U.S. patent application number 10/167588 was filed with the patent office on 2003-03-20 for technique for depth of field viewing of images using an endoscopic instrument.
Invention is credited to Loth, Stanislaw, Petitto, Tony, Worth, Howard.
Application Number | 20030055314 10/167588 |
Document ID | / |
Family ID | 27485641 |
Filed Date | 2003-03-20 |
United States Patent
Application |
20030055314 |
Kind Code |
A1 |
Petitto, Tony ; et
al. |
March 20, 2003 |
Technique for depth of field viewing of images using an endoscopic
instrument
Abstract
An endoscopic instrument capable of being optically coupled to a
video monitor adapted with a prismatic screen is disclosed. The
instrument includes a working channel of 0.35 mm and a biopsy
instrument having a substantially tubular end. The prismatic screen
is mounted between a flat image and a viewer. Additional optical
elements may be provided to enlarge a viewed image. A light hood
may be provided to reduce glare and other effects of ambient light.
Coating the screen with an anti-reflective coating may provide
further protection from ambient light. Restructuring the image into
smaller image elements provides image quality for a video image or
the like. An aspherical lens may be used to minimize or remove
distortion of the image perceived by a viewer to the side, above or
below the center viewing axis of the screen.
Inventors: |
Petitto, Tony; (Beverly
Hills, CA) ; Loth, Stanislaw; (Sloatsburg, NY)
; Worth, Howard; (Venice, CA) |
Correspondence
Address: |
ARNOLD & PORTER
IP DOCKETING DEPARTMENT; RM 1126(b)
555 12TH STREET, N.W.
WASHINGTON
DC
20004-1206
US
|
Family ID: |
27485641 |
Appl. No.: |
10/167588 |
Filed: |
June 13, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10167588 |
Jun 13, 2002 |
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09524746 |
Mar 14, 2000 |
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6500114 |
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09524746 |
Mar 14, 2000 |
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09115810 |
Jul 15, 1998 |
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09115810 |
Jul 15, 1998 |
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09006894 |
Jan 14, 1998 |
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6067191 |
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09006894 |
Jan 14, 1998 |
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08345806 |
Nov 22, 1994 |
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5774260 |
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08345806 |
Nov 22, 1994 |
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08155748 |
Nov 23, 1993 |
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5400177 |
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Current U.S.
Class: |
600/109 ;
348/E13.004; 348/E13.014; 348/E13.022; 348/E13.029; 348/E13.033;
348/E13.034; 348/E13.038; 348/E13.04; 348/E13.044; 348/E13.058;
348/E13.071 |
Current CPC
Class: |
H04N 13/363 20180501;
H01J 2229/893 20130101; H04N 13/204 20180501; G02B 5/045 20130101;
H04N 13/327 20180501; H04N 13/361 20180501; G02B 30/40 20200101;
H04N 13/189 20180501; H04N 13/239 20180501; H04N 13/305 20180501;
H04N 13/341 20180501; H04N 13/286 20180501; H04N 13/337 20180501;
H01J 29/89 20130101; H04N 13/194 20180501; H04N 13/324
20180501 |
Class at
Publication: |
600/109 |
International
Class: |
A61B 001/04 |
Claims
What is claimed is:
1. A system comprising: (a) an endoscope including a guide having a
working channel, a light source and a lens, said guide coupled to
means for receiving a medical instrument, to means for irrigating
and to means for supplying a video image; and (b) said endoscope
coupled to a video camera; (c) said video camera coupled to a video
monitor; (d) said video monitor coupled to a transparent screen
which includes a plurality of generally parallel microprisms formed
in the screen and extending horizontally across the width of the
screen, said screen also coupled to an optical element operable to
adjust the paths of light transmitted through said screen.
2. The system of claim 1 wherein said optical element is an
aspherical lens.
3. The system of claim 1 further comprising said medical instrument
and wherein said medical instrument is substantially tubular on its
distal end.
4. The system of claim 2 wherein said aspherical lens has a
magnification power of approximately 1.25 to 2 times.
5. The system of claim 4 wherein a first radius of said aspherical
lens is 10 to 50 percent greater than a second radius of said
aspherical lens.
6. The system of claim 5 wherein a first radius of said aspherical
lens blends into a second radius of said aspherical lens.
7. The apparatus of claim 2 wherein said aspherical lens is
comprised of more than two radii.
8. A system comprising: an instrument for retrieving biopsy cells
from a body coupled to an apparatus for depth of field viewing,
said apparatus including: a transparent screen for positioning
between a flat image and a viewer, said transparent screen
including a plurality of optical elements formed in said screen;
and an aspherical lens for positioning between said screen and a
viewer, said lens being curved across its width which curvature is
defined by at least two radii.
9. The system of claim 8 wherein said instrument includes a guide
having a working channel, a light source and a lens, said guide
coupled to means for receiving a medical instrument, to means for
irrigating and to means for supplying a video image.
10. The system of claim 8 wherein said aspherical lens has a
magnification power of approximately 1.25 to 2 times.
11. The system of claim 8 wherein a first radius of said aspherical
lens is 10 to 50 percent greater than a second radius of said
aspherical lens.
12. The system of claim 8 wherein a first radius of said aspherical
lens blends into a second radius of said aspherical lens.
13. The apparatus of claim 8 wherein said aspherical lens is
comprised of more than two radii.
14. A method of inspecting a breast with an endoscopic instrument
wherein said endoscopic instrument includes a guide having a
working channel, a light source and a lens; a first tube having a
biopsy channel; a second tube having an irrigation channel; a third
tube having an interior passageway; and a medical instrument for
inserting into said biopsy channel and said working channel; said
method comprising the steps of: (a) inserting the distal end of
said medical instrument into the dilated nipple of said breast; and
(b) projecting an image of the interior of said breast on a video
monitor.
15. The method of claim 14 further comprising the step of: (c)
irrigating the interior of said breast by injecting liquid through
said irrigation channel.
16. The method of claim 14 further comprising the step of (c)
extracting biopsy cells from said breast.
17. A method of extracting biopsy cells using an endoscopic
instrument having a distal end that is substantially needle like,
said method comprising the steps of: (a) inserting said instrument
into a body; (b) causing liquid to be ejected from the distal end
of said instrument; (c) causing reverse pressure to form at the
distal end of such instrument so that said liquid and biopsy cells
are retrieved into said instrument; and (d) extracting said cells
from said body.
18. A method of performing a medical procedure on the interior of a
blood vessel using an endoscope having a substantially flexible
guide of a length greater than one meter and which is optically
coupled to a video monitor, said method comprising the steps of;
(a) inserting said guide into a blood vessel; and (b) projecting an
image of the interior of said blood vessel on said video
monitor.
