WO2002100238A2 - Endoscope with cleaning optics - Google Patents

Endoscope with cleaning optics Download PDF

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Publication number
WO2002100238A2
WO2002100238A2 PCT/IL2002/000429 IL0200429W WO02100238A2 WO 2002100238 A2 WO2002100238 A2 WO 2002100238A2 IL 0200429 W IL0200429 W IL 0200429W WO 02100238 A2 WO02100238 A2 WO 02100238A2
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
gas
nozzle
channel
pressure
Prior art date
Application number
PCT/IL2002/000429
Other languages
French (fr)
Other versions
WO2002100238B1 (en
WO2002100238A3 (en
Inventor
Michael Shalman
Original Assignee
Michael Shalman
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Michael Shalman filed Critical Michael Shalman
Priority to EP02735946A priority Critical patent/EP1420680A4/en
Priority to US10/480,170 priority patent/US7341556B2/en
Priority to AU2002309228A priority patent/AU2002309228A1/en
Publication of WO2002100238A2 publication Critical patent/WO2002100238A2/en
Publication of WO2002100238A3 publication Critical patent/WO2002100238A3/en
Publication of WO2002100238B1 publication Critical patent/WO2002100238B1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00091—Nozzles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
    • A61B1/126—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning in-use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
    • A61B1/127—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements with means for preventing fogging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/76—Handpieces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/80—Suction pumps
    • A61M1/804—Suction pumps using Laval or Venturi jet pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
    • A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/70—Cleaning devices specially adapted for surgical instruments
    • A61B2090/701—Cleaning devices specially adapted for surgical instruments for flexible tubular instruments, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/70—Cleaning devices specially adapted for surgical instruments

Definitions

  • This invention relates generally to medical instruments for the operation in patient's body cavity requiring the visualization of internal organs. More particularly, it relates to intubating laryngoscopes, bronchoseopes, endoscopes of various applications, vacuum curettage devices, and the like.
  • All the endoscope systems applied for the visualization of patient's internal organs comprise at least one endoscope distal optical member disposed at the endoscope distal end.
  • the dirtying of the distal optical member surface with patient's secretions such as blood, mucus, vomit, fat creates significant difficulties for the internal organs visualization.
  • These problems arise in the cases of bleeding an esophageal and gastrointestinal lesions, bleeding or copious secretions in airways, colonoscopy for poorly prepared patient, hysteroscopy during and after curettage and the like.
  • Another problem obstructing the visualization is fogging the distal optical surface due to the temperature difference between the optical surface and patient's cavity. Therefore, cleaning the distal optical surface from patient's secretions and fog presents one of the most important problems of current endoscope developments.
  • U.S. Patent 4509507, 4548197, 4667655 disclose endoscope devices comprising an air supply pipe and a water supply pipe disposed within an endoscope housing and connected with a distal nozzle through which air and water are alternately supplied in front of a distal optical surface (viewing window).
  • the disadvantage of these endoscopes is low effectiveness of optical surface cleaning from very adhesive substances such as blood, mucus, fat due to low air pressure and the direction of air / water flow, which is not collides with the optical surface and, therefore, cannot sweep off the dirt.
  • U.S. Patent 3903877 discloses an endoscope comprising air and water pipes for alternate supply air and water to the distal optical surface through a nozzle. There are also the pump and control means providing the alternate supply of air and water to the nozzle and disposed beyond the endoscope device. Moreover, there is a suction port at the endoscope distal end and a suction pump disposed beyond the endoscope. The endoscope distal end is provided with a rubber barrier ring around the nozzle, distal optical surface and suction port.
  • the disadvantage of this patent is very cumbersome and expensive design due to dual cleaning system including the numerous equipment disposed outside the endoscope device. The presence of the suction means and circular rubber barrier lowers the danger of internal organ barotrauma.
  • U.S. Patent 3980078 discloses an endoscope having a nozzle supplying air and water to the distal optical surface, a suction pipe with a distal suction port, a distal circular hood, supply and suction pump means and control means disposed beyond the device.
  • air and water are transferred to the nozzle with only one pipe. This somewhat simplifies the tubing, but complicates the supply control system.
  • Patents 3903877 and 3980078 have the same disadvantages above noted for Patent 3903877.
  • the common disadvantages of the endoscope systems with cleaning optics are: their excessive complexity caused by dual (gas and liquid) cleaning system and cumbersome and expensive pump and control means disposed outside the endoscope device; low cleaning effectiveness due to low pressure of cleaning fluid (gas and liquid); the absence of effective means for catching and removing the cleaning flow; the absence of reliable control means allowing to adjust the pressure in body cavity required for surgical operations.
  • U.S. Patent 4497550 discloses "Device for preventing the observing objective lens window of an endoscope from collecting moisture" by directing a small flow of air over the front surface of the observing objective lens window to form a layer of air which has the same temperature as the ambient atmosphere".
  • the device comprises only one supplying gas channel and one nozzle and prevents the distal optical surface from fog arising.
  • the device cannot provide cleaning the optical surface from patient's secretion due to low air pressure.
  • the device does not comprise any means preventing patient internal organs from barotrauma. Therefore, its air pressure cannot be increased up to the value sufficient for effective cleaning the optic surface.
  • U.S. Patent 4971034 discloses "Body Cavity Pressure Adjusting Device” comprising a suction mechanism, gas sending mechanism, pressure and vacuum pipes, and pressure control system.
  • the device is adapted to the use with an endoscope and designed for the adjustment of required pressure in body cavity.
  • Main disadvantage of the device is that its application with the endoscope presents very cumbersome, expensive, and inconvenient combination including device suction and pressurized gas supply means, device pressure control system, device vacuum and pressure pipes as well as endoscope cleaning system with identical equipment.
  • the vacuum curettage devices are disclosed by U.S. Patents 3863624, 3889682, 4063556, 4178932, 4870975. They include: a cannula (or curette) communicated with a vacuum pump, which is disposed beyond the curettage device; a valve for selective applying the vacuum to the cannula; a reservoir for the collection of blood, body solid particles and the like; a filter partition separated the reservoir from the vacuum pump.
  • the disadvantage of known curettage devices is the absence of a visualization means eliminating the possibility of operative estimate of curettage results. Practically, the curettage procedure is performed blindly. This worsens the quality of the procedure, leads to patient traumatization and successive complications, and extends the operation duration.
  • the object of the present invention is to provide an endoscope with the complete visualization of patient's internal organs even in the most awkward cases.
  • Another object of the present invention is to provide the cleaning the endoscope distal optic surface only by means of gas jet.
  • Another object of the present invention is to entirely prevent patient's internal organs from barotrauma.
  • Another object of the present invention is to simplify the endoscope design and to lower its manufacturing cost.
  • Another object of the present invention is to reduce the general duration of endoscopy procedure. Another object of the present invention is to improve the convenience of user operation.
  • Another object of the present invention is to broaden the endoscope functional properties, specifically, to provide its possibility to serve as a means for body cavity pressure adjusting.
  • Another object of the present invention is to broaden the endoscope applicability including the possibility of its application in laryngoscopes, bronchoscopes, vacuum curettage devices and the like.
  • endoscope system comprising: an elongated endoscope housing, an optical channel with distal optical surface, a cleaning system for cleaning the optic surface comprising a pressurized gas supply channel connected with a pressure gas source and having an outlet nozzle at housing distal end.
  • the outlet nozzle is directed towards the optic surface so that a gas jet going out of the nozzle touches the optic surface providing its cleanness.
  • the pressure value of gas supplied to the outlet nozzle is sufficient to enable the gas jet to clean completely the optic surface from any patient's secretions and to be a single means for cleaning the optic surface.
  • All the components of the cleaning system are disposed inside of the endoscope device, with the exception of the pressure gas source disposed beyond the endoscope. There is also a safety means preventing the patient internal organs from barotrauma by the gas jet.
  • gas jet as a single means for cleaning the optic surface significantly simplifies the endoscope design and lowers its manufacturing cost.
  • the location of the all components of cleaning means inside the endoscope device also lowers the endoscope manufacturing cost and, moreover, improves the convenience of device control by user.
  • Sufficiently high gas pressure supplied to the outlet nozzle as well as gas jet direction towards the optic surface provide complete cleaning the optical surface from any patient's secretion and a fog.
  • the gas jet of high pressure is not dangerous for patient internal organs due to the noted safety means.
  • Complete uninterrupted visualization obtained with the noted cleaning means enables reducing the endoscopy procedure and heightening its quality.
  • the safety means presents the combination of gas pressure value, the nozzle dimensions, the distance between the optic surface and nozzle, the angle between gas jet direction and optic surface, enabling safe dissipation of the gas jet after its passage of the optical surface. Moreover, additional gas jet dissipation and its deflecting proximally are provided with a barrier disposed in the path of gas jet movement.
  • This safety means prevents patient internal organs from injury by gas jet, is characterized with simple design and low manufacturing cost, and can be applied for the operation in open body cavity, for instance in laryngoscopes.
  • the safety means includes a return channel designed for backward movement of cleaning gas, communicated with atmosphere by its proximal end, and having a catcher at its distal end.
  • the catcher is designed for substantially entire catching the gas jet after its passage of said optic surface and for deflecting all the gas jet inward the return channel.
  • the return channel prevents the patient internal organs from barotrauma caused both with the gas jet and with excessive gas pressure in body cavity.
  • the safety means comprises a suction pump of ejection type communicated with the return channel, disposed inside of endoscope device, and fed from the pressure gas source of the nozzle.
  • the noted type, disposition, and gas source of the suction pump provide the design simplicity and low manufacturing cost of endoscope system.
  • the suction pump improves the prevention of patient internal organs from barotrauma.
  • the suction pump in the combination with the pressurized gas supply channel and the control valve for the control of gas consumption through the return channel allows the adjustment of the pressure in patient body cavity.
