WO2013128136A2

WO2013128136A2 - Precision micro-endoscopic device and associated micro-endoscope

Info

Publication number: WO2013128136A2
Application number: PCT/FR2013/050429
Authority: WO
Inventors: Yves SUTTER
Original assignee: Sutter Yves
Priority date: 2012-03-01
Filing date: 2013-02-28
Publication date: 2013-09-06
Also published as: WO2013128136A3; FR2987554B1; FR2987554A1

Abstract

The invention relates to a device which includes a micro-endoscope (2) and a micromanipulator (4) precision movement system (3). The micro-endoscope comprises a body, an ultrafine endoscopic probe (11), and an optical connection part (12), which is connected to the body (8) of the endoscope via an optical line and to an image capture and display device. The endoscopic probe (11) includes a tubular sheath that surrounds an illumination channel (16) and an image channel (17) containing ultrafine optical fibers (20), as well as an operating channel (18) used for passing instruments therethrough. Said channels extend into the body of the micro-endoscope (2) and, in the case of the illumination channel (16) and the image channel (17), up to the optical connection part (12). In an alternative embodiment, a digital camera and portable microcomputer are used. The invention is useful for human and veterinary medicine, as well as for corresponding scientific laboratory research.

Description

Precision micro-endoscopy device and associated micro-endoscope

The present invention relates to a precision micro-endoscopy device for vision, detection, diagnosis, sampling or intervention.

This micro-endoscopy device is intended for very diverse applications in medicine or in human and / or veterinary surgery. It is particularly advantageous for scientific research and experimentation in the medical, pharmaceutical, biological or veterinary field.

It also relates to all applications in the fields of medicine and human microsurgery, especially neonatal.

In general, the invention relates to an interventional endoscopy device or examination of reduced size which offers a very high accuracy of use.

Endoscopy, which allows to see and possibly intervene remotely within the body of a living being without having to perform a traumatic cutting to reach the target site, has developed considerably in recent years that this either for interventional purposes or for experimentation or simply for examination, diagnosis or sampling.

Endoscopic surgery has, for example, broadened its field of application by including interventions in the intraperitoneal abdominal cavity, thorax, joints and even superficial operations such as for example that of the carpal tunnel, the arthroscopy of the knee, or non-invasive operations such as hysteroscopy, cystoscopy, sinuscopy, otoscopy, rhinoscopy, gastroscopy or other.

For this, the endoscope used is introduced through a natural orifice or a small incision of the body of the examined living being, then is moved in a conduit or an internal cavity of the body to the site of examination or intervention .

Despite the considerable advantages of this technique, There are situations in which it can not unfortunately be used. This is particularly the case when the access dimensions are reduced, when the ducts are of very small diameter and / or when a very high precision is required.

For example, we can mention the interventions affecting delicate areas, neurosurgery or micro-ophthalmology for example, or those performed on small living beings such as newborns and premature babies, or even small animals in veterinary medicine.

In such situations, one is most often forced to use microsurgery under a microscope. This technique is very delicate to implement, restrictive, long and allows only a limited gesture. It also requires the use of a microscope which is a very expensive equipment. All these disadvantages make it a little practiced technique.

Another example is medical, pharmaceutical, veterinary or biological research laboratories that perform tests on laboratory animals.

Most of the animals used by these laboratories are small animals, most often mice or rats, where, because of their small size, it is very difficult to carry out sampling, analysis or inspection of the animals. their internal organs without sacrificing the animal. An evolutionary follow-up is thus almost impossible to obtain.

On the other hand, researchers in these laboratories often need to inject a liquid product in controlled amounts behind the eardrum or other walls or membranes of these laboratory animals. In the case of a mouse or other small animal, this injection is done under general anesthesia using a microscope to avoid injuring the animal.

However, such a procedure is cumbersome and complex and requires the use of a microscope which is a very expensive apparatus. The entire manipulation takes a long time and causes a number of losses due to the duration of the anesthesia or unintentional injuries caused by lack of precision when handling.

Small endoscopes are also known which constitute the instruments of the present micro-endoscopy.

However, the possible diameters of the probe are limited to dimensions greater than one millimeter, to which must be added the additional channel of the operating tool, generally a rod or a needle sliding in said additional channel. This rod has a technical end, for example pointed or sharp.

In addition, to do a good job, it is necessary to have an image of good quality. However, this optical quality can not be maintained at a satisfactory level for a specific examination or work in the case of very small diameters targeted and particularly sought for the fineness of exploration and the least trauma during interventions.

The present invention aims to overcome these drawbacks and to meet many technical constraints to achieve the various benefits.

The purpose of the invention is to provide in all these cases, an alternative to the expensive and complex use of a microscope.

An object of the invention is therefore to provide a precision micro-endoscopy device compact, easy to use and inexpensive.

Another object of the invention is to provide a device for micro-endoscopy improving the accuracy of interventions and substantially reduce the time required to perform these interventions.

