Endoscopic surgery system

Abstract

Described herein is an endoscopic surgery system. The endoscopic surgery system comprises a handle; a shaft having a first channel and a second channel; an endoscope camera; and an endoscope camera steering mechanism for articulating the endoscope camera. The endoscope camera steering mechanism articulates the endoscope camera inserted into the first channel to acquire an image of a tip of a surgical instrument, which is inserted via the second channel.

Description

[0001] ENDOSCOPIC SURGERY SYSTEM

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims priority under 35 U.S.C. § 1 19(e) to U.S. Provisional Application No. 63 / 558,301, filed February 27, 2024, which is hereby incorporated by reference in its entirety.

[0004] STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH

[0005] This invention was made with government support under FD007962 awarded by the Food And Drug Administration. The government has certain rights in the invention.

[0006] BACKGROUND

[0007] Worldwide, as many as 168,000 fetuses per year could benefit from fetal surgeries to improve pediatric / adult outcomes. Conditions such as open neural tube defect, severe congenital diaphragmatic hernia, and amniotic band syndrome in fetuses are treatable by fetal surgeries, which utilize endoscope technologies.

[0008] However, specialized endoscopes suitable for fetal surgeries are lacking, and surgeons are often forced to use equipment not designed with fetal surgeries in mind, which add complexity to and heightens the risk of the surgical operations.

[0009] Therefore, there is a need for endoscopic surgery systems that are suitable for fetal surgeries. The present invention addresses this need.

[0010] SUMMARY

[0011] In one aspect, described herein is an endoscopic surgery' system, comprising a handle; a shaft, which has a first channel for accommodating an endoscope camera having an associated optical fiber, and a second channel for accommodating a surgical instrument; the endoscope camera and associated optical fiber; and an endoscope camera steering mechanism for articulating the endoscope camera, wherein the endoscope camera steering mechanism articulates the endoscope camera to acquire an image of a tip of the surgical instrument, and an area surrounding the tip of the surgical instrument. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] The following detailed description of exemplary' embodiments will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating, non-limiting embodiments are shown in the drawings. It should be understood, however, that the instant specification is not limited to the precise arrangements and instrumentalities of the embodiments shown in the drawings.

[0013] Fig. 1 illustrates certain aspects of an endoscopic surgery system, in accordance with some embodiments.

[0014] Figs. 2A-2C illustrate certain aspects of a handle of the endoscopic surgery system, in accordance with some embodiments. Fig. 2A: Constructions of a non-limiting example of the handle. Fig. 2B: Operation of non-limiting example of the handle during fetal surgery'. Fig. 2C: Steering controller mounted on the handle.

[0015] Figs. 3A-3D illustrate certain aspects of a shaft of the endoscopic surgery system, in accordance with some embodiments. Figs. 3A-3B: Cross-sections of non-limiting examples of the shaft. Figs. 3C-3D: Shaft junctions of non-limiting examples of the shaft.

[0016] Figs. 4A-4D illustrate certain aspects of an endoscope camera steering mechanism, in accordance with some embodiments.

[0017] Figs. 5A-5D illustrate certain aspects of an instrument steering mechanism, in accordance with some embodiments.

[0018] DETAILED DESCRIPTION

[0019] The following disclosure provides many different embodiments, or examples, for implementing different features of the provided subject matter. Specific examples of components and arrangements are described below to simplify the present disclosure. These are, of course, merely examples and are not intended to be limiting. For example, the formation of a first feature over or on a second feature in the description that follows may include embodiments in which the first and second features are formed in direct contact, and may also include embodiments in which additional features may be formed between the first and second features, such that the first and second features may' not be in direct contact. In addition, the present disclosure may repeat reference numerals and / or letters in the various examples. This repetition is for the purpose of simplicity and clarity and does not in itself dictate a relationship between the various embodiments and / or configurations discussed. The risks of fetal surgery decrease with the size of the endoscope used to introduce the camera, and the number of punctures for separate instruments. However, there are currently no general-purpose fetoscopes on the market that minimize scope size and include a working channel. As a results, surgeons are often forced to use scopes not optimized for fetal surgery, off-label. Several individual scopes have been designed by fetal centers around the world. This small group of instruments are seldom optimized or applicable to all major fetal procedures.

[0020] To address this need, the present invention proposes a novel endoscopic surgery system that, while useful for various types of endoscopic surgeries, is particularly adapted for performing fetal surgeries.

[0021] Specifically, it was discovered that conventional endoscopic surgery systems suffer from several draw backs when used in fetal surgeries.

[0022] The first issue with the conventional systems is that the shafts of the conventional endoscopic surgery' systems have larger than desirable diameters, and are too long for the purpose of fetal surgeries. In some embodiments, the endoscopic surgery systems herein comprise a shaft (or shafts) with smaller diameter and / or length.

