Endoscope with pressure sensing tip

Abstract

An endoscope can include a handle for holding and controlling the endoscope and an elongated member extending from a distal section of the handle. The elongated member can include a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member. A pressure sensor can be coupled to the distal portion of the elongated member and can be configured to detect pressure.

Description

ENDOSCOPE WITH PRESSURE SENSING TIPCLAIM OF PRIORITY

[0001] This patent application claims the benefit of priority, under 35 U.S.C. Section 119(e), to Kamaldeep Singh U.S. Patent Application Serial Number 63 / 602,728, entitled “ENDOSCOPE WITH A PRESSURE SENSING TIP,” filed on November 27, 2023 (Attorney Docket No. 5409.913PRV), which is hereby incorporated by reference herein in its entirety.TECHNICAL FIELD

[0002] The examples described herein generally relate to endoscopes, specifically endoscopes with a pressure-sensing capabilities.BACKGROUND

[0003] Conventional endoscopes can be used in a variety of clinical procedures, including, for example, illuminating, imaging, detecting and diagnosing one or more disease states, providing fluid delivery (e.g., saline or other preparations via a fluid channel) toward an anatomical region, providing passage (e.g., via a working channel) of one or more therapeutic devices for sampling or treating an anatomical region, providing suction passageways for collecting fluids (e.g., saline or other preparations), and the like. Such anatomical regions can include the gastrointestinal tract (e.g., esophagus, stomach, duodenum, pancreaticobiliary duct, intestines, colon, and the like), renal area (e.g., kidney(s), ureter, bladder, urethra), other internal organs (e.g., reproductive systems, sinus cavities, submucosal regions, respiratory tract), and the like.SUMMARY

[0004] In examples, an endoscope system can include a control system configured to control components of the endoscope system. The endoscope system can also include an endoscope configured to be inserted within a patient during a medical procedure. The endoscope can include a handle for holding and controlling the endoscope during a medical procedure and an elongated member extending from a distal section of the handle. The elongated member can include a lumen extending from a proximal portion of the elongated member to a distal portion of the elongatedmember. A pressure sensor can be coupled to the distal portion of the elongated member and be configured to detect pressure at a target site of the medical procedure.

[0005] In examples, an endoscope can be configured to be inserted within a patient during a medical procedure. The endoscope can include a handle for holding and controlling the endoscope during a medical procedure and an elongated member extending from a distal section of the handle. The elongated member can include a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member. A pressure sensor can be coupled to the distal portion of the elongated member and can be configured to detect pressure at a target site of the medical procedure.

[0006] In examples, a method of forming an endoscope can include coupling a first pressure sensor to a distal portion of an elongated member. The elongated member can include a lumen extending from the distal portion to a proximal portion. The first pressure sensor can be configured to detect pressure at a target site. Coupling a second pressure sensor to the elongated member proximal to the first pressure sensor. The method can also include connecting the first and second pressure sensors to a pressure signal monitoring circuit with an electrode.BRIEF DESCRIPTION OF THE DRAWINGS

[0007] Various examples are illustrated in the figures of the accompanying drawings. Such examples are demonstrative and not intended to be exhaustive or exclusive examples of the present subject matter.

[0008] FIG. l is a schematic diagram of an example of a medical device system.

[0009] FIG. 2 is a schematic diagram of an example of an imaging and control system of a medical device system.

[0010] FIG. 3 is a schematic diagram of an example of an endoscope.

[0011] FIG. 4 is a block diagram of an example of an endoscopy system.

[0012] FIG. 5 is a block diagram of an example of an endoscopy system.

[0013] FIG. 6 is a schematic diagram of an example of an endoscopy system.

[0014] FIG. 7 is a schematic diagram of an example of an endoscope.

[0015] FIG. 8 is a graphical representation indicative of pressure signals along an example elongated member.

[0016] FIG. 9 is a schematic diagram of an example of a computer-based clinical decision support system (CDSS).

[0017] FIG. 10 is a block diagram illustrating an example of a machine upon which one or more examples can be implemented.

[0018] FIG. 11 is a block diagram illustrating an example method for forming an example of an endoscope.DETAILED DESCRIPTION

[0019] Pressure within the kidneys can result in pyelovenous backflow during the medical procedure. Such pyelovenous backflow can increase a likelihood of sepsis during post-procedural recovery of the patient. To help measure the pressure within the kidneys during the medical procedure, endoscopes can include integrated pressure sensors. The present disclosure discusses an endoscope that can accurately measure pressure near a distal tip to determine the pressure within a kidney of a patient during a medical procedure.

[0020] According to the present disclosure, an endoscope can include a pressure sensor, applied to, fabricated on, or covering a distal end surface of the endoscope tip using piezoelectric materials. Piezoelectric materials can generate a range of electric signals when pressure is applied; thus, the piezoelectric materials used in the pressure sensor enable the sensor to detect pressure near the endoscope tip surface. The piezoelectric pressure sensor can include Lead Zirconate Titanate (PZT), quartz, Aluminum Nitride, or the like.

[0021] The endoscope can include electrodes (e.g., conductive wires), which can be made from material with a high conductivity or flexibility, such as, for example, gold, copper or aluminum. The electrodes can be fabricated to be routed along the endoscope shaft and connected to the piezoelectric pressure sensor. The electrodes can be completely or partially on an exterior or in an interior of the endoscope shaft. The electrodes can interface with a pressure monitoring circuit to measure the electric signals generated by the piezoelectric pressure sensor. The pressure monitoring circuit can be installed within the handle of the endoscope or external to the endoscope but connected, either wirelessly or via a wired connection, to any component of the endoscopic system. A biocompatible conformal coating can encapsulate the electrodes and piezoelectric layer.

[0022] Sampling devices can be inserted into the patient directly or through another endoscope (e.g., a bronchoscope) such that the bronchoscope and the sampling device form an endoscope-accessory instrument relationship (sometimes referred to as a parent-child relationship). As such, the endoscope can be inserted into a desired position within the patient. After the endoscope is in the desired position, the child device (e.g., the sampling device) can be inserted into the endoscope (e.g., via a working channel) and out of a distal end of the endoscope. The child device can be of a smaller diameter than the endoscope such that the child device can extend into passageways of the patient with smaller diameters than the endoscope. The child device (e.g., sampling device) can be extended from the distal end of the endoscope to a target area within the patient, and an instrument (e.g., a biopsy needle, ablation probe, etc.) of the child device can be deployed to extend from the distal end of the child device and obtain a tissue sample from the patient and / or to treat tissue of the patient (e.g., via ablation, medical delivery, etc.). Although other use cases are contemplated, the child device is primarily discussed herein in the particular context of being a sampling device that includes a side exit port such that the instrument is a biopsy needle that is extendable into the patient’s tissue at an angle with respect to a longitudinal axis of the sampling device.

[0023] The above discussion is intended to provide an overview of the subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the present disclosure. The description below is included to provide further information about the present patent application.

[0024] FIG. 1 is a schematic diagram of an endoscope system 100 that can include a control system 102 and an endobronchial ultrasound sampling arrangement including an endoscope 104 and a medical device 108 that is attachable to the endoscope 104 and which includes a distal portion 110 that extends from the distal end of the endoscope 104 via a distal working channel port (e.g., working channel port 112). The system of FIG. 1 is an illustrative example of an endoscopy system suitable for use with the systems, devices, and methods described herein.

[0025] The endoscope 104 can be insertable into an anatomical region for imaging or attachment to (e.g., via tethering) one or more sampling devices for biopsies or therapeutic devices for treating the anatomical region. The endoscope 104 can interface or connect to the control system 102. The endoscope 104 is described in the present example as a bronchoscope, though other types of endoscopes arecontemplated for use with the features and teachings of the present disclosure. The control system 102 can include a control unit 114, a display unit 116, an input unit 118, a light source 120, a fluid source 122, and a suction pump 124.

