Distal tip straightening for introducer

Abstract

Methods and systems are described relating to straightening a distal tip of an introducer based on its position. Straightening of the distal tip may be positioning the distal tip in a straight, semi-rigid configuration or slacking the distal tip. The video laryngoscope may cause a distal tip of an introducer to straighten when detecting that the distal tip has advanced through vocal cords of the patient and / or when detecting that the distal tip has been retracted beyond a certain point. The video laryngoscope may cause the distal tip to straighten by generating and providing steering instructions to the introducer. The straightening may be caused automatically or may be based on user input. Detecting positioning of the distal tip may be based on analysis of images acquired from the camera of the video laryngoscope and / or camera of the introducer.

Description

A0013434W001DISTAL TIP STRAIGHTENING FOR INTRODUCERCROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 761,023, filed February 20, 2025, the entire content of which is incorporated herein by reference.INTRODUCTION

[0002] Laryngoscopes are commonly used during intubation of a patient (e.g., an insertion of an endotracheal tube into a trachea of the patient). In video laryngoscopy, a medical professional (e.g., a doctor, therapist, nurse, clinician, or other practitioner) views a real-time video feed, captured via a camera of the video laryngoscope, of the patient’ s larynx on a display screen to facilitate navigation and insertion of tracheal tubes within the airway.

[0003] An introducer is a long, flexible instrument that may be used to assist in placing an endotracheal tube into a patient’s trachea during an intubation. Introducers may aid a physician with intubations in difficult airway environments. Some introducers may have a tip, or distal end, which may house sensors (e.g., camera, lights, proximity sensors, etc.) and may be steerable. For example, the distal end may be actively controllable to bend, turn, rotate, or otherwise move the distal end in a desired direction, such as to navigate through or towards anatomy of the patient. The introducer itself may not have a camera or other visualization component (e.g., the introducer may be blind).

[0004] It is with respect to this general technical environment that aspects of the present technology disclosed herein have been contemplated. Furthermore, although a general environment is discussed, it should be understood that the examples described herein should not be limited to the general environment identified herein.SUMMARY

[0005] Certain embodiments commensurate in scope with the originally claimed subject matter are summarized below. These embodiments are not intended to limit the scope of the disclosure. Indeed, the present disclosure may encompass a variety of forms that may be similar to or different from the embodiments set forth below.A0013434W001

[0006] Among other things, aspects of the present disclosure include systems and methods for automatically straightening a distal end of an introducer connected to a video laryngoscope. The systems and methods may cause the distal tip of the introducer to straighten (e.g., articulate to a straight configuration and / or slacked configuration) in certain situations. For example, the video laryngoscope may cause a distal tip of an introducer to straighten when detecting that the distal tip has advanced through vocal cords of the patient. In another example, the video laryngoscope may cause a distal tip of an introducer to straighten when detecting that the distal tip has been retracted beyond a certain point, such as out of view of a camera of the video laryngoscope or outside of a cavity (e.g., mouth, nose, etc.) of a patient. The video laryngoscope may cause the distal tip to straighten by generating and providing steering instructions to the introducer. The straightening may be caused automatically or may be based on user input after detecting the advancement and / or retraction of the distal tip. Detecting advancement of the distal tip through the vocal cords may be based on analysis (e.g., machine learning models and / or artificial intelligence algorithms) of images acquired from the camera of the video laryngoscope. Additionally or alternatively, detecting retraction of the distal tip may be based on analysis of images acquired from the camera of the video laryngoscope and / or from a camera of the introducer.

[0007] This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter. Additional aspects, features, and / or advantages of examples will be set forth in part in the description which follows and, in part, will be apparent from the description, or may be learned by practice of the disclosure.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] The following drawing figures, which form a part of this application, are illustrative of aspects of systems and methods described below and are not meant to limit the scope of the disclosure in any manner, which scope shall be based on the claims.

[0009] FIG. 1A is a schematic of an example patient environment including a video laryngoscope and an introducer.

[0010] FIG. IB is a schematic of the video laryngoscope of FIG. 1.A0013434W001

[0011] FIG. 2A depicts another example combination of a laryngoscope and an introducer.

[0012] FIG. 2B depicts a bottom perspective view of an example detachable cartridge.

[0013] FIGS. 3A-3B are block diagrams of components of example video laryngoscope and endoscope systems.

[0014] FIGS. 4A-4B show an introducer with a steerable distal tip.

[0015] FIGS. 5A-5D show an introducer with the distal tip in different configurations.

[0016] FIG. 6 shows example display screens of a video laryngoscope showing images acquired from a camera of a video laryngoscope during a straightening of a distal tip of an introducer.

[0017] FIG. 7 shows example display screens of a video laryngoscope showing images acquired from a camera of an introducer during a straightening of a distal tip of an introducer.

[0018] FIG. 8 shows an example method for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the video laryngoscope.

[0019] FIG. 9 shows another example method for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the video laryngoscope.

[0020] FIG. 10 shows an example method for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the introducer.

[0021] While examples of the disclosure are amenable to various modifications and alternative forms, specific aspects have been shown by way of example in the drawings and are described in detail below. The intention is not to limit the scope of the disclosure to the particular aspects described. On the contrary, the disclosure is intended to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure and the appended claims.DETAILED DESCRIPTION

[0022] As discussed briefly above, video laryngoscopes are commonly used during intubation of a patient (e.g., an insertion of an endotracheal tube into a trachea of the patient). During intubation, the patient’s airway and larynx may be visualized by a medical professionalA0013434W001(e.g., a doctor, therapist, nurse, clinician, or other practitioner), such as via video laryngoscopy. In video laryngoscopy, the medical professional may view a real-time video feed of the patient’s larynx, other patient anatomy, or other objects or structures in the upper airway of the patient, as captured via a camera of the video laryngoscope and displayed on a display screen of the video laryngoscope. The video feed may assist a medical professional to visualize the patient’s airway and facilitate manipulation and insertion of a tracheal tube.

[0023] An introducer is a long, flexible instrument that may be used to assist in placing an endotracheal tube into a patient’s trachea during an intubation. Introducers may aid a physician with intubations in difficult airway environments. Some introducers may have a tip, or distal end, which may house sensors (e.g., camera, lights, proximity sensors, etc.) and may be steerable. For example, the distal end may be actively controllable to bend, turn, rotate, or otherwise move the distal end in a desired direction, such as to navigate through or towards anatomy of the patient. The introducer itself may not have a camera or other visualization component (e.g., the introducer may be blind).

[0024] When manipulating and inserting a tracheal tube using an introducer (e.g., running an endotracheal tube over an introducer for placement during an intubation), the tracheal tube may be difficult to advance over sections of the introducer that are angled, bent, semi-rigid, and / or relatively inflexible. Additionally, during intubation, when an introducer is retracted and then re-advanced, a medical professional performing the intubation may desire that any bend or angling of the distal tip of the introducer be straightened (e.g., articulated to a substantially straight configuration or slacked) for ease of re-entry and / or restarting steering towards patient anatomy.

[0025] Provided herein are examples of causing a distal tip of an introducer to straighten (e.g., articulate to a straight configuration and / or slacked configuration) in certain situations. For example, the video laryngoscope may cause a distal tip of an introducer to straighten when detecting that the distal tip has advanced through vocal cords of the patient. In another example, the video laryngoscope may cause a distal tip of an introducer to straighten when detecting that the distal tip has been retracted beyond a certain point, such as out of view of a camera of the video laryngoscope or outside of a cavity (e.g., mouth, nose, etc.) of a patient. The video laryngoscope may cause the distal tip to straighten by generating and providing steering instructions to the introducer. The straightening may be caused automatically or may be based on user input after detecting the advancement and / or retraction of the distal tip. DetectingA0013434W001advancement of the distal tip through the vocal cords may be based on analysis (e.g., machine learning models and / or artificial intelligence algorithms, etc.) of images acquired from the camera of the video laryngoscope. Additionally or alternatively, detecting retraction of the distal tip may be based on analysis of images acquired from the camera of the video laryngoscope and / or from a camera of the introducer.