  • the optic channel with the distal optic surface and pressurized gas supply channel with the outlet nozzle are disposed inside the tubular curettage cannula, which serves as the return channel for endoscope cleaning system.
  • Endoscope safety means and vacuum curettage device have one common suction pump of ejection type disposed in the curettage housing and fed from the pressure gas source of the endoscope cleaning system.
  • the device is equipped with the pressure control means for the adjustment of required pressure in the curettage cannula.
  • the device provides good visualization of uterus internal wall even during curettage procedure, is entirely safe and characterized with compact, convenient, simple, and inexpensive design. This curettage device enables to reduce curettage procedure duration, to decrease the uterus traumatization, and to improve the curettage quality.
  • FIG.l shows the conceptual sketch of an intubating laryngoscope with the means for the dissipation and deflection of gas jet.
  • FIG.2 shows the cross section of the laryngoscope shown in FIG.l.
  • FIG.3 shows the conceptual sketch of an intubating laryngoscope with a return channel.
  • FIG. 4 shows the conceptual sketch of the endoscope with separate return channel and simplified suction pump.
  • FIG.5 shows the conceptual sketch of the endoscope with separate return channel without suction pump.
  • FIG.6 shows the conceptual sketch of the endoscope with the housing serving as a return channel.
  • FIG.7 shows the conceptual sketch of the endoscope with separate return channel, enhanced suction pump and the means for the adjustment of body cavity pressure.
  • FIG.8 shows the side elevation of the handle of the endoscope shown in FIG.7.
  • FIG.9 shows the back view of the endoscope shown in FIG.7.
  • FIG.10 shows the partial front view of the distal end of the endoscope shown in FIG.7
  • FIG.11 shows the conceptual sketch of the vacuum curettage device with a visualization means.
  • FIG.12 shows exterior side view of the vacuum curettage device with an endoscope.
  • FIG.13 shows the cross section of vacuum curettage device cannula.
  • FIG.14 shows the underside view of the curettage device distal end.
  • Fig.l shows a laryngoscope 20 with a blade 21, a handle 22, an optic channel 23 with a distal optic surface 24, an eyepiece 25 and a connector 26 for computer display connection.
  • a pressurized gas supply channel 27 extending along the blade 21 and having an inlet port 28 connected with a pressure gas source (not shown), a valve 29 of type ON/OF, and an outlet nozzle 30 at its distal end.
  • the nozzle 30 is directed towards the optic surface 24 so that a gas jet 31 going out of the nozzle 30 touches the optic surface 24 sweeping off the dirt from it.
  • the pressure value of gas supplied to the nozzle 30 is sufficient to enable the gas jet 31 to completely clean the optic surface 24 from any patient's secretions and to be a single means for cleaning the optic surface 24.
  • This pressure value provides complete cleanness of the optic surface 24 however a safety means is necessary to prevent patient internal organs from barotrauma by the gas jet 31.
  • This safety means presents the combination of the endoscope parameters enabling safe deflection and dissipation of the gas jet 31 after its passage of the optic surface 24.
  • the noted endoscope parameters include the gas pressure value P, the nozzle 30 diameter D, the distance L between the optic surface 24 and the nozzle 30, the angle ⁇ between the optic surface 24 and gas jet 31 direction, and the angle ⁇ between the gas jet direction and the distal extension of the axis of the optic channel 23 distal portion.
  • the angle ⁇ provides the gas jet direction proximally away of patient internal organs located in front of the optic surface 24.
  • the other parameters provide the dissipation of the gas jet 31. Additional dissipation and proximal deflection of gas jet 31 is accomplished by a barrier 32 disposed in the path of gas jet movement after its passage of the optic surface 24 (fig.l, 2).
  • the barrier 32 is equipped also with lateral deflectors 33, 34 restricting the gas jet movement in the side directions.
  • described safety means prevent the internal organs from barotrauma by the gas jet 30.
  • Laryngoscope 20 provides complete cleaning the optic surface 24 thereby reducing the intubation procedure and patient's organ trauma. Moreover, it is characterized by simple, reliable, and inexpensive design due to using only gas for cleaning the optic surface 24 and the location of all its components inside of the laryngoscope (with the exception of the pressure gas source and computer display).
  • laryngoscope 35 in fig.3 has a return channel 36 designed for backward movement of cleaning gas proximally from the zone of the optic surface 24.
  • the proximal end of the return channel 36 is communicated with atmosphere through a collector (not shown) of blood, mucus and other patient's secretions.
  • the distal end of the return channel 36 presents a catcher 37 for substantially entire catching the gas jet 31 after its passing the optic surface 24 and deflecting it inward the return channel 36.
  • the catcher 37 includes a barrier portion 38 of the return channel 36 inner wall disposed in the path of the gas jet 31 at acute angle to it, deflecting the gas jet inwards the return channel 36 and thereby inducing gas backward movement in the return channel.
  • the laryngoscope 35 includes an ejection gas channel 39 in form of a branch of the gas supply channel 27 disposed in the suction pipe 40, which presents a portion of the return channel36.
  • the ejection gas channel 39 has an ejection outlet 41 directed proximally.
  • the noted suction pipe 40 and the ejection outlet 41 form a simplified suction pump of ejection type, which additionally induces backward gas movement in the return channel 36. This suction pump enhances laryngoscope safety means enabling the operation in closed body cavity and the removal abundant patient's secretions, for instance in the case of nasopharyngeal or oral cavity injuries.
  • the laryngoscope 35 includes a control means for the control of gas pressure inward the body cavity.
  • This control means presents a control valve in the form of a throttle valve 42 allowing the change of gas consumption through the return channel 36. It can be used, for instance, for some increasing the oxygen pressure in oral cavity for the purpose of patient oxygenation, when oxygen is used as a cleaning gas.
  • laryngoscope 35 All the components of the laryngoscope 35, with the exception of pressure gas source and secretion's collector, are located inside the laryngoscope. All the advantages, noted for the laryngoscope 20, are inherent also in the laryngoscope 35. Both laryngoscopes can be used with the gas source of standard medical pressure, preferably oxygen piping system or pressure vessel. Therewith, the pressure of gas supplied to the nozzle 30 can be equal to the pressure in standard medical oxygen source, approximately 50 psig.
  • the endoscopes shown in fig. 4 to 10, have identical designations of the same details distinguished only by the first numeral.
  • the endoscope 143 in fig. 4 comprises an elongated housing 144, a handle 145, an optic channel 123 with a distal optic surface 124, an eyepiece 125, and a connector 126 of a computer display (not shown).
  • the nozzle 130 is directed towards the optic surface 124 so that the gas jet 131 going out of the nozzle 130 touches the optic surface 124 cleaning it from patient's secretions and fog.
  • the pressure of gas supplied to the nozzle 130 is sufficient to entirely clean the optic surface 124 from any patient's secretions and fog and to be a single means for complete cleaning the optic surface 124.
  • the endoscope 143 provides entire visualization of patient internal organs in all the cases of its application.
  • the endoscope 143 is equipped with a safety means preventing patient internal organs from barotrauma.
  • the safety means include a return channel 136 with a catcher 137 for substantially entire catching the gas jet 131 , a safety release valve 146, and a simplified suction pump of ejection type. This pump comprises an ejection gas channel 139 with an ejection outlet 141 and a suction pipe 140 presenting a portion of the return channel 136.
  • the operation of identical simplified suction pump was described above as applied to the laryngoscope 35 in fig.3.
  • the gas jet 131 enters the catcher 137 at acute angle to a barrier portion 138 of the return channel 136, which deflects the gas jet inward the return channel 136.
  • the ejection suction pump induces a backward movement of cleaning gas with patient's secretion and draws off the gas to atmosphere through the return channel proximal end and a secretion's collector (not shown) disposed beyond the laryngoscope.
  • the safety release valve 146 automatically opens in the case of unforeseen closing the control valve 142, for instance because of its jamming, thereby preventing body cavity from excessive pressure.
  • the safety means entirely prevents patient internal organs from barotrauma caused by the gas jet 131 and excessive pressure in body cavity.
  • Manually controlled valve 142 allows the adjustment of the required pressure in body cavity.
  • the endoscope also has an indication means including a pressure sensor 148 and indication device 147 for the measurement and indication of the pressure in body cavity.
  • the sensor 148 presents the distal end of the pipe 149 communicated with usual mechanical mano-vacuumeter.
  • the safety release valve 146 can be used for required pressure adjustment in body cavity. For this purpose, it is set for the required pressure. After partial or entire closing the vale 142 and heightening the pressure in body cavity to expected value, the valve 146 opens maintaining automatically the required pressure in body cavity.
  • All the components of the endoscope 143 are located inside of the endoscope device providing compact, simple, and inexpensive design.
  • Important merit of the endoscope 143 is the arrangement of the nozzle 130 and the catcher 137 beyond the vision field ⁇ of the optic surface 124.
  • the endoscope 243 shown in fig.5 comprises many the same details with identical designations as in fig.4. Therefore, it is expedient to describe only the distinctions of the endoscope 243.
  • This endoscope is embodied without the suction pump.
  • the catcher 237 has the barrier portion 238 of curvilinear form smoothly deflecting the gas jet 231 inward the return channel 236 with minimal losses of the dynamic thrust of the gas jet 231.
  • the gas jet 231 induces gas backward movement in the return channel 236 thereby providing the removal of cleaning gas from body cavity.
  • the electronic digital manometer 247 is used for the indication of body cavity pressure.
  • the barrier portion 238 has a distal baffle 250 additionally preventing some part of the gas jet 231 from going out into patient's cavity.
  • a special feature of the endoscope 343 is that its elongated housing 344 is used also as the return channel 336 providing substantial design simplification and decreasing its manufacturing cost.
