Endoscopic instrument

Abstract

To provide improved surgical instruments including endoscopes.SOLUTION: This disclosure relates to instruments and methods of performing an endoscopy. An endoscope for producing images of a surgery in vivo may include a hub and an imaging rod extending from the hub, the imaging rod being configured to receive light and direct the light to an imaging sensor located adjacently to a distal end of the imaging rod, the hub and the imaging rod being attached to form an assembly having a center of mass established distally to the hub. In other implementations, the hub may be omitted.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 63 / 065,037, filed August 13, 2020, which is incorporated herein in its entirety.

[0002] SUMMARY The present disclosure relates to surgical instruments and methods, including endoscopes and methods for performing endoscopic examinations. [Background technology]

[0003] The present disclosure relates to instruments and methods associated with performing surgical procedures, such as endoscopy. The instrument may be inserted into a patient. One or more images may be obtained using the instrument. Summary of the Invention

[0004] An endoscope for generating images of a surgical procedure in vivo according to implementations of the present disclosure includes, among other things, a hub and an imaging rod extending from the hub. The imaging rod may be configured to receive light and direct light to an area adjacent a distal end of the imaging rod. An imaging sensor may be located at a distal end portion of the imaging rod. The hub and imaging rod may be attached to form a hub assembly that may have a center of gravity within the imaging rod.

[0005] An endoscope for generating images of a surgical procedure in vivo according to implementations of the present disclosure includes, among other things, a communications assembly, a hub coupled to the communications assembly, and an imaging rod extending from the hub. The hub and imaging rod may be attached to form a hub assembly having a center of gravity that may be established distal to the hub. An imaging sensor may be coupled to a distal end portion of the imaging rod.

[0006] An endoscope for generating images of a surgical procedure in vivo according to an embodiment of the present disclosure includes, among other things, a communication assembly and a hub assembly coupled to the communication assembly. The hub assembly may include an imaging rod, an imaging sensor, and electronics coupled to the imaging sensor. The imaging rod may include a main body extending a first length between a proximal end portion and a distal end portion relative to a longitudinal axis. The imaging sensor may be disposed adjacent to the distal end portion of the imaging rod. The electronics may be disposed within an internal cavity of the imaging rod. The hub assembly may have a center of gravity established within the imaging rod at a second length from the proximal end portion. The second length may be 50 percent or more of the first length.

[0007] A method of performing an endoscopy according to implementations of the present disclosure includes, among other things, inserting a distal end portion of an imaging rod through an insertion point in a patient, where the imaging rod extends from a hub to the distal end portion, and the hub and imaging rod are attached to establish a hub assembly having a center of gravity established distal to the hub, and then inserting the center of gravity through the insertion point. An imaging sensor may be located at the distal end portion of the imaging rod. The method may include obtaining an image by the imaging sensor at a location inside the insertion point subsequent to the step of inserting the center of gravity. [Brief description of the drawings]

[0008] [Figure 1] FIG. 1 is a perspective view of an exemplary endoscope including a needle hub assembly and a cable assembly. [Figure 2A] FIG. 2 is a perspective view of the needle hub assembly of FIG. [Figure 2B] FIG. 2 is a side view of the needle hub assembly of FIG. [Diagram 3] FIG. 2 is an exploded view of the endoscope of FIG. 1. [Figure 4] FIG. 2 is a perspective view of the needle hub assembly of FIG. 1, including a support boot shown in phantom. [Diagram 5] FIG. 2 is a perspective view of another exemplary endoscope. [Figure 6] FIG. 1 illustrates exemplary electronic components. [Figure 7] FIG. 1 illustrates another exemplary endoscope. [Figure 8] 1 is a flow chart of a method of performing a surgical procedure. [Figure 9] FIG. 1 illustrates an instrument positioned adjacent an insertion point on a patient. [Figure 10] FIG. 10 shows a portion of an instrument inserted through the insertion point of FIG. 9. [Figure 11] FIG. 11 shows a portion of the instrument withdrawn from the insertion point of FIG. 10. [Figure 12] FIG. 1 illustrates another exemplary device. [Figure 13] FIG. 1 illustrates another exemplary device. [Figure 14] FIG. 1 illustrates another exemplary device. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Like reference numbers and designations in the various drawings indicate like elements.

[0010] FIELD OF THE DISCLOSURE The present disclosure relates to instruments and methods that may be utilized during surgical procedures such as endoscopy, which generally involves the insertion of a tube into a patient's body to view internal organs or tissue.

[0011] The endoscope is provided with novel features. The endoscope is designed to free the hands of the surgeon or other assistant. The endoscope may have features that allow it to be inserted into a patient and remain in place without being held by the surgeon or assistant. A unique combination of size, weighting, and / or form factor may enable these attributes. The endoscope may have an electronics housing and a rod extending therefrom for insertion into the patient. The rod may include a tip attached to a distal end that includes an imaging sensor.

[0012] In some implementations, the chip may also include illumination elements (e.g., LED elements, fiber optic bundles, light pipes, etc.) to generate illumination in vivo. In other implementations, the illumination elements are omitted. The area may be flushed with fluid, which may help cool the chip, which may otherwise impose heating concerns, raising design concerns for combining an imaging sensor and LED illumination on the same chip. The illumination elements may be configured to surround the imaging sensor and may be individually controllable. Groups of elements on the chip may have the same wavelength or different wavelengths, and intensity may be controlled based on several factors, including using image and / or sensor features for feedback. In some implementations, one or more illumination sources may be included within the needle hub assembly, as described further below.