[0026] The control system 102 can include various ports for coupling with the endoscope system 100. For example, the control unit 114 can include a data input / output port for receiving data from and communicating data to the endoscope 104. The light source 120 can include an output port for transmitting light to the endoscope 104, such as via a fiber optic link. The fluid source 122 can include a port for transmitting fluid to the endoscope 104. The fluid source 122 can include, for example, a pump and a fluid tank or can be connected to an external tank, vessel, or storage unit. The suction pump 124 can include a port to draw a vacuum from the endoscope 104 to generate suction, such as for withdrawing fluid from the anatomical region into which the endoscope 104 is inserted. The display unit 116 and the input unit 118 can be used by an operator of the endoscope system 100 to control functions of the endoscope system 100 and view the output of the endoscope 104. The control unit 114 can also generate signals or other outputs from treating the anatomical region into which the endoscope 104 is inserted. In examples, the control unit 114 can generate electrical output, acoustic output, fluid output, or the like for treating the anatomical region with, for example, cauterizing, cutting, freezing, or the like.

[0027] The endoscope 104 can include an elongated member 126, a functional section 128, and a handle section 130, which can be coupled to a cable section 132 and a coupler section 134. The elongated member 126 can extend distally from the handle section 130, and the cable section 132 can extend proximally from the handle section 130. The elongated member 126 can be elongated and include a bending section and a distal end to which the functional section 128 can be attached. The bending section can be controllable (e.g., by a steering control 136 on the handle section 130) to maneuver the distal end through tortuous anatomical passageways (e.g., stomach, duodenum, kidney, ureter, trachea, lungs, or the like). The elongated member 126 can also include one or more working channels (e.g., an internal lumen) that can be elongated and can support the insertion of one or more therapeutic tools of the functional section 128, such as a bronchoscope. The working channel can extend between the handle section 130 and the functional section 128. Additional functionalities, such as fluid passages, guide wires, and pull wires, can also be provided with the elongated member 126 (e.g., via suction or irrigation passageways, or the like).

[0028] A coupler section 134 can be connected to the control unit 114 to connect the endoscope 104 to multiple features of the control unit 114, such as the input unit 118, the light source 120, the fluid source 122, and the suction pump 124.

[0029] The handle section 130 can include the steering control 136 and the port 138. The steering control 136 can be a knob, lever, or other actuation mechanism or the like, which can be used to navigate the endoscope 104 within the patient. The steering control 136 can be connected to a pull wire or other actuation mechanisms, extending through the elongated member 126. The port 138, as well as other ports, such as a port 140 can be configured to couple various electrical cables, guide wires, auxiliary scopes, tissue collection devices, fluid tubes, and the like to the handle section 130, such as for coupling with the elongated member 126. The examples shown in FIG. 1 and FIG. 2 are examples of endoscopes 104.

[0030] According to examples, the control system 102 can be provided on a mobile platform (e.g., a cart 142) with shelves for housing the light source 120, the suction pump 124, an image processing unit 202 (FIG. 2), or the like. Alternatively, components of the control system 102, shown in FIG. 1 and FIG. 2, can be provided directly on the endoscope 104 to make the endoscope “self-contained.”

[0031] The functional section 128 can include components for treating and diagnosing the anatomy of a patient. The functional section 128 can include an imaging device 144 (e.g., a complementary metal oxide semiconductor (CMOS) based, Chip-on-the-Tip image sensor), an illumination device 146 (e.g., a light emitting diode), and the working channel port 112 at a distal face of the functional section 128.

[0032] As shown in FIG. 1, a medical device 108 can extend from the working channel port 112 at the distal face of the functional section 128 of the medical device 108. The medical device 108 can be configured to be attached to the port 138 such that the medical device 108 extends through a working channel (e.g., the extending through the elongated member 126 to the working channel port 112) of the endoscope 104 and out the distal end of the endoscope 104. The medical device 108 can include an actuator 148 for advancing or retracting the elongated member 126 within the working channel so as to control how far distally from the working channel port 112 the distal end of the medical device 108 extends, an instrument actuator 150 (e.g., for actuating a biopsy needle from a side exit port of the medical device 108), and a distal portion 110. The instrument actuator 150 can be configured to extend the medical device 108 beyond a distal end of the endoscope 104, such as to navigate the medical device 108to the target area within the patient. The instrument actuator 150 can slide along a housing 152 of the medical device 108. The housing 152 can include indicia, which can indicate an amount of extension of the medical device 108 beyond a distal end of the endoscope 104 (e.g., beyond the working channel port 112). The instrument actuator 150 can be configured to extend an instrument from the medical device 108 to obtain a tissue sample from the patient. A distal portion 110 of the medical device 108 can include a transducer (or other imaging device) and a side exit port located proximal from the transducer for directing an instrument configured to obtain a tissue sample from the patient into the field of view of the transducer.

[0033] FIG. 2 is a schematic diagram of the endoscope system 100 of FIG. 1 including the control system 102 and an endobronchial ultrasound arrangement, which includes a medical device 108 extendable via a working channel of an endoscope 104. FIG. 2 shows components of the control system 102 coupled to the endoscope 104. The control system 102 can include the control unit 114, which can include or be coupled to an image processing unit 202, a treatment generator 204, and a drive unit 206, as well as the light source 120, the input unit 118, and the display unit 116. The control unit 114 can include, or can be in communication with, an endoscope, a surgical instrument, and an endoscopy system, which can include a device configured to engage tissue and collect and store a portion of that tissue and through which imaging equipment (e.g., a camera) can view target tissue via the inclusion of optically enhanced materials and components. The control unit 114 can be configured to activate a camera to view target tissues distal of the endoscopy system. The control unit 114 can be configured to activate the light source 120 to shine a light on the surgical instrument, which can include select components configured to reflect light in a particular manner, such as tissue cutters being enhanced with reflective particles.

[0034] The coupler section 134 can be connected to the control unit 114 to connect to the endoscope 104 to multiple features of the control unit 114, such as the image processing unit 202, the treatment generator 204, or the like. In examples, the port 138 can be used to insert another instrument or device, such as a child scope or auxiliary scope, or a sampling needle, biopsy needle, ablation instrument, scalpel, or the like, into the endoscope 104. Such instruments and devices can be independently connected to the control unit 114 via the cable section 132. In examples, the port 140 can be used to connect the coupler section 134 to various inputs and outputs, such as video, air, light and electric.

[0035] The image processing unit 202, the ultrasound image processing unit 208, and the light source 120 can interface with the endoscope 104 (e.g., at the functional section 128) or the medical device 108 by wired or wireless electrical connections. The control system 102 can generate signals to other components of the endoscope system 100 to illuminate an anatomical region, collect signals representing the anatomical region, process signals representing the anatomical region, and display images representing the anatomical region on the display unit 116. The ultrasound image processing unit 208 can be configured to receive ultrasonic signals from either of the endoscope 104 or the medical device 108 (or any other component of the endoscope system 100), which can be converted into ultrasonic images and transmitted to the display unit 116 or any other component of the endoscope system 100. The control system 102 can include the light source 120 used to illuminate the anatomical region using light of a desired spectrum (e.g., broadband white light, narrow-band imaging using electromagnetic wavelengths, and the like). The control system 102 can connect (e.g., via an endoscope connector) to the endoscope 104 for signal transmission (e.g., light output from the light source, video signals from the imaging system in the distal end, diagnostic and sensor signals from a diagnostic device, and the like).

[0036] The fluid source 122 (shown in FIG. 1) can be in communication with the control unit 114 and can include one or more sources of air, saline, or other fluids, as well as associated fluid pathways (e.g., air channels, irrigation channels, suction channels, and the like) and connectors (barb fittings, fluid seals, valves, and the like). The control system 102 can also include a drive unit 206, which can include a motorized drive for advancing or retracting a distal section of endoscope 104.

