Endoscope with rotating camera and related methods

Abstract

To provide an endoscopic instrument operated in a narrow anatomical space in a body by using an endoscope or an arthroscope.SOLUTION: The endoscope assembly comprises a handle and a shaft with an optical housing at its distal end, enclosing a camera sensor whose optical axis is at an angle to the shaft rotation axis. The camera sensor rotates with the shaft relative to the base housing of the handle. A rotation sensor in the handle senses an angle of rotation of the camera sensor relative to the base housing. The processor converts rotational changes in the field of view into translational changes to correct the angular orientation of the image from the image sensor. The processor applies variable smoothing to the rotation of the displayed image, the smoothing being greater during deceleration of the rotation than during acceleration of the rotation. The shaft is surrounded by a trocar, and the space between the shaft and the trocar allows irrigation fluid to be conveyed to and from the space at the distal end of the shaft.SELECTED DRAWING: Figure 91

Description

[Technical Field]

[0001] The present invention relates to endoscopic instruments for viewing and operating in difficult to access spaces, and in one aspect, to endoscopic instruments for operating in tight anatomical spaces within the body, such as with an endoscope or arthroscope. [Background technology]

[0002] The use of endoscopic instruments in the medical field, which allow for remote viewing and operation in difficult-to-access spaces, has become well established. Such instruments are also useful in the automotive, aircraft, plumbing, electronics, and many other industrial fields. In medical and veterinary practice, endoscopy and arthroscopy are often used to view or treat anatomical areas where minimal or no incision is desired, or to avoid disturbing nearby tissues. For example, in orthopedic surgery, conditions in joints such as the knee or shoulder can be accessed using one or more arthroscopic instruments inserted into the joint through one or more small incisions. These instruments are also used to repair tissue within various joints. Standard open surgery to view and repair these anatomical areas involves significant risks and patient trauma, is comparatively more time-consuming, and results in a longer recovery period. Additionally, anesthesia associated with open surgery is more complex and costly. For improved visibility, endoscopes feature an actively flexible tip that is manipulated by the user at the end of the instrument's handle. This is not an effective option when the tip is located in a tight space that does not have the range of motion to bend the endoscope tip. In medical applications, one such example would be intra-articular surgery. Generally, if it is difficult to use an instrument with an actively flexible tip, it is preferable to use an instrument with a rigid insertion shaft. A non-flexible shaft offers improved optics or image reproduction, increased space within the instrument for additional functionality, and greater durability. However, rigid endoscopes and arthroscopes have limited fields of view and may require frequent repositioning or rotation to increase the field of view. Some endoscopes and arthroscopes require physical removal from the patient and replacement of parts to change the field of view. Cannula systems facilitate this approach but complicate the procedure and require larger incisions. This limitation reduces operator efficiency, increases surgical time, and increases the risk of iatrogenic injury. In medical and other practices, it would be advantageous for endoscopes to have an increased or variable field of view without the use of an actively flexible tip. It would also be advantageous to combine multiple functions into a single conduit to reduce the overall diameter of the endoscope shaft. Additionally, current instruments are prone to degradation of function and optical quality with repeated use, cleaning, and / or disinfection. An endoscope design with low enough manufacturing and assembly costs to economically justify not reusing them would also be advantageous. Eliminating the costs of repeated cleaning or disinfection and repackaging would facilitate standardization of sterility, quality, and reliability for disposable devices. Summary of the Invention

[0003] In one embodiment, a two-part handle endoscope, with a distal handle housing connected to an endoscope shaft with a distally mounted camera sensor, is rotatable relative to a proximal handle housing that can be grasped by a user's hand. The camera sensor is mounted within an optical housing that positions the camera so that the camera's optical axis maintains a constant, non-zero angle with the endoscope shaft, optical housing, and camera sensor. Rotation of the distal handle housing will rotate the image produced by the camera sensor unless the image rotation is corrected using a signal that traces the degree of rotation of the distal handle housing relative to a predetermined horizontal plane. While this image rotation correction can be achieved if both the base and distal handle housings rotate together, it would be useful to correct for image rotation when the distal handle housing rotates relative to the base handle housing. This is accomplished by attaching a magnet to the inner wall of the proximal handle housing, such as a three-axis absolute position sensor, that covers a PCB attached to the distal handle housing that contains a magnetic position sensor. As the distal handle housing (and attached camera sensor) rotates, a processor receives input from the position sensor and rotates the image alignment by approximately the same amount in the opposite direction, so that the displayed image maintains a constant angular orientation. In this manner, as the camera rotates about the axis of rotation from a first angular orientation to a second angular orientation, the displayed image moves from a first field of view to a different, second field of view. The controller may also generate and display a directional pointer adjacent the displayed image to inform a viewer or user of the actual rotational displacement of the camera sensor relative to the base handle housing of the handle. In one embodiment, the optical axis of the camera may be fixed between 30° and 70° relative to the axis of rotation. A non-zero angle of the optical axis of the camera, in conjunction with the angular position signal, can transform the image display from the camera from a rotating image of a changing field of view to a translating image of the changing field of view. The processor may be configured to smooth the rotation signal from the rotation sensor such that the smoothing is greater when the camera rotation slows than when it increases.

[0004] The above system is not limited to endoscopes or arthroscopes, but is adapted for use with a rotating camera having an optical axis at a non-zero angle relative to the axis of rotation.

[0005] In another aspect, an optical housing for the distal end of an endoscope shaft includes a molded member configured to partially enclose a camera sensor and a light source, fix the angular positions of the camera sensor and the light source relative to the longitudinal axis of the distal end of the endoscope shaft, and securely fasten the camera sensor and the light source within the distal end of a cylindrical sheath comprising the endoscope. The molded member may have an outer diameter that provides a leak-tight seal with a portion of the cylindrical sheath of the endoscope shaft, and may include a plurality of grooves formed on the outer surface of the molded member to provide one or more fluid flow paths between the fluid path of the endoscope shaft and the outer surface of the endoscope shaft. The camera may include a lens adjacent to the sensor, and the optical housing may include a lens opening at the distal end of the endoscope shaft for the lens to receive light. The light source may include a light-emitting diode (LED) adjacent to the lens, and the optical housing may include an LED opening for the LED to illuminate an area outside the distal end of the endoscope shaft. The camera sensor is mounted on a camera sensor printed circuit board, and the camera sensor printed circuit board is enclosed within the optical housing. The light source is mounted on a light source printed circuit board, and the light source printed circuit board is enclosed within the optical housing. The light source may include a light-emitting diode mounted on a light source printed circuit board, which may include an opening through which a lens proximate the camera sensor protrudes. The sheath may have an end proximate the distal end of the optical housing, and one or more grooves on the outer surface of the molded member may communicate with one or more lateral openings between the optical housing and the sheath at the distal end of the sheath. The sheath may include a cleaning opening proximate the distal end of the sheath at the distal end of the endoscope shaft, which may be in fluid communication with one or more grooves in the optical housing. The cleaning fluid flow path may be formed during the molding process of the optical housing. In one embodiment, the upper flow path may be oriented to allow fluid to exit the distal end of the endoscope shaft at one or more openings adjacent to the camera sensor lens located proximate the camera sensor. Fluid flow from these openings helps to wash away air bubbles, debris, and other material that may contact the lens surface (and thereby interfere with the operation of the camera sensor). Additionally, lateral channels are formed in the optical housing to direct some of the irrigation fluid out of openings on the sides and inside the distal shaft of the endoscope adjacent the camera-lens-LED assembly.The sheath and optic housing may be adapted to be inserted into a trocar, and the trocar may include a trocar opening that aligns with the irrigation opening in the sheath.

[0006] The processor may use filters to reduce the effects of noise in the position sensor signals and small positional changes in the image caused by the user's unintentional hand movements or tremors. Stabilization of the rotating image may be achieved using a number of filtering techniques, either in the analog stage of the position sensor signals, after digital conversion, or while the controller software code is transmitting the image display during rotation. Small rotational movements, which inherently have high-frequency components, can be filtered using one of a number of low-pass filtering techniques. To increase the responsiveness of the display controller to the user's rotational input, the controller may determine whether the camera sensor is being rotated at a relatively high speed, or with a relatively high acceleration or deceleration, or whether the spectrum of the rotation signal should weight lower-frequency components more heavily. In that case, the controller's low-pass filter coefficients may be adjusted in real time to reduce their effect, allowing rotational modifications of the image to be displayed with low latency once rotation has begun and continued. As the user approaches the end of the camera rotation, or if the user attempts to maintain the camera sensor in a fixed position, the controller may determine whether to begin filtering the rotation signal more heavily, either by measuring the rotation rate or acceleration, or by spectral analysis of the signal.

[0007] In some aspects, a rotation sensor may be configured to measure the angle of rotation of the camera relative to the axis of rotation. The processor may be configured to filter the rotation signal from the rotation sensor to smooth the rotation of the displayed image. The filter may also be configured to provide greater smoothing when the camera is decelerating than when it is accelerating. The filter may be a low-pass filter, and the smoothing may have an inverse relationship to the corner frequency of the low-pass filter. The filter may maintain a constant smoothing of the rotation of the displayed image if the camera is rotating at a constant speed.

[0008] The quality of a displayed image may also be enhanced by selectively adjusting the saturation of the displayed image. In a single-use endoscope, the image quality of a low-cost camera sensor may be improved by selectively enhancing the saturation of the image without reducing the intensity of white. The saturation of a pixel is enhanced by a saturation factor in a hue, saturation, and brightness (HSV) color space and by a brightness factor in a hue, saturation, and brightness (HSL) color space. In one aspect, an image processing method comprises assigning an HSV value to a pixel of image data in the HSV color space, the saturation of the pixel being within a predetermined range of saturation numbers, and assigning an HSL value to a pixel of image data in the HSL color space, the brightness of the pixel being within a predetermined range of brightness numbers. The processor can calculate a first factor comprising a fraction between 0 and 1, the first factor fraction being determined by a probability distribution centered around a number within the lower half of the predetermined range of saturation numbers. The processor may calculate a second factor comprising a fraction between 0 and 1, the second factor fraction being determined by a probability distribution centered around a number in the middle of a predetermined range of luminance numbers. The processor adjusts the saturation of the pixel in the HSV color space by multiplying the assigned saturation of the pixel in the HSV color space by a value equal to 1 + (the product of the predetermined fixed fraction and the product of the first factor and the second factor). The processor then adjusts the saturation of the pixel in the HSV color space by multiplying the assigned saturation of the pixel in the HSV color space by a value equal to 1 + (the product of the predetermined fixed fraction and the product of the first factor and the second factor). The predetermined fixed fraction may be 0.5. The probability distribution may be a Gaussian distribution. The probability distribution may be centered around a number comprising approximately 25-40% of the predetermined range of chroma numbers. The probability distribution may also be centered around a number comprising approximately 25-40% of the predetermined range of luminance numbers.

[0009] A Gaussian function transformed to small saturation values ​​is designed to boost non-saturated pixels without over-boosting already saturated pixels. A second Gaussian function is used on the luminance of the HSL color space to reduce the saturation boost for mostly white and mostly black pixels. These factors are used to boost saturation using the following commands: Enhanced saturation value = (original saturation value) x (1 + (factor 1 x factor 2 x 0.5))

[0010] To reduce electromagnetic emissions from the endoscope shaft, rigid or flexible extension boards carrying signal wiring between the camera sensor at the endoscope tip and the main PCB inside the endoscope handle are preferably configured as striplines rather than the microstrips commonly used in conventional constructions. The stripline design provides ground planes above and below the transmission lines (including the signal wiring) embedded in the rigid or flexible extension board. This provides a uniform ground plane across the entire board, preventing high-frequency electromagnetic emissions from propagating from above the board.

[0011] An optical coupling scheme is implemented to enhance the electrical isolation (through patient extension) of the endoscope from the chassis ground of the digital electronics and the imaging unit external to the endoscope. In an exemplary scheme, a USB 3.0 power and signal interface is used to provide the electrical and electronic connection between the endoscope PCB and the imaging unit electronic control. The signal interface is configured to operate up to 5 GHz. Therefore, optical coupling of the connection between the endoscope cable and the imaging unit provides an adequate form of isolation. For example, a USB 3.0 fiber optic extension cable can be used to provide USB 3.0 signal isolation. The digital communication interface between the local and remote extensions can be optically coupled with a 0.5 m fiber optic cable.

[0012] In another aspect, an endoscope assembly may include an endoscope and a trocar. The shaft may include a single conduit adapted for conveying irrigation fluid between a shaft port at a proximal portion of the shaft and an irrigation port at a distal portion of the shaft. The shaft is adapted to be inserted into the trocar, the trocar having a distal opening through which the distal end of the shaft can protrude. The proximal portion of the trocar may be connected to a trocar fluid port, and the distal portion of the trocar may include one or more side ports to allow fluid to enter and exit the trocar space defined by the inner wall of the trocar and the outer wall of the endoscope shaft. Thus, the endoscope assembly may be adapted for simultaneous irrigation and aspiration using a trocar irrigation space and a suction shaft conduit, or a suction trocar space and a irrigation shaft conduit.

[0013] These and other aspects will become more apparent from the following detailed description of various embodiments of the present disclosure, taken in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0014] [Figure 1] FIG. 1 is an illustration of a two-piece handle design for an endoscope. [Figure 2] FIG. 2 illustrates additional features of the illustration of FIG. [Figure 3A] FIG. 3A shows an exemplary side view of an endoscope. [Figure 3B] FIG. 3B shows an exemplary perspective view of another endoscope. [Figure 4] FIG. 4 shows an exploded view of the handle proximal section of the endoscope. [Figure 5] FIG. 5 shows an exploded view of another example of the handle proximal section of an endoscope. [Figure 6] FIG. 6 shows an exploded view of another example of the handle proximal section of an endoscope. [Figure 7A] FIG. 7A shows a perspective view of an example of the handle proximal section of an endoscope. [Figure 7B] FIG. 7B shows a side view of an exemplary endoscope with the handle portion removed. [Figure 7C] FIG. 7C shows a detailed view of a portion of an exemplary handle distal section of an endoscope. [Figure 8] FIG. 8 shows an exploded view of an example of an endoscope handle distal section and rotation sensing assembly. [Figure 9A] FIG. 9A shows a partial assembly view of an exemplary endoscope handle. [Figure 9B] FIG. 9B shows a partial cutaway view of the handle of an endoscope including an exemplary rotation sensing arrangement. [Figure 10A] FIG. 10A shows an illustrative illustration of a flow-through fluid barrier that allows utility components to flow from the handle to the conduits of the endoscope. [Figure 10B] FIG. 10B shows an illustrative diagram of a walk-through barrier having flexible components. [Figure 11A] FIG. 11A shows an exploded view of an example inner sheath mount that functions as a flow-through fluid barrier. [Figure 11B] FIG. 11B shows an example of a septum or flow-through fluid barrier. [Figure 11C] FIG. 11C shows an example of a septum or flow-through fluid barrier. [Figure 11D] FIG. 11D shows an example of a flow-through fluid barrier with several utility components passing through it. [Figure 12] FIG. 12 shows an exploded view of an embodiment of the swing control assembly. [Figure 13] FIG. 13 shows a perspective view of an example of a sealing member. [Figure 14] FIG. 14 shows a partial assembly view of an exemplary endoscope with the inner sheath mount, pivot control structure or assembly, and seal member in the assembled position. [Figure 15] FIG. 15 shows a partial assembly view of an exemplary endoscope having a pass-through barrier, a pivot control structure, and a printed circuit board encased in a protective material or housing. [Figure 16A] FIG. 16A shows a perspective view of the outer sheath and mount of the endoscope. [Figure 16B] FIG. 16B shows an opposite perspective view of the outer sheath and mount of FIG. 16A. [Figure 17] FIG. 17 shows a perspective view of the outer sheath mount. [Figure 18] FIG. 18 shows an enlarged, partial cutaway view of the endoscope with the inner sheath mount, inner sheath, and outer sheath in the assembled position. [Figure 19]FIG. 19 shows an exemplary obturator inserted into the outer sheath or trocar of an endoscope. [Figure 20] FIG. 20 shows an example of a camera assembly mount separated from the inner sheath. [Figure 21] FIG. 21 shows another example of a camera assembly mount as part of the inner sheath. [Figure 22] FIG. 22 shows a cross-sectional view of the exemplary camera assembly mount and inner sheath of FIG. 21 taken along line 20-20 shown in FIG. [Figure 23] FIG. 23 shows an example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 24] FIG. 24 shows another example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 25] FIG. 25 shows another example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 26] FIG. 26 shows a perspective view of the distal end of an endoscope shaft with a camera assembly mounted at the distal end of the shaft without any protective guards, shields or tip structures. [Figure 27] Figure 27 shows the rotating camera housing with pull wires and the LED bank at the bare end of the endoscope shaft (with the surrounding sheath removed). [Figure 28] FIG. 28 shows one half of a spheroid rotating housing for a camera assembly. [Figure 29] FIG. 29 shows the other half of the spheroid rotating housing for the camera assembly. [Figure 30] FIG. 30 shows the pivoting and bearing elements that rotate the housing for the camera assembly. [Figure 31] FIG. 31 shows the pivoting and bearing elements that rotate the housing for the camera assembly. [Figure 32] FIG. 32 shows a perspective view of the camera assembly. [Figure 33]FIG. 33 shows a side view of the camera assembly and camera assembly mount with the walls of the camera assembly mount removed for clarity. [Figure 34] FIG. 34 shows a side view of another example camera assembly and camera assembly mount with the walls of the camera assembly mount removed for clarity. [Figure 35] FIG. 35 shows a side view of another example camera assembly and camera assembly mount with the walls of the camera assembly mount removed for clarity. [Figure 36] FIG. 36 shows one possible rotational position of the alternative camera assembly. [Figure 37] FIG. 37 shows one possible rotational position of the alternative camera assembly. [Figure 38] FIG. 38 shows one possible rotational position of the alternative camera assembly. [Figure 39] FIG. 39 shows one possible rotational position of the alternative camera assembly. [Figure 40] FIG. 40 shows one possible rotational position of the alternative camera assembly. [Figure 41] FIG. 41 shows an exemplary camera assembly. [Figure 42] Figure 42 shows the relationship between the camera assembly and the LEDs and their respective power and communication extension PCBs. [Figure 43] FIG. 43 shows the form factor of an endoscope PCB with extensions for the endoscope shaft. [Figure 44] FIG. 44 shows the PCB of FIG. 43 with one flexible extension of the PCB folded over the other extension. [Figure 45] FIG. 45 shows how the extended PCB is positioned on the endoscope shaft (with the sheath removed). [Figure 46] FIG. 46 shows a partially assembled endoscope showing the fluid barrier or septum and PCB passing through. [Figure 47] Figure 47 shows the relationship of the endoscope PCB to other internal components of the endoscope handle. [Figure 48]FIG. 48 shows an internal fluid carrying space and an expanded PCB disposed within the inner sheath of the endoscope shaft. [Figure 49] FIG. 49 shows the internal fluid flow paths within the endoscope handle. [Figure 50] FIG. 50 shows an exemplary camera assembly with fiber optic bundles and electrical flex cables attached. [Figure 51] FIG. 51 shows a top view of an exemplary camera assembly and camera assembly mount. [Figure 52] FIG. 52 shows a perspective view of the camera assembly and flexible fiber optic bundle or ribbon. [Figure 53] FIG. 53 shows a perspective view of a camera assembly having a monolithic camera housing and lighting features. [Figure 54] FIG. 54 shows a side view of the camera assembly of FIG. [Figure 55] FIG. 55 shows an example of a flexible optical fiber bundle or ribbon. [Figure 56] FIG. 56 shows a side view of the flexible optical fiber ribbon of FIG. [Figure 57] FIG. 57 shows a perspective view of an example light emitting element. [Figure 58] FIG. 58 shows a perspective view of another example of a light emitting element. [Figure 59] FIG. 59 shows a perspective view of another example of a light emitting element. [Figure 60] FIG. 60 shows a bottom perspective view of the light emitting element shown in FIG. [Figure 61] FIG. 61 shows a cross-sectional view of the light emitting element shown in FIGS. 59 and 60 taken along line 43-43 in FIG. [Figure 62] FIG. 62 shows a cross-sectional view of the light emitting element shown in FIGS. 59 and 60 taken along line 44-44 in FIG. [Figure 63] FIG. 63 shows a cross-sectional view of the light emitting element shown in FIGS. 59 and 60 taken along line 45-45 in FIG. [Figure 64] FIG. 64 shows a top perspective view of a camera assembly in which the light emitting element of FIG. 59 is implemented. [Figure 65]FIG. 65 shows a cross-sectional view of an exemplary camera assembly taken along line 61-61 of FIG. [Figure 66] FIG. 66 shows a cross-sectional view of an exemplary camera assembly taken along line 62-62 of FIG. [Figure 67] FIG. 67 shows a cross-sectional view of an exemplary camera assembly taken along line 62-62 of FIG. [Figure 68] FIG. 68 shows a specific diagram of the camera assembly at the tip of the endoscope, along with example sensors and multiple illumination sources. [Figure 69] FIG. 69 shows a top view of an exemplary printed circuit board including an extension that protrudes into the endoscope shaft. [Figure 70] FIG. 70 shows a side view of an example printed circuit board including a protruding portion. [Figure 71] FIG. 71 shows an example flowchart listing some exemplary steps that may be used to control at least one variable light source of an endoscope with a processor based on received sensor data. [Figure 72] FIG. 72 shows a side view of an overhanging portion of a printed circuit board that implements an example camera assembly, an example sensor, and several example light sources. [Figure 73] FIG. 73 shows a top view of the tip of an exemplary endoscope including an exemplary protruding portion of the printed circuit board shown in FIG. [Figure 74] FIG. 74 shows a cross-sectional view of the tip of the endoscope taken along line 72-72 in FIG. [Figure 75] FIG. 75 shows a perspective view of the tip of an endoscope with a light source located in the shaft and emitting light in a direction generally away from the field of view of the camera assembly. [Figure 76] FIG. 76 shows an exemplary endoscope and an exemplary calibration fixture. [Figure 77] FIG. 77 shows an example flowchart including some exemplary steps used to calibrate illumination parameter values ​​of a variable illumination source in an endoscope. [Figure 78]FIG. 78 shows a partial assembly drawing of the endoscope with the handle printed circuit board, power / HDMI® cable, illumination fiber, and cleaning lines in assembled position. [Figure 79] FIG. 79 shows a block diagram of an exemplary image processing system. [Figure 80] FIG. 80 shows a diagram illustrating how input from the rotation sensing assembly is used to rectify the image. [Figure 81] Figure 81 shows the relative position of the magnet in the proximal handle housing to the rotation sensor on the endoscope PCB. [Figure 82] FIG. 82 shows a schematic diagram that can be seen by a camera sensor. [Figure 83A] FIG. 83A shows the effect on the processor's field of view caused by correcting the image rotation. [Figure 83B] FIG. 83B shows the effect on the processor's field of view caused by correcting the image rotation. [Figure 83C] FIG. 83C shows the effect on the processor's field of view caused by correcting the image rotation. [Figure 83D] FIG. 83D shows the effect on the processor's field of view caused by correcting the image rotation. [Figure 84] FIG. 84 shows the processor algorithm for varying the image motion filter depending on the motion speed or acceleration of the camera sensor. [Figure 85] FIG. 85 shows the processor algorithm for varying the image rotation filter depending on the speed or acceleration of the camera sensor. [Figure 86] FIG. 86 shows the second processor algorithm that varies the image rotation filter depending on the rotation speed or acceleration of the camera sensor. [Figure 87] FIG. 87 shows the third processor algorithm that varies the image rotation filter depending on the rotational speed or acceleration of the camera sensor. [Figure 88A] FIG. 88A shows a variation of the PCB configuration for the elongated PCB components of the endoscope shaft. [Figure 88B] FIG. 88B shows a variation of the PCB configuration for the elongated PCB components of the endoscope shaft. [Figure 89] FIG. 89 is a block diagram illustrating electrical isolation of the endoscope from an image processing unit located external to the endoscope. [Figure 90A] FIG. 90A shows an arrangement of a camera sensor and associated LEDs with a fixed angular position relative to the endoscope shaft. [Figure 90B] FIG. 90B shows another arrangement of the camera sensor and associated LEDs with a fixed angular position relative to the endoscope shaft. [Figure 91] Figure 91 shows the PCB of the endoscope including the handle and shaft components along with a fixed camera and LED at the end of the shaft component. [Figure 92] FIG. 92 shows an exploded view of an endoscope equipped with the PCB of FIG. [Figure 93] FIG. 93 shows a cutaway view of a portion of the endoscope shaft PCB that provides power to the LEDs adjacent to the camera sensor at the tip of the shaft. [Figure 94] FIG. 94 shows the placement of an optical housing or mount surrounding a camera and LED at the tip of an endoscope shaft. [Figure 95] FIG. 95 shows the optical housing into which the camera sensor and LED of FIG. 90 fit. [Figure 96] FIG. 96 shows another view of the optical housing of FIG. [Figure 97] FIG. 97 shows the optical housing inserted into the inner sheath of the endoscope shaft. [Figure 98] FIG. 98 shows the fluid flow path of a cleaning fluid for an endoscope shaft including an optical housing. [Figure 99] FIG. 99 shows an outer sheath or trocar that surrounds the optical housing and inner sheath of the endoscope shaft. [Figure 100] FIG. 100 shows another fluid flow path associated with the optical housing. [Figure 101] FIG. 101 shows the fluid holes in the inner sheath that correspond to the fluid flow paths in FIG. [Figure 102] FIG. 102 shows similar fluid holes in the outer sheath or trocar that match the fluid flow paths of FIGS. [Figure 103] FIG. 103 shows a longitudinal cross-sectional view of a representative schematic of a combined endoscope-trocar that allows fluid irrigation and aspiration through separate flow paths. [Figure 104] FIG. 104 shows an exemplary arrangement of distal ports near the distal end of the endoscope shaft for alternative fluid irrigation and aspiration. [Figure 105] FIG. 105 shows simultaneous irrigation and aspiration using the arrangement shown in FIG. [Figure 106] FIG. 106 shows a processor-based algorithm for selectively enhancing the saturation of images from a camera. DETAILED DESCRIPTION OF THE INVENTION

[0015] As used herein, the terms "endoscope" and "arthroscope" are used interchangeably and given their broad interpretations, and each refers to an instrument having an elongated portion that is inserted into otherwise difficult-to-access spaces in a minimally invasive manner for the purposes of visual inspection, diagnosis, and / or treatment or repair. In the medical and veterinary practice, such spaces may include body cavities, tissue cavities, joint spaces, tissue planes, or other bodily structures. The instruments are also used in many non-medical (e.g., industrial) applications, such as borescopes, where the diameter of the viewing instrument's insertion portion (whether flexible or rigid) is minimized, or where the space in which a rigid borescope operates is too narrow to use an actively flexible tip.

[0016] The two-piece handle design of endoscope 10 is shown in FIG. 1. The exemplary endoscope 10 includes a handle proximal section 16 and a handle distal section 30. The handle proximal section 16 may be a housing. As shown, the handle distal section 30 extends at least partially within the handle proximal section 16. The handle distal section 30 and the handle proximal section 16 are rotatable relative to one another. In one embodiment, a user may hold the handle proximal section 16 stationary and rotate the handle distal section 30 with their thumb or fingers. Endoscope 10 may include components such as, but not limited to, a rotational sensing assembly, fluid conduits, lighting, an imaging or camera assembly, and a rotation control for the imaging device.

[0017] Further features of endoscope 10 are shown in FIG. 2. Endoscope 10 includes a handle proximal section 16 and a handle distal section 30. In this example, at least a portion of insertion shaft or section 14 is fixed to and moves with handle distal section 30. Handle distal section 30 includes a handle protrusion or fin 36 that provides a surface for a user to press against to facilitate rotation of handle distal section 30 relative to handle proximal section 16. In one embodiment, the handle proximal section 16 is held stationary in the user's hand and one of the user's fingers is used to rotate the handle distal section 30.

[0018] In some embodiments, one or both of the handle proximal section 16 and the handle distal section 30 may function as a housing or provide support for other components of the endoscope 10. The endoscope 10 shown in FIG. 2 may include a rotational sensing assembly 150. The rotational sensing assembly 150 tracks rotation of the handle distal section 30 relative to the handle proximal section 16. In some embodiments, the rotational sensing assembly 150 includes components that are stationary relative to the handle proximal section 16 and components that are stationary relative to the handle distal section 30. For example, the rotational sensing assembly 150 may include a potentiometer and a keyed shaft. The potentiometer may be mounted to a support member that comprises, for example, the internal housing of the handle proximal section 16. Alternatively, the handle distal section 30 may also include a support member that mounts one or more components of the rotational sensing assembly 150 (see, for example, the rotational sensor holder in FIG. 8). In either case, the rotating or moving components of the rotational sensing assembly are positioned to move in proportion to the amount of rotation of the handle distal section 30 relative to the handle proximal section 16.

[0019] An exemplary endoscope (or, for example, arthroscope) 10 is shown in FIG. 3A. The endoscope 10 can be used in a variety of endoscopic procedures, including arthroscopy, among others. As shown, the endoscope 10 includes a handle 12 and an insertion section or shaft 14 comprising an elongated, hollow shaft within which one or more actuation members, electrical / communication wires, illumination or light transmission cables, and / or fluid paths can be disposed. As shown, in certain embodiments, the handle 12 is generally cylindrically round in shape. The insertion section 14 may also be generally cylindrical in shape and extend along a longitudinal axis. In certain embodiments, the insertion section 14 may be rigid and relatively straight. In other embodiments, the insertion section 14 may be curved or bent along at least one portion of its length. In yet other embodiments, the insertion section 14 may comprise a semi-rigid, malleable material that can be bent and retain a desired shape. The diameter of the insertion section 14 is significantly smaller than the diameter of the handle 12. In some embodiments, the diameter of the insertion section 14 is approximately 5.5 mm or less. The insertion section 14 of the endoscope 10 may be approximately the same length as the handle 12. In other embodiments, the lengths and shapes of the handle 12 and insertion section 14 may be significantly different.