[0013] The housing may be symmetrical and balanced. For example, the housing may be cylindrical. The housing may be concentric with the rod. The housing and rod may be fixedly attached to form a single operable body. The housing may have a weight less than twice the weight of the rod, and in some implementations may be less than 1.5 times the weight of the rod. The housing may, in some cases, beneficially have a weight less than the weight of the rod.

[0014] The housing may have a length less than 0.75 times the length of the rod. The housing may, in some cases, beneficially have a length less than 0.25 times the length of the rod. In some cases, components of the housing may be integrated into the rod.

[0015] The housing may have a diameter less than 5 times the diameter of the rod. The housing may in some cases beneficially have a diameter equal to or less than the diameter of the rod.

[0016] The combined body of the housing and rod may have a center of gravity located distally from the housing, for example, within the rod. In this manner, the center of gravity may be configured to be within the patient's body when inserted during surgery. Having the center of gravity within the rod and / or inside the patient allows the endoscope to stay more securely in place without intervention by the surgeon or assistant.

[0017] The housing may communicate wirelessly with the display or controller. Alternatively, the housing may have a cable from the housing to the controller / display that is greater than 1.5 feet long, allowing the body to be positioned with sufficient cable slack to eliminate or otherwise reduce any cable tension that would impact the ends of the housing and cause forces to act at an angle to the central axis of the endoscope that would cause the endoscope to tilt off-axis.

[0018] An endoscope for generating images of a surgical procedure in vivo according to implementations of the present disclosure includes, among other things, a hub and an imaging rod extending from the hub. The imaging rod may be configured to receive light and direct the light to an area adjacent a distal end of the imaging rod. An imaging sensor may be located at a distal end portion of the imaging rod. The hub and imaging rod may be attached to form a hub assembly that may have a center of gravity within the imaging rod.

[0019] In a further implementation, the imaging rod may extend a first length between the distal end portion and an interface between the imaging rod and the hub. A center of gravity may be established within the imaging rod at a second length from the interface. The second length may be 10 percent or more of the first length.

[0020] In a further implementation, the hub may include electronics configured to transmit image data from the imaging sensor.

[0021] In further implementations, the second length may be greater than or equal to 25 percent of the first length.

[0022] In a further implementation, the hub may include a light supply.

[0023] In a further implementation, the hub may include a power supply.

[0024] In a further implementation, the hub may include electronics configured to wirelessly transmit image data.

[0025] In a further implementation, the hub may include electronics configured to transmit the image data digitally.

[0026] In a further implementation, the hub may include electronics configured to transmit image data as an analog signal over the coaxial cable.

[0027] In a further implementation, the hub assembly may be symmetrical about a reference plane that extends along the longitudinal axis of the hub assembly.

[0028] In a further implementation, the hub may be cylindrical.

[0029] In a further implementation, the length of the hub may be less than 0.75 times the length of the imaging rod.

[0030] In a further implementation, the diameter of the hub may be less than five times the diameter of the imaging rod.

[0031] In a further implementation, the weight of the hub may be less than twice the weight of the imaging rod.

[0032] In a further implementation, the hub may include electronics including electronic circuitry, a light supply, and an optical coupler. The electronic circuitry may be configured to transmit image data from the imaging sensor. The light supply may be connected to the electronic circuitry. The light supply may be configured to generate illumination in vivo, and the optical coupler may be configured to communicate light from the light supply to the optical fiber. The optical fiber may be configured to transmit light from the hub to a distal end portion of the imaging rod. A housing may be configured to encapsulate the electronic circuitry, the light supply, and the optical coupler. The hub coupler may connect the imaging rod to the housing.

[0033] In a further implementation, the cable assembly may include a first cable, a second cable, a connector, and a button yoke having one or more controls. The first cable may be coupled to a proximal end portion of the hub assembly. The button yoke may interconnect the first cable and the second cable. The second cable may interconnect the button yoke and the connector. The connector may have a terminal configured to interface with an external device.

[0034] An endoscope for generating images of a surgical procedure in vivo according to implementations of the present disclosure includes, among other things, a communications assembly, a hub coupled to the communications assembly, and an imaging rod extending from the hub. The hub and imaging rod may be attached to form a hub assembly having a center of gravity that may be established distal to the hub. An imaging sensor may be coupled to a distal end portion of the imaging rod.

[0035] In a further implementation, the center of gravity may be established within the imaging rod.

[0036] In a further implementation, the light source may be within the imaging rod adjacent the distal end portion.

[0037] In a further implementation, the hub may include a housing configured to enclose the electronics.

[0038] In a further implementation, multiple light sources may be arranged in an array to surround the imaging sensor.

[0039] In a further implementation, the multiple light sources may be respective paths configured to diverge from a common light source.

[0040] In a further implementation, the light sources may be individually controllable.

[0041] An endoscope for generating images of a surgical procedure in vivo according to an embodiment of the present disclosure includes, among other things, a communication assembly and a hub assembly coupled to the communication assembly. The hub assembly may include an imaging rod, an imaging sensor, and electronics coupled to the imaging sensor. The imaging rod may include a main body extending a first length between a proximal end portion and a distal end portion relative to a longitudinal axis. The imaging sensor may be disposed adjacent to the distal end portion of the imaging rod. The electronics may be disposed within an internal cavity of the imaging rod. The hub assembly may have a center of gravity established within the imaging rod at a second length from the proximal end portion. The second length may be 50 percent or more of the first length.