[0023] The second issue is that the endoscope cameras of the conventional systems are either rigid or passively flexible. The former are often unable to see difficult areas due to their tunnel vision, and the passive flexibility of the latter causes uncertainty of the exact location of the camera tip, in three-dimensional space. These systems can limit visualization, disorient surgeons, and thus compromise safety when used off-label in fetal procedures. In some embodiments, the endoscopic surgery systems herein comprise an endoscope camera steering mechanism that allows the camera to be easily articulated to difficult-to-reach positions while maintaining certainty of tip location, to keep surgeons oriented within three- dimensional space.

[0024] The third issue is that the handles of the conventional systems are not easily gripped and too heavy for fetal surgeries, which require operating over a pregnant uterus. Since a uterus is more delicate than an abdominal wall which conventional systems are designed to work with. The conventional handles do not allow easy operation of the various steering mechanisms, making fetal surgeries more difficult. In some embodiments, the endoscopic surgery' systems herein comprise an ergonomic handle with integrated controllers of steering mechanisms.

[0025] Definitions As used herein, each of the following terms has the meaning associated with it in this section. Unless defined otherwise, all technical and scientific terms used herein generally have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Generally, the nomenclature used herein are those well-known and commonly employed in the art. It should be understood that the order of steps or order for performing certain actions is immaterial, so long as the present teachings remain operable. Any use of section headings is intended to aid reading of the document and is not to be interpreted as limiting; information that is relevant to a section heading may occur within or outside of that particular section. 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.

[0026] In the application, where an element or component is said to be included in and / or selected from a list of recited elements or components, it should be understood that the element or component can be any one of the recited elements or components and can be selected from a group consisting of two or more of the recited elements or components.

[0027] In the methods described herein, the acts can be carried out in any order, except when a temporal or operational sequence is explicitly recited. Furthermore, specified acts can be carried out concurrently unless explicit claim language recites that they be carried out separately. For example, a claimed act of doing X and a claimed act of doing Y can be conducted simultaneously within a single operation, and the resulting process will fall within the literal scope of the claimed process.

[0028] In this document, the terms "a," "an," or "the" are used to include one or more than one unless the context clearly dictates otherwise. The term "or" is used to refer to a nonexclusive "or" unless otherwise indicated. The statement "at least one of A and B" or "at least one of A or B" has the same meaning as "A, B, or A and B."

[0029] "About" as used herein when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of ±20% or ±10%, in certain embodiments ±5%. in certain embodiments ±1%, in certain embodiments ±0.1% from the specified value, as such variations are appropriate to perform the disclosed methods.

[0030] Endoscopic Surgery System

[0031] In some aspects, the present invention is directed to an endoscopic surgery system. In some embodiments, the endoscopic surgery system is a surgery system for the surgical operation on a fetus, such as a fetus inside a uterus. In some embodiments, the endoscopic surgery system is a fetoscope.

[0032] In some embodiments, the fetus is a mammalian fetus. In some embodiments, the fetus is a human fetus.

[0033] Referring to Fig. 1. in some embodiments, the endoscopic surgery’ system 100 comprises a handle 101 and a shaft 103 and / or 105. In some embodiments, the shaft 103 / 105 is a rigid shaft. In some embodiments, the shaft 103 / 105 is a flexible shaft. In some embodiments, the shaft 103 / 105 comprises a rigid shaft 103 at a proximal end and a flexible shaft 105 at a distal end.

[0034] As used herein, the term “distal end’7refers to the end closer to the subject of the surgical operation and further away from the operator, and the term “proximal end” refers to the end closer to the operator and further away from the subject.

[0035] In some embodiments, the endoscopic surgery system 100 has a first channel 107 for accommodating an endoscope camera 109. In some embodiments, the first channel 107 allows the endoscope camera 109 to slide inside the shaft 103 / 105 in a length direction, such that the tip (which comprises the image acquiring portion and / or the light source) of the endoscope camera 109 can protrude out of the distal end of the shaft 103 / 105 for a length according to the operator’s choice.

[0036] In some embodiments, the endoscope camera 109 is part of the endoscopic surgery system 100. Endoscopic camera 109 can have an associated optical fiber.

[0037] In some embodiments, during the fetal surgery, the tip of the endoscope camera 109 extends beyond the distal end of the shaft 103 / 105 for about 1 mm to about 100 mm, such as for about 20 mm to about 80 mm, or for about 30 mm to about 60 mm. In some embodiments, during the fetal surgery, the tip of the endoscope camera 109 extends beyond the distal end of the shaft 103 / 105 for about 1 mm, about 10mm, about 20 mm, about 30 mm, about 40 mm, about 50 mm, about 60 mm, about 70 mm, about 80 mm, about 90 mm, about 100 mm, or any ranges therebetween.

