Eustachian Tube Dilator System

Abstract

To provide, e.g., an endoscope and attachment mechanisms improved for removably coupling and decoupling an endoscope to a handle portion and / or a tool portion of a variety of different instruments.SOLUTION: An endoscope comprises a rigid proximal end, the rigid proximal end comprising a rigid proximal attachment segment to removably couple the endoscope to a handle portion of an instrument; and a flexible distal end to be inserted into a patient cavity to image the cavity. Some implementations describe designs for instruments that may be coupled to the flexible-rigid endoscope described herein or other endoscopes. Such instruments may include sinus and laryngeal forceps, a laryngeal syringe gun, an endoscopic Eustachian tube balloon dilator, an endoscopic tracheal dilator, and an endoscopic trans-oral esophageal balloon dilator. Some implementations describe an endoscope that may be removably coupled to a portable control box using a connector cable.SELECTED DRAWING: Figure 1

Description

[Background technology]

[0001] An endoscope is an optical microscope used to view the inside of body cavities in a procedure called endoscopy. A lighted tubular instrument with a piece or camera. The instrument is inserted into a patient's body cavity. During the performance of a medical procedure using an endoscope, the endoscope visualizes medical instruments and body cavities during the procedure. For example, endoscopes can be used to allow a physician to use suction or other instruments to remove tissue from a cavity. allows for viewing of tissue or other material within a patient's cavity while using the grasping forceps. It can be used for:

[0002] In procedures that utilize a medical device in combination with an endoscope, the endoscope typically During the procedure, the medical professional uses the endoscope as a The instrument is held and guided in one hand and used to treat the patient with the other hand. Such endoscopes may be either rigid or flexible.

[0003] Current implementations of rigid endoscopes have significant limitations with regard to visualizing the patient's body cavity during the procedure. For example, the current implementation of rigid nasal endoscopes does not allow for the removal of difficult-to-reach sinus tissue. Rigid endoscopes do not allow for direct visualization of the area to be removed or cauterized in areas that are difficult to reach. Inability to directly insert into the frontal sinus or to adequately visualize the medial inferior maxillary sinus cavity Removal of laryngeal tissue and foreign bodies, as well as tissue from patients with nasopharyngeal stenosis, is also difficult when visualization is not possible. This is difficult because it is insufficient and difficult to reach the desired anatomical sites. Additionally, visualization with an angled rigid endoscope often distorts the surgeon's perspective and can be difficult in small cavities. Use in conjunction with secondary instruments such as forceps is cumbersome.

[0004] As a result, ear, nose and throat (ENT) physicians typically perform all No direct visualization of maxillary sinus tissue removal. Working in areas that are difficult for sinus instruments to reach The rigidity of the endoscope and the angle of visualization can be an obstacle for surgeons when attempting to perform Even when angled rigid endoscope visualization is available, surgeons are still at a disadvantage. Furthermore, particularly in children, simply placing multiple devices simultaneously over the nostrils or sinus openings is not an option. Sometimes there isn't enough space to insert it.

[0005] Similarly, the implementation of flexible endoscopes at present presents its own challenges. Some flexible endoscope systems currently in use have microinstrument channels that are integrated into the entire length of the flexible endoscope. In such systems, the size of the tool is not obvious. The diameter of the endoscope channel limits the tool options available for endoscopic tissue manipulation. For example, a typical ear, nose and throat (ENT) flexible nasopharyngoscope is Although it may be used to visualize around the corners of the cavity, grasping forceps, laser, balloon, cautery The surgical instrument does not have a channel for accommodating an instrument or other appropriately sized surgical tool.

[0006] Conversely, a thin flexible endoscope can be inserted into a channel that is attached to the outside of a larger instrument or shaft. It is also difficult to pass the flexible endoscopes used for this purpose. These flexible endoscopes are difficult to stabilize and have weak fibers. Currently available To use a flexible endoscope, both hands are needed, and one hand is used to operate the bending part at the tip and the other is used to operate the endoscope. Use your other hand to stabilize the tip in your nostril. For example, Botox and / or Radeis The current method for oral laryngeal administration of se® HydroxyLappetite Paste is These methods involve a flexible nasopharyngoscope in the nose and a separate needle injector, and that they are operated in a way that is difficult for doctors to use and uncomfortable for patients. If the physician wishes to perform a biopsy, cauterization, or injection under the guidance of a flexible endoscope, The hand in the nostril must not be removed to activate a second instrument, balloon, cautery, or aspirator. It is necessary. Summary of the Invention

[0007] The implementations described herein allow the endoscope to be attached to the handles and / or tools of a variety of different instruments. An endoscope and an attachment mechanism improved to be removably attached to a tool portion Further implementations described herein relate to hybrid flexible-rigid designs. The present invention relates to the design of instruments that can be coupled to the described flexible-rigid endoscope or other endoscopes. A further implementation described herein is a removably connected to the control box using a cable connector. The present invention relates to a lightweight and flexible endoscope system design, including an endoscope that can be connected to a surgical instrument.

[0008] In some embodiments, the endoscope has a rigid proximal end, allowing the endoscope to be attached to the handle of an instrument. a rigid proximal attachment segment for releasably connecting to the proximal portion; and a flexible distal end for insertion into a body cavity of a patient to image the body cavity. Thus, the endoscope may include a tapered transition between a rigid proximal end and a flexible distal end.

[0009] In some implementations, there are metal bands spaced along the length of the distal flexible segment. A metal band may be used to protect the distal soft segment and / or to protect the distal The soft segment may be for magnetically coupling to a tool portion of the instrument.

[0010] In some implementations, the rigid proximal end may consist of a rigid proximal attachment segment and a distal non- and a rigid proximal attachment segment. It may include a plurality of longitudinally spaced slots for releasably connecting to an instrument. These slots are to be inserted into the ridges of the attachment mechanism of the instrument. The rigid proximal attachment segment is adapted to releasably connect the endoscope to the instrument. In some implementations, the proximal attachment segment may also include a plurality of longitudinal grooves. The tube has a rectangular or circular cross section.

[0011] In some implementations, the proximal attachment segment releasably couples the endoscope to the instrument. The twist lock mechanism includes one or more protrusions for locking the locking mechanism.

[0012] In implementation, the endoscope includes a lens and a light source positioned at the tip of a flexible distal tip. wherein the light emitter illuminates the cavity and the lens collects the light reflected by the cavity. The lens and light source are connected to a rigid proximal end, along with an eyepiece or camera mount. It may also include Assam bristle.

[0013] In one implementation, the endoscope includes a housing adjacent a rigid proximal end, the housing including an illumination device. A housing that contains a light source (e.g., one or more LEDs) and a connector adjacent to the housing. The endoscope is connected to a connector cable that connects the endoscope to a control box. and a connector, the control box including a battery pack, an image sensor, and a W Contains one or more of the IFI modules.

[0014] Depending on the implementation, the rigid proximal end has a longitudinal length of 10 cm to 20 cm and a diameter of 0.5 cm. The flexible distal end has a longitudinal length of 2.5 cm to 15 cm and a thickness of 2.5 cm to 2 cm. and has a thickness of 1mm to 4mm.

[0015] In another embodiment, the endoscope system includes an endoscope having a flexible distal end and a rigid proximal end. The endoscope is removably connected to the endoscope at both the rigid proximal end and the flexible distal end of the endoscope. In this embodiment, the rigid proximal end of the endoscope is detachably attached to a handle portion of the instrument. The flexible distal end of the endoscope may be removably coupled to the tool portion of the instrument. For example, the handle portion of the instrument may be coupled to a handle mechanism as described herein. and / or Alternatively, the tool portion of the instrument may be configured as described herein with a handle portion detachable to a rigid proximal end. The nucleic acid may include a variety of means for coupling to a function.

[0016] In some implementations, the instrument may include a chamber positioned above the working portion of the handle portion of the instrument. a tubular housing that is fitted over the rigid proximal end of the endoscope; activating a retractable internal protrusion which engages one or more longitudinally spaced slots of the The device includes a depressible button that

[0017] In some implementations, the rigid proximal end includes longitudinally spaced slots and at least one and a handle portion of the instrument aligned with the longitudinally spaced slots. The elongated channel (tube) has ridges spaced apart to engage the longitudinal grooves. and a retractable internal bar for

[0018] In some implementations, the rigid proximal end of the endoscope is fitted with a proximal attachment that includes a twist lock mechanism. the twist lock mechanism includes one or more projections; and The instrument includes a slotted instrument channel that receives the protrusion.

[0019] In some implementations, the tool portion of the instrument is a flexible distal tip of a hybrid flexible-rigid endoscope. The loop includes a loop that engages with the

[0020] In some implementations, the flexible distal end may include metal or The tool portion of the instrument includes a magnetic band and is made of metal or An instrument shaft having a magnetized segment is included.

[0021] In some implementations, the tool portion of the instrument has a series of clips that attach to a flexible distal end. The instrument shaft includes a

[0022] In some implementations, the tool portion of the instrument is a distal portion of the instrument into which the flexible distal tip of the endoscope is inserted. It includes one or more elongated tubes spaced along the shaft.

