WO2013131578A1

WO2013131578A1 - Endoscopic multifunction device for medical therapy

Info

Publication number: WO2013131578A1
Application number: PCT/EP2012/054093
Authority: WO
Inventors: Felix GÜTTLER; Jens Rump; Ulf TEICHGRÄBER; Christian SEEBAUER; Kim Winterwerber
Original assignee: Charité-Universitätsmedizin Berlin
Priority date: 2012-03-09
Filing date: 2012-03-09
Publication date: 2013-09-12
Also published as: DE112012005999T5

Abstract

An endoscopic multifunction device for medical therapy comprises a shaft having a front end and a far end, at least one channel defined by a bore extending from the front end to the far end of the shaft, and an optical system arranged on the shaft for optically imaging a region at the far end of the shaft. Herein it is provided that the optical system (31, 32) is arranged on an endoscope element (3) releasably arranged in the at least one channel (20-23) of the shaft (10). In this way an endoscopic multifunction device for medical therapy is provided which may be fabricated in a cheap manner and can easily be sterilized for example by using an autoclave.

Description

Endoscopic Multifunction Device for Medical Therapy

Description

The invention relates to an endoscopic multifunction device for medical therapy according to the preamble of claim 1 .

An endoscopic multifunction device of this kind comprises a shaft having a front end and a far end, at least one channel defined by a bore extending from the front end to the far end of the shaft, and an optical system arranged on the shaft for optically imaging a region at the far end of the shaft.

An endoscopic multifunction device of this kind can for example be used for minimal- invasive endoscopic surgery, for example for treating a herniated vertebral disc of a patient. Within such surgery, a medical instrument such as medical pliers may be guided through an endoscopic device to access a spinal disc in order to remove disc tissue, to treat pain receptors at the spinal disc or to stabilize tissue, in particular fibrous tissue, at the spinal disc. In order to inspect the operation site during operation an optical system is used to obtain images of the operation site, wherein a camera may be arranged at the far end (also denoted as the "tip") of the shaft or an optical lens system may be integrated into the shaft for guiding light from the operation site to an external camera system connected to the shaft.

It is desirable to carry out such minimal-invasive surgery under constant control by using magnetic resonance imaging (MRI). For this, however, the components of the endoscopic multifunction device must be fabricated from MRI compatible materials, i.e. materials which produce minimal artefacts within magnetic resonance images.

In addition, it must be ensured that the entire endoscopic multifunction device is sterile when using it in a surgery on a patient. For this, it is desirable that the endoscopic multifunction device is autoclavable, i.e. it can be sterilized by means of an autoclave in which the device is subjected to water vapour in a pressure container. Because an optical system, in particular a camera system and a lighting system, cannot easily be made autoclavable, endoscopic devices having an integrated optical system such as a camera and a lighting system allowing for a sterilization by means of an autoclave are in general expensive. This is due to high temperatures occurring in an autoclave, which affect the components of the endoscopic device and their connections within the device such as the connections of light guiding means, the adhesion of lenses to the shaft and the attachment of other components.

In summary, current endoscopic devices of this kind are complex in their structure which limit their applicability, in particular their autoclavability.

Endoscopic devices which are compatible with magnetic resonance imaging are for example known from EP 0 850 595 B1 and US 5,876,338 A which describe endoscopic devices having integrated magnetic resonance receive coil elements.

It is an object of the instant invention to provide an endoscopic multifunction device for medical therapy which may be fabricated in a cheap manner and can easily be sterilized for example by using an autoclave.

This object is achieved by an endoscopic multifunction device having the features of claim 1 . Accordingly, within such endoscopic multifunction device the optical system is arranged on an endoscope element releasably arranged in the at least one channel of the shaft.

The instant invention makes use of the idea to, on the one hand, provide a shaft of an endoscopic multifunction device having one or multiple channels defined by one or multiple bores extending through the shaft and allowing for example to guide medical instruments such as medical pliers or other minimal-invasive medical instruments through the shaft towards an operation site. The shaft is fabricated such that it can be used multiple times and can easily be sterilized. In particular, the shaft may be fabricated as a rigid element not comprising any electric or electronic components such that it can easily be sterilized by means of an autoclave. The optical system of the endoscopic multifunction device, on the other hand, is arranged on an endoscope element which, in a functional state of the endoscopic multifunction device, is received in a channel of the shaft and is releasably held within such channel. Because the endoscope element carrying the optical system such as a camera chip and/or a lighting system can be released from the shaft and is produced in a modular fashion as a modular element, it can easily be replaced by another endoscope element after a surgery such that the endoscope element may be produced as a single-use element which is not reused for multiple surgeries. The endoscope element itself may be fabricated such that it also can be sterilized using an autoclave. Because within a single-use element a cross infection between multiple patients is not possible, this is however not absolutely necessary.