19. A method of clearing a clogged area in a lacrimal duct using an
endoscope that includes a guide having an outer diameter of not
more than about 1.2 mm and a working channel defined therein having
an outer diameter of not more than about 0.35 mm, a first tube
portion coupled to said guide having a biopsy channel defined
therein; said biopsy channel being capable of receiving a medical
instrument, a second tube portion coupled to said guide and having
an irrigation channel defined therein, and a third tube portion
coupled to said guide and having defined therein an interior
passageway for holding fiber optic strands; said method comprising
the steps of: (a) inserting said guide into the lacrimal duct of a
patient; (b) projecting an image of the interior of said duct on a
video monitor; (c) identifying the clogged area; and (d) clearing
said area with a laser.
20. The method of claim 19 further comprising the step of: (e)
irrigating the formerly clogged area by injecting a liquid through
the irrigation channel.
21. A method of treating a tumor in an interior cavity of a body
using an endoscopic instrument comprising a guide having a working
channel, a light source and a lens; a first tube having a biopsy
channel; said first tube coupled to said guide; a second tube
having an irrigation channel; said second tube coupled to said
guide; a third tube having an interior passageway; said third tube
coupled to said guide; and a medical instrument for inserting into
said biopsy channel and said working channel; said medical
instrument being substantially needle like at its distal end, said
method comprising: (a) inserting said guide into said cavity to
approximately the position of the tumor; (c) projecting an image of
said tumor onto a video monitor; and (b) injecting a
chemotherpuetic liquid directly into said tumor by forcing said
liquid through said irrigation channel and said working
channel.
22. The method of performing a medical procedure on the interior of
a body using an endoscope coupled to a video monitor, said video
monitor being coupled to a transparent screen which includes a
plurality of generally parallel microprisms formed therein, said
microprisms extending horizontally across the width of the screen,
said screen coupled to an optical element operable to adjust the
paths of light transmitted through said screen, said method
comprising the steps of: (a) inserting said endoscope into said
body; and (b) projecting an image of the interior of said body on
said screen.
23. The method of claim 22 wherein said optical element is an
aspherical lens.
24. A system comprising: an endoscope; a video monitor coupled to
said endoscope; and an aspherical lens coupled to said video
monitor.
25. The system of claim 24 wherein said endoscope comprises a guide
having a working channel, said guide coupled to means for supplying
a video image.
26. The system of claim 25 wherein said video monitor is coupled to
a prismatic screen.
27. A system comprising: means for examining the interior of a
bodily cavity or hollow organ; means for displaying a video image
coupled to said means for examining the interior of a bodily cavity
or hollow organ; and aspherical lens means coupled to said means
for displaying a video image, said aspherical lens means configured
for adjusting the path of light transmitted through said means for
displaying a video image.
28. The system of claim 27 wherein said aspherical lens means
comprises a first radius of curvature and a second radius of
curvature, wherein said second radius of curvature is at least 10
percent greater than said first radius of curvature.
29. The system of claim 28 wherein said aspherical lens means
comprises a third radius of curvature.
30. A method of viewing the progress of a medical procedure
comprising the steps of: generating an image of the interior of a
bodily cavity or organ; displaying the image on a video monitor;
and passing the image through an aspherical lens.
31. A method according to claim 30, further comprising the step of:
inserting a medical instrument into a bodily cavity.
32. The method of claim 30 wherein the image is generated by a
video camera, said video camera coupled to an endoscope comprising
a guide having a working channel, a light source, and a lens.
33. A system comprising: an endoscope having a working channel of
approximately 0.35 mm; a video monitor coupled to said endoscope;
and an optical element, wherein said video monitor is coupled to
said optical element.
34. The system of claim 33 wherein said optical element is an
aspherical lens.
35. A system comprising: an endoscope; a cytology instrument,
wherein said cytology instrument is slidably and releasably coupled
within said endoscope; a video monitor coupled to said endoscope;
and an optical element, said optical element coupled to said video
monitor.
36. The system of claim 35 wherein said optical element is an
aspherical lens.
37. The system of claim 36 wherein said aspherical lens comprises a
first radius of curvature and a second radius of curvature, wherein
said second radius of curvature is at least 10 percent greater than
said first radius of curvature.
38. The system of claim 37 wherein said aspherical lens comprises a
third radius of curvature.
39. A system comprising: an endoscope for examining the interior of
a bodily cavity or hollow organ; a video monitor coupled to said
endoscope for displaying a video image; a stepped aspherical lens
coupled to said video monitor, said stepped aspherical lens
configured to adjust the path of light transmitted through said
video monitor.
40. The system of claim 39 wherein said stepped aspherical lens
comprises at least a first radius of curvature and a second radius
of curvature, wherein said second radius of curvature is at least
10 percent greater than said first radius of curvature.
41. The system of claim 40 wherein said stepped aspherical lens
comprises a third radius of curvature.
42. A method for making an ashperical lens from a lens material,
comprising the steps of: cutting a plurality of radii steps into a
surface of the lens material; and polishing the plurality of radii
steps.
43. The method of claim 42, wherein said polishing step forms the
plurality of radii steps into a plurality of curved portions having
a plurality of discrete radii.
44. The method of claim 43, wherein an arrangement of the plurality
of curved portions having the plurality of discrete radii gives the
aspherical lens an aspherical quality.
45. The method of claim 42, wherein said cutting step occurs along
a predefined curved path, which gives the aspherical lens a
pseudo-spherical quality.
46. The method of claim 42, further comprising, prior to said
cutting step, the steps of: mounting the lens material; molding the
lens material into a block of lens material; and forming the lens
material into a spherical lens.
47. An aspherical lens produced in accordance with the method of
claim 42.
48. A cytology instrument for removing cells from a bodily material
comprising: a longitudinally extending main body portion having a
proximal and a distal end, said distal end having a roughened
surface and wherein said main body portion has a diameter of up to
about 0.30 mm.
49. A cytology instrument according to claim 48, wherein said
instrument is made substantially from Nitinol or an alloy
thereof.
50. A cytology instrument according to claim 48, wherein said
roughened surface is formed by exposing said distal end to a laser
energy source.
51. A cytology instrument according to claim 48, wherein said
roughened surface is formed by stone grinding said distal end.
52. A cytology instrument according to claim 48, wherein said
roughened surface is formed by scoring said distal end using a
combination of a tool and a die.
53. A method of retrieving cells from a bodily material using a
cytology instrument having a diameter of up to about 0.30 mm, said
method comprising the steps of: inserting the cytology instrument
through a working channel of an endoscopic device; scraping a
surface of a targeted bodily tissue to remove material from the
surface; injecting a fluid through an irrigation channel of an
endoscopic device, wherein the fluid mixes with the material
removed from the surface forming a fluid-material mixture; removing
the cytology instrument from the working channel; and aspirating
the fluid-material mixture through the working channel.
54. A method according to claim 53, wherein the cytology instrument
is made from Nitinol.
55. A method according to claim 53, wherein the cytology instrument
comprises a longitudinally extending main body portion having a
proximal and a distal end, said distal end having a roughened
surface.
