WO2011128610A1

WO2011128610A1 - Video apparatus

Info

Publication number: WO2011128610A1
Application number: PCT/GB2011/000375
Authority: WO
Inventors: Timothy Bateman; Stuart Robert Chisholm
Original assignee: Smiths Medical International Ltd
Current assignee: Smiths Medical International Ltd
Priority date: 2010-04-15
Filing date: 2011-03-17
Publication date: 2011-10-20
Anticipated expiration: 2012-10-15

Abstract

An introducer (1) for an endotracheal tube (30) comprises a bendable rod (10) with a video camera unit (11) at its patient end (12) that connects with a Bluetooth or other RF transmitter (13) within the rod. The transmitter (13) transmits video signals of the field of view of the camera unit (11) to a display monitor (2) on which a representation of the field of view is displayed. The user monitors the display (2) to ensure correct insertion of the rod (10) during intubation. The wireless transmission of video signals avoids the need for wires so that the endotracheal tube (30) can be slid along the rod (10) without any need to interrupt the display.

Description

VIDEO APPARATUS

This invention relates to video apparatus of the kind including a rod and a camera unit mounted at the forward end of the rod.

The invention is more particularly, but not exclusively, concerned with video apparatus of the kind used for aiding insertion of a tube into a body space, such as the insertion of an endotracheal tube into the trachea. Traditional introducers take the form of a simple rod that can be bent to an approximate desired shape and flex to accommodate the shape of the anatomy during insertion. The introducer may be made with an angled, Coude tip to facilitate introduction. The introducer can be inserted more easily than the tube itself because it has a smaller width and can be bent and flex to the ideal shape for insertion. The small width also gives the clinician a better view of the trachea around the outside of the introducer. When the introducer has been correctly inserted, a tube can be slid along the outside of the introducer to the correct location, after which the introducer is pulled out of the tube, which is left in position. Preferably the introducer only takes the desired shape temporarily and returns to its original shape after insertion, so that the introducer can be removed easily from the tube without disturbing it. Also, the introducer is preferably softened by the heat of the body, thereby making removal easier. Introducers are available from Smiths Medical. GB2312378 describes an introducer moulded of an aliphatic polyurethane material and also describes an earlier introducer made from a braided polyester filament repeatedly coated in layers of resin.

More recently it has been proposed to use fibre optics or a CCD camera with an introducer to provide the clinician with a view of the trachea as the introducer is inserted. WO2007/089491 describes an arrangement with an introducer and a separate camera assembly clipped onto the outside of the introducer, which is removed before an

endotracheal tube can be slid along the introducer. Alternative arrangements have a handle at the machine end of the introducer so that the apparatus has to be inserted with the tube already loaded on the introducer from its patient end. Such arrangements are more difficult to use because of the presence of the tube during insertion. WO2010/136748 describes a video bougie that enables a tube to be slid along the bougie over its rear end. GBl 012446.9 describes a video bougie inserted with a sleeve extending along its outside, which is left in place to provide a guide along which a catheter can be inserted after removal of the bougie. GB 1006238.8 describes an arrangement for attaching a camera unit to a bougie.

One problem with such previous arrangements is that the cables extending from the viewing device to the monitor can hinder free movement of the viewing device. Also, if anything is to be slid along the device it is necessary to uncouple the cables before this can be done, thereby interrupting the image on the monitor.

It is an object of the present invention to provide alternative video apparatus.

According to one aspect of the present invention there is provided video apparatus of the above-specified kind, characterised in that the apparatus includes wireless transmission means connected with the camera unit to provide a video signal to remote utilisation means.

The wireless transmission means may be incorporated within the rod or it could be arranged to be connected and disconnected from the rod, such as at the machine end of the rod. Where the wireless transmission means is connectible with the rod, its dimensions are preferably such as to enable it to pass along the bore of a tube extended along the rod. The wireless transmission means is preferably an RF transmitter, such as a Bluetooth transmitter.

According to another aspect of the present invention there is provided a video system including video apparatus according to the above one aspect of the present invention and utilisation means arranged to receive and utilise the transmissions from the wireless transmission means.

The utilisation means may include a display monitor on which a display

representation of the field of view of the camera unit is presented to the user.

