Video laryngoscope

Abstract

A video laryngoscope comprising a fixed blade and a movable blade detachably and removably mounted in a selective manner on the fixed blade and along said fixed blade, wherein said movable blade is suitable for accessing the airway of a patient and wherein said fixed blade also is appropriate for accessing the airway of a patient when the movable blade is dismounted, is disclosed. The video laryngoscope optionally comprises a blade channel removably mounted in said fixed blade, which comprises a guide channel for coupling of an endotracheal tube.

Description

[0001] VIDEO LARYNGOSCOPE

[0002] Field of the Invention

[0003] The present invention relates to the field of medical devices that provide access to the human airway or larynx area, particularly to be used in diagnostic and surgical procedures of the larynx, hypopharynx, and proximal esophagus, as well as for the practice of orotracheal intubation using a cannula under anesthesia, or in mechanical ventilation procedures. More preferably, it refers to a laryngoscope, and even more particularly to a video laryngoscope having detachable and adjustable parts allowing adaptation to different types of patients.

[0004] As known in the state of the art, a laryngoscope is a medical device used to visualize the larynx and the vocal cords. It consists of a thin metal rod with a light at its end which is inserted into a patient’s mouth to provide a clear vision of the larynx. The laryngoscope may also have a camera on the end to transmit real-time images to a screen. The laryngoscopy procedure is commonly performed in the context of a direct laryngoscopy, where it is used to diagnose conditions related to the larynx and vocal cords, such as nodules, polyps, tumors, inflammation, or paralysis of the vocal cords. It may also be useful for placing endotracheal tubes during surgical interventions or in emergency situations.

[0005] The laryngoscope may be of different sizes and shapes, suitable for patients of different ages and sizes, and may be of a rigid or flexible type. The rigid type is generally used for more invasive and specific procedures, whereas the flexible type is less intrusive and allows for exploring areas which are more difficult to reach. Over the years, several constructions and designs of these devices have been used, but basically they consist of a metal blade attached to a handle as a support.

[0006] Thus, laryngoscopes are inserted through the mouth of the patient, who is in a dorsal decubitus position, through the oropharynx area to lift the tongue and enable access to the exolarynx, supraglottis and hypopharynx; and onwards under the tongue and epiglottis to access the glottic area directly. It is then possible to perform intubation with tracheal cannulas through the larynx, as well as the most diverse diagnostic, surgical and therapeutic procedures. According to the types of viewing or imaging means, there are two large groups of laryngoscopes providing access the larynx and its surrounding area. The first group uses direct human vision as an optical means. Some examples of this group of laryngoscopes are the McIntosh, Miller, Jackson-Winsconsin designs, with both curved and straight blades; these models vary in size, ergonomics and the use or not of lamps or optical fiber light sources, but they share the same optical principle, that is, the direct vision by the operator.

[0007] The second group of laryngoscopes comprises the video laryngoscopes known in the art, which employ endoscopic and video technology as a means of magnification and image visualization. They require the use of fiber optic and video endoscopic exocameras or micro cameras, integrated circuit boards and LCD screens as components of the device, which may either include a blade, such as the C-Mac set of laryngoscopes marketed by Storz and the IntuBrite VLS 6630 EDGE Plus video laryngoscope, or not include a blade such as the King Vision video laryngoscope (Ambu, Denmark). In another aspect they may have or have not a channel to guide the endotracheal tube.

[0008] Patent Application EP2567725A2, published on March 13, 2013, entitled TRACHEAL INTUBATION DEVICE, describes a tracheal intubation device for placing an endotracheal tube in the trachea of a patient. The tracheal intubation device includes a bar-shaped camera, a handle portion, a guiding portion and a display device. The bar-shaped camera for capturing images is placed inside the endotracheal tube. The display device is electrically connected to the camera for displaying images captured by the camera. The guiding portion connected to the handle portion has a front end and a rear end, wherein the rear end is connected to the handle portion, and the camera and the endotracheal tube are movably located in the guiding portion.

[0009] Patent Application CN108095677A, published on June 1 , 2018, entitled VIDEO LARYNGOSCOPE OF ADJUSTABLE ANGLE, describes a video laryngoscope of adjustable angle comprising an eyeglass, a guide-localization slide bar, a rotation axis, a handle, a camera assembly system, a spring, a link stopper, a slide-and-guide pin and a push-button, and is characterized in that the handle placed in the outmost side of the whole structure, the push-button is arranged on the left side of the upper portion outside the handle, the guide- locating sliding bar is arranged on the lower portion of the sliding guide pin and the camera component system is arranged on the inner side of the lens. Consequently, a patient is examined by controlling the handle with one hand, the regular actions of pressing the pushbutton inwards and moving outwards are performed with the index finger, and by means of the lever principle, the guide locating sliding rod and the lens connected with the guide locating sliding rod are driven to rotate clockwise and anticlockwise to be adjusted to the proper angles and positions to meet the requirements..

[0010] Patent Application GR20180100390A, published on April 15, 2020, entitled VIDEO LARYNGOSCOPE FOR INTUBATION, describes a low cost video laryngoscope made with 3D printing technology for a quick, painless and easy patient intubation. It is potentially composed of a removable viewing camera / USB guide that can be connected to any mobile phone, tablet or computer and provides high-resolution image and video storage. In addition, it has a custom channel for the trachea. The tracheal channel and the camera housing are angled to be directed to the center of the trachea. The design of the handle takes into account the anatomical characteristics of the hands of the physician using the device.