[0038] In some embodiments, the endoscopic surgery system 100 has a second channel 113 for accommodate a surgical instrument 115. In some embodiments, the second channel 113 allows the surgical instrument 115 to slide inside the shaft 103 / 105 in a length direction, such that the tip of the surgical instrument 115 can protrude out of the distal end of the shaft 103 / 105 for a length chosen by the operator. In some embodiments, the surgical instrument 115 is part of the endoscopic surgery' system 100. In some embodiments, the surgical instrument 115 is not considered part of the endoscopic surgery' system 100, as it can be completed removed from the endoscopic surgery system 100 and replaced with a different surgical instrument.

[0039] In some embodiments, the surgical instrument 115 is a grasper, a scalpel blade, surgical scissors, a clamp, an injector, a laser treatment system including a laser fiber, and the like.

[0040] In some embodiments, during the fetal surgery, the tip of the surgical instrument 115 extends beyond the distal end of the shaft 103 / 105 for about 1 mm to about 100 mm, such as for about 20 mm to about 80 mm, or for about 30 mm to about 60 mm. In some embodiments, during the fetal surgery, the tip of the surgical instrument 115 extends beyond the distal end of the shaft 203 / 205 for about 1 mm, about 10mm, about 20 mm, about 30 mm, about 40 mm, about 50 mm, about 60 mm, about 70 mm, about 80 mm, about 90 mm, about 100 mm, or any ranges therebetween.

[0041] It is worth noting that the endoscopic surgery system 100 can have more than one second channel 113 to accommodate multiple surgical instruments 115, as more than one surgical instrument 115 are needed at the same time for performing some surgical operations. In some embodiments, the multiple surgical instruments 115 share the same second channel 113. In some embodiments, the one or more surgical instruments 115 and the camera 109 share the same channel.

[0042] In some embodiments, the endoscope camera 109 is steerable such that the distal end of the endoscope camera 109 can be steered to a desired position to shine a light on, focus on, and / or acquire an image of the tip of the surgical instrument 115, as well as regions in the vicinity of the tip of the surgical instrument 115. The endoscope camera 109. as well as the steering mechanism thereof, is described in more details elsewhere herein.

[0043] In some embodiments, the endoscope camera 109 is connected to a computer 111 via an optical fiber of the endoscope camera 109. In some embodiments, the computer 111 operates the endoscope camera 109, such as to turn on / off image acquiring, change focus / field of view, turn on / off the light, change the intensity of the light, and etc. In some embodiments, the computer 111 comprises a display for displaying the image acquired by the endoscope camera 109.

[0044] In some embodiments, the endoscopic surgery system 100 comprises a shaft steering mechanism for steering the shaft 103 / 105 (in the case where the shaft 103 / 105 is a flexible shaft), or for steering the flexible shaft 105 (in the case that the system 100 comprises a rigid shaft 103 and a flexible shaft 105).

[0045] In some embodiments, the endoscopic surgery system 100 comprises a steering mechanism for steering the section of the surgical instrument 115 protruding out of the shaft 103 / 105.

[0046] In some embodiments, the endoscopic surgery system 100 comprises both the shaft steering mechanism and the surgical instrument steering mechanism. In some embodiments, the endoscopic surgery system 100 comprises either the shaft steering mechanism or the surgical instrument steering mechanism. The shaft steering mechanism and the surgical instrument steering mechanism are not shown in Fig. 1, and are described elsewhere herein.

[0047] Handle

[0048] During the surgical operation, the operator grabs the handle with one hand and positions and orients the endoscopic surgical system.

[0049] The configuration of the handle is not limited and existing endoscope handles or catheter handle designs can be used.

[0050] The material for forming the handle is not limited. In some embodiments, the handle is formed from a medical grade material, such as a medical grade metal, alloy, polymer, silicone, and the like. In some embodiments, the handle is made from a light weight polymer such as a medical grade polymer, such that the operator can hold the handle for extended period of time. In some embodiments, the handle is made from a material that can withstand sterilization process for surgical equipment, such as steaming or autoclaving.

[0051] Referring to Fig. 2A, in some embodiments, the handle is a cylindrical or spindle shape having one or more finger grooves. In some embodiments, the handle is assembled from two or more pieces.

[0052] In some embodiments, a cross-sectional shape of the assembled handle in a plane perpendicular to the longitudinal direction is substantially circular. In some embodiments, the handle has circular symmetry along the longitudinal direction such that the operator can rotate the handle (and hence the entire endoscopic surgery system) without changing the feeling of grip.

[0053] Referring to Fig. 2B, in some embodiments, a handle rotatable without affecting gripping simplifies surgical operation in the case where the steering mechanism of the shaft and / or the surgical instrument only allow articulations within one single plane. According to these embodiments, when the tip of the surgical instrument needs to be navigated to a location outside its plane of articulation, the operator can rotate the handle to reach the location. While a circularly symmetrical handle is not required for such an operation, it eliminates the need for the operator to re-familiarize with the grip after rotation.

