WO2011079910A2

WO2011079910A2 - Endoscope, in particular for minimally invasive surgery on the spinal column

Info

Publication number: WO2011079910A2
Application number: PCT/EP2010/007639
Authority: WO
Inventors: Wolfgang Ries
Original assignee: Joimax Gmbh
Priority date: 2009-12-18
Filing date: 2010-12-15
Publication date: 2011-07-07
Also published as: WO2011079910A3; DE202009017097U1

Abstract

The invention relates to an endoscope, in particular for minimally invasive surgery, comprising a handpiece having a rigid tubular outer tube, in which at least one tubular working channel, a tubular flushing channel, and at least one tubular optical channel are formed. The channels are arranged asymmetrically inside the outer tube in such a way that a maximum illumination intensity is achieved in remaining free spaces of the outer tube by means of a light-conducting glass fiber bundle.

Description

Endoscope especially for minimally invasive surgery on the spine

The invention relates to an endoscope, in particular for minimally invasive surgery, with a handle with a rigid tubular outer tube, in which at least one tubular working channel, a tubular flushing channel and at least one tubular optical channel are provided.

In many areas of medicine, endoscopy is a widespread and successful method in the

Diagnosis and treatment of a variety of diseases. It has proven to be expedient to provide in particular imaging endoscopes with arrangements having one channel or more channels, for example, for the guidance of implements, as described in DE 195 33 856 AI. However, flexible arrangements of the aforementioned type prove to be impractical, especially in spinal surgery, since the required rigid surgical tools, such as e.g. Cutter or

Drill, usually another access must be laid or the illumination of the work area is too weak to receive a suitable recording of the operating area to be operated. Especially in operations on the spinal column, it is important to obtain a very good illumination of the working area in order to avoid an intervention in which e.g. one

Part of the bone is removed by milling, not to damage the surrounding nerve tissue. The operation of such

BESTÄTIÖUNGS pugs Endoscopes are therefore tiring for a surgeon. Furthermore, the arrangements of such endoscopes are usually too flexible, so that rigid tools such as milling cutters or drills can not be used.

Another endoscope is disclosed in DE 25 58 081. The endoscope has a rigid needle-shaped outer tube. Within the needle, light-conducting and image-conducting glass fiber bundles and a working channel are arranged. Such endoscopes are also heavy and cumbersome due to the integrated in the handpiece optics.

It is therefore an object of the invention to provide an improvement for an endoscope, in particular for use in the

Spinal surgery, whereby a simple and handy use of a variety of surgical tools is possible, and continue to optimally illuminated the work area and a high-resolution imaging is guaranteed.

The above object is achieved in an endoscope of the type mentioned above in that the channels are arranged so asymmetrically within the outer tube, so that by means of a photoconductive glass fiber bundle in all remaining free spaces of the outer tube (10) a maximum illumination intensity can be achieved. The aforementioned tubular channels are usually in particular, a circular cross-section. Dielectric material devices suitable for directing light, such as glass fibers, are particularly preferred. According to the purpose of the light pipe, a distinction must be made between light-conducting glass fiber bundles, so-called light guides, for pure fiber optic illumination and image-guiding glass fiber bundles, so-called image conductors, for optical image transmission.

In a particularly preferred embodiment, it is provided that the optical channel is filled with such an image-conducting glass fiber bundle, an image guide. An image guide is used for optical image transmission and is a fiber bundle in which the fibers are arranged geometrically the same at the entrance and exit, i. Each fiber in the light entrance and the light exit plane are assigned the same geometric locations or coordinates.

In a preferred embodiment, an image guide has a diameter of 0.72 mm, has a protective sheath

Silicone on and consists inside of individual fibers in said geometric arrangement with a diameter of 0.6 mm. The special composition of the glass fiber allows low-loss transmission of the image information due to the high transmission coefficient. Furthermore, this gives a high-resolution glass fiber, which achieves a resolution between 13,000 and 18,000 pixels. The invention provides in a preferred embodiment, that for additional illumination of the work area, the remaining spaces between the

Channels are filled with an epoxy resin and optical fibers. The remaining between the outer tube and the channels, such as working, flushing and optical channel, gaps are filled with optical fibers and epoxy resin, wherein the remaining gaps are formed substantially crescent-shaped, wherein at least one, at most two intermediate spaces are formed. It can be filled with light guides the entire spaces. The Optical fibers are suitable for fiber optic illumination. The thus filled cross section is larger than that of a comparable coaxial ring of a rigid endoscope. This ensures a powerful and homogeneous illumination of the work area.

