Medical device

Abstract

The invention relates to a medical device comprising a measuring adapter (2), wherein the measuring adapter (2) is designed and configured to be detachably connected to different respiratory gas path devices, wherein at least one sensor (39) is arranged on the measuring adapter (2), which is designed to measure a measurement variable of the different respiratory gas path devices, the different respiratory gas path devices having ventilation parameters, wherein an evaluation unit is designed to assign correction factors to the ventilation parameters on the basis of measurement values of the sensor (39).

Description

[0001] Medical device

[0002] The invention relates to a medical device according to the features of patent claim 1.

[0003] Endoscopes are used for minimally invasive surgical procedures on humans and animals, as well as for the visual inspection of hard-to-reach cavities. Endoscope tubes of different diameters are used depending on the intended purpose. In bronchoscopy, strong stainless steel bronchoscopes with wall thicknesses of 0.6 mm are often used. Diameters in the range of 10 mm with lengths of approximately 400 mm are common. To place the commonly used silicone stents, tube diameters of 10-16 mm are required, corresponding to the width of a normal larynx. Handling thicker devices for stent insertion requires practice and experience. In endoscopy, it is not possible to switch from a smaller diameter to a larger diameter, or vice versa, without considerable effort.This usually requires replacing the entire endoscope tube, including the endoscope head attached to it, and reattaching all of its connectors. In bronchoscopy, these connectors include, in particular, connectors for lung ventilation and connectors for measuring pressure conditions within the endoscope.

[0004] DE 10 2020 110 840 A1 discloses an endoscope head that allows for the simple use of different endoscope tubes and the uncomplicated establishment of the necessary connections to the endoscope head. At least one measuring channel is arranged in the endoscope head. The measuring channel has an inner connection opening that is connected to a longitudinal channel in the endoscope head and an outer connection opening that is arranged outside the endoscope head. The outer connection opening can be connected to a measuring adapter, which in turn can be detachably coupled to the endoscope head. The measuring adapter serves as a quick coupling to a measuring device that is connected to the measuring adapter in a gas-conducting manner. If there are multiple measuring channels in the endoscope head, the measuring adapter can be connected to the endoscope head with a single plug-in movement, without having to connect each measuring channel individually. The measuring adapter is preferably configured as a U-shaped clamp.

[0005] The use of such a measuring adapter offers considerable advantages. In bronchoscopy, however, the fact that changing endoscope tube diameters result in different boundary conditions for ventilation makes things more difficult. Ventilation is usually achieved using a turbine and / or a jet ventilator. The inspiratory volume depends largely on the diameter of the endoscope tube. As the diameter decreases and the cross-sectional area of ​​the endoscope tube decreases quadratically, the differences become increasingly significant, i.e. the inspiratory volume decreases significantly. The operator is required to set the correct ventilation volume and to ensure the desired ventilation depending on the design of the endoscope head or the endoscope tube used. The object of the invention is to provide a medical device which facilitates the setting of ventilation parameters.

[0006] This object is achieved by a medical device according to the features of patent claim 1.

[0007] The subclaims relate to advantageous developments of the invention.

[0008] The medical device comprises a measuring adapter designed and configured to be detachably connected to various respiratory gas path devices. A respiratory gas path device within the meaning of the invention is, in particular, an endoscope head, an endoscope tube, an intubation tube, but also a breathing tube, a breathing tube of a spirometer, and also a bite block that has a respiratory gas guide. With regard to its basic functionality, the measuring adapter can be constructed as described in DE10 2020 110 840 A1, i.e., it can be easily mechanically coupled without having to connect individual measuring lines when changing the endoscope.

[0009] The term “breathing gas pathway devices” includes devices that are partially or completely located inside or outside a patient’s airway. The term particularly includes devices that lead from a breathing gas source to a patient’s breathing opening. An endoscope head and a spirometer that can be coupled to the endoscope head, or the breathing tube of a spirometer, as well as a breathing gas hose, are examples of breathing gas pathway devices that are completely located outside a patient’s airway. An endoscope tube or intubation tube is partially located in the patient’s airway during use. A mouthpiece of a breathing tube of a spirometer is also partially located in the patient’s upper airway during use, while the breathing gas enters the breathing tube of the spirometer from an external breathing air source. Even if a breathing gas inlet and also a breathing gas outlet of a specific breathing gas pathway device, such asAn external spirometer, which is positioned in front of or connected to an endoscope head, lies completely outside the patient's natural airway, i.e., particularly outside the upper respiratory tract (nasal cavity, oral cavity, pharynx), and is considered a respiratory gas path device within the meaning of the invention. When using the measuring adapter with a spirometer breathing tube, the term "ventilation parameters" refers to any spirometer parameters that influence ventilation.