  • the gas jet 331 collides with a barrier portion 338 at acute angle and is deflected inward the return channel 336 inducing a backward gas movement in the return channel.
  • the merits of the return channel 336 are its relatively large dimensions and, as a consequence, low resistance to gas removal from body cavity as well as little restrictions of the vision field ⁇ of the optical surface 324.
  • the return channel 336 with its catcher 337 is able to provide the gas consumption through the return channel 336 substantially equal to one through the nozzle 330.
  • the special features of the endoscope 443 are the catcher 437 of special form, enhanced suction pump 453, and complicated pressure control system.
  • the catcher 437 has a curvilinear form in the longitudinal section of the return channel 436 (fig.7) and horse-shaped distal aperture faced to the nozzle 430 by its concave side (fig.10). This increases the completeness of gas jet 431 catching and lowers the resistance to gas jet entering the return channel 436.
  • the suction pump 453 includes a separate ejection gas channel 454 and an ejection pipe in form of a short gas pipe 455 connected with the ejection gas channel 454 and having a narrowed portion 456 with side openings 457.
  • Openings 457 are communicated with the proximal end 458 of the return channel 436.
  • the short gas pipe 455 communicates with the secretion's collector (not shown) by the pipe 459.
  • the suction pump 453 is able to create higher vacuum and to provide increased consumption of gas and patient's secretions through the return channel 436. It can operate not only as the noted safety means, but as an effective means for the removal of abundant secretions from patient's cavity as well.
  • the pump 453 is characterized by simple, inexpensive design and small overall dimensions enabling its location inside of the endoscope handle 445.
  • the pump 453 is fed from the same pressure gas source that is used for gas supply to the nozzle 430.
  • the pressure control system of the endoscope 443 includes the members of the cleaning means (the pressurized gas supply channel 427, the nozzle 430), the safety means (the return channel 436, the suction pump 453), and the control means.
  • the latter includes the manually controlled first control valve 442 for the control of gas consumption through the return channel 436 and the second control valve 451 presenting a valve of automatic pressure regulator 460 equipped with the means for manual setting the maintained pressure (standard widely spread pressure regulator).
  • the endoscope 443 has the knob 452 of the valve 429 and the knob 453 of the valve 457 (fig.8, 9), which are conveniently located at the right side of the handle 445.
  • the control valve 442 has three following operation positions while the valve 429 is open (fig.8): the first position I, wherein gas consumption through the nozzle 430 is more than one through the return channel 436; the second position ⁇ , wherein gas consumption through the nozzle 430 is equal to one through the return channel 436; the third position m, wherein gas consumption through the nozzle 430 less than one through the return channel 436.
  • the first position enables to maintain required positive pressure in patient's cavity.
  • the second position is neutral and does not exert some action on the pressure in patient's cavity.
  • the third position can create the vacuum in patient's cavity and may be used for the removal of abundant secretions from patient's cavity.
  • the endoscope 443 provides complete visualization of patient internal organs.
  • the second control valve 451 additionally enhances the possibility of endoscope control.
  • Fig.11 - 14 show a vacuum curettage device 543 with a visualization means, comprising a tubular curettage cannula 544 with a distal window 571 connected with a curettage housing 545 and a curettage suction pump 553 for applying vacuum to the cannula 544.
  • the suction pump 553 is communicated with the cannula 544 via a suction pipe 561, a filter 562, a reservoir 568, and proximal end 567 of the cannula 544.
  • the detachable reservoir 568 is designed for the collection of curettage products (blood, body particles), connected with the curettage housing 545 by latches 563, 564 and with the cannula proximal end 567 and the suction pipe 561 by means of sealing O-rings 565, 566.
  • the filter 562 is permeable for gas and impermeable for curettage products to prevent the suction pump from dirtying with them.
  • the reservoir 568 is separated from the curettage housing 545 and connected with the pipes 561 and 567 by hoses (not shown).
  • the device 543 also comprises: an optic channel 523 with a distal optic surface 524, an eyepiece 525, and a connector 526 for the connection with a display (not shown); and a pressurized gas supply channel 527 having an inlet port 528 connected with a pressure gas source (not shown), a common valve 529 of type ON/OFF, the first control valve 560 and a nozzle 530.
  • the optic channel 523 and the pressurized gas supply channel 527 pass within the cannula 544 and, in version embodiment (fig.13, 14), are enclosed in a sheath 569.
  • the presence of the sheath 569 allows the use of the members 523 and 527 along with the curettage housing 545 as a reusable device parts while the cannula 544 and the reservoir 568 are disposable details.
  • the optic surface 524 is disposed within the cannula 544 at its distal end and faces to the cannula distal window 571 so that the optic surface 524 vision field passes through the window 571.
  • the nozzle 530 is disposed within the cannula 544 and directed towards the optic surface 524 so that the gas jet 531 going out of the nozzle 530 touches the optic surface 524 providing its cleaning.
  • the pressure value of gas supplied to the nozzle 530 is sufficient to clean completely the optic surface from any curettage products in spite of their abundance. As a result, the device provides complete visualization of uterus internal wall during the curettage procedure.
  • the device has a safety means preventing patient internal organs from barotrauma by gas going out of the nozzle 530.
  • the curettage cannula 544 is used as a return channel of the safety means for the backward movement of cleaning gas.
  • the curettage suction pump 553 is used also as a safety suction pump removing the cleaning gas via the return channel.
  • the distal end of the cannula 544 has a barrier wall portion 538, which serves as a barrier disposed in the path of the gas jet 530 at acute angle to gas jet direction deflecting the gas jet 530 inward the cannula 544.
  • the safety means entirely prevents patient internal organs from barotrauma.
  • the suction pump 553 of ejection type is described above for the endoscope 443. It is simple, compact, fed from the pressure gas source of the nozzle 530, and disposed inside of the curettage housing 545. In version embodiment (not shown), the suction pump of any type is disposed beyond the curettage device and connected with it by hoses. This design is some more expensive, but can be expedient for the replacement of existent vacuum curettage devices with using existent suction pump.
  • the device 543 has a pressure control means for the control of the pressure inward the cannula 544.
  • This means includes a common valve 529 of ON/OFF type with a knob 571, the first control valve 560 installed in the pressurized gas supply channel 527 and equipped with a knob 569, and the second control valve 570 with a knob 572 installed in the path of gas moving through the cannula 544, and the suction pump 553,
  • the device 543 is inoperative, when the valve 529 is in position OFF.
  • the valves 529 and 570 are open.
  • the valve 560 also can be open, if the user needs the visualization during the curettage procedure.
  • valves 529 and 560 are open and the valve 570 is open partly so that gas pressure in uterus is some more than atmosphere pressure. As a result, small excessive pressure some expandes uterus improving the visualization of its internal wall.
  • the valves 529, 560, and 570 allow also the other position combinations, which are desirable for user.
  • valve 570 is disposed in the cannula proximal end 567 preventing the reservoir 568 from the noted small excessive pressure.
  • the cannula 544 is equipped with the safety release valve, whose design, designation, and operation are identical with the valves 146, 246 in the endoscopes 143, 243 (fig.4, 5).

Abstract

The invention relates to medical instruments for the operation in patient's body cavity with the visualization of internal organs. The instrument (20) has an original cleaning system, which includes a gas nozzle (30) supplying a gas jet (31) onto the optical surface (24) under high pressure. This pressure is sufficient to enable the gas jet (31) to be a single cleaning means for cleaning the optical surface (24) in all clinical instances. A safety means prevents the patient's internal organs from barotrauma by the gas jet und includes a gas jet catcher (37) and a suction pump (40) of ejection type. The latter is arranged in the instrument's handle (22) and can be used also for the removal of abundant secretions or body's small particles from the patient's cavity. The gas jet (31) and the suction pump (40) along with a control means (42) form the system for pressure control within the patient's cavity.

Description

ENDOSCOPE WITH CLEANING OPTICS
Background of the Prior Art
Field of the Invention
This invention relates generally to medical instruments for the operation in patient's body cavity requiring the visualization of internal organs. More particularly, it relates to intubating laryngoscopes, bronchoseopes, endoscopes of various applications, vacuum curettage devices, and the like.
Brief Description of the Prior Art
All the endoscope systems applied for the visualization of patient's internal organs comprise at least one endoscope distal optical member disposed at the endoscope distal end. The dirtying of the distal optical member surface with patient's secretions such as blood, mucus, vomit, fat creates significant difficulties for the internal organs visualization. These problems arise in the cases of bleeding an esophageal and gastrointestinal lesions, bleeding or copious secretions in airways, colonoscopy for poorly prepared patient, hysteroscopy during and after curettage and the like. Another problem obstructing the visualization is fogging the distal optical surface due to the temperature difference between the optical surface and patient's cavity. Therefore, cleaning the distal optical surface from patient's secretions and fog presents one of the most important problems of current endoscope developments.
U.S. Patent 4509507, 4548197, 4667655 disclose endoscope devices comprising an air supply pipe and a water supply pipe disposed within an endoscope housing and connected with a distal nozzle through which air and water are alternately supplied in front of a distal optical surface (viewing window). There is also a complex system for supply and control air and water disposed beyond the endoscope device and including a pump means, a control means, a water reservoir, and communications. The disadvantage of these endoscopes is low effectiveness of optical surface cleaning from very adhesive substances such as blood, mucus, fat due to low air pressure and the direction of air / water flow, which is not collides with the optical surface and, therefore, cannot sweep off the dirt. The supply of air/water flow of sufficient pressure is impossible, since this leads to barotrauma of patient internal organs by air/water jet. Moreover, the internal organ barotrauma also can be caused by internal pressure during the operation in closed body cavity. The devices have not any means for the removal of excessive air/ water from body cavity or for the dissipation of air/water jet. Another disadvantage is excessive complexity and manufacturing cost of the endoscope system due to the dual (air and water) cleaning system and cumbersome supply and control system disposed beyond the endoscope device. Another disadvantage is the arrangement of air/water nozzle in front of the optical surface (see Patents 4509507, 4667655) restricting the vision field of the optical surface.
