Endoscope with camera capable of panning and related methods

Abstract

The present invention provides an endoscope having a proximal handle housing that is rotatable relative to the distal handle housing. [Solution] A handle assembly comprising an insertion shaft 14, a proximal handle portion 16, and a distal handle portion 30, wherein the distal handle portion is rigidly coupled to the insertion shaft, and the distal handle portion is configured to rotate along the longitudinal axis of the insertion shaft with respect to the proximal handle portion; and a printed circuit board. A base located at the distal handle portion, and a first extension from the base having an image sensor at its distal end, The endoscope 10 comprises a printed circuit board and a second extension from the base, which has one LED even if not at its distal end, and the first and second extensions extend in close proximity to each other through the lumen of the insertion shaft.

Description

Technical Field

[0001] Cross - reference to Related Applications This is a patent application claiming priority from U.S. Provisional Application No. 62 / 306,288 (filed on March 10, 2016, titled "Endoscope with a Camera Capable of Panning and Related Methods") (Attorney Docket No.: R44) and U.S. Provisional Application No. 62 / 212,871 (filed on September 1, 2015, titled "Endoscope with a Camera Capable of Panning and Related Methods") (Attorney Docket No.: Q57), and these U.S. provisional applications are hereby incorporated by reference in their entirety.

[0002] Technical Field The present disclosure relates to endoscopic instruments for observing and working in relatively inaccessible spaces, and in some aspects, for performing surgery in narrow spaces within the body using an endoscope or arthroscope, etc., on body structures.

Background Art

[0003] The use of endoscopic instruments in the field of medicine has been established to enable the observation of remote locations and surgery in inaccessible spaces. Such instruments are also useful in the automotive industry, aircraft industry, plumbing industry, electronics industry, and many other industries. In the fields of medical and veterinary practice, endoscopy and arthroscopy are often used to observe and treat anatomical areas when minimizing or eliminating incisions or avoiding disturbing nearby tissues. For example, in orthopedics, the condition of joints such as the knee and shoulder can be examined using at least one arthroscopic instrument introduced into the joint through at least one small skin incision. Such instruments are also used to repair various intra-articular tissues. Standard open surgery techniques for observing and repairing these anatomical areas are considerably more time-consuming, carry greater risks and trauma to the patient, and result in longer recovery periods. Furthermore, the anesthesia associated with open surgery is more complex, risky, and expensive. In the field of more advanced observation, endoscopes may feature an actively flexible distal end that can be controlled by the user at the end of the instrument's handle. This is not a viable option when the tip of the instrument is located in a confined space where bending the distal end of the endoscope cannot provide the necessary range of motion. In medical applications, one such example would involve intra-articular surgery. Generally, instruments with a rigid insertion shaft would be preferred when the use of instruments with an actively flexible distal end is impractical. A rigid shaft can offer improved field of view and image reproduction, expanded space for instruments with additional functions, and greater durability. However, rigid endoscopes and arthroscopes have a limited field of view and require repeated repositioning and rotation to expand the field. Some endoscopes and arthroscopes must be physically removed from the patient to change parts in order to alter the field of view. While cannula systems facilitate this method, they increase procedural complexity and the size of the incision. Such limitations reduce surgeon efficiency, increase surgical time, and increase the risk of iatrogenic injury. In medicine and other applications, it is advantageous for endoscopes to have an enlarged or variable field of view without the use of an actively flexible distal section. It is also advantageous to integrate the function into a single conduit to reduce the overall diameter of the endoscope shaft. Furthermore, current instruments tend to degrade in function and optical quality with repeated use, cleaning, and / or disinfection. Endoscope designs that have low manufacturing and assembly costs, justifying non-reuse, are also advantageous. This eliminates the costs of repeated cleaning, disinfection, and repackaging, and makes it easier to standardize the sterility, quality, and reliability of disposable instruments. [Disclosure of the Invention]

[0004] The endoscope may comprise a shaft having a proximal handle and a distal insertion end in which a camera assembly is mounted within a rotatable housing. The rotatable housing is configured to rotate around an axis generally perpendicular to the long axis of the insertion end, and the rotatable housing is the most distal element of the endoscope at the insertion end. The camera assembly may include a lens adjacent to an image sensor, which may be a CMOS or CCD device. A pull wire may extend from the handle to the insertion end of the shaft, and the pull wire is wound around a portion of the rotatable housing and configured to rotate the housing during the back-and-forth movement of the pull wire within the endoscope shaft. The housing may have a range of motion that gives the camera assembly a field of view including a region along the long axis of the insertion end and a region at least perpendicular to the long axis of the insertion end. In some cases, this may include a range of about 0 to about 120 degrees, or about 35 to about 115 degrees, with respect to the long axis of the insertion end. The housing may be a spheroidal shell consisting of two semi-shells, one or both of which have notches configured to house an image sensor or camera assembly (e.g., lens + image sensor). A light source may be mounted in a rotatable housing so as to illuminate the field of view pointed to by the camera assembly.

[0005] In another embodiment, the endoscope comprises a shaft having a proximal handle and a distal insertion end, and the camera assembly is configured to rotate around an axis substantially perpendicular to the long axis of the insertion end. A light source may be positioned at the insertion end of the shaft and oriented to project light in a direction substantially perpendicular to the long axis of the insertion end. The rotational range of the camera assembly's field of view may include or exclude the area illuminated by the light source. In this case, illumination by the light source provided in the image sensor or camera is indirect, reflected, or ambient light. The light source may comprise one or more LEDs.

[0006] In another embodiment, the endoscope includes a printed circuit board (PCB), which includes a base located within the handle of the endoscope and one or more elongated extensions of the PCB configured to extend from the base of the PCB in the handle through the shaft of the endoscope, terminating at the distal insertion end of the shaft. The base of the PCB may be a composite of a flexible substrate fitted to or clamped on a rigid substrate, and may include at least one flexible substrate extension or at least one extension including a rigid substrate extension, or at least two extensions including a flexible substrate extension and a rigid substrate extension. The proximal leg of the flexible substrate extension may be at an angle of about 90 degrees with respect to the proximal end of the rigid substrate extension, and the distal leg of the flexible substrate extension may be curved parallel to the rigid substrate extension. The proximal leg of the flexible substrate extension can then be bent to align the distal leg of the flexible substrate extension adjacent to the rigid substrate extension. Both the rigid substrate extension and the flexible substrate extension can extend through the lumen of the shaft of the endoscope. The PCB and its extension may be coated with a water-resistant coating or film so that the extension can extend through the fluid transport lumen of the endoscope shaft. The flexible substrate extension can be connected to a rotatable image sensor (such as a CMOS or CCD) in the distal insertion end of the endoscope shaft, and the rigid substrate extension can be connected to one or more fixed light sources at the insertion end of the shaft. The flexible substrate extension is configured to have sufficient slack to allow the image sensor to rotate freely within a predetermined range of rotation.

[0007] In another embodiment, the endoscope may include a proximal handle housing configured to house an electronic processing board for processing signals from an image sensor located at the distal end of the endoscope shaft. The distal handle housing is configured to hold the electronic processing board in a fixed position relative to the distal handle portion. One or more magnets are attached to the inner wall of the proximal handle housing, and the magnets are positioned next to a Hall effect sensor on the electronic processing board. Thus, the proximal handle housing is rotatable relative to the distal handle housing, and the Hall effect sensor is configured to provide the electronic processor with a signal representing the relative rotation of the proximal handle housing relative to the distal handle housing. The electronic processor may be connected to a user interface that displays images generated by the image sensor, and the direction of rotation of the image can be changed by a change in the relative rotation of the proximal handle housing relative to the distal handle housing.

[0008] In another embodiment, the endoscope includes a handle surrounding an electronic processing board for processing signals from an image sensor located at the distal end of the endoscope shaft. A button on the handle includes a component surrounding a magnet located on or near a portion of the electronic processing board on which the Hall effect sensor is located. Thus, pressing, releasing, or operating the button alters the magnetic field near the Hall effect sensor to a degree sufficient to modify the signal generated by the Hall effect sensor. The button may be configured to cause an electronic controller connected to the electronic processing board to start recording an image generated by the image sensor, stop recording an image generated by the image sensor, or capture an image generated by the image sensor, based on the user's movement or release of the button. The button may also be configured to cause an electronic control unit connected to the electronic processing board to turn on, turn off, or adjust a light source located at the distal insertion end of the endoscope shaft, based on the user's operation or release of the button. Movement or release of the button may include pressing the button for a short or longer duration, a predetermined series of two or more presses and releases of the button, or releasing the button between two or more upward presses having two or more variable durations. [Brief explanation of the drawing]

[0009] These and other embodiments are described below in detail with reference to the drawings and various embodiments of the present disclosure. It will become clearer and clearer. [Figure 1] Figure 1 illustrates the handle design of two components of an endoscope. [Figure 2] Figure 2 shows an additional mechanism to the illustration in Figure 1. [Figure 3A] Figure 3A shows a side view of an example endoscope. [Figure 3B] Figure 3B shows a perspective view of another example endoscope. [Figure 4] Figure 4 shows an exploded view of an example of the proximal portion of the handle of an endoscope. [Figure 5] Figure 5 shows an exploded view of another example of the proximal portion of the endoscope handle. [Figure 6] Figure 6 shows an exploded view of an example of a replacement for the proximal portion of the endoscope handle. [Figure 7A] Figure 7A shows a top perspective view of an example of the distal portion of the handle of an endoscope. [Figure 7B] Figure 7B shows a side view of an example endoscope with part of the handle removed. [Figure 7C] Figure 7C shows a detailed view of a portion of the distal handle of an example endoscope. [Figure 8] Figure 8 shows an exploded assembly diagram of an example of the distal handle portion and rotation detection assembly of an endoscope. [Figure 9A] Figure 9A shows a partial assembly diagram of an example endoscope. [Figure 9B] Figure 9B shows a partial cutaway view of the endoscope handle, including an exemplary rotation detection configuration. [Figure 10A] Figure 10A illustrates a pass-through fluid barrier that allows useful components to pass from the handle to the endoscope conduit. [Figure 10B] Figure 10B shows a typical illustration of a pass-through barrier with a flexible component. [Figure 11A] Figure 11A is an exploded view of an example of an inner sheath mount that serves as a pass-through fluid barrier. [Figure 11B] Figure 11B shows an exemplary embodiment of a bulkhead or through-fluid barrier. [Figure 11C] Figure 11C shows another exemplary embodiment of a bulkhead or pass-through fluid barrier. [Figure 11D] Figure 11D shows an embodiment of a pass-through barrier through which several useful components extend. [Figure 12] Figure 12 is an exploded view of an example of a slewing control assembly. [Figure 13] Figure 13 is a perspective view of an example of a sealing member. [Figure 14] Figure 14 is a partial assembly diagram of an exemplary endoscope having an inner sheath mount, a swivel control structure or assembly, and a sealing member in the assembly position. [Figure 15] FIG. 15 shows another partial assembly view of an exemplary endoscope including a through-barrier, a turning control structure, and a printed circuit board housed in a protective material or housing. [Figure 16] FIG. 16 is a perspective view of an outer sheath mount. [Figure 16A] FIG. 16A shows a perspective view of the sheath and mount of an endoscope. [Figure 16B] FIG. 16B is a rear perspective view of the outer sheath and mount of FIG. 16A. [Figure 17] FIG. 17 is an enlarged partial view of an endoscope in which an inner sheath mount, an inner sheath, and an outer sheath are in an assembled position. [Figure 17A] FIG. 17A shows an exemplary trocar or obturator for insertion into the outer sheath of an endoscope. [Figure 18] FIG. 18 shows an example of a camera assembly mount separated from an inner sheath. [Figure 19] FIG. 19 shows another example of a camera assembly mount as part of an inner sheath. [Figure 20] FIG. 20 shows a cross-sectional view of the exemplary camera assembly mount of FIG. 19 and the inner sheath as viewed along line 20-20 of FIG. 19. [Figure 21] FIG. 21 shows an example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 22] FIG. 22 shows another example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 23] FIG. 23 shows another example of a camera assembly, a portion of an outer sheath, and a portion of a camera assembly mount. [Figure 23.1] FIG. 23.1 shows a perspective view of the distal end of an endoscope shaft with a camera assembly attached to the tip of the shaft without a protective guard, shield, or tip structure. [Figure 23.2]Figure 23.2 shows a rotatable camera housing with a pull wire, along with an LED at the exposed end of the endoscope shaft (with the surrounding sheath removed). [Figure 23.3] Figure 23.3 shows half of a spheroidal rotatable housing for a camera assembly. [Figure 23.4] Figure 23.4 shows half of the spheroidal rotatable housing for the camera assembly. [Figure 23.5] Figure 23.5 shows the pivot and bearing elements that allow the housing for the camera assembly to rotate. [Figure 23.6] Figure 23.6 shows the pivot and bearing elements that allow the housing for the camera assembly to rotate. [Figure 24] Figure 24 shows a perspective view of the camera assembly. [Figure 25] Figure 25 shows the camera assembly and a side view of the camera assembly mount with the wall of the camera assembly mount removed for clarity. [Figure 26] Figure 26 shows another example camera assembly and a side view of the camera assembly mount with the wall removed for clarity. [Figure 27] Figure 27 shows another example camera assembly and a side view of the camera assembly mount with the wall removed for clarity. [Figure 28] Figure 28 shows a possible rotational position of another camera assembly. [Figure 29] Figure 29 shows a possible rotational position of another camera assembly. [Figure 30] Figure 30 shows a possible rotational position of another camera assembly. [Figure 31] Figure 31 shows a possible rotational position of another camera assembly. [Figure 32] Figure 32 shows a possible rotational position of another camera assembly. [Figure 33]Figure 33 shows an example camera assembly. [Figure 33.1] Figure 33.1 shows the relationship between the camera assembly, the LEDs, and their respective power and communication PCB extensions. [Figure 33.2] Figure 33.2 shows the form factor of an endoscope PCB with an extension component for the endoscope shaft. [Figure 33.3] Figure 33.3 shows the PCB of Figure 33.2, with one flexible extension folded over another extension of the PCB. [Figure 33.4] Figure 33.4 shows how the PCB extension is positioned on the endoscope shaft (with the sheath removed). [Figure 33.5] Figure 33.5 shows a partially assembled endoscope illustrating a pass-through fluid barrier or bulkhead and PCB. [Figure 33.6] Figure 33.6 shows the relationship between the endoscope PCB and other internal components of the endoscope handle. [Figure 33.7] Figure 33.7 shows the fluid transport lumen and PCB extension located within the inner sheath of the endoscope shaft. [Figure 33.8] Figure 33.8 shows the internal fluid pathways within the handle of the endoscope. [Figure 34] Figure 34 shows an exemplary camera assembly in which an optical fiber bundle and an electronic flexible cable are connected. [Figure 35] Figure 35 shows an illustrative top view of a camera assembly and camera assembly mount. [Figure 36] Figure 36 shows a perspective view of the camera assembly and a flexible fiber optic bundle or ribbon. [Figure 37] Figure 37 shows a perspective view of a camera assembly with a robust camera housing and light-emitting mechanism. [Figure 38] Figure 38 shows a side view of the camera assembly shown in Figure 37. [Figure 39] Figure 39 shows an example of a flexible optical fiber bundle or ribbon. [Figure 40]Figure 40 shows a side view of the flexible optical fiber ribbon shown in Figure 39. [Figure 41] Figure 41 shows a perspective view of an example of a light projection element. [Figure 42] Figure 42 shows a perspective view of another example of a light projection element. [Figure 43] Figure 43 shows a perspective view of another example of a light projection element. [Figure 44] Figure 44 shows a bottom perspective view of the light projection element shown in Figure 43. [Figure 45] Figure 45 shows a cross-sectional view of the light projection element shown in Figures 43 and 44, as seen along line 43-43 in Figure 43. [Figure 46] Figure 46 shows a cross-sectional view of the light projection element shown in Figures 43 and 44, as seen along line 44-44 in Figure 43. [Figure 47] Figure 47 shows a cross-sectional view of the light projection element shown in Figures 43 and 44, as seen along line 45-45 in Figure 43. [Figure 48] Figure 48 shows a top perspective view of the camera assembly to which the light projection element from Figure 43 is attached. [Figure 49] Figure 49 shows a cross-sectional view of an exemplary camera assembly as seen along line 61-61 in Figure 24. [Figure 50] Figure 50 shows a cross-sectional view of an exemplary camera assembly as seen along line 62-62 in Figure 34. [Figure 51] Figure 51 shows a cross-sectional view of an exemplary lens assembly as seen along line 62-62 in Figure 34. [Figure 52] Figure 52 shows the camera assembly at the distal tip of the endoscope, in addition to the exemplary sensors and numerous exemplary illumination sources. [Figure 53] Figure 53 shows a top view of an exemplary printed circuit board including an extension that protrudes into the endoscope shaft. [Figure 54] Figure 54 is a side view of an example printed circuit board including protruding parts. [Figure 55]Figure 55 shows an illustrative flowchart detailing several exemplary steps that may be used to control at least one variable light source of an endoscope using a processor based on received sensor data. [Figure 56] Figure 56 shows a side view of a protruding portion of a printed circuit board having an exemplary camera assembly, an exemplary sensor, and several examples of light sources attached thereto. [Figure 57] Figure 57 shows a top view of the distal tip of an exemplary endoscope, including the exemplary protruding portion of the printed circuit board shown in Figure 56. [Figure 58] Figure 58 shows a cross-sectional view of the distal tip of the endoscope as seen along line 72-72 in Figure 57. [Figure 58.1] Figure 58.1 is a perspective view of the distal end of the endoscope shaft, in which the light source is positioned on the shaft and projects light in a direction generally away from the field of view of the camera assembly. [Figure 59] Figure 59 shows an exemplary endoscope and an exemplary calibrator. [Figure 60] Figure 60 shows a flowchart containing several illustrative steps that may be used to calibrate the illumination parameter values ​​of a variable illumination source in an endoscope. [Figure 61] Figure 61 shows a partially assembled endoscope diagram with the handle, printed circuit board, power / HDMI® cable, lighting fiber, and cleaning line in its assembled position. [Figure 62] Figure 62 is a block diagram of an example image processing system. [Figure 63] Figure 63 is an illustrative diagram illustrating how the image is returned to its correct position using input from the rotation detection assembly. [Modes for carrying out the invention]

[0010] In this book, the terms “endoscope” and “arthroscope” are used interchangeably and given the broadest possible interpretation, each term referring to an instrument with a slender portion that is inserted into otherwise inaccessible spaces for the purpose of visual inspection, diagnosis, and / or treatment or repair. In the fields of medicine and veterinary practice, such spaces include body cavities or tissue cavities, joint cavities, tissue planes, or other body structures. The instrument may also be used in many non-medical applications (e.g., industrial), in which the diameter of the insertion portion of the endoscope is minimized, or the space in which the endoscope operates is restricted, making the use of the actively flexible distal portion unacceptable.

[0011] Figure 1 shows the handle design of the two components of the endoscope 10. The exemplary endoscope 10 includes a proximal handle portion 16 and a distal handle portion 30. The proximal handle portion 16 may be a housing. As shown, the distal handle portion 30 extends at least partially into the proximal handle portion 16. The distal handle portion 30 and the proximal handle portion 16 may rotate relative to each other. In some embodiments, the user rotates the distal handle portion 30 while gripping the proximal handle portion 16 with their fingers. The endoscope 10 may have many mechanisms, such as, but not limited to, a rotation detection assembly, fluid conduits, illumination, an imaging device or camera assembly, and rotation control for the imaging device.

[0012] Additional mechanisms of the endoscope 10 are shown in Figure 2. The endoscope 10 includes a proximal handle portion 16 and a distal handle portion 30. In this example, at least a portion of the insertion shaft or portion 14 is fixed to the distal handle portion 30 and moves together with the distal handle portion 30. The distal handle portion 30 includes a handle projection or fin 36 which provides a surface for the user to press to facilitate rotation of the distal handle portion 30 relative to the proximal handle portion 16. In some embodiments, the user's hand grips the proximal handle portion 16 to prevent it from moving while the distal handle portion is being rotated using one of the user's fingers.

[0013] In some embodiments, one or both of the proximal handle portion 16 and the distal handle portion 30 function as housings for other components of the endoscope 10 or provide support structures. The endoscope 10 shown in Figure 2 includes a rotation detection assembly 150. The rotation detection assembly 150 monitors the rotation of the distal handle portion 30 relative to the proximal handle portion 16. In some embodiments, the rotation detection assembly 150 includes components stationary with respect to the proximal handle portion 16 and components stationary with respect to the distal handle portion 30. For example, the rotation detection assembly 150 includes a potentiometer and a keyed shaft. The potentiometer is mounted on a support member, for example, which has an internal housing for the proximal handle portion 16. Alternatively, the distal handle portion 30 may have a support member to which at least one component of the rotation detection assembly 150 (for example, the rotation sensor holder in Figure 8) is mounted. In either case, the rotational or translational component of the rotation detection assembly is configured to move in proportion to the degree of rotation of the distal handle portion 30 relative to the proximal handle portion 16.

[0014] Figure 3A shows an exemplary embodiment of an endoscope (or, for example, an arthroscope) 10. The endoscope 10 is used in various endoscopic treatments, particularly arthroscopy. As shown, the endoscope 10 includes a handle 12 and an insertion portion or shaft 14, the shaft 14, the insertion portion 14 comprising an elongated hollow shaft through which one or more working members, electrical / communication cables, lighting or optical transmission cables and / or fluid pathways are placed. As shown, in one embodiment, the handle 12 is roughly cylindrical and rounded. The insertion portion 14 is roughly cylindrical and extends in the longitudinal direction. In one embodiment, the insertion portion 14 may be rigid and relatively straight. In other embodiments, the insertion portion 14 may be curved or bent at an angle for at least a portion of its total length. In yet another embodiment, the insertion portion 14 may be made of a semi-rigid malleable material and be bent to maintain a desired shape. The diameter of the insertion portion 14 is considerably smaller than the diameter of the handle 12. In some embodiments, the diameter of the handle 12 is approximately 5.5 mm or less. The insertion portion 14 of the endoscope 10 is roughly the same length as the handle 12. In alternative embodiments, the length and shape of the handle 12 and the insertion portion 14 may differ considerably.

[0015] Preferably, at least a portion of the insertion portion 14 is detachable from the handle 12. In such embodiments, the insertion portion 14 or the detachable portion of the insertion portion 14 is coupled to the handle 12 by any of various means, including but not limited to friction fitting, snap fitting, screw coupling, bayonet mount, etc. In some embodiments, the insertion portion 14 may be a disposable component and the handle 12 may be a reusable component. In embodiments where the insertion portion 14 is disposable, the insertion portion 14 is discarded after use. In other embodiments, the insertion portion 14 is disinfected after use by autoclaving, immersion solution, or other appropriate disinfection treatment. In preferred embodiments, both the handle 12 and the insertion portion 14 are disposable and discarded after use, preventing the need and cost of disinfection treatment and equipment (apart from pre-use disinfection during manufacturing, assembly, or packaging of the equipment, for example, with ethylene oxide, radiation, etc.). In addition, by making the handle 12 and insertion portion 14 of the endoscope 10 disposable, there is no deterioration of function or reliability that would result from repeated use or cleaning. Making the entire endoscope 10 disposable has other advantages, some of which are described below.

[0016] Preferably, the disposable endoscope 10 includes means to prevent its reuse, particularly in cases where disinfection of the used instrument degrades its function. For example, the endoscope 10 includes a memory chip that stores an identification code recognized by a processor in a base unit to which the endoscope 10 must be connected for operability and image display. The connection includes wired communication between the controller of the base unit and the memory chip of the endoscope 10, or wireless communication using, for example, an RFID device attached to the endoscope 10. (Other types of wireless communication, such as Bluetooth® or WiFi, may also be used.) In one embodiment, the base unit may be programmed to encode the memory device of the endoscope 10 upon first use, and whenever the endoscope 10 is later reconnected to the base unit, it may be programmed to read and confirm a code indicating that the endoscope 10 has been previously used. Confirmation that the endoscope 10 is "used" allows the controller to be programmed to prevent electronic and image communication between the endoscope 10 and the base unit. The code and communication may be encrypted to enhance the security of the system. Alternatively, the endoscope 10 may include a deactivation mechanism in its software that renders the endoscope 10 unusable after use.

[0017] As shown in Figure 3A, the handle 12 of the endoscope 10 includes several different mechanisms. The handle 12 includes a proximal handle portion 16. The proximal handle portion 16 is relatively smooth, as shown in Figure 3A. The proximal handle portion 16 may have one or more recessed portions. The proximal handle portion 16 is contoured to include several ergonomic features. In some embodiments, at least a portion of the proximal handle portion 16 does not have a smooth surface and may include a serrated, undulating, roughened, honeycomb-like structure and / or a rubberized or elastic surface layer to facilitate gripping the endoscope 10 during operation. In exemplary embodiments, several finger grooves 18 are formed in the proximal handle portion 16. In some embodiments, the proximal handle portion 16 is made of a material (e.g., rubber or other elastic material) that has a soft feel or is comfortable to grip. In some embodiments, a pistol grip-like mechanism (not shown) is included as part of the proximal handle portion 16.

[0018] As shown in Figure 3A, the proximal handle portion 16 is divided into two separate parts. The proximal handle portion 16 in Figure 3A includes an upper handle portion 20 and a lower handle portion 22. The upper handle portion 20 and the lower handle portion 22 of the proximal handle portion 16 are manufactured as two separate parts and joined together by appropriate means such as adhesive, screws, or snap fasteners. As shown, the upper handle portion 20 is smooth and contoured in a different shape from the lower handle portion 22. This helps the user to quickly and easily determine the direction of the endoscope 10 by touch. In some embodiments, the upper handle portion 20 and the lower handle portion 22 may have surface materials with different textures (e.g., metal and plastic, metal and elastic, smooth and rough, etc.).

