Endoscopic instruments

Abstract

To provide improved surgical instruments including endoscopes.SOLUTION: This disclosure relates to instruments and methods of performing an endoscopy. An endoscope for producing images of a surgery in vivo may include a hub and an imaging rod extending from the hub, the imaging rod being configured to receive light and direct the light to an imaging sensor located adjacently to a distal end of the imaging rod, the hub and the imaging rod being attached to form an assembly having a center of mass established distally to the hub. In other implementations, the hub may be omitted.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] Cross - reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 63 / 065,037, filed on August 13, 2020, the entire content of which is incorporated herein by reference.

[0002] This disclosure relates to surgical instruments and methods, including endoscopes and methods of performing endoscopic examinations.

Background Art

[0003] This disclosure relates to instruments and methods associated with performing surgical procedures such as endoscopic examinations. The instruments may be inserted into a patient. One or more images may be obtained using the instruments.

Summary of the Invention

[0004] An endoscope for generating images of a surgical procedure in a living body according to an implementation of this disclosure includes, among other things, a hub and an imaging rod extending from the hub. The imaging rod may be configured to receive light and direct the light to an area adjacent to the distal end of the imaging rod. An imaging sensor may be located at the distal end portion of the imaging rod. The hub and the imaging rod may be attached to form a hub assembly having a center of gravity within the imaging rod.

[0005] An endoscope for generating images of a surgical procedure in a living body according to an implementation of this disclosure includes, among other things, a communication assembly, a hub coupled to the communication assembly, and an imaging rod extending from the hub. The hub and the imaging rod may be attached to form a hub assembly having a center of gravity established distally of the hub. An imaging sensor may be coupled to the distal end portion of the imaging rod.

[0006] An endoscope for generating surgical images in vivo according to embodiments of the present disclosure includes, among other things, a communication assembly and a hub assembly connected to the communication assembly. The hub assembly may include an imaging rod, an imaging sensor, and electronic equipment connected to the imaging sensor. The imaging rod may include a main body extending a first length between a proximal end portion and a distal end portion with respect to the longitudinal axis. The imaging sensor may be positioned adjacent to the distal end portion of the imaging rod. The electronic equipment may be positioned within an internal cavity of the imaging rod. The hub assembly may have a center of gravity established within the imaging rod at a second length from the proximal end portion. The second length may be 50 percent or more of the first length.

[0007] A method for performing an endoscopic examination according to the implementation of the present disclosure includes, in particular, the step of inserting the distal end portion of an imaging rod through a patient insertion point, wherein the imaging rod extends from a hub to its distal end portion, and the hub and the imaging rod are mounted to establish a hub assembly having a center of gravity established distal to the hub; and the step of inserting the center of gravity through the insertion point. An imaging sensor may be located at the distal end portion of the imaging rod. The method may also include the step of obtaining an image at a position inside the insertion point using the imaging sensor, following the step of inserting the center of gravity. [Brief explanation of the drawing]

[0008] [Figure 1] This is an exemplary perspective view of an endoscope including a needle hub assembly and a cable assembly. [Figure 2A] Figure 1 is a perspective view of the needle hub assembly. [Figure 2B] Figure 1 is a side view of the needle hub assembly. [Figure 3] Figure 1 is a disassembled and assembled diagram of the endoscope. [Figure 4] Figure 1 is a perspective view of the needle hub assembly, including the support boot shown as a phantom. [Figure 5] This is another illustrative perspective view of an endoscope. [Figure 6] This is a diagram illustrating an example of an electronic component. [Figure 7] This is a diagram showing another exemplary endoscope. [Figure 8] This is a flowchart showing how to perform a surgical procedure. [Figure 9] This diagram shows the instrument positioned adjacent to the patient's insertion point. [Figure 10] This figure shows a portion of the instrument inserted through the insertion point in Figure 9. [Figure 11] This figure shows a portion of the instrument after it has been withdrawn from the insertion point in Figure 10. [Figure 12] This figure shows another exemplary device. [Figure 13] This figure shows another exemplary device. [Figure 14] This figure shows another exemplary device. [Modes for carrying out the invention]

[0009] Similar reference numbers and names within various drawings refer to the same elements.

[0010] This disclosure relates to instruments and methods that may be used during surgical procedures such as endoscopy. Endoscopy generally involves inserting a tube into a patient's body to observe internal organs or tissues.

[0011] The endoscope offers novel features. The endoscope is designed to free the hands of the surgeon or other assistant. The endoscope may have features that allow it to be inserted into and remain in place within the patient without being held by the surgeon or assistant. A specific combination of size, weighting, and / or form factor may enable these attributes. The endoscope may have an electronic housing and a rod extending from it for insertion into the patient. The rod may include a tip attached to the distal end containing an imaging sensor.

[0012] In some implementations, the chip may also include illumination elements (e.g., LED elements, fiber optic bundles, optical pipes, etc.) to generate illumination within the body. In other implementations, the illumination elements are omitted. The area may be flushed with a fluid, which may help cool the chip; otherwise, the chip may give rise to heating concerns, which would raise design concerns for combining an imaging sensor and LED illumination on the same chip. The illumination elements may be configured to surround the imaging sensor, or they may be individually controllable. The group of elements on the chip may have the same wavelength or different wavelengths, and their intensity may be controlled based on several factors, including the use of image and / or sensor features for feedback. In some implementations, one or more illumination sources may be included within the needle hub assembly, as further described below.