The objects assigned to the invention are achieved by means of a precision micro-endoscopy device for observation, intervention or sampling, comprising a micro-endoscope intended to be introduced into an organ, a conduit , a small cavity or orifice of the body of a baby, a patient or an animal to be examined or treated, or through a wall for applications in medicine or in human or veterinary surgery, or for the research scientific and experimental in the surgical, medical, pharmaceutical, biological or veterinary field, characterized in that it comprises a device for precision displacement of the micro-endoscope which allows it to be moved accurately independently along three perpendicular directional axes, and in that the micro-endoscope comprises a body, an optical connection piece connecting the microendoscope to a vision device and a compotant optical input adapted to be optically connected to an LED light source and an optical output connected to a device vision and a rectilinear rigid or semi-flexible microendoscopic probe having a proximal end connected to the body of the endoscope and a distal end intended to be introduced into the body of the patient or the animal; and comprising a tubular sheath which encloses at least two bundles of optical fibers each wrapped in a sheath each forming a longitudinal channel, including an illumination channel, extending into the body of the micro-endoscope and up to input of the optical connection piece, this illumination channel containing a continuous bundle of optical fibers for conducting the light to illuminate the observation or intervention site, and an image channel extending into the body of the micro-endoscope and to the optical output of the optical connection piece, this channel containing a continuous beam of optical fibers for conducting the image of the observation or intervention site to the vision device.

According to an exemplary embodiment of the precision micro-endoscopy device according to the invention, the vision device comprises an optical lens connected to the body of the micro-endoscope via an optical conduit.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the vision device comprises a digital camera and a video system with a display screen.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the video display screen system comprises a portable microcomputer. According to an exemplary embodiment of the precision microendoscopy device according to the invention, the connection piece constitutes an optical interface between the digital camera and an optical conduit which is connected to the body of the micro-endoscope.

According to an exemplary embodiment, the precision microendoscopy device according to the invention comprises a single block integrating the LED light source and the digital camera, said block and the connection piece comprising mutual coupling means.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the digital camera comprises an imaging sensor connected to a portable microcomputer via a computer link and a power supply link from the source. cold light also connected to the portable microcomputer and in that the digital camera has a receiving cavity for an enlargement eyepiece integrated in the optical connection piece and receiving the image from the image channel.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the computer link and the power supply link are made with at least one wired connection of the "USB" link type.

According to another exemplary embodiment of the precision microendoscopy device according to the invention, the computer link is a wireless link of the "BLUE TOOTH" type.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the microendoscopic probe also comprises an operating channel which is a hollow longitudinal channel, open at the distal end of the microendoscopic probe and intended to the passage of intervention, sampling or diagnostic instruments.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the operating channel extends into the body of the micro-endoscope and opens out at an access opening located at the rear of the body.

According to an exemplary embodiment of the micro-device precision endoscopy according to the invention, the operating channel extending in the micro-endoscopic probe, has at least in said probe, a diameter of between 0.10 mm and 0.5 mm.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the micro-endoscopic probe is semi-rigid and an outside diameter less than 1.5 mm.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the micro-endoscopic probe has a useful length of between 5 mm and 700 mm.

According to another exemplary embodiment of the precision microendoscopy device according to the invention, the micro-endoscopic probe has a useful length of between 10 mm and 2000 mm.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the micro-endoscopic probe has an outer diameter of between 0.3 mm and 4.5 mm.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the microendoscopic probe further comprises, at the distal end of its image channel, an optical block with extended depth of field allowing obtain a clear vision in the immediate vicinity of a wall, a membrane or any other element or part of the body of the patient or the animal.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the optical block is an inverted zone of sharpness allowing a clear vision, at least between 0.5 mm and 10 mm of a wall or an obstacle or organ.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the precision displacement device comprises a substantially vertical or horizontal arm which supports the body of the micro-endoscope.

According to an exemplary embodiment of the micro-device precision endoscopy according to the invention, the precision displacement device is a micromanipulator whose displacement is controlled manually or electrically.

According to an exemplary embodiment of the precision microendoscopy device according to the invention, the precision displacement device comprises an augmented reality optical system for displaying virtual information on the display screen, which makes it possible to control with more Precisely the displacement and positioning of the distal end of the microendoscopic probe, for example with respect to an organ not appearing on the display screen.

According to an exemplary embodiment of the microendoscopy device according to the invention, the micro-endoscopic probe is in the form of a sleeve comprising at least one illumination channel and an image channel formed for the first channel of a beam of crescent section-shaped optical fibers having a large curvilinear contour in contact with the lateral surface of the sheath and for the illumination channel of a fiber bundle of generally circular cross-sectional shape whose curvilinear portion of the perimeter is in contact with the inner portion of the curvilinear contour of the crescent shape of the image channel.