U.S. Patent 3903877 discloses an endoscope comprising air and water pipes for alternate supply air and water to the distal optical surface through a nozzle. There are also the pump and control means providing the alternate supply of air and water to the nozzle and disposed beyond the endoscope device. Moreover, there is a suction port at the endoscope distal end and a suction pump disposed beyond the endoscope. The endoscope distal end is provided with a rubber barrier ring around the nozzle, distal optical surface and suction port. The disadvantage of this patent is very cumbersome and expensive design due to dual cleaning system including the numerous equipment disposed outside the endoscope device. The presence of the suction means and circular rubber barrier lowers the danger of internal organ barotrauma. However, upon sufficient air/water high pressure, these suction port and the barrier do not create a catcher able completely to catch air/water jet and to exclude its deflection towards patient internal organs and barotrauma them. Consequently, the possibility of optical surface effective cleaning is restricted. Moreover, during water supply, the suction means cannot remove only water from body cavity. Inevitably, it sucks in also air creating undesirable (and dangerous) vacuum in body cavity. Another disadvantage is relatively great duration of the cleaning process consisting of washing the distal surface and successive drying it by air.
U.S. Patent 3980078 discloses an endoscope having a nozzle supplying air and water to the distal optical surface, a suction pipe with a distal suction port, a distal circular hood, supply and suction pump means and control means disposed beyond the device. As distinct from U.S. Patent 3903877, air and water are transferred to the nozzle with only one pipe. This somewhat simplifies the tubing, but complicates the supply control system. Moreover, there is a circular gap between the distal circular hood and endoscope distal end. This gap is communicated with the suction port to improve water removal from body cavity. On the other hand, the gap decreases the vacuum in the path of airflow going out of the nozzle and thereby lowers the possibility of its catch and removal. Generally, Patents 3903877 and 3980078 have the same disadvantages above noted for Patent 3903877.
Thus, the common disadvantages of the endoscope systems with cleaning optics are: their excessive complexity caused by dual (gas and liquid) cleaning system and cumbersome and expensive pump and control means disposed outside the endoscope device; low cleaning effectiveness due to low pressure of cleaning fluid (gas and liquid); the absence of effective means for catching and removing the cleaning flow; the absence of reliable control means allowing to adjust the pressure in body cavity required for surgical operations.
U.S. Patent 4497550 discloses "Device for preventing the observing objective lens window of an endoscope from collecting moisture" by directing a small flow of air over the front surface of the observing objective lens window to form a layer of air which has the same temperature as the ambient atmosphere". The device comprises only one supplying gas channel and one nozzle and prevents the distal optical surface from fog arising. However, the device cannot provide cleaning the optical surface from patient's secretion due to low air pressure. The device does not comprise any means preventing patient internal organs from barotrauma. Therefore, its air pressure cannot be increased up to the value sufficient for effective cleaning the optic surface.
The attempts of cleaning the distal optic surface in laryngoscopes are disclosed by U.S. Patents 5431152 and 5183031. In both cases, there is an oxygen channel supplying oxygen to the zone of the distal optic surface. However, this oxygen supply cannot effectively clean the optic surface due to the low oxygen pressure and the absence of special oxygen flow directing towards the optic surface. It is impossible to apply sufficient oxygen pressure here because the oxygen flow is directed distally and can cause the barotrauma of patient internal organs. The main object of such oxygen supply is the partial oxygenation of the patient.
It should be noted, that the laryngoscopes with high pressure oxygen (~ 50 psig) are applied in medical practice for high pressure jet ventilation (see U.S. Patents 5193533 and 6106458). However, the application of oxygen high pressure for cleaning the optical surface is not disclosed in the prior art.
U.S. Patent 4971034 discloses "Body Cavity Pressure Adjusting Device" comprising a suction mechanism, gas sending mechanism, pressure and vacuum pipes, and pressure control system. The device is adapted to the use with an endoscope and designed for the adjustment of required pressure in body cavity. Main disadvantage of the device is that its application with the endoscope presents very cumbersome, expensive, and inconvenient combination including device suction and pressurized gas supply means, device pressure control system, device vacuum and pressure pipes as well as endoscope cleaning system with identical equipment.
The vacuum curettage devices are disclosed by U.S. Patents 3863624, 3889682, 4063556, 4178932, 4870975. They include: a cannula (or curette) communicated with a vacuum pump, which is disposed beyond the curettage device; a valve for selective applying the vacuum to the cannula; a reservoir for the collection of blood, body solid particles and the like; a filter partition separated the reservoir from the vacuum pump. The disadvantage of known curettage devices is the absence of a visualization means eliminating the possibility of operative estimate of curettage results. Practically, the curettage procedure is performed blindly. This worsens the quality of the procedure, leads to patient traumatization and successive complications, and extends the operation duration. The application of the visualization means immediately in the curettage device is hampered due to very significant dirtying the optical surface by curettage products. Another disadvantage of the curettage devices is the arrangement of the vacuum pump beyond the curettage device. This increases the number of communication, heightens the manufacturing cost of the curettage system, and is inconvenient in the operation.
Summary of the Invention
The object of the present invention is to provide an endoscope with the complete visualization of patient's internal organs even in the most awkward cases.
Another object of the present invention is to provide the cleaning the endoscope distal optic surface only by means of gas jet.
Another object of the present invention is to entirely prevent patient's internal organs from barotrauma.
Another object of the present invention is to simplify the endoscope design and to lower its manufacturing cost.
Another object of the present invention is to reduce the general duration of endoscopy procedure. Another object of the present invention is to improve the convenience of user operation.
Another object of the present invention is to broaden the endoscope functional properties, specifically, to provide its possibility to serve as a means for body cavity pressure adjusting.
Another object of the present invention is to broaden the endoscope applicability including the possibility of its application in laryngoscopes, bronchoscopes, vacuum curettage devices and the like.
The above noted objects are accomplished by endoscope system, comprising: an elongated endoscope housing, an optical channel with distal optical surface, a cleaning system for cleaning the optic surface comprising a pressurized gas supply channel connected with a pressure gas source and having an outlet nozzle at housing distal end. The outlet nozzle is directed towards the optic surface so that a gas jet going out of the nozzle touches the optic surface providing its cleanness. The pressure value of gas supplied to the outlet nozzle is sufficient to enable the gas jet to clean completely the optic surface from any patient's secretions and to be a single means for cleaning the optic surface. All the components of the cleaning system are disposed inside of the endoscope device, with the exception of the pressure gas source disposed beyond the endoscope. There is also a safety means preventing the patient internal organs from barotrauma by the gas jet.
Using the gas jet as a single means for cleaning the optic surface significantly simplifies the endoscope design and lowers its manufacturing cost. The location of the all components of cleaning means inside the endoscope device also lowers the endoscope manufacturing cost and, moreover, improves the convenience of device control by user. Sufficiently high gas pressure supplied to the outlet nozzle as well as gas jet direction towards the optic surface provide complete cleaning the optical surface from any patient's secretion and a fog. Therewith, the gas jet of high pressure is not dangerous for patient internal organs due to the noted safety means. Complete uninterrupted visualization obtained with the noted cleaning means enables reducing the endoscopy procedure and heightening its quality.
The safety means presents the combination of gas pressure value, the nozzle dimensions, the distance between the optic surface and nozzle, the angle between gas jet direction and optic surface, enabling safe dissipation of the gas jet after its passage of the optical surface. Moreover, additional gas jet dissipation and its deflecting proximally are provided with a barrier disposed in the path of gas jet movement. This safety means prevents patient internal organs from injury by gas jet, is characterized with simple design and low manufacturing cost, and can be applied for the operation in open body cavity, for instance in laryngoscopes.
As applied to closed body cavity, the safety means includes a return channel designed for backward movement of cleaning gas, communicated with atmosphere by its proximal end, and having a catcher at its distal end. The catcher is designed for substantially entire catching the gas jet after its passage of said optic surface and for deflecting all the gas jet inward the return channel. The return channel prevents the patient internal organs from barotrauma caused both with the gas jet and with excessive gas pressure in body cavity.
In version embodiment, the safety means comprises a suction pump of ejection type communicated with the return channel, disposed inside of endoscope device, and fed from the pressure gas source of the nozzle. The noted type, disposition, and gas source of the suction pump provide the design simplicity and low manufacturing cost of endoscope system. The suction pump improves the prevention of patient internal organs from barotrauma. Moreover, the suction pump in the combination with the pressurized gas supply channel and the control valve for the control of gas consumption through the return channel allows the adjustment of the pressure in patient body cavity.
As applied to vacuum curettage device, the optic channel with the distal optic surface and pressurized gas supply channel with the outlet nozzle are disposed inside the tubular curettage cannula, which serves as the return channel for endoscope cleaning system. Endoscope safety means and vacuum curettage device have one common suction pump of ejection type disposed in the curettage housing and fed from the pressure gas source of the endoscope cleaning system. The device is equipped with the pressure control means for the adjustment of required pressure in the curettage cannula. The device provides good visualization of uterus internal wall even during curettage procedure, is entirely safe and characterized with compact, convenient, simple, and inexpensive design. This curettage device enables to reduce curettage procedure duration, to decrease the uterus traumatization, and to improve the curettage quality.
Brief Description of the Drawing
FIG.l shows the conceptual sketch of an intubating laryngoscope with the means for the dissipation and deflection of gas jet. FIG.2 shows the cross section of the laryngoscope shown in FIG.l.