[0013] The housing may be symmetrical and balanced. For example, the housing may be cylindrical. The housing may be concentric with the rod. The housing and rod may be fixedly mounted to form a single operable body. The housing may weigh less than twice the weight of the rod, and in some implementations, less than 1.5 times the weight of the rod. In some cases, the housing may even beneficially weigh less than the weight of the rod.

[0014] The housing may have a length of less than 0.75 times the length of the rod. In some cases, the housing may, for the benefit of some cases, have a length of less than 0.25 times the length of the rod. In some cases, the components of the housing may be incorporated into the rod.

[0015] The housing may have a diameter less than five times the diameter of the rod. In some cases, the housing may even have a diameter less than or equal to the diameter of the rod, which may be beneficial.

[0016] The combined housing and rod body may have a center of gravity located distally from the housing, for example, within the rod. Thus, the center of gravity may be configured to be within the patient's body when inserted during surgery. Having the center of gravity within the rod and / or inside the patient allows the endoscope to be more securely held in place without the intervention of a surgeon or assistant.

[0017] The housing may communicate wirelessly with a display device or a control device. Alternatively, the housing may have a cable longer than 1.5 feet from the housing to the control device / display device, eliminating or otherwise reducing any cable tension that would affect the end of the housing and create a force acting at an angle to the central axis of the endoscope that would cause the endoscope to deviate from the axis and tilt.

[0018] An endoscope for generating surgical images in vivo according to an implementation of the present disclosure includes, among other things, a hub and an imaging rod extending from the hub. The imaging rod may be configured to receive light and direct the light to an area adjacent to the distal end of the imaging rod. The imaging sensor may be located at the distal end portion of the imaging rod. The hub and the imaging rod may be attached to form a hub assembly that may have a center of gravity within the imaging rod.

[0019] In a further implementation, the imaging rod may extend a first length between the distal end portion and an interface between the imaging rod and the hub. The center of gravity may be established within the imaging rod at a second length from the interface. The second length may be 10 percent or more of the first length.

[0020] In a further implementation, the hub may include electronics configured to transmit image data from the imaging sensor.

[0021] In a further implementation, the second length may be 25 percent or more of the first length.

[0022] In further implementations, the hub may include an optical supply unit.

[0023] In further implementations, the hub may include a power supply.

[0024] In further implementations, the hub may include electronic devices configured to transmit image data wirelessly.

[0025] In further implementations, the hub may include electronic devices configured to transmit image data digitally.

[0026] In further implementations, the hub may include electronic equipment configured to transmit image data as an analog signal over a coaxial cable.

[0027] In further implementations, the hub assembly may be symmetrical with respect to a reference plane extending along the longitudinal axis of the hub assembly.

[0028] In further implementations, the hub may be cylindrical.

[0029] In further implementations, the length of the hub may be less than 0.75 times the length of the imaging rod.

[0030] In further implementations, the diameter of the hub may be less than five times the diameter of the imaging rod.

[0031] In further implementations, the weight of the hub may be less than twice the weight of the imaging rod.

[0032] In further implementations, the hub may include electronic components, including an electronic circuit, an optical supply unit, and an optical coupler. The electronic circuit may be configured to transmit image data from an imaging sensor. The optical supply unit may be connected to the electronic circuit. The optical supply unit may be configured to generate illumination within a biological system, and the optical coupler may be configured to transmit light from the optical supply unit to an optical fiber. The optical fiber may be configured to transmit light from the hub to the distal end of the imaging rod. The housing may be configured to enclose the electronic circuit, the optical supply unit, and the optical coupler. The hub coupler may connect the imaging rod to the housing.

[0033] In further implementations, the cable assembly may include a first cable, a second cable, a connector, and a button yoke having one or more controls. The first cable may be connected to the proximal end portion of the hub assembly. The button yoke may interconnect the first cable and the second cable. The second cable may interconnect the button yoke and the connector. The connector may have terminals configured to interface with an external device.

[0034] An endoscope for generating surgical images in vivo according to an implementation of this disclosure includes, among other things, a communication assembly, a hub connected to the communication assembly, and an imaging rod extending from the hub. The hub and the imaging rod may be mounted to form a hub assembly having a center of gravity which may be established distal to the hub. An imaging sensor may be connected to the distal end portion of the imaging rod.

[0035] In further implementations, the center of gravity may be established within the imaging rod.

[0036] In further implementations, the light source may be located within the imaging rod adjacent to the distal end.

[0037] In further implementations, the hub may include a housing configured to enclose electronic devices.

[0038] In further implementations, multiple light sources may be arranged in an array to surround the imaging sensor.

[0039] In further implementations, multiple light sources may have separate paths configured to branch off from a common light source.

[0040] In further implementations, the light sources may be individually controllable.

[0041] An endoscope for generating surgical images in vivo according to embodiments of the present disclosure includes, among other things, a communication assembly and a hub assembly connected to the communication assembly. The hub assembly may include an imaging rod, an imaging sensor, and electronic equipment connected to the imaging sensor. The imaging rod may include a main body extending a first length between a proximal end portion and a distal end portion with respect to the longitudinal axis. The imaging sensor may be positioned adjacent to the distal end portion of the imaging rod. The electronic equipment may be positioned within an internal cavity of the imaging rod. The hub assembly may have a center of gravity established within the imaging rod at a second length from the proximal end portion. The second length may be 50 percent or more of the first length.

[0042] In further implementations, the second length may be more than 50 percent of the first length.

[0043] In further implementations, the electronic equipment may be positioned adjacent to the distal end of the imaging rod.

[0044] In further implementations, the second length may be more than 75 percent of the first length.