[0026] FIG. 1 A shows an example patient environment 100 including a video laryngoscope 102 and an intubation tool 150 (e.g., an endoscope, an introducer, a tracheal tube or bougie, and / or an endotracheal tube, etc.). The patient environment 100 may be any room where an airway procedure (e.g., intubation) is being performed, such as a medical suite in a hospital or other care setting, an operating or other procedure room, patient recovery room, an emergency intubation setting, or other environments. As described herein, the video laryngoscope 102 may be used for airway visualization of a patient 101 and / or visualization of an intubation tool 150 (e.g., endoscope or introducer 150) positioned inside the airway 140 of the patient 101. The introducer 150 may be positioned in the airway 140 of the patient 101 concurrently with a portion of a blade of the video laryngoscope 102. The introducer 150 includes a proximal end 154 and a distal end 152. Aspects of the video laryngoscope 102 are further shown in FIGS. IB, 2A, 2B, and 3 and aspects of the introducer 150 are further shown in FIG. 2A and FIGS.3A-B.

[0027] A medical professional 130 may hold a video laryngoscope 102 in a first hand 132 (e.g., a left hand 132 of the medical professional 130) and an introducer 150 in a second hand 134 (e.g., a right hand 134 of the medical professional 130). As further described herein, the video laryngoscope 102 may be positioned in the airway 140 of the patient 101 to manipulate and / or visualize the patient’ s airway 140, such as with an arm 114 or blade 118 (shown in FIG.2). Visualization of the airway 140 of the patient 101 may include viewing patient’s anatomy (e.g., larynx, trachea, esophagus, vocal cords, etc.) with a camera 116 of the video laryngoscope 102. The medical professional 130 may move the introducer 150 proximally (e.g., retract the endoscope 150) or distally (e.g., advance the introducer 150), while watching the resulting images from the camera 116 of the video laryngoscope 102 on the display 108 of the video laryngoscope 102.

[0028] Video laryngoscope images (video images and / or still-shot images) may be acquired by the video laryngoscope 102 during operation by a medical professional. The acquired laryngoscope images may be displayed at an integrated display screen (e.g., displayA0013434W001108) of the video laryngoscope 102 in the line of sight of the operator (e.g., medical professional 130). The acquired laryngoscope images may be stored in a memory of the video laryngoscope 102. In some examples, the stored images may be reviewed or replayed on the display screen of the video laryngoscope 102 itself. In other examples, stored acquired images may be transferred to, or communicated to, a remote device / system (e.g., a computer). The stored images may be reviewed, edited, or otherwise interacted with at the remote device.

[0029] The video laryngoscope 102 may be configured to connect with or communicate with one or more tools or remote devices or systems via any of a variety of techniques. For example, the introducer 150 may be configured to connect with the video laryngoscope 102 via a wired or wireless connection. The video laryngoscope 102 may include a tool port 126 configured to electrically couple with an input / output port of the endoscope 150. The tool port 126 may be anywhere on the body of the video laryngoscope 102 that is not intended to be inserted into a body of a patient (e.g., on the display portion 106, the handle portion 110, but not the arm). Images (video images and / or still-shot images) acquired by a camera of the introducer 150 may be received by the video laryngoscope 102 for display at an integrated display screen (e.g., display 108) of the video laryngoscope 102. The laryngoscope images and the introducer images may be displayed individually or concurrently at the display 108.

[0030] As an alternative to a direct electrical connection between the video laryngoscope 102 and the introducer 150, communication between the video laryngoscope 102 and a tool or remote device / system may be facilitated by one or more communication devices (e.g., wireless transceivers or hubs, which may be a wireless adapter, dongle, bridge device) that are configured to establish wireless communication with one another using any suitable protocol and may be movable between multiple tools or remote devices / systems.

[0031] FIG. IB shows a schematic of a video laryngoscope 102. As shown, the video laryngoscope 102 has a body 104 (e.g., reusable body). The body 104 includes a display portion 106 having a display 108 that is configured to display images and / or other data, a handle portion 110 having a handle 112 that is configured to be gripped by the medical professional during the laryngoscopy procedure, and an elongate portion or arm 114 that supports a camera 116 and light source (e.g., light-emitting diodes (LEDs)) that is configured to obtain images, which may be still-shot images and / or moving images (e.g., a video feed). The camera 116 and light source may be incorporated on the distal end of the arm 114. The light source may be provided as part of the camera 116 or separate from the camera 116 on the blade 118 or arm 114.A0013434W001

[0032] In examples, the display portion 106 and the handle portion 110 may not be distinct portions, such that the display 108 is integrated into the handle portion 110. In the illustrated embodiment, an activating cover, such as a removable laryngoscope blade 118 (e.g., activating blade, disposable cover, sleeve, or blade), is positioned about the arm 114 of the body 104 of the video laryngoscope 102. Together, the arm 114 of the body 104 and the blade 118 form an insertable assembly that is configured to be inserted into the patient's oral cavity. It should be appreciated that the display portion 106, the handle portion 110, and / or the arm 114 that form the body 104 of the video laryngoscope 102 may be fixed to one another or integrally formed with one another (e.g., not intended to be separated by the medical professional during routine use) or may be removably coupled to one another (e.g., intended to be separated by the medical professional during routine use) to facilitate storage, use, inspection, maintenance, repair, cleaning, replacement, or interchangeable parts (e.g., use of different arms or extensions with one handle portion 110), for example.

[0033] The handle 112, arm 114, and / or display portion 106 may include one or more sensors 122 capable of monitoring functions (e.g., different, additional, and / or advanced monitoring functions). The sensors 122 may include a torque sensor, force sensor, strain gauge, accelerometer, gyroscope, magnet, magnetometer, proximity sensor, reed switch, Hall effect sensor, infrared sensor, wireless connectivity sensor, etc. disposed within or coupled to any suitable location of the video laryngoscope 102. The sensors 122 may detect interaction of the video laryngoscope 102 with other objects, such as a blade 118, physiological structures of the patient (e.g., teeth, tissue, muscle, etc.), or proximity of an airway tool (e.g., introducer 150). For example, a sensor such as a magnet, pressure sensor, proximity sensor, etc. may enable the video laryngoscope 102 to determine when a blade is securely coupled (e.g., as distinguished between a secure coupling and a partial decoupling) with the arm 114 of the video laryngoscope 102.

[0034] The video laryngoscope 102 may also include a power button 120 that enables a medical professional to power the video laryngoscope 102 off and on. In examples, the video laryngoscope 102 may be powered by a power source (e.g., battery) that is coupled to the video laryngoscope 102. The power source may be removably coupled to the video laryngoscope 102. In an instance where the power source is removably couplable to the video laryngoscope 102, the power button 120 may be positioned on the removable power source, instead of on the video laryngoscope 102 itself. The power button 120 may also be used as an input device toA0013434W001access settings of the video laryngoscope 102, including a mode of operation (e.g., routine operation, settings, etc.). Additionally, the video laryngoscope 102 may include an input button or digital input device, such as a touch sensor 124 or proximity sensor 124 (e.g., capacitive sensor, proximity sensor, or the like) that is configured to detect a touch or object (e.g., a finger or stylus). The touch sensor 124 may enable the medical professional operating the video laryngoscope 102 to efficiently provide inputs or commands associated with functions of the video laryngoscope and / or the communicatively coupled introducer 150, such as steering inputs for the introducer 150 (e.g., steering the introducer in a direction, causing straightening of a distal tip of the introducer, etc.), capturing an image acquired by a camera of the introducer 150, capturing an image acquired by a camera of the video laryngoscope, accessing menus or options, or any other inputs relating to function of the video laryngoscope 102 and / or the introducer 150.

[0035] The video laryngoscope 102 may also include a tool port 126 configured to electrically couple with an input / output port of the introducer 150. An alternative to an integrated tool port 126 is further described with respect to FIGS. 2A-2B. The tool port 126 may be integrated anywhere on the body of the video laryngoscope 102 that is not intended to be inserted into a body of a patient (e.g., on the display portion 106, the handle portion 110, etc.). Images (video images and / or still-shot images) acquired by a camera of the introducer 150 may be received by the video laryngoscope 102 for display at an integrated display screen (e.g., display 108) of the video laryngoscope 102. The laryngoscope images and the introducer images may be displayed individually or concurrently at the display 108. The images acquired by the video laryngoscope 102, introducer 150, or both may be analyzed (e.g., via machine learning (ML) and / or artificial intelligent (Al) models) to determine a position of the distal tip of the introducer 150 to determine if straightening of the distal tip is desirable at that location.