The objects assigned to the invention are also achieved by means of a micro-endoscope characterized in that it has a micro-endoscopic probe in the form of a sleeve comprising at least one illumination channel and a channel image formed for the first channel of a crescent shaped cross-section optical fiber bundle with a large curvilinear contour in contact with the side surface of the sleeve and for the illumination channel of a fiber bundle of generally cross-sectional shape circular sector whose curvilinear portion of the perimeter is in contact with the inner portion of the curvilinear contour of the crescent shape of the image channel.

According to an exemplary embodiment of the micro-endoscope according to the invention, the sheath of the micro-endoscopic probe comprises an operating channel extending in the image channel. The micro-endoscopy device according to the invention can thus advantageously be used in natural conduits of very small diameter and / or when the access dimensions are reduced. It also requires only access passages of small diameter when it is necessary to perforate a wall.

The procedure, examination and work are noticeably simpler, faster to implement, more reliable and less traumatic than those using a microscope. The gesture is more precise and less limited, thus reducing all risks. In addition, the micro-endoscopy device according to the invention is approximately ten times cheaper than a microscope and provides a considerable gain in productivity.

In order to achieve such precision and fineness, the invention provides a precision micro-endoscopy device which comprises a micro-endoscope and a device for precision displacement of the micro-endoscope, preferably of the micromanipulator type.

The micro-endoscope includes a body, a very thin endoscopic probe and an optical connection piece or optical interface.

The endoscopic probe comprises a rigid, semi-rigid or flexible tubular sheath that envelops an illumination channel and an image channel containing very thin optical fibers, and possibly an operating channel for the passage of an instrument. It furthermore comprises, at the distal end of its image channel, a particularly extended depth-of-field optical unit, in particular, with an inverted zone of sharpness, that is to say which makes it possible to obtain a clear vision at immediate proximity to a wall, membrane or any other element or part of the body of a living being.

These channels extend into the body of the micro-endoscope and, for the illumination channel and the image channel, to the optical connection piece or optical interface at which they are intended to be connected for the first time. to a cold light source and for the second to a vision device for example camera type.

In an alternative version, a camera is used Digital integrated source of cold light. It is therefore no longer necessary to have a separate cold light input on the eyepiece of the micro-endoscope or a complementary digital imaging device.

The quality and sharpness of the image provided by the micro-endoscopy device according to the invention is thus improved. In addition, the compactness of the constituent elements of the micro-endoscopy device according to the invention makes it easy to transport and use, for example on sites without hospitals or medical facilities.

In order to provide greater precision of movement, the optical connection piece is preferably remote from the body of the micro-endoscope to which it is connected via an optical conduit.

More generally, the combination of means constituting the present invention comprises any type of moving means of the micro-endoscope including those of the manual type.

Other features and advantages of the invention will appear on reading the detailed description which follows, description made with reference to the accompanying drawings, in which:

FIG. 1 is a general view of an exemplary microendoscopy device according to the invention;

FIG. 2 is a diagrammatic view in longitudinal section of an exemplary embodiment of the distal end of the endoscopic probe of the micro-endoscope of FIG. 4 along the section line referenced II-II in FIG. 3;

FIG. 3 is a cross-sectional view of a current section of the endoscopic probe of the micro-endoscope of FIG. 4;

FIG. 4 is an isolated view of the micro-endoscope belonging to the device of FIG. 1;

FIG. 5 is a view of the micro-endoscope of FIG. 4 in which an injection needle has been engaged;

FIG. 6 is a schematic view illustrating an example of a complete assembly integrating the micro-endoscopy device according to the invention for an injection application of a liquid product behind the eardrum of a mouse,

FIG. 7 is a general schematic view similar to that of FIG. 1 in the case of a micro-endoscope according to the invention, connected to a digital camera and to a display screen,

FIG. 8 is a general schematic view of a first variant embodiment of a micro-endoscope according to the invention, connected to a digital camera and to a portable-type microcomputer,

FIG. 9 is a general schematic view of a second variant embodiment of a micro-endoscope according to the invention, connected to a digital camera and to a portable-type microcomputer,

FIGS. 10 and 11 are respectively longitudinal and transverse cross sections of an exemplary embodiment of a micro-endoscopic probe of a micro-endoscope according to the invention,

and FIGS. 12 and 13 are respectively longitudinal and transverse cross sections of another exemplary embodiment of a micro-endoscopic probe of a micro-endoscope according to the invention.

In the following, the equivalent elements shown in the different figures, will bear the same numerical or alphanumeric references.

It should be noted that the application examples described are in no way limiting, but on the contrary the invention applies to all possible areas of micro-endoscopy.

In the various figures, there is shown an example of micro-endoscopy device 1 of precision according to the invention. This micro-endoscopy device 1 comprises a micro-endoscope 2 and a precision displacement assembly 3.

Precision displacement assembly 3 is a device that moves the micro-endoscope 2 along three directional axes with great accuracy and stability. It is preferably a micromanipulator type device 4.