[0020] At least a portion of the insert section 14 is removable from the handle 12. In such embodiments, the insert section 14 or the removable portion of the insert section 14 may be coupled to the handle 12 by various methods, including, but not limited to, an interference fit, a snap fit, a threaded coupling, a bayonet mount, etc. In some embodiments, the insert section 14 may be a disposable component and the handle 12 may be a reusable component. In embodiments in which the insertion section 14 is disposable, the insertion section 14 may be disposed of after use. In other embodiments, the insertion section 14 may be sterilized after use by autoclaving, soaking in a solution, or other suitable sterilization process. In a preferred embodiment, both the handle 12 and the insertion section 14 are disposable and disposed of after use, eliminating the need and expense of sterilization processes and equipment (apart from sterilization prior to use with ethylene oxide, radiation, etc., or during manufacturing, assembly, or packaging of the device). Furthermore, by making both the handle 12 and the insertion section 14 of the endoscope 10 disposable, there is no degradation in functionality or reliability due to repeated use or repeated cleaning. Making the endoscope 10 entirely disposable provides other advantages, some of which are described below.

[0021] Preferably, the single-use endoscope 10 is equipped with a means to prevent reuse, especially in cases where sterilization of a reused instrument would compromise its functionality. For example, the endoscope 10 may include a memory chip that stores an identification code recognizable by the electronic processor of a base unit to which the endoscope 10 is connected for use and image display. The connection may include wired communication between the base unit's controller and the endoscope's 10 memory chip, or wireless communication, for example, using an RFID device implemented on the endoscope 10. (Other wireless communication methods, such as Bluetooth or Wi-Fi, may also be used.) In one embodiment, the base unit may be programmed to encode the endoscope's 10 memory device upon first use, or, when the endoscope 10 is subsequently reconnected to any base unit, to read and recognize a code indicating that the endoscope 10 has been previously used. If the controller recognizes a used endoscope 10, it may be programmed to terminate electronic and image communication between the endoscope 10 and the base unit. Such codes and communications may be encrypted to enhance system security. Alternatively, the endoscope 10 may include a software disablement mechanism that renders the endoscope 10 unusable after use.

[0022] As shown in FIG. 3A, the handle 12 of the endoscope 10 may have several different features. The handle 12 includes a handle base section 16. The handle base section 16, as shown in FIG. 3A, is relatively flat. The handle base section 16 may include one or more recessed sections. The handle base section 16 may also be shaped to include several ergonomic features. In some embodiments, at least a portion of the handle base section 16 does not have a smooth surface, but may include texture such as knurling, ridges, honeycomb, and / or a rubberized or elastomeric surface to facilitate gripping the endoscope 10 during operation. In an exemplary embodiment, the handle base section 16 may be formed with several finger grooves 18. In some embodiments, the handle base section 16 may be formed from a material that is soft-feeling or comfortable to grip (e.g., rubber or other elastomer). In some embodiments, a pistol grip-like feature (not shown) may be included as part of the handle base section 16 .

[0023] As shown in FIG. 3A, the handle proximal section 16 may be divided into two separate pieces. The handle proximal section 16 of FIG. 3A includes an upper handle section 20 and a lower handle section 22. The upper handle section 20 and lower handle section 22 of the handle proximal section 16 may be manufactured as two separate pieces and connected together by suitable means, such as adhesive bonding, screwing, or a snap fit. As shown, the upper handle section 20 may be smooth and have a different contour than the lower handle section 22. This allows the user to quickly and easily determine the orientation of the endoscope 10 by feel. In some embodiments, the upper handle section 20 and lower handle section 22 may have different textured surfaces (e.g., metal and plastic, metal and elastomer, smooth and textured, etc.).

[0024] The handle 12 of the endoscope 10 may also include a handle distal section 30. As shown in FIG. 3A, the handle distal section 30 extends from the handle proximal section 16 toward the insertion section 14. The handle distal section 30 may have a smaller diameter than the handle proximal section 16. As shown, the handle distal section 30 is longer than the handle proximal section 16, although in other embodiments, the relative dimensions of the handle distal section 30 and the handle proximal section 16 may vary.

[0025] At least a portion of the handle tip section 30 may have a gripping texture, as shown in FIG. 3A. In the exemplary embodiment shown in FIG. 3A, the gripping texture is a series of spiral ribs 32. In other embodiments, non-spiral ribs, bumps, protrusions, grooves, honeycomb patterns, or other shapes of jagged or checkered patterns may be used. As shown, the spiral ribs 32 in the exemplary embodiment surround most of the outer diameter of the handle tip section 30. In some embodiments including a gripping texture on the handle tip section 30, the gripping texture may not be formed as a continuous part of the handle tip section 30. In such embodiments, the gripping texture may be a skin or sleeve applied to the handle tip section 30. The gripping texture skin may be connected to the handle tip section 30 by any suitable means, such as, but not limited to, adhesive, a snap fit, various fasteners, etc. In some embodiments, the gripping texture skin may be formed of a different material than the handle tip section 30. For example, the gripping textured outer skin may be a soft, elastomeric or rubber material that is easier to grip and less slippery than the material of the handle tip section 30 .

[0026] In the illustrated embodiment of Figure 3, the handle tip section 30 includes a raised handle portion 34 that protrudes from the tip of the handle tip section 30. In this example, the raised handle portion 34 does not protrude sharply from the remainder of the handle tip section 30. Instead, the raised handle portion 34 is configured to gently curve upward from the remainder of the handle tip section 30. In this example, the spiral rib 32 does not extend beyond or to the top of the raised handle portion 34. Further features of the raised handle portion 34 are described in more detail below.

[0027] In some embodiments, protruding from the bottom of the handle tip section 30 may be a handle fin or paddle 36. In this example, the handle fin 36 may be gently curved from the remainder of the handle tip section 30 toward a lowered or subordinate position on the endoscope 10. The helical rib 32 may or may not extend beyond the bottom of the handle fin 36. In other embodiments, the handle fin 36 may be configured to protrude from the top of the handle tip section 30, with the raised handle portion 34 protruding from another location on the handle tip section 30. The handle fin 36 is positioned to correspond to the entry points of various cables, irrigation fluids, etc. into the endoscope, as is well known to those skilled in the art. This is preferred because such entry points can serve as a pushing surface to facilitate rotation or as a directional marker. Further features of the handle fin 36 are described below.

[0028] An alternative embodiment of an endoscope (or, for example, an arthroscope) 10 is shown in FIG. 3B. As shown, the endoscope 10 includes a handle 12 and an insertion section or shaft 14 comprising an elongated, hollow shaft within which one or more actuation members, electrical / communication wires, illumination or light transmission cables, and / or fluid paths may be disposed. At least a portion of the shaft 14 may be detachable from the handle 12. In the illustrated embodiment, the endoscope shaft 14 includes an outer sheath, trocar, or cannula 318 attached to a mounting structure 15 that facilitates removal of the cannula from the handle 12 by various means, including, but not limited to, an interference fit, a snap fit, a threaded coupling, a bayonet mount, or the like.

[0029] As shown in FIG. 31B, the handle 12 of the endoscope 10 may include a handle base section 16 that encloses a printed circuit board (PCB) for control or processing image data detected by a sensor at the tip of the shaft and / or for powering a light source (e.g., an LED) at the end of the shaft. It may also house fluid conduits connecting to a fluid-carrying interior space within the shaft 14. The handle base section 16 may be separable into two separate pieces. The handle base section 16 of FIG. 3B includes a first handle half shell and a second handle half shell 23. The first handle half shell 21 and the second handle half shell 23 of the handle base section 16 may be manufactured as two separate pieces and connected to each other during assembly by any suitable means, such as adhesive, screwing, or a snap fit, and may be symmetrical. For example, the first handle half shell 21 may be ultrasonically welded to the second handle half shell 23 using ultrasonic welding techniques. Additionally, as an alternative or option, the handle half shells 21 and 23 may be manufactured using injection molding techniques known in the art.

[0030] The handle 12 of the endoscope 10 may also include a handle tip section 30. As shown in FIG. 31B, the handle tip section 30 extends from the handle base section 16 toward the shaft 14. The portion protruding from the bottom of the handle tip section 30 may be a half-dolphin or paddle 36. The handle tip section 30 also includes a recess 35 sized to accommodate a fingertip contact 98 of a pivot control structure 100 (see, e.g., FIG. 14). An example of a pivot control structure 100 is described below and is used to rotate a pivotable sensor housing at the tip of the shaft 14.

[0031] Also shown in FIG. 31B is an image or camera control button 37, which is used to save images generated by the image sensor at the tip of the shaft 14 to a file. In some embodiments, a user may press the button 37 in a predetermined pattern or sequence to, for example, start or stop video recording of the image shown on the display in the field of view of the image sensor at the tip of the shaft 14, record snapshots of the image shown on the display in the field of view of the image sensor at the tip of the shaft 14, change the brightness of light elements (e.g., LEDs) at the end of the endoscope shaft 14, or adjust other characteristics of the sensor or the displayed image (e.g., white balance, color saturation, digital magnification, etc.). Controlling the sensor characteristics and LED illumination from a processor associated with a graphical user interface connected to the endoscope, rather than from the endoscope PCB itself, is preferable because it reduces the on-board processing power and cost of the endoscope PCB.

[0032] The button 37 may operate an electromechanical switch located on the main PCB within the endoscope handle distal section 30. To maximize moisture resistance of the PCB electronics, a magnetic or optical sensor is preferably used to detect the movement of the button 37. As shown in FIG. 46 (showing the relative positions of some components within the handle 12), in one embodiment, a Hall Effect sensor on the endoscope PCB 518 may be located nearby, below the location where the shaft 38 connects to the button 37. The button 37 may be spring loaded, and the end of the shaft 38 closest to the PCB 518 may include an embedded magnet. As the button shaft 38 moves toward or away from the Hall Effect sensor on the PCB, the sensor can generate an appropriate signal corresponding to the position of the button shaft 38 and the duration of its position.

[0033] 4 and 5 show exemplary embodiments of the upper handle section 20 and lower handle section 22 of the handle base section 16 shown in FIG. 3A. The upper handle section 20 and lower handle section 22 are shown in a disassembled or exploded view. When assembled, the handle base section 16 forms a shell-like structure. The lower handle section 22 may include a ledge 40 that wraps around the lower section inner wall 42 a predetermined distance from the upper surface 46 of the lower handle section 22. As shown, the lower handle section 22 has a curved or U-shaped notch 44 disposed at a generally perpendicular angle to the upper surface 46 of the lower handle section 22. Two peg projections 47 may be included near the rear of the lower handle section 22. The peg projections 47 may extend slightly above the ledge 40 and be at a generally perpendicular angle to the upper surface of the ledge 40.

[0034] As shown in Figures 4 and 5, a portion of the handle upper section 20 is dimensioned to overlap the handle lower section 22 when the handle base section 16 is assembled. The overlapping section 48 may be recessed from the handle upper section outer surface 50, as shown in Figures 4 and 5. The height of the overlapping section 48 is selected to be approximately the same as or slightly longer than the distance between the top of the ledge 40 on the handle lower section 22 and the top surface 46 of the handle lower section 22. In such an embodiment, when fully assembled, the bottom surface 52 of the handle upper section 20 (relative to the assembled orientation) abuts the top of the ledge 40 on the handle lower section 22. Furthermore, in such an embodiment, the handle upper section outer surface 50 and the handle lower section outer surface 54 may be flush with one another, forming a substantially continuous surface with little or no gap between the two. In some embodiments, there may be a small gap between the handle upper section outer surface 50 and the handle lower section outer surface 54 (such as the small gap shown in Figure 3).

[0035] As shown, the handle upper section 20 may include a peg notch 59 shaped and positioned to receive the peg protrusion 47 of the handle lower section 22. The handle upper section 20 may include a curved notch 58 at the root or base portion of the handle upper section 20. As shown, the curved notch 58 may be recessed into the handle upper section 20 at a substantially perpendicular angle to the underside 52 of the handle upper section 20 (referenced to its orientation when assembled). When the handle base section 16 is assembled, the curved or U-shaped notch 44 of the handle lower section 22 and the curved notch 58 of the handle upper section 20 together form a substantially circular or oval handle space or opening 60, described below. It should be understood that the terms "notch," "cut," and the like, as used herein, need not be construed to imply that material must be physically removed by the cutting or material removal process. In some embodiments, the curved or U-shaped notch 44 and curved notch 58 may be formed without physically removing material during manufacturing.

[0036] As shown in FIG. 4, the handle lower section 22 may include a shaft support member 63. The shaft support member 63 in FIG. 4 has a bent or semicircular portion that roughly corresponds to the location of the toothed projection 62 in FIG. 5. The shaft support member 63 also includes a post. The post protrudes from the center point of the semicircular portion, leaving approximately 90° semicircular portions on either side of the post. A shaft support section 65 protrudes from the top of the post of the shaft support member 63 in a direction perpendicular to the distal end of the handle base section 16. The shaft support section 65 may include a recess in which a portion of the sensor gear shaft 120 (see FIG. 8) is seated. The post of the shaft support member 63 may be as long as the radius of the semicircular portion when the handle base section 16 is fully assembled. The shaft support member 63, toothed projection 62, and toothed projection 64 are further described below.

[0037] 5, the handle lower section 22 may alternatively or optionally include a curved toothed projection 62 that is completed by a similar toothed projection 64 included on the handle upper section 20. The toothed projections 62 and 64 are arranged such that they align with one another to form an annular or inner ring gear when the handle base section 16 is fully assembled.

[0038] As shown in Figures 4 and 5, the surface of the handle lower section 22 opposite the bend or U-shaped notch 44 and the surface of the handle base section 20 opposite the curved notch 58 may include semicircular openings or gaps 70. Bend or U-shaped wiring 72 may be recessed into the edges of the semicircular gaps 70 across the entire arc of each semicircular gap 70, as shown in Figures 4 and 5.

[0039] FIG. 6 illustrates an exemplary embodiment of the first handle half shell 21 and the second handle half shell 23 of the handle base section 16 shown in FIG. 3B. The first handle half shell 21 and the second handle half shell 23 are shown unconnected or exploded. The handle base section 16 forms a shell-like structure when assembled. One of the first handle half shell 21 and the second handle half shell 23 may include a slot 41 sized to fit with the co-walled extension 43 of the other one of the first handle half shell 21 and the second handle half shell 23 for ease of assembly. As with FIGS. 4 and 5, the exemplary embodiment of FIG. 6 may include curved cutouts 58. These curved cutouts 58 allow access to the interior space of the handle base section 16 when the handle base section 16 is assembled.

[0040] It would be beneficial to be able to trace the rotational direction of the handle base section 16 relative to the handle tip section 30, the shaft 14, and a sensor or camera at the shaft tip. In one embodiment, this is accomplished through the interaction between a Hall Effect sensor and an associated magnet. A Hall Effect sensor may be located on the handle base section 16 and a magnet may be located on an internal component within the handle base section 16, or one or more magnets may be located in the handle base section 16 and one or more associated Hall Effect sensors may be mounted on a PCB within the handle base section 16. In some embodiments, one or more magnets 51 may be embedded or attached to a portion of the handle 12. In the exemplary embodiment shown in FIG. 6, the handle base section 16 includes two magnets 51 positioned generally opposite each other. In other embodiments, a different number of magnets 51 are used. As shown, in this case, the first handle half shell 21 and the second handle half shell 23 each include a magnet 51 inserted into their interior walls. In the illustrated embodiment, the magnet 51 is coupled to a retaining structure 53 that holds the magnet 51 in place in the handle base section 16. The magnet may optionally be made from a suitable rare earth or transition metal or alloy thereof.

[0041] The exemplary handle tip section 30 of Figure 3A is shown separated from the remainder of the handle 12 in Figure 7A. Figure 7A shows the handle tip section 30 in a perspective view generally from above. As shown, the spiral rib 32 and raised front handle portion 34, described in detail above, are visible on the handle tip section 30. As indicated by the seam running down the vertical center plane of the handle tip section 30, the handle tip section 30 may be made as two or more separate pieces (30a and 30b in the exemplary embodiment) that are connected by any suitable means or combination of suitable means, such as a snap fit, adhesive, and / or screw fastening.

[0042] The handle tip section 30 of Figure 7A includes additional sections not shown in Figure 3A. As in Figure 3A, when the endoscope 10 is assembled, a portion of the handle tip section 30 may be housed within the handle base section 16. For example, a housed handle electronics portion 80 protrudes proximally from the outer handle distal portion 82 (visible in both Figures 3A and 7A). The housed handle electronics portion 80 is described further below.

[0043] Between the housed handle electronics portion 80 and the external handle distal portion 82 is a narrowed diameter span 84. As shown, the narrowed diameter span 84 includes a groove 86 recessed into the outer surface of the narrowed diameter span 84. In some embodiments, when fully assembled, the narrowed diameter span 84 of the handle tip section 30 may be positioned within the semicircular opening 70 of the handle base section 16. The groove 86 of the narrowed diameter span 84 and the bent or U-shaped wiring 72 of the semicircular opening 70 may be aligned with one another. This allows the handle tip section 30 and the handle base section 16 to rotate relative to one another when the endoscope 10 is in use. Optionally, ball bearings (not shown) or other types of bearings may be used along the groove 86 of the narrowed diameter span 84 of the handle tip section 30 and the U-shaped wiring 72 of the semicircular opening 70 of the handle base section 16. In a preferred embodiment, an O-ring (not shown) may be placed in the groove 86 of the narrowed diameter span 84 of the handle tip section 30. An O-ring (not shown) acts as a dynamic seal between the handle base section 16 and the handle tip section 30. In such an embodiment, the handle base section 16 and the handle tip section 30 can rotate relative to each other while still sealing off fluid from the interior of the handle base section 16.

[0044] The handle fins or paddles 36 or other raised features can act as directional markers for the user as the handle base section 16 and handle tip section 30 rotate relative to one another. Orientation can be determined visually or by feel. In some embodiments, the gripping texture on the handle fins or paddles 36 differs from the spiral ribs 32 on the remainder of the handle tip section 30, facilitating orientation by feel.

[0045] As shown in FIG. 7A , the raised handle portion 34 may include a button 90. In some embodiments, the raised handle portion 34 may include two or more buttons 90, or may not include any buttons at all. The button 90 may be located anywhere on the handle tip section 30 or anywhere on the handle 12. In some embodiments, the raised handle portion 34 may include one button 90, and one or more other buttons 90 may be located anywhere on the handle 12. In some embodiments, the button 90 is a mechanically actuated switch that includes a depressible part that makes or breaks a circuit when pressed. The button 90 may also include a magnetic or Hall effect switch by fitting a magnet into the button portion near a Hall effect sensor in the handle tip section 30. Other types of buttons or switches may also be used. The button 90 may be assigned multiple functions that are activated by various user actions. In some embodiments, one or more of the buttons 90 are sealed with respect to the outer handle distal portion 82 to prevent liquid ingress.

[0046] Button 90 may be an image save button. In such embodiments, pressing button 90 records a photograph of an image generated by endoscope 10. In some embodiments, a user may connect an imaging device to endoscope 10 and begin video recording by double-tapping, long-pressing, or holding button 90. To stop video recording, a user may double-tap, long-press, or release button 90. In some embodiments, a user may only be required to press and release button 90 to stop video recording. In some embodiments, while endoscope 10 is recording video, a user may press button 90 once to record a still image without interrupting the video recording. Alternatively, a quick press and release of button 90 may trigger the recording of a still image, while a longer press and release or press and hold may trigger the recording of a video segment.

[0047] The raised handle portion 34 may further include a slide button recess 92. As shown in FIG. 7A, the slide button recess 92 is positioned to allow fore-and-aft movement of a slide button or fingertip contact 98 (see FIG. 14) while restraining lateral movement. The slide button may, in some embodiments, be part of a pivot control or pivot control structure 100 (see, e.g., FIG. 14). In some embodiments, including the embodiment shown in FIG. 7A, the slide button recess 92 may be slightly curved to conform to the shape of the portion of the handle in which it is placed.

[0048] As shown in FIG. 7A , the slide button recess 92 may include several protrusions or detents 94 that can engage with corresponding elements on the slide button, providing a series of distinct, distinct stops as the user moves the slide button back and forth. In some embodiments, the protrusions 94 may not be included. In some embodiments, the portion of the pivot control structure 100 (see FIG. 12 ) that the user acts on protrudes through a pivot control structure notch 96 (see FIG. 14 ) that is positioned within the slide button recess 92 in the raised handle portion 34. In the exemplary embodiment shown in FIG. 7A , such portion of the pivot control structure 100 includes a fingertip contact 98. As shown, the fingertip contact 98 may have a sloped profile for ergonomic reasons. The pivot control structure 100 is further described below.

[0049] 7B and 7C show alternative embodiments of recess 35 used to accommodate fingertip contact 98 of pivot control structure 100. Portions of handle base section 16 and handle tip section 30 have been removed for clarity. FIG. 7C shows a detailed view of area 7C of FIG. 7B. As best seen in FIG. 7C, in an embodiment, recess 35 includes protrusions 94 for incremental movement of the pivot control structure, similar to the movement of slide button recess 96 shown in FIG. 7A. Alternatively, recess 35 may be substantially smooth and curved to accommodate the path of travel of pivot control structure 100.

[0050] The interior of the handle tip section 30 may include a shelf 95 located below the recess 35. The shelf 95 has a surface whose contours closely resemble those of the recess 35. The shelf 95 includes one or more protrusions or detents 94, providing a series of discrete, distinct stops as the user moves the pivot control structure 100 back and forth. These protrusions 94 interact with one or more arms 97 extending from the pivot control structure 100. The arms 97 are free to move on the smooth, protrusion- or detent-free portion of the shelf 95. When one of the arms 97 encounters a protrusion 94, the protrusion abuts the arm 97, preventing further movement of the pivot control structure 100 until sufficient force is applied to overcome the mechanical interaction provided by the protrusion 94. That is, the protrusion 94 forms a force barrier that prevents the fingertip contact 98 from actuating out of position. Depending on the embodiment, the protrusions 94 may be placed in pairs on the surface of the shelf 95. Each protrusion 94 of a pair of protrusions 94 may be spaced apart by as much as the width of the arm 97 of the swing control structure 100.

[0051] Figure 8 shows a more detailed view of the exemplary handle tip section 30 without the attached insert section 14. An exemplary rotation sensing assembly 150 is also shown in Figure 8. As shown, the handle tip section 30 is manufactured in two parts, 30a and 30b. In the illustrated embodiment, the two portions 30a and 30b of the handle tip section 30 include several threaded holes 102 for threading. Screws (not shown) or other suitable fasteners are used to connect the two portions 30a and 30b of the handle tip section 30 together. In some embodiments, the two portions 30a and 30b may be connected together by a snap fit, ultrasonic welding, adhesive, etc.

[0052] In some embodiments, one of the two separate portions 30a and 30b of the handle tip section 30 may include a peg-like protrusion 104 that fits into a complementary peg-receiving cavity 106 on the other one of the two separate portions 30a and 30b, thereby helping to align and / or connect the two separate portions 30a and 30b together. In some embodiments, including the example shown in FIG. 8, the outer handle distal portion 82 is essentially hollow. In some embodiments, the hollow portion of the outer handle distal portion 82 may not be sealed against fluids. In the exemplary embodiment shown in FIG. 8, drain passages 108 may be included, for example, in the handle fins 36. The drain passages 108 allow any fluids to enter the hollow portion of the outer handle distal portion 82 and be easily removed. Alternate embodiments may include additional and / or different drain arrangements.

[0053] The handle distal section 30 may also include a rotation sensor holder 110, as shown in FIG. 8. The rotation sensor holder 110 holds a rotation sensing assembly 150 when the endoscope 10 is fully assembled. As shown, the rotation sensing assembly 150 may include an advancement gear 112. The advancement gear 112 is disposed on an advancement gear shaft 114. As shown in FIG. 8, a distribution gear 116 may also be disposed on the advancement gear shaft 114, such that rotation of the advancement gear 112 rotates the distribution gear 116 as well. The distribution gear 116 may mesh with a sensor shaft gear 118 disposed on a sensor gear shaft 120. As the advancement gear 112 rotates, the sensor shaft gear 118 and the sensor gear shaft 120 also rotate. The use of a gear assembly allows the attached potentiometer 122 to be offset from the central axis of rotation of the handle tip section 30, allowing other internal structures (e.g., irrigation conduits, fiber optic bundles, electrical flexible cables, or other electronic components) to be centered.

[0054] As in the exemplary embodiment of FIG. 8, the sensor gear shaft 120 may include a keyed or keyed (e.g., D-shaped) portion. The keyed portion may operatively engage one or more rotary potentiometers 122. In the exemplary embodiment of FIG. 8, there are two rotary potentiometers 122. The potentiometers 122 may be mounted to or attached to a mounting element of the handle or to a portion of a printed circuit board, as described with reference to FIG. 78. Each potentiometer 122 includes a keyed (e.g., D-shaped) cavity and connects with a corresponding keyed portion of the sensor gear shaft 120. As the sensor gear shaft 120 rotates, the electrical resistance of the potentiometers 122 changes proportionally. Because the resistance changes predictably with the amount of rotation of the sensor gear shaft 120, the measured resistance of the potentiometers 122 can be used to determine the amount of rotation occurring between the handle base section 16 and the handle tip section 30 (and, by extension, the insert section 14).

[0055] In some embodiments, the housing of each potentiometer 122 is mounted to an element of the handle electronics section 80 (or other element attached to the handle tip section 30) in which it is housed, and is thus fixed relative to the handle tip section 30 (and, by extension, the insert section 14), while the shaft or rotating hub of the potentiometer 122 is connected to the handle base section 16. In other embodiments, the housing of the potentiometer 122 may be fixed relative to the handle base section 16, and the shaft or rotating hub may be connected to an element of the handle tip section 30 or the handle electronics section 80.

[0056] The illustrated embodiment of FIG. 8 includes two rotary potentiometers 122 stacked together and rotationally offset from one another. In alternative embodiments, the potentiometers 122 may be spaced apart but have a common axis of rotation (e.g., the wipers of both potentiometers 122 are driven by a common shaft). In this arrangement, the controller receives electrical resistance values ​​from both potentiometers 122 and can calculate the rotation angle of the sensor shaft (and ultimately components of the endoscope tip) with the desired accuracy through 360° of rotation, thereby helping to eliminate calculation "blind spots" in measuring the rotation of components of the endoscope tip shaft (e.g., the camera). Any blind spots caused by the position of the wiper of one potentiometer 122 at the extreme end of its range of motion are compensated for by the wiper of a second potentiometer 122 that is not at the extreme end of its range of motion. In alternative embodiments, potentiometers 122 offset by more than two rotations may be used. The rotational offset between the potentiometers 122 may be 180° for simplicity of calculation, but other degrees of rotational offset may be used to achieve similar results, provided the rotational offset allows the blind spot created by one potentiometer 122 to overlap the operating range of the other potentiometer 122. In alternative embodiments, the gear ratio between the forward gear 112, the distributor gear 116, and the sensor shaft gear 118 may vary depending on the accuracy required in the rotational measurement, the sensitivity of the potentiometer 122, and other factors. In alternative embodiments, the rotational sensing assembly 150 may use a belt rather than one or more gear assemblies. For example, the distributor gear 116 and the sensor shaft gear 118 may be replaced with a belt. Other rotation-rotation arrangements known in the art may also be used. In some embodiments, the forward gear shaft 114 may include a key feature (e.g., a D-shaped portion) that operably directly engages the potentiometer 122. Rotational sensors other than the potentiometer 122 may also be used. Alternate embodiments may include a rotational sensor such as a rotary encoder, a rotary variable differential transformer, or other encoding device. In embodiments using a rotary encoder, the encoder may be a Gray encoder, a magnetic encoder (see, e.g., FIG. 9B), an optical encoder, or the like.

[0057] In one embodiment, the sensor gear shaft 120 may not extend all the way to the shaft gear section of the shaft support member 63. Rather, the rotation sensing assembly 150 may be supported by the rotation sensor holder 110. Among other advantages, this arrangement allows for an unlimited angle of rotation of the handle tip section 30 relative to the handle base section 16. Furthermore, as will be appreciated by those skilled in the art, this allows the components of the rotation sensing assembly 150 to be located off-center. This provides several advantages during assembly. For example, it can simplify the routing of the cleaning line 434 (see FIG. 78), power cable 432 (see FIG. 78), etc.

[0058] In another embodiment, a shaft directly connects the shaft support member 63 and the potentiometer 122. A keyed shaft extends from the shaft gear section of the shaft support member 63 and into a correspondingly keyed (e.g., D-shaped) cavity in the potentiometer 122. Because the shaft support member 63 is fixed relative to the handle base section 16, rotation of the handle tip section 30 relative to the handle base section 16 changes the resistance measured by the potentiometer 122. As described above, because resistance changes predictably as one handle section is rotated relative to another, the resistance measurement can be used to determine the amount of rotation by the handle tip section (and ultimately, for example, the tip of an endoscope or camera assembly 350 shown in FIG. 23).

[0059] In another embodiment, the rotation sensing assembly 150 may include a range finder located in the housed handle electronics portion 80 (see FIG. 7A). The interior wall of the handle base section 16 (see FIG. 4) may include a raised surface of varying thickness or height that wraps around most or all of 360° of the interior wall of the handle base section 16, varying in thickness or height in a predetermined manner along its circumferential path. As the handle base section 16 and the handle tip section 30 rotate relative to one another, the range finder provides the controller with a signal that varies in response to the distance to the varying surface (either varying in thickness or height) read by the range finder. This signal relates to a thickness / height or distance relative to a predetermined home position measured by the range finder, where the surface has a particular thickness or height and is associated with a particular angular rotation of the handle tip section 30 relative to the handle base section 16. This distance is compared to the previous distance to determine the amount of rotation that has occurred. The range finder may be any type of range finder (eg, a mechanical position sensor, an acoustic range finder, a laser or other optical range finder, etc.).