[0023] In some implementations, the endoscope system further includes an attachment having first and second channel grooves. a removable insert, the first channel groove being adapted to be attached to an instrument shaft of an instrument; and the second channel groove is attached to a flexible distal end of an endoscope. The removable insert may further be adapted to deliver at least one of a suction or an irrigation. The hollow channel includes one or more hollow channels configured as follows:

[0024] In some implementations, the instrument is a syringe gun that includes a gun handle, a syringe, and an injection needle. and the rigid proximal end of the endoscope removably connects to the upper portion of the gun handle.

[0025] In some implementations, the device is a Eustachian tube dilator that includes a balloon cannula of hollow tubing. wherein the flexible distal end of the endoscope is removably attached to the distal portion of the hollow balloon cannula. are concatenated.

[0026] In some implementations, the instrument is a balloon dilator and the rigid proximal end of the endoscope is adapted to extend beyond the distal end of the instrument. It is removably connected to the balloon pump handpiece.

[0027] In some implementations, the device is an endoscopic transoral or transnasal esophageal balloon dilator, a handpiece and a hollow tube extending from the handpiece, the hollow tube including a balloon catheter The rigid proximal end of the endoscope receives the distal end of the catheter and is removably connected to the handpiece.

[0028] In one embodiment, the endoscope system includes an endoscope and a cable connector for connecting the endoscope. and a handheld control box that can be removably coupled to the endoscope. a rigid distal end, a rigid proximal end, and a housing adjacent the rigid proximal end, a housing including a seat; and a connector adapted to removably couple to a first end of the cable connector. The portable control box of the system may include a second end of the cable connector. The handheld control box may be connected to a power source for powering the endoscope and a The imaging device may include an image sensor that collects light captured by the imaging device, and a network interface. stomach.

[0029] Other features and aspects of the disclosed technology are described in detail below and may be implemented by the disclosed technology. The features of the invention will become apparent when taken in conjunction with the accompanying drawings, which illustrate, by way of example, the following figures: In short, there is no intent to limit the scope of any invention described herein, which is set forth in the claims. The scope of the invention is defined by the scope of the claims and their equivalents.

[0030] All combinations of the aforementioned concepts (unless such concepts are mutually exclusive) are within the scope of this It should be recognized that these are contemplated as being part of the inventive subject matter disclosed in the specification. In particular, all combinations of subject matter recited in the claims appearing at the end of this disclosure. are contemplated as part of the inventive subject matter disclosed herein.

[0031] The present disclosure, in accordance with one or more implementations, will now be described in detail with reference to the following drawings, in which: is provided for illustrative purposes only and the implementations depicted are merely examples. Additionally, for clarity and simplicity of illustration, elements in the figures have not necessarily been drawn to scale. Note that this is not included.

[0032] Some drawings included herein show various implementations of the disclosed technology from different viewing angles. The accompanying legend refers to these views as "top view," "bottom view," or "side view." Although references may be made to the Unless expressly stated, it is not intended to imply that the disclosed technology is to be implemented or used in any particular spatial orientation. or is not required. [Brief description of the drawings]

[0033] [Figure 1] FIG. 1 is a perspective view of an implementation of a flexible-rigid hybrid endoscope including a square proximal attachment segment. [Diagram 2] FIG. 2 shows a side view of the flexible-rigid hybrid endoscope of FIG. [Diagram 3] FIG. 13 is a perspective view showing another flexible-rigid hybrid endoscope including a circular proximal attachment in accordance with an implementation of the present disclosure. [Figure 4] FIG. 1 is a perspective view showing a flexible-rigid hybrid endoscope including a rectangular proximal attachment segment in accordance with an implementation of the present disclosure. [Diagram 5] FIG. 5 shows a side view of the flexible-rigid hybrid endoscope of FIG. [Figure 6] FIG. 13 is a perspective view showing another flexible-rigid hybrid endoscope including a square proximal attachment segment in accordance with an implementation of the present disclosure. [Figure 7] FIG. 1 is a perspective view showing another flexible-rigid hybrid endoscope in accordance with an implementation of the present disclosure. [Figure 8] FIG. 13 is a perspective view illustrating a laryngeal forceps instrument including a top-down ratchet attachment mechanism to which an endoscope may be coupled, in accordance with an implementation of the present disclosure. [Figure 9] FIG. 9 shows a side view of the laryngeal clamp instrument of FIG. 8. [Figure 10] 9 shows a perspective view of the laryngeal clamp instrument of FIG. 8 including an attached endoscope. [Figure 11] FIG. 1 is a perspective view showing a flexible distal end of an endoscope magnetically coupled to a tool portion of a laryngeal forceps. [Figure 12] FIG. 1 is a perspective view showing a flexible distal end of an endoscope magnetically coupled to a tool portion of a laryngeal forceps. [Figure 13] 1 is a perspective view showing a laryngeal forceps instrument in an implementation, the laryngeal forceps instrument including a curved open channel with one or more clips to which a flexible distal end of an endoscope may be coupled. [Figure 14] 14 shows a side view of the laryngeal clamp instrument of FIG. 13; [Figure 15] FIG. 1 is a perspective view showing a flexible distal end of an endoscope coupled to a tool portion of a laryngeal forceps, the tool portion including an open channel with one or more clips for coupling to the flexible distal end. [Figure 16] FIG. 1 is a perspective view showing a flexible distal end of an endoscope coupled to a tool portion of a laryngeal forceps, the tool portion including an open channel with one or more clips for coupling to the flexible distal end. [Figure 17] 1 is a perspective view showing a laryngeal forceps instrument, according to an implementation, including a curved open channel with one or more elongated tubes to which a flexible distal end of an endoscope may be coupled. [Figure 18] 18 shows another perspective view of the laryngeal clamp instrument of FIG. 17; [Figure 19] FIG. 1 is a perspective view showing a flexible distal end of an endoscope coupled to a tool portion of a laryngeal forceps, the tool portion including an open channel with one or more elongated tubes for coupling to the flexible distal end. [Figure 20] FIG. 1 is a perspective view showing a flexible distal end of an endoscope coupled to a tool portion of a laryngeal forceps, the tool portion including an open channel with one or more elongated tubes for coupling to the flexible distal end. [Figure 21] FIG. 1 is a perspective view illustrating a laryngeal forceps instrument including a top-down ratchet attachment mechanism to which an endoscope is coupled, in accordance with an implementation of the present disclosure. [Figure 22] FIG. 1 is a perspective view illustrating a laryngeal clamp instrument including an insertable ratchet attachment mechanism to which an endoscope may be coupled, in accordance with an implementation of the present disclosure. [Figure 23] 23 shows another perspective view of the laryngeal clamp instrument of FIG. 22. [Figure 24] 23 shows a rear perspective view of the laryngeal clamp instrument of FIG. 22. [Diagram 25] 23 shows a perspective view of the laryngeal clamp instrument of FIG. 22 including an attached endoscope. [Figure 26] FIG. 1 is a perspective view illustrating a sinus forceps instrument including an insertable ratchet attachment mechanism to which an endoscope may be coupled, in accordance with an implementation of the present disclosure. [Figure 27] 27 illustrates another perspective view of the sinus forceps instrument of FIG. 26. [Figure 28] 27 shows a perspective view of the sinus forceps instrument of FIG. 26 including an attached endoscope. [Figure 29] 1 is a perspective view illustrating a laryngeal clamp instrument including an insertable twist mechanism to which an endoscope may be coupled, in accordance with an implementation of the present disclosure; FIG. [Diagram 30] 30 shows another perspective view of the laryngeal clamp instrument of FIG. 29. [Diagram 31] 13 illustrates the internal components of an insertable twist mechanism for connecting an endoscope to an instrument, according to an implementation of the present disclosure. [Diagram 32] FIG. 1 is a perspective view showing an injection syringe gun including a mechanism for coupling to an endoscope according to an implementation of the present disclosure. [Diagram 33] 33 shows another perspective view of the injection syringe gun of FIG. 32. [Diagram 34] FIG. 33 is a side view showing the injection syringe gun of FIG. 32 including an attached needle and endoscope in accordance with an implementation of the present disclosure. [Diagram 35] FIG. 33 is a perspective view showing the injection syringe gun of FIG. 32 including an attached needle and endoscope according to an implementation of the present disclosure. [Diagram 36] 1 is a perspective view showing a needle including a ring for securing a distal end of an endoscope that may be used with an injection syringe gun in accordance with an implementation of the present disclosure. [Figure 37] FIG. 1 is a side view showing an injection syringe gun coupled to an endoscope and suction and irrigation lines in accordance with an implementation of the present disclosure. [Figure 38] 38 shows a perspective view of the injection syringe gun of FIG. 37. [Figure 39] 1 is a perspective view illustrating a needle that may be used with an injection syringe gun in accordance with an implementation of the present disclosure. [Diagram 40]1 illustrates an aspiration line and irrigation line assembly that may be coupled to the distal end of an instrument and endoscope in accordance with an implementation of the present disclosure. [Diagram 41] FIG. 1 is a perspective view illustrating another injection syringe gun including an associated endoscope in accordance with an implementation of the present disclosure. [Diagram 42] FIG. 1 is a perspective view illustrating an endoscopic Eustachian tube balloon dilator including an insertable ratchet mechanism for coupling to an endoscope, according to an implementation of the present disclosure. [Diagram 43] FIG. 43 is a perspective view showing the endoscopic Eustachian tube balloon dilator of FIG. 42 coupled with an endoscope and a balloon catheter according to an implementation of the present disclosure. [Diagram 44] FIG. 43 is a perspective view showing the endoscopic Eustachian tube balloon dilator of FIG. 42 coupled with an endoscope and a balloon catheter according to an implementation of the present disclosure. [Diagram 45] FIG. 43 is a side view showing the endoscopic Eustachian tube balloon dilator of FIG. 42 coupled with an endoscope and a balloon catheter in accordance with an implementation of the present disclosure. [Diagram 46] FIG. 13 is a perspective view illustrating a removable insert that may be used to couple an endoscope to a distal end of an instrument, according to an implementation of the present disclosure. [Figure 47] 47 shows another perspective view of the removable insert of FIG. 46. [Figure 48] FIG. 1 is a perspective view showing a balloon hand pump to be used during endoscopic tracheal, sinus or esophageal balloon dilation according to an implementation of the present disclosure. [Figure 49] 49 shows another perspective view of the balloon hand pump of FIG. 48. [Figure 50] 49 shows another perspective view of the balloon hand pump of FIG. 48. [Figure 51] FIG. 49 is a side view of the balloon hand pump of FIG. 48 including an associated endoscope and tracheal balloon expansion assembly. [Figure 52] FIG. 49 is a side view of the balloon hand pump of FIG. 48 including an associated endoscope and balloon expansion assembly. [Figure 53]1 illustrates a stopper that may be used with an endoscopic tracheal dilator in accordance with an implementation of the present disclosure. [Figure 54] 1 illustrates a balloon expander assembly in accordance with an implementation of the present disclosure. [Figure 55] 1 illustrates an expansion tracheostomy tube in accordance with an implementation of the present disclosure. [Figure 56] FIG. 1 is a perspective view illustrating an endoscopic transesophageal balloon dilator to which an endoscope may be coupled, in accordance with an implementation of the present disclosure. [Figure 57] 1 shows a balloon catheter that may be used with an endoscopic transesophageal balloon dilator in accordance with an implementation of the present disclosure. [Figure 58] FIG. 1 is a perspective view illustrating an endoscopic transesophageal balloon dilator to which an endoscope may be coupled, in accordance with an implementation of the present disclosure. [Figure 59] FIG. 59 is a perspective view showing the endoscopic transesophageal balloon dilator of FIG. 58 coupled with an endoscope according to an implementation of the present disclosure. [Figure 60] FIG. 1 is a perspective view showing an endoscopic transesophageal balloon dilator coupled to an endoscope, according to an implementation of the present disclosure. [Figure 61] 61 shows another perspective view of the endoscopic transoral esophageal balloon dilator connected to the endoscope of FIG. 60. [Figure 62] 41 illustrates an alternative location for irrigation and suction ports within the connector of the suction line and irrigation line assembly of FIG. 40. [Figure 63] FIG. 13 is a perspective view of another flexible-rigid hybrid endoscope that includes a lever-type, top-down ratchet mechanism for attaching the endoscope to an instrument, according to an implementation. [Figure 64] FIG. 13 is a perspective view showing an implementation of a lever-type top-down ratchet mechanism. [Figure 65] 65 shows another perspective view of the lever-type top-down ratchet mechanism of FIG. [Figure 66] FIG. 65 is a schematic side view showing the lever-type top-down ratchet mechanism of FIG. 64 in a closed position. [Figure 67] FIG. 65 is a schematic side view showing the lever-type top-down ratchet mechanism of FIG. 64 in an open position. [Figure 68] FIG. 13 is a side view illustrating another endoscopic Eustachian tube balloon dilator coupled to an endoscope and a balloon catheter in accordance with an implementation of the present disclosure. [Figure 69] FIG. 1 is a side view showing an implementation of a charge-coupled device flexible-rigid hybrid endoscope. [Figure 70] 7 shows an implementation of a cable that can be detachably connected to the endoscope of FIG. 69, and a portable control box that can be communicatively connected to the endoscope using the detachable cable. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0034] These drawings are not exhaustive and therefore the disclosure may not be construed to be in the precise form disclosed. It is not limited to that.

