Endoscope System
Patent Information
- Application Number
- JP2023579346
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2021-06-25
- Filing Date
- 2022-06-20
- Publication Date
- 2025-06-05
AI Technical Summary
Existing endoscopic systems for spinal surgery face challenges in maintaining a clear surgical field while preventing undesirable pressure increases during continuous fluid irrigation.
An endoscopic system comprising a working sleeve and an endoscope with a unique fluid channel design, allowing for simultaneous supply and return flow of fluid, ensuring continuous cleaning of the surgical field and preventing pressure buildup, while providing mechanical stability and rotational functionality.
The system maintains a clear surgical field by continuous cleaning and prevents pressure increases, ensuring effective fluid management and mechanical stability during spinal surgery.
Smart Images
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Abstract
Description
[Technical field]
[0001] The present invention relates to an endoscopic system, and more particularly to an endoscopic system for spinal surgery. [Background technology]
[0002] Surgeries, especially fully endoscopic spinal surgery, are often performed during continuous liquid irrigation. Continuous liquid irrigation ensures a free viewing field, since blood and tissue particles are carried out of the viewing field by the irrigation. Apart from reliable irrigation, there is also the difficulty that intraoperative pressure must not be increased too much during spinal surgery. Summary of the Invention [Problem to be solved by the invention]
[0003] It is an object of the present invention to provide an improved endoscopic system, in particular an endoscopic system for spinal surgery, which allows for improved cleaning of the surgical area while avoiding undesirable pressure build-up. [Means for solving the problem]
[0004] This object is achieved by an endoscopy system having the features defined in claim 1. Preferred embodiments result from the dependent claims, the following description and the accompanying drawings.
[0005] The endoscope system according to the invention comprises as essential elements a working sleeve and an endoscope which can be inserted into the working sleeve. The endoscope can be pushed into the working sleeve from the distal end. In this respect, the endoscope is preferably displaceable in the working sleeve in the axial direction and rotatable about its angular position around the longitudinal axis. The endoscope and the working sleeve are preferably designed as rigid elements or bodies. A first fluid channel is formed inside the endoscope, which is open at the distal end. This means that the fluid channel has an opening at the distal end of the endoscope. Furthermore, the endoscope comprises at its proximal end a fluid connection, in which the fluid channel is connected to a supply device which can direct the fluid through the fluid channel. A changeover cock and a connection element suitable for connection, for example, to a hose, can be arranged at the fluid connection in a known manner.
[0006] The outer cross section of the endoscope and the inner cross section of the working sleeve are specially adapted to each other in such a way that, when the endoscope is inserted in the working sleeve, the endoscope supports the inner circumference of the working sleeve in a first section of its circumference and is at a distance to the inner circumference of the working sleeve in a second section of its circumference. Here, the cross section relates to a plane perpendicular to the longitudinal axis of the working sleeve extending from the proximal end to the distal end. In the first section, the outer circumference of the endoscope is preferably designed corresponding to the inner contour of the working sleeve, so that an extensive contact or parallel path of the walls is achieved. The first section preferably extends over more than 90 degrees, more preferably over at least half of the inner circumference of the working sleeve, so that the endoscope supports the inner circumference of the working sleeve extensively or runs parallel to said inner circumference, preferably in a peripheral section of at least more than 90 degrees, even more preferably in a peripheral section of at least 180 degrees. Here, preferably, the contact area is not interrupted in the circumferential direction. This in particular allows a guide for rotating the endoscope inside the working sleeve to be achieved. By providing a distance between the outer circumference of the endoscope and the inner circumference of the working sleeve, a free space is created in the region between the inner circumference of the working sleeve and a second section of the outer circumference. This free space forms a second fluid channel that is open to the distal end. For this reason, the free space preferably extends over the entire axial length of the working sleeve, i.e. from the distal end to the proximal end. Preferably, the cross section of the working sleeve and the endoscope is constant over the axial extension from the proximal end to the distal end. The working sleeve according to a preferred design comprises a second fluid connection in the region of its proximal end, said second fluid connection being connected to the free space that defines the second fluid channel. This fluid connection may be a connection element for connection to a hose, possibly a changeover cock in a known manner. Fluid circulation may be achieved by means of a first and a second fluid channel, the fluid flowing in one direction through the fluid channel inside the endoscope and in the other direction through the free space between the endoscope and the working sleeve.Here, the first fluid channel forms a supply channel through which fluid is conducted into the surgical field, and the second fluid channel forms a return or drain channel through which fluid and possibly particles or substances to be washed are conducted out of the surgical field.