[0019] The handle 12 of the endoscope 10 also includes a distal handle portion 30. As shown in Figure 3A, the distal handle portion 30 extends from the proximal handle portion 16 toward the insertion portion 14. The distal portion 30 of the handle has a smaller diameter than the proximal portion 16 of the handle. As shown in the figure, the distal portion 30 of the handle is longer than the proximal portion 16 of the handle, but in another embodiment, the relative dimensions of the distal portion 30 and the proximal portion 16 of the handle are different.

[0020] At least a portion of the distal portion 30 of the handle may have a gripping texture, as shown in Figure 3A. In the exemplary embodiment shown in Figure 3A, the gripping texture is a series of helical ridges 32. In other embodiments, other gripping textures are used, such as non-helical ridges, bumps, protrusions, grooves, honeycomb-like or other shaped ridges or bumps. As shown, the helical ridges 32 in the exemplary embodiment surround most of the outer circumference of the distal portion 30 of the handle. In some embodiments including the gripping texture of the distal portion 30 of the handle, the gripping texture is not formed as a continuous portion of the distal portion 30 of the handle. In such embodiments, it may be an "outer shell" or sleeve attached to the gripping texture. The outer shell of the gripping texture may be attached to the distal portion 30 of the handle by any suitable means (but not limited to) such as adhesive, snap fasteners, various fasteners, or overmolding. In some embodiments, the rough outer layer for gripping may be made of a different material than the distal portion 30 of the handle. For example, the rough outer layer for gripping may be made of a softer, more elastic, or rubber-like material that is more comfortable and less slippery to grip than the material of the distal portion 30 of the handle.

[0021] In the exemplary embodiment shown in Figure 3A, the distal portion of the handle 30 includes a raised handle portion 34 that rises from the top of the distal portion of the handle 30. In this example, the raised handle portion 34 does not rise sharply from the other part of the distal portion of the handle 30. Rather, the raised handle portion 34 is configured to curve gently upward from the other part of the distal portion of the handle 30. In this example, the helical ridge 32 does not extend to the top of the raised handle portion 34. Further details of the mechanism of the raised handle portion 34 are described below.

[0022] In one embodiment, the handle fin or paddle 36 may protrude from the bottom of the distal portion 30 of the handle. In this example, the handle fin 36 is configured to curve gently away from the rest of the distal portion 30 of the handle towards the interior or dependent position of the endoscope 10. The helical ridge 32 may or may not extend to the bottom of the handle fin 36. In another embodiment, a raised handle portion 34 is made to protrude from another side of the distal portion 30 of the handle, and the handle fin 36 is configured to protrude from the top of the distal portion 30 of the handle. The handle fin 36 is positioned to correspond to the inlet locations of various cables and cleaning fluids in the endoscope, which are already familiar to physicians. This is preferable because such inlets are often used as surfaces to press to facilitate rotation and as directional markers. Further mechanisms of the handle fin 36 are described in more detail below.

[0023] Another embodiment of the endoscope (or, for example, arthroscopy) 10 is shown in Figure 3B. As shown, the endoscope 10 includes a handle 12 and an insertion portion or shaft 14 which includes an elongated hollow shaft in which one or more working members, electrical / communication wires, illumination or optical transmission cables, and / or fluid channels may be disposed inside. At least a portion of the shaft 14 may be detachable from the handle 12. In the exemplary embodiment, the shaft 14 of the endoscope is equipped with an outer sheath or cannula 318 attached to a mounting structure 15, which is by means of any means including, but not limited to, friction fit, snap fit, screw coupling, or push mount to facilitate attachment of the cannula to the handle 12 and removal of the cannula.

[0024] As shown in Figure 3B, the handle 12 of the endoscope 10 includes a proximal handle portion 16, which surrounds a printed circuit board (PCB) (among other components) for controlling or processing image data detected by a sensor at the distal end of the shaft, and / or supplies power to a light source (e.g., an LED) at the end of the shaft. It may also house a fluid conduit for connecting to a fluid transport lumen in the shaft 14. The proximal handle portion 16 may be divided into two separate parts. In Figure 3B, the proximal handle portion 16 includes a first handle half shell 21 and a second handle half shell 23. The first handle half shell 21 and the second handle half shell 23 of the proximal handle portion 16 may be manufactured as two separate parts and joined symmetrically by any suitable means, such as adhesive, screws, or snap fasteners. For example, the first handle half shell 21 may be ultrasonically welded to the second handle half shell 23 using any ultrasonic welding technique. Additionally, alternatively, or selectively, the hand half shells 21 and 23 may be manufactured using injection molding techniques known in the art.

[0025] The handle 12 of the endoscope 10 may also include a distal handle portion 30. As shown in Figure 2 and Figure 3B, the distal handle portion 30 extends from the proximal handle portion 16 toward the shaft 14. Any projection from the bottom of the distal handle portion 30 may be a handle fin or paddle 36. The distal handle portion 30 also includes a recess 35 sized to accommodate the finger contacts 98 of the pivot control structure 100 (for example, Figure 14). An example of the pivot control structure 100 is also described below and is used to rotate a pivotable sensor housing at the distal end of the shaft 14.

[0026] Also shown in Figure 3B is a display or camera control button 37. This may be used to capture images generated by the image sensor at the distal end of the shaft 14. In some embodiments, the user can press the button 37 using a predetermined pattern or sequence to turn on or off video recording of the image displayed on the display of the image sensor's field of view at the distal end of the shaft 14, record a snapshot of the image shown on the display of the image sensor's field of view at the distal end of the shaft 14, change the brightness of the optical elements (e.g., LEDs), or adjust other characteristics of the sensor or the displayed image (e.g., white balance, saturation, digital magnification, etc.). To reduce the amount of onboard processing power and cost of the endoscope PCB, it is preferable to have sensor characteristics and LED illumination controlled by a processor associated with a graphical user interface connected to the endoscope, rather than those of the endoscope PCB itself.

[0027] Button 37 can operate an electromechanical switch located on the main PCB within the distal portion 30 of the endoscope handle. To ensure maximum moisture resistance of the PCB electronic components, it is preferable to use a magnetic or optical sensor assembly to detect the movement of button 37. As shown in Figure 2, in one embodiment, a Hall effect sensor on the endoscope PCB 518 can be located below and near the position of the shaft 38 connected to button 37 (showing the relative positions of several components within the handle 12). Button 37 may be spring-loaded, and the end of the shaft 38 closest to the printed circuit board 518 may be constructed to include an embedded magnet. As the button shaft 38 approaches or moves away from the PCB-based Hall effect sensor, the sensor can generate an appropriate signal corresponding to the position of the button shaft 38 and its duration at that position.

[0028] Figures 4 and 5 show exemplary embodiments of the upper handle portion 20 and lower handle portion 22 of the handle proximal portion 16 shown in Figure 3A. The upper handle portion 20 and lower handle portion 22 are shown disassembled or separated. When assembled, the handle proximal portion 16 forms a shell-like structure. The lower handle portion 22 includes a ledge 40 that wraps around the periphery of the lower inner surface 42 at a distance from the upper surface 46 of the lower handle portion 22. As shown, the lower handle portion 22 has a curved or U-shaped notch 44 positioned at an angle substantially perpendicular to the upper surface 46 of the lower handle portion 22. Two peg projections 47 are included near the rear side of the lower handle portion 22. The peg projections 47 extend slightly above the ledge 40 and are positioned at an angle approximately perpendicular to the upper surface of the ledge 40.

[0029] As shown in Figures 4 and 5, a portion of the upper handle portion 20 is sized to overlap the lower handle portion 22 when the proximal handle portion 16 is assembled. The overlapping portion 48 is inserted from the outer surface 50 of the upper handle portion, as shown in Figures 4 and 5. The height of the overlapping portion 48 is selected to be approximately the same as, or slightly greater than, the distance between the top of the ledge 40 of the lower handle portion 22 and the top surface 46 of the lower handle portion 22. In such embodiments, when fully assembled, the bottom surface 52 of the upper handle portion 20 (depending on the orientation when assembled) is in contact with the top of the ledge 40 of the lower handle portion 22. In such embodiments, the outer surface 50 of the upper handle portion and the outer surface 54 of the lower handle portion are further contiguous, forming a nearly continuous surface with little gap between them. In some embodiments, there may be a small gap between the outer surface 50 of the upper handle portion and the outer surface 54 of the lower handle portion (the small gap shown in Figure 3).

[0030] As illustrated, the upper handle portion 20 includes a peg notch 59 shaped and positioned to correspond to the peg projection 47 of the lower handle portion 22. The upper handle portion 20 includes a curved notch 58 at its base or proximal portion. As illustrated, the curved notch 58 recesses into the upper handle portion 20 at an angle substantially perpendicular to the bottom surface 52 of the upper handle portion 20 (depending on the orientation when assembled). When the proximal handle portion 16 is assembled, the curved or U-shaped notch 44 of the lower handle portion 22 and the curved notch 58 of the upper handle portion 20 together form a substantially circular or oval handle gap or opening 60, which will be further described below. It should be understood that the use of terms such as “notch” and “cutout” as used in this document should not be interpreted as meaning that the material has been physically removed by cutting, or the process by which the material is removed. In some embodiments, the curved or U-shaped cuts 44 and the curved cuts 58 are formed during manufacturing without physically removing material.

[0031] As shown in Figure 4, the lower handle portion 22 includes a shaft support member 63. The shaft support member 63 in Figure 4 has a curved or semicircular portion, the semicircular portion roughly corresponding to the position of the toothed projection 62 in Figure 5. The shaft support member 63 also includes a strut. The strut projects orthogonally from the midpoint of the semicircular portions, separated by approximately 90° from the semicircular portions on both sides of the strut. The shaft support portion 65 projects orthogonally from the top of the strut of the shaft support member 63 toward the distal end of the handle proximal portion 16. The shaft support portion 65 includes a recess into which a portion of the sensor gear shaft 120 (see Figure 8) is mounted. The strut of the shaft support member 63 is approximately the length of the radius of the semicircular portion when the handle proximal portion 16 is fully assembled. The shaft support member 63, toothed projection 62 and toothed projection 64 are described further below.

[0032] As shown in Figure 5, the lower handle portion 22 may, instead or optionally, include a curved toothed projection 62. The curved toothed projection 62 is matched with a similar toothed projection 64 included in the upper handle portion 20. When the proximal handle portion 16 is fully assembled, the toothed projections 62 and 64 are aligned with each other to form an annular or inner ring gear.

[0033] As shown in Figures 4 and 5, the face of the lower handle portion 22 opposite the curved or U-shaped cutout 44 and the face of the distal handle portion 20 opposite the curved cutout 58 contain a semicircular opening or void 70. The curved or U-shaped path 72 recesses into the edge of each semicircular void 70 along the entire arc of each semicircular void 70, as shown in Figures 4 and 5.

[0034] Figure 6 shows exemplary embodiments of the first handle half shell 21 and the second handle half shell 23 of the handle proximal portion 16 shown in Figure 3B. The first handle half shell 21 and the second handle half shell 23 are shown in disassembled or exploded views. The handle proximal portion 16 forms a shell-like structure when assembled. One of the first or second handle half shells 21, 23 may include a slot 41 sized to fit into a wall extension 43 that cooperates with the other of the first and second handle half shells 21, 23 to facilitate assembly. Similar to Figures 4 and 5, the exemplary embodiment in Figure 6 includes curved notches 58. These notches 58 allow the proximal handle portion 16 to enter the internal volume of the proximal handle portion 16 when it is assembled.

[0035] It is useful to be able to track the rotational direction of the proximal handle portion 16 with respect to the distal handle portion 30, the shaft 14, and a sensor or camera at the distal end of the shaft. In one embodiment, this can be achieved by the interaction between a Hall effect sensor and associated magnets. The Hall sensor may be located on the proximal handle portion 16, the magnets may be located on internal components within the proximal handle portion 16, or one or more magnets may be located within the proximal handle portion 16, or mounted on a PCB within the proximal handle portion 16. In some embodiments, one or more magnets 51 can be embedded in or attached to a portion of the handle 12. In the exemplary embodiment shown in Figure 6, the proximal handle portion 16 includes two magnets 51 positioned substantially opposite each other. In other embodiments, a different number of magnets 51 can be used. As shown, in this case, each of the first and second handle half-shells 21, 23 includes magnets 51 inserted into the inner wall of each half-portion. In the exemplary embodiment, the magnets 51 are connected to a retaining structure 53 that holds the magnets 51 in place on the proximal handle portion 16. The magnets can be selectively made of any suitable rare earth or transition metal, or an alloy thereof.

[0036] An example of the handle distal portion 30 illustrated in Figure 3A is shown in Figure 7A, separated from the rest of the handle 12. Figure 7A shows the handle distal portion 30 in a substantially top perspective view. As shown, the helical ridge 32 and the raised front handle portion 34 described in detail above are visible in the handle distal portion 30. As shown by the seam descending the central vertical plane of the handle distal portion 30, the handle distal portion 30 is composed of two or more separate parts (30a and 30b in the illustrative embodiment) which are joined together by suitable means or a combination of suitable means, such as snap fastening, adhesive and / or screws.

[0037] The distal handle portion 30 in Figure 7A includes portions not shown in Figure 3A. When the endoscope 10 is assembled as shown in Figure 3A, a portion of the distal handle portion 30 is housed within the proximal handle portion 16. For example, the housed handle electronic portion 80 protrudes proximally from the outer distal handle portion 82 (which is visible in both Figure 3A and Figure 7A). The housed handle electronic portion 80 is described further below.

[0038] A small diameter span 84 is located between the housed handle electronic portion 80 and the outer handle distal portion 82. As shown, the small diameter span 84 may include a rounded groove 86 recessed into the outer surface of the span 84. In some embodiments, when fully assembled, the small diameter span 84 of the handle distal portion 30 is located within a semicircular opening 70 of the handle proximal portion 16. The rounded groove 86 of the small diameter span 84 and the curved or U-shaped path 72 of the semicircular opening 70 are aligned with each other. This allows the handle distal portion 30 and the handle proximal portion 16 to rotate relative to each other when the endoscope 10 is in use. Optionally, ball bearings (not shown) or other types of bearings run along the rounded groove 86 of the small diameter span 84 of the handle distal portion 30 and the U-shaped path 72 of the semicircular opening 70 of the handle proximal portion 16. In a preferred embodiment, an O-ring (not shown) is placed in a rounded groove 86 across a small diameter 84 of the distal portion 30 of the handle. The O-ring (not shown) functions as a dynamic seal between the proximal portion 16 of the handle and the distal portion 30 of the handle. In such an embodiment, the proximal portion 16 of the handle and the distal portion 30 of the handle rotate relative to each other while sealing the inside of the proximal portion 16 from liquid.

[0039] The handle fin or paddle 36 or other protrusions serve as directional indicators for the user as the proximal portion 16 and distal portion 30 of the handle rotate relative to each other. Direction is confirmed visually or by touch. In some embodiments, the gripping roughness on the handle fin / paddle 36, unlike the helical ridges 32 on the rest of the distal portion 30 of the handle, facilitates tactile direction confirmation.

[0040] As shown in Figure 7A, the raised handle portion 34 includes a button 90. In some embodiments, the raised handle portion 34 includes multiple buttons 90 or does not include any buttons at all. The button 90 may be located anywhere on the distal portion 30 of the handle or anywhere on the handle 12. In some embodiments, the raised handle portion 34 includes one button 90, and one or more additional buttons 90 are located somewhere on the handle 12. In some embodiments, the button 90 may be a mechanical activation switch, which includes a pressable member that completes or breaks a circuit when pressed. The button 90 includes a magnetic or Hall effect-based switch by embedding a magnet in part of the button near a Hall effect sensor in the distal portion 30 of the handle. Other types of buttons or switches may be used. Multiple functions are assigned to the button 90, which are activated by various user operations. In some embodiments, at least one of the buttons 90 is sealed with respect to the external handle portion 82 to prevent liquid ingress.

[0041] Button 90 may also be an imaging button. In such embodiments, pressing button 90 results in a recording of the display image generated by the endoscope 10. In some embodiments, the user double-tap button 90, long-press button 90, or hold down button 90 to connect the display device to the endoscope 10 and start recording video. To stop recording video, the user double-tap button 90, long-press button 90, or release button 90. In some embodiments, to stop recording video, the user only needs to press and release button 90. In some embodiments, a still image is recorded without interrupting video recording by the user pressing button 90 once while the endoscope 10 is recording video. In other configurations, a quick push-up and release of button 90 may initiate still image recording, while a longer press-down and release, or holding down, may initiate video recording.

[0042] The raised handle portion 34 may further include a slide button recess 92. As shown in Figure 7A, the slide button recess 92 is positioned to allow the slide button or fingertip contact 98 (see Figure 14) to move back and forth while restricting lateral movement. The slide button may be part of a swivel control or swivel control structure 100 (see, for example, Figure 14) in some embodiments. In some embodiments, including the exemplary embodiment shown in Figure 7A, the slide button recess 92 is slightly curved to conform the shape of that portion of the handle in which the slide button recess 92 is located.

[0043] As shown in Figure 7A, the slide button recess 92 includes several projections or recesses 94 that can engage with the corresponding elements of the slide button, providing a series of discontinuous and distinct stops when the user moves the slide button back and forth. Some embodiments do not include the projections 94. In some embodiments, a portion of the swivel control structure 100 (see Figure 12) with which the user interacts protrudes through a swivel control structure notch 96 (see Figure 14) located in the slide button recess 92 of the raised handle portion 34. In the exemplary embodiment of Figure 7A, such a portion of the swivel control structure 100 includes a fingertip contact 98. As shown, the fingertip contact 98 has an inclined contour for ergonomic reasons. The swivel control structure 100 is described further below.

[0044] Figures 7B and 7C show alternative embodiments of the recess 35 that may be used to accommodate the finger contact 98 of the pivot control structure 100. Parts of the proximal portion 16 and distal portion 30 of the handle have been removed for clarity. Figure 7C shows a detailed view of area 7C in Figure 7B. As best shown in Figure 7C, in some embodiments the recess 35 includes a raised portion 94 for stepwise movement of the pivot control structure, similar to the slide button recess 96 shown in Figure 7A. Alternatively, the recess 35 may be generally smooth or curved to accommodate the movement path of the pivot control structure 100.

[0045] The interior of the distal handle portion 30 may include a shelf 95 located below the recess 35. The shelf 95 may have a surface whose contour mimics the contour of the recess 35. The shelf 95 may include one or more ridges or stoppers 94 to provide a series of separate positive stops when the user moves the pivot control structure 100 back and forth. These ridges 94 can interact with one or more arms 97 extending from the pivot control structure 100. The arms 97 can move freely over the smooth portion of the shelf 95 that is free of protrusions or ribs 94. When one of the arms 97 encounters a ridge 94, the ridge abuts against each arm of the arms 97, preventing further displacement of the pivot control structure 100 until sufficient force is applied to overcome the mechanical interference provided by the ridge 94. That is, the ridge 94 can form a force barrier that prevents the finger contact portion 98 from acting from the dwell position. Depending on the embodiment, the protrusions 94 may be arranged in pairs along the surface of the shelf 95. Each rib or ridge 94 of the pair of protrusions 94 may be spaced apart by the width of the arms 97 of the pivot control structure 100.

[0046] Figure 8 shows a more detailed illustration of the exemplary handle distal portion 30 with the attached insertion portion 14 removed. An exemplary rotation sensing assembly 150 is also shown in Figure 8. As illustrated, the handle distal portion 30 is manufactured as two separate portions 30a and 30b. In the exemplary embodiment, the two separate portions 30a and 30b of the handle distal portion 30 include several screw holes 102, which are threaded. The two separate portions 30a and 30b of the handle distal portion 30 are joined together using screws (not shown) or other suitable fasteners. In some embodiments, the two separate portions 30a and 30b are joined together by snap fitting, ultrasonic welding, adhesive, etc.

[0047] In some embodiments, one of the two dividing portions 30a, 30b of the distal handle portion 30 includes a peg-like projection 104, which fits into a complementary peg-receiving cavity 106 of the other dividing portion 30a, 30b. This helps to align and / or connect the two dividing portions 30a, 30b together. In some embodiments, including the embodiment shown in Figure 8, the outer handle distal portion 82 is essentially hollow. In some embodiments, the hollow portion of the outer handle distal portion 82 is not sealed to fluid. In the exemplary embodiment shown in Figure 8, a drain passage 108 is included, for example, in the handle fin 36. The drain passage 108 allows for easy drainage of any liquid that enters the hollow portion of the outer handle distal portion 82. In other embodiments, additional and / or different drain arrangements may be included.

[0048] The distal portion of the handle 30 may include a rotation sensor holder 110, as shown in Figure 8. The rotation sensor holder 110 holds the rotation detection assembly 150 when the endoscope 10 is fully assembled. As shown, the rotation detection assembly 150 includes a forward gear 112. The forward gear 112 is positioned around a forward gear shaft 114. As shown in Figure 8, a distribution gear 116 is also positioned on the forward gear shaft 114, and the rotation of the forward gear 112 causes the distribution gear 116 to rotate as well. The distribution gear 116 meshes with a sensor shaft gear 118 positioned on a sensor gear shaft 120. When the forward gear 112 rotates, the sensor shaft gear 118 and the sensor gear shaft 120 also rotate. The use of a gear assembly has the advantage of allowing the attached potentiometer 122 to be positioned off-center from the central axis of rotation of the distal portion of the handle 30, thereby allowing other internal structures (e.g., cleaning fluid conduits, fiber optic bundles, electronic flexible cables, or other electronic components) to be centrally located.

[0049] As in the exemplary embodiment shown in Figure 8, the sensor gear shaft 120 may include a keyed portion (e.g., D-shaped) with a keyway. The keyed portion operably engages with one or more potentiometers 122. The exemplary embodiment shown in Figure 8 has two rotary potentiometers 122. The potentiometers 122 are mounted to a mounting element or part of the printed circuit board of the handle, as described with reference to Figure 96, or otherwise connected. Each potentiometer 122 includes a keyed gap (e.g., D-shaped) into which the corresponding keyed portion of the sensor gear shaft 120 engages. As the sensor gear shaft 120 rotates, the electrical resistance of the potentiometers 122 changes proportionally. Since the resistance value changes as expected with respect to the amount of rotation of the sensor gear shaft 120, the measured resistance value of the potentiometers 122 is used to determine the amount of rotation occurring between the proximal portion 16 of the handle and the distal portion 30 of the handle (and the insertion portion 14 on the extension line).

[0050] In some embodiments, the housing of each potentiometer 122 is attached to an element of the housed handle electronic component 80 (or other element attached to the handle distal component 30), so that the shaft or rotary hub of the potentiometer 122 is fixed to the handle distal component 30 (and the insertion component 14 on the extension line) while its shaft or rotary hub is connected to the handle proximal component 16. In other embodiments, the housing of the potentiometer 122 is fixed to the handle proximal component 16 while its shaft or rotary hub is connected to an element of the handle distal component 30 or the handle electronic component 80.

[0051] The exemplary embodiment in Figure 8 includes two potentiometers 122 stacked together, with their axes of rotation offset from each other. In another embodiment, the potentiometers 122 are separated from each other but share a common axis of rotation (for example, the wipers of both potentiometers 122 are driven by a common shaft). This arrangement allows a controller receiving electrical resistance values ​​from both potentiometers 122 to calculate the rotation angle of the sensor shaft (and ultimately the components at the distal end of the endoscope) with desired accuracy during a 360-degree rotation, thus helping to eliminate a "blind spot" in the calculation of the rotation of components on the distal shaft of the endoscope (e.g., the camera). The blind spot caused by the position of the wiper of one potentiometer 122 at the end of its range of motion is compensated for by the wiper of a second potentiometer 122 that is not at the end of its range of motion. In another embodiment, three or more offset potentiometers 122 may be used. The rotational offset between the potentiometers 122 may be 180 degrees for the sake of simplification of calculations, but the same result may be achieved using other angular offsets, as long as the blind spots created by one potentiometer 122 overlap with the functional range of another potentiometer 122. In another embodiment, the gear ratio between the forward gear 112, the distribution gear 116, and the sensor shaft gear 118 varies depending on the desired accuracy for measuring rotation, the sensitivity of the potentiometers 122, and other factors. In another embodiment, the rotation sensing assembly 150 may use a belt instead of at least one gear assembly. For example, the distribution gear 116 and the sensor shaft gear 118 may be replaced by a belt. Other rotation transmission arrangements known in the art may also be used. In some embodiments, the forward gear shaft 114 may include a keyed mechanism (e.g., a D-shaped section) that operably engages directly with the potentiometer 122. Rotation sensors other than the potentiometers 122 may also be used. Another embodiment 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, for example, Figure 9B), an optical encoder, or the like.

[0052] In one embodiment, the sensor gear shaft 120 does not extend to the shaft bearing portion of the shaft support member 63. Rather, the rotation detection assembly 150 is supported by the rotation sensor holder 110. Among other advantages, this arrangement allows the distal portion 30 of the handle to rotate relative to the proximal portion 16 of the handle without limiting the rotation angle. Furthermore, as will be apparent to those skilled in the art, this allows the components of the rotation detection assembly 150 to be placed in an offset position. This provides advantages during assembly. For example, the routing of the cleaning line 434 (see Figure 96), power cable 432 (see Figure 96), etc., can be simplified.