[0042] In further implementations, the second length may be greater than 50 percent of the first length.

[0043] In a further implementation, the electronics may be located adjacent to a distal end portion of the imaging rod.

[0044] In further implementations, the second length may be greater than 75 percent of the first length.

[0045] A method of performing an endoscopy according to implementations of the present disclosure includes, among other things, inserting a distal end portion of an imaging rod through an insertion point in a patient, where the imaging rod extends from a hub to the distal end portion, and the hub and imaging rod are attached to establish a hub assembly having a center of gravity established distal to the hub, and then inserting the center of gravity through the insertion point. An imaging sensor may be located at the distal end portion of the imaging rod. The method may include obtaining an image by the imaging sensor at a location inside the insertion point subsequent to the step of inserting the center of gravity.

[0046] In a further implementation, the center of gravity may be established within the imaging rod.

[0047] In a further implementation, the hub may be outside the insertion point during the obtaining process.

[0048] In further implementations, the method may include releasing the hub assembly such that the center of gravity can be in vivo. The method may include releasing the hub assembly such that the hub can be substantially cantilevered from the imaging rod outwardly of the insertion point.

[0049] In further implementations, the length of the hub may be less than 0.75 times the length of the imaging rod. The weight of the hub may be less than twice the weight of the imaging rod.

[0050] In a further implementation, the method may include communicating the light to an imaging sensor prior to the obtaining step.

[0051] In a further implementation, the step of communicating may include communicating light from the hub, then through the imaging rod, and then toward an area adjacent the distal end portion of the imaging rod.

[0052] In a further implementation, the step of communicating may include communicating light from a plurality of light sources adjacent a distal end portion of the imaging rod. The light sources may be arranged in an array to surround the imaging sensor.

[0053] In a further implementation, the step of communicating may include individually controlling the light sources to communicate the light.

[0054] In a further implementation, the insertion point may be established by an incision in the patient's skin.

[0055] 1-4 illustrate an exemplary endoscope 110 that may be utilized to generate images of a surgical procedure in vivo. With reference to FIG. 1, the endoscope 110 may include a needle hub assembly 112 and a cable (e.g., communication) assembly 113. The needle hub assembly 112 may include a scope 114 (e.g., a camera or imaging rod) secured within a needle hub 116, as illustrated in FIGS. 1 and 2B. The scope 114 extends from a distal end of the needle hub 116. The scope 114 and the needle hub 116 may be dimensioned such that the needle hub assembly 112 is substantially symmetrical (e.g., mirror symmetrical) with respect to a reference plane REF extending along a longitudinal (e.g., central) axis X of the assembly 112 to divide the assembly 112 into two opposing portions, as illustrated in FIGS. 2A-2B.

[0056] Various techniques may be utilized to dimension the hub assembly 112. With continued reference to FIGS. 1 and 2A, and with reference to FIG. 2B, the scope 114 may extend a first length L1 between a terminal end (e.g., distal end) 117 and an interface 121 between the scope 114 and the distal end of the hub 116 relative to the longitudinal axis X. The interface 121 may be established at or adjacent to the proximal end of the scope 114. In implementations in which the scope 114 is flexible, the first length L1 corresponds to a maximum configurable length of the scope 114. In implementations in which the hub 116 is omitted, the first length L1 may be established between the proximal and distal ends of the scope 114. In implementations, the first length L1 may be approximately 100 millimeters (mm) to 300 mm. The needle hub 116 may extend a second length L2 between opposing proximal and distal ends of the needle hub 116 relative to the longitudinal axis X. The scope 114 may establish a first diameter D1. The needle hub 116 may establish a second diameter D2. The first length L1 and the second length L2, and / or the first diameter D1 and the second diameter D2 may be the same or different. In some implementations, the length L2 of the needle hub 116 is less than 0.75 times the length L1 of the scope 114, the diameter D2 of the hub 116 is less than 5 times the diameter D1 of the scope 114, and / or the weight of the hub 116 is less than 2 times the weight of the scope 114.

[0057] The hub 116 and the scope 114 can be attached to form a hub assembly 112 having a center of gravity CM. The center of gravity CM can be established at a longitudinal location relative to the longitudinal axis X. The longitudinal location of the center of gravity CM can be aligned with a longitudinal location along the scope 114 relative to the longitudinal axis X. The center of gravity CM can be established distal to the needle hub 116 relative to the longitudinal axis X. In an implementation, the center of gravity CM can be established within the scope 114 along the longitudinal axis X. In other implementations, the needle hub assembly 112 can be configured such that the center of gravity can be established adjacent to but offset from the scope 114, as illustrated by the center of gravity CM' (FIG. 2A). The endoscope 110 can be configured such that the center of gravity CM can be inside or outside the patient during a surgical procedure.

[0058] The hub 116 and / or the scope 114 may be symmetrical or asymmetrical to establish the center of gravity CM. For example, the scope 114 may have a curvilinear geometry such that one or more portions of the scope 114 are offset from the longitudinal axis X to establish an asymmetrical configuration. As another example, the component(s) within the hub 116 may be arranged such that the center of gravity of the component(s) is offset from the longitudinal axis X.

[0059] The center of gravity CM may be established at various locations relative to the scope 114 and / or needle hub 116. The hub assembly 112 may be configured such that a portion of the hub assembly 112 including the center of gravity CM may be positioned within the patient to improve holding of the endoscope 110 without intervention by the surgeon or an assistant, while another portion of the hub assembly 112 may be positioned outside of the patient. The center of gravity CM may be established at, adjacent to, or distal to the distal end of the needle hub 116.