[0054] Referring to Fig. 2C, in some embodiments, the handle further comprises a controller for controlling the articulation of the shaft and / or the surgical instrument.

[0055] Shaft

[0056] In some embodiments, the shaft is one hollow tube, or two or more consecutive hollow tubes for providing rigidity to the endoscopic system during the surgical operations such that the unintended movements of the surgical instrument(s) and the endoscope camera are minimized.

[0057] The material for forming the shaft is not limited. In the case where the shaft is rigid or semi-rigid, the shaft can be made from a medical grade metal, alloy, rigid polymer, or the like. In the case where the shaft is flexible or semi-flexible, the shaft can be made from a medical grade flexible polymer, silicone, or the like.

[0058] Referring to Fig. 3A. in some embodiments, a length of the shaft 203 / 205, or a sum of the lengths of the first shaft 203 and the second shaft 205 ranges from about 2 cm to about 20 cm, such as from about 3 cm to about 18 cm, from about 5 cm to about 15 cm, or from about 8 cm to about 12 cm. In some embodiments, a length of the shaft 203 / 205, or a sum of the lengths of the first shaft 203 and the second shaft 205 is about 2 cm, about 3 cm, about 4 cm, about 5 cm, about 6 cm, about 7 cm, about 8 cm, about 9 cm, about 10 cm, about 1 1 cm, about 12 cm, about 13 cm, about 14 cm, about 15 cm, about 16 cm, about 17 cm, about 18 cm. about 19 cm, about 20 cm, or any ranges therebetween.

[0059] In some embodiments, an average diameter of the shaft 203 / 205, or an average diameter of the first shaft 203 is about 5 mm or less, such as about 4.5 mm or less, about 4 mm or less, about 3.5 mm or less, about 3 mm or less, about 2.5 mm or less, or about 2 mm or less.

[0060] Channels

[0061] Referring to Fig. 3A, in some embodiments, the shaft 203 / 205, the first shaft 203 and / or the second shaft 205 has a first channel 207 for accommodating the endoscope camera 209.

[0062] In some embodiments, the shaft 203 / 205, the first shaft 203 and / or the second shaft 205 has a second channel 213 for accommodating the surgical instrument 215. In some embodiments, the shaft 203 / 205, the first shaft 203 and / or the second shaft 205 has one or more steering wire channels 217 / 217' for accommodating one or more steering wires.

[0063] In some embodiments, the shaft 203 / 205, the first shaft 203 and / or the second shaft 205 has a laser fiber channel 219 for accommodating a laser fiber.

[0064] It is worth noting that the shaft 203 / 205, the first shaft 203 and / or the second shaft 205 do not need to have a circular or oval cross-sectional shape; rather, the shaft(s) can have any cross-sectional shapes, as long as such cross-sectional shape do not affect the rigidity and / or steerability of the shaft(s). Referring to Fig. 3B, in some embodiments, the shaft(s) has an almond shaped cross-section.

[0065] Single shaft

[0066] In some embodiments, the endoscopic surgery system 200 comprises one continuous shaft 203 / 205.

[0067] In some embodiments, the shaft 203 / 205 is a rigid or semi-rigid shaft that does not bend substantially during the surgical operation.

[0068] In some embodiments, the steering wire channels 217 and 217’ are absent. According to these embodiments, the articulation of the surgical instrument 215 is achieved by steering the portion of the surgical instrument 215 that protrudes out of the distal end of the shaft 203 / 205, which is described elsewhere herein.

[0069] Two or more consecutive shafts

[0070] Alternatively, in some embodiments, the endoscopic surgery system 200 comprises a first shaft 203 at a proximal end. and a second shaft 205 at a distal end. In some embodiments, the first shaft 203 is a rigid or semi-rigid shaft, and the second shaft 205 is a flexible or semi-flexible shaft.

[0071] In some embodiments, the flexible or semi-flexible second shaft 205 is steerable by a steering mechanism and articulates in response to an input into from the steering mechanism. In some embodiments, the articulation of the second shaft 205 guides the distal ends of endoscope camera 209 and / or the surgical instrument 215 running inside the second shaft 205 to a desired location / orientation.

[0072] In some embodiments, the first shaft 203 and / or the second shaft 205 has one or more steering channels 217 and 217’ for accommodate one or more steering wires. In some embodiments, only one pair of steering channels 217 or one pair of steering channels 217’ is present for the second shaft 205 to articulate within one single plane, and the rotation of the handle and / or the articulation of the surgical instrument (described elsewhere herein) are used to achieve the degrees of movements the tip of the surgical instrument needs.

[0073] In some embodiments, the steering wires are attached to a controller, such as a controller comprising one or more pulleys. In some embodiments, the controller is incorporated into the handle.

