Medical optical fiber with intra-operative updatable tip

Abstract

The present disclosure provides a medical optical fiber comprising an updatable distal end. The updatable distal end includes a plurality of separable segments, where the separable segments can be selectively and / or automatically separated to update the distal-most tip of the optical fiber.

Description

Cross Reference to Related Applications

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 512,266, filed July 6, 2023, the disclosure of which is incorporated herein by reference. TECHNICAL FIELD

[0002] The present disclosure relates generally to medical optical fibers. In particular, but not exclusively, the present disclosure relates to renewing a tip on a distal end of a medical optical fiber intraoperatively and, in particular, without removing the optical fiber from an endoscope. BACKGROUND

[0003] Medical optical fibers typically include an optical fiber and a sheath surrounding the optical fiber. The optical fiber can include an innermost optical core and, optionally, a cladding surrounding the optical core. Some optical fibers can optionally include a mechanical support layer surrounding the cladding. Additionally, medical optical fibers often include a sheath (or protective layer), and many medical optical fibers have a portion of their sheath stripped at the distal end, leaving the bare optical fiber at the distal end (e.g., similar to an electrical wire). Medical optical fibers have diameters in the range of tens to hundreds of microns.

[0004] A common use of medical optical fibers is in ureteroscopy laser lithotripsy (URSL). During a URSL procedure, a flexible endoscope is inserted through a patient’s urethra to access the kidney region. A small core optical fiber (less than 300 pm) is inserted through the working channel of the flexible endoscope and used to treat (e.g., fragment, ablate, etc.) a stone in the kidney region. It should be appreciated that during such procedures, laser energy is emitted from the distal end of the optical fiber, which can cause degradation of the distal tip before the procedure is complete.

[0005] Holmium:Yttrium Aluminum Garnet (Ho:YAG) lasers have been the preferred lithotripter for the treatment of urinary stones since shortly after their introduction in the 1990s because they fragment stones of all compositions and produce less stone migration (retropulsion) during treatment than short-pulse lasers. As more small core optical fibers become available for high power (> 20 W) laser applications, degradation of the optical fiber distal tip during URSL has become a more critical issue because small core optical fibers have lower mechanical strength and higher laser energy intensity compared to large core optical fibers. SUMMARY

[0006] The present disclosure provides a medical optical fiber including an optical fiber disposed along a longitudinal axis. The medical optical fiber further includes an optical fiber distal tip configured to be repaired intraoperatively without removing the tip from an endoscope. Further, some embodiments provide an endoscope configured to repair the distal tip of the optical fiber.

[0007] Embodiments of this disclosure can be implemented as a medical optical fiber. The medical optical fiber may include: a non-renewable portion; and a renewable portion coupled to a distal end of the non-renewable portion, the renewable portion comprising a plurality of separable segments.

[0008] In a further embodiment of the medical optical fiber, each of the plurality of separable segments includes an optically transparent material having a generally cylindrical shape.

[0009] In a further embodiment of the medical optical fiber, each of the plurality of separable segments has a length between 0.2 mm and 6.0 mm.

[0010] In a further embodiment of the medical optical fiber, each of the plurality of separable segments may include a ferrous material configured to interact with an electromagnetic field to selectively decouple one of the plurality of separable segments.

[0011] In a further embodiment of the medical optical fiber, the medical optical fiber is configured to be inserted through the working channel of an endoscope, the endoscope including a catheter having one or more electromagnets disposed at a distal end, the one or more electromagnets being configured to generate an electromagnetic field.

[0012] In a further embodiment of the medical optical fiber, multiple separable segments are coupled to each other via an adhesive material.

[0013] In a further embodiment of the medical optical fiber, the adhesive material is configured to melt, dissolve, or substantially weaken when exposed to light of a specific wavelength, when exposed to a selected combination of laser pulse frequency and / or power, once a specific temperature is reached, or once exposed to a certain amount of transmitted laser energy.

[0014] In a further embodiment of the medical optical fiber, the adhesive material between a first of a plurality of separable segments and a second of a plurality of separable segments is configured to melt upon exposure to a first amount of laser energy, wherein the adhesive material between a second of a plurality of separable segments and a third of a plurality of separable segments is configured to melt upon exposure to a second amount of laser energy, wherein the second of a plurality of separable segments is located proximal to the first of a plurality of separable segments, wherein the third of a plurality of separable segments is located proximal to the second of a plurality of separable segments, and wherein the second amount of laser energy is higher than the first amount of laser energy.