[0007] Preferably, the endoscope supports the inner circumference of the working sleeve with its outer circumference, so that, viewed in the diametric direction, a free space is formed only on one side, i.e. on one side of the longitudinal axis of the instrument, while the outer circumference of the endoscope supports the inner circumference of the working sleeve on the diametrically opposite side to the free space, thereby generating greater mechanical stability, in particular greater resistance to buckling loads. The outer circumference of the endoscope supports the inner circumference of the working sleeve over a continuous area of more than 180 degrees.
[0008] According to one embodiment, the endoscope comprises an observation window at its distal end, for example in the form of an objective lens. The observation window preferably has a circular cross section. Observation of the surgical field is achieved through this observation window or through this objective lens, and image transmission can be achieved by a video system or by a connecting endoscope optical system. The observation window is preferably arranged in a sealed manner at the distal end face of the endoscope. The observation window, to which the endoscope optical system connects, can define a linear observation direction parallel to the longitudinal axis of the instrument, or an angled observation direction. The angled observation direction is preferably oriented in the axial extension direction of the working channel, so that the working space located distally in front of the working channel can be observed through the observation window by the endoscope optical system.
[0009] Preferably, the opening of the first fluid channel and the free space forming the second fluid channel are located on the side of the observation window that is separated from each other, more preferably on the side that is substantially diametrically separated from each other. Such a design allows the fluid to flow from one fluid channel into the other fluid channel, preferably through the observation window, i.e. along the outside of the observation window, from the first fluid channel into the second fluid channel. The observation field is thus continuously washed and a free view into the operating area is guaranteed.
[0010] Preferably, at the distal end, the opening of the first fluid channel and the free space defining the second fluid channel are arranged with respect to the observation window, i.e. preferably with respect to the observation window of the endoscope optical system, such that the fluid flow through the observation field located in front of the observation window flows between the first and second fluid channels, as described above. That is, when a fluid is supplied through the first fluid channel and led out through the second fluid channel, the fluid flow leaves the first fluid channel at the distal end, flows through the observation field in front of the observation window and is led out through the second fluid channel. Alternatively, the fluid flow can also flow in the opposite direction. If the observation direction through the observation window is at an angle to the longitudinal axis of the instrument, the opening and the free space of the first fluid channel are preferably located such that the flow passes through the angled part of the observation field. For this reason, the opening and the free space can be arranged, possibly offset in the observation direction, preferably towards the working channel.
[0011] The working sleeve preferably has a circular inner cross section. More preferably, the working sleeve is designed as a tube with a circular cross section as a whole. The circular inner cross section allows the endoscope to rotate inside the working sleeve, and the endoscope can slide along or move parallel to the inner circumference of the working sleeve in the region of the first section of its outer circumference.
[0012] According to a further embodiment, the endoscope has in the first section of its outer circumference an outer contour that is arc-shaped in cross section, and more preferably the arc-shaped outer contour has a radius of curvature that substantially corresponds to the radius of the inner circumference of the working sleeve. The radius of the inner circumference of the working sleeve and the radius of the outer contour of the endoscope may differ slightly from each other, so that a press fit is formed that allows the arc-shaped outer circumference section of the endoscope to slide along or move parallel to the inner circumference of the working sleeve. The circular inner contour of the working sleeve extends here concentrically with the longitudinal axis of the working sleeve, which extends from the proximal end to the distal end. The arc-shaped outer circumference section of the endoscope in the first section of the outer circumference of the endoscope is thereby curved around the same longitudinal axis, which is preferably also the axis of rotation, around which the endoscope can rotate inside the working sleeve.