[0035] As mentioned previously, current endoscopic implementations require the use of other instruments during the procedure. Rigid endoscopes are not flexible enough to effectively visualize a patient's body cavities. Flexible endoscopes may not be effectively stabilized or easily used in combination with other medical instruments. In many cases, it is difficult for the endoscope to visualize the tissue being grasped or removed. Therefore, in hard-to-reach areas, such procedures are performed blindly, resulting in tissue removal. In addition, the physician must simultaneously operate and align the endoscope and the instrument. Combining these factors can be tricky.

[0036] To this end, implementations of the present disclosure include improved hybrid flexible-rigid designs for endoscopes. and a simplified mechanism for releasably attaching and detaching an endoscope to a variety of different instruments. Further implementations described herein include coupling to the flexible-rigid endoscopes described herein. The present invention relates to a novel design of instruments that can be used to remove larynx and sinus forceps, laryngeal ... Head Syringe Gun, Endoscopic Eustachian Tube Balloon Dilator, Endoscopic Tracheal Dilator and Endoscope Transoral esophageal balloon dilators are included.

[0037] As will be further appreciated from the implementation described below, the endoscope designs described herein are This can provide a variety of benefits to both the surgeon and the patient. For example, the endoscope can be removably connected to the instrument. By providing a rapid, simplified and reliable mechanism for connecting the The endoscope designs described herein can save physicians and patients time. The endoscope design can be adapted to be removably coupled to a variety of different instrument types. However, this may provide additional cost savings and convenience. The described design allows physicians to use a single-handed endoscope with a variety of different instruments to perform procedures on patients. In some cases, this may allow for the assistance of a second person to assist with the procedure. More surgeries could be performed in the doctor's office, eliminating the need for a medical professional, The costs of various procedures may be reduced.

[0038] Additionally, the endoscope designs described herein provide a method for inserting endoscopes and instruments into body orifices (e.g., The device and endoscope are inserted simultaneously, eliminating the need for separate insertion into the nose or throat. Reducing the overall profile of the catheter may improve patient comfort. The endoscope design described in this document is designed to allow for access to previously difficult-to-reach areas such as the nasopharynx, frontal sinus, premaxillary sinus, base of tongue, and others. The present invention may improve surgical access, visualization, and instrumentation in difficult anatomical sites. These and other advantages that may be realized through implementations of the described techniques will become more apparent from the following description. It can be recognized by others.

[0039] 1-2 show an implementation of a flexible-rigid hybrid endoscope 100 according to the present disclosure. As shown in FIG. 1, the endoscope 100 includes an eyepiece 110, a connection portion 120 for a light source, and a rigid A proximal end 130, a flexible distal end 140, and an objective lens 15 disposed at the end of the distal end 140. During operation of the endoscope 100, a light source (e.g., For example, an optical fiber cable) emits light, which is transmitted by one or more optical fibers (not shown). It may be conveyed distally and emitted at the distal end (e.g., end 140) of endoscope 100. For example, The emitted light may illuminate the internal cavity of the patient. The light reflected by the internal cavity of the patient may be , which is collected by the objective lens 150 and routed closer to one or more optical cables (not shown). 110 and / or a camera, an image of the interior cavity is generated. An optical cable used to carry light emitted at the distal end of the endoscope 100, and / or or carries light collected from the objective lens 150 to generate an image at the proximal end of the endoscope 100. The optical cable used for may be enclosed by ends 130 and 140 or may not otherwise be It may be wrapped.

[0040] In the example of FIG. 1, the light is directed back to the eyepiece 110, which doubles the image. The eyepiece may include a control for adjusting the magnification and / or focus. A video camera unit that can be connected to a display monitor for displaying the video being recorded. (e.g., a unit including a CCD sensor). The source may be coupled to a video camera unit using a suitable adapter. Therefore, the video camera unit can stream the captured video to an external display device. The device may include a wireless transmitter (e.g., a WIFI transmitter) for wirelessly transmitting to the device. , video camera units, video, display for mobile devices, desktop The image may be transmitted to a mobile phone's display device or other suitable display device. In some implementations, the video camera unit replaces the eyepiece 110 entirely. In such an implementation, the video camera unit may be adapted to adjust the magnification, orientation and For example, the endoscope may include a control device for adjusting the optical fiber and / or the focus. Instead of a camera or eyepiece, a rigid or flexible camera housing a lens system or CCD sensor The tube may include:

[0041] In some implementations, endoscope 100 may include one or more light sources (e.g., in place of connector 120). For example, the light sources to be integrated may be light sources that emit different wavelengths of light (e.g., red, In some implementations, the endoscope 100 may be configured to emit a backlight. The device may include an integrated power supply such as a power strip.

[0042] The endoscope 100 has a proximal end 130 which is rigid and a distal end 140 which is flexible. The rigid structure of the 0 can provide stability and facilitate coupling of the endoscope with the instrument. Materials may include stainless steel, magnetic metals, plastics, ceramics, and others. The flexibility of the distal tip 140 allows the distal endoscope to bend to accommodate various instrumentation and anatomical configurations. The joint between the two ends may be tapered to allow for conformance to bending and bending angulation. 145, which can be both rigid and flexible. The transition 145 minimizes distortion. This can help prevent breakage of the optical fiber within the endoscope 100. The row 145 may be a segment of the proximal end 130 or the distal end 140 .