Because a functional guiding system is provided by means of the shaft and an optical imaging system is provided by means of the endoscope element, a functional separation between the shaft and the endoscope element is achieved. This makes it possible to fabricate the endoscopic multifunction device in an easy and cheap manner, in particular, alleviating the necessity for fixedly integrating optical components into the shaft. The optical system may for example comprise a camera chip and/or a lighting element such as a light emitting diode (LED) which preferably are arranged on the endoscope element in proximity to the far end of the shaft (at the "tip" of the endoscope element).

The shaft is preferably made as a rigid element which can be used to access an operation site within a patient. The endoscope element, in contrast, can be made flexible and does not require any particular stability, because it is received within the channel of the shaft and hence is held and stabilized by the shaft.

The endoscope element may be arranged in the associated channel in the shaft such that it is movable during surgery within the channel of the shaft such that its position can be varied depending on the needs of optical inspection of the operation site during surgery. For example, the endoscope element may extend with its tip beyond the far end of the shaft and may comprise means for moving the tip such that the orientation and position of the tip can be varied, hence allowing for an adjustment of the viewing region visible through the optical system. The endoscope element arranged in the associated channel of the shaft may fill the channel such that it tightly seals the channel and hence prevents a fluid flow through the channel. This may be of importance if the operation site shall be flushed during surgery using a medical fluid, the tight sealing of the endoscope element in the channel preventing a fluid flow through the channel to avoid leakage of fluid through the channel.

The shaft advantageously comprises multiple channels. In a first channel, for example, a medical instrument such as medical pliers may be received, and in a second channel the endoscope element is arranged. Furthermore, further channels may be present, for example to allow for a fluid flow towards and from an operation site for the purpose of flushing the operation site.

The endoscopic multifunction device preferably is fabricated such that it is compatible with magnetic resonance imaging and in particular does not produce any artefacts (such as image distortions due to magnetic materials exceeding the actual shape of the device) when using magnetic resonance imaging. For this, the shaft and the endoscope element as well as their components are made of a non-magnetic material (a material having a small magnetic susceptibility) such that artefacts caused by the multifunction device within a magnetic resonance image are reduced to a minimal.

The shaft may for example be made of titanium, hence yielding a non-magnetic rigid element providing a guide for both the endoscope element and a medical instrument inserted into an appropriate channel of the shaft. The endoscope element may for example be made of a plastic material, such as PEEK, or it also may be made of a non- magnetic metallic alloy such as a nickel-titanium alloy.

Also other components of the shaft or the endoscope element, in particular components of the optical system of the endoscope element, are preferably made of a non-magnetic material. Lenses and prisms for example may be made of glass. Windows may be made of sapphire. Further shafts, pipes, connectors or buttons may be made of nickel, titanium, brass or plastic such as PEEK.

The endoscope element extends through the associated channel of the shaft such that, in a functional state of the multifunction device, a tip of the endoscope element is positioned in proximity of the far end of the shaft and, by means of the shaft, hence may be brought and guided towards an operation site of a patient. The endoscope element, at a location removed from the tip, may further comprise a control device which may be constituted to control the optical system and its settings, for example a zoom setting and a focus setting. For this, the imaging characteristics of a camera chip may be controlled electronically. It also is possible to arrange the camera chip and/or a lens in a movable fashion on the tip of the endoscope element such that via the control device the position of the camera chip and/or the lens may be adjusted for adjusting the setting or viewing region of the optical system.

The endoscope element may furthermore comprise a connector allowing for an electrical connection of the optical system to an external control and display unit. Such connector may for example be constituted as a USB connector allowing for a connection to a standardized USB interface of the external control and display unit. For operating the endoscope element and in particular to display images received via the optical system of the endoscope element on the control and display unit (which for this purpose may comprise a monitor) the endoscope element by means of its connector is connected to the control and display unit, wherein the endoscope element and its electrical components are also supplied with electrical power via the control and display unit.

