Conductive optical elements

Abstract

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

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims the benefit of U.S. Patent Application No. 14 / 728,812, filed on Jun. 2, 2015, which is hereby incorporated by reference in its entirety.

Background Art

[0002] Minimal and less invasive surgeries (or surgical procedures) and interventional therapies for patients are generally safer, faster, and less traumatic for the patient. Thus, these procedures are associated with a reduction in inflammation, postoperative pain, infection risk, and healing time compared to more invasive forms of surgery, including general surgery and open - bloodletting therapy.

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

[0004] Various scopes are used when it comes to remote visualization of the inside of a patient's body. The scope used depends on the type of surgical instrument used in the procedure and the degree of invasiveness appropriate for the type of procedure, when the physician needs to navigate inside the body. For example, visualization of the gastrointestinal tract may involve the use of endoscopy in the form of flexible gastroscopes and colonoscopes and specialized duodenal scopes that can be tens of feet long and have a diameter exceeding 1 centimeter. These scopes can be rotated, integrated, or manipulated by the physician as the scope is navigated through the patient. Many of these scopes include one or more working channels for passing and supporting (or supporting, support) instruments, fluid channels and irrigation channels for irrigating tissue and the scope, ventilation channels for improving navigation and visualization, and one or more light guides for illuminating the scope's field of view.

[0005] Small, inflexible, or rigid scopes, or scopes that combine flexibility and rigidity, are also used in medical applications. For example, when examining joints and performing arthroscopic surgery (e.g., shoulder or knee surgery), smaller, narrower, and much shorter scopes are used. When a surgeon is using arthroscopy to repair a meniscus tear in the knee, a shorter, stiffer scope is inserted through a small incision on the opposite side of the knee to visualize the damage while instruments are passed through an incision on one side of the knee. Inside the knee, instruments can be cleaned to maintain visualization and to manipulate the tissue to complete the repair.

[0006] Other scopes can be used for diagnosis and treatment using less invasive endoscopic procedures, including, but are not limited to, the use of scopes in examination and treatment situations in the lungs (bronchoscope), mouth (colonoscope), urethra (cystoscopy), abdomen and abdominal cavity (laparoscope), nose and sinuses (laryngoscopy), anus (sigmoidoscopy), chest and thoracic cavity (thoracoscopy), and heart (cardioscope). Furthermore, robotic medical devices rely on scopes to remotely visualize the area being evaluated and treated by the robotic device.

[0007] The above-mentioned scopes and other scopes may be inserted through natural openings (e.g., mouth, sinuses, ears, urethra, anus, and vagina), through the patient's skin, cavities, skull, joints, or other medically appropriate insertion sites. Examples of endoscopic diagnosis using the above-mentioned medical scopes include diagnosing or diagnosing symptoms of gastrointestinal diseases (e.g., nausea, vomiting, abdominal pain, gastrointestinal bleeding) or diagnosing them (e.g., diagnosing anemia, bleeding, inflammation, and cancer by biopsy), or performing surgical procedures for diseases (e.g., removal of a ruptured appendix or cauterization of gastric bleeding).

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

[0009] Additional devices are used in conjunction with remote visualization devices to treat or repair in medical and non-medical procedures. For example, in medical applications, it is common to use separate devices such as graspers to manipulate and shift tissue to obtain different views, and to use a third device to cauterize or excise tissue in the case of bleeding or disease, and in such cases, this approach can be effectively treated. These devices may be used through different access points such as separate incisions or ports, or through working channels designed for specific scopes such as colonoscopes.

[0010] There is a need to improve the overall visualization and manipulation of tissues and other materials by adding more therapeutic and restorative capabilities for use with scopes and other optical elements. [Overview of the Initiative]

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

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

[0013] The device can be detachably positioned within a remote visualization device. Alternatively, the device can be designed as a permanent element of a remote visualization device, such as a scope.

[0014] Optical imaging elements may be configured to move away from or into tissue or other materials to reduce liquid (or fluid), debris, and particulate matter, and to manipulate and shift tissue or other materials (including manipulating and realigning tissue to conform to a desired shape or incision). Conductive coatings may be configured to generate sufficient energy to alter tissue or other materials. One or more conductive coatings may be applied to the device to form a single electrode for altering tissue or other materials. Conductive coatings may be applied to the device in multiple patterns to form multiple electrodes for altering tissue or other materials in multiple ways. Alterations to tissue or substance may include, for example, activation and curing of adhesives and other chemicals or formulations, which are activated by effects related to ablation, cobbling, cauterizing, molding, sealing, incision, debriding, resecting, cutting and coagulation of tissue, evaporation of blood or fluids, and the delivery of energy to manipulate or alter substances.

[0015] Areas of the conductive coating may be at least partially optically transparent. Optically transparent areas may be positioned to overlap with structures and other materials that are manipulated and excited. Depending on a given power source and intended application, the conductive coating may have a thickness of half a micron or less, or other such thicknesses, to produce a specific change in structure or material. The conductive coating may not be insulating, or may be partially or completely insulating by another material, including one or more dielectric (or insulating) coatings or materials.

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

[0017] Optical couplers (or optical couplers, or optical coupling devices) and / or their connectors and power supplies may have one or more feedback elements for determining the degree of change in tissue or material. These feedback elements may include one or more temperature sensors, thermocouples, or other elements for measuring one or more forms of energy change, influence, or effect when applied to tissue or other material.

[0018] In another embodiment, the method includes the steps of bringing at least a portion of a tissue or material into contact with an optical element and applying energy to a coating on the optical element to alter the portion of the tissue or material. The tissue or material is altered by conducting energy over or through the portion of the tissue or material using the coating on the optical element as an electrode for delivering energy.

[0019] Altering tissue or other material may include heating, cauterizing, shaping, sealing, incision, excision, wound cleaning, cutting, joining, coagulation, coblation, ablation, or contact with tissue or material by energy delivered through or via a coating. Applying energy may include applying bipolar power through or across the surface of an optical element. Contact with tissue or material may include joining, coagulating, sealing blood vessels in tissue, or contact with tissue or material by energy delivered by a coating on an optical element.

[0020] One or more coatings used on an optical element may have different water contact angles, making it easy to transform the optical element into an element with different properties (including coatings with water contact angles that result in hydrophilic, hydrophobic, and superhydrophobic properties). One or more coatings may also have anti-reflective properties that reduce or minimize light reflection in the scope's field of view, and other modifications of the coatings may have scratch resistance and other hardness properties to protect the optical element. The coatings may be conductive and transparent.

[0021] Embodiments of the optical element may include the ability to clean (or irrigate) tissue or substance, and the ability to inject one or more drugs, adhesives or other compounds into a target area for excitation and manipulation by the device. In another embodiment, the scope is a means for observing inside the body.