[0043] The length and caliper of the endoscope depend on the anatomical location, the desired application, and the size of the endoscope attachment. In a particular implementation, the distance from the eyepiece 110 to the distal end 1 The total length of the endoscope from the eyepiece 110 to the end of the eyepiece 110 may be 20 to 40 cm. The combined length of end 130 and end 140 that extends to the distal end may vary depending on the medical application. However, in at least some applications, it may be 15 to 35 cm. The length of the rigid proximal end 130 may be 10-20 cm, and the length of the flexible distal end 140 may be 10-20 cm. The length of the flexible portion 145 may be between 4 and 15 cm. The length of the flexible end 140 is about 8.5 cm, and the length of the rigid end 130 is about 15.5 cm. In implementation, the stiff proximal end 130 has a thickness in the range of 0.8 cm to 1.5 cm. (e.g., diameter), and the flexible distal end 140 may have a length in the range of 1.2 cm to 4 cm. In certain implementations, the tapered transition portion 145 may have a length may be 0.5 cm to 1.5 cm.

[0044] In this example endoscope 100, the rigid proximal end 130 is made up of two segments: a rigid proximal attachment segment for releasably connecting the endoscope 100 to an instrument; a stiff distal segment 131 that transitions to a distal end 140 at a transition 145; In the example of FIGS. 1-2, the proximal attachment segment 131 has a square cross section. The endoscope has a surface on which the position (and thus the position of the endoscope) is determined when the endoscope is removably connected to the instrument. has longitudinally spaced slots 133 that can be used to adjust the length of the For example, if the distance between adjacent slots 133 is 1 cm, The position of the endoscope 100 along the tool can be adjusted in 1 cm increments. In addition, the segment 131 includes a groove 134 extending longitudinally along the surface thereof. The combination with Slot 133 allows users to easily install the unit on various types and configurations of equipment. This may allow the endoscope to be configured and secured in a variety of circumferential and longitudinal positions. Depending on the implementation, consecutive slots may be separated by a distance between 0.1 cm and 3.0 cm. In a particular implementation, consecutive slots 133 are spaced apart by a distance between 0.5 cm and 2.0 cm. This may be done.

[0045] In implementation, the attachment segment consists of 1-12 slots and 1-12 In a particular implementation, the attachment segment may include an attachment segment. In the example of FIGS. 1 and 2, there may be 4 to 8 grooves spaced equidistantly around the periphery of the segment. The attachment segment 131 of the endoscope 100 is It has five slots and four grooves spaced equidistantly around the periphery. Five slots 233 and six grooves 234 extend longitudinally along the surface of the segment 231. Another exemplary endoscope 20 having a circular attachment segment 231 with a Indicates 0.

[0046] The flexible distal tip 140 is the distal end of the device that is inserted into a cavity (e.g., nose or throat) of a patient. As will be further explained with reference to the figures below, the distal end 140 is adapted to The endoscope 100 is flexible and can bend to fit the contours of the medical instrument. The flexible distal end 140 has magnetic metal bands 141 spaced along the length of its surface. A magnetic band 141 magnetically couples and secures the distal end 140 to the distal end of the instrument. The magnetic band 141 may be used to attach an internal optical fiber or Additional reinforcement may also be added to protect the optical components from distortion and damage. The end 140 may be positioned to retain its flexibility and maximum bending radius. The bands shall be made of a suitable ferromagnetic material such as iron, nickel, cobalt or alloys thereof. In other embodiments, the surface of the distal end 140 may include a continuous magnetic field along the length of the end 140. The magnetic material may be coated or otherwise covered with a magnetic material to prevent damage during use. In yet another implementation, the distal end 140 may be reasonably flexible and bendable. does not contain magnetic material, but instead has magnetic material contained on or within the device to which it is attached The distal end 140 may also include a metal band that connects to the distal end of the instrument. The connection may be made using any other attachment mechanism described in detail below. 3 shows an example 340 of a distal end of an endoscope 300 that does not include any magnetic material, such as

[0047] In various implementations, the flexible distal tip 140 is covered by a protective flexible outer sheath (not shown). The sheath may be sterilized prior to the medical procedure depending on the application needs. In implementations where the end 140 has magnetic material along its surface (e.g., a magnetic band 141), A sheath may cover the magnetic material, and a magnetic field generated by the magnetic material passes through the sheath. Optionally, it may be strong enough to couple and secure distal end 140 to the distal end of the instrument.

[0048] FIG. 69 illustrates an implementation of a charge-coupled device (CCD) flexible-rigid hybrid endoscope 200. The endoscope 2000 has a rigid proximal end 2030 and a flexible distal end 20 40. The rigid proximal end 2030 removably couples the endoscope 2000 to an instrument. The proximal attachment segment 2031 is rigid for the insertion of the endoscopic catheter 200 and the transition portion 2045 is flexible. and a rigid distal segment 2032 transitioning to a distal end 2040. The optic segment 2031 includes a square cross section and has a surface on which the endoscope is attached to the instrument. Can be used to adjust its position (and thus its length) when releasably connected The segments 2031 further include longitudinally spaced slots 2033. The support 2031 includes a groove 2034 extending longitudinally along the surface thereof.

[0049] The endoscope 2030 may include an illumination device (e.g., an LED module) at its proximal end. and a housing 2020 for connecting the endoscope to a control box. 030 and a connector 2010 that can be removably coupled to the 030. 2, a portable device that can be connected to the connector 2010 of the endoscope 2000 using a connector cable 2100. A band control box 2200 is shown. In the example shown, the connector 2010 is a female The connector cable 2100 is an ODU cable, and the end 2110 of the connector cable 2100 is a connector 2010 2100 is a male ODU cable that couples to A male USB cable connects to the control box 2200. However, the endoscope 2 A variety of suitable connector types (e.g. , a type suitable for transferring high-resolution image data in real time) can be used. For example, USB 3.x connectors, USB TYPE-C connectors, etc. connector, THUNDERBOLT connector, HDMI 1.x or 2.x connector In implementation, the length of the connector cable 2100 may be as long as The control box 2200 and the endoscope 2000 may be adjusted based on factors such as the spacing between the control box 2200 and the endoscope 2000, etc. For example, the length of the connector cable 2100 may be 1 meter, 2 meters, , 3 meters, 5 meters and others.

[0050] In this example, the control box 2200 includes a battery pack that provides power to the endoscope 2000. , control board, network interface (e.g. WIFI board), image sensor (e.g. For example, CCD or CMOS chips) and other components that may be used to operate the endoscope 2000. For example, the LED light source may house one or more of the following components: The mirror is contained within the housing 2020 while all other components are housed within the control box. The control box may be housed within the storage 2200. (for communication with mobile devices such as smartphones, laptops or tablets) It may also be linked to a Noh ceremony.

[0051] A cable 2100 is used to removably connect the endoscope 2000 to the control box 2200. This configuration may optimize or improve the ergonomics of the endoscope 2000. For example, During the procedure, the physician can wear the handheld control box 2200 on his belt or carry the control box 220 0 may be placed in a pocket or other convenient location. This design also reduces the weight of the endoscope. And separation of the cable allows the endoscope and cable to be sterilized separately. Such designs are ideal for ERs, third world countries, NASA, EMTs, and ENTs. This can be practical in clinics and surgical suites. and cameras are housed or attached to the endoscope itself. This is in contrast to the current bulky WiFi endoscopes. These current endoscopes are not suitable for surgical procedures. It can be too heavy and difficult to handle.

[0052] In an alternative implementation, the cable 2100 may be placed onto a surgical video tower unit. It may also be connected to a non-WiFi hardwired control box.

[0053] Attachment mechanism for flexible-rigid hybrid endoscope

[0054] As alluded to above, the flexible-rigid hybrid endoscope described herein is capable of detecting a variety of different The two main attachment points to various types of medical devices are the rigid proximal end and For example, a rigid proximal attachment may be used to removably couple the distal end of the catheter to the proximal end of the catheter. The handle segments 131, 231, 331, 431, and 530 can be detached and attached to the handle of the device. Additionally, depending on the type of instrument and tool, a flexible distal end 14 may be attached to the instrument. 0, 340 is a flexible distal end objective lens for inserting an instrument tool (e.g., into a patient's cavity for treatment) The distal surface or distal end of the instrument is aligned proximally to the distal end of the instrument component that performs the The objective lens may be removably connected to the end and along its contour. The device provides adequate visualization of the instrument tools and the patient cavity while performing a procedure on the patient. obtain.

[0055] Providing a quick, safe and / or simple mechanism for releasably connecting an endoscope to an instrument For such attachment mechanisms that may be configured to do so, see FIGS. The present disclosure relates to the specific attachment mechanisms described and illustrated herein. Other mechanisms for releasably connecting a flexible-rigid endoscope to an instrument are also contemplated, without limitation. It should be noted that some attachment mechanisms are primarily Although described in the context of an endoscope (e.g., endoscope 100), the attachment The attachment mechanism described herein is assumed to be compatible with the attachment mechanism. It should also be noted that the present invention may be applied to other flexible-rigid endoscopes or variations thereof. Furthermore, the different attachment mechanisms described herein are not mutually exclusive. and thus they may be used together to the extent that they are interchangeable. For example, in some cases, multiple attachment mechanisms may be provided for the endoscope. may be used to attach the rigid proximal end to a handle portion of the instrument; and / or A plurality of attachment mechanisms are provided for attaching the flexible distal end of the endoscope to the tool portion of the instrument. It may also be used for

[0056] Magnetic attachment mechanism

[0057] In one implementation shown in FIGS. 1-6 and 8, the magnetic attachment mechanism is attached to an endoscope 10. 0 stiffness proximal attachment segments 131, 231, 331, 431, 530, Removable in a top-down manner into the open channel segment 625 of the tool housing 624 In such an implementation, the segment 625 (e.g., The surface of the open channel is magnetized and / or the rigid surface of the flexible hybrid scope is magnetized. The proximal attachment segment may be magnetized. This type of magnetic mounting may be used alone. Other specific attachment mechanisms may also be used as described and illustrated herein. It may also be used in combination with.