[0074] In some embodiments, a length of the rigid or semi-rigid first shaft 203 ranges from about 3 cm to about 15 cm, such as from about 4 cm to about 14 cm, from about 5 cm to about 13 cm, from about 6 cm to about 12 cm, or from about 7 cm to about 11 cm. In some embodiments, the length of the first shaft 203 is about 3 cm, about 4 cm, about 5 cm. about 6 cm, about 6 cm, about 7 cm. about 8 cm, about 9 cm, about 10 cm, about 11 cm, about 12 cm, about 13 cm, about 14 cm, about 15 cm, or any ranges therebetween.

[0075] In some embodiments, a length of the flexible or semi-flexible second shaft 205 ranges from about 1 cm to about 8 cm, such as from about 2 cm to about 6 cm, or from about 3 cm to about 5 cm. In some embodiments, the length of the second shaft is about 1 cm, about 2 cm. about 3 cm, about 4 cm. about 5 cm, about 6 cm, about 7 cm. about 8 cm, or any ranges therebetween.

[0076] In some embodiments, during surgical conditions, the flexible or semi-flexible second shaft 205 is steerable to be bend for 30 degrees or more, such as about 40 degrees or more, about 50 degrees or more, about 60 degrees or more, about 70 degrees or more, about 80 degrees or more, about 90 degrees or more, about 100 degrees or more, about 1 10 degrees or more, about 120 degrees or more, about 130 degrees or more, about 140 degrees or more, about 150 degrees or more, about 160 degrees or more, about 170 degrees or more, or about 180 degrees or more.

[0077] Shaft junction

[0078] Referring to Fig. 3C, in some embodiments, the shaft (in the case of a single shaft configuration) or the first shaft (in the case of a multi-shafts configuration) comprises a shaft junction 250 at the proximal end thereof.

[0079] In some embodiments, the shaft junction 250 comprises a first entrance tube 251 for inserting the surgical instrument, and a second entrance tube 253 for inserting the camera.

[0080] Referring to Fig. 3D, in some embodiments, the shaft junction 250 is enclosed in the handle, and the entrances thereof are accessible from the handle. Referring back to Fig. 3C, in some embodiments, a distance between the proximal end of the first entrance tube 251 and the proximal end of the second entrance tube 253 is about 2 cm or larger, such as 3 cm or larger, 4 cm or larger, or 5 cm or larger, such that the chance of hand that operate the surgical instrument and the hand that operate the camera bumping into each other is reduced.

[0081] In some embodiments, the shaft junction 250 further comprises one or more additional entrance tubes (not shown) for inserting two or more surgical instrument simultaneously. In some embodiments, the proximal end(s) of such additional entrance tubes are also placed apart from each other, as well as the proximal ends of the first and second entrances.

[0082] It is worth nothing that, in some embodiments, some or all of the entrance tubes can be replaced with a cutout in the shaft or the first shaft. In some embodiments, the cutout(s) are spaced apart from each other and the proximal end(s) of entrance tube(s) according to the description in this section.

[0083] Endoscope camera steering mechanism

[0084] In some embodiments, the endoscope camera comprises, at the distal tip thereof, a camera lens for acquiring an image of an area in front of the lens, and a light source for shining a light on the same area. In some embodiments, the endoscope camera further comprises a steering mechanism.

[0085] In some embodiments, the steering mechanism of the endoscope camera articulates distal tip of the endoscope camera to acquire an image of the tip of the surgical instrument, as well as areas surrounding the tip.

[0086] In some embodiments, the steering mechanism articulates the endoscope camera within the plane which contains both the endoscope camera and the surgical instrument.

[0087] Referring to Fig. 4A, in some embodiments, the steering mechanism 300 of the endoscope camera comprises a sheath 301 (which surround the optical fiber of the endoscope camera in accordance with some embodiments), a distal anchor 303, a first steering wire 305 attached to the distal anchor below7the sheath 301, a proximal anchor 307, and a second steering wire 309 attached to the proximal anchor 307 above the sheath 301. In some embodiments, when the first steering wire 305 (and therefore the distal anchor 303) is pulled, the portion of the sheath 301 proximal to the distal anchor 303 bends downwardly. In some embodiments, when the second steering wire 309 (and therefore the proximal anchor 307) is pulled, the portion of the sheath 301 proximal to the proximal anchor 307 bend upwardly. As used herein, the terms “below,” “above”, “upward” and “downward” refer to relative positions or directions in relative to the y-axis.

[0088] In some embodiments, by adjusting the lengths of the first steering wire 305 and the second steering wire 309, the tip of the endoscope camera articulates within the xy plane, in which the tip of the surgical instrument is also located. According to these embodiments, since the steering of the endoscope camera is limited to a 2D plane, the chance of failing to focus on the surgical instrument is significantly reduced, and the operator who is watching the images acquired by the endoscope camera is less likely to be disorientated.