[0015] In a further embodiment of the medical optical fiber, each of the plurality of separable segments includes a machined end face, wherein the machined end face of the first of the plurality of separable segments is configured to attract the machined end face of the second of the plurality of separable segments via intermolecular attraction when the end face is positioned close to each other.

[0016] Embodiments of this disclosure can be implemented as an endoscope system configured for use with a replaceable optical fiber. The system may include an endoscope having a working channel; and a replaceable optical fiber configured to be inserted through the working channel, the replaceable optical fiber including a non-replaceable portion; and a replaceable portion located at the distal end of the non-replaceable portion, the replaceable portion including a plurality of separable segments.

[0017] In a further embodiment of the endoscope system, the endoscope may include a catheter with a working channel extending from a proximal end to a distal end of the catheter, the distal end of the catheter including a splitting device configured to split a plurality of separable segments.

[0018] In a further embodiment of the endoscope system, the endoscope may include a handle that includes an actuator arranged to actuate a splitting device.

[0019] In a further embodiment of the endoscope system, each of the plurality of separable segments includes an optically transparent material having a generally cylindrical shape.

[0020] In a further embodiment of the endoscope system, each of the plurality of separable segments has a length between 0.2 mm and 6.0 mm.

[0021] In a further embodiment of the endoscope system, the endoscope may include a catheter with a working channel extending from a proximal end to a distal end of the catheter, the distal end of the catheter including one or more electromagnets, each of a plurality of separable segments comprising a ferrous material configured to interact with an electromagnetic field generated by the one or more electromagnets to selectively decouple one of the plurality of separable segments.

[0022] Embodiments of this disclosure can be implemented as a lithotripsy method comprising: providing a medical optical fiber having a plurality of separable segments coupled to a distal end of the medical optical fiber; inserting the medical optical fiber through a working channel of an endoscope; irradiating a target with laser energy via the medical optical fiber; and updating the distal end of the medical optical fiber by separating one of the plurality of separable segments.

[0023] In a further embodiment of the crushing method, each of the plurality of separable segments includes an optically transparent material having a generally cylindrical shape.

[0024] In a further embodiment of the crushing method, each of the plurality of separable segments has a length between 0.2 mm and 6.0 mm.

[0025] In a further embodiment of the crushing method, each of the plurality of separable segments includes an iron material configured to interact with an electromagnetic field to selectively decouple one of the plurality of separable segments.

[0026] In a further embodiment of the lithotripsy method, the endoscope may include a catheter having one or more electromagnets disposed at a distal end, the one or more electromagnets being configured to generate an electromagnetic field. Attached Figure Description

[0027] To facilitate identification of any discussion of an element or action, one or more of the most significant digits in the reference number refer to the figure number in which the element was first introduced.

[0028] Figure 1A and Figure 1B An endoscope system according to at least one embodiment of the present disclosure is shown.

[0029] Figure 2 A medical optical fiber with an updatable distal end is shown according to at least one embodiment of the present disclosure.

[0030] Figure 3 Another medical optical fiber according to at least one embodiment of the present disclosure is shown, as well as the distal end of an endoscope configured to update the distal end of the optical fiber.

[0031] Figure 4 Another medical optical fiber with an updatable distal end is shown according to at least one embodiment of the present disclosure.

[0032] Figure 5 Another medical optical fiber with an updatable distal end is shown according to at least one embodiment of the present disclosure.

[0033] Figure 6 A method according to at least one embodiment of the present disclosure is shown. Detailed Implementation

[0034] As previously described, this disclosure provides apparatus and methods for updating lithotripsy laser fibers that mitigate the inherent problem of distal fiber tip degradation during ureteroscopic laser lithotripsy (URSL). This disclosure provides several examples or embodiments of such “self-renewing” fibers. It should be understood that although these examples are described as separate embodiments, features from one example may be combined with features from another example without departing from the spirit of this disclosure.

