Conductive optical element

Abstract

To provide a device comprising an optical element having conductive coating.SOLUTION: A device may comprise, an optical element, a conductive material and at least one connector. The conductive material is arranged on at least a part of the optical element. The optical element may be, for example, an objective lens of an endoscope, or an optical coupler. The connector (acting as a terminal) can supply energy (for example, power) to the conductive material. In one embodiment, the conductive material is an optically transparent material. The device can visualize an object, concurrently to application of energy to an object (for example, a body tissue or other substance) through the conductive coating, advantageously. Therefore, when the energy is supplied, a user can observe at real time, change of the tissue and other substance.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of U.S. Patent Application No. 14 / 728,812, filed June 2, 2015, which is incorporated by reference herein in its entirety. [Background technology]

[0002] Minimal and less invasive surgery and interventional procedures are generally safer, faster and less traumatic for patients, and therefore involve reduced inflammation, postoperative pain, risk of infection and healing time compared to more invasive forms of surgery, including general surgery and open procedures.

[0003] In medical applications, minimally invasive approaches typically involve direct or remote visualization, either by hand or with remote instruments used for diagnosis, treatment or manipulation. Applications include surgery with small incisions (called mini-thoracotomy) and direct visualization of the surgical site. Alternatively, one or more forms of remote visualization can be used, such as using a flexible colonoscope to inspect the colon or a laparoscope to visualize the surgical site.

[0004] A variety of scopes are used when it comes to remote visualization inside a patient's body. The scope used depends on the degree of need for the physician to navigate inside the body, the type of surgical instruments used for the procedure, and the level of invasiveness appropriate for the type of procedure. For example, visualization inside the gastrointestinal tract may involve the use of endoscopy in the form of flexible gastroscopes and colonoscopes and specialized duodenal scopes with lengths that can be tens of feet and over a centimeter in diameter. These scopes may be rotated, integrated, or manipulated by the physician as the scope is navigated through the patient. Many of these scopes contain one or more working channels to pass and support instruments, fluid and irrigation channels to flush tissue and clean the scope, aeration channels to improve navigation and visualization, and one or more light guides to illuminate the scope's field of view.

[0005] Small, inflexible or rigid scopes, or scopes that combine flexibility and rigidity, are also used in medical applications. For example, smaller, narrower, and much shorter scopes are used to examine joints and perform arthroscopic surgery (e.g., shoulder or knee surgery). When a surgeon is using arthroscopic surgery to repair a torn meniscus in a knee, a shorter, more rigid scope is inserted through a small incision on the other side of the knee to visualize the damage while passing instruments through an incision on one side of the knee. The instruments can be washed inside the knee to maintain visualization and also manipulate tissue to complete the repair.

[0006] Other scopes can be used for diagnosis and treatment using less invasive endoscopic procedures, including, but not limited to, the use of scopes for examination and treatment situations in the lungs (bronchoscopes), mouth (enteroscopes), urethra (cystoscopes), abdomen and abdominal cavity (laparoscopes), nose and sinuses (laryngoscopy), anus (sigmoidoscopy), chest and thoracic cavity (thoracoscopes), and heart (cardioscopes). Additionally, robotic medical devices rely on scopes to remotely visualize the area the robotic device is evaluating and treating.

[0007] These and other scopes can be inserted through natural orifices (e.g., mouth, sinuses, ears, urethra, anus, and vagina), through a patient's skin, cavities, skull, joints, or through other medically suitable insertion ports. Examples of endoscopic diagnosis using the medical scopes include diagnosing symptoms of digestive disorders (e.g., nausea, vomiting, abdominal pain, gastrointestinal bleeding), or diagnosing (e.g., anemia, bleeding, inflammation, and cancer by performing a biopsy), or surgically treating disease (e.g., removing a ruptured appendix or cauterizing intragastric bleeding).

[0008] Direct and remote visualization devices, such as scopes used in endoscopy, robotics, and other medical procedures, communicate images to the observer in a variety of ways through the use of image capture elements, including (i) relay lenses between the objective lens and eyepiece at the distal end of the scope, (ii) optical fibers, (iii) charge-coupled device (CCD) and complementary metal-oxide semiconductor (CMOS) sensors, as well as other image capture and transmission methods known to those skilled in the art. A typical endoscope consists of an element that holds the image capture elements and (often) a light source that illuminates the field of view of the scope, such as a LED or light directed by a fiber optic system. Frequently, a video capture system is connected to the visualization device to display a video image on a display monitor that can be viewed by the user while using the visualization device. The system may include the ability to adjust the focus of the display via manual adjustment or an autofocus function in a video processor system used with the optical imaging device.

[0009] Additional devices are used in conjunction with remote visualization devices to treat or repair in medical and non-medical procedures. For example, in medical applications, it is common to use a separate device, such as a grasper, to manipulate and shift tissue to gain a different perspective, and a third device to cauterize or ablate tissue if there is bleeding or disease, which can be effectively treated with this approach. These devices may be used through different access points, such as a separate incision or port, or through a working channel designed into a particular scope, such as a colonoscope.

[0010] There is a need to improve the overall visualization and manipulation of tissue and other materials through the addition of more therapeutic and repair capabilities for use with scopes and other optical elements. Summary of the Invention

[0011] Aspects of the present disclosure solve the problems of the prior art by providing a device that includes an optical element, one or more conductive coatings, and at least one connector region for transmitting energy to the device. The conductive layer coating can be at least partially optically transparent. It can include a conductive oxide, such as titanium oxide or aluminum oxide, or other conductive material.

[0012] The connector region may be configured to connect to a power source. The connection to the power source may be part of the device. The device may also connect to a catheter (e.g., a flex transistor or wire), cord or other element that connects to the connector and the power source. The power source may be part of the device. The power source may include an electrical power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a plasma generator, or any other form of generator or other power source (including a battery) that can generate and transmit energy to or across the optical element or conductive coating.

[0013] The device may be removably positioned in the remote visualization device. The device may also be designed as a permanent component of the remote visualization device, such as a scope.

[0014] The optical imaging elements may be configured to reduce fluids, debris and particulate matter, move away from or contact tissue or other matter, and manipulate and shift tissue or other matter (including manipulating, realigning tissue to conform to a desired shape or incision). The conductive coating may be configured to generate sufficient energy to alter tissue or other matter. One or more conductive coatings may be applied to the device to form a single electrode to alter tissue or other matter. The conductive coating may be applied to the device in multiple patterns to form multiple electrodes that alter tissue or other matter in multiple ways. Altering tissue or matter can include, for example, ablation, coblation, cauterizing, shaping, sealing, incising, debriding, resecting, cutting and coagulating tissue, vaporizing blood or fluids, activation and hardening of adhesives and other chemicals or formulations activated by energy and effects associated with the delivery of energy to manipulate or alter matter.

[0015] The conductive coating regions may be at least partially optically transparent. The optically transparent regions may be positioned overlapping on the tissue and other material to be manipulated and excited. The conductive coating may have a thickness of half a micron or less or other such thickness to generate a particular tissue or material change depending on the given power source and intended application. The conductive coating may be uninsulated, or may be partially insulated by another material, including one or more dielectric coatings or materials, or may be completely insulated.

[0016] The conductive coating may be configured to convert the power source into one or more forms of energy for alteration of tissue or other matter, including monopolar energy, bipolar energy, argon gas energy, coblation energy, plasma energy, thermal energy, ultrasound, focused ultrasound, or other forms of energy that can be transmitted across or through the conductive coating to alter tissue or matter. One or more biocompatible materials and any other materials reasonably suitable may be selected or configured to promote adhesion of the conductive coating and overall performance of the device.

[0017] The optical coupler and / or its connectors and power source may have one or more feedback elements for determining the degree of change in the tissue or substance. These feedback elements may include one or more temperature sensors, thermocouples, or other elements for measuring the change, influence, or effect of one or more forms of energy when applied to the tissue or other substance.

[0018] In another aspect, a method includes contacting at least a portion of the tissue or material with an optical element and applying energy to a coating on the optical element to alter the portion of the tissue or material, the tissue or material being altered by conducting energy on or through the portion of the tissue or material using the coating on the optical element as an electrode for delivering energy.

[0019] Altering tissue or other matter may include heating, cauterizing, shaping, sealing, incising, excising, debriding, cutting, joining, coagulating, coblation, ablation, or other operations involving contacting tissue or matter with energy delivered through or via the coating. Applying energy may include applying bipolar power through or across the surface of the optical element. Contacting tissue or matter may include joining tissue or matter, coagulating, sealing blood vessels in tissue, or other operations involving contacting tissue or matter with energy delivered by a coating on the optical element.

[0020] One or more coatings used on the optical elements may have different water contact angles, facilitating the optical elements into different performance elements, including coatings with water contact angles that result in hydrophilic, hydrophobic and superhydrophobic performance. One or more of the coatings may also have anti-reflective properties to reduce or minimize light reflection in the field of view of the scope, and other variations of coatings may have scratch resistance and other hardness properties to protect the optical elements. The coatings may be conductive or transparent.