[0053] In other embodiments, the shaft support member 63 and the potentiometer 122 are directly connected to the shaft. A keyed or keyed shaft with a keyway at its distal end extends from the shaft bearing portion of the shaft support member 63 and extends through the corresponding keyed or keyed (e.g., D-shaped) gap of the potentiometer 122. Since the shaft support member 63 is fixed with respect to the proximal portion 16 of the handle, rotation of the distal portion 30 of the handle relative to the proximal portion 16 of the handle changes the electrical resistance measured by the potentiometer 122. As described above, the electrical resistance changes with rotation of one handle relative to the other, so the measurement of the electrical resistance is used to determine the amount of rotation by the distal portion of the handle (and, ultimately, the distal end of the endoscope or, for example, the camera assembly 350 shown in Figure 21).

[0054] In other embodiments, the rotation detection assembly 150 includes a range finder located in the housed handle electronic portion 80 (see Figure 7A). The inner wall of the handle proximal portion 16 (see Figure 4) includes a raised surface that is variable in thickness or height, enclosing almost or all of the 360 ​​degrees of the inner wall of the handle proximal portion 16, and varying in thickness or height in a predetermined manner along a circumferential path. As the handle proximal portion 16 and the handle distal portion 30 rotate relative to each other, the range finder provides the controller with a signal that varies in proportion to the distance to the changing surface (whether its thickness or height changes) read by the range finder. The signal may correlate to a thickness / height or distance relative to a predetermined base position measured by the range finder, where the surface has a predetermined thickness or height and correlates to a predetermined angle of rotation of the handle distal portion 30 relative to the handle proximal portion 16. This distance is compared to the previous distance to determine the amount of rotation resulting therefrom. The rangefinder may be of any type (e.g., a mechanical position sensor, an acoustic rangefinder, a laser rangefinder, or other optical rangefinder).

[0055] In yet another embodiment, a sensor arrangement similar to that of an optical mouse is used. The sensor is attached to one of the housed handle electronic portion 80 and the handle proximal portion 16 and is configured to track the movement of the other housed handle electronic portion 80 or the other handle proximal portion 16. In such an embodiment, the amount and direction of movement sensed by the sensor is used to determine the amount and direction of the resulting rotational displacement. In some embodiments, the surface traced by the sensor has a reference grid, several unique indicators, patterns, marks, or other distinguishing mechanisms, which enable the sensor to determine the starting direction of rotation. Various other rotation sensing assemblies 150 known to those skilled in the art can be used in various embodiments.

[0056] As shown in Figure 8, the rotation sensor holder 110 of the distal portion of the handle 30 is shaped such that the rotation detection assembly 150 is sandwiched between the two separate portions 30a and 30b of the distal portion of the handle 30 and the forward gear shaft channel 124 when the two separate portions 30a and 30b of the distal portion of the handle 30 are joined together. Each side of the rotation sensor holder 110 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 serve as support surfaces for the forward gear shaft 114 and the sensor gear shaft 120, respectively. Each side of the rotation sensor holder 110 also includes a holder gap 128. The holder gap 128 is sized and shaped so that the distribution gear 116, sensor shaft gear 118, and potentiometer 122 fit within the rotary sensor holder 110 when the distal portion 30 of the handle is fully assembled.

[0057] Figure 9A shows a partially assembled diagram of the handle 12 of the endoscope 10. Only the lower handle portion 22 and the proximal handle portion 16 are shown in Figure 9A. As shown, a portion of the lower handle portion 22 is cut off from the proximal handle portion 16. Furthermore, in the embodiment shown in Figure 9A, the distal handle portion 30 is assembled from two separate portions 30a and 30b (see Figure 8). One of the halves of the distal handle portion 30 (30b) is omitted in Figure 9A for clarity. (In the embodiment shown in Figure 9A, the distal handle portion 30 is assembled from two separate parts 30a and 30b (see, for example, Figure 8).) One half (30a) of the distal handle portion 30 is omitted in Figure 9A for clarity. The housed handle electronic portion 80 is located within the proximal handle portion 16. The outer distal handle portion 82 extends beyond the proximal handle portion 16 and is exposed to the environment.

[0058] As described above, the rotation detection assembly 150 is located within the rotation sensor holder 110. As shown in the figure, the forward gear 112 of the rotation detection assembly 150 meshes with an annular gear formed from toothed projections 62 and 64 (best shown in Figure 5). In such an embodiment, when the handle 12 is fully assembled, the rotation of the distal portion 30 of the handle with respect to the proximal portion 16 of the handle meshes with the annular gear formed by the toothed projections 62 and 64, thereby rotating the forward gear 112. This rotation is then converted by the other parts of the rotation detection assembly 150 so that the rotation is measured by the rotation detection assembly 150. In a preferred embodiment, the overall gear ratio is approximately 1:1.

[0059] Alternatively, instead of a gear element, the proximal portion 16 of the handle may comprise a keyed shaft or a partially keyed shaft mounted on a shaft support portion 65 of a shaft support member 63, as shown in Figure 4. The keyed portion of the shaft is positioned to couple with the hub of at least one potentiometer 122, which is held within a rotation sensor holder 110. Thus, as the distal portion 30 of the handle rotates relative to the proximal portion 16, the wipers of the at least one potentiometer 122 can convert the relative positions of the distal portion 30 and the proximal portion 16 of the handle into electrical resistance values ​​that help determine the direction of rotation.

[0060] Referring to Figure 9B, another embodiment of the handle 12 of the endoscope 10, including the rotation sensing assembly 150, is shown. Only the first half shell 21 of the handle is shown in Figure 9B, allowing the interior of the handle 12 to be seen. Furthermore, a portion of the first half shell 21 of the handle is cut away.

[0061] Figure 9B shows a housing 431 for a printed circuit board (PCB) containing electronic components for processing image data from an image sensor at the distal end of the shaft and for selectively powering a light source (e.g., an LED) at the distal end of the endoscope shaft. The enclosure 431 is of any construction, as the PCB may be covered with or additionally housed in a water-resistant material. The water-resistant material may be any suitable potting material, such as parylene or other chemical vapor deposition polymers, to coat and protect the individual electronic components mounted on the PCB. A magnet 51 contained in the handle first half shell 21 is also shown. The printed circuit board within the enclosure 431 may include one or more magnetic position sensors 430g, such as a Hall effect sensor or a sensor array. As shown in Figure 6, in some embodiments, each of the handle first half shell 21 and the handle second half shell 23 may contain a magnet 51 or more magnets 51. In one embodiment, two magnets 51 are positioned facing each other in each half of the handle 16. As the proximal portion 16 of the handle rotates relative to the distal portion 30 of the handle, the magnet 51 moves relative to the housing 431 and the enclosed printed circuit board. A magnetic 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 transmitted to a controller or processor and the sensor data is positioned at the rotational position of the proximal portion 16 of the handle relative to the distal portion 30 of the handle (and at the distal end of the endoscope shaft relative to the position of the optical sensor or camera). Thus, the displayed image of the camera's field of view can be rotated to any desired orientation without actually moving the camera at the distal end of the endoscope shaft.

[0062] Referring here to Figure 10A, in one embodiment, the insertion portion 14 of the endoscope 10 includes a conduit 157 through which operations or functions are performed. In industrial or medical applications, this conduit 157 is used to pass tools (e.g., gripping devices, forceps, clamps, wire baskets, dilators, knives, scissors, magnetic pickups, etc.) that manipulate objects at the end of the insertion portion 14. Fluids (gas or liquids) are also passed to and from an external source and to and from the space in which the insertion portion 14 is placed. In medical applications, such a conduit 157 is used to blow gas into a body cavity, to remove gas from a body cavity, to flush a space with a liquid, or to aspirate liquid and / or airborne particles from a space. The conduit 157 optionally supports useful components such as optical transmission components, information transmission components, power transmission components, and mechanical control components, saving space within the insertion portion 14 and helping to reduce the overall diameter of the insertion portion 14. Optical transmission components include, for example, fiber optic bundles, ribbons, optical conductors, optical projection elements, and / or similar. Information transmission components include, for example, bundles of electrical cables or ribbons that connect an imaging device or image sensor at the end of the insertion section 14 to an image processing unit located inside the handle 12 or outside the endoscope 10. Such cables also supply power to the image sensor. Mechanical control components include, for example, push rods, pull wires, etc., that control the movement of elements near the end of the insertion section 14. This includes, for example, an actively flexible distal portion of the insertion section 14 that is actively bent by the use of mechanical control components extending from the handle 12. It also includes, for example, a rotating camera or camera mount at the end of the insertion section 14 that is actively bent by the use of mechanical control components extending from the handle 12.

[0063] In one embodiment, the fluid transport conduit 157 within the insertion shaft or section 14 is configured to surround useful components of the endoscope 10, such as fiber optic bundles, communication cables, and mechanical actuators. In a further embodiment, the conduit 157 is in fluid communication with a camera assembly 350 (see, for example, Figure 21) at the distal end of the insertion shaft 14. The camera assembly 350 includes a camera sensor or imaging device connected to a communication cable. In this case, the connection between the camera sensor and the communication cable, and the internal components of the accompanying lens assembly, are sealed against exposure to the fluid pressure within the conduit 157. Exposure of the camera assembly 350, lens assembly, communication cable, mechanical actuator (e.g., pull wire), and fiber optic cable or bundle thereof to a "wet" conduit is feasible if at least a portion of the endoscope 10 is made into a disposable device, i.e., disposable after use in a medical procedure. Thus, the technical challenge of adequately disinfecting the components inside the conduit is prevented.

[0064] Several components of the endoscope 10, particularly electronic components located within the handle portion 12, are preferably kept dry. A bulkhead or barrier element 159 between the conduit 157 of the insertion portion 14 and the interior of the handle 12 allows components to pass from the handle 12 to the conduit 157 of the insertion portion 14 (indicated by a dividing line 155 in Figure 10A and referred to as a pass-through component), while preventing liquid from entering the internal space of the handle 12 from the conduit 157. The barrier 159 includes a passage (hole, slit, etc.) through which pass-through components 155, such as the useful components described above, pass from the handle 12 to the conduit 157 of the insertion portion 14. The passage is formed to provide a relatively tight fit around the outer surface of the pass-through component 155. In some embodiments, an elastomer gasket, O-ring, or other similar element is used to further prevent liquid from entering the internal space of the handle 12 from the conduit 157 of the insertion portion 14. The barrier 159 comprises a wall that divides the coupling region between the handle 12 and the proximal end of the insertion portion 14. The coupling region is near the area where the conduit 157 connects to a conduit port that provides the conduit 157 with a connection to an external fluid. The barrier 159 may instead comprise a block through which the route selection channel connects a utility hole in a first side of the block that is connected to the conduit 157 to at least one mechanism (e.g., a conduit port) on a second side opposite the first side of the block, or on a third side of the block (in some embodiments, approximately perpendicular to the first side of the block). The passage for a cable, ribbon, wire, push rod or other component from the handle 12 may be formed on the second side opposite the first side of the block and may be aligned with the utility hole in the block. The conduit 157 may be formed from a sheath (such as the inner sheath 312 in Figure 17) that is connected to or attached to the handle 12 of the tool. In some embodiments, the pass-through barrier 159 between the handle 12 and the sheath of the insertion portion 14 includes a sheath mount, which supports the sheath of the insertion portion 14 near the end proximal to the handle 12 and serves to attach or connect the sheath to the handle 12.In some embodiments, the insertion portion 14 comprises a cannula with a sheath located inside. The cannula is attached to the handle 12 via a cutting mechanism, allowing the endoscope 10, including the handle 12 and sheath, to be removed from the site while the cannula remains in its original position.

[0065] Referring here to Figure 10B, in some embodiments, the barrier 159 may include a flexible or elastomer member 153. One or more through-parts 155 may extend through the flexible member 153 of the barrier 159 to the conduit 157 of the insertion part 14. In some embodiments, one or both of the inlet and outlet points of the through component 155 within the flexible member 153 may be sealed with a sealing member or agent 151. The sealing member or agent 151 can prevent fluid flow between the conduit 157 and the handle 12. The sealing member or agent 151 may also hold the through component 155 so as to prevent it from moving relative to the inlet and / or outlet points of the flexible member 153. Any suitable sealing member or agent 151 can be used, such as adhesive, epoxy, or other adhesives. In other embodiments, the through component may be solvent-bonded, thermally bonded, etc., to the flexible member 153. In yet another embodiment, the flexible member 153 may be formed in a fixed position around the through component 155 during manufacturing so as to form a seal between the through component 155 and the flexible member 153.

[0066] As the through component 155 moves (for example, when the pull wire is actuated for the rotation of the camera assembly), the flexible member 153 comes into contact with the flexible member 153 by the sealing member or agent 151, as the through component 155 is fixed in place. Thus, the entry or leakage of fluid from the conduit 157 to the handle can be substantially or completely suppressed while the through component 155 moves back and forth. Through components 155 that remain in a fixed position and do not displace do not necessarily have to pass through the flexible member 153. Instead, these components can pass through the rigid portion of the barrier 159, which may or may not be connected to the flexible member 153. The flexible member 153 can be made of, for example, an elastomer, a flexible membrane, a fragile wall, a bellows-like arrangement, a diaphragm, and the like.

[0067] The barrier 159 described in relation to Figure 10A is shown in Figure 11A and may also be referred to as the inner sheath mount 160. As shown, the inner sheath mount 160 includes a distal portion 161a and a proximal portion 161b, which are separated from each other in Figure 11A to show the interior of the inner sheath mount 160. As shown, the distal portion 161a includes notches 162 on both sides of the distal portion 161a. As shown in the exemplary embodiment of Figure 11A, a portion of the inner surface 164 (when assembled) of the distal portion 161a is recessed. The scrub or suction path selection channel 166 is also recessed within the distal portion 161a of the inner sheath mount 160. As shown, the scrub path selection channel 166 is located within the recessed surface 164. The scrub path selection channel 166 communicates with a utility hole 168 at its first end. In the exemplary embodiment, the utility hole 168 is located substantially near the center of the distal portion 161a, within a recessed surface 164 (however, in other embodiments, the utility hole 168 is not central).

[0068] The proximal portion 161b of the inner sheath mount 160 also includes notches 170 on the left and right sides, as well as a recessed notch 162 within the distal portion 161a. The notches 170 may extend into the proximal portion 161b. The notches 162 and 170 of the inner sheath mount 160 are sized to receive the projection of the distal portion 30 of the handle, which helps to hold the inner sheath mount 160 in place when the endoscope 10 is fully assembled.

[0069] The proximal portion 161b may also include a raised portion 172 on its internal surface (when assembled). As shown, the raised portion 172 has similar external dimensions to the recessed surface 164 of the distal portion 161a. When assembled, the raised portion 172 is pressed into the recessed surface 164, integrally connecting the distal portion 161a and the proximal portion 161b. In some embodiments, the proximal portion 161b is fixed to the distal portion 161a using glue or other suitable adhesive between the recessed surface 164 and the raised portion 172. This also helps to create a fluid seal between the two components.

[0070] The proximal portion 161b includes several mechanisms. As shown in the figure, the proximal portion 161b includes a lavage or suction passage 174. The lavage or suction passage 174 is positioned to align with the second end of the lavage route selection channel 166 when the proximal portion 161b is combined with the distal portion 161a. During use of the endoscope 10, the lavage or suction fluid flows between the utility hole 168 and the lavage passage 174 via the lavage route selection channel 166.

[0071] As illustrated in the exemplary embodiment of Figure 11A, the proximal portion 161b of the inner sheath mount 160 includes a sheath mount slit 176. As shown, the sheath mount slit 176 is oriented horizontally (see orientation shown in Figure 11A) and is located in the proximal portion 161b of the inner sheath mount 160, approximately aligned with the utility hole 168. In another embodiment, the sheath mount slit 176 may be oriented differently. In the exemplary embodiment of Figure 11A, the sheath mount slit 176 extends through the entire proximal portion 161b at an angle substantially perpendicular to the inner surface (when assembled) of the proximal portion 161b.

[0072] The proximal portion 161b of the inner sheath mount 160 may also include several openings 178. In the exemplary embodiment of Figure 11A, the openings 178 are small-diameter holes extending through the entire proximal portion 161b, used to allow a pull cable, push cable, or wire to pass from inside the handle to the distal end of the endoscope 10. The proximal portion 161b may also include an optical fiber passage 179. In the exemplary embodiment, the openings 178 and the optical fiber passage 179 are at an angle perpendicular to the inner surface of the proximal portion 161b (when assembled). In another embodiment, the openings 178 and the optical fiber passage 179 are at a different angle or have a different diameter. As shown, the openings 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 openings 178 align with the utility hole 168 of the distal portion 161a.

[0073] In other embodiments, the shape, position, dimensions, etc., of some mechanisms of the bulkhead, pass-through barrier, or inner sheath mount 160 may differ. The pass-through barrier or inner sheath mount 160 may include additional mechanisms, or some mechanisms may be omitted. In some embodiments, there are more or fewer openings 178. In some embodiments, the openings 178 may not be arranged in the spatial configuration shown in Figure 11A. There may be two or more cleaning passages 174. In some embodiments, the inner sheath mount 160 is used with or includes a gasket to further prevent fluid from entering sensitive areas within the endoscope handle.

[0074] The handle electronic portion 80 (see, for example, Figure 7A) is preferably configured to contain sealed mechoelectronic components that prevent the ingress of excessive amounts of fluid. (Small amounts of fluid or moisture do not need to impede the proper mechanical or electrical operation of the endoscope, especially if the electrical components are covered with a moisture-resistant film). The handle distal outer portion 82 (swivel control housing), configured to house the swivel control structure and operating cables that control the movement of the camera assembly at the distal end of the endoscope shaft or insertion shaft handle, may be exposed to fluid with minimal impact on the operation of the endoscope. Therefore, it is more important to maintain a fluid seal between the handle electronic portion 80 and the handle distal outer portion 82. As shown in Figures 13 and 14, a bulkhead or pass-through barrier such as the sealing member 210 is made to provide a tight seal (e.g., an elastomer seal) around electronic flexible cables, fiber optic bundles and other structures that must pass from the distal end to the proximal end of the endoscope before exiting. On the other hand, as shown in Figures 11A and 14, pass-through barriers such as the inner sheath mount 160 allow for inferior sealing, particularly when applied to pull wires or cables passing from the swivel control structure to the distal end of the endoscope shaft. Fluid that enters the distal portion 82 of the handle can exit the housing through at least one drain hole passage made in an independent part of the housing, such as the passage 108 shown in Figure 8.

[0075] In another embodiment, the pass-through barrier 159 (see Figure 10B) between the distal portion of the handle or the swivel control housing 82 and the shaft of the endoscope comprises a complete sealing structure that allows movement of a pull cable or actuation cable extending from the swivel control housing to the distal end of the endoscope shaft. For example, the pass-through barrier comprises a flexible (or soft) diaphragm, a pleated elastomer diaphragm, an accordion-structured rubber protective cover, a bellows structure, or a displaceable diaphragm connected around the housing, which forms a fluid-tight seal around the structure passing through it near its center, and their central region moves freely distally and proximal to allow free movement of the swivel control cable passing through it. A more complete seal in this portion of the endoscope can reduce or eliminate the need for a secondary seal between the swivel control housing and the handle electronic portion 80.

[0076] Figure 11B shows an alternative embodiment of a bulkhead or pass-through barrier 159 including a flexible member 153. As shown, the pass-through barrier 159 includes a rigid structure 167 and a flexible member 153. The rigid part or structure 167 can function as a frame to which the flexible member 153 is attached or fused. In some embodiments, the rigid structure 167 can be joined together during manufacturing using a double-molding process, and can include one or more mating shape portions 173 that can be sized to mate with cooperating mating features of the distal handle portion 30 (see, for example, Figure 15). In some embodiments, the interaction between the mating mechanism 173 and the cooperating portion of the distal handle portion 30 (see, for example, Figure 15) can form a seal between the pass-through barrier 159 and the distal handle portion (see, for example, Figure 15).

[0077] Referring here to Figure 11C, a gasket member 163 may be included around the pass-through barrier 159 to facilitate the formation of such a seal. Such a gasket member 163 may be positioned along the outer edge 165 of the pass-through barrier 159 (Figure 11B). Alternatively, a double-molding process can be used to attach the gasket member 163 to the pass-through barrier 159 during manufacturing. The gasket member 163 can completely surround the rigid structure 167 and can be formed from a compressible or elastic material such as Metaprene®.

[0078] Referring still to Figures 11B and 11C, the flexible member 153 includes a number of through elements. A number of orifices 178 are included in the exemplary flexible member 153. Furthermore, the flexible member 153 may include an optional illumination or fiber optic passage 179. Such an illumination passage 179 may not necessarily be an embodiment in which the illumination is provided by one or more LEDs at the distal end of the endoscope shaft, for example. Furthermore, a slit or slot 177 may be included in the flexible member 153. In the exemplary embodiment, the slit 177 extends from the flexible member 153 through the rigid structure 167 to the edge of the through barrier 159.

[0079] Passage elements and passages within the pass-through barrier 159 may also be located within the rigid frame structure 167 of the pass-through barrier 159. For example, passage elements or passages related to fixed or non-displaceable elements may be desirable to be located within the rigid structure 167 of the pass-through barrier 159. In the exemplary embodiment, a rigid structure passage 169 is shown that provides a passage through the rigid structure 167.

[0080] The conduit mounting site or port 256 may be included in the pass-through barrier 159. As shown, the conduit mounting port 256 protrudes from the rigid structure 167 and optionally includes a barbed fitting on which a flexible tube or conduit can be secured. The conduit attachment point 256 may include an internal lumen extending through the pass-through barrier 159. In the exemplary embodiment shown in Figure 11B, the internal lumen is an irrigation or suction passage 174 that can transfer fluid from one side of the pass-through barrier 159 to the other.

[0081] Referring here to Figure 11D, when assembled, various through-components 155 can pass through the orifice 178, passage 179, and slit 177 of the through-barrier 159. When these through-components 155 are positioned within the through-barrier 159, a sealing member or agent 151 can be selectively applied to one or both of the inlet and / or outlet points of the through-components 155 within the through-barrier 159. In the exemplary embodiment, the sealing member or agent 151 is a fixative such as an adhesive, but in other embodiments, any suitable sealing member or adhesive can be used. The sealing member or agent 151 can prevent fluid communication through the through-components within the through-barrier 159. Furthermore, when applied to a flexible member 153, it can pass through and fix the components 155 so that they do not displace relative to their inlet and outlet points within the flexible member 153. As a result, in this case, the displacement of the through-components 155 causes the flexible member 153 to move back and forth.

[0082] Figure 12 shows an exemplary exploded view of an embodiment of the swivel control structure 100. The swivel control structure 100 controls the swivel of the structure. The structure may be, for example, a camera assembly 350 (see Figure 21) at the distal end of the insertion portion 14 (see Figure 3A). In another embodiment, the swivel control structure 100 is used, either alternatively or additionally, to control the bending of the flexible portion of the insertion portion 14. Some embodiments of the swivel control structure 100 include gear devices, motors, multi-rod linkage mechanisms, dials, etc., unlike the embodiments disclosed below.

[0083] The illustrative swivel control structure 100 in Figure 12 is shown in an exploded view. The fingertip contact 98, detailed above, is shown separated from the swivel control structure 100. As shown, the bottom surface of the fingertip contact 98 optionally includes several peg protrusions 180. In the illustrative embodiment shown in Figure 12, there are generally four cylindrical peg protrusions 180 (the number and shape of the peg protrusions may vary). Additionally, the fingertip contact 98 may include a fingertip contact slot 182 located on the bottom surface of the fingertip contact 98.

[0084] Below the fingertip contact 98, an exemplary embodiment of the swivel member 184 of the swivel control structure 100 is shown. The top of the swivel member 184 of the swivel control structure 100 includes a slider 186. A fingertip contact post 188 protrudes from the center of the slider 186, positioned to engage with a fingertip contact slot 182. Optionally, fingertip contact peg holes 190 are provided on each side of the fingertip contact post 188. When the fingertip contact 98 is mounted to the swivel control structure 100, the fingertip contact slot 182 slides on the fingertip contact post 188 on the slider 186. Additionally, if there are peg projections 180 on the fingertip contact 98 when assembled, the peg projections 180 may be located in the fingertip contact peg holes 190 of the slider 186.

[0085] The rotation control structure 100 interacts with at least one mechanism of the endoscope to lock or hold the rotation control structure 100 in a desired direction. As shown, the bottom surface of the slider 186 of the rotation member 184 optionally includes at least one retaining rod or recessed element 192. In other embodiments, multiple retaining rods 192 are arranged along the bottom of the slider 186 and are positioned to engage with opposing raised mechanisms or projections 94 of the handle 12.

[0086] The retaining rod or recess element 192 may interact with the raised mechanism or projection 94 (clearly visible in Figure 7A) of the slide button recess 92 of the handle protrusion 32 described above. When the swivel control structure 100 is moved by the user, the space between the projections 94 acts as a recess in which the retaining rod 192 of the slider 186 is “retained.” This helps to stop the drift or movement of the swivel control structure 100 when the user moves the swivel control structure 100 to a desired position and releases it. It also helps to ensure that the swivel control structure 100 is not accidentally moved during use of the tool. In alternative embodiments, and as also described above in relation to Figure 7C, in some embodiments, the swivel control structure 100 may also include an arm 97 which acts as the retaining rod or recess element 192.