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

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

[0024] Another aspect includes an assembly having an image capture (or capture) device having a viewing end, a positioning assembly (or positioning assembly) for supporting the viewing end, a conductive surface (or conductive surface) disposed on the viewing end and configured and arranged to transmit energy across the viewing end, and a power connection configured to supply energy to the conductive surface. The positioning assembly may include an elongated member configured to be inserted through a restricted aperture. The positioning assembly may also include a control unit coupled to an end of the elongated member opposite the viewing end.

[0025] The image capture device may be configured to convey a liquid to the viewing end. The image capture device may include, for example, a working channel (or groove, or flow path, channel). The working channel may be configured to convey a liquid.

[0026] In another aspect, the conductive surface may be optically transparent. Also, the conductive surface can overlap or conform to the tissue.

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

[0028] The advantages of the aspect include: (i) improved visualization in liquids, debris (or fragments), and blood; (ii) the ability to turn the scope into a therapeutic device by delivering energy to a target area through the optical elements on the scope, eliminating the need for separate instrument exchanges to deliver energy to tissue or other substances; (iii) the ability to provide anti-fogging ability for the lens; (iv) the ability to maintain visualization through the application of energy, thereby controlling energy delivery for treating narrow to wide areas of substances and tissues without losing sight of the target area; (v) the ability to use a working channel in certain variations of the device to supply complementary devices such as a grasper while maintaining the ability to supply energy simultaneously; and (vi) other benefits including improved procedures in medical applications such as diathermy (or high-frequency therapy), electrocautery, electro-surgery, biopsy, ablation, coblation, fogging reduction, as well as improved procedures in non-medical applications such as pipeline inspection and repair by remote visualization. The above and other features and advantages of the aspects of the present disclosure will become more readily apparent to those skilled in the art by considering the following detailed description and the accompanying drawings that describe both preferred and alternative aspects of the present disclosure.

Brief Description of the Drawings

[0029] [Figure 1] Figure 1 is a cross-sectional side view of a device of one aspect of the present invention, including an optical coupler attached to the distal end of an endoscope. [Figure 2] Figure 2 shows a cross-sectional side view of the optical coupler of Figure 1. [Figure 3] Figure 3 shows a rear cross-sectional elevation view of the optical coupler of Figure 1. [Figure 4] Figure 4 shows another cross-sectional view of the device of Figure 1. [Figure 5] Figure 5 shows a cross-sectional view of a device of another aspect of the present invention. [Figure 6] Figure 6 shows another cross-sectional view of the device of Figure 5. [Figure 7]Figure 7 shows another cross-sectional view of the device shown in Figure 5. [Figure 8A] Figure 8A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 8B] Figure 8B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 8C] Figure 8C shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 9A] Figure 9A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 9B] Figure 9B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 10] Figure 10 is a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11A] Figure 11A shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11B] Figure 11B shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 11C] Figure 11C shows a cross-sectional view of a device according to another embodiment of the present invention. [Figure 12] Figure 12 shows a schematic diagram of a device according to another embodiment of the present invention. [Figure 13] Figure 13 shows another embodiment of the present invention, which has a catheter that supplies energy from a power source to a connector in the device. [Modes for carrying out the invention]

[0030] The aspects of this disclosure are described in full below. In fact, these aspects can be implemented in many different forms and should not be construed as being limited to the aspects described herein. Rather, these aspects are provided to satisfy the legal requirements to which this disclosure applies. As used herein and in the appended claims, the singular forms “a or an” and “the” refer to multiple subjects unless otherwise explicitly indicated by the context. The terms “comprising” and its variations as used herein are used synonymously with the terms “including” and its variations and are non-restrictive terms.

[0031] Despite the many advantages associated with using image capture devices to improve visualization, including remote visualization, the inventors have identified significant problems with these technologies that need improvement for diagnosing and treating patients in medical settings, or separately for examining and correcting conditions in non-medical applications. Image capture elements are easily obscured by liquids, debris, and particulate matter that can obscure visualization. Furthermore, image capture elements may rely on instruments and other elements to provide treatment, correct, manipulate, and repair the object.

[0032] In non-medical applications, non-invasive inspection and repair of remote areas and defects in non-medical fields (whether sewer lines, hydraulic lines, oil pipelines, gas lines, or other non-medical fields) is generally preferable to opening up the area more invasively for inspection and repair, as it allows for inspection and / or repair with less damage and intrusion.

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

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

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

[0036] Generally, the inventors have found that these instruments need to be advanced, retracted, and exchanged through incisions, ports, working channels, or other access points. This approach means that the right instrument is not always readily available when needed. For example, in laparoscopic surgery, while the doctor makes small incisions in the tissue to access the treatment point, a blood vessel may be severed, causing bleeding. The doctor may not have a cauterizing or vascular sealing instrument in one of the ports used to advance and retract instruments within the patient for the procedure. If bleeding occurs, the doctor retracts one of the instruments and inserts a cauterizing or vascular sealing device (called a device exchange) to locate the bleeding site and stop it while the bleeding continues. Due to the time it takes to complete the device exchange, the bleeding area may become filled with blood, obscuring the location of the bleeding. Furthermore, during this time, the scope may become covered or clouded with blood, debris, or other fluids, causing additional problems that complicate the discovery and treatment of the bleeding.

[0037] Similar limitations arise with scopes that have working channels. For example, when performing a colonoscopy and removing precancerous polyps to diagnose the presence of cancer, blood vessels may be inadvertently severed, potentially causing small amounts of gastrointestinal bleeding. To treat the bleeding, the physician must change instruments, withdraw the device from the working channel of a long, flexible scope (200 cm in length), and insert and advance the cauterizing device into the working channel of the scope. The location of the scope and bleeding must be confirmed (as the scope may shift), and cauterization must be attempted to address the bleeding. This attempt can be hindered by fluids, debris, and blood that obscure the visualization of the scope. In addition, the application of cauterization is very limited. This is because the cauterizing device is limited so as not to be wider than the diameter of the working channel within the scope, which is typically 2-3 millimeters. Thus, cauterization limitations from current devices are usually only a few millimeters wide, and with current technology, multiple cauterizations are required to treat longer, wider, or uneven bleeding areas.

[0038] This same set of problems and other issues also apply to the application of other scopes, including the treatment of upper gastrointestinal bleeding. Furthermore, other problems and limitations arise when scopes without working channels are applied, yet must advance at a certain distance from the user. For example, such problems arise in borescopes for non-medical applications as well as in certain medical applications of the ear, nose, and throat. These problems also apply to other applications that rely on the scope of visualization, such as robotic navigation and robotic surgery and treatment.