[0089] The design of the endoscope camera sheath 301 is not limited. Referring to Fig. 4B, in some embodiments, the sheath is symmetric bidirectional, unidirectional asymmetric, or asymmetric bidirectional. Referring to Fig. 4C, in some embodiments, the sheath is asymmetric bidirectional, as such a configuration allows higher degrees of bending.

[0090] The designs of the distal anchor and the proximal anchor are not limited. Referring to Fig. 4D, in some embodiments, the anchors are cylindrical cases with attachment points for the steering wires.

[0091] In some embodiments, during surgical conditions, the steering mechanism of the endoscope camera is able to be bend the endoscope camera at each of the two anchors by about 30 degrees or more, such as about 40 degrees or more, about 50 degrees or more, about 60 degrees or more, about 70 degrees or more, about 80 degrees or more, about 90 degrees or more, about 100 degrees or more, about 110 degrees or more, about 120 degrees or more, about 130 degrees or more, about 140 degrees or more, about 150 degrees or more, about 160 degrees or more, about 170 degrees or more, or about 180 degrees or more.

[0092] Steering mechanism for the surgical instrument

[0093] In some embodiments, the endoscopic surgery system comprises a surgical instrument steering mechanism.

[0094] Referring to Fig. 5A, in some embodiments, the instrument steering mechanism 400 comprises a deflector 421 and a deflector wire 425 attached thereto. The deflector 421 comprises an axle 423 which is mounted on the distal end of the shaft, and around which the deflector 421 rotates.

[0095] When the deflector ware 425 is not pulled, the deflector 421 either rests on the surgical instrument 412 without exerting sufficient force to bend the surgical instrument 412, or does not touch the surgical instrument 412. Upon pulling the deflector wire 425. the deflector 425 rotates around the axle 423 thereof, and deflects the surgical tool 415 downwardly, thereby steering the tip of the surgical tool 415.

[0096] According to these embodiments, since the deflector-based steering mechanism steers the surgical tool 415 with the same plane that contains the endoscope camera, the articulation of the endoscope camera is simplified.

[0097] Referring to Figs. 5B and 5C, in some embodiments, the distal end of the shaft has a cut. such as an angled cut. such as a Chamfer cut. which allows greater rotational movement of the deflector 425 and increased achievable degree of bending of the surgical tool.

[0098] In some embodiments, during surgical conditions, the steering mechanism for the surgical instrument is able to bend the surgical instrument for 10 degrees or more, such as about 20 degrees or more, about 30 degrees or more, about 40 degrees or more, about 50 degrees or more, about 60 degrees or more, about 70 degrees or more, about 80 degrees or more, or about 90 degrees or more.

[0099] The foregoing outlines features of several embodiments so that those skilled in the art may better understand the aspects of the present disclosure. Those skilled in the art should appreciate that they may readily use the present disclosure as a basis for designing or modifying other processes and structures for carrying out the same purposes and / or achieving the same advantages of the embodiments introduced herein. Those skilled in the art should also realize that such equivalent constructions do not depart from the spirit and scope of the present disclosure, and that they may make various changes, substitutions, and alterations herein without departing from the spirit and scope of the present disclosure.

[0100] Identifiers Used in Drawings

[0101] Endoscopic surgery’ system: 100

[0102] Handle: 101

[0103] Shaft: 103+105; 203+205

[0104] First shaft: 103; 203

[0105] Second shaft: 105; 205

[0106] First channel (endoscope camera channel): 107; 207; 207”

[0107] Endoscope camera: 109; 209

[0108] Computer: 111

[0109] Second channel (surgical instrument channel): 113; 213; 213”

[0110] Surgical instrument: 115; 215; 415

[0111] Shaft steering wire channel: 217; 217’; 217” Laser fiber channel: 219; 219’"

[0112] Shaft junction: 250

[0113] First entrance tube of shaft junction: 251

[0114] Second entrance tube of shaft junction: 253

[0115] Endoscope camera steering mechanism: 300

[0116] Endoscope camera sheath: 301

[0117] Distal anchor on endoscope camera sheath: 303

[0118] First steering wire of endoscope camera steering mechanism: 305

[0119] Proximal anchor on endoscope camera sheath: 307

[0120] Second steering wire of endoscope camera steering mechanism: 309

[0121] Surgical instrument steering mechanism: 400

[0122] Deflector: 421

[0123] Axle of deflector: 423

[0124] Deflector wire: 425

[0125] Enumerated Embodiments

[0126] In some aspects, the present invention is directed to the following non-limiting embodiments:

[0127] Embodiment 1 : An endoscopic surgery system. In certain embodiments, the endoscopic surgery system comprises a handle. In certain embodiments, the endoscopic surgery system comprises a shaft, which has a first channel for accommodating an endoscope camera having an associated optical fiber, and a second channel for accommodating a surgical instrument. In certain embodiments, the endoscopic surgery system comprises the endoscope camera and associated optical fiber. In certain embodiments, the endoscopic surgery system comprises an endoscope camera steering mechanism for articulating the endoscope camera. In certain embodiments, the endoscope camera steering mechanism articulates the endoscope camera to acquire an image of a tip of the surgical instrument, and an area surrounding the tip of the surgical instrument.