[0013] In the region of the second section of the outer periphery of the endoscope, its outer contour is preferably flat or designed in the shape of an elliptical arc, which means that in this section, for example, the radius of the outer periphery is smaller than the radius of the inner periphery of the working sleeve, so that the above-mentioned free space is created.
[0014] As already explained, the endoscope is rotatable inside the working sleeve, preferably around its longitudinal axis. For this, the endoscope can be rotatably mounted or held in a receiver at the proximal end of the working sleeve. When rotating, as explained, the outer peripheral surface of the endoscope slides along the inner wall of the working sleeve in the area of the first section. A free space formed between the second section of the outer circumference of the endoscope and the inner wall of the working sleeve, which serves as a second fluid channel, now rotates together with the endoscope around the longitudinal axis of the working sleeve. In this regard, the second fluid channel always retains a defined relative position with respect to the endoscope, independent of its angular position inside the working sleeve.
[0015] The second fluid channel preferably has a larger cross-sectional area than the first fluid channel. In particular, this is advantageous when the second fluid channel functions as a drain or suction channel. If the return has a larger cross-section than the supply through the first fluid channel, it is ensured that the fluid does not cause an undesirable pressure increase in the operating area. Preferably, the free space has a cross-section at least 20% larger than the cross-section of the first fluid channel, and even more preferably more than 50%. The cross-section of the free space can also be 3 to 5 times larger than the cross-section of the first fluid channel, or can be designed to be larger.
[0016] It is further preferred that the endoscope comprises in its interior a working channel that is open towards the distal end, preferably with a circular cross section. The working channel preferably extends parallel to the longitudinal axis of the endoscope and with it parallel to the longitudinal axis of the working sleeve. The working channel extends from the proximal end to the distal end of the endoscope. At the proximal end, the working channel is connected to a receiver for a working insert, which is preferably designed such that the working insert or an instrument can be pushed into the working channel in a sealed manner. Here, the working instrument is preferably movable in the working channel in a known manner. In cross section, the working channel is preferably located in the endoscope next to the first fluid channel and possibly the endoscope optics. The opening of the working channel at the distal end of the endoscope is preferably located in relation to the observation window such that an instrument advanced through the working channel into the endoscope field is located in the observation field through the observation window.
[0017] According to a further preferred embodiment, the cross-sectional axis of the working channel, preferably the diametric axis of the working channel, and the cross-sectional axis of the observation window, preferably the diametric axis of the observation window, lie on a common straight line, which further preferably extends parallel to or along the diameter of the working sleeve, which allows optimal utilization of the diameter of the endoscope or working sleeve to achieve a maximum size of the working channel and observation window.
[0018] It is further preferred that the straight line defined by the above-mentioned cross-sectional axis and the outer contour of the first section of the outer periphery of the endoscope define a semicircle. This means that, when viewed in cross-section, the endoscope has a semicircular shape in its first section. However, in the second section, the endoscope is designed in a flattened manner or has an elliptical outer contour that is smaller than the inner contour of the working sleeve, so that in the above-mentioned manner a free space, i.e. in particular a circular arc-shaped free space, is formed between the endoscope and the inner circumference of the working sleeve, which in the above-mentioned manner serves as a second fluid channel.
[0019] Advantageously, the sum of the diameters of the observation window and the working channel is greater than 75% of the inner diameter of the working sleeve, thus optimally utilizing the inner cross section of the working sleeve.
[0020] As mentioned above, image transmission in an endoscope can be achieved via a video system or an endoscope optical system. With regard to a video system, a video sensor can be arranged in the area of the distal end of the endoscope, i.e. in particular behind the observation window or the objective lens that connects to the observation window. Alternatively, the picture can be transmitted from the distal end of the endoscope to the proximal end via a rigid endoscope optical system, for example a lens or a fiber optic device, and in some cases a camera can be arranged in the area of the proximal end of the endoscope, for example on the handle.