[0037] FIG. 3 is a schematic diagram of an example of a portion of the distal portion 110 of an example of the medical device 108. The distal portion 110 of the medical device 108 can include one or more pressure sensors 310 and one or more electrodes 320 (e.g., conductive wires). As shown in FIG. 3, the pressure sensor 310 can be on the distal end of the medical device 108 or the sides of the medical device 108 and adjacent to the distal end of the medical device 108. The pressure sensor 310 can be configured to detect pressure near the distal end of the medical device 108.

[0038] The pressure sensor 310 can include micro-electromechanical components, which can use piezoelectric material. For example, the pressure sensor 310 can include a micro-electro-mechanical system (MEMS) based piezoelectricsensor. The pressure sensor 310 can be attached to the medical device 108 by adhesive or other affixing structures such as bands or straps. The pressure sensor 310 can be formed directly on the medical device 108 using deposition techniques. The pressure sensor 310 provided near the distal portion 110 of the medical device 108 can enable sensing of anatomical pressure around the distal end of the medical device 108. The pressure sensor 310 can be disposed on the distal portion 110 of the medical device 108 such that the pressure sensor 310 defines the distal end of the medical device 108. At least a portion of the pressure sensor 310 can define a periphery of the distal portion 110.

[0039] The piezoelectric materials used to make the pressure sensor 310 can be configured to generate a range of electric voltages. The voltages can be in the micro range. The piezoelectric materials can be connected to an electrical circuit that can receive the voltages, which may be generated in response to physical pressure. Examples of piezoelectric materials that can be used to make the pressure sensor 310 include quartz, Lead Zirconate Titanate (PZT), Aluminum Nitride, lithium niobate, and the like.

[0040] The electrode 320 (e.g., conductive wire) can be connected to the pressure sensor 310 and configured to transfer electrical signals generated by the pressure sensor 310 to one or more components of the medical device 108. For example, the electrode 320 can connect the pressure sensor 310 to a pressure signal monitoring circuit 330. The electrode 320 can be configured to be deposited on the surface of the medical device 108 along with the pressure sensor 310. The electrode 320 can extend along a periphery of the medical device 108. Such versions of the electrode 320 can include a masking material to control the width of the electrode plating and compensate for cross-coupling capacitance. A biocompatible conformal coating can be applied over the electrode 320 and the pressure sensor 310 to protect the pressure sensor 310, the electrode 320, or the pressure signal monitoring circuit 330 from the surrounding anatomy of the patient. The electrode 320 can be routed within the medical device 108 such that it does not extend beyond a periphery of the electrode 320.

[0041] Although multiple electrodes 320 are illustrated in FIG. 3, a single electrode 320 can be implemented. The pressure sensor 310 can be operated in reference mode, where one contact for the pressure sensor 310 can be coupled to a reference point, such as a ground reference, and another contact can be coupled to theelectrode 320. The pressure sensor 310 can be operated in a differential mode, where each of two distinct contacts for the pressure sensor 310 are connected to a distinct electrode 320.

[0042] The pressure sensor 310 can include piezoelectric materials to generate a range of electric signals, such as voltages or currents, that represent a range of pressures applied to the piezoelectric materials. The electric signals can be received by a connected electrical circuit (e.g., the pressure signal monitoring circuit 330) to process the electric signals. More specifically, the piezoelectric effect can cause the asymmetric crystalline structure of materials like quartz, lead zirconate titanate (PZT), Aluminum Nitride, lithium niobate, or the like, to become slightly electrically charged when mechanical stress is applied.

[0043] For example, when external pressure is placed on the pressure sensor 310, the pressure causes the piezoelectric material to deform. This deformation of the asymmetric crystal structure generates an electrical charge that manifests as a voltage between the electrodes of the pressure sensor 310. The properties of this voltage, such as, for example, magnitude or frequency, can be proportional to or otherwise representative of the amount of mechanical stress placed on the pressure sensor 310.

[0044] The pressure signal monitoring circuit 330 can process the electric signals from the pressure sensor 310. For example, the electric signals can be captured, compensation can be applied, the electric signals can be amplified, or otherwise converted into pressure readings. The pressure sensor 310 can use microscopic crystal deformations to transduce physical pressure into measurable electrical signals. The arrangement and sensitivity of the piezoelectric material can be tailored to detect pressure ranges and changes relevant to medical applications. The pressure signal monitoring circuit 330 can include an oscillator circuit to detect changes in signals received from the pressure sensor 310. For example, the pressure signal monitoring circuit 330 can include a pierce crystal oscillator.

[0045] The pressure signal monitoring circuit 330 can be configured to receive and process the signal from the pressure sensor 310 via the electrode 320 and, for example, amplify, capture, compensate or convert the signal into pressure readings. The pressure signal monitoring circuit 330 can transmit the pressure readings to one or more systems of the endoscope system 100, such as the control unit 114 (FIG. 1) or any other system of the endoscope system 100. The pressure signal monitoring circuit 330 pressure readings can be transmitted to the clinician via the display unit 116 or anaudible, visual, haptic, or other representation. The pressure signal monitoring circuit 330 can be disposed within the handle (e.g., the handle section 130, see FIG. 1).

[0046] FIG. 4 is a block diagram of an example of a portion of the endoscope system 100. As shown in FIG. 3 and FIG. 4, the medical device 108 (e.g., a distal portion 110 of the elongated member 126, see FIG. 1) can include one or more pressure sensors 310 and one or more electrodes 320. The pressure sensor 310 can be communicatively connected to the pressure signal monitoring circuit 330 by the electrode 320. As shown in FIG. 4, the pressure signal monitoring circuit 330 can be disposed within the handle section 130 (FIG. 1). The pressure signal monitoring circuit 330 can be in communication with a frequency response monitor 404. In another example, the pressure signal monitoring circuit 330 can be included in the control system 102 (FIG. 1).

[0047] The endoscope system 100 can include the frequency response monitor 404 within the control system 102. In examples, the pressure signal monitoring circuit 330 can include the frequency response monitor 404. The frequency response monitor 404 can be connected to the pressure signal monitoring circuit 330. The frequency response monitor 404 can be configured to receive a pressure signal 406 from the pressure signal monitoring circuit 330. The pressure signal 406 can be indicative of pressure detected by one or more of the pressure sensors 310.

[0048] The control system 102 can also include a controller 408, including processing circuitry 410, and memory 412, including instructions 414. The memory 412 can be coupled to the controller 408. The instructions 414 can be executed by the processing circuitry 410 to cause the processing circuitry 410 to receive, via the frequency response monitor 404, the pressure signal 406 from the pressure signal monitoring circuit 330. The instructions 414 can be executed by the processing circuitry 410 to generate an output 416 on condition that the pressure signal 406 is beyond a threshold 428. The threshold 428 can be stored on a database 426 in communication with the controller 408.

[0049] The output 416 can include an alert 420 and a control signal 422. In examples, the instructions 414 can be executed by the processing circuitry 410 to cause the controller 408 to signal the output 416 to transmit the alert 420 to a display unit 116. The controller 408 can transmit a visual representation of the combined pressure signal to the output 416, which can provide the representation to the display unit 116 to map an average pressure detected along the elongated member 126 and at the targetsite of the medical procedure. The instructions 414 can be executed by processing circuitry 410 to configure the controller 408 to output a control signal 422 to the control unit 114 to control components of the endoscope system 100 including a fluid management system 424 (e.g., a control system for the fluid source 122). The control signals transmitted to the fluid management system 424 form a closed-loop control system for pressure management with the medical device 108.