FIG.3 shows the conceptual sketch of an intubating laryngoscope with a return channel. FIG. 4 shows the conceptual sketch of the endoscope with separate return channel and simplified suction pump. FIG.5 shows the conceptual sketch of the endoscope with separate return channel without suction pump. FIG.6 shows the conceptual sketch of the endoscope with the housing serving as a return channel. FIG.7 shows the conceptual sketch of the endoscope with separate return channel, enhanced suction pump and the means for the adjustment of body cavity pressure. FIG.8 shows the side elevation of the handle of the endoscope shown in FIG.7. FIG.9 shows the back view of the endoscope shown in FIG.7. FIG.10 shows the partial front view of the distal end of the endoscope shown in FIG.7 FIG.11 shows the conceptual sketch of the vacuum curettage device with a visualization means. FIG.12 shows exterior side view of the vacuum curettage device with an endoscope. FIG.13 shows the cross section of vacuum curettage device cannula. FIG.14 shows the underside view of the curettage device distal end.
Detailed Description of the Invention
An explanation of the present invention is offered with reference made to the attached drawings in fig.1 to 14.
Fig.l shows a laryngoscope 20 with a blade 21, a handle 22, an optic channel 23 with a distal optic surface 24, an eyepiece 25 and a connector 26 for computer display connection. There is also a pressurized gas supply channel 27 extending along the blade 21 and having an inlet port 28 connected with a pressure gas source (not shown), a valve 29 of type ON/OF, and an outlet nozzle 30 at its distal end. The nozzle 30 is directed towards the optic surface 24 so that a gas jet 31 going out of the nozzle 30 touches the optic surface 24 sweeping off the dirt from it. The pressure value of gas supplied to the nozzle 30 is sufficient to enable the gas jet 31 to completely clean the optic surface 24 from any patient's secretions and to be a single means for cleaning the optic surface 24. This pressure value provides complete cleanness of the optic surface 24 however a safety means is necessary to prevent patient internal organs from barotrauma by the gas jet 31. This safety means presents the combination of the endoscope parameters enabling safe deflection and dissipation of the gas jet 31 after its passage of the optic surface 24. The noted endoscope parameters include the gas pressure value P, the nozzle 30 diameter D, the distance L between the optic surface 24 and the nozzle 30, the angle α between the optic surface 24 and gas jet 31 direction, and the angle β between the gas jet direction and the distal extension of the axis of the optic channel 23 distal portion. In version embodiment, the noted parameters have following values: P = 40-60 psig, D = 0.8-1 mm, L = 2-12 mm, α = 5-30°, β < 70°. The angle β provides the gas jet direction proximally away of patient internal organs located in front of the optic surface 24. The other parameters provide the dissipation of the gas jet 31. Additional dissipation and proximal deflection of gas jet 31 is accomplished by a barrier 32 disposed in the path of gas jet movement after its passage of the optic surface 24 (fig.l, 2). The barrier 32 is equipped also with lateral deflectors 33, 34 restricting the gas jet movement in the side directions. Thus, described safety means prevent the internal organs from barotrauma by the gas jet 30. However, they can be applied only in open patient's cavity, for instance in open mouth cavity, allowing free gas exit and thereby excluding the barotrauma of internal organs by excessive pressure in body cavity. Laryngoscope 20 provides complete cleaning the optic surface 24 thereby reducing the intubation procedure and patient's organ trauma. Moreover, it is characterized by simple, reliable, and inexpensive design due to using only gas for cleaning the optic surface 24 and the location of all its components inside of the laryngoscope (with the exception of the pressure gas source and computer display).
The versions of the laryngoscope shown in fig.1, 2, 3 have the same designations of identical details. As distinct from fig.l, 2, laryngoscope 35 in fig.3 has a return channel 36 designed for backward movement of cleaning gas proximally from the zone of the optic surface 24. The proximal end of the return channel 36 is communicated with atmosphere through a collector (not shown) of blood, mucus and other patient's secretions. The distal end of the return channel 36 presents a catcher 37 for substantially entire catching the gas jet 31 after its passing the optic surface 24 and deflecting it inward the return channel 36. The catcher 37 includes a barrier portion 38 of the return channel 36 inner wall disposed in the path of the gas jet 31 at acute angle to it, deflecting the gas jet inwards the return channel 36 and thereby inducing gas backward movement in the return channel. In version embodiment, the laryngoscope 35 includes an ejection gas channel 39 in form of a branch of the gas supply channel 27 disposed in the suction pipe 40, which presents a portion of the return channel36. The ejection gas channel 39 has an ejection outlet 41 directed proximally. The noted suction pipe 40 and the ejection outlet 41 form a simplified suction pump of ejection type, which additionally induces backward gas movement in the return channel 36. This suction pump enhances laryngoscope safety means enabling the operation in closed body cavity and the removal abundant patient's secretions, for instance in the case of nasopharyngeal or oral cavity injuries.
In version embodiment, the laryngoscope 35 includes a control means for the control of gas pressure inward the body cavity. This control means presents a control valve in the form of a throttle valve 42 allowing the change of gas consumption through the return channel 36. It can be used, for instance, for some increasing the oxygen pressure in oral cavity for the purpose of patient oxygenation, when oxygen is used as a cleaning gas.
All the components of the laryngoscope 35, with the exception of pressure gas source and secretion's collector, are located inside the laryngoscope. All the advantages, noted for the laryngoscope 20, are inherent also in the laryngoscope 35. Both laryngoscopes can be used with the gas source of standard medical pressure, preferably oxygen piping system or pressure vessel. Therewith, the pressure of gas supplied to the nozzle 30 can be equal to the pressure in standard medical oxygen source, approximately 50 psig.
The endoscopes, shown in fig. 4 to 10, have identical designations of the same details distinguished only by the first numeral.
The endoscope 143 in fig. 4 comprises an elongated housing 144, a handle 145, an optic channel 123 with a distal optic surface 124, an eyepiece 125, and a connector 126 of a computer display (not shown). There is also a cleaning system with a pressurized gas supply channel 127 having an inlet port 128 connected with a pressure gas source (not shown), outlet nozzle 130, and a valve 129 of type ON/OF. The nozzle 130 is directed towards the optic surface 124 so that the gas jet 131 going out of the nozzle 130 touches the optic surface 124 cleaning it from patient's secretions and fog. The pressure of gas supplied to the nozzle 130 is sufficient to entirely clean the optic surface 124 from any patient's secretions and fog and to be a single means for complete cleaning the optic surface 124. As a result, the endoscope 143 provides entire visualization of patient internal organs in all the cases of its application. The endoscope 143 is equipped with a safety means preventing patient internal organs from barotrauma. The safety means include a return channel 136 with a catcher 137 for substantially entire catching the gas jet 131 , a safety release valve 146, and a simplified suction pump of ejection type. This pump comprises an ejection gas channel 139 with an ejection outlet 141 and a suction pipe 140 presenting a portion of the return channel 136. The operation of identical simplified suction pump was described above as applied to the laryngoscope 35 in fig.3. The gas jet 131 enters the catcher 137 at acute angle to a barrier portion 138 of the return channel 136, which deflects the gas jet inward the return channel 136. The ejection suction pump induces a backward movement of cleaning gas with patient's secretion and draws off the gas to atmosphere through the return channel proximal end and a secretion's collector (not shown) disposed beyond the laryngoscope. The safety release valve 146 automatically opens in the case of unforeseen closing the control valve 142, for instance because of its jamming, thereby preventing body cavity from excessive pressure. Thus, the safety means entirely prevents patient internal organs from barotrauma caused by the gas jet 131 and excessive pressure in body cavity. Manually controlled valve 142 allows the adjustment of the required pressure in body cavity. For this purpose, the endoscope also has an indication means including a pressure sensor 148 and indication device 147 for the measurement and indication of the pressure in body cavity. In fig.4, the sensor 148 presents the distal end of the pipe 149 communicated with usual mechanical mano-vacuumeter. The safety release valve 146 can be used for required pressure adjustment in body cavity. For this purpose, it is set for the required pressure. After partial or entire closing the vale 142 and heightening the pressure in body cavity to expected value, the valve 146 opens maintaining automatically the required pressure in body cavity. All the components of the endoscope 143, with the exception of the pressure gas source and secretion's collector, are located inside of the endoscope device providing compact, simple, and inexpensive design. Important merit of the endoscope 143 is the arrangement of the nozzle 130 and the catcher 137 beyond the vision field γ of the optic surface 124.
The endoscope 243 shown in fig.5 comprises many the same details with identical designations as in fig.4. Therefore, it is expedient to describe only the distinctions of the endoscope 243. This endoscope is embodied without the suction pump. The catcher 237 has the barrier portion 238 of curvilinear form smoothly deflecting the gas jet 231 inward the return channel 236 with minimal losses of the dynamic thrust of the gas jet 231. As a result, the gas jet 231 induces gas backward movement in the return channel 236 thereby providing the removal of cleaning gas from body cavity. This allows as well the adjustment of required pressure in body cavity by control valve 242. The electronic digital manometer 247 is used for the indication of body cavity pressure. The barrier portion 238 has a distal baffle 250 additionally preventing some part of the gas jet 231 from going out into patient's cavity.
A special feature of the endoscope 343 (fig.6) is that its elongated housing 344 is used also as the return channel 336 providing substantial design simplification and decreasing its manufacturing cost. The gas jet 331 collides with a barrier portion 338 at acute angle and is deflected inward the return channel 336 inducing a backward gas movement in the return channel. The merits of the return channel 336 are its relatively large dimensions and, as a consequence, low resistance to gas removal from body cavity as well as little restrictions of the vision field γ of the optical surface 324. The return channel 336 with its catcher 337 is able to provide the gas consumption through the return channel 336 substantially equal to one through the nozzle 330.