[0011] Finally, Application W02022090454A1 , to the same inventor, discloses a video laryngoscope comprising a handle, the handle comprising an internal cavity which is open along its entire length on one of its sides and has a cap on the opposite side; said cavity houses a blade of the video laryngoscope when it is folded over the handle, which is rotatably mounted to be rotated about the axis symmetry of the handle by means of a pivot axis of a movable blade support that houses an automatic locking mechanism of the blade, and wherein the blade comprises a movable blade overlappingly connected to the movable blade support by means of a longitudinal slide, and said movable blade being movable along said slide by actuating a lock of an extension-retraction mechanism of la the movable blade.

[0012] These groups of laryngoscopes, to a greater o lesser extent, allow to view the laryngeal area depending on their particular design, but at the expense of counting with multiple designs of both curved and straight blades; and using multiple blade sizes, so it should be more appropriate to call them a laryngoscopy set, with the difficulty this entails when handling devices in the case of laryngoscopes having a blade. In the case of those laryngoscopes not having a blade (“ablade”), such as King Vision or Airtraq, different sizes of plastic cannulas-sleeves or even different sizes of laryngoscopes are required, which also involve certain inconveniences in handling, transportation and costs.

[0013] As a consequence of the above , it is necessary to optimize the design of the blade to improve laryngeal visualization and thus speed up and simplify the orotracheal intubation procedure, for both adult and pediatric patients. As is known, not all blade sizes are compatible with every type of person. Depending on the anatomy of the patient, a type of blade having a certain length should be used for performing the video laryngoscopy.

[0014] There are also additional needs for a mountable and detachable guide channel for the endotracheal tube, for improving the laryngoscope size, in order to optimize its transportation; having the versatility of multiple loading options, and for achieving a design that significantly reduces the aerosol dispersion and contamination index of the operator during the procedure.

[0015] By virtue of the current state of the art available for video laryngoscopy procedures, it would be very desirable to have a video laryngoscope that facilitates the procedures, as well as adjustable to different types of patients, from adults, including obese patients with difficult airways, to pediatric patients, including premature neonates, in a practical, rapid and easy manner. This would make it possible to avoid storing and / or transporting all types of blades having suitable sizes for each type of patient together with the device.

[0016] BRIEF DESCRIPTION OF THE INVENTION

[0017] It is thus an object of the present disclosure to provide a new video laryngoscope comprising a laryngeal blade which may be adapted such that the video laryngoscope may be used in a broad range of patients: from pediatric patients, including premature neonates, to adults, for example, obese adults with difficult airways. This ability to adapt to a broad range of patients is particularly useful for mobile emergency units, where the ability of carrying devices is limited, as it would be possible to avoid transporting blades of all suitable sizes for all types of patients.

[0018] It is still another object of the present disclosure to provide a video laryngoscope comprising a multipurpose laryngeal blade having a movable blade whose extension may be longitudinally regulated such that the video laryngoscope may be adapted to the anatomy of a wide variety of patients; this movable blade being mounted on a fixed blade so that, when the movable blade is dismounted, said fixed blade may be used as a laryngeal blade.

[0019] Still another object of the present disclosure is a video laryngoscope which allows for assembling and disassembling a channel which is a guide channel for an endotracheal tube, wherein said channel can be mounted and dismounted in a practical, rapid and easy manner.

[0020] In yet another aspect of the present disclosure, a video laryngoscope is contemplated comprising a handle which comprises a proximal portion comprising a display screen or monitor and a distal portion connected to a laryngoscope blade comprising a camera, wherein said laryngoscope blade is a multipurpose laryngeal blade comprising: at least one fixed blade connected to the distal portion of said handle; at least one movable blade dismountably and removably mounted onto the fixed blade in a selective manner along said fixed blade; wherein said movable blade is suitable for accessing the airway of a patient and may be moved to different selective positions, from a fully retracted position to one or more extended positions; and wherein said fixed blade is also suitable for accessing the airway of a patient when the movable blade is dismounted.

[0021] In one embodiment, the fixed blade is useful for accessing the airway of a neonate patient, for example, wherein the fixed blade is functionally compatible with Macintosh 00 and 0 blades or with Miller 00 and 0 blades. In yet another embodiment, the one or more extended positions of the movable blade correspond to final lengths of the multipurpose laryngeal blade which, taken together, may be functionally compatible with at least Macintosh 1 , 2, 3, and / or 4 blades, with Miller 1-4 blades, and / or with a blade of the hyper-angled type such as D-BLADE blades from C-MAC®.

[0022] According to one embodiment of the present disclosure, the video laryngoscope comprises at least one blade channel removably mounted on said fixed blade, wherein said blade channel comprises a guide channel for connection to an endotracheal tube. In one embodiment, said lateral guide channel is comprised by said slide and movable blade in its upper portion, laterally by one of the lateral sides of said fixed blade, and below by said blade channel. In yet another embodiment, said blade channel comprises a flap of semicircular cross-section which fits in a groove provided in a lateral side of said fixed blade.

[0023] In yet another embodiment, said fixed blade is pivotally connected to the distal portion of said handle which allows for a pivoting movement of the multipurpose laryngeal blade from a handle housing, for example, from a recessed region of said handle, towards its operative position and vice versa. In one embodiment, the pivoting mechanism may be in pivotal connection with a locking mechanism provided in the distal portion of said handle, wherein said locking mechanism allows for a positional fixation of the multipurpose laryngeal blade in the handle housing and in its operative position.

[0024] In one embodiment, the fixed blade comprises a lower portion of said fixed blade comprising, on its upper side, a slide along which the movable blade can move, and on its distal portion, an extension-retraction mechanism of the movable blade which allows for selectively extending or retracting the movable blade such that it can be positioned in said selective positions. In one embodiment, said extension-retraction mechanism provided in said fixed blade is arranged within a housing mechanism and preferably the extensionretraction mechanism can be removed from the housing mechanism for cleaning and maintenance purposes.

