument, comprising a push-pull assembly, the assembly comprising a finger grip, a push-pull button movable distally and proximally relative to the finger grip, and a cable with a surgical device fixed distally; wherein the proximal end of the cable is fixed to the push-pull button, the cable extends from the push-pull button to the surgical device through the hub port and the lumen, and can move the surgical device distally and proximally relative to the cannula as the push-pull button moves relative to the finger grip; a locking knob secured to the intermediate portion of the cable, movable distally and proximally with the cable relative to the hub, and selectively locking the cable to the hub, thereby locking the surgical device in a selected position relative to the cannula; Easily identifiable marking structures on the hub and / or the push-pull button can indicate the axial position of the locking knob relative to the hub and / or the push-pull button relative to the finger grip, thereby indicating the axial position of the surgical device relative to the cannula.

2. The compact robotic endoscope according to claim 1, wherein: The cannula is rotatable about a cannula axis relative to the reusable portion, a motor is operably coupled to the cannula to rotate the cannula about the cannula axis through a selected angle relative to the reusable portion, and a manual controller is operably coupled to the motor to selectively cause the motor to drive the cannula to rotate through the angle.

3. The compact robotic endoscope according to claim 1, wherein: The surgical device secured to the distal end of the cable includes a grasper movable between a retracted position within the cannula and an extended position in which the grasper protrudes distally from the cannula.

4. The compact robotic endoscope according to claim 3, wherein: The grasper is a spring-biased grasper that opens upon distal axial movement relative to the cannula and closes upon proximal axial movement relative to the cannula.

5. The compact robotic endoscope according to claim 1, wherein: The distal portion of the cannula is configured to be angled, and the reusable portion includes a manual control to angle the cannula through a selected angle relative to the long dimension of the cannula.

6. The compact robotic endoscope according to claim 1, wherein: The reusable portion includes a slot extending along the cannula axis, the slot allowing the proximal portion of the single-use portion to be inserted into the slot during movement transverse to the cannula axis.

7. The compact robotic endoscope according to claim 1, wherein: The cannula further includes a proximal fluid port coupled to the lumen, the proximal fluid port being selectively rotatable with the cannula about the cannula axis relative to the reusable portion.

8. The compact robotic endoscope according to claim 1, wherein: The hub port is equipped with a valve to prevent fluid from flowing out of the hub port.

9. The compact robotic endoscope according to claim 1, wherein: The surgical device fixed to the distal end of the cable includes a grasping forceps having spring-biased distal resilient jaws that are spaced apart from each other and a proximal arched portion that can engage with the cannula when the grasping forceps moves proximally relative to the cannula, thereby overcoming the spring bias and bringing the jaws closer together.

10. The compact robotic endoscope according to claim 1, wherein: The single-use portion together with the surgical instrument is configured to be shipped to an end user in a sterile package.

11. The compact robotic endoscope according to claim 1, wherein: The surgical instrument is permanently embedded in the single-use portion.

12. The compact robotic endoscope according to claim 1, wherein: The markings are large enough to be felt with a gloved finger.

13. An endoscope comprising: a reusable portion and a single-use portion releasably secured to the reusable portion; The single-use portion includes: a proximal portion, which is releasably coupled to the reusable portion to form the endoscope; a hub, which extends from the proximal portion to the distal end along the cannula axis; a cannula, which extends from the hub to the distal end; and an inner lumen; in: The cannula has an imaging module at a distal end thereof and a distal port communicating with the lumen; The hub has a hub port communicating with the lumen; The single-use portion further includes a surgical instrument including a manually operable control assembly secured to the hub port, a cable extending through the hub port and the lumen, and a surgical device at a distal end of the cable, the surgical device movable relative to the cannula between a distal position and a retracted position in response to manual operation of the control assembly; A physical marker on at least one of the hub and control components moves relative to the hub and / or control component, and its movement matches the movement of the surgical device relative to the cannula and provides an instantaneous position indication of the surgical device relative to the cannula.

14. The endoscope of claim 13, comprising a locking mechanism secured to at least one of the cable and the control assembly, the locking mechanism selectively locks the surgical device in a selected position relative to the cannula.

15. The endoscope according to claim 14, wherein: The marking includes a ridged indentation on the hub, and the locking mechanism includes a knob secured to the cable, the knob being movable with the cable relative to the indentation to momentarily indicate the position of the surgical device relative to the cannula.

16. The endoscope according to claim 13, wherein: The manually operable control assembly includes a finger grip that can be maintained at a set distance from the hub port; and a push-pull member that is coupled to the proximal end of the cable and can be moved relative to the finger grip, the marking including a ridge indentation on the movable member, the movable member moving relative to the finger grip to indicate the position of the surgical device relative to the cannula.

17. An endoscopic examination method, comprising: advancing the cannula portion of the single-use endoscope into the internal space of the human body; An imaging module at the tip of the cannula is used to capture images of the internal space; manually operating a built-in control assembly in the single-use portion to selectively move a cable originating from the control assembly, passing through a proximal port of the single-use portion and a lumen therein, and terminating distally in a surgical device, the surgical device moving between a distal position in which at least a portion of the surgical device protrudes from the cannula and a retracted position in the cannula; The position of the surgical device relative to the cannula is detected by detecting visible displacement of the cable or a member secured to the cable relative to physical markings on the single-use portion and located proximal to the cannula.

18. The method according to claim 17, wherein: The steps of manually operating the control assembly include: selectively moving the push-pull button relative to the finger grip to push or pull the cable axially along the length of the lumen to move the surgical device distally or proximally relative to the distal end of the cannula.

19. The method according to claim 17, wherein: The step of moving the surgical device relative to the cannula includes: moving the grasping forceps, the grasping forceps having offset distal jaws that are separated from each other, when the grasping forceps moves distally relative to the cannula, the distal jaws can move away from each other, when the grasping forceps moves proximally relative to the cannula, the distal jaws can move toward each other.

20. The method of claim 17, further comprising: The surgical device is selectively locked in a selected position relative to the cannula using a locking knob coupled to the cable and capable of selectively locking the cable to the cannula.

21. The method according to claim 20, wherein: The step of detecting the position of the surgical device relative to the cannula includes detecting the position of the locking knob relative to the marking on the single-use portion.

Images