[0021] Embodiments of the optical elements may include the ability to wash (or irrigate) tissue or material, and to inject one or more drugs, adhesives or other compounds into the area of ​​interest for excitation and manipulation by the device. In another embodiment, the scope is a means for viewing inside the body.

[0022] In one embodiment, the scope includes an optical element, a conductive material on at least a portion of the optical element, and at least one connector capable of providing energy to the conductive material. In another embodiment, the optical element is integrally mounted to the distal end of the scope. The optical element may be a lens, the portion being the outer distal surface of the lens. The scope may also be a means for observing inside the body.

[0023] In another embodiment, the connector is configured to connect to a power source. The conductive material may be at least partially transparent. The device may also include an additional power source. For example, the power source may be selected from the group consisting of an electrical power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cyclogenerator, and a plasma generator.

[0024] Another embodiment includes an assembly including an image capture device having a viewing end, a positioning assembly supporting the viewing end, a conductive surface disposed on the viewing end and positioned and configured to transmit energy across the viewing end, and a power connection configured to provide energy to the conductive surface. The positioning assembly may include an elongated member configured to be inserted through a restricted opening. The positioning assembly may also include a controller coupled to an end of the elongated member opposite the viewing end.

[0025] The image capture device can be configured to convey a liquid to the observation end. The image capture device can include, for example, a working channel. The working channel can be configured to convey a liquid.

[0026] In another embodiment, the conductive surface may be optically transparent and may overlap or conform to tissue.

[0027] The conductive surface may be connected to a power source by a second conductive surface, such as a platinum surface.

[0028] Advantages of embodiments include: (i) improved visualization in liquids, debris, and blood; (ii) the ability to turn the scope into a therapeutic device by delivering energy to the area of ​​interest through the optical elements on the scope, eliminating the need for a separate instrument exchange to deliver energy to tissue or other materials; (iii) the ability to provide anti-fogging capabilities of the lens; (iv) the ability to control energy delivery to treat small to large areas of materials and tissues without losing sight of the area of ​​interest due to the ability to maintain visualization through the application of energy; (v) the ability to use the working channel in certain modifications of the device to feed complementary devices such as graspers while maintaining the ability to simultaneously deliver energy; and (vi) other benefits including improved procedures in medical applications such as diathermy, electrocautery, electrosurgery, biopsy, ablation, coblation, fogging mitigation, as well as improved procedures in non-medical applications such as pipeline inspection and repair with remote visualization. The above and other features and advantages of the embodiments of the present disclosure will become more readily apparent to those of ordinary skill in the art upon consideration of the following detailed description and accompanying drawings, which describe both preferred and alternative embodiments of the present disclosure. [Brief description of the drawings]

[0029] [Figure 1] FIG. 1 is a cross-sectional side view of a device according to one embodiment of the present invention, including an optical coupler attached to the distal end of an endoscope. [Diagram 2] FIG. 2 shows a cross-sectional side view of the optical coupler of FIG. [Diagram 3] FIG. 3 illustrates a rear cross-sectional elevation view of the optical coupler of FIG. [Figure 4] FIG. 4 shows another cross-sectional view of the device of FIG. [Diagram 5] FIG. 5 shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 6] FIG. 6 shows another cross-sectional view of the device of FIG. [Figure 7]FIG. 7 shows another cross-sectional view of the device of FIG. [Figure 8A] FIG. 8A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 8B] FIG. 8B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 8C] FIG. 8C shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 9A] FIG. 9A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 9B] FIG. 9B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 10] FIG. 10 is a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11A] FIG. 11A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11B] FIG. 11B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11C] FIG. 11C shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 12] FIG. 12 shows a schematic diagram of a device according to another embodiment of the present invention; and [Figure 13] FIG. 13 shows another embodiment of the invention having a catheter that delivers energy from a power source to a connector in the device. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] The embodiments of the present disclosure are described more fully below. Indeed, these embodiments may be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. As used herein and in the appended claims, the singular forms "a," "an," "the," and "the" include plural referents unless the context clearly dictates otherwise. As used herein, the term "comprising" and variations thereof are used synonymously with the term "including" and variations thereof and are open-ended terms.

[0031] Despite the many advantages associated with using image capture devices to improve visualization, including remote visualization, the inventors have identified significant problems with these technologies that require improvement in order to diagnose and treat patients in medical settings, or separately to examine and correct conditions in non-medical applications. Image capture elements quickly become clouded with liquids, debris, and particulate matter that obscure visualization. Additionally, image capture elements may be dependent on instruments and other elements to deliver treatment and to correct, manipulate, and repair the subject.

[0032] In non-medical applications, non-invasive inspection and repair of remote areas and defects in non-medical fields (whether sewer mains, hydraulic lines, oil pipelines, gas lines, or other non-medical fields) that can be inspected and / or repaired with less disruption and intrusion is generally superior to more invasive opening up of areas for inspection and repair.

[0033] In non-medical applications, small ports can be used for direct visualization, for example by drilling holes in a pipeline to inspect the line at a specific point. Another example is the use of a borescope to remotely navigate and advance through a pipeline to visualize inspection areas for possible remote repairs.

[0034] In non-medical applications such as oil pipeline inspection, robotic arms with grasping and articulating capabilities are used along with remote visualization devices for diagnosis and repair.

[0035] Remote visualization devices and related elements are also common to non-medical scopes and applications include rigid and non-rigid borescopes, videoscopes, flexoscopes, fiberscopes and other scopes used for remote visualization in non-medical applications.

[0036] Typically, we have found that these instruments need to be advanced, retracted, and exchanged through incisions, ports, working channels, or other access points. This approach means that the correct instruments are not always readily available when needed. For example, in the case of laparoscopic surgery, while the physician cuts tissue finely to access the treatment point, he may cut blood vessels and cause bleeding. The physician may not have a cauterizing or vessel sealing instrument in one of the ports used to advance and retract the instruments in the patient for the procedure. When bleeding occurs, the bleeding continues while the physician retracts one of the instruments and inserts a cauterizing or vessel sealing device (called a device exchange) to locate and stop the bleeding. Due to the time it takes to complete a device exchange, the bleeding area may fill with blood, obscuring the location of the bleeding. Additionally, during this time, the scope may become covered or clouded with blood, debris, or other fluids, causing additional problems that complicate the detection and treatment of the bleeding.

[0037] Similar limitations occur with scopes that have working channels. For example, when performing a colonoscopy and removing precancerous polyps to diagnose whether cancer is present, blood vessels may be inadvertently severed, and small amounts of gastrointestinal bleeding may occur. To treat the bleeding, the physician must change instruments, withdraw the device from the working channel of the long, flexible scope (200 centimeters long), and insert and advance the cauterization device into the working channel of the scope. The physician must then verify the location of the scope and the bleeding (as the scope may shift) and attempt cauterization to address the bleeding. This attempt may be hindered by fluid, debris, and blood that obscure visualization of the scope. In addition, the application of cauterization is very limited. This is because cauterization devices are restricted to be no wider than the diameter of the working channel in the scope, which is typically 2-3 millimeters. Thus, cauterization lesions from current devices are typically a few millimeters wide, and current technology requires multiple cauterizations to treat longer or wider or uneven areas of bleeding.

[0038] This same set of problems and others apply to other scope applications, including the treatment of upper gastrointestinal bleeding. Additionally, other problems and limitations apply to scopes that do not have a working channel, but must travel some distance from the user. For example, such problems arise in bore scopes in non-medical applications as well as in certain ear, nose and throat medical applications. These problems also apply to other applications that rely on the range of visualization, such as robotic navigation and robotic surgery and therapy.

[0039] An embodiment of the present disclosure overcomes this problem by providing a device having an optical element with a conductive coating. For example, one embodiment of the device 11 as shown in FIG. 1 comprises an optical element 10, a conductive material 302, and at least one connector 300. The conductive material 302 is provided on at least a portion of the optical element 10. The optical element may be, for example, an objective lens of an endoscope 110 or an optical coupler. The connectors (acting as terminals) 300, 300a, 300b can provide energy (e.g., power) to the conductive material 302. In one embodiment, the conductive material is an optically transparent material.

[0040] Advantageously, device 11 allows visualization of a target (such as body tissue or other material 200) simultaneously with the application of energy to the target via the conductive coating. This allows a user to observe changes in tissue and other material in real time as energy is delivered. For example, device 11 can deliver power via transparent conductive material 302 to cauterize tissue 200 while the tissue is viewed directly via endoscope 72 and optical elements on the endoscope.

[0041] As shown in FIGS. 1-4, in an embodiment, the optical element 10 may be a type of optical coupler that includes a visualization section 12 at a distal end 14 and an attachment section 46 at a proximal end 48. In an embodiment, the optical coupler 10 is made of a transparent material, at least a portion of which may cover the optical region of an underlying endoscope 72 to clearly retain obscuring debris within the body. Additionally, the exterior surface of the optical coupler 10 may displace fluid, blood, debris, and particulate matter on tissue being inspected by the endoscope 72. Further details of the optical coupler are disclosed in U.S. Patent Application Publication No. 2013 / 0110097, filed on Jan. 17, 2019, which is incorporated herein by reference.