[0050] FIG. 5 is a block diagram of an example of an endoscope system 500 (e.g., the endoscope system 100, see FIG. 1). The medical device 108 can include pressure sensor 502a and pressure sensor 502b (e.g., pressure sensor 310, see FIG. 3). In an example, the pressure sensor 502a can be disposed at the distal portion 110, or adjacent to the distal portion 110 of the medical device 108. The pressure sensor 502b can be disposed proximally to the pressure sensor 502a. The pressure sensor 502a can transmit a signal 504a via an electrode 506a to the pressure signal monitoring circuit 330. The pressure sensor 502b can transmit a signal 504b via an electrode 506a to the pressure signal monitoring circuit 330. The pressure sensors 502a and 502b can be coupled to the medical device 108 (FIG. 1) with a thin film deposition process.

[0051] The pressure signal monitoring circuit 330 can be configured to output a signal 508a and a signal 508b indicative of the signal 504a and the signal 504b, respectively, to the frequency response monitor 404. The instructions 414 can be executed by processing circuitry 410 to cause the frequency response monitor 404, to receive the signal 508a and the signal 508b via the pressure signal monitoring circuit 330 and generate a combined pressure signal 418. In one example, the frequency response monitor 404 can combine the signal 508a and the signal 508b to form the combined pressure signal 418 by determining an average of the signal 508a and the signal 508b. Each of the signals 508a and 508b can be averaged and then combined by averaging to determine an average of the signals. Alternatively, the signals 508a and 508b can be combined by averaging directly, e.g., without averaging each signal. The combined pressure signal 418 can be indicative of an average pressure detected in the distal portion 110 of the medical device 108. Other processing of the signals (504a, 504b, 508a, or 508b) can be carried out, including compensating, weighting or amplifying the signals (504a, 504b, 508a, or 508b), as well as the application of other signal processing and statistical techniques, such as filtering or statistical signal combination to produce the combined pressure signal 418.

[0052] The output 416 can include an alert 420 and a control signal 422. In examples, the instructions 414 can be executed by the processing circuitry 410 to cause the controller 408 to signal the output 416 to transmit the alert 420 to a display unit 116. The controller 408 can transmit a visual representation of the combined pressure signal to the output 416, which can provide the representation to the display unit 116 to map an average pressure detected along the elongated member 126 and at the target site of the medical procedure. The instructions 414 can be executed by processing circuitry 410 to configure the controller 408 to output a control signal 422 to the control unit 114 to control components of the endoscope system 100 including a fluid management system 424 (e.g., a control system for the fluid source 122). The control signals transmitted to the fluid management system 424 form a closed-loop control system for pressure management with the medical device 108.

[0053] The endoscope system 500 can include more pressure sensors (e.g., the pressure sensors 502a and 502b) than the endoscope system 100, which allows the endoscope system 500 to detect the pressures experienced by the medical device 108 at more points. Detecting pressure at more points of the medical device 108 can lead to more accurately representing pressure throughout the medical procedure. The multiple pressure sensors can be in a redundant configuration to provide error checking and increase measurement reliability.

[0054] FIG. 6 is a schematic diagram of an example endoscopy control system, which can include a medical device 108 with a distal portion 110 and a handle section 130. The medical device 108 can include sensors (e.g., the pressure sensor 310, FIG. 3) to detect pressure using a piezoelectric pressure sensor. As discussed herein, the pressure sensor 310 can be connected to the pressure signal monitoring circuit 330 via one or more electrodes (e.g., the electrode 320). The pressure sensor 310 can detect anatomical pressure and can be in communication with the pressure signal monitoring circuit 330. The pressure signal monitoring circuit 330 can include a Pierce crystal oscillator to output a frequency signal indicative of the pressure detected by the pressure sensor 310.

[0055] As shown in FIG. 6, the pressure signal monitoring circuit 330 can monitor the frequency response from the PZT material (e.g., the pressure sensors 310, 502a or 502b, shown as the pressure sensor 310 in FIG. 6). The pressure signal monitoring circuit 330 can be coupled to a frequency response monitor 404, such as is shown in FIGS. 4 and 5. The frequency response monitor 404 can track the frequencyresponse of the pressure sensor 310 as an output of the pressure signal monitoring circuit 330. A shift in frequency response, such as from 14.7 kHz to 14.9 kHz (a change of 0.2 kHz), can be detected by the frequency response monitor 404, and can be used to calculate a related pressure change. The pressure signal monitoring circuit 330 can be implemented as a differential circuit or a reference (e.g., ground) based circuit. The frequency response monitor 404 can employ a digital algorithm to determine pressure values or changes in pressure based on the output of the pressure signal monitoring circuit 330, with inputs from the pressure sensor 310.

[0056] The control unit 114 can be connected to the frequency response monitor 404, allowing for the processing and interpretation of the frequency data produced by the frequency response monitor 404. The control unit 114 can provide the representative pressure readings to a system user as discussed above.

[0057] FIG. 7 is a schematic diagram of an example of the distal portion 110 of an example of the medical device 108. The medical device 108 can include multiple pressure sensors 310. The pressure sensors 310 can be located near the distal end of the distal portion 110, proximal to the distal end of the distal portion 110, or along the medical device 108 from the distal portion 110 toward the proximal end. The electrodes 320 can extend from the pressure sensors 310 to connect the pressure sensors 310 to the pressure signal monitoring circuit 330. The pressure signal monitoring circuit 330 can receive the signals generated (e.g., signals 402, FIG. 4 or signal 504a or signal 504b, FIG. 5) and provide an output to the frequency response monitor 404 (FIG. 4). The multiple pressure sensors can be in a redundant configuration to provide multiple points of measurement to enable error checking and increase measurement reliability.

[0058] FIG. 8 is a graphical representation indicative of pressure signals (e.g., a first pressure signal 802, a second pressure signal 804, a third pressure signal 806, a fourth pressure signal 808, and a fifth pressure signal 810) along an example elongated member (e.g., the elongated member 126 of the medical device 108, see FIG. 1). As discussed herein, the system (e.g., endoscope system 100, FIG. 1) can include a display unit 116 (FIG. 1). The instructions 414 (FIG. 4) can be used by the processing circuitry 410 to configure the controller 408 (FIG. 4) to generate a visual representation (e.g., graphical representation 800) of the combined pressure signal to map an average pressure detected along the elongated member (e.g., the elongated member 126 of the medical device 108, see FIG. 1) and at the target site. As shown, the pressure sensors(which are indicated on the graphical representation 800 via the pressure signals 802 - 810) can extend along the elongated member from a proximal portion to a distal portion. As such, the graphical representation 800 can represent the pressures along the elongated member and at the surgical site. The multiple pressure sensors can be in a redundant configuration to provide multiple points of measurement to enable error checking and increase measurement reliability.

[0059] FIG. 9 shows a schematic diagram of an example of a computer-based clinical decision support system (CDSS) 900 that is configured to control one or more aspects ofan endoscopic system, e.g., the endoscope system 100 or 500, including the medical device 108 of FIG. 1. The CDSS 900 can receive input from and provide output to the components of the endoscopic system. In examples, the CDSS 900 can include an input interface 904 through which information can be input. For example, medical information such as age, weight, sex, which can be specific to a patient, or procedure specific information, such as, location of anomaly, planned path for the procedure, planned steps of the procedure, or the like, can be provided to the CDSS 900 via the input interface 904. The input interface 904 may include a user interface (UI) through which information may be input by a user, such as, for example, medical information or selection of medical information.