[0025] It is still another object of the present invention, to provide a video laryngoscope that is a watertight device, i.e. , water resistant, which facilitates its cleaning and sterilization. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] For further clarity and understanding of the object of the present disclosure, the following Figures show several embodiments, all by way of example:

[0027] Figure 1 shows an exploded view of the video laryngoscope according to one embodiment of the present disclosure;

[0028] Figure 2 shows a perspective front view of the video laryngoscope according to one embodiment of the disclosure;

[0029] Figure 3 shows a perspective rear view of the video laryngoscope of one embodiment of the disclosure; Figure 4 shows a lateral view of the video laryngoscope of one embodiment of the disclosure, showing the arrangement of the handle cap;

[0030] Figure 5 shows a partial perspective view of the video laryngoscope of one embodiment of the disclosure, wherein a monitor chassis with display screen and its mounting mechanism on the handle is shown;

[0031] Figure 6 shows a partial perspective view of the rear portion of a monitor chassis according to one embodiment of the disclosure, wherein a wireless charging receiver Wireless is shown, among others;

[0032] Figure 7 shows an enlarged and cutaway view of a pivoting mounting zone between the handle and a multipurpose laryngeal blade according to one embodiment of the present disclosure;

[0033] Figure 8 shows an enlarged view of the pivoting mounting mechanism between the handle and the multipurpose laryngeal blade according to one embodiment of the disclosure;

[0034] Figures 9a to 9i show different stages or positions of the multipurpose laryngeal blade of one embodiment of the disclosure, wherein Figure 9i illustrates dismounting of some of its components;

[0035] Figure 10 shows a partial bottom view of a lower portion of a fixed blade in which a slide and an extension-retraction mechanism are provided according to one embodiment of the present disclosure;

[0036] Figure 11 shows another view of Figure 10, wherein the extension-retraction mechanism has been removed according to one embodiment of the disclosure;

[0037] Figure 12 shows a perspective front view of the extension-retraction mechanism according to one embodiment of the disclosure;

[0038] Figure 13 shows a perspective rear view of the extension-retraction mechanism according to one embodiment of the disclosure;

[0039] Figure 14 shows a perspective and cutaway view of the extension-retraction mechanism mounted in the respective housing provided in said fixed blade, according to one embodiment of the disclosure;

[0040] Figure 15 is a connection diagram of the portions of one embodiment of the disclosure;

[0041] Figure 16 is a perspective front view of a video laryngoscope of one embodiment of the disclosure placed on its charging base;

[0042] Figure 17 is a perspective front view of the charging base of a video laryngoscope of one embodiment of the disclosure;

[0043] Figure 18 shows another perspective view of a video laryngoscope of one embodiment of the disclosure placed on its charging base;

[0044] Figure 19 is a perspective rear view of a video laryngoscope of one embodiment of the disclosure placed on its charging base;

[0045] Figures 20 to 22 show views of the folding stages of a video laryngoscope according to one embodiment of the present disclosure;

[0046] Figure 23 shows a cutaway lateral view of a multipurpose laryngeal blade according to the present disclosure; and

[0047] Figures 24 and 25 show schematic views which illustrate the assembly of an endotracheal tube in a video laryngoscope according to one embodiment of the present disclosure.

[0048] Figure 26 shows different views illustrating the dimensions of the fixed and movable blades of a video laryngoscope according to one embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0049] The present disclosure refers to a new video laryngoscope featuring the arrangement of a multipurpose laryngeal blade or laryngoscope blade comprising at least one fixed blade and at least one extensible and detachably movable blade, wherein the video laryngoscope may be adjusted to different desired blade lengths and furthermore to different patients from premature neonates to adults, in a practical, rapid and easy manner.

[0050] Furthermore, the video laryngoscope according to one embodiment of the present disclosure allows for mounting a channel comprising a guide channel for an endotracheal tube in a practical and detachable manner.

[0051] Referring to Figures 1 to 26, the video laryngoscope of one embodiment of the present disclosure is indicated by general reference 1 and comprises a handle 2, to which a screen 16 is connected, wherein the handle 2 is also connected to a multipurpose laryngeal blade 27 comprising a fixed blade 28 and a movable blade 29.

[0052] In one embodiment, the handle 2 has a handle housing 3 defined by an opening in one or both of its lateral sides, alternatively making up the wall or bottom of the opposing lateral to said operating lateral side. For example, in the embodiment illustrated in Figure 1 , the open lateral of handle 2 is the right side, but one embodiment wherein the open lateral is the left side or both lateral sides are open is also contemplated.

[0053] In one embodiment, the handle 2 has a substantially curved shape.

[0054] In one embodiment, the handle 2 has a handle front portion 4 and a handle rear portion 5. Wherein, said handle front portion 4 may comprise an upper resting portion 6 of the screen, an intermediate handle portion, and a lower handle portion. In one embodiment, the display screen or monitor is connected to the intermediate portion of said handle, but may be at another position in alternative embodiments. In one embodiment, the intermediate portion is provided with a pivot axis housing 7 to connect a monitor chassis 10, by means of a pivot axis 9 in said chassis, although said pivot axis housing 7 may be at another portion of said handle. Further contemplated are alternative embodiments wherein the pivot axis may be in the handle, and also any other type of relationship between the handle and the monitor chassis.

[0055] Pivot axis 9 of one embodiment according to the present disclosure can be made of different suitable materials known to a person skilled in the art. For example, in one embodiment, the pivot axis is made of aluminum or an aluminum alloy, but this is not limiting to the invention.

