MXPA97003590A - Diagnost surgical image formation device - Google Patents

Abstract

The present invention relates to an endoscope comprising: an elongated support shaft having a distal end and a longitudinal axis, an image sensing device mounted in a camera housing, the housing having an image axis; a pivotally connected chamber adjacent to the distal end of the elongate support shaft, together with an axis tverse to the longitudinal axis, thereby allowing the camera housing to pivot and thereby move the image axis in a plane parallel to the longitudinal axis of the support shaft lifting means for pivoting the chamber housing; an elongated cover within which the chamber housing and at least a portion of the supporting shaft and lifting means are ared, the cover has a longitudinal axis that is substantially coincident with the supporting shaft of the longitudinal axis, and azimuth means for rotating the supporting shaft around the longitudinal axis thereof, thus rotating the support arrow in relation to the longitudinal axis of the cover

Description

SURGICAL / DIAGNOSTIC IMAGE FORMING DEVICE TECHNICAL FIELD OF THE INVENTION This invention relates to an image forming device for use in interabdominal, interthoracic and other surgical and diagnostic procedures in the human body.

BACKGROUND Endoscopic surgery and diagnosis are considerably less invasive than conventional procedures. This results in a lower mortality rate and minimizes the patient's hospital stay and recovery time. Conventional endoscopes include a rigid elongated member, a lens assembly and an image forming device mounted either on or in the endoscope. Examples of such endoscopes are described in U.S. Patent Nos. 4,697,210 (Toyota et al.); 4,791,479 (Ogiu et al.) And 4,989,586 (Furukawa). Although a conventional endoscope can be constructed to have a wide field of view, image quality is impaired. As a practical matter, the field of vision of common endoscopes can be relatively narrow. As a result, a conventional endoscope can be placed carefully at the start of the procedure, then held in place throughout the procedure, which usually requires the full-time attention of a member of the surgical team. U.S. Patent No. 5,351,678 (Clayton et al) refers to the problem of initial placement by providing an endoscope having a distal end that is misaligned from the longitudinal axis of the endoscope. With the endoscope of Clayton et al. , the surgeon can easily change the observed area by rotating the endoscope around its longitudinal axis. However, the endoscope of Clayton et al. , must be held in place during the entire procedure by a member of the surgical team.

BRIEF DESCRIPTION OF THE INVENTION A surgical / diagnostic imaging device that modalizes the invention includes a coupled charge device ("CCD") and an associated lens mounted within a chamber orifice in a chamber housing. The chamber housing is pivotally mounted at the distal end of an elongated chamber support. High intensity lights are also mounted inside the holes in the camera housing that are coaxial with the camera hole and therefore with the CCD axis. Before use, the chamber housing and the chamber support tube are inserted into a disposable sterile sheet. The distal portion of the leaf is then inserted into the patient through an incision in the patient. Batch motors and associated components are provided to move the camera housing (and hence the CCD) in elevation and azimuth. The image forming device is electrically connected to a control console. The control console is in turn electrically connected to a display device and to a control assembly. The display device exhibits the image received by the CCD and the control assembly allows the surgeon to control the elevation and azimuth of the camera housing. The surgical / diagnostic imaging device is easily directed by the surgeon in the area of interest within the patient. In addition, the surgical / diagnostic imaging device need not be held in position in the patient by a member of the surgical team.

BRIEF DESCRIPTION OF THE DRAWINGS An embodiment of the invention will be described, by way of example only, with reference to the accompanying drawings, in which: Fig. 1 is a front view of a surgical / diagnostic image forming device according to the invention; Fig. 2 is a partially cut-away side view of the image forming device of Fig. 1; Fig. 3 is a cutaway top view of the blade cover taken through the plane 3-3 in Fig. 1; Fig. 4 is a cut-away and enlarged side view of the upper housing and the lower portion of the image forming device; Fig. 5 is a cutaway top view of the upper housing taken through the plane 5-5 in Fig. 4; FIG. 6 is a cutaway top view of the lower portion of the image forming device taken through the plane 6-6 in FIG. 4; Fig. 7 is a block diagram of a system for controlling the image forming device of Fig. 1 and for displaying the images transmitted by the image forming device; Fig. 8 is a block diagram of a second control and visualization system of the image forming device of the Fig.1; Fig. 9 is a cut-away side view of a second image forming device according to the invention; Fig. 10 is a front view of the camera housing shown in Fig. 10; and Fig. 1 1 is a cut-away side view of the camera housing taken through the plane 1 1 -1 1 in Fig. 10 DETAILED DESCRIPTION Figures 1-3 show a surgical / diagnostic image formation device 1 for use in intra-abdominal, intrathoracic and other surgical and diagnostic procedures. The device 1 comprises an upper housing 3, a chamber housing 5 and left and right chamber housing supports 7, 9. Before use, the device 1 is inserted into a sterile sheet 1 1. The device and blade 11 (collectively, the "camera") are then inserted through an incision (not shown) within the patient's body (not shown). The chamber is inserted so that the chamber housing 5 is positioned in a position from which it can be aimed at the surgical site or the area to be diagnosed. The incision is sealed around the chamber with a bag cord suture, thus avoiding the escape of CO2 gas that is used to distend the patient's abdomen or chest during surgery or diag- nosis. In this embodiment, sheet 1 1 is constructed of medical grade plastic and is intended to be discarded after use.