[0045] A method for performing an endoscopic examination according to the implementation of the present disclosure includes, in particular, inserting the distal end portion of an imaging rod through the patient's insertion point, wherein the imaging rod extends from a hub to the distal end portion, and the hub and imaging rod are mounted to establish a hub assembly having a center of gravity established distal to the hub, and then inserting the center of gravity through the insertion point. An imaging sensor may be located at the distal end portion of the imaging rod. The method may also include obtaining an image at a position inside the insertion point using the imaging sensor following the step of inserting the center of gravity.

[0046] In further implementations, the center of gravity may be established within the imaging rod.

[0047] In further implementations, the hub may be located outside the insertion point during the process of obtaining.

[0048] Further implementations may include releasing the hub assembly so that the center of gravity can be in vivo. The method may also include releasing the hub assembly so that the hub can be substantially cantilevered away from the imaging rod outside the insertion point.

[0049] In further implementations, the length of the hub may be less than 0.75 times the length of the imaging rod. The weight of the hub may be less than twice the weight of the imaging rod.

[0050] In further implementations, the method may include communicating light to the imaging sensor before the acquisition process.

[0051] In further implementations, the communication process may include communicating light from the hub, then through the imaging rod, and then toward an area adjacent to the distal end of the imaging rod.

[0052] In further implementations, the communication process may include communicating light from multiple light sources adjacent to the distal end of the imaging rod. The light sources may be arranged in an array to surround the imaging sensor.

[0053] In further implementations, the process of establishing communication may include individually controlling the light sources to establish communication.

[0054] In further implementations, the insertion point may be established by making an incision in the patient's skin.

[0055] Figures 1 to 4 illustrate an exemplary endoscope 110 that may be used to generate images of surgical procedures in vivo. Referring to Figure 1, the endoscope 110 may include a needle hub assembly 112 and a cable (e.g., communication) assembly 113. The needle hub assembly 112 may include a scope 114 (e.g., a camera or imaging rod) fixed within the needle hub 116, as shown in Figures 1 and 2B. The scope 114 extends from the distal end of the needle hub 116. The scope 114 and the needle hub 116 can be dimensioned such that the needle hub assembly 112 is substantially symmetrical (e.g., mirror symmetry) with respect to a reference plane REF extending along the long axis (e.g., center) axis X of the assembly 112, in order to divide the assembly 112 into two opposing parts, as shown in Figures 2A to 2B.

[0056] Various techniques may be used to dimension the hub assembly 112. Referring to Figure 2B, continuing with reference to Figures 1 and 2A, the scope 114 may extend a first length L1 between its terminal end (e.g., distal end) 117 and an interface 121 between the scope 114 and the distal end of the hub 116 with respect to the longitudinal axis X. The interface 121 may be established at or adjacent to the proximal end of the scope 114. In implementations where the scope 114 is flexible, the first length L1 corresponds to the maximum configurable length of the scope 114. In implementations where the hub 116 is omitted, the first length L1 may be established between the proximal and distal ends of the scope 114. In implementations, the first length L1 may be approximately 100 millimeters (mm) to 300 mm. The needle hub 116 may extend a second length L2 between the opposing proximal and distal ends of the needle hub 116 with respect to the longitudinal axis X. The scope 114 may establish a first diameter D1. The needle hub 116 may establish a second diameter D2. The first length L1 and the second length L2, and / or the first diameter D1 and the second diameter D2, may be the same or different. In some implementations, the length L2 of the needle hub 116 is less than 0.75 times the length L1 of the scope 114, the diameter D2 of the hub 116 is less than 5 times the diameter D1 of the scope 114, and / or the weight of the hub 116 is less than 2 times the weight of the scope 114.

[0057] The hub 116 and scope 114 can be mounted to form a hub assembly 112 having a center of gravity CM. The center of gravity CM may be established at a longitudinal position with respect to the longitudinal axis X. The longitudinal position of the center of gravity CM may be aligned with the longitudinal position along the scope 114 with respect to the longitudinal axis X. The center of gravity CM may be established distal to the needle hub 116 with respect to the longitudinal axis X. In an implementation, the center of gravity CM may be established within the scope 114 along the longitudinal axis X. In other implementations, the needle hub assembly 112 may be configured such that the center of gravity can be established adjacent to the scope 114, but offset from the scope 114, as illustrated by the center of gravity CM' (Figure 2A). The endoscope 110 may be configured such that the center of gravity CM may be inside or outside the patient during the surgical procedure.

[0058] The hub 116 and / or scope 114 may be symmetrical or asymmetrical in order to establish a center of gravity CM. For example, the scope 114 may have a curved geometric shape such that one or more parts of the scope 114 are offset from the longitudinal axis X to establish an asymmetric configuration. As another example, the components(s) within the hub 116 may be arranged such that the center of gravity of the components(s) is offset from the longitudinal axis X.

[0059] The center of gravity (CM) may be established at various positions relative to the scope 114 and / or needle hub 116. The hub assembly 112 may be configured such that a portion of the hub assembly 112, including the center of gravity (CM), can be positioned within the patient to improve the retention of the endoscope 110 without intervention by the surgeon or assistant, while other portions of the hub assembly 112 can be positioned outside the patient. The center of gravity (CM) may be established at the distal end of the needle hub 116, adjacent to the distal end, or distal to the distal end.