[0060] The center of gravity CM may be established at a distance LCM from a proximal boundary of the first length L1. The proximal boundary of the first length L1 may be established by an interface 121 between the scope 114 and the distal end of the hub 116, or for implementations in which the hub 116 is omitted, by the proximal end of the scope 114. The hub assembly 112 may be configured such that the center of gravity CM' is offset from the scope 114. The distance LCM may be less than 10 percent of the first length L1. The center of gravity CM may be established at the interface 121 between the scope 114 and the distal end of the needle hub 116. In implementations, the center of gravity C M ″ may be established proximal to the interface 121 within the hub 116. The hub assembly 112 may be configured such that the distance L C M is 10 percent or more of the first length L1, or more specifically, approximately 25 percent or more of the first length L1. In implementations, the distance L C M may be approximately 50 percent or less of the first length L1. For purposes of this disclosure, the terms “substantially,” “approximately,” and “about” mean ±10 percent of a stated value or relationship, unless otherwise indicated. Utilizing the techniques disclosed herein, including the disclosed dimensional relationships and distributions, a surgeon or assistant may position the hub assembly 112 in vivo in a manner that reduces the likelihood of movement or intervention while the endoscope 110 is not being held.

[0061] With continued reference to FIG. 1, and with reference to FIG. 3, cable assembly 113 may include a first cable 118 (e.g., a micro-coaxial cable), a button yoke 120, a second cable 126, and a connector 128. Connector 128 may include a terminal 130 configured to communicate with an external device, such as a display or controller 131 (shown in dashed lines in FIG. 1 for illustrative purposes). In other implementations, endoscope 110 communicates wirelessly with controller 131. Needle hub assembly 112 or cable assembly 113 may include a power source 133 (shown in dashed lines in FIG. 3 coupled to electronic circuitry 138 for illustrative purposes) that provides power to various electrical components of endoscope 110 during operation. In other implementations, power is provided by an external device and communicated to the various electrical components by terminal 130.

[0062] The scope 114 may include an imaging sensor 108 located on, at, or otherwise adjacent to the distal end portion 115 of the scope 114 to obtain an image of the surgical site. The imaging sensor 108 may be a sensor assembly including a sensor and an optical element. The scope 114 may be configured to receive light and direct the light to or otherwise toward an area adjacent the distal end portion 115 of the scope 114 (e.g., a scene or space being viewed by the surgeon). The light may be reflected back from the area toward the sensor 108.

[0063] The scope 114 and each cable 118, 126 may be relatively rigid or flexible. A distal end portion 115 of the scope 114 establishes a terminal end 117 (e.g., tip) of the endoscope 110. At least a portion of the scope 114, including the distal end portion 115, may be relatively flexible or bendable and may comprise, for example, a Nitinol material. Configuring the scope 114 to be relatively flexible may facilitate orienting the sensor 108, including, for example, bending or steering the sensor 108 around corners and viewing various angles of the surgical site.

[0064] The first cable 118 may be a coaxial cable (e.g., a micro-coaxial cable). The first cable 118 may be coupled to a proximal end portion 119 of the hub assembly 112 as illustrated in FIGS. 1 and 4. In some implementations, the first cable 118 may communicate analog signals between the needle hub 116 and the button yoke 120. The button yoke 120 may interconnect the first cable 118 and the second cable 126. The second cable 126 may interconnect the button yoke 120 and the connector 128.

[0065] The button yoke 120 may have one or more controls (e.g., buttons, dials, levers, etc.), such as, for example, button 122 and button 124. Each button 122, 124 may have one or more functions, such as image and video capture. Each button 122, 124 may be programmable for several functions. Additionally, multiple functions may be accessed based on the number of times the button 122, 124 is pressed, the amount of time during which the button 122, 124 is pressed multiple times, and / or the amount of time the button 122, 124 remains continuously pressed.

[0066] First cable 118 and second cable 126 can have a variety of dimensions. In some implementations, second cable 126 has a length of approximately 2 feet, which may allow button yoke 120 to rest on a surface when endoscope 110 is in use and may minimize or otherwise reduce the impact on the fixed position of hub 116.

[0067] The needle hub 116 may include a hub coupler 134 that connects the scope 114 to other components of the needle hub 116. The needle hub 116 may include various electronics 123, including a flexible circuit board 135, electronic circuitry 138, a light supply 137, and an optical coupler 136. The flexible circuit board 135 may extend from the needle hub 116 through the scope 114 to the sensor 108. The flexible circuit board 135 may be connected to the electronic circuitry 138. The electronic circuitry 138 may be in the form of a printed circuit board and may include one or more chips. The electronic circuitry 138 may be configured to transmit image data in analog signals over a coaxial cable, such as the first cable 118. In an implementation, one or more of the electronics 123, including the power supply 133, the flexible circuit board 135, the optical coupler 136, the light supply 137, and / or the electronic circuitry 138, may be integrated into the button yoke 120, and the separate hub 116 including the housing 139 may be omitted.