[0010] According to the invention, the measuring adapter additionally comprises at least one sensor. The sensor is intended to determine properties associated with different respiratory gas path devices, in particular specific designs of the endoscope head and / or the endoscope tube and / or the intubation tube, which influence ventilation. In particular, the sensor is intended to enable conclusions to be drawn about the cross-sectional area of ​​the endoscope tube or the intubation tube or other respiratory gas path devices in the respiratory gas path through which breathing air can flow. If a cross-sectional area smaller than a previously defined reference value is determined, at least one ventilation parameter must be adjusted. The degree of adjustment is expressed as a correction factor. In an evaluation unit, previously stored correction factors for the at least one ventilation parameter are assigned to the sensor's measurement data.The correction factors can be displayed to enable manual adjustment of a breathing gas source. The correction factors can also be used for automated adjustment of ventilation parameters.

[0011] The sensor is used to determine a measured value, for example, of the endoscope head or endoscope tube. A measured value can also be a marking or coding. The measured coding allows the design to be assigned to a correction factor.

[0012] According to a first embodiment, the sensor converts information from an information carrier on the respiratory gas path device, in particular on the endoscope head, endoscope tube, or intubation tube, into a signal, in particular an electrical signal. The correction factor is assigned to this signal. The correction factor is displayed.

[0013] The information carrier on the airway device, particularly on the endoscope tube, endoscope head, or intubation tube, contains information about the type of airway device, particularly the endoscope head, the type of endoscope tube, or the type of intubation tube. The term intubation tube refers to tubes that are inserted into the mouth or nose to establish a secure airway. Unconscious, sedated, or anesthetized patients can be ventilated using intubation tubes. The term includes both endotracheal tubes and laryngeal tubes.

[0014] The information on the information carrier is preferably an optical code, in particular a barcode. Information carriers on the respiratory gas path device, in particular on the endoscope tube, endoscope head, or intubation tube, can have a binary (black and white) or multicolor code. Reading is performed contactless.

[0015] In principle, it is also possible to mechanically read out mechanically scannable information in the form of raised and non-raised areas, such as discrete dots similar to Braille, surface roughness, or other tactile information, for example, using one or more displacement sensors or mechanical scanners. The invention also includes electromagnetic information carriers, such as radiofrequency systems (oscillating circuits, RFID tags). Near-field communication (NFC) is particularly well-suited for the contactless exchange of data via electromagnetic induction using loosely coupled coils over short distances of a few centimeters. The communication is particularly active-passive.

[0016] A correlation of measurement data with the correction factors of ventilation parameters of different respiratory gas path devices, in particular endoscope heads and endoscope tubes, is stored in a storage unit in order to make them available to the evaluation unit. This can involve one or more correlation functions, particularly in the case of analog sensors. The correlation can also include a discrete assignment. Correction factors can be transferred to the storage unit via an interface in accordance with the respiratory gas path device used, in particular endoscope heads, endoscope tubes, or intubation tubes. The ventilation unit and / or the measuring adapter have, in particular, a display unit to signal which correction factor is necessary and, preferably, additionally, which type of respiratory gas path device, in particular an endoscope head, endoscope tube, or intubation tube, is connected to the measuring adapter.

[0017] The ventilation unit is preferably connected to the measuring adapter for data transmission, with a control unit of the ventilation unit being configured to automatically adjust the ventilation parameters taking the correction factors into account. The ventilation parameters are preferably adjusted immediately after the data transmission. The adjustment occurs continuously. Optionally, provision can be made for manual confirmation of the adjustment in advance.

[0018] The signal or correction factor can be transmitted from the measuring adapter to a receiving unit. The receiving unit is, in turn, connected to the ventilation unit, i.e., the respiratory gas source, or is itself a component of the ventilation unit. The receiving unit is particularly suitable for retrofitting and can be connected to the ventilation unit via an interface.

[0019] With regard to the respiratory gas path device, the medical device according to the invention relates in particular to both endoscope heads to which endoscope tubes of different diameters can be connected and endoscope heads with fixed endoscope tubes. In endoscope heads to which the endoscope tube is interchangeable, the information regarding which endoscope head is connected is not sufficient to identify the current diameter of the endoscope tube. In an advantageous development of the invention, the measuring adapter can identify endoscope tubes of different diameters. This is achieved by means of at least one second sensor. The measured variable is converted by the at least one second sensor into a measurement signal and evaluated. The determination and in particular measurement of the diameter takes place in particular in a contactless manner, preferably by optical measurements. Sensors can be used as components of light barriers.The scattered light from a light source can also be measured, which in turn allows conclusions to be drawn about the diameter of the connected endoscope tube. The measurement can also be performed using ultrasonic sensors. The invention includes the use of multiple sensors to increase measurement accuracy, to combine measurement methods, or to enable redundant measurement.