[0060] The centroid CM may be established at a distance LCM from the proximal boundary of a first length L1. The proximal boundary of the first length L1 may be established by the interface 121 between the scope 114 and the distal end of the hub 116, or, in implementations where the hub 116 is omitted, by the proximal end of the scope 114. The hub assembly 112 may be configured such that the centroid CM' is offset from the scope 114. The distance LCM may be less than 10 percent of the first length L1. The centroid CM may be established at the interface 121 between the scope 114 and the distal end of the needle hub 116. In implementations, the centroid CM” may be established proximal to the interface 121 within the hub 116. The hub assembly 112 may be configured such that the distance LCM is 10 percent or more of the first length L1, or more strictly, approximately 25 percent or more of the first length L1. In implementations, the distance LCM may be approximately 50 percent or less of the first length L1. For the purposes of this disclosure, the terms “substantially,” “approximately,” and “about” mean ±10 percent of the stated values ​​or relationships unless otherwise indicated. By utilizing the techniques disclosed herein, including the disclosed dimensional relationships and distributions, a surgeon or assistant may position the hub assembly 112 in vivo in a manner that reduces the possibility of movement or intervention while the endoscope 110 is not being held.

[0061] Referring to Figure 3, continuing with Figure 1, the cable assembly 113 may include a first cable 118 (e.g., a microcoaxial cable), a button yoke 120, a second cable 126, and a connector 128. The connector 128 may include a terminal 130 configured to communicate with an external device such as a display or control device 131 (shown as a dashed line in Figure 1 for illustrative purposes). In other implementations, the endoscope 110 communicates wirelessly with the control device 131. The needle hub assembly 112 or cable assembly 113 may include a power supply 133 (connected to an electronic circuit 138 and shown as a dashed line in Figure 3 for illustrative purposes) that provides power to various electrical components of the endoscope 110 in operation. In other implementations, power is provided by an external device and communicated to various electrical components by the terminal 130.

[0062] The scope 114 may include an imaging sensor 108 located on the distal end portion 115 of the scope 114, on the distal end portion 115 of the scope 114, or otherwise adjacent to the distal end portion 115 of the scope 114, in order to obtain an image of the surgical site. The imaging sensor 108 may be a sensor assembly including a sensor and optical elements. The scope 114 may be configured to receive light and direct the light to an area adjacent to the distal end portion 115 of the scope 114 (e.g., a scene or space viewed by the surgeon), or otherwise toward such an area. The light may be reflected back from the area toward the sensor 108.

[0063] The scope 114 and each cable 118, 126 may be relatively rigid or flexible. The distal end portion 115 of the scope 114 establishes the terminal portion 117 (e.g., tip) of the endoscope 110. At least a portion of the scope 114, including the distal end portion 115, can be relatively flexible or bendable and may include, for example, a nitinol material. Configuring the scope 114 to be relatively flexible can facilitate orienting the sensor 108, including bending or steering the sensor 108 around corners and viewing various angles of the surgical site.

[0064] The first cable 118 may be a coaxial cable (e.g., a microcoaxial cable). The first cable 118 may be connected to the proximal end portion 119 of the hub assembly 112, as shown in Figures 1 and 4. In some implementations, the first cable 118 may communicate analog signals between the needle hub 116 and the button yoke 120. The button yoke 120 may interconnect the first cable 118 and the second cable 126. The second cable 126 may interconnect the button yoke 120 and the connector 128.

[0065] The button yoke 120 may have one or more controls (e.g., buttons, dials, levers, etc.), such as buttons 122 and 124. Each button 122, 124 may have one or more functions, such as image and video capture. Each button 122, 124 may be programmable for several functions. In addition, multiple functions can be accessed based on the number of times buttons 122, 124 are pressed, the amount of time during which buttons 122, 124 are pressed multiple times, and / or the amount of time that buttons 122, 124 remain pressed continuously.

[0066] The first cable 118 and the second cable 126 can have various dimensions. In some implementations, the second cable 126 may be approximately 2 feet long, which may allow the button yoke 120 to be positioned on the surface when the endoscope 110 is in use, and may also minimize or otherwise reduce the impact on the fixed position of the hub 116.

[0067] The needle hub 116 may include a hub coupler 134 that connects the scope 114 to other components of the needle hub 116. The needle hub 116 may include various electronic components 123, including a flexible circuit board 135, an electronic circuit 138, an optical supply unit 137, and an optical coupler 136. The flexible circuit board 135 may extend from the needle hub 116 through the scope 114 to the sensor 108. The flexible circuit board 135 may be connected to the electronic circuit 138. The electronic circuit 138 may be in the form of a printed circuit board and may include one or more chips. The electronic circuit 138 may be configured to transmit image data in analog signals through a coaxial cable, such as the first cable 118. In the implementation, one or more of the electronic components 123, including the power supply 133, the flexible circuit board 135, the optical coupler 136, the optical supply unit 137, and / or the electronic circuit 138, may be incorporated into the button yoke 120, and the separate hub 116, including the housing 139, may be omitted.

[0068] The scope 114 may be configured to receive light and direct the light to or toward an area adjacent to the distal end portion 115 of the scope 114. The light may communicate directly or indirectly from the scope 114 to the sensor 108. For example, the light may be reflected from the area back to the sensor 108 or otherwise toward the sensor 108. The circuit 138 and / or flexible circuit board 135 may be connected to a light supply unit 137 (e.g., a light source or illumination element). The light source 137 may be, for example, a light-emitting diode (LED) and may be configured and used to generate illumination in a biological environment. The optical coupler 136 may be configured to communicate light from the light source 137 to an optical fiber (e.g., an optical pipe) 103 (shown as a dashed line in Figure 3 for illustrative purposes). The optical fiber 103 may be configured to transmit light from the needle hub 116 to the distal end portion 115 of the scope 114. In other implementations, the optical fiber 103 may be omitted, and the light source 137 may be located within the scope 114 distal to the needle hub 116. In some implementations, a separate light source may be located adjacent to the distal end portion 115 of the scope 114, but in an external environment, to illuminate the surgical site.