[0058] Top-down ratchet mechanism

[0059] 8 to 10, 13 to 14, 17 to 18, 21, 41, 48 to 52, and In some implementations, such as those shown in Figures 58-59, the rigid proximal attachment segment of the endoscope A top-loading ratchet mechanism is used to secure the device to the handle of the device. For example, as shown in Figs. 8 to 10, 13 to 14, and 17 to 18, The handle portion 620 of the instrument 600 houses the rigid proximal attachment segment 131. 624 into the elongated open channel 625 of the housing 624. The instrument housing 6 has an elongated open channel 625 for removably connecting down 24 may also be provided.

[0060] The inner surface of the instrument housing 625 is bounded by a contiguous rigid proximal attachment segment 131. The slots 133 are spaced apart at intervals corresponding to the spacing between the slots 133 (e.g., about 1 cm apart). During installation, the housing 6 24 is pressed and positioned against the inner surface of an open channel 625. The horizontal bar 628 may be retracted. When the bar 628 is retracted, the lip The screw 626 may be aligned with the slot 133 and inserted into the slot 133. By aligning the inner vertical ridges with the longitudinally spaced slots in such a manner, This fixes the endoscope and prevents it from moving back and forth. That is, when the ridges are inserted into the slots, the endoscope is guided upward and outwardly of the channel 625. To prevent movement, release button 622 so that bar 128 is no longer in contact with the attachment segments. The endoscope 100 may be secured in one of the longitudinal grooves 134 of the endoscope 100. (e.g., to rotate the endoscope along the instrument or move it back and forth) by pressing button 622 3 to lift the endoscope 100 and then insert it into the new slot 133 and / or groove 134. 134 may be pressed down to secure it to the ridges 626 and / or bars 628 .

[0061] Advantageously, the top-loading ratchet mechanism described herein allows the endoscope to be Provides a quick and easy means for fastening to the instrument. Removal and / or repositioning can be accomplished by simply pressing the button 622 so that the ridge 626 is in a particular slot. Lift (in case of repositioning) and push the endoscope 100 so that it is inserted into the set 133. All it takes is lowering it.

[0062] In certain implementations, the top-loading ratchet mechanisms described herein include: It may also be implemented as a lever-type top-down ratchet mechanism. The implementation of the above is shown in Figs. 21, 41, 58-59 and 63-67. Referring to FIG. 67, the flexible-rigid hybrid endoscope 1800 has a handle portion ( to a lever-type, top-loading ratchet mechanism 1810 that can be positioned on a It may be removably connected.

[0063] This top-loading ratchet mechanism 1810 is a rigid proximal attachment center. The inner segment is pushed down into an elongated open channel 1825 of the housing 1824. an elongated open channel 1825 for removably connecting to a top-down endoscope 1800; The instrument housing 1824 may include an instrument housing having a rigid inner surface. 1833 of the proximal attachment segment. The ridges 1826 may be spaced apart at intervals. In this implementation, actuation of a button 1822 located on the exterior of the housing 1822 A portion 1828 of the lever 1823 positioned inside the housing 1824 is For example, FIG. 66 shows the closed or unretracted position. 67 shows the lever 1823 in the open or retracted position. 66 to 67, the lever 1823 is connected to the button 182. 2 may be hinged with a pin 1829 that allows for this retraction when actuated.

[0064] FIG. 21 shows a lever-type top-loading latch integrated into the handle portion 920 of the device. 9 shows another exemplary instrument implementation 900 that includes a jet mechanism. In this example, pressing a button 922 This can release a lever 923 that is fixed in a longitudinal groove in the endoscope.

[0065] In an alternative implementation, a top-down ratchet mechanism is attached to the rigid proximal attachment of the endoscope. The slots of the segments are replaced with ridges, and the ridges of the instrument housing are placed in the slots. This may be implemented by replacing

[0066] In an alternative implementation, the rigid proximal segment of the endoscope is attached top-down to the handle of the instrument. Other attachment mechanisms may be used to releasably attach the device. For example, a rigid The proximal segment can be fitted with a clamp, screw-type turn, press fit, snap fit, friction fit, magnetic coupling, Attachment with a secondary device and / or other suitable means to securely hold the endoscope It may be attached by means of a

[0067] Insertion type ratchet mechanism

[0068] 22 to 28, 32 to 35, 37 to 38, 42 to 45 and 60 to 63. In some implementations, such as those shown at 61, the rigid proximal attachment segment of the endoscope is secured to the instrument. For example, a ratchet mechanism of the insertion type may be used to set the locking mechanism. Thus, the handle portion 1020 of the tool is provided with a handle that is positioned above the working portion of the handle portion. The housing 1021 may include a chamber 1022 having an opening and an exit opening. During installation, the endoscope 100 may include a channel 1023. During insertion, it can be positioned on the side of the endoscope (e.g., a square or round scope). Longitudinally spaced slots (e.g., slots 133, 233, 333) are positioned , etc.) are retractable internal projections 1024 that are actuated by a button 1022 on the outside of the housing. (e.g., spring-loaded protrusions). Once inserted into one of the spaced apart slots, the endoscope can be locked into place. .

[0069] Insertion type twist mechanism

[0070] In some implementations, such as those shown in Figures 7 and 29-31, the rigid proximal attachment of the endoscope An insert-type twist mechanism may be used to secure the segment to the instrument. For example, Referring to FIG. 7, a flexible-rigid hybrid endoscope 500 includes one or more series of projections. A proximal elongated rigid attachment segment 530 including a protuberance 533 (e.g., a metal protrusion) A housing 1221 on top of the handle or working portion 1220 of the device. The slotted instrument channel 1223 shown in FIGS. 29-31 is positioned The protrusion 533 may be accommodated during insertion of the speculum.

[0071] During insertion, the protrusion 533 can be inserted through the slot 1225 of the inner channel, thus The endoscope can be inserted to a desired length by inserting the protrusion 533 into the channel 1223. 1224 and twisting the endoscope to lock it into place. The endoscope can be locked into place by pressing the To do this, the user rotates the endoscope to position its outer projection 533 in the slot 1225. The endoscope may be withdrawn from the channel by aligning the endoscope with the twist lock. In this case, rotation may be required during the procedure (e.g. to realign the light cord and camera). It may be enabled through an arc of approximately 120 degrees allowing for scope rotation.

[0072] Attachment mechanism for the flexible distal end of an endoscope

[0073] As used herein, the flexible distal end 140, 340 of the hybrid endoscope is referred to as the distal end of the instrument (e.g. Several mechanisms for attachment to the tool tip (e.g., the tool end) are described. These exemplary mechanisms are not necessarily mutually exclusive and therefore should be considered depending on the type of equipment and the It is noted that depending on the application, different attachment mechanisms may need to be used. Additionally, the flexible distal end of the hybrid endoscope described herein can be subsequently It is also understood that other attachment mechanisms may be used in addition to the exemplary implementation detailed. It should be recognized.

[0074] As alluded to above, in one implementation shown in Figures 8-12, 21 and 25-31: for releasably connecting the flexible distal end 140 of the endoscope to the distal / tool ​​portion of the instrument; A magnetic attachment mechanism may be used. For example, the tool portion 610 or 111 of the instrument may be 0 includes a curved open channel 612 or 1112 for mounting the distal end of an endoscope. These examples may include an instrument shaft or instrument segment 611 or 1111. 1, the surface of the channel 612 or 1112 is magnetically coupled to the band 141 of the distal end 140. In such an implementation, the segments 611 or 1111 (e.g., open-ended The surface of the channel may be magnetized and / or the band 141 of the device may be magnetized.

[0075] In another implementation shown in FIGS. 13-16, the tool portion 710 of the instrument is a flexible An instrument shaft or instrument segment including a curved open channel 712 for attaching a distal end 711 and the distal end of the endoscope are spaced apart longitudinally along the channel. One or more clips 713 (e.g., metal clips) for semicircular retention; This implementation provides additional stability to the flexible distal end of the endoscope and may include This may be combined with a magnetic attachment implementation to prevent distal tip migration. The implementation may be such that the flexible distal end of the endoscope is not configured to magnetically attach to the distal end of the instrument. It may also be effective to secure the endoscope to an instrument clip or other attachment implement. To protect the delicate endoscopic fibers during insertion, gold strips are intermittently placed along the flexible distal end of the endoscope. The generic bands may be spaced apart.

[0076] In another implementation shown in Figures 17-20, the tool portion 810 of the instrument is An instrument shaft or instrument segment including a curved open channel 812 for attaching a distal end 811 and a distal end of the endoscope spaced apart longitudinally along the channel. and one or more elongated tubes 813 for circumferential retention. The mounting of provides additional stability to the flexible distal end of the endoscope and prevents movement of said distal end. This implementation may be combined with a magnetic attachment implementation to attach the flexible This is also effective when the distal end of the device is not configured to magnetically attach to the distal end of the device. obtain.