[0056] The handle material of a video laryngoscope according to one embodiment of the present disclosure may also be any suitable material known to a person skilled in the art. By way of example, but not limiting for the invention, the handle 2 according to one embodiment of the present disclosure may be composed of two parts of thermoplastic polymer, aluminum, aluminum alloy or a combination thereof, for example aluminum alloy 7075 (Zicral alloy), without this being limiting to the invention. In turn, said parts composing the handle may be, in one preferred embodiment, but not limiting thereto, manufactured by injection or may be machined from a solid body, for example, by means of a numerical control lathe, CNC. By way of example, in one embodiment of the present disclosure, said parts conforming handle 2 may be said handle 2 itself and a lateral handle cap 8, which may be welded to handle body 2 by ultrasonic, solvent (chemical), watertight laser welding or the like, but this is not limiting to the invention. Alternatively, the handle 2 and handle cap 8 can be made of ABS (acylonitrile butadiene styrene), but this does no limit the scope of the present disclosure. For example, in alternative embodiments, other materials may be used, such as polypropylene, nylon, polycarbonate. The abovementioned materials may further be combined with glass fiber in order to achieve mechanical strength.

[0057] Referring again to pivot axis housing 7 of the handle front portion 4, in one embodiment, it receives a hollow pivot shaft 9 of monitor chassis 10, being pivotably mounted in said housing through tubular retainer 11 , both ends of which comprise an O-ring type circular flange, a nut 12 and a housing cap 13, which together provide sufficient water tightness and strength to the connection between axis and housing. A person normally skilled in the art would understand that there may be many alternatives for the connection between handle 2 and monitor chassis 10, including other pivotable or fixed connection options.

[0058] Furthermore, in one embodiment, said monitor chassis 10 has a front side 14 of the monitor chassis and a rear side 15 of the monitor chassis. In one embodiment, said front side 14 of the monitor chassis is provided with a display screen 16. In yet another embodiment, said rear side 15 of the monitor chassis is provided with one or more buttons which comprise, i.a., for example, on / off buttons 17, selection buttons 18, among others. In other embodiments, the buttons may be located at other positions of monitor chassis 10 or of handle 2, or in the screen in the case of touch screens. Likewise, in one embodiment, said rear side 15 of the monitor chassis comprises a battery housing 19 which includes a micro USB 20 port and a connector, for example, a two-pin connector, for connection of a wireless charging receptor Wireless 21 which is coupled via a two-pin connector, not being this a limiting factor, and acting as a cap of said battery housing 19, as may be seen in Figure 6. In one embodiment, the micro USB port is located inside the battery housing to maintain water tightness, i.e., the ability to be waterproof, of the video laryngoscope. In one embodiment, said monitor chassis 10 may pivot via rotation of the hollow pivot shaft 9. Further, in one embodiment, said monitor chassis 10 may rest on said upper resting portion 6 of handle front portion 4. For example, in one embodiment, the monitor chassis 10 may pivot at an angle of at least 90°.

[0059] By way of example, but not limiting to the invention, said display screen 16 of one embodiment of the present disclosure may be an active matrix TFC-LCD screen which may be covered by a protective plate, preferably made of acrylic or polycarbonate. In alternative embodiments, other types of screens or display means may be used, for example, resistive screens, capacitive screens, or the images may also be exported in real time via WiFi.

[0060] A person normally skilled in the art would understand that the USB ports, micro cameras, screens, wireless connections, charging base, as well as any accessory technology associated to a video laryngoscope may be modified or upgraded as appropriate, and that in these aspects the present disclosure are not limited to what is specifically described herein.

[0061] In one embodiment, the video laryngoscope comprises a laryngoscope blade 27 comprising a fixed blade 28 and a movable blade 29 and, optionally, a mountable and detachable blade channel 30. In one embodiment, said fixed blade 28 comprises an upper portion of fixed blade 31 which is connected to a distal portion of handle 2 of the video laryngoscope. In one embodiment, the fixed blade 28 is connected to handle 2 by means of pivot mechanism 32. In one embodiment, pivot mechanism 32 is in pivotal connection with a locking mechanism 33 provided at distal portion 34 of said handle 2. In one embodiment, the pivot mechanism 32 allows for the movement of the multipurpose laryngeal blade between handle housing 3 and its operative position and vice versa. In one embodiment, the locking mechanism allows for fixing the position of the multipurpose laryngeal blade so that it folds to be arranged both inside a handle housing 3 and in its operative position outside the same, as illustrated in Figures 20 to 22.

[0062] In one embodiment, said pivot mechanism 32 of the fixed blade 28 comprises a circular pivot plate 35 which receives pivot axis 36 of the fixed blade which has a straight wall recess 37 at 90° to the extended multipurpose blade (movable blade) and a vertical wall recess 37 at 30° to the folded multipurpose blade (movable blade) and a thread at the distal end of which there is conical threaded nut 38 as a ball-joint, said pivot mechanism being in turn provided with an upper washer 39, a lower washer 40 and an O-ring 41. In one embodiment, said handle 2 is internally provided, at its distal portion 34, with an insert chassis 42 which optionally may be over injected in ABS, where in one embodiment said insert chassis 42 has, but not limited to, a rectangular prismatic shape, inside which said pivot mechanism 32 and said locking mechanism 33 are arranged. In one embodiment, the locking mechanism 33 comprises at least one automatic locking strap 43 which has a first strap end 44 connected to said pivot axis 36 of the pivot mechanism 32 of said fixed blade 28, and a second strap end 45 fixed to a strap support 46 by means of respective fixing screws 47, and in turn said strap support 46 is fixed in said insert chassis 42 through a fixation screw 48. In yet another embodiment, said locking mechanism 33 is provided with at least one lock 49 arranged in a middle portion of said automatic locking strap 43 and which projects into a lock button 50 being jointly supported by means of a locking cap 51 .