[0060] The CDSS 900 can include an Al (artificial intelligence) model 906 that is configured to accept inputs, such as, for example, from input interface 904. A processor 908 may be included in the endoscope system 100 or 500. The processor 908 may be provided with, e.g., the control unit 114, FIG. 1 or the controller 408, FIG. 4. The processor 908 can perform an inference operation using the Al model 906 based on one or more input sources. For example, data from any of the components of the endoscopic system, as well as data from external sources, can be collected and input to the input interface 904. External data sources may include medical information, such as information about a medical condition, such as an injury, abnormality or disease, or procedure-specific information, or the like. The data input into the input interface 904 can be processed by the processor 908 to be applied to the Al model 906 to generate an output. Examples of such outputs include a suggested medical procedure, identification of an injury, disease or abnormality and / or enhanced parameters for operation of the endoscopic system. Outputs can be provided to an output interface 910, which may include the user interface through which suggested medical procedure is communicated to a user, e.g., a clinician.

[0061] The input interface 904 can include a direct data link between the CDSS 900 and one or more medical devices (e.g., the control unit 114, FIG. 1 or the controller 408, FIG. 4) to communicate data from the one or more medical devices as the input features for the CDSS 900. For example, the input interface 904 can receive input from any one of the components of the endoscopic system, can receive medical information or procedure-specific information, or the like, including during a therapeutic and / or diagnostic medical procedure. Additionally, or alternatively, the input interface 904 can include the user interface that facilitates interaction between a user and the CDSS 900. For example, the input interface 904 can facilitate the user interface through which the user can manually enter or select medical information, procedure-specific information, or the like. Additionally, or alternatively, the input interface 904 can provide the CDSS 900 with access to an electronic patient record from which one or more input features can be extracted. Such electronic patient records can be stored on a database 902. In any of these example cases, the input interface 904 can be configured to collect one or more input features in association with a specific patient or procedure before, during or after a time at which the CDSS 900 is used for a medical procedure.

[0062] Based on one or more of the above input features, the processor 908 performs an inference operation using the Al model 906. For example, input interface 904 can communicate any of the medical information, medical procedure information, outputs from any one of the components of the endoscopic system, or feedback signals from an output layer of the Al model 906 to an input layer of the Al model 906. The Al model 906 processes and propagates the input features communicated to the input layer to the output layer. The Al model 906 can make inferences based on patterns found in the analysis of data. The Al model 906 may use algorithms (e.g., machinelearning algorithms) that can learn from existing data and make predictions about new data. The Al model 906 can be constructed using example training data in order to make data-driven predictions or decisions expressed as outputs or assessments.

[0063] There are two common modes for machine learning (ML): supervised ML and unsupervised ML. Supervised ML uses prior knowledge (e.g., examples that correlate inputs to outputs or outcomes) to learn the relationships between the inputs and the outputs. The goal of supervised ML is to learn a function that, given some training data, best approximates the relationship between the training inputs and outputs so that the ML model can implement the same relationships when given inputsto generate the corresponding outputs. Unsupervised ML is the training of an ML algorithm using information that is neither classified nor labeled and allowing the algorithm to act on that information without guidance. Unsupervised ML is useful in exploratory analysis because it can automatically identify structure in data.

[0064] Common tasks for supervised ML are classification problems and regression problems. Classification problems, also referred to as categorization problems, aim at classifying items into one of several category values (for example, is this object an apple or an orange?). Regression algorithms aim at quantifying some items (for example, by providing a score to the value of some input). Some examples of commonly used supervised ML algorithms are Logistic Regression (LR), Naive- Bayes, Random Forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and Support Vector Machines (SVM).

[0065] Some common tasks for unsupervised ML include clustering, representation learning, and density estimation. Some examples of commonly used unsupervised ML algorithms are K-means clustering, principal component analysis, and auto-encoders.

[0066] Another type of ML is federated learning (also known as collaborative learning) that trains an algorithm across multiple decentralized devices holding local data, without exchanging the data. This approach stands in contrast to traditional centralized machine-learning techniques where all the local datasets are uploaded to one server, as well as to more classical decentralized approaches which may assume that local data samples are identically distributed. Federated learning enables multiple actors to build a common, robust machine learning model without sharing data, to address issues such as data privacy, data security, data access rights and access to heterogeneous data.

[0067] In examples, the Al model 906 can be trained continuously or periodically prior to performance of the inference operation by the processor 908. During the inference operation, the patient specific input features provided to the Al model 906 can be propagated from the input layer, through one or more hidden layers, and ultimately to the output layer. The output layer can provide data that corresponds to an outcome, such as, for example, identification of an injury, disease or abnormality and / or a suggested medical procedure. For example, the age of the patient, size of the patient, or any other medical information of the patient, such as, for example, a location of the patient sample site, can be used as input to CDSS 900. This input maybe used by the CDSS 900 to indicate that the sample may be difficult to obtain. In response, the processor 908 can suggest approaches, such as use of a smaller version of the endoscope, a different path that can improve imaging and sampling efforts, and / or an energy level suited for the situation for use with cutting, ablation, or removal procedures.

[0068] Before, during and / or subsequent to the inference operation, the output interface 910 can provide recommendations that can be communicated to the user via the user interface and / or can provide a signal or control to any component of the endoscopic system for performing a desired action. For example, an image sensor can provide an image, or an indication of image quality to the input interface 904. The input interface can provide the image or the indication to The Al model 906, which can process the related data to provide an output to the output interface 910. If the output provided to the output interface 910 determines or indicates that the imaging quality is poor, the processor 908 can transmit a signal via the output interface 910 to components of the endoscope system 100,500 to compensate. For example, the processor 908 can provide a signal to a light source control unit to alter the brightness, color, saturation, or any other parameter of the light source 120. The processor 908 can send a controlling signal to the fluid source 122 to change a fluid supplied to the pump(s). The processor 908 can send a signal to the pump(s) to alter a velocity or volume of fluid supplied to the imaging site. The processor 908 can send a signal to the pump(s) to increase or decrease an amount of suction provided to the imaging site. These are exemplary actions that can be implemented by the CDSS 900 to aid in the data processing and implementation of the medical procedure. The CDSS 900 can help with any aspect of the medical procedure, such as, planning preoperatively, performing intraoperatively, or analyzing the procedure postoperatively, or the like.

[0069] FIG. 10 is a block diagram of an example machine 1000 upon which any one or more of the techniques (e.g., methodologies) discussed herein can perform. Examples, as described herein, can include, or can operate by, logic or a number of components, or mechanisms in the machine 1000. Circuitry (e.g., processing circuitry) is a collection of circuits implemented in tangible entities of the machine 1000 that include hardware (e.g., simple circuits, gates, logic, etc.). Circuitry membership can be flexible over time. Circuitries include members that may, alone or in combination, perform specified operations when operating. In an example, hardware of the circuitry can be immutably designed to carry out a specific operation (e.g., hardwired). In anexample, the hardware of the circuitry can include variably connected physical components (e.g., execution units, transistors, simple circuits, etc.), including a machine-readable medium physically modified (e.g., magnetically, electrically, moveable placement of invariant massed particles, etc.) to encode instructions of the specific operation. In connecting the physical components, the underlying electrical properties of a hardware constituent are changed, for example, from an insulator to a conductor or vice versa. The instructions enable embedded hardware (e.g., the execution units or a loading mechanism) to create members of the circuitry in hardware via the variable connections to carry out portions of the specific operation when in operation. Accordingly, in an example, the machine-readable medium elements are part of the circuitry or are communicatively coupled to the other components of the circuitry when the device is operating. In an example, any of the physical components can be used in more than one member of more than one circuitry. For example, under operation, execution units can be used in a first circuit of a first circuitry at one point in time and reused by a second circuit in the first circuitry, or by a third circuit in a second circuitry at a different time. Additional examples of these components with respect to the machine 1000 follow.