The displacement along each of these directional axes is controlled independently, for example manually by means of a lever, a wheel 5 or any other similar actuating means allowing a significant reduction of the movement. This displacement can also be electrically controlled. In all cases in this example, the resulting displacement of the micro-endoscope is very small amplitude and extremely accurate.

In the schematic example shown, the precision displacement device 3 is formed of a base 6 from which rises an arm 7 on the upper part of which is fixed the body 8 of the microendoscope 2. The arm 7 can be translated along three perpendicular axes and its displacement along each of these three axes is controlled independently by the actuation of one or more wheel (s) 5 being on the base 6.

According to the variants of the invention, the precision displacement device 3 and the micro-endoscope 2 can be made in the form of a unitary assembly as shown schematically in FIG. 1, or of two separable elements as represented in FIGS. to 9.

In the latter case, the micro-endoscope 2 can, according to the needs or the wishes of the user, be mounted on the precision displacement device 3 to guarantee a very high precision of handling or be dissociated from it to be kept and handled directly by the user.

This generalization allows greater freedom of movement on the part of the operator and thus to target multiple applications.

According to the example illustrated in FIG. 6, the arm 7 of the micromanipulator 4 then ends preferentially with a receiving element 9 of the body 8 of the micro-endoscope, such as, for example, a ring 10 or an adjustable clamp, in which the body 8 of the micro-endoscope 2 can be engaged and immobilized removably.

In the examples shown in FIGS. 1, 6 and 7, the arm 7 of the precision displacement device 3 is substantially vertical and supports the micro-endoscope 2 in a horizontal position. According to another variant not shown, the arm 7 can also extend substantially horizontally so as to support the micro-endoscope 2 in a vertical position.

More generally, the body 8 of the micro-endoscope 2 can also be used as a handpiece or a handle for holding and holding.

In addition to the body 8, the micro-endoscope 2 also comprises a micro-endoscopic probe 11 and an optical connection piece 12.

The microendoscopic probe 11 is the part of the micro-endoscope 2 intended to be at least partially introduced into the body of the patient or animal to be examined or treated.

It is an elongate rectilinear piece which is connected to the body 8 by its proximal end 13 and whose distal end 14 is intended to be brought to the observation or interventional site. We can refer to Figures 4, 5, 8 or 9 in particular.

Depending on the intended applications, the microendoscopic probe 11 may be semi-rigid or flexible and has a length preferably between 5 and 700 mm.

According to the applications this length can be substantially increased even up to 2000 mm.

It is a low or very small diameter tube used as a jacket or sheath with two or three longitudinal spaces, hereinafter called channels, delimited by thin walls of synthetic or metallic material. The tube is for example made of stainless steel and the channels are for example made by sheaths consisting of metal braids coated with a material based on "Teflon".

Its outer diameter is extremely small so that it can be introduced into orifices, ducts and cavities of very small dimensions such as those belonging especially to neonates or small animals or through a human or animal wall.

Thus, the micro-endoscopic probe 1 1 has an outside diameter preferably less than 1.5 mm, preferably between 0.3 mm and 4.5 mm and for example substantially equal to 1.2 mm in the case of an example of use of a micro-endoscope 2 interventional.

In the case of a micro-endoscope 2 examination, the endoscopic probe 1 1 can be even thinner and even extremely thin.

As seen in Figures 2 and 3, the endoscopic probe 1 1 is formed of a hollow tubular sheath 15 which encloses several longitudinal channels, namely an illumination channel 16, an image channel 17 and optionally a channel 18 .

For a rigid or semi-rigid version of the microendoscopic probe 11, the tubular sheath 15 is for example a stainless steel tube of surgical quality.

According to an exemplary embodiment, these channels are longitudinal spaces each existing in a flexible sheath 19 of extruded plastic material. It is then internal partitions delimiting longitudinal volumes that are or will be occupied by light guides for example optical fibers or by a sampling instrument or surgical work or an injection needle or irrigation.

The sheath 19 lined with optical fibers beam, is engaged in the tubular sheath 15 which maintains it.

It may be individual sheaths for each bundle of optical fibers, one being intended to constitute the image channel 17 and the other being intended to constitute the illumination channel.

The illumination channel 16 and the image channel 17 contain a set of optical fibers 20 each forming a bundle of optical fibers which extend from one end to the other of the microendoscopic probe 11 and thereby constitute an optical system for illumination and visual observation at a point remote from the microendoscopic probe 1 1.

For this, two distinct beams of optical fibers 20 are used, one placed in the illumination channel 16 from the proximal end 13 to the distal end 14 of the micro-endoscopic probe 11 and intended to lead the light. and the other arranged in the image channel 17 of the distal end 14 at the proximal end 13 of the microendoscopic probe 11 and serving to convey the image to the eye of a patient. observer or up to a camera preferably digital.

In order to satisfy the general objective of miniaturization fixed by the invention, the optical fibers used are also very thin, preferably of the order of one or two tenths of a millimeter in diameter.