[0069] In some implementations, the imaging sensor 308 and one or more light sources 316 are integrated with or mounted on a common circuit board 323 (e.g., a chip), as shown in Figure 6, to establish an electrical component 325. The light sources 316 may be configured in an array surrounding the sensor 308 and may also be individually controllable. In implementations, the light sources 316 may be configured in separate paths branching from a single common light source 327 (shown by dashed lines for illustrative purposes). The light sources 316 may be used to improve the communication of light in a relatively compact arrangement. The common light source 327 may be connected to the circuit board 323 or to another part of the endoscope. The group of light sources 316 on the circuit board 323 may have the same wavelength or different wavelengths, and their intensity may be controlled based on several factors, including the use of image features and / or sensor features for feedback. The electrical component 325 may be in any of the locations of the imaging sensor disclosed herein. For example, the electrical components 325 can be connected to or mounted on the distal end portion 115 of the scope 114, or adjacent to the distal end portion 115 of the scope 114 (Figure 1). Combining the imaging sensor 308 and the light source(s) 316 on the same circuit board 323 may improve cooling enhancement by fluids delivered to the surgical site, such as fluids used to flush the surgical site during surgical procedures.

[0070] Various electronic components of the needle hub assembly 112 can be configured to wirelessly and / or digitally transmit image data from the imaging sensor 108 to external devices such as the control unit 131 and / or other components of the endoscope 110, such as the button yoke 120. Other sensors can be incorporated into the endoscope 110. For example, one or more sensors, such as a temperature sensor and a pressure sensor, may be configured to sense or measure various conditions at the distal end portion 115 of the scope 114. In some implementations, an accelerometer and / or gyroscope are positioned within the needle hub 116 and / or scope 114 to sense changes in the position and / or orientation of the endoscope 110.

[0071] The terminal portion 117 of the distal end portion 115 can be established at various angles with respect to the central axis or longitudinal axis of the endoscope 110. For example, the terminal portion 117 can be substantially perpendicular to the longitudinal axis X of the scope 114, as shown in Figures 1 and 2A-2B. In some implementations, the terminal portion 117' of the distal end portion 115' establishes an angle α that is transverse to the central axis X or longitudinal axis X of the scope 114', as shown in Figure 7. The sensor image obtained by the sensor 108' can be oriented, for example, to an angle corresponding to angle α (e.g., 30 degrees). The electronic circuit 138', or another part of the endoscope 110', can be programmed or otherwise incorporated with logic to perform correction or transformation of the captured image(s) so that the orientation of the captured image(s) can be changed as the sensor 108' rotates during the procedure.

[0072] Still referring to Figure 3, the needle hub 116 may include a housing 139 configured to enclose the components of the needle hub 116. The housing 139 may include a first shell 162 and a second shell 164 that cooperate to enclose the electronics and other components of the needle hub 116 (e.g., light source 137, circuit 138, and optical coupler 136). The hub coupler 134 may connect the scope 114 to the shells 162 and 164 of the housing 139. The hub coupler 134 may be a separate and distinct component, or it may be incorporated into the housing 139 and / or scope 114.

[0073] The shield 230 may at least partially or completely enclose the housing 139, as shown in Figure 4. The shield 230 may take the form of a flexible shield and may be formed from a conductive material such as copper. As a result, the shield 230 may take the form of copper foil. The support boot 166 may support the housing 139 and the first cable 118, as shown in Figure 4 (shown as a phantom).

[0074] For comparative purposes, Figure 5 illustrates another exemplary endoscope 410. The endoscope 410 may have a handpiece 412 and a camera rod 414. The handpiece 412 may be designed to be held by a surgeon or assistant and to include all control electronics. In these implementations, the center of gravity of the endoscope 410 may be quite far back within the handpiece 412 and therefore may be more broadly held by the assistant rather than remaining stationary without being guided by the assistant.

[0075] Figure 8 illustrates an exemplary method for performing a surgical procedure in flowchart 540. Method 540 may be used to perform an endoscopic examination. Method 540 can be used with any of the instruments and assemblies disclosed herein, including endoscopes 110, 110' and endoscopes 710, 810 (Figures 12-13). The resulting images may be used preoperatively, intraoperatively, and / or postoperatively, and may also be used to restore joint function when performing various surgical procedures such as arthroplasty. Fewer or more steps than those listed below may be performed within the scope of this disclosure, and the order of the listed steps is not intended to limit this disclosure. For illustrative purposes, see the instruments (e.g., endoscopes) 610 in Figures 9-11.

[0076] Referring to Figure 9, continuing with Figure 8, the apparatus 610 may include a hub assembly 612 connected to a cable assembly 613. The hub assembly 612 may include a hub 616 and a scope 614 (e.g., a camera or imaging rod) connected to the hub 616. The hub 616 may have a generally or substantially tubular geometric shape and may also serve as a handle for positioning the hub assembly 612. The hub assembly 612 may include an imaging sensor 608 located at the distal end portion 615 of the imaging rod 614. The imaging rod 614 may extend from the hub 616 to the distal end portion 615. The hub 616 and the imaging rod 614 may be mounted to establish a hub assembly 612 having a center of gravity CM. The center of gravity CM may be established distal to the hub 616 with respect to the longitudinal axis X of the hub assembly 612 (Figure 10). The hub assembly 612 may be configured such that the center of gravity CM can be established within or adjacent to the imaging rod 614. The hub assembly 612 may be configured according to any of the techniques disclosed herein. In the implementation, the length of the hub 616 may be less than 0.75 times the length of the imaging rod 614, the weight of the hub 616 may be less than 2 times the weight of the imaging rod 614, and / or the diameter of the hub 616 may be less than 5 times the diameter of the imaging rod 614.