[0021] Further preferably, the endoscope comprises an illumination device. In this regard, it is preferred that at least one light output surface, through which the surgical field can be illuminated, is arranged at the distal end. At least one light emitting diode can be arranged at the light output surface for illumination. Alternatively, illumination can also be achieved via an optical fiber that transmits light from the proximal end to the distal end of the endoscope. A suitable illumination coupling or light source can be arranged at the proximal end of the endoscope, through which light is guided into the optical fiber, which then transmits light to the distal end to the aforementioned light output surface.
[0022] Particularly preferably, the optical fiber serving for illumination is arranged in the cross-sectional area of the endoscope that is not filled by the endoscope optics, the first fluid channel and the working channel, and more preferably, the optical fiber fills the entire remaining free space inside the endoscope so as to surround the endoscope optics, the first fluid channel and the working sleeve. Thus, maximum transmission of light through the endoscope barrel can be achieved. Instead of the optical fiber, one or more LEDs serving for illumination can be arranged in the area of the distal end face of the endoscope that surrounds the observation window, the outlet opening of the first fluid channel and the opening of the working channel.
[0023] The invention will now be described, by way of example only, with reference to the accompanying drawings, in which: [Brief description of the drawings]
[0024] [Figure 1] 1 is a side view of an endoscopic system according to the present invention. [Diagram 2] 2 is an enlarged plan view of the distal end of the endoscopic system according to the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0025] The endoscopic system according to the invention comprises two essential elements: a working sleeve 2 and an endoscope 4 which can be inserted therein. The working sleeve 2 is designed like a tube, and the endoscope 4 is pushed into the working sleeve 2 through an opening or receiver 6 at the proximal end of the working sleeve 2, so that the endoscope 4 emerges from the working sleeve 2 at the distal end. The endoscope 4 comprises a handle 8 at its proximal end. An internal working channel 10 of the endoscope 4 opens at the proximal end into a receiver 12, through which a working insert or instrument can be pushed into the working channel 10.
[0026] The working sleeve 2 has a circular cross section, in particular a circular inner cross section transverse to the longitudinal axis X extending from the proximal end to the distal end. The inner circumferential surface of the working sleeve 2 extends concentrically around the longitudinal axis X. The endoscope 4 has a cross section in which a first section is designed in a semicircular manner and a second section is designed in an elliptical manner. In this example, a first section of the outer periphery of the endoscope 4 extends over 180 degrees, i.e. the first half, the half to the left of the axis Y in FIG. 2. In this first section, the outer contour of the endoscope is semicircular and has a radius that essentially corresponds to the radius of the inner periphery of the working sleeve 2, so that the endoscope 4 with its outer periphery can slide along the inner circumferential surface 2 in the first section 14 when the endoscope 4 is rotated around the longitudinal or central axis X of the working sleeve 2. This can be achieved by rotation in the opening 6 of the working sleeve 2. A second section 16 of the outer periphery of the endoscope 4, the part to the right of the axis Y in FIG. 2, is designed in a flat or elliptical form, so that a free space 18 is formed between the outer periphery of the endoscope 4 and the inner periphery of the working sleeve 2. This free space 18 rotates together with the endoscope 4 when it is rotated inside the working sleeve 2 about the longitudinal axis X. Viewed in a diametric direction perpendicular to the transverse axis Y shown in FIG. 2, the free space 18 is only on one side of the longitudinal axis X, while the endoscope 4 with its outer periphery supports the inner periphery of the working sleeve 2 on this diametrically opposite or remote side. Overall, the endoscope 4 supports with it the inner periphery of the working sleeve 2 over a continuous section of approximately 180°. This achieves a great stability of the instrument also with respect to buckling, since the endoscope 4 inside the working sleeve 2 stabilizes or strengthens this working sleeve.