[0063] By way of example, but not limiting to the invention, both of said lock button 50 as well as the conic nut 38 according to one embodiment, can be made of AISI 316 L steel, whereas said automatic locking strap 43 can be made of carbon steel 1070, but this is not limiting to the invention. All of the abovementioned components can be manufactured, in alternative embodiments, with any suitable material, where the suitable materials are well- known to a person skilled in the art.

[0064] According to one embodiment, actuating lock button 50 will allow for releasing the automatic locking strap 43 and the subsequent pivoting or rotating movement of the multipurpose laryngeal blade 27 relative to handle 2. In one embodiment, the pivoting movement may rotate approximately 180°. In one embodiment, said insert chassis 42 can be made of aluminum or an aluminum alloy, preferably 7075, but this is not limiting, and at the same time said conic nut 38 threaded on said pivot axis 36 is arranged on a portion of said insert chassis 42, thereby being retained and fixed by means of said upper washer 39 and O-ring 41. Furthermore, in one embodiment, said lower washer 40 separates said insert chassis 42 from said circular pivot plate 35. All the aforementioned components can be manufactured, in alternative embodiments, with any suitable material, as is well-known to a person skilled in the art.

[0065] The fact that the laryngeal blade of a video laryngoscope according to one embodiment of the present disclosure can be folded and housed in the handle contributes to, in its non-operative position, a more compact equipment and that at the same time it may be moved without endangering the integrity of the blade. However, a person normally skilled in the art would understand that a fixed connection between the blade and the handle or any other type of connection could be another option.

[0066] In one embodiment, said fixed blade 28 can have a curved shape. Furthermore, in one embodiment, said fixed blade 28 comprises a lower portion of fixed blade 52 and an upper portion of fixed blade 31 .

[0067] In one embodiment, the fixed blade 28 supports the movable blade 29.

[0068] The lower portion of fixed blade 52, according to one embodiment of the present disclosure, has an upper side provided with a slide 53 and an extension-retraction mechanism of movable blade 54, which may be internal and may be arranged at a distal portion 55 of said lower portion of the fixed blade 52. In one embodiment, said slide 53 comprises respective guide protuberances 56 through which respective guide profiles 57 of the movable blade 29 fit. The arrangement of the slide will allow for the displacement of movable blade 29 relative to and along the fixed blade 28, the movable blade being able to be positioned at different selective positions, starting from a fully retracted position as illustrated in Figure 9a, to an extended position as illustrated in Figures 9c-f. In one embodiment, the movable blade may be located in more than one position, for example, two, three, four, five or more positions. In one preferred embodiment, the movable blade may be located in at least five positions l-V (see Figures 9b-9f, respectively).

[0069] Also, in one embodiment, said upper portion of fixed blade 31 comprises a radius of curvature of approximately 38 mm, but this is not limiting to the invention, whereas slide 53 has a radius of curvature of approximately 85 mm, this not being limiting either to the invention.

[0070] In one embodiment, at least one blade channel 30 removably mounted in said fixed blade 28 is provided, wherein said blade channel 30 comprises a guide channel for coupling of an endotracheal tube. In one embodiment of the present disclosure, a lateral guide channel 73 is provided, which is formed by said slide 53 above and the movable blade 29, by means of one of the lateral sides of said fixed blade 28 laterally, and by means of said blade channel 30 below which has an extension 74 of the channel for a better fit of endotracheal tube 75. In one embodiment, extension 74 of the channel has a proximal portion 76 which may be narrower than the distal portion 77 in order to allow for a slight movement in the endotracheal tube 75 so that it can be accommodated and easily and practically manipulated, providing it, for example, with a left skewed direction of more than 4° with 8.5 01 tubes being higher with thinner tubes, and thereby allowing it to coincide with the axis of the tip of the multipurpose blade. In one embodiment, said blade channel 30 has a recess 78 in accordance with the position of the extension-retraction mechanism housing 61.

[0071] In one embodiment, both the movable blade 29 and the blade channel 30 can be disassembled, independently, from fixed blade 28. For example, blade channel 30 may be disassembled as shown in Figures 9g-i in the case the operator requires so, which facilitates operation in complex situations such as the case of a maxillofacial surgery, among others, even when the device is operating using the movable blade. This is possible, in part, because disassembling the blade channel reduces total thickness of the blade. Likewise, when desired to operate only with the fixed blade 28, both the movable blade 29 and blade channel 30 may be disassembled, as illustrated in Figure 9i.

[0072] In yet another embodiment, said movable blade 29 comprises at least one longitudinal groove 58 in at least one of its lateral sides so as to better fit in said blade channel 30.

[0073] In one embodiment, blade channel 30 is provided with a flap 59, optionally of semicircular cross-section, thereby producing a mortise and tenon type joint. In one embodiment, blade channel 30 may support the movable blade 29 and fit into the lower portion of fixed blade 28.