As can be seen in FIG. 2, the image channel 17 is terminated by an optical block 21 at a window located at the end 14 called distal window 22. This optical unit 21 consists of several optical components contiguous or juxtaposed to allow to fulfill the general optical function of an objective with a large depth of field in very close vision. It is in particular to have a sharpness zone extremely close to the distal end 14 so as to see perfectly what is in the immediate vicinity thereof with a sufficient viewing angle for example 90 °.

The optical block 21 is advantageously closed by a clogging window 21a.

By way of example, there can be mentioned the perfect and simultaneous vision of the tip of a needle emerging from the operating channel 18 and the wall to be perforated situated at a short distance just opposite the distal end 14.

In a preferred embodiment of the invention, the optical block 21 allows a perfectly clear vision between 0.5 mm and 10 mm of a wall.

The optical block 21 is successively composed, going towards the distal end, of a viewing window 23, a viewing angle window 24 and a complementary sealing window 25, each being materialized by at least an optical component, for example, of an assembly of the concave and convex or objective lens association type.

In a first variant of the invention, the micro-endoscopy device 1 is reserved for examination. In this case not shown, the micro-endoscopic probe 11 comprises only one illumination channel 16 and an image channel 17.

In a variant of the invention corresponding to that shown in FIGS. 2, 3, 4, 5 and 10, the microendoscopic probe 1 1 comprises an operating channel 18. It is a hollow longitudinal channel open at the distal end 14 of the micro-endoscopic probe 11. This channel extends over the entire length of the micro-endoscopic probe 1 1 and extends into the body 8 of the micro-endoscope 2 until it opens at an access opening 26 preferably located at the rear of the body 8.

This operating channel 18, preferably rectilinear over its entire length, is left empty so that it can pass and possibly move one or more instruments to act remotely on the interventional site. For example, it is possible, for example, to pass therein and possibly to move an injection needle 27 connected to a syringe pump 28 with an end engaged in the access opening 26 of the operating canal 18, or an irrigation cannula, a probe, a catheter, a micro-biopsy forceps, an electrode, a sampling tool, a suction tube, a laser, ultrasonic or radio frequency device, a cutting device or any other suitable instrument of any kind by example of intervention or sampling.

The operating channel 18 integrated in the microendoscopic probe 11 occupies for example the inner upper space. Its diameter is small, for example generally between 0.3 mm and 0.5 mm, but can reach 1, 2 mm. However, a much smaller diameter, for example of the order of 0.10 mm, can be considered perfectly if it is desired to make a particularly fine micro-endoscopic probe 1 1.

With this operating channel 18, it is possible to perform remotely any kind of interventions of high precision on the patient or the animal for example small. It is thus possible, among other things, to inject a liquid, solid or gaseous product behind a membrane or any other anatomical separation structure, to carry out a biopsy sample for analysis, to carry out an inspection, to take internal samples by puncture, aspirate or using a micro-biopsy forceps, to instill a therapeutic agent, a marker or a contrast agent, or to irrigate or, for example, blow a gas in order to a laparoscopy. As the eventual operating channel 18, the illumination channel 16 and the image channel 17 each containing optical fibers 20, extend into the body 8 of the micro-endoscope 2 until they emerge at an outlet opening 29 , preferentially common, located for example on the side of the body 8.

An optical conduit 30 makes it possible to connect this outlet opening 29 to the optical connection part 12, the optical fibers 20 thus being able to be continuous from the distal end 14 of the microendoscopic probe 11 to the optical connection piece 12.

The optical connection piece 12 conventionally comprises an inlet 31 of a light pipe and an optical shroud 32 for direct observation by a user. This optical lens 32 may be coupled to a vision device. The latter comprises, for example, a camera sensor 33, a micro-camera, or a video display system 34. According to the exemplary embodiment illustrated in FIG. 6, a generator and control unit 36 comprising a source of cold light, connected to the input 31, makes it possible to inject the light into the illumination duct. This results in easier and more comfortable use as well as shooting and video recording.

Advantageously, the optical connection piece 12 is not made in the extension of the body 8 of the micro-endoscope 2, but is preferably remote from it to which it is connected via the optical conduit 30. This allows a gesture very precise and therefore a better precision of movement of the endoscopic probe 1 1.

A particularly advantageous example of application of the device according to the invention, for the injection of a liquid product through the tympanum of a laboratory mouse 37 is detailed below by way of example, with reference to FIG. 6.

This figure shows in a nonlimiting way a particular use in the context of an experiment on an animal of the laboratory mouse type. We want to inject a small controlled amount of a liquid product behind the eardrum of the mouse 37. After anesthesia, the mouse 37 is placed on a support 38 of adjustable height.

With the precision displacement device 3, the micro-endoscopic probe 1 1 is introduced into the ear of the animal and guided precisely in its ear canal to the immediate vicinity of its tympanic membrane.

The optical block 21 makes it possible to have a clear vision of the intervention zone even in the immediate vicinity of the eardrum.

