JP7675278B2 - Endoscope with removable sensor - Google Patents

Description

This disclosure relates to an endoscope having a detachable sensor.

Such endoscopes may include, for example, ultrasound endoscopes. Ultrasound endoscopes have, for example, an ultrasound sensor at a distal end (or section) of the ultrasound endoscope. The ultrasound sensor produces an ultrasound image of the region or area of the patient being examined. The endoscope may have a position sensor for determining the position of a particular portion of the endoscope.

The objective of this disclosure is to reliably determine the exact location of a particular endoscopic portion or area to be examined, both in space and relative to the patient.

This object is achieved by the endoscope described in claim 1.

Examples are detailed in the dependent claims.

The endoscope has a tube for insertion into a patient. Distal to the tube is a distal end. The sensor is attachable to the outside of the endoscope. The sensor is configured to be detached from the endoscope.

A sensor removably attached to the endoscope can retrieve (interrogate or sample) desired information retrieved by the sensor regarding the portion of the endoscope to which the sensor is temporarily attached and provide this information to an operator.

If the sensor is designed as a position determining sensor (position detection sensor), it can retrieve information about the position and orientation of the part of the endoscope to which it is temporarily attached and provide this information to the operator.

The sensor may be removably attachable to the distal end of the endoscope and may be connected to a signal transmission cable configured to be connected to a signal processing device at an end of the signal transmission cable opposite the sensor. This allows the sensor to be used to reliably determine information regarding the position and orientation of the distal end of the endoscope in space and relative to the patient.

Alternatively, the endoscope can be provided without a signal transmission cable and the sensor signal from the sensor can be transmitted wirelessly by a suitable device.

The signal transmission cable can be removably attached to the tube of the endoscope that connects the distal end of the endoscope to the proximal gripping unit (handle unit) of the endoscope, and a processor connector (processor terminal) configured to be connected to the processor is provided on the proximal side of the proximal gripping unit. This prevents the signal transmission cable from interfering with the handling of the endoscope.

The sensor can be removably attachable to the endoscope by a snap-in connection (clip-in/on connection), a removable (releasable) adhesive connection, or a mechanical plug-in connection. This allows the sensor to be attached to the endoscope and easily removed again.

The signal transmission cable may be removably attachable to the tube section by a snap-in connection, a removable adhesive connection, or a mechanical plug-in connection. This allows the signal transmission cable to be attached to the tube section and easily removed again.

A slip-on sheath (slip-on cover/coating) can be removably attached to the tube section, and the signal transmission cable is integrated in the slip-on sheath. Such a slip-on sheath, which serves as the signal transmission cable, can have a surface that facilitates and does not hinder the insertion of the tube section. Furthermore, if a particularly thin slip-on sheath is selected, the diameter of the tube section only increases slightly when the slip-on sheath is placed on the tube section. The appearance of the tube section when the slip-on sheath is attached corresponds to the appearance of a conventional tube section. In addition, the use of a slip-on sheath ensures in a particularly advantageous manner that the signal transmission cable does not displace (move) on the tube section. In this way, the signal transmission cable is placed on the tube section in a manner that is fixed with respect to rotation and position.

The distal end of the endoscope may have (include) an ultrasound sensor, which may be removably mountable on the endoscope with respect to the ultrasound sensor in such a way that relative position information between the sensor and the ultrasound sensor is known or determinable (identifiable). This allows the precise position of the ultrasound sensor in space and relative to the patient to be reliably determined. The sensor may be removably mounted at any suitable location on the endoscope.

The sensor may be removably mountable to the distal end of the endoscope adjacent to the ultrasound sensor, thereby allowing the relative positions of the removably mounted sensor and the ultrasound sensor to be easily determined.

The sensor can be a Hall effect sensor (Hall sensor) or any other positioning sensor, such as a so-called EM sensor. For example, a passive sensor can be used, which receives electromagnetic or other radiation, for example from an active sensor (which outputs radiation or radiation permanently or when switched on) that can be removably attached to the endoscope. Thereby, positioning can be realized by the sensor in a technically simple and cost-effective manner.

In addition, in a combination (set) of an endoscope having a removably attachable sensor, a signal processing device, and a processor, the signal processing device can be separate from the processor (control device). This allows information determined by the removably attachable sensor to be handled separately from information processed by the processor.