[0027] A first fluid channel 20 is formed inside the endoscope 4, which terminates in a first fluid connection 22 at the proximal end or handle 8 of the endoscope 4. Furthermore, a working channel 10, which extends proximally to the receiver 12, opens into the distal end of the endoscope 4. Furthermore, an observation window 24, which can be designed for example as an objective lens, is located at the distal end of the endoscope 4, said observation window forming the distal end of the endoscope optics, which extends in the longitudinal direction X through the endoscope body 4 to the proximal end, i.e. towards the handle 8. An eyepiece can be provided in the handle 8 or a camera mounted for recording images. Alternatively, a video chip can be arranged in or behind the observation window 24.
[0028] Two LEDs 26 are disposed at the distal end of the endoscope 4 for illumination. As an alternative to the LEDs 26, an optical fiber may also be disposed inside the endoscope 4, extending from the distal end to an illumination fitting on the handle 8. The optical fiber may preferably fill the complete free space surrounding the working channel 10, the first fluid channel 20 and the endoscope optics.
[0029] In the illustrated example, the working channel 10 and the observation window 24 are located in the endoscope 4 such that their diametric axes lie on a common diametric axis Y transverse to the longitudinal axis X, i.e. extend along a common straight line. The first fluid channel 20 is arranged with respect to the free space 18 forming the second fluid channel such that the first fluid channel 20 and the free space 18 are located on either side of the observation window 24, i.e. away from each other, on either side of the axis Y. The free space 18 is connected to a second fluid connection 28 at the proximal end of the working sleeve 2 as a second fluid channel. The first fluid connection 22 and the second fluid connection 28 can be connected to hoses for the supply and discharge of fluids. The first fluid channel 20 serves as a supply flow, while the second fluid channel 18 serves as a discharge or return flow. The cross section of the free space 18 is larger than the cross section of the first fluid channel 20, so that a larger flow cross section is ensured to be available for the return flow, so that a pressure increase due to the supply of fluids in the surgical field can be avoided. It is ensured that the return flow is always greater than the supply flow. Since the opening of the first fluid channel 20 at the distal end and the opening of the free space 18 are located on both sides of the observation window 24, i.e. on both sides of the axis Y, which are also located on both sides of the axis Y, it is ensured that the fluid flow that flows out of the first fluid channel 20 to the free space 18 flows over the observation window 24 on the outside, continuously cleaning the observation field in the observation direction and keeping it free of interfering contaminants such as blood or tissue parts. This flow direction co-rotates when rotating the endoscope 4 in the working sleeve 2, so that a flow over the observation window 24 is always ensured, regardless of the angular position of the endoscope 4 in the working sleeve 2. In this example, the opening of the first fluid channel 20 is slightly offset relative to the observation window 24 in a direction parallel to the axis Y towards the working channel 10. This makes it possible to optimally utilize the cross-sectional area of the endoscope 4. Furthermore, in this example, the observation direction outward from the observation window 24 is angled, i.e. towards the working channel 10. Due to the offset arrangement of the openings of the fluid channels 20, the fluid flow from the first fluid channel 20 into the free space 18 succeeds in flowing through the observation field in an angled observation direction in front of the observation window 24.