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

[0040] A key advantage of device 11 is that it allows for the application of energy to a target via a conductive coating while simultaneously enabling visualization of the target (e.g., body tissue or other material 200). This allows the user to observe changes in the tissue and other materials in real time as energy is supplied. For example, device 11 can supply power via a transparent conductive material 302 to cauterize the tissue 200 while simultaneously allowing direct observation of the tissue through the endoscope 72 and the optical elements on the endoscope.

[0041] As shown in Figures 1 to 4, in some embodiments, the optical element 10 may be an optical coupler of the type including a visualization section 12 at the distal end 14 and an attachment section 46 at the proximal end 48. In some embodiments, the optical coupler 10 is made of a transparent material and at least a portion thereof can cover the optical area of ​​the endoscope 72 below to clearly hold obscured debris in the body. The outer surface of the optical coupler 10 can also move fluids, blood, debris and particulate matter on the tissue being examined by the endoscope 72. Further details of the optical coupler are disclosed in U.S. Patent Application Publication No. 2013 / 0110097, filed on 17, 2019, which is incorporated herein by reference.

[0042] Referring again to Figure 4, the visualization section 12 includes an outer surface 16 that is distal to the proximal surface 22. In some embodiments, at least a portion of the visualization section 12 covers part or all of the optical area of ​​the endoscope 72. As shown in Figure 1, the outer surface 16 has a rounded convex shape. The outer surface 16 curves continuously, for example, across the second outer boundary 20 opposite to the first outer boundary 18 of the visualization section 12. In some embodiments, the outer surface may be convex but eccentric, concave and flat, or positioned at an angle to the optical lens of the endoscope. For example, the outer surface may be positioned at an angle inclined from or relative to the optical lens of the endoscope. A medical professional may advance the outer surface 16 in contact with tissue or other material 200 and maintain visualization for the design of the optical coupler. Furthermore, a medical professional may move liquids, blood, debris and particulate matter out of the field of view by bringing tissue or other material into contact with the optical coupler on the scope. This provides a better view of the underlying tissue or material for evaluation and treatment, including the transmission of energy through this device. The shape of the outer surface 16 may be traumatic.

[0043] In other embodiments, the device may have one or more channels for allowing the passage of the scope and instruments through the device, or for providing cleaning or ventilation (or air supply, insulation), or for exposing the optical guide of the scope to alter the performance of light over a range. For example, these channels may be hollow and pass through the outer surface of the device. The channels may also be self-sealing and therefore, when the channels are not in use, do not pass completely through the outer surface of the device to seal the channels. In other embodiments, there may be more than one channel. One channel may be aligned with the working channels of the scope and the device to allow instruments to pass through. Another channel may allow liquid and air to radiate from the scope and pass through the device. A third channel may allow liquid to be discharged from the liquid water on the scope into the working channels within the device, across the outer surface of the device.

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

[0045] In other embodiments, devices using more than one material may connect materials by adhesive or other chemical bonding, integral molding of materials, overmolding one material onto another, placement of mechanical connectors between or over the materials, or a combination thereof. The connection may also be made by coating one material onto the other, screwing one material onto the other, or by other means of connecting materials to one another, where at least one of the materials is a substrate for conductive coating.

[0046] As used herein, the term “transparent” is not necessarily limited to optically transparent. Instead, transparency may include the ability or property of energy waves to pass through, including infrared and / or ultraviolet light. Transparency also does not have to be limited to completely transparent, but instead may refer to some ability to facilitate or enable the passage of light rays (e.g., translucent).

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

[0048] As shown in Figure 4, the mounting section 46 may include a cylinder wall 50 extending from the proximal end 48 of the optical element 10. Generally, the mounting section 46 is configured to mate with the visualization section 12 to fix the visualization section 12 to the end of the endoscope 72 or other optical imaging device. For this purpose, the cylinder wall 50 is sized to define a hollow cylindrical opening 70 for pressing the distal end of the endoscope 72 or other fixed mating. It should be noted that the mounting section 46 may also include other structures for mounting and / or be fixed by welding, adhesive, screwing, mechanical connectors, interference between one or more materials and the optical imaging device, or other forms of connection between the device and the remote / optical imaging device. Also, the mounting section 46 does not have to be cylindrical and can be formed to match the shape of the distal end of various optical imaging devices or remote visualization devices. Alternatively, the mounting section may be shaped to facilitate other functions of the device, including shaping the sides and distal end to more effectively fit and manipulate tissues and materials. The shape and materials of the device can be selected to minimize device trauma when in contact with tissues and other materials. The device's visualization section can also be integrated into a remote visualization device.

[0049] As shown in Figures 1 and 4, the endoscope 72 includes a sheath 76 having a distal end and supporting an optical assembly. The sheath 76 is a generally elongated member configured to enter and extend through a passage to provide remote visualization of the body and other passages. In some embodiments, the endoscope includes some form of positioning (or positioning, or manual control) assembly attached to the proximal end of the sheath 76 so that an operator can operate the scope. In other embodiments, the scope is part of a robotic element that makes the scope maneuverable and positions it to a desired position, which examines and focuses the scope. The sheath 76 also includes a distal end 74, as shown in Figures 1 and 4, and extends to a cylindrical opening 70 of the optical coupler 10.

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

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

[0052] As shown in Figure 1, once the mounting section 46 is fixed, the cylinder wall 50 extends to cover the outer surface 78 of the distal end 74 of the sheath 76. The proximal surface 22 is in contact with the end surface 80 of the distal end of the sheath 76. The third lumen 104 is aligned with a hollow fixture receptacle (or receiving section) 40 defined in the visualization section 12 of the optical coupler 10.

[0053] As shown in Figures 1 to 4, the conductive material 302 can be applied in various configurations to create one or more electrode designs, depending on the desired effect on tissue and other materials. The electrode designs can be modified to suit the needs of other applications, such as creating a combination of capabilities for visualization elements that can prevent fogging (or clouding, or fogging) of remote visualization elements, or that can be intermittently or continuously heated to suppress or prevent fogging. The electrode designs can also address the ability of the conductive material 302 to rapidly increase energy transfer when it is necessary to contact and cauterize or excise tissue or other materials.

[0054] Heating optical lens components with a conductive coating allows for continuous heating that prevents significant temperature differences at the ends of the scope or optical element (the distal end is where cameras are often positioned and fogging is a problem). Temperature differences cause fogging, obscuring visualization through the scope or optical element. Furthermore, the materials of the optical coupler (e.g., silicone and polycarbonate) have insulating properties that promote anti-fogging. Anti-fogging can be achieved, for example, by heating the optical element to near body temperature. While not bound by theory, the inventors believe that temperature differences at the distal end of the scope cause the temperature around the end of the scope to rise, particularly in the range of about 95 to 110 or even 120 degrees Fahrenheit when certain heating devices such as harmonic scalpels are used. Thus, generally, anti-fogging applications are at power and temperature lower than cauterization or other tissue modification temperatures.