[0042] Referring again to FIG. 4, visualization section 12 includes an outer surface 16 that is distal from proximal face 22. In an embodiment, at least a portion of visualization section 12 covers some or all of the optical region of endoscope 72. As shown in FIG. 1, outer surface 16 has a rounded convex shape. Outer surface 16 is continuously curved, for example, from a first outer boundary 18 across an opposing second outer boundary 20 of visualization section 12. In an embodiment, the outer surface may be convex but eccentric, concave, flat, or positioned at an angle to the optical lens of the endoscope. For example, the outer surface may be positioned at an angle that is oblique from or relative to the optical lens of the endoscope. A medical practitioner may advance outer surface 16 in contact with tissue or other material 200 and maintain visualization due to the design of the optical coupler. Additionally, a medical practitioner may move liquid, blood, debris, and particulate matter out of the field of view by contacting tissue or other material with the optical coupler on the scope. This provides a better view of the underlying tissue or material for evaluation and treatment, including the delivery of energy through the device.The shape of the outer surface 16 may be atraumatic.

[0043] Also, in other embodiments, the device may have one or more channels to allow passage of instruments through the scope and device, or to expose the light guide of the scope to provide cleaning or insufflation, or to change the performance of the light in some areas. For example, these channels may be hollow and pass through the exterior of the device. The channels may also be self-sealing, and thus not pass completely through the exterior of the device to seal the channel when the channel is not in use. In other embodiments, there may be more than one channel. One channel may be aligned with the working channel of the scope and device to allow instruments to pass through. Another channel may allow liquid and air to be emitted from the scope and pass through the device. A third channel may drain liquid from liquid water on the scope to a working channel in the device and over the exterior of the device.

[0044] The visualization section 12 can be formed from a range of materials that improve visualization of the object for the endoscope 72. For example, the visualization section can be formed of a transparent material that can transmit an optical image of the surface area. Any type of transparent material can be used (at least in part), but materials that adhere well (and remain adhered) to the conductive material 302 are particularly desirable. Materials with attractive refractive indices and levels of optical transmission are particularly suitable. Stability when used with energy applications is also desirable to minimize the impact of the substrate on the conductive material and the effect of the energy supply on the optical performance. For example, polycarbonate material is a suitable material for the visualization section due to polycarbonate's refractive index and performance over various temperature ranges. Additional materials include acrylic, polystyrene, cyclic olefin copolymers, polyetherimide, glass, silicone, and other optical materials. These materials offer a combination of relatively low refractive index, high optical transmission, and suitable temperature properties, including insulating properties and relatively low levels of thermal expansion when used with the application of various forms of energy.

[0045] In other embodiments, devices using more than one material may connect the materials via adhesives or other chemical bonds, co-molding of the materials, overmolding one material onto the other, placement of mechanical connectors between or over the materials, or combinations thereof. Connections can also be made by coating one material onto the other, screwing one material onto the other, or other methods of connecting materials to one another, where at least one of the materials is a substrate for a conductive coating.

[0046] The term "transparent" as used herein is not necessarily limited to meaning optically transparent. Instead, transparency may include the ability or properties of passing energy waves, including infrared and / or ultraviolet. Transparent also need not be limited to the meaning of complete transparency, but instead can refer to some ability to facilitate or allow the passage of light rays (e.g., translucency).

[0047] Alternatively, coupler 10 need not be formed from a transparent material, and in some embodiments may be made from one or more materials suitable for a particular remote visualization application. In embodiments, the coupler may serve as a support and applicator for conductive material 302 that has limited or no ability to improve visualization.

[0048] As shown in FIG. 4, the mounting section 46 may include a cylindrical wall 50 extending from the proximal end 48 of the optical element 10. Generally, the mounting section 46 is configured to mate with the visualization section 12 to secure the visualization section 12 to the end of an endoscope 72 or other optical imaging device. To this end, the cylindrical wall 50 is sized to define a hollow cylindrical opening 70 into which the distal end of the endoscope 72 is press-fit or otherwise secured. It should be noted that the mounting section 46 may also include other structures to provide attachment and / or may be secured by welding, adhesives, threading, mechanical connectors, interference between one or more materials and the optical imaging device, or other forms of connection between the device and the remote / optical imaging device. Additionally, the mounting section 46 need not be cylindrical, but may be formed to conform to the shape of the distal end of various optical imaging or remote visualization devices. Alternatively, the mounting section may be shaped to facilitate other functions of the device, including shaping the sides and distal end to more effectively conform and manipulate tissue and matter. The shape and materials may be selected to make the device less traumatic when in contact with tissue and other substances. The visualization section of the device may also be integrated into a remote visualization device.

[0049] As shown in Figures 1 and 4, the endoscope 72 includes a sheath 76 having a distal end and supporting an optical assembly. The sheath 76 is a generally elongated member configured to enter and extend through passageways of the body and other passageways to provide remote visualization of the body and other passageways. In some embodiments, the endoscope includes some form of positioning assembly (e.g., manual control) attached to the proximal end of the sheath 76 to allow an operator to manipulate the scope. In other embodiments, the scope is part of a robotic element that allows the scope to be steered and positioned to a desired location, which interrogates and focuses the scope. The sheath 76 also includes a distal end 74 and extends into a cylindrical opening 70 of the optical coupler 10, as shown in Figures 1 and 4.

[0050] The sheath 76 may include one or more openings or lumens extending therethrough for various purposes. For example, as shown in FIGS. 1-4, the sheath 76 defines a first lumen 100, a second lumen 102, and a third lumen 104. Each lumen extends from the proximal end to the distal end 74 of the sheath 76. The first lumen 100 may provide a passageway through which, for example, a light guide 106 may be positioned to transmit light toward the distal end 74. The second lumen 102 may provide a passageway for accommodating a remote visualization lens, camera, sensor, fiber, or other element 108 for carrying visual information back to the proximal end of the sheath 76. The third lumen 104 may provide a passageway through which additional instruments, such as wires, catheters, biopsy forceps, guidewires, or other instruments 202, may extend into tissue or other material 200.

[0051] As mentioned above, the sheath 76 in the embodiment of Figures 1-4 provides access to an optical assembly. In some embodiments, the optical assembly includes a light guide 106, an image capture element 108, and an objective lens 110. As mentioned above, the light guide 106 transmits light from the proximal end to the distal end of the sheath 76 to illuminate the biological tissue 200. The objective lens 110 is positioned at the distal end of the optical fiber 108 and is configured to direct and focus the reflected light returning to the distal end of the optical fiber. In general, the objective lens 110 can be any optical device capable of transmitting and refracting light, including a compound lens that includes an array of lenses with a common axis.

[0052] 1, when the mounting section 46 is secured, the cylinder wall 50 extends over an outer surface 78 of the distal end 74 of the sheath 76, and the proximal face 22 abuts an end face 80 at the distal end of the sheath 76. The third lumen 104 is aligned with a hollow instrument receptacle 40 defined in the visualization section 12 of the optical coupler 10.

[0053] As shown in Figures 1-4, the conductive material 302 may be applied in various configurations to create one or more electrode designs depending on the desired effect on tissue and other materials. The electrode designs may be modified to suit the needs of other applications, such as creating combinations of capabilities such as preventing fogging of remote visualization elements, or visualization elements that can be intermittently or continuously heated to reduce or prevent fogging. The electrode designs may also address the ability of the conductive material 302 to rapidly increase energy transfer when needed to contact and cauterize or ablate tissue or other materials.

[0054] Heating the optical lens components with a conductive coating allows for continuous heating that prevents significant temperature differences at the end of the scope or optical element (the distal end is where cameras are often located and where fogging is an issue). Temperature differences would cause fogging and obscure visualization through the scope or optical element. Additionally, the materials of the optical coupler (e.g., silicone and polycarbonate) have insulating properties that promote anti-fogging. Anti-fogging can be achieved, for example, by heating the optical element to approximately body temperature. Without being bound by theory, the inventors believe that the temperature difference at the distal end of the scope increases the temperature around the end of the scope, in the range of about 95°F to about 110°F or even about 120°F, especially when certain heating instruments such as harmonic scalpels are used. Thus, anti-fogging applications are generally at powers and temperatures lower than cauterization or other tissue modification temperatures.

[0055] In some embodiments, the conductive material may be in the form of layers, strips, particles, nanoparticles, or other shapes, and is applied in some type of discrete, continuous, or intermittent pattern and various combinations thereof. Variations in the shape or pattern of the conductive material are possible to the extent that one material can be added to another by depositing or combining coatings and other materials to achieve a desired result.

[0056] The conductive material may comprise a transparent conductive oxide (TCO), a conductive metal such as platinum, a polymer, or an organic semiconductor, or other material capable of conducting or transmitting energy across the device. The term "layer" refers to at least some region of the conductive material 302 having a relatively uniform thickness and / or some region using a method of application of the conductive material 302. For example, the conductive material may be formed or applied via dipping, deposition coating, spraying, sputtering, ultrasonic application, brushing, painting, or other application of the conductive material that can form a layer or other pattern on the intended substrate. In some embodiments, the conductive material may be a uniform material thickness. In other embodiments, the conductive material may have a varying thickness. No portion of the conductive material 302 needs to be of a precise thickness and can vary continuously throughout. Instead, the thickness of the material can be varied depending on the intended electrode function (e.g., a target level (and variation) of resistance throughout the coating for a particular application, etc.).