The idea underlying the invention shall subsequently be described in more detail according to the embodiments of the figures. Herein,

Fig. 1 shows a schematic view of a shaft of an endoscopic multifunction device;

Fig. 2 shows a schematic view of a different embodiment of an endoscopic multifunction device comprising multiple shafts;

Fig. 3 shows a front view of a far end of a shaft of a multifunction device;

Fig. 4 shows a schematic view of an endoscope element arranged in a channel of a shaft of an endoscopic multifunction device;

Fig. 5 shows a tip of an endoscope element comprising a camera chip and a lighting element of an optical system; and

Fig. 6 shows a schematic view of an embodiment of an endoscope element. Fig. 1 shows a first embodiment of an endoscopic multifunction device 1 comprising a single shaft 10 having a far end 103 and a front end 104 carrying a connection interface 100. A second embodiment of an endoscopic multifunction device comprising a first shaft 10 and a second shaft 1 1 is shown in Fig. 2. The multifunction device of Fig. 2 comprises multiple connection interfaces 100, 101 , 102, 1 10 for connecting tubes or inserting medical instruments or other equipment to be used during medical surgery in connection with the endoscopic multifunction device 1 .

The endoscopic multifunction device 1 , in its simple embodiment of Fig. 1 or its more complicated embodiment of Fig. 2, serves to perform a minimal-invasive surgery on a patient by accessing an operation site through guiding the shaft 10 with its far end 103 towards an operation site. For example, within a minimal-invasive surgery for treating a herniated vertebral disc the shaft 10 may be guided to an operation site through a small cut in a dorsolateral back region of the patient, and by means of the endoscopic multifunction device 1 tissue of a spinal disc may be removed, pain receptors may be destroyed or regions of the spinal disc may be stabilized. To access the operation site with medical instruments, for example with medical pliers, a channel 20 defined by a longitudinal bore extending from the front end 104 to the far end 103 of the shaft 10 (or through the shaft 1 1 and the shaft 10 within the embodiment of Fig. 2) is provided which allows inserting a medical instrument into the shaft 10 and guiding the medical instrument through the shaft 10 towards the operation site. This is visible in Fig. 3 and 4.

Furthermore, to allow inspection of the operation site, an endoscope element 3 is inserted into another channel 21 of the shaft 10 and extends through the channel 21 , as shown in Fig. 4, towards the far end 103 of the shaft 10. The endoscope element 3 carries, as visible in Fig. 5, components of an optical system, such as a camera chip 31 and a lighting element 32, for example an LED, which are arranged on a tip 30 of the endoscope element 3 and are electrically connected by appropriate cables to for example an external control and display unit 5, as shown in Fig. 6. As can be seen in Fig. 5, the camera chip 31 is arranged on the tip 30 of the endoscope element 3 in connection with a lens 310 for optically guiding light towards the camera chip 31 . The camera chip 31 may for example be a CCD chip. The endoscope element 3 is fabricated as a single-use element which releasably is arranged in the channel 21 of the shaft 10. The endoscope element 3 hence can be replaced after a surgery such that a cross-infection between different patients can be avoided.

Because the optical system with its camera chip 31 and its lighting element is arranged on the endoscope element 3 replaceably connected to the shaft 10 of the multifunction device 1 , the multifunction device 1 without the endoscope element 3 can easily be sterilized by means of an autoclave without particular modifications to the multifunction device 1 and hence can be reused. In particular, outside the endoscope element 3 with its optical system 31 , 32, no electric or electronic elements are arranged on the shaft 10 or the shaft 1 1 such that, after removing the endoscope element 3, the multifunction device 1 can easily be sterilized.

The endoscope element 3, in its functional state in which it is arranged in the associated channel 21 of the shaft as shown in Fig. 4, can be constituted to tightly seal the channel 21 such that no fluid can pass through the channel 21 once the endoscope element 3 has been inserted into the channel 21 . This is beneficial if a flushing of an operation site by means of further channels 22, 23 (see Fig. 3) shall be carried out, hence preventing a leakage of fluid through the channel 21 out of the operation site. (One of the channels 22, 23 is provided for providing a medical flushing fluid towards an operation site and the other channel 22, 23 is used to remove the flushing fluid from the operation site such that the fluid is flushingly moved through the operation site.)