[0077] In another embodiment shown in Figures 34-36 and 41, the soft end of the endoscope is a series of loops 129 (e.g., metal loops) attached to a distal tool portion (e.g., a needle) of It may be advanced via

[0078] In another implementation shown in Figures 37 to 38, 40, 43 to 47 and 62, The removable hard or soft reusable or disposable inserts 1333 are attached to each distal end of the instrument. It may be possible and / or necessary to accommodate the length, curvature and shape of the shaft. The removable insert may be customized with two channel grooves 1334 and and 1335, which correspond to the instrument shaft below groove 1334 and the groove, respectively. 1335 on the flexible (and some rigid, depending on implementation) aspects of the hybrid endoscope Acts as an elongated clasp that is fixed (or vice versa depending on the design and application of the device) Within the walls of such an insert, aspirators 1336, 57 or irrigators 1337 may be provided. , 56 (FIGS. 40 and 62) through which the distal endoscope, lens or instrument tool components can be inserted. The catheter may incorporate one or more hollow channels through which fluid may be delivered to the component. For example, Figures 37-38 and 40 may be mounted adjacent to the insert 1333. The figure depicts the suction line 1338 and irrigation line 1339 that are connected to the suction line 1338 and irrigation line 1339. To minimize leakage, the irrigation and suction lines converge at junction 1341. , one that extends from the removable insert to a point away from the handle or proximal portion of the instrument 13, resulting in a smaller caliper double line 1340 acting as the line.

[0079] For each of the attachment mechanisms at the flexible distal end of the endoscope, the mounting is attached to the instrument shaft. The flexible tip of the endoscope is stabilized along the end point, allowing proper alignment of the patient's internal cavity and the instrument tool. To aid in alignment of the tip for visualization and to prevent further advancement of the endoscope As shown in FIG. 62, the ring may include a small hollow ring or cap 55 for The gasket / cap mechanism protects the tip of the scope from secretions, blood or other debris encountered during medical procedures. Suction and / or irrigation ports 56 to help remove other debris that may be encountered , 57 may be incorporated.

[0080] Equipment

[0081] The flexible-rigid endoscope implementations described herein can be attached to a variety of different instruments, which are detailed below. The devices described herein are only examples. The tool portion of the instrument to which the endoscope described in the specification can be connected includes a grasper, a cutter, a bite forceps, Scissors, balloons, needle injectors, cautery tools, lasers, curettes, culture tools, suction tools, Includes any number of surgical tools such as microdebriders, snares, staplers, fasteners, etc. This may also be the case.

[0082] Further, in some implementations, the devices described herein may include the novel rigid- It should be noted that in addition to flexible hybrid endoscopes, other endoscopes may also be coupled. It is.

[0083] laryngeal forceps

[0084] In some implementations, the flexible-rigid endoscopes described herein are coupled to a laryngeal clamping device. 8 to 25 and 29 to 30 show such implementations. The catheter portion or shaft may be inserted through the patient's mouth, down the throat, and into the patient's laryngeal cavity. For example, the blade 619 of the laryngeal forceps 600 is aligned near the tissue that needs to be removed. The blade 619 of the forceps 600 may be positioned just in front of the lens 150 of the endoscope 100. Alignment allows the physician to properly align the blade and laryngeal cavity when the blade contacts the tissue. Thus, the physician can visualize the tissue being grasped by the blade 619. While viewing the surgical procedure or cutting, the handle 629 of the forceps 600 can be actuated.

[0085] Sinus forceps

[0086] In some implementations, the flexible-rigid endoscopes described herein are coupled to a sinus forceps instrument. 26-28 show such an implementation. During use, the tool portion or the shank of the instrument may The forceps 1100 may be inserted through the nostrils into the patient's sinuses. The sinus 1119 may be positioned near the tissue within the maxillary sinus that needs to be removed. The blade 1119 of the cavity forceps 1100 is positioned immediately in front of the lens 150 of the endoscope 100. This allows the physician to properly visualize the blade and the sinuses as the blade contacts the tissue. Thus, the physician may be able to control the grasping or cutting of tissue by the blade 1119. While viewing the cross section, the handle 1029 of the sinus forceps 1100 can be actuated.

[0087] Laryngeal Syringe Gun

[0088] Injection syringe gun 130 for endoscopic injections (e.g. vocal cord injections) performed in the clinic An example of the implementation of the syringe gun 1300 is shown in FIG. The outer portion includes a gun handle 1345 for holding the instrument, a trigger mechanism 1357, and an inner An endoscope attachment mechanism 1346 and one or more needles for routing a needle 1353. The inside of the syringe gun 1300 may include a number of grooves or channels 1354. A syringe 1352, a connector 1355, and a clip 1356 for holding the syringe 1352. , wheel 1358, band 1359, plunger 1360, and rubber stopper 136 1.

[0089] As shown in FIGS. 36 and 39, the injection needle 1300 is used with a syringe gun 1300. 53 accommodates the shape and contours of the syringe gun 1300 and the flexible distal end of the endoscope. The needle 1353 may be a pre-bent or malleable needle configured to During setup, the syringe 1352 and The needle 1353 is inserted into a series of clips 1356 that push the syringe into the syringe. The syringe gun 13 is inserted into a groove 1354 formed in the upper portion of the syringe gun. 00. The syringe 1352 contains the local anesthetic hydroxyl Appetite paste or needle tip 1351 is injected into the treatment site (e.g., vocal cords) It may also be filled with any other liquid or substance that is suitable for use.

[0090] Once the syringe and needle are in place, the flexible-rigid hybrid scope is used for endoscopic examination. Even if the mirror attachment mechanism 1346 is inserted into the gun handle, In the examples shown in FIGS. 34 to 35 and 37 to 38, the endoscope may include a gun 130. 0, the endoscope attachment mechanism 1346, the insertion type ratchet mechanism described above, In the example shown in FIG. 41, the endoscope is attached to an endoscope that is a part of the gun. 21. The endoscope attachment mechanism includes a top-down ratchet mechanism as described above with reference to FIG. The endoscope is attached in the same way as the syringe gun. A stenting mechanism may be used. The flexible distal end 1348 of the endoscope is fitted with a needle shaft 1349. The curvature of the needle tip 135 is measured by an objective lens 1350 positioned at the end of the flexible distal end 1348. 1. The flexible portion of the scope may be traced to be closely aligned with the In one embodiment (e.g., FIGS. 34-36), a series of metals are attached to the manufactured needle 1353. The distal end of the scope may be attached to the needle as previously suggested. Other implementations for inserting the needle into the submucosal tissue are also envisioned. In the illustrated configuration, the needle tip 1351 is inserted into the submucosal tissue. Direct visualization of the needle tip during entry was achieved via an attached hybrid flexible-rigid endoscope. This can be made possible.

[0091] When all components of the syringe gun 1330 are assembled, the syringe gun: With the endoscope docked, it can be held and aligned with one hand while simultaneously using the other hand The trigger mechanism 135 may be used to stabilize and extend the tongue or perform some other task. 7, when activated, a thin, firm, flexible band or belt 1359 (e.g., The rotating mechanism may rotate one or two circular wheels 1358 connected to a metal band. At the distal end of the band (after going around the second wheel on the side), the band is attached to the needle At the end opposite the catheter, a rubber stopper 1361 is assembled into the syringe 1352. Diametrically opposed and aligned in contact with a cylindrical metal plunger 1360 (FIG. 37) Each time the trigger is depressed, the plunger 1360 moves a predetermined distance. 1352 into the syringe, thereby removing the rubber stopper 1361 in the syringe 1352. is moved proximally, thereby forcing a predetermined amount (e.g., about 0.1 cc) of material into the needle tip 1. 351 is dispensed to the injection site (eg, laryngeal tissue).

[0092] One or both of the wheels 1358 around which the bands turn may be motorized, or The teeth 136 interact with perforations 1365 along the length of the band 1359 to prevent slippage. 4. Band 1359 fits into narrow stabilizing groove 1362 in the handle of the syringe gun. The groove 1362 may pass through the hard plastic or machined surface of the handle piece 1364. In practice, the upper portion of the syringe gun 1300 may be made of a stainless steel material. Directly below the syringe needle and endoscope attachment, there is a The vehicle may also include a battery compartment housing one or more batteries (for powering the motor). good.

[0093] After use, the syringe 1352 and needle 1353 may be discarded, thus eliminating the need for a syringe. The syringe 1300 may be reused with a new syringe and needle during a subsequent procedure. Mechanically actuated injection mechanisms are also envisioned.

[0094] Endoscopic Eustachian Tube Balloon Dilator

[0095] The flexible-rigid hybrid endoscope described herein is adapted to view the Eustachian tube, paranasal sinuses, trachea, and any number of balloon catheter devices, including those used for dilating esophageal strictures. Current balloon expansion devices on the market are This requires the surgeon to separately insert a balloon dilatation catheter and an endoscope into the body cavity. This requires two hands to control two devices simultaneously and is This is problematic because it can increase the number of device profiles that can be used.