[0036] As an alternative to the example integrated tool port 126 shown in FIGS. 1A-1B, FIG. 2A shows another example of coupling mechanism for a video laryngoscope 202 and an introducer (e.g., endoscope 206). FIG. 2B depicts a bottom perspective view of the example detachable cartridge 204 of FIG. 2A. In the example system 200 shown in FIGS. 2A-2B, a video laryngoscope 202 (VL 202) is couplable to a steerable endoscope 206 via cartridge 204 (e.g., via endoscope port 207 that receives the endoscope proximal end 214), which, when coupled to the VL 202, comes into contact with, and engages, a drive housing 220. The endoscope 206 may have similar features as those described herein, such as a proximal endA0013434W001214, a distal end 216, a steerable tip 218, and / or an accessory interface or camera 219. The endoscope proximal end 214 may include additional features that interact with and engage counter-facing features of the cartridge 204 (further described below) to aid in alignment between mechanical and / or electrical elements of the endoscope proximal end 214 and corresponding mechanical and / or electrical elements of the cartridge 204. The drive housing 220 includes elements that impart rotational force to elements of the cartridge 204 for control of (steering of) the endoscope steerable tip 218 by the VL 202. The VL 202 also includes a handle 208, blade 210, and display 212, which may be similar to, or the same as, corresponding elements described in FIGS. 1 A-1B. The drive housing 220 may be positioned on a rear surface 203 (opposite a front surface 201 which houses the display 212). A surface (e.g., the top surface 221) of the drive housing 220 includes an electrical interface 223C and VL output drives (e.g., hubs 224 A, 224B connected to motors within the drive housing 220 or elsewhere in the VL 202) that transmit rotational force from the drive housing 220 to the cartridge 204.

[0037] In the example shown in FIGS. 2A-2B, each of the drums 222 A-B in the introducer 206 (e.g., endoscope 206) may control bidirectional movement of the endoscope steerable tip 218 (distal tip 218) at the distal end 216 of the introducer 206 in a plane, and a single motor of the VL 202 may provide independent bidirectional control of the endoscope steerable tip 218 within that plane. Corresponding hubs 224A-B include features that engage and impart rotation to corresponding features of the cartridge mechanical receivers 209A-B when the cartridge 204 is coupled to the VL 202. The input mechanical receivers 209A-B in the cartridge 204 may include features capable of receiving rotational force from the hubs 224A-B.

[0038] As shown, the VL 202 also includes an electrical interface 223C that includes a set of conductive elements for providing power to the cartridge 204 and endoscope 206 and for allowing communication signals to be transmitted / received to / from the VL 202. The cartridge bottom surface 205 (FIG. 2B) includes a corresponding cartridge- VL electrical interface 223D that mates with the electrical interface 223C. The cartridge 204 also includes a cartridgeendoscope electrical interface for making electrical connection with the endoscope electrical interface 223 A. Additional elements and features of a detachable cartridge 204 for coupling an introducer to a video laryngoscope are described in U.S. Patent Application 18 / 421,476, filed November 25, 2024, which is hereby incorporated by reference in its entirety.

[0039] FIG. 3 is a block diagram of components of the video laryngoscope 102 and an introducer device / system 151. As shown, the video laryngoscope 102 and / or the introducerA0013434W001device 151 may include various components that enable the video laryngoscope 102 to carry out the techniques disclosed herein. For example, the video laryngoscope 102 may include the display 108, the camera 116, a light source (e.g., which may integrated into the camera or separate from the camera), sensor(s) 122, and input (e.g., touch sensor and / or proximity sensor) 124, as well as a controller 160 (e.g., electronic controller), one or more processors 162, a hardware memory 164, a power source 166 (e.g., battery, which may be removably couplable with the video laryngoscope 102), input / output (I / O) ports 168, a communication device 170, and a timer 172. In examples, the input / output (I / O) ports 168 may include the tool port 126 (e.g., introducer input port 126) and / or a port to support coupling of a cartridge (e.g., cartridge 204 and / or other elements described in FIGS. 2A-2B), which may be configured to electrically couple an introducer (e.g., introducer system 151 or introducer 150) with the video laryngoscope 102. In other examples, the timer 172 may track relative time (e.g., a start time, an end time, a frequency of image frame sampling), which may be referenced to acquire stillshot input images for analysis and / or to determine an operational timeout for powering down the video laryngoscope 102.

[0040] The introducer device 151 may include a controller 174 (e.g., electronic controller), one or more processors 176, a hardware memory 178, I / O ports 182, and a communication device 184. As described herein, the introducer system 151 or introducer 150 may send or transmit images (e.g., video images and / or still-shot images, etc.) to the video laryngoscope 102 via I / O ports 182 and / or communication devices 170, 184. The I / O ports 182 of the introducer system 151 may include an output port at a proximal end 154 to electrically couple the introducer system 151 with the I / O ports 182 of the video laryngoscope 102. For example, the proximal end 154 of the introducer 150 may include an electrical interface. The electrical interface may include electrical conductive elements (e.g., electrical contacts, conductive pads, receptacles, pins, balls, ports) for receiving power and / or transmitting / receiving signals to / from the video laryngoscope 102. The electrical interface may provide a power source (e.g., power source 180) for operating components of the introducer system 151 and / or a data path. For example, the introducer system 151 may transmit / send data via the electrical interface, such as sensor data, camera images (video and / or still-shot), information relating to the steering system 158, etc. For example, video data captured by the camera 159 of the introducer 150 may be transmitted to the video laryngoscope 102 via the electrical interface of the introducer system 151 (e.g., an I / O port 182) interfacing with the I / O ports 168 of the video laryngoscope 102 (e.g., such as tool port 126).A0013434W001

[0041] Additionally or alternatively, the communication device 170 of the video laryngoscope 102 may communicatively couple with the communication device 184 of the introducer device 151 to allow communication between the video laryngoscope 102 and the introducer device / system 151 (e.g., sending or receiving signal between the devices). The communication devices 170, 184 may enable wired or wireless communication. Wireless communication may include transceivers, adaptors, and / or wireless hubs that are configured to establish and / or facilitate wireless communication with one another. By way of example, the communication devices 170, 184 may be configured to communicate using the IEEE 802.15.4 standard, and may communicate, for example, using ZigBee, WirelessHART, or MiWi protocols. Additionally or alternatively, the communication devices 170, 184 may be configured to communicate using the Bluetooth standard or one or more of the IEEE 802.11 standards.

[0042] The video laryngoscope 102 may be capable of detecting the presence / absence of the introducer system 151 or introducer 150. When detected that the introducer 150 is connected, the video laryngoscope 102 may energize power and / or signal connections to the introducer 150 and / or may acquire or receive camera images from the camera 159 of the introducer 150. The introducer 150 may be connected or disconnected from the video laryngoscope 102 at any time during operation, any number of times.

[0043] As further described herein, the introducer system 151 may further include sensors 156, a steering system 158, and an introducer camera 159. The sensors 156 may include an inertial measurement unit (IMU), accelerometer, gyroscope, magnetometer, and / or other sensors. The sensors 156 may be positioned at the distal tip of the introducer 150, and signals from the sensors 156 may be used to determine a current amount of articulation and the directionality of such articulation. Additionally or alternatively, the current articulation state may be determined from the steering system 158 itself, such as by determining the amount of rotation of the respective motors.

[0044] The steering system 158 may include a steerable tip at a distal end 152 of the introducer 150 that is controllable by a drive system. The drive system may include drum(s) and / or pull wires connected to the drums that are configured to move the steerable tip along two or more planes. The introducer 150 may include the gearboxes / drums for steering / control of the introducer 150. Due to this positioning of the gearbox, shaping / bending of the distal tip may not be easily malleable (e.g., the distal tip of the introducer holds its shape well such thatA0013434W001it is not easily repositioned / straightened / etc. via manual input from a hand of a medical professional). Actuating motors (e.g., two or more, such as 2, 3, 4, etc.) may rotate to tighten or loosen the pull wires to steer / control the distal tip of the introducer. The introducer system 151 may receive steering instructions from the video laryngoscope 102, which may be determined from user input received at a user interface of the video laryngoscope 102 or determined based on image analysis (e.g., analysis of images acquired from the camera 116 of the video laryngoscope 102 and / or the camera 159 of the introducer 150).

[0045] While the introducer system 151 is connected to the video laryngoscope 102, the video laryngoscope 102 receives data (such as video images) from the introducer system 151 / introducer 150 through connection mechanism(s) (e.g., electrical interface and / or communication devices). The received data may be displayed at the display 108 of the video laryngoscope 102. The display 108 may be capable of displaying images from multiple cameras concurrently or simultaneously, such as images from the camera 116 of the video laryngoscope 102 and the camera 159 of the introducer 150, such as by split screen, image overlay, picturein-picture, or other display methods. In examples, the display 108 may be touch-sensitive (e.g., a capacitive touch-sensitive display, such as a graphical user interface) that allows user input to be received through the display 108. Additionally, a user interface of the video laryngoscope (e.g., button, joystick, key, switch, graphical user interface at display 108, etc.) may be configured to receive steering inputs from a user of the video laryngoscope 102 to steer the introducer 150 from interactions with the video laryngoscope 102 (which may include causing straightening of the distal tip of the introducer).