[0068] The scope 114 can be configured to receive light and direct the light to or toward an area adjacent to the distal end portion 115 of the scope 114. The light may be communicated directly or indirectly from the scope 114 to the sensor 108. For example, the light may be reflected from the area back to or otherwise toward the sensor 108. The circuitry 138 and / or the flexible circuit board 135 may be connected to a light supply 137 (e.g., a light source or illumination element). The light source 137 may be, for example, a light emitting diode (LED) and may be configured and utilized to generate illumination in vivo. The optical coupler 136 may be configured to communicate light from the light source 137 to an optical fiber (e.g., a light pipe) 103 (shown in dashed lines in FIG. 3 for illustrative purposes). The optical fiber 103 may be configured to transmit light from the needle hub 116 to the distal end portion 115 of the scope 114. In other implementations, the optical fiber 103 may be omitted and the light source 137 may be positioned within the scope 114 distal to the needle hub 116. In implementations, a separate light source may be in an external environment but adjacent the distal end portion 115 of the scope 114 to illuminate the surgical site.

[0069] In some implementations, the imaging sensor 308 and one or more light sources 316 are integrated with or mounted on a common circuit board 323 (e.g., chip) as illustrated in FIG. 6 to establish electrical components 325. The light sources 316 can be configured in an array to surround the sensor 308 and may be individually controllable. In implementations, the light sources 316 may be respective paths configured to branch off from a single common light source 327 (shown in dashed lines for illustrative purposes). The light sources 316 may be utilized to improve light communication in a relatively compact arrangement. The common light source 327 may be coupled to the circuit board 323 or another portion of the endoscope. The groups of light sources 316 on the circuit board 323 may have the same wavelength or different wavelengths, and the intensity may be controlled based on several factors, including using image and / or sensor features for feedback. The electrical components 325 can be in any of the locations of the image sensor disclosed herein. For example, the electrical components 325 can be coupled or mounted on or adjacent to the distal end portion 115 of the scope 114 (FIG. 1). Combining the imaging sensor 308 and the light source(s) 316 on the same circuit board 323 may improve cooling augmentation with fluids delivered to the surgical site, such as fluids utilized to flush the surgical site during a surgical procedure.

[0070] The various electronics of the needle hub assembly 112 can be configured to wirelessly and / or digitally transmit image data from the imaging sensor 108 to an external device, such as the controller 131, and / or to another component of the endoscope 110, such as the button yoke 120. Other sensors can be incorporated into the endoscope 110. For example, one or more sensors, such as a temperature sensor, a pressure sensor, etc., may be configured to sense or measure various conditions at the distal end portion 115 of the scope 114. In some implementations, an accelerometer and / or gyroscope is positioned within the needle hub 116 and / or the scope 114 to sense changes in the position and / or orientation of the endoscope 110.

[0071] The end 117 of the distal tip portion 115 can be established at various angles relative to the central or longitudinal axis of the endoscope 110. For example, the end 117 can be substantially perpendicular to the longitudinal axis X of the scope 114, as illustrated in FIGS. 1 and 2A-2B. In some implementations, the end 117' of the distal tip portion 115' establishes an angle α that is transverse to the central or longitudinal axis X of the scope 114', as illustrated in FIG. 7. The sensor image acquired by the sensor 108' can be oriented, for example, at an angle corresponding to the angle α (e.g., 30 degrees). The electronic circuitry 138', or another portion of the endoscope 110', can be programmed or otherwise incorporate logic to perform corrections or transformations of the captured image(s) to change the orientation of the captured image(s) as the sensor 108' rotates during the procedure.

[0072] 3, the needle hub 116 may include a housing 139 configured to enclose the components of the needle hub 116. The housing 139 may include a first shell 162 and a second shell 164 that cooperate to enclose the electronics and other components of the needle hub 116 (e.g., the light source 137, the circuitry 138, and the optical coupler 136). The hub coupler 134 may couple the scope 114 to the shells 162 and 164 of the housing 139. The hub coupler 134 may be a separate and distinct component or may be incorporated into the housing 139 and / or the scope 114.

[0073] The shield 230 may at least partially or completely surround the housing 139, as illustrated in Figure 4. The shield 230 may take the form of a flexible shield and may be formed from a conductive material such as copper. As a result, the shield 230 may take the form of a copper foil. A support boot 166 may support the housing 139 and the first cable 118, as illustrated in Figure 4 (shown in phantom).

[0074] For comparative purposes, FIG. 5 illustrates another exemplary endoscope 410. The endoscope 410 may have a handpiece 412 and a camera rod 414. The handpiece 412 may be designed to be held by the surgeon or an assistant and to contain all the control electronics. In these implementations, the center of gravity of the endoscope 410 may be far back within the handpiece 412 and therefore may be held more broadly by an assistant rather than remaining stationary without guidance by the assistant.

[0075] FIG. 8 illustrates in a flow chart 540 an exemplary method of performing a surgical procedure. The method 540 may be utilized to perform an endoscopy. The method 540 may be utilized with any of the instruments and assemblies disclosed herein, including the endoscopes 110, 110' and endoscopes 710, 810 (FIGS. 12-13). The images obtained may be utilized pre-operatively, intra-operatively, and / or post-operatively, and may be utilized to restore function of a joint during various surgical procedures, such as joint arthroplasty. Fewer or additional steps than those listed below may be performed within the scope of the present disclosure, and the order of the steps listed is not intended to limit the present disclosure. For purposes of illustration, reference is made to the instrument (e.g., endoscope) 610 of FIGS. 9-11.