[0087] As shown in the figure, the swivel member 184 of the swivel control structure 100 includes a curved internal shield 194. The internal shield 194 is stepped below the slider 186 and below the handle housing when assembled. A column 196 spans the distance between the top surface of the internal shield 194 and the bottom surface of the slider 186. In some embodiments, a retaining rod 192 is located at the top of the internal shield 194. In such embodiments, the projection 94 is located on the inner wall of the housing of the distal portion 30 of the handle such that the projection 94 forms a recess in the internal shield 194 for the retaining rod 192. As described above, this allows the swivel control structure 100 to be "locked" in the desired position.

[0088] The swivel arm 198 extends from the bottom surface of the internal shield 194. In the exemplary embodiment, the swivel arm 198 includes two mechanical cable connection points or holes 202. One hole 202 is located on one side of the swivel shaft 204, and the second hole 202 is located on the other side of the swivel shaft 204. In the illustrated embodiment, forward movement of the slider 186 retracts the mechanical cable connected to the lower hole 202 proximally, and backward movement of the slider 186 retracts the mechanical cable connected to the upper hole 202 proximally. To allow the optical fiber or electrical cable to pass relatively smoothly from the proximal end to the distal end of the handle, the swivel arm 198 is notched, for example, in the swivel shaft 204, so that the passing cable is free to rest on the swivel shaft 204 (or a concentric sleeve or hub surrounding the swivel shaft 204). Such arrangement allows for a passage with minimal movement in the lateral or vertical direction.

[0089] Referring here to Figures 12 and 14, the slewing arm 198 is configured to have a slewing region 200 and a lateral displacement portion 199 that covers the slewing shaft 204. Thus, the hub or sleeve covering the slewing shaft 204 (when assembled) is shown to function as a support surface on which the passing cable 250 rests. The lower part of the slewing arm 198 extends downward from a position directly below the hub or sleeve of the slewing shaft 204. In some embodiments, the lower part of the slewing arm 198 is optionally aligned vertically with the upper part of the slewing arm 198, and the mechanical cable connected to the point or hole 202 is also aligned vertically. In another embodiment, at least one cable (e.g., cable 250) travels around (or through) the hub of the slewing shaft 204 in various other ways, and its path is least obstructed by the slewing arm 198 of the slewing control structure 100.

[0090] Optionally, a secondary pass-through seal provides an additional barrier between the liquid entering the housing of the distal handle portion 30 and the housing of the proximal handle portion 16, which houses the electronic portion 80. The seal includes openings, holes, or slits through which components such as, but not limited to, optical fiber bundles, electronic cables, and / or fluid conduit tubes pass. The holes or slits are sized to fit snugly to the components as they pass through the seal. In one embodiment, the secondary pass-through seal is formed from rubber or other elastomer material to enhance its liquid sealing properties. In some embodiments, for example, those including a pass-through barrier 159 including a flexible member 153 may not include a secondary pass-through seal. In such embodiments, the electronic portion 80 and the extension handle portion 82 are of the same volume or a combined volume.

[0091] Figure 13 shows an exemplary embodiment of a secondary seal, i.e., a sealing member 210. The sealing member 210 is generally rectangular in shape, as shown in Figure 13. As shown in Figure 13, one end of the sealing member 210 has a first shape (e.g., rectangular), and the second end of the sealing member 210 has a second shape (e.g., has or is rounded). This has the advantage of ensuring that the sealing member 210 is installed in the correct orientation during assembly. The sealing member 210 includes several openings. In the exemplary embodiment, the sealing member 210 includes an optical fiber bundle (e.g., lighting fiber) opening 212, a flexible cable (e.g., electronic cable) opening 214, and a fluid tube (e.g., cleaning line) opening 216. In the exemplary embodiment shown in Figure 13, the lighting fiber opening 212, the flexible cable opening 214, and the cleaning line opening 216 extend throughout the entire sealing member 210. The illumination fiber opening 212 is relatively small in diameter and matches the diameter of the fiber bundle or optical conductor. The flexible cable opening 214 is a slit that matches the size and shape of the electronic flexible cable. The cleaning line opening 216 is cylindrical and has a larger diameter than the illumination fiber opening 212. The illumination fiber opening 212, the flexible cable opening 214, and the cleaning line opening 216 extend through the sealing member 210 at an angle substantially perpendicular to the front of the sealing member 210 (with respect to Figure 13). In another embodiment, the openings of the sealing member 210 may differ in number, size, and shape. In some embodiments, the sealing member 210 includes an additional hole for wiring to, for example, a button 90.

[0092] As illustrated in the exemplary embodiment of Figure 13, the sealing member 210 also includes several gasket arms 218. In the exemplary embodiment shown in Figure 13, the gasket arms 218 are near the sealing member 210 and protrude from the top and bottom surfaces of the sealing member 210. As shown, there are two gasket arms 218. In some embodiments, the gasket arms 218 may be straight. In the exemplary embodiment, the gasket arm 218 includes two straight sections connected by a curved section that bends the gasket arm 218 away from the sealing member 210.

[0093] Figure 14 shows an exemplary embodiment of half (30a) of the distal portion 30 of the handle. As shown, the inner sheath mount 160, the swivel control structure 100, and the sealing member 210 are assembled and placed within the illustrated half (30a) of the distal portion 30 of the handle. A flexible cable 250 (e.g., a flexible electronic communications / power cable) is also shown. In the exemplary embodiment shown in Figure 14, the distal portion 161a of the inner sheath mount 160 includes a sheath mount hub 252. The sheath mount hub 252 extends distally along the same axis as the utility hole 168 (see Figure 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 may be approximately the same as or slightly larger than the diameter of the utility hole 168. In the exemplary embodiment, it protrudes upward from the outer surface of the sheath mount hub 252. The sheath mount tab 254 is located next to the surface of the insertion side piece 160a from which the sheath mount hub 252 protrudes. The sheath mount tab 254 helps to properly orient the sheath (for example, the inner sheath 312 shown in Figure 17) when it is attached to the sheath mount hub 252, and optionally also functions as a fastener to secure the sheath to the sheath mount hub 252 and the sheath mount 160.

[0094] In other embodiments, the sheath mount tab 254 is positioned on the inner surface of the sheath mount hub 252. This is preferable because it eliminates the limitation on the diameter of the sheath conduit and prevents the need to insert the inner sheath mount hub 252 into the sheath. As a result, the flow velocity through such conduit can be increased. Alternatively, in some embodiments, the sheath mount tab 254 may not be included. Instead, the sheath is oriented and fixed to the sheath mount hub 252 with appropriate fasteners (not shown).

[0095] As shown in the figure, 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 portion 161a of the inner sheath mount 160. The flexible cable 250 is also routed to pass through the sheath mount slit 176 of the proximal portion 161b.

[0096] The proximal portion 161b of the inner sheath mount 160 includes a fluid conduit connection position or port 256. The fluid conduit connection position 256 is hollow and is a generally cylindrical projection extending from the proximal portion 161b of the inner sheath mount 160 to the right of its page (relative to Figure 14). The tubing of the flush line 434 (see Figure 96) slides over the outer surface of the fluid conduit port 256 and is barbed to help hold any optionally installed portion of the tubing. As shown, the right edge of the fluid conduit port 256 is chamfered in such a way that it facilitates the installation of the tubing portion into the fluid conduit port 256. Furthermore, as shown in Figure 14, the proximal end of the fluid conduit port 256 is tapered to have a slightly larger diameter than the rest of the surface of the fluid conduit port 256. This acts as a barb and helps ensure that the tubing of the flush line 434 (see Figure 96) does not easily come loose once connected. In another embodiment, the fluid conduit port 256 extends into and fits into the cleaning line opening 216 of the sealing member 210. Then, the rib / connection position for the cleaning line 434 is located in the sealing member 210.

[0097] The swivel control structure 100 is swivelably connected to the distal portion 30 of the handle, as shown in Figure 14. As shown, the swivel shaft 204 extends through the swivel shaft hole 200 of the swivel arm 198 of the swivel control structure 100. The end of the swivel shaft 204 (or perimeter hub) inserted to the opposite wall of the distal portion 30 of the handle rests on a swivel bearing 260 protruding from the inner wall of the distal portion 30 of the handle. When fully assembled, the opposite end of the swivel shaft 204 is similarly positioned on a swivel bearing 260 protruding from the inner wall of the other half (30b) of the distal portion 30 of the handle.

[0098] As shown in Figure 14, the slider 186 and internal shield 194 of the swivel control structure 100 are offset from each other by a column 196 by a distance slightly greater than the wall thickness of the distal portion of the handle 30. The column 196 extends through the swivel control structure notch 96 described above. The curvature of the slider 186 and internal shield 194 is selected so that the slider 186 and internal shield 194 can move freely back and forth in response to user input without interfering with the wall of the housing of the distal portion of the handle 30. The length of the swivel control structure notch 96 determines the amount of swivel movement created by the user's input to the swivel control structure 100.

[0099] In some embodiments, the walls of the swivel control structure notch 96 generate a frictional force against the column 196. In such embodiments, the frictional force causes the swivel control structure 100 to "hold in place" in a predetermined position. In such embodiments, the walls of the swivel control structure notch 96 are made of a material with a high coefficient of friction, such as rubber or other elastomer. In such embodiments, the swivel control structure 100 does not need to include the retaining rods 192 or projections 94 as described above.

[0100] 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 otherwise extending from the handle of the endoscope 10 to the movable element at the distal end of the insertion portion. The elongated member may be flexible or substantially rigid. The elongated member may be curled (as in the example of a cable), oval, relatively flat, or have other shapes or cross-sections. In some embodiments, the actuator may be a belt.

[0101] In endoscopes having a pan-capable camera or camera mount at or near the distal end of the shaft or insertion portion, the pan-capable camera or camera mount is rotated using a pull wire or push rod. In the pull wire embodiment, the camera rotation cable may be connected or coupled to the cable connection hole 202, or may form a loop through the cable connection hole 202. In some embodiments, two camera rotation cables are connected to their respective cable connection holes 202. In a preferred embodiment, both ends of a single camera rotation cable are connected to their respective cable connection holes 202 to form a loop. Alternatively, a single camera rotation cable is looped in the middle through a cable connection hole 202, and both ends of the cable are connected distally to the rotating camera or camera mount. The camera rotation cable extends from the cable connection hole 202 of the swivel arm 198 and is routed through at least one opening 178 in the proximal portion 160b of the inner sheath mount 160. The camera rotation cable passes through a utility hole 168, through a conduit formed in the inner sheath, and optionally extends along the longitudinal direction of an electronic flexible cable 250 and / or optical fiber bundle. By swiveling the swivel control structure 100, the camera rotation cable connected to one of the cable connection holes 202 is pulled, and the cable connected to the other connection hole 202 is loosened. By connecting a camera rotation cable associated with one cable connection hole 202 to one side of the rotation point and a camera rotation cable associated with the other cable connection hole 202 to the opposite side of the rotation point, the rotation control structure 100 selectively rotates the target of rotation of the insertion portion of the endoscope distally. In other embodiments, a similar cable mechanism may be used to bend the flexible distal portion of the insertion portion.

[0102] In some embodiments, the swivel arm 198 of the swivel control structure 100 is swiveled via a gear mechanism. In such embodiments, the fingertip contact 98, fingertip contact post 188 (see Figure 12), slider 186, vertical column 196, and internal shield 194 are not required. At least a portion of the user input gear included in the distal portion 30 of the handle protrudes from the raised handle portion 34. The user input gear rotates around a pivot axis located within the distal portion 30 of the handle. This rotation is initiated by the user, for example, via the user's fingers or thumb. The user input gear may mesh with a slewing shaft gear located around a slewing shaft 204 for the slewing arm 198 of the slewing control structure 100. In such embodiments, the rotation of the user input gear causes the slewing shaft gear and the slewing arm 198 to rotate, acting on the slewing actuator (e.g., for camera rotation, driving, or pull wire) as described above. In some embodiments, there are one or more intermediate gears between the user input gear and the slewing shaft gear to provide desired gear reduction to suit the precision of the movement and ergonomic requirements.

[0103] In other embodiments, the swivel arm 198 may be configured to rotate via an electric motor (e.g., a brushless motor, a stepping motor, etc.). Rotation via the motor is controlled by at least one user input means, such as a button 90. In embodiments including at least one button 90, the button 90 controls the speed and direction of movement of the swivel arm 198.

[0104] In some embodiments, the swivel shaft 204 protrudes outward from the distal portion 30 of the handle. In such embodiments, the swivel shaft 204 (or the covering hub or sleeve) is directly rotated by the user. In some embodiments, the portion of the swivel shaft 204 protruding from the distal portion 30 of the handle includes a knob, dial, crank, etc., which the user can easily rotate by grasping and turning the knob, dial, crank, etc.

[0105] As shown in Figure 14, the sealing member 210 is positioned in the gasket recess 270. The gasket recess 270 includes the gasket arm recess 272. As described above, various components pass through the sealing member 210. As shown, the flexible cable 250, which connects to the printed circuit board 430a (see, for example, Figure 96) in the electronic section 80 housed in the proximal section 16 of the handle, passes through the flexible cable opening 214 of the sealing member 210, extends beyond the sealing member 210 through the distal section 30 of the handle and the sheath mount 160, and finally extends distally to the insertion section of the endoscope. The cleaning line 434 (see Figure 96) and the optical fiber bundle (e.g., illumination fiber 364; see Figure 96) pass through the cleaning line opening 216 and the optical fiber bundle opening 212, respectively, and extend through the housing of the distal section 30 of the handle, similar to the flexible cable 250. In some embodiments, the sealing member 210 may not be included. Alternatively, the electronic component portion 80 may not be separated from the rest of the handle 12. In such embodiments, the enclosed printed circuit board 431 (see, for example, Figure 15) is covered or encased in a protective covering or layer, such as ceramic. In embodiments including the sealing member 210, the printed circuit board (see, for example, Figure 15) is still encased in a protective covering or layer. In addition to or instead of this, the inner sheath mount 160 includes a flexible member 153 similar to that shown in Figures 11B-C, which seals and allows any pass-through components (e.g., flexible cable 250, actuator / cable, lighting fiber, etc.) to move through the inner sheath mount 160.

[0106] Only half of the gasket recess 270 is shown in Figure 14. The other half of the gasket recess 270 may be located elsewhere, rather than on the illustrated half of the distal portion 30 of the handle (e.g., 30b; see Figure 8). When fully assembled, the sealing member 210 is trapped between the two halves of the gasket recess 270. When fully assembled, the sealing member 210 ensures that any liquid present in the distal portion 30 of the handle penetrates into the proximal portion 16 of the handle, which contains the electronic component comprising the electronic portion 80. The sealing member 210 is made of a appropriately flexible (e.g., elastomer) material or other suitable gasket material and is pressed into the gasket recess 270 to ensure a tight seal. In some embodiments, the sealing member 210 may be held in place using an adhesive.

[0107] Figure 15 shows another exemplary embodiment of one half (30a) of the distal portion 30 of the handle. As shown, the pass-through barrier 159 and the swivel control structure 100 are assembled and positioned within the shown half (30a) of the distal portion 30 of the handle. The enclosure 431 of the printed circuit board, encased in protective material 752, is also shown in place within the portion 30a of the distal portion 30 of the handle. In some embodiments, the protruding portion 430h may be a ribbon or flexible cable 250 (see, for example, Figure 14). The printed circuit board can communicate with components at the distal end of the shaft 14 via one or more ribbon cables passing through the bulkhead or the pass-through barrier 159. These cables may or may not need to slide slightly back and forth through the bulkhead to adapt to the rotational movement of the sensor or camera housing at the distal end of the endoscope shaft, or, if the shaft 14 is a flexible shaft, to adapt to its bending and extension. Alternatively, the PCB may include an extension 430h of the PCB itself that extends into the shaft or insertion portion 14 via a pass-through barrier 159. In some specific embodiments, the printed circuit board and its extension 430h may be similar to those shown and described in relation to Figures 33.2 and 33.3, or Figure 67. A sealant 151 is provided around the protrusion 430h. The pass-through barrier 159 may include a peripheral gasket 163 (see, for example, Figure 11D). The pass-through barrier 159 can be bonded to the distal portion 30 of the handle by any number of methods, including, but not limited to, adhesive, epoxy, glue, solvent bonding, press-fitting, etc.

[0108] The pivot control structure 100 in Figure 15 is similar to those shown in Figures 12 and 14. However, the pivot control structure 100 may include an arm 97 that contacts the raised portion 94 described above with respect to Figure 7C. Furthermore, in this particular embodiment, the pivot arm 198 of the pivot control structure 100 does not include a pull wire mounting hole 202 (see, for example, Figure 14). Alternatively, a similar structure including a fastener 203 or eyelet 201 may be attached as part of the pivot arm 198, or provided as part of the pivot arm 198. The pull wire may be attached to the pivot arm via the eyelet 201, and the swivel control structure 100 may be used to actuate the pull wire. The flexible shaft or insertion section 14 can be bent, or the camera assembly within the insertion section 14 can be rotated. The pull wire can pass through the flexible member 153 of the pass-through barrier 159 to actuate the components within the insertion section 14.

[0109] As shown in Figure 15, the pass-through barrier 159 may be the only barrier separating the insertion portion 14 from the electronic components housed within the distal portion 30 and proximal portion 16 of the handle. The sealing member 210 (see, for example, Figure 14) may not be included. In some embodiments, the electronic equipment portion 80 may not be separated from or fluidly isolated from the rest of the handle 12. As described above with respect to Figure 11C, in some embodiments, the pass-through barrier 159 may include a peripheral gasket member 163 to provide an additional seal.

[0110] Figure 16 shows an exemplary embodiment of the outer sheath or cannula mount 300. As shown in Figures 16A and 16B, the outer sheath or cannula 318 is used to provide additional protection to the distal end component of the insertion portion, or to allow the user to withdraw the insertion portion of the endoscope while returning the cannula 318 to its original position, and to allow it to be reinserted into the insertion portion of the endoscope afterward. As illustrated, the cannula mount 300 has a frustoconical shape, with a large diameter portion proximal to a connector (e.g., a bayonet mount) that mounts the cannula 318 onto the inner sheath 312 (see, for example, Figure 17). The cannula mount hole 302 extends through the cannula mount 300 and integrates with the cannula passage. The cannula or outer sheath mount hole 302 is configured to receive and hold the cannula 318. The cannula 318 may be configured to act as a sleeve on the inner sheath 312 of the insertion portion.

[0111] As shown in the illustration, the female part 304 of the bayonet mount includes two slots 306. The slots 306 optionally have different dimensions to ensure the proper orientation of the cannula 318 with respect to the (male) connector to which the distal portion of the handle distal portion 30 is combined. In some embodiments, the slots 306 of the female part 304 of the bayonet mount include a serration, to which the male part 308 of the bayonet mount is spring-loaded, for example, using a disc spring washer. In such embodiments, the spring-loaded connection helps to ensure that the two parts (cannula 318 and the handle distal portion 30) are more firmly and integrally fixed.

[0112] In some embodiments, the cannula mount 300 includes an alignment mechanism to properly orient the cannula 318 relative to the cannula mount 300 during assembly, and ultimately orient it relative to the inner sheath 312 (see, for example, Figure 17) when it is placed on the inner sheath 312 of the insertion portion. In the exemplary embodiment of Figure 16, the outer sheath mount tab 310 protrudes from the inner wall of the outer sheath mount hole 302. The outer sheath mount tab 310 extends from the distal surface of the female portion 304 of the bayonet mount and is used to align the bayonet mount 300 with the cannula 318 having a coupling slot during assembly. Alternatively, the need for such a mechanism is eliminated by connecting the outer sheath or cannula 318 to the cannula mount 300 with a suitable fastener.

[0113] Figure 17 shows a partial cutaway view of an exemplary embodiment of the distal surface of the distal portion 30 of the handle. The inner sheath 312 is attached to the sheath mount hub 252 of the side sheath mount 160. The inner sheath 312 includes a sheath mount notch 314. The inner sheath mount notch 314 is sized to receive a sheath mount tab 254 on the sheath mount hub 252. In such embodiments, the sheath mount tab 254 and the inner sheath mount notch 314 ensure that the inner sheath 312 is correctly oriented on the endoscope 10.

[0114] The inner sheath 312 (and / or outer sheath or cannula 318; see Figure 16) may be formed from steel, some hardened plastic, or other rigid and durable material. Alternatively, the inner sheath 312 or a portion thereof may be flexible, allowing the insertion portion of the endoscope to bend if insertion into an area not in the line of sight of the target area is required. In these embodiments, the user may do not use the outer sheath or cannula 318, or the cannula 318 itself may be made of a similarly flexible material.

[0115] The male portion 308 of the bayonet mount is also visible in the exemplary embodiment shown in Figure 17. The male portion 308 of the bayonet mount includes two projections 316. The projections 316 are sized to fit into the feet of the L-shaped slot 306 of the female portion 304 of the bayonet mount, also referring here to Figure 16. The outer sheath 318 and the cannula mount 300 are connected to the distal portion 30 of the handle by aligning the projections 316 into the slot 306, pressing the bayonet mount onto the projections 316, and then rotating the bayonet mount to secure it in place. Optionally, as shown, the two projections 316 may be of different dimensions so that the outer sheath mount 300 has only one orientation when connected to the distal portion 30 of the handle.

[0116] Referring further to both Figures 16 and 17, the outer sheath or cannula 318 slides onto the inner sheath 312, forming a sleeve. 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 an outer sheath mounting tab 310 when the endoscope is fully assembled. In some embodiments, the outer sheath 318 is friction-fitted, bonded, fused, or glued to the wall surrounding the outer sheath mounting hole 302. The outer sheath mounting tab 310 helps ensure that the outer sheath 318 is oriented correctly when the endoscope 10 is fully assembled.

[0117] When the shaft or insertion portion 14 (see Figure 3) of the endoscope 10 is inserted into the target region, the outer sheath 318 and outer sheath mount 300 are detached from the rest of the endoscope 10 as described above. This allows the outer sheath 318 to be used as a cannula and remains in its original position so that the endoscope 10 can be reinserted into the target region.

[0118] Figure 17A shows a trocar or obturator 319 adapted for use with an outer sheath 318. During the introduction of the endoscope into the surgical site, the trocar can be inserted into the outer sheath 318 to facilitate its entry into the desired position, after which the trocar can be withdrawn and the inner sheath 312 of the shaft 14 can be inserted. If the shaft 14 needs to be substantially repositioned within the surgical site during surgery, the endoscope shaft 14 can be withdrawn from the patient while keeping the outer sheath 318 in place, allowing the trocar to be introduced into the outer sheath 318, and the trocar / outer sheath assembly can be repositioned as needed. When in the appropriate position, the trocar can be withdrawn from the outer sheath 318, and the endoscope shaft with the inner sheath 312 can be reinserted into the outer sheath 318. In the illustrated example, the trocar 319 includes a solid shaft portion 321 with a pointed or blunt end 323 and a base portion 325. The base 325 is optionally equipped with a locking mount that matches that of the distal handle portion 30 of the endoscope handle, allowing the trocar to be secured to the outer sheath 318 during use. If necessary, the outer sheath or cannula 318 can be used as a conduit through which other instruments can pass to their target location. The outer sheath 318 can also function as a conduit for fluids to be guided to or withdrawn from their target location.

[0119] The camera assembly housing 330 or distal working portion is separated from the distal end of the inner sheath 312 and is shown in Figure 18. In this embodiment, the distal working portion of the endoscope insertion section is manufactured separately from the inner sheath 312 and then joined to the distal end of the inner sheath 312 during assembly. In other embodiments, the inner sheath 312 is manufactured as a single part incorporating the distal working portion. In embodiments where the distal working portion is manufactured separately, the distal working portion may be made from a different material than the inner sheath 312. Furthermore, the distal working portion may be made from several assembled parts.

[0120] In the exemplary embodiment shown in Figure 18, the distal edge of the inner sheath 312 includes an inner sheath distal notch 322. The camera assembly housing 330 is shaped to be suitable for insertion into the distal end of the inner sheath 312 during the assembly of the endoscope 10 and includes a nesting portion 332 having a suitable outer diameter. The nesting portion 332 includes a nesting tab 334 or other alignment mechanism. The nesting tab 334 is sized to engage 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 to ensure that the camera assembly housing 330 is properly oriented and aligned when the endoscope 10 is assembled.

[0121] The camera assembly housing 330 further includes an actuation section 336. As shown in Figure 18, the actuation section 336 includes a top gap 338, with or without a bottom gap 340. The top gap 338 and the bottom gap 340 extend along most of the actuation section 336 of the camera assembly mount 330. A rounded tip 342 is included at the distal end of the actuation section 336 of the camera assembly mount 330. As shown in Figure 18, the rounded tip 342 optionally includes a bell-shaped opening 344. The edges of the bell-shaped opening 344 may be beveled, chamfered, or rounded. In the exemplary embodiment, the bell-shaped opening 344 is continuous with the top gap 338. In some embodiments, the top gap 338 and the bottom gap 340 are also bell-shaped.

[0122] The rounded tip 342, as shown in Figure 18, offers several advantages. The rounded tip 342 facilitates the insertion of the insertion portion 14 into the patient's target area. In some cases, this eliminates the need for a trocar. In arthroscopic applications, the contour of the rounded tip 342 allows the endoscope 10 to be manipulated into the narrow spaces within the joint. The rounded tip 342 also allows the surgeon to apply pressure in a way that avoids damaging tissue within the target area. The rounded tip 342 also functions as a protective mechanism for the camera assembly 350.