[0077] In step 542, the instrument 610 may be positioned at the surgical site S within the patient's body B relative to the insertion point 611. The insertion point 611 may be an incision, opening, or other opening created through the skin in the patient's body B. Method 540 may include forming an incision prior to step 542.

[0078] Referring to Figure 10, continuing with reference to Figures 8 and 9, step 542 may include moving the instrument 610 in direction D1, and then, in step 544, inserting a portion of the instrument 610 through the insertion point 611. Step 544 may be performed so that a portion of the instrument 610 is in a biological state. Step 544 may include inserting at least the distal end portion 615 of the imaging rod 614 through the patient's insertion point 611, and then subsequently inserting the centroid CM of the instrument 610 through the insertion point 611. A portion of the hub assembly 612 including the centroid CM may be positioned within the patient, while another portion of the hub assembly 612, such as the hub 616 and / or a portion of the imaging rod 614 proximal to the centroid CM including the proximal end of the imaging rod 614, may be positioned outside the patient.

[0079] In step 546, method 540 may include communicating light to the imaging sensor 608. Various techniques may be used to communicate light to the imaging sensor 608. In implementations, step 546 may include communicating light from the hub 616, then through the imaging rod 614, and then to a patient area adjacent to the distal end portion 615 of the imaging rod 614. The light may be reflected from the area so as to return to the imaging sensor 608 or in another way toward the imaging sensor 608 (see also hub 116, imaging sensor 108, and imaging rod 114 in Figure 1). In implementations, step 546 may include communicating light from one or more light sources adjacent to the distal end portion 615 of the imaging rod 614. The light sources may be arranged in an array surrounding the imaging sensor 608 (see, for example, imaging sensor 308 and light source 316 in Figure 6). Step 546 may include individually controlling the light sources in order to communicate light in step 548.

[0080] In step 550, the surgeon or assistant may cause the instrument 610 to acquire one or more images by the imaging sensor 608 at a position inside the insertion point 611. Step 550 may follow the positioning of the instrument 610 in step 542 and / or the communication of light in step 546. The center of gravity CM of the instrument 610 may be inside the insertion point 611 or otherwise in a biological context, and the hub 116 may be outside the insertion point 611 or otherwise in a biological context while acquiring the image(s) in step 550. In step 552, the image(s) may be communicated to an external device (see, for example, external device 131 in Figure 1).

[0081] In step 554, the surgeon or assistant may release control of the instrument 610 while the distal end portion 615, the imaging sensor 608, and / or the center of gravity CM of the instrument 610 are in a biosituation, as illustrated in Figure 10. Step 554 may also include releasing control of the hub assembly 612 so that the center of gravity CM may be in a biosituation and the hub 116 can be substantially cantilevered from the imaging rod 614 outside the insertion point 611. For the purposes of this disclosure, the term “substantially” cantilevered means that no more than 10 percent of the hub assembly 112 outside the insertion point 611 is supported by means other than the imaging rod 614. In response to releasing control of the hub assembly 612, step 554 may also include balancing the hub assembly 612 at or otherwise adjacent to the insertion point 611. The instrument 610 may remain in place without being held or otherwise supported by the surgeon or assistant, which may improve flexibility and reduce the time required to perform other steps during the surgical procedure.

[0082] Referring to Figure 11, continuing with Figure 8, in step 556, a portion of the instrument 610 in vivo may be moved in direction D2 until the instrument 610 is withdrawn from the insertion point 611 and removed from the patient. Step 556 may also include withdrawing the imaging sensor 608, the distal end portion 615, and the center of gravity CM of the instrument 610 from the patient.

[0083] Figure 12 illustrates another exemplary instrument 710. Instrument 710 may be an endoscope used to obtain images of one or more surgical sites. Instrument 710 may include a needle hub assembly 712 connected to a cable (e.g., communications) assembly 713 (shown by dashed lines for illustrative purposes). In the implementation of Figure 12, a separate hub is omitted from the hub assembly 712.

[0084] The hub assembly 712 may include a scope 714 (e.g., a camera or imaging rod). The scope 714 may include a main body 729 extending along the longitudinal axis X between the distal end portion 715 and the proximal end portion 719 of the hub assembly 712. The main body 729 may have a generally or substantially tubular geometric shape and may have an internal cavity 725. The scope 714 may have a first diameter D1. The main body 729 may be dimensioned such that the first diameter D1 is substantially constant between the distal end portion 715 and the proximal end portion 719 of the scope 714.

[0085] The scope 714 may include an imaging sensor 708 configured to obtain images of the surgical site. The imaging sensor 708 may be located within the internal cavity 725, or it may be located in the distal end portion 715 of the scope 714 to obtain images of one or more surgical sites. The surgeon or assistant may use a portion of the scope 714 as a handle to position the imaging sensor 708 in a desired position and orientation within the patient.

[0086] The hub assembly 710 may include various electronic components 760, which may include any of the electronic components disclosed herein, such as a flexible circuit board, electronic circuits, an optical supply unit, an optical coupler, and / or a power supply (see, for example, Figure 3). The electronic components 760 may be integrated onto a single chip to establish an electronic unit that may integrate with or be coupled to the image sensor 708. The electronic components 760 may be located at various positions within the cavity 725 of the scope 714. The electronic components 760 may be located near the center of gravity CM of the hub assembly 712, such as in the proximal end portion 719 of the scope 714, or adjacent to the proximal end portion 719 of the scope 714. The electronic components 760 may include a light source in the scope 714 adjacent to the proximal end portion 719.