[0030] The combination of the circular working sleeve 2 and the cross-section of the endoscope 4, the cross-section of which is designed in an elliptical configuration, on the one hand allows free rotatability of the endoscope 4 inside the working sleeve 2 and, on the other hand, allows a large second fluid channel for the return of fluids. At the same time, the endoscope cross-section is optimally adapted for the working channel 10, the endoscope optics terminating in the observation window 24, and the fluid channel 20. [Explanation of symbols]
[0031] 2 Working sleeve 4 Endoscopy 6 Openings 8 Handle 10 Working Channels 12 Receptor 14 First Outer Section 16 Second outer section 18 Free space / secondary fluid channel 20 First Fluid Channel 22 First fluid connection 24 Observation window / distal end of endoscope optical system 26 LED 28 Second fluid connection X Longitudinal axis, rotation axis Y Horizontal Axis
Claims
1. An endoscopic system comprising a working sleeve (2) and an endoscope (4) that can be inserted into the working sleeve (2), wherein a first fluid channel (20) opening at a distal end is formed inside the endoscope (4), 1. An endoscope system comprising: an endoscope and an endoscope sleeve, the endoscope supporting the inner circumference of the working sleeve within a first section of its outer circumference and spaced apart from the inner circumference of the working sleeve within a second section of its outer circumference when the endoscope is inserted into the working sleeve, the endoscope supporting the inner circumference of the working sleeve within a first section of its outer circumference and spaced apart from the inner circumference of the working sleeve within a second section of its outer circumference, the endoscope forming a second fluid channel extending over the axial length of the working sleeve and opening at the distal end in a region between the inner circumference of the working sleeve and the second section of the outer circumference of the endoscope.
2. 2. An endoscope system according to claim 1, characterized in that the endoscope (4) is provided at its distal end with an observation window (24), preferably with a circular cross section.
3. The endoscope system according to claim 1, characterized in that one opening of the first fluid channel (20) and the free space (18) forming the second fluid channel are located on either side of the observation window (24) and are spaced apart from each other.
4. 2. The endoscopic system of claim 1, wherein at the distal end, an opening of the first fluid channel (20) and the free space (18) defining the second fluid channel are positioned relative to the observation window (24) such that fluid flow through an observation field in front of the observation window (24) flows between the first fluid channel and the second fluid channel.
5. 2. The endoscope system according to claim 1, characterized in that the working sleeve (2) has a circular inner cross section.
6. The endoscopic system according to claim 1, characterized in that the endoscope (4) has, within the first section (14) of its outer periphery, an outer contour which has a circular arc-shaped cross-section, preferably with a radius of curvature which substantially corresponds to the radius of the inner circumference of the working sleeve (2).
7. The endoscopic system according to claim 1, characterized in that the outer contour of the endoscope (4) is flat or designed in the shape of an elliptical arc in the region of the second section (16) of the periphery.
8. 2. The endoscopic system according to claim 1, characterized in that the endoscope (4) is rotatable about a longitudinal axis X inside the working sleeve (2).
9. The endoscopic system of claim 1 , wherein the second fluid channel (18) has a larger cross-sectional area than the first fluid channel (20).
10. 2. The endoscope system according to claim 1, characterized in that the first fluid channel (20) is designed as a supply channel and the second fluid channel (18) is designed as a drain channel.
11. 2. The endoscope system according to claim 1, characterized in that the endoscope (4) comprises therein a working channel (10) which opens at the distal end and which preferably has a circular cross section.
12. The endoscopic system according to claim 11, characterized in that the cross-sectional axis Y of the working channel (10) and the cross-sectional axis Y of the observation window (24) are in a straight line, which line preferably extends parallel to or along a diameter of the working sleeve (2).
13. The endoscopic system of claim 12, characterized in that the straight line defined by the cross-sectional axis Y and the outer contour within the first section (14) of the periphery of the endoscope (4) define a semicircle.
14. An endoscopic system as described in claim 11, characterized in that the sum of the diameters of the observation window (24) and the working channel (10) is greater than 75% of the inner diameter of the working sleeve (2).
15. The endoscopic system of claim 1 , wherein the endoscope (4) comprises an endoscope optical system extending from the distal end to a proximal end.
16. The endoscope system according to claim 1, characterized in that the endoscope (4) comprises at least one light exit surface (26) at its distal end.
17. The endoscopic system of claim 1, characterized in that optical fibers useful for illumination are arranged in the cross-sectional area of the endoscope not filled by the endoscope optical system (24), the first fluid channel (20) and the working channel (10), or one or more LEDs (26) useful for illumination are arranged at the distal end of the endoscope (4).