[0060] Yet another alternative embodiment may use a sensor array similar to an optical mouse. The sensor may be mounted on one housed handle electronics portion 80 or handle base section 16 and configured to trace the movement of the other housed handle electronics portion 80 or handle base section 16. In such an embodiment, the amount and direction of movement sensed by the sensor can be used to determine the amount and direction of rotational displacement that occurred. In some embodiments, the surface traced by the sensor has a reference grid, some unique markings, marks, or other distinguishing representation that allows the sensor to determine the starting rotational direction. Other types of rotational sensing assemblies 150 known to those skilled in the art may be used in various embodiments.

[0061] As shown in FIG. 8 , the rotation sensor holder 110 of the handle tip section 30 may be shaped so that the rotation sensing assembly 150 is captured between the two separate portions 30a and 30b of the handle tip section 30 when the two separate portions 30a and 30b are coupled together. The rotation sensor holder 110 on each side includes a forward gear shaft groove 124 and a sensor gear shaft groove 126. When assembled, the forward gear shaft groove 124 and the sensor gear shaft groove 126 can act as bearing surfaces for the forward gear shaft 114 and the sensor gear shaft 120, respectively. The rotation sensor holder 110 on each side may also include a retaining cavity 128. The retaining cavity 128 may be sized and shaped so that the distributor gear 116, the sensor shaft gear 118, and the potentiometer 122 fit within the rotation sensor holder 110 when the handle tip section 30 is fully assembled.

[0062] FIG. 9A is a partially assembled view of the handle 12 of the endoscope 10. Only the handle lower section 22 of the handle base section 16 is shown in FIG. 9. A portion of the handle lower section 22 of the handle base section 16 has been cut away for clarity. Additionally, in the embodiment shown in FIG. 9A, the handle tip section 30 is assembled from two separate parts 30a and 30b (see FIG. 8). One half (30b) of the handle tip section 30 has been removed in FIG. 9A for clarity. {In the embodiment shown in FIG. 9A, the handle tip section 30 is assembled from two separate parts 30a and 30b (see, e.g., FIG. 8). One half (30a) of the handle tip section 30 has been removed in FIG. 9A for clarity.} The housed handle electronics 80 is located within the handle base section 16. An external handle distal portion 82 extends beyond the handle base section 16 and is exposed to the environment.

[0063] As described above, the rotation sensing assembly 150 is disposed within the rotation sensor holder 110 . As shown, the forward gear 112 of the rotation sensing assembly 150 meshes with the ring gear formed by the toothed projections 62 and 64 (shown most clearly in FIG. 5). In such an embodiment, when the handle 12 is fully assembled, rotation of the handle tip section 30 relative to the handle base section 16 rotates the forward gear 112 as it meshes with the ring gear formed by the toothed projections 62 and 64. This rotation is then transmitted through the remainder of the rotation sensing assembly 150, where it can be measured by the rotation sensing assembly 150. In a preferred embodiment, the overall gear ratio is approximately 1:1.

[0064] Alternatively, rather than a gear element, the handle base section 16 may include a keyed or partially keyed shaft secured to the shaft support section 65 of the shaft support member 63, similar to that shown in Figure 4. The keyed portion of the shaft is positioned to mate with the hub of one or more potentiometers 122 held within the rotation sensor holder 110. Thus, as the handle tip section 30 rotates relative to the handle base section 16, the wipers of the one or more potentiometers 122 can convert the relative position of the handle tip section 30 and base section 16 into an electrical resistance that can be used to determine the direction of rotation.

[0065] 9B, an exemplary handle 12 of an endoscope 10 will be described that includes a rotational sensing assembly 150. Only the first handle half shell 21 is shown in FIG. 9B to provide visibility into the interior of the handle 12. Additionally, a portion of the first handle half shell 21 has been cut away.

[0066] Shown in FIG. 9B is an enclosure 431 for a printed circuit board (PCB) containing electronic components for processing image data from an image sensor at the tip of the shaft and, optionally, for providing power to a light source (e.g., an LED) at the tip of the endoscope shaft. The enclosure 431 is optional, as the PCB may also or additionally be encased in a waterproofing material. The waterproofing material may be a suitable potting material, such as Parylene or other chemical vapor deposited polymer, that coats and protects the individual electronic components mounted on the PCB. Also shown is a magnet 51 included in the first handle half shell 21. The printed circuit board within the enclosure 431 may include one or more magnet position sensors 430g, such as, for example, a Hall Effect sensor or sensor arrangement. As discussed above in connection with FIG. 6, the first handle half shell 21 and the second handle half shell 23 each include one or more magnets 51 in some embodiments. In one embodiment, two magnets 51 are positioned opposite each other in each half of the handle base section 16. As the handle proximal section 16 rotates relative to the handle distal section 30, the magnet 51 moves relative to the housing 431 and the enclosed printed circuit board. A magnet position sensor 430g on the printed circuit board can detect the relative position of the magnet 51 by the change in magnetic field strength and position as the magnet moves relative to the printed circuit board. In one embodiment, a single three-axis position sensor is used to sense the magnet 51. Data from one or more sensors is communicated to a controller or processor which converts the sensor data into the relative position of the handle proximal section 16 relative to the handle distal section 30 (and thus relative to the position of the optical sensor or camera at the tip of the endoscope shaft). Thus, the displayed image of the camera's field of view can be rotated to a desired orientation without actually moving the camera at the tip of the endoscope shaft.

[0067] Referring now to FIG. 10A, in one embodiment, the insertion section 14 of the endoscope 10 includes a conduit 157 through which an action or function is performed. In industrial or medical applications, this conduit 157 may be used to pass instruments (such as graspers, forceps, clamps, wire baskets, dilators, knives, scissors, magnetic pickups, and other instruments) to manipulate an object at the distal end of the insertion section 14. Fluids (gases or liquids) may also be passed between an external source and the space in which the insertion section 14 is located. In medical applications, such conduits 157 may be used to insufflate and evacuate body cavities, irrigate spaces with liquids, and aspirate liquids and / or airborne particles. The conduit 157 may optionally carry utility components, such as light transmission, information transmission, power transmission, and mechanical control components, which helps conserve space within the insertion section 14 and reduce the overall diameter of the insertion section 14. Light transmission components include, for example, optical fiber bundles, ribbons, light conductors, light-emitting elements, and / or the like. Communication components include, for example, electrical cable bundles or ribbons connecting an imaging device or image sensor at the distal end of the insertion section 14 to an image processing unit located within the handle 12 or external to the endoscope 10. Such cables also provide power to the image sensor. Mechanical control components include, for example, push rods, pull wires, etc. that control the movement of elements near the distal end of the insertion section 14. This includes, for example, an actively flexible distal portion of the insertion section 14 that is actively bent using mechanical control components extending from the handle 12. This also includes, for example, a rotating camera or camera mount at the distal end of the insertion section 14 that is actively moved using mechanical control components extending from the handle 12.

[0068] In one embodiment, a fluid-carrying conduit 157 within the insertion shaft or section 14 is configured to enclose utility components of the endoscope 10, such as fiber optic bundles, communication cables, and mechanical actuators. In a further embodiment, the conduit 157 may be in fluid communication with a camera assembly 350 (see, e.g., FIG. 23 ) at the distal end of the insertion shaft 14. The camera assembly 350 includes a camera sensor or imaging device that connects to a communication cable. In this case, the camera sensor and communication cable junctions and the associated lens assembly internal components are sealed against exposure to liquids present in the conduit 157. Allowing the camera assembly 350, lens assembly, communication cables, mechanical actuators (e.g., pull wires), and fiber optic cables or bundles to be "wet" conduits is feasible if at least a portion of the endoscope 10 is a disposable device, i.e., disposable after use in a medical procedure. The technical challenge of adequately disinfecting internal conduit components is thus eliminated.

[0069] Some components of the endoscope 10, particularly electronic components located within the handle section 12, are preferably kept dry. A bulkhead or barrier element 159 between the conduit 157 of the insertion section 14 and the handle 12 may allow components to pass through from the handle 12 to the conduit 157 of the insertion section 14 while preventing fluid from entering the interior space of the handle 12 from the conduit 157 (represented in FIG. 10A by line segment 155 and referred to as a "flee-through component"). The barrier 159 may include a passageway (hole, slit, etc.) through which a pass-through component 155, such as a utility component, can pass from the handle 12 to the conduit 157 of the insertion section 14. The passageway may be formed to fit fairly tightly around the outer surface of the pass-through component 155. In some embodiments, an elastomeric gasket, O-ring, or other similar element may help prevent liquid from entering the interior space of the handle 12 from the insertion section 14. The barrier 159 may comprise a wall separating the connection area between the handle 12 and the base of the insertion section 14. The connection area may be near the area where the conduit 157 connects to a conduit opening that provides an external fluid connection for the conduit 157. The barrier 159 may alternatively comprise a block through which a passageway connects a utility hole communicating with the conduit 157 on a first side of the block with one or more features (e.g., a conduit opening) on ​​a second side of the block opposite the first side of the block, or on a third side of the block (in some embodiments, generally perpendicular to the first side of the block). Passageway for cables, ribbons, wires, push rods, or other components from the handle 12 may be formed on the second side of the block opposite the first side of the block and may be aligned with the utility holes in the block. The conduit 157 may be formed from a sheath (such as the inner sheath 312 of FIG. 18 ) connected to or attached to the instrument handle 12. In some embodiments, the pass-through barrier 159 between the handle 12 and the sheath of the insertion section 14 comprises a sheath mount that supports the sheath of the insertion section 14 proximally on the handle 12 and contacts or connects to the handle 12. In some embodiments, the insertion section 14 may comprise a cannula within which the sheath is positioned.The cannula may be mounted to the handle 12 via a cutting mechanism such that the handle 12 and the sheath, including the endoscope 10, are withdrawn from the site while the cannula remains in place.

[0070] 10B , in some embodiments, the barrier 159 may include a flexible or elastomeric member 153. One or more feed-through elements 155 may extend through the flexible member 153 of the barrier 159. In some embodiments, one or both of the feed-through element 155's ports in the flexible member 153 may be sealed with a sealing member or substance 151. The sealing member or substance 151 prevents fluid flow between the conduit 157 and the handle 12. The sealing member or substance 151 holds the feed-through element 155 within the flexible member 153 against movement relative to the ports. Suitable sealing members or substances 151 may be used, such as glue, epoxy, or other adhesives. In other embodiments, the feed-through element may be solvent bonded, heat bonded, or the like, to the flexible member 153. In yet other embodiments, the flexible member 153 may be formed around the feed-through element 155 during manufacturing such that a seal is created between the feed-through element 155 and the flexible member 153.

[0071] As the pass-through member 155 moves (e.g., by actuating a pull wire to rotate the camera assembly), the flexible member 153 stretches or bends because the pass-through member 155 is fixed and prevented from displacing relative to the port in the flexible member 153 by the seal member or substance 151. Thus, ingress or leakage of fluid from the conduit 157 into the handle is substantially or completely prevented, while allowing the pass-through member 155 to move back and forth. Pass-through members 155 that remain in a fixed position and do not move do not necessarily pass through the flexible member 153. Instead, these members may pass through a rigid portion of the barrier 159, which may or may not be connected to the flexible member 153. The flexible member 153 may be made of, for example, an elastomeric member, a flexible membrane, a flexible wall, a bellows-like structure, a diaphragm, or the like.

[0072] The barrier 159 described in connection with FIG. 10A is shown in FIG. 11A and is also referred to as an inner sheath mount 160. As shown, the inner sheath mount 160 includes a tip section 161a and a base section 161b, which are separated from each other in FIG. 11A to reveal the interior of the inner sheath mount 160. As shown, the tip section 161a includes a notch 162 on each side of the tip section 161a. As shown in the exemplary embodiment of FIG. 11A, the tip section 161a A portion of the inner surface 164 (when assembled) of the inner sheath mount 160 is recessed. An irrigation or aspiration pathway tube 166 is also recessed within the distal section 161 a of the inner sheath mount 160. As shown, the irrigation pathway tube 166 is located within the recessed surface 164. The irrigation pathway tube 166 communicates at a first end with a utility bore 168. In the illustrated embodiment, the utility bore 168 is located within the recessed surface 164 approximately near the center of the distal section 161 a (although in other embodiments, the utility bore 168 need not be central).

[0073] Proximal section 161b of inner sheath mount 160 also includes notches 170 on both sides, similar to notches 162 recessed in distal section 161a. Notches 170 may extend the entire length of proximal section 161b. Notches 162 and 170 in inner sheath mount 160 are sized to accommodate the protrusion of handle distal section 30 and help hold inner sheath mount 160 in place when endoscope 10 is fully assembled.

[0074] Base section 161b may also include a raised portion 172 on its inner surface (when assembled). As shown, raised portion 172 has approximately the same outer dimensions as recessed surface 164 of tip section 161a. When assembled, raised portion 172 is pressed into recessed surface 164, joining tip section 161a and base section 161b together. In some embodiments, base section 161b may be bonded to tip section 161a using glue or other suitable adhesive between recessed surface 164 and raised portion 172. This also serves to create a hydraulic seal between the two components.

[0075] The base section 161b may include several other features. As shown, the base section 161b includes an irrigation or aspiration passageway 174. The irrigation or aspiration passageway 174 is mounted to align with the second end of the irrigation pathway tube 166 when the base section 161b is mated with the tip section 161a. When the endoscope 10 is in use, irrigation or aspiration fluid flows between the utility bore 168 and the irrigation pathway 174 via the irrigation pathway tube 166.

[0076] As shown in the exemplary embodiment of FIG. 11A, the base section 161b of the inner sheath mount 160 may include a sheath mount slit 176. As shown, the sheath mount slit 176 is oriented horizontally (see orientation shown in FIG. 11A) and is located in the base section 161b of the inner sheath mount 160 generally aligned with the utility hole 168. In alternative embodiments, the sheath mount slit 176 may be oriented differently. In the exemplary embodiment of FIG. 11A, the sheath mount slit 176 extends across the entire base section 161b at an angle generally perpendicular to the plane of the inner surface (when assembled) of the base section 161b.

[0077] The base section 161b of the inner sheath mount 160 may also include several holes 178. In the illustrated embodiment of FIG. 11A, the holes 178 are small diameter holes that run entirely through the base section 161b, allowing for the passage of pull or push cables or wires from within the handle to the tip of the endoscope 10. The base section 161b may also include an optical fiber passageway 179. In the illustrated embodiment, the holes 178 and optical fiber passageway 179 are at a perpendicular angle to the inner surface of the base section 161b (when assembled). In alternative embodiments, the holes 178 and optical fiber passageway 179 may be at different angles or have different diameters. As shown, the holes 178 are positioned around the sheath mount slit 176. When the inner sheath mount 160 is fully assembled, the sheath mount slit 176 and the holes 178 align with the utility holes 168 in the tip section 161a.

[0078] In alternative embodiments, the shape, location, size, etc. of some features of the septum, pass-through barrier, or inner sheath mount 160 may be different. The pass-through barrier or inner sheath mount 160 may have additional features or may not include certain features. In some embodiments, there are more or fewer holes 178. In some embodiments, the holes 178 may not be arranged in the spatial arrangement shown in FIG. 11A. There may be more than one irrigation passageway 174. In some embodiments, the inner sheath mount 160 may incorporate or include a gasket to further prevent fluid infiltration into sensitive areas within the handle of the endoscope.

[0079] The handle electronics section 80 (see FIG. 7A) is configured to enclose mechanical and electronic components that preferably prevent excessive fluid ingress. (Small amounts of liquid or moisture do not necessarily interfere with proper mechanical or electrical operation of the endoscope, provided that the electronic components are preferably covered with a moisture-resistant film.) The outer handle distal portion 82 (swivel control housing) is adapted to house the swing control structure and actuation cables that control movement of the endoscope shaft or the camera assembly at the tip of the insertion shaft, and is exposed to liquids with relatively minimal impact on the operation of the endoscope. Therefore, maintaining a liquid seal between the handle electronics section 80 and the outer handle distal portion 82 is even more important. A bulkhead or pass-through barrier, such as the seal member 210 shown in FIGS. 13 and 14, may be constructed to provide a tight seal (e.g., an elastomeric seal) around electrical flex cables, fiber optic bundles, or other structures passing from the distal end of the endoscope to the end of the proximal portion before exiting the endoscope. Alternatively, a pass-through barrier, such as the inner sheath mount 160 shown in FIGS. 11A and 14, may provide a simpler seal, particularly when used for pull wires or cables passing from the rotation control structure to the distal end of the endoscope shaft. Fluids entering the handle distal section 82 may be permitted to exit the housing through one or more drain holes or passageways created in the depending portion of the housing, such as passageway 108 shown in FIG. 8.

[0080] In an alternative embodiment, the pass-through barrier 159 (see FIG. 10B) between the handle distal section or pivot control housing 82 and the endoscope shaft may comprise a complete seal structure that allows movement of the pull or actuation cable from the pivot control housing to the distal end of the endoscope shaft. For example, the pass-through barrier may comprise a flexible (soft) membrane, a pleated elastomeric membrane, an accordion-shaped rubber cylinder, a bellows structure, or other displaceable membrane attached near the housing, forming a fluid-tight seal around the pass-through structure near its center, while the central region is free to move back and forth in a distal direction to allow free movement of the pass-through pivot control cable. A more complete seal in this portion of the endoscope reduces or eliminates the need for a secondary seal between the pivot control housing and the handle electronics section 80.

[0081] FIG. 11B illustrates an alternative embodiment of a barrier or penetration barrier 159 comprising a flexible member 153. As shown, the penetration barrier 159 includes a rigid structure 167 and a flexible member 153. The rigid portion or structure 167 acts as a frame to which the flexible member 153 is attached or coupled. In some embodiments, a double-molding process may be used to couple the flexible member 153 and the rigid portion or structure 167 together during manufacturing. The rigid structure 167 may include one or more mating features 173 sized to couple with cooperating mating features of the handle tip section 30 (see, e.g., FIG. 15). In some embodiments, the interaction of the mating features 173 with cooperating portions of the handle tip section 30 (see, e.g., FIG. 15) creates a seal between the penetration barrier 159 and the handle tip section (see, e.g., FIG. 15).

[0082] 11C, to facilitate the creation of such a seal, a gasket member 163 is included around the periphery of the pass-through barrier 159. Such a gasket member 163 is positioned along the outer edge 165 (FIG. 11B) of the pass-through barrier 159. Alternatively, a double-molding process may be used to attach the gasket member 163 to the pass-through barrier 159 during manufacturing. The gasket member 163 completely surrounds the rigid structure 167 and is formed of a compressible or elastomeric material.

[0083] 11B and 11C, flexible member 153 includes several pass-through elements. Several holes 178 are included in the exemplary flexible member 153. Additionally, flexible member 153 may include optional lighting or fiber optic passageways 179. Such lighting passageways 179 are not required in embodiments where lighting is provided, for example, by one or more LEDs at the tip of the endoscope shaft. Additionally, slits or slots 177 may be included in flexible member 153. In the exemplary embodiment, slits 177 extend from flexible member 153, through rigid structure 167, to the edge of pass-through barrier 159.

[0084] The pass-through elements and passageways in the pass-through barrier 159 may also be disposed in the rigid frame structure 167 of the pass-through barrier 159. For example, pass-through elements and passageways associated with fixed or immovable components are preferably disposed in the rigid structure 167 of the pass-through barrier 159. In the illustrated embodiment, the passageways 169 in the rigid structure are shown as providing passageways through the rigid structure 167.

[0085] Conduit attachment points or openings 256 may also be included in the walk-through barrier 159 . As shown, the conduit attachment opening 256 protrudes from the rigid structure 167 and optionally includes a barbed fitting onto which a flexible tube or conduit may be securely fastened. The conduit attachment point 256 may include an interior space that extends through the walk-through barrier 159. In the exemplary embodiment shown in FIG. 11B, the interior space is an irrigation or aspiration passageway 174 that transports fluid from one side of the walk-through barrier 159 to the other.

[0086] 11D , when assembled, the various pass-through components 155 pass through holes 178, passageways 179, and slits 177 in the pass-through barrier 159. Once the pass-through components 155 are installed in the pass-through barrier 159, a sealing member or substance 151 may optionally be applied to one or both of the entry and exit ports of the pass-through components 155 in the pass-through barrier 159. In the illustrated embodiment, the sealing member or substance 151 is a fastener such as an adhesive, although other embodiments may use any suitable sealing member or substance. The sealing member or substance 151 may prevent liquid from passing through the pass-through elements of the pass-through barrier 159. Additionally, when applied to the flexible member 153, the sealing member or substance 151 may secure the pass-through components 155 against movement relative to the entry ports in the flexible member 153. As a result, in this case, displacement of the pass-through components 155 causes the flexible member 153 to move back and forth as well.

[0087] FIG. 12 shows an exemplary exploded view of an embodiment of the swing control structure 100. The swing control structure 100 controls the swing of a structure, such as the camera assembly 350 (see FIG. 23) at the tip of the insertion section 14 (see FIG. 14). In alternative embodiments, the swing control structure 100 may instead or additionally be used to control the bending of a flexible section of the insertion section 14. Some embodiments of the swing control structure 100 may include gearing, motors, articulated links, dials, etc., different from the embodiments disclosed below.

[0088] The exemplary pivot control structure 100 in Figure 12 is shown in an exploded view. The fingertip contact 98, described in detail above, is shown separated from the pivot control structure 100. Optionally, as shown, the bottom surface of the fingertip contact 98 may include a number of peg protrusions 180. In the exemplary embodiment shown in Figure 12, there are four generally cylindrically shaped peg protrusions 180. (The number and shape of the peg protrusions may vary.) Additionally, the fingertip contact 98 includes a fingertip contact slot 182 seated in the underside of the fingertip contact 98.

[0089] Below the fingertip contact 98 is shown an exemplary embodiment of the pivot portion 184 of the pivot control structure 100. The top of the pivot member 184 of the pivot control structure 100 may include a slider 186. Protruding from the center of the slider 186 is a fingertip contact post 188 positioned to mate with the fingertip contact slot 182. Optionally, fingertip contact peg holes 190 may be located on each side of the fingertip contact post 188. When the fingertip contact 98 is attached to the pivot control structure 100, the fingertip contact slot 182 slides over the fingertip contact post 188 of the slider 186. Additionally, when assembled, the peg projections 180 of the fingertip contacts 98 , if present, are seated within the fingertip contact peg holes 190 of the slider 186 .

[0090] The pivot control structure 100 may interact with one or more features of the endoscope to secure or hold it in a desired orientation. As shown, the bottom surface of the slider 186 of the pivot member 184 may optionally include one or more retaining bars or detent elements 192. In another embodiment, multiple retaining bars 192 may be located on the bottom of the slider 186 and positioned to engage opposing raised features or protrusions 94 on the handle 12.

[0091] The catch bar or detent element 192 may interact with the raised features or protrusions 94 (clearly shown in FIG. 7A ) of the slide button recess 92 of the raised handle portion 32 described above. As the pivot control structure 100 is moved by the user, the spaces between the protrusions 94 can act as detents for the catch bar 192 of the slider 186 to “stay” in. This helps prevent the pivot control structure 100 from sticking or moving when the user moves the pivot control structure 100 back to a desired position. It also helps ensure that the pivot control structure 100 does not move unintentionally while the instrument is in use. In an alternative embodiment, as described above in connection with FIG. 7C , in some embodiments, the pivot control structure 100 may include an arm 97 that acts as the catch bar or detent element 192.

[0092] As shown, the pivot member 184 of the pivot control structure 100 includes a curved inner shield 194. The inner shield 194 is positioned below the slider 186 and overlaps the bottom of the handle housing when assembled. A post 196 spans the distance between the top surface of the inner shield 194 and the bottom surface of the slider 186. In some embodiments, a retaining bar 192 is located at the top of the inner shield 194. In such embodiments, the protrusion 94 described above may be located on the interior wall of the handle tip section 30 such that the protrusion 94 forms a detent for the retaining bar 192 on the inner shield 194. As described above, this allows the pivot control structure 100 to "stay" in a desired position.

[0093] Extending from the bottom surface of the inner shield 194 may be a pivot arm 198. In the illustrated embodiment, the pivot arm 198 includes two mechanical cable attachment points or holes 202. One hole 202 is mounted on one side of the pivot shaft 204 and the second hole 202 is mounted on the opposite side of the pivot shaft 204. In the illustrated embodiment, forward movement of the slider 186 retracts the mechanical cable connected to the lower hole 202 toward the proximal side, and rearward movement of the slider 186 retracts the mechanical cable connected to the upper hole 202 toward the proximal side. To provide a relatively smooth passage for optical fiber or electrical cables from the proximal end of the handle to the distal end of the handle, the pivot arm 198 may, for example, have a notch on the pivot shaft 204 (or a coaxial sleeve or hub surrounding the pivot shaft 204) so ​​that the passing cable rests freely on the pivot shaft 204. Such an arrangement allows minimal lateral or vertical displacement of the passageways.

[0094] 12 and 14, the pivot arm 198 is constructed with a pivot region 200 and a side-offset section 199 that surrounds the pivot shaft 204. Thus, a hub or sleeve (when assembled) surrounding the pivot shaft 204 is shown to act as a bearing surface against which the cables passing through rest. The lower portion of the pivot arm 198 extends downward from a location below the hub or sleeve of the pivot shaft 204. In some embodiments, the lower portion of the pivot arm 198 is optionally vertically aligned with the upper portion of the pivot arm 198, so that the machine cables connecting to the attachment points or holes 202 are also vertically aligned. In other embodiments, one or more cables (e.g., cable 250) may be routed around (or through) the hub of the pivot shaft 204 in a variety of other ways, with their paths minimally obstructed by the pivot arm 198 of the swing control structure 100.

[0095] Optionally, the secondary pass-through seal provides an additional barrier between fluids entering the housing of the handle tip section 30 and the housing of the handle base section 16, in which the electronics section 80 is housed. The seal may include holes, holes, or slits through which components, including but not limited to fiber optic bundles, electronic cables, and / or fluid tubing, may pass. The holes or slits are sized to fit snugly against these components as they pass through. In certain embodiments, the secondary pass-through seal is formed from a rubber or elastomeric material to enhance fluid sealing properties. Some embodiments may include, for example, a pass-through barrier 159 that includes a flexible member 153 but does not include a secondary pass-through seal. In such embodiments, the electronics section 80 and the outer handle distal portion 82 may be the same volume or may be connected volumes.

[0096] FIG. 13 illustrates an exemplary embodiment of a secondary seal, namely, seal member 210. As shown in FIG. 13, seal member 210 has a generally rectangular shape. As shown in FIG. 13, a first end of seal member 210 may have a first shape (e.g., rectangular) while a second end may have a second shape (e.g., rounded or rounded). This has the advantage of ensuring that seal member 210 is installed in the correct orientation during assembly. Seal member 210 may include several holes. In the exemplary embodiment, seal member 210 includes a fiber optic bundle (e.g., illumination fiber) hole 212, a flexible cable (e.g., electronic cable) hole 214, and a fluid tubing (e.g., irrigation line) hole 216. In the exemplary embodiment shown in FIG. 13 , illumination fiber holes 212, flex cable holes 214, and cleaning line holes 216 extend entirely through the seal member 210. The illumination fiber holes 212 are relatively small in diameter, matching the diameter of the fiber bundle or light guide. The flex cable holes 214 are slits that match the size and shape of the electrical flexible cables. The cleaning line holes 216 are cylindrical and have a larger diameter than the illumination fiber holes 212. The illumination fiber holes 212, flex cable holes 214, and cleaning line holes 216 extend through the seal member 210 at a substantially perpendicular angle to the front face (with respect to FIG. 13 ) of the seal member 210. In alternative embodiments, the holes in the seal member 210 may vary in number, size, or shape. In some embodiments, the seal member 210 may include additional holes, for example, for wiring to buttons.

[0097] As shown in the exemplary embodiment of FIG. 13, the seal member 210 may also include several gasket arms 218. In the exemplary embodiment of FIG. 13, the gasket arms 218 protrude away from the top and bottom surfaces of the seal member 210 near the rear edge of the seal member 210. As shown, there may be two gasket arms 218. In some embodiments, the gasket arms 218 may be straight. In the exemplary embodiment, the gasket arms 218 include two straight sections connected by an arcuate section that bends the gasket arms 218 away from the seal member 210.

[0098] FIG. 14 illustrates an exemplary embodiment of one half (30a) of the handle tip section 30. As shown, the inner sheath mount 160, the pivot control structure 100, and the seal member 210 are assembled and positioned within the illustrated half (30a) of the handle tip section 30. A flexible cable 250 (e.g., a flexible electronic communication / power cable) is also illustrated. In the exemplary embodiment shown in FIG. 14, the tip section 161a of the inner sheath mount 160 includes a sheath mount hub 252. The sheath mount hub 252 extends distally on the same axis as the utility bore 168 (see FIG. 11A). In the exemplary embodiment, the sheath mount hub 252 is hollow and substantially cylindrical. Optionally, the inner diameter of the sheath mount hub 252 is approximately the same as or slightly larger than the diameter of the utility bore 168. In the exemplary embodiment, a sheath mount hub tab 254 projects upwardly from the outer surface of the sheath mount hub 252. Sheath mount hub tab 254 is located adjacent to the surface of insertion piece 160a from which sheath mount hub 252 protrudes. Sheath mount hub tab 254 serves to orient a sheath (e.g., inner sheath 312 shown in FIG. 18) when mounted to sheath mount hub 252 and can optionally act as a fastener to secure the sheath to sheath mount hub 252 and sheath mount 160.

[0099] In other embodiments, sheath mount hub tab 254 may be located on the inner surface of sheath mount hub 252. This is preferred because it eliminates the restriction on the diameter of the sheath's conduit and eliminates the need to nest inner sheath mount hub 252 inside the sheath. As a result, faster flow through such conduits can be achieved. Alternatively, in some embodiments, sheath mount hub tab 254 may not be included. Instead, the sheath may be secured to sheath mount hub 252 with some suitable fastener (not shown).

[0100] As shown, the flexible cable 250 extends through the inner sheath mount 160. The flexible cable 250 passes through the sheath mount hub 252 into the distal section 161a of the inner sheath mount 160. The flexible cable 250 also routes through the sheath mount slit 176 in the proximal section 161b.