[0074] As illustrated in Figures 10 to 14, referred to one embodiment of the present disclosure, the extension-retraction mechanism 54 provided internally in a distal portion of said fixed blade 28 is arranged within a housing 61 of the extension-retraction mechanism of said fixed blade 28. In one embodiment, the extension-retraction mechanism 54 comprises a trigger chassis 62 which supports at least one actuating lock trigger 63 arranged substantially perpendicular to slide 53 and movable blade 29, being said lock trigger 63 selectively coupled above between a plurality of half-round movable blade holes 64 arranged on the lower side of movable blade 29 and connected on its lower end to a spring 65 which in turn is connected to a lower bolt 66 connected to a housing 67 at the lower side of fixed blade 28. In one embodiment, the lower bolt 66 is operatively connected to a safety lock 68 which fits into a hole of the safety lock 69 provided in said fixed blade 28. In one embodiment, the extension-retraction mechanism provided in said fixed blade is arranged within a housing mechanism and preferably the extension-retraction mechanism can be removed from the housing mechanism for cleaning and maintenance purposes. In one embodiment, safety lock 68 allows for assembling and disassembling the trigger chassis 62 for cleaning and maintenance of the extension - retraction mechanism 54. Furthermore, said actuating lock trigger 63 comprises a central hemicylinder 70 and at its ends lateral to the central hemicylinder two right and left flaps 71. In one embodiment, said lock trigger 63, lock trigger chassis 62, spring 65 and spring bolt 66 are assembled and connected by means of a through stud bolt 72, being co-jointly housed in said extension-retraction mechanism housing 61 of fixed blade 28 of blind bottom with an opening on a lateral side thereof.

[0075] In one embodiment, the extension-retraction mechanism 54 allows for a selective extension or retraction of the movable blade 29 such that it can be positioned in different positions, for example positions l-V (Figures 9b-9f), starting from a fully retracted position (for example, position I - Figure 9a, b), an extended position (for example, positions ll-V - Figures 9c-f), wherein, when in the fully extended position (for example, position V - Figure 9f), blade channel 30 may be released (Figure 9h). Upon releasing of blade channel 30, the movable blade 29 can be retracted again to return to any of the mentioned positions (for example, positions l-l V) without the blade channel 30. For example, in Figure 9g the movable blade is shown in position I without the blade channel. This is particularly useful because in some situations some operators may prefer to avoid using blade channel 30. Likewise, movable blade 29 can be extended until it is disassembled from the fixed blade (Figure 9i). In one embodiment, when the movable blade 29 is disassembled, blade channel 30 is also released.

[0076] In one embodiment, the movable blade may be located in at least 5 positions, but a person skilled in the art would understand that alternative embodiments may be designed having fewer or more positions for the movable blade. By way of example, but not limiting to the invention, each position of the movable blade is spaced approximately 10 mm from the one immediately preceding and / or following it. In one embodiment, movable blade 29, considering its different positions, is functionally compatible, for example, with Macintosh 1 , 2, 3 and 4 blades, with Miller 1-4 blades, and / or with a blade of the hyperangled type such as D-BLADE blades from C-MAC®. Thereby, there is no need of interchanging these types or sizes of blades having different lengths according to the anthropometry of the patient.

[0077] Upon releasing movable blade 29 and blade channel 30, the fixed blade 28 is functionally compatible (according to the portion introduced into the oropharynx) with Macintosh 00 and 0 blades or with Miller 00 and 0 blades.

[0078] In one embodiment, blade channel 30 may be released and movable blade 29 can be used with a lower final blade thickness. Likewise, as shown in the embodiment of Figure 9i, movable blade 29 and blade channel 30 may be released so as to only operate with the fixed blade 28 having a much smaller size and thickness, and which is suitable for neonate patients, including premature neonates. This possibility of adapting to neonate patients, including premature neonates, is a substantial difference with respect to the video laryngoscopes of the prior art (for example, relative to the previous version of the inventor disclosed in W02022090454A1), which implies an important advantage since the current arrangements do not allow for adapting the same device to this type of patients, i.e., neonates, and adult patients, for example, obese adults with difficult airways and even to complex situations as may be a maxillofacial surgery. In contrast, generally video laryngoscopes which are not specific for neonates have a recommended minimum age of 2 years. On the contrary, thanks to its practicality the present invention can be used both with neonates as well as adults without any inconvenience. As explained above, this is achieved thanks to the fact that it has a detachable blade channel 30 and a movable blade 29 which may be located, for example, in at least 5 positions, and may be disassembled to operate with fixed blade 28 which is adequate for neonates. In one preferred embodiment, movable blade 29 in its different positions (for example, positions l-V) and fixed blade 28 may have

[0079] The specified measures constitute an additional advantage of a video laryngoscope according to one embodiment of the present disclosure, as it represents a small thickness

[0080] (with or without a channel) for a suitable useful length.

[0081] Although the multipurpose laryngeal blade of a video laryngoscope according to one embodiment of the present disclosure may be of any suitable design, in one preferred embodiment, said movable blade 29 comprises a bevel-shaped free end 60 which facilitates its introduction into the airway of the patient.

[0082] In one embodiment, movable blade 29 allows for achieving a better exposure of the anterior commissure, following a biomechanical / technical pattern characterized by a protrusion-like bulge of a free edge (described below) followed by a bending at an angle of approximately 20° terminals of this edge of a movable blade (described below) and a line joining the end of said free edge towards the body of the movable blade with an approximate upper radius of curvature of 85mm. The movable blade 29 bent at its tip according to one embodiment of the present disclosure is a biomechanical pattern that causes a change in its points and vectors of application of forces from the video laryngoscope 1 towards the larynx and surrounding tissues, precisely on the are of the base of the tongue and hyoid through a protrusion of the tip followed by a terminal bending of this tip of approximately 20 mm in length with an angle of approximately 20° between the tip of the blade and the body of the movable blade with am upper radius of curvature of approximately 85mm, unlike all known laryngoscopes which have a damaging tip as their main force vector. This causes a rising of the base of the tongue and a relative descent of the laryngeal crown, apart from being its anatomical structures with no stress and with less trauma to laryngeal and perilaryngeal tissues, thus optimized the endotracheal intubation procedure from all angles, either from a substantial reduction in the times used for essentially less trauma to the patient. This bending achieves a better and excellent exposure of the endolarynx, because with this design instead of exerting lever forces on the inner FACE of the thyroid cartilage or vallecula bed, also called glossoepiglottic recess, these forces are exerted mainly on the hiodes / base of the tongue complex, which is why rising of this complex is achieved and, as a result of this, a relative descent of the thyroid cartilage and the entire laryngeal crown, there being no need to perform external compression maneuvers on the thyroid cartilage area, as is usually done, to improve glottic exposure and also decreasing the use of stylets such as the Eschmann guide.