Description
BACKGROUND OF THE INVENTION
[0001] The present application is a continuation-in-part of U.S.
patent application Ser. No. 09/115,810, filed Jul. 15, 1998, which
is a continuation-in-part of U.S. patent application Ser. No.
09/006,894, filed Jan. 14, 1998, which is a continuation-in-part of
U.S. patent application Ser. No. 08/345,806, filed Nov. 22, 1994,
by Tony Petitto and Stanislaw Loth, for "Technique for Depth of
Field Viewing of Images With Increased Clarity and Contrast," now
U.S. Pat. No. 5,774,260, which is a continuation-in-part of U.S.
patent application Ser. No. 08/155,748, filed Nov. 23, 1993, by
Tony Petitto and Stanislaw Loth, for "Technique for Depth of Field
Viewing of Images With Improved Clarity and Contrast," now U.S.
Pat. No. 5,400,177, hereby incorporated by reference in their
entirety.
[0002] Depth of field viewing, as described in U.S. Pat. No.
5,400,177, is accomplished by enhancing depth cues which are
present in every flat image, whether photographed or recorded
electronically, without the requirement of special glasses, eye
shutters or similar devices used in front of the viewers eyes. The
depth cues are enhanced by a specially designed prismatic screen
that separates the viewer's eye focus and convergence. The
separation triggers the brain of the viewer to disregard
convergence information indicating that the screen is flat, and to
interpret the image depth cues as real.
[0003] To strengthen the focus and convergence separation and add
additional image magnification, the present invention utilizes a
specially designed magnifying lens as a supplement to the prismatic
screen. The lens helps trigger the eye focus and convergence
separation--making it stronger when combined with a prismatic
screen such as is disclosed in U.S. Pat. No. 5,744,260. In
addition, depending upon the particular design of the lens, the
viewed image may magnified from 1.25.times. to 2..times., and at
the same time is cleared (cleaned) from the magnified raster of the
video scanning lines. The clearing (cleaning) of the viewed image
from the magnified raster is accomplished with the prismatic
screen, as described in the parent application. With particular
reference to FIGS. 29 to 36 of that application, the prismatic
screen PR preferably includes three miniature prisms for each video
scan line. As a result, each raster video scan line is divided two
or three times, thereby providing a significant reduction in the
visibility of the raster lines. In accordance with the present
invention, as described in greater detail below, the prismatic
screen may be either a flat or curved structure, depending upon the
choice of additional optical elements in the system.
[0004] A number of designs on how to magnify a video small screen
image to a larger screen image are described in patent literature.
For example U.S. Pat. No. 2,449,886 and U.S. Pat. No. 5,061,052
disclose such systems. Each of these designs are based on using a
positive lens, or a lens combined with a Fresnel lens, and each
technique places the optical system near the front of the video
monitor screen. The lenses are designed with a short focal length
which may cause distortion, because the magnification of the image
is not equal in the center and on the edges. Additionally, the
Fresnel lens, which is a concentric design of a magnifying lens,
may cause image degradation by lowering the image resolution.
According to U.S. Pat. No. 5,061,052, the described system is
intended to allow individuals of limited means to enjoy the
entertainment and education provided by large screen television
images, without the necessity of purchasing a large television set.
However, such prior art television magnification of a small screen
image to a larger screen image may cause distortion and a poor
image, particularly since these systems magnify the raster of
scanned video lines which make up the image. When the lines are
magnified, the image is degraded and becomes distorted, and
eyestrain may result. These and other disadvantages of the prior
art are overcome by the present invention.
[0005] Recently, video monitoring and imaging technology has made
its way into the operating room and the physician's office. One
example of such medical uses for this technology includes the
optical connection of a video camera and monitoring device to an
endoscope or similar instrument that is adapted with fiber optics.
Such instruments are used to perform medical procedures, such as
biopsies, on internal organs without the need for extremely
invasive surgery. They usually comprise a longitudinally extending
hollow tube made of plastic or metal that is inserted into the body
through an orifice or incision. A smaller passageway is included in
the channel of the tube longitudinally, through which a medical
instrument of some type, such as a biopsy brush or scrape, may be
inserted for performing various procedures on the internal organ of
interest. The physician, using a handle at the proximal end of the
medical instrument, may manipulate the instrument as desired.
[0006] Such instruments have in the past involved a number of
drawbacks. For example, because the instrument is inserted into the
patient's body, it has been difficult to accurately view how the
procedure is progressing. Some scopes have included fiber optic
strands that allow the physician to see an image of the organ or
tissue being treated. However, because of the small areas involved
and the limited amount of light in such areas, such images have
been of poor quality and limited use.
[0007] The dimensions of the scope have also often been too large.
In order to minimize the invasiveness of the procedure, and
therefore the pain and discomfort of the patient, the physical
dimensions of the endoscope and its various parts are best
minimized. Furthermore, many cavities of the human body are
extremely small or difficult to get to and are incapable of
receiving prior art scopes without damage to the surrounding
tissue.
[0008] In addition, conventional biopsy brushes or other
instruments used for cytological procedures in these small body
cavities do not have the necessary flexibility or strength to
provide for sufficient scraping and/or removal of cells from
papillomas or other abnormalities.
BRIEF OBJECTS AND SUMMARY OF THE INVENTION
[0009] It is therefore an object of this invention to provide an
endoscope that is capable of being used in many of the smallest
cavities of the human body in various different procedures while
generating an image of the area of the body being treated, which
image has increased clarity and depth of field viewing.
[0010] The present invention satisfies these and other objects
through the provision of an endoscope capable of being coupled to a
video monitor adapted with a prismatic screen. The endoscope
provides a view into the smallest cavities of the body and the
monitor and screen project the image to the viewer with enhanced
clarity and depth cues. The present invention further provides a
stepped aspherical lens and a method of making the same for further
increasing the quality of depth of field viewing.
[0011] It is another object of the present invention to facilitate
removal of cells, tissue or other materials from the body. The
present invention satisfies this and other objects through the
provision of a Nitinol cytology instrument having improved strength
and biocampatibility characteristics.
[0012] In one aspect, the present invention relates to a system
including an endoscope comprising a guide having a working channel,
a light source and a lens, said guide coupled to means for
receiving a medical instrument, to means for irrigating and to
means for supplying a video image. The endoscope is preferably
coupled to a video camera, the video camera is preferably coupled
to a video monitor. The video monitor is preferably coupled to a
transparent screen which includes a plurality of generally parallel
microprisms formed in the screen and extending horizontally across
the width of the screen, said screen also coupled to an optical
element operable to adjust the paths of light transmitted through
said screen.
[0013] In another aspect, the present invention relates to a system
including an instrument for retrieving biopsy cells from a body
coupled to an apparatus for depth of field viewing. The apparatus
includes a transparent screen for positioning between a flat image
and a viewer, said transparent screen including a plurality of
optical elements formed in said screen and an aspherical lens for
positioning between said screen and a viewer, said lens being
curved across its width which curvature is defined by at least two
radii.