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

[0056] The conductive material may comprise transparent conductive oxides (TCOs), conductive metals such as platinum, polymers, or organic semiconductors, or other materials capable of conducting or transmitting energy across the device. The term “layer” refers to at least some areas of the conductive material 302 having a relatively uniform thickness and / or some areas using the method of application of the conductive material 302. For example, the conductive material may be formed or applied through dipping, vapor deposition (or deposition) coating, spraying, sputtering, ultrasonic application, brushing, painting, or other applications of the conductive material that can form layers or other patterns on an intended substrate. In some embodiments, the conductive material may have a uniform material thickness. In other embodiments, the conductive material may have varying thicknesses. The conductive material 302 does not need to have a precise thickness, and there are no areas that can vary continuously throughout. Instead, the thickness of the material can be varied according to the intended electrode function (e.g., a target level of resistance (and its variability) for the entire coating for a particular application).

[0057] Furthermore, conductive material 302 can be applied to form specific shapes (other than layers) for applying energy of different patterns and densities to the material. Conductive material 302 can also be applied non-layered, such as by forming it in a mold and then attaching it to an optical element by bonding, welding, or other means. Here again, the shape of conductive material 302 may correspond to a desired pattern of energy application by the conductive material, including a specific electrode design that includes connectors to the conductive material and conductive material 300.

[0058] In some embodiments, the conductive material layer is applied to the distal end 14 of the optical element so as to extend over a portion of the visualization section 12. In one embodiment, the portion of the visualization section 12 covered by the conductive material includes the entire distal outer surface region 16 on one side of the visualization section. However, the portion of the visualization section may include only a portion of the surface region on one side of the visualization section, or may include one or more gaps between multiple applications of the conductive material layer, depending on the desired electrode design and desired results. For example, the conductive material 302 may cover only a portion of the field of view of the objective lens 110 of the endoscope 72, or may be applied to a portion of the field of view, or may be outside the field of view. In other alternatives, the conductive material 302 may be applied in the form of patterns (stripes, stripes, dimples, voids, ridges, curves, circles, semicircles), irregular patterns, and other approaches for forming electrodes for the intended result of applying energy in the device 200.

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

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

[0061] Alternatively, a wire or other power transmission means may pass through a visualization section within the instrument receptacle 40 (not shown). The wire may be transmitted in another alternative manner, including the inductive transmission of current to the device or a battery embedded in the device. Power may be supplied by current from a battery, catheter, cable, radio waves, or other power transmission device, or by a manner that extends to a terminal or connector.

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

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

[0064] It should be noted that the optical element 10 (in the form of a coupler, lens, coupler or other attachment, or integrated as part of a scope) may be used in a range of different scopes or other image capture devices. Here, the term coupler more generally refers to an optical element mounted to cover a scope or integrated as part of a scope, or one that is integrally formed or mounted to a scope or other technology for capturing and transmitting images. As used herein, the term "coupler" refers to a separately manufactured and / or separately, later-attachable coupler, cap, or lens.

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

[0066] Furthermore, the term “endoscope” generally refers to any scope used for medical purposes (including on the body (human or other)), including laparoscopes, arthroscopes, colonoscopes, bronchoscopes, intestinal scopes, cystoscopes, laparoscopes, laryngoscopes, sigmoidoscopes, thoracoscopy, cardioscopes, and saphenous vein collectors with scopes, which may be robotic or non-robotic, and also includes scopes used for non-medical purposes, such as borescopes, videoscopes, flexoscopes, and fiberscopes, which may be robotic or non-robotic, and other scopes disclosed herein.

[0067] As used herein, the term “image capture device” does not necessarily refer only to a device having only a lens or other optically directional structure. Instead, for example, an image capture device includes (i) a lens between the objective lens and the eyepiece at the distal end of a scope, (ii) an optical fiber, (iii) a charge-coupled element (CCD), or (iv) a complementary metal-oxide-semiconductor (CMOS) sensor. An image capture device may also be merely a chip for sensing light and generating an electrical signal or other technique for transmitting an image for information corresponding to the sensed light. An image capture device may have an observation end where light is captured, and the conduction surface 302 may extend to cover a portion of the image capture element or may be applied in other manner away from the image capture element. In general, an image capture device can be any device capable of observing an object, capturing an image, and / or capturing video.

[0068] While one particular embodiment of an optical coupler has been described above, additional types of optical couplers may include several types of conductive materials applied thereto. For example, U.S. Patent Application Publication 2012 / 0209074, filed February 16, 2012, which is incorporated herein by reference, discloses several variations of optical elements to which conductive materials may be applied.

[0069] For example, Figure 5 of this disclosure shows another embodiment of the optical element 10 attached to the endoscope 72. As shown in Figure 5, a portion of the outer surface 16 of the visualization section 12 is dome-shaped, and the portion of the dome-shaped outer surface of the visualization section is within the field of view A of the endoscope 72. Due to the dome shape, the conductive material 302 may be required on an increased surface area having smoother transmission (compared to Figures 1-4 if the entire dome is covered), and may be applied only within the field of view A.

[0070] Generally, dome shapes can improve imaging by increasing the working space, allowing organs to be pushed out of the field of view. Other shapes can be used to optimize the field of view, optical clarity, and lens fit to target tissue or other materials. Other performance-related reasons for shaping optical elements include light transmission, material adhesion between shapes, and the need for navigation through specific regions, including target lumens.

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

[0072] The barrier section 42 is a portion of the visualization section 12 that interposes between the surroundings and the instrument receptacle 40 (before the medical instrument 202 passes through). In one embodiment, the barrier section is covered with an insulating material 310 to prevent direct contact by the medical instrument 202 having a conductive material 302. The insulating material 310 may, for example, extend from the outer surface 16 and may be the same thickness as or greater than the layer of conductive material 302. Advantageously, the insulating material 310 can prevent conductive breakdown of the conductive material 302 by, for example, a metal instrument that causes a short circuit in the electrically energized conductive material layer. Alternatively, the insulating material may be a more elastic and physical guard against damage by the medical instrument 202.

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

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

[0075] In the embodiments shown in Figures 8A to 8C, the optical element 10 has a frustoconical shape with a wider base extending distally. In this embodiment, the conductive material 302 is relatively flat and can be easily applied to a relatively flat tissue surface. The conductive material 302 may also be in a layer having an opening surrounded by an insulating material 310. As described above, this can prevent short circuits or damage to the conductive material by the biopsy forceps 61. The electrodes 300a and 300b may also extend downward from the inclined sides of the frustoconical shape and may be partially or completely insulated or not insulated.