[0083] Preliminary anthropometric data on random samples revealed that the distance between the midpoint of the hyoid bone and the midpoint of the thyroid cartilage on the anatomical midsagittal plane in adults, is on average approximately 21.6 mm, being 17.8 mm + / - 2.7 mm in adult women, and 22.5 mm + / - 6.6 mm in adult men; values subject to height and racial variations. These anthropometric data also revealed that, in the midsagittal plane of the human larynx, the angle formed by the anterior edge of the thyroid cartilage with the axial cephalo-caudal axis of the laryngeal cylinder, i.e. axis perpendicular to the base of the cricoid ring, is on average approximately 24.1 °, being 22° + / - 6° in adult women, and 25.7° + / - 8.5° in adult men; values subject to height and racial variations. Therefore, the bent at the distal end of the tip of the movable blade of the video laryngoscope according to the present invention is coupled integrally with the epiglottis, deflecting and supporting it on the angle of the thyroid cartilage notch and on the hyoid bone given its great flexibility. As an alternative technique, the epiglottis can be deflected indirectly, that is, by not loading it through pressure on the hypoepiglottic ligament, in order to transmit the lever forces from the upper side of the laringeal valve, from its protuberance, to the base of the tongue and the hyoid bone. This is completely different from what occurs with other laryngoscope designs, wherein most of the forces are transmitted to the thyroid cartilage or vallecula bed from the potentially damaging tip of the laringeal valve. Said tip of the movable blade facilitates the intubation technique since, in the face of this relative drop of the laryngeal crown, the larynx is better exposed and with less tension on this tissue for the passage of the endotracheal tube.

[0084] Although a person normally skilled in the art would understand that different suitable materials may be used to make the components of the video laryngoscope of the present disclosure, in one embodiment, the movable blade 29 as well as the fixed blade 28 are made of AISI 316L steel, but this does not limit the scope of the present invention. Also, the lock trigger of blade 53, the spring bolt of lock trigger 57 and lock trigger chassis 58 are made of AISI 316 L steel and the spring of lock trigger 56 of AISI 303 or 308 steel, but this does no limit the scope of the present disclosure.

[0085] Regarding the angulation of the multipurpose laryngeal blade, in one embodiment, the same is adjusted once the movable blade body and its end are introduced in the patient’s airway and depending on the degree of introduction of the fixed blade arm. This highlights the video laryngoscope during its operation in the so-called difficult airway, where generally an angulation of the blade is more required and not the length thereof, so by introducing maximally the blade over the oropharynx in the fully retracted position of its movable blade, it is possible to achieve a significant angulation of said multipurpose laryngeal blade thus performing the function of an hyperangulated blade. Thus, a better performance of this video laryngoscope in difficult airways is achieved.

[0086] Furthermore, in one embodiment, said handle 2 comprises a receptacle for a button 22 for taking photos or videos which is operably connected to a camera 23, for example, a microcamera which may comprise a LED light 25. In one embodiment, as illustrated in Figure 15, said display screen 16, one or more buttons 17,18, battery housing 19, micro USB 20 port, a wireless charging receptor Wireless 21 , button 22 for taking photos or videos, a microcamera 23 with a LED light 25 and a WiFi 24 transceiver for wirelessly transmitting real time video, are in communication with a microprocessor 26 responsible for receiving and transmitting data between parts. In one embodiment, microprocessor 26 is mounted on a printed circuit board (PCB) comprising a plurality of image adjustment controls and embedded firmware connected respectively to said selection buttons 18, said microprocessor being in turn powered by one or more batteries arranged in the battery housing 19. It is noted that the batteries may be disposable or rechargeable, or a combination thereof with no inconvenience, whereas said selection buttons may correspond to functions of the MENU / OK, BACK, UP, DOWN type, WiFi signal command, or the like, but this is not limiting to the invention. In one embodiment, in turn, said microcamera 23 is provided with LED light 25, for example, a high potency LED light. In a preferred embodiment, the microcamera may be a camera with a viewing direction angle of respective 0°, a 55° angle of view or FOV and a 5 DOF at 100mm, but this is not limiting to the invention.

[0087] In one embodiment, the operator can visualize the patient’s airway on display screen 16 which shows what is captured by microcamera 23 arranged at the distal end of the fixed blade 28. In one embodiment, said microcamera 23 can be cemented in a microcamera housing, for example, using an epoxy resin, to achieve water-tightness. In yet another embodiment, said microcamera can be connected to said screen 16 through a microprocessor 26. In yet another embodiment, said microcamera 23 is connected to its respective capture button 22 for taking photos or recording videos, for example, by means of connecting cables which may be housed within an internal channel 79 which extends along the handle and fixed blade 28. In one embodiment, the internal channel 79 may be formed between a hemichannel defined in handle cap 8 and a hemichannel on a lateral side of handle 2, and when overlapping both hemichannels said internal channel 79 is created for carrying connecting cables.