[0014] In another aspect, the present invention relates to a method
of inspecting a breast with an endoscopic instrument wherein said
endoscopic instrument includes a guide having a working channel, a
light source and a lens; a first tube having a biopsy channel; a
second tube having an irrigation channel; a third tube having an
interior passageway; and a medical instrument for inserting into
said biopsy channel and said working channel. The method includes
inserting the distal end of said medical instrument into the
dilated nipple of said breast and projecting an image of the
interior of said breast on a video monitor.
[0015] In another aspect, the present invention relates to a method
of extracting biopsy cells using an endoscopic instrument having a
distal end that is substantially needle like. The method includes
inserting said instrument into a body and causing liquid to be
ejected from the distal end of said instrument. The method further
includes causing reverse pressure to form at the distal end of such
instrument so that said liquid and biopsy cells are retrieved into
said instrument and extracting said cells from said body.
[0016] In yet another aspect, the present invention relates to a
method of performing a medical procedure on the interior of a blood
vessel using an endoscope having a substantially flexible guide of
a length greater than one meter and which is optically coupled to a
video monitor. The method includes inserting said guide into a
blood vessel and projecting an image of the interior of said blood
vessel on said video monitor.
[0017] In another aspect, the present invention relates to a method
of clearing a clogged area in a lacrimal duct using an endoscope
that includes a guide having an outer diameter of not more than
about 1.2 mm and a working channel defined therein having an outer
diameter of not more than about 0.35 mm, a first tube portion
coupled to said guide having a biopsy channel defined therein; said
biopsy channel being capable of receiving a medical instrument, a
second tube portion coupled to said guide and having an irrigation
channel defined therein, and a third tube portion coupled to said
guide and having defined therein an interior passageway for holding
fiber optic strands. The method includes inserting said guide into
the lacrimal duct of a patient and projecting an image of the
interior of said duct on a video monitor. The method also includes
identifying the clogged area and clearing said area with a
laser.
[0018] In another aspect, the present invention relates to a method
of treating a tumor in an interior cavity of a body using an
endoscopic instrument comprising a guide having a working channel,
a light source and a lens; a first tube having a biopsy channel;
said first tube coupled to said guide; a second tube having an
irrigation channel; said second tube coupled to said guide; a third
tube having an interior passageway; said third tube coupled to said
guide; and a medical instrument for inserting into said biopsy
channel and said working channel; said medical instrument being
substantially needle like at its distal end. The method including
inserting said guide into said cavity to approximately the position
of the tumor and projecting an image of said tumor onto a video
monitor. The method also includes injecting a chemotherpuetic
liquid directly into said tumor by forcing said liquid through said
irrigation channel and said working channel.
[0019] In yet another aspect, the present invention relates to a
method of performing a medical procedure on the interior of a body
using an endoscope coupled to a video monitor, said video monitor
being coupled to a transparent screen which includes a plurality of
generally parallel microprisms formed therein, said microprisms
extending horizontally across the width of the screen, said screen
coupled to an optical element operable to adjust the paths of light
transmitted through said screen. The method includes inserting said
endoscope into said body and projecting an image of the interior of
said body on said screen.
[0020] In another aspect, the present invention relates to a system
including an endoscope, a video monitor coupled to said endoscope,
and an aspherical lens coupled to said video monitor.
[0021] In another aspect, the present invention relates to a system
including means for examining the interior of a bodily cavity or
hollow organ and means for displaying a video image coupled to said
means for examining the interior of a bodily cavity or hollow
organ. The system also includes aspherical lens means coupled to
said means for displaying a video image, said aspherical lens means
configured for adjusting the path of light transmitted through said
means for displaying a video image.
[0022] In yet another aspect, the present invention relates to a
method of viewing the progress of a medical procedure comprising
the steps of generating an image of the interior of a bodily cavity
or organ, displaying the image on a video monitor, and passing the
image through an aspherical lens.
[0023] In another aspect, the present invention relates to a system
including an endoscope having a 0.35 mm working channel, a video
monitor coupled to said endoscope, and an optical element, wherein
said video monitor is coupled to said optical element.
[0024] In another aspect, the present invention relates to a system
including an endoscope, a cytology instrument, wherein said
cytology instrument is slidably and releasably coupled within said
endoscope, a video monitor coupled to said endoscope, and an
optical element, said optical element coupled to said video
monitor.
[0025] In another aspect, the present invention relates to a system
including an endoscope for examining the interior of a bodily
cavity or hollow organ, a video monitor coupled to said endoscope
for displaying a video image, and a stepped aspherical lens coupled
to said video monitor, said stepped aspherical lens configured to
adjust the path of light transmitted through said video
monitor.
[0026] In another aspect, the present invention relates to a method
for making a stepped ashperical lens from a lens material,
including the steps of cutting a plurality of radii steps into a
surface of the lens material and polishing the plurality of radii
steps.
[0027] In another aspect, the present invention relates to a
cytology instrument for removing cells from a bodily material
comprising a longitudinally extending main body portion having a
proximal and a distal end, said distal end having a roughened
surface and wherein said main body portion has a diameter of up to
about 0.30 mm.
[0028] In yet another aspect, the present invention relates to a
method of retrieving cells from a bodily material using a cytology
instrument having a diameter of up to about 0.30 mm. The method
comprising inserting the cytology instrument through a working
channel of an endoscopic device and scraping a surface of a
targeted bodily tissue to remove material from the surface. The
method also includes injecting a fluid through an irrigation
channel of an endoscopic device, wherein the fluid mixes with the
material removed from the surface forming a fluid-material mixture
and removing the cytology instrument from the working channel. The
method further includes aspirating the fluid-material mixture
through the working channel.
BRIEF DESCRIPTION OF THE DRAWINGS
[0029] The foregoing objects, as well as additional objects,
features and advantages of the present invention, will be apparent
from the following detailed description when read in light of the
accompanying drawings, wherein:
[0030] FIG. 1 is an illustration of the present invention including
the magnifying lens 4;
[0031] FIG. 2 is an illustration of how a plano convex lens
magnifies an image;
[0032] FIG. 3 is an illustration of how the plano convex lens
magnifies the video image in accordance with one aspect of the
present invention;
[0033] FIG. 4 is an illustration of how the magnifying lens 4
enhances the depth cues of the viewed video image;
[0034] FIG. 5A is an illustration of the location of the prismatic
screen in front of the video screen as illustrated in U.S. Pat No.