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

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

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

[0079] Figure 11A of this disclosure is a cross-sectional view of an optical element 10 having a concave outer surface 16 attached to an endoscope 72 approaching tissue covered with blood 800. Figure 11B shows the optical element 10 pressed against a cavity in the tissue 200, trapping (or capturing) a nonconductive (or opaque) fluid 91. Figure 11C shows the fluid from an instrument receptacle 40 flushing (or washing away) the trapped nonconductive fluid 91. Advantageously, when the pressure of the introduced fluid exceeds the pressure applied to the body cavity 200 by the optical element 10, the fluid 891 flushes the trapped opaque fluid 91 out of the area.

[0080] In Figures 11A and 11B, the conductive material 302 is applied to a concave layer, similar to the concave outer surface 16. The terminals 300 extend along the side surface of the optical element 10 so as to contact the end of the concave conductive material 302.

[0081] (Applications of devices and conductive materials) The conductive material 302, which is a various embodiment of device 11, can be used to transmit many types of energy and can be used in many medical and non-medical applications. Examples of such types of energy and applications are provided below for illustrative purposes and should not be considered limiting.

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

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

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

[0085] The advantage of these different generators lies in providing a specific form of power for a particular application, where one form of power has advantages over others. For example, when cutting and coagulating tissue, unipolar electricity can typically cut and coagulate through tissue more effectively than bipolar power. However, unipolar energy requires the use of a grounding pad to avoid arching of the unipolar energy into unintended areas. Thus, a grounding pad can be used in unipolar applications to affect tissue and to prevent arching and subsequent burns to the patient from the power and unipolar energy (the grounding pad completes the circuit of the power passing through the patient).

[0086] In contrast, with bipolar power, the circuit is complete within the device itself, so energy travels through and across the device, affecting tissue without arching through the body. This approach can be highly effective for creating lesions, sealing vessels, and other applications, including targeted tissue treatment. However, due to the aspects of bipolar power involved, it tends to be less effective for cutting and coagulating tissue as a substitute for a surgical knife. Similarly, microwave energy may be used for specific types of tissue ablation due to its unique tissue effects, while bipolar energy may be used for other types of excision. Other forms of energy, such as FM energy, may be used because the frequency does not stimulate (excite) specific sub-elements, such as nerve bundles.

[0087] Coablation generators can be used in non-thermal-driven processes that surgically dissociate soft tissue using high-frequency energy. They excite electrolytes in a conductive medium, such as saline, to form a precisely focused plasma field. Energy-impregnated particles or ions in the plasma field can possess sufficient energy to break or dissociate organic molecular bonds within soft tissue at relatively low temperatures (i.e., typically 40°C–70°C). This allows the coablation device to remove the target tissue by volumetric analysis with minimal damage to surrounding tissue. Coablation can also provide hemostasis and tissue shrinkage capabilities. The amount of power delivered is determined by the field intensity and can be adjusted based on local environmental conditions.

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

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

[0090] Ultrasound devices can typically operate at frequencies ranging from 20 kHz to several GHz. The therapeutic ultrasound frequencies used are typically between 0.7 and 3.3 MHz. Ultrasound energy, or TENS energy, can accelerate the healing process by increasing blood flow in the treatment area, and can also reduce pain caused by the contraction of swelling and edema by gently massaging the muscle tendons and / or ligaments in the treatment area.

[0091] Ultrasound can also ablate tumors or other tissues non-invasively or invasively. This can be achieved using a technique known as high-intensity focused ultrasound (HIFU), also called focused ultrasound surgery (FUS). This procedure generally uses lower frequencies than medical diagnostic ultrasound (250-2000 kHz). Other common situations in which ultrasound may be used for treatment include, for example, ligament sprains, muscle pain, tendinitis, arthritis, plantar fasciitis, metatarsalgia, surface irritation, impingement syndrome, bursitis, rheumatoid arthritis, osteoarthritis, and scar tissue adhesion.

[0092] Device 11 also enables physicians to perform, in particular, tissue cauterization, vascular sealing, tissue incision and re-incision, tissue formation, tissue excision and tissue coagulation, tissue ablation and instrument heating, all in a precise location where the operator can observe. This solves, at least in part, the problem of performing aspects of endoscopic surgery in the blind. It also eliminates the need to swap one device for another in order to apply energy to tissue or material, or to change the direction of light on tissue or other material, or to engage in other operations while maintaining visualization.

[0093] More specific medical applications include, in particular, the application of energy acting on tissue in trauma cases, arthroscopic surgery, spinal surgery, neurosurgical surgery, shoulder joint surgery, lung tumor ablation, ablation of cancerous tissue in bladder cancer patients, and cauterization or ablation of uterine tissue for women's health issues (e.g., endometriosis). In these applications (and other applications listed herein), the device is used to come into contact with tissue, and then cauterize, ablate, or shape the tissue (e.g., performed with coblation energy in shoulder procedures), creating unparalleled performance characteristics by allowing physicians to observe the changes occurring in the tissue in real time, for example, through optically clear lenses and coatings.

[0094] This device can also be used with heated optically clear lenses to prevent fogging in applications including laparoscopy, borescopes, videoscopes, or other optical capture technologies.

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

[0096] Electrocautery is a process that uses heat conduction from electric current to repair tissue. This procedure is used to stop bleeding from small blood vessels (which can ligate larger vessels) or from cuts through soft tissue. High-frequency alternating current is used in electrocautery in unipolar or bipolar configurations. It can be a continuous waveform (cutting tissue) or an intermittent type (coagulating tissue). In the unipolar type, to prevent electric burns, the exit point of the circuit has a large surface area (e.g., the buttocks), while the tissue being coagulated / cut is in contact with a small electrode. The heat generated depends on the size of the contact area, the power setting or frequency of the current, the application time, and the waveform. A continuous waveform (generally) generates more heat than an intermittent waveform because the frequency used when cutting tissue is set higher than in coagulation mode. Bipolar electrocautery establishes a circuit between two points to affect tissue or other material.

[0097] As an alternative, the conductive layer 302 and device 11 can be used for cauterization by applying an application-appropriate power range in the range of 50°C to 100°C, or even 50°C to 70°C, or lower temperatures where recommended. Advantageously, the ability to visualize the energy applied through the device as a form allows for precise power delivery, including varying energy levels and resulting temperatures, using power settings suitable for specific applications, applying energy over longer periods to broaden the range, applying energy along multiple electrodes to achieve multiple effects, and stopping the process to more definitively confirm that the tissue or other material has been sufficiently converted (this advantage, of course, also applies to other applications of device 11, where real-time visual monitoring of the energy application enables more precise application).