[0076] With continued reference to FIG. 8 and with reference to FIG. 9, the instrument 610 may include a hub assembly 612 coupled to a cable assembly 613. The hub assembly 612 may include a hub 616 and a scope 614 (e.g., a camera or imaging rod) coupled to the hub 616. The hub 616 may have a generally or substantially tubular geometry and may serve as a handle for positioning the hub assembly 612. The hub assembly 612 may include an imaging sensor 608 located at a distal end portion 615 of the imaging rod 614. The imaging rod 614 may extend from the hub 616 to the distal end portion 615. The hub 616 and imaging rod 614 may be attached to establish the hub assembly 612 having a center of gravity CM. The center of gravity CM may be established distal to the hub 616 relative to a longitudinal axis X of the hub assembly 612 (FIG. 10). Hub assembly 612 may be configured such that a center of gravity CM may be established within or adjacent to imaging rod 614. Hub assembly 612 may be configured according to any of the techniques disclosed herein. In implementations, the length of hub 616 may be less than 0.75 times the length of imaging rod 614, the weight of hub 616 may be less than 2 times the weight of imaging rod 614, and / or the diameter of hub 616 may be less than 5 times the diameter of imaging rod 614.

[0077] At step 542, the instrument 610 may be positioned at a surgical site S in the patient's body B relative to an insertion point 611. The insertion point 611 may be an incision, opening, or another opening made through the skin in the patient's body B. The method 540 may include forming the incision prior to step 542.

[0078] 10 with continuing reference to FIGS. 8-9, step 542 may include moving the instrument 610 in a direction D1, and then, in step 544, inserting a portion of the instrument 610 through an insertion point 611. Step 544 may be performed such that a portion of the instrument 610 is in an in vivo situation. Step 544 may include inserting at least a distal end portion 615 of an imaging rod 614 through an insertion point 611 in a patient, and then inserting a center of mass CM of the instrument 610 through the insertion point 611. A portion of the hub assembly 612 including the center of mass CM may be positioned within the patient, while another portion of the hub assembly 612 may be positioned outside the patient, such as the hub 616, and / or a portion of the imaging rod 614 proximal to the center of mass CM including a proximal end of the imaging rod 614.

[0079] At step 546, the method 540 may include communicating light to the imaging sensor 608. Various techniques may be utilized to communicate light to the imaging sensor 608. In an implementation, step 546 may include communicating light from the hub 616, then through the imaging rod 614, and then to an area of ​​the patient adjacent the distal end portion 615 of the imaging rod 614. The light may be reflected from the area back to or otherwise toward the imaging sensor 608 (see also hub 116, imaging sensor 108, and imaging rod 114 of FIG. 1). In an implementation, step 546 may include communicating light from one or more light sources adjacent the distal end portion 615 of the imaging rod 614. The light sources may be arranged in an array to surround the imaging sensor 608 (see, for example, imaging sensor 308 and light source 316 of FIG. 6). Step 546 may include individually controlling the light sources to communicate light in step 548.

[0080] At step 550, the surgeon or assistant may have the instrument 610 obtain one or more images with the imaging sensor 608 at a position inside the insertion point 611. Step 550 may occur following positioning the instrument 610 at step 542 and / or communicating light at step 546. The center of gravity CM of the instrument 610 may be inside the insertion point 611 or otherwise in an in vivo situation, and the hub 116 may be outside the insertion point 611 or otherwise in an ex vivo situation during obtaining the image(s) at step 550. At step 552, the image(s) may be communicated to an external device (see, e.g., external device 131 of FIG. 1).

[0081] In step 554, the surgeon or assistant may release control of the instrument 610 while the distal end portion 615, the imaging sensor 608, and / or the center of gravity CM of the instrument 610 are in an in vivo situation, as illustrated in FIG. 10 . Step 554 may include releasing control of the hub assembly 612 such that the center of gravity CM may be in an in vivo situation and such that the hub 116 may be substantially cantilevered from the imaging rod 614 outboard of the insertion point 611. For purposes of this disclosure, the term “substantially” cantilevered means that no more than 10 percent of the hub assembly 112 outboard of the insertion point 611 is supported by means other than the imaging rod 614. Step 554 may include balancing the hub assembly 612 at or otherwise adjacent to the insertion point 611 in response to releasing control of the hub assembly 612. The instrument 610 may remain in place without being held or otherwise supported by the surgeon or an assistant, which may improve flexibility and reduce time to perform other steps during the surgical procedure.

[0082] 11 , with continuing reference to FIG 8 , in step 556, the portion of the instrument 610 in the in vivo situation may be moved in a direction D2 until the instrument 610 is withdrawn from the insertion point 611 and removed from the patient. Step 556 may include withdrawing the imaging sensor 608, the distal end portion 615, and the center of gravity CM of the instrument 610 from the patient.

[0083] 12 illustrates another exemplary instrument 710. The instrument 710 may be an endoscope utilized to obtain one or more images of a surgical site. The instrument 710 may include a needle hub assembly 712 coupled to a cable (e.g., communication) assembly 713 (shown in dashed lines for illustrative purposes). In the implementation of FIG. 12, the separate hub is omitted from the hub assembly 712.

[0084] The hub assembly 712 may include a scope 714 (e.g., a camera or imaging rod). The scope 714 may include a main body 729 extending along a longitudinal axis X between a distal end portion 715 and a proximal end portion 719 of the hub assembly 712. The main body 729 may have a generally or substantially tubular geometry and may define an interior cavity 725. The scope 714 may establish a first diameter D1. The main body 729 may be dimensioned such that the first diameter D1 is substantially constant between the distal end portion 715 and the proximal end portion 719 of the scope 714.