[0035] Figure 1A and Figure 1BAn endoscope system 100 is shown, which has an integrated cleaving device configured to update the distal end of an optical fiber. As depicted, the endoscope system 100 includes an endoscope 102 having a handle 104 and a catheter 106. The catheter 106 has at least one working channel into which an optical fiber 108 can be inserted. At the distal end of the catheter 106 is a cleaving device 112, which can be actuated by an actuator 114 disposed on the handle 104 to update the distal end (118) of the optical fiber 108. This is achieved by... Figure 1B The enlarged view 116 shown depicts the scene in more detail.

[0036] from Figure 1B As can be seen in the magnified view 116, the distal end 110 of the conduit 106 includes a splitting device 112. The distal end of the optical fiber 118 can extend from the distal end 110, and the splitting device 112 can be actuated by the actuator 114 to split the distal end of the optical fiber 118, thereby exposing the fresh end of the optical fiber 108.

[0037] In some embodiments, the splitting device 112 may include teeth 120 having razor blade edges, arranged to cut or split the distal end of the optical fiber 118. The teeth may be arranged circumferentially and configured to collapse or rotate inward to compress the opening of the working channel into which the optical fiber 108 is inserted, such that the teeth 120 cut or split the distal end of the optical fiber 118. It should be understood that the optical fiber 108 typically includes an inner fiber core and one or more covering layers (e.g., cladding). In some embodiments, the teeth 120 may be configured to strip (e.g., cladding) a portion of the distal end of the optical fiber 118 to expose a fresh portion of the inner fiber core, and then split the exposed fiber core to renew the distal end of the optical fiber 118.

[0038] Once the distal end of fiber 118 is updated, fiber 108 can be further extended through the working channel of conduit 106 to expose the operating length of the newly updated distal end of fiber 118.

[0039] Figure 2An optical fiber 200 according to various embodiments of the present disclosure is shown. The optical fiber 200 includes a self-renewing end 202 disposed at the distal end of a non-renewable portion 204. The non-renewable portion 204 may include an optical fiber core and one or more covering layers (e.g., cladding, shielding, protective layer, etc.). The self-renewing end 202 includes several (e.g., one or more) separable segments or “bullets”. As depicted, the self-renewing end 202 includes separable segments 206a, 206b, 206c, and 206d. It should be noted that more or fewer than four (4) separable segment couplers may be provided. However, for clarity of representation, four (4) segments are used in this example. Each of the separable segments 206a to 206d includes a rod-shaped optically transparent segment body with a length ranging from 0.2 mm to 6.0 mm. Each of the separable segments 206a to 206d can be separated from the next nearest side segment (e.g., after exposure to a specific amount of laser energy, after a quantifiable amount of degradation). In some embodiments, the segment may detach from the next proximal segment automatically. In some embodiments, the segment may detach from the next proximal segment by a controller or user actuation.

[0040] In some embodiments, the interface between each of the separable segments 206a, 206b, 206c, and 206d may be adhesive, optically diffused, or electromagnetically bonded. It should be appreciated that the separable segments (e.g., separable segment 206a, etc.) may be small enough (e.g., less than 1.0 mm, less than 0.5 mm, etc.) that the patient can expel the separable segments naturally (e.g., through the urinary system, etc.).

[0041] Therefore, fiber 200 provides a fiber that can be updated intraoperatively without removing it from the endoscope. Consequently, the distal end of fiber 200 maintains relatively high transmittance to the laser beam, ensuring effective laser treatment throughout the procedure.

[0042] Figure 3 Embodiments of separable segments 302a and 302b are shown, which can be provided as Figure 2The optical fiber 200 has separable segments 206a to 206d. Generally, separable segments 302a and 302b are coupled to the ends of the optical fiber via an electromagnetic field. Each of the separable segments 302a and 302b includes ferrous wires 304a and 304b, which can act under the electromagnetic field to hold the segment in place until the user selects to detach the segments. For example, an electromagnet 310 can be positioned near the distal end of a conduit of endoscope 308 (e.g., 110 of conduit 106, etc.) and activated to load multiple separable segments (e.g., 302a, 302b, etc.) onto the distal end of the renewable optical fiber 306. When the distal end of the optical fiber on which the separable segments 302a and 302b are mounted is advanced beyond the distal end of the endoscope, the electromagnetic field generated by the electromagnet 310 weakens, and the distal segment (e.g., separable segment 302a, etc.) detaches, thereby renewing the end of the optical fiber.