[0128] Embodiment 2: The endoscopic surgery system of Embodiment 1, wherein the endoscope camera steering mechanism articulates the endoscope camera within a plane in which the tip of the surgical instrument is located.

[0129] Embodiment 3: The endoscopic surgery system of any one of Embodiments 1-2, wherein the endoscope camera comprises at least one of the following, and / or all of the following: a flexible sheath surrounding a portion of the optical fiber of the endoscope camera that extend beyond a distal end of the shaft; a distal anchor on the flexible sheath; a first steering wire attached to the distal anchor below the flexible sheath; a proximal anchor on the flexible sheath; and a second steering wire attached to the proximal anchor above the flexible sheath, In certain embodiments, pulling the first steering wire and / or the second steering wire articulates the endoscope camera within the plane in which the tip of the surgical instrument is located.

[0130] Embodiment 4: The endoscopic surgery system of Embodiment 3, wherein the handle comprises an endoscope camera steering controller for pulling or releasing the first steering wire and / or the second steering wire.

[0131] Embodiment 5: The endoscopic surgery system of Embodiment 4, wherein the endoscope camera steering controller comprises a first wire pulley for pulling or releasing the first steering wire and a second wire pulley for pulling or releasing the second steering wire.

[0132] Embodiment 6: The endoscopic surgery system of any one of Embodiments 1-5. further comprising a surgical instrument steering mechanism at a distal tip of the shaft for steering the tip of the surgical instrument.

[0133] Embodiment 7: The endoscopic surgery system of Embodiment 6, wherein the surgical instrument steering mechanism articulates the tip of the surgical instrument within a plane in which the endoscope camera is located.

[0134] Embodiment 8: The endoscopic surgery' system of any one of Embodiments 6-7, wherein the surgical instrument steering mechanism comprises at least one of the following, and / or all of the following: a deflector; and a deflector wire attached to the deflector,

[0135] In certain embodiments, pulling the deflector tilts the deflector, which pushes the tip of the surgical instrument to articulate the tip of the surgical instrument.

[0136] Embodiment 9: The endoscopic surgery system of Embodiment 8, wherein the handle comprises a deflector wire controller for pulling or releasing the deflector wire.

[0137] Embodiment 10: The endoscopic surgery system of Embodiment 9, wherein the deflector wire controller comprises a deflector wire pulley for pulling or releasing the deflector wire. Embodiment 11 : The endoscopic surgery system of any one of Embodiments 1-10, wherein the shaft is a rigid shaft which does not bend substantially during a surgical operation.

[0138] Embodiment 12: The endoscopic surgery system of Embodiment 11, wherein at least one of the following applies: (a) an average diameter of the shaft ranges from about 1 mm to about 5 mm; (b) a length of the shaft ranges from about 5 cm to about 15 cm.

[0139] Embodiment 13: The endoscopic surgery system of any one of Embodiments 1-10, wherein the shaft comprises at least one of the following, and / or all of the following: a first shaft at a proximal end thereof; and a second shaft at a distal end thereof.

[0140] In certain embodiments, the first shaft is a rigid shaft which does not bend substantially during a surgical operation. In certain embodiments, the second shaft is a flexible shaft which is steerable for articulating the endoscope camera and the surgical instrument.

[0141] Embodiment 14: The endoscopic surgery system of Embodiment 13, wherein at least one of the following applies: (a) an average diameter of the first shaft ranges from about 1 mm to about 5 mm; (b) a length of the first shaft ranges from about 5 cm to about 15 cm. and wherein a length of the second shaft ranges from about 1 cm to about 6 cm.

[0142] Embodiment 15: The endoscopic surgery system of any one of Embodiments 13-14, wherein the endoscopic surgery system further comprises a shaft steering mechanism for steering the second shaft.

[0143] Embodiment 16: The endoscopic surgery system of Embodiment 15, wherein the shaft steering mechanism comprises a shaft steering wire.

[0144] Embodiment 17: The endoscopic surgery system of Embodiment 16, wherein the handle comprises a shaft steering mechanism controller for pulling or releasing the shaft steering wire.

[0145] Embodiment 18: The endoscopic surgery system of any one of Embodiments 1-17, wherein the handle has one or more finger grooves.

[0146] Embodiment 19: The endoscopic surgery system of any one of Embodiments 1-18, wherein the handle has circular symmetry in a plane perpendicular to the longitudinal direction, such that a rotation of the endoscopic surgery system using the handle does not substantially change the grip of the handle by an operator.