[0057] Additionally, the conductive material 302 may be applied to form specific shapes (other than layers) for applying different patterns and densities of energy to the material. The conductive material 302 may also be applied in a non-layer manner, such as formed in a mold and then glued, welded, or otherwise attached to the optical element. Again, the shape of the conductive material 302 may correspond to a desired pattern of energy application by the conductive material, including a specific electrode design that includes the conductive material and connectors to the conductive material 300.

[0058] In some embodiments, the conductive material layer is applied to the distal end 14 of the optical element such that it extends over a portion of the visualization section 12. In one embodiment, the portion of the visualization section 12 covered by the conductive material includes the entirety of the distal exterior surface area 16 on one side of the visualization section. However, the portion of the visualization section may include only a portion of the surface area on one side of the visualization section, or may include one or more gaps between multiple applications of the conductive material layer, depending on the desired electrode design and the desired outcome. For example, the conductive material 302 may cover only an area within the field of view of the objective lens 110 of the endoscope 72, or may be applied to a portion of the field of view, or may be outside of the field of view. In other alternatives, the conductive material 302 may be applied in patterns (stripes, stripes, dimples, voids, undulations, curves, circles, semicircles), irregular patterns, and other approaches to form electrodes for the intended outcome of applying energy with the device 200.

[0059] 1-4, the device 11 may also include one or more connectors 300 for supplying energy to the conductive material. In this embodiment, the connectors include a first positive terminal 300a and a second negative terminal 300b. Current flows from the positive terminal through the conductive material 302 (energizing the conductive material) and out through the negative terminal.

[0060] The terminals themselves may comprise inert electrodes such as graphite (carbon), platinum, gold, and rhodium. In addition, the terminals may comprise copper, zinc, lead, and silver, or aluminum, or any other conductive material or material known to those skilled in the art to be suitable for transmitting energy. Wires 304 or other power transmission means connect the electrodes to a power cable (not shown) that is embedded within the sheath 76 of the endoscope 72 and runs parallel to and adjacent to the hollow instrument receptacle 40.

[0061] Alternatively, wires or other power transmission means may pass through the visualization section in the instrument receptacle 40 (not shown). The wires may be conveyed in other alternative ways, including inductive transmission of current to the device or a battery embedded in the device. Power may be provided by current from a battery, catheter, cable, radio wave, or other power transmission device, or by a method that can extend to a terminal or connector.

[0062] FIG. 13 illustrates an energy catheter 500 configured to extend through a channel of, for example, a delivery catheter. The energy catheter includes a connector 502 at its distal end. The elongated body of the energy catheter 500 defines an irrigation channel 506. The energy catheter connects to a power and / or irrigation source 504 at its proximal end. The energy catheter 500 is configured to extend through the scope and into a working channel 508 of the optical coupler 10. Expansion continues until the connector 502 abuts and / or otherwise mates or connects with a corresponding contact or terminal 300 in communication with the working channel.

[0063] The terminals 300 may be any device (including radio, inductive or other wireless connection) that delivers some type of energy to the conductive material 302. The conductive material itself may form or include the terminals 300 into a shape for mating with or communicating with an energy generator (or other power source), excitation of the conductive material in a wireless case, or extension of the conductive material.

[0064] It should be noted that the optical element 10 (whether in the form of a coupler, lens, coupler or other attachment, or integrated as part of a scope) can be used with a range of different scopes or other image capture devices. The term coupler here refers more generally to an optical element mounted over or integrated as part of a scope, integrally formed or attached to a scope or other technology that captures and transmits images. As used herein, the term "coupler" refers to a separately manufactured and / or separately, later attachable coupler, cap or lens.

[0065] The optical element can be adapted for use with optical capture elements of various sizes, including, for example, relatively large telescopes. Alternatively, the optical element 10 can be a telescope objective lens, and the device 11 is formed by providing a conductive material 302 on at least a portion of the telescope lens, and by providing at least one terminal 300 for supplying energy to the conductive material 302 on the lens. This can be useful, for example, to prevent fogging of the lens. The optical element can be used with a microscope in a similar manner, or as part of a microscope. Other scopes that can be used with or for the optical element include hydroscopes, haploscopes, carpathoscopes, ecoscopes, fiberscopes, videoscopes, stauroscopes, stereoscopes, and nasoscopes.

[0066] Additionally, the term "endoscope" refers generally to any scope used in medical applications (including on the body, human or otherwise) and includes laparoscopes, arthroscopes, colonoscopes, bronchoscopes, enteroscopes, cystoscopes, laparoscopes, laryngoscopes, sigmoidoscopes, thoracoscopes, cardioscopes, and saphenous vein harvesters with scopes, which may be robotic or non-robotic, and includes scopes used in non-medical applications, such as, for example, borescopes, videoscopes, flexoscopes, and fiberscopes, which may be robotic or non-robotic, and other scopes disclosed herein.

[0067] The term "image capture device" as used herein also need not refer to a device having only a lens or other light directing structure. Instead, for example, an image capture device may include (i) a lens between an objective lens and an eyepiece at the distal end of the scope, (ii) an optical fiber, (iii) a charge-coupled device (CCD), (iv) a complementary metal-oxide semiconductor (CMOS) sensor. An image capture device may simply be a chip for sensing light and generating an electrical signal for information corresponding to the sensed light or other technology for sending an image. An image capture device may have an observation end where light is captured, and the conductive surface 302 may extend to cover a portion of the image capture element or may be applied in other manners away from the image capture element. In general, an image capture device may be any device capable of observing an object, capturing an image, and / or capturing video.

[0068] Although one particular embodiment of an optical coupler is described above, additional types of optical couplers may include some type of conductive material applied thereto. For example, U.S. Patent Application Publication No. 2012 / 0209074, filed February 16, 2012, which is incorporated herein by reference, discloses several variations of optical elements to which a conductive material may be applied.

[0069] For example, Figure 5 of the present disclosure illustrates another embodiment of optical element 10 attached to endoscope 72. As shown in Figure 5, a portion of exterior surface 16 of visualization section 12 is dome-shaped, and a portion of the dome-shaped visualization section exterior surface is within the field of view A of endoscope 72. Because of the dome shape, conductive material 302 may be needed over an increased surface area with a smoother transition (compared to Figures 1-4 if the entire dome were covered) and may be applied only within the field of view A.

[0070] In general, a dome shape may increase working space to improve imaging, such that organs can be pushed out of the field of view, and other shapes may be utilized to optimize field of view, optical clarity, and lens fit to target tissue or other material. Other performance-related reasons for matching the shape of an optical element include light transmission, material adhesion between shapes, and the desire for navigation through specific areas, including the target lumen.

[0071] As another example, Figures 6 and 7 show an exemplary optical element 10 engaging a region of a body cavity 200. First, the optical element 10 is positioned in contact with the region of the body cavity 200. Next, a physician can insert a medical instrument 202 (Figure 6) into the third lumen 104 of the sheath 76 of the endoscope 72. The medical instrument passes through the instrument receptacle 40 in the optical element, and then the medical instrument 202 penetrates the barrier section 42 and the outer surface 16 of the optical element 10 (Figure 7 of this disclosure). The region of the body cavity 200 can then be treated with the medical instrument.

[0072] The barrier section 42 is a portion of the visualization section 12 that is interposed between the environment and the instrument receptacle 40 (before the medical instrument 202 passes therethrough). In one embodiment, the barrier section is coated with an insulating material 310 to prevent direct contact by the medical instrument 202 having the conductive material 302. The insulating material 310 may extend from the exterior surface 16, for example, and may be as thick or thicker than the layer of conductive material 302. Advantageously, the insulating material 310 may prevent conductive breakdown of the conductive material 302, for example, by a metallic instrument shorting out the electrically energized conductive material layer. Alternatively, the insulating material may be a more resilient, physical guard against damage by the medical instrument 202.

[0073] 8A shows a cross-sectional view of another embodiment of an optical element attached to an endoscope 72. This embodiment includes a biopsy forceps 61 positioned through one of the lumens 104 of the endoscope 72 and the instrument receptacle 40 of the optical element 10.

[0074] As shown in Figure 8A, the jaws of biopsy forceps 61 are open. Figure 8B is a cross-sectional view with the jaws of the biopsy forceps closed to obtain a biopsy sample from body cavity 200. Figure 8C is a cross-sectional view of the biopsy forceps being withdrawn after obtaining a biopsy sample.

[0075] In the embodiment of Figures 8A-8C, the optical element 10 has a frusto-conical shape with a wider base extending distally. In this embodiment, the conductive material 302 is relatively flat and can be easily applied to a relatively flat tissue surface. The conductive material 302 may also be in a layer with an opening surrounded by insulating material 310. As discussed above, this can prevent shorting or damage to the conductive material by the biopsy forceps 61. The electrodes 300a and 300b may also extend down the sloping sides of the frusto-conical shape and may be partially or completely insulated or uninsulated.