The special features of the endoscope 443 (fig.7 to 10) are the catcher 437 of special form, enhanced suction pump 453, and complicated pressure control system. The catcher 437 has a curvilinear form in the longitudinal section of the return channel 436 (fig.7) and horse-shaped distal aperture faced to the nozzle 430 by its concave side (fig.10). This increases the completeness of gas jet 431 catching and lowers the resistance to gas jet entering the return channel 436. The suction pump 453 includes a separate ejection gas channel 454 and an ejection pipe in form of a short gas pipe 455 connected with the ejection gas channel 454 and having a narrowed portion 456 with side openings 457. Openings 457 are communicated with the proximal end 458 of the return channel 436. The short gas pipe 455 communicates with the secretion's collector (not shown) by the pipe 459. The suction pump 453 is able to create higher vacuum and to provide increased consumption of gas and patient's secretions through the return channel 436. It can operate not only as the noted safety means, but as an effective means for the removal of abundant secretions from patient's cavity as well. As distinct from the prior art, the pump 453 is characterized by simple, inexpensive design and small overall dimensions enabling its location inside of the endoscope handle 445. The pump 453 is fed from the same pressure gas source that is used for gas supply to the nozzle 430. The pressure control system of the endoscope 443 includes the members of the cleaning means (the pressurized gas supply channel 427, the nozzle 430), the safety means (the return channel 436, the suction pump 453), and the control means. The latter includes the manually controlled first control valve 442 for the control of gas consumption through the return channel 436 and the second control valve 451 presenting a valve of automatic pressure regulator 460 equipped with the means for manual setting the maintained pressure (standard widely spread pressure regulator). There is also the indication means including the pressure sensor 448 and the manometer 447 above described for the endoscopes 143, 243. The endoscope 443 has the knob 452 of the valve 429 and the knob 453 of the valve 457 (fig.8, 9), which are conveniently located at the right side of the handle 445. The control valve 442 has three following operation positions while the valve 429 is open (fig.8): the first position I, wherein gas consumption through the nozzle 430 is more than one through the return channel 436; the second position π, wherein gas consumption through the nozzle 430 is equal to one through the return channel 436; the third position m, wherein gas consumption through the nozzle 430 less than one through the return channel 436. The first position enables to maintain required positive pressure in patient's cavity. The second position is neutral and does not exert some action on the pressure in patient's cavity. The third position can create the vacuum in patient's cavity and may be used for the removal of abundant secretions from patient's cavity. In all these positions, the endoscope 443 provides complete visualization of patient internal organs. The second control valve 451 additionally enhances the possibility of endoscope control.
Fig.11 - 14 show a vacuum curettage device 543 with a visualization means, comprising a tubular curettage cannula 544 with a distal window 571 connected with a curettage housing 545 and a curettage suction pump 553 for applying vacuum to the cannula 544. The suction pump 553 is communicated with the cannula 544 via a suction pipe 561, a filter 562, a reservoir 568, and proximal end 567 of the cannula 544. The detachable reservoir 568 is designed for the collection of curettage products (blood, body particles), connected with the curettage housing 545 by latches 563, 564 and with the cannula proximal end 567 and the suction pipe 561 by means of sealing O-rings 565, 566. The filter 562 is permeable for gas and impermeable for curettage products to prevent the suction pump from dirtying with them. In version embodiment, the reservoir 568 is separated from the curettage housing 545 and connected with the pipes 561 and 567 by hoses (not shown). The device 543 also comprises: an optic channel 523 with a distal optic surface 524, an eyepiece 525, and a connector 526 for the connection with a display (not shown); and a pressurized gas supply channel 527 having an inlet port 528 connected with a pressure gas source (not shown), a common valve 529 of type ON/OFF, the first control valve 560 and a nozzle 530. The optic channel 523 and the pressurized gas supply channel 527 pass within the cannula 544 and, in version embodiment (fig.13, 14), are enclosed in a sheath 569. The presence of the sheath 569 allows the use of the members 523 and 527 along with the curettage housing 545 as a reusable device parts while the cannula 544 and the reservoir 568 are disposable details. The optic surface 524 is disposed within the cannula 544 at its distal end and faces to the cannula distal window 571 so that the optic surface 524 vision field passes through the window 571. The nozzle 530 is disposed within the cannula 544 and directed towards the optic surface 524 so that the gas jet 531 going out of the nozzle 530 touches the optic surface 524 providing its cleaning. The pressure value of gas supplied to the nozzle 530 is sufficient to clean completely the optic surface from any curettage products in spite of their abundance. As a result, the device provides complete visualization of uterus internal wall during the curettage procedure.
The device has a safety means preventing patient internal organs from barotrauma by gas going out of the nozzle 530. In the device 543 the curettage cannula 544 is used as a return channel of the safety means for the backward movement of cleaning gas. The curettage suction pump 553 is used also as a safety suction pump removing the cleaning gas via the return channel. The distal end of the cannula 544 has a barrier wall portion 538, which serves as a barrier disposed in the path of the gas jet 530 at acute angle to gas jet direction deflecting the gas jet 530 inward the cannula 544. Thus, the safety means entirely prevents patient internal organs from barotrauma. Note, all the components of the safety means present at the same time the components of the curettage device. As a result, substantial design simplification and lowering the device manufacturing cost are achieved. Moreover, this shows that device 543 is not simple sum of a vacuum curettage device and an endoscope.
The suction pump 553 of ejection type is described above for the endoscope 443. It is simple, compact, fed from the pressure gas source of the nozzle 530, and disposed inside of the curettage housing 545. In version embodiment (not shown), the suction pump of any type is disposed beyond the curettage device and connected with it by hoses. This design is some more expensive, but can be expedient for the replacement of existent vacuum curettage devices with using existent suction pump.
The device 543 has a pressure control means for the control of the pressure inward the cannula 544. This means includes a common valve 529 of ON/OFF type with a knob 571, the first control valve 560 installed in the pressurized gas supply channel 527 and equipped with a knob 569, and the second control valve 570 with a knob 572 installed in the path of gas moving through the cannula 544, and the suction pump 553, The device 543 is inoperative, when the valve 529 is in position OFF. Upon the curettage procedure, the valves 529 and 570 are open. The valve 560 also can be open, if the user needs the visualization during the curettage procedure. In the visualization position between or after curettage operations, the valves 529 and 560 are open and the valve 570 is open partly so that gas pressure in uterus is some more than atmosphere pressure. As a result, small excessive pressure some expandes uterus improving the visualization of its internal wall. The valves 529, 560, and 570 allow also the other position combinations, which are desirable for user.
In version embodiment (not shown), the valve 570 is disposed in the cannula proximal end 567 preventing the reservoir 568 from the noted small excessive pressure. In another version embodiment (not shown), the cannula 544 is equipped with the safety release valve, whose design, designation, and operation are identical with the valves 146, 246 in the endoscopes 143, 243 (fig.4, 5).

Claims

Claims:
1. An endoscope system, comprising:
• an endoscope,
• an elongated endoscope housing having a distal and a proximal ends,
• an endoscope handle affixed at said housing proximal end,
• at least one optical channel designed for the visualization of patient internal organs, extending along said housing from said housing proximal end to said housing distal end, and having a distal optical surface at the distal end of said optical channel,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel which extends along said housing and has an inlet port connected with a pressure gas source as well as at least one outlet nozzle disposed at said housing distal end,
• said nozzle directed towards said optical surface so that a gas jet going out of said nozzle touches said optical surface providing its cleanliness,
• the pressure value of gas supplied to said nozzle is sufficient to enable said gas jet to provide complete cleanness of said optical surface from any patient's secretions and a fog and to be a single means for cleaning said optical surface,
• all the components of said cleaning system are disposed inside of said endoscope, with the exception of said pressure gas source disposed beyond said endoscope,
• a safety means preventing the patient internal organs from barotrauma by said gas going out of said nozzle.
2. The endoscope system of claim 1, wherein all the components of said safety means are disposed inside of said endoscope.
3. The endoscope system of claim 2, wherein said safety means prevents the patient internal organs from injury by said gas jet going out of said nozzle and presents the combination of said endoscope parameters enabling safe dissipation of said gas jet after its passage of said optical surface and including a gas pressure value, the dimensions of said nozzle, the distance between said optical surface and said nozzle, the angle between the direction of said gas jet and said optical surface as well as between said gas jet direction and the longitudinal axis of the distal portion of said optical channel.
4. The endoscope system of claim 3, wherein said endoscope has following parameters: said gas pressure - 40-60 psig, said nozzle diameter - 0.8-1.0 mm, said distance - 2-12 mm, said angle between gas jet direction and optical surface - 5-30°, said angle between the axis of said optical channel distal portion and gas jet direction - less than 70°.
5. The endoscope system of claim 1, wherein the axis of said nozzle is positioned at acute angle to said optical surface, which, for instance, lies in the range of 5-30°.
6. The endoscope system of claim5, wherein said safety means includes a barrier disposed in the path of said gas jet movement after its passage of said optical surface; said barrier has a surface, which additionally dissipates said gas jet and deflects it proximally, and includes also lateral deflectors restricting said gas jet movement in the side directions..
7. The endoscope system of claim 1, wherein said pressure gas source presents the standard medical gas source such as piping system or pressure vessel.
8. The endoscope system of claim 7, wherein said pressure value of gas supplied to said nozzle equals the pressure in said standard medical gas source.
9. The endoscope system of claim 1, wherein said safety means includes a return channel having a distal and a proximal ends and designed for backward movement of cleaning gas proximally from the zone of said optical surface.
10. The endoscope system of claim 9, wherein said return channel proximal end is communicated with atmosphere through a collector of blood, mucus and other patient's secretions.
11. The endoscope system of claim 10, wherein all the components of said safety means are disposed inside of said endoscope, with the exception of said secretion's collector, which is disposed beyond said endoscope.
12. The endoscope system of claim 9, wherein said housing at the same time is said return channel.
13.The endoscope system of claim 9, wherein said return channel presents a separate channel extended along said housing.