[0147] Embodiment 20: The endoscopic surgery system of any one of Embodiments 1-19, wherein the endoscopic surgery system further comprises the surgical instrument, wherein the surgical instrument is at least one selected from the group consisting of a grasper, a scalpel blade, surgical scissors, a clamp, an injector, and a laser treatment system.

Claims

CLAIMSWhat is claimed is:

1. An endoscopic surgery system, comprising: a handle; a shaft, which has a first channel for accommodating an endoscope camera having an associated optical fiber, and a second channel for accommodating a surgical instrument; the endoscope camera and associated optical fiber; and an endoscope camera steering mechanism for articulating the endoscope camera, wherein the endoscope camera steering mechanism articulates the endoscope camera to acquire an image of a tip of the surgical instrument, and an area surrounding the tip of the surgical instrument.

2. The endoscopic surgery system of claim 1, wherein the endoscope camera steering mechanism articulates the endoscope camera within a plane in which the tip of the surgical instrument is located.

3. The endoscopic surgery system of any one of claims 1-2, wherein the endoscope camera comprises: a flexible sheath surrounding a portion of the optical fiber of the endoscope camera that extend beyond a distal end of the shaft; a distal anchor on the flexible sheath; a first steering wire attached to the distal anchor below the flexible sheath; a proximal anchor on the flexible sheath; and a second steering wire attached to the proximal anchor above the flexible sheath, wherein pulling the first steering wire and / or the second steering wire articulates the endoscope camera within the plane in which the tip of the surgical instrument is located.

4. The endoscopic surgery system of claim 3, wherein the handle comprises an endoscope camera steering controller for pulling or releasing the first steering wire and / or the second steering wire.

5. The endoscopic surgery system of claim 4, wherein the endoscope camera steering controller comprises a first wire pulley for pulling or releasing the first steering wire and a second wire pulley for pulling or releasing the second steering wire.

6. The endoscopic surgery system of any one of claims 1-5, further comprising a surgical instrument steering mechanism at a distal tip of the shaft for steering the tip of the surgical instrument.

7. The endoscopic surgery system of claim 6, wherein the surgical instrument steering mechanism articulates the tip of the surgical instrument within a plane in which the endoscope camera is located.

8. The endoscopic surgery system of any one of claims 6-7, wherein the surgical instrument steering mechanism comprises: a deflector; and a deflector wire attached to the deflector, wherein pulling the deflector tilts the deflector, which pushes the tip of the surgical instrument to articulate the tip of the surgical instrument.

9. The endoscopic surgery system of claim 8, wherein the handle comprises a deflector wire controller for pulling or releasing the deflector wire.

10. The endoscopic surgery system of claim 9, wherein the deflector wire controller comprises a deflector wire pulley for pulling or releasing the deflector wire.

11. The endoscopic surgery system of any one of claims 1-10, wherein the shaft is a rigid shaft which does not bend substantially during a surgical operation.

12. The endoscopic surgery system of claim 11. wherein at least one of the following applies:(a) an average diameter of the shaft ranges from about 1 mm to about 5 mm;(b) a length of the shaft ranges from about 5 cm to about 15 cm.

13. The endoscopic surgery system of any one of claims 1-10, wherein the shaft comprises a first shaft at a proximal end thereof; and a second shaft at a distal end thereof, wherein the first shaft is a rigid shaft which does not bend substantially during a surgical operation, and wherein the second shaft is a flexible shaft which is steerable for articulating the endoscope camera and the surgical instrument.

14. The endoscopic surgery' system of claim 13, wherein at least one of the following applies:(a) an average diameter of the first shaft ranges from about 1 mm to about 5 mm;(b) a length of the first shaft ranges from about 5 cm to about 15 cm, and wherein a length of the second shaft ranges from about 1 cm to about 6 cm.

15. The endoscopic surgery system of any one of claims 13-14. wherein the endoscopic surgery7system further comprises a shaft steering mechanism for steering the second shaft.

16. The endoscopic surgery system of claim 15, wherein the shaft steering mechanism comprises a shaft steering wire.

17. The endoscopic surgery system of claim 16, wherein the handle comprises a shaft steering mechanism controller for pulling or releasing the shaft steering wire.

18. The endoscopic surgery system of any one of claims 1-17, wherein the handle has one or more finger grooves.

19. The endoscopic surgery system of any one of claims 1-18, wherein the handle has circular symmetry in a plane perpendicular to the longitudinal direction, such that a rotation of the endoscopic surgery system using the handle does not substantially change the grip of the handle by an operator.

20. The endoscopic surgery system of any one of claims 1-19, wherein the endoscopic surgery' system further comprises the surgical instrument, wherein the surgical instrument isat least one selected from the group consisting of a grasper, a scalpel blade, surgical scissors, a clamp, an injector, and a laser treatment system.

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