[0085] The scope 714 may include an imaging sensor 708 configured to obtain images of the surgical site. The imaging sensor 708 may be disposed within the interior cavity 725 or may be disposed at a distal end portion 715 of the scope 714 to obtain one or more images of the surgical site. A surgeon or an assistant may utilize a portion of the scope 714 as a handle to position and orient the imaging sensor 708 in a desired location within the patient.

[0086] The hub assembly 710 may include various electronics 760, including any of the electronics disclosed herein, such as a flexible circuit board, electronic circuitry, optical supply, optical coupler, and / or power source (see, e.g., FIG. 3). The electronics 760 may be integrated onto a single chip to establish an electronics unit that may integrate or be coupled to the imaging sensor 708. The electronics 760 may be located at various locations within the cavity 725 of the scope 714. The electronics 760 may be located proximal to the center of gravity CM of the hub assembly 712, such as at or adjacent to the proximal end portion 719 of the scope 714. The electronics 760 may include a light source within the scope 714 adjacent to the proximal end portion 719.

[0087] The center of gravity CM may be established at a longitudinal location between the distal end portion 715 and the proximal end portion 719 of the hub assembly 712, including within the scope 714. The center of gravity CM may be established at a distance LCM from a proximal boundary of the first length L1 of the scope 714. The hub assembly 712 may be configured such that the center of gravity CM is established according to any ratio of the distance LCM to the first length L1 disclosed herein. In implementations, the hub assembly 712 may be configured such that the distance LCM is 25 percent or more of the first length L1, or more narrowly, approximately 50 percent or more of the first length L1. In implementations, the distance LCM may be approximately 75 percent or less of the first length L1.

[0088] Placing at least a portion, most, or all of the electronics 760 and / or other internal components of the hub assembly 712 into the scope 714 may be utilized to shift the center of gravity CM of the hub assembly 712 relatively more distally relative to the proximal end portion 719 of the hub assembly 712, which may improve grip of the instrument 710 without intervention by the surgeon or an assistant.

[0089] 13 illustrates another exemplary instrument 810. The instrument 810 may be an endoscope utilized to obtain one or more images of a surgical site. The instrument 810 may include a hub assembly 812 coupled to a cable (e.g., communication) assembly 813. In the implementation of FIG. 13, the separate hub is omitted.

[0090] The instrument 810 may include various electronics 860 disposed at various locations within the cavity 825 of the scope 814. The electronics 860 may include a first set of electronics 860-1 and a second set of electronics 860-2, which may include any of the electronics disclosed herein.

[0091] The electronics 860 may be distributed within the scope 814 to establish a center of gravity CM at various locations between the distal end portion 815 and the proximal end portion 819 of the hub assembly 812. The center of gravity CM may be established at a longitudinal location between the distal end portion 815 and the proximal end portion 819, including within the scope 814. A first set of electronics 860-1 may be located distal to the center of gravity CM of the hub assembly 812. A second set of electronics 860-2 may be located proximal to the center of gravity CM. The first set of electronics 860-1 may be located at or adjacent to the distal end portion 815 of the scope 814. The second set of electronics 860-2 may possibly be located at or adjacent to the proximal end portion 819 of the scope 814. In implementations, the second set of electronics 860-2 is omitted such that substantially all of the electronics of the hub assembly 812 are located in the distal half of the imaging rod 814. The electronics 860-1 may include a light source, such as an LED, that may be positioned adjacent and proximal to the imaging sensor 808.

[0092] The center of gravity CM may be established at a longitudinal location between the distal end portion 815 and the proximal end portion 819 of the hub assembly 812, including within the scope 814. The center of gravity CM may be established at a distance LCM from a proximal boundary of the first length L1 of the scope 814. The hub assembly 812 may be configured such that the center of gravity CM is established according to any ratio of the distance LCM to the first length L1 disclosed herein. In implementations, the hub assembly 812 may be configured such that the distance LCM is 25 percent or more of the first length L1, more specifically approximately 50 percent or more of the first length L1, or even more specifically approximately 75 percent or more of the first length L1. In implementations, the distance LCM may be approximately 90 percent or less of the first length L1.

[0093] Locating at least a portion, most, or all of the electronics 860 and / or other internal components of the hub assembly 812 adjacent to the distal end portion 815 of the instrument 810 may be utilized to shift the center of gravity CM of the hub assembly 812 relatively more distally relative to the proximal end portion 819 of the hub assembly 812, which may improve grip of the instrument 810 without intervention by the surgeon or assistant.

[0094] 14, the instrument 910 may include electronics 960. One or more of the electronics 960 may be incorporated into the cable assembly 913. The cable assembly 913 may include a button yoke 920 that may incorporate the electronics 960-2. The electronics 960-2 may include any of the electronics disclosed herein, including the power source 133, the flexible circuit board 135, the optical coupler 136, the light supply 137, and / or the electronics 138 (FIG. 3). A separate hub including a housing for enclosing the electronics may be omitted. The instrument 910 may include the electronics 960-1 adjacent the distal end portion 915 of the imaging rod 914, or the electronics 960-1 may be omitted and / or may be incorporated into the button yoke 920.

[0095] The novel devices and methods of the present disclosure provide versatility in obtaining images of a patient's anatomy during endoscopy. The disclosed instruments may be configured to allow the instruments to be inserted into a patient and remain in place without being held or otherwise supported by a surgeon or assistants. The disclosed instruments may be configured with a center of gravity that improves holding of the instruments without intervention from the surgeon or assistants, which can reduce the complexity and time to perform a surgical procedure.