[0123] As illustrated in Figure 18, the inner wall of the actuation section 336 of the camera assembly housing 330 includes two camera mount swivel bearings 346. In the exemplary embodiment shown in Figure 18, the camera swivel bearings 346 protrude substantially perpendicularly from the inner wall of the camera assembly mount 330. The camera assembly housing 330 is made of steel, some hardened plastic, or other suitable strong and rigid material.

[0124] In the exemplary embodiment shown in Figure 18, the internal wall of the actuation section 336 of the camera assembly housing 330 includes several cable guide holes 348. In a preferred embodiment, there are only two cable guide holes 348. One cable guide hole 348 is located on one side wall, and the other cable guide hole 348 is located on the opposite side wall. Preferably, the cable guide holes 348 are located below the camera mount swivel bearing 346, and the distal end of the control cable is angled with respect to the camera, camera mount, or camera assembly 350 (see, for example, Figure 23) to which it is connected. The camera assembly housing 330 also includes one or more restraint mechanisms. In the exemplary embodiment shown in Figure 16, there are two restraint notches 349. One restraint notch 349 is located on one side wall, and the other restraint notch 349 is located on the opposite side wall. As shown in Figure 16, the restraint notches 349 are roughly in line with the cable guide holes 348. The cable guide hole 348 and the restraining notch 349 will be explained further below.

[0125] Figure 19 depicts an embodiment of the distal working portion or camera assembly housing 330 and inner sheath 312 made as a single piece. See also Figure 20, which shows a cross-section of the camera assembly housing 330 as seen from line 20-20 in Figure 19. In embodiments in which the distal working portion or camera assembly housing 330 and inner sheath 312 are made as a single piece, they are made from steel. In such cases, the inner sheath 312 and the tip of the camera assembly housing 330 are made by a rolling process. Various gaps, openings and other mechanisms, such as those described above, are later machined into the part. In the exemplary embodiment of Figure 19, the camera assembly housing 330 includes only the camera mount swivel bearing 346.

[0126] There are advantages to manufacturing the inner sheath 312 and the camera assembly housing 330 as a single unit. Among these advantages is the increased durability of the unit. Another advantage is the elimination of the need for nesting parts. As a result, the "constricted point" at the cross-sectional area where the inner sheath 312 and the camera assembly housing 33 intersect is removed. This yields several benefits. By removing such a constricted point, more space can be provided for various components, such as useful components within the inner sheath 312 and the camera assembly housing 330. Furthermore, by removing such a constricted point, more cleaning fluid can flow into 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 strengthens the unit. Since thickening strengthens the unit, the outer sheath or cannula 318 can be made thinner. The thinness of the outer sheath or cannula 318 allows for a larger diameter for the inner sheath 312 and the camera assembly housing 330. In other words, the cross-sectional area of ​​the conduit within the insertion portion 14 can be increased without increasing the overall diameter of the insertion portion 14 (which consists of the outer sheath 318, the inner sheath 312, and the camera assembly housing 330). The increased thickness further ensures that the camera mount swivel bearing 346 has a larger support surface, distributing the pressure acting on the bearing over a wider area.

[0127] Figure 21 is an assembled view of the tip of the insertion portion 14 (best shown in Figure 3A). In Figure 21, the camera assembly housing 330, the camera assembly 350, and the outer sheath or cannula 318 are visible. As shown, the rounded tip 342 of the camera assembly housing 330 protrudes beyond the distal end of the outer sheath or cannula 318. The visual notch 352 is recessed into the top of the outer sheath 318. The camera assembly 350 pans over the field of view defined by the aperture created by the combination of the bell-shaped aperture 344 and the visual notch 352. In some embodiments, the panning range is approximately 180°. When panning, the camera assembly 350 pivots on the camera swivel bearing 346 (see, for example, Figure 18). The drive for panning is described further below.

[0128] In some embodiments, the outer sheath 318 rotates relative to the insertion position (not shown) when the insertion portion 14 of the endoscope 10 (see Figure 3) is inserted into the target region. At the insertion position, the visual notch 352 does not need to be aligned with the bell-shaped opening 344 or the apical gap 338. This helps protect the camera assembly 350 during insertion, and in medical applications, reduces the risk of tissue damage during insertion of the insertion portion 14. After insertion, the outer sheath 318 returns to a position where the visual notch 352 rotates and aligns with the bell-shaped opening 344 and apical gap 338, allowing the entire field of view to be seen again.

[0129] In some embodiments, a cap or window material covers or fills the opening defining the visual notch 352 and the bell-shaped opening 344 to protect the camera assembly 350. In some embodiments, the distal edge of the outer sheath 318 and the visual notch 352 are surrounded, rounded, beveled, etc., to prevent damage resulting from having sharp edges.

[0130] In the exemplary embodiment, no cap or window is used. Such an arrangement has several advantages. For example, by not using a cap or window at the tip of the insertion section 14, the cost of the endoscope can be reduced because expensive, scratch- and abrasion-resistant materials such as sapphire or special glass are not used. Also, by not having a cap or window, undesirable reflections from the surface of a cap or window, which affect the clarity of the image captured by the camera, can be eliminated. Furthermore, by not using a cap or window, cleaning of the target area can be performed through the conduit of the inner sheath 312 (see Figure 15) of the endoscope 10. This allows the overall diameter of the insertion section 14 to be kept small while maintaining cleaning capacity. In addition, the flow of cleaning fluid in the inner sheath 312 helps to remove and clean debris or material from the camera assembly 350 and its associated lens. As an example, the user can effectively clean the camera assembly 350 by panning the camera assembly 350 during cleaning so that the flow of cleaning fluid washes the lens assembly 354 of the camera assembly 350 (see, for example, Figure 24) and carries away debris and unwanted material. An additional benefit is that the flow of the cleaning fluid also helps to cool the image sensor 380 associated with the camera assembly 350 (see, for example, Figure 63).

[0131] As illustrated, the bell-shaped opening 344 and the visual notch 352 are sized to protect the camera assembly 350 without the need for a cap or window. In the exemplary embodiment of Figure 21, the bell-shaped opening 344 and the visual notch 352 partially cover the camera assembly 350, and the camera assembly 350 is recessed from the outer surface formed by the bell-shaped opening 344 and the visual notch 352. Thus, the bell-shaped opening 344 and the visual notch 352 define the edge of the protective covering for the camera assembly 350. The partial covering helps protect the movable components and associated components of the camera assembly 350 (e.g., control cables, electrical cables, information cables, etc.) from contact with external objects, either while inserting the insertion portion into the target area or while using a tool inserted into the target area. The bell-shaped opening 344 and visual notch 352 provide the camera assembly 350 with an unrestricted field of view, while exposing only a small portion of the camera assembly 350 to the potential for damage from external objects (such as medical instruments like razors) relative to the insertion site. This helps ensure that the camera assembly 350 is not damaged during insertion or operation.

[0132] 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 enters 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 greater the amount of the outer sheath 318 that enters the field of view of the camera assembly 350. Therefore, the optimal amount of protection that gives the camera assembly 350 an unrestricted field of view is achieved by changing the width of the visual notch 352.

[0133] Figure 22 is another assembled view of the tip of the insertion portion 14 (best shown in Figure 3A) having a variable width for the visual notch 352. The width of the visual notch 352 varies so that the visual notch 352 is just outside the field of view of the camera assembly 350 in any angular direction of the camera assembly 350. This allows for a greater degree of encirclement of the camera assembly 350 by the outer sheath 318.

[0134] Figure 23 shows yet another embodiment of the tip of the insert portion 14 (best shown in Figure 3A) in which several openings 353 separated by the bar 351 are included instead of the visual notch 352 as shown in Figure 20. According to such an arrangement, additional protection can be provided to the camera assembly 350. To minimize the amount by which the bar 351 obstructs the field of view of the camera assembly 350, the bar 351 is made of a transparent material. In other embodiments, the bar 351 may be made of an opaque material, for example, the same material as the outer sheath 318.

[0135] Alternatively, a cover member (not shown) that partially covers the visual notch 352 (see Figure 22) or at least one opening 353 (see Figure 23) may be attached to the distal end of the shaft or insertion portion 14 (see, for example, Figure 1). Such a cover member may be, for example, a cage that provides the camera assembly 350 with an essentially clear field of view while providing additional protection to the camera assembly 350. In some embodiments, the cover member includes a visually transparent partial cover.

[0136] In another embodiment, the camera assembly may be attached to the distal end of the endoscope shaft without the protective tip structure 342. The tip structure 342 can provide some protection to the camera assembly, but it can also restrict the camera's full field of view at all positions within its range of motion. An example of another configuration is shown in Figure 23.1. In this example, the sensor or the camera housing 500 itself is configured to provide adequate protection to the enclosed camera assembly (e.g., the lens and sensor assembly). For example, the camera housing 500 may be made at least partially of steel or a similarly strong material and can be configured to withstand physical abuse, at least the outer shell of the housing, when the insertion end of the endoscope is introduced or repositioned. The exposed portion of the housing 500 preferably has an outer spherical, ellipsoidal (flattened, oblong, etc.), dome-shaped, or other rounded shape, giving it rounded edges that help prevent tissue damage when the endoscope shaft is inserted or moved within the surgical site. Placing the camera assembly in a reinforced and at least partially rounded housing 500 at the distal end or tip 550 of the endoscope shaft 14 provides an unobstructed view of much of the surgical site without damaging the camera assembly or the surrounding tissue. In this example, the sensor or camera housing 500 can be rotated around axis 504 using a pull wire 502, cable, or band so that the optical axis of the camera assembly (lens and sensor assembly) can be directed from less than 0 degrees to more than 90 degrees relative to the long axis of the distal end 550 of the endoscope shaft 14. When the sensor or camera assembly is configured to have a wide field of view, the range of motion of the camera housing is an optical axis movement range between approximately 35 degrees and approximately 115 degrees relative to the long axis at the distal end or insertion end of the endoscope shaft. In this configuration, the operator can still see the surgical site directly in front of the distal end of the endoscope shaft, but can also see the area of ​​the surgical site behind the tip of the endoscope.This arrangement also allows the operator to clean the surface of the camera assembly and remove accumulated surface deposits by rotating it to a position of 90 degrees or more.

[0137] The camera assembly 350 is shown separately in Figure 24. This configuration is more suitable for the insertion section or shaft shown in Figure 23 because of the physical protection provided by the rounded tip 342 of the working end of the distal endoscope shaft shown in Figures 18-23. As illustrated, a ribbon or flexible cable 250 is connected to 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 structure configured to support the camera of the endoscope 10. In embodiments where the camera assembly 350 is panned, the camera assembly 350 includes a swivel actuator mounting mechanism.

[0138] As shown in the illustration, the camera assembly 350 includes a lens assembly 354. As illustrated, the lens assembly 354 is held in place between the camera housing top 356 and the camera housing bottom 358. When assembled, the camera housing top 356 and the camera housing bottom 358 are joined together by suitable means, but not limited to, glue, adhesive, ultrasonic welding, pressure fitting of a cooperating mechanism, etc. In the exemplary embodiment of Figure 24, the lens assembly 354 protrudes through the lens opening 360 of the camera housing top 356, providing a clear field of view of the target anatomical region. In some embodiments, at least a portion of the lens assembly 354 protrudes from the camera housing top 356.

[0139] The camera housing top 356 may include several other voids. In the exemplary embodiment shown in Figure 24, the camera housing top 356 includes two elongated light projection voids 362 located on the left and right (with respect to Figure 24) sides of the lens aperture 360, the voids 362 being made to accommodate end-face elements of optical fibers (or optionally other light sources such as LEDs) that radiate light into a target area corresponding to a direction directed toward the camera lens or lens assembly 354. In the illustrated example, the right elongated void 362 is trapezoidal, and the left elongated void 362 is parallelogram-shaped. In another embodiment, the shapes of the voids 362 may differ, for example, both may be oval-shaped. In another embodiment, there may be additional voids 362. For example, in some embodiments, there are three voids 362 arranged in a triangular shape around the lens aperture 360. In some embodiments, there are four voids 362 arranged in a rectangular, square, circular, or oval shape around the lens aperture 360.

[0140] One or more illumination sources for the endoscope 10 are included at least partially within the endoscope 10. The illumination sources illuminate the camera's field of view of the camera assembly 350, regardless of the panning position. In some embodiments, the illumination sources are located within the camera assembly 350. In the exemplary embodiment of Figure 24, the illumination sources consist of several optical fibers 364 that transmit light from external illumination elements (not shown) of the endoscope 10. The optical fibers 364 are led into and connected to a gap 362 within the top of the camera housing 356. In the exemplary embodiment, 28 optical fibers 364 are led into the gap 362 of the top of the camera housing 356. The number of optical fibers 364 varies in other embodiments. The light-emitting ends of the optical fibers 364 are generally coplanar with the top surface of the top of the camera housing 356. In some embodiments, other illumination sources, such as LEDs, may be used. The optical fibers 364 or other illumination sources are configured to provide light of a desired color or intensity at a given light emission angle.

[0141] As illustrated, in the exemplary embodiment of Figure 24, the camera assembly 350 includes a swivel pin 366. The swivel pin 366 is swivelably connected to a swivel pin bearing 346 (see Figure 18) of the camera assembly housing 330. The swivel pin 366 protrudes substantially orthogonally from the longitudinal axis of the insertion portion. The swivel pin 366 allows the camera assembly 350 and the optical fiber 364 (or other illumination source) to swivel in cooperation with each other.

[0142] The camera assembly 350 also includes a swivel actuator mounting mechanism, as described above. In the exemplary embodiment shown in Figure 24, the camera assembly 350 includes a top cable mounting mechanism or anchor point 372 and a bottom cable mounting mechanism or anchor point 374. The top cable mounting mechanism 372 and the bottom cable mounting mechanism 374 are described further below.

[0143] As described above, the endoscope 10 also includes a swivel actuator. The swivel actuator is an elongated member used to pull or push the camera assembly 350 via a swivel mounting mechanism. In the illustrated examples, the swivel actuator is usually a pull cable or wire, but these examples should not be interpreted as limiting the swivel actuator to cable-like structures. The elongated member may be flexible or inherently rigid. The elongated member may be round (as in the cable example), flat, or have other shapes or cross-sections. In some embodiments, the swivel actuator is a belt guided around a cooperative mounting mechanism that engages with a mechanism on the inner circumference of the belt by frictional engagement or other means. In a preferred embodiment, a swivel actuator is used to provide only tensile force. In such an arrangement, the swivel actuator does not need to be sufficiently thick or have a reinforced cross-section, or is confined within a support path to prevent substantially lateral displacement within the insertion portion 14 in response to a pushing force on the swivel actuator, so the insertion portion 14 can be small in diameter (see Figure 3A). The arrangement of a pull wire or pull cable allows for the use of a wide range of materials to make the swivel actuator, as the material only needs to have tensile strength and not compressive stiffness.

[0144] As shown in Figure 25, the camera rotation cables are attached to the camera assembly 350 above and below the swivel pin 366. In the exemplary embodiment, the camera rotation cables are shown in a relatively slack state for simplicity of illustration. During operation, one or more camera rotation cables on one side of the swivel pin 366 are taut, while one or more camera rotation cables on the other side of the swivel pin 366 are slack. As described above, and also with reference here to Figure 14, the camera rotation cables are attached proximal to the cable connection holes 202 (see Figure 14) of the swivel control structure 100. In some embodiments, two camera rotation cables are attached to the respective cable connection holes 202. The camera rotation cables extend from the cable connection holes 202 of the swivel arm 198 and pass through one or more openings 178 (see Figure 11A) of the proximal portion 161b of the inner sheath mount 160. The camera rotation cable then extends along the flexible cable 250 through the utility hole 168. Since the cable connection holes 202 are located on the opposite side of the pivot point of the swivel arm 198, when the swivel control structure 100 is swiveled, the camera rotation cable connected to one of the cable connection holes 202 is loosened, and the camera rotation cable connected to the other cable connection hole 202 becomes taut. The camera assembly 350 is selectively rotated using the swivel control structure 100 by attaching the camera rotation cable associated with one cable connection hole 202 to the camera assembly 350 on one side of the swivel pin 366, and connecting the camera rotation cable associated with the other cable connection hole 202 to the opposite side of the swivel pin 366. In some embodiments, pushing the swivel control structure 100 forward pans the camera assembly 350 forward, and pulling the swivel control structure 100 backward pans the camera assembly 350 backward. In some embodiments, when assembled, all camera rotation cables are under tension.

[0145] In a preferred embodiment, a single camera rotation cable is attached to each cable connection hole 202 (see Figure 14) of the swivel arm 198 of the swivel control structure 100. In such an embodiment, there is 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 the top cable attachment mechanism 372 of the camera assembly 350 and returns from its origin to the same cable connection hole 202 of the swivel arm 198. The lower camera rotation cable 370 wraps around the bottom cable attachment mechanism 374 of the camera assembly 350 and returns from its origin to the same cable connection hole 202. Alternatively, the camera rotation cable forms a loop covering the attachment hole 202, with both ends of the cable terminated distally on the cable attachment mechanism.

[0146] In the exemplary embodiment, the top cable attachment mechanism 372 (best shown in Figure 24) includes two holes in the top 356 of the camera housing. The top cable attachment mechanism 372 further includes a recess that connects to the two holes. The upper camera rotation cable 368 enters one of the holes, passes through the recess, exits the other of the two holes, and returns to the cable connection hole 202 on the handle (see Figure 14). The bottom cable attachment mechanism 374 (best shown in Figure 24) includes two connection points or two hooks protruding from the opposite side of the bottom 358 of the camera housing. The bottom cable attachment mechanism 374 is located opposite the swivel pin 366 to the top cable attachment mechanism 372. The bottom camera rotation cable 370 wraps around one connection point or hook of the bottom cable mounting mechanism 374, stretches to a second connection point or hook of the bottom cable mounting mechanism 374, and from there returns to the cable connection hole 202 of the handle's swivel arm 198. In another embodiment, the top cable mounting mechanism 372 and / or bottom cable mounting mechanism 374 include, for example, eyelets, protrusions, pegs, etc.

[0147] The upper camera rotation cable 368 and the lower camera rotation cable 370 are made from any cable or wire-like material, such as metal or synthetic resin, braided or monofilament. The upper camera rotation cable 368 and the lower camera rotation cable 370 are, for example, elongated pieces or bands of metal or plastic that are flexible laterally. In a preferred embodiment, the upper camera rotation cable 368 and the lower camera rotation cable 370 are made from a material that is resistant to elongation under tension. It is preferable to wrap one camera rotation cable from the cable connection hole 202 of the swivel arm 198 (see Figure 14) around the swivel actuator mounting mechanism of the camera assembly 350. This ensures that the camera rotation cable extending to the camera assembly 350 is under the same tension as the camera rotation cable on the side leaving the camera assembly 350. Elongation of any portion of the cable due to time or use has an equal effect on both halves of the cable.

[0148] In a preferred embodiment, the upper camera rotation cable 368 is routed through one of the cable guide holes 348 in each inner wall of the camera assembly mount 330. As shown in Figure 25, the upper camera rotation cable 368 proceeds 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 is a recess or groove that recesses 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 may serve as a guide. The recess or groove also helps to ensure that the upper camera rotation cable 368 is approximately flush with the outer surface of the camera assembly housing 330. This ensures that the outer sheath 318 (see Figure 21) does not bump into the upper camera rotation cable 368 in such a way that its movement is impaired during use of the fully assembled endoscope 10.

[0149] As shown in Figure 25, the upper camera rotation cable 368 re-enters the interior of the camera assembly housing 330 and is stretched through the restraint notch 349. The upper camera rotation cable 368 then extends to the top cable mounting mechanism 372, as described above. Returning to the cable connection hole 202 (see Figure 14), the upper camera rotation cable 368 extends from the top cable mounting mechanism 372 to the restraint notch 349 (see Figure 18) on the opposite wall of the camera assembly housing 330. The upper camera rotation cable 368 then extends along the outer surface of the front wall of the camera assembly housing 330, optionally along any recesses or grooves in the wall. The upper camera rotation cable 368 then re-enters the interior space of the camera assembly housing 330 and returns to the cable connection hole 202 of the handle, as described above.

[0150] The terminal segment of the proximal swivel actuator (e.g., a wire or cable) connecting to the swivel assembly at the distal end of the insertion portion is constrained at a pivot or support point, changing the direction of the actuator to be at an angle to the longitudinal axis of the insertion portion or shaft. For example, by routing the upper camera rotation cable 368 through the cable guide hole 348 and the constraining or reversing notch 349 and aligning it with the top cable mounting mechanism 372 on the other side of the swivel pin 366, a wider swivel range is enabled for the swivel camera assembly 350. Thus, an image sensor with a predetermined or fixed angle field of view can rotate, enabling a rotating field of view and increasing the field of view to a range of up to 180 degrees. In other embodiments, the image sensor rotates to achieve a field of view greater than 180 degrees. Routeping the cable as described above, as shown in Figure 25, places the cable at a sharper angle of incidence relative to the connection point 372, thus allowing for larger angles of backward rotation of the camera assembly 350.

[0151] In some embodiments, also with reference to Figure 26, the camera assembly 350 can rotate a full 180 degrees or more due to the presence of two sets of cable guide holes 348: a lower set of guide holes 348 controlling the upper camera housing portion and an upper set of guide holes 348 controlling the bottom camera housing portion. The angle by which the camera assembly 350 can rotate is a function of the angle that the end of the camera rotation cable makes with respect to the longitudinal axis of the proximal or insertion portion (or endoscope shaft) 14 (see Figure 1) of the camera rotation cable. The larger the angle that the end of the camera rotation cable makes with respect to the longitudinal axis of the insertion portion 14 when it re-enters the camera assembly housing 330, the greater the range of motion that can be guided into the camera assembly 350. In a preferred embodiment, the re-entry surface or guide for the camera assembly housing 330 is positioned so that the angle of the end of the camera rotation cable is within a range of approximately 30–90 degrees with respect to the longitudinal axis of the insertion portion 14. In other embodiments, the range of rotation of the camera assembly 350 can be improved while limiting the frictional resistance of the camera rotation cable by positioning the re-entry surface or guide for the camera rotation cable so that the angle of the end of the camera rotation cable is within a range of approximately 45–80 degrees. As described above, in such embodiments, only tensile force is required on either a pair of complementary cables 368, 370, namely one bent upward at the distal or terminal position of the insertion portion 14 to be attached to the top cable attachment mechanism 372, and the other bent upward at the distal or terminal position of the insertion portion 14 to the corresponding bottom cable attachment mechanism 374. In this arrangement, for most of the length of the insertion portion 14, it is not necessary to move the drive cable laterally or transversely, which allows for a smaller internal space of the insertion portion 14 and helps to minimize the overall diameter.

[0152] In some embodiments, the restraining or redirecting notch 349 may not be used. In some embodiments, another type of restraining or redirecting element may be used, which is contained within the wall at the distal end of the insertion portion. In some embodiments, a pulley or eyelet may be used as a restraint. Pins, pegs, posts, etc., can also be used as restraining or redirecting elements. In some embodiments, curved fixing claws or projections may be formed on the side wall of the camera assembly housing 330. The curved fixing claws extend into the internal space of the camera assembly housing 330 such that there is a space between the internal wall of the camera assembly housing 330 and the curved fixing claws. The upper camera rotation cable 368 passes through this space so as to be secured by the curved fixing claws. In most embodiments, it is preferable that the contact point between the restraint and the cable has a smooth or radius of curvature sufficient to minimize the possibility of frictional damage to the camera rotation cable during endoscope operation. In some cases, the restraint may be coated with a material having a low coefficient of friction, such as Teflon®.

[0153] In some embodiments, the bottom camera rotation cable 370 may be constrained instead of the top camera rotation cable 368, as described above, to allow the camera assembly 350 to rotate in one direction relative to the other, enabling a larger swivel range. As shown in Figure 26, both the bottom camera rotation cable 370 and the top camera rotation cable 368 may be constrained or reoriented to allow an even larger swivel range.

[0154] Figure 26 shows the outer sheath 318, the camera assembly housing 330, and the camera assembly 350. There are two sets of cable guide holes 348. One set is above the longitudinal axis of the camera assembly housing 330, and the other is below the longitudinal axis of the camera assembly housing 330. There are also two restraint notches 349. One of the restraint notches 349 is located above the longitudinal axis of the camera assembly housing 330, and the other is located below the longitudinal axis of the camera assembly housing 330.

[0155] The improved mechanical advantages of the camera rotation cable are obtained by positioning the direction-changing element (e.g., a notch) on one side (e.g., downward) of the pivot axis of the camera assembly 350, and attaching the end of the camera rotation cable to a point on the camera assembly 350 located on the opposite side (e.g., upward) of the pivot axis of the camera assembly 350.

[0156] As shown in the figure, the upper camera rotation cable 368 passes through one of the cable guide holes 348 below the longitudinal axis and re-enters the camera assembly housing 330 at a restraining notch 349 below the longitudinal axis. The upper camera rotation cable 368 then changes direction upward toward the top cable mounting mechanism 372 on the camera assembly 350. In Figure 26, the bottom camera rotation cable 370 passes through the cable guide hole 348 above the longitudinal axis of the camera assembly housing 330. The bottom camera rotation cable 370 then re-enters the camera assembly housing 330 through a restraining notch 349 above the longitudinal axis of the camera assembly housing 330. The bottom camera rotation cable 370 then changes direction downward toward the bottom cable mounting mechanism 374. The upper camera rotation cable 368 and the lower camera rotation cable 370 wrap around a portion of the camera assembly 350 depending on the direction in which the camera assembly 350 rotates. In Figure 26, the lower camera rotation cable 370 is shown wrapped around a portion of the camera assembly 350.