Also, in a combination of an endoscope having a removably attachable sensor, a signal processing device, and a processor, the signal processing device can be a unit combined with the processor. The signal processing device can be integrated into the processor or can be plugged into the processor.

FIG. 1 shows an example of an endoscope to which a sensor is removably attached. FIG. 13 illustrates a spring clip that removably attaches the sensor's cable to the endoscope. 3 is a perspective view of the spring clip of FIG. 2 attached to a tube portion (insertion portion) of an endoscope. FIG. FIG. 1 is a perspective view of a distal portion of an endoscope having a sensor removably attached thereto. FIG. 5 is a perspective view of the distal portion of the endoscope of FIG. 4, with the location of the ultrasound image symbolically indicated. 5 illustrates a perspective view of the distal portion of the endoscope of FIG. 4 with the location of an ultrasound image symbolically indicated and a biopsy tool being advanced forward through the working channel. FIG. 1 illustrates a distal portion of an endoscope with an attachable sensor detached from the endoscope. FIG. 8 shows a distal portion of the endoscope of FIG. 7 with a sensor attached to the endoscope. 13A-13C show a second example of a ring element for releasably fastening a cable of a sensor to an endoscope. 10 is a perspective view of a second example of the ring element of FIG. 9 attached to a tube of an endoscope. FIG. 11 is a perspective view of an open ring element according to a second example. FIG. 13 is a perspective view of an open ring element when placed on a tube of an endoscope. FIG. 13 is a diagram showing a third example of an endoscope equipped with a sensor. FIG. 13 is a diagram showing a fourth example of an endoscope equipped with a sensor.

An example of this disclosure is provided below.

First Example First, a first example will be described with reference to FIGS.

1 shows a perspective view of an endoscope 10. In a first example, the endoscope 10 is designed as an ultrasound endoscope.

The endoscope 10 has a gripping unit 100 as a control body of the endoscope 10. The gripping unit 100 has an optional control knob 110 for, for example, rotating the distal portion 300. The gripping unit 100 also has an insertion portion 120 for, for example, a working channel formed therein. The working channel extends to the distal portion 300 of the insertion portion of the endoscope 10 embodied as a tube portion 200. The tube portion 200 extends from the distal side of the gripping member 100 and is used for insertion into a patient for the purpose of examination, treatment, etc. Thus, the tube portion 200 is connected to the distal portion 300 at its distal side. When the distal portion 300 is rotated, the distal portion 300 moves relative to the tube portion 200 (with respect to the distal end of the tube portion 200).

At the proximal side of the gripping unit 100, an endoscope cable 400 is connected to the gripping unit 100. The endoscope cable 400 is used to supply power to the gripping unit 100 and to pass data between the gripping unit 100 and a processor 801 (schematically shown in FIG. 1). At the proximal end of the endoscope cable 400, a processor connector 500 is provided. Thus, the endoscope cable 400 extends from the gripping unit 100 to the processor connector 500. The processor connector 500 is used to form a connection with (connect to) the processor 801. The processor 801 evaluates data obtained by the endoscope 10 and displays it on a display (not shown).

The distal portion 300 has an ultrasonic head or ultrasonic sensor 30. See, for example, FIG. 5. The distal portion 300 also includes a working channel outlet 320, as shown in FIGS. 5, 6 and 7. Otherwise, the distal portion 300 may have any other known features.

The ultrasonic sensor 30 has a signal output window 31. Through the signal output window 31, the ultrasonic sensor 30 can emit/receive ultrasonic signals within a predetermined detection range shown as an angular range 36. An angle bisector 35 of the angular range 36 indicates the alignment of the ultrasonic sensor 30. See Figures 5 and 6. The received signal is sent to the processor 801 via a signal line running inside the endoscope 10. The ultrasonic signal is evaluated in a known manner.

As shown in FIG. 6, the instrument 321 can be advanced in a known manner from the working channel exit 320 to the area sampled by the ultrasonic sensor 30 in the angular range 36. The instrument 321 can be a biopsy probe for tissue examination.

The sensor 28 can be used as a positioning sensor coupled to the distal portion 300 of the ultrasound endoscope so that the exact location of the area being examined can be displayed in space and in relation to the patient.