14. The endoscope system of claim 9, wherein said return channel distal end is provided with a catcher for substantially entire catching said gas jet after its passage of said optical surface and for entire deflecting it inward said return channel.
15. The endoscope system of claim 14, wherein said catcher includes a barrier portion of the inner wall of said return channel distal end disposed on the way of said gas jet and adapted to the deflection of said gas jet inwards said return channel.
16. The endoscope system of claim 15, wherein said catcher at the same time presents a means inducing said gas backward movement in said return channel.
17. The endoscope system of claims 15, 16, wherein said barrier portion is disposed at acute angle to said gas jet direction.
18. The endoscope system of claims 15, 16, wherein said barrier portion, in longitudinal section of said return channel, has a curvilinear form enabling smooth deflecting said gas jet with minimal losses of its dynamic thrust.
19. The endoscope system of claim 15, 16, wherein said barrier portion has a distal baffle additionally preventing some part of said gas jet from going out into the patient's cavity.
20. The endoscope system of claims 15, 16, wherein said barrier portion presents a portion of said return channel wall extended distally relative to said return channel distal end.
21. The endoscope system of claim 15, 16, wherein said catcher presents a horse-shaped aperture faced to said nozzle by its concave side.
22. The endoscope system of claim 9, wherein said safety means comprises a suction pump of ejection type inducing said backward gas movement in said return channel, communicated with said return channel, disposed inside of said endoscope and including a suction pipe, an ejection gas channel as well as common with said nozzle said pressurized gas source.
23. The endoscope of claim 22, wherein said ejection pipe presents a portion of said return channel with located inwardly an ejection outlet directed in the direction of said backward gas movement and connected with said ejection gas channel.
24. The endoscope system of claim 23, wherein said ejection gas channel presents a side branch of said gas supply channel.
25. The endoscope system of claim 23, wherein said ejection gas channel presents a channel separate from said gas supply channel.
26. The endoscope system of claim 22, wherein said ejection pipe presents a separate short gas pipe with the first and the second ends connected with said ejection gas channel by first its end and having a narrowed portion with a side openings, which are communicated with said return channel proximal end.
27. The endoscope system of claims 11, 26, wherein said ejection pipe second end is communicated with said secretion's collector.
28. The endoscope system of claim 26, wherein said suction pump is located in said handle.
29. The endoscope system of claim 22, wherein there is the equality of gas consumption through said nozzle and said return channel.
30. The endoscope system of claim 9, wherein there is a pressure control system for the control of pressure inward the patient's cavity, comprising said cleaning means, said safety means, and a control means.
31. The endoscope system of claim 30, wherein said pressure control system is entirely disposed inside of said endoscope.
32. The endoscope system of claim30, wherein said control means includes a control valve for the control of gas consumption through said return channel.
33. The endoscope system of claim 32, wherein said control valve has at least three following positions: the first position, wherein gas consumption through said nozzle is more than one through said return channel; the second position, wherein gas consumption through said nozzle is equal to one through said return channel; the third position, wherein gas consumption through said nozzle is less than one through said return channel.
34. The endoscope system of claim 33, wherein said control valve is installed in said return channel.
35. The endoscope system of claim 34, wherein said control valve presents a throttle valve provided with a manual drive.
36. The endoscope system of claims 22, 33, wherein said control valve is installed in said ejection gas channel.
37. The endosccope system of claim 36, wherein said control valve presents a valve of automatic pressure regulator provided with the means for manual setting the maintained pressure.
38. The endoscope system of claim 30, wherein there is an indication means for the measurement and indication of the pressure in the patient's cavity.
39. The endoscope system of claim 38, wherein said indication means includes a pressure sensor disposed at said housing distal end and an indicating device disposed preferably at said handle.
40. The endoscope system of claim 1, wherein there is a safety release valve preventing the patient's cavity from excessive pressure. is
41. The endoscope system of claim 1, wherein said nozzle and the members of said safety means are disposed beyond the field of vision of said optical surface.
42. An endoscope, comprising:
• an elongated endoscope housing having a distal and a proximal ends,
• an endoscope handle affixed at said housing proximal end,
• at least one optical channel designed for the visualization of patient internal organs, extending along said housing from said housing proximal end to said housing distal end, and having a distal optical surface at the distal end of said optical channel,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel, which extends along said housing and has an inlet port connected with a pressure gas source as well as at least one outlet nozzle disposed at said housing distal end,
• said nozzle directed towards said optical surface so that a gas jet going out of said nozzle touches said optical surface providing its cleanliness,
• the pressure value of gas supplied to said nozzle is sufficient to enable said gas jet to provide complete cleaning said optical surface from any patient's secretions and to be a single means for cleaning said optical surface,
• all the components of said cleaning system are disposed inside of said endoscope, with the exception of said pressure gas source disposed beyond said endoscope,
• a safety means preventing the patient internal organs from barotrauma by gas going out of said nozzle and comprising a gas return channel for the backward movement of cleaning gas proximally from said distal housing end as well as a suction pump of ejection type inducing said backward gas movement; said suction pump is disposed inside of said endoscope and fed from said pressurized gas source.
43. The endoscope of claim 42, wherein said suction pump is communicated with a collector of patient's secretions disposed beyond said endoscope.
44. The endoscope of claim 42, wherein the axis of said nozzle is positioned at acute angle to said optical surface lied in the range of 5-30°.
45. The endoscope of claim 42, wherein the distal end of said return channel is provided with a catcher for substantially entire catching said gas jet after its passage through said optical surface and for entire deflecting it inward said return channel.
46. The endoscope of claim 45, wherein said catcher presents a barrier portion of the inner wall of said return channel distal end disposed in the path said gas jet at acute angle to said gas jet direction.
47. The endoscope of claim 42, wherein said suction pump includes a suction pipe and an ejection gas channel.
48. The endoscope of claim 47, wherein said ejection pipe presents a portion of said return channel with located inwardly an ejection outlet of said ejection gas channel directed in the direction of said backward gas movement.
49.The endoscope system of claim 47, wherein said ejection pipe presents a separate short gas pipe connected with said ejection gas channel by one of its end and having a narrowed portion with a side openings, which is communicated with said return channel proximal end.
50.The endoscope of claim 42, wherein there is a pressure control system for the control of pressure inward the patient's cavity, comprising said cleaning means, said safety means, and a control means.
51. The endoscope of claim 50, wherein said pressure control system is entirely disposed inside of said endoscope.
52.The endoscope of claim50, wherein said control means includes a control valve designed for the control of gas pressure in the patient's cavity and having at least three following positions: the first position, wherein gas consumption through said nozzle is more than one through said return channel; the second position, wherein gas consumption through said nozzle is equal to one through said return channel; the third position, wherein gas consumption through said nozzle is less than one through said return channel.
53. The endoscope of claim 50, wherein there is an indication means for the measurement and indication of the pressure in the patient's cavity.
54. The endoscope of claim 53, wherein said indication means includes a pressure sensor disposed at said housing distal end and an indicating device disposed preferably at said handle.
55. The endoscope of claim 42, wherein there is a safety release valve preventing the patient's cavity from excessive pressure.
56. An endoscope, comprising:
• an elongated endoscope housing having a distal and a proximal ends,
• an endoscope handle affixed at said housing proximal end, • at least one optical channel designed for the visualization of patient internal organs, extending along said housing from said housing proximal end to said housing distal end, and having a distal optical surface at the distal end of said optical channel,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel which extends along said housing and has an inlet port connected with a pressure gas source as well as at least one outlet nozzle disposed at said housing distal end,
• said nozzle directed towards said optical surface so that a gas jet going out of said nozzle touches said optical surface providing its cleanness,
• the pressure value of gas supplied to said nozzle is sufficient to enable said gas jet to provide complete cleaning said optical surface from any patient's secretion and to be a single means for cleaning said optical surface,
• all the components of said cleaning system are disposed inside of said endoscope, with the exception of said pressure gas source disposed beyond said endoscope,
• a safety means preventing the patient internal organs from barotrauma by gas going out of said nozzle and comprising a return gas channel for the backward movement of cleaning gas proximally from said distal housing end as well as a suction pump of ejection type inducing said backward gas movement, fed from common with said nozzle said pressurized gas source and disposed inside of said endoscope,
• a pressure control system designed for the control of the pressure inward the patient's cavity and including said cleaning means, said safety means and a control means so that said cleaning means simultaneously serves both for cleaning said optical surface and as a component of said pressure control system supplying gas into the patient's cavity, and said safety means simultaneously serves both for preventing patient from barotrauma and as a component of said pressure control system removing gas from the patient's cavity.
57. The endoscope of claim 56, wherein said suction pump is communicated with a collector of patient's secretions disposed beyond said endoscope.
58. The endoscope of claim 56, wherein the axis of said nozzle is positioned at acute angle to said optical surface lied in the range of 5-30°.
59. The endoscope of claim 56, wherein said return channel distal end is provided with a catcher for catching said gas jet after its passage through said optical surface and for deflecting it inward said return channel.
60. The endoscope of claim 59, wherein said catcher presents a barrier portion of the inner wall of said return channel distal end disposed in the path of said gas jet at acute angle to said gas jet direction.
61. The endoscope of claim 56, wherein said suction pump includes a suction pipe and an ejection gas channel.
62. The endoscope of claim 56, wherein said pressure control system is entirely disposed inside of said endoscope.
63.The endoscope of claimβl, wherein said control means includes a control valve designed for the control of gas pressure in the patient's cavity and having at least three following positions: the first position, wherein gas consumption through said nozzle is more than one through said return channel; the second position, wherein gas consumption through said nozzle is equal to one through said return channel; the third position, wherein gas consumption through said nozzle is less than one through said return channel..
64. The endoscope of claim 63, wherein said control valve is installed in said return channel and presents a throttle valve provided with a manual drive.