The needle 27 is then inserted into the operating channel 18 of the micro-endoscope 2 and the progression of its tip is visually monitored beyond the distal end 13 of the microendoscopic probe 11 on the display screen 35. thanks to the micro-endoscope 2.

The needle 27 is pushed with great precision through the eardrum and the desired injection is made.

The needle 27 is removed and the tympanic membrane is awaited to return to fullness, which is all the more rapid as the crossing has been precise and punctual.

The endoscopic probe 1 1 is carefully removed, the mouse 37 is awake and the study can continue.

Thanks to the device according to the invention, this act can be performed reproducibly without tearing the structure to be crossed, namely in this case the tympanum of the mouse, or injure any other anatomical structure not targeted by the act itself, such as the round window for example.

It is thus possible to perform iterative interventions in the same animal without sacrifice.

In addition, the implementation time of such a procedure is a few minutes, much lower than that required with an operating microscope whose use requires several hours. The productivity gain is considerable and the chances of success are improved by the shortness of the anesthesia.

Another yet improved variant of the micro-endoscopy device according to the invention will now be described. In this embodiment, the vision device comprises a camera or digital micro-camera 38 with reference to FIGS. 7 to 9.

The digital camera 38 comprises a cold light source, for example of the electroluminescent diode (s) type, also called LED light source 39. For practical and compact reasons, this cold light source 39 is integrated into the light source. digital camera 38 for example in the form of a single block 40, forming part of the body of the digital camera 38. The latter comprises an image sensor 41 in the form of a detector plane and imaging for example with CCD sensor network or any other sensor or detector. The assembly is connected by a computer link 42, of the double cable type, to the display screen 35 of a computer, preferably a portable microcomputer 43. A computer program allows the formation of images on a screen 43b of the microcomputer 43 or on another independent screen 35, from the image sensor 41 of the digital camera 38.

In an improved version, the transport or transmission of the components and characteristics of the image to the microcomputer 43 can be performed by a wireless link 42a by any means of remote transmission. Transmitters / receivers 40a and 43a are advantageously provided for this purpose. The transceiver 40a, connected or integrated with the single block 40 advantageously comprises a power supply. The transmitter / receiver 40a is for example connected to the cold light source 39 and the image sensor 41, respectively by two wire links 39a and 41a.

The dual cable 42 has on the one hand a functional connection with the CCD sensor array of the image sensor 41 and, on the other hand, a power connection of the cold light source both connected to the microcomputer.

In the case of a wireless transmission, the power supply of the LED light source 39 and the circuits of the digital camera 38 can be performed internally or externally by an integrated or external battery.

Inside the digital camera 38, the cold light is injected into an optical fiber bundle 39b which serves to transport it to the outside of the body of the digital camera 38.

The digital camera 38 also has a receiver housing 38b terminated by an optical protection wall in front of the image sensor 41.

The receiver housing 38b is designed to receive a wide-angle eyepiece 44 protruding from the connecting piece 12 or from an optical interface assembly whose mechanical block 45 is for example removable from the body of the digital camera 38 or the block single 40.

The mechanical block 45 is extended by a cylindrical portion equipped with lenses forming the eyepiece 44 which is an optical assembly of the wide angle type, intended to project a large field of view image on the image sensor 41 of the digital camera 38 The eyepiece 44 is extended inside the block 45 by an optical link 48 which optically couples with the optical fiber beam 20 for conveying an optical conduit 30 constituting the connection to the micro-endoscope 2.

The optical conduit 30 also encloses a bundle of light-transmitting optical fibers coupled to the cold light source 39 integrated with the digital camera 38 through the optical interface 45 by an input light coupler 46 and a light coupler Release. The input light coupler 46 is located on the small face of the mechanical block 45 of the part constituting the optical interface and coming to face a portion of the front edge of the single block 40. On this small face is located advantageously two positioning guides allowing perfect relative positioning between the optical output of the LED light source 39 and the input light coupler 46.

The input coupler is in front of an output lens 39b of the body of the digital camera 38 when the optical interface 45 is mounted on the digital camera 38. This output lens 54 receives light from the light source LED 39 integrated in the single block 40 comprising the digital camera 38.

The optical conduit 30 arrives at the optical input of the microendoscope 2 and more precisely of the micro-endoscopic probe 11.

An example of a microendoscopic probe 11 that can equip such a micro-endoscope 2 that can be used is described below. in the context of the present invention.

It is a rectilinear and elongate piece, for example rigid or semi-rigid or even flexible, which has an inlet 58 for the optical conduit and whose distal end 14 is intended to be brought to the observation site or interventional. Its length is preferably between 5 and 700 mm, but can reach 2000 mm in the case of veterinary applications on large animals.

As before, it is a tube of small or very small diameter, serving as a jacket or sheath 15 with two or three longitudinal spaces, hereinafter called channels occupied by bundles of optical fibers enveloped by sheaths forming thin plastic walls holding each beam according to particular sectional shapes, for example those shown in FIG. 9.