[0157] Some embodiments use a belt 384 as a swivel actuator. An embodiment including a belt 384 as a swivel actuator is shown in Figure 27. As shown, the belt 384 wraps around one of the swivel pins 366 of the camera assembly 350. In some embodiments, the swivel pin 366 is elongated, and a portion of at least one swivel pin 366 extends from the swivel bearing 346. In such embodiments, the belt 384 wraps around this portion of the swivel pin 366 as shown in Figure 27. In some embodiments, the shape of the camera assembly 350 may differ so that the belt 384 wraps around the camera assembly 350. For example, the camera assembly 350 may be substantially cylindrical. The substantially cylindrical shape of the camera assembly 350 is coaxial with the swivel pin 366. In such embodiments, the belt 384 wraps around the camera assembly 350.

[0158] In some embodiments, the surface around which the belt 384 is wrapped is recessed (e.g., V-shaped) relative to the side surfaces. This helps to keep the belt 384 in place during operation. In other embodiments, other types of guides are used. For example, the surface around which the belt 384 is wrapped may have two walls on the sides that keep the belt 384 in place during operation.

[0159] The belt 384 is made of a high-friction material to prevent slippage on the surface it wraps around when driven. In some embodiments, the belt 384 has a rough surface or is toothed to help grip or securely engage the swivel pin 366 (which may be geared) of the camera assembly. The use of the belt 384 allows for a wide swivel range of the camera assembly 350 without the pull-cable swivel actuator needing to be reoriented laterally within the insertion portion 14, thereby achieving an equivalent range of motion for the camera assembly 350. This allows for a smaller diameter insertion portion 14.

[0160] In embodiments using belt 384, belt 384 is configured to be driven by the displacement of the swivel control structure 100 (see Figure 14). In some embodiments, the opposite end of belt 384 that wraps around the camera assembly 350 or the swivel pin 366 wraps around the swivel shaft 204 of the swivel control structure 100. In such embodiments, the rotation of the swivel shaft 204 drives belt 384. The portion of the swivel shaft 204 around which belt 384 wraps has a relatively large diameter. This is preferable when small swivel movements of the swivel shaft 204 must drive belt 384 by a relatively large amount. In embodiments where belt 384 is toothed, the teeth of belt 384 mesh with gears located on the swivel shaft 204 of the swivel control structure 100. In such embodiments, the rotation of the swivel shaft 204 and the gears on the swivel shaft 204 drives belt 384. When belt 384 is driven, the movement of belt 384 provides driving force to camera assembly 350, causing camera assembly 350 to pivot.

[0161] In other embodiments, the pivot actuator may be the rack of a rack and pinion device. In such embodiments, the pivot pin 366 of the camera assembly 350 may include a toothed portion. The toothed portion of the pivot pin 366 may be a pinion gear that meshes with the rack of the pivot actuator. When the rack is displaced longitudinally within the insertion 14, this motion is converted into rotation of the camera assembly 350 via the toothed pinion portion of the pivot pin 366. Although such embodiments do not rely solely on tensile force to rotate the camera assembly 350, the pivot actuator still does not require lateral displacement of the actuator within the insertion 14. Nevertheless, in some specific embodiments, the push-pull rack actuator may require characteristics (e.g., stiffness, thickness, etc.) that would otherwise be constrained within the track to prevent lateral or lateral deflection while a compressive force is applied to the rack.

[0162] In yet another configuration using at least one camera rotation cable, a similar range of rotation is achieved without passing the camera rotation cable through various mechanisms included in the camera assembly mount 330. This is preferable because it allows for a smaller diameter of the insertion portion 14 (see Figure 1). Furthermore, the camera assembly mount 330 for such embodiments does not require drilling (e.g., the cable guide hole 348 in Figure 18) or directional elements / constraints (e.g., the constraint notch 349 in Figure 18), thus simplifying the manufacture of the camera assembly mount. Such embodiments, for example, use the camera assembly mount 330 and inner sheath 312 shown in the exemplary embodiment of Figure 19.

[0163] In such embodiments, the camera assembly 350 includes at least one winding mechanism or surface 1400. The winding mechanism winds at least partially the end of the camera rotation cable onto the housing of the camera assembly 350. The connection or link point for the end of the camera rotation cable is located on the camera assembly housing distal to the spool mechanism. The winding mechanism preferably has a curved, somewhat concave surface that partially or completely encloses a portion of the camera assembly housing. Thus, in various embodiments, the camera rotation cable may only partially wrap around the housing, or it may wrap around the housing in one or more complete turns. A longer winding mechanism provides a wider range of rotation of the camera assembly. During operation, the associated camera rotation cable is wound onto and unwound from the winding mechanism 1400. The winding mechanism 1400 extends the swivel range of the camera assembly 350. The winding mechanism 1400 ensures that a more consistent torque acts on the rotating camera assembly 350. The winding mechanism 1400 may be configured to create a moment arm of a desired or variable length. Furthermore, positioning the winding mechanism 1400 radially away from the axis of rotation of the camera assembly helps the camera rotation cable generate rotational torque more efficiently.

[0164] The consecutive Figures 28–32 conceptually illustrate a camera assembly 350 including a winding mechanism 1400 in several rotational positions. As shown, the winding mechanism 1400 includes a curved section and a straight section. The curved 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 mechanism. Furthermore, the straight section of the winding mechanism 1400 allows the camera housing 355 to be made of more material (which must be removed to continue the curved section), thus increasing the structural integrity of the camera housing 355. This is particularly important in embodiments in which the camera assembly 350 is designed to fit into a very small space and therefore must be made with very small shape dimensions.

[0165] As shown in Figure 28, the upper camera rotation cable 368 is wound around the winding mechanism 1400. The tensile force acting on the upper camera rotation cable 368 generates torque around the pivot axis of the camera assembly 350, causing the camera assembly 350 to rotate clockwise. Furthermore, the straight section of the winding mechanism 1400 generates a longer moment arm, thereby increasing the torque generated in response to a given amount of tensile force.

[0166] As the camera assembly 350 rotates to the position shown in Figure 29, the upper camera rotation cable 368 begins to unwind from the winding mechanism 1400. As the force continues to be applied and the camera assembly continues to rotate, the upper camera rotation cable 368 continues to unwind from the winding mechanism as shown in Figure 30. Once fully unwound, the point where the upper camera rotation cable 368 separates from the winding mechanism 1400 lies on the curved portion of the winding mechanism 1400 (as shown in both Figures 29 and 30). In one embodiment, all points on the curved portion of the winding mechanism 1400 are at equal distances from the pivot axis.

[0167] In the exemplary embodiment, as a tensile force is continuously applied by the upper camera rotation cable 368, the camera assembly 350 continues to rotate, as shown in Figure 31, until the upper camera rotation cable 368 no longer contacts the surface of the winding mechanism 1400. The camera assembly 350 then continues to rotate until the tensile force of the upper camera rotation cable 368 approaches the axis of rotation of the camera assembly 350. This position is illustrated in Figure 32. As will be understood by those skilled in the art, the camera rotation cable 368 is wrapped around the winding mechanism 1400 once or more times, increasing the amount of rotation produced by using the camera rotation cable 368. The angle at which the camera rotation cable 368 wraps around the contact surface of the camera assembly 350 allows for a range of rotation of the camera assembly 350 exceeding 90 degrees. The rotation angle of the camera assembly 350 is then limited only by the amount of slack and flexibility of the connected electronic flexible cable and / or fiber optic bundle.

[0168] In one embodiment, the camera rotation cable and winding surface are positioned so that the camera assembly 350 can rotate to a position between approximately 90 and 120 degrees of the longitudinal axis of the distal endoscope shaft, such that the lens surface of the camera assembly faces, at least partially, toward the proximal end of the endoscope shaft. At this position, any debris or other contaminants on the lens surface are washed away by a cleaning fluid moving distally within the endoscope shaft.

[0169] To rotate the camera assembly 350 from the position shown in Figure 32 to the position shown in Figure 30, a tensile force is applied via the bottom camera rotation cable 370. In some embodiments, the bottom camera rotation cable 370 may be associated with a winding mechanism. For example, the corners and edges of the camera assembly 350 around which the bottom camera rotation cable 370 winds are rounded.

[0170] Figures 33 and 34 show a top perspective view of a particular exemplary embodiment of a camera assembly 350 including a winding mechanism 1400. The camera assembly 350 includes a lens assembly 354, which is located inside the camera housing 355. As shown, the winding mechanism 1400 is recessed into the side of the camera housing 355. The winding mechanism 1400 in the exemplary embodiment includes a curved section and a straight section. The curved portion of the winding mechanism 1400 is shaped to have a radius of curvature extending from the center of the pivot pin 366 or pivot axis.

[0171] As shown in Figure 33, the wall on which the winding mechanism 1400 is placed includes a first gap 1402. The camera housing 355 also includes a second gap 1404. The second gap 1404 passes over the top surface of the camera housing 355 and through to the bottom surface of the camera housing 355.

[0172] As shown in the illustration, only one camera rotation cable 1406 is used. The camera rotation cable 1406 extends through both the first gap 1402 and the second gap 1404 of the camera housing 355. One end of the camera rotation cable 1406 is connected to a cable connection hole 202 (see Figure 14) of the swivel arm 198. The other end of the camera rotation cable 1406 is connected to another cable connection hole 202 of the swivel arm 198. In some embodiments, the camera rotation cable 1406 is fixedly connected to the camera housing 355 at one or more points. For example, glue adhesive is applied to one of the gaps 1402 or 1404. This prevents the camera rotation cable 1406 from slipping or shifting on the surface of the camera housing 355 during operation. In some further embodiments, a knot may be made in the camera rotation cable 1406 at at least one location. For example, the camera rotation cable 1406 is fed through one of the gaps 1402 or 1404, a knot is made, and then it is fed through the other gap 1402 or 1404. Preferably, the width of the knot is wide enough so that it does not pass through either gap 1402 or 1404. Such a knot helps to prevent the camera rotation cable 1406 from slipping or shifting on the surface of the camera housing 355 during operation.

[0173] As will be apparent to those skilled in the art, the embodiments shown in Figures 33 and 34 can be easily modified to use two camera rotation cables. One camera rotation cable is connected to the camera housing 355 in a fixed manner, with its termination within or at the location of the first gap 1402. A second camera rotation cable is connected to the camera housing 355 in a fixed manner, with its termination within or at the location of the second gap 1404.

[0174] In another example, Figure 23.2 shows how a pull wire 502, operated by a rotation control structure 100, is wrapped around and / or attached to a round or 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 roughly circumferential slot 501 offset to one side of the housing 500 so as not to interfere with the lens / camera assembly housed within the housing 500 (preferably positioned roughly in the center of the two assembled halves of the housing). The pull wire 502 is held within the slot 501 and may be secured to the housing 500 in a recess 503. A knot positioned on the pull wire 502 may be embedded in the recess 503 so as to serve as a mounting point that rotates the housing 500 as the pull wire 502 moves back and forth along the endoscope shaft. Optionally, a small amount of adhesive may be used to provide additional mounting security during endoscope assembly. In a preferred embodiment, the pull wire 502 comprises Kevlar® yarn, which provides substantial longitudinal strength and resistance to stretching. Other wire forms may include steel (braided or single-strand), nylon, or other materials having suitable strength and resistance to stretching.

[0175] The rounded sensor housing 500 shown in Figures 23.1 and 23.2 can enclose a more easily configured lens 510 and image sensor 512, and a light source for illuminating the surgical site can be placed near the sensor / camera housing 500 without needing to be mounted on the housing itself. Figures 23.3 and 23.4 show how a rounded or domed sensor / camera housing 500 is constructed from two parts 500a and 500b. Each of these parts can be molded or machined to have an internal notch for accommodating a PCB extension 514 or the distal end of a flexible cable, its associated sensor 512 (e.g., CMOS or CCD), and a suitable lens 510. The two parts 500a and 500b can be joined on top of each other by several methods. In the illustrated example, one or more pins 500c of part 500b can mate with corresponding arrangements of matching recesses 500d of part 500a. As shown in Figure 23.5, the outer swivel shaft 505 of each section can be inserted into corresponding holes, bearings, or bushings 507 at the distal end of the elastically flexible inner sheath 312 of the endoscope shaft to allow assembly. The assembled housing 500 can be press-fitted or snap-fitted into place within the holes 507, which helps to maintain the two sections 500a and 500b joined together. Optionally, adhesive can also be used to securely bond the pin 500c to the corresponding recess 500d. The illustrated sensor / camera housing 500 does not include a light source, but this is optional and may include an appropriately sized LED or group of LEDs around the lens, or the end of an optical fiber cable may be mounted in a similar configuration as described below.

[0176] In an exemplary configuration, one or more LEDs 508 can be positioned along the opening 506 of the inner sheath 312 of the endoscope shaft 14. Figure 33.1 shows the sensor 512 and lens 510 assembly within the sensor housing 500 (half of the housing is removed for clarity). Both the lens 510 and the sensor 512 (e.g., a CMOS or CCD sensor) are properly sealed to prevent liquid from entering between them. The sensor 512 may be 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 may be connected to a ribbon or flexible cable to receive power, or to a separate ribbon or flexible cable adjacent to the sensor communication cable. In another example, the main PCB of the endoscope handle may be manufactured with an elongated extension positioned to extend through the endoscope shaft to one or more components at the distal end of the shaft. The PCB may be configured to have flexible components sandwiched together with rigid components. The flexible components may extend from the main PCB and form a PCB extension for the endoscope shaft. Similarly, rigid components may extend from the main PCB and form a PCB extension for the endoscope shaft. One or both of these extensions can, alternatively, be combined with a ribbon or flexible cable coming from the main PCB to provide power or communication to components at the distal end of the endoscope shaft. For example, the sensor 512 may be mounted from the main PCB in the endoscope handle 12 to the distal end of a flexible PCB extension 514. The sensor PCB extension 514 is flexible and has sufficient slack to allow the sensor 512 and lens 510 to rotate when the sensor housing 500 is rotated. The light source in this example also includes one or more LEDs 508 mounted on one of the sensor PCB extensions, or preferably on a separate light source PCB extension 516. To meet the power requirements of the light source, attaching the power supply wire to a separate flexible cable or PCB extension 516 may increase the reliability of the endoscope. Furthermore, if the endoscope shaft 14 is rigid (for example, as in most arthroscopes), the light source power wire can be attached to a rigid PCB extension, further enhancing the overall robustness of the endoscope. In the example shown in Figure 33.1, the flexible sensor PCB extension 514 is folded at its base and positioned on the rigid light source PCB extension 516, and both extensions converge on the main PCB within the endoscope handle 12 (see below).

[0177] The form factors for the printed circuit boards (PCBs) for the embodiments shown in Figures 23.1 and 33.1 are shown in Figure 33.2. Note that the form factors shown in Figures 33.2 and 33.3 are also used to illustrate how the ribbon or flexible cable is folded and extended along the endoscope shaft to the connecting components at the distal end of the shaft, adjacent to the companion ribbon or flexible cable, or adjacent to the companion PCB extension passing through the bulkhead. In one example, a rigid main PCB 518 (on which numerous electronic processing components are mounted) includes a composite that sandwiches both rigid and flexible elements together, and the main PCB 518 is located within the endoscope handle. The flexible PCB extension 514 emerges from the composite main PCB 518 at an angle to the direction of the rigid extension 516, and as a result, the proximal leg 514a of the flexible extension 514 folds at point 520 (Figure 33.3) and can extend adjacent to the rigid portion 516, as shown in Figure 33.3. In the illustrated example, the proximal leg 514a of the flexible substrate extension is at an angle of about 90 degrees to the rigid substrate extension. In some embodiments, the angle may be less or greater than 90 degrees due to the flexibility of the flexible substrate extension, which allows the proximal leg 514a to accommodate an imperfectly aligned fold. The flexible PCB extension 514 extends adjacent to the rigid PCB extension 516 in Figure 33.4 and is shown to follow the path of the endoscope shaft (with the inner sheath, sensor housing, and lens removed for clarity). In this way, both PCB extensions can pass through elastomer slots in bulkheads or fluid barriers, such as slot 177 shown in Figure 11B or Figure 11C.

[0178] Figure 33.5 shows a cross-section of an exemplary endoscope. The main PCB 518 is shown in relation to the handle proximal portion 16, camera control button 37, bulkhead or pass-through barrier 159, and swivel control structure 100. The rotational position sensor magnet 51 is shown in relation to both the handle proximal portion 16 and the main PCB 518. An exemplary fluid conduit 434 (for irrigation or suction) approaching the bulkhead 159 is shown. This can be connected to the bulkhead 159 via a barbed fitting 256, as shown in Figure 33.6, or via other suitable safety connection means. In this case, the inner sheath 312 is removed for clarity of explanation.

[0179] Figure 33.6 shows the endoscope PCB without the handle, internal sheath, pivot control structure, and fluid conduit when its extension passes through the bulkhead or pass-through barrier 159. Furthermore, the rotational position sensing magnet 51, camera control button 37, and shaft 38 (in which the magnet is embedded) are shown with respect to the main PCB 518, providing an indication of where on the PCB 518 the Hall effect sensor for the magnet can be positioned. As shown, the fold point 520 of the flexible PCB extension is positioned close to the bulkhead 159 so that the combination of adjacent flexible and rigid PCB extensions can pass through the bulkhead in the slot 177. Sufficient slack in the flexible PCB extension 514 is provided distally near its end in the sensor 512 so that the slot in this case is tightly sealed against fluid penetration.

[0180] As shown in Figure 33.7, the fluid or air transport lumen 157 shares space within the endoscope shaft 14 with the PCB extensions 514, 516 (or one or two ribbons or flexible cables), which power the light source and communicate with the sensor / camera located at the distal end of the endoscope shaft 14. The sensor / camera housing has been removed for clarity. (Note that the inner sheath 312 of the shaft 14 has a notch or opening proximal to the sensor / camera housing on the upper side, which provides illumination by the light source or LED, and on the lower side, which selectively improves the fluid flow around the sensor / camera housing. This is shown, for example, in Figures 23.1 and 72.6).

[0181] Figure 33.8 shows a cross-sectional view of the interior of the distal portion 30 of the endoscope handle described above. A bulkhead or fluid barrier 159 separates the relatively dry area (where the pivot control structure, camera control buttons, and the distal end of the main PCB are located) from the wet portion 30a. A fluid or air conduit 434 extends from the outside of the endoscope handle through the proximal portion 16 of the handle and connects to a port 256 of the bulkhead 159. In this example, the fluid passing through the conduit 434 and port 256 communicates with the lumen 157 of the endoscope shaft 14 through the space occupied by the wet portion 30a. Appropriate seals can be used to prevent this fluid from leaking between the distal portion housing and the proximal end of the endoscope internal sheath 312.

[0182] Returning to Figures 7C and 14, the swivel control structure 100 can be “retained” in a recess defined by the projection 94 in the slide button recess 92 of the raised handle portion 34 or other part of the handle 12. In some embodiments, the projection 94 is spaced such that the recess formed by the projection 94 corresponds to a specific angular direction of the camera assembly 350. In some embodiments, the recess formed by the projection 94 is spaced such that the position of the recess corresponds to a specific angular increment (e.g., 30°) of the camera assembly 350.

[0183] As described above (see Figure 7A), the distal handle portion 30 is rotatable relative to the proximal handle portion 16. Such rotation similarly rotates the longitudinal axis of the insertion portion 14. Consequently, the camera assembly 350 rotates together with the insertion portion 14. This allows the user to obtain a nearly omnidirectional view of the anatomical region in question with minimal or no angular repositioning of the endoscope 10. The user can obtain the desired view within the anatomical region simply by panning the camera assembly 350 and rotating the distal handle portion 30 relative to the proximal handle portion 16.

[0184] Repeated twisting and bending of an optical fiber, such as optical fiber 364, can lead to the breakage or damage of one or more fibers. In the case of optical fiber 364, this leads to increased light or illumination loss as more optical fibers 364 are at risk. Such bending can occur when optical fiber 364 has a termination and is connected to or fused with part of the swivel camera assembly 350, as described above. If the endoscope 10 is designed as disposable, the degradation of the integrity or performance of optical fiber 364 is within acceptable limits with respect to the planned lifespan of the instrument. As a result, in some embodiments, optical fiber 364 is connected to or fused with a swivel camera assembly 350 with minimal concern regarding the breakage of optical fiber 364 and the resulting light loss. In some embodiments, it is advantageous that the termination illumination, light projection element, or light emitter associated with optical fiber 364 is mounted on the camera assembly 350 so as to emit light regardless of how the camera assembly 350 rotates or pans. Such an arrangement helps to ensure that the field of view of the lens assembly 354 (shown by dashed lines in Figures 23-25) is always illuminated by the optical fiber 364, regardless of how the camera assembly 350 rotates within the pan range of the camera assembly 350.

[0185] In some embodiments, the lighting system includes a light guide or light conductor 375. In some embodiments, the optical fiber 364 is provided with a light guide or optical conductor 375 (see, for example, Figure 35) along at least part of the path of the lighting system. The terms “light guide” and “optical conductor” are used synonymously in this document. When an optical fiber is relatively straight, the angle of incidence of light in the fiber is shallow enough to promote almost total internal reflection within the fiber, resulting in relatively low optical loss. However, bending the optical fiber may change the angle of incidence to a point where light can be transmitted out of the fiber. However, bending of an optical conductor or guide can be controlled. For this reason, the use of a light guide 375 where applicable helps to minimize optical loss in lighting systems with optical fibers 364, or even replaces the optical fiber entirely. The light guide 375 also offers several other advantages. For example, the light guide 375 assists in the assembly of the equipment and reduces assembly time. The light guide 375 may be of the type described herein, or any type of light guide known to those skilled in the art.

[0186] Figure 35 shows an exemplary embodiment of an endoscope 10 using optical conductors 375. Two large-diameter optical conductors 375 extend into the camera assembly housing 330 along at least one portion of the wall of the inner sheath 312 (see Figure 18) and bend into one of the swivel bearings 346 of the camera assembly. The bend of each optical conductor 375 is coated with a highly reflective material 376 to minimize light loss from the optical conductor 375 when the direction is changed. Any highly reflective material 376 known to those skilled in the art may be used. In such embodiments, the camera assembly 350 may have an internal camera assembly optical conductor 377 formed at the contact point with the optical conductor 375 in the swivel bearing 346. Light carried by the optical conductor 375 is transmitted to the camera assembly optical conductor 377 at the contact point. The camera assembly optical conductor 377 extends into the camera assembly 350 from each swivel pin 366. The camera assembly optical conductor 377 has an end in the light projection gap 362, so that the field of view of the camera assembly 350 is illuminated regardless of the rotational position of the camera and lens assembly. In such embodiments, the bend of the camera assembly optical conductor 377 is preferably coated with a highly reflective material 376, as described above. In some embodiments, the highly reflective material 376 may be included in other parts of the optical conductor 375 and the camera assembly optical conductor 377, in addition to the bend of the optical conductor 375 and the camera assembly optical conductor 377.

[0187] Creating optical conductor contacts in the same location as the swivel region of the camera assembly 350 is preferable because it avoids bending and twisting of the optical fiber 364 when the camera assembly 350 rotates, thereby eliminating the risk of damage to the optical fiber 364. Such a design is suitable for use with either a reusable endoscope 10 or a disposable endoscope 10.

[0188] In another exemplary embodiment (not shown) using the optical conductor 375, the large-diameter optical conductor 375 essentially extends along the path of the flexible cable 250. The end of the optical conductor 375 closest to the inner sheath mount 160 may form a contact with the optical fiber 364 or be positioned to draw in light from another illumination source. The end of the optical conductor 375 closest to the camera assembly 350 may also form a contact with the illumination fiber 364 extending to the camera assembly 350.

[0189] In some embodiments, the optical fiber 364 leading to the camera assembly 350 is arranged to form a flexible ribbon 1000, creating a linear array of fibers having terminations within the light projection element with minimal or unidirectional bending (see, for example, Figure 36). Alternatively, the flexible ribbon 1000 does not have to be a linear array of fibers; in some embodiments, it may instead be a flexible ribbon of light guide material. In some embodiments, there are two flexible ribbons 1000, each extending into one of the light projection gaps 362 of the camera assembly 350. In some embodiments, the flexible ribbon 1000 is coated with a reflective material 376 to maximize the amount of light in the camera assembly 350. In some embodiments, the flexible ribbon 1000 forms contact with an optical conductor.

[0190] In some embodiments, the top of the camera housing 356 is provided with an optically conductive material and functions as a light projection element or illumination. In this case, light is emitted from most of the top of the camera housing 356 into the field of view of the camera assembly 350. In some embodiments, certain areas of the top of the camera housing 356 are de-illuminated or masked so that light is emitted only from desired areas of the top of the camera housing 356. In some embodiments, certain areas of the top of the camera housing 356 are coated with a highly reflective material 376 to prevent unwanted light emission from those areas.

[0191] Figure 36 shows an embodiment in which the optical fiber 364 is contained within a flexible ribbon 1000, which is optionally coated with a highly reflective material 376. The flexible ribbon 1000 may be overmolded into the camera assembly 350, embedded into the camera assembly 350, fused into the camera assembly 350, or connected in any other way.