Advantageously, the endoscopic multifunction device 1 is compatible with magnetic resonance imaging in that its components are made from non-magnetic materials, hence materials exhibiting a low magnetic susceptibility and producing no or only little artefacts within magnetic resonance images. In particular, the shaft 10 and the shaft 1 1 may be made of titanium and are preferably rigid. The endoscope element 3 may be provided in the shape of a tube being made of a plastic material such as PEEK. The components of the optical system, namely the camera chip 31 , the lens 310 and the lighting element 32, are as well made of non-magnetic materials. Hence, by means of the endoscopic multifunction device 1 an intervention may be carried out under constant, possibly real time magnetic resonance imaging without the endoscopic multifunction device 1 producing artefacts within acquired magnetic resonance images. An overall view of the endoscope element 3 to be inserted into the associated channel 21 of the shaft 10 of the multifunction device 1 is shown in Fig. 6. The endoscope element 3 comprises a first section 3A which may be formed in a flexible manner. The section 3A is to be inserted into the associated channel 21 of the shaft 10 and, hence, is guided within the channel 21 such that it is supported by the shaft 10. Connected to the section 3A is a control device 33 having control buttons 330, 331 for controlling the settings of the optical system 31 , 32, for example for controlling a zoom setting, a focus setting and/or a brightness setting of the optical system 31 , 32. The control device 33 is connected via a cable 3B to a connector 34 being constituted as a USB connector, which can be plugged into a standardized USB connection interface of the control and display unit 5. The control and display unit 5 comprises a monitor 50 for displaying images acquired via the optical system 31 , 32 of the endoscope element 3 and may be placed within a surgery room such that a surgeon during surgery may directly inspect the operation site by means of the monitor 50.

The invention is not limited to the embodiments described above.

In particular, an endoscopic multifunction device of this kind with a replaceable endoscope element carrying an optical system can also be used in connection with other imaging modalities and not necessarily must be constituted in a fashion compatible with magnetic resonance imaging.

Furthermore, an endoscopic multifunction device may not only be used for treatment of a herniated vertebral disc but can also be employed for other minimal-invasive surgeries on a patient.

List of Reference Numerals

1 Endoscopic multifunction device

10 Shaft

100-102 Connection interface

103 Far end

104 Front end

1 1 Shaft

1 10 Connection

20-23 Channel

3 Endoscope element

3A Section

3B Cable

30 Tip

31 Camera

310 Lens

32 Lighting element

33 Control device

330, 331 Button

34 Connector

4 Medical instrument

5 Display unit

50 Monitor

V1 , V2 Movement

Claims

Claims:

Endoscopic multifunction device for medical therapy, comprising

- a shaft having a front end and a far end,

- at least one channel defined by a bore extending from the front end to the far end of the shaft, and

- an optical system arranged on the shaft for optically imaging a region at the far end of the shaft, characterized in that the optical system (31 , 32) is arranged on an endoscope element (3) releasably arranged in the at least one channel (20-23) of the shaft (10).

Endoscopic multifunction device according to claim 1 , characterized in that the optical system comprises a camera chip (31 ) and/or a lighting element (32).

Endoscopic multifunction device according to claim 2, characterized in that the camera chip (31 ) and/or the lighting element (32) are arranged on the endoscope element (3) in proximity to the far end of the shaft (10).

Endoscopic multifunction device according to one of claims 1 to 3, characterized in that the shaft (10) is rigid.

Endoscopic multifunction device according to one of the preceding claims, characterized in that the endoscope element (3), at least at a section (3A) extending through the at least one channel (20-23), is flexible.

Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the endoscope element (3) is movable within the at least one channel (20-23) of the shaft (10).

7. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the endoscope element (3) tightly seals the at least one channel (20-23) it is arranged in such that fluids cannot pass through the at least one channel (20-23).

8. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the shaft (10) comprises a first channel (20) for receiving medical instruments (4) and a second channel (21 ) for receiving the endoscope element (3).

9. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the shaft (10) comprises at least one third channel (22, 23) for allowing a fluid flow through the shaft (10).

10. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the shaft (10) and the endoscope element (3) are made of a non-magnetic material.

1 1 . Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the shaft (10) is made of titanium.

12. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the endoscope element (3) is made of a plastic material.

13. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that components of the optical system (31 , 32) are made of a nonmagnetic material.

14. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the endoscope element (3) comprises a control device (33) for controlling the optical system (31 , 32).

15. Endoscopic multifunction device according to at least one of the preceding claims, characterized in that the endoscope element (3) comprises a connector (34) for electrically connecting the optical system (31 , 32) to a control and display unit (5).