[0098] The optical element 10 may also be beneficial in non-medical applications. Embodiments of the optical element can be attached to the distal end (objective lens) of a borescope, or to a micro or conventional video camera, inspection scope, or still camera, or to other visualization devices that would be beneficial by improving the visualization of liquids, debris and / or blood, as well as energy delivery. This provides the possibility of improved field of view and reparative capabilities in piping, holding tanks, containers, hydraulic lines, and other situations where visualization may be impaired, including when the liquid is opaque, such as petroleum products, sewage, food, and paints. Biopharmaceutical manufacturing, pharmaceuticals, and other applications would benefit from this innovation, as it would eliminate the need to empty pipes or containers (e.g., oil tanks) or open lines for inspection.

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

[0100] Optical elements can be used in conjunction with image capture elements and robotic vehicles or robotic arms to observe remote locations. Optical components having working channels allow devices to pass through the optical element for repair using screws, adhesive patches, adhesives, chemicals, welding, soldering, and other repair and modification applications. In some embodiments, the optical element may be formed from a material that can withstand the acidity, alkalinity, high heat, or viscosity of the liquid transferred by the optical element. In some embodiments, the device may be a disposable or reusable device.

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

[0102] (Composition of conductive material) The conductive material 302 may have various compositions and can be applied to the optical element 10 in various ways. Examples of such compositions and applications are provided below for illustrative purposes and should not be considered limiting. For medical applications, it is preferable that the conductive material 302 can withstand sterilization, for example, by gamma irradiation, ethylene oxide, steam, or other forms of sterilization.

[0103] Electrically conductive / responsive coatings can be applied in multiple configurations to produce one or more electrodes. These electrodes can be optically transparent and can have various thicknesses, including thicknesses of less than half a micron and thicker, depending on the intended effect on tissue or other materials.

[0104] The conductive material can be at least partially transparent and may comprise any component of the general classification of materials known as transparent conductive oxides (TCOs), including, for example, titanium oxide (TiO2) and aluminum-doped zinc oxide (AZO). Applications may also include other conductive materials applied in a manner that enables visualization, such as silver nanoparticles and gold nanoparticles, as well as other conductive materials applied in a manner that enables energy conduction and visualization.

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

[0106] The transparent conductive film can be indium tin oxide, zinc oxide doped with Al or Ga, titanium oxide doped with Ta or Nb, tin oxide doped with F, or mixtures thereof. The oxide layer can be formed by directly oxidizing an ultrathin metal layer or by depositing the oxide. The TCO material may have a polycrystalline, crystalline, or amorphous microstructure to affect the film properties (among other properties, for example, transmittance and conductivity).

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

[0108] TiO2 can function as a biocompatible material and offers the potential to coat substrates in a temperature range from room temperature to several hundred degrees Celsius. TiO2 has several different and diverse phase forms, which can depend on the initial particle size, initial phase, dopant concentration, reaction atmosphere, and annealing temperature. TiO2 films are commonly synthesized by many methods, including sol-gel, thermal spraying, and physical vapor deposition.

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

[0110] Physical changes from the grown thin film can also be achieved by changing process parameters (such as temperature or pressure) or by adding process gases (such as oxygen or hydrogen). Generally, zinc oxide is n-doped with aluminum. Separately, n-doping can be carried out with metals such as copper (Cu), silver (Ag), gallium (Ga), magnesium (Mg), cadmium (Cd), indium (In), tin (Sn), scandium (Sc), yttrium (Y), cobalt (Co), manganese (Mn), chromium (Cr), and boron (B). p-doping of ZnO can be achieved using nitrogen (N) and phosphorus (P).

[0111] Furthermore, in TCO, incorporating subwavelength metal nanostructures can bring about a change in the wavelength at which the TCO becomes transparent. Embedded particle articles can also be used to control absorption and scattering at desired wavelengths. Other optical effects of the material (including effects such as absorption, scattering, light confinement or decomposition, filtration, and photo-induced heating) can also be influenced. These effects can be designed by the morphology of the particles (including size, shape, density, uniformity, fit, separation, arrangement, and random or periodic distribution).

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

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

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

[0115] Films of conductive materials can be deposited onto substrates via a variety of deposition methods, including metal-organic chemical vapor deposition (MOCVD), metal-organic molecular beam deposition (MOMBD), spray pyrolysis, and pulsed laser deposition, dip coating, painting, bonding, or other applications suitable for properly adhering conductive materials to a given substrate for specific applications. TCO manufacturing techniques include magnetron sputtering, sol-gel techniques, electrodeposition, vapor deposition, magnetron DC sputtering, magnetron RF sputtering, or sputter deposition methods, as well as combinations of ultrasonic delivery and welding. In addition, high-quality deposition methods using thermal plasma, (low-pressure (LP), metal-organic (MO), plasma-enhanced (PE)) chemical vapor deposition (CVD), electron beam evaporation, pulsed laser deposition, and atomic layer deposition (ALD) can be particularly applied.

[0116] Thin films such as ALDs, with a thickness of only a few nanometers, are flexible and therefore less prone to cracking, formation, spreading, and diffusion of harmful particles inside the human body or within a given non-medical examination site. Furthermore, affinity coatings that bind low and high proteins can be deposited using ALDs. They are particularly useful in diagnostic and preparation fields, as well as for surface coatings resistant to bacterial growth.

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

[0118] As used herein, the term “connector” should be broadly interpreted to mean any structure that enables the transmission of electrical or other energy to a conductive coating. The term “connector” can refer to a permanent connection (solder, adhesive, stranded wire, conductive path with conductive coating) or a replaceable connection (connection such as plugs and harness assemblies), or any other method of delivering energy from a power source to a conductive coating. All methods of connecting to the coating do not necessarily have to be physical connections. For example, connections can be made via electromagnetic fields, for example, by inductance. The term “connector” may also include structures and / or functions that enable, mediate, enhance, or otherwise facilitate connections. Certain types of connectors are terminals, for example, areas of conductive material that are provided with or capable of providing an electrical connection to a power source. Terminals may be, for example, conductive metal layers deposited on a surface and molded to contact the ends of wires on an energy supply catheter.

[0119] The "connector area" is an area on which a connector can be attached, mounted, covered, bonded, fixed, adhered, layered, or overlapped, or otherwise an area on which energy can be transferred to a conductive coating.

[0120] Numerous embodiments of systems, devices, and methods are described. Nevertheless, it should be understood that various modifications may be made without departing from the spirit and scope of this disclosure. Accordingly, other embodiments are also within the scope of the appended claims.