[0076] 9A and 9B show another embodiment of an optical element 10 having a sloped outer surface 16. For example, the optical element 10 may be an optical coupler mounted on a borescope 77. The optical coupler 10 has a visualization section 12 having a first outer boundary 515 and a second outer boundary 516. The first and second outer boundaries 515, 516 extend outwardly from the borescope at an angle. The outer surface 514 of the coupler 10 is also sloped to have a first segment 514a and a second segment 514b. In this configuration, the conductive material layer 302 is similarly laminated.

[0077] Figure 9B shows the optical element 10 of Figure 9A inspecting a weld lodged between two plates 88, 90. Advantageously, an electrode 300 can supply energy to a conductive layer 302 which heats and / or modifies the tilted plates 88, 90 such that the weld is repaired, for example, while the weld is directly observed by an operator.

[0078] FIG. 10 shows the optical element 10 attached to an endoscope having an auxiliary channel via a third lumen 104. A nozzle 943 is provided at the distal end of the auxiliary channel 104 for conveying liquid, air or other substances. The optical coupler includes a chamber 945 extending around the long axis of the scope that can receive liquid 947 from the auxiliary liquid channel 104 and the nozzle 943. This allows the liquid 947 to pass into and through the instrument receptacle 40 in the optical element 10. This channel can convey liquids including water and saline for washing tissue, rinsing debris from the field of view, cleaning the exterior of the coupler, or for conveying drugs and other chemicals, as well as substances such as air, CO2, argon gas and other substances to act on the tissue or other substances of interest. In FIG. 10, the conductive material 302 is applied with layers similar to those in FIGS. 1-4. An opening may extend through conductive material 302 to apply positive pressure to instrument receptacle 40 when an instrument is opened to the outside, due to aspiration of the outside environment.

[0079] FIG. 11A of the present disclosure is a cross-sectional view of an optical element 10 having a concave outer surface 16 attached to an endoscope 72 approaching tissue covered with blood 800. FIG. 11B shows the optical element 10 being forced into the cavity of tissue 200, trapping opaque liquid 91. FIG. 11C shows liquid from the instrument receptacle 40 flushing the blocked opaque liquid 91. Advantageously, when the pressure of the introduced liquid exceeds the pressure exerted by the optical element 10 against the body cavity 200, liquid 891 flushes the blocked opaque liquid 91 from the area.

[0080] 11A and 11B, conductive material 302 is applied to a concave layer similar to concave outer surface 16. Terminals 300 extend along the sides of optical element 10 to contact ends of concave conductive material 302.

[0081] (Devices and Conductive Materials Applications) The conductive material 302 of various embodiments of the device 11 may be used to deliver many energy types and may be used for many medical and non-medical applications. Examples of such energy types and applications are provided below for illustrative purposes and should not be considered limiting.

[0082] As shown diagrammatically in FIG. 12, the conductive material 302 is a resistor and / or capacitor attached via terminals 300a and 300b and connector 304 and cable 96 to power source 94. Connector 304 may extend, for example, through the sheath 76 of the endoscope to cable 96 attached to the proximal end of the endoscope. These connectors may connect to power source 94, which may be one or more forms of energy for alteration of tissue or other matter, including monopolar energy, bipolar energy, argon gas energy, coblation energy, plasma energy, thermal energy, microwave energy, ultrasound, focused ultrasound, or other forms of energy, including the generation and transmission of multiple energy forms that may be transmitted across or through a conductive coating to alter tissue or matter, including therapeutic effects. These may be delivered by direct current, alternating current, pulsed current, and other variable forms of energy delivery.

[0083] There are many ways to transfer energy to the terminal 300 and conductive material 302. The cable 96 can transmit power to the conductive material via the terminals 300, 300a, 300b. The cable can access the terminals, for example, by being adjacent to the scope and outside the scope or wrapping around the outside of the scope 72. Alternatively, the cable 96 or connector 304 can be attached to an energy delivery catheter that runs down the working channel of the scope (e.g., first lumen 100) and docks with the terminal. At its distal end, the energy delivery catheter can be connected to an electrical terminal in the working channel of the lens 110. The connector 304 is embedded within the sheath 76 of the endoscope 72 and runs parallel to and adjacent to the hollow instrument receptacle connector 40. The connector can comprise a flexible circuit, one or more coatings, wires, conductive springs, inductive material for receiving and transmitting power, cables, or other techniques for directing power from a power source to a delivery point.

[0084] In another embodiment, the power generator may comprise a signal generator, such as, for example, a function generator, an RF signal generator, a microwave signal generator, a pitch generator, an arbitrary waveform generator, a digital pattern generator or a frequency generator. Existing electrosurgical generators may be used with the advantage that they meet the standards required for medical use. These generators may power electronic devices that generate repetitive or non-repetitive electronic signals (either in the analog or digital domain). RF signal generators range from a few kHz to 6 GHz. Microwave signal generators can cover a wider frequency range, from less than 1 MHz to at least 20 GHz. Some models can be used up to 70 GHz for direct coaxial output and up to several hundred GHz for external waveguide source modules. FM and AM signal generators may also be used.

[0085] The advantage of these different generators etc is that they provide a specific form of power for the intended application where one form of power has an advantage over the other. For example, when cutting and coagulating tissue, monopolar electricity can typically cut and coagulate through tissue more effectively than bipolar power. However, monopolar energy requires the use of a grounding pad to avoid arching of the monopolar energy into unintended areas. Thus, a grounding pad can be used with monopolar applications to affect tissue and to prevent arching and subsequent burns to the patient with the power and monopolar energy (the grounding pad completes the circuit of the power through the patient).

[0086] In contrast, bipolar power completes the circuit with the device itself, so the energy travels through and across the device, affecting tissue without arching through the body. With this approach, bipolar power can be very effective for creating lesions, sealing vessels, and other applications involving targeted treatment of tissue. However, because of the contained aspect of bipolar power, it tends to be less effective at cutting and coagulating tissue as an alternative to a surgical knife. Similarly, microwave energy may be used for certain types of tissue ablation due to its unique tissue effects, and bipolar energy may be used for other types of resection. Other forms of energy, such as FM energy, may be used because the frequency does not excite certain subelements, such as nerve bundles.

[0087] Coablation generators can be used in a non-thermally driven process to surgically dissociate soft tissue using radio frequency energy, exciting electrolytes in a conductive medium such as saline to form a precisely focused plasma field. The energized particles or ions in the plasma field can have enough energy to break or dissociate organic molecular bonds in soft tissue at relatively low temperatures (i.e., typically 40°C-70°C). This allows the coblation device to volumetrically remove targeted tissue with minimal damage to the surrounding tissue. Coblation can also provide hemostasis and tissue contraction capabilities. The amount of power delivered is determined by the strength of the field and can be adjusted based on local environmental conditions.

[0088] Coblation can typically be used at a temperature range up to 90°C.

[0089] The ultrasonic generator can generate sound waves having a frequency greater than about 20 kilohertz (20,000 hertz). The ultrasonic waves can be conducted to the tissue 200 by the conductive material 302. The ultrasonic waves can be absorbed by body tissue, particularly ligaments, tendons and fascia, or other substances.

[0090] Ultrasound devices can typically operate at frequencies from 20 KHz up to several GHz. Therapeutic ultrasound frequencies used are typically 0.7-3.3 MHz. Ultrasound or TENS energy can accelerate the healing process by increasing blood flow in the treatment area and can also reduce pain due to swelling and contraction of edema by gently massaging the muscles tendons and / or ligaments in the treatment area.

[0091] Ultrasound may also ablate tumors or other tissues non-invasively or invasively. This can be accomplished using a technique known as High Intensity Focused Ultrasound (HIFU), also known as Focused Ultrasound Surgery (FUS Surgery). This procedure uses frequencies that are typically lower than medical diagnostic ultrasound (250-2000 kHz). Other common conditions in which ultrasound may be used for treatment include, for example, ligament sprains, muscle pain, tendonitis, joint inflammation, plantar fasciitis, midfoot pain, facet irritation, impingement syndrome, bursitis, rheumatoid arthritis, osteoarthritis, and scar tissue adhesions.

[0092] The device 11 also allows the physician to perform, among other things, tissue cauterization, vessel sealing, tissue dissection and resection, tissue shaping, tissue resection and coagulation, tissue ablation, and instrument heating, all at a precise location that the practitioner can observe. This at least partially solves the problem of performing aspects of endoscopic surgery in the blind. It can also eliminate the need to exchange one device for another to apply energy to tissue or material, or to redirect light through tissue or other material, or to engage in other operations while maintaining visualization.