[0088] Thus, in one embodiment, the operator may capture images and record videos simultaneously in vivo, this being activated by means of said capture button 22 for taking photos or recording videos. The microcamera 23 allows for viewing, taking photos and recording videos in real time, thus using it in various specialties such as anesthesiology, emergentology, pathology, diagnostics, intensive care, and otorhinolaryngology.

[0089] Furthermore, a video laryngoscope according to one embodiment of the present disclosure can be mounted in a charging base 80 having a geometry which allows for mounting the video laryngoscope. Said charging base 80 may be fixed or fastened be means of respective fixing holes 81 of base 80.

[0090] One of the major inconveniencies in the state of the art is related to the lack of practicality at exchanging the laryngoscope blades. This is because there is a blade of a given length for each type of patient. That is, depending on the type of patient one blade or another is used according to the required dimensions. The fact of having a plurality of blades of different lengths makes it an impractical instrument to transport or have on hand, either for an emergency or a transfer.

[0091] Although W02022090454A1 discloses a video laryngoscope of extensible movable blade, the disclosed device therein does not contemplate the possibility of being adaptable to neonates, which is possible in the case of a video laryngoscope according to one embodiment of the present disclosure, wherein the movable blade may be disassembled so that the operator can use a fixed blade appropriate for neonates. Furthermore, W02022090454A1 does not contemplate the possibility of a detachable blade channel (for example, blade channel 30), which facilitates, among others, operation in complex situations such as a maxillofacial surgery wherein the operator can disassemble the channel for reducing blade thickness.

[0092] In particular, the video laryngoscope of the present disclosure has the advantage that, thanks to the arrangement of the multipurpose laryngeal blade composed of a fixed blade, a movable blade and a blade channel, the extension of the movable blade running along a slide provided in said fixed blade can be regulated. The extension of the movable blade is performed at different points, the lengths of which allow for covering a wide range of patients, being the different positions functionally compatible with at least the Macintosh 1 , 2, 3 and / or 4 blades, the Miller 1-4 blades, and / or with a blade of the hyperangled type such as the D-BLADE blades from C-MAC®. In turn, in the case of neonate patients, it is only required to disassemble the movable blade and the blade channel, leaving the fixed blade whose length and dimensions are more than appropriate for the treatment of neonates, including premature neonates, with no inconvenience, as the fixed blade, depending on the degree of introduction of the blade arm can be functionally compatible with the Macintosh 0 and 00 blades and / or Miller 0 and 00 blades, this being completely novel in the state of the art since so far there did not exist an “all-in-one" device which can be adapted to the whole range of patients from adults, for example, obese adults with difficult airways, to premature neonates. Furthermore, the detachable blade channel of a video laryngoscope according to one embodiment of the present invention is also an advantage relative to the prior art.

[0093] In addition, conventional video laryngoscopes of the art must be connected to a power source through respective cables, making their maneuverability difficult. In the present disclosure, embodiments are contemplated in which the video laryngoscope has wireless charging, this being an additional improvement. Finally, another advantage of the video laryngoscope according to one embodiment of the present disclosure is that it is a watertight device, i.e., water resistant, which facilitates cleaning and sterilization.

Claims

CLAIMS1. A video laryngoscope comprising a handle having a proximal portion comprising a display screen or monitor and a distal portion connected to a laryngoscope blade comprising a camera, the video laryngoscope characterized in that said laryngoscope blade is a multipurpose laryngeal blade comprising: at least one fixed blade connected to the distal portion of said handle; at least one movable blade dismountably and removably mounted onto the fixed blade in a selective manner along said fixed blade; wherein said movable blade is suitable for accessing the airway of a patient and may be moved to different selective positions, from a fully retracted position to one or more extended positions; and wherein said fixed blade is also suitable for accessing the airway of a patient when the movable blade is dismounted.

2. A video laryngoscope according to claim 1 , characterized in that the fixed blade is suitable for accessing the airway of a neonate patient.

3. A video laryngoscope according to claim 1 , characterized by comprising at least one blade channel removably mounted in said fixed blade, wherein said blade channel comprises a guide channel for connection to an endotracheal tube.

4. A video laryngoscope according to claim 1 , characterized in that said fixed blade is connected to the distal portion of said handle by means of a pivot mechanism which allows for a pivoting movement of the multipurpose laryngeal blade from a handle housing to its operative position and vice versa.

5. A video laryngoscope according to claim 4, characterized in that the pivoting mechanism is in pivotal connection with a locking mechanism provided in the distal portion of said handle, wherein said locking mechanism allows for a positional fixation of the multipurpose laryngeal blade in the handle housing and in its operative position.

6. A video laryngoscope according to claim 1 , characterized in that the fixed blade comprises a lower portion of a fixed blade comprising, in its upper side a slide along which the movable blade can move, and in its distal portion an extension-retractionmechanism of a movable blade which allows for selectively extending or retracting the movable blade such that it can be positioned in said selective positions.

7. A video laryngoscope according to claim 6, characterized in that said extension-retraction mechanism provided in said fixed blade is arranged within a housing mechanism, and preferably the extension-retraction mechanism can be removed from the housing mechanism for cleaning and maintenance purposes.

8. A video laryngoscope according to claim 4, characterized in that said guide channel is conformed above by said slide, the movable blade laterally by one of the lateral sides of said fixed blade, and below by said blade channel.

9. A video laryngoscope according to claim 4, characterized in that said blade channel comprises a flap of semicircular cross-section which fits in a groove provided in a lateral side of said fixed blade.

10. A video laryngoscope according to any of claims 1-10, characterized in that it is a watertight device.

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