[0101] The base section 161b of the inner sheath mount 160 includes a fluid conduit attachment point or opening 256. The fluid conduit attachment point 256 is a hollow, generally cylindrical protrusion that extends from the base section 161b of the inner sheath mount 160 toward the right side of the page (with respect to FIG. 14). The tubing of the irrigation line 434 (see FIG. 78) skirts the outer surface of the fluid conduit opening 256, and optionally, the fluid conduit opening 256 may be barbed to help maintain an installed section of tubing. As shown, the right edge of the fluid conduit opening 256 may be chamfered in a manner that facilitates installation of a piece of tubing into the opening 256. Additionally, as shown in FIG. 14, the base end of the fluid conduit opening 256 may be tapered to a slightly larger diameter than the rest of the opening 256 surface. This acts as a barb and helps ensure that the tubing of the irrigation line 434 (see FIG. 78) cannot be easily removed once installed. In an alternative embodiment, the conduit opening 256 extends into and fits into the flush line hole 216 of the seal member 210 , and the barb / mounting location of the flush line 434 rests against the seal member 210 .

[0102] 14, the pivot control structure 100 is pivotally coupled to the handle tip section 30. As shown, a pivot shaft 204 extends through a pivot shaft hole 200 in the pivot arm 198 of the pivot control structure 100. The end of the pivot shaft 204 (or surrounding hub) inserted into the far wall of the handle tip section 30 may rest in a pivot bearing 260 that protrudes from the inner wall of the handle tip section 30. When fully assembled, the opposite end of the pivot shaft 204 may likewise rest in a pivot bearing 260 that protrudes from the inner wall of the other half (30b) of the handle tip section 30.

[0103] 14, the slider 186 and inner shield 194 of the pivot control structure 100 may be offset from one another by a post 196 a distance slightly greater than the wall thickness of the handle tip section 30. The post 196 extends through the pivot control structure notch 96, as described above. The curvature of the slider 186 and inner shield 194 is selected so that the slider 186 and inner shield 194 can move freely back and forth upon user input without interfering with the housing wall of the handle tip section 30. The length of the pivot control structure notch 96 determines the amount of pivotal displacement that the user will cause upon input to the pivot control structure 100.

[0104] In some embodiments, the walls of the swing control structure notch 96 exert a frictional force on the post 196 . In such embodiments, this frictional force allows the pivot control structure 100 to "stay" in place. In such embodiments, the pivot control structure notch 96 may be made of a high-friction material, such as rubber or other elastomeric material. In such embodiments, the pivot control structure 100 need not include the retaining bar 192 or protrusion 94 described above.

[0105] The endoscope 10 may also include a mechanical pivot actuator in the form of a pull cable or wire, a belt, or a push rod. The actuator may be an elongated member, solid, braided, or other object extending from the handle of the endoscope 10 to a moving member at the distal end of the insertion section. The elongated member may be flexible or substantially rigid. The elongated member may be round, oval (as in the example of a cable), substantially flat, or may have any shape or cross-sectional configuration. In some embodiments, the actuator is a belt.

[0106] In endoscopes with a pannable camera or camera mount at or near the distal shaft tip or insertion section, the pannable camera or camera mount may be rotated using a pull wire or push rod. In embodiments using a pull wire, a camera rotation cable may be attached to, connected to, or looped through the cable attachment holes 202. In some embodiments, two camera rotation cables may be attached to each cable attachment hole 202. In a preferred embodiment, both ends of a single camera rotation cable may be attached and looped through each cable attachment hole 202. Alternatively, a single cable may be looped through the cable attachment holes 202 near its midpoint, with both ends of the cable distally connected to a rotating camera or camera mount. The camera rotation cable may extend from the cable attachment holes 202 in the pivot arm 198 and be routed through one or more holes in the base section 160b of the inner sheath mount 160. The camera rotation cable may then pass through the utility hole 168 and through a conduit formed by the inner sheath, optionally extending parallel to the length of the electrical flex cable 250 and / or fiber optic bundle. By pivoting the pivot control structure 100, the camera rotation cable or cables connected to one of the cable mounting holes 202 are tensioned, while the cables connected to the other mounting holes 202 are slack. By attaching the camera rotation cable(s) associated with one cable mounting hole 202 to one side of the pivot point and the camera rotation cable(s) associated with the other cable mounting hole 202 to the opposite side of the pivot point, the pivot control structure 100 can be used to selectively rotate a pivot object distal to the insertion section of the endoscope. In other embodiments, a similar cable mechanism may be used to actively bend the flexible distal portion of the insertion section.

[0107] In some embodiments, the pivot arm 198 of the swing control structure 100 may be pivoted via a gearing system. In such embodiments, the fingertip contact 98, fingertip contact post 188 (see FIG. 12 ), slider 186, vertical post 196, and inner shield 194 are not required. At least a portion of the user input gear, housed within the handle tip section 30, need only protrude from the raised handle portion 34. The user input gear can rotate about a pivot axis located within the handle tip section 30. This rotation is activated by the user, for example, by the user's finger. The user input gear meshes with a pivot shaft gear located about a pivot shaft 204 for the swing arm 198 of the swing control structure 100. In such embodiments, rotation of the user input gear also rotates the pivot shaft gear and swing arm 198, acting on a swing actuator (e.g., a camera rotation wire, an actuation wire, or a pull wire) as described above. In some embodiments, there may be one or several intermediate gears between the user input gear and the pivot shaft gear to provide the desired gear reduction to suit the precision and ergonomic requirements of the movement.

[0108] In other embodiments, the pivot arm 198 may be rotated via an electric motor (e.g., a brushless motor, a stepper motor, etc.). Rotation by the motor may be controlled by one or more user input means, such as buttons 90. In embodiments including at least one button 90, the button(s) 90 may control the speed and direction of movement of the pivot arm 198.

[0109] In some embodiments, the pivot shaft 204 protrudes outside the handle tip section 30. In such embodiments, the pivot shaft 204 (or a covering hub or sleeve) may be rotated directly by a user. In some embodiments, the portion of the pivot shaft 204 that protrudes from the handle tip section 30 may include a knob, dial, crank, etc., allowing a user to simply grasp and turn the knob, dial, crank, etc. to rotate the pivot shaft 204.

[0110] As shown in FIG. 14 , the seal member 210 is positioned in a gasket recess 270. The gasket recess 270 may include a gasket arm recess 272. As described above, various components pass through the seal member 210. As shown, a flexible cable 250 connected to a printed circuit board 430a (see, e.g., FIG. 78 ) of the electronics section 80 housed in the handle base section 16 passes through the flexible cable hole 214 in the seal member 210, extends through the handle tip section 30 and the housing of the sheath mount 160, past the seal member 210, and ultimately to the insertion section of the endoscope. An irrigation line 434 (see FIG. 78 ) and a fiber optic bundle (e.g., illumination fiber 364; see FIG. 78 ) pass through the irrigation line hole 216 and fiber optic bundle hole 212, respectively, and, like the flexible cable 250, extend through the handle tip section 30. In some embodiments, the seal member 210 may not be included. Alternatively, the electronics section 80 may not be separated from the remainder of the handle 12. In such embodiments, the enclosed printed circuit board 431 (see, e.g., FIG. 15 ) may be coated or encapsulated in a protective coat or layer, such as potting. Even in embodiments including the seal member 210, the printed circuit board (see, e.g., FIG. 15 ) may be encapsulated in a protective coat or layer. Additionally or alternatively, the inner sheath mount 160 may include a flexible member 153 that forms a perimeter seal and displaces upon displacement of a pass-through component (e.g., flexible cable 250, actuator or cable, illumination fiber, etc.) passing through the inner sheath mount 160, similar to that shown in FIGS. 11B-C .

[0111] Only one half of the gasket recess 270 is shown in FIG. 14 . The other half of the gasket recess 270 is located on the opposite side (30b; see, e.g., FIG. 8 ) of the handle tip section 30, not shown. When fully assembled, the seal member 210 is captured between the two halves of the gasket recess 270. When fully assembled, the seal member 210 can prevent liquids present in the handle tip section 30 from seeping into the handle base section 16, which includes the electronics section 80 and contains the electronic components. The seal member 210 can be made of a suitably compliant (e.g., elastomeric) or other gasket material and pressed into the gasket recess 270 to ensure a tight seal. In some embodiments, the seal member 210 can be held in place using an adhesive.

[0112] FIG. 15 shows another exemplary embodiment of one half (30a) of the handle tip section 30. As shown, the pass-through barrier 159 and pivot control structure 100 are assembled and placed within the illustrated half (30a) of the handle tip section 30. A printed circuit board housing 431, encased in a protective material 752, is also shown placed within half 30a of the handle tip section 30. In an embodiment, the protruding portion 430h may be a ribbon or flexible cable 250 (see, for example, FIG. 14). The printed circuit board can communicate with components at the tip of the shaft 14 through one or more ribbon cables that pass through the bulkhead or pass-through barrier 159. These cables may or may not need to be slightly displaced back and forth through the bulkhead to accommodate rotational movement of a sensor or camera housing at the tip of the endoscope shaft, or to accommodate bending or stretching if the shaft 14 is a flexible shaft. Alternatively, the PCB may include its own extension 430h that extends through the feed-through barrier 159 and into the shaft or insert section 14. In some specific embodiments, the printed circuit board and its extension 430h are similar to those shown and described in connection with Figures 43 and 44 or 69. Sealing material 151 is shown in place around the protruding portion 430h. The feed-through barrier 159 may, in some embodiments, include a peripheral gasket 163 (see, for example, Figure 11D). The feed-through barrier 159 may be coupled to the handle tip section 30 in any number of ways, such as with adhesive epoxy, glue, solvent bonding, or a press fit.

[0113] The pivot control structure 100 of FIG. 15 is similar to that shown in FIGS. 12 and 14 . However, the pivot control structure 100 includes an arm 94 that interfaces with the protrusion 94 described above in connection with FIG. 7C . Furthermore, in this particular embodiment, the pivot arm 198 of the pivot control structure 100 does not include a pull wire attachment hole 202 (see, for example, FIG. 14 ). Instead, a fastener 203 or similar structure including an eyelet 201 is attached to or provided as part of the pivot arm 198. A pull wire may be attached to the pivot arm through the eyelet 201, and the pivot control structure 100 may be used to actuate the pull wire, such as to bend the flexible shaft or the insertion section 14 or to rotate the camera assembly of the insertion section 14. The pull wire may pass through the flexible member 153 of the pass-through barrier 159 to actuate a component of the insertion section 14.

[0114] As shown in FIG. 15 , the pass-through barrier 159 may simply be a barrier separating the insert section 14 from the electronics housed in the handle tip section 30 and base section 16. The seal member 210 (see, e.g., FIG. 14 ) may not be included. In some embodiments, the electronics section 80 may not be separated or fluidly isolated from the remainder of the handle 12. As discussed above in connection with FIG. 11C , the pass-through barrier 159 may, in some embodiments, include a peripheral gasket member 163 to provide an additional seal.

[0115] FIG. 17 illustrates an exemplary embodiment of an outer sheath, trocar, or cannula mount 300. As shown in FIGS. 16A and 16B, an outer sheath, trocar, or cannula 318 can be used to provide additional protection to components at the distal end of the insertion section or to allow the user to withdraw the insertion section of the endoscope while leaving the cannula 318 in place, allowing for later reinsertion of the insertion section of the endoscope. As shown, the cannula mount 300 may have a frustoconical shape and a proximal enlarged diameter section that forms a connector (e.g., a bayonet mount) for mounting the trocar or cannula 318 on the inner sheath 312 (see, e.g., FIG. 18). A cannula mount hole 302 may extend through the cannula mount 300 and merge with a cannula groove. The cannula or outer sheath mount hole 302 may be configured to receive and retain the cannula 318. Cannula 318 may be configured to act as a sleeve over inner sheath 312 of the insertion section that defines the shaft of the endoscope or arthroscope.

[0116] As shown, the female bayonet mount portion 304 includes two slots 306. Optionally, the slots 306 may be differently sized to ensure proper orientation of the cannula 318 with respect to the mating (male) connector at the distal end of the handle tip section 30. In some embodiments, the slot 306 in the female bayonet mount portion 304 may include serrations onto which the male bayonet mount portion 308 is spring-loaded, for example, using a Belleville spring washer. In such embodiments, the spring-loaded connection helps ensure that the two pieces (cannula 318 and handle tip section 30) are more securely fastened together.

[0117] In some embodiments, alignment features may be included in the cannula mount 300 to properly orient the cannula 318 with the cannula mount 300 during assembly, and ultimately with the inner sheath 312 when installed in the insertion section's inner sheath 312 (see, e.g., FIG. 18 ). In the exemplary embodiment of FIG. 17 , an outer sheath or trocar mount tab 310 may protrude from the inner wall of the outer sheath mount hole 302. The outer sheath mount tab 310 extends from the distal face of the female bayonet mount portion 304 and is used to align the bayonet mount 300 with the cannula 318, which has a mating slot, during assembly. Alternatively, the need for such features may be eliminated by connecting the outer sheath or cannula 318 and the cannula mount 300 with an appropriate fastener.

[0118] 18 shows a partial cutaway view of an exemplary embodiment of the pictorial surface of the handle distal section 30. The inner sheath 312 mounts to the sheath mount hub 252 of the inner sheath mount 160. The inner sheath 312 includes a sheath mount notch 314. The inner sheath mount notch 314 is sized to receive the sheath mount hub tab 254 of the sheath mount hub 252. In such an embodiment, the sheath mount hub tab 254 and the inner sheath mount notch 314 ensure that the inner sheath 312 is properly oriented on the endoscope 10.

[0119] The inner sheath 312 (and / or outer sheath, trocar, or cannula 318; see FIG. 17) may be formed from steel, hardened plastic, or other rigid, sturdy material. Alternatively, the inner sheath 312, or portions thereof, may be flexible, allowing the insertion section of the endoscope to bend as needed for insertion into a non-linear target area. In such an embodiment, the user may disengage the outer sheath or cannula 318, or the cannula 318 itself may be made from a similarly flexible material.

[0120] A male bayonet mount portion 308 is also shown in the exemplary embodiment depicted in FIG. 18. The male bayonet mount portion 308 may include two prongs 316. Referring now also to FIG. 17, the prongs 316 may be sized to fit within the legs of the L-shaped slots 306 of the female bayonet mount portion 304. The outer sheath 318 and cannula mount 300 may be coupled to the handle tip section 30 by aligning the prongs 316 with the slots 306, pressing the bayonet mount against the prongs 316, and rotating to lock the bayonet mount in place. As shown, optionally, the two prongs 316 may be sized differently so that the outer sheath or trocar mount 300 has only one possible orientation when coupled to the handle tip section 30.

[0121] 16 and 17, the outer sheath, trocar, or cannula 318 may form a sleeve to pass over the inner sheath 312. The inner diameter of the outer sheath 318 is slightly larger than the outer diameter of the inner sheath 312 to ensure a snug fit. The outer sheath 318 may include an outer sheath notch 320. The outer sheath notch 320 is sized to receive the outer sheath mount tab 310 when the endoscope 10 is fully assembled. In some embodiments, the outer sheath 318 is interference fit, glued, or otherwise fused or attached to the walls surrounding the outer sheath mount hole 302. The outer sheath mount tab 310 helps ensure the outer sheath 318 is properly oriented when the endoscope 10 is fully assembled.

[0122] Once the shaft or insertion section 14 (see FIG. 3) of the endoscope 10 has been inserted into the target area, the outer sheath 318 and outer sheath mount 300 are disconnected from the remainder of the endoscope 10, as described above. This allows the endoscope 10 to be redirected to the target area in situ, with the outer sheath 318 being used as a cannula.

[0123] Illustrated in FIG. 19 is an obturator 319 adapted for use with an outer sheath 318. During placement of the endoscope at the surgical site, the obturator is inserted into the outer sheath or trocar 318, which facilitates placement of the obturator in the desired position. The trocar is then withdrawn, and the inner sheath 312 of the shaft 14 is inserted. If the shaft 14 needs to be significantly displaced at the surgical site during surgery, the endoscope shaft 14 can be withdrawn from the patient while the outer sheath 318 remains in place, the obturator can be inserted into the outer sheath 318, and the obturator / trocar assembly can be repositioned to the desired position. Once in the proper position, the obturator can be withdrawn from the outer sheath or trocar 318, and the endoscope shaft, along with the inner sheath 312, can be reinserted into the outer sheath or trocar 318. In the illustrated example, the obturator 319 includes a rigid shaft portion 321 having a pointed or blunt end 323 and a base portion 325. Optionally, base portion 325 may include a fixed mount that mates with the fixed mount on handle tip section 30 of the endoscope handle to secure the obturator to outer sheath / trocar 318 during use. If desired, outer sheath, trocar, or cannula 318 may be used as a conduit to direct other instruments to the area of ​​interest. The outer sheath or trocar 318 can also function as a conduit to direct and withdraw fluids to the area of ​​interest.

[0124] The camera assembly housing 330, or distal working section, is shown in FIG. 20 separated from the distal end of the inner sheath 312. In this embodiment, the distal working section of the insertion section of the endoscope may be fabricated separately from the inner sheath 312 and then integrated with the distal end of the inner sheath 312 during assembly. In other embodiments, the inner sheath 312 may be fabricated as one piece, including the distal working section. In embodiments in which the distal working section is fabricated separately, the distal working section may be fabricated from a different material than the inner sheath 312. Additionally, it may be fabricated from several components that can be assembled together.

[0125] In the exemplary embodiment shown in FIG. 20 , the distal edge of the inner sheath 312 includes an inner sheath distal notch 322. The camera assembly housing 330 may include a nesting portion 332 of a shape and outer diameter suitable for insertion into the distal end of the inner sheath 312 during assembly of the endoscope 10. The nesting portion 332 may include a nesting tab 334 or other alignment feature. The nesting tab 334 is dimensioned to mate with the inner sheath distal notch 322 when the endoscope 10 is assembled. The nesting tab 334 and the inner sheath distal notch 322 help ensure proper orientation and alignment of the camera assembly housing 330 when the endoscope 10 is assembled.

[0126] The camera assembly housing 330 may further include an actuating portion 336. As shown, the actuating portion 336 of FIG. 20 includes a top cleft 338 with or without a bottom cleft 340. The top cleft 338 and the bottom cleft 340 may extend along most of the length of the actuating portion 336 of the camera assembly housing 330. A rounded tip 342 may be included at the tip of the actuating portion 336 of the camera assembly housing 330. As shown, the rounded tip 342 may optionally include a flared opening 344. The edges of the flared opening 344 may be beveled, chamfered, or rounded. In the illustrated embodiment, the flared opening 344 is contiguous with the top cleft 338. In some embodiments, the top cleft 338 and the bottom cleft 340 are flared as well.

[0127] A rounded tip 342, such as the rounded tip 342 shown in FIG. 20, has several advantages. The rounded tip 342 can facilitate insertion of the insertion section 14 into the target area of ​​the patient. In some embodiments, this can eliminate the need for an obturator. In arthroscopic applications, the contours of the rounded tip 342 allow the endoscope 10 to be inserted into tight spaces within a joint. Additionally, the rounded tip 342 can allow the operator to apply atraumatic pressure to tissue within the target area. The rounded tip 342 also acts as a protective feature for the camera assembly 350.

[0128] As shown in Figure 20, the interior wall of the actuation section 336 of the camera assembly housing 330 includes two camera mount pivot bearings 346. In the exemplary embodiment shown in Figure 20, the camera mount pivot bearings 346 protrude substantially orthogonally from the interior wall of the camera assembly housing 330. The camera assembly housing 330 may be made of steel, hardened plastic, or other suitable sturdy, rigid material.

[0129] In the exemplary embodiment shown in FIG. 20, the interior wall of the actuation section 336 of the camera assembly housing 330 includes several cable guide holes 348. In a preferred embodiment, there may be only two cable guide holes 348. One cable guide hole 348 may be located on one side wall and the other cable guide hole 348 may be located on the opposite side wall. Preferably, the cable guide holes 348 are positioned below the camera mount pivot bearing 346 so that the ends of the control cables are angled relative to the connected camera, camera mount, or camera assembly 350 (see, for example, FIG. 25). The camera assembly housing 330 may also include one or several restraining mechanisms. In the exemplary embodiment shown in FIG. 17, there are two restraining notches 349. One restraining notch 349 is located on one side wall and the other restraining notch 349 is located on the opposite side wall. As shown in FIG. 17, the restraining notches 349 are generally aligned with the cable guide holes 348. Cable guide holes 348 and restraining notches 349 are further described below.

[0130] FIG. 21 illustrates an embodiment in which the distal working section or camera assembly housing 330 and inner sheath 312 are fabricated as a single piece. Referring also to FIG. 22, a cross section of the camera assembly housing 330 of FIG. 21 is shown taken along line 20-20. In embodiments in which the distal working section or camera assembly housing 330 and inner sheath 312 are fabricated as a single piece, they may be made of steel. In such cases, the distal shape of the inner sheath 312 and camera assembly housing 330 may be created in a rolling process. For example, various slots, apertures, and other features, as described above, are later machined into the single piece. In the exemplary embodiment illustrated in FIG. 21, the camera assembly housing 330 includes only the camera mount pivot bearing 346.

[0131] It may be advantageous to create the inner sheath 312 and the camera assembly housing 330 as a single piece. Among other benefits, a single piece may be stronger. Another advantage is that the need for nesting sections is eliminated. As a result, a "weak spot" in the cross-sectional area at the juncture between the inner sheath 312 and the camera assembly housing 330 is eliminated. This has several benefits. Eliminating such a weak spot allows more space for various components, such as utility components, within the inner sheath 312 and the camera assembly housing 330. Additionally, eliminating such a weak spot may increase the flow rate of irrigation fluid within the inner sheath 312 and the camera assembly housing 330. Alternatively or additionally, the overall diameter of the inner sheath 312 and the camera assembly housing 330 can be reduced. The inner sheath 312 and the camera assembly housing 330 can also be thickened. This helps strengthen the single piece. Because the thickening strengthens the single piece, the outer sheath or cannula 318 can be made thinner. The thinner outer sheath or cannula 318 in turn allows for a larger diameter inner sheath 312 and camera assembly housing 330. That is, the cross-sectional area of ​​the conduit within the insertion section 14 can be increased without increasing the overall diameter of the insertion section 14 (consisting of the outer sheath 318, inner sheath 312, and camera assembly housing 330). The increased thickness also allows for a larger bearing surface for the camera mount pivot bearing 346, distributing the pressure acting on the bearing over a larger area.

[0132] FIG. 23 shows an assembled view of the distal end of insertion section 14 (clearly shown in FIG. 3A). Camera assembly housing 330, camera assembly 350, and outer sheath or cannula 318 are shown in FIG. 23. As shown, the rounded distal end 342 of camera assembly housing 330 protrudes past the distal end of outer sheath or cannula 318. A visual notch 352 is recessed at the distal end of outer sheath 318. Camera assembly 350 can rotate and capture images within a visual range defined by the aperture created by the combination of flared aperture 344 and visual notch 352. In some embodiments, the range of rotation is approximately 180°. When rotating and capturing images, camera assembly 350 may pivot on camera mount pivot bearing 346 (see, e.g., FIG. 20). Activating rotational capture is described further below.

[0133] In some embodiments, the outer sheath 318 may be rotated to an insertion position (not shown) when the insertion section 14 (see FIG. 3) of the endoscope 10 is inserted into a target area. In the insertion position, the optical notch 352 is not aligned with the flared opening 344 and the upper cleft 338. This protects the camera assembly 350 during insertion and, in medical applications, reduces the risk of tissue damage due to insertion of the insertion section 14. After insertion, the outer sheath 318 is rotated back to a position where the optical notch 352 is aligned with the flared opening 344 and the upper cleft 338, thereby re-enabling full visual range.

[0134] In some embodiments, a cap or window may cover or be placed over the openings defining visual notch 352 and flared opening 344 to protect camera assembly 350 . In some embodiments, the leading edges of the outer sheath 318 and visual notch 352 may be flared, rounded, beveled, etc. to help prevent injury from having sharp edges.

[0135] In the illustrated embodiment, no cap or window is used. Such an arrangement has several benefits. For example, not using a cap or window at the tip of the insertion section 14 reduces the cost of the endoscope by avoiding the use of expensive scratch- and abrasion-resistant materials, such as sapphire or specialty glass. The absence of a cap or window also eliminates unwanted reflections from the cap or window, which could affect the clarity of the images captured by the camera. Furthermore, the absence of a cap or window allows cleaning of the target area to occur through conduits in the inner sheath 312 (see FIG. 15 ) of the endoscope 10. This allows the overall diameter of the insertion section 14 to be reduced while maintaining cleaning capabilities. Furthermore, the cleaning flow within the inner sheath 312 helps to remove / clean debris from the camera assembly 350 and any attached lenses. In one example, a user can effectively clean the camera assembly 350 by rotating the camera assembly 350 between cleanings, so that the cleaning flow washes the lens assembly 354 (see, e.g., FIG. 32 ) of the camera assembly 350, flushing away debris and unwanted material. As an added benefit, the wash flow also helps cool the camera assembly 350 and associated image sensor 380 (see, eg, FIG. 65).

[0136] As shown, flared opening 344 and optical notch 352 may be sized to protect camera assembly 350 without the need for a cap or window. In the exemplary embodiment shown in FIG. 23 , flared opening 344 and optical notch 352 partially enclose camera assembly 350, recessed from the exterior surface formed by flared opening 344 and optical notch 352. Thus, flared opening 344 and optical notch 352 define a protective edge for camera assembly 350. The partial enclosure helps protect moving parts of camera assembly 350 and associated components (e.g., control cables, electrical cables, information cables, etc.) from contact with external objects during insertion of the insertion section into the target area or during use of the instrument at the target area. The flared opening 344 and the visual notch 352 expose only a small portion of the camera assembly 350 to potential damage from objects unrelated to the insertion section (e.g., medical instruments such as razors) while providing the camera assembly 350 with an unrestricted field of view, which helps ensure that the camera assembly 350 is not damaged during insertion or operation.

[0137] As the camera assembly 350 rotates, the distance between the camera assembly 350 and the outer sheath 318 changes. As a result, the amount of the outer sheath 318 that is within the field of view of the camera assembly 350 also changes. The greater the distance from the camera assembly 350 to the outer sheath 318, the more of the outer sheath 318 that is within the field of view of the camera assembly 350. Thus, the optimal amount of protection and unrestricted field of view afforded to the camera assembly 350 is achieved by varying the width of the optical notch 352.

[0138] 24 shows an alternative assembly view of the tip of insertion section 14 (clearly shown in FIG. 3A) in which visual notch 352 has a varying width, such that visual notch 352 is outside the field of view of camera assembly 350 in any angular orientation of camera assembly 350. This allows camera assembly 350 to be enclosed by outer sheath 318 to a greater extent.

[0139] Figure 25 shows yet another alternative assembly view of the tip of insertion section 14 (clearly shown in Figure 3A), including several openings 353 separated by a bar 351 in predetermined locations, similar to that shown in Figure 22. Such an arrangement can provide additional protection for camera assembly 350. Bar 351 may be made of a transparent material so that it minimizes obstruction of the camera assembly's 350 field of view. In other embodiments, bar 351 may be made of an opaque material, for example the same material as outer sheath 318.

[0140] Alternatively, a cover member (not shown) may be implemented at the tip of the shaft or insertion section 14 (see, e.g., FIG. 1) that partially covers the visual notch 352 (see FIG. 24) or one or more openings 353 (see FIG. 25). Such a cover member may be, for example, a cage that provides additional protection for the camera assembly 350 while allowing a substantially clear view of the camera assembly 350. In some embodiments, the cover member may include an optically clear partial shroud.

[0141] In another embodiment, the camera assembly may be mounted at the tip of the endoscope shaft without the protective tip structure 342. While the tip structure 342 provides some protection for the camera assembly, it may also obstruct the camera's full field of view at all positions within its range of motion. An example of an alternative arrangement is shown in FIG. 26. In this example, the sensor or camera housing 500 itself is constructed to provide sufficient protection for the enclosed camera assembly (e.g., lens and sensor assembly). For example, the camera housing 500 may be constructed at least in part from steel or a similarly durable material, and at least the outer shell of the housing may be constructed to withstand physical disturbances when the insertion tip of the endoscope is inserted or repositioned. The exposed portion of the housing 500 preferably has an outer spherical, spheroidal (oblate, prolate, etc.), or dome-shaped shape, or other rounded shape that provides rounded edges to prevent tissue damage when the endoscope shaft is inserted or moved within the surgical site. By placing the camera assembly in a reinforced, at least partially rounded housing 500 at the distal end 550 of the endoscope shaft 14, an unobstructed view of a larger portion of the surgical site can be obtained without placing the camera assembly in a position that risks damaging it or nearby tissue. In this example, the sensor or camera housing 500 can be rotated about an axis 504 using a pull wire 502, cable, or band to orient the optical axis of the camera assembly (lens and sensor assembly) from an angle less than 0° to an angle greater than 90° relative to the longitudinal axis of the distal end 550 of the endoscope shaft 14. When the sensor or camera assembly is positioned to have a wide field of view, the range of motion of the camera housing can be arranged to provide an optical axis range of motion between approximately 35° and 135° relative to the longitudinal axis at the distal or insertion end of the endoscope shaft. This arrangement allows the operator to view the surgical site directly opposite the distal end of the endoscope shaft, as well as view areas of the surgical site behind the distal end of the endoscope. This arrangement also allows the operator to rotate the camera assembly through a 90° or greater position to clean the surface of the camera assembly and remove accumulated surface debris.

[0142] The camera assembly 350 is shown in isolation in FIG. 32. This arrangement is more suitable for the insertion section or shaft shown in FIG. 25 due to the physical protection provided by the rounded tip 342 at the working end of the distal endoscope shaft shown in FIGS. 18-23. As shown, a ribbon or flexible cable 250 is coupled within the camera assembly 350 and provides a power and data communication path to and from the camera assembly 350. The camera assembly 350 may be any suitable structure configured to support a camera on the endoscope 10. In embodiments in which the camera assembly 350 rotates, the camera assembly 350 may include a pivot actuator mounting feature.