65. The endoscope of claims 63, wherein said control valve is installed in said ejection gas channel and presents a valve of automatic pressure regulator provided with the means for manual setting the maintained pressure.
66. The endoscope of claim 63, wherein said control valve is installed in said gas supply channel.
67. The endoscope of claim 56, wherein there is an indication means for the measurement and indication of the pressure in the patient's cavity.
68. The endoscope of claim 67, wherein said indication means includes a pressure sensor disposed at said housing distal end and an indicating device disposed preferably at said handle.
69. The endoscope of claim 56, wherein there is a safety release valve preventing the patient's cavity from excessive pressure.
70. An endoscope system, comprising:
• an endoscope with an elongated endoscope housing having a distal and a proximal ends as well as an endoscope handle affixed at said housing proximal end, • at least one optical channel designed for the visualization of patient internal organs, extending within said housing from said housing proximal end to said housing distal end, and having a distal optical surface at the distal end of said optical channel,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel which extends along said housing and has an inlet port connected with a pressure gas source as well as at least one outlet nozzle disposed at said housing distal end,
• said nozzle directed towards said optical surface to clean it,
• a return gas channel for the backward movement of gas proximally from said distal housing end,
• a suction pump inducing said backward gas movement,
• a pressure control system designed for the control of the pressure inward the patient's cavity and including said pressurized gas supply channel, said nozzle, said pressure gas source, said return channel, said suction pump and a control means.
71. The endoscope system of claim 70, wherein the pressure value of gas supplied to said nozzle is sufficient to enable the gas jet going out of said nozzle to provide complete cleaning said optical surface from any patient's secretion and to be a single means for cleaning said optical surface.
72. The endoscope system of claim 70, wherein all the components of said cleaning system are disposed inside of said endoscope, with the exception of said pressure gas source disposed beyond said endoscope.
73. The endoscope system of claim 71, wherein there is a safety means preventing the patient's internal organs from barotrauma by gas going out of said nozzle and comprising said return gas channel and said suction pump.
74. The endoscope system of claim 73, wherein said suction pump is of ejection type, fed from common with said nozzle said pressurized gas source and disposed inside of said endoscope.
75. The endoscope system of claim 73, wherein said return channel distal end is provided with a catcher for catching said gas jet after its passage of said optical surface and for deflecting it inward said return channel.
76. The endoscope system of claim 70, wherein said control means includes a control valve designed for the control of gas pressure in the patient's cavity and having at least two following positions: the first position, wherein gas consumption through said nozzle is more than one through said return channel; the second position, wherein gas consumption through said nozzle is equal to one through said return channel.
77. The endoscope system of claim 76, wherein said control valve is installed in said return channel and presents a throttle valve provided with a manual drive.
78. The endoscope system of claim 70, wherein there is an indication means for the measurement and indication of the pressure in the patient's cavity.
79. An endoscope, comprising:
• an elongated endoscope housing having a distal and a proximal ends,
• an endoscope handle affixed at said housing proximal end,
• at least one optical channel designed for the visualization of patient internal organs, extending along said housing from said housing proximal end to said housing distal end, and having a distal optical surface at the distal end of said optical channel,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel which extends along said housing and has an inlet port connected with a pressure gas source as well as at least one outlet nozzle disposed at said housing distal end,
• said nozzle directed towards said optimal surface so that a gas jet going out of said nozzle touches said optical surface providing its cleanness,
• the pressure value of gas supplied to said nozzle is sufficient to enable said gas jet to provide complete cleaning said optical surface from any patient's secretion and to be a single means for cleaning said optical surface,
• all the components of said cleamng system are disposed inside of said endoscope, with the exception of said pressure gas source disposed beyond said endoscope,
• a safety means preventing the patient internal organs from barotrauma by said gas going out of said nozzle and including a gas return channel for backward movement of cleaning gas proximally from said distal housing end; said return gas channel extending along said housing and having a receiving opening at its distal end, which is disposed in the path of said gas jet after its passage through said optical surface so that an inner portion of said return channel collides with said gas jet at acute angle deflecting it inward said return channel and thereby inducing said backward movement of cleaning gas inside said return channel.
80. The endoscope of claim 79, wherein a proximal end of said return channel is communicated with atmosphere via a collector of patient's secretions disposed beyond said endoscope.
81. The endoscope of claim 80, wherein all the components of said safety means, with the exception of said secretion's collector, are disposed inside of said endoscope.
82. The endoscope of claim 79, wherein the axis of said nozzle is positioned at acute angle to said optical surface lied in the range of 5-30°.
83. The endoscope of claim 79, wherein said housing at the same time is said return channel.
84. The endoscope of claim 79, wherein said return channel presents a separate channel extended along said housing.
85. The endoscope of claim79, wherein said inner portion of return channel presents a distal end portion of said return channel inner wall faced to said nozzle.
86. The endoscope of claim 85, wherein an angle between the direction of said gas jet and the distal extension of said return channel axis is, preferably less than 45°.
87. The endoscope of claim 85, wherein said return channel inner portion, in longitudinal section of said return channel, has curvilinear form, for instance circular form, enabling smooth deflecting said gas jet with minimal losses of dynamic thrust.
88. The endoscope of claim 85, wherein said return channel inner portion, in transverse section, has a horseshoe-shaped form faced to said nozzle by its concave side.
89. The endoscope of claim 79, wherein there is the equality of gas consumption through said nozzle and said return channel.
90. The endoscope of claim 79, wherein there is a pressure control system for the control of pressure inward the patient' cavity, comprising said cleaning means, said safety means, and a control means.
91. The endoscope of claim 90, wherein said pressure control system is entirely disposed inside of said endoscope.
92. The endoscope of claim90, wherein said control means includes a control valve designed for the control of gas consumption through said return channel and having at least two following positions: the first position, wherein gas consumption through said nozzle is more than one through said return channel; the second position, wherein gas consumption through said nozzle is equal to one through said return channel.
93. The endoscope of claim 92, wherein said control valve is installed in said return channel.
94. The endoscope of claim 93, wherein said control valve presents a throttle valve provided with a manual drive.
95. The endoscope of claim 90, wherein there is an indication means for the measurement and indication of the pressure in the patient's cavity.
96. The endoscope of claim 95, wherein said indication means includes a pressure sensor disposed at said housing distal end and an indicating device disposed preferably at said handle.
97. The endoscope of claim 79, wherein there is a safety release valve preventing the patient's cavity from excessive pressure.
98. A vacuum curettage device with a visualization means, comprising:
• a tubular curettage cannula with a distal open window and a proximal end connected with a curettage housing,
• a curettage suction pump for applying vacuum to said cannula,
• at least one optical channel designed for the visualization of uterus internal surfaces, extending along said curettage device, and having a distal optical surface disposed at the distal end of said cannula,
• a cleaning system designed for cleaning said optical surface and comprising a pressurized gas supply channel, which extends along said curettage device, has an inlet port connected with a pressure gas source as well as at least one outlet nozzle at its distal end disposed at said cannula distal end,
• said nozzle directed towards said optical surface so that a gas jet going out of said nozzle touches said optical surface providing its cleanness,
• the pressure value of gas supplied to said nozzle is sufficient to enable said gas jet to provide complete cleaning of said optical surface from any patient's secretions and any curettage products and to be a single means for cleaning said optical surface,
• a safety means preventing the patient internal organs from barotrauma by gas going out of said nozzle.
99. The vacuum curettage device of claim 98, wherein said optical channel and said pressurized gas supply channel pass within said cannula and said distal optical surface and said nozzle are disposed inside said cannula.
100. The vacuum curettage device of claim 99, wherein said optical channel and said pressurized gas supply channel are enclosed in a sheath located inside said cannula.
101. The vacuum curettage device of claim 99, wherein said distal optical surface is faced to said cannula distal window and the vision field of said optical surface passes through said window.
102. The vacuum curettage device of claim 99, wherein said safety means includes a return gas channel for the backward movement of cleaning gas proximally from said cannula distal end, safety suction pump inducing said backward gas movement, and a barrier wall disposed in the path of said gas jet after its passage through said optical surface.
103. The vacuum curettage device of claim 102, wherein said cannula serves also as said return channel, said curettage suction pump serves also as said safety suction pump, and said barrier wall presents a portion of said cannula inner wall.
104. The vacuum curettage device of claim 103, wherein said suction pump is of ejection type, fed from said pressure gas source and disposed in said curettage housing.
105. The vacuum curettage device of claim 103, wherein said suction pump is disposed beyond said vacuum curettage device.
106. The vacuum curettage device of claim 98, wherein there is a pressure control means designed for the control of the pressure inward said cannula and including at least one first control valve installed in said pressurized gas supply channel and at least one second control valve installed in the path of gas, which moves through said cannula and said suction pump, as well as, preferably, a common valve of ON/OFF type at said pressurized gas inlet port.
107. The vacuum curettage device of claim 106, wherein there are following positions of said valves: an inoperative position, wherein said common valve is closed (position OFF); a curettage position, wherein said common valve and said second control valve are open; a visualization position, wherein said common and said first control valves are open.
108. The vacuum curettage device of claim 107, wherein said first valve is open in said curettage position providing the visualization also in curettage regime.
109. The vacuum curettage device of claim 107, wherein, in said visualization position, the second control valve is open partly so that the gas pressure in uterus is some more than atmosphere pressure enabling some uterus expansion for its convenient visualization.
PCT/IL2002/000429 2001-06-11 2002-06-03 Endoscope with cleaning optics WO2002100238A2 (en)

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WO2002100238B1 (en) 2004-04-29
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US7341556B2 (en) 2008-03-11
EP1420680A2 (en) 2004-05-26
AU2002309228A1 (en) 2002-12-23
WO2002100238A3 (en) 2004-03-18
US20040220452A1 (en) 2004-11-04

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