In this example, the sensor 28 is removably attached to the endoscope 10 as part of the sensor assembly 20. In this example, the sensor 28 is removably attached to the distal portion 300 of the endoscope 10. More precisely, the sensor 28 is disposed within a distal connection element 27 that forms the distal end of the sensor assembly 20. For example, the sensor 28 is embedded in the distal connection element 27. The distal connection element 27 can be made of plastic. The distal connection element 27 is removably attachable to a predetermined docking portion 37 of the distal portion 300. In other words, the distal connection element 27 is removably attachable to a predetermined docking portion 37 of the ultrasonic sensor 30.

The docking portion 37 can be formed on the outer periphery of the distal portion 300. The docking portion 37 can have positioning devices such as protrusions/protrusions and recesses or snap-in hooks, snap-in lugs, etc. that allow the docking portion 37 to be accurately positioned relative to the ultrasonic sensor 30. The distal connection element 27 can be provided with a suitable counter/mating device that engages with the positioning device of the docking portion 37 when the distal connection element 27 is attached to the docking portion 37. This defines a unique relative positional relationship between the distal connection element 27 and the docking portion 37. This in turn defines a unique relative positional relationship between the sensor 28 and the ultrasonic sensor 30, since the position of the sensor 28 in the distal connection element 27 is known.

The distal connection element 27 can be removably attached to the docking portion 37 in a rotationally fixed (non-rotating) and non-displaceable manner.

In this example, the distal connection element 27 is formed in a U-shape with two wings 271 and 272. The sensor 28 is disposed on at least one of the wings 271 and 272. The sensor 28 can also extend across the entire distal connection element 27. The sensor 28 can also be otherwise integrated into the distal connection element 27. The sensor 28 can be cast into the distal connection element 27.

In this example, the sensor 28 is implemented as a positioning sensor. The sensor 28 is preferably a six degree of freedom (three translational and three rotational data; translational along three perpendicular axes, front/back, up/down, and left/right, combined with rotation about the transverse, longitudinal, and perpendicular axes) sensor for detecting the position of the ultrasonic sensor 30.

In this example, the sensor 28 is implemented as a Hall sensor. For this purpose, a known magnetic field generator is used in the deployed position of the endoscope 10 to generate a magnetic field. The position of the sensor 28 implemented as a Hall sensor is determined. This gives the position and orientation of the ultrasonic sensor 30, which is located next to the ultrasonic sensor 30 and at a known distance from it.

The sensor assembly 20 is configured as a connection cable. The sensor assembly 20 has a cable 21 with a distal connection element 27 at a distal end and a plug connector 24 at a proximal end. See FIG. 1.

Thus, in the sensor assembly 20, the sensor 28 is connected via the cable 21 to the plug connector 24. The plug connector 24 is located at the proximal end of the cable 21. The plug connector 24 can be connected to the processor 801 described above or to a signal processing device 802 that is separate from the processor 801. The signal processing device 802 is shown diagrammatically in FIG. 1.

The length of the cable 21 is approximately equal to the sum of the length of the tube portion 200 of the endoscope 10 and the length of the endoscope cable 400 of the endoscope 10. The cable 21 is attached to the tube portion 200 of the endoscope 10 by a removable fastening device 22. Along the length of the tube portion 200, the cable 21 may be provided with one or more fastening devices 22.

In this example, multiple fastening devices 22 are provided along the length of the tube section 200 on the cable 21 (five fastening devices 22 are shown in FIG. 1). Each fastening device 22 can be removably attached to the tube section 200.

In this example, the fastening device 22 is configured as a spring clip, which is described in more detail below.

Figure 2 shows a spring clip 22 attached to a cable 21 as a fastening device.

The spring clip 22 has a streamlined shape and a body 223 through which the cable 21 passes in the longitudinal direction. More specifically, the cable 21 is routed on the inner circumference of the body 223. The body 223 cannot be displaced (is not displaceable) relative to the cable 21.