[0143] As shown, camera assembly 350 includes lens assembly 354. As shown, lens assembly 354 is held in place between upper camera housing 356 and lower camera housing 358. When assembled, upper camera housing 356 and lower camera housing 358 are joined together by suitable means, such as, but not limited to, glue, adhesive, ultrasonic welding, press-fitting of cooperating features, etc. In the exemplary embodiment of FIG. 32, lens assembly 354 protrudes through lens opening 360 in upper camera housing 356 to provide a clear view of the anatomical region of interest. In some embodiments, at least a portion of the lens assembly 354 protrudes from the top of the camera housing 356 .

[0144] The camera housing top 356 may include several other cavities. In the embodiment shown in FIG. 32 , the camera housing top 356 includes two elongated light-projecting cavities 362 located on the left and right (as viewed in FIG. 32 ) sides of the lens opening 360. The cavities 362 are adapted to accommodate fiber optic end elements (or optionally, other light sources, such as LEDs) to project light onto a target area consistent with the direction in which the camera lens or lens assembly 354 is pointed. In the example shown, the right elongated cavity 362 is trapezoidal in shape, and the left elongated cavity 362 is diamond-shaped. In alternative embodiments, the cavities 362 have different shapes, e.g., both are oval-shaped. In alternative embodiments, there may be additional cavities 362. For example, some embodiments may have three cavities 362 arranged in a triangular configuration around the lens opening 360. Some embodiments may have four cavities 362 arranged in a rectangular, square, circular, or oval configuration around the lens opening 360.

[0145] One or more illumination sources for the endoscope 10 may be contained at least partially within the endoscope 10. The illumination source illuminates the field of view of the camera of the camera assembly 350 regardless of the rotated position of the camera assembly 350. In some embodiments, the illumination source may be within the camera assembly 350. In the exemplary embodiment of FIG. 32, the illumination source is a number of optical fibers (e.g., fiber optic fibers) 364 that can transmit light from an illumination element (not shown) external to the endoscope 10. The optical fibers 364 may be routed and coupled within a cavity 362 in the camera housing top 356. In the exemplary embodiment, the optical fibers 364 are routed within the cavity 362 in the camera housing top 356. The number of optical fibers 364 may vary in most embodiments. The light emitting ends of the optical fibers 364 may be approximately flush with the top surface of the camera housing top 356. In some embodiments, other illumination sources, such as LEDs, may be used. The optical fiber 364 or other illumination source is configured to provide a desired color or intensity of light at a predetermined illumination angle.

[0146] As shown in the exemplary embodiment of Figure 32, the camera assembly 350 may include a pivot pin 366. The pivot pin 366 is pivotally coupled to the pivot pin bearing 346 of the camera assembly housing 330 (see Figure 20). The pivot pin 366 may project approximately perpendicularly from the longitudinal axis of the insertion section. The pivot pin 366 allows the camera assembly 350 and the optical fiber 364 (or other illumination source) to pivot in line with one another.

[0147] Camera assembly 350 may also include the pivot actuator mounting features described above. In the exemplary embodiment of Figure 32, camera assembly 350 includes upper cable mounting feature or anchor point 372 and lower cable mounting feature or anchor point 374. Upper cable mounting feature 372 and lower cable mounting feature 374 are further described below.

[0148] As mentioned above, the endoscope 10 may also include one or more pivot actuators. The pivot actuator may be an elongated member used to pull or push the camera assembly 350 through the pivot mounting features. In the illustrated example, the pivot actuator is often a pull cable or wire, but the pivot actuator is not limited to a cable-like structure. The elongated member may be flexible or substantially rigid. The elongated member may be round (as in the cable example), flat, or have other shapes or cross-sections. In some embodiments, the pivot actuator may be a belt having a path around cooperating connecting features that frictionally engage or interlock with features on the inner circumference of the belt. In a preferred embodiment, the pivot actuator may be used solely to provide a pulling surface. Such an arrangement allows for a smaller diameter insertion section 14 (see FIG. 3A) because the pivot actuator does not need to be thick or cross-sectionally strong enough to prevent substantial lateral displacement within the insertion section 14 in response to the force pushing on the pivot actuator, or be confined within a support track. A pull wire or cable arrangement also allows for a greater range of materials to be used to construct the pivot actuator because the material only needs to have tensile strength, not compressive stiffness.

[0149] As shown in FIG. 33 , camera rotation cables are connected to the camera assembly 350 above and below the pivot pin 366. In the illustrated embodiment, they are shown relatively slack for ease of illustration. In operation, one or more camera rotation cables on one side of the pivot pin 366 are in tension, and one or more camera rotation cables on the other side of the pivot pin 366 are slack. As described in detail above and now referring to FIG. 14 , the camera rotation cables are attached near the cable attachment holes 202 of the pivot control structure 100 (see FIG. 14 ). In some embodiments, the camera rotation cables are attached to respective cable attachment holes 202. The camera rotation cables extend from the cable attachment holes 202 of the pivot arm 198 and are routed through one or more holes 178 in the base section 161 b of the inner sheath mount 160 (see FIG. 11A ). The camera rotation cables then extend through the utility holes 168 in parallel with the flexible cables 250. Because the cable mounting holes 202 are located on opposite sides of the pivot point of the pivot arm 198, pivoting the pivot control structure 100 will slacken the camera rotation cable attached to one of the cable mounting holes 202 and tighten the camera rotation cable attached to the other. By attaching the camera rotation cable associated with one cable mounting hole 202 to the camera assembly 350 on one side of the pivot pin 366 and attaching the camera rotation cable associated with the other cable mounting hole 202 to the opposite side of the pivot pin 366, the pivot control structure 100 can be used to selectively rotate the camera assembly 350. In some embodiments, pushing the pivot control structure 100 forward may rotate the camera assembly 350 forward, and pulling the pivot control structure 100 rearward may rotate the camera assembly 350 rearward. In some embodiments, when assembled, all of the camera rotation cables may be in tension.

[0150] In a preferred embodiment, only one camera rotation cable may be attached to each cable attachment hole 202 of the pivot arm 198 (see FIG. 14 ) of the swing control structure 100. In such an embodiment, there may be an upper camera rotation cable 368 and a lower camera rotation cable 370. The upper camera rotation cable 368 and the lower camera rotation cable 370 extend to the camera assembly 350 as described above. The upper camera rotation cable 368 wraps around an upper cable attachment feature 372 of the camera assembly 350 and returns to the same cable attachment hole 202 of the swing arm 198 from which it extends. The lower camera rotation cable 370 wraps around a lower cable attachment feature 374 of the camera assembly 350 and returns to the same cable attachment hole 202 of the swing arm 198 from which it extends. Alternatively, the camera rotation cables may be looped through the attachment holes 202 with both ends distally terminating on cable attachment features.

[0151] In the illustrated embodiment, the upper cable attachment feature 372 (shown most clearly in FIG. 32 ) includes two holes in the camera housing top 356. The upper cable attachment feature 372 also includes a recess connecting the two holes. The upper camera rotation cable 368 enters one of the two holes, follows the recess, exits the other of the two holes, and returns to the cable attachment hole 202 (see FIG. 14 ) in the handle. The lower cable attachment feature 374 (shown most clearly in FIG. 32 ) includes two attachment points or hooks protruding from opposite sides of the camera housing bottom 358. The lower cable attachment feature 374 is on the opposite side of the pivot pin 366 from the upper cable attachment feature 372. The lower camera rotation cable 370 wraps around one attachment point or hook in the lower cable attachment feature 374, hooks onto the second attachment point or hook in the lower cable attachment feature 374, and then returns to the cable attachment hole 202 in the handle's pivot arm 198. In alternative embodiments, the upper cable attachment feature 372 and / or the lower cable attachment feature 374 may comprise, for example, eyelets, prongs, pegs, or the like.

[0152] The upper camera rotation cable 368 and the lower camera rotation cable 370 may be made from any suitable cable or wire-like material, whether metallic, synthetic polymeric, braided, monofilament, etc. The upper camera rotation cable 368 and the lower camera rotation cable 370 may be, for example, metal or plastic strips or bands that bend laterally. In a preferred embodiment, the upper camera rotation cable 368 and the lower camera rotation cable 370 are made from a material that resists stretching under tension. Wrapping one camera rotation cable from each cable mounting hole 202 in the pivot arm 198 (see FIG. 14) around the pivot actuator mounting feature of the camera assembly 350 is preferred because it ensures that the camera rotation cable leading to the camera assembly 350 is under the same tension as the camera rotation cable returning from the camera assembly 350. Stretching of any one cable over time or with use will have the same effect on both halves of the cable.

[0153] In a preferred embodiment, the upper camera rotation cable 368 is routed through one of the cable guide holes 348 in each interior wall of the camera assembly housing 330. As shown in FIG. 33 , the upper camera rotation cable 368 passes through one of the cable guide holes 348 and continues to extend along the outside of the camera assembly housing 330 toward the camera assembly 350. In some embodiments, there may be a recess or groove recessed into the outside of the camera assembly housing 330 along the path taken by the upper camera rotation cable 368. In such embodiments, the recess or groove acts as a guide. The recess or groove also helps to ensure that the upper camera rotation cable 368 is generally flush with the outer surface of the camera assembly housing 330. This helps to ensure that the outer sheath 318 (see FIG. 23 ) does not catch on the upper camera rotation cable 368 and inhibit its movement during use of the fully assembled endoscope 10.

[0154] As shown in FIG. 33 , upon re-entering the interior of camera assembly housing 330, upper camera rotation cable 368 is tensioned through captive notch 349. Upper camera rotation cable 368 then leads to upper cable attachment feature 372, as described above. On its return to cable attachment hole 202 (see FIG. 14 ), upper camera rotation cable 368 leads from upper cable attachment feature 372 to captive notch 349 in the opposite wall (see FIG. 20 ) of camera assembly housing 330. Upper camera rotation cable 368 then follows the outer surface of the front wall of camera assembly housing 330, optionally following a recess or groove in the wall. Upper camera rotation cable 368 then re-enters the interior space of camera assembly housing 330 and returns to cable attachment hole 202 in the handle, as described above.

[0155] The terminal segment of the pivot actuator (e.g., wire or cable) proximal to its connection to the pivot assembly at the tip of the insertion section may be constrained at a fulcrum or support point that redirects the actuator and may be at an angle relative to the longitudinal axis of the insertion section or shaft. For example, an increased pivot range for pivoting the camera assembly 350 can be achieved by pulling the upper camera rotation cable 368 through the cable guide hole 348 and the restraining or redirecting notch 349, and then bending it toward the upper cable attachment feature 372 opposite the pivot pin 366. Thus, an image sensor with a predetermined or fixed angular field of view can be rotated to enable a rotating field of view, extending the viewable area to a range of up to 180°. In other embodiments, rotation may be performed to achieve a viewable area greater than 180°. As shown in FIG. 33 , pulling the cable as described places the cable at a more precise angle of incidence to the attachment point 372, thereby enabling a greater degree of reverse rotation of the camera assembly 350.

[0156] In some embodiments, and referring now also to FIG. 34 , the camera assembly 35 can rotate more than 180° due to the presence of two sets of cable guide holes 348. Note that the lower set of cable guide holes 348 controls the upper camera housing section, and the upper set of cable guide holes 348 controls the lower camera housing section. The angle through which the camera assembly 350 can rotate is a function of the angle that the distal end of the camera rotation cable makes with respect to the proximal end of the camera rotation cable or insertion section (or endoscope shaft) 14 (see FIG. 1 ). The greater the angle that the distal end of the camera rotation cable makes with respect to the longitudinal axis of the insertion section 14 as it re-enters the exterior of the camera assembly housing 330, the greater the range of motion afforded to the camera assembly 350. In a preferred embodiment, the re-entry surface or redirection guide of the camera assembly housing 330 is positioned so that the angle of the distal end of the camera rotation cable is within a range of approximately 30-90° with respect to the longitudinal axis of the insertion section 14. In other embodiments, the rotational range of motion of the camera assembly 350 can be improved while limiting frictional resistance of the camera rotation cables by positioning the cable re-entry surfaces or guides so that the distal ends of the camera rotation cables are angled within a range of approximately 45-80°. As noted above, in such embodiments, only a pulling force is required to bend one of a pair of complementary cables 368, 370 upward at the leading or distal end of the insert section 14, one cable until it attaches to an upper cable attachment feature 372, and one cable downward at the leading or distal end of the insert section 14 until it reaches a corresponding lower cable attachment feature 374. With this arrangement, neither actuation cable needs to move laterally or transversely for most of the length of the insert section 14, thereby reducing the interior space of the insert section 14 and helping to minimize its overall diameter.

[0157] In some embodiments, the constraint or redirecting notch 349 may not be used. Some embodiments use another type of constraint or redirecting element integrated into the wall of the distal end of the insertion section. In some embodiments, the constraint may be a pulley or eyelet. Pins, pegs, posts, etc. may also be used as constraints or redirecting elements. In some embodiments, a comb-shaped or curved protrusion may be formed on the side wall of the camera assembly housing 330. The comb may extend into the interior space of the camera assembly housing 330 so that there is a space between the comb and the interior wall of the camera assembly housing 330. The upper camera rotation cable 368 may pass through this space and be constrained by the comb. In many embodiments, the contact point between the constraint and the cable is preferably smooth or has a radius of curvature to minimize the possibility of frictional damage to the camera rotation cable during operation of the endoscope. In some cases, the constraint may be coated with a material with a low coefficient of friction, such as Teflon.

[0158] In some embodiments, the lower camera rotation cable 370, instead of the upper camera rotation cable 368, may be constrained in a similar manner as described above, allowing a greater range of rotation of the camera assembly 350 in one direction than in the other. As shown in Figure 34, in some embodiments, both the lower camera rotation cable 370 and the upper camera rotation cable 368 may be constrained or redirected while allowing a greater range of rotation.

[0159] 34 shows outer sheath 318, camera assembly housing 330, and camera assembly 350. There are two sets of cable guide holes 348: one set above the longitudinal axis of camera assembly housing 330 and one set below the longitudinal axis of camera assembly housing 330. There are also two captive notches 349: one is located above the longitudinal axis of camera assembly housing 330 and the other is located below the longitudinal axis of camera assembly housing 330.

[0160] Improved mechanical advantage of the camera rotation cable is obtained by placing a redirecting element (e.g., a notch) on one side (e.g., below) of the longitudinal axis of the camera assembly 350 and connecting the end of the camera rotation cable to a point on the camera assembly 350 on the opposite side (e.g., above) of the pivot axis of the camera assembly 350.

[0161] As shown, upper camera rotation cable 368 passes through one of the cable guide holes 348 below the longitudinal axis and re-enters camera assembly housing 330 at a restraining notch 349 below the longitudinal axis. Upper camera rotation cable 368 then redirects toward upper cable attachment feature 372 of camera assembly 350. In FIG. 34 , lower camera rotation cable 370 passes through cable guide hole 348 above the longitudinal axis of camera assembly housing 330. Lower camera rotation cable 370 then passes through restraining notch 349 above the longitudinal axis of camera assembly housing 330 to re-enter camera assembly housing 330. Lower camera rotation cable 370 then redirects toward lower cable attachment feature 374. Upper camera rotation cable 368 and lower camera rotation cable 370 may be wrapped around a portion of camera assembly 350 depending on the position to which camera assembly 350 is pivoted. In FIG. 34, the lower camera rotation cable 370 is shown wrapped around a portion of the camera assembly 350 .

[0162] In some embodiments, a belt 384 is used as the pivot actuator. An embodiment including a belt 384 as the pivot actuator is shown in FIG. 35. As shown, the belt 384 wraps around one of the pivot pins 366 of the camera assembly 350. In some embodiments, the pivot pin 366 may be elongated such that at least a portion of the pivot pin 366 extends from the pivot bearing 346. In such embodiments, the belt 384 wraps around this portion of the pivot pin 366, as shown in FIG. 35. In some embodiments, the shape of the camera assembly 350 may be different such that the belt 384 wraps around the camera assembly 350. For example, the camera assembly 350 may have a substantially cylindrical shape. The substantially cylindrical shape of the camera assembly 350 may be coaxial with the pivot pin 366. In such embodiments, the belt 384 wraps around the camera assembly 350.

[0163] In some embodiments, the surface over which belt 384 wraps may be recessed (e.g., V-shaped) relative to the side surfaces. This helps to keep belt 384 in place during operation. In other embodiments, other types of guides may be used. For example, the surface over which belt 384 wraps may be flanked by two walls that keep belt 384 in place during operation.

[0164] Belt 384 may be formed of a high-friction material to prevent belt 384 from slipping on the surface around which it is wrapped when driven. In some embodiments, belt 384 may have a roughened surface or be toothed to help grip or securely engage camera assembly pivot pin 366 (which may be geared). Use of belt 384 allows for a wide range of pivoting of camera assembly 350, eliminating the need to laterally redirect the pull cable pivot actuator within insertion section 14 to achieve an equivalent range of motion of camera assembly 350. This allows for a smaller diameter insertion section 14.

[0165] In embodiments using a belt 384, the belt 384 may be configured to be driven by displacement of the pivot control structure 100 (see FIG. 14 ). In some embodiments, the end of the belt 384 opposite that which wraps around the camera assembly 350 or the pivot pin 366 may wrap around the pivot shaft 204 of the pivot control structure 100. In such embodiments, rotation of the pivot shaft 204 drives the belt 384. The portion of the pivot shaft 204 around which the belt 384 wraps may be relatively large in diameter. This is preferable because only a small pivotal displacement of the pivot shaft 204 is required to move the belt 384 relatively large. In embodiments in which the belt 384 includes teeth, the teeth of the belt 384 may intermesh with gears disposed on the pivot shaft 204 of the pivot control structure 100. In such embodiments, rotation of the pivot shaft 204 and the gears on the pivot shaft 204 drives the belt 384. When belt 384 is driven, the movement of belt 384 exerts a driving force on camera assembly 350, causing camera assembly 350 to pivot.

[0166] In other embodiments, the pivot actuator may be a rack-and-pinion type rack. In such embodiments, the pivot pin 366 of the camera assembly 350 includes a toothed portion. The toothed portion of the pivot pin 366 may be a pinion gear that intermeshes with the rack of the pivot actuator. As the rack is displaced longitudinally within the insert section 14, this movement is translated into rotation of the camera assembly 350 via the toothed pinion portion of the pivot pin 366. While such embodiments do not rely solely on a pulling force to rotate the camera assembly 350, the pivot actuator still does not require lateral displacement of the actuator within the insert section 14. In certain embodiments, a push-pull rack-type actuator nevertheless requires certain features (e.g., stiffness, thickness) or is constrained in a path to prevent lateral or side-to-side bending while a compressive force is applied to the rack.

[0167] In yet another approach using one or more camera rotation cables, a similar range of rotation can be achieved without the need to route the camera rotation cables through various features included in the camera assembly housing 330. This is preferable because it allows for a smaller diameter of the insertion section 14 (see FIG. 1). Furthermore, the camera assembly housing 330 for such an embodiment does not require drilling (e.g., cable guide holes 348 in FIG. 20) or redirecting elements / constraints (e.g., constraint notch 349 in FIG. 20), thereby facilitating the manufacture of the camera assembly mount. In such an embodiment, the camera assembly housing 330 and inner sheath 312 may be used, as shown in the exemplary embodiment of FIG. 21.

[0168] In such embodiments, camera assembly 350 may include one or more winding mechanisms or surfaces 1400. The winding mechanism is configured to at least partially wrap a distal portion of the camera rotation cable around the housing of camera assembly 350. The distal connection or attachment point of the camera rotation cable is mounted on the camera assembly housing distal to the winding mechanism. The winding mechanism preferably has a curved, somewhat concave surface that wraps partially or completely around a portion of the camera assembly housing. Thus, in various embodiments, the camera rotation cable may only partially wrap around the housing or may make one or more complete loops around the housing. A longer winding mechanism provides a wider range of rotation for the camera assembly. During operation, the associated camera rotation cable is wound or unwound on the winding mechanism 1400. The winding mechanism 1400 can increase the pivot range of the camera assembly 350. The winding mechanism 1400 can apply a more consistent torque to the camera assembly 350 during rotation. The winding mechanism 1400 can be configured to create a moment arm of desired or varying length. Additionally, locating the winding mechanism 1400 circumferentially away from the axis of rotation of the camera assembly helps the camera rotation cable efficiently generate rotational torque.

[0169] A series of Figures 36-40 conceptually illustrate a camera assembly 350 including a winding mechanism 1400 in several rotational positions. As shown, the winding mechanism 1400 may include an arcuate section and a straight section. The arcuate section is shaped to have a radius of curvature extending from the pivot axis of the camera assembly 350. The straight section of the winding mechanism 1400 is angled to act as a torque-increasing feature. Additionally, the straight section of the winding mechanism 1400 allows the camera housing 355 to be made with more material (material that would otherwise have to be removed to continue the arcuate section), thereby increasing the structural integrity of the camera housing 355. This is especially important in embodiments where the camera assembly 350 must fit into a very small space and therefore be made with a very small form factor.

[0170] 36, upper camera rotation cable 368 is wound around take-up mechanism 1400. A pulling force exerted by upper camera rotation cable 368 creates a torque about the pivot axis of camera assembly 350, causing camera assembly 350 to rotate in a clockwise direction. Additionally, the straight portion of take-up mechanism 1400 creates a long moment arm, thereby increasing the torque available for a given amount of pulling force.

[0171] As the camera assembly 350 rotates to the position shown in Figure 37, the upper camera rotation cable 368 begins to unwind from the take-up mechanism 1400. As the force continues to act and the camera assembly continues to rotate, the upper camera rotation cable 368 continues to unwind from the take-up mechanism, as shown in Figure 38. When fully unwound, the point at which the upper camera rotation cable 368 leaves the take-up mechanism 1400 will be located on an arcuate section of the take-up mechanism 1400 (as shown in Figures 37 and 38). In one embodiment, all points on the arcuate section of the take-up mechanism 1400 may be equidistant from the pivot axis.

[0172] In the illustrated embodiment, as tension continues to be exerted by the upper camera rotation cable 368, the camera assembly 350 will continue to rotate until the upper camera rotation cable 368 is no longer in contact with the surface of the reel mechanism 1400, as shown in FIG. 39 . The camera assembly 350 will then continue to rotate until the force pulling on the upper camera rotation cable 368 approaches and coincides with the axis of rotation of the camera assembly 350. This position is shown in FIG. 40 . As will be appreciated by those skilled in the art, the camera rotation cable 368 may be wrapped more than once around the reel mechanism 1400 to increase the amount of rotation produced using the camera rotation cable 368. The angle at which the camera rotation cable 368 is wrapped around the contact surface of the camera assembly 350 allows for a rotation range of the camera assembly 350 in excess of 90°. The rotation angle of the camera assembly 350 will then be limited only by the slack and flexibility of the attached electrical flex cable and / or fiber optic bundle.

[0173] In one embodiment, the camera rotation cable and take-up surface are configured to allow the camera assembly 350 to rotate to a position between about 90° and about 120° from the longitudinal axis of the distal endoscope shaft, with the lens surface of the camera assembly facing at least partially toward the proximal end of the endoscope shaft. In this position, dirt and contaminants on the lens surface can be washed away by cleaning fluid flowing distally down the endoscope shaft.

[0174] To rotate camera assembly 350 from the position in Figure 40 to the position shown in Figure 38, a pulling force is applied through lower camera rotation cable 370. In some embodiments, lower camera rotation cable 370 may be associated with a retraction feature. For example, the corners or edges of camera assembly 350 around which lower camera rotation cable 370 retracts may be rounded.

[0175] 41 shows a top perspective view of a particular exemplary embodiment of a camera assembly 350 including a take-up mechanism 1400. The camera assembly 350 includes a lens assembly 354. The lens assembly 354 is disposed within a camera housing 355. The take-up mechanism 1400 may be recessed into the side of the camera housing 355, as shown. The take-up mechanism 1400 of the exemplary embodiment includes an arcuate portion and a straight portion. The arcuate portion of the take-up mechanism 1400 is shaped to have a radius of curvature extending from the center of the pivot pin 366 or pivot axis.

[0176] 41 , the wall into which the winding mechanism 1400 is recessed may include a first cavity 1402. The camera housing 355 may also include a second cavity 1404. The second cavity 1404 may run from the top of the camera housing 355 to the bottom of the camera housing 355.

[0177] As shown, only one camera rotation cable 1406 may be used. The camera rotation cable 1406 extends through both the first cavity 1402 and the second cavity 1404 of the camera housing 355. One end of the camera rotation cable 1406 is attached to a cable attachment hole 202 in the pivot arm 198 (see FIG. 14 ). The other end of the camera rotation cable 1406 is attached to another cable attachment hole 202 in the pivot arm 198. In some embodiments, the camera rotation cable 1406 may be rigidly attached to the camera housing 355 in one or more locations. For example, a glue adhesive may be placed in cavity 1402 or one of cavities 1404. This ensures that the camera rotation cable 1406 does not slide or move across the surface of the camera housing 355 during operation. Additionally, in some embodiments, the camera rotation cable 1406 may be knotted in one or more locations. For example, the camera rotation cable 1406 may be pulled across one of the first cavity 1402 and the second cavity 1404, tied, and then pulled across the other of the first cavity 1402 and the second cavity 1404. Preferably, the width of the knot is large enough so that it does not fit into either the first cavity 1402 or the second cavity 1404. Such a knot also helps to prevent the camera rotation cable 1406 from slipping or moving across the surface of the camera housing 355 during operation.

[0178] As will be appreciated by those skilled in the art, the embodiment shown in Figures 41-43 can be easily modified to use two camera rotation cables. One camera rotation cable terminates in or at the first cavity 1402 and is rigidly attached to the camera housing 355. A second camera rotation cable terminates in or at the second cavity 1404 and is rigidly attached to the camera housing 355.

[0179] As an alternative example, FIG. 27 shows how a pull wire 502 operated by the pivot control structure 100 is wrapped around or attached to a rounded, dome-shaped sensor or camera housing 500 at the distal end of the endoscope shaft 14. The inner sheath 312 has been removed for clarity. In this example, the camera housing 500 includes a generally circumferential slot 501 (preferably located approximately in the center of the two assembled housing halves) offset to one side of the housing 500 so as not to interfere with the lens / camera assembly contained within the housing 500. The pull wire 502 is retained within the slot 501 and secured to the housing 500 by a recess 503. A knot in the pull wire 502 fits into the recess 503 and acts as an attachment point for rotating the housing 500 as the pull wire 502 is moved back and forth along the endoscope shaft. Optionally, a small amount of adhesive may be used to provide additional attachment means during endoscope assembly. In a preferred embodiment, the pull wire 502 comprises Kevlar® thread, which has high longitudinal strength and resistance to stretching. Other wire types may include steel (braided or single strand), nylon, or other materials with suitable strength and resistance to stretching.

[0180] The rounded sensor housing 500 shown in Figures 26 and 23.2 can enclose a more simply configured lens 510 and image sensor 512, and a light source for illuminating the surgical site can be located near the sensor / camera housing 500 without needing to be mounted on the housing itself. Figures 28 and 29 show how the rounded or dome-shaped sensor / camera housing 500 can be made from two sections 500a and 500b. Each of these sections is molded or machined to have internal cutouts for placement of an extension PCB 514 or flexible cable tip, an associated sensor 512, and an associated sensor 512 (e.g., CMOS or CCD) and appropriate lens 510. The two sections 500a and 500b can be joined over these components in several ways. In the illustrated example, one or more pins 500c of section 500b connect with a corresponding array of matching recesses 500d of section 500a. As shown in FIG. 30 , the outer pivot shaft 505 of each section is inserted into a corresponding hole, bearing, or bushing 507 in the distal end of the resiliently flexible inner sheath 312 of the endoscope shaft to assemble it. The assembled housing 500 is then pressed or snap-fit ​​into place within the hole 507, bonding the two sections 500a and 500b together. Optionally, an adhesive may be used to securely bond the pin 500c to the corresponding recess 500d. While the sensor / camera housing 500 shown does not include a light source, this is optional; an appropriately sized LED or group of LEDs could be included around the periphery of the lens, as described below, or the end of a fiber optic cable could be similarly located.

[0181] In an exemplary arrangement, one or more LEDs 508 can be positioned along the opening 506 in the inner sheath 312 of the endoscope shaft 14. FIG. 42 shows the sensor 512 and lens 510 assembly within the sensor housing 500 (with half of the housing removed for clarity). Both the lens 510 and the sensor 512 (e.g., a CMOS or CCD sensor) are appropriately sealed to prevent liquid from entering between them. The sensor 512 is connected to a ribbon or flexible cable that runs through the endoscope shaft to a PCB in the endoscope handle. Similarly, the light source / LED is connected to a ribbon or flexible cable for power or to a separate ribbon or flexible cable adjacent to the sensor communication cable. In an alternative example, the main PCB in the endoscope handle can be manufactured with an elongated extension that extends through the endoscope shaft to one or more components at the shaft tip. The PCB can be configured with a flexible component sandwiched between rigid components. The flexible component can emerge from the main PCB to form a PCB extension for the endoscope shaft. Rigid components may also emerge from the main PCB to form a PCB extension of the endoscope shaft. Either or both of these extensions may be interdigitated with ribbon or flexible cables from the main PCB to provide power or communications to components at the distal end of the endoscope shaft. For example, the sensor 512 may be mounted on the distal end of a flexible PCB extension from the main PCB of the endoscope handle 12. The sensor PCB extension 514 is flexible and has sufficient slack to allow rotation of the sensor 512 and lens 510 as the sensor housing 500 rotates. The light source in this example also includes one or more LEDs 508 mounted on the sensor PCB extension or, preferably, on a separate light source PCB extension 516. Due to the power requirements of the light source, mounting the power supply wires on a separate flexible cable or PCB extension 516 increases the reliability of the endoscope. Additionally, if the endoscope shaft 14 is rigid (e.g., as in many arthroscopes), the light source power wires can be mounted on a rigid PCB extension, further enhancing the overall structural stability of the endoscope. In the example shown in FIG. 42, a flexible PCB extension 514 is folded over its base and placed against a rigid light source PCB extension 516, both extensions being integrated into the main PCB within the endoscope handle 12 (see below).