[0096] 42-45 and 68 show a removable endoscope as described herein. An exemplary embodiment of the present invention improves upon these conventional designs by providing a mechanism for coupling. 1 shows a vascular Eustachian tube balloon dilator 1400. As shown, the dilator 140 0 includes a housing 1467 for inserting an endoscope and a balloon catheter 1468. Balloon cannula 1466 (rigid, semi-rigid, malleable or soft) of hollow tubing for insertion and the cannula 1466 has a distal segment 1472. In this embodiment, the housing 1467 may be fixedly connected to the cannula 1466 or may be removable. The hybrid endoscope 1447 may be coupled to a proximal opening 1467 of the housing 1467. In the illustrated example, the housing 1469 may be inserted through In another implementation, the endoscope includes a ratchet mechanism for securing the endoscope as described above. Other mechanisms may be used to secure the endoscope to the dilator. For example, the top A down-type ratchet mechanism may be utilized (FIG. 68).

[0097] A stopper 1470 positioned along the shaft of the balloon catheter secures the sheath The present invention provides an easy grip for advancing the balloon through the balloon catheter and A separate hard or soft connector 1333 may be provided to limit the degree of advancement. The distal flexible segment of the endoscope is then fitted to the curved distal segment of the balloon cannula 1466. The illustrated dilator may be used to fixate the device to the nasal cavity 1472. One-handed, one-instrument operation maximizes space utilization, patient comfort, and surgeon dexterity Currently available paranasal sinus balloon catheters, such as the Accla Rent Aera (registered trademark) was also hybridized in the same manner as shown in Figs. It may also be adapted for attachment to a dososcope.

[0098] Endoscopic tracheal dilator

[0099] Occasionally, patients require elective or emergency ventilation in association with accidental tracheostomy tube dislodgement. If the tracheostomy tube is accidentally removed (extubated), The stoma tube often constricts, thus preventing reinsertion of the tracheostomy tube. Forcible attempts to reinsert the tube can result in trauma, bleeding, airway compromise, and sometimes the tube can penetrate the skin. into the soft tissue tract below and outside the tracheal lumen, potentially resulting in patient death. At present, the established method used for dilating tracheostoma stenosis is tapered bougie dilatation. Unfortunately, these bougie dilators (e.g., Cook et al. (Trademark) Medical, Blue Rhino (R)) blocks the airway during passage, This causes respiratory distress and increases patient anxiety. Proper alignment of the dilator cannot be visually confirmed.

[0100] 48-55 show how the operator can adjust the placement of the balloon expander 1477 within the tracheal stoma and tracheal lumen. An example implementation of an endoscopic tracheal dilator that allows for visual confirmation of correct alignment prior to inflation The dilator is a hybrid flexible-rigid endoscope with a balloon pump and handpiece. A top-down ratchet mechanism 1535 for releasably connecting to the base 1573. The mechanism 1535 may operate similarly to the top-down ratchet mechanism described above. For example, this may be the spacing between successive slots in the rigid proximal attachment segment of the endoscope. The recessed portion 1532 may include spaced ridges 1536 that may be spaced apart at intervals corresponding to the spacing of the recessed portion 1532. During attachment, button 1522 locks into a groove in the rigid proximal attachment segment of the endoscope. In this example, the top down bar can be actuated to retract. Although a ratchet-type attachment mechanism is shown, other mechanisms may be used to allow the endoscope to attach to the instrument. For example, the insert-type ratchet mechanism discussed above may be used. This is also fine.

[0101] When the balloon pump handpiece 1573 is activated, the balloon pump handle 1 Air or gas is supplied through a flexible tube 1575 which connects to a connection 1576 at the base of 573. The device may include a pump handle 1574 for pumping liquid (e.g., water or saline). The pressurized air or fluid then exits the pump handle connector 1576 at the base of the flexible A distal end 1574 is circumferentially attached to a hollow inner cannula 1578 via a tube 1575. Pressure can be transmitted to the pump handle 1573 (e.g., as shown in The pressure may be measured by a pressure gauge 1590 incorporated in the stomach.

[0102] Directly below the pressure gauge is a button 1591 that, when activated, can release pressure from the balloon. The hollow inner cannula may have an opening 1583 (FIG. 54) at its proximal end. Preferably, the flexible distal end of the hybrid endoscope is inserted through this opening 1583 and The distal tip may be advanced until it exits the distal portion 1579 of the hollow inner cannula. The distal end of the scope, contained within an empty inner cannula 1578 and balloon 1577, Through the tracheal stoma (the soft tissue area between the integument and the anterior tracheal wall) until the lumen of the trachea is visualized. Proper alignment of the inner cannula within the trachea is confirmed. The endoscope may then be withdrawn so that the patient can continue to walk through the hollow inner cannula 1578. You can keep breathing.

[0103] In this example, the high pressure balloon dilator is external to the hollow inner cannula 1578. The patient then holds the hollow inner cannula while the balloon is inflated by actuating the pump handle. The patient can continue to breathe safely through the balloon 1577. to help stabilize the balloon and prevent inadvertent advancement of the balloon or cannula inside the airway. To prevent over-pressing, a small removable stopper 1584 (Figs. 51-53) is provided. A small curved soft spring 1585 may be fitted over the hollow inner cannula 1587. The stopper clamp may be aligned to allow for expansion of the stopper clamp. When 586 are tightened together, a spring is activated, removing stopper 1584 from the cannula. The flexible tube can be attached to the coupling at the base of the handle. Before inserting the tubing into the tracheostomy tube, insert a separate tracheostomy tube into the tracheostomy tube so that the tubing passes completely through the lumen of the tracheostomy tube. Bubs 1582 and 1595 may be advanced over the tubing.

[0104] For this implementation, a #4 tracheostomy tube may be used, but with soft tubing and Any tracheotomy tube with an inner diameter small enough to accommodate the bore of the empty inner cannula. Once the stoma is dilated with the balloon, the stopper clamp 1584 is removed. 2, so that the tracheostomy tube extends beyond the soft tubing and inner cannula and is extended. The tube may then be advanced through the stoma into the tracheal lumen. The slits may be fixed in place.

[0105] A dilation tracheotomy tube 1595 for this purpose is shown in FIG. The tube 1595 may be used independently or to connect the stoma to the initial balloon inflation. It may also be used to expand the catheter beyond the diameter provided by the catheter. For example, This is required if a larger diameter #6 or #8 tracheostomy tube is required The dilatation tube has two separate balloons on its shaft, i.e., the distal The distal balloon 1580 and the proximal balloon 1581 may be The 1580 has a low-pressure cuff similar to that of cuffed tracheostomy tubes already on the market. This distal balloon / cuff is typically advanced to a point within the tracheal lumen and then Similar to standard tracheotomy designs, the device can be inflated via the low pressure inflation port 1588. When inflated, the distal cuff protects the airway by creating a seal against the tracheal wall. It may function to protect against

[0106] The proximal balloon 1581 remains adhesive in its uninflated state and is secured to the tube 15. 82. The tube may be a high pressure balloon that may be flush with 82. When advanced through the recently dilated stoma (along with the proximal and distal balloons), the proximal The high pressure balloon may be inflated to a larger diameter via inflation port 1589. This increases the diameter of the tracheostoma. When the tracheostoma is maximally dilated, the proximal Rune 1581 may be deflated and the double balloon tube removed, thus A larger diameter, more conventional tracheostomy tube could be inserted in its place. This is called upsizing the tracheostomy tube and is used in neonates or those with adequate artificial ventilation. of insufficient size or diameter to provide respiratory support or tracheal / pulmonary hygiene This may be beneficial for chronically ventilated patients with smaller tracheostomy tubes.

[0107] Endoscopic transesophageal balloon dilator

[0108] Patients with swallowing difficulties secondary to cervical esophageal stenosis or chronic cricopharyngeal spasm may require esophageal dilation. Esophageal dilation is rarely performed in a clinic setting and is almost always performed in a gastrointestinal setting. The procedure is performed under sedation by an enterologist. Esophageal dilation is usually performed using esophagogastroduodenoscopy ( EGD is sometimes necessary, but is performed as often as the patient requires dilation. This is especially true in patients with conditions that occur following radiation therapy or chronic laryngopharyngeal reflux. This is true for patients who may require multiple dilations over time. The procedure consisted of sequential esophageal catheterization using incrementally sized bougie catheters and esophageal balloon catheters. May involve expansion.

[0109] 56-61 are views of a novel endoscopic transoral esophageal balloon dilator system according to the present disclosure. The system is implemented in a clinical environment under endoscopic guidance and with anesthesia or Simple, low-cost, safe, and may be performed without the need for a concomitant EGD procedure Another implementation, not shown, is a transoral balloon esophageal dilation. Similar in concept to the dilator may be an endoscopic transnasal esophageal balloon dilator.