[0020] If, for example, only two different endoscope tubes can be connected to an endoscope head, it may be sufficient to detect which endoscope tube is connected. In this case, it is sufficient for the second sensor to determine any distinguishing feature, e.g., a different light transmittance as an identifier for the endoscope tube. The invention therefore includes the possibility of determining different diameters using the second sensor without directly measuring the diameter.

[0021] In an advantageous development of the invention, the measuring adapter has at least one sensor configured and designed to detect the presence of an instrument in the endoscope tube or in the intubation tube without contact. This sensor can be the same sensor used to detect the diameter or at least one additional sensor.

[0022] An inserted instrument has a significant influence on the flow conditions within the endoscope tube or the intubation tube, whereby sufficient ventilation of the patient must also be ensured via the remaining annular space between the instrument and the wall of the endoscope tube or the intubation tube. The sensor serves to detect at least the presence of an instrument in the endoscope tube or in the intubation tube. The endoscope tube or the intubation tube is designed to enable this measurement. For this purpose, the endoscope tube or the intubation tube has at least one area permeable to the measured variable of the at least one sensor. In the case of endoscope tubes or intubation tubes made of plastic, in particular of translucent plastic, the entire endoscope tube or the entire intubation tube can be regarded as the area permeable to the measured variable of the at least one sensor.For metal endoscope tubes, however, a correspondingly permeable area is required. The signal obtained by at least one sensor is assigned correction factors, or the correction factors are derived from the measured values. The presence and / or dimension of an instrument in the endoscope tube or in the intubation tube can be considered as a correction factor. The dimension of an instrument refers in particular to the diameter of the instrument in the endoscope tube or in the intubation tube. The term "instrument" represents any body that is inserted into the channel of the endoscope tube or in the intubation tube and thus influences the cross-sectional ratios in the endoscope tube or in the intubation tube.The aim of the invention is to be able to determine the freely flowable annular space within the endoscope tube or in the intubation tube as accurately as possible in order to be able to adapt the ventilation parameters to the respective situation better and, in particular, automatically in real time.

[0023] The area permeable to the measured variable is, in particular, optically transparent, i.e., translucent. The term "light" does not imply any restriction to a specific wavelength or to visible light. The term light within the meaning of the invention also encompasses the infrared range. Therefore, infrared sensors can also be used, for example, to detect the transmission of the light signal through a permeable area of ​​the endoscope tube or the intubation tube. All sensors of the measuring adapter according to the invention are, in particular, connected to a signal processing unit integrated into the measuring adapter.

[0024] A region permeable to the measured variable can be used for ultrasonic measurements. The at least one sensor can be an ultrasonic probe.

[0025] If an optical measurement is taken, the light-permeable area can extend in particular over the entire circumference of the endoscope tube or the intubation tube. This makes it possible to arrange the measuring clamp in any radial orientation on the endoscope tube or on the intubation tube if the measuring adapter is not placed directly on the endoscope head. Depending on the measuring method, it may be necessary to generate the measured variables, e.g. ultrasound or light of a specific wavelength. The use of Hall sensors or magnetic sensors also requires corresponding measured variables. In a further development, the invention therefore provides that at least one signal source for generating the measured variable of the at least one sensor is arranged on the measuring adapter and / or on the respiratory gas path device, in particular on the endoscope head and / or endoscope tube and / or on the intubation tube. The signal source can be a light source, for example.The invention provides, particularly for optical measurements, an opposing and particularly diametrically opposed arrangement of a signal source and a sensor, comparable to the principle of a light barrier. Magnets, voice coils, RFID tags, optical markings, changing material compositions, etc., can be detectable features via sensors. The invention is not limited to a specific physical measurement principle. The decisive factor for the choice of measurement method is the ability to assign a sufficiently accurate correction factor to the measured value.

[0026] All sensors used convert the measured value into an electrical signal. The sensor signal can be transmitted wirelessly from the measuring adapter to the ventilation unit. It is not necessary for the entire transmission path to be wireless. An external receiver, particularly one that can be retrofitted, can be assigned to the ventilation unit, serving as the receiving unit. The external receiver, in turn, is connected to the ventilation unit via a cable.

[0027] For signal transmission, a power source, in particular a battery or a rechargeable accumulator, can be arranged in the measuring adapter. The power source in the measuring adapter can be charged in a contactless manner. The measuring adapter includes, in particular, a transmitter.