[0093] More specific medical applications include, among others, the application of energy to act on tissue in trauma cases, arthroscopic surgery, spinal surgery, neurosurgery, shoulder surgery, lung tumor ablation, ablation of cancerous tissue in bladder cancer patients, cauterization or ablation of uterine tissue for women's health issues (e.g., endometriosis). In these applications (and others enumerated herein), the device is used to contact the tissue and then cauterize, ablate, or shape the tissue (e.g., as done with Coblation energy in shoulder procedures), creating unparalleled performance characteristics by allowing the physician to observe the changes occurring in the tissue in real time, e.g., through optically clear lenses and coatings.

[0094] The device can also be used to heat optically clear lenses to prevent fogging in applications involving laparoscopes, borescopes, videoscopes or other optical capture technologies.

[0095] To further elaborate on medical applications, the use of the device in diathermy applications is an area of ​​utility, whether accomplished using shortwave radio frequency (in the range of 1-100 MHz) or microwave energy (typically 915 MHz or 2.45 GHz). Diathermy used in surgery can comprise at least two types. Monopolar energy is where the current flows from one electrode near the tissue to be treated to an electrode fixed at another location within the body. Typically, this type of electrode is positioned at a specific location on the body (e.g., in contact around the buttocks or legs). Alternatively, bipolar energy can be used, where both electrodes are placed adjacent to the proximal end (in this case, two separate conductive material portions 302 on the optical element 10) that form a closed electrical circuit on the device, and the current passes only through or on the tissue to be treated. The advantage of bipolar electrosurgery is that it prevents the current from flowing through other tissues of the body and is also focused only on the tissue that is in contact or proximity to the electrodes. This is useful, for example, in microsurgery, laparoscopic surgery, cardiac surgery and other procedures, including for patients with cardiac pacemakers and conditions unsuitable for use with other devices and other forms of energy.

[0096] Electrocautery is a process that utilizes heat transfer from an electric current to modify tissue. This procedure is used to stop bleeding from small blood vessels (larger vessels can be ligated) or from cuts through soft tissue. High frequency alternating current is used for electrocautery in unipolar or bipolar mode. It can be of continuous waveform (to cut tissue) or intermittent type (to coagulate tissue). In the monopolar type, the tissue to be coagulated / cut is in contact with a small electrode while the exit point of the circuit has a large surface area (e.g., buttocks) to prevent electrical burns. The heat generated depends on the size of the contact area, the power setting or frequency of the current, the duration of application, and the waveform. Constant waveforms (generally) generate more heat than intermittent waveforms because the frequency used in cutting tissue is set higher than in coagulation mode. Bipolar electrocautery establishes a circuit between two points to affect tissue or other material.

[0097] As another option, conductive layer 302 and device 11 can be used for thermal ablation at temperatures ranging from 50° C. to 100° C., or even 50° C. to 70° C., or lower if recommended, applying a power range appropriate for the application. Advantageously, the ability to visualize the form of energy being applied through the device allows for precise delivery of power, including the ability to vary the level of energy and resulting temperature, use power settings appropriate for a particular application, apply energy for longer periods to increase range, apply energy along multiple electrodes for multiple effects, as well as the ability to be more certain that tissue or other material has been sufficiently transformed to stop the process (this advantage, of course, applies to other applications of device 11, where real-time visual monitoring of energy application allows for more precise application).

[0098] The optical element 10 may also be beneficial in non-medical applications. An embodiment of the optical element may be attached to the distal end (objective lens) of a borescope, or may be attached to a micro or conventional video camera, inspection scope, or still camera, or other visualization device that would benefit from improved visualization and delivery of energy to liquids, debris, and / or blood. This provides improved visibility and potential repair capabilities for piping, holding tanks, containers, hydraulic lines, and other situations where visualization may be compromised, including where the liquid is opaque, such as petroleum products, sewers, food, paints, etc. Biopharmaceutical manufacturing, pharmaceutical, and other applications would benefit from this innovation, eliminating the need to open lines to empty or inspect pipes or vessels (e.g., oil tanks).

[0099] The size or flexibility of the optical elements can be scaled (or designed to scale) for a particular application (e.g., moving large volumes of liquid when examining a large area). The shape of the optical elements can generally be flat, convex (with different levels of curvature), angled, sloped, stepped, or other shapes for a particular purpose for a particular task. For example, the optical elements can be square or angular in shape to move opaque liquid in the corners of a tank to inspect seams. In pipes, lines, tubes, tunnels, and other passages, the examination of joints, welds, seams for corrosion, pipes, flexible and non-flexible tubular members, or cracks, surface aberrations, and other points for inspection and repair.

[0100] The optical element can be used with an image capture element and a robotic vehicle or robotic arm to view a remote location. The optical element with a working channel allows devices to pass through the optical element to perform repairs using screws, adhesive patches, glue, chemicals, welding, soldering, and other repair and modification applications. In aspects, the optical element can be formed from a material that withstands the acidity, alkalinity, high heat, or viscosity of the liquid transferred by the optical element. In aspects, the device can be a disposable device or a reusable device.

[0101] Advantageously, embodiments of device 11 provide the ability to apply energy through conductive material 302 in these various non-medical applications. The energy provided to the object being observed may heat, change, or otherwise affect the object being observed by optical element 10.

[0102] (Conductive material composition) The conductive material 302 may have a variety of compositions and may be applied to the optical element 10 in a variety of ways. Examples of such compositions and applications are provided below for illustrative purposes and should not be considered limiting. In medical applications, the conductive material 302 is preferably capable of withstanding sterilization, for example, by gamma radiation, ethylene oxide, steam, or other forms of sterilization.

[0103] The electrically conductive / responsive coating can be applied in a number of configurations to create one or more electrodes, which can be optically transparent and can have a variety of thicknesses, including sub-half-micron thicknesses and greater thicknesses, depending on the intended effect on tissue or other materials.

[0104] The conductive material may be at least partially transparent and may comprise, for example, any member of the general class of materials known as transparent conductive oxides (TCOs), which include (two examples being) titanium dioxide (TiO2) and aluminum doped zinc oxide (AZO). It may also include the use of other conductive materials applied in a manner that allows visualization, such as silver nanoparticles and gold nanoparticles, as well as other conductive materials applied in a manner that allows energy conduction and visualization.

[0105] The optical diffraction index of the visualization material includes materials having refractive indices ranging from 1.3 to 2.3, depending on the application, the desired light transmission level, the overall optical performance, and other factors. The transparent conductive oxide can comprise a transparent material having a band gap with an energy corresponding to wavelengths shorter than the visible range of 380 nm to 750 nm. The TCO film can have a conductivity that varies across a point on its surface, for example. In one embodiment, the film is free or substantially free of pores, pinholes, and / or defects. In another embodiment, the number and size of pores, pinholes, and / or defects in the layer do not adversely affect the performance of the layer in the device. The thickness of the film can range from less than 1 to about 3500 nm. In embodiments, different thicknesses can be achieved depending on different manufacturing methods and intended applications, such as, for example, thicknesses of about 10, 20, 30, 40, 50, 60, 70, 80, 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1300, and 1500 nm.

[0106] The transparent conductive film can be indium tin oxide, Al or Ga doped zinc oxide, Ta or Nb doped titanium oxide, F doped tin oxide, and mixtures thereof. The oxide layer can be formed by directly oxidizing an ultra-thin metal layer or by vapor deposition of an oxide. TCO materials can have polycrystalline, crystalline, or amorphous microstructures to affect the film properties (including, among other properties, transmittance and conductivity).

[0107] Biocompatible TCOs can also be used as transparent conductive materials. For example, these materials include aluminum oxide (Al2O3), hydroxyapatite (HA), silicon dioxide (SiO2), titanium carbide (TiC), titanium nitride (TiN), titanium dioxide (TiO2), and zirconium dioxide (ZrO2). These materials can be n-doped with other metals, such as aluminum (Al), copper (Cu), silver (Ag), gallium (Ga), magnesium (Mg), cadmium (Cd), indium (In), tin (Sn), scandium (Sc), yttrium (Y), cobalt (Co), manganese (Mn), chromium (Cr), and boron (B). p-doping can be achieved with nitrogen (N) and phosphorus (P), among others.

[0108] TiO2 can function as a biocompatible material and offers the possibility of coating substrates at temperatures ranging from room temperature to several hundred degrees Celsius. TiO2 has several different polymorphic phases that may depend on the initial particle size, initial phase, dopant concentration, reaction atmosphere, and annealing temperature. TiO2 films are commonly synthesized by a number of methods including sol-gel, thermal spraying, and physical vapor deposition.

[0109] Transparent conductive aluminum-doped zinc oxide thin films (Al x Zinc y O z , ZnO:Al) contains small amounts of aluminum (typically less than 5% by weight). The underlying substrate can affect the grown structure and optoelectronic properties of the film of material. Even if the substrate is the same, the layer thickness (deposition time, position on the substrate) itself affects the physical values ​​of the deposited thin film.

[0110] Changes in physical values ​​from the grown thin film can also be achieved by varying process parameters (such as temperature or pressure) or by additions to the process gas (such as oxygen or hydrogen). Typically, zinc oxide is n-doped with aluminum. Alternatively, n-doping can be performed with metals such as copper (Cu), silver (Ag), gallium (Ga), magnesium (Mg), cadmium (Cd), indium (In), tin (Sn), scandium (Sc), yttrium (Y), cobalt (Co), manganese (Mn), chromium (Cr), and boron (B). p-doping of ZnO can be achieved with nitrogen (N) and phosphorus (P).