It is further provided that the working channel, the flushing channel and the optical channel are arranged asymmetrically within the outer tube, wherein it is preferably provided that at least two channels are arranged with their outer diameter along a central axis of the outer tube. Also, the invention particularly preferably provides that the channels are in contact with each other and / or with an inner wall of the outer tube at least at one point of their respective circumference. This ensures that both the optical channel and in particular ^¬ special of the working channel can be designed to be maximally large and space for other functionalities such as

a flushing channel remains. An inventive endoscope in particular has an outer tube with a length of approx.

100 mm and an outer diameter greater than or equal to 3, 6 mm, the working channel having a diameter greater than or equal to 2.2 mm, the flushing channel having a diameter greater than or equal to 0.7 mm and the optical channel having a diameter greater than or equal to 0, 8 mm has. The arrangement according to the invention preferably provides for this, that a ratio of an outer diameter of the working channel to an inner diameter of the outer tube is between 0.6 and 0.8, whereby the existing cross section is optimally exploitable.

So that an optimal connection to surgical tools is accomplished, it is particularly preferred that the handle has a knot part made of stainless steel. The node part is formed as an association of Luer-lock connections for the different channels, wherein

special milling cutters or drills, is provided and that the node part of the handpiece has proximally another Luer lock connection for a flushing device. By aligned with the outer tube training of the working channel is conditional that the handle has proximally formed in an acute VJinkel angled from the outer tube channel for the optical fiber optic.

For an optimal imaging result, it is particularly preferred that the handpiece is connected to an optical part via an image-conducting glass fiber bundle, wherein the image guide from 'dista-len end of the hand part to z! m formed proximal end of the optical part consistently. The optical part contains the required components for decoupling the image signal from the image conductor. The spatial separation of a handset and the image-processing optical part ensures that the handset can be particularly lightweight and handy, making an operator easier and more precise work. In order to protect the image conductor connecting the two parts from external influences, it is provided that this is protected by a silicone protective tube. For this purpose, it is further provided that the joints between the handpiece and protective tube or optical part and protective tube have a kink protection made of silicone.

For an optimal receiving response of the working area, it is provided in a particularly preferred embodiment that the optical channel is located at a distal end of the handpiece. Partly has a lens for object imaging and a distal window to protect the lens from dirt. At the proximal end of the optical part, an optical fiber connection is arranged, through which photoconductive glass fibers, so-called optical fibers, can be coupled to the optical part and various light sources can be connected. For a decoupling of the image signal from the image conductor, the invention further provides that a lens system is arranged downstream of the image conductor at the proximal end of the optical part, and that at the proximal end of the optical system

Optics part is arranged a proximal window for the protection of the lens system. Characterized in that a closure cap is arranged at the proximal end of the optical part, which has a connection, a flexible connection with camera and light devices is possible.

The special arrangement of the various channels ensures maximum utilization of the inner diameter of the outer tube within the endoscope. In addition, the endoscope has the advantage that the working part and the optically processing part are spatially separated, so that a handy and consequently more precise work with this endoscope is possible.

Further advantages and features of the invention will become apparent from the claims and from the following description, in which a preferred embodiment of the inventive endoscope is shown. Showing:

Fig. 1 is a perspective view of a

Endoscopes according to the invention, wherein the better Overview a protective hose in shortened

View is shown;

Fig. 2 is a schematic front view of the

Endoscopes according to the invention, wherein a handpiece is shown in an end view;

Fig. 3 shows a detail A of Fig. 2 of the handpiece of the endoscope according to the invention in one

Front view;

Fig. 4 is a longitudinal section through the handpiece of

endoscopes according to the invention; and FIG. 5 shows a longitudinal section through an optical part.

1 shows an endoscope 1 according to the invention which essentially comprises two parts, a handpiece 2 and an optical part 3. Both parts are connected to one another by a protective tube 4 made of silicone. Both the handpiece 2 and the optical part 3 have, at their ends facing the protective tube 4, in each case a tubular kink protection 5 made of silicone, which is arranged between the handpiece or optical part 3 and the protective tube 4 leading out and is of elongated design.

The handpiece 2 has a node part 6, which is made of stainless steel. At a proximal end a, the node part 6 has a connection for illumination and image transmission as well as two Luer lock connections, as entry into the working channel and for connection of a flushing / suction device. A first terminal 7 serves as a connection of the

Handpiece 2 with the optical part 3 leading protective tube. 4 and is formed bent at an acute angle from the node part 6. A second port 8 is formed proximally in alignment with the outer tube 10 as a luer lock port for inserting a tool into the handpiece 2. A third connection 9 is also angled at an acute angle from the outer tube 10 of the handpiece 2 and serves as a connection for a flushing device.