5,400,177;
[0035] FIG. 5B is an illustration of one embodiment of the present
invention with the lens 4 placed in front of the prismatic
screen;
[0036] FIG. 5C is an illustration of an embodiment of the present
invention with the lens 4 and the curved prismatic screen "PR" in
place;
[0037] FIG. 5D is an illustration of an embodiment of the present
invention with the lens 4 and the prismatic screen "PR" applied to
the plano surface of lens 4;
[0038] FIG. 5E is an illustration of an embodiment of the present
invention with the light pass "e" passing the lens L4 and the
single prism of the prismatic screen "PR";
[0039] FIG. 5F is an illustration of an embodiment of the present
invention wherein the light path "e" passes angled lens 4 and a
single prism of a prismatic screen PR laminated to the lens;
[0040] FIG. 5G is another illustration of an embodiment with a
prismatic screen laminated to the lens 4, wherein the angles of the
prism and the lens 4 have been changed from those of FIG. 5F;
[0041] FIG. 6A is an illustration of an embodiment of the present
invention with the lens 4 made in BK7 glass;
[0042] FIG. 6B is an illustration of another embodiment of the
present invention with the lens 4 made with high refraction index
SK16 glass;
[0043] FIG. 7 is an illustration of yet another embodiment of the
present invention with the lens 4 designed as a hollow optical
structure which is filled with a liquid high refraction index
filler;
[0044] FIG. 8 is an illustration of the present invention with the
lens 4 replaced by a parallel transparent plate;
[0045] FIG. 8A is an illustration of an embodiment of the present
invention with the prismatic screen "RP" placed behind the
transparent plate;
[0046] FIG. 9 is an illustration of the present invention with the
prismatic screen "PR" attached to the parallel transparent
plate;
[0047] FIG. 9A is an illustration of the present invention with the
parallel transparent plate demonstrating how the viewers eyes see
the virtual video image S2, which appears in front of the video
screen S1;
[0048] FIG. 10 is an illustration of the present invention with the
parallel transparent plate which is hollow and is filled with a
liquid high refraction index filler;
[0049] FIG. 11 is an illustration of two viewing points along the
center axis of a video monitor with a depth of field prismatic
screen and a spherical magnifying lens attached thereto;
[0050] FIG. 12 is an illustration of a viewing point shifted to one
side of the center axis of a video monitor with a depth of field
prismatic screen and a spherical magnifying lens attached
thereto;
[0051] FIG. 13 is an illustration of a viewing point shifted to one
side of the center axis of a depth of field prismatic screen and an
adjacent spherical magnifying lens;
[0052] FIG. 14 is an illustration of a depth of field prismatic
screen and an adjacent aspherical magnifying lens;
[0053] FIG. 15 is an illustration of two viewing points along the
center axis of a depth of field prismatic screen and an aspherical
magnifying lens;
[0054] FIG. 16 is an illustration of a viewing point shifted to one
side of the center axis of a depth of field prismatic screen and an
aspherical magnifying lens;
[0055] FIG. 17 is an illustration of two viewing points along the
center axis of a depth of field prismatic screen and an aspherical
magnifying lens as those viewing points are related to left and
right eye inter ocular distance;
[0056] FIG. 17a is an illustration of an exemplary aspherical lens
designed to account for the interocular distance between the eyes
of a viewer;
[0057] FIG. 18 is an illustration of the reduction in lens
thickness corresponding to use of an aspherical magnifying lens in
the present invention;
[0058] FIG. 19 is an illustration of three viewing points, one
along, one above and one below the center axis of a depth of field
prismatic screen and an aspherical magnifying lens;
[0059] FIG. 20 shows one example of the prismatic screen of the
present invention used in the context of a computer monitor;
[0060] FIG. 21 shows an aspherical lens having defined therein 50
or more radii that blend on into the other;
[0061] FIG. 22 shows an aspherical lens magnifying a computer
image;
[0062] FIG. 23 shows the prismatic screen and aspherical lens
placed in front of a computer monitor screen;
[0063] FIG. 24 shows a computer monitor screen framed with a liquid
crystal screen;
[0064] FIG. 25 is a side elevational view of one embodiment of the
endoscope of the present invention;
[0065] FIG. 26 is a cross-sectional view of the guide of the
endoscope of the disclosed embodiment;
[0066] FIG. 27 is a side elevational view of one embodiment of the
biopsy tube of the present invention;
[0067] FIG. 28 is a side elevational view of the endoscope of the
disclosed embodiment coupled to a syringe for biopsy cell
extraction and to video equipment for increased depth of field
viewing;
[0068] FIG. 29 is a side elevational view of a molding step in a
method for forming a stepped aspherical lens in accordance with the
present invention;
[0069] FIG. 30 is a side elevational view of a cutting step in a
method for forming a stepped aspherical lens in accordance with the
present invention;
[0070] FIG. 31 is an illustration of a preferred step arrangement
on a lens in an embodiment of the present invention;
[0071] FIG. 32 is a side elevational view of a stepped aspherical
lens of the present invention;
[0072] FIG. 33 is a side elevational view of a stepped aspherical
lens of the present invention;
[0073] FIG. 34 is an illustration of varying radii of a stepped
aspherical lens of the present invention;
[0074] FIG. 35 is a side elevational view of a polishing step in a
method for forming a stepped aspherical lens in accordance with the
present invention;
[0075] FIG. 36 is a top elevational view of a stepped aspherical
lens of the present invention;
[0076] FIG. 37 is an illustration of a conventional endoscope
employing a 1/2 inch video camera chip;
[0077] FIG. 38 is an illustration of an embodiment of the present
invention employing a 1/4 inch video camera chip; and
[0078] FIG. 39 is an illustration of an embodiment of the depth of
field viewing system of the present invention employing the 1/4
inch video camera chip.
DETAILED DESCRIPTION
[0079] Although the present invention is described below in
connection with specific embodiments, it will be appreciated that
the invention is not limited to the described embodiments. For
example, portions of the present invention are housed and the
optical elements are aligned with high precision in a frame that is
constructed in height and width to be attached to the front of any
existing video monitor. However, other techniques for housing and
mounting the optical elements may also be used. Moreover, other
portions of the invention are describing as being of various
dimensions, forms and uses. However, except as specifically
claimed, the invention is not intended to be so limited.
[0080] The present invention, when attached to a 19" or 13" medical
video monitor, is designed to permit the viewer to observe the 2"
diameter, micro endoscopic image as described in application Ser.
No. 08/155,748, magnified 1.25.times. to 2.0.times.. The image also
appears to the viewer with improved resolution, with enhanced image
detail and image depth cues, which are not recognizable in a less
detailed video image.
[0081] In Laparoendoscopic/Endoscopic surgery procedures, the video
image is transmitted directly from the inside of the patient's body
to a 19" or 13" video monitor. Of particular importance is Micro
Endoscopic procedures that are viewed through a micro fiber optic
image conduit. The image is typically taken in a relatively low
light environment, and the final image that appears on the 19"
medical monitor is only 2" in diameter and is often noisy and
characterized by relatively poor resolution quality.