[0028] The measuring adapter according to the invention fulfills, in particular, the same basic functions as in DE 102020 110 840 A1, i.e., it has at least one measuring channel whose position corresponds to the measuring channels in the endoscope head. A fluid-conducting, in particular gas-conducting, connection to external connections of measuring channels in the endoscope head is established via the measuring channels. Information about the pressure conditions within the endoscope head can be obtained via the measuring channels.

[0029] The measuring adapter is preferably configured as a U-shaped clamp with a back and two arms connected to the back. In this way, the measuring adapter can be detachably coupled to a respiratory gas path device, in particular an endoscope head, endoscope tube, or an intubation tube. It serves as a link and in particular as a quick coupling between a measuring device, which is connected to the measuring adapter, for example, via a hose, and the respiratory gas path device, in particular the endoscope head, endoscope tube, or intubation tube. The multiple measuring channels in the endoscope head can be connected via a single plug-in movement of the measuring adapter. In this way, it is possible to easily prepare the endoscope head for use.

[0030] The measuring adapter is preferably held on the respiratory gas path device, in particular on the endoscope head, endoscope tube or intubation tube, using a clamping force. For this purpose, at least one of the two arms can be resilient. In particular, the entire measuring adapter is made of a resilient material, so that both arms can be resilient due to the material properties. The spring force can alternatively or additionally be generated by elastic deformation of the back. The arms are bent apart slightly when laterally attached to the endoscope head. Preferably, inclined surfaces are arranged on the respiratory gas path device, in particular on the endoscope head and / or on the free ends of the arms, which slide off one another so that the clamp is bent open. Once the chamber is in its final position, the arms spring back and rest in a clamping and sealing manner against the respiratory gas path device, in particular on the endoscope head.In the same way, the clamp can be fastened to other respiratory gas path devices, in particular to the endoscope tube or to the intubation tube. It is considered advantageous if the connection to the respiratory gas path device, in particular to the endoscope head, is not just clamped, i.e. force-fitting, but additionally or alternatively is form-fitting. A form-fitting connection in the plug-on direction or against the plug-on direction, with appropriately selected tolerances, prevents the measuring adapter from slipping and thus incorrect positioning, incorrect operation or falsification of measured values. It is therefore provided that at least one arm and in particular both arms have locking projections by means of which the measuring adapter can be coupled in a form-fitting manner to the respiratory gas path device, in particular to the endoscope head.A positive fit in the attachment direction can be achieved simply by the back of a U-shaped clamp coming into contact with a contact section on the respiratory gas path device, in particular the endoscope head. This can limit the attachment depth. Lateral guides for one or both arms on the arms and / or on the respiratory gas path device, in particular on the endoscope head, ensure the position of the measuring adapter in the longitudinal direction of the respiratory gas path device, in particular the endoscope head. A combination of a positive fit connection for positional orientation and a force fit connection for sealing the transition in the area of ​​the external connection openings of the measuring channels is considered particularly advantageous.

[0031] Sensor integration can be achieved through a multi-part design of the measuring adapter, which serves as a carrier or housing for the sensors. The housing carries sensors, has measurement channels, and houses microelectronics and, optionally, an energy storage device. The housing is therefore a multifunctional component that goes far beyond the function of a mere adapter or clamp for mounting.

[0032] Particularly advantageously, the at least one first sensor is located in the back of the U-shaped clamp. The lateral arrangement of the measuring adapter is in particular always in the same position on the respiratory gas path device, in particular on the endoscope head, so that it is always ensured that the first sensor can also read the information carrier on the respiratory gas path device, in particular on the endoscope head. A further sensor is preferably arranged in or on the arm. For sensors that require signal sources to generate the measured variable, the corresponding sensor and / or the signal source is preferably located on at least one of the arms. The arms enable the opposing and preferably diametrical arrangement of signal sources and sensors in order to detect the diameter or dimension of an instrument in the endoscope tube.

[0033] Both analog and digital sensors can be considered. Analog signal acquisition makes it possible to evaluate the scattering of a light signal and thereby obtain additional information, for example whether an instrument is located in a translucent area of ​​an endoscope tube or an intubation tube. The instrument creates a shadow that can be measured. Using a correction factor and knowing the diameter of the endoscope tube or intubation tube, it is possible to determine how the jet stream or a turbine of a breathing gas source must be controlled to deliver breathing air in order to ventilate the patient to the desired extent even when the instrument is inserted. When the instrument is removed again, a control unit preferably automatically regulates the ventilation pressure or ventilation volume back to the desired value.For the application according to the invention, analog sensors, in combination with translucent endoscope tubes or intubation tubes, offer the possibility of obtaining information regarding both the diameter of the endoscope tube or intubation tube and the instrument inserted into the endoscope tube or intubation tube. This is done by using one or, optionally, several light barriers positioned such that at least one of the light barriers provides information about the diameter of the endoscope tube or intubation tube, and, if necessary, another light barrier provides information about the presence of an instrument in the endoscope tube or intubation tube. Ideally, only a single additional sensor is required to obtain sufficiently accurate measured values ​​for an appropriate correction factor.