[0046] The processors 162, 176 may include multiple microprocessors, one or more “general-purpose” microprocessors, one or more special-purpose microprocessors, and / or one or more application specific integrated circuits (ASICS), or some combination thereof. For example, the processors 162, 176 may include one or more reduced instruction set (RISC) processors. It should be appreciated that the various processing steps may be carried out by either processor 162, 176 or may be distributed between the processors 162, 176 in any suitable manner.

[0047] The hardware memory 164, 178 may include a volatile memory, such as random access memory (RAM), and / or a nonvolatile memory, such as read-only memory (ROM). It should be appreciated that the hardware memory 164, 178 may include flash memory, a hard drive, or any other suitable optical, magnetic, or solid-state storage medium, other hardwarememory, or a combination thereof. The memory 164, 178 may store a variety of information and may be used for various purposes. For example, the memory 164, 178 may store processorexecutable instructions (e.g., firmware or software) for the processors 162, 176 to execute, such as instructions for processing signals generated by the camera 116 to generate the image, provide the image on the display 108, etc. The hardware memory 164, 178 may store data (e.g., acquired images, tags, or labels, etc.), instructions (e.g., software or firmware for generating images, storing the images, analyzing the images, etc.), and any other suitable data.

[0048] FIG. 3B depicts another example of a video laryngoscope system. The system of FIG. 3B is similar to the system of FIG. 3 A with the exception that the video laryngoscope 102 directly controls and operates the endoscope 150. For example, the endoscope 150 may be removably connectable from the video laryngoscope 102, such as in the system depicted in FIGS. 2A-2B. In such examples, steering controls are generated by the controller 160 of the video laryngoscope 102 and transmitted to the steering system 158 of the endoscope 150. Similarly, the signals from the endoscope camera 159 and the endoscope sensor(s) 156 are transmitted back to the video laryngoscope 102. The processing and analysis of the images captured by both the endoscope camera 159 and the VL camera may then both be analyzed and processed by the controller 160 (e.g., processor 162) of the video laryngoscope 102.

[0049] FIGS. 4A-4B show an introducer 150 with a steerable distal tip 152. As described herein, the distal end 152 of the introducer 150 may be steered or controlled (e.g., via steering instructions generated by the video laryngoscope, which may be automatic or based on user input at the video laryngoscope). The distal end 152 of the introducer 150 may steer by bending, turning, rotating, curving, or other movement. For example, the distal end 152 of the introducer 150 may bend up to 90 degrees in any direction or dimension (not just in a single plane, such as up / down or right / left), enabling steering of the distal end 152 of the introducer 150 within a hemisphere. As shown in FIG. 4A, the distal end 152 of the introducer 150 may be bent at a bending angle 0 off of center axis A. When the bending angle 9 is substantially non-zero at an articulated position (e.g., rigid, not slacked), the distal tip is in a non-straightened configuration. Alternatively, as shown in FIG. 4B, when the bending angle 9 is substantially zero at a position (e.g., rigid, not slacked), or if the distal tip is in a slacked configuration (e.g., the distal tip is non-rigid and flexible), then the distal tip is in a straightened configuration. Steering may be implemented via an actuation system, including one or more pull wires or similar mechanisms, which move to bend, un-bend, and / or slack the distal tip 152 of the introducer 150. SomeA0013434W001examples of a steerable introducers are described in U.S. Patent Application No. 16 / 995,181, filed August 17, 2020, and U.S. Patent Application No. 18 / 600,251, filed March 8, 2024, the entireties of which is hereby incorporated by reference.

[0050] FIGS. 5A-5D show an introducer with the distal tip in different configurations. Specifically, FIGS. 5 A-5B show the distal tip 152 of the introducer 150 advanced past the vocal cords in an airway 140. FIG. 5 A shows the distal tip 152 in a non-straightened configuration (e.g., the distal tip 152 is articulated to a rigid, bent configuration). This non-straight configuration may be desirable during active advancement of the distal tip 152 towards and through the vocal cords in the airway. As described herein, a medical professional may desire that the distal tip 152 be positioned in a straightened configuration (as shown in FIG. 5B) when running a tracheal tube over the introducer. In the straightened configuration of FIG. 5B, the distal tip 152 may be articulated to a straightened configuration (e.g., rigid with a substantially zero bending angle) or may be in a slacked configuration (e.g., flexible, non-rigid). The straightened configuration allows smooth passing of the tracheal tube over the distal tip 152 (e.g., there is less friction and / or obstruction in movement of the tracheal tube when running over the distal tip 152).

[0051] FIGS. 5C-5D show the distal tip 152 of the introducer 150 retracted to a retraction position, out of view of a camera of the video laryngoscope 102. FIG. 5C shows the distal tip 152 in a non-straightened configuration (e.g., the distal tip 152 is articulated to a rigid, bent configuration). As described herein, a medical professional may desire that the distal tip 152 be in a straightened configuration (as shown in FIG. 5D) when retracting the introducer from the patient (e.g., removing the introducer from the mouth or nose of the patient) and / or reinserting the introducer. In the straightened configuration of FIG. 5D, the distal tip 152 may be articulated to a straightened configuration (e.g., rigid with a substantially zero bending angle) or may be in a slacked configuration (e.g., flexible, non-rigid). The straightened configuration allows easier reentry and restarting the steering of the distal tip 152 to advance in the airway 140.

[0052] FIG. 6 shows example display screens 600 of a video laryngoscope (e.g., display screen 108 of video laryngoscope 102). As described herein, the VL camera 116 of the video laryngoscope 102 may capture a view of the distal end of the introducer in relation to patient upper airway anatomy. The images from the captured view are displayed on a display 108 of the video laryngoscope 102. Some or all of the image frames may be analyzed using the Al orA0013434W001ML models described herein during a straightening of a distal tip of an introducer (e.g., distal tip 152 of introducer 150). Although four display screens 600 are provided in FIG. 6 to represent advancement and / or retraction of a distal tip of an introducer, any number of captured images may be displayed and / or analyzed to detect the distal tip and / or determine its position in the airway or relative to patient anatomy. The display screens 600 shown in FIG. 6 include a vocal cord portion 610, a trachea portion 612, and an introducer portion 614. The portions of the images associated with the introducer (e.g., introducer 150 and introducer portion 614) or with patient anatomy (e.g., vocal cord portion 610 and / or a trachea portion 612) may be determined based on image analysis.

[0053] Display 602 shows a camera feed (e.g., as acquired by the VL camera 116 of the video laryngoscope 102) including patient anatomy. In display 602, the introducer is not visible (e.g., out of view of a camera of the video laryngoscope 102). The introducer may be outside of the patient (e.g., not yet inserted into the nose or mouth), or in the airway outside of view (e.g., in the mouth, such as the positioning shown in FIGS. 5C-5D, or nostril).

[0054] Displays 604, 606 show camera feeds including patient anatomy and a portion of the introducer (which may include all or a portion of the distal tip of the introducer). The displays 604, 606 show at least a portion of the distal tip of the introducer positioned in the view of the camera, but not positioned past the vocal cords or in the trachea. The position of the introducer in display 604 is in a relatively retracted position (e.g., further from the vocal cords and trachea) compared to the position of the introducer in display 606 (which is in a relatively advanced position, closer to the vocal cords and trachea).

[0055] Display 608 shows a camera feed including patient anatomy and a portion of the introducer, with at least a portion of the distal tip positioned through the vocal cords (in the trachea). As described herein, the video laryngoscope may determine that the distal tip is positioned through the vocal cords based on machine learning and / or artificial intelligence models using one or more images acquired from the camera of the video laryngoscope 102. Display 608 may be associated with the positioning of the introducer shown in FIGS. 5A-5B.