Alternatively, sheet 1 1 can be constructed of heat resistant materials so as to allow it to be sterilized using an autoclave and then reused. The camera housing 5 contains a CCD (not shown) and a variable focal length lens assembly (not shown). A plurality of high intensity lights 13 are mounted within a light housing 15 that extends around the outer circumference of the camera housing 5. The lights 13 are aligned with the focal axis 17 of the CCD and provide illumination of the area in the that the camera housing 5 and therefore the CCDs are targeted. When the device 1 is inserted into the blade 11, the left and right chamber housing supports 7, 9 engage complementary locking keys 19, 21 within a blade cover 23. As a result, the chamber housing 5 is locked in a position in which the focal axis of the CCD 17 is aligned perpendicular to an optically clear window 25. Furthermore, as will be described below in relation to Figs. 4-6, the locking keys 19, 21 cause the blade cover 123 to rotate about the longitudinal axis 27 of the chamber when the camera housing supports 7, 9 are rotated about that axis. A camera cable 29 extends between the camera housing 5 and the upper housing 3. The camera cable 29 contains conductors carrying the CCD signals to the upper housing 3 and supplying electrical power to the CCD and lights 13. A The image forming device cable is provided for transporting control signals and supplying electrical power to the device 1 and transporting the CCD signals to external processing and display devices (not shown). The length of the chamber housing supports 7, 9 and the length of the blade 11 are varied to accommodate the variation in the thickness of the abdominal walls of the patients and to allow the chamber to be used in the diagnostic surgery of the thorax. Three lengths are provided: 7.62, 15.24 and 27.94 cm below the upper housing 3. Referring now to Figs 4-6, a lifting motor 51 drives a lifting arrow 53 by means of gears 55, 57. The lifting arrow 53 extends downwardly through the left hollow chamber support 7. A differential ring and pinion arrangement 59 at the lower end of the lift shaft 53 transfers the rotary movement of the lift shaft 53 to the housing chamber 15, thus causing the chamber housing 15 to rise or fall, depending on the direction of rotation of the hoisting motor 51.

In this embodiment of the invention, the chamber housing 15 can be raised 70 degrees above the horizontal and lowered 90 degrees below the horizontal. The lifting motor is mounted on a plate 63. The plate 63 is rotatably mounted inside the upper housing 3 on a support 65. An azimuth motor 67 is also mounted on the plate 63. The azimuth motor 67 drives an azimuth gear 69. The azimuth gear 69 engages a housing gear 71 which is fixed to the inner surface of the upper housing 3. When the azimuth motor 67 rotates, the plate 63 rotates inside the upper housing 3. In this embodiment, the plate 63 rotates about 180 degrees to minimize the amount that the camera cable turns 21. The 360 degree rotation can be easily achieved using conventional slip rings. A variable focal length / focus motor 72 drives the gears 73, 75, which rotate a variable focal length / focus 77 target arrow. The variable focal length / focus arrow extends downward through the right camera support 9 At the bottom of the focus arrow 77, a ring and pinion arrangement 79 transfers the rotary movement of the focus arrow 77 to a variable focal length lens mechanism (not shown) within the camera housing 5. Referring now to Fig. 7, the image forming device 1 is connected to a control console 101 by means of the image forming device cable 31. The signals from the image forming device 1 are amplified by the circuits in the control console 101 and directed towards a display device 103. In this embodiment of the invention, the display device 103 is a conventional television. A pedal control assembly 105 allows the surgeon (not shown) to control the image forming device 1. The pedal control assembly 105 includes four controls (not shown): (1) left and right camera housing; (2) upper and lower chamber housing; (3) objective of internal and external variable focal distance; and (4) high and low light intensity. The signals from the pedal control assembly 105 are routed to the control console 101. The circuits (not shown) in the control console 101 convert the signals from the control assembly into signals that are suitable for controlling the training device. image 1, then channeling the converted signals to the image forming device 1. In the embodiment of the invention shown in FIG. 8, a computer 7 is interposed between the control console 101 and the display device 103. A plurality of computer programs contained in the computer 107 allow the staff of the surgical team. manipulate and / or store the signals from the image forming device 1. Figs. 9-1 illustrate a second surgical / diagnostic image forming device according to the invention.