[0034] The invention is explained below using exemplary embodiments which are illustrated in purely schematic drawings.

[0035] Figure 1 shows a schematic view of a medical device;

[0036] Figure 2 shows an endoscope head according to the prior art;

[0037] Figure 3 shows a first embodiment of the invention in a perspective view;

[0038] Figure 4 shows a cross section through the embodiment of Figure 3;

[0039] Figure 5 is a perspective view of another embodiment;

[0040] Figure 6 shows a cross section through the embodiment of Figure 5;

[0041] Figure 7 shows the embodiment of Figure 5 in a further application;

[0042] Figure 8 shows a cross section through the embodiment of Figure 7;

[0043] Figure 9 shows a cross section through another embodiment of a measuring adapter;

[0044] Figure 10 shows a measuring adapter on an endoscope head;

[0045] Figure 11 shows a measuring adapter on a breathing tube of a spirometer;

[0046] Figure 12 shows a measuring adapter on a bite block;

[0047] Figure 13 shows a breathing tube of a spirometer in a first view;

[0048] Figure 14 shows the breathing tube of a spirometer of Figure 13 in a second view and

[0049] Figure 15 shows the breathing tube of a spirometer according to Figures 13 and 14 with a connected measuring adapter.

[0050] Figure 1 shows a medical device 1 with a measuring adapter 2 connected to an endoscope head 3. The endoscope head 3 carries an endoscope tube 4. The endoscope head 3 is connected to a ventilation unit 5 via ventilation tubes 6, 7 for ventilation or jet ventilation. The measuring adapter 2 is connected to the ventilation unit 5 via a signal-transmitting channel 8. The signal transmission can be wired and / or contactless, for example, via Bluetooth. In this embodiment, an instrument 9 is arranged in the endoscope tube 4.

[0051] Figure 2 shows a medical device 10 with a measuring adapter 11 according to the prior art (DE 10 2020 110 840 A1). According to the invention, such a measuring adapter 11 is further developed. The measuring adapter 11 according to the prior art is configured as a U-shaped clamp. The endoscope head 12 according to the prior art has a longitudinal channel 13. The endoscope tube 14 is only partially shown. It can be detachably coupled to the endoscope head 12 via corresponding adapters 15, 16. The measuring adapter 11 can be detachably coupled to the adapter head 13 by being plugged laterally onto the essentially cylindrical endoscope head 12 in the direction of arrow P1. It can be removed again in the opposite direction. No tools are required for attachment and removal. In addition to the actual longitudinal channel 13, which serves as the working channel, the endoscope head 12 has connections for ventilation.These ports are intended for use with the endoscope head 12 during bronchoscopy. A first port 17 is used for jet ventilation. A second port 18 is intended for conventional ventilation at lower pressures. Ports 17 and 18 can be used alternatively.

[0052] In addition, the endoscope head 12 has measuring channels 19, 20 that are arranged diametrically. They are located near the distal end of the endoscope head so that they can be aligned with measuring channels 21, 22 in the adapter sleeves 15, 16. The measuring channels 19, 20 open into the longitudinal channel 13 and each have an inner connection opening 23 and an outer connection opening 24. The outer connection opening 24 is located in a lateral adapter connection area 25. In contrast to the remaining outer contour of the essentially cylindrical endoscope head 12, the adapter connection area 25 is not rounded but flattened. Since the corresponding connection openings 24 are diametrically opposite one another on the outside, the corresponding adapter connection areas 25, 26 are also arranged opposite one another. The measuring adapter 11 can be pushed in the direction of the arrow P1 over the flattened adapter connection areas 25, 26.The measuring adapter 11 has a back 26 and two arms 27, 28 connected to the back 26. The arms 27, 28 are resiliently configured to contact the adapter connection areas 25 with their contact surfaces 29, 30 formed on the inside of the arms 27, 28, respectively, and to establish a fluid-conducting, in particular gas-conducting, connection to the outer connection openings 24 of the measuring channels 19, 20 in the endoscope head 12. The arms 27, 28 are spaced apart at a distance adapted to the distance between the adapter connection areas 25.