[0082] Micro Endoscopic procedures for the Parotid tear duct,
Lacrimal tear duct, breast exploration and reconstructive surgery,
disorders of the spine, Neurosurgery of the brain and nerve system,
inner ear, nose and throat (Otolaryngology), reconstructive plastic
surgery, Fallopascopy, Gynecology, reproductive genetics and
minimally invasive veterinary surgery are performed using scopes
with fiber optic bundles that range in diameter from 0.3 mm to 3.0
mm. These difficult procedures have opened new avenues of
improvement on surgery of the human body. Such procedures eliminate
the need to open large operation areas and allow one to reach into
and see inside very small and narrow body ducts. It also reduces
the patient's trauma, stress, danger of infection, and allows the
patient in most cases to recover quickly.
[0083] With all the latest improvements in the lens, fiber optic,
video camera, high-resolution video monitor and actual technique in
the different micro procedures the image quality transmitted to the
video monitor often remains poor. The relatively poor quality is
not only caused by the small size of the viewed image, but also
results from poor sharpness and clarity of the image. This is the
result of the lens at the end of the fiber optic conduit being only
a minimum {fraction (1/50)}th of an inch in diameter of the
environment in which the image is taken.
[0084] The 2" micro image transmitted through the fiber optic is
focused into the video camera as a relatively small and dark image.
The image is only 1/6th of the height of a 19" monitor screen, and
occupies only {fraction (1/40)}th of the monitor screen surface.
However, the 19" monitor is the monitor of choice for most surgeons
for Micro Endoscopic procedures because on the 13" monitor the
micro image is only 1.25" in diameter. It is often very difficult
to perform micro procedures with such a small image.
[0085] Both the 19" and 13" medical video monitor images are
constructed with the same components, the video image pixels (small
electronic dots which form the raster of scanning lines which form
the image). Both 19" and 13" basic video monitors contain the same
amount of 200 scanning resolution lines. A raster scanning line,
which runs the width of the video screen, is approximately 1.0 mm
high, {fraction (1/25)}th of an inch; and the space between the
raster lines is normally 0.5 mm, {fraction (1/50)}th of an inch.
The thickness of the lines and the space between the lines creates
200 scanning lines of basic image resolution that fills, top to
bottom, the video monitor screen.
[0086] In comparing the video image with a film image, the video
image resolution is as much as 15 times lower. Quality photographic
lenses are usually manufactured with 100 times better resolution
(100 lines per 1.0 mm).
[0087] Normal endoscopic video systems project the image to the
full size of the video screen. This is because they are not
restricted to the {fraction (1/24)}th of an inch diameter of the
fiber optic light conduit and are equipped with a powerful light
source to illuminate the viewing area. This, however, is impossible
to achieve with the micro endoscopic imaging systems.
[0088] The micro endoscopic video system is an electronic and
optical breakthrough in surgical technique that allows the small,
confined areas of the human body like the tear duct and the spinal
canal to be imaged. However, the poor image quality and its 2"
diameter size have limited its application and effectiveness. It is
for this reason that the present invention achieves significant
improvement over the deficiencies of prior art television screen
magnification screen systems and is an extension to micro
endoscopic technology, which helps solve the surgeon's needs for an
enlarged, enhanced quality, depth of field image as viewed on the
video monitor screen.
[0089] Referring now to FIG. 1, a 19" video monitor 1, includes a
video screen 2. A housing 5 is attached in front of the video
screen 2, and contains the mounted depth of field prismatic screen
3. The screen 3 is assembled in a frame 3A. As described in
application Ser. No. 08/155,748, now U.S. Pat. No. 5,400,177, the
depth of field screen is a multi prismatic structure with a
plurality of horizontal micro prisms which extend across the width
of the inner surface of the depth of field screen 3. Particular
reference is made to FIGS. 5-12, 25-36 and 39 of that patent and
the accompanying written specification for a more detailed
description of the depth of field screen.
[0090] In one embodiment of the present invention, a magnifying
lens 4 placed in the front portion of the housing 5 provides
stronger depth cue enhancement and magnifies the image for easier
viewing. In relation to the 2" diameter micro image, the
magnification does not exceed 2.0.times.. In relation to a full
screen video image, the magnification does not exceed 1.25.times..
In accordance with the present invention, the prismatic screen 3
and the lens 4 are designed as a single optical system. Without the
prismatic screen, the lens 4 would magnify the image as well as the
raster scan lines, making the image unacceptable. The prismatic
screen as described in application Ser. No. 08/155,748 without the
lens 4, does not magnify the image 1.25.times. to 2.0.times..
[0091] The housing 5 attaches the optical elements to the front of
the video monitor. Preferably, the front and rear portions of the
housing are scaled with front and rear tempered glass windows,
respectively, which are treated with anti-reflection coatings. The
lens 4 may be an acrylic plano convex lens which is designed to
provide focus and convergence separation. The focal length of the
lens 4 is relatively long, preferably about 30 inches, but
advantageously may range from 10" to 40". The lens 4 is preferably
mounted about 5 inches from the video screen.
[0092] The prismatic screen 3, described fully in parent
application Ser. No. 08/155,748 (incorporated herein by reference)
is placed between the lens 4 and the video screen to provide
additional focus and convergence information, and to reduce the
size of video raster lines by three times. The prismatic screen is
preferably mounted near the video screen with the "rows" of prism
lenses running parallel to the video scan lines. The interior
portion of the housing is preferably blackened to separate the
viewed image from ambient light and reflections, which also helps
to strengthen depth cues. Preferably, the outside front portion of
the housing includes a black frame which tilts the optical front
window by approximately 50 degrees to 100 degrees toward the inside
of the housing to help eliminate reflections of bright objects and
ambient light that may be present in front of the glass window.
[0093] The manner in which viewers eyes perceive depth cues is
described in application Ser. No. 08/155,748 with particular
reference to FIGS. 13 to 22. In the same application, the manner in
which the prismatic screen reduces the raster of video scanning
lines is described with reference to FIGS. 31 to 36B. In the
present invention, the plano convex lens 4, when combined with the
prismatic screen also serves as a depth cue enhancement lens. The
screen 3 and the lens 4 are designed as a single optical system
3-4.
[0094] FIG. 2 illustrates how a plano convex lens magnifies a video
image. A viewed object O.sub.1 is magnified by the lens L to
provide a magnified object image O.sub.2. In one embodiment, the
eye viewing distance to the lens is variable and the focal length
of the lens is preferably a relatively long focal length.
[0095] FIG. 3 illustrates how the long focal length lens is used in
the present invention. In one embodiment, the magnification of the
video screen S1, to the virtual image S2, is accomplished with a 25
inch diameter lens having a focal length of 762 mm and placed at
the distance of 126 mm from the video screen. Since the primary
object in the design of the lens is to strengthen the depth cues in
the video image, the magnification can be kept as low as about
1.25.times., which is below the distortion range caused by image
magnification.