These bundles of optical fibers 20 serve as light guides. One of the beams is the illumination beam whose cross-section is generally crescent-shaped, which carries the light in one illumination channel 16a, while the other beam is an image beam which serves for the observation of the image illuminated by the illumination beam and carries the image along an image channel 17a.

The cross section of the image channel is generally of semicircular shape and occupies approximately the same surface of the cross section of the microendoscopic probe 2 as that occupied by the illumination channel. The remainder of the cross-section is generally occupied by an operating channel 18 intended to serve as a guide for holding and possibly for movement to an operating instrument, for example to a sampling or surgical instrument or to an injection needle or a needle. 'irrigation.

The surfaces of the illumination and image beams are in contact with each other and with the inner lateral surface of the micro-endoscopic probe 11.

As can be seen in FIG. 9, the overall crescent shape of the cross-section of the illumination beam has a large curvilinear side in contact with the wall of the sheath 15, while its short side curvilinear is in contact with the side opposite the cross-sectional area of the image beam. The reason is that it is necessary to lessen the diffusion of the light brought by the beam of illumination. Most of its surface is in contact with the inner wall of the sleeve 15 of the micro-endoscopic probe 11, which is opaque.

Furthermore, it is noted that the cross section of the micro-endoscopic probe 1 1 is fully occupied by the illumination and image beams so as to maximize the optical capabilities including light density of these beams.

As before and as can be seen in FIGS. 10 and 12, the image channel 17a is terminated by an optical block 21 associated with a window or protective lens 21b and 21c located at the distal end 14 of the probe micro-endoscopic 2.

The optical block 21 consists of several optical components contiguous or juxtaposed to allow to fulfill the optical function of a lens with a large depth of field in very close net vision. It is in particular to have a sharpness zone extremely close to the distal end 14 so as to see perfectly what is in the immediate vicinity thereof with a sufficient viewing angle for example 90 °.

The optical block 21 is composed successively, for example of a succession of optical components 23, 24, 25, for example of the lens or lens type, which towards the distal end 14 are a corner objective, a sharpness objective. close, and a clogging lens.

The purpose of near or inverse sharpness can be achieved by the use of a lens having a concave face followed by a convex face facing the distal end 14 or any equivalent optical device.

In the variant of the invention reserved exclusively for the examination, the micro-endoscopic probe 11 comprises only an illumination channel 16a and an image channel 17a, as illustrated in FIGS. 12 and 13.

In other cases, there is an operating channel 18, preferably rectilinear over its entire length and defining a free space in which can move and possibly move one or more instruments to act remotely on the interventional site. For example, an injection needle or an irrigation cannula, a probe, a catheter, a biopsy micro-clip, an electrode, a sampling suction tube, laser, ultrasonic or radio frequency device, cutting device or any other suitable instrument of any kind.

Thanks to this operating channel 18, it is possible to perform remotely all kinds of interventions and samples or injections of high precision on the patient or the animal.

Obviously, the invention is not limited to the preferred embodiments described above and represented for some, in the various figures, the skilled person can make many changes and imagine other variants without leaving or the scope, or the scope of the invention defined by the claims.

In addition to those already mentioned above, a number of examples of applications such as examination and neonatal surgery, those of the joints, shallow organs and all the applications that the a person skilled in the art can imagine.

Claims

1. Precision micro-endoscopy device for observation, intervention or sampling, comprising a micro-endoscope (2) intended to be introduced into a body, a conduit, a cavity or a small-sized orifice of the body of a baby, a patient or an animal to be examined or treated, or through a wall for applications in medicine or human or veterinary surgery, or for scientific research and experimentation in the surgical, medical field , pharmaceutical, biological, or veterinary,

characterized in that it comprises a precision displacement device (3) of the micro-endoscope (2) which allows it to be moved precisely independently along three perpendicular directional axes;

and in that the micro-endoscope (2) comprises:

a body (8);

an optical connection piece (12) connecting the micro endoscope (2) to a vision device and containing an optical input (31) intended to be optically connected to an LED light source and an optical output connected to a lightning device; vision; and

- a rectilinear microendoscopic probe (1 1) having a proximal end (13) connected to the body (8) of the microendoscope (2) and a distal end (14) intended to be introduced into the body of the patient or the patient. animal; and comprising a tubular sleeve (15) which encloses at least two bundles of optical fibers (20) each wrapped in a sheath each forming a longitudinal channel, of which: an illumination channel (16, 16a) extending into the body of the micro-endoscope (2) and up to the input (31) of the optical connection piece (12), this illumination channel (16). , 16a) containing a continuous bundle of optical fibers (20) for conducting light to illuminate the observation or intervention site, and

. an image channel (17, 17a) extending into the body of the microendoscope (2) and up to the optical output (32) of the optical connection part (12), this channel (17, 17a) containing a beam continuous fiber optic (20) for conducting the image of the observation or intervention site to the vision device.