According to a further aspect of the present invention there is provided an assembly of a medico-surgical tube and video apparatus including a rod and a camera unit mounted at the forward end of the rod, the apparatus including wireless transmission means connected with the camera unit to provide a video signal to remote utilisation means, the rod being arranged to extend within the medico-surgical tube such that the tube can be slid into position along the rod and the rod subsequently removed by pulling rearwardly from the tube.

A video system including video apparatus both according to the present invention, will now be described, by way of example, with reference to the accompanying drawings, in which:

Figure 1 is a side elevation view of the system showing the patient end of the rod partly cut away;

Figure 2 is an enlarged cross-sectional side elevation view of a part of the rod;

and

Figure 3 is a side elevation view of a modified form of the video apparatus.

With reference first to Figure 1 , the system includes video apparatus in the form of a tracheal bougie or introducer 1 and utilisation means in the form of a receiver and display unit or monitor 2.

The bougie 1 comprises a rod 10, a camera unit 1 1 mounted at the forward, patient end 12 of the rod, a Bluetooth wireless transmitter unit 13 and a power source in the form of a battery 14 mounted within the rod. The rod 10 is similar to that used in conventional endotracheal introducers or bougies, being about 720mm long (about twice the length of a typical endotracheal tube) with a circular section about 5mm in diameter, although other sizes could be used. In its natural state the rod 10 is straight apart form a short, preformed Coude tip portion 16 at its patient end 12 extending at an angle of about 40° to the remainder of the rod. The rod 10 is made of a PVC material by extruding and then heat forming the Coude tip 16, although other techniques could be used such as injection moulding. The rod 10 is formed with a narrow bore 17 along its length within which the Bluetooth transmitter 13 and battery 14 are housed. The rear end of the bore 17 could be left open or filled with a suitable material.

With reference now also to Figures 2, the camera unit 1 1 comprises a forward, transparent lens 1 10 with several LEDs 1 1 1 or other illuminating means disposed around the edge of its forward surface 1 12. The lens 1 10 is mounted on the forward end of a video chip assembly 1 13 having a CCD or similar array 1 14 of light-sensitive elements at its forward end and connected to electronics 1 15 including addressing and processing circuits. Flexible wires 1 16 extend from the rear of the video chip assembly 1 13 to connect with the

Bluetooth transmitter unit 13, which is of conventional form. Alternative RF or other wireless transmitters could be used instead of the Bluetooth unit. The battery 14 is located rearwardly of the video chip assembly 1 13 and the Bluetooth unit 13 and connects with these units via wires 1 18. Alternative electrical power sources could be used, such as an inductive power pick-up coupled wirelessly with an inductive power source. The power source can be relatively small because it is only intended to be used for relatively short periods of time. The power provided must be sufficient to energise the LEDs 1 1 1 , the video chip assembly 1 13 and the Bluetooth transmitter unit 13. The bougie 1 has some form of switch (not shown) to turn power on and off. This could be a conventional switch encapsulated under a flexible sealing membrane so that the switch can be pushed to turn on and off without allowing ingress of fluids. Alternatively, the switch could be actuated by some contactless arrangement, such as by using an external magnet to change the state of a reed switch or Hall effect sensor. The arrangement is such that the LEDs 1 1 1 illuminate a region forwardly of the patient end 12 of the rod 10 in the field of view of the lens 1 10 and the CCD array 1 14. The lens 1 10 focuses an image of the illuminated field of view onto the array 1 14 and the associated electronics 1 15 processes the output from the array into a form suitable for supply to the Bluetooth unit 13. The Bluetooth unit 13 converts the video data into an RF form and transmits this to the monitor 2. Typically the Bluetooth system has a power of Class 2 or 3 enabling transmission in a range of about 10m or lm respectively.

The monitor unit 2 includes a housing 20 with a viewing screen 21 of any

conventional form. The unit 2 also includes a Bluetooth receiver 22 arranged to receive the output from the bougie transmitter 13 and to provide an output to drive circuits within the unit such that the screen 21 is energised to provide a display representation of the field of view of the camera unit 1 1. The monitor unit 2 is preferably of a compact, pocket size and powered by an internal battery so that it is very portable and does not require any wire connection. A power switch 23 on the housing 20 is used to turn the unit 2 on and off.