[0056] Progression through the display screens 600 in a rightward direction (e.g., flow from one or more of display 602 to display 604 to display 606 to display 608) is associated with advancement of the introducer in the airway of the patient. As shown, flow from display 602 to display 604 is associated with an introducer being advanced from outside of the camera viewA0013434W001of the video laryngoscope 102 (e.g., from outside of a cavity of the patient or from within a cavity outside of the camera view) to inside the camera view, towards the vocal cords and trachea. Flow from display 604 to display 606 is associated with the introducer being advanced within the camera view of the video laryngoscope 102 towards the vocal cords and trachea. Flow from display 606 to display 608 is associated with the introducer being advanced within the camera view of the video laryngoscope 102 through the vocal cords and into the trachea.

[0057] Progression through the display screens 600 in a leftward direction (e.g., flow from one or more of display 608 to display 606 to display 604 to display 602) is associated with retraction of the introducer in the airway of the patient. As shown, flow from display 608 to display 606 is associated with the introducer being retracted within the camera view of the video laryngoscope 102 out through the vocal cords and away from the trachea. Flow from display 606 to display 604 is associated with the introducer being retracted within the camera view of the video laryngoscope 102 away from the vocal cords and trachea. Flow from display 604 to display 602 is associated with an introducer being retracted from inside the camera view to outside of the camera view of the video laryngoscope 102 (e.g., from outside of a cavity of the patient or from within a cavity outside of the camera view), away from the vocal cords and trachea.

[0058] As described herein, straightening the distal tip of the introducer may be desirable at certain positions, such as those shown at display 602 and display 608. Determining that the distal tip of the introducer has advanced through the vocal cords (e.g., flow from display 606 to display 608) may automatically result in the video laryngoscope 102 causing straightening of the distal tip (e.g., by automatically generating and providing steering instructions to cause the distal tip to change to a straightened configuration or a slacked configuration). Similarly, determining that the distal tip of the introducer has retracted out of the camera view (e.g., flow from display 604 to display 602) may automatically result in the video laryngoscope 102 causing straightening of the distal tip.

[0059] As an alternative to automatically causing the distal tip to straighten, a straightening icon 616 may be displayed when the video laryngoscope 102 determines that the distal tip is in a position that is desirable for straightening (e.g., display 602, display 608). In response to a user interaction with the straightening icon 616 (e.g., a selection of the icon), the video laryngoscope 102 may cause the distal tip to straighten. The straightening icon 616 may be displayed on the display 108 when the positioning of the distal tip is associated with a desirableA0013434W001straightening (e.g., display 602, display 608). Additionally, the straightening icon 616 may not be displayed or may not be selectable when the distal tip position is undesirable for straightening (e.g., display 604, display 606). The straightening icon may be positioned anywhere on the display 108, such as in a lower, left quadrant (e.g., adjacent an operator’s thumb), in a position where steering instructions for the introducer are being received from the user, overlaying the introducer portion 614, or any other position on the display. The straightening icon 616 may be any shape or size, may be translucent or partially transparent, and / or may include text or images to indicate to a user of the video laryngoscope 102 that interaction with the straightening icon 616 may result in straightening of the distal tip of the introducer.

[0060] FIG. 7 shows example display screens 700 of a video laryngoscope showing images acquired from a camera of an introducer (e.g., endoscope or introducer camera 159 of introducer 150) during a straightening of a distal tip of an introducer.

[0061] The images acquired by the camera view of the introducer include multiple characteristics that may be analyzed by the technology disclosed herein. The characteristics may be used to determine if the camera of the introducer is positioned inside of a body cavity or outside of a body cavity, regardless of obstruction of the camera of the introducer (examples of obstructed views are described with respect to displays 704, 706). Such characteristics may include image color (e.g., redness), detectable straight lines, detectable patient airway anatomy, fluctuations in color / brightness, etc. For example, image analysis of the introducer images may determine that the camera (and distal tip) of the introducer is positioned outside of a body cavity of a patient when redness is below a threshold value, straight lines are detected (because straight lines rarely occur within patient anatomy), no airway anatomy is detected, and / or fluctuations in color / brightness are detected. Alternatively, in another example, image analysis of the introducer images may determine that the camera (and distal tip) of the introducer is positioned inside a body cavity of a patient when redness is above a threshold value, straight lines are not detected, airway anatomy is detected, and / or fluctuations in color / brightness are not detected.

[0062] Display 702 shows a camera feed (e.g., as acquired by a camera of the introducer) including patient airway anatomy. In display 702, the introducer is positioned inside of a body cavity of a patient (e.g., a portion of the introducer may be visible on a camera of a video laryngoscope when the arm of the video laryngoscope is also positioned inside the body cavity). The camera feed of display 702 has a view that is unobstructed (e.g., a view of the camera isA0013434W001substantially clear and the lens is substantially free of buildup or bodily fluid interference). The set of image characteristics of display 702 may include redness is above a threshold value, straight lines are not detected, airway anatomy is detected (e.g., the esophagus, trachea, vocal cords, etc.), and / or fluctuations in color / brightness are not detected.

[0063] Display 704 shows the camera feed of the introducer positioned inside the body cavity of the patient with an obstructed view (e.g., buildup of bodily fluids on the distal tip of the introducer may cause the camera view of the introducer to be obstructed or blurry). When the camera view of the introducer is obstructed, a medical professional may desire to retract the introducer to clean the camera and then readvance the introducer with an unobstructed view. The set of image characteristics of display 704 may include redness is above a threshold value, straight lines are not detected, airway anatomy is detected (e.g., the esophagus, trachea, vocal cords, etc.), and / or fluctuations in color / brightness are not detected. In an example, the set of characteristics may not be able to determine the presence of straight lines and / or patient airway anatomy in an obstructed view, in such a situation the image characteristics may include that the image is obstructed.

[0064] Display 706 shows the camera feed of the introducer positioned outside of the body cavity of the patient with an obstructed view, prior to cleaning the camera of the introducer. The set of image characteristics of display 706 may include redness is below a threshold value, straight lines are detected, no airway anatomy is detected, and / or fluctuations in color / brightness are detected. Similar to display 704, in an example, the set of characteristics may not be able to determine the presence of straight lines and / or patient airway anatomy in an obstructed view, in such a situation the image characteristics may include that the image is obstructed.

[0065] Display 708 shows the camera feed of the introducer positioned outside of the body cavity of the patient with an unobstructed view. The set of image characteristics of display 708 may include redness is below a threshold value, straight lines are detected, no airway anatomy is detected, and / or fluctuations in color / brightness are detected (e.g., from ambient lighting in a medical environment, cleaning the camera lens, moving from inside the body cavity to outside of the body cavity, etc.).

[0066] Display 710 shows a camera feed including patient airway anatomy. In display 710, the distal tip of the introducer is positioned inside of a trachea inside of a body cavity of aA0013434W001patient (e.g., a portion of the introducer, but not the distal tip, may be visible on a camera of a video laryngoscope when the arm of the video laryngoscope is also positioned inside the body cavity). The camera feed of display 710 has a view that is unobstructed. The set of image characteristics of display 710 may include redness is above a threshold value, straight lines are not detected, airway anatomy is detected (e.g., the trachea and / or vocal cords), and / or fluctuations in color / brightness are not detected. Display 710 may be associated with the positioning of the introducer shown in FIGS. 5A-5B.

[0067] Progression from display 702 to display 704 to display 706 shows obstruction of the camera and retraction of the introducer from the body cavity of the patient. For example, between display 702 to display 704 the camera of the introducer is obstructed within the cavity of the patient. From display 704 to display 706 the introducer, with an obstructed view of the camera, is retracted from within the body cavity of the patient to outside of the body cavity of the patient. From display 706, the camera lens of the introducer may be cleaned to unobstruct the view of the camera outside the body cavity of the patient, as shown in the flow from display 706 to display 708. The introducer may then be reintroduced into the body cavity of the patient and flow progresses from to display 708 to display 702. Additional obstruction may result in flow progression of displays 702, 704, 706, and / or 708 repeating (e.g., the camera view becomes obstructed, the introducer is retracted for cleaning, and / or the introducer is reinserted into the body cavity of the patient). Alternatively, with a continued unobstructed view the distal tip of the introducer may be advanced into the trachea past the vocal cords, as shown in the flow from display 702 to display 710. Unobstructed retraction of the introducer is shown as flow progression from display 710 to display 702 (retraction within the body cavity to position the distal tip of the introducer within the body cavity) and / or to display 708 (retraction outside of the body cavity).