[0043] Figure 4 Embodiments of separable segments 402a and 402b are shown, which can be provided as Figure 2 The separable segments 206a to 206d of the optical fiber 200. Generally, separable segments 402a and 402b are coupled to the ends of the optical fiber via adhesive 406. Separable segments 402a and 402b can be coupled to a renewable optical fiber 404 via adhesive 406, wherein the adhesive is configured to weaken, melt, or dissolve based on selected conditions. For example, adhesive 406 can be configured to dissolve when exposed to light of a specific wavelength, when exposed to a selected frequency and / or power combination of laser energy, once a specific temperature is reached, or once exposed to a certain amount of transmitted energy.

[0044] For example, adhesive 406 can be configured to melt at a specific temperature such that once a specific segment (e.g., separable segment 402a, etc.) is exposed to the operating environment and heated to a specific temperature that may indicate the deterioration of the farthest end of that segment, adhesive 406 coupling the specific segment to the next proximal segment will melt, thereby allowing the segment to detach and allowing the optical fiber 400 to advance, so that the remaining distal segment is exposed to the appropriate operating length.

[0045] For example, the adhesive 406 coupling the separable segments 402a and 402b can be configured to melt after exposure to a specified amount of laser energy, while the adhesive 406 coupling the separable segment 402b and the replaceable fiber 404 can be configured to melt after exposure to a higher specified amount of laser energy. In such an example, the separable segment 402a can be configured to detach before the separable segment 402b detaches (e.g., due to the dissolution of the adhesive 406 between the separable segments 402a and 402b).

[0046] Figure 5 Embodiments of separable segments 502a and 502b are shown, which can be provided as Figure 2 The separable segments 206a to 206d of the optical fiber 200. Generally, separable segments 502a and 502b are coupled to the ends of the optical fiber via intermolecular attraction. Because the machined surface 506 is sufficiently flat, when the machined surfaces 506 are brought close together, intermolecular attraction adheres separable segment 502a to separable segment 502b, thereby allowing separable segments 502a and 502b to be coupled to the renewable optical fiber 504.

[0047] During the operation, one of the separable segments 502a and / or 502b can be removed by tapping the segment to be removed using a tool inserted through another working channel of the endoscope.

[0048] Figure 6 A method 600 for updating the distal end of a medical optical fiber is shown. Method 600 may begin at block 602. At block 602, “Providing a medical optical fiber having multiple separable segments coupled to the distal end of a medical optical fiber,” a medical optical fiber having multiple separable segments coupled to the distal end of a medical optical fiber may be provided. For example, an optical fiber 200 having separable segments 206a to 206d of a self-renewing end 202 coupled to a non-renewable portion 204 may be provided.

[0049] Continuing to box 604, "Insertion of a medical optical fiber through the working channel of the endoscope," a medical optical fiber can be inserted through the working channel of the endoscope. For example, fiber optic 200 can be inserted as follows: Figure 1A The optical fiber 108, as depicted, is inserted through the working channel of the endoscope 102.

[0050] Continuing to box 606, “Irradiation of a Target with Laser Energy via Medical Fiber Optics,” the target can be irradiated with laser energy via medical fiber optics. For example, fiber optic 200 can be coupled to a laser source (not shown), which is arranged to generate laser energy and guide that energy to the target via the medical fiber optic. For example, fiber optic 200 can be coupled to the laser source at its proximal end, and its distal end (e.g., self-renewing end 202) can be positioned proximal to the target (e.g., a stone, tissue, etc.) via endoscope 102. The target can be irradiated with laser energy via fiber optic 200.

[0051] Continuing to box 608, “Renewing the distal end of a medical optical fiber by separating the most distal of a plurality of separable segments,” the distal end of a medical optical fiber can be renewed by separating one of the separable segments. For example, one of the separable segments 206a to 206d can be separated by renewing the self-renewing end 202. It should be understood that as the target is irradiated with laser energy (e.g., at box 606, etc.), the distal end of the medical optical fiber (e.g., the self-renewing end 202, etc.) will deteriorate. Therefore, when one of the separable segments 206a to 206d is separated, the self-renewing end 202 will be renewed, and the effectiveness of laser treatment can be maintained at an optimal level.