[0096] Although different non-limiting embodiments are illustrated as having particular components or steps, embodiments of the present disclosure are not limited to those particular combinations. Some of the components or features from any of the non-limiting embodiments can be used in combination with features or components from any of the other non-limiting embodiments.

[0097] The foregoing description is to be interpreted as illustrative and not in any limiting sense. Those skilled in the art will appreciate that certain modifications may fall within the scope of the present disclosure. For these reasons, the following claims should be studied to determine the true scope and content of the present disclosure. [Explanation of symbols]

[0098] 103 Optical fibers (e.g., light pipes) 103 Optical Fiber 108 Image Sensor 110 Endoscope 112 Hub Assembly 113 Cable Assembly 114 Imaging rod, scope 115 Distal end section 116 Hub 117 End 118 First Cable 119 Proximal end portion 120 Button Yoke 121 Interface 122 Buttons 123 Electronic equipment 124 Buttons 126 Second Cable 128 Connector 130 Terminal 131 Control device 133 Power supply 134 Hub coupler 135 Flexible circuit board 136 Optical Coupler 137 Light source 138 Electronic circuit 139 Case 162 First Shell 164 Second Shell 166 Support Boots 230 Shield 308 Image Sensor 308 Sensor 316 light source 323 Circuit Board 325 Electrical Components 327 Common light source 410 Endoscope 412 Handpiece 414 Camera Rod 608 Image Sensor 610 Equipment 611 Insertion point 612 Hub Assembly 613 Cable Assembly 614 Imaging rod, scope 615 Distal end section 616 Hub 708 Image Sensor 710 Endoscope 712 Hub Assembly 713 Cable Assembly 714 Scope 715 Distal end section 719 Proximal end part 725 Internal cavity 729 Main Body 760 Electronic equipment 808 Image Sensor 810 Endoscope 812 Hub Assembly 813 Cable Assembly 814 Imaging Rod 814 Scope 815 Distal end section 819 Proximal end part 825 Cavity 860 Electronic equipment 910 Equipment 913 Cable Assembly 914 Imaging Rod 915 Distal end section 920 Button Yoke 960 Electronic equipment

Claims

1. 1. An endoscope for producing in vivo surgical images, comprising: Hub and an imaging rod extending from the hub, the imaging rod configured to receive light and direct the light to an area adjacent a distal end portion of the imaging rod, an imaging sensor located at the distal end portion of the imaging rod, and the hub and the imaging rod attached to form a hub assembly having a center of gravity distal to the hub; An endoscope comprising:

2. The endoscope of claim 1 , wherein the hub comprises electronics configured to transmit image data from the imaging sensor.

3. The endoscope of claim 1 , wherein the hub comprises a light supply.

4. An endoscope according to any preceding claim, wherein the hub comprises a power source.

5. The endoscope of claim 4 , wherein the power source is proximal to the interface between the imaging rod and the hub.

6. The endoscope of claim 5 , wherein a distal-most portion of the hub is connected to the imaging rod at the interface.

7. The endoscope of claim 1 , wherein the hub comprises electronics configured to transmit image data in an analog signal, wirelessly, digitally, and / or over a coaxial cable.

8. The endoscope of claim 1 , wherein the hub assembly is symmetrical about a reference plane that extends along a longitudinal axis of the hub assembly.

9. The endoscope of claim 1 , wherein the hub is cylindrical.

10. The endoscope of claim 1 , wherein the length of the hub is less than 0.75 times the length of the imaging rod.

11. The endoscope of claim 1 or 10, wherein the diameter of the hub is less than five times the diameter of the imaging rod.

12. The endoscope of claim 1 or 10, wherein the weight of the hub is less than twice the weight of the imaging rod.

13. The hub is an electronic device including an electronic circuit, a light supply, and an optical coupler, the electronic circuitry is configured to transmit image data from the imaging sensor; the light providing unit is connected to the electronic circuitry, and the light providing unit is configured to generate illumination in vivo; electronics, the optical coupler configured to communicate light from the light supply to an optical fiber, the optical fiber configured to transmit light from the hub to the distal end portion of the imaging rod; a housing configured to enclose the electronic circuit, the light providing portion, and the optical coupler; a hub coupler connecting the imaging rod to the housing; The endoscope of claim 1 .

14. a cable assembly including a first cable, a second cable, a connector, and a button yoke having one or more controls; 14. The endoscope of claim 13, wherein the first cable is coupled to a proximal end portion of the hub assembly, the button yoke interconnects the first and second cables, the second cable interconnects the button yoke and the connector, and the connector has a terminal configured to interface with an external device.

15. 1. An endoscope for producing in vivo surgical images, comprising: A communication assembly; a hub coupled to the communication assembly; an imaging rod extending from the hub, the hub and the imaging rod attached to form a hub assembly having a center of gravity distal to the hub; an imaging sensor coupled to a distal end portion of the imaging rod; An endoscope comprising:

16. The endoscope of claim 15 further comprising a light source within the imaging rod adjacent the distal end portion.

17. 17. An endoscope according to claim 15 or 16, wherein the hub includes a housing configured to enclose electronics.

18. A plurality of light sources arranged in a line to surround the image sensor; Further equipped with The endoscope of claim 15, wherein the multiple light sources are respective paths configured to branch off from a common light source and / or the multiple light sources are individually controllable.

19. and electronics coupled to the imaging sensor. The endoscope of claim 15 , wherein the electronics are disposed within an interior cavity of the imaging rod.

20. The endoscope of claim 19 , wherein the electronics are disposed adjacent the distal end portion of the imaging rod.

Images