[0110] Referring to FIGS. 56 to 59, an endoscopic transoral esophageal balloon dilator as shown in the drawings The system 1600 includes a flexible-rigid hybrid that is removably coupled to a handpiece 1693. The lid includes an endoscope 1692. The handpiece 1693 may be disposable or reusable. In the example of FIGS. 56 to 59, the hand piece 1693 is connected to the endoscope 16 Lever-type top-down ratchet attachment to accept a stiff proximal end of 92 The mechanism 1699 includes a lever-type top-down ratchet mechanism as previously discussed. For example, mechanism 1699 may be attached to the rigid proximal endoscope. 1698, a ridge to accept the slot of the attachment segment, and a button 697. The endoscope may include a lever that can be retracted from the channel of the endoscope by pressing 697. FIG. 61 shows another example of an attachment mechanism - an insert type ratchet mechanism 1799. This is a method to connect the handpiece 1793 of the endoscopic transoral esophageal balloon dilator system to the rigid endoscope. The mechanism 1799 may be used to releasably couple to the proximal end of the It may be similar to an insert-type ratchet attachment mechanism. In other implementations, other attachment mechanisms may be used. By using the endoscopic mechanism, the flexible-rigid hybrid endoscope according to the present disclosure is capable of performing endoscopic transoral esophageal It may be releasably connected to a balloon dilator system.

[0111] From the handpiece 1693 comes a hollow tube which may be rigid, malleable or soft. The hollow tube 1694 may extend from the distal end of the catheter. The diameter of the hollow tube 1694 is approximately equal to that of a thin, flexible balloon catheter. The catheter may be flexible enough to accommodate the catheter 1695 therein. 1695 may have an inflatable balloon 1696 at its distal end. In its unexpanded state, it can be advanced through a hole 1697 in the side of the handpiece. Flexible balloon catheters have a balloon that extends beyond the distal end of a hollow tube. The flexible end of the hybrid endoscope may be long enough to allow the user to extend the 46-47, insert a removable hard The endoscope may be attached by a rigid or flexible insert. As it advances from the distal end into the cervical esophagus, the balloon 1696 and the balloon catheter 169 5. A small marker on the catheter proximal to the balloon may be used to visualize the King used endoscopy to determine the appropriate distance to insert the catheter into the esophagus prior to balloon inflation. The tracheal catheter as shown in Figures 56 to 61 may be used to help estimate the The Lune Pump Handpiece may also be adapted for use with an esophageal dilator. and may facilitate one-handed operation.

[0112] The endoscopes, attachment mechanisms and instruments described herein are generally used in the otolaryngology (ear, nose and throat) field. Although described in connection with surgical applications in the general medical field (ENT, nose and throat, ENT), the present disclosure It should be noted that endoscopes need not be limited to these applications. For example, The endoscopes described herein are useful in the treatment of various conditions, including general surgery, gastroenterology, pulmonology, urology, plastic surgery, and the like. In other surgical and medical specialties such as neurosurgery and orthopedic surgery, surgical staplers are used The technology disclosed herein may also be used in commercial, non-surgical applications such as surgical rings. Other applications are also possible.

[0113] Although the above has been described in connection with various exemplary implementations and implementations, it is understood that any one of the individual implementations may be modified without departing from the spirit or scope of the present invention. The applicability of various features, aspects and functions described herein or further herein is not to be construed as limiting the scope of the present invention. These are not limited to the specific implementations described, but may be used alone or in various combinations. to one or more of the other implementations of the application, whether or not such implementations are mentioned and whether or not such features are presented as part of the described implementation. It should be understood that the present application may be applied to any device, device, or method. should not be limited by any of the exemplary implementations described thus far.

[0114] All combinations of the aforementioned concepts (unless such concepts are mutually exclusive) are within the scope of this It should be recognized that these are contemplated as being part of the inventive subject matter disclosed in the specification. In particular, all combinations of subject matter recited in the claims appearing at the end of this disclosure. are contemplated as part of the inventive subject matter disclosed herein.

[0115] As used throughout this disclosure, including the claims, the terms "substantially" and "about" refer to It is recognized that the method is used to describe and explain slight variations in the nature of For example, these terms should be used to refer to conditions such as ±2% or less, ±1% or less, ±0.5% or less, etc. It can refer to ±5% or less, such as ±0.2% or less, ±0.1% or less, ±0.05% or less, etc. do.

[0116] To the extent applicable, the terms "first," "second," and "third" are used herein. Terms such as, etc., are merely used to distinguish the individual objects described by those terms. These are used to denote entities other than those specified in this specification. Unless otherwise specified, they are not intended to have a chronological meaning.

[0117] Terms and phrases used in this document, and variations thereof, unless otherwise stated Insofar as this is the case, it should be interpreted as open-ended and not restrictive. The term "including" shall not be read as meaning "including without limitation" or the like. The term "example" should be used to refer to several instances of the item being discussed. used to provide a comprehensive or exclusive list of Instead, the indefinite articles "one" and "a" mean "at least one," "one or more" or the like, and "conventional ", "traditional," "general," "standard," "known," and other adjectives of similar meaning. A term with the sign "is a given item during a given period of time or at a given point in time." should not be construed as limiting to items currently available, but instead conventional, traditional, commonly used, or commonly available technology that may be available or known at any time now or in the future. or standard technology. Although reference is made to techniques that would be apparent or known to one of ordinary skill in the art, Such techniques include those now or at any time in the future that are apparent or known to those skilled in the art. This includes techniques.

[0118] "One or more," "at least," "but not limited to" in some instances The presence of expansive words and phrases such as "not specified" or other similar phrases shall not be construed as limiting the scope of this In instances where such broader language does not exist, the narrower case is intended or The term "module" should not be construed to mean that it is required. Use is subject to all of the components or functionality described or claimed as part of the module. It does not imply that they are organized in a common package. In fact, Any or all of the components may be control logic or other components. Regardless, they can be combined into a single package or kept separately. Yes, and in multiple groupings or packages, or multiple locations It is possible for the data to be distributed over a range of

[0119] Moreover, various implementations described herein may be illustrated in the form of example block diagrams, flowcharts, and the like. This description is provided in conjunction with the accompanying drawings and other figures, which will be apparent to those of ordinary skill in the art upon reading this document. However, the illustrated implementations and their various alternative implementations are limited to the illustrated examples. For example, block diagrams and the accompanying description may be implemented without the need for a particular structure. It should not be construed as mandating the construction or configuration of any

[0120] Although various implementations of the present disclosure have been described above, it should be understood that these implementations are presented by way of example only. It should be understood that the various figures are illustrative and not limiting. may represent exemplary structures or other configurations, which are not intended to be encompassed by this disclosure. The disclosure is provided to aid in understanding possible features and functions. The present invention is not limited to any particular structure or configuration, and the desired features may be implemented in various alternative structures and configurations. Indeed, those skilled in the art will appreciate that the present disclosure may be implemented using the same techniques and configurations as those described herein. How alternative functional, logical or physical divisions and configurations can be used to implement the features of the It will be apparent that the present invention can be implemented in many other ways than those shown in this specification. Different configuration module names can be applied to various partitions. The steps presented herein in conjunction with the flow diagrams, operational descriptions and method claims. The order of the types is the order in which the various implementations are listed, unless the context indicates otherwise. There is no requirement that the functions be implemented in the same order.

Claims

1. 1. A Eustachian tube dilator system, comprising: a housing for removably inserting an endoscope, the housing including an insert-style ratchet mechanism or a top-down style ratchet mechanism for coupling to a rigid proximal end of the endoscope; a hollow balloon cannula coupled to and extending distally from the housing, the hollow balloon cannula having a curved distal end configured to couple to a flexible distal end of the endoscope, the hollow balloon cannula configured for insertion of a balloon catheter used for Eustachian tube dilation such that a distal balloon of the balloon catheter advances through the hollow balloon cannula from a proximal opening of the hollow balloon cannula to a distal opening of the hollow balloon cannula; 1. A Eustachian tube dilator system comprising:

2. 2. The Eustachian tube dilator system of claim 1, wherein a proximal portion of the hollow balloon cannula extends distally below the housing, the proximal portion including the proximal opening for receiving the balloon catheter.

3. 10. The Eustachian tube dilator system of claim 1, further comprising a connector configured to removably secure the flexible distal end of the endoscope to the curved distal segment of the hollow balloon cannula.

4. 4. The Eustachian tube dilator system of claim 3, wherein the connector comprises a first channel groove that couples to the flexible distal end of the endoscope and a second channel groove that couples to the curved distal segment of the hollow balloon cannula.

5. 2. The Eustachian tube dilator system of claim 1, wherein the housing comprises the insertable ratchet mechanism, the insertable ratchet mechanism comprising a closed channel including a first opening on a proximal side of the housing and a second opening on a distal side of the housing.

6. 6. The Eustachian tube dilator system of claim 5, wherein the insertable ratchet mechanism further comprises a retractable internal protrusion configured to engage a slot extending perpendicular to the longitudinal direction of the endoscope to lock the endoscope in place, the retractable internal protrusion configured to be actuated by an external housing button.

7. 2. The Eustachian tube dilator system of claim 1, wherein the housing comprises a top-down ratchet mechanism integrated into an upper side of the housing, the top-down ratchet mechanism including an elongated open channel for removably connecting the endoscope in a top-down manner.

8. The top-down ratchet mechanism includes: longitudinally spaced ridges for receiving slots extending perpendicular to each longitudinal axis of the rigid proximal attachment segment of the endoscope; and a retractable internal protrusion disposed on an interior surface of the open channel for engaging a longitudinal groove of the rigid proximal attachment segment of the endoscope.

9. The Eustachian tube dilator system of claim 1 , wherein the hollow balloon cannula is removably coupled to the housing.

10. The Eustachian tube dilator system of claim 1 , wherein the hollow balloon cannula is fixedly coupled to the housing.

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