FIG. 2 shows the endoscope 1 according to the invention with a view of the distal end side of the handpiece 2. The node part 6 of the handle 2 points in

distal direction, a tubular outer tube 10. The outer diameter of the outer tube 3 is preferably 3.6 mm, with a wall thickness of less than or equal to 0.3 mm. The outer tube 10 is preferably 100 mm long. Within the outer tube 10, three channels of different diameter are arranged in an asymmetrical manner, as the enlargement A in Fig. 3 shows. In addition to a working channel 11 with a diameter of 2.2 mm, an optical channel 12 is formed with a diameter of 0.8 mm and a flushing channel 13 with a diameter of 0.7 mm. Due to the asymmetrical arrangement of the channels, a maximum utilization of the space within the outer tube 10 is given, so that in particular the ratio of diameter of the working channel 11 to the inner diameter (3.0 mm) including the metallic outer tube 10 is relatively large, namely approximately 0.7 , Remaining sickle-shaped gaps 14 between the channels and the wall of the outer tube 10 are to ensure a better

Stability of the channels filled with an epoxy resin, wherein in the epoxy resin light guide 15 in the form of light-conducting glass fiber strands for fiber optic illumination can be integrated to better illumination of the Reach working area. Within the optical channel 12, a picture conductor 16 is embedded 0.72 mm in diameter. This image guide 16 shows a percentage of less than 0.1% of lattice defects, with which a high resolution of the recorded image can be achieved. The smallest possible radius of curvature of such an image-guiding glass fiber bundle is 30 mm. The image bundle 16 has a sheath of silicone and light-conducting fibers. The image conductor has, for example, an active diameter of 0.6 mm, with a particularly high resolution being achievable, which lies in particular in the range of 13,000 to 18,000 pixels.

4 shows a longitudinal section through the handle 2. The above the working channel 11 pictured optical

Channel 12 continues to be at a distal end b of the handle 2 for the image conductor 16 therein

Lens 17 for object imaging and a distal window (not shown). The distal window protects the lens from contamination and closes the optical channel 12 distally. The working channel 11 is, as described, formed in alignment with the outer tube 10 and has at the proximal end a of the handpiece 2 to the Luer-lock connection 8. By this connection 8 are rigid surgical instruments, such as e.g. Cutters or drills, easy to insert and lock. Towards the proximal end a, the image conductor 16 is formed by the angled connection 7 and the anti-buckling device 5 in the

Silicone protection hose 4 out. The length of the protective tube 4 is arbitrary.

Fig. 5 shows a longitudinal section through which the protective tube 4 subsequent optical part 3. The optical part 3 has an endoscope body 18 which, like the knot part 6 of the hand part 2, is made of stainless steel. The image conductor 16 is guided through the protective tube 4 and the anti-buckling 5 in the interior of the optical part 3 and connected by means of a screw-sealing element 19 liquid and gas tight. Downstream of the image conductor 16 is an eyepiece 20, which serves to focus the image to be transmitted. The assembly is protected proximally by a closure cap 21. In order to make image-processing functionalities, such as a camera or a signal transmission connectable to a computer, an optical port 22 with a proximal window 23 liquid and gas tight connected to the cap 21. The optical connector 23 is implemented via a mechanical coupling to a camera head (not shown) and via a

Rubber ring seal 24 hermetically seals the interior of the endoscope body 18. The lens system 20 may in this case be mounted axially movable in order to achieve optimum

To achieve focus of the picture. For a further illumination of the work area by light guide 15 angled for this at an acute angle from the endoscope body 18 and further guided parallel to the endoscope body 18, a light guide 25 is provided, wherein the light guides 15 of the light guide 25 passes freely through the optical part 3 in the protective tube 4 are. Various light sources can be connected to this light guide connection 25.

The special arrangement of the various channels within the endoscope ensures maximum utilization of the inner diameter. The between the

Outer tube and the channels remaining clearances are complete with optical fibers 15 to the fiber optic illumination fillable. The thus filled cross section is larger than a comparable ring in a rigid endoscope with comparable dimensions. This achieves powerful and homogeneous illumination to optimally illuminate the working area and record it using the imaging fiber. In addition, the endoscope has the advantage that the working part and the optical processing part are spatially separated, so that a handy and more precise

Working with this endoscope is possible.