[0087] The centroid CM may be established at a longitudinal axis position between the distal end portion 715 and the proximal end portion 719 of the hub assembly 712, including within the scope 714. The centroid CM may be established at a distance LCM from the proximal boundary of a first length L1 of the scope 714. The hub assembly 712 may be configured such that the centroid CM is established according to any ratio of the distance LCM to the first length L1 disclosed herein. In implementation, the hub assembly 712 may be configured such that the distance LCM is 25 percent or more of the first length L1, or more strictly, approximately 50 percent or more of the first length L1. In implementation, the distance LCM may be approximately 75 percent or less of the first length L1.

[0088] Placing at least some, most, or all of the electronic components 760 and / or other internal components of the hub assembly 712 within the scope 714 may be used to shift the center of gravity CM of the hub assembly 712 relatively distal to the proximal end portion 719 of the hub assembly 712, which may improve the retention of the instrument 710 without intervention by the surgeon or assistant.

[0089] Figure 13 illustrates another exemplary instrument 810. Instrument 810 may be an endoscope used to obtain images of one or more surgical sites. Instrument 810 may include a hub assembly 812 connected to a cable (e.g., communication) assembly 813. In the implementation shown in Figure 13, a separate hub is omitted.

[0090] The apparatus 810 may include various electronic devices 860 positioned at various locations within the cavity 825 of the scope 814. The electronic devices 860 may include a first set of electronic devices 860-1 and a second set of electronic devices 860-2, which may include any of the electronic devices disclosed herein.

[0091] The electronic components 860 may be distributed within the scope 814 to establish the center of gravity CM at various locations between the distal end portion 815 and the proximal end portion 819 of the hub assembly 812. The center of gravity CM may be established at a longitudinal axis position between the distal end portion 815 and the proximal end portion 819, including within the scope 814. A first set of electronic components 860-1 may be positioned distal to the center of gravity CM of the hub assembly 812. A second set of electronic components 860-2 may be positioned proximal to the center of gravity CM. The first set of electronic components 860-1 may be positioned at the distal end portion 815 of the scope 814, or adjacent to the distal end portion 815 of the scope 814. The second set of electronic components 860-2 may be positioned at the proximal end portion 819 of the scope 814, or adjacent to the proximal end portion 819 of the scope 814. In the implementation, the second set of electronics 860-2 is omitted so that substantially all of the electronics of the hub assembly 812 are located on the distal half of the imaging rod 814. The electronics 860-1 may include a light source, such as an LED, which may be located adjacent to and proximal to the imaging sensor 808.

[0092] The centroid CM may be established at a longitudinal axis position between the distal end portion 815 and the proximal end portion 819 of the hub assembly 812, including within the scope 814. The centroid CM may be established at a distance LCM from the proximal boundary of a first length L1 of the scope 814. The hub assembly 812 may be configured such that the centroid CM is established according to any ratio of the distance LCM to the first length L1 disclosed herein. In implementation, the hub assembly 812 may be configured such that the distance LCM is 25 percent or more of the first length L1, more strictly about 50 percent or more of the first length L1, or even more strictly about 75 percent or more of the first length L1. In implementation, the distance LCM may be approximately 90 percent or less of the first length L1.

[0093] Placing at least some, most, or all of the electronic components 860 and / or other internal components of the hub assembly 812 adjacent to the distal end portion 815 of the instrument 810 may be used to shift the center of gravity CM of the hub assembly 812 relatively distal to the proximal end portion 819 of the hub assembly 812, which may improve the retention of the instrument 810 without intervention by the surgeon or assistant.

[0094] Referring to Figure 14, the apparatus 910 may include electronic equipment 960. One or more of the electronic equipment 960 may be incorporated into the cable assembly 913. The cable assembly 913 may include a button yoke 920 into which electronic equipment 960-2 may be incorporated. Electronic equipment 960-2 may include any of the electronic equipment disclosed herein, including a power supply 133, a flexible circuit board 135, an optical coupler 136, an optical supply unit 137, and / or an electronic circuit 138 (Figure 3). A separate hub including a housing for enclosing the electronic equipment may be omitted. The apparatus 910 may include electronic equipment 960-1 adjacent to the distal end portion 915 of the imaging rod 914, or electronic equipment 960-1 may be omitted and / or incorporated into the button yoke 920.

[0095] The novel devices and methods of this disclosure offer versatility in obtaining images of a patient's anatomical structures during endoscopy. The disclosed instruments may be configured to allow them to be inserted into the patient and remain in place without being held or otherwise supported by the surgeon or assistant. The disclosed instruments may be configured to have a center of gravity that improves instrument retention without intervention from the surgeon or assistant, which can reduce the complexity and time required to perform the surgical procedure.

[0096] While different non-limiting embodiments are illustrated as having certain components or processes, the embodiments of this disclosure are not limited to any particular combination thereof. Some components or features from any of the non-limiting embodiments can be used in combination with features or components from any of the other non-limiting embodiments.