2. Precision micro-endoscopy device according to claim 1, characterized in that the vision device comprises an optical lens (32) connected to the body (8) of the micro-endoscope (2) via a conduit optical (30).

Precision microendoscopy device according to claim 1 or 2, characterized in that the vision device comprises a digital camera (38) and a video display system (34) (35,43b).

Precision microendoscopy device according to claim 3, characterized in that the video display system (34) (35) comprises a portable microcomputer (43).

Precision microendoscopy device according to claim 3 or 4, characterized in that the connecting piece (12) constitutes an optical interface between the digital camera (38) and an optical conduit (30) which is connected to the body (8) the micro-endoscope (2).

6. micro-endoscopy precision device according to any one of claims 3 to 5, characterized in that it comprises a single block (40) incorporating the LED light source and the digital camera (38), said single block (40) and the connecting piece (12) having mutual optical coupling means.

Precision microendoscopy device according to claim 4, characterized in that the digital camera (38) comprises an image forming sensor (41) connected to a portable microcomputer via a computer link (42) and a power connection of the LED light source also connected to the portable microcomputer (43) and in that the digital camera (38) has a receiving cavity (38b) for an enlargement eyepiece (44) integrated with the optical connection piece (12) and receiving the image from the image channel (17).

8. Precision microendoscopy device according to claim 7, characterized in that the computer link (42) and the power supply link are made with at least one wired link of the "USB" link type.

9. Precision microendoscopy device according to claim 7, characterized in that the computer link (42) is a wireless link of the type "BLUE TOOTH".

10. Precision microendoscopy device according to any one of claims 1 to 9, characterized in that the micro-endoscopic probe (1 1) also comprises an operating channel (18) which is a hollow longitudinal channel, open to the distal end (14) of the micro-endoscopic probe (1 1) and intended for the passage of intervention instruments, sampling or diagnosis.

1 1. Precision microendoscopy device according to claim 10, characterized in that the operative channel (18) extends into the body (8) of the microendoscope (2) and opens out at an access opening (26). ) located at the rear of the body (8).

12. Device for precision microendoscopy according to claim 10 or 11, characterized in that the operating channel (18) extending in the micro-endoscopic probe (1 1), has at least in said probe, a diameter between 0.10 mm and 0.5 mm.

13. Micro-endoscopy precision device according to any one of claims 1 to 12, characterized in that the micro-endoscopic probe (1 1) is semi-rigid and an outer diameter less than 1.5 mm.

14. Micro-endoscopy precision device according to any one of claims 1 to 13, characterized in that the micro-endoscopic probe (1 1) has a useful length of between 5 mm and 700 mm.

15. Device for precision micro-endoscopy according to any one of claims 1 to 13, characterized in that the micro-endoscopic probe (1 1) has a useful length of between 10 mm and 2000 mm.

16. Precision microendoscopy device according to any one of the preceding claims, characterized in that the micro-endoscopic probe (1 1) has an outer diameter of between 0.3 mm and 4.5 mm.

17. Precision micro-endoscopy device according to any one of the preceding claims, characterized in that the micro-endoscopic probe (1 1) further comprises, at the distal end of its image channel (17, 17a), an optical block (21) with a depth extended field of view to obtain a clear vision in the immediate vicinity of a wall, a membrane or any other element or part of the body of the patient or the animal.

Precision microendoscopy device according to claim 17, characterized in that the optical block (21) has an inverted zone of sharpness allowing clear vision, at least between 0.5 mm and 10 mm from a wall or an obstacle or organ.

Precision microendoscopy device according to any one of the preceding claims, characterized in that the precision displacement device (3) comprises a substantially vertical or horizontal arm (7) which supports the body (8) of the microphone. - endoscope (2).

20. Precision microendoscopy device according to any one of the preceding claims, characterized in that the precision displacement device (3) is a micromanipulator (4) whose displacement is controlled manually or electrically.

21. Precision microendoscopy device according to one of the preceding claims, characterized in that the precision displacement device (3) comprises an augmented reality optical system for displaying virtual information on the display screen (35, 43b), which make it possible to control with more precision the displacement and the positioning of the distal end (14) of the micro-endoscopic probe (11), for example with respect to an organ not appearing on the screen viewing (35).

22. Micro-endoscope (2) characterized in that it has a micro-endoscopic probe (1 1) in the form of a sheath (15) comprising at least one illumination channel (16, 16a) and a channel image (17, 17a) formed for the first channel of a crescent shaped sectional optical fiber bundle having a large curvilinear contour in contact with the side surface of the sleeve (15) and for the illumination channel (16, 16a ) a fiber bundle with a general cross-sectional shape circular whose curvilinear part of the perimeter is in contact with the inner part of the curvilinear contour of the crescent shape of the image channel (17,17a).

23. Micro-endoscope (2) according to claim 22, characterized in that the sleeve (15) of the micro-endoscopic probe (1 1) comprises an operating channel (18) extending in the image channel (17a ).