Bezugszeichenl

1 endoscope

2 hand part

3 optics part

4 protective hose

5 kink protection

6 node part

7 optical connection

8 Connection of surgical tools 9 Flush connection

10 outer tube

11 working channel

12 optical channel

13 flushing channel

14 spaces

15 light guides

16 picture ladder

17 lens

18 endoscope body optic part

19 sealing element

20 lens system

21 cap

22 optical connection

23 proximal window

24 ring seal

25 Fiber optic connection a proximal end Handpiece b distal end Handpiece

c proximal end optic part

Claims

claims

Endoscope, especially for the minimally invasive

Surgery, comprising a handpiece (2) with a rigid tubular outer tube (10) in which at least one tubular working channel (11), a tubular flushing channel (13) and at least one tubular optical channel (12) are provided, characterized in that Channels within the outer tube (10) are arranged asymmetrically such that by means of a photoconductive glass fiber bundle in the remaining free spaces of the outer tube (10) a maximum illumination intensity can be achieved.

Endoscope according to claim 1, characterized in that at least two channels are arranged with their outer diameter along a central axis of the outer tube (10).

Endoscope according to claim 1 or 2, characterized in that the channels are in contact with each other and / or with an inner wall of the outer tube (10) at least at one point of their respective circumference.

Endoscope according to one of claims 1 to 3, characterized in that a ratio of an outer diameter of the working channel (11) to an inner diameter of the outer tube (10) between 0.6 and 0.8 lies .

Endoscope according to one of claims 1 to 4, characterized in that in the optical channel (12) an image guide (16) is embedded in the form of an image-guiding glass fiber bundle.

Endoscope according to one of claims 1 to 5, characterized in that the remaining intermediate spaces (14) are substantially sickle-shaped, wherein at least one, at most two intermediate spaces (14) are formed.

Endoscope according to one of claims 1 to 6, characterized in that the remaining intermediate spaces (14) between the channels are filled with an epoxy resin and light guides (15).

Endoscope according to claim 1, characterized in that the handpiece (2) has a knot part (6) made of stainless steel.

Endoscope according to one of the preceding claims, characterized in that the handpiece (2) at the proximal end of a Luer-lock connection (8) for

Insertion of rigid surgical tools,

in particular of milling cutters or drills.

Endoscope according to one of the preceding claims, characterized in that the handpiece (2) has proximally a Luer-lock connection (9) for a purging device. Endoscope according to one of the preceding claims, characterized in that the handpiece (2) has proximally a connection (7) for the glass fiber optic, which is angled at an acute angle from the outer tube (10).

Endoscope according to one of the preceding claims, characterized in that at a distal end (6) of the handpiece (2) the optical channel (12) has a lens (17) for imaging and a distal window for protection of the lens from contamination.

Endoscope according to one of claims 1 to 12, characterized in that the handpiece (2) with a

Optical part (3) via an image conductor (16) within a protective tube (4) is connected, wherein the optical part (3) includes an optical device for coupling the image signal from the image guide.

Endoscope according to claim 13, characterized in that the image conductor (16) between the distal end (b) of the handpiece (2) and the proximal end (c) of the optical part (3) is formed continuously.

Endoscope according to claim 13 or 14, characterized in that the image guide (16) of a

Protective tube (4) is protected.

Endoscope according to claim 15, characterized in that the optical part (3) has an endoscope body (18) which is made of stainless steel.

17. An endoscope according to one of the preceding claims, characterized in that the connection points between the handpiece (2) and protective tube (4) and / or between the optical part (3) and protective tube (4) have a kink protection (5) made of silicone.

18. An endoscope according to one of the preceding claims,

characterized in that at the proximal end (c) of the optical part (3), a light conductor connection (25) is arranged, through which optical fiber (15) in the optical part (3) can be coupled and light sources are connected.

19. An endoscope according to one of the preceding claims,

characterized in that the image conductor (16) at the proximal end (c) of the optical part (3) has a lens system

(20) is subordinate to the focus.

20. Endoscope according to one of the preceding claims,

characterized in that a proximal window (23) for protecting the lens system is arranged at the proximal end (c) of the optical part (3).

21. An endoscope according to one of the preceding claims,

characterized in that at the proximal end (c) of the optical part (3) a closure cap (21) is arranged, which has an optical port (22) to which a camera can be connected.

22. An endoscope according to one of the preceding claims,

characterized in that on the closure cap

(21) an annular seal (24) is designed for sealing.