[0111] Additionally, the incorporation of sub-wavelength metallic nanostructures in TCOs can result in a shift in the wavelengths at which the TCO becomes transparent. Embedded particle articles can also be used to control absorption and scattering at desired wavelengths. Other optical effects of the material can also be influenced (effects including absorption, scattering, light trapping or decomposition, filtration, light-induced heating, etc.). Particle morphology (morphology including size, shape, density, uniformity, conformity, separation, arrangement, and random or periodic distribution) can engineer these effects.

[0112] The substrate of the electrode of the present invention can consist of any suitable material to which the transparent electrode structure of the present invention is applied. It can include other conductive or dielectric materials. In one exemplary embodiment, the optical element 10 serves as the substrate. Other substrates include, inter alia, glass, semiconductors, inorganic crystals, rigid or flexible plastic materials. Exemplary examples are, inter alia, silica (SiO2), borosilicate (BK7), silicon (Si), lithium niobate (LiNbO3), polyethylene naphthalate (PEN), polyethylene terephthalate (PET).

[0113] Organic materials can also act as conductive materials. These include polymer networks such as poly(3,4-ethylenedioxythiophene) and its derivatives, as well as carbon nanotube networks and graphene, which can be made highly transparent to infrared light.

[0114] Polymers can also act as conductive materials. For example, conductive polymers such as polyacetylene, polyaniline, polypyrrole or polythiophene derivatives. Examples are poly(3,4-ethylenedioxythiophene) (PEDOT) and PEDOT:poly(styrenesulfonate) PSS. In addition, iodine-doped poly(4,4-dioctylcyclopentadithiophene) or 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) can be used. Other polymers with n-type or p-type dopants can also be used.

[0115] Films of conductive materials can be deposited on substrates via a variety of deposition methods, including metal organic chemical vapor deposition (MOCVD), metal organic molecular beam deposition (MOMBD), spray pyrolysis, and pulsed laser deposition, dip coating, painting, gluing, or other methods suitable for adequately adhering the conductive material to a given substrate for a particular application. Fabrication techniques for TCOs include magnetron sputtering of films, sol-gel techniques, electrodeposition, vapor phase deposition, magnetron DC sputtering, magnetron RF sputtering, or a combination of both sputter deposition methods, ultrasonic delivery, and welding. In addition, high quality deposition methods using thermal plasma, (low pressure (LP), metal organic (MO), plasma enhanced (PE)) chemical vapor deposition (CVD), electron beam evaporation, pulsed laser deposition, and atomic layer deposition (ALD) are particularly applicable.

[0116] Thin films, such as ALD, only a few nanometers thick, are flexible and therefore less susceptible to cracking and formation and spreading and diffusion of harmful particles inside the human body or within a given non-medical examination site. Low and high protein binding affinity coatings can also be deposited by ALD. They are particularly useful in diagnostic and preparative fields, as well as for surface coatings that are resistant to bacterial growth.

[0117] Pre- and post-deposition treatments (e.g., oxygen plasma and heat treatments) can be combined to obtain improved conductive material properties. Oxygen plasma is preferred when the substrate or conductive material is affected by high temperatures. Conductive material films can have a wide range of material properties depending on the variation of process parameters. For example, by varying the process parameters, a wide range of conductive properties and film morphologies can be obtained.

[0118] The term "connector" as used herein should be broadly construed to mean any structure that allows for the transfer of electrical or other energy to the conductive coating. The term "connector" can refer to a permanent connection (solder, adhesive, twisted wire, conductive path with conductive coating) or a replaceable connection (connection such as plug and harness assembly), or other method of transferring energy from a power source to the conductive coating. Not all methods of connection to the coating need be physical connections. For example, connections can be made via electromagnetic fields, for example, by inductance. The term "connector" can also include structures and / or features that enable, mediate, enhance, or otherwise facilitate a connection. A particular type of connector is a terminal, which can be, for example, an area of ​​conductive material that is provided for or capable of electrical connection with a power source. A terminal can be, for example, a conductive metal layer deposited on a surface and shaped to contact the end of a wire on the energy delivery catheter.

[0119] A "connector area" is an area in which a connector can be attached, mounted, coated, glued, fastened, adhered, layered, overlapped, or otherwise capable of conducting energy to a conductive coating.

[0120] Numerous aspects of the systems, devices and methods have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the disclosure. Accordingly, other aspects are within the scope of the following claims.

[0121] [Embodiment 1-1] 1. A device for use with an endoscope, comprising: an optical coupler having a visualization section at a distal end and a mounting section at a proximal end for mounting to said endoscope; a coating on at least a portion of the optical coupler, the coating being made of a conductive material that is at least partially transparent; at least one connector capable of providing energy to the conductive material; and A working channel within the optical coupler for passing instruments or fluids A device comprising: [Embodiment 1-2] The device of embodiment 1-1, wherein the endoscope includes a scope lens and the visualization section is configured to cover at least a portion of the scope lens and transmit optical images through the optical coupler. [Embodiment 1-3] The device of embodiment 1-1, wherein the conductive material comprises a conductive oxide selected from the group consisting of titanium conductive oxide and aluminum conductive oxide. [Embodiment 1-4] The device of embodiment 1-1, wherein the connector is configured to be connected to a power source. [Embodiments 1-5] The device of embodiment 1-1, wherein the coating is configured to receive power from the connector and to generate and transfer thermal energy to tissue adjacent to the coating. [Embodiments 1-6] The device of embodiment 1-1, further comprising an optically transparent dielectric layer configured to create a capacitance field between the conductive material and tissue. [Embodiments 1-7] The device of embodiment 1-1, wherein the conductive material comprises at least two substantially parallel conductive strips. [Embodiments 1-8] An assembly comprising: an image capture device having a viewing end; A positioning assembly that supports the observation end, a conductive surface disposed on the viewing end and positioned and configured to transmit energy across the viewing end; a working channel within said positioning assembly for passing instruments or fluids therethrough; and a power connection configured to supply energy to said conductive surface; The assembly comprises: [Embodiments 1-9] The assembly of any one of embodiments 1-8, wherein the conductive surface is an optically transparent surface, and / or the observation end includes a scope lens, and / or the conductive surface includes a coating on the scope lens. [Embodiments 1-10] An assembly as described in embodiments 1-8 or 9, wherein the assembly includes at least one connector coupled to the conductive surface, and further comprises a conductor electrically coupled to the connector at a distal end, supported by the positioning assembly, and connected to the power connection portion at a proximal end. [Embodiments 1-11] An assembly as described in any of embodiments 1-8 to 10, comprising a plurality of non-overlapping conductive surfaces and / or the conductive surfaces are connected to the power connection by a second conductive surface, the second conductive surface comprising platinum. [Embodiments 1-12] The device of any one of embodiments 1-1 to 7, wherein the conductive material is configured to receive power from the connector and to generate and transfer thermal energy to inhibit fogging.