[0121] [Embodiment 1-1] A device used in conjunction with an endoscope, An optical coupler having a visualization section at its distal end and a mounting section at its proximal end for attachment to the endoscope, A coating made of a conductive material which is provided on at least a portion of the optical coupler and is at least partially transparent, At least one connector capable of supplying energy to the conductive material, and A working channel located within the optical coupler, through which an instrument or liquid passes. A device comprising [a certain element]. [Embodiment 1-2] The device according to Embodiment 1-1, wherein the endoscope includes a scope lens, and the visualization section covers at least a portion of the scope lens and is configured to transmit an optical image through the optical coupler. [Embodiment 1-3] The device according to Embodiment 1-1, wherein the conductive material includes a conductive oxide, and the conductive oxide is selected from the group consisting of titanium conductive oxide and aluminum conductive oxide. [Embodiment 1-4] The device according to Embodiment 1-1, wherein the connector is configured to be connected to a power supply. [Embodiment 1-5] The device according to Embodiment 1-1, wherein the coating is configured to receive power from the connector and to generate thermal energy which is transmitted to tissue adjacent to the coating. [Embodiment 1-6] The device according to Embodiment 1-1, further comprising an optically transparent dielectric layer configured to create a capacitance field between the conductive material and the tissue. [Embodiment 1-7] The device according to Embodiment 1-1, wherein the conductive material includes at least two substantially parallel conductive strips. [Embodiment 1-8] It is an assembly, Image capture device having an observation end, Positioning assembly supporting the observation end, A conduction surface provided on the observation end, arranged and configured so as to transmit energy across the observation end, A working channel located within the positioning assembly through which an instrument or liquid passes, and Power supply connection part configured to supply energy to the conductive surface An assembly comprising [a certain element]. [Embodiment 1-9] The assembly according to Embodiments 1-8, wherein the conduction surface is an optically transparent surface, and / or the observation end includes a scope lens, and / or the conduction surface includes a coating on the scope lens. [Embodiment 1-10] The assembly according to Embodiments 1-8 or 9, wherein the assembly further comprises a conductor electrically connected to the connector at its distal end, supported by the positioning assembly, and connected to the power supply connection at its proximal end. [Embodiment 1-11] An assembly according to any one of embodiments 1-8 to 10, comprising a plurality of conduction surfaces, wherein the plurality of conduction surfaces do not overlap, and / or the conduction surfaces are connected to the power supply connection portion by a second conduction surface, and the second conduction surface contains platinum. [Embodiment 1-12] The device according to any one of embodiments 1-1 to 7, wherein the conductive material is configured to receive power from the connector and to generate and transmit thermal energy in order to suppress fogging.

[0122] [Embodiment 2-1] A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler having a visualization section at its distal end and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, An electrically conductive material which is at least partially transparent and is disposed in at least a portion of the visualization section of the optical coupler, A connector capable of supplying energy to the electrically conductive material, An insulating material placed in part of the aforementioned visualization section, It has, A device wherein the insulating material has an opening for receiving an instrument and is configured to insulate the instrument passing through the visualization section from the electrically conductive material. [Embodiment 2-2] The device according to Embodiment 2-1, further comprising a working channel within the optical coupler for receiving an instrument, liquid, or gas, wherein the insulating material is substantially aligned longitudinally with the distal opening of the working channel. [Embodiment 2-3] The device according to Embodiment 2-2, wherein the working channel has a distal opening in the visualization section and a proximal end configured to connect to the distal end of the working channel in the endoscope. [Embodiment 2-4] The apparatus according to Embodiment 2-2, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material. [Embodiment 2-5] The device according to any one of embodiments 2-1 to 4, wherein the electrically conductive material includes a conductive oxide. [Embodiment 2-6] The device according to Embodiment 2-5, wherein the conductive oxide is selected from the group consisting of titanium conductive oxide and aluminum conductive oxide. [Embodiment 2-7] The device according to any one of embodiments 2-1 to 6, further comprising a power supply coupled to at least one of the connectors, wherein the power supply is one of a power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cryo-generator, and a plasma generator. [Implementation 2-8] The device according to any one of embodiments 2-1 to 4, wherein the electrically conductive material is configured to receive power from the connector and to generate thermal energy and transfer the thermal energy to tissues located adjacent to the conductive material. [Embodiment 2-9] The device according to any one of embodiments 2-1 to 8, further comprising an optically transparent dielectric layer configured to generate a capacitance field between the electrically conductive material and the tissue. [Embodiment 2-10] The device according to any one of embodiments 2-1 to 4, wherein the electrically conductive material is configured to receive power from the connector and to generate and transmit thermal energy in order to suppress fogging. [Embodiment 2-11] The device according to any one of embodiments 2-1 to 4, wherein the electrically conductive material has electrodes configured to supply energy to tissue adjacent to or in contact with the optical coupler. [Embodiment 2-12] The device according to any one of embodiments 2-1 to 3, wherein the visualization section has an outer surface enclosing at least a portion of the visualization section, extending continuously from a first outer boundary of the visualization section to a second outer boundary of the visualization section, so as to prevent liquid, tissue fragments, or particulate matter from coming into contact with the optical lens of the endoscope. [Embodiment 2-13] A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler having a visualization section at its distal end and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, An electrically conductive material which is at least partially transparent and is disposed in at least a portion of the visualization section of the optical coupler, A connector capable of supplying energy to the electrically conductive material, An insulating material placed in part of the aforementioned visualization section, The optical coupler includes a working channel for receiving an instrument, liquid, or gas, It has, The device wherein the insulating material is substantially aligned in the longitudinal direction with the distal opening of the working channel. [Embodiment 2-14] The apparatus according to Embodiment 2-13, wherein a portion of the visualization section further comprises a barrier section positioned between the distal opening of the working channel and the electrically conductive material. [Embodiment 3-1] A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler comprising a substantially transparent visualization section and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, An electrically conductive material having electrodes disposed in at least a portion of the visualization section of the optical coupler, which is at least partially transparent and configured to supply energy to tissue adjacent to or in contact with the optical coupler, A connector capable of supplying energy to the electrically conductive material, An insulating material is disposed between the electrically conductive material and a portion of the visualization section, A device having [Embodiment 3-2] The device according to Embodiment 3-1, further comprising a working channel within the optical coupler for receiving an instrument, liquid, or gas, wherein the insulating material is disposed between the working channel and the electrically conductive material. [Embodiment 3-3] The device according to Embodiment 3-2, wherein the insulating material is substantially aligned in the longitudinal direction with the distal opening of the working channel. [Embodiment 3-4] The device according to Embodiment 3-2, wherein the working channel has a distal opening in the visualization section and a proximal end configured to connect to the distal end of the working channel in the endoscope. [Embodiment 3-5] The device according to Embodiment 3-3, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material. [Embodiment 3-6] The device according to any one of embodiments 3-1 to 5, wherein the electrically conductive material includes a conductive oxide. [Embodiment 3-7] The device according to Embodiments 3-6, wherein the conductive oxide is selected from the group consisting of titanium conductive oxide, titanium oxide, indium tin oxide, doped oxide, and aluminum conductive oxide, and combinations thereof. [Implementation 3-8] The conductive oxide has a thickness of approximately 1 nm to approximately 3500 nm, as described in Embodiment 3-6 of the device. [Embodiment 3-9] The conductive material has a refractive index of about 1.3 to about 2.3, as described in any one of embodiments 3-1 to 8. [Embodiment 3-10] The device according to any one of embodiments 3-1 to 9, further comprising a power supply coupled to at least one of the connectors, wherein the power supply is one of a power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cryo-generator, and a plasma generator. [Embodiment 3-11] The device according to any one of embodiments 3-1 to 3-10, wherein the electrically conductive material is configured to receive power from the connector and to generate thermal energy and transfer the thermal energy to tissue located adjacent to the conductive material. [Embodiment 3-12] The device according to any one of embodiments 3-1 to 3-11, further comprising an optically transparent dielectric layer configured to generate a capacitance field between the electrically conductive material and the tissue. [Embodiment 3-13] The device according to any one of embodiments 3-1 to 3-12, wherein the electrically conductive material is configured to receive power from the connector and to generate and transmit thermal energy in order to suppress fogging. [Embodiment 3-14] The device according to any one of embodiments 3-1 to 3-13, wherein the visualization section has an outer surface enclosing at least a portion of the visualization section, extending continuously from a first outer boundary of the visualization section to a second outer boundary of the visualization section, so as to prevent liquid, tissue fragments, or particulate matter from coming into contact with the optical lens of the endoscope. [Embodiment 3-15] The device according to any one of embodiments 3-1 to 3-14, wherein the conductive material is configured to receive power from the connector and to generate and transmit thermal energy in order to suppress fogging. [Embodiment 3-16] The device according to any one of embodiments 3-1 to 15, wherein the conductive material includes at least two substantially parallel conductive strips. [Embodiment 3-17] A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler comprising a substantially transparent visualization section and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, An electrically conductive material which is at least partially transparent and is disposed in at least a portion of the visualization section of the optical coupler, A connector capable of supplying energy to the electrically conductive material, An insulating material is disposed between the electrically conductive material and a portion of the visualization section, It has, A device in which the electrically conductive material is configured to receive power from the connector and to generate thermal energy and transfer the thermal energy to tissue located adjacent to the conductive material. [Implementation 3-18] A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler comprising a substantially transparent visualization section and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, An electrically conductive material which is at least partially transparent and is disposed in at least a portion of the visualization section of the optical coupler, A connector capable of supplying energy to the electrically conductive material, An insulating material is disposed between the electrically conductive material and a portion of the visualization section, It has, The device comprises an electrically conductive material configured to receive power from the connector and to generate and transmit thermal energy in order to suppress fogging.