[0182] The form factor of a printed circuit board (PCB) for the embodiment shown in Figures 26 and 42 is shown in Figure 43. Note that the form factors shown in Figures 43 and 44 can also be used to describe how a ribbon or flexible cable can be folded and pulled adjacent to a mating ribbon or flexible cable, or adjacent to a mating PCB, through a bulkhead and along the endoscope shaft to a connecting component at the shaft tip. In one example, a rigid main PCB 518 (on which several electronic processing components are mounted) includes both rigid and flexible components stacked on top of each other, and the main PCB 518 is placed in the endoscope handle. A flexible PCB extension 514 emerges from the composite main PCB 518 at an angle pointing toward the rigid extension 516, and the proximal leg 514a of the flexible PCB extension 514 is folded at point 520 (Figure 44) and pulled adjacent to the rigid extension 516, as shown in Figure 44. In the illustrated example, the proximal leg 514a of the flexible extension portion is at an angle of approximately 90° relative to the rigid extension portion. In some embodiments, the angle may be less than or greater than 90° due to the flexibility of the flexible extension portion, which allows for imperfectly aligned folds of the proximal leg 514a. The flexible PCB extension 514 is shown in FIG. 45 adjacent to the rigid PCB extension 516, drawn along the endoscope shaft (with the inner sheath, sensor housing, and lens removed for clarity). In this manner, both expansion PCBs can pass through slots in the elastomer of the bulkhead or fluid barrier, such as slot 177 shown in Figure 11B or 11C.

[0183] FIG. 46 shows an exemplary internal cutaway view. The main PCB 518 is shown in relation to the handle base section 16, the camera control button 37, the septum or walk-through barrier 159, and the pivot control structure 100. A rotational position sensor magnet 51 is shown in relation to both the handle base section 16 and the main PCB 518. An exemplary fluid conduit 434 (for irrigation or aspiration) is shown leading to the septum 159. The fluid conduit 434 may connect to the septum 159 through a barbed fitting 256, as shown in FIG. 47, or through any other means of secure connection. In this case, the inner sheath 312 has been removed for clarity of illustration.

[0184] FIG. 47 shows the endoscope PCB without the handle, inner sheath, pivot control structure, and fluid conduits, with its extension passing through a bulkhead or pass-through barrier 159. Additionally, the rotational position sensing magnet 51 and the camera control button 37 and shaft 38 (with embedded magnets) are shown in relation to the main PCB 518 to suggest where the Hall effect sensors for each of these magnets could be located on the PCB 518. As shown, the fold point 520 of the flexible PCB extension is located proximal to the bulkhead 159, and the combined adjacent flexible and rigid PCB extensions pass through the bulkhead at slot 177. The slot in this case provides a sufficient amount of slack in the flexible PCB extension 514 with the sensor 512 near its distal end to create a tight seal against fluid ingress.

[0185] As shown in FIG. 48, the fluid or air carrying interior space 157 shares space within the endoscope shaft 14 with an expansion PCB 514, 516 (or one or more ribbon or flexible cables) that provides power to a light source and communicates with a sensor / camera located at the tip of the endoscope shaft 14. The sensor / camera housing has been removed for clarity. (The inner sheath 312 of the shaft 14 has cutouts or openings proximal to the sensor / camera housing to provide illumination from a light source or LED above and, optionally, to improve fluid flow around the sensor / camera housing below. This is shown, for example, in FIGS. 26 and 72.6.)

[0186] Figure 49 shows a cutaway view of the interior of the handle distal section 30 of the upper endoscope. A septum or fluid barrier 159 separates the relatively dry area (where the pivot control structure, camera control buttons, and tip of the main PCB are located) from the wetted section 30a. A fluid or air conduit 434 runs from the outside of the endoscope handle through the handle proximal section 16 and connects to an opening 256 in the septum 159. In this example, fluid passing through the conduit 434 and opening 256 communicates with the interior space 157 of the endoscope shaft 14 via the space occupied by the wetted section 30a. Appropriate seals can be used to contain this fluid or air so that it does not leak between the distal section housing and the proximal end of the endoscope inner sheath 312.

[0187] 7C and 14, the pivot control structure 100 may be "snapped" into detents defined by protrusions 94 in the slide button recess 92 of the raised handle portion 34 or other portion of the handle 12. In some embodiments, the protrusions 94 may be spaced apart so that the detents formed by the protrusions 94 coincide with particular angular orientations of the camera assembly 350. In some embodiments, the detents formed by the protrusions 94 may be spaced apart so that their positions correspond to particular angular increments (e.g., 30°) of the camera assembly 350.

[0188] As described above (see FIG. 7A ), the handle distal section 30 may be rotated relative to the handle proximal section 16. Such rotation also rotates the longitudinal axis of the insertion section 14. The camera assembly 350 may then rotate along with the insertion section 14. This allows the user to obtain a close and wide view of the anatomical region of interest with minimal or no angular repositioning of the endoscope 10. The user simply pans the camera assembly 350 and rotates the handle distal section 30 relative to the handle proximal section 16 to obtain a desired view within the anatomical region.

[0189] Repeated twisting and bending of optical fibers, such as optical fiber 364, can result in breakage or damage to one or more fibers. In the case of optical fiber 364, this can lead to light and illumination loss, which increases as more optical fibers 364 are damaged. Such bending can occur when optical fiber 364 terminates, is connected to, or is coupled to a portion of camera assembly 350 that pivots, as described above. If endoscope 10 is intended to be disposable, degradation of the integrity and performance of optical fiber 364 may be within acceptable limits for the intended life of the device. As a result, in some embodiments, optical fiber 364 may be attached to or coupled to pivotable camera assembly 350 with minimal concern about damage to optical fiber 364 and resulting loss of light source. End lighting, a light-emitting element, or illuminator associated with optical fiber 364 may be advantageously implemented in camera assembly 350 in some embodiments to illuminate a target or field of view as lens assembly 354 of camera assembly 350 is rotated or panned. Such an arrangement helps ensure that the field of view of lens assembly 354 (shown by dashed lines in FIGS. 25-27) is always illuminated by optical fiber 364 regardless of where camera assembly 350 is rotated within its rotational range.

[0190] In some embodiments, the illumination system may include a light guide or light conductor 375. In some embodiments, the optical fiber 364 may include a light guide or light conductor 375 (see, e.g., FIG. 51 ) along at least a portion of the path of the illumination system. The terms “light guide” and “light conductor” are used interchangeably herein. When an optical fiber is relatively straight, the angle of incidence of light within the fiber is shallow enough to cause almost all reflection within the optical fiber, resulting in relatively little light loss. However, bending the optical fiber changes the angle of incidence to the point where transmission of light out of the fiber can occur. However, the bending of the light conductor or guide can be controlled. For this reason, the use of a light guide 375 where possible helps minimize light loss in illumination systems that include optical fiber 364, or may replace optical fiber entirely. The light guide 375 also provides several other benefits. For example, the light guide 375 can aid in device assembly and reduce assembly time. The light guide 375 may be of the type described herein or any other suitable type of light guide known to those skilled in the art.

[0191] FIG. 51 illustrates an exemplary embodiment of an endoscope 10 utilizing light guides 375. Two large-diameter light guides 375 extend along one or more sections of the wall of the inner sheath 312 (see FIG. 20) into the camera assembly housing 330 and then bend into one of the camera assembly pivot bearings 346. The bent portion of each light guide 375 may be coated with a highly reflective material 376 to minimize loss of light exiting the light guide 375 when it is turned. Any suitable highly reflective material 376 known to those skilled in the art may be used. In such an embodiment, the camera assembly 350 may also have a built-in camera assembly light guide 377 formed at the junction with the light guides 375 at the pivot bearing 346. Light carried by the light guides 375 is transmitted to the camera assembly light guide 377 at the junction. A camera assembly light guide 377 may extend from each pivot pin 366 into the camera assembly 350. Camera assembly light guide 377 terminates in light projection cavity 362, providing an illuminated field of view for camera assembly 350 regardless of the rotational position of the camera and lens assembly. In such embodiments, the bends made by camera assembly light guide 377 are coated with highly reflective material 376, as described above. In some embodiments, highly reflective material 376 may be included in other portions of light guide 375 and camera assembly light guide 377, in addition to the bends in light guide 375 and camera assembly light guide 377.

[0192] Creating a light guide contact that coincides with the pivot area of ​​the camera assembly 350 is preferred because it avoids bending or kinking the optical fiber 364 as the camera assembly 350 rotates, eliminating the risk of damage to the optical fiber 364. Such a design can be employed for use with both reusable and single use endoscopes 10. This arrangement can also reduce the manufacturing or assembly costs of the endoscope 10.

[0193] In another exemplary embodiment (not shown) using a light guide 375, the large diameter light guide 375 extends generally along the path of the flexible cable 250. The end of the light guide 375 closest to the inner sheath mount 160 may be positioned to form a contact with the optical fiber 364 or to extract light from another illumination source. The end of the light guide 375 closest to the camera assembly 350 may also form a contact with the illumination fiber 364 that extends to the camera assembly 350.

[0194] In some embodiments, the optical fibers 364 to the camera assembly 350 may be arranged to form a flexible ribbon 1000, creating a linear array of fibers with minimal bending, or bending in only one dimension (see, e.g., FIG. 52 ), that terminate within the light emitting elements. Alternatively, the flexible ribbon 1000 may not be a linear array of fibers; instead, in some embodiments, it may be a single, ribbon-like, flexible piece of light guide material. In some embodiments, there may be two flexible ribbons 1000, each extending into one of the light projection cavities 362 of the camera assembly 350. In some embodiments, the flexible ribbon 1000 may be coated with a highly reflective material 376 to maximize the amount of light at the camera assembly 350. In some embodiments, the flexible ribbon 1000 may form contacts with the light guides.

[0195] In some embodiments, the top camera housing 356 may include a light guiding material that acts as a light emitting element or illuminator. In this case, light is projected from most of the top camera housing 356 into the field of view of the camera assembly 350. In some embodiments, certain areas of the top camera housing 356 are turned off or masked to project light only from desired areas of the top camera housing 356. In some embodiments, certain areas of the top camera housing 356 are coated with a highly reflective material 376 to prevent unwanted light from emitting from those areas.

[0196] 52 illustrates an embodiment in which optical fibers 364 are incorporated into a flexible ribbon 1000 and optionally coated with a highly reflective material 376. As shown, the flexible ribbon 1000 extends to the camera assembly 350. The flexible ribbon 1000 may be overmolded, potted, fused, or otherwise coupled to the camera assembly 350.

[0197] In the exemplary embodiment of FIG. 52, the camera assembly 350 includes a monolithic camera housing 1002. An example of the monolithic camera housing 1002 without the attached flexible ribbon 1000 is shown in more detail in FIG. 53. In the exemplary embodiment, the monolithic camera housing 1002 is made of a light guiding or transmitting material and functions as a light emitting element. The monolithic camera housing 1002 of the exemplary embodiment is almost entirely coated with a highly reflective material 376 to maximize light output from uncoated or unmasked areas of the monolithic camera housing 1002. The light illumination or illumination surface 1004 has a shape suitable for placement in proximity to the lens and image sensor assembly of the monolithic camera housing 1002 and is created by masking that area during application of the highly reflective material 376 (or simply a light blocking mask). In the exemplary embodiment, the light illumination surface 1004 has a ring-like shape. In other embodiments, the light projection surface 1004 may be crescent-shaped, semicircular, or have any other desired shape. Light is emitted from the light projection surface 1004 of the monolithic camera housing 1002 and illuminates the field of view of the lens assembly 354. As in the above-described embodiment, the illumination field preferably pivots with the camera assembly 350 to ensure that the field of view of the lens assembly 354 is illuminated at all times.

[0198] FIG. 54 illustrates another exemplary embodiment of a monolithic camera housing 1002. As shown in outline, the monolithic camera housing 1002 includes a mating recess 1006. The mating recess 1006 allows a flexible ribbon 1000 to be appropriately coupled to the monolithic camera housing 1002. In some embodiments, the mating recess 1006 allows the flexible ribbon 1000 to be coupled to the monolithic camera housing 1002, for example, by a snap fit. In some embodiments, the mating recess 1006 accommodates an optical fiber 364 that is not incorporated into the flexible ribbon 1000. Similar to FIG. 53, in FIG. 54, the monolithic camera housing 1002 can function as a light-emitting element. The monolithic camera housing 1002 may also be coated and / or masked similarly to the monolithic camera housing 1002 described in connection with FIG. 53.

[0199] 55 and 56 illustrate embodiments in which a light emitting element 1005 is incorporated into the end of a flexible ribbon 1000. The light emitting element 1005 is formed from a light conductor material and, in some embodiments, may be a fiber optic bundle or a group of fibers fused together in a desired manner into a shape suitable for projecting light from the flexible ribbon 1000. In some embodiments, the light emitting element 1005 and the flexible ribbon 1000 may be two separate pieces fused together (e.g., by heating or chemical means). In other embodiments, the light emitting element 1005 and the flexible fiber optic ribbon 1000 may be a single molded piece. In some embodiments, the light emitting element 1005 may be fabricated as described in connection with FIGS. 49-62.

[0200] 55 and 56, the flexible ribbon 1000 may be coated with a highly reflective material 376. The bottom and side walls of the light-emitting element 1005 may also be coated with the highly reflective material 376. This ensures that light is only emitted from the uncoated top of the light-emitting element 1005 into the field of view of the lens assembly 354. As shown in FIG. 56, the light-emitting element 1005 or the flexible ribbon 1000 may include a coupling mechanism 1008. The coupling mechanism 1008 allows the light-emitting element 1005 and the flexible ribbon 1000 to be coupled to the top of or within the camera assembly 350. The coupling mechanism 1008 may be an integral part of the light-emitting element 1005.

[0201] Figures 57 and 58 show two exemplary embodiments of a flexible ribbon 1000 including light emitting elements 1005 formed from a light guiding material. The light emitting elements 1005 in Figure 57 have a generally ring shape, and the light emitting elements 1005 in Figure 58 have a generally crescent shape, although other shapes may be selected as desired. In the exemplary embodiments of Figures 57 and 58, only the top surfaces of the light emitting elements 1005 remain uncoated with the highly reflective material 376.

[0202] The light emitting element 1005 comprises one or more textures 1010 that help direct the light emitted from the light emitting element 1005. In some embodiments, the texture 1010 causes the light to be emitted in a diffuse manner. The texture 1010 may be created, for example, during molding of the light emitting element 1005, or the light guide material forming the light emitting element 1005 may contain a filler that causes the light to be emitted in a diffuse manner from the light emitting element 1005.

[0203] FIGS. 59 and 60 show top and bottom perspective views, respectively, of another exemplary embodiment of a light-emitting element 1005. As shown, the light-emitting element 1005 is ring-shaped. The light-emitting element 1005 also includes a coupling mechanism 1008, as shown in the bottom perspective view of FIG. 60. The coupling mechanism 1008 in FIG. 6 is an integral part of the light-emitting element 1005. In the exemplary embodiment, the coupling mechanism 1008 is a ledge or shelf. The ledge coupling mechanism 1008 serves to position and align the light-emitting element 1005 on another component, such as the camera assembly 350. Additionally, in some embodiments, an adhesive or glue may be placed along the ledge coupling mechanism 1008 to secure the light-emitting element 1005 to another component, such as the camera assembly 350. In FIG. 64, the light-emitting element 1005 is shown attached to the exemplary camera assembly 350.

[0204] The light-emitting element 1005 shown in Figures 59-60 does not include a highly reflective coating or material 376 (see, for example, Figure 55). The need for such a highly reflective coating or material 376 is minimized by dimensioning the light-emitting element 1005 to increase or maximize total internal reflection of incident light within the light-emitting element 1005 where light emission is undesirable. This is accomplished by creating large radii of bends in areas of the light-emitting element 1005 where light emission is undesirable. Furthermore, this is accomplished by dimensioning the light-emitting element 1005 so that thickness variations within the light-emitting element 1005 do not result in variations in the angle of incidence of light at the light-emitting element 1005, variations that may cause the angle of incidence to be less than the critical angle. The thickness of the light emitting element 1005 is preferably no thinner than the thickness of the optical fiber or flexible ribbon to which the light emitting element 1005 is attached, and where light emission is undesirable, the surface of the light emitting element 1005 is preferably smoothed.

[0205] Figures 61, 62, and 63 show several cross sections of the light-emitting element 1005 shown in Figures 59-60. The cross sections are taken along lines 43-43, 44-44, and 45-45 in Figure 59. As shown, light entering the light-emitting element 1005 must traverse a first bend 1300 and a second bend 1302 before emitting from the top surface of the light-emitting element 1005. As shown in Figures 61-63, the light-emitting element 1005 is shaped such that these radii vary across the surface of the light-emitting element 1005. The radii of each of these bends 1300 and 1302 are selected to be as gradual as possible within the available space for a given surface. Also, as shown, the thickness of the light-emitting element 1005 is kept generally constant. This minimizes changes in the angle of incidence due to thickness variations.

[0206] The light emitting element 1005 shown and described in connection with Figures 59-63 is mounted to the example camera assembly 350 of Figure 64. As shown, the light emitting element 1005 is positioned to project light onto an initial illumination area (the area surrounding this initial illumination area may also be brightened due to scattering and reflection of the emitted light), which initial illumination area substantially coincides with the field of view of the lens assembly 354.

[0207] Exemplary methods for manufacturing fiber optic light emitting elements are described in U.S. Patent Application Serial No. 14 / 170,080, filed January 31, 2014 (U.S. Application Publication No. 2014 / 0221749), which is incorporated herein by reference in its entirety.

[0208] FIG. 65 shows a cross-sectional view of an exemplary camera assembly including a lens assembly 354, taken along the plane indicated by line 61-61 in FIG. 32. The lens assembly 354 is shown housed between an upper camera housing 356 and a lower camera housing 358, as in FIG. 32. As shown, the lens assembly 354 is positioned to project an image onto the face of an image sensor 380. Types of image sensor 380 include, for example, a CCD image sensor, a CMOS image sensor, etc. Preferably, the image sensor 380 is housed in a sealed section of the camera assembly 350 and protected from exposure to fluids. In a single-use endoscope, the assembly does not have to withstand the rigors of disinfection and reuse, so a cost-effective process may be used to seal the image sensor against exposure to fluids.

[0209] As shown in FIG. 65, the image sensor 380 may be electrically coupled to a flexible substrate 381 of the flex cable 250. In some embodiments, a conformal coating material may be used to provide additional protection against moisture and may optionally be configured to support a ball grid array connection implemented for the image sensor 380. The flex cable 250 may provide power to the image sensor 380 in addition to transporting data and / or commands to and from the image sensor 380. In some embodiments, the camera assembly 350 may include a stiffener 382. In the exemplary embodiment shown in FIG. 65, the stiffener 382 is positioned to reinforce the structure on which the image sensor 380 is supported and helps to protect the physical integrity of the image sensor 380. The stiffener 382 may comprise, for example, a thin aluminum backing (approximately 0.05 mm (0.002 inches) thick in the exemplary embodiment).

[0210] The camera assembly 350 may include one or several fiber guides 384 . In the example shown in FIG. 65 , the fiber guide 384 is coupled to the underside of the lower camera housing portion 358. The example fiber guide 384 includes a guide groove 386. The rear wall of the guide groove 386 of the fiber guide 384 may be seen to protrude toward the bottom of the page in FIG. 65 . The fiber guide 384 may be, or may include, several orientation notches or grooves 388, which in the example fiber guide 384 shown in FIG. 65 are recessed into the rear wall of the guide groove 386. In some embodiments, including the example embodiment of FIG. 65 , the orientation notches or grooves 388 are formed in one or both of the upper camera housing portion 356 and the lower camera housing portion 358. The fiber guide 384 helps to route the illumination fiber 364 during assembly of the endoscope 10. The fiber guide 384 also serves to maintain the illumination fiber 364 in place during operation of the endoscope 10. The location, shape, number, size, etc. of the fiber guides 384 may vary depending on the particular configuration of the endoscope 10. In some embodiments, glue, epoxy, or other suitable adhesive may be used in addition to the fiber guides 384 to help maintain the illumination fibers 364 in the desired position. For example, if a light guide or light-emitting element (e.g., as shown in FIGS. 51-58 or in FIG. 66) is used, the fiber guides 384 may not be used during assembly.

[0211] FIG. 66 shows a cross section of the camera assembly 350 shown in FIG. 5 taken along line 62-62 in FIG. As shown, lens assembly 354 is shown in place on camera housing 355. The lens assembly is positioned to project an image onto image sensor 380. As mentioned above, image sensor 380 may be any type of image sensor (e.g., CCD, CMOS, etc.) and is sealed against exposure to liquids. Also as mentioned above, image sensor 380 is coupled to a flexible substrate 381 that is attached to flexible cable 250. Camera assembly 350 shown in FIG. 66 does not include fiber guide 384 (see FIG. 65). Instead, light emitting element or light emitter 2005 is in place on camera assembly 350 in FIG. 66.

[0212] As shown, in the illustrated embodiment, the flexible cable 250 is folded back on itself. This is accomplished by bending the flexible cable 250 and then applying glue or other fixative to the affected area of ​​the flexible cable 250 to maintain the bend. Doubling the flexible cable 250 beneath the camera assembly 350 is advantageous in embodiments where the camera assembly 350 is enclosed within a tight space. For example, confining the camera assembly 350 to a space within the inner sheath 312, as shown in FIG. 24, limits the amount of flexible cable 250 available for bending. Furthermore, the flexible cable 250 may have to bend at an undesirably small radius at certain rotational positions of the camera assembly 350. Such small bend radii can be detrimental to the flexible cable 250, especially if they occur repeatedly. This problem becomes more pronounced as the diameter of the inner sheath 312 becomes smaller. However, by arranging the flexible cable 250 to fold back on itself, a longer flexible cable 250 is available for repeated bending as the camera assembly 350 rotates, increasing the minimum bend radius, which in turn allows the inner sheath 312 to be made smaller in diameter without concern for the integrity of the flexible cable 250 due to repeated bending and straightening at small radii.

[0213] The flexible cable 250 and the optical fiber 364 leading to the light emitting element 2005 offer some resistance to bending. Additionally, they both exert a spring force that restores them to their original shape when bent. This resistance to bending increases the camera assembly 350's resistance to rotation. As shown in FIG. 67, the flexible cable 250 and the optical fiber 364 are angled relative to one another. This arrangement utilizes the stiffness of the flexible cable 250 relative to the optical fiber 364, and vice versa, to help rotate the camera assembly 350. To best illustrate this concept, in FIG. 67, the flexible cable 250 is not folded back on itself.

[0214] In some embodiments, at least one illumination source for camera assembly 350 is positioned to emit light in a direction other than toward the field of view of camera assembly 350. That is, the direct illumination range of the illumination source is outside of or does not coincide with the field of view of the camera assembly. Such illumination sources may be referred to as indirect illumination sources, and illumination sources that directly illuminate the field of view of camera assembly 350 are referred to as direct illumination sources. Indirect illumination sources may, for example, emit light toward the back of camera assembly 350 or in a direction opposite the field of view of camera assembly 350. For example, instead of or in addition to light emitting element 2005 coupled around the periphery of lens assembly 354 or a lens and emitting light toward the field of view of lens assembly 354 or a lens, light emitting element 2005 may be attached to the portion of camera assembly 350 opposite lens assembly 354 or a lens.

[0215] Although counterintuitive, shining light outside the field of view of the camera assembly 350 (e.g., behind the camera assembly 350 in the direction opposite the field of view) provides improved image quality and reduces the need for image processing. For example, such a lighting arrangement helps to provide greater depth perception because shading is maintained in areas that would otherwise be directly illuminated. By emitting light from the light-emitting element 2005 or other illumination source to points outside the field of view of the camera assembly 350, hot spots or areas that appear washed out and dark spots or areas that appear underexposed are reduced. Such a lighting arrangement helps to provide more uniform illumination within the field of view of the camera assembly 350.

[0216] A specific embodiment of a lighting arrangement that emits light from several light sources 702a-d to areas inside and outside the field of view 700 of the camera assembly 350 is shown in FIG. 68. As shown, a printed circuit board extension 430h within the endoscope handle is shown extending to the camera assembly 350. The printed circuit board extension 430h can provide power and data communication paths to various components within the insertion section 14. In some embodiments, a ribbon or flexible cable 250 (see, e.g., FIG. 14) can be used in place of the printed circuit board extension 430h. Several components are mounted on the printed circuit board extension 430h. These components can be any component or a variety of different components, such as sensors, light emitters, etc. In the illustrated embodiment, the components are described as light sources 702a-d. The light sources 702a-d can be any suitable power source, such as, but not limited to, a fiber optic cable, a light emitting element 2005 (see, e.g., FIG. 62), an LED, an LED string, etc.

[0217] In certain embodiments, the use of LEDs is preferred for a variety of reasons. For example, the use of LEDs eliminates the need for illumination fiber bundles / ribbons. Optical fibers tend to degrade with prolonged bending during use and experience light loss when bent. LEDs are long-lasting and do not require long bundles of fiber that are subject to bending. The use of LEDs also minimizes the number of pass-through elements between the dry section (e.g., handle 12) and the wet section (e.g., insertion section 14) of the endoscope. Additionally, the elimination of optical fibers allows a smaller portion of the cross-sectional area of ​​the fluid conduits in the insertion section 14 to be blocked or filled. This allows for faster flow rates of irrigation fluid through the insertion section 14. LEDs also facilitate simpler or easier manufacturing.

[0218] As shown, a first light source 702a is positioned to project light generally toward the field of view 700 of the camera assembly 350. Such light source 702a typically provides direct illumination of the field of view 700. In some embodiments, the direct light source 702a may be omitted or accompanied by one or more other indirect illumination sources, such as one or a combination of light sources 702b-d. In embodiments in which a direct illumination source 702a is included in conjunction with one or more indirect illumination sources, the direct illumination source 702a may provide light of a lower intensity than the one or more indirect illumination sources. In some embodiments, the direct illumination source 702a may provide light in a different spectrum or a subset of the spectrum emitted by the indirect illumination source. For example, the direct illumination source 702a may be an RGB LED, while the indirect illumination source emits white light.

[0219] Several other light sources 702b-d are also shown in FIG. 68. These light sources are shown together for illustrative purposes and not all are required in the preceding embodiments. In various embodiments, any number of light sources 702a-d may be included. In various embodiments, some of the light sources 702a-d may be omitted. Each of the light sources 702b-d is an indirect illumination source and is positioned so as not to emit light directly into the field of view 700 of the camera assembly 350. The light sources 702b-d are positioned to emit light in a direction substantially opposite the field of view 700 of the camera assembly 350. The light source 702d may be attached to the camera assembly 350 and positioned to emit light from the side of the camera assembly 350. In a preferred embodiment, backlighting provides the only illumination source for the surgical site. In this case, the illumination source at the tip of the endoscope only comprises one or more LEDs positioned, for example, at location 702b. That is, light is emitted from the side of the endoscope shaft, away from the side from which most of the camera assembly's field of view is directed. Thus, the light provides more indirect, diffuse illumination of the space viewed by the camera assembly, preventing bright reflections of light aimed directly at the camera or reducing shadow casting, improving the operator's field of view. On the other hand, placing the LED at location 702a can improve illumination of the area of ​​the surgical site toward which camera field of view 700 is directed.

[0220] The camera assembly 350 may include one or more optical filters to selectively use wavelengths emitted by one or more of the light sources 702a-d, for example, polarizing filters or bandgap filters, to increase the resolution of images captured by the camera assembly 350.

[0221] In some embodiments, the camera assembly 350 is rotatable within the insertion section 14. In such embodiments, the light sources 702a-d may remain stationary as the camera assembly 350 rotates. Alternatively, one or more of the light sources 702a-d may rotate with the camera assembly 350 (e.g., the light sources 702a-d are attached to the camera assembly 350 and thus rotate with it). The light sources 702a-d may be positioned so that they do not emit light directly into the field of view 700 in some or a large percentage (e.g., about 70% to 100%) of the camera assembly 350's possible rotational positions. In some embodiments, the entire shaft tip or the insertion section 14 (or the entire insertion section 14) may be transparent, allowing the camera assembly 350 to rotate within it and obtain multiple viewing angles through the transparent portion. Optionally, in this particular embodiment, the distal portion of the insertion section 14 may be fluidly sealed from the surrounding space, and the cameras and light sources may rely on the transparency of the shaft tip.

[0222] Additionally, in some embodiments, a controller monitoring the rotational position of the camera assembly 350 may increase or decrease the intensity of light emitted from the various light sources 702a-d depending on the position of the field of view 700. For example, the controller may monitor the displacement of the pivot control structure 100 (see, e.g., FIG. 14) via a sensor, such as a rotary potentiometer, attached to the pivot shaft 204 (see, e.g., FIG. 14). Based on the data collected from the sensor, the controller may determine whether the light sources 702a-d should change from direct to indirect light sources, or vice versa. The controller may then adjust the intensity of the light generated by those light sources 702a-d. In response to the sensor readings, the controller may, for example, determine which light sources 702a-d are emitting light into the field of view 700 of the camera assembly 350 and reduce the intensity of the light generated by those light sources 702a-d. The controller may use the sensor readings to determine whether the camera assembly 350 has rotated such that a light source 702a-d that previously emitted direct light into the field of view 700 is now operating as an indirect light source. Upon determining that a light source 702a-d has been changed from a direct light source to an indirect light source, the intensity of the light produced by the light source 702a-d may be increased. The adjustment of the emitted light may be made in a continuous, gradual manner, a stepwise manner, or a binary manner (e.g., switching between predetermined direct and indirect intensity levels).

[0223] An example of a printed circuit board (PCB) 430a including several LED light sources 750 and a sensor 754 on an extension 430h of the printed circuit board 430a is shown in Figures 69-70. A sensor or camera assembly 350 is also shown at the end of the PCB extension 430h. Figure 69 shows a top view of the printed circuit board 430a, and Figure 70 shows a side view of the printed circuit board 430a.