[0070] In alternative examples, the machine 1000 can operate as a standalone device or can be connected (e.g., networked) to other machines. In a networked deployment, the machine 1000 can operate in the capacity of a server machine, a client machine, or both in server-client network environments. In an example, the machine 1000 can act as a peer machine in peer-to-peer (P2P) (or other distributed) network environment. The machine 1000 can be a personal computer (PC), a tablet PC, a set- top box (STB), a personal digital assistant (PDA), a mobile telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein, such as cloud computing, software as a service (SaaS), other computer cluster configurations.

[0071] The machine 1000 can include a hardware processor 1002 (e.g., a central processing unit (CPU), a graphics processing unit (GPU), a hardware processor core, or any combination thereof), a main memory 1004, a static memory (e.g.,memory or storage for firmware, microcode, a basic-input-output (BIOS), and mass storage 1008 (e.g., hard drives, tape drives, flash storage, or other block devices) some or all of which can communicate with each other via an interlink 1030 (e.g., bus). The machine 1000 can further include a display unit 1010, an alphanumeric input device 1012 (e.g., a keyboard), and a user interface navigation device 1014 (e.g., a mouse). In examples, the display unit 1010, input device 1012 and UI navigation device 1014 can be a touch screen display. The machine 1000 can additionally include a signal generation device 1018 (e.g., a speaker), a network interface device 1020, and one or more sensors 1016, such as a global positioning system (GPS) sensor, compass, accelerometer, or other sensor. The machine 1000 can include an output controller 1028, such as a serial (e.g., universal serial bus (USB), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection to communicate or control one or more peripheral devices (e.g., a printer, card reader, etc.).

[0072] Registers of the processor 1002, the main memory 1004, the static memory 1006, or the mass storage 1008 can be, or include, a machine-readable medium 1022 on which is stored one or more sets of data structures or instructions 1024 (e.g., software) embodying or utilized by any one or more of the techniques or functions described herein. The instructions 1024 can also reside, completely or at least partially, within any of registers of the processor 1002, the main memory 1004, the static memory 1006, or the mass storage 1008 during execution thereof by the machine 1000. In an example, one or any combination of the hardware processor 1002, the main memory 1004, the static memory 1006, or the mass storage 1008 can constitute the machine-readable media 1022. While the machine-readable medium 1022 is illustrated as a single medium, the term “machine-readable medium” can include a single medium or multiple media (e.g., a centralized or distributed database, and / or associated caches and servers) configured to store the one or more instructions 1024.

[0073] The term “machine-readable medium” can include any medium that is capable of storing, encoding, or carrying instructions for execution by the machine 1000 and that causes the machine 1000 to perform any one or more of the techniques of the present disclosure, or that is capable of storing, encoding or carrying data structures used by or associated with such instructions. Non-limiting machine-readable medium examples can include solid-state memories, optical media, magnetic media, and signals (e.g., radio frequency signals, other photon-based signals, sound signals,etc.). In an example, a non-transitory machine-readable medium comprises a machine- readable medium with a plurality of particles with invariant (e.g., rest) mass, and thus are compositions of matter. Accordingly, non-transitory machine-readable media are machine-readable media that do not include transitory propagating signals. Specific examples of non-transitory machine-readable media can include: non-volatile memory, such as semiconductor memory devices (e.g., Electrically Programmable Read-Only Memory (EPROM), Electrically Erasable Programmable Read-Only Memory (EEPROM)) and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

[0074] In an example, information stored or otherwise provided on the machine-readable medium 1022 can be representative of the instructions 1024, such as instructions 1024 themselves or a format from which the instructions 1024 can be derived. This format from which the instructions 1024 can be derived can include source code, encoded instructions (e.g., in compressed or encrypted form), packaged instructions (e.g., split into multiple packages), or the like. The information representative of the instructions 1024 in the machine-readable medium 1022 can be processed by processing circuitry into the instructions to implement any of the operations discussed herein. For example, deriving the instructions 1024 from the information (e.g., processing by the processing circuitry) can include: compiling (e.g., from source code, object code, etc.), interpreting, loading, organizing (e.g., dynamically or statically linking), encoding, decoding, encrypting, unencrypting, packaging, unpackaging, or otherwise manipulating the information into the instructions 1024.

[0075] In an example, the derivation of the instructions 1024 can include assembly, compilation, or interpretation of the information (e.g., by the processing circuitry) to create the instructions 1024 from some intermediate or preprocessed format provided by the machine-readable medium 1022. The information, when provided in multiple parts, can be combined, unpacked, and modified to create the instructions 1024. For example, the information can be in multiple compressed source code packages (or object code, or binary executable code, etc.) on one or several remote servers. The source code packages can be encrypted when in transit over a network and decrypted, uncompressed, assembled (e.g., linked), and compiled or interpreted (e.g., into a library, stand-alone executable etc.) at a local machine, and executed by the local machine.

[0076] The instructions 1024 can be further transmitted or received over a communications network 1026 using a transmission medium via the network interface device 1020 utilizing any one of a number of transfer protocols (e.g., frame relay, internet protocol (IP), transmission control protocol (TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP), etc.). Example communication networks can include a local area network (LAN), a wide area network (WAN), a packet data network (e.g., the Internet), LoRa / LoRaWAN, or satellite communication networks, mobile telephone networks (e.g., cellular networks such as those complying with 3G, 4G LTE / LTE-A, or 5G standards), Plain Old Telephone (POTS) networks, and wireless data networks (e.g., Institute of Electrical and Electronics Engineers (IEEE) 802.11 family of standards known as Wi-Fi®, IEEE 802.15.4 family of standards, peer-to-peer (P2P) networks, among others. In an example, the network interface device 1020 can include one or more physical jacks (e.g., Ethernet, coaxial, or phone jacks) or one or more antennas to connect to the communications network 1026. In an example, the network interface device 1020 can include a plurality of antennas to wirelessly communicate using at least one of single-input multiple-output (SIMO), multiple-input multiple-output (MIMO), or multiple-input single-output (MISO) techniques. The term “transmission medium” shall be taken to include any intangible medium that is capable of storing, encoding or carrying instructions for execution by the machine 1000, and includes digital or analog communications signals or other intangible medium to facilitate communication of such software. A transmission medium is a machine-readable medium.

[0077] FIG. 11 is a block diagram illustrating an example method 1100. The method 1100 can be for forming an example of an endoscope. The method 1100 can be forming any of the endoscopes discussed herein (e.g., the medical device 108, first shown in FIG. 1). The method 1100 can include one or more of operations 1110-1130.

[0078] At operation 1110, the method 1100 can include coupling a first pressure sensor (e.g., pressure sensor 310, FIG. 3) to a distal portion (e.g., the distal portion 110, FIG. 1) of an elongated member (e.g., the elongated member 126, FIG. 1). As discussed in FIG. 1, the elongated member 126 can include a lumen extending from the distal portion (e.g., the distal portion 110) to a proximal portion. The first pressure sensor 310 can be configured to detect pressure at a target site. For example, the pressure sensor 310 can be configured to detect pressure at, adjacent to, or around the distal portion 110 of the medical device 108.

[0079] At operation 1120, the method 1100 can include coupling a second pressure sensor (e.g., pressure sensor 310, FIG. 3) to the elongated member 126 proximal to the first pressure sensor. The second pressure sensor can be installed adjacent to the first pressure sensor and extend proximally along the elongated member 126. The second pressure sensor can be proximally spaced from the first pressure sensor and coupled to the elongated member 126. In examples, the medical device 108 can include many pressure sensors extending along the 126 from the distal portion 110 to the proximal end of the elongated member 126.

[0080] At operation 1130, the method 1100 can include connecting the first and second pressure sensors to a pressure signal monitoring circuit (e.g., the pressure signal monitoring circuit 330, FIG. 3) with an electrode (e.g., electrode 320). As shown in FIG. 3, two of the electrode 320 can extend between the first pressure sensor and the second pressure sensor. In examples, a single electrode can extend between the first pressure sensor and the second pressure sensor, or more than two (e.g., three, four, five, six, or more) electrodes can extend between the pressure sensors and the pressure signal monitoring circuit 330).