[0192] In the exemplary embodiment shown in Figure 36, the camera assembly 350 comprises a rugged camera housing 1002. The exemplary rugged camera housing 1002 without the flexible ribbon 1000 attached is shown in more detail in Figure 37. In the exemplary embodiment, the rugged camera housing 1002 is made from an optical conductor or optical transmission material and functions as an optical projection element. In the exemplary embodiment, the rugged camera housing 1002 is coated with a highly reflective material 376 almost entirely to maximize the optical output from the uncoated or unmasked areas of the rugged camera housing 1002. An optical projection or illumination surface 1004 having a shape suitable for positioning a lens image sensor assembly adjacent to the rugged camera housing 1002 is made by masking the area while applying the highly reflective material 376 (or a simple dark mask as an alternative). In the exemplary embodiment, the optical projection surface 1004 has a ring 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 robust camera housing 1002, illuminating the field of view of the lens assembly 354. As in the embodiments described above, the illumination area preferably rotates with the camera assembly 350 to ensure that the field of view of the lens assembly 354 is always illuminated.

[0193] Figure 38 shows another exemplary embodiment of the rugged camera housing 1002. As shown in contour, the rugged camera housing 1002 includes a coupling recess 1006. The coupling recess 1006 allows the flexible ribbon 1000 to be properly coupled into the rugged camera housing 1002. In some embodiments, the coupling recess 1006 may allow the flexible ribbon 1000 to be coupled into the rugged camera assembly 1002, for example, via a snap-fit. In some embodiments, the coupling recess 1006 may accommodate an optical fiber 364 that is not formed in the flexible ribbon 1000. Similar to Figure 37, in Figure 38, the rugged camera housing 1002 functions as an optical projection element. The rugged camera housing 1002 may also be coated or masked, similar to the rugged camera housing 1002 described in relation to Figure 37.

[0194] Figures 39 and 40 show embodiments in which the optical projection element 1005 is incorporated at the end of a flexible ribbon 1000. The optical projection element 1005 is formed from an optical conductor material and, in some embodiments, is a fusion of a group of optical fibers into a shape suitable for projecting light from an optical fiber bundle or flexible ribbon 1000 in a desired manner. In some embodiments, the optical projection element 1005 and the flexible ribbon 1000 may be two separate parts that are fused together (e.g., by heating or chemically). In other embodiments, the optical projection element 1005 and the flexible optical fiber ribbon 1000 may be a single molded part. In some embodiments, the optical projection element 1005 can be fabricated as described in relation to Figures 49-62.

[0195] Referring further to Figures 39 and 40, the flexible ribbon 1000 is coated with a highly reflective material 376. The bottom and side walls of the light projection element 1005 may also be coated with the highly reflective material 376. This ensures that light is projected into the field of view of the lens assembly 354 only from the uncoated top of the light projection element 1005. As shown in Figure 40, the light projection element 1005 or the flexible ribbon 1000 includes a coupling mechanism 1008. The coupling mechanism 1008 couples the light projection element 1005 and the flexible ribbon 1000 on or inside the camera assembly 350. The coupling mechanism 1008 may be an integral part of the light projection element 1005.

[0196] Figures 41 and 42 show two exemplary embodiments of a flexible ribbon 1000 including light projection elements 1005 formed from an optical conductive material. The light projection elements 1005 in Figure 41 generally have a ring shape, and the light projection elements 1005 in Figure 42 generally have a crescent shape, but other shapes may be selected as desired. In the exemplary embodiments of Figures 41 and 42, only the top surface of the light projection elements 1005 is left uncoated with the highly reflective material 376.

[0197] The light projection element 1005 includes one or more textures 1010 that help direct the light projected from the light projection element 1005. In some embodiments, the textures 1010 are included to cause the light to be scattered and projected. The textures 1010 may be created, for example, during the molding of the light projection element 1005, or alternatively, the optical conductive material forming the light projection element 1005 may include fillers that cause the light projected from the light projection element 1005 to be scattered.

[0198] Figures 43 and 44 show top and bottom perspective views of other exemplary embodiments of the light projection element 1005, respectively. As shown, the light projection element 1005 has a ring-like shape. The light projection element 1005 also includes a coupling mechanism 1008, as shown in the bottom perspective view of Figure 44. The coupling mechanism 1008 in Figure 44 is an integral part of the light projection element 1005. In the exemplary embodiments, the coupling mechanism 1008 is a ledge or shelf. The ledge coupling mechanism 1008 helps to position the light projection element 1005 on other components, such as the camera assembly 350, and align it with other components. In addition, in some embodiments, adhesive or glue is applied along the ledge coupling mechanism 1008 to secure the light projection element 1005 to other components, such as the camera assembly 350. In Figure 48, the light projection element 1005 is shown mounted on the exemplary camera assembly 350.

[0199] The light projection element 1005 shown in Figures 43 and 44 does not include a high-reflectivity coating or material 376 (see, for example, Figure 39). The need for something like a high-reflectivity coating or material 376 is minimized by dimensioning the light projection element 1005 such that it increases or maximizes the total internal reflection of light entering and within the light projection element 1005 where emission is undesirable. This is done by having a large radius of curvature within the region of the light projection element 1005 where emission is undesirable. Furthermore, this may be done by dimensioning the light projection element 1005 such that variations in thickness within the light projection element 1005 do not incorporate changes in the angle of incidence of light within the light projection element 1005 that cause the angle of incidence to be smaller than the critical angle. It is preferable that the thickness of the light projection element 1005 is not so thin as to be thinner than the thickness of the optical fiber or flexible ribbon to which the light projection element 1005 is attached. Furthermore, the surface of the light projection element 1005 is preferably smooth in areas where light emission is undesirable.

[0200] Figures 45, 46, and 47 illustrate several cross-sections of the light projection element 1005 shown in Figures 43 and 44. The cross-sections are seen along lines 43-43, 44-44, and 45-45 in Figure 43, respectively. As shown, light entering the light projection element 1005 must cross the first bend 1300 and the second bend 1302 before being projected from the top surface of the light projection element 1005. As shown in Figures 45-47, the light projection element 1005 is shaped such that the radii of these bends vary depending on the surface of the light projection element 1005. The radii of these bends 1300 and 1302 are selected to be as gentle as possible within the available space on a given surface. Also, as shown, the thickness of the light projection element 1005 is kept approximately constant. This minimizes the change in the angle of incidence due to variations in thickness.

[0201] A typical method for manufacturing an optical fiber projection element is disclosed in U.S. Patent Application No. 14 / 170,080 (U.S. Patent Publication No. 2014 / 0221749), filed on 31 January 2014, which is incorporated herein by reference in its entirety.

[0202] The light projection element 1005, shown in Figures 43-47 and described in relation to those figures, is mounted on the illustrative camera assembly 350 in Figure 48. As shown, the light projection element 1005 is positioned to project light onto a primary illumination field (the surrounding area around this primary illumination field is also illuminated due to scattering and reflection of the projected light), and the primary illumination field essentially coincides with the field of view of the lens assembly 354.

[0203] Figure 63 shows a cross-sectional view of an exemplary camera assembly including a lens assembly 354, taken in the section represented by line 61-61 in Figure 24. The lens assembly 354 is shown housed between the top 356 and bottom 358 of the camera housing, as shown in Figure 24. As illustrated, the lens assembly 354 is positioned to project an image onto the surface of the image sensor 380. Types of image sensors 380 include, for example, a CCD image sensor, a CMOS image sensor, and the like. Preferably, the image sensor 380 is housed in a sealed portion of the camera assembly 350 and protected from exposure to fluids. In disposable endoscopes, since the assembly is not designed to withstand harsh disinfection and reuse, less costly methods may be used to seal the image sensor from exposure to fluids (for example, by using a clear epoxy compound).

[0204] As shown in Figure 63, the image sensor 380 is electrically connected to the flexible substrate 381 of the flexible cable 250. In some embodiments, insulating protective coating material is used to provide further protection against moisture and, optionally, to support the contacts of a ball grid array that is mounted on the image sensor 380. The flexible cable 250 supplies power to the image sensor 380, in addition to providing means for carrying data and / or commands to and from the image sensor 380. In some embodiments, a reinforcement 382 may be included in the camera assembly 350. In the exemplary embodiment shown in Figure 63, the reinforcement 382 is positioned to reinforce the structure on which the image sensor 380 is supported, and helps protect the physical integrity of the image sensor 380. For example, the reinforcement 382 may comprise a thin aluminum backing (approximately 0.051 mm {0.002 inches} thick in the exemplary embodiment).

[0205] The camera assembly 350 may also include one or more fiber guides 384. In the example shown in Figure 63, the fiber guide 384 is connected to the bottom surface of the camera housing bottom 358. The exemplary fiber guide 384 includes a guide groove 386. The back wall of the guide groove 386 of the fiber guide 384 is shown to protrude toward the bottom of the page in Figure 63. The fiber guide 384 is also several directional notches or channels 388 recessed into the back wall of the guide groove 386 in the exemplary fiber guide 384 shown in Figure 63, or includes several directional notches or channels 388. In some embodiments, including the exemplary embodiment in Figure 63, the directional notches or channels 388 are formed on one or both of the camera housing top 356 and the camera housing bottom 358. The fiber guide 384 helps to determine the path of the illumination fiber 364 during the assembly of the endoscope 10. The fiber guide 384 also serves to keep the illumination fiber 364 in place during the operation of the endoscope 10. The position, shape, number, size, etc. of the fiber guide 384 may vary depending on the specific structure of the endoscope 10. In some embodiments, in addition to the fiber guide 384, glue, epoxy, or other adhesives or chemicals are used to help maintain the lighting fiber 364 in the desired position. For example, in some cases where a light guide or light projection element is used (as shown in Figures 35-42, for example, or in Figure 64), the fiber guide 384 may not be used in the assembly.

[0206] Figure 64 shows a cross-section of the camera assembly 350 shown in Figure 34, viewed from line 62-62 in Figure 34. As shown, the lens assembly 354 is positioned in place within the camera housing 355. The image sensor 380 is also positioned within the camera housing 355. The lens assembly is positioned to project an image onto the image sensor 380. As described above, the image sensor 380 may be any type of image sensor (e.g., CCD, CMOS, etc.) and is sealed to prevent exposure to fluid. Also as described above, the image sensor 380 is connected to a flexible substrate 381 attached to a flexible cable 250. The camera assembly 350 shown in Figure 64 does not include a fiber guide 384 (see Figure 63). Instead, a light projection element or light emitter 2005 is positioned in place within the camera assembly 350 in Figure 64.

[0207] As illustrated, the flexible cable 250 is doubled in the exemplary embodiment to back itself up. This is achieved by bending the flexible cable 250 and applying glue or other fastener to the area affected by the flexible cable 250. Doubling the flexible cable 250 below the camera assembly 350 is advantageous in embodiments where the camera assembly 350 is confined to a limited space. For example, confining the camera assembly 350 to the space within the inner sheath 312 shown in Figure 22 limits the amount of flexible cable 250 that can be bent. Thus, the flexible cable 250 must bend at an improperly small radius at a certain rotational position of the camera assembly 350. This small bending radius can damage the flexible cable 250, especially when it occurs repeatedly. This problem becomes more significant as the diameter of the inner sheath 312 decreases. However, by doubling the flexible cable 250 to back itself up, a larger length of the flexible cable 250 can be used for repeated bending as the camera assembly 350 rotates, resulting in a larger minimum bending radius. Thus, this allows the inner sheath 312 to be made smaller in diameter without concerns about the integrity of the flexible cable 250 due to repeated bending and unbending at small radii.

[0208] Both the flexible cable 250 and the optical fiber 364 connected to the optical projection element 2005 exhibit some degree of resistance to bending. Furthermore, both exhibit a restorative spring force when bent. This resistance to bending increases the resistance of the camera assembly 350 to rotation. As illustrated in Figure 65, the flexible cable 250 and the optical fiber 364 are at an angle to each other. Such an arrangement utilizes the rigidity 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 Figure 65, the flexible cable 250 is not duplicated for its own backup.

[0209] In some embodiments, at least one illumination source of the camera assembly 350 may be positioned to project light in a direction other than within the field of view of the camera assembly 350. That is, the direct field of illumination of the illumination source may be oriented so as not to be outside or coincide with the field of view of the camera assembly. Such illumination sources may be referred to as indirect illumination sources, while illumination sources that project light directly into the field of view of the camera assembly 350 may be referred to as direct illumination sources. Indirect illumination sources may be oriented, for example, to radiate light behind the camera assembly 350 or in a direction substantially opposite to the direction of the field of view of the camera assembly 350. For example, instead of, or in addition to, the light projection element 2005 coupled around the lens assembly 354 or lens and projecting light into the field of view of the lens assembly 354 or lens, the camera assembly 350 may be positioned opposite the lens assembly 354 or lens.

[0210] Although counterintuitive, having projected light outside the field of view of the camera assembly 350 (for example, behind the camera assembly 350 in the opposite direction from the field of view) improves image quality and reduces the need for image processing. For example, such an illumination arrangement can help provide deeper perception in endoscopic procedures because it can maintain shadowing in areas that would otherwise be directly illuminated. By emitting light from the light-emitting element 2005 or other illumination source to a point outside the field of view of the camera assembly 350, faint hot spots or areas and unexposed dark spots or areas are mitigated. Such an illumination arrangement can help provide more uniform illumination within the field of view of the camera assembly 350.

[0211] Figure 66 shows a typical embodiment of an illumination configuration that can radiate light from several light sources 702a-d to areas inside and outside the field of view 700 of the camera assembly 350. As shown, an extension 430h of a printed circuit board 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 portion 14. In some embodiments, a ribbon or flexible cable 250 (see, for example, Figure 14) can be used instead of the printed circuit board extension 430h. Many components are attached to the printed circuit board extension 430h. These components may be any or a variety of different components such as sensors and light emitters. In exemplary embodiments, the components are described as light sources 702a-d. Light sources 702a-d may be any suitable light source, but are not limited to, optical fiber cables, light projectors 2005 (see, for example, Figure 62), LEDs, or arrays of LEDs.

[0212] The use of LEDs can be desirable in some specific embodiments for a variety of reasons. For example, the use of LEDs can eliminate the need for bundles / ribbons of illumination fibers in some specific embodiments. Some optical fibers degrade when subjected to prolonged bending during use and tend to lose light when bent. LEDs are long-lasting and do not require long fiber bundles that are subject to bending. The use of LEDs can also minimize the number of elements passing between the dry part of the endoscope (e.g., the handle 12) and the wet part of the endoscope (e.g., the insertion section 14). Furthermore, by omitting optical fibers, it is prevented that the cross-sectional area of ​​the fluid conduit in the insertion section 14 becomes smaller. This allows for an increase in the flow rate of irrigation fluid through the insertion section 14. LEDs can also help simplify or improve ease of manufacture.

[0213] As illustrated, the first light source 702a is positioned to project light generally toward the field of view 700 of the camera assembly 350. Such a light source 702a can generally provide direct illumination of the field of view 700. In some embodiments, the direct light source 702a may be omitted or may be accompanied by one or more other indirect illumination sources, such as any or a combination of light sources 702b-d. In embodiments in which the 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 one or more indirect illumination sources. In some embodiments, the direct illumination source 702a may provide light of a different spectrum or a subset of the spectrum emitted by the indirect illumination sources. For example, the direct illumination source 702a may be an RGB LED array, and the indirect illumination sources may emit white light.

[0214] Numerous other light sources 702b-d are also shown in Figure 66. These light sources are shown together for illustrative purposes and are not required to be present in any given embodiment. Any number of illumination sources 702a-d may be included in various embodiments. Some of the illumination sources 702a-d may be omitted in various embodiments. 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 substantially the opposite direction to the field of view 700 of the camera assembly 350. Light source 702d may be mounted on the camera assembly 350 and may be configured to emit light from the side of the camera assembly 350. In a preferred embodiment, the backlight provides the sole illumination source for the surgical site. In this case, the illumination source for the distal end of the endoscope may include only one or more LEDs located, for example, at position 702B, that is, projecting light from the side of the endoscope shaft away from the side towards which the majority of the field of view of the camera assembly is facing. The light thus provided illuminates the space viewed by the camera assembly more indirectly and diffusely, preventing bright reflections of light directly shining on the camera or reducing shadow casting, and improving the operator's field of view. On the other hand, placing the LED at position 702A can improve the illumination of the surgical site area to which the camera field of view 700 is directed.

[0215] The camera assembly 350 may include one or more optical filters that selectively use wavelengths emitted from one or more light sources 702a to d. For example, a polarizing filter or a bandgap filter can be used to enhance imaging by the camera assembly 350.

[0216] Depending on the embodiment, the camera assembly 350 may be rotatable within the insertion section 14. In such embodiments, the illumination sources 702a-d may remain stationary when the camera assembly 350 is rotated. Alternatively, one or more illumination sources 702a-d may rotate with the camera assembly 350 (for example, the light sources 702a-d may be mounted on the camera assembly 350 and rotated with the camera assembly 350). The light sources 702a-d may be positioned so as not to emit light directly into the field of view 700 at any or a large percentage (e.g., about 70% to 100%) of the possible rotational positions of the camera assembly 350. In some embodiments, the entire distal end of the shaft or insertion section 14 (or the entire insertion section 14) is transparent, and the camera assembly 350 can be rotated to obtain a wide field of view through the transparent portion or multiple portions. In this particular embodiment, the distal portion of the insertion section 14 may optionally be fluid-sealed from the surrounding space, and the camera and light sources rely on the transparency of the distal end of the shaft.

[0217] Furthermore, in some embodiments, a controller that monitors the rotational position of the camera assembly 350 can increase or decrease the intensity of light emitted by various light sources 702a-d depending on the position in the field of view 700. For example, the controller may monitor the displacement of the swivel control structure 100 (see Figure 14) via a sensor such as a rotary potentiometer mounted on the pivot axis 204 (see Figure 14, for example). Based on the data collected from the sensor, the controller can determine whether the light sources 702a-d have shifted from direct to indirect sources or vice versa. The controller can adjust the intensity of light produced by the light sources 702a-d accordingly. Based on the sensor readings, the controller can determine, for example, which light sources 702a-d are emitting light into the field of view 700 of the camera assembly 350 and reduce the intensity of light produced by these light sources 702a-d. The controller can use sensor readings to determine whether the camera assembly 350 has been rotated so that the light sources 702a to d, which were directly emitting light into the camera field of view 700, operate as indirect light sources. If it is determined that light sources 702a to d have shifted from direct to indirect light sources, the intensity of the light produced by those light sources 702a to d can be increased. The adjustment of the emitted light may be performed in a continuous, gradual, stepwise, or binary manner (for example, by switching between a preset direct intensity level and an indirect intensity level).

[0218] An example of a printed circuit board 430a including several LED light sources 750 and a sensor 754 on an extension 430h of the printed circuit board 430a is shown in Figure 67-68. A sensor or camera assembly 350 is also shown at the end of the PCB extension 430h. Figure 67 shows a top view of the printed circuit board 430a, and Figure 68 shows a side view of the printed circuit board 430a.

[0219] The printed circuit board 430a may include a main portion 430L from which a shaft portion 430H extends. The main portion 430I of the printed circuit board 430a may be housed within the handle 12 of the endoscope 10 (see, for example, Figure 3A or Figure 3B). In the exemplary embodiments shown in Figures 67–68, for simplification, the main portion 430I is not shown with the electronic components mounted. An exemplary printed circuit board 430a with exemplary components 430b–f arranged is shown in Figure 96. In some embodiments, as shown in Figure 68, at least a portion of the main portion 430L of the printed circuit board 430a may be coated or encased with a protective coating or a layer of material. The protective material may be any of a variety of potting materials or conformal coating materials. Acrylic, epoxy, polyurethane, silicone, parylene, thermosetting plastics, rubber, or any other potting material or conformal coating material may be used. Preferably, the protective material is biocompatible and provides waterproof properties. The transparent protective coating can also be placed on the LED 750 and sensor 754 located on the protruding portion 430h.

[0220] The PCB extension (or optionally a ribbon cable) 430h can pass through the through barrier 159 (see, for example, Figure 15) and extend along the axis of the insertion section 14 of the endoscope 10 (see, for example, Figure 15). The projection 430h can provide power and data communication paths to various components within the insertion section 14 (e.g., camera assembly 350 and / or LED 750) (see, for example, Figure 15). The projection 430h can be divided into several different parts. In the illustrated example, the projection 430h includes a first part 430i, a second part 430j, and a third part 430k. (In other embodiments, the projection 430h may be divided into a different number of components). Each part of the projection 430h may have different properties. For example, each part of the projection 430h may have different degrees of flexibility. Some parts may be rigid circuit boards and others may be flexible cables. Furthermore, each part of the circuit board may have a different number of layers, a different width, a different number of traces on each layer, and so on. At least a portion of the protruding portion 430h of the printed circuit board 430a may be a flexible cable or otherwise pliable. This may help facilitate the rotation of the camera assembly 350.

[0221] In some embodiments, the first portion 430i may be a six-layer rigid circuit board. The second portion 430j may be a two-layer flexible cable. The third portion 430k may be a four-layer rigid board. Each portion can transition to the next portion, or connectors may be used between one or more portions of the protrusion 430h. To simplify manufacturing and reduce costs, communication and power lines within the endoscope shaft are preferably included in flexible and / or rigid extensions of the main PCB located within the endoscope handle. The entire PCB with extensions can be manufactured as shown in Figure 33.2. Any flexible PCB extensions can be folded as shown in Figure 33.3. During endoscope assembly, they pass adjacent to the companion PCB extension (rigid or flexible).

[0222] The sensor 754 may be any of the various sensors. In some embodiments, the sensor 754 may be a temperature sensor such as a thermistor, thermocouple, or resistance temperature detector. In some specific embodiments, the sensor 754 may be a thermistor. The temperature sensor 754 can be used to monitor the temperature of the vicinity of the LED 750 or the surrounding environment.

[0223] During endoscopic procedures, irrigation fluid may flow over the LED 750. This fluid can help cool the LED 750 to keep its temperature within the desired temperature range. When the endoscope 10 is outside the patient and no irrigation fluid is flowing, the controller monitors data from 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 can command a reduction in the current flow to the LED 750 or command the LED 750 to turn off. The temperature sensor can also be used as a irrigation fluid flow rate sensor. During endoscopic procedures, the flow rate of the irrigation fluid may be sufficient to dissipate the heat generated by the LED 750 by convection so that the area surrounding the LED 750 remains within the desired temperature range. If the flow rate decreases by more than a certain amount, the temperature of the area adjacent to the LED 750 may rise. In some embodiments, this rise may be interpreted by the controller as a decrease in the irrigation fluid flow rate. In response, the controller may generate a notification to the user.

[0224] FIG. 69 shows a flowchart detailing many exemplary steps that can be used by a controller to control the LEDs within the insertion portion 14 based on the detected temperature. At step 756, the controller receives a data sample from a temperature sensor near the LED. Next, the controller analyzes the data sample at step 758. If at branch 760 the temperature is not outside a first predetermined range, step 756 can be repeated. If at branch 760 the temperature is outside the first predetermined range, the controller can transition one or more LEDs from a first state to a second state at step 762. The temperature range can have an upper boundary of 40-50° C (e.g., 50° C). The first state may be an on state with a high light output intensity, and the second state may be an off state. In the exemplary flowchart, the second state is a light or off state. The controller receives a data sample from the temperature sensor at step 764 and analyzes the data sample at step 766. If at branch 768 the data sample indicates that the temperature is outside a second predetermined range, step 764 can be repeated. If at branch 768 the data sample indicates that the temperature is within the second predetermined range, at step 770, at least one LED can be commanded to turn on or the intensity of the light it generates can be increased.

[0225] The first and second predetermined ranges may be the same, or the first and second predetermined ranges may be different, and the second predetermined range is smaller than the first predetermined range. This allows the controller to increase the intensity of the light from the LED without rapidly repeating between on / off or dimming. In some embodiments, after reaching step 762, a timer can be started. The timer may be a minimum on / off timer for at least one LED whose brightness has been changed. If the minimum off or dimmer timer has not elapsed, even if the temperature is within the second predetermined range, at least one LED cannot be turned back on or commanded to increase the light output intensity. This also helps prevent rapid cycling between LED states.

[0226] FIG. 70 is a side view showing an enlarged example of an end portion of the protruding portion 430h of the printed circuit board 430a. As shown, the protruding portion 430h includes a first portion 430i, a second portion 430j, and a third portion 430k. A camera assembly 350 is attached to the third portion 430k. The sensor 754 is attached in the vicinity of a number of LEDs 750a - d on the first portion 430i. The sensor 754 may be a temperature sensor such as a thermistor and may be used to assist in the control of the LEDs 750a - d. It is also possible to use sensors for detecting characteristics of a fluid environment other than temperature (e.g., conductivity, pH, etc.).

[0227] LED 750a may be a direct illumination source and generally projects light into the field of view 700 of the camera assembly 350. LED 750a is attached to the first side surface 430m of the first portion 430i of the protruding portion 430h. LEDs 750b - d are attached to the second side surface 430n opposite to the first side surface 430m of the first portion 430i. These LEDs 750b - d may be indirect light sources and in some embodiments, cannot directly project light into the field of view 700 of the camera assembly 350 in any rotational direction of the camera assembly 350. In some embodiments, LED 750a may be an RGB LED array. LED 750a can be adjusted to provide light of a spectrum useful for correcting the color of an image generated by the image sensor of the camera assembly 350 in a desired manner. For example, LED 750a may be adjusted to correct the color bias of the image sensor of the camera assembly 750a. LEDs 750b - d may be white light LEDs. As shown, the first portion 430i of the protruding portion 430h may be a thicker portion of the printed circuit board with respect to the other portions 430j, 430k of the protruding portion 430h. This enables the power requirements of the LEDs 750a - d to be easily accommodated.

[0228] The first portion 430i can transition into the second portion 430j of the protruding portion 430h. The second portion 430j may be a relatively thin flexible cable. The second portion 430j can facilitate the rotation of the camera assembly 350 around the axis of the pivot pin 366 of the camera assembly 350. As shown, the second portion 430j may be of a length such that it is curved or arched when the first portion 430i and the third portion 430k are parallel to each other. This can help to increase the range of motion of the camera assembly 350.