[0224] The printed circuit board 430 includes a main portion 430L from which a shaft portion 430H extends. The main portion 430L of the printed circuit board 430a may be housed within the handle 12 of the endoscope 10 (see, e.g., FIGS. 3A and 3B). In the exemplary embodiment shown in FIGS. 69-70, the main portion 430L is shown without electronic components for simplicity. An exemplary printed circuit board 430a with exemplary components 430b-f is shown in FIG. 78. In some embodiments, and as shown in FIG. 70, at least a portion of the main portion 430L of the printed circuit board 430a may be coated or encapsulated in a protective coat or layer of material. The protective material may be any of a variety of potting or conformal coating materials. Examples of suitable potting or conformal coating materials include acrylic, epoxy, polyurethane, silicone, parylene, thermoset resin, rubber, or other potting or conformal coating materials. Preferably, the protective material is biocompatible and provides waterproof properties. A clear protective coat may also be placed over the LED 750 and sensor 754 on the protruding portion 430h.

[0225] The PCB extension (or any ribbon cable) 430h passes through the pass-through barrier 159 (see, e.g., FIG. 15) and extends along the axis of the insertion section 14 (see, e.g., FIG. 15) of the endoscope 10. The protruding portion 430h can provide a power and data communication path to various components (e.g., the camera assembly 350 and / or the LED 750) within the insertion section 14 (see, e.g., FIG. 15). The protruding portion 430h can be divided into several different portions. In the illustrated example, the protruding portion 430h includes a first portion 430i, a second portion 430j, and a third portion 430k. (In other embodiments, the protruding portion 430h can be divided into a different number of portions.) Each portion of the protruding portion 430h can have different properties. For example, each portion of the protruding portion 430h can have a different flexibility. One portion can be a rigid circuit board and another portion can be a flexible cable. Additionally, each of the circuit boards may have a different number of layers, different widths, different numbers of wires on each layer, etc. It is preferred that at least a portion of protruding portion 430h of printed circuit board 430a be a flexible cable or otherwise flexible, which helps facilitate rotation of camera assembly 350.

[0226] In some embodiments, first section 430i is a six-layer rigid circuit board. Second section 430j is a two-layer flexible cable. Third section 430k is a four-layer rigid circuit board. Each section may transition to the next, or connectors may be used between one or more sections of protruding section 430h. To simplify manufacturing and reduce costs, communication and power lines for the endoscope shaft preferably comprise flexible and / or rigid extensions of the main PCB located within the endoscope handle. The entire PCB with extensions is fabricated as shown in FIG. 43, and the flexible PCB extension is folded as shown in FIG. 44 and pulled adjacent to the mating PCB extension (rigid or flexible) during assembly of the endoscope.

[0227] Sensor 754 can be any of a variety of sensors. In some embodiments, sensor 754 can be a temperature sensor such as a thermistor, thermocouple, or resistance thermometer. In some particular embodiments, sensor 754 is a thermistor. Temperature sensor 754 can be used to monitor the temperature of an environment at or near LED 750.

[0228] During endoscopic operation, a cleaning fluid may flow over the LED 750. This fluid cools the LED 750 and helps maintain the temperature of the LED 750 within a desired temperature range. When the endoscope 10 is external to a patient and no cleaning fluid is flowing, the controller may monitor data from the sensor 754 to determine if the environment near the LED 750 is hotter than the desired temperature range. If the temperature exceeds the temperature range, the controller may command a reduction in current to the LED 750 or may command the LED 750 to be turned off. The temperature sensor may also be used as a flow sensor for the cleaning fluid. During endoscopic operation, the flow rate of the cleaning fluid should be sufficient to convectly dissipate heat generated by the LED 750 so that the area surrounding the LED 750 is within the desired temperature range. If the flow rate decreases beyond a certain amount, the temperature in the area near the LED 750 will increase. This increase, in some embodiments, is interpreted by the controller as a decrease in the flow rate of the cleaning fluid. In response, the controller may generate a notification to this effect to the user.

[0229] FIG. 71 shows a flowchart detailing some example steps used by the controller to control the LEDs in the insert section 14 based on the measured temperature. In step 756, the controller receives a data sample from a temperature sensor near the LEDs. The controller then analyzes the data sample in step 758. If the temperature is not outside the first predetermined range in step 760, step 756 is repeated. If the temperature is outside the first predetermined range in step 760, the controller transitions one or more LEDs from the first state to a second state in step 762. The temperature range may have an upper limit between 40°C and 50°C (e.g., 50°C). The first state may be an on state with high light output, and the second state may be an off state. In the example flowchart, the second state is a dimmed or off state. The controller receives a data sample from the temperature sensor in step 764 and analyzes the data sample in step 766. If the data sample indicates that the temperature is outside the second predetermined range in step 768, step 764 is repeated. If the data sample in step 768 indicates that the temperature is within a second predetermined range, then in step 770 at least one LED is illuminated or commanded to increase its light intensity.

[0230] The first and second predetermined ranges may be the same, or the second predetermined range may be smaller and different than the first predetermined range. This ensures that the controller does not rapidly switch between turning on and off or increasing or decreasing the intensity of light from the LEDs. In some embodiments, after step 762 is reached, a timer is started. The timer is a minimum dim or extinguish timer for at least one LED whose brightness has been adjusted. If the minimum dim or extinguish timer has not elapsed, that at least one LED will not be commanded to turn on or load light output, even if the temperature is within the second predetermined range. This again prevents rapid switching of the LED's state.

[0231] FIG. 72 shows an enlarged side view of the end of protruding portion 430h of printed circuit board 430a. As shown, protruding portion 430h includes a first portion 430i, a second portion 430j, and a third portion 430k. Camera assembly 350 is attached to third portion 430k. Sensor 754 is mounted on first portion 430i near several LEDs 750a-d. Sensor 754 may be a temperature sensor, such as a thermistor, used to assist in controlling LEDs 750a-d. Sensors that detect characteristics of the fluid environment other than temperature (e.g., conductivity, pH, etc.) may also be used.

[0232] LED 750a is a direct light source that typically illuminates the field of view 700 of camera assembly 350. LED 750a is mounted on first side 430m of first portion 430i of protruding portion 430h. LEDs 750b-d are mounted on second side 430n of first portion 430i, opposite first portion 430m. These LEDs 750b-d are indirect light sources that, in some embodiments, do not directly illuminate the field of view 700 of camera assembly 350 in any rotational orientation of camera assembly 350. In some embodiments, LED 750a is an array of RGB LEDs. LED 750a may be tuned to emit light in a spectrum useful for desired color modification of images generated by an image sensor of camera assembly 350. For example, LED 750a may be tuned to correct for color bias of the image sensor of camera assembly 350. As shown, the first portion 430i of the protruding portion 430h is a thicker portion of the printed circuit board than the other portions 430j, 430k of the protruding portion 430h, which can more easily meet the power demands of the LEDs 750a-d.

[0233] First portion 430i transitions into second portion 430j of protruding portion 430h. Second portion 430j may be a relatively thin flexible cable. Second portion 430j facilitates rotation of camera assembly 350 about the axis of pivot pin 366 of camera assembly 350. As shown, second portion 430j has a length such that it forms a bow or arch when first portion 430i and third portion 430k are parallel to one another. This helps to increase the range of motion of camera assembly 350.

[0234] FIG. 73 shows an exemplary embodiment of a camera assembly housing 330 of the insert section 14. FIG. 74 shows a cross-sectional view of camera assembly housing 330 taken along line 72-72 in FIG. 73. Camera assembly housing 330 is continuous with inner sheath 312, and both may be formed as a single piece. As shown in FIGS. 73 and 74, protruding portion 430h of printed circuit board 430a (see, e.g., FIG. 70) is shown within camera assembly housing 330. Protruding portion 430h is similar to that shown in FIG. 72 and includes camera assembly 350, several LEDs 750a-d, and, optionally, a sensor 754. As shown, LEDs 750a-d are arranged to emit light out of upper and lower openings 338, 340 of camera assembly housing 330. Camera assembly 350 is rotated so that the field of view traces from flared opening 344 in rounded tip 342 to the opening provided by upper cleft 338. When fully assembled, outer sheath 318 (see, eg, FIG. 24) is placed over camera assembly housing 330 and inner sheath 312 to protect camera assembly 350 while providing an unobstructed field of view.

[0235] FIG. 26 is a perspective view of the distal end of an endoscope (or arthroscope) shaft 14, with a sensor or camera housing 500 located at the shaft tip. In this case, the inner sheath 312 does not have a leading-edge protective guard, shield, or tip structure. At least a portion of the rotatable sensor or camera housing 500 (i.e., the leading-edge portion) forms the leading-edge element of the endoscope insertion tip. Thus, the sensor housing 500 is preferably configured to withstand repeated contact with anatomical structures, including soft tissue, bone, cartilage, or articular surfaces. In one embodiment, as described above for the camera assembly 350, the rounded or dome-shaped camera housing 500 may also include a light source that is movable with the rotating camera housing and continuously aimed at the field of view of the camera housing 500. The light source may comprise, for example, one or more LEDs or the end of a fiber optic bundle. In the example shown in FIG. 26, the light source 508 (in this case, a bank of LEDs) is located on the side of the shaft, immediately adjacent to the location of the rotating sensor or camera housing 500. In the illustration, the light source 508 is on a side that directs illumination toward the general field of view of the camera / lens assembly 500 when rotated approximately 90° relative to the longitudinal axis of the endoscope shaft 14. (Alternatively, the light source may be positioned opposite the side toward which the camera assembly—lens and sensor—can face.) In the illustrated configuration, the optical axis of the camera assembly is generally aimed in the direction of light projected from a first side of the endoscope's insertion tip. In an alternative configuration, the light source may be located on a second, opposite side of the insertion tip, projecting light from the second side of the endoscope's insertion tip, with the camera assembly's optical axis generally aimed toward the opposite field of view on the first side of the endoscope's insertion tip. FIG. 75 shows a perspective view of this latter configuration, with light emitted by the light source 508 (an LED in this example) directed toward an area generally away from the field of view of the sensor and lens 512. The alternative second configuration is intended to provide indirect illumination (or backlighting) of the camera assembly's field of view and relies on ambient light generated by the endoscope's surgical site illumination source. The illumination source or LED is mounted flush with or recessed from the outer surface of the inner sheath or shaft at the insertion end, so that heat generated by the LED is less likely to directly contact and damage tissue around the surgical site. Selective Saturation Enhancement

[0236] The quality of images generated and displayed by low-cost image sensors (such as those found in single-use endoscopes) can be enhanced through selective enhancement of the saturation of the displayed image. In clinical environments where endoscopes or arthroscopes are used, red and white hues are known to be particularly important for producing pleasing images. Therefore, image quality from a camera sensor can be improved by selectively enhancing the saturation of the image without reducing the intensity of unsaturated pixels. Each pixel is analyzed by its hue, saturation, and lightness or luminance. The saturation of a pixel is enhanced by a saturation factor in the HSV (hue, saturation, lightness) color space and a luminance factor in the HSL (hue, saturation, luminance) color space. In this example, a Gaussian function transformed to low saturation values ​​is designed to enhance unsaturated pixels without overly amplifying already saturated pixels. Similarly, a second Gaussian function is used for luminance in HSL color space to reduce saturation enhancement of mostly white and mostly black pixels. Distributions other than Gaussian functions (i.e., other types of probability distributions) may be used, and the selective enhancement process need not specifically rely on the use of Gaussian functions.

[0237] As shown in FIG. 106, in one example, given a pixel 1050 in the mid-saturation red range, the processor may assign a value ("factor 1") 1052 within the range of 0-1, assigning a value of 1 to saturation values ​​in the HSV color space 1056 in the low / mid saturation range based on a probability distribution 1054 (e.g., a Gaussian distribution). The probability distribution may be centered 1058 anywhere in the lower half of the saturation range; in one example, the probability distribution is centered around values ​​of approximately 25-40% of the saturation range. This provides a pixel saturation weighting factor that is biased toward relatively low-saturation pixels, leaving relatively high-saturation untouched pixels relatively untouched. A second value ("factor 2") may then be calculated and based on a probability distribution (e.g., a Gaussian distribution) of the pixel's luminance in the HSL color space 1064. The probability distribution may be centered 1066 around a luminance value at approximately 50% of the range, with values ​​toward each end of the spectrum being assigned values ​​closer to zero. If the pixel is mostly white, the second factor will greatly weaken the enhancement in the final calculation. The saturation of the pixel is enhanced by the following formula:

[0238] Enhanced saturation value = (original saturation value) x (1 + (coefficient 1 x coefficient 2 x 0.5)) [Formula 0003] In this example, the fixed fraction 0.5 multiplied by the factors 1 and 2 is an arbitrary number that may be adjusted empirically through observation of the effect of the enhancement process on the displayed image.

[0239] 76, in embodiments including at least one variable illumination source producing light of different intensities and / or spectra, the endoscope 10 may be placed in a calibration fixture 780 to aid in setting various illumination parameters. An embodiment with one or more white LEDs and one or more colored LEDs (e.g., an RGB LED array) may, for example, be placed in the calibration fixture prior to use to adjust the light output intensity of the LEDs and adjust the color output of one or more colored LEDs. This helps ensure a more uniform image and minimizes variations between endoscopes 10 due to variations between LEDs and / or between images.

[0240] The calibration fixture 780 may be a light-tight box or other container that includes an opening 782 sized to fit the insertion section 14 of the endoscope 10. The opening 782 may be gasketed so that a light-tight seal is formed against the insertion section 14 of the endoscope 10 when the endoscope 10 is placed in the calibration fixture 780. The interior of the calibration fixture 780 contains one or more targets with known indicia that are placed within the field of view of the camera assembly 350 (see, e.g., FIG. 73 ) of the endoscope 10. For example, targets with indicia of known colors may be placed within the calibration fixture 780.

[0241] The controller may monitor one or more target indicia in images captured by the image sensor of the camera assembly 350. Because the target indicia (e.g., color) is known, the controller can adjust the illumination provided by the variable light source until the target indicia in the captured images matches or falls within the known target indicia. For example, the intensity or spectrum of the light produced by several LEDs 750a-d (see, e.g., FIG. 72) included in the insert section 14 may be adjusted.

[0242] FIG. 77 shows a flowchart detailing some example steps used to calibrate one or more parameters of at least one variable light source included in an endoscope. In step 784, a portion of the insertion section of the endoscope, including the camera assembly, is placed in a calibration fixture. Once inserted, the controller commands the variable illumination source within the endoscope to emit light in step 786. The light may be emitted based on default parameters (e.g., light intensity and color parameters). In step 788, the controller receives image data from an image sensor in the endoscope's camera assembly. This data is analyzed by the controller in step 790. The image data may be analyzed, for example, to determine one or more features of interest on the target in the captured image. These features may be compared to known or expected features on the imaged target in step 792. If the features of the target in the captured image are within a range of known or expected features in step 794, the calibration is considered complete in step 796. If the target indicia in the captured image is not within a known or expected range of indicia at 794, the controller may adjust one or more illumination parameters of the endoscope's at least one variable illumination source at step 798. In an exemplary embodiment, the intensity or spectrum of the light produced by the at least one variable illumination source is adjusted at step 798. After adjustment, step 788 may be repeated. Images continue to be compared and analyzed, and illumination parameters are adjusted until the target indicia in the captured image is within a known or expected range of values. Various methods are used in the manufacture and assembly of lenses or lens groups to focus the image on a sensor or camera at the tip of the endoscope shaft. Examples of such methods and techniques are disclosed in U.S. Patent Application Serial No. 14 / 170,080, filed January 31, 2014 (U.S. Patent Application Publication No. 2014 / 0221749), the entire contents of which are incorporated herein by reference.

[0243] Figure 78 shows another exemplary embodiment of an endoscope 10. An outer sheath 318 is shown installed on the endoscope in Figure 8. Additionally, only the lower half-shell 22 of the handle proximal section 16 and one half (30a) of the handle distal section 30 are visible for clarity of this description. As shown, the endoscope 10 includes a printed circuit board 430a (also referred to herein as the handle or main PCB 430a) enclosed in the handle. Electronic cables (e.g., power / HDMI cable, etc.) 432, optical fiber 364, and irrigation / aspiration lines 434 are also shown. 78 shows an example routing of the power / HDMI cable 432, the optical fiber 364, and the irrigation line 434. As shown, the electronics cable 423, the optical fiber 364, and the irrigation line 434 enter the endoscope 10 through an opening 60 in the rear or butt end of the handle base section 16. This entry has an advantage over an entry in the side of the handle because it reduces the chance of tangling of various cords and cables when the insertion section is rotated relative to the handle base section 16.

[0244] In some embodiments, the electronic cable 432, the optical fiber 364 (if present), and the irrigation line 434 may enter the endoscope at an angle relative to the rear handle opening 60. Such an approach may provide an ergonomic benefit to the user by allowing the user to grasp a larger portion of the rear of the handle base section 16.

[0245] As shown, the electronics cable 432, the optical fiber 364 (if implemented within the endoscope), and the irrigation line 434 extend beyond the handle PCB 430a after entering the handle base section 16. The electronics cable 432 plugs into a connector 430b (e.g., a power / HDMI connector) on the handle PCB 430a. The electronics cable 432 may provide power to the endoscope 10. Image data may be passed to the handle PCB 430a via the flexible cable 250. The electronics cable 432 may transmit video data collected by the endoscope 10 to an external graphical user interface display (not shown). The optical fiber 364 (if implemented within the endoscope) and the irrigation line 434 extend below the handle PCB 430a and follow the paths previously described. In embodiments in which the endoscope 10 is disposable, the electronic cable 432, optical fiber 364, and cleaning line 434 are all included as disposable components to ensure sterility between uses of the endoscope or to avoid the cost of packaging for disinfection and reuse.

[0246] In this example, control lines 91 for button 90 are also shown in FIG. 78. As shown, control lines 91 pass through holes in seal member 210. Control lines 91 communicate with handle PCB 430a. Also shown in FIG. 78, handle PCB 430 includes handle PCB flex cable 430e. Handle PCB flex cable 430e connects to handle PCB section 430f, allowing handle PCB section 430f to be oriented at an angle (e.g., perpendicular) relative to the rest of handle PCB 430a. When assembled, the attached flexible handle PCB section 430f is positioned between the two potentiometers 122 of example rotation sensing assembly 150 (see FIG. 8).

[0247] In some embodiments, the handle PCB 430a may include an image or graphics processing unit 430c. However, the image processing unit 430c is preferably located external to the endoscope 10. The image processing unit 430c can function as an electronic correction mechanism for the endoscope 10. The image processing unit 430c receives images captured by the image sensor 380, which are sent from the image sensor 380 to the handle PCB 430a via flexible cable 250. In a preferred embodiment, the images captured by the image sensor 380 are then sent to the image processing unit 430c, which is external to the endoscope 10, via electronic cable 432. The image processing unit 430c may also receive signals from the rotation sensing assembly 150. In some embodiments, an analog-to-digital converter 430d may be included on the handle PCB 430a to convert the signals from the rotation sensing assembly 150. The image processing unit 430c uses the signals from the rotation sensing assembly 150 to electronically "correct" the image to the desired orientation. In some embodiments, the image is rotated by image processing unit 430c to display the image as if it were taken from the user's point of view. In some embodiments, image processing unit 430c may correct for the effects of lens distortion.

[0248] If the orientation of the image displayed in the graphical user interface is not first corrected, the displayed image will be disorienting to the user. By determining the orientation according to the user's viewpoint, image processing unit 430c uses data from rotation sensing assembly 150 to automatically rotate the image so that it matches the user's viewpoint.

[0249] FIG. 79 shows an example block diagram of an imaging system. As shown, the imaging system includes an image sensor 380 that captures images. The images captured by the image sensor 380 are passed to an image processing unit 452 via a camera serial interface (CSI) 450 (e.g., MIPI - Mobile Industry Processor Interface - Camera Serial Interface). The image processing unit 452 (IPU) then passes the image frames to other hardware components of the imaging system, including, but not limited to, a memory device and a graphical processing unit (GPU) 430c. The graphical processing unit 430c can correct distortions introduced by the lens assembly 354.

[0250] In some embodiments, graphical processing unit 430c corrects this distortion by representing the image with a surface texture loaded into graphical processing unit 430c. This adjusts or stretches the image in a manner that corrects and / or removes the distortion introduced by lens assembly 354. In embodiments in which the image is straightened, graphical processing unit 430c may then rotate the corrected image with input from rotation sensing assembly 150 (see, e.g., FIG. 8). For example, measurements from rotation sensing assembly 150 may be passed to graphical processing unit 430c through analog-to-digital converter 430d (see, e.g., FIG. 78). The signal from analog-to-digital converter 430d is then used to rotate the image to its correct orientation. In some embodiments, a user can toggle image straightening, distortion correction, and / or various other image operations to be performed or not. Image straightening is further described herein below in connection with FIG. 80.

[0251] The processed images from image processing unit 430c may be displayed on a graphical user interface or display 454. In some embodiments, the processed images from image processing unit 430c may be stored in memory. In such embodiments, a user may take an image and store it in memory for later recall, for example, by activation with button 90. Some embodiments may include a video processing unit 456 that encodes frames from image sensor 380 into a recordable video format. In such embodiments, the encoded video may be stored in memory. A user may command the endoscope to start and stop saving the video to a file by interacting with a button, such as button 90, as described above.

[0252] In some embodiments, image processing unit 430c may perform feedback analysis of the captured image. In certain embodiments, an image histogram is generated from all pixels of the image. The image histogram may then be used to adjust the image or adjust the exposure of subsequent images received by image chip or sensor 380. Such further processing by image processing unit 430c helps to reduce washed-out or underexposed dark areas of the image. Other means of adjusting the image, such as tone mapping, may also be used.

[0253] FIG. 80 shows an exemplary schematic diagram illustrating how images are rectified using input from the rotation sensing assembly 150 (see, for example, FIG. 80). As shown, a first block 2100 and a second block 2102 are shown. Within each block 2100, 2101, an endoscope 10 is shown having a field of view 2104. The field of view 2104 of the endoscope 10 in the first block 2100 is approximately 180° from the endoscope 10 in the second block 2102. This is accomplished by rotating the distal end of the endoscope 10 relative to the proximal end of the endoscope 10. In a conventional endoscope 10, the image sensor is housed in the proximal section and does not rotate while the distal section is rotated relative to the proximal section. Thus, both the endoscope 10 shown in the first block 2100 and the second block 2102 would have captured image 2106.

[0254] This is not the case in the embodiment described herein, where the image sensor 380 rotates with the tip of the endoscope 10. The endoscope 10 shown in first block 2100 would capture image 2106, and the same endoscope 10 rotated to the position shown in second block 2102 would capture image 2108. When the image sensor rotates with the tip of the endoscope 10, the image sensor inverts the image. In this position, for example, the top of the image sensor picks up what a person familiar with a conventional endoscope 10 would expect to see at the bottom of the image.

[0255] Optionally, the image may be rotated proportionally to the number of degrees of rotation of the tip of the endoscope 10. Thus, the image is always displayed in a manner that would be expected by a user accustomed to a conventional endoscope 10. This helps to mitigate problems associated with a rotating image sensor. Image rotation correction

[0256] In Figure 81, magnets 51 are shown in opposing positions. In reality, they would be mounted on the inside surface of the proximal handle housing of the endoscope handle, but in this view, both the proximal and distal handle housings have been removed for clarity. Rotation sensor 704 is mounted on the handle PCB and is shown in a position that corresponds to the position of magnet 51 in the plane of rotation that includes sensor 704. Note that, optionally, only one magnet 51 can be used to perform the function of providing sensor 704 with position data of the magnet (and thus the proximal handle housing) relative to the sensor (and thus the PCB and distal handle housing to which the sensor is mounted). A relative rotation signal is provided to the controller, allowing the distal handle housing and shaft to rotate relative to the proximal handle housing, while the orientation of the displayed image remains static.

[0257] A "correction mechanism" provided in either the PCB's controller (or, more remotely, in an image processing unit external to the endoscope) is adapted to simulate the image orientation of a conventional rod-lens endoscope, in which the image sensor (camera) proximal to the endoscope shaft is held in a fixed position and the angle of the angled lens at the end of the rod rotates as the rod and shaft rotate. (The angled or angled lens at the end of the rod acts as a prism, and the camera's image remains upright during rotation of the rod lens, while various sections of the surrounding image move in and out of the camera's field of view.) In this case, the camera is placed at the tip of the rotating endoscope shaft, and the camera is mounted at an angle less than 90° relative to the endoscope shaft. The controller in the endoscope or image processing unit tracks the rotational position of the "rod" (or, in this case, camera) portion relative to the endoscope's proximal handle portion, and the controller counter-rotates the displayed image to keep it appearing upright. The end result is a displayed image that remains upright and unrotated, and the field of view appears to change with horizontal translation rather than with rotation.

[0258] FIG. 82 schematically illustrates the regions of an image received by a camera sensor mounted at an angle at the end of an endoscope shaft. The central feature 904—and any central element, if present—is shown in an upright position. The camera sensor is tilted upward relative to the longitudinal axis of the tip of the endoscope shaft, as shown in FIG. 99. The optical axis 841 of the camera sensor and lens (representing the line of rotational symmetry of the camera and lens) is at a non-zero angle Φ with respect to the axis of rotation 843 of the tip of the endoscope and camera sensor 812. The angled orientation of the camera 812 is indicated in FIG. 82 by marker 900. The upper peripheral field is represented by region 906. The right peripheral field is represented by region 908. The lower peripheral field is represented by region 910. The peripheral field of view on the left is represented by region 912. Because the camera sensor and its mount are tilted upward from the longitudinal axis of the distal endoscope shaft, a central element 904 and an upper region 906 are seen predominantly by a viewer of the image processed by the camera sensor array, as shown as image boundary 902. Other peripheral regions move into the dominant field of view without rotation as the endoscope shaft and associated camera sensor and mount are rotated. The angle of the camera sensor introduces different fields of view into the translationally displayed image due to image rotation correction performed by the processor.

[0259] Figures 83A-D illustrate the effect produced by the image rotation correction processor. Arrow 900 indicates the position of the camera sensor mount (and camera sensor) with a beveled end angled toward the arrow, and the optical axis of the camera sensor 802 is angled in the direction of the arrow from the axis of rotation of the endoscope shaft. While the angle itself is arbitrary and could be any angle relative to the longitudinal axis of the shaft tip, in this case the optical axis is at a non-zero angle, e.g., approximately 30° from horizontal (i.e., relative to the longitudinal axis of the endoscope shaft tip). To assist the operator, arrow 900 or a similar graphic indicator is projected on the operator's video display screen so that the operator can continuously identify the orientation of the camera sensor 802. As the endoscope shaft or insertion section rotates relative to the base handle, the camera orientation rotates with respect to a camera field 904, which remains in a fixed position as the camera rotates from Figure 83A to Figure 83D. In a first position, for example, a field of view 906 above a central object 904 is in view (Figure 83A). In the second position, a field of view 908 to the right of the central object 904 comes into view (FIG. 83B). In the third position, a field of view 910 below the central object 904 comes into view (FIG. 83C). In the fourth position, a field of view 912 to the left of the central object 904 comes into view (FIG. 83D). Note that the image correction, or image rotation correction controller, can project a target field of view that changes continuously between these positions, with peripheral fields moving in and out of view translationally rather than rotationally. Without this feature, the image projected on the display screen would rotate with the endoscope shaft; for example, in FIG. 83A, the central object 904 in its upright position (along with the rest of its field of view) would rotate with the camera sensor 802, showing a corresponding rotation of object 914 (and associated fields of view) rather than a translational field of view of object 904, which remains stationary. Thus, the image rotation correction controller receives images from a rotating rod lens to simulate the visual effect of a stationary camera sensor.

[0260] In one embodiment, the rotation correction system may employ a "triaxial" magnetic absolute position sensor mounted on a PCB that can measure magnetic flux density in the x, y, and z axes of space associated with one, two, or more magnets mounted on the inner surface of the proximal handle. (An example sensor includes the Melexis MLX90365 Triaxis® position sensor.) The board-mounted magnetic sensor is fixed relative to the PCB, distal handle housing, and endoscope shaft. The magnetic sensor is configured to rotate with the distal handle housing and about the z axis with little or minimal deviation in the x and y directions. The magnet faces the proximal handle housing and rotates in the xy plane about the sensor's z axis, maintaining constant field uniformity at the sensor's location during a 360° rotation. In a more robust embodiment, two magnets are used in opposing positions on the proximal handle housing (although one magnet may be sufficient for practical system operation).

[0261] The magnetic sensor is configured to provide a linear output corresponding to the angle of the x-y vector components of the magnetic flux density passing therethrough. The angle is calculated using the following formula:

[0262]

number

[0263] where α is the magnetic angle, βx and βy are the x and y components of the magnetic flux density, Vx and Vy are the measured values ​​of the βx and βy Hall signals, and k is a programmable scale factor that defines the sensor sensitivity mismatch between βx and βy. The position sensor itself performs calculations internally to linearize the output. The end result is a linear voltage output between 0V and 5V that corresponds to the angular position using the above equation.

[0264]

number

[0265] The ADC values ​​are read by an on-board microcontroller. The output of the sensor is proportional to its supply voltage, so the supply voltage is also read by the ADC in order to scale the output appropriately.

[0266] In one embodiment, upon request from the controller, the rotation values ​​read from the ADC are sent from the endoscope PCB over a USB link to an external image processing unit (IPU). The values ​​are received by the application through a dynamic link library (DLL) that acts as an interface between the hardware and the controller application. The rotation values ​​measured by the ADC are converted from counts to degrees of rotation in firmware running on the endoscope, in the DLL, or in the application itself. In the illustrated architecture, the conversion is performed in the DLL.