The first wing 221 and the second wing 222 extend from the body 223. The first wing 221 and the second wing 222 are shaped to surround a portion of the outer circumference of the tube portion 200 of the endoscope 10. This allows the spring clip 22 to be securely attached to the tube portion 200, as shown in FIG. 3. The wings 221, 222 are resilient. This allows the wings 221, 222 to bend open so that the space between the wings 221 and 222 widens and the wings 221, 222 can slide around the outer circumference of the tube portion 200.

The wings 221 and 222 are designed as flat leaf-shaped wings. As described above, when the spring clip 22 is removably attached to the tube section 200, the outer diameter of the wings 221, 222 of the spring clip 22 is only slightly larger than the outer diameter of the tube section 200, as shown in FIG. 3.

This means that the cable 21 of the sensor assembly 20 can be removably attached to the tube section 200 by respective fastening devices 22, as shown in Figures 1 and 4. This allows the cable 21 to be securely fastened and attached to the tube section 200, such that the cable 21 does not interfere with the cable loop. See Figure 1.

The cable 21 is securely positioned on the tube section 200 by the fastening device 22, so that the tube section 200 can be inserted into the patient without interference from the cable 21.

Modes of Operation The sensor assembly 20 is removably attached to the endoscope 10 in such a manner that the distal connection element 27 is rotationally fixed and non-translatably attached to the docking portion 37, and the fastening device 22 of the cable 21 is clipped into an appropriate position on the tube portion 200 in such a manner that the cable 21 firmly abuts against the tube portion 200.

The endoscope 10 is now ready for use. The exact position of the ultrasonic sensor 30 can be determined. Any changes in the position and/or orientation of the ultrasonic sensor 30 can be determined by the sensor 28.

Effects of the Present Disclosure The sensor assembly 20 having the cable 21, the fastening device 22, and the sensor 28 has a very small lateral/width dimension (a very small dimension perpendicular to the extension direction) and is firmly abutted against the tube section 200. The fastening device 22 prevents the cable 21 from being displaced or rotated relative to the tube section 200. Therefore, the sensor assembly 20 attached to the tube section 200 has little effect on handling during insertion and operation of the endoscope 10.

When attached to the distal portion 300, the sensor 28 has a fixed, well-defined relationship to the ultrasonic sensor 30. Because the sensor 28 has a fixed, well-defined relationship to the ultrasonic sensor 30, the precise location and orientation of the ultrasonic sensor 30 can be determined by the sensor 28. By positively positioning the sensor 28 on the docking portion 37, accidental rotation or displacement of the sensor 28 is prevented.

The exact position and orientation of the ultrasound sensor 30, including any changes in position and/or orientation, can therefore be detected by the sensor 28. This allows the position of the ultrasound image determined by the ultrasound sensor 30 in space and relative to the patient to be determined and visualized. The exact position of the area inspected by the ultrasound sensor 30, including the ultrasound sensor 30 itself, can therefore be determined with particular reliability in space and relative to the patient and shown on a display. It is possible to superimpose/overlay the ultrasound image with other imaging techniques such as CT and MR. Three-dimensional ultrasound images can also be generated.

The sensor 28 can be easily and quickly attached to and removed from the endoscope 10.

The principles described above can also be applied to existing endoscopes. Endoscopes can be retrofitted with sensors that can be removably attached from the outside.

The distal connection element 27 has a small radial dimension. Thus, when removably attached to the distal portion 300, the distal connection element 27 only slightly increases the radial dimension at the distal portion 300. Thus, when removably attached to the distal portion 300, the distal connection element 27 has little effect on the insertion of the tube portion 200 and the handling of the tube portion 200 during insertion and operation of the endoscope 10.

The sensor assembly 20 having the sensor 28 is formed separately from the endoscope 10, so that the relatively inexpensive sensor 28 can be replaced with another sensor 28 without the need to make any modifications to the relatively expensive endoscope 10.

The sensor module 20 with the sensor 28 can be used in the endoscope as a later retrofit.

The sensor assembly 20 having the sensor 28 is formed separately from the endoscope 10, so that if necessary, the user may use the endoscope 10 without the sensor assembly 20, i.e., without the sensor 28, if desired. This provides the user with an endoscope equipped with position determination capabilities, if desired, to determine the position and orientation of the ultrasonic sensor.

Second Example In the following, a second example will be described with reference to FIGS.