[0068] As described herein, straightening the distal tip of the introducer may be desirable at certain positions, such as those shown at displays 706, 708, and / or 710. Determining that the distal tip of the introducer has advanced through the vocal cords (e.g., flow from display 702 to display 710) may automatically result in the video laryngoscope 102 causing straightening of the distal tip (e.g., by automatically generating and providing steering instructions to cause the distal tip to change to a straightened configuration or a slacked configuration). Similarly, determining that the distal tip of the introducer has retracted out of the camera view (e.g., flow from display 704 to display 706, and / or flow from display 706 to display 708, and / or flow fromA0013434W001display 702 to display 708) may automatically result in the video laryngoscope 102 causing straightening of the distal tip.

[0069] As an alternative to automatically causing the distal tip to straighten, a straightening icon 716 may be displayed when the video laryngoscope 102 determines that the distal tip is in a position that is desirable for straightening (e.g., displays 706, 708, 710). The straightening icon 716 may be similar to the straightening icon 616 described with respect to FIG. 6.

[0070] FIGS. 8-10 show example methods according to the disclosed technology. The example methods include operations that may be implemented or performed by the systems and devices disclosed herein. For example, the video laryngoscope 102, 202 and / or introducer system 151 / introducer 150, 206 depicted in at least FIGS. 1-3 may perform the operations described in the methods. In addition, instructions for performing the operations of the methods disclosed herein may be stored in a memory of the video laryngoscope and / or introducer (e.g., system memories 164, 178 described in FIGS. 3A-B).

[0071] FIG. 8 and FIG. 9 show example methods for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the video laryngoscope. FIG. 10 show example methods for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the introducer.

[0072] Regarding FIG. 8, method 800 is a method for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the video laryngoscope. At operation 802, the video laryngoscope is powered on. The video laryngoscope may be powered on from a power button positioned on the handle of the video laryngoscope. At operation 804, images are acquired using a camera of the video laryngoscope. The camera may be coupled to an arm of the video laryngoscope such that a view from the camera when the arm is inserted into a mouth of a patient includes view of patient airway anatomy, such as a trachea, vocal cords, and / or an esophagus, etc. The acquiring of images may be in the form of acquiring a video feed from the VL camera. The acquired images may include a first image (or first set of images) captured at a first time and a second image (or second set of images) captured at a second time after the first time. For instance, the second image(s) may be the next captured image(s) after the first image(s)

[0073] At operation 806, a distal tip of an introducer is detected in the first image(s) at a first position. The distal tip of the introducer is identified at a first position. The first positionA0013434W001may be defined relative identified patient anatomy in the acquired image, and / or relative to an edge or frame of the images. As described herein, the distal tip of the introducer may be controllable and / or steerable to navigate patient anatomy during an intubation. Identifying the introducer and / or distal tip of the introducer in the image may be based on ML and / or Al models.

[0074] At operation 808, the second image or images are analyzed to determined if the introducer is still positioned within the second image. For instance, over time the introducer moves from its first position to a second position. That second position may be a further advanced position of the introducer or a retracted position of the introducer. As an example, the clinician may advance the introducer through the vocal cords. As another example, the clinician may retract the introducer to a point where the introducer is no longer within the field of view of the VL camera (e.g., not shown in the second image).

[0075] The object detection and tracking features of the present technology may be accomplished through the use computer vision and / or AI / ML models that process the frames of the video feeds. In one example, a trained convolutional neural network (CNN) may be used to process the image frames of the video feed. A CNN is a class of deep neural networks that are effective at analyzing visual imagery. CNNs are composed of layers that include convolutional layers, pooling layers, and fully connected layers. The convolutional layers apply various filters to the input to create feature maps, which highlight specific features in the image. In the initial layers, simple features like edges and colors may be detected. As the data progresses through the network, more complex features like textures and patterns are identified. Some methods generate potential bounding boxes in the image where objects might be located. For each bounding box, the CNN predicts the probability of each object class (e.g., introducer and / or vocal cords). The final output includes the class labels (e.g., vocal cords, introducer) and bounding box coordinates for each detected object in the image or video frame.

[0076] At determination 810, the video laryngoscope may determine if the introducer is outside of a view of the VL camera when the distal tip is in the second position in the second image(s). The introducer is outside a view of the camera when no portion of the acquired image includes a portion associated with the introducer (e.g., no portion of the introducer is visible in the acquired image). If the video laryngoscope determines that the introducer is outside of view when the distal tip is in the second position, the method 800 flows “YES” to operation 816 where the distal tip is caused to straighten. As described herein, straightening may be performedA0013434W001automatically or based on user input at the video laryngoscope. Straightening may include positioning the distal tip in a straight, rigid position or slacking the distal tip. The distal tip may be caused to be straightened based on instructions generated by the video laryngoscope and provided to the introducer. For instance, the straightening operation may include the video laryngoscope generating a steering instruction that is issued to a motor and / or actuator of the introducer steering system. In some examples, the steering instruction is an instruction to return to the neutral or straightened position, and such a neutral position is programmed into the steering system and / or actuators thereof. In other examples, the steering instruction may be based on the current articulation state, which may be determined from the steering system state and / or signals from the sensor(s) (e.g., IMU) in the distal tip of the introducer. For instance, if the current articulation state is 15 degrees in a particular direction, the steering instructions is to move 15 degrees in the opposite direction. This steering instruction causes the motor(s) of the steering system to activate accordingly to return the distal tip to the neutral position. In still other examples, the straightening steering instructions may cause the steering system to slack the tension of the steering wire(s) of the steering system. When the distal tip of the introducer has been retracted outside of camera view, a medical professional may desire the distal tip to be straightened for ease of fully retracting the introducer and / or reinserting the introducer (e.g., after cleaning the camera lens).

[0077] If, alternatively, at least a portion of the introducer is inside of the camera view when the distal tip is in the second position in the second image(s), then the method 800 flows “NO” to operation 812. At operation 812, patient anatomy in the acquired images is detected. Patient anatomy may include any patient airway anatomy that may be used or referenced to determine if the distal tip of the introducer has advanced to a desirable position for intubation (e.g., past the vocal cords, in the trachea, etc.). Identifying the patient anatomy in the image may be based on ML and / or Al models, as discussed further herein.

[0078] At determination 814, the video laryngoscope determines if the second position of the distal tip is in the detected anatomy. For example, based on the second position of the introducer and the detected patient anatomy, the video laryngoscope determines if the distal tip of the introducer is positioned in the trachea through the vocal cords. If the video laryngoscope determines that the distal tip has advanced into the detected anatomy at the second position, the method 800 flows “YES” to operation 816. Operation 816 is further described above. When the distal tip of the introducer has been advanced through the vocal cords, a medicalA0013434W001professional may desire the distal tip to be straightened for ease of running an endotracheal tube over the introducer to intubate the patient.

[0079] If, alternatively, the video laryngoscope determines that the distal tip has not advanced through / into the detected anatomy at the second position, the method 800 flows “NO” back to operation 808. Operations 808 to 814 may repeat as required or desired for subsequently acquired images. For example, movement of the introducer within the body cavity of the patient, with a least a portion of the introducer being visible in the acquired images, may continue until the distal tip is retracted out of view or until the distal tip is advanced into the trachea past the vocal cords, at which point the distal tip of the introducer is caused to be straightened.

[0080] FIG. 9 shows another example method 900 for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the video laryngoscope. At operation 902, images of a camera of a video laryngoscope are acquired.

[0081] At operation 904, a distal tip of an introducer is detected in the acquired images. At operation 906, vocal cords are detected in the acquired images. Detection of the introducer and / or distal tip of the introducer and / or vocal cords may be based on ML or Al models.

[0082] At operation 908, the video laryngoscope detects, in the acquired images, that the distal tip of the introducer has advanced through the vocal cords. Determination that the distal tip has advanced through the vocal cords may be based on comparison of positioning of the introducer in prior acquired images, shape analysis of the portion of the introducer that is visible (e.g., determine that the distal tip of the introducer is not visible while other portions of the introducer are visible), movement analysis, etc.

[0083] At operation 910, the distal tip of the introducer is caused to be straightened. This may be similar to operation 816 described in FIG. 8. When the distal tip of the introducer has been advanced through the vocal cords, a medical profession may desire the distal tip to be straightened for ease of running an endotracheal tube over the introducer to intubate the patient.

[0084] FIG. 10 shows an example method 1000 for straightening a distal tip of an introducer with a video laryngoscope based on images acquired from a camera of the introducer (e.g., an endoscope). At operation 1002, images from a camera of an endoscope are received. The endoscope may send or provide images acquired by a camera of the endoscope to a videoA0013434W001laryngoscope (e.g., via a wired or wireless connection). The camera of the endoscope may be positioned at a distal tip of the endoscope, which may be steerable / controllable (from the endoscope and / or from the video laryngoscope). The images of the endoscope may include a set of image characteristics, which may be used to determine a position of a distal tip of the endoscope. Image characteristics may include image color (e.g., redness), detectable straight lines, detectable patient airway anatomy, fluctuations in color / brightness, camera obstruction, etc.