[0267] Through a calibration procedure, in an exemplary arrangement, the minimum and maximum values ​​seen at the sensor intersection from 360° to 0° are measured and stored in an on-board EEPROM (electrically erasable read-only memory) (or other suitable memory chip) on the endoscope PCB. These maximum and minimum output values ​​are scaled to the supply voltage before being stored. The scaled values ​​are read when the endoscope is connected to the controller application and used to determine the rotation value. The formula for converting the current-scaled ADC value to the appropriate angle is, for example:

[0268]

number

[0269] After receiving the scaled rotation values, the image being processed by the application is rotated in the opposite direction by the same amount before being displayed on the screen. Additionally, the controller may optionally generate and display a pointer around the periphery of the displayed image, which rotates around the displayed image and indicates to the end user its current rotation position relative to the 0° point. To ensure that there is no jitter in either the displayed image or the pointer, a filter is applied to the position values ​​for each component to remove any minor adjustments that would result from jitter in the raw ADC values ​​read by the electronic system. The resulting effect seen by the end user is a static image in an upright position regardless of which way the sensor is facing, and a projected field of view that rotates around the sensor's axis of rotation.

[0270] Image motion smoothing

[0271] The act of moving a camera lens from a start position to an end position can be associated with undesirable visual artifacts when viewed on a monitor. This is especially true if the camera movement is performed manually by an operator. Unless the visual impact of the abruptness of the movement is softened or filtered, the image display from the camera sensor will exhibit jitter, resulting in unnatural movements from small, unintended camera movements during movement or when attempting to stop, to overshoots or back and forth. Several methods exist for filtering image rotations and translations before, during, or after camera rotation or translation to reduce the visual artifacts of unnatural movement, signal noise, or hand tremors. Filtering can be performed on the actual measured translational or rotational angular position of the camera. It has been found that the image display of a rotated or translated image can be improved by providing a low-pass filter with one or more variable filter coefficients, with the processor selecting the filter coefficients based on whether the camera is beginning or ending a movement or whether the camera is moving quickly or slowly. When applied to camera movements that aim to align with a moving object or pan a scene, the degree of filtering may be decreased during fast movements and increased during slow movements. When applied to camera movements that aim to move to a new field of view, the degree of filtering of the camera's rotational or translational position may be decreased at the beginning of the camera movement and increased as the camera approaches the visual destination. (The beginning of a camera movement typically correlates with camera acceleration, and the end of a camera movement typically correlates with camera deceleration.) This creates a "soft landing" visual effect for images near the end points of the rotation or translation, while allowing the displayed image to move quickly to a point near the intended destination image. If the image rotation is corrected by the processor to maintain the upright orientation of the field of view, the "soft landing" effect is observed as the viewed image moves to the end point.

[0272] Typically, the low-pass filter used in smoothing is calibrated or programmed to have a variable corner frequency, which varies according to rotational or translational data generated by a motion or position sensor associated with the camera. For example, a position sensor 704, shown in FIG. 81, may be used to detect the angular position of the camera relative to the proximal endoscope handle (which holds the magnet 51). Alternatively, a position sensor may be coupled to the pull wire 502 of the pivotable camera housing 500, shown in FIG. 27, or to a handle-based mechanism, shown in FIG. 12, that moves a pull wire or cable that rotates the camera housing. The position data may be related to rotational or translational velocity or rotational or translational acceleration. Furthermore, filtering or smoothing may vary differently depending on whether the position signal or data indicates camera acceleration or deceleration. As used herein, a low-pass filter is defined as one that performs more filtering or smoothing as its corner or cutoff frequency is lowered. Digitally, this is accomplished by more strongly biasing or relating the actual current position data to the most recently filtered or unfiltered position data. There are several ways to configure or program the filter, but typically the end result is that the processor automatically adjusts one or more filter coefficients of the low-pass filter in real time in response to the nature of the camera rotation or translation detected by the sensor. An exemplary implementation of this feature is provided by an endoscope having a camera at the tip of a rotatable endoscope shaft. In this example, the rotation signal generated by a sensor in the endoscope handle can be filtered without image rotation correction, or before or after image rotation correction processing has been performed.

[0273] FIG. 84 shows a flowchart of a processor implementing a camera acceleration-based smoothing algorithm, allowing the displayed image to respond quickly to the onset of camera movement or to arrive at the target image position more slowly if the operator slows the camera movement before the displayed image arrives at the view target. The time step increment is assumed to be constant. A position sensor detects the camera's position (920). This position is compared to the position in the previous time step, and the processor determines whether the change in position indicates the camera is accelerating (922), decelerating (924), or maintaining a constant velocity (926). If accelerating, the processor adjusts the digital filter to reduce smoothing of the position data (928). If decelerating, the processor adjusts the digital filter to increase smoothing of the position data (930). If at a constant velocity, the processor maintains the previous filter smoothing (932). A low-pass filter is applied to the camera position data using selected filter characteristics (934), and the processor time step advances (936).

[0274] FIG. 85 shows a flowchart of a processor implementing a camera rotation-based smoothing algorithm, allowing the displayed image to respond quickly to the initiation of camera rotation or to arrive more slowly at the target image position if the operator slows the camera rotation before arriving at the view target. The time step increment is assumed to be constant. A position sensor detects the camera's position (940). This position is compared to the position in the previous time step, and the processor determines whether the change in position indicates the camera is accelerating (942), decelerating (944), or maintaining a constant velocity (946). If accelerating, the processor adjusts the digital filter to reduce smoothing of the position data (948). If decelerating, the processor adjusts the digital filter to increase smoothing of the position data (950). If at a constant velocity, the processor maintains the previous filter smoothing (952). A low-pass filter is applied to the camera position data using selected filter characteristics (954), and the processor time step advances (956).

[0275] Suitable low-pass filters include, for example, infinite impulse response (IIR) filters such as single-pole filters, exponentially weighted moving average filters, and second-order Butterworth filters, or finite impulse response (FIR) filters such as moving average filters and moving window filters. In one example, a discrete, infinite impulse response (IIR), single-pole, low-pass filter can be used on the measured translation or angular position. The low-pass filter can have variable filter coefficients that affect smoothing based on angular velocity and a slew rate based on the sign of each acceleration.

[0276] An example of an IIR response filter is:

number

[0277] The effect of smoothing on the filter coefficients is the corner frequency (f C ) related to:

number

[0278] FIG. 86 is a flow chart of a processor implementing an IIR low pass filter algorithm to filter the rotation signal of a rotating camera. The low pass filter can have variable filter coefficients based on the rotation rate and rotation acceleration. The algorithm begins in step 962 with the current angle θ of the camera. i In step 964, the algorithm receives the filtered angular velocity θ′ f,i where the filtered angular velocity is determined by the current angle θ i and the front camera angle θ i-1 Based on the angular velocity θ' f,i is the time step (θ m , i -θ f , i-1 ) In step 966, the algorithm calculates the filtered angular acceleration θ″ f,i where the filtered angular acceleration is the current angular velocity of the camera, θ' f,i and the previous angular velocity θ' f,i-1 Based on the angular velocity θ' f,i is the time step (θ m , i -θf , i-1 ) is equal to each rate of change coefficient (e.g., θ' f,i For example, the Δt portion of the equation may be implicitly related to the coefficients of the equation (e.g., velocity terms) or may be omitted because it is not necessary (e.g., in one embodiment, only the acceleration terms are calculated to determine the sign).

[0279] Variable filter coefficient β i is determined in step 1000 and is characterized as decreasing the smoothing effect (increasing the corner frequency) when the angular acceleration is positive, keeping the smoothing effect constant when it is zero, and increasing the smoothing effect (decreasing the corner frequency) when the angular acceleration is negative. In one example, the filter coefficient β i The variation of can be described mathematically as follows:

[0280]

number

[0281] Here, θ' f,i is the angular velocity of the camera position, θ'' f,i is the angular acceleration of the camera position, β i-1 is the variation of the filter coefficients at the previous time step. The terms 2 and 0.1 in Equation C are arbitrary and can be other constants or determined empirically by testing to find the most visually appealing effect of the filter on image rotation.

[0282] A discretization, infinite impulse response, and single-pole low-pass filter are performed in step 1010 to obtain the current angle signal θ i Part α of i is added to the angle signal θ i-1 The second part of the filtered value before (1-α i ) This filtering process is expressed by Equations D and E.

number

[0283] The filter expressed by equation CD in step 1010 may be implemented in a variety of codes, including but not limited to C++, Python, machine language, etc. The choice of code is arbitrary. f,i-1 is output to a processor that rotates the image, or optionally corrects the rotated image to maintain an upright position of the displayed field of view as the camera rotates.

[0284] In one example, the IIR method described in Figure 84 can be applied more generally to translational motion of a camera sensor. i , velocity X' i , acceleration X'' i is the angular position θ i , angular velocity θ' i , angular acceleration θ'' i It remains unchanged except that it changes to

[0285] A discretized, infinite impulse response, single-pole low-pass filter implementation for translational motion is given by:

number

[0286] Variable filter coefficient β i can be based on the signs of the velocity and acceleration.

number

[0287]

number

[0288] 87 shows another example of a processor algorithm 1020 adapted to enhance a displayed image by filtering the image rotation angle based on the angular acceleration of the camera rotation. The algorithm 1020 includes steps to modify the received camera angle and limit intermediate values ​​to improve the stability of the algorithm. In step 1022, the processor calculates the current camera angular position θ i In step 1024, the processor corrects the wrap angle, e.g., if it is greater than 360° or less than 0°, it corrects the angle value to an equivalent angle between 0° and 360°. This step need not be included if the angle sensor is configured to report only angles within one revolution, e.g., between 0° and 360°.

[0289] In step 1026, the algorithm calculates the current angular position θ i,c and the previous filtered angular position θ f,i-1 The minimum angle Δθ between i Note that between any two angular positions on the circle, there are two angles: a smallest angle with a magnitude less than 180° and a second angle with a magnitude greater than 180°. Algorithm 1020 calculates the smallest angle Δθ to improve the stability of the algorithm and the stability of subsequent calculations. i Note that for a fixed time step, the minimum angle can also be thought of as the angular velocity.

[0290] In step 1028, the angular acceleration coefficient dm i is the minimum angle Δθ normalized by 180 iand the previous filter coefficient β i-1 Angular acceleration coefficient dm i is effectively the normalized acceleration, which is equal to the normalized change in angular velocity. In step 1028, the resulting angular acceleration coefficient is calculated as the minimum value dm MIN Not less than the maximum value dm MAX In some cases, the dm MIN is -1, dm MAX is set to 1.0. As above, Δθ i is the angular velocity, and dividing by 180 normalizes the angle to the ratio of the largest possible angle difference. As explained below, the filter coefficient β i is β i is β i-1 Plus it is equal to normalized acceleration, so it can be thought of as normalized angular velocity.

[0291] In step 1030, the filter coefficient βi is calculated based on the acceleration coefficient dm i The smoothing effect is decreased (the filter corner frequency is increased) when the acceleration factor is greater than zero. When the acceleration factor is less than zero, the smoothing effect is increased (the filter corner frequency is decreased). When the acceleration factor is zero, the smoothing effect is unchanged. Next, step 1030 calculates the resulting filter coefficient β i The minimum value dβ MIN Not less than the maximum value dβ MAX In some cases, dβ MIN is -1, dβ MAX can be set to 1.0.

[0292] The filter implemented in step 1040 is a discretized, infinite impulse response, single-pole low-pass filter. i The part is the rotation position θ f,i-1 is added to the new filtered angular position θ fiThe coefficient C3 is a constant, set to 0.95 in one example, but may be set to other fractions based on empirical observations of the visual effect of the filter. The filter coefficients are determined in step 1030 as described above. In other examples, the filter identified in step 1040 may be another type of filter, such as a Butterworth filter (where the node frequency is related to the smoothing effect) or a finite impulse response filter, such as a moving window filter (where the window width is proportional to the smoothing effect).

[0293] In step 1042, the new filtered rotational position or angle θ fi represents the rate of the total rotation, and θ MIN Not smaller than θ MAX In this case, θ MIN is 0, θ MAX is set to 1. In that way, the percentage angular position is maintained to within a fraction of 1 (which indicates a full 360° rotation). Finally, in step 1044, the filtered and limited new rotation angle is output to a processor that rotates the image, or optionally corrects the rotated image to maintain the orientation of the displayed field of view as the camera rotates.

[0294] When used in conjunction with image rotation correction, a viewer of the displayed image will notice that the image rotation correction occurs rapidly with little latency during the beginning of the camera sensor rotation, and that as the target rotation position is approached and the operator slows down the camera rotation, the image rotation latency before approaching the target position increases. Alternatively, the image rotation latency may also increase as the controller corrects for an overshoot of the target rotation position. The visual effect is similar to the image rotation appearing to make a "soft landing" at the target rotation position. Reduced electromagnetic radiation

[0295] FIG. 88A shows a schematic diagram of a typical layout of signal, communication, and clock wiring 706 embedded in a printed circuit board 708 having a microstrip structure. This type of structure is standard and generally suitable for most applications. However, in PCBs (whether rigid or flexible) extending along the shaft of an endoscope, high-frequency transmission (which can reach the gigahertz range) can cause excessive electromagnetic radiation from the board and shaft. A single uniform ground plane 710 in a microstrip structure may be insufficient to suppress the propagation of such radiation from the upper side of the board. FIG. 88B shows a schematic diagram of an implementation of a stripline board 712 structure. In this case, a ground plane 710 is located below the signal wiring embedded in the board, and a second ground plane 714 is located above the signal wiring. The ground planes 710 and 714 are connected by a ground plane VIA (vertical interconnect access) 716. The addition of an upper ground plane 714 and a lower ground plane 710 has been found to significantly reduce electromagnetic radiation from elongated boards extending the entire length of an endoscope shaft.

[0296] Electrical isolation from the endoscope's image processing unit

[0297] FIG. 89 shows a block diagram illustrating how the endoscope is electrically isolated from the external image processing unit. In this example, an optical coupling arrangement is implemented to enhance electrical isolation of the endoscope (and by extension, the patient) from the digital electronics of the image processing unit and chassis ground external to the endoscope. In the illustrated arrangement, a USB 3.0 power signal interface is used to provide electrical and electronic connections between the endoscope's PCB 720 and the image processing unit's electronic controls. The signal interface is adapted to operate up to approximately 5 GHz. Optical couplings 724, 726 between the endoscope's cable and the image processing unit can therefore provide a suitable form of isolation. For example, a USB 3.0 fiber optic extension cable can be used to provide USB 3.0 signal isolation. The digital communication interface between the local 726 and remote 724 is optically coupled via a 0.5M fiber optic cable. Examples include the Icron Spectra® 3022, Intelix® DIGI-FO-USB3.0, and Newnex FIreNEX®-5000H board set, among other options. Fixed Angle Camera Sensor and LED Housing Assembly

[0298] In one embodiment, the camera sensor and LED light may be fixed at a predetermined angle, as shown in Figures 90A and B and 99. In this example, a rigid printed circuit board 800 holds a camera sensor 802, as shown in Figures 90A and B and 91. The circuit board 800 (in this case a flexible / rigid hybrid) extends adjacent to a flexible board 804 that is bent to place the optical axis of the camera sensor 802 at a desired angle (in this case, approximately 30°) relative to the longitudinal axis of the tip of the endoscope shaft. A second board 804 (flexible or rigid) that carries power to the LED 806 extends adjacent to the flexible board 808 or cable. The board 804 has a hole 810 through which a lens 812 protrudes to focus a target image onto the camera sensor 802.

[0299] 90B, in an alternative configuration, a flexible substrate or cable 808 extends from a lowered portion or end of the circuit board 800 to provide a ground plane to support the LEDs 806. In this arrangement, the LED substrate 804 does not need to extend beyond the camera lens 812, eliminating the need to create holes in the LED substrate through which the LEDs 812 protrude.

[0300] FIG. 91 illustrates a fixed-angle camera assembly including a handle portion PCB 518 and a shaft portion PCB 804 (flexible, rigid, hybrid flexible and rigid, or a combination thereof). The tip 800 of the shaft portion PCB 804 may be rigid and provide a mount for the camera / lens assembly 812 or LED 806. A flexible substrate would be suitable for the portion 808 that determines the angle of the optics. Either a flexible substrate, a rigid substrate, or a combination thereof can be used for the portion 804 that is inserted into the endoscope shaft. As shown, the shaft portion PCB 804 forms a permanent connection to the handle portion PCB 518, and the combined electronics form a single, inseparable structure. In some cases, the shaft portion PCB may simply be an extension of the handle portion PCB. In other cases, it may be convenient to form the permanent attachment or connection 805 of the shaft portion PCB 804 to the handle portion PCB 518 after pre-assembly of the endoscope (e.g., insertion of the shaft portion PCB and optical housing into the inner sheath). A permanent connection can be made to the handle portion PCB 518. The entire assembly can be coated as a unit against liquid ingress (e.g., with a parylene coating on the electronics) since the two PCB parts are not separated after assembly.

[0301] Figure 92 shows an exploded view of an example endoscope with a fixed-angle camera and LED at the shaft tip. A hybrid flexible / rigid substrate within the inner sheath 312 terminates at its distal end with a camera sensor / LED assembly of optical bench 820. A distal handle housing or handle section 30 is partially enclosed within the proximal handle assemblies 21, 23. In this example, the handle PCB is located within a housing 431 connected to the handle distal section 30. An irrigation line 434 is connected to a conduit within the inner sheath 312 and, in this example, exits the rear end of the endoscope handle 21, 23.

[0302] Figure 93 shows a partial cutaway view of a flexible / rigid substrate 808 for an LED 806 that is located on a corresponding substrate of a camera sensor 802. In this example, a hole is formed in the LED substrate 808 to accommodate the protruding portion of a camera lens 812. Figure 94 shows an optical housing or mount 820 in which the camera sensor and LED are mounted or installed. The optical housing 820 extends distally outward from the end of an inner sheath 826 of the endoscope. The optical housing and the end of the associated camera lens and LED are substantially covered or protected by an outer sheath or trocar 840 when the endoscope is in use (shown in Figure 99).

[0303] FIG. 95 shows a top perspective view of the optical housing or mount 820. The distal end of the endoscope shaft flexible substrate or cable, the camera sensor, and associated LEDs can be mounted at a fixed angle relative to the longitudinal axis of the endoscope shaft by encasing the optical elements, the substrates on which they are mounted, and the distal end portions of one or more flexible substrates in the optical housing 820. This can be a molded plastic part, cast (e.g., injection molded) around the optical components and flexible substrates at the distal end of the endoscope. This serves both to secure the optical and lighting elements (camera sensor, LEDs) and their flexible substrates in place and to seal them from contact with liquids. Once formed and cured, the assembly (optical housing 820 and encased optical and lighting components) can be inserted into the endoscope shaft (via a press fit or, for example, with an adhesive). While any angle can be chosen, in some examples, the optical axis of the camera sensor and / or LEDs is fixed at a non-zero angle, such as an angle between approximately 30° and 70°, relative to the longitudinal axis of the distal end of the endoscope shaft.

[0304] 96 shows a bottom perspective view of the optical housing 820. A molded-in LED hole 822 and a molded-in camera lens hole 824 are shown, along with surface grooves on the exterior surface of the housing 820 to direct cleaning fluid in various directions.

[0305] FIG. 97 shows the optical housing 820 after it has been inserted into the distal end of the inner sheath 826 of the endoscope shaft. At the top, the distal end 828 of the inner sheath 826 abuts the raised section 830 of the optical housing 820, forming a liquid seal with the housing 820 excluding the channels formed on the housing's exterior. An upper channel 832 is shown communicating with a side hole 834 between the distal lateral side 836 of the inner sheath 826 and the lateral side 838 of the housing 820. In this example, the side holes 834 are present on both sides of the housing 820, each providing a liquid exit channel from the central channel of the endoscope shaft to the area covering the camera lens 812 and LED 806. Thus, liquid flow through these side holes helps flush away air bubbles, debris, or other materials that come into contact with the lens and LED surfaces during endoscope use. Optionally, the upper channel may also be molded to direct cleaning fluid directly to the upper side of the end optical elements 812, 806.

[0306] FIG. 98 shows a top perspective view of the optical housing 820 inserted into the inner sheath 826. An illustration of the general direction of the upper fluid flow 838 is shown. Note that the distal portion of the optical housing 820 is intended to be at least partially covered by the outer sheath (trocar) of the endoscope during use. This is shown in FIG. 99, where the endoscope shaft (including the inner sheath and optical housing) is shown inserted into an outer sheath or trocar 840. Note that the trocar gap / hole 842 leaves the side hole 834 open to the exterior surfaces of the lens 812 and LED 806. In this arrangement, there is no hole above the top of the optical housing to allow fluid exit. In another embodiment, the trocar design provides an upper gap to allow irrigation flow over the top of the end optical elements 812, 806. Also shown in this view is a lower hole 844 in the outer sheath / trocar 840 to allow irrigation fluid to exit the endoscope shaft more proximally, away from the optical axis of the optical elements 812, 806.

[0307] Additionally, a lateral channel is also formed in the optical housing to direct cleaning fluid out a lower lateral hole in the distal shaft of the endoscope near the camera-lens-LED assembly. As shown in FIG. 100, a bottom perspective view of the optical housing 820 shows channels formed in the molding that allow cleaning fluid to flow both laterally 846 and downward 848 along the exterior surface of the housing 820. FIG. 101 shows both a lower hole 850 and a lateral hole 852 in the inner sheath 826 of the endoscope shaft, completing the channel walls through which cleaning fluid flows from the interior of the endoscope shaft toward the exterior surface of the endoscope shaft. FIG. 102 shows the endoscope shaft with the inner sheath and optical housing inserted into an outer sheath or trocar 840, as positioned during use. In this example, the outer sheath / trocar includes a lower hole 854 and a side hole 856, in addition to the distal hole 842, which completes the cleaning pathway available to the endoscope during use. It should be noted that this particular arrangement is by no means exclusive, and other hole arrangements and sizes may be selected depending on the particular cleaning fluid flow characteristics desired. Combination irrigation and suction arrangement

[0308] When used in combination with a properly designed trocar, the endoscope can be configured to simultaneously irrigate and aspiration, or more conveniently alternate between irrigation and aspiration. FIG. 103 shows a schematic longitudinal cross-sectional view of an endoscopic trocar / insertion shaft combination that creates a fluid flow path between the inner wall of the trocar 860 and the outer wall of the endoscope shaft 862. In this case, the sheath of the endoscope shaft 862 has a smaller cross-sectional internal spatial area to accommodate a fluid passageway 864 between the inner sheath and the outer sheath carrying the trocar. In other configurations, the diameter of the trocar can be increased to provide an inter-sheath space 864, i.e., the space between the outer sheath (trocar) 860 and the inner sheath 862 of the endoscope shaft. Note that the endoscope shaft tip 866 must be large enough to accommodate a camera (CCD) and / or lens and LED mount or housing. The dimensional requirements of the camera and / or lens will likely dictate how small the minimum diameter of the endoscope shaft tip 866 can be. However, it should be noted that the remainder of the endoscope shaft 862 can be smaller in diameter than the tip 866 because the components therein (fluid interior, LED / camera power lines, camera signal lines) occupy less cross-sectional space than the tip 866. Thus, the overall diameter of the endoscope shaft-trocar assembly does not need to be large to accommodate the fluid passageway 864 between the trocar 860 and the endoscope shaft sheath 862.

[0309] In the illustration of FIG. 103 , a central interior space 868 of the endoscope shaft communicates with an opening associated with a tip structure 866, such as the illustrated distal opening 870. The central interior space 868 communicates with a proximal opening 872, which can branch off from a distal end 874 of an endoscope handle (not shown), as shown, or can pass through the endoscope handle via opening 876 and exit the handle at its proximal end (e.g., as shown in FIGS. 46 and 78 ). Preferably, the inter-sheath interior space (or exterior interior space) 864 communicates with a distal opening 878 formed in the distal portion of the trocar 860 near the location of the distal end 866, such that the central interior space 868 and its opening 870, and the inter-sheath interior space 864 and its opening 878, communicate with the same anatomical space during the procedure or examination. The intersheath or outer interior space 864 communicates with a base opening 880 formed in a base housing 882 of the trocar 860. Such a base opening 880 may be included, for example, in the trocar mounting structure 15 shown in FIG. 3B, the cannula mount 300 of FIGS. 16A-B, or the base of the cannula 318 shown in FIG. 78. Optionally, an elastomeric seal may be included distally or proximally to isolate the fluid contents of the central interior space 868 from the intersheath or outer interior space 864. For example, an O-ring 884 may be located between the tip mount 866 and the trocar 860 . In another example, an O-ring 886 may be located between the trocar base housing 882 and the coupling to the distal end portion 874 of the endoscope handle. In the illustrated arrangement, either the central interior space 868 or the inter-sheath interior space 864 may be used as an irrigation or aspiration conduit, depending on the particular application to which the endoscope is being applied. FIG. 104 shows an example of how the distal central conduit opening 870 and the distal inter-sheath opening 878 may be aligned. If a distal housing 820, as shown in FIGS. 85-92, is used, the distal central conduit opening would be positioned in a more complex manner.

[0310] However, the openings can be positioned so that the fluid pressure and flow rate delivered to the dissection site can be automatically adjusted by adjusting the relative irrigation and suction pressures applied to the endoscope. This can be done manually through valves connected to the proximal openings or electronically. For example, one or more electromechanical valves can be connected to one or both proximal openings and controlled by the user via a controller using buttons or switches located on the endoscope handle. This arrangement allows the user to adjust the insufflation pressure exerted by the irrigation fluid on the anatomical tissue defining the cavity being examined. Furthermore, the flow rate of the irrigation fluid can be adjusted to remove debris from a location within the cavity being investigated or from the surface of a camera, lens, LED, or other optical element at the tip of the endoscope shaft. The controller can also be used to adjust the internal cavity pressure at the dissection site by adjusting the irrigation inlet pressure to a given suction pressure provided by a negative pressure source or to a given outlet flow resistance provided by an outlet valve connected to the proximal suction opening. The controller can also be used to control the irrigation fluid flow rate by adjusting the differential pressure between the irrigation inlet and suction outlet. This may involve controlling the pressure (either positive or negative) of the pressure source or varying the flow resistance using valves connected to the irrigation and aspiration openings. The controller may monitor either the fluid flow rate or pressure using sensors connected to the aspiration and irrigation lines and control the flow rate or pressure. Alternatively, the required pressure and flow adjustments may be made empirically by the operator using one or more electronic buttons or switches on the endoscope handle and visually observing the effect of the adjustments.

[0311] In a preferred arrangement, the inter-sheath space (i.e., the space between the trocar / outer sheath and the endoscope shaft / inner sheath) may be used to provide suction to remove fluid from spaces located near the endoscope tip. The advantages of this arrangement are shown in FIG. 99. The distal opening 870 connected to the central interior space 868 may also be configured to direct clean fluid toward a camera, lens, LED, and / or other optical elements located at the endoscope shaft tip before the fluid enters the anatomical space 888. Return fluid can be aspirated via the inter-sheath distal opening 878, located more proximally on the endoscope shaft. Thus, the irrigation fluid helps to keep the optical elements free of debris during the procedure and also fill and / or widen the anatomical space being examined or treated.

[0312] The various embodiments shown in the drawings are presented only to illustrate certain examples of the features of the disclosure. Not all features shown in a given drawing must be included in a claimed device or feature. The drawings are to be understood as being for illustrative purposes only, and the dimensions of some elements may be exaggerated and not drawn to any particular scale. Furthermore, elements shown in the drawings with the same reference numerals may represent identical elements or similar or similar elements, depending on the context.

[0313] The terms "first," "second," "third," and the like, whether used in the detailed description or in the claims, are intended to distinguish between similar elements and do not necessarily dictate a sequential or chronological order. Terms so used are interchangeable where appropriate (unless expressly stated otherwise), and it should be understood that the disclosed embodiments described herein are capable of operation in other orders and / or arrangements other than those described or illustrated herein. A first aspect of the present invention is 1. An optical housing for a distal end of an endoscope shaft, comprising: a molded member that partially encloses the camera sensor and the light source, fixes the angular position of the camera sensor and the light source relative to a longitudinal axis of the distal end of the endoscope shaft, and secures the camera sensor and the light source within the distal end of a cylindrical sheath that comprises the endoscope shaft; a molded member having an outer diameter for leak-tight, sealed engagement with at least a portion of the sheath of the endoscope shaft; the molded member includes a plurality of grooves formed in an outer surface of the molded member to provide one or more fluid flow paths between the endoscope shaft fluid path and the outer surface of the endoscope shaft; It is an optical housing. A second aspect of the present invention is the camera sensor includes a lens adjacent to the camera sensor, and the optical housing includes a lens opening through which the lens receives light at the distal end of the endoscope shaft; 1 is an optical housing according to a first embodiment. A third aspect of the present invention is the light source comprises a light emitting diode, or LED, located adjacent the lens, and the optical housing includes an LED opening through which the LED projects light onto an area outside the tip of the endoscope shaft; 1 is an optical housing according to a second embodiment. A fourth aspect of the present invention is the camera sensor is mounted on a camera sensor printed circuit board, the camera sensor printed circuit board being enclosed in the optical housing; 1 is an optical housing according to a first embodiment. A fifth aspect of the present invention is the light source is mounted on a light source printed circuit board, and the light source printed circuit board is surrounded by the optical housing; 1 is an optical housing according to a first embodiment. A sixth aspect of the present invention is the light...

Claims

1. 1. An endoscope and a processor, the endoscope having a camera located at the tip of a shaft of the endoscope: the shaft and the camera are rotatable together about an axis of rotation; the endoscope having a rotation sensor adapted to measure an angle of rotation of the camera about the axis of rotation; the processor is configured to filter the rotation signal from the rotation sensor to smooth rotation in the displayed image; the filter is configured to provide greater smoothing when the camera rotation is decelerating than when the camera rotation is accelerating; Endoscope and processor.

2. the filter is a low pass filter, and the smoothing has an inverse relationship to the corner frequency of the low pass filter; The endoscope and processor of claim 1 .

3. The filter maintains constant smoothing of the rotation of the displayed image if the camera is rotating at a constant speed; The endoscope and processor of claim 1 .

4. 1. A filter for processing a rotation signal of a rotating camera sensor, comprising: The filter is configured to smooth a displayed rotation of an image from the camera sensor; the rotation signal is configured to measure the angular orientation of the camera sensor; the filter is configured to provide greater smoothing when the camera sensor is decelerating than when the camera sensor is accelerating; filter.

Images