In the first example, the fastening device 22 is implemented in the form of a spring clip. In this second example, the fastening device 22 is implemented in the form of an elastic strap holder (strap) 2022. See Figures 9 and 10.

The elastic strap holder 2022 has an elastic strap 2024, at the end of which a ring 2025 acting as an eye is fixedly arranged. At the end opposite the ring 2025, the strap 2024 is connected to a body 2026 which is fixedly connected to the cable 21. The body 2026 serves as a cable fastening for the strap holder 2022 and cannot be displaced relative to the cable 21.

The body 2026 is formed with a protrusion 2027 that faces radially outward. The outer diameter of the protrusion 2027 is selected so that the protrusion 2027 passes through the ring 2025. This allows the ring 2025 to fit onto the protrusion 2027. See Figures 9 and 10.

The strap 2024 has a length that corresponds to the circumferential dimension of the tube 200. More precisely, the length of the strap 2024 is selected so that the strap 2024 fits snugly around the circumference of the tube 200 and is hooked onto the ring under tension. See Figures 12 and 10.

The function of the elastic strap holder 2022 is similar to the spring clip of the first example. The elastic strap holder 2022 functions as a fastening device, by which the cable 21 of the sensor assembly 20 is removably attached to the tube section 200 in a fixed and stable manner such that the cable 21 is temporarily fixed in a non-displaceable and non-rotatable manner relative to the tube section 200.

Third Example Hereinafter, a third example will be described with reference to FIG.

Figure 13 shows a third example of an endoscope equipped with a sensor.

A sensor assembly having a cable 21 is removably attached to the endoscope. The structure is similar to the first example. In the third example, the cable 21 is removably fastened to the endoscope cable 400 in addition to the removably fastening of the cable 21 to the tube section 200 (as in the first example). For this purpose, a permanently integrated fastening device 22 is provided in the proximal region of the cable 21, and the cable 21 can be temporarily attached to the endoscope cable 400 so that the cable 21 can be temporarily and securely fastened to the endoscope cable 400.

The fastening device 22 in the proximal region of the cable 21 can have the same design as in the first or second example.

The cable 21 is routed to a processor or signal processing device, and the plug connector 24 is inserted into either of them, fastened to the endoscope cable 400, rather than left loose.

In the third example, the cable 21 and the endoscope cable 400 are prevented from being damaged. So-called cable entanglement is avoided.

Fourth Example FIG. 14 is a diagram showing a fourth example of an endoscope equipped with a sensor.

The sensor 28 in this example is a wirelessly operated sensor. The sensor 28 is removably attached to the distal end 300 of the endoscope 10, for example by plug-on or snap-in means. Removable attachment of the sensor 28 to the distal end 300 can be achieved in a similar manner to the first example.

The sensor 28 can be powered wirelessly and the sensor 28 can transmit information wirelessly. This means that the sensor 28 does not require cables or cable fastenings.

Fifth Example In the following, a fifth example is described which is not shown separately in the drawings.

In this example, the structure corresponds to the endoscope 10 and sensor assembly 20 of FIG. 1.

The sensor assembly 20 has a number of fasteners 22 along its longitudinal extent. Additional sensors for determining position are integrated in at least one of the fasteners 22, or in more than one of the fasteners 22, or in all of the fasteners 22.

In this example, in addition to accurately determining the position of the ultrasonic sensor 30, the exact position of the tube portion 200 in the patient can be determined and preferably displayed, for example, on a display.

Alternatives The embodiments disclosed herein may be combined in any combination.

In a first example, the instrument 321, embodied as a biopsy probe, is pushed forward from the working channel exit to the area sampled by the ultrasound sensor 30 at an angle range 36. The present disclosure is not limited in this respect. The instrument 321 can be any other instrument or else a micro-endoscope.

The docking section 37 does not need to have a positioning device. The positional relationship between the sensor 28 and the ultrasonic sensor 30 can be defined in other ways. The distal connection element 27 with the sensor 28 can be removably attached to the endoscope 10 by a snap-in connection, a removable adhesive connection, or a mechanical plug-in connection, or any other removable connection.

The sensor 28 does not have to be integrated into the distal connection element 27. The sensor 28 can be located proximal to the connection element 27. The sensor 28 can be integrated into the cable 21 of the sensor assembly 20 proximal to the connection element 27.