[0085] At operation 1004, a distal tip of the endoscope has been determined to be retracted from a cavity of the patient. The determination may be performed by the endoscope and / or the video laryngoscope. The determination may be based on the set of image characteristics of the acquired images. For example, a determination that a distal tip of the endoscope has been retracted outside of a body cavity of a patient may have a set of image characteristics that include redness below a threshold value, straight lines detected, no airway anatomy detected, obstruction detected, and / or fluctuations in color / brightness detected. In some examples, a first image of the endoscope images and / or VL images is first analyzed to detect objects or features from within the first image. Then, a second, subsequent image of the endoscope images and / or VL images is analyzed to detect objects or features from within the second image. Based on objects or features detected (and / or the absence of the objects or features detected) in the respective images, the retraction determination may be made. For example, patient anatomy may be detected in the first image of the endoscope images, and absence of patient anatomy may be detected in the second image of the endoscope images. Alternatively or additionally, the introducer may be detected in the first image of the VL images, and an absence of patient anatomy may be detected in the second image of the VL images.

[0086] Alternatively, at operation 1006, it is determined that a distal tip of the endoscope has been advanced through vocal cords of the patient. The determination may be performed by the endoscope and / or the video laryngoscope. The determination may be based on the set of image characteristics of the acquired images. For example, a determination that a distal tip of the endoscope has been advanced through vocal cords of a patient may have a set of image characteristics that include redness above a threshold value, straight lines not detected, airway anatomy detected (e.g., the trachea and / or vocal cords), unobstructed view, and / or fluctuations in color / brightness not detected.A0013434W001

[0087] At operation 1008, the distal tip of the endoscope is caused to be straightened. As described herein, straightening may be performed automatically or based on user input at the video laryngoscope and / or endoscope. Straightening may include positioning the distal tip in a straight, rigid position or slacking the distal tip. The distal tip may be caused to be straightened based on instructions generated by the video laryngoscope and received at the endoscope. In either the case of operation 1004 and / or operation 1006, a medical professional may desire the distal tip to be straightened.

[0088] Although the methods of FIGS. 8-10 describe using acquired images from only one camera (e.g., a camera of the video laryngoscope or camera of the introducer) to determine when the distal tip of the introducer is desirable to be straightened, one or more sets of images acquired by more than one camera (e.g., both the cameras of the video laryngoscope and the introducer) may be analyzed concurrently to determine positioning of the distal tip of the introducer. If images acquired from more than one camera are analyzed, one or more of the images may be concurrently displayed at a display of the video laryngoscope and / or endoscope (e.g., one or more of the images may not be displayed, or alternatively, all of the images analyzed may be displayed concurrently).

[0089] In an aspect, the technology relates to a method, performed by a video laryngoscope, that includes acquiring images using a camera of the video laryngoscope; detecting, in the acquired images, a distal end of an introducer; based on the detected distal end, determining that the distal end of the introducer has advanced through the vocal cords of the patient; and in response to determining that the distal end of the introducer has advanced through the vocal cords, causing straightening of the distal end of the introducer.

[0090] In an example, straightening the distal end of the introducer is automatically performed in response to determining that the distal end of the introducer has advanced through the vocal cords. In another example, the method further includes detecting, in the acquired images, the vocal cords of the patient, wherein determining the distal end has advanced through the vocal cords is further based on the detection of the vocal cords. In a further example, the method further includes in response to determining that the distal end of the introducer has advanced through the vocal cords, displaying a straightening indicator on the display; and receiving a selection of the straightening indicator, wherein straightening the distal end of the introducer is further in response to receiving a selection of the straightening indicator. In yet another example, causing straightening of the distal end of the introducer includes generatingA0013434W001a steering instruction for the introducer.

[0091] In another aspect, the technology relates to a video laryngoscope system that includes an endoscope having a distal tip with an endoscope camera that acquires endoscope images when the endoscope is powered on; and a video laryngoscope connected to the endoscope. The video laryngoscope includes an integrated display; and a processor that operates to: receive the endoscope images from the endoscope; based on the acquired endoscope images, determine that the distal tip of the endoscope has been retracted from a first position to a second position, wherein the first position is in a cavity of a patient and the second position is outside the cavity of the patient; in response to determining the retraction, generate a straightening steering instruction associated with straightening the distal tip of the endoscope; and provide the straightening steering instruction to the endoscope to cause straightening of the distal tip.

[0092] In an example, generating the steering instruction and providing the steering instruction are automatically performed in response to determining the retraction. In another example, determining the retraction is based on a color analysis of the endoscope images. In yet another example, determining the retraction further includes detecting, in a first image of the endoscope images, patient anatomy; and detecting, in a second, subsequent image of the endoscope images, an absence of patient anatomy. In still another example, the endoscope further includes at least one actuator and pull wires for steering the distal tip, wherein the actuators move the pull wires in response to steering instructions provided by the video laryngoscope. In yet another example, determining the retraction is based on straight-line detection. In still another example, the distal tip of the endoscope further comprises an inertial measurement unit (IMU), and the steering instruction is further based on data received from the IMU. In a further example, determining the retraction further includes providing the endoscope images as input to a machine learning (ML) model; and receiving, as output form the ML model in response to the input, one or more detected objects in the endoscope images.

[0093] In another aspect, the technology relates to a method, performed by a video laryngoscope, that includes acquiring images from a camera of the video laryngoscope; detecting, in first image of the acquired images, a distal end of an introducer inside a cavity of a patient; detecting, in a second, subsequent image of the acquired images, an absence of the introducer; based on the detections performed on the first image and the second image, determining that the distal end of the introducer has retracted outside a view of the camera; andA0013434W001in response to determining that the distal end of the introducer has retracted outside of the view of the camera, causing straightening of the distal end of the introducer.

[0094] In an example, the introducer is a blind bougie. In another example, the camera of the video laryngoscope is positioned inside the cavity of the patient such that the view of the camera includes an anatomical feature inside the cavity of the patient. In a further example, the anatomical feature is vocal cords, and the vocal cords are detected in the second image. In yet another example,

[0095] determining retraction is based on a trained machine-learning model. In still another example, causing straightening of the distal end of the introducer is automatically performed in response to determining that the distal end of the introducer has retracted outside of the view of the camera. In still yet another example, causing straightening of the distal end of the introducer includes transmitting, from the video laryngoscope, a steering instruction to the introducer steering system.

[0096] The techniques introduced above may be implemented for a variety of medical devices or devices where direct and indirect views are possible. A person of skill in the art will understand that the technology described in the context of a video laryngoscope for human patients could be adapted for use with other systems such as laryngoscopes for non-human patients or medical video imaging systems.

[0097] Those skilled in the art will recognize that the methods and systems of the present disclosure may be implemented in many manners and as such are not to be limited by the foregoing aspects and examples. In other words, functional elements being performed by a single component or multiple components, in various combinations of hardware and software or firmware, and individual functions, can be distributed among software applications at either the client or server level or both. In this regard, any number of the features of the different aspects described herein may be combined into single or multiple aspects, and alternate aspects having fewer than or more than all of the features herein described are possible.

[0098] Functionality may also be, in whole or in part, distributed among multiple components, in manners now known or to become known. Thus, a myriad of software / hardware / firmware combinations are possible in achieving the functions, features, interfaces, and preferences described herein. Moreover, the scope of the present disclosure covers manners for carrying out the described features and functions and interfaces, and thoseA0013434W001variations and modifications that may be made to the hardware or software firmware components described herein as would be understood by those skilled in the art now and hereafter. In addition, some aspects of the present disclosure are described above with reference to block diagrams and / or operational illustrations of systems and methods according to aspects of this disclosure. The functions, operations, and / or acts noted in the blocks may occur out of the order that is shown in any respective flowchart. For example, two blocks shown in succession may in fact be executed or performed substantially concurrently or in reverse order, depending on the functionality and implementation involved.

[0099] Further, as used herein and in the claims, the phrase “at least one of element A, element B, or element C” is intended to convey any of element A, element B, element C, elements A and B, elements A and C, elements B and C, and elements A, B, and C. In addition, one having skill in the art will understand the degree to which terms such as “about” or “substantially” convey in light of the measurement techniques utilized herein. To the extent such terms may not be clearly defined or understood by one having skill in the art, the term “about” shall mean plus or minus ten percent.