[0081] The following non-limiting examples detail certain implementations of the present subject matter that solve the challenges and provide the benefits discussed herein, among other things.

[0082] Example 1 is an endoscope system comprising: a processor configured to process data related to components of the endoscope system; and an endoscope, the endoscope including: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

[0083] In Example 2, the subject matter of Example 1 optionally includes wherein the endoscope system comprises: a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

[0084] In Example 3, the subject matter of Example 2 optionally includes wherein the endoscope system comprises: a pressure signal monitoring circuit; and an electrode connecting the pressure sensor and the second pressure sensor and the pressure signal monitoring circuit.

[0085] In Example 4, the subject matter of Example 3 optionally includes wherein the processor comprises: a frequency response monitor connected to thepressure signal monitoring circuit and configured to receive a pressure signal from the pressure signal monitoring circuit, the pressure signal indicative of pressure detected by at least one of the pressure sensor or the second pressure sensor.

[0086] In Example 5, the subject matter of Example 4 optionally includes wherein the processor comprises: memory that includes instructions, that when processed by the processor, implement steps to: receive, with the frequency response monitor, the pressure signal from the pressure signal monitoring circuit; and generate an alert based on the pressure signal being beyond a pressure threshold.

[0087] In Example 6, the subject matter of Example 5 optionally includes wherein the second pressure sensor is coupled to the distal portion of the elongated member proximal to the pressure sensor, and wherein the pressure signal monitoring circuit is configured to output a first pressure signal and a second pressure signal.

[0088] In Example 7, the subject matter of Example 6 optionally includes wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and generate an alert based on the combined pressure signal relative to an average pressure threshold.

[0089] In Example 8, the subject matter of any one or more of Examples 6-7 optionally include wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and transmit control signals to at least one component of the endoscope, based on the combined pressure signal, to implement a closed-loop control system for pressure management.

[0090] In Example 9, the subject matter of Example 8 optionally includes wherein the closed-loop control system includes a fluid management subsystem to regulate fluid pressure at a surgical site based on the combined pressure signal.

[0091] In Example 10, the subject matter of any one or more of Examples 8-9 optionally include wherein the endoscope system includes a user interface, andwherein the instructions are configured to be processed by the processor to implement steps to: generate a visual representation of the combined pressure signal to map an average pressure detected along the elongated member or at a target site.

[0092] In Example 11, the subject matter of any one or more of Examples 1-10 optionally include wherein the elongated member includes multiple pressure sensors distributed along a length of the elongated member to permit measurement of pressure gradients along the length.

[0093] In Example 12, the subject matter of Example 11 optionally includes wherein the multiple pressure sensors are configured to operate in a redundant configuration to provide error checking and increase measurement reliability.

[0094] Example 13 is an endoscope comprising: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

[0095] In Example 14, the subject matter of Example 13 optionally includes wherein the endoscope comprises a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

[0096] In Example 15, the subject matter of Example 14 optionally includes wherein the pressure sensor is disposed on a distal tip of the elongated member, and wherein the second pressure sensor is disposed on an exterior of a distal portion of the elongated member proximal the pressure sensor.

[0097] In Example 16, the subject matter of any one or more of Examples 14- 15 optionally include wherein the endoscope comprises an electrode connecting the pressure sensor and the second pressure sensor to a pressure signal monitoring circuit.

[0098] In Example 17, the subject matter of Example 16 optionally includes wherein at least one of the pressure sensor or the second pressure sensor comprises a micro-electro-mechanical system (MEMS) based piezoelectric sensor.

[0099] In Example 18, the subject matter of Example 17 optionally includes wherein the MEMS based piezoelectric sensor is formed on an exterior surface of the distal portion of the elongated member using a thin film deposition process, and wherein the electrode defines at least a portion of a periphery of the elongated member.

[0100] Example 19 is a method of forming an endoscope comprising: coupling a first pressure sensor to a distal portion of an elongated member, the elongatedmember including a lumen extending from the distal portion to a proximal portion, the first pressure sensor configured to detect pressure at a target site; coupling a second pressure sensor to the elongated member proximal to the first pressure sensor; and connecting the first and second pressure sensors to a pressure signal monitoring circuit with an electrode.

[0101] In Example 20, the subject matter of Example 19 optionally includes connecting the pressure signal monitoring circuit to a processor to provide a pressure signal from at least one of the first pressure sensor or the second pressure sensor, the pressure signal indicative of a pressure detected by the respective pressure sensor.

[0102] Example 21 is an endoscope system comprising: a processor configured to process data related to components of the endoscope system; and an endoscope, the endoscope including: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

[0103] In Example 22, the subject matter of Example 21 optionally includes wherein the endoscope system comprises: a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

[0104] In Example 23, the subject matter of Example 22 optionally includes wherein the endoscope system comprises: a pressure signal monitoring circuit; and an electrode connecting the pressure sensor and the second pressure sensor and the pressure signal monitoring circuit.

[0105] In Example 24, the subject matter of Example 23 optionally includes wherein the processor comprises: a frequency response monitor connected to the pressure signal monitoring circuit and configured to receive a pressure signal from the pressure signal monitoring circuit, the pressure signal indicative of pressure detected by at least one of the pressure sensor or the second pressure sensor.

[0106] In Example 25, the subject matter of Example 24 optionally includes wherein the processor comprises: memory that includes instructions, that when processed by the processor, implement steps to: receive, with the frequency response monitor, the pressure signal from the pressure signal monitoring circuit; and generate an alert based on the pressure signal being beyond a pressure threshold.

[0107] In Example 26, the subject matter of Example 25 optionally includes wherein the second pressure sensor is coupled to the distal portion of the elongatedmember proximal to the pressure sensor, and wherein the pressure signal monitoring circuit is configured to output a first pressure signal and a second pressure signal.

[0108] In Example 27, the subject matter of Example 26 optionally includes wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and generate an alert based on the combined pressure signal relative to an average pressure threshold.

[0109] In Example 28, the subject matter of any one or more of Examples 26- 27 optionally include wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and transmit control signals to at least one component of the endoscope, based on the combined pressure signal, to implement a closed-loop control system for pressure management.

[0110] In Example 29, the subject matter of Example 28 optionally includes wherein the closed-loop control system includes a fluid management subsystem to regulate fluid pressure at a surgical site based on the combined pressure signal.

[0111] In Example 30, the subject matter of any one or more of Examples 28-29 optionally include wherein the endoscope system includes a user interface, and wherein the instructions are configured to be processed by the processor to implement steps to: generate a visual representation of the combined pressure signal to map an average pressure detected along the elongated member or at a target site.

[0112] In Example 31, the subject matter of any one or more of Examples 21-30 optionally include wherein the elongated member includes multiple pressure sensors distributed along a length of the elongated member to permit measurement of pressure gradients along the length.

[0113] In Example 32, the subject matter of Example 31 optionally includes wherein the multiple pressure sensors are configured to operate in a redundant configuration to provide error checking and increase measurement reliability.

[0114] Example 33 is an endoscope comprising: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

[0115] In Example 34, the subject matter of Example 33 optionally includes wherein the endoscope comprises a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

[0116] In Example 35, the subject matter of Example 34 optionally includes wherein the pressure sensor is disposed on a distal tip of the elongated member, and wherein the second pressure sensor is disposed on an exterior of a distal portion of the elongated member proximal the pressure sensor.

[0117] In Example 36, the subject matter of any one or more of Examples 34- 35 optionally include wherein the endoscope comprises an electrode connecting the pressure sensor and the second pressure sensor to a pressure signal monitoring circuit.