[0096] FIG. 4 illustrates the manner in which depth cues are
enhanced. When a light beam passes through a transparent structure
of glass or plastic, depending on the refraction index and the
thickness of the structure, the image will focus at a shorter
distance. When the structure is a piano convex lens, the image will
be focused at a shortened distance "a" at the center of the lens,
where the lens is thicker. Light passing through the thinner
peripheral portions of the lens will be focused at "b". By using
BK7 glass, which has a refraction index of 1.5163, the effective
length of the light beam is shortened by about 1/3 of the BK7 glass
thickness, and less at the edge of the lens.
[0097] A planar image p at the location of the screen S1 is seen
through the lens 4 as a slightly curved image S2. This added
curvature separates focus and convergence distances perceived by
the eye and enhances the depth cues present in the planar image. As
shown in FIG. 4, a light beam a passing through the central portion
of the lens 4 encounters a lens thickness t.sub.a. On the other
hand, the light beam b passes through a peripheral portion of the
lens 4 having a reduced thickness t.sub.b. The lens causes focus
displacing (shifting) across the image of BK7 glass approximately
X=t.sub.a/3-t.sub.b/3. The shifting "X" causes an inconsistent
reading of the eye focus and convergence relative to the planar
video image p.
[0098] The image shifting caused by the lens provides a similar
effect to the prismatic screen as described in application Ser. No.
08/155,748. The lens and the prismatic screen combined into a
single optical system causes an increased focus and a convergence
displacement, which cuts off the convergence ability of the eyes to
indicate to the viewer that the video image is flat. This allows
the brain to analyze the depth cues to be perceived as real
depth.
[0099] FIG. 5A illustrates the arrangement in application Ser. No.
08/155,748 of the prismatic screen PR, the video screen S1 and the
virtual image S2. The virtual image S2, appears behind the video
screen S1, shifted down by the angle alpha. This image shifting is
also related to the tilt of the prismatic screen angle beta. A
typical value for the angle beta would be approximately 60.
[0100] FIG. 5B illustrates the optical system of FIG. 5A combined
with the lens L into a single optical system. The resultant virtual
image S2 is magnified, causing a stronger focus and convergence
displacement, and therefore a stronger depth cue effect
enhancement. In addition, as described in the parent application,
particularly with reference to FIGS. 29 to 36b, the prismatic
screen PR preferably includes three miniature prisms for each video
scan line. As a result, each raster video scanning line is divided
into three, thereby providing a significant reduction in visibility
of raster video scanning lines.
[0101] FIG. 5C illustrates a design configuration similar to that
shown in FIG. 5B, but the prismatic screen PR is curved from
side-to-side along the horizontal axis. To accommodate the curved
prismatic screen PR, the lens L is changed from spherical to
non-spherical, and is designed to follow the curve of the prismatic
screen. This arrangement corrects image distortions for an
increased angle of viewing of the image.
[0102] FIG. 5D illustrates a side view of another configuration
similar to the arrangement of FIG. 5B. As shown in FIG. 5D, the
prismatic screen PR may be applied directly to the piano surface of
the plano convex lens L by any known technique. For example, the
micro prisms may be etched, rolled or milled with high precision
directly in the surface of the lens 4. Alternatively, the prisms
could be mechanically or chemically attached appropriately to the
lens. S1 is the video image, S2 is the magnified video image.
[0103] FIG. 5E illustrates the light beam path being directed by
the lens 4 and by a single prism section of the prismatic screen
PR. The light beam from the lens 4 enters the prism on the angle
beta, thereby modifying the prismatic screen's design angle alpha,
according to the focal length and the refraction index of the lens
4.
[0104] FIG. 5F shows a section of lens 4 which is laminated,
cemented, rolled, etched or milled directly to the prismatic screen
PR. For clarity, only a section of the prismatic screen is
illustrated. The prismatic screen has a prism angle of 45 degrees
and the plano surface of the lens 4 is tilted 60 degrees from the
viewing axis. FIG. 5G illustrates an alternative embodiment wherein
the prismatic screen PR has a prism angle of 60 degrees and the
plano surface of the lens is tilted 75 degrees from the viewing
axis. Assuming a horizontal viewing axis, the lens 4 is preferably
placed in a more upright position as the prism angle increases.
[0105] FIGS. 6A, 6B and 7, show different designs of the lens 4.
FIG. 6A illustrates the same lens 4 described in connection with
the system of FIG. 5B. In FIG. 6B, the lens 4, instead of being
made from BK7 glass (having a refraction index of 1.5163), is made
with SK16 glass which has a higher refraction index of 1.6204. The
lens also can be made from acrylic and polycarbonate plastic
materials having a relatively high index of refraction. By using a
material with a higher refraction index the center thickness (FIG.
6B) and therefore the weight of the lens can be reduced.
[0106] FIG. 7 illustrates a design of a hollow plano convex lens
which is similar to the lens in FIG. 5B. The lens is manufactured
as an empty, molded, cut and polished element which is then filled
with a high refractive index liquid and sealed. Even with
difficulties in sealing the edges to prevent leaking of the high
index liquid, this design is still cost efficient and reduces the
weight of the entire system.
[0107] Referring now to FIG. 8, when magnification of the video
image is not desired or needed, the lens 4 may be replaced with an
optically flat plate F having a thickness, for example, of 1 inch.
The thick plate operates in a manner similar to the lens 4 by
shortening the length of the light beam passing through the
transparent plate by approximately 1/3 of the glass thickness;
X=D.sub.1-D.sub.2. As illustrated in FIG. 8A, the virtual image S2
appears in front of the video screen S1. As with the systems
utilizing the piano convex lens, the system of FIG. 8A causes a
focus and convergence displacement which enhances the depth cues of
the viewed image.
[0108] FIGS. 9 and 9A illustrate the plate from FIG. 8 with the
prismatic screen surface PR, applied to the flat surface of the
transparent plate F. FIG. 10 shows the optically flat plate
replaced by a hollow molded or cut plate that is filled with a high
refraction index liquid and sealed.
[0109] Use of an aspherical lens in the present invention to
diminish or remove distortion will now be described in relation to
FIGS. 11 through 19.
[0110] FIG. 11 illustrates a top view of one embodiment of the
depth of field viewing apparatus of the present invention,
comprising video monitor 100, video monitor screen 101, prismatic
screen housing 102, prismatic screen 103 and spherical magnifying
lens 104. FIG. 1 also illustrates two separate viewing points, A
and B, along the center axis O-O1 of the device. Viewing point A is
at a distance FD from spherical magnifying lens 104. Viewing point
B is at a distance CD from lens 104.
[0111] A viewer at viewing point A would see light beams along
paths L1 and L2 exiting the spherical magnifying lens 104 at angles
<L1 and <L2, respectively. A viewer at viewing point B would
see light beams along paths L3 and L4 exiting the spherical
magnifying lens 104 at angles <L3 and <L4, respectively.
Because the lens is spherical and these viewing points are on the
center axis of the device, the angles created by light beam paths
L1 and L2 are equal. Similarly, the angles created by light beam
paths L3 and L4 are equal. Thus, the magnification of those light
beams along those paths by the spherical magnifying lens is equal
and the viewer sees little or no image distortion due to the
lens.