[0053] The measuring channels 19, 20 from the endoscope head 12 are continued by further measuring channels 31, 32 in the measuring adapter 11. Running in the longitudinal direction of the arms 27, 28, there is a measuring channel 31, 32 each. The two measuring channels 31, 32 each have connection openings 33, 34 in the mutually facing contact surfaces 29, 30. The measuring channels 31, 32 in the measuring adapter 11 each open into connection nozzles 35, 36, to each of which a hose can be connected in order to tap and evaluate the pressure at the measuring adapter 11.

[0054] The above statements made on the state of the art with regard to the arrangement and function of the measuring channels with regard to the fastening possibility of the measuring adapter 11 and with regard to the design of the endoscope head 12 also apply to the endoscope head 3 of Figures 1 and 3 or to the measuring adapter 2 in the figures.

[0055] The further development of such a measuring adapter according to the invention is explained below with reference to Figures 3 to 9.

[0056] Figure 3 shows a greatly abbreviated view of the endoscope head 3 with an endoscope tube 4 and the attached measuring adapter 2. The measuring adapter 2 is also designed as a U-shaped clamp here, with arms 27, 28 gripping the endoscope head 3. The arms 27, 28 are connected to one another via a back 26. Two handles 37, 38 are attached to the back 26. The two handles 37, 38 are located on the side of the back 26 facing away from the arms 27, 28. They are used to handle the measuring adapter 2. A first sensor 39 is located between the handles 37, 38 in the area of ​​the back 26. The sensor 39 is located at the level of an information carrier 40 on the endoscope head 3. The information carrier 40 contains information about the design of the endoscope head 3 (Figure 4). The sensor 39 reads this information and converts it into a signal that can be transmitted via channel 8 (Figure 1) to the ventilation unit 5. There, it can be displayed on a display unit 41.The ventilation unit 5 has a storage unit 42 and an evaluation unit 43. The signals from the first transmitter 39 are evaluated in the evaluation unit 43. Correction factors or correction functions for determining correction factors for ventilation parameters of specific designs of endoscope heads 3 and / or endoscope tubes 4 are stored in the storage unit 42. They are made available to the evaluation unit 43. The determined correction factor is assigned to the identified endoscope head 3. A control unit 44 is designed to adapt the ventilation parameters of the ventilation unit 5 to the detected endoscope head 3 using the correction factor, either automatically or after acknowledgment by an operator of the medical device 1.

[0057] From the illustration in Figure 4, it is clear that the measurement of the first sensor 39 is contactless. The information on the information carrier 40 is, in particular, optical, e.g., a barcode.

[0058] Furthermore, the sectional view of Figure 4 shows a second sensor 45 arranged almost diametrically. The sensors 45 serve to detect whether an endoscope tube 4 is arranged within the endoscope head 3. In a manner not shown in detail, openings can be provided in the area of ​​the endoscope head 3 for this detection, so that the sensors 45 can also optically detect the presence of an endoscope tube.

[0059] As Figure 2 shows, different endoscope tubes 14 can be connected to the endoscope head 12 via corresponding adapters 15, 16. The same applies to the endoscope head 2 according to the invention. The second sensors 45 serve to determine the diameter of the endoscope tube 3.

[0060] The measuring clamp can be attached not only directly to the endoscope head 3, but also to the endoscope tube 4. The embodiment of Figures 5 and 6 shows this embodiment of the invention. The endoscope head is not shown because the measuring adapter 2 is now attached directly to the endoscope tube 4. In this case, too, the arms 27, 28 encompass the endoscope tube 4 to be determined. Information from the endoscope tube 4 can be read out via the first sensor 39 in the same way as in connection with the endoscope head 3. In addition, the presence of the endoscope tube 4 and preferably also its diameter can be determined via the second sensors 45. The sensors 45 operate in particular optically. The sensor arrangement can be in the form of a light barrier, wherein this sensor arrangement has a signal source 46 in the form of a light source. The light transmittance in the region of the endoscope tube 4 is measured.The scattering of the light can be used to determine whether an endoscope tube 4 is present or the diameter of the endoscope tube 4. The invention is not limited to the arrangement of a single signal source 46 or a single second sensor 45. Several such sensors 45 can also be arranged distributed around the circumference to enable a more precise determination of the diameter of the endoscope tube 4.

[0061] The embodiment of Figures 7 and 8 differs from that of Figures 5 and 6 in that the instrument 9 mentioned in Figure 1 is inserted into the channel of the endoscope tube 4. The measuring adapter 2 now additionally has the function of determining whether an instrument 9 is inserted into the endoscope tube 4. If the type of endoscope tube 4 and therefore its light transmittance is known, deviations from the previously known values ​​can be used to determine whether an instrument 9 has been inserted into the endoscope tube 4. In the purely schematic representation of Figures 7 and 8, a light path between a signal source 46 and the sensor 45 would be completely interrupted. This is a reliable signal that an instrument 9 is arranged in the endoscope tube 4. The correction factor can be determined accordingly, and ventilation parameters can be adjusted.