[0052] In this discussion, unless otherwise stated, adjectives such as “substantially” and “approximately” modifying one or more features of embodiments of this disclosure are understood to mean that the condition or feature is limited to an acceptable tolerance for the operation of the embodiment in its intended application. Unless otherwise stated, the word “or” in the specification and claims is inclusive rather than exclusive and means at least one or any combination of the items it connects.

[0053] While the presented concepts have been described with respect to a limited number of embodiments, it will be understood that many variations, modifications and other applications of this disclosure may be implemented without departing from the scope of the appended claims.

Claims

1. A medical optical fiber, said medical optical fiber comprising: Non-updatable parts; as well as An updatable portion is coupled to the far end of the non-updatable portion, and the updatable portion includes multiple separable segments.

2. The medical optical fiber according to claim 1, wherein, Each of the plurality of separable segments comprises an optically transparent material having a generally cylindrical shape.

3. The medical optical fiber according to any one of claims 1 or 2, wherein, Each of the plurality of separable segments has a length between 0.2 mm and 6.0 mm.

4. The medical optical fiber according to any one of claims 1 to 3, each of the plurality of separable segments comprising an ferrous material configured to interact with an electromagnetic field to selectively decouple one of the plurality of separable segments.

5. The medical optical fiber of claim 4, wherein the medical optical fiber is configured to be inserted through the working channel of an endoscope, the endoscope including a catheter having one or more electromagnets disposed at a distal end, the one or more electromagnets being configured to generate the electromagnetic field.

6. The medical optical fiber according to any one of claims 1 to 5, wherein, The multiple separable segments are coupled to each other via an adhesive material.

7. The medical optical fiber according to claim 6, wherein, The adhesive material is configured to melt, dissolve, or substantially weaken when exposed to light of a specific wavelength, when exposed to a selected combination of laser pulse frequency and / or power, once a specific temperature is reached, or once exposed to a certain amount of transmitted laser energy.

8. The medical optical fiber according to claim 6, wherein, The adhesive material between the first of the plurality of separable segments and the second of the plurality of separable segments is configured to melt upon exposure to a first amount of laser energy, wherein the adhesive material between the second of the plurality of separable segments and the third of the plurality of separable segments is configured to melt upon exposure to a second amount of laser energy, wherein the second of the plurality of separable segments is located proximal to the first of the plurality of separable segments, wherein the third of the plurality of separable segments is located proximal to the second of the plurality of separable segments, and wherein the second amount of laser energy is higher than the first amount of laser energy.

9. The medical optical fiber according to claim 1, wherein, Each of the plurality of separable segments includes a machined end face, wherein the machined end face of a first of the plurality of separable segments is configured to attract the machined end face of a second of the plurality of separable segments via intermolecular attraction when the end faces are positioned close to each other.

10. An endoscope system, the endoscope system comprising: An endoscope configured for use with a replaceable optical fiber, the endoscope having a working channel; as well as The replaceable optical fiber, configured to be inserted through the working channel, comprises: Non-updatable parts; as well as An updatable portion located at the distal end of the non-updatable portion, the updatable portion comprising a plurality of separable segments.

11. The endoscope system of claim 10, wherein the endoscope includes a catheter, the working channel extending from a proximal end of the catheter to a distal end of the catheter, the distal end of the catheter including a splitting device configured to split the plurality of separable segments.

12. The endoscope system of claim 11, wherein the endoscope includes a handle, the handle including an actuator arranged to actuate the splitting device.

13. The endoscopic system according to any one of claims 10 to 12, wherein, Each of the plurality of separable segments comprises an optically transparent material having a generally cylindrical shape.

14. The endoscopic system according to any one of claims 10 to 13, wherein, Each of the plurality of separable segments has a length between 0.2 mm and 6.0 mm.

15. The endoscopic system according to any one of claims 11 to 14, wherein the distal end of the catheter includes one or more electromagnets, wherein, Each of the plurality of separable segments includes an iron material configured to interact with an electromagnetic field generated by the one or more electromagnets to selectively decouple one of the plurality of separable segments.

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