The sensor 28 only needs to be in a unique and precisely known positional relationship with the ultrasonic sensor 30. The positional relationship between the sensor 28 and the ultrasonic sensor 30 may be predefined or at least determinable.

In the first and second examples, the sensor 28 is implemented as a Hall effect sensor. The sensor 28 can be implemented by applying any suitable technological principle for determining the position. For position detection, the sensor 28 can be implemented as a magnetic 3D position sensor (such as NDI Aurora) or as a 5D or 6D sensor. The sensor 28 can also be implemented as any inductive, capacitive or magnetic sensor for detecting the position and orientation of the ultrasonic sensor 30 in space.

In addition to the sensor 28, several further position detection sensors can be mounted at regular intervals along the tube 200 to detect the position of the tube 200 inside the body. This allows the position of the endoscope tube 200 inside the body to be visualized. These further position detection sensors can use the same technical principle for position detection as the sensor 28 or can be different types of position detection sensors.

In these examples, sensor 28 is used to detect the position of ultrasonic sensor 30. The present disclosure is not limited thereto. Sensor 28 can be a sensor for detecting the position of an endoscope part other than an ultrasonic sensor. Also, sensor 28 does not have to be a sensor for detecting position, and can be a gas sensor, a biosensor that decodes DNA, a sensor that detects molecules, or an optical sensor.

In a first example, the fastening device is designed as a spring clip 22. In a second example, the fastening device is designed as an elastic strap holder 2022. Other methods of fastening the cable 21 to the tube section 200 can be used. Removable snap-in fasteners, adhesive tapes, Velcro® fasteners, elastic rings for pushing the endoscope through, etc. can be selected as fastening devices.

Furthermore, a separate sheath member can be pressed against the tube section 200, the sheath member having the function of the cable 21. In addition to the sensor 28 close to the ultrasonic sensor 30, further sensors can be incorporated into this separate sheath member along the longitudinal extent of the sheath element. The appearance of such an alternative endoscope is the same as the endoscope 10 of FIG. 1 without the sensor assembly 20. This separate sheath member can be detachable from the endoscope 10 and thus temporarily attachable to the endoscope. This separate sheath member can be used to determine the position and orientation of the ultrasonic sensor 30 and the tube section 200, as explained in the above example. The separate sheath member not only guides the cable and the sensor, but also protects the patient from injury. The separate sheath member can be formed with little or no undercuts, thus providing good protection against contamination.

The present disclosure is particularly applicable to ultrasound endoscopes. However, the principles of the present disclosure are also applicable to any other type of endoscope.

10 Endoscope 20 Sensor assembly 21 Cable 22 Spring clip (fastening device)
24 Plug connector 27 Distal connection element 28 Sensor 30 Ultrasonic sensor 31 Signal output window 35 Angle bisector 36 Angular range of ultrasonic sensor 37 Docking section 100 Grip unit 110 Control knob 120 Insertion section 200 Tube section 221 Wing 222 Wing 223 Body 271 Wing section 272 Wing section 300 Distal portion 320 Working channel outlet 321 Instrument 400 Endoscope cable 500 Processor connector 801 Processor 802 Signal processing device 2022 Elastic strap holder 2024 Strap 2025 Ring 2026 Body 2027 Protrusion

Claims (1)

An endoscope (10), comprising:
A tube portion (200) for insertion into a patient, the tube portion (200) having an ultrasonic sensor (30) provided at a distal end portion (300) which is the distal end portion of the tube portion (200);
A plurality of sensors (28);
Equipped with
the plurality of sensors (28) measure the positions of a plurality of locations on the tube portion (200), including the distal end portion (300) and a location proximal to the distal end portion (300);
a sensor (28) among the plurality of sensors (28) that measures the position of the distal end portion (300) is positioned relative to the ultrasonic sensor (30) and is removably attached to the outer periphery of the distal end portion (300) of the tube portion (200 ) ; and a sensor (28) among the plurality of sensors (28) that measures the position of the location proximal to the distal end portion (300) is connected to the sensor (28) that measures the position of the distal end portion (300) by a cable (21) and is removably attached to the outer periphery of the location proximal to the distal end portion (300) of the tube portion (200) .
An endoscope (10).

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