Claims

1. A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler having a substantially transparent visualization section and a mounting section at its proximal end for attachment to the endoscope, An electrically conductive coating comprising at least two spaced conductive strips, positioned in at least part of the visualization section and configured to supply energy to tissue adjacent to or in contact with the optical coupler, A connector capable of supplying energy to the electrically conductive coating, A device having

2. The device according to claim 1, further comprising an insulating material disposed between the electrically conductive coating and a portion of the visualization section.

3. The device according to claim 2, further comprising a working channel within the optical coupler for receiving an instrument, liquid, or gas, wherein the insulating material is disposed between the working channel and the electrically conductive coating.

4. The device according to claim 3, wherein the insulating material is substantially aligned in the longitudinal direction with the distal opening of the working channel.

5. The device according to claim 4, wherein the working channel has a distal opening in the visualization section and a proximal end configured to connect to the distal end of the working channel in the endoscope.

6. The device according to claim 3, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive coating.

7. The device according to any one of claims 1 to 6, wherein the electrically conductive coating comprises a conductive oxide.

8. The device according to claim 7, wherein the electrically conductive coating comprises a conductive oxide selected from the group consisting of titanium conductive oxide, titanium oxide, indium tin oxide, doped oxide, and aluminum conductive oxide, and combinations thereof.

9. The device according to claim 8, wherein the conductive oxide has a thickness of about 1 nm to about 3500 nm.

10. The conductive coating has a refractive index of about 1.3 to about 2.3, the device according to any one of claims 1 to 9.

11. The device according to any one of claims 1 to 10, further comprising a power supply coupled to at least one of the connectors, wherein the power supply comprises one of a power generator, an electrosurgical generator, a coblation generator, an argon gas generator, an ultrasonic generator, a cryo-generator, and a plasma generator.

12. A device used in conjunction with an endoscope equipped with an optical lens, An optical coupler comprising a substantially transparent visualization section and a mounting section at its proximal end for attachment to the endoscope, wherein the visualization section is configured to cover at least a portion of the optical lens of the endoscope, and the visualization section has an outer surface enclosing at least a portion of the visualization section, extending from a first outer boundary of the visualization section to a second outer boundary of the visualization section, to prevent liquid, tissue fragments, or particulate matter from coming into contact with the optical lens of the endoscope, An electrically conductive material comprising at least two spaced-apart conductive strips attached to at least a portion of the outer surface of the visualization section of the optical coupler, A connector capable of supplying energy to the electrically conductive material, A device having

13. The device according to claim 12, further comprising an insulating material disposed between the electrically conductive material and a portion of the visualization section.

14. The device according to claim 13, further comprising a working channel within the optical coupler for receiving an instrument, liquid, or gas, wherein the insulating material is disposed between the working channel and the electrically conductive material.

15. The device according to claim 14, wherein the insulating material is substantially aligned in the longitudinal direction with the distal opening of the working channel.

16. The device according to claim 14, wherein the working channel has a distal opening in the visualization section and a proximal end configured to connect to the distal end of the working channel in the endoscope.

17. The device according to claim 14, wherein a portion of the visualization section further comprises a barrier section disposed between the distal opening of the working channel and the electrically conductive material.

18. The device according to any one of claims 12 to 17, wherein the electrically conductive material is at least partially transparent.

19. The device according to claim 18, wherein the electrically conductive material includes a conductive oxide selected from the group consisting of titanium conductive oxide, titanium oxide, indium tin oxide, doped oxide, and aluminum conductive oxide, and combinations thereof.

20. The device according to claim 19, wherein the conductive oxide has a thickness of about 1 nm to about 3500 nm.

21. The conductive material has a refractive index of about 1.3 to about 2.3, the device according to any one of claims 12 to 20.

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