[0062] The embodiment of Figure 9 additionally shows the measuring adapter 2 on an endoscope tube 4, with a display unit 47 directly indicating whether and which endoscope tube 4, referred to here as "Tube B," was detected by the second sensor 45 and / or the first sensor 39. The measuring adapter 2 contains miniaturized electronics which, particularly in combination with optical sensors, infrared diodes, pressure sensors, and one or more microcontrollers, allows the desired information to be displayed to an operator as a stand-alone device, in particular the correction factors calculated in real time. For this purpose, an evaluation unit is located in the measuring adapter. The operator directly learns the correction factor via the display on the measuring clamp and, preferably, which endoscope head is connected, whether an instrument is inserted, and which endoscope tube is currently connected.

[0063] The medical device according to the invention relates in particular to single-use endoscope heads and endoscope tubes. These components are made, in particular, of plastic. The measuring adapter is reusable.

[0064] Figure 10 shows the application of the measuring adapter 2 on the endoscope head 3, while Figure 12 shows an alternative application of the measuring adapter 2 on a breathing tube 48. The breathing tube 48, together with the measuring adapter 2, forms a spirometer 49, or rather just its measuring device. This is a differential pressure flowmeter in which the flow velocity is determined via pressure differences in the breathing tube 48 as the blood flows through a perforated wall 50. The perforated wall 50 is arranged diagonally in the breathing tube 48. The perforated wall 50 is designed like a sieve. A measuring channel 31 is arranged upstream of the perforated wall 50 in the direction of flow, and another measuring channel 32 is arranged downstream of the perforated wall 50 in the direction of flow (Figure 15). The pressure differences are recorded via the measuring channels 31, 32. The flow velocity and thus the breathing volumes can be deduced from the pressure difference.The ventilation parameters associated with the respective breathing tube are detected by the measuring adapter and used to determine correction factors. If the measuring adapter 2 detects that a spirometer 49 is formed in combination with the measuring adapter 2, the differential pressure is evaluated, preferably automatically, in an evaluation unit in order to determine the respiratory volumes, i.e., the unit switches to the spirometer function. Figure 12 shows a breathing tube 51 of a different design on a bite block 52. The connection to the bite block 52 can be detachable. The operating principle is the same as in Figure 11. It is a differential pressure flowmeter in which a pressure in front of and behind a perforated wall is measured by means of the measuring adapter 2 in order to determine a pressure difference and thereby the respiratory volumes.

[0065] Figures 13 to 15 refer to the embodiment of Figure 11. The breathing tube 48 is shown in Figures 13 and 14 in two different side views, so that the position of the perforated wall 50 in the breathing tube 48 is clear. In addition, the diametrical arrangement of the measuring channels 53, 54 in the breathing tube 48 is shown. The position of the measuring channels 53, 54 is coordinated with the measuring adapter 2, which is connected in Figure 15. The measuring adapter 2 has the measuring channels 31, 21 shown in Figure 2 with the end openings 33, 34, which in this case are aligned with the measuring channels 53, 54.

[0066] Reference symbol:

[0067] 1 - medical device

[0068] 2 - Measuring adapter

[0069] 3 - Endoscope head

[0070] 4 - Endoscope tube

[0071] 5 - Ventilation unit

[0072] 6 - Ventilation tube

[0073] 7 - Ventilation tube

[0074] 8 - Channel for data transmission

[0075] 9 - Instrument

[0076] 10 - medical device

[0077] 11 - Measuring adapter

[0078] 12 - Endoscope head

[0079] 13 - Longitudinal channel of 12

[0080] 14 - Endoscope tube

[0081] 15 - Adapter

[0082] 16 - Adapter

[0083] 17 - Connection to 13

[0084] 18 - Connection to 13

[0085] 19 - Measuring channel

[0086] 20 - Measuring channel

[0087] 21 - Measuring channel in 16

[0088] 22 - Measuring channel in 15

[0089] 23 - inner connection opening of 19

[0090] 24 - outer connection opening of 19

[0091] 25 - Adapter connection area on 2

[0092] 26 - Back

[0093] 27 - Arm

[0094] 28 - Arm

[0095] 29 - Contact surface

[0096] 30 - Contact surface

[0097] 31 - measuring channel in 27 32 - measuring channel in 28

[0098] 33 - Opening of 31

[0099] 34 - Opening

[0100] 35 - Connection piece

[0101] 36 - Connection piece

[0102] 37 - Handle

[0103] 38 - Handle

[0104] 39 - first sensor

[0105] 40 - Information carrier

[0106] 41 - Display unit of 5

[0107] 42 - Storage unit of 5

[0108] 43 - Evaluation unit of 5

[0109] 44 - Control unit of 5

[0110] 45 - second sensor

[0111] 46 - Signal source

[0112] 47 - Display unit

[0113] 48 - Breathing tube

[0114] 49 - Spirometer

[0115] 50 - perforated wall

[0116] 51 - Breathing tube

[0117] 52 - Bite Block

[0118] 53 - Measuring channel

[0119] 54 - Measuring channel

[0120] P1 - Arrow

Claims

Claims Medical device (1) with a measuring adapter (2), wherein the measuring adapter (2) is designed and configured to be detachably connected to different breathing gas path devices, characterized in that at least one sensor (39) is arranged on the measuring adapter (2) which is designed to measure a measurement parameter of the different breathing gas path devices, wherein the different Respiratory gas path devices exhibit ventilation parameters, whereby a The evaluation unit (44) is configured to assign correction factors to the ventilation parameters based on measured values ​​from the sensor (39). Medical device (1) according to claim 1, characterized in that the measuring adapter (2) is designed and configured to be detachably connected to different respiratory gas path devices from the following group: endoscope heads (3), endoscope tubes (4), intubation tubes, breathing tubes, breathing tubes (48, 51) of spirometers (49), bite blocks (52). Medical device (1) according to claim 1 or 2, characterized in that the various respiratory gas path devices have an information carrier (40) that can be read by the sensor (39).Medical device (1) according to any one of claims 1 to 3, characterized in that a correlation of measurement data to the correction factors of ventilation parameters for different respiratory gas path devices is stored in a storage unit (43) in order to make it available to the evaluation unit. Medical device (1) according to any one of claims 1 to 4, characterized in that the ventilation unit (5) is connected to the measuring adapter (2) for data transmission, wherein a control unit (44) of the ventilation unit (5) is configured to automatically adjust the ventilation parameters taking into account the correction factors. Medical device (1) according to any one of claims 1 to 5, characterized in that the ventilation unit (5) and / or the measuring adapter (2) has a display unit (41, 47) configured to display a correction factor. Medical device (1) according to any one of claims 2 to 5, characterized in that the endoscope head (3) can be coupled to endoscope tubes (4) of different diameters, wherein at least one second sensor (45) on the measuring adapter (2) is provided for detecting different diameters of the connected endoscope tube (4). Medical device (1) according to any one of claims 2 to 6, characterized in that the measuring adapter (2) has at least one sensor (45) configured and designed to detect the presence of an instrument (9) in the endoscope tube (4) or in the endotracheal tube.Medical device (1) according to claim 8, characterized in that the endoscope tube (4) has at least one area permeable to the sensor (45) for detecting the presence of an instrument (9) in the endoscope tube (4) or in the intubation tube. Medical device (1) according to claim 9, characterized in that the permeable area of ​​the endoscope tube (4) or the intubation tube is transparent. Medical device (1) according to claim 10, characterized in that the transparent area extends over the entire circumference of the endoscope tube (4) and / or the intubation tube. Medical device (1) according to any one of claims 7 to 11, characterized in that at least one signal source (46) for generating a measurement from the at least one sensor (45) is arranged on the measuring adapter (2). Medical device (1) according to any one of claims 5 to 12, characterized in that the data transmission between the measuring adapter (2) and the ventilation unit (5) is wireless. Medical device (1) according to any one of claims 2 to 13, characterized in that at least one measuring channel (19) is arranged in the endoscope head (3), the measuring channel having at least one inner connection opening (23) connected to a longitudinal channel (13) in the endoscope head (3), and at least one outer connection opening (24) arranged on the outside of the endoscope head (3), wherein the outer connection opening (24) is connectable to at least one measuring channel (31) in the measuring adapter (2). Medical device (1) according to any one of claims 1 to 14, characterized in that the measuring adapter (2) is configured as a U-shaped clamp, with a back (26) and with two arms (27, 28) connected to the back (26).Medical device (1) according to claim 15, characterized in that the at least one first sensor (39) is arranged in the back (26). Medical device (1) according to claim 15 or 16, characterized in that the at least one second sensor (45) is arranged in or on the arms (27, 28). Medical device (1) according to any one of claims 1 to 17, characterized in that the measuring adapter (2) has an evaluation unit for determining a correction factor in the measuring adapter (2) and a display unit (47) for displaying the correction factor on the measuring adapter (2).

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