In use, the bougie 1 is first bent to the desired shape, turned on and its patient end 12 is insert through the patient's mouth into the upper part of the trachea while the clinician checks positioning of the tip of the bougie by observation of the screen 21 on the monitor unit 2. When the image on the monitor unit 2 indicates that the patient end 12 of the bougie 1 is in the correct position the clinician slides an endotracheal tube 30 over the rear end 18 of the bougie. Because the bougie 1 has no wires attached to it, there is no need electrically to disconnect the bougie from the monitor unit 2 in order to insert the tube 30. This simplifies the procedure and avoids interrupting the display image. Also, there is no need for the endotracheal tube 30 to be mounted on the bougie 1 prior to insertion as with some previous viewing arrangements connected by a wire to a display, thereby making the bougie considerably easier to manipulate. The clinician continues to slide the tube 30 along the bougie 1 while monitoring the display 2 to ensure that the tip 12 of the bougie does not come out of place. When the clinician sees the tip of the endotracheal tube 30 extend over the tip 12 of the bougie 1 he pulls the bougie 1 out, leaving the tube in position. Correct positioning of the tube 30 can be subsequently confirmed by any of the usual techniques such as listening for breath sounds, checking the output of a capnograph or a colorimetric C0₂ sensor or the like.

The bougie shown in Figures 1 and 2 is intended to be entirely disposable. The arrangement shown in Figure 3, however, enables a part of the apparatus to be reused.

Components in Figure 3 equivalent to those in Figures 1 and 2 have been given the same reference numerals with the addition of a prime '. The arrangement of Figure 3 differs from that of Figures 1 and 2 in that the Bluetooth module 13' is mounted at the rear end of the bougie rod 10' by means of a plug-in connection provided by a connector 1 19' at the rear end of the bougie and a mating connector 120' formed on the Bluetooth module. In this way, after use, the Bluetooth module 13' can be unplugged from the bougie rod 10', which is disposed of, allowing the Bluetooth module to be reused on a different bougie rod. The lateral dimensions of the Bluetooth module 13' are preferably not much greater than those of the bougie rod 10' itself so that the module does not provide any impediment to sliding an endotracheal tube along the assembly of the rod and module. Preferably, the Bluetooth module 13' has a rechargeable battery and can be recharged by plugging into a recharging port 24' on the monitor 2'.

It will be appreciated that the apparatus could be modified in various different ways. The dimensions and shape of the apparatus could be modified for various different applications. The rod could be rigid or flexible depending on the application. The invention is not limited to devices for inserting a tracheal tube but could find application in other apparatus where a camera needs to be mounted at the end of a rod or elongate member.

Claims

1. Video apparatus including a rod (10, 10') and a camera unit (11, 11 ') mounted at the forward end (12) of the rod, characterised in that the apparatus includes wireless transmission means (13, 13') connected with the camera unit (1 1, 11 ') to provide a video signal to remote utilisation means (2, 2').

2. Video apparatus according to Claim 1 , characterised in that the wireless transmission means (13) is incorporated within the rod (10).

3. Video apparatus according to Claim 1 , characterised in that the wireless transmission means (13') is arranged to be connected and disconnected from the rod (10').

4. Video apparatus according to Claim 3, characterised in that the wireless transmission means (13') is arranged to be connected and disconnected from the machine end of the rod (10').

5. Video apparatus according to Claim 3 or 4, characterised in that the dimensions of the wireless transmission means (13') are such as to enable it to pass along the bore of a tube (30) extended along the rod (10').

6. Video apparatus according to any one of the preceding claims, characterised in that the wireless transmission means (13, 13') is an RF transmitter, such as a Bluetooth transmitter.

7. A video system including video apparatus according to any one of the preceding claims and utilisation means (2, 2') arranged to receive and utilise the transmissions from the wireless transmission means (13, 13').

8. A video system according to Claim 7, characterised in that the utilisation means includes a display monitor (2, 2') on which a display representation of the field of view of the camera unit (1 1 , 1 Γ) is presented to the user.

9. An assembly of a medico-surgical tube (30) and video apparatus including a rod (10, 10') and a camera unit (11, 1 1 ') mounted at the forward end (12) of the rod, characterised in that the apparatus includes wireless transmission means (13, 13') connected with the camera unit (1 1 , 1 1 ') to provide a video signal to remote utilisation means (2, 2'), and that the rod (10, 10') is arranged to extend within the medico-surgical tube (30) such that the tube can be slid into position along the rod (10, 10') and the rod subsequently removed by pulling rearwardly from the tube (30).