Referring first to Fig. 10, the image forming device comprises two main assemblies: a chamber assembly 150 and a disposable blade assembly 152. In the chamber assembly 150, a rotary stage motor 154 is rigidly mounted in an upper housing 156. A motor stepped linear 158 and the distal end of a planetary gear assembly 162 and press fit into a linear stepped motor housing 164. The proximal end of the planetary gear assembly 162 is fixed to the upper housing 156 by screws 168. Three gears Planetary 170 (only two of which are shown in Fig. 9) are rotatably mounted on pins 172 within the planetary gear assembly 162. The rotary stepper motor 154 drives the planet gears 170 through a sun gear 174. The proximal end of a chamber support tube 178 is press fit into the linear stepped housing 164. A chamber housing 180 is pivotally mounted between the pair of arms 182 (only one of which is shown in FIG. 9) that are integral with and extend from the far end of the camera support tube 178. The linear stepper motor 158 acts through a push rod 186 and a fork 188 to control the elevation of the camera housing 180. The disposable blade assembly 152 comprises a sheet 190, a blade housing 192 and a serrated ring 194. The distal portion of the sheet 190 is optically clear. The proximal end of the sheet 190 is adhesively bonded to the distal end of the sheet housing 192. The toothed ring 194 is adhesively bonded within the proximal end of the sheet housing 192. Prior to use, the camera assembly 150 is inserted into the blade assembly 152 and, the planetary gears 170 couple the gear ring. As a result, when the rotary stepper motor 154 is driven, the chamber assembly 150 rotates relative to the longitudinal axis 202 of the blade assembly. As best shown in Figs. 10 and 1 1, a CCD assembly 204 and a lens 206 are mounted within a chamber hole 208 in the chamber housing 180. A pair of high intensity lights 210 are mounted in holes that are coaxial with the chamber orifice 208. A flexible polyconductor cable 212 provides the necessary connections for the CCD assembly 204, for the lights of the chamber housing 210 and for three high intensity lights 214 which are placed in holes in the push rod 186. The flexible cable 212 extends from the chamber housing 180 to the upper housing 156. In the upper housing 156, the flexible cable 212 is combined with the power and control cables (not shown) so that the stepper motor 154 and the linear stepper motor 158 form the camera assembly cable 218. The camera assembly cable 218 passes through a hole 210 in the upper housing 152. As with the embodiment of the invention shown in Figs. 1-8, the camera assembly cable 218 connects the camera assembly 150 to external control and display devices (not shown).

Claims (14)

1. CLAIMS 1 . A surgical / diagnostic imaging device comprising: a pivotally connected image detector adjacent to the distal end of an elongated support; and a first actuator connected to the image detector, whose actuator is adapted to pivot the image detector relative to the support. The image forming device of claim 1, wherein the first actuator is adapted to pivot the image detector in a plane parallel to the longitudinal axis of the support. 3. The image forming device of claim 2, wherein the actuator is connected to the image detector by a gear and arrow assembly. 4. The image forming device of claim 2, further comprising a second actuator for rotating the support about the longitudinal axis thereof. 5. The image forming device of claim 1, further comprising viewing means connected to the image detector. The image forming device of claim 2, further comprising a lifting controller connected to the first actuator. 7. The image forming device of claim 4, further comprising an azimuth controller connected to the second actuator. The image forming device of claim 1, further comprising light means positioned adjacent the image detector and substantially coaxial therewith. 9. The image forming device of claim 2, further comprising an elongate blade positioned around the holder and the image detector. 10. The image forming device of the claim 9, further comprising a second actuator for rotating the support within the sheet. eleven . The image forming device of the claim I, which further comprises a lens positioned adjacent to the image detector. 12. The image forming device of the claim I I, wherein the lens is movable relative to the image detector, the image forming device further comprising a focus actuator connected to the lens. 13. A surgical / diagnostic imaging device comprising: image sensing means pivotally connected adjacent the distal end of an elongate support; and lifting means for pivoting the image detector means in a plane parallel to the longitudinal axis of the support. 14. The image forming device of claim 1, further comprising rotating the support about the longitudinal axis thereof.