[0118] In Example 37, the subject matter of Example 36 optionally includes wherein at least one of the pressure sensor or the second pressure sensor comprises a micro-electro-mechanical system (MEMS) based piezoelectric sensor.

[0119] In Example 38, the subject matter of Example 37 optionally includes wherein the MEMS based piezoelectric sensor is formed on an exterior surface of the distal portion of the elongated member using a thin film deposition process, and wherein the electrode defines at least a portion of a periphery of the elongated member.

[0120] Example 39 is a method of forming an endoscope comprising: coupling a first pressure sensor to a distal portion of an elongated member, the elongated member including a lumen extending from the distal portion to a proximal portion, the first pressure sensor configured to detect pressure at a target site; coupling a second pressure sensor to the elongated member proximal to the first pressure sensor; and connecting the first and second pressure sensors to a pressure signal monitoring circuit with an electrode.

[0121] In Example 40, the subject matter of Example 39 optionally includes connecting the pressure signal monitoring circuit to a processor to provide a pressure signal from at least one of the first pressure sensor or the second pressure sensor, the pressure signal indicative of a pressure detected by the respective pressure sensor.

[0122] Example 41 can include a method, system, device, and endoscope, or the like including any element of any of Examples 1-40.

[0123] The above-detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific examples that can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. The present disclosure includes examples in which those elements shown or described are provided. Moreover, the present disclosure includes examples using any combination or permutation of those elements shown or described (or one or more implementations thereof), either with respect to a particular example (or one or more implementations thereof), or with respect to other examples (or one or more implementations thereof) shown or described herein.

[0124] All publications, patents, and patent documents referred to in this document are incorporated by reference herein in their entirety, as though individually incorporated by reference. In the event of inconsistent usages between this document and those documents so incorporated by reference, the usage in the incorporated reference(s) should be considered supplementary to that of this document; for irreconcilable inconsistencies, the usage in this document controls.

[0125] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In the appended claims, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.

[0126] When the term “about” is used in conjunction with a numerical range, it modifies that range by extending the boundaries above and below the numerical values set forth. In general, the term “about” is used herein to modify a numerical value above and below the stated value by a variance of 10%. For example, the term“about” means plus or minus 10% of the numerical value of the number with which it is being used. Therefore, about 50% means in the range of 45%-55%. Numerical ranges recited herein by endpoints include all numbers and fractions subsumed within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.90, 4, 4.24, and 5). Similarly, numerical ranges recited herein by endpoints include subranges subsumed within that range (e.g., 1 to 5 includes 1-1.5, 1.5-2, 2-2.75, 2.75-3, 3-3.90, 3.90-4, 4-4.24, 4.24-5, 2-5, 3-5, 1-4, and 2-4). It is also to be understood that all numbers and fractions thereof are presumed to be modified by the term “about.”

[0127] The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more implementations thereof) can be used in combination with each other. Other examples can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is to allow the reader to quickly ascertain the nature of the technical disclosure and is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features can be grouped together to streamline the disclosure. This grouping should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter can lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment. The scope of the examples should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

[0128] The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include a combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and / or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those of ordinary skill in the art will appreciate that the reconditioning of a device can utilize a variety of different techniques for disassembly,cleaning / replacement, and reassembly. The use of such techniques and the resulting reconditioned device are all within the scope of the present application.

[0129] Preferably, the devices described herein are processed before surgery. The processing can include obtaining a new or used instrument and determining if the instrument should be cleaned, and employing a cleaning process based on the determination. The instrument can be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK® bag. The container and instrument are placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or higher energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile. The instrument can also be sterilized using any other technique known in the art, including but limited to beta or gamma radiation, ethylene oxide, or steam.

Claims

CLAIMSWhat is claimed is:

1. An endoscope system comprising: a processor configured to process data related to components of the endoscope system; and an endoscope, the endoscope including: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

2. The endoscope system of claim 1, wherein the endoscope system comprises: a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

3. The endoscope system of claim 2, wherein the endoscope system comprises: a pressure signal monitoring circuit; and an electrode connecting the pressure sensor and the second pressure sensor and the pressure signal monitoring circuit.

4. The endoscope system of claim 3, wherein the processor comprises: a frequency response monitor connected to the pressure signal monitoring circuit and configured to receive a pressure signal from the pressure signal monitoring circuit, the pressure signal indicative of pressure detected by at least one of the pressure sensor or the second pressure sensor.

5. The endoscope system of claim 4, wherein the processor comprises: memory that includes instructions, that when processed by the processor, implement steps to: receive, with the frequency response monitor, the pressure signal from the pressure signal monitoring circuit; andgenerate an alert based on the pressure signal being beyond a pressure threshold.

6. The endoscope system of claim 5, wherein the second pressure sensor is coupled to the distal portion of the elongated member proximal to the pressure sensor, and wherein the pressure signal monitoring circuit is configured to output a first pressure signal and a second pressure signal.

7. The endoscope system of claim 6, wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and generate an alert based on the combined pressure signal relative to an average pressure threshold.

8. The endoscope system of claim 6, wherein the instructions are configured to be processed by the processor to implement steps to: receive, with the frequency response monitor, the first pressure signal and the second pressure signal; generate, by averaging the first pressure signal and the second pressure signal, a combined pressure signal, the combined pressure signal indicative of an average pressure detected in the distal portion of the elongated member; and transmit control signals to at least one component of the endoscope, based on the combined pressure signal, to implement a closed-loop control system for pressure management.

9. The endoscope system of claim 8, wherein the closed-loop control system includes a fluid management subsystem to regulate fluid pressure at a surgical site based on the combined pressure signal.

10. The endoscope system of claim 8, wherein the endoscope system includes a user interface, and wherein the instructions are configured to be processed by the processor to implement steps to: generate a visual representation of the combined pressure signal to map an average pressure detected along the elongated member or at a target site.

11. The endoscope of claim 1, wherein the elongated member includes multiple pressure sensors distributed along a length of the elongated member to permit measurement of pressure gradients along the length.

12. The endoscope of claim 11, wherein the multiple pressure sensors are configured to operate in a redundant configuration to provide error checking and increase measurement reliability.

13. An endoscope comprising: an elongated member including a lumen extending from a proximal portion of the elongated member to a distal portion of the elongated member; and a pressure sensor coupled to the distal portion of the elongated member.

14. The endoscope of claim 13, wherein the endoscope comprises a second pressure sensor coupled to the elongated member, the second pressure sensor configured to detect pressure along the elongated member.

15. The endoscope of claim 14, wherein the pressure sensor is disposed on a distal tip of the elongated member, and wherein the second pressure sensor is disposed on an exterior of a distal portion of the elongated member proximal the pressure sensor.

16. The endoscope of claim 14, wherein the endoscope comprises an electrode connecting the pressure sensor and the second pressure sensor to a pressure signal monitoring circuit.

17. The endoscope of claim 16, wherein at least one of the pressure sensor or the second pressure sensor comprises a micro-electro-mechanical system (MEMS) based piezoelectric sensor.

18. The endoscope of claim 17, wherein the MEMS based piezoelectric sensor is formed on an exterior surface of the distal portion of the elongated member using a thin film deposition process, and wherein the electrode defines at least a portion of a periphery of the elongated member.

19. A method of forming an endoscope comprising: coupling a first pressure sensor to a distal portion of an elongated member, the elongated member including a lumen extending from the distal portion to a proximal portion, the first pressure sensor configured to detect pressure at a target site; coupling a second pressure sensor to the elongated member proximal to the first pressure sensor; and connecting the first and second pressure sensors to a pressure signal monitoring circuit with an electrode.

20. The method of claim 19, comprising: connecting the pressure signal monitoring circuit to a processor to provide a pressure signal from at least one of the first pressure sensor or the second pressure sensor, the pressure signal indicative of a pressure detected by the respective pressure sensor.

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