[0097] The foregoing statements are to be construed as illustrative and not in any restrictive sense. Those skilled in the art will understand that certain modifications may fall within the scope of this disclosure. For these reasons, the following claims should be studied to determine the true scope and content of this disclosure. [Explanation of symbols]

[0098] 103 Optical fiber (e.g., optical pipe) 103 Optical Fiber 108 Image sensor 110 Endoscope 112 Hub Assembly 113 Cable Assembly 114 Imaging rod, scope 115 Distal end section 116 Hub 117 Termination 118 First Cable 119 Proximal end portion 120 Button Yoke 121 Interface 122 buttons 123 Electronic equipment 124 buttons 126 Second Cable 128 connectors 130 terminals 131 Control device 133 Power supply 134 Hub coupler 135 Flexible circuit board 136 Optical Coupler 137 Light source 138 Electronic circuit 139 cabinets 162 The First Shell 164 The Second Shell 166 Support Boots 230 Shield 308 Image Sensor 308 Sensors 316 light source 323 Circuit board 325 Electrical Components 327 Common light source 410 Endoscope 412 Handpiece 414 Camera Rod 608 Image sensor 610 Equipment 611 Insertion point 612 Hub Assembly 613 Cable Assembly 614 Imaging rod, scope 615 Distal end section 616 Hub 708 Image sensor 710 Endoscope 712 Hub Assembly 713 Cable Assembly 714 Scope 715 Distal end section 719 Proximal end portion 725 Internal cavity 729 Main unit 760 Electronic equipment 808 Image Sensor 810 Endoscope 812 Hub Assembly 813 Cable Assembly 814 Imaging Rod 814 Scope 815 Distal end section 819 Proximal end portion 825 Cavity 860 Electronic equipment 910 Equipment 913 Cable Assembly 914 Imaging Rod 915 Distal end section 920 Button Yoke 960 Electronic equipment

Claims

1. An endoscope for generating surgical images in vivo, Hub and, An imaging rod extending from its distal end to a joint with the hub, wherein the imaging rod is configured to receive light and direct the light toward an area adjacent to the distal end of the imaging rod, an imaging sensor is positioned adjacent to the distal end of the imaging rod, the hub and the imaging rod are mounted to form a hub assembly having a center of gravity, and the center of gravity is located at a distance of 10% or more of the length of the imaging rod from the distal end of the hub toward the distal side of the hub, An endoscope equipped with [specific features / equipment].

2. The endoscope according to claim 1, wherein the hub comprises an electronic device configured to transmit image data from the imaging sensor.

3. The endoscope according to claim 1, wherein the hub comprises a light supply unit.

4. The endoscope according to any one of claims 1 to 3, wherein the hub is equipped with a power supply.

5. The endoscope according to claim 4, wherein the power supply is located near the interface between the imaging rod and the hub.

6. The endoscope according to claim 5, wherein the most distal part of the hub is connected to the imaging rod in the interface.

7. The endoscope according to claim 1, wherein the hub comprises electronic equipment configured to transmit image data digitally via cable or wireless transmission, or to transmit image data in analog signals through a coaxial cable.

8. The endoscope according to claim 1, wherein the hub assembly is symmetrical with respect to a reference plane extending along the longitudinal axis of the hub assembly.

9. The endoscope according to claim 1, wherein the hub is cylindrical.

10. The endoscope according to claim 1, wherein the length of the hub is less than 0.75 times the length of the imaging rod.

11. The endoscope according to claim 1 or 10, wherein the diameter of the hub is less than five times the diameter of the imaging rod.

12. The endoscope according to claim 1 or 10, wherein the weight of the hub is less than twice the weight of the imaging rod.

13. The hub is an electronic device that includes an electronic circuit, an optical supply unit, and an optical coupler. The aforementioned electronic circuit is configured to transmit image data from the imaging sensor. The light supply unit is connected to the electronic circuit, and the light supply unit is configured to generate illumination within a living organism. The optical coupler is configured to transmit light from the light supply unit to the optical fiber, and the optical fiber is configured to transmit light from the hub to the distal end portion of the imaging rod, and the electronic device is configured to do so. A housing configured to enclose the aforementioned electronic circuit, the aforementioned optical supply unit, and the aforementioned optical coupler, A hub coupler for connecting the imaging rod to the housing, The endoscope according to claim 1, comprising:

14. The cable assembly further includes a first cable, a second cable, a connector, and a button yoke having one or more controls. The endoscope according to claim 13, wherein the first cable is connected to the proximal end portion of the hub assembly, the button yoke interconnects the first and second cables, the second cable interconnects the button yoke and the connector, and the connector has a terminal configured to interface with an external device.

15. An endoscope for generating surgical images in vivo, Communication assembly and, A hub connected to the aforementioned communication assembly, An imaging rod extending from its distal end to the joint with the hub, wherein the hub and the imaging rod are mounted to form a hub assembly having a center of gravity, and the center of gravity is located at a distance of 10% or more of the length of the imaging rod from the distal end of the hub toward the distal side of the hub, An imaging sensor adjacent to the distal end portion of the imaging rod, An endoscope equipped with [specific features / equipment].

16. The endoscope according to claim 15, further comprising a light source within the imaging rod adjacent to the distal end portion.

17. The endoscope according to claim 15 or 16, wherein the hub includes a housing configured to enclose electronic equipment.

18. Multiple light sources arranged in an array to surround the aforementioned imaging sensor, Furthermore, The endoscope according to claim 15, wherein the plurality of light sources are each configured to branch off from a common light source, or the plurality of light sources are individually controllable.

19. The system further comprises electronic equipment connected to the aforementioned image sensor, The endoscope according to claim 15, wherein the electronic equipment is located inside the internal cavity of the imaging rod.

20. The endoscope according to claim 19, wherein the electronic device is arranged adjacent to the distal end portion of the imaging rod.

Images