[0100] Numerous other changes may be made which will readily suggest themselves to those skilled in the art and which are encompassed in the spirit of the disclosure and as defined in the appended claims. While various aspects have been described for purposes of this disclosure, various changes and modifications may be made which are well within the scope of the disclosure. Numerous other changes may be made which will readily suggest themselves to those skilled in the art and which are encompassed in the spirit of the disclosure and as defined in the claims.

[0101] The following examples are illustrative of the techniques described herein.

[0102] Example 1. A method, performed by a video laryngoscope, comprising: acquiring images using a camera of the video laryngoscope; detecting, in the acquired images, a distal end of an introducer; based on the detected distal end, determining that the distal end of the introducer has advanced through the vocal cords of the patient; and in response to determining that the distal end of the introducer has advanced through the vocal cords, causing straightening of the distal end of the introducer.A0013434W001

[0103] Example 2. The method of Example 1, wherein straightening the distal end of the introducer is automatically performed in response to determining that the distal end of the introducer has advanced through the vocal cords.

[0104] Example s. The method of Example 1, the method further comprising detecting, in the acquired images, the vocal cords of the patient, wherein determining the distal end has advanced through the vocal cords is further based on the detection of the vocal cords.

[0105] Example 4. The method of Example 3, the method further comprising: in response to determining that the distal end of the introducer has advanced through the vocal cords, displaying a straightening indicator on the display; and receiving a selection of the straightening indicator, wherein straightening the distal end of the introducer is further in response to receiving a selection of the straightening indicator.

[0106] Example 5. The method of Example 1, wherein causing straightening of the distal end of the introducer includes generating a steering instruction for the introducer.

[0107] Example 6. A video laryngoscope system, comprising: an endoscope having a distal tip with an endoscope camera that acquires endoscope images when the endoscope is powered on; and a video laryngoscope connected to the endoscope, the video laryngoscope comprising: an integrated display; and a processor that operates to: receive the endoscope images from the endoscope; based on the acquired endoscope images, determine that the distal tip of the endoscope has been retracted from a first position to a second position, wherein the first position is in a cavity of a patient and the second position is outside the cavity of the patient; in response to determining the retraction, generate a straightening steering instruction associated with straightening the distal tip of the endoscope; and provide the straightening steering instruction to the endoscope to cause straightening of the distal tip.

[0108] Example 7. The system of Example 6, wherein generating the steering instruction and providing the steering instruction are automatically performed in response to determining the retraction.

[0109] Example 8. The system of Example 6, wherein determining the retraction is based on a color analysis of the endoscope images.A0013434W001

[0110] Example 9. The system of Example 6, wherein determining the retraction further comprises: detecting, in a first image of the endoscope images, patient anatomy; and detecting, in a second, subsequent image of the endoscope images, an absence of patient anatomy.

[0111] Example 10. The system of Example 6, wherein the endoscope further includes at least one actuator and pull wires for steering the distal tip, wherein the actuators move the pull wires in response to steering instructions provided by the video laryngoscope.

[0112] Example 11. The system of Example 10, wherein determining the retraction is based on straight-line detection.

[0113] Example 12. The system of Example 10, wherein the distal tip of the endoscope further comprises an inertial measurement unit (IMU), and the steering instruction is further based on data received from the IMU.

[0114] Example 13. The system of Example 10, wherein determining the retraction further comprises: providing the endoscope images as input to a machine learning (ML) model; and receiving, as output form the ML model in response to the input, one or more detected objects in the endoscope images.

[0115] Example 14. A method, performed by a video laryngoscope, comprising: acquiring images from a camera of the video laryngoscope; detecting, in first image of the acquired images, a distal end of an introducer inside a cavity of a patient; detecting, in a second, subsequent image of the acquired images, an absence of the introducer; based on the detections performed on the first image and the second image, determining that the distal end of the introducer has retracted outside a view of the camera; and in response to determining that the distal end of the introducer has retracted outside of the view of the camera, causing straightening of the distal end of the introducer.

[0116] Example 15. The method of Example 14, wherein the introducer is a blind bougie.

[0117] Example 16. The method of Example 14, wherein the camera of the video laryngoscope is positioned inside the cavity of the patient such that the view of the camera includes an anatomical feature inside the cavity of the patient.A0013434W001

[0118] Example 17. The method of Example 16, wherein the anatomical feature is vocal cords, and the vocal cords are detected in the second image.

[0119] Example 18. The method of Example 14, wherein determining the retraction is based on a trained machine-learning model.

[0120] Example 19. The method of Example 14, wherein causing straightening of the distal end of the introducer is automatically performed in response to determining that the distal end of the introducer has retracted outside of the view of the camera.

[0121] Example 20. The method of Example 14, wherein causing straightening of the distal end of the introducer includes transmitting, from the video laryngoscope, a steering instruction to the introducer steering system.

Claims

A0013434W001CLAIMSWhat is claimed is:

1. A method (900), performed by a video laryngoscope, comprising:acquiring (902) images using a camera of the video laryngoscope;detecting (904), in the acquired images, a distal end of an introducer;based on the detected distal end (908), determining that the distal end of the introducer has advanced through the vocal cords of the patient; andin response to determining that the distal end of the introducer has advanced through the vocal cords, causing (910) straightening of the distal end of the introducer.

2. The method of claim 1, wherein straightening the distal end of the introducer is automatically performed in response to determining that the distal end of the introducer has advanced through the vocal cords.

3. The method of claim 1, the method further comprising detecting, in the acquired images, the vocal cords of the patient, wherein determining the distal end has advanced through the vocal cords is further based on the detection of the vocal cords.

4. The method of claim 3, the method further comprising:in response to determining that the distal end of the introducer has advanced through the vocal cords, displaying a straightening indicator on the display; andreceiving a selection of the straightening indicator, wherein straightening the distal end of the introducer is further in response to receiving a selection of the straightening indicator.

5. The method of claim 1, wherein causing straightening of the distal end of the introducer includes generating a steering instruction for the introducer.

6. A video laryngoscope system, comprising:an endoscope (150) having a distal tip with an endoscope camera that acquires endoscope images when the endoscope is powered on; anda video laryngoscope (102) connected to the endoscope (150), the video laryngoscope comprising:an integrated display (108); anda processor (162) that operates to:A0013434W001receive the endoscope images from the endoscope (150);based on the acquired endoscope images, determine that the distal tip of the endoscope (150) has been retracted from a first position to a second position, wherein the first position is in a cavity of a patient and the second position is outside the cavity of the patient;in response to determining the retraction, generate a straightening steering instruction associated with straightening the distal tip of the endoscope (150); andprovide the straightening steering instruction to the endoscope (150) to cause straightening of the distal tip.

7. The system of claim 6, wherein generating the steering instruction and providing the steering instruction are automatically performed in response to determining the retraction.

8. The system of claim 6, wherein determining the retraction is based on a color analysis of the endoscope images.

9. The system of claim 6, wherein determining the retraction further comprises:detecting, in a first image of the endoscope images, patient anatomy; and detecting, in a second, subsequent image of the endoscope images, an absence of patient anatomy.

10. The system of claim 6, wherein the endoscope further includes at least one actuator and pull wires for steering the distal tip, wherein the actuators move the pull wires in response to steering instructions provided by the video laryngoscope.

11. The system of claim 10, wherein determining the retraction is based on straight-line detection.

12. The system of claim 10, wherein the distal tip of the endoscope further comprises an inertial measurement unit (IMU), and the steering instruction is further based on data received from the IMU.A0013434W00113. The system of claim 10, wherein determining the retraction further comprises:providing the endoscope images as input to a machine learning (ML) model; and receiving, as output form the ML model in response to the input, one or more detected objects in the endoscope images.

14. A method (800), performed by a video laryngoscope, comprising:acquiring (804) images from a camera of the video laryngoscope;detecting (806), in first image of the acquired images, a distal end of an introducer inside a cavity of a patient;detecting (808), in a second, subsequent image of the acquired images, an absence of the introducer;based on the detections performed on the first image and the second image, determining (810) that the distal end of the introducer has retracted outside a view of the camera; andin response to determining that the distal end of the introducer has retracted outside of the view of the camera, causing (816) straightening of the distal end of the introducer.

15. The method of claim 14, wherein the introducer is a blind bougie.

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