[0122] [Embodiment 2-1] 1. A device for use with an endoscope having an optical lens, comprising: an optical coupler comprising a visualization section at a distal end and a mounting section at a proximal end for mounting to the endoscope, the visualization section configured to cover at least a portion of the optical lens of the endoscope; an electrically conductive material disposed on at least a portion of the visualization section of the optical coupler, the electrically conductive material being at least partially transparent; at least one connector capable of supplying energy to the electrically conductive material; an insulating material disposed in a portion of the visualization section; having A device wherein the insulating material has an opening for receiving an instrument and is configured to insulate the instrument passing through the visualization section from the electrically conductive material. [Embodiment 2-2] A device as described in embodiment 2-1, further comprising a working channel within the optical coupler for receiving an instrument, liquid or gas, and the insulating material is substantially aligned longitudinally with a distal opening of the working channel. [Embodiment 2-3] The device of embodiment 2-2, wherein the working channel has a distal opening in the visualization section and a proximal end configured to couple to a distal end of a working channel in the endoscope. [Embodiment 2-4] The device of embodiment 2-2, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material. [Embodiment 2-5] The device of any one of embodiments 2-1 to 4, wherein the electrically conductive material comprises a conductive oxide. [Embodiment 2-6] The device of any one of embodiments 2-5, wherein the conductive oxide is selected from the group consisting of titanium conductive oxide and aluminum conductive oxide. [Embodiment 2-7] The device of any one of embodiments 2-1 to 6, further comprising a power source coupled to the at least one connector, the power source comprising one of an electrical power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cryo-generator, and a plasma generator. [Embodiment 2-8] The device of any one of embodiments 2-1 to 4, wherein the electrically conductive material is configured to receive power from the connector and configured to generate thermal energy and transfer the thermal energy to tissue positioned adjacent to the conductive material. [Embodiment 2-9] A device described in any one of embodiments 2-1 to 8, further comprising an optically transparent dielectric layer configured to generate a capacitance field between the electrically conductive material and tissue. [Embodiment 2-10] The device of any one of embodiments 2-1 to 4, wherein the electrically conductive material is configured to receive power from the connector and to generate and transfer thermal energy to inhibit fogging. [Embodiment 2-11] The device of any one of embodiments 2-1 to 4, wherein the electrically conductive material has an electrode configured to supply energy to tissue adjacent to or in contact with the optical coupler. [Embodiment 2-12] A device described in any one of embodiments 2-1 to 3, wherein the visualization section has an outer surface that surrounds at least a portion of the visualization section and extends continuously from a first outer boundary of the visualization section to a second outer boundary of the visualization section so as to prevent liquids, tissue debris or particulate matter from contacting the optical lens of the endoscope. [Embodiment 2-13] 1. A device for use with an endoscope having an optical lens, comprising: an optical coupler comprising a visualization section at a distal end and a mounting section at a proximal end for mounting to the endoscope, the visualization section configured to cover at least a portion of the optical lens of the endoscope; an electrically conductive material disposed on at least a portion of the visualization section of the optical coupler, the electrically conductive material being at least partially transparent; at least one connector capable of supplying energy to the electrically conductive material; an insulating material disposed in a portion of the visualization section; a working channel within the optical coupler for receiving an instrument, a liquid, or a gas; having The device, wherein the insulation is substantially aligned longitudinally with a distal opening of the working channel. [Embodiment 2-14] The device of any one of embodiments 2-13, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material. [Embodiment 3-1] 1. A device for use with an endoscope having an optical lens, comprising: an optical coupler comprising a substantially transparent visualization section and a mounting section at a proximal end for mounting to the endoscope, the visualization section configured to cover at least a portion of the optical lens of the endoscope; an electrically conductive material disposed on at least a portion of the visualization section of the optical coupler, the material being at least partially transparent and having electrodes configured to deliver energy to tissue adjacent to or in contact with the optical coupler; at least one connector capable of supplying energy to the electrically conductive material; an insulating material disposed between the electrically conductive material and a portion of the visualization section; A device having [Embodiment 3-2] The device of embodiment 3-1, further comprising a working channel within the optical coupler for receiving an instrument, liquid or gas, and the insulating material is disposed between the working channel and the electrically conductive material. [Embodiment 3-3] The device of embodiment 3-2, wherein the insulating material is substantially aligned longitudinally with a distal opening of the working channel. [Embodiment 3-4] The device of embodiment 3-2, wherein the working channel has a distal opening in the visualization section and a proximal end configured to couple to a distal end of a working channel in the endoscope. [Embodiment 3-5] A device as described in embodiment 3-3, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material. [Embodiments 3-6] The device of any one of embodiments 3-1 to 3-5, wherein the electrically conductive material comprises a conductive oxide. [Embodiment 3-7] 7. The device of any one of embodiments 3-6, wherein the conductive oxide is selected from the group consisting of titanium conductive oxide, titanium oxide, indium tin oxide, doped oxides, and aluminum conductive oxide, and combinations thereof. [Embodiment 3-8] The device of any one of embodiments 3-6, wherein the conductive oxide has a thickness of about 1 nm to about 3500 nm. [Embodiment 3-9] The device of any one of embodiments 3-1 to 8, wherein the conductive material has a refractive index of about 1.3 to about 2.3. [Embodiment 3-10] The device of any one of embodiments 3-1 to 9, further comprising a power source coupled to the at least one connector, the power source comprising one of an electrical power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cryo-generator, and a plasma generator. [Embodiment 3-11] The device of any one of embodiments 3-1 to 10, wherein the electrically conductive material is configured to receive power from the connector and configured to generate thermal energy and transfer the thermal energy to tissue positioned adjacent to the conductive material. [Embodiment 3-12] A device described in any one of embodiments 3-1 to 11, further comprising an optically transparent dielectric layer configured to generate a capacitance field between the electrically conductive material and tissue. [Embodiment 3-13] The device of any one of embodiments 3-1 to 12, wherein the electrically conductive material is configured to receive power from the connector and to generate and transfer thermal energy to inhibit fogging. [Embodiment 3-14] A device described in any one of embodiments 3-1 to 13, wherein the visualization section has an outer surface that surrounds at least a portion of the visualization section and extends continuously from a first outer boundary of the visualization section to a second outer boundary of the visualization section so as to prevent liquids, tissue debris or particulate matter from contacting the optical lens of the endoscope. [Embodiment 3-15] The device of any one of embodiments 3-1 to 14, wherein the conductive material is configured to receive power from the connector and to generate and transfer thermal energy to inhibit fogging. [Embodiment 3-16] The device of any one of embodiments 3-1 to 15, wherein the conductive material comprises at least two substantially parallel conductive strips. [Embodiment 3-17] 1. A device for use with an endoscope having an optical lens, comprising: an optical coupler comprising a substantially transparent visualization section and a mounting section at a proximal end for mounting to the endoscope, the visualization section configured to cover at least a portion of the optical lens of the endoscope; an electrically conductive material disposed on at least a portion of the visualization section of the optical coupler, the electrically conductive material being at least partially transparent; at least one connector capable of supplying energy to the electrically conductive material; an insulating material disposed between the electrically conductive material and a portion of the visualization section; having The device, wherein the electrically conductive material is configured to receive power from the connector and configured to generate and transfer thermal energy to tissue positioned adjacent to the conductive material. [Embodiment 3-18] 1. A device for use with an endoscope having an optical lens, comprising: an optical coupler comprising a substantially transparent visualization section and a mounting section at a proximal end for mounting to the endoscope, the visualization section configured to cover at least a portion of the optical lens of the endoscope; an electrically conductive material disposed on at least a portion of the visualization section of the optical coupler, the electrically conductive material being at least partially transparent; at least one connector capable of supplying energy to the electrically conductive material; an insulating material disposed between the electrically conductive material and a portion of the visualization section; having The electrically conductive material is configured to receive electrical power from the connector and is configured to generate and transfer thermal energy to inhibit fogging.

Claims

1. A device, comprising: optical elements, a conductive material disposed on at least a portion of the optical element; and At least one connector capable of providing energy to the conductive material. A device comprising:

2. The device of claim 1 , wherein the optical element is configured for use with an image capture device.

3. The device of claim 2 , wherein the optical element is configured to mate with an image capture device.

4. The device of claim 3 , wherein the image capture device is a scope.

5. 5. The device of claim 4, wherein an end of the image capture device includes a scope lens and the optical element includes a coupler configured to fit over at least a portion of the scope lens.

6. The device of claim 5 , wherein the coupler comprises a lens.

7. The device of claim 1 , wherein the optical element is integrally mounted to a distal end of a scope.

8. The device of claim 7 , wherein the optical element is a lens.

9. The device of claim 8 , wherein the portion of the optical element is a portion of an outer, distal surface of the lens.

10. The device of claim 1 , wherein the conductive material is a coating provided on a portion of the optical element.

11. The device of claim 10 , wherein the conductive material is at least partially transparent.

12. The device of claim 11 , wherein the conductive material comprises a conductive oxide.

13. 13. The device of claim 12, wherein the conductive oxide is selected from the group consisting of titanium conductive oxide and aluminum conductive oxide.

14. The device of claim 1 , wherein the connector is configured to be connected to a power source.

15. The device of claim 14 , wherein the conductive material is at least partially transparent.

16. The device of claim 15 further comprising the power source.

17. The device of claim 1 , wherein the conductive material is configured to receive electrical power from the connector and to generate and transfer thermal energy to tissue disposed adjacent the conductive material.

18. The device of claim 1 , further comprising an optically transparent dielectric layer configured to create a capacitive field between the conductive material and tissue.

19. The device of claim 1 , wherein the conductive material comprises at least two generally parallel conductive strips.

20. An assembly comprising: an image capture device having a viewing end; a positioning assembly for supporting the observation end; a conductive surface disposed on the viewing end and positioned and configured to transmit energy across the viewing end; and a power connection configured to supply energy to said conductive surface; The assembly comprises:

21. The assembly of claim 20 , wherein the conductive surface is an optically transparent surface.

22. 21. The assembly of claim 20, wherein the viewing end includes a scope lens.

23. 23. The assembly of claim 22, wherein the conductive surface comprises a coating on the scope lens.

24. The assembly of claim 20 , wherein the assembly includes at least one connector coupled to the conductive surface.

25. 25. The assembly of claim 24, further comprising a conductor electrically coupled at a distal end to the connector and supported by the positioning assembly and connected at a proximal end to the power connection.

26. 21. The assembly of claim 20, wherein the power connection comprises a catheter configured to convey power from the power source to the image capture device.

27. 21. The assembly of claim 20, comprising a plurality of conductive surfaces, the conductive surfaces being non-overlapping.

28. 21. The assembly of claim 20, wherein the conductive surface is connected to the power connection by a second conductive surface, the second conductive surface comprising platinum.

29. The assembly of claim 20 , wherein the power connection comprises stainless steel.

30. The device of claim 1 , wherein the conductive material is configured to receive electrical power from the connector and to generate and transfer thermal energy to limit fogging.

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