[0229] Figure 71 shows an exemplary embodiment of the camera assembly housing 330 of the insertion section 14. Figure 72 shows a cross-sectional view of the camera assembly housing 330 as seen along line 72-72 in Figure 71. The camera assembly housing 330 is continuous with the inner sheath 312, and the two can be formed as a single part. As shown in Figure 2, Figures 71 and 72 show a protruding portion 430h of the printed circuit board 430a (see, for example, Figure 68) within the camera assembly housing 330. The protruding portion 430h is similar to that shown in Figure 4. The camera assembly 350 includes a number of LEDs 750a-d and, optionally, a sensor 754. As shown, the LEDs 750a-d are positioned to emit light from the top and bottom openings 338, 340 of the camera assembly housing 330. The camera assembly 350 may be panned so that its field of view can be swept through the opening provided by the upper gap 338 from the opening 344 surrounded by the rounded tip 342. When fully assembled, the outer sheath 318 (see, for example, Figure 22) can be positioned over the camera assembly housing 330 and the inner sheath 312 to protect the camera assembly 350 while providing an unobstructed field of view.

[0230] Figure 23.1 shows a perspective view of the distal end of the shaft of an endoscope (or arthroscope) 14, in which the sensor or camera housing 500 is positioned at the tip of the shaft. In this case, the inner sheath 312 does not have the most distal protective guard, shield, or tip structure. At least a portion of the rotatable sensor or camera housing 500 (i.e., the most distal portion) forms the most distal element of the endoscope insertion end. Therefore, it is preferable that the sensor housing 500 be 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 housing 350, the round or dome-shaped camera housing 500 may also be movable with the rotatable camera housing and may include a light source that is continuously directed toward the field of view of the camera housing 500. The light source may include, for example, one or more LEDs or the end of a fiber optic bundle. As shown in Figure 23.1, the light source 508 (in this case, a bank of LEDs) is positioned on the axis side just proximal to the position of the rotatable sensor or camera housing 500. In this figure, the light source 508 is positioned on the side that directs illumination toward the general field of view of the camera / lens assembly 500 when rotated approximately 90 degrees with respect to the long axis of the endoscope shaft 14. (Alternatively, the light source may be positioned on the opposite side from which the camera assembly (lens and sensor) can face.) In the shown configuration, the optical axis of the camera assembly can be roughly oriented toward the direction of light projected from the first side of the insertion end of the endoscope. In other configurations, the light source is positioned on the second opposing side of the insertion end, projecting light from the second side of the insertion end of the endoscope, while the optical axis of the camera assembly is on the opposite side of the first side of the insertion end of the endoscope. Figure 72.1 shows a perspective view of this latter configuration, in which the light emitted by the light source 508 (an LED in this example) is directed toward an area roughly away from the field of view of the sensor and lens 512. An alternative second arrangement is intended to provide indirect illumination (or backlighting) of the camera assembly's field of view, relying on ambient light generated by an illumination source at the surgical site of the endoscope. The illumination source or LED is mounted either coplanar with or recessed to the inner sheath of the insertion end or the outer surface of the shaft. When recessed, the heat generated by the LED is less likely to directly contact or damage nearby tissue within the surgical site.

[0231] Referring here to Figure 73, in embodiments including at least one variable illumination source capable of generating light at different intensities and / or spectra, the endoscope 10 may be placed in a calibration fixture 780 to help set various illumination parameters. Embodiments having one or more white LEDs and one or more colored LEDs (e.g., an RGB LED array) may, for example, be placed in a calibration fixture before use to adjust the light output intensity of its LEDs and the color output of one or more colored LEDs. This can help ensure more uniform image quality and minimize differences between endoscopes 10 that may be due to variations between LEDs and / or image sensors.

[0232] The calibration fixture 780 may be a light-shielding box or other volume including an opening 782 sized to fit into the insertion section 14 of the endoscope 10. This opening 782 may be gasketed so as to form a light-shielding seal against the insertion section 14 of the endoscope 10 when the endoscope 10 is attached to the calibration fixture 780. The interior of the calibration fixture 780 may include one or more targets having known characteristics that are placed within the field of view of the camera assembly 350 of the endoscope 10 (see, for example, Figure 71). For example, targets having known color characteristics may be placed inside the calibration fixture 780.

[0233] The controller can monitor the characteristics of one or more targets in the image captured by the image sensor of the camera assembly 350. Since the characteristics of the targets (e.g., color) are known, the controller can adjust the illumination provided by the variable light source until the characteristics of the targets in the captured image match or fall within the range of the target or within the range of the known characteristics of the target. For example, the intensity and / or spectrum of the light produced by the numerous LEDs 750a-750d contained in the insertion unit 14 (see, for example, Figure 70) can be adjusted.

[0234] Figure 74 shows a flowchart detailing several exemplary steps that may be used to calibrate one or more illumination parameters of at least one variable light source contained in an endoscope. In step 784, a portion of the insertable section of the endoscope, including the camera assembly, can be placed in a calibration fixture. Once inserted, the controller can, in step 786, command the variable illumination source in the endoscope to emit light. The light may be emitted based on default parameters (e.g., light intensity and color parameters). In step 788, the controller can receive image data from the image sensor of the camera assembly of the endoscope. This data may be analyzed by the controller in step 790. The image data may be analyzed, for example, to determine one or more characteristics of one or more targets of interest in the captured image. These characteristics may be compared in step 792 with known or expected characteristics of the imaged targets. If the characteristics of the targets in the image acquired at branch 794 are within the range of known or expected characteristics, the calibration may be considered complete in step 796. If the characteristics of one or more targets in the image acquired at branch 794 are not within the range of known or expected characteristics, the controller may, in step 798, adjust one or more illumination parameters of at least one variable illumination source of the endoscope. In the exemplary embodiment, in step 798, the intensity and / or spectrum of light produced by at least one variable light source is adjusted. Step 788 may be repeated after adjustment. Images are continued to be compared and analyzed, and illumination parameters may be adjusted until the characteristics of targets in the illuminated images fall within the range of their known or expected values. Various methods can be used for the configuration and assembly of lenses or lens groups to focus images onto a sensor or camera at the distal end of the endoscope shaft. Examples of such methods and techniques are disclosed in U.S. Patent Application No. 14 / 170,080 (Publication No. 2014 / 0221749), filed on 31 January 2014, which is incorporated herein by reference in its entirety.

[0235] Figure 96 shows another embodiment of the endoscope 10. The outer sheath 318 is shown attached to the endoscope in Figure 96. Furthermore, for the sake of clarity in this explanation, only the lower hemiscaphe 22 of the proximal handle portion 16 and half (30a) of the distal handle portion 30 are visible. As illustrated, the endoscope 10 includes a printed circuit board 430a (also referred to as the handle or main PCB 430a) enclosed in the handle. Electronic cables (e.g., power / HDMI® cables) 432, optical fibers 364, and a cleaning / suction line 434 are also illustrated. Figure 96 also illustrates the exemplary routing of the power / HDMI® cable 432, optical fibers 364, and cleaning line 434. As illustrated, the electronic cables 432, optical fibers 364, and cleaning line 434 enter the endoscope 10 through an opening 60 behind or in the remnant of the proximal handle portion 16. This entrance is more advantageous than the entrance on the side of the handle because the insertion portion rotates relative to the proximal portion 16 of the handle, reducing the possibility of various cords and cables becoming entangled.

[0236] In some embodiments, the electronic cable 432, the optical fiber 364 (if present), and the cleaning line 434 may enter the endoscope 10 at an angle to the rear handle opening 60. Such arrangement provides an ergonomic advantage for the user, as it allows the user to grasp a larger portion of the rear part of the proximal handle portion 16.

[0237] As shown in the figure, the electronic cable 432, the optical fiber 364 (if implemented in the endoscope), and the cleaning line 434 extend beyond the handle PCB 430a after entering the proximal portion 16 of the handle. The electronic cable 432 plugs into connector 430b (e.g., a power / HDMI® connector) on the handle PCB 430a. The electronic cable 432 supplies power to the endoscope 10. Image data is transmitted to the handle PCB 430a via the flexible cable 250. The electronic cable 432 transmits the video data collected by the endoscope 10 to an external graphical user interface display (not shown). The optical fiber 364 (if implemented in the endoscope) and the cleaning line 434 extend below the handle PCB 430a, following the aforementioned path. In a disposable embodiment of the endoscope 10, the electronic cable 432, optical fiber 364, and cleaning line 434 are all included in the disposable component, ensuring that the endoscope is sterile after each use, or saving costs for sterilization and packaging for reuse.

[0238] In this example, a control wire 91 for the button 90 is also illustrated in Figure 96. As shown, the control wire 91 passes through an opening in the sealing member 210. The control wire 91 communicates with the handle PCB 430a. Also as shown in Figure 96, the handle PCB 430a includes a handle PCB flexible cable 430e. The handle PCB flexible cable 430e connects to the handle PCB section 430f, causing the handle PCB section 430f to be oriented at a certain angle (for example, perpendicular) to the rest of the handle PCB 430a. When assembled, the flexible cable connected to the handle PCB section 430f is positioned between the two potentiometers 122 of the exemplary rotation sensing assembly 150 (see Figure 8).

[0239] In some embodiments, the handle PCB 430a includes an image or graphics processing unit 430c. However, it is preferable that the image processing unit 430c be located outside the endoscope 10. The image processing unit 430 functions as the electronic righting mechanism of 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 the flexible cable 250. In a preferred embodiment, the images captured by the image sensor 380 are then transmitted to the image processing unit 430c outside the endoscope 10 via the electronic cable 432. The image processing unit 430c also receives signals from the rotation detection assembly 150. In some embodiments, an analog-to-digital converter 430d is included in the handle PCB 430a to convert the signals from the rotation detection assembly 150. The image processing unit 430c may use the signals from the rotation detection assembly 150 to electronically "right" its image in the desired direction. In some embodiments, the image is rotated by the image processing unit 430c so that it is displayed as if it were captured from the user's viewpoint. In some embodiments, the image processing unit 430c also corrects for the effects of lens distortion.

[0240] Unless the orientation of the image displayed in the graphical user interface is initially corrected, the displayed image will appear disorienting to the user. By determining the orientation according to the user's viewpoint, the image processing unit 430c uses data from the rotation detection assembly 150 to automatically rotate the image so that it corresponds to the user's viewpoint.

[0241] Figure 97 shows an illustrative block diagram of an image system. As shown, the image system includes an image sensor 380 that captures images. Images captured by the image sensor 380 are passed to an image processing unit 452 via a camera serial interface 450 (for example, a MIPI camera serial interface). The image processing unit 452 (IPU) then moves the image frames to other hardware components in the image system. These other hardware components include, but are not limited to, a memory device and a graphics processing unit 430c (GPU). The graphics processing unit 430c corrects distortions that occur in the lens assembly 354.

[0242] In some embodiments, the graphics processing unit 430c corrects this distortion by representing the image as a texture on a surface mounted on the graphics processing unit 430c. This adjusts or stretches the image in a way that corrects and / or eliminates the distortion introduced by the lens assembly 354. In embodiments where the image is returned to its correct position, the graphics processing unit 430c rotates the corrected image via an input from the rotation detection assembly 150 (see, for example, Figure 8). For example, the measurement result from the rotation detection assembly 150 is passed to the graphics processing unit 430c through the analog-to-digital converter 430d (see, for example, Figure 96). Using the signal from the analog-to-digital converter 430d, the image is rotated in the direction to which it was returned to its correct position. In some embodiments, the user can switch between returning the image to its correct position, correcting distortion, and / or various other image operations, which are turned on or off. Returning the image to its correct position is described further below herein in relation to Figure 98.

[0243] The processed images from the image processing unit 430c are then displayed on a graphical user interface or on a display 454. In some embodiments, the processed images from the image processing unit 430c are stored in memory. In such embodiments, the user captures an image and stores it in memory for later recall by, for example, activating button 90. Some embodiments include a video processing unit 456 that encodes frames from the image sensor 380 into a recordable video format. In such embodiments, the encoded video is stored in memory. The user commands the endoscope to start and stop video recording via the interaction of buttons such as button 90 described above.

[0244] In some embodiments, the image processing unit 430c applies exposure feedback analysis to the captured image. In certain embodiments, an image histogram is created from all pixels of the image. The image histogram is used to adjust the image or adjust the exposure of subsequent images received by the image chip or sensor 380. Such further processing by the image processing unit 430c helps reduce blown-out white areas or underexposed dark areas in the image. Other means of adjusting the image, such as tone mapping, may also be used.

[0245] Figure 98 is an illustrative diagram illustrating how the image is returned to the correct position using input from the rotation detection assembly 150 (see, for example, Figure 98). As shown, a first block 2100 and a second block 2102 are illustrated. Within each block 2100, 2102, an endoscope 10 having a field of view 2104 is shown. The field of view 2104 of the endoscope 10 in the first block 2100 is directed approximately 180 degrees from the endoscope 10 in the second block 2102. This can be achieved by rotating the distal end of the endoscope 10 with respect to its proximal end. In conventional endoscopes 10, the image sensor is housed in the proximal portion, so the image sensor does not rotate during the rotation of the distal portion with respect to the proximal portion. Thus, both the endoscopes 10 shown in the first block 2100 and the second block acquire an image 2106.

[0246] This is not true in some embodiments described herein where the image sensor 380 rotates relative to the distal end of the endoscope 2106. The endoscope 10 shown in the first block 2100 acquires image 2106, and the same endoscope 10 rotated to the position shown in the second block 2102 acquires image 2108. As the image sensor rotates relative to the distal end of the endoscope 10, the image sensor inverts the image. At this position, for example, the top of the image sensor acquires what a person familiar with conventional endoscopes 10 would expect to see at the bottom of the image.

[0247] Optionally, the image is rotated in proportion to the degree of rotation of the distal end of the endoscope 10. Therefore, the image can always be displayed as expected by users accustomed to conventional endoscopes 10, which helps to mitigate problems associated with rotating image sensors.

[0248] The various embodiments shown in the drawings are shown only for the purpose of illustrating examples of the features of the present disclosure. The features shown in a given drawing are not necessarily to be included in the claimed device or feature. And the drawings are to be interpreted for illustrative purposes only. Thus, the size of an element is exaggerated and not drawn to a particular scale. Further, elements shown in the drawings having the same reference numbers are, depending on the context, the same element or similar or like elements.

[0249] For example, any terms such as "first", "second", "third", etc., whether used in the specification or in the claims, are intended to distinguish similar elements and do not necessarily imply a sequential or temporal order. Such terms can be interchanged under appropriate circumstances (unless expressly stated otherwise), and the embodiments of the disclosure described herein can be implemented in other orders and arrangements than those described and illustrated herein. A first aspect of the present invention is an endoscope comprising a proximal handle, a shaft having a distal insertion end, and a camera assembly attached to a rotatable housing on the insertion end, the rotatable housing being configured to rotate about an axis generally perpendicular to the long axis of the insertion end, where the rotatable housing is the most distal element of the insertion end of the shaft. A second aspect of the present invention is the endoscope according to the first aspect, wherein the camera assembly includes a lens adjacent to an image sensor. A third aspect of the present invention is the endoscope according to the second aspect, wherein the image sensor is a CMOS or CCD device. A fourth aspect of the present invention is In a first embodiment of the endoscope, the endoscope comprises a pull wire extending from the handle to the insertion end of the shaft, the pull wire wrapping around a portion of the rotatable housing, and the pull wire is configured to rotate the rotatable housing back and forth in accordance with the forward or backward movement of the pull wire within the shaft. A fifth aspect of the present invention is: In the endoscope of the first embodiment, the rotatable housing is an endoscope having a range of motion that gives the camera assembly a field of view including a region along the long axis of the insertion end and a region at least perpendicular to the long axis of the insertion end. A sixth aspect of the present invention is: In the endoscope of the first embodiment, the rotatable housing is an endoscope having a range of motion such that the optical axis of the camera assembly is movable from about 0 degrees to about 120 degrees with respect to the long axis of the insertion end. A seventh aspect of the present invention is: In the endoscope of the first embodiment, the rotatable housing is an endoscope having a range of motion such that the optical axis of the camera assembly is movable from about 35 degrees to about 115 degrees with respect to the long axis of the insertion end. An eighth aspect of the present invention is: In the endoscope of the first embodiment, the rotatable housing of the camera assembly comprises a spheroidal shell composed of an assembly of two half-shells, one or both of the half-shells having an internal notch for housing the camera assembly. A ninth aspect of the present invention is: An endoscope according to a first embodiment further comprises a light source located on the rotatable housing, wherein the light source is configured to illuminate the field of view of the camera assembly. A tenth aspect of the present invention is: It is an endoscope, A shaft having a proximal handle and a distal insertion end, The camera assembly attached to the insertion end comprises The camera assembly is configured to rotate around an axis that is substantially perpendicular to the long axis of the insertion end, The endoscope further, The endoscope is equipped with a light source positioned at the insertion end of the shaft and oriented to project light in a direction approximately perpendicular to the long axis of the insertion end. An eleventh aspect of the present invention is: In the tenth endoscope, the camera assembly is configured to rotate to have a field of view that includes an area directly illuminated by the light source. A twelfth aspect of the present invention is: In the tenth embodiment of the endoscope, the camera assembly is configured to rotate to have a field of view that excludes the area directly illuminated by the light source. A thirteenth aspect of the present invention is: In the twelfth embodiment of the endoscope, the field of view of the camera assembly is illuminated indirectly, or by reflected light from the light source or by ambient light. A fourteenth aspect of the present invention is: In the endoscope according to any of the 10th to 12th embodiments, the light source is one or more light-emitting diodes. A fifteenth aspect of the present invention is: A printed circuit board for use in endoscopes, The base of the printed circuit board is configured to be located within the handle of the endoscope, One or more elongated extensions of the printed circuit board are configured to extend from the base of the printed circuit board in the handle through the shaft of the endoscope and terminate at the distal insertion end of the shaft. A sixteenth aspect of the present invention is: In the printed circuit board of the 15th embodiment, the base is a composite of a flexible substrate bonded to a rigid substrate, and at least one of the one or more extensions is a printed circuit board including a flexible substrate extension. A 17th aspect of the present invention is: In the printed circuit board of the 15th embodiment, the base is a composite of a flexible substrate bonded to a rigid substrate, and at least one of the one or more extensions is a printed circuit board including a rigid substrate extension. An eighteenth aspect of the present invention is: In the printed circuit board of the 15th embodiment, the base is a composite of a flexible substrate bonded to a rigid substrate, the first of the one or more extensions includes a flexible substrate extension, and the second of the one or more extensions is a printed circuit board including a rigid substrate extension. A 19th aspect of the present invention is: In the printed circuit board of the 18th embodiment, the flexible substrate extension and the rigid substrate extension emerge from the base portion adjacent to each other, and the proximal leg portion of the flexible substrate extension extends from the rigid substrate extension portion at an angle of approximately 90 degrees. A 20th aspect of the present invention is: In the printed circuit board of the 19th embodiment, the proximal leg of the flexible circuit board extension is folded such that the distal leg of the flexible circuit board extension is positioned parallel to and adjacent to the rigid circuit board extension that passes through the shaft of the endoscope. A 21st aspect of the present invention is: In the printed circuit board of the 19th embodiment, the distal leg of the flexible substrate extension extends parallel to the rigid substrate extension and away from the base. A 22nd aspect of the present invention is: In the 21st embodiment of the printed circuit board, the base portion of the printed circuit board, the rigid substrate extension portion, and the flexible substrate extension portion are covered with a water-resistant coating or film. A 23rd aspect of the present invention is: In the 22nd embodiment of the printed circuit board, the rigid substrate extension and the flexible substrate extension are printed circuit boards that extend through the fluid transport lumen of the endoscope shaft. A 24th aspect of the present invention is: In the 18th embodiment of the printed circuit board, the rigid substrate extension is a printed circuit board that carries electrical lines connected to one or more light sources at the insertion end of the endoscope shaft. A 25th aspect of the present invention is: In the printed circuit board of the 18th embodiment, the flexible circuit board extension is a printed circuit board that carries a communication line connected to an image sensor at the insertion end of the endoscope shaft. A 26th aspect of the present invention is: In the 25th embodiment of the printed circuit board, the image sensor is a printed circuit board which is a CCD or CMOS sensor. A 27th aspect of the present invention is: In the 26th embodiment of the printed circuit board, the flexible circuit board extension is a printed circuit board configured to allow the image sensor to rotate about an axis that is substantially perpendicular to the axis of the endoscope shaft. A 28th aspect of the present invention is: It is an endoscope, A proximal handle housing configured to accommodate an electronic processing board for processing signals from an image sensor located at the distal end of the shaft of the endoscope, A distal handle housing configured to hold the electronic processing substrate in a fixed position relative to the distal handle portion, The magnets include one or more magnets attached to the inner wall of the proximal handle housing, and a magnet positioned next to the Hall effect sensor on the electronic processing substrate, The endoscope is configured such that the proximal handle housing is rotatable relative to the distal handle housing, and the Hall effect sensor provides an electronic processor with a signal representing the relative rotation of the proximal handle housing relative to the distal handle housing. A 29th aspect of the present invention is: In the 28th embodiment of the endoscope, the electronic processor is connected to a user interface that displays an image generated by the image sensor, and the rotation direction of the image is changed by a change in the relative rotation of the proximal handle housing with respect to the distal handle housing. A 30th aspect of the present invention is: It is an endoscope, A handle surrounding an electronic processing board for processing signals from an image sensor located at the distal end of the shaft of the endoscope, A button on the handle having a component surrounding a magnet, The device comprises a magnet positioned on or adjacent to a portion of the electronic processing substrate on which the Hall effect sensor is located, Pressing, releasing, or moving the aforementioned button is an endoscope that changes the magnetic field near the Hall effect sensor to a degree sufficient to alter the signal generated by the Hall effect sensor. A 31st aspect of the present invention is: In the 30th embodiment of the endoscope, the button causes an electronic control device connected to the electronic processing board to start recording the image generated by the image sensor, to stop recording the image generated by the image sensor, and to take a photograph of the image generated by the image sensor based on the movement or release of the button by the user. A 32nd aspect of the present invention is: In the 30th embodiment of the endoscope, the button is configured to cause an electronic control device connected to the electronic processing board to turn on, turn off, or adjust a light source located at the distal insertion end of the axis of the electronic processing board, based on the user's movement or release of the button. A 33rd aspect of the present invention is: In an endoscope according to the 31st or 32nd embodiment, the movement or release of the button includes pressing down the button for a short or longer duration, pressing down and releasing the button two or more predetermined sequences of times, or releasing the button between two presses having two or more variable durations.

Claims

1. Insertion shaft and; A handle assembly comprising a proximal handle portion and a distal handle portion, wherein the distal handle portion is rigidly coupled to the insertion shaft, and the distal handle portion is configured to rotate with respect to the proximal handle portion along the longitudinal axis of the insertion shaft; Printed circuit board, The base located at the distal handle portion, A first extension from the base, having an image sensor at its distal end, A printed circuit board comprising a second extension from the base having at least one LED at its distal end; The first extension and the second extension extend in close proximity to each other through the lumen of the insertion shaft; Endoscope.

2. The first extension and the second extension extend to the distal end of the insertion shaft. The endoscope according to claim 1.

3. The lumen of the insertion shaft is designed to transport liquid to its distal end. The endoscope according to claim 1.

4. The first extension and the second extension are coated with a water-resistant coating or film. The endoscope according to claim 1.

5. The aforementioned printed circuit board is coated with a water-resistant coating or film. The endoscope according to claim 1.

6. The aforementioned image sensor comprises a CCD or CMOS sensor. The endoscope according to claim 1.

7. The image sensor further comprises a lens assembly mounted on the aforementioned image sensor, The endoscope according to claim 1.

8. At least one of the first extension and the second extension is rigid. The endoscope according to claim 1.

9. At least one of the first extension and the second extension is flexible. The endoscope according to claim 1.

10. The distal handle portion is further provided with a bulkhead to separate a relatively dry area from the lumen of the insertion shaft that transports the liquid. The endoscope according to claim 3.

11. The first extension and the second extension pass through the bulkhead. The endoscope according to claim 10.

12. Insertion shaft and; A handle assembly comprising: a proximal handle portion including at least one magnet; and a distal handle portion, the distal handle portion being tightly coupled to the insertion shaft, and the distal handle portion being configured to rotate with respect to the proximal handle portion along the longitudinal axis of the insertion shaft; Printed circuit board, A base located at the distal handle portion, the base includes a Hall effect sensor configured to detect the relative position of at least one magnet, A first extension from the base, having an image sensor at its distal end, A printed circuit board comprising a second extension from the base having at least one LED at its distal end; At least one of the first extension and the second extension is connected to the base by a connector, and the first extension and the second extension extend in close proximity to each other through the lumen of the insertion shaft; Endoscope.

13. The first extension and the second extension extend to the distal end of the insertion shaft. The endoscope according to claim 12.

14. The lumen of the insertion shaft is designed to transport liquid to the distal end. The endoscope according to claim 12.

15. The first extension and the second extension are coated with a water-resistant coating or film. The endoscope according to claim 12.

16. The proximal handle portion includes two magnets located on the opposite side of the distal handle portion. The endoscope according to claim 12.

17. The Hall effect sensor is a single three-axis position sensor. The endoscope according to claim 12.

18. At least one of the first extension and the second extension is connected to the base by a connector. The endoscope according to claim 1.

Images