[0112] FIG. 12 illustrates the device of FIG. 11, again having
video monitor 100, video monitor screen 101, prismatic screen
housing 102, prismatic screen 103 and spherical magnifying lens
104. FIG. 12, however, shows viewing point C at a distance CD from
the magnifying lens 104 and shifted a distance S to the left of
center axis O-O1. A viewer at point C sees light beams exiting the
spherical lens 104 along paths L5 and L6 and creating angles <L5
and <L6, respectively. Unlike light viewed at points A and B as
described with respect to FIG. 11, angles <L5 and <L6 are not
equal. The magnification of light along paths L5 and L6 is
therefore different and may cause significant image distortion.
[0113] FIG. 13 is a more detailed view of the spherical magnifying
lens 104 and prismatic screen 103 of FIGS. 11 and 12. There it can
be seen that the curvature of the lens 104 is defined by the radius
R1 of that lens and determines the angles <L5 and <L6
associated with light viewed by the viewer at viewing point C. As
described above, where <L5 and <L6 are different, the image
seen by a viewer at point C may be distorted.
[0114] An advantageous way to avoid or minimize this problem is to
replace the spherical magnifying lens 104 of FIGS. 11 through 13
with an aspherical lens defined by multiple radii. FIG. 14
illustrates such an aspherical lens 105 along with prismatic screen
103 and having center axis O-O1. In one embodiment, aspherical lens
105 magnifies the image created by the screen 1 to 2 times without
distortion. Aspherical lens 105 is made up of center section S1 and
side section S2. The curvature of the lens along the center section
S1 is defined by radius R1, which is the same radius that defines
spherical magnifying lens 104 in FIGS. 11 through 13. The curvature
of the lens along the side section S2 is defined by radius R2,
which most advantageously is 10 to 50 percent greater than radius
R1 (as indicated by dotted line 400, which depicts what the
curvature of a spherical lens defined by radius R1 would be in
section S2).
[0115] Over a portion of the lens, denoted as BL in FIG. 14, the
radius of the curvature of the lens will be transitioning, or
blending, from R1 to R2. This blending will take place over only a
small portion of the lens, and is defined by a succession of, for
example, three or four radii of increasing magnitudes between R1
and R2. Thus, the actual radius of curvature at any given point in
portion BL will be between R1 and R2 and will change over a small
portion of the lens. The aspherical lens 105 is described as being
defined by only two principal radii (R1 and R2) for purposes of
clarity of description so that the invention is not obscured.
However, the present invention is not limited to an aspherical lens
with only two principal radii. The invention could be practiced
with a lens having more than two such radii, though at a greater
cost and complexity of manufacture.
[0116] Referring now to FIG. 15, aspherical lens 105 and prismatic
screen 103, along with center axis O-O1 are shown. Here, viewing
points A' and B' are shown at distances FD and CD from the lens,
respectively. In one embodiment, the far distance (FD) center axis
viewing point is 9 feet and the close distance (CD) center axis
viewing point is 3 feet. By this it is meant that the dimensions of
the lens are chosen such that a viewer a distance FD from the lens
can clearly view the image solely through portion S1 of lens 105,
as can a viewer at distance CD from the lens. Determining exactly
what lens dimensions are necessary to achieve this will depend on
the characteristics of the specific device being used, such as
diameter and magnification of lens, and is well within the
competence of the ordinarily skilled artisan. As can be seen from
the Figure, viewing angle <A' at point A' and viewing angle
<B' at point B' are such that the image on the screen is viewed
substantially through the center section S1 of the lens, defined by
radius R1. Thus, little or no image distortion is perceived by the
viewer.
[0117] Referring now to FIG. 16, aspherical lens 105 and prismatic
screen 103, along with center axis O-O1 are shown. Here, however,
viewing point C', which is at distance CD from the lens 105 and
shifted a distance S to the left of center axis O-O1, is depicted.
As shown, light beams along path L6 pass through center section S1,
defined by radius R1, of the lens and form angle <L6 upon
exiting. Light beams along path L5, however, pass through side
section S2, defined by radius R2, and form angle <L5 upon
exiting.
[0118] As can be seen by shaded area X, the angle <L5 formed by
using the aspherical lens is less than that angle would have been
had a spherical lens defined only by radius R1 been used. Thus, the
differences between angles <L5 and <L6 are diminished as are
the differences between the magnifications of light along paths L5
and L6 thereby minimizing or removing image distortion caused by
varying magnifications.
[0119] FIG. 17 illustrates the aspherical lens 105, screen 103 and
center axis O-O1. FIG. 17 also illustrates interocular distance
O.D. at points A', B' and C'. That is, when designing an aspherical
lens to be used with the present invention, one must take into
account the interocular distance between the eyes of the viewer
when choosing the dimensions of the lens so that the image being
viewed is not seen through one section of the lens (e.g., S1) by
one eye and through another section of the lens (e.g., S2) by the
other eye, thereby causing distortion of the image. Such a
situation is shown in FIG. 17a with respect to viewing point A'.
There, the light along path L1 passes through portion S1 of lens
105 and is seen by the viewer's right eye at point A.sub.R'. The
light along path L2 passes through portion S2 of lens 105 and is
seen by the viewer's left eye at point A.sub.L'. This may cause the
viewer to perceive a distorted image. In order to avoid this
situation, the two-point eye viewing distance should be 20% of the
lens diameter.
[0120] FIG. 18 illustrates another advantage of the use of an
aspherical lens in the apparatus of the present invention. FIG. 18
again shows aspherical lens 105 and prismatic screen 103, along
with center axis O-O1. Had a spherical lens, defined solely by
radius R1, been used, the lens would have been of diameter D and
thickness LSC1. An aspherical lens, defined by radii R1 and R2
where R2 is greater than R1, has a diameter of D', even though only
diameter D is necessary. This permits use of lens of lesser
thickness. That is, an aspherical lens defined by radii R1 and R2
where R2 is greater than R1 need only be of thickness LSC2 to
achieve diameter D. This center thickness reduction results in a
lens weight reduction, making the device more convenient.
[0121] FIG. 19 illustrates a side view of the apparatus of the
present invention using the aspherical lens 105 and comprising
video monitor 100, video monitor screen 101, prismatic screen
housing 102, prismatic screen 103 and aspherical lens 105. FIG. 19
also illustrates center axis O-O1 and three viewing points, O, OT
and OB, each a distance OD from the lens. Viewing point O is on the
center axis O-O1, while point OT is above the center axis and point
OB is below it.
[0122] Similar to the situation described above where the viewing
point is displaced horizontally from the center axis of the device,
FIG. 19 illustrates how use of an aspherical lens in the present
invention can minimize or remove image distortion when the viewing
point is displaced vertically from the center axis. Specifically,
light beams along path L7 and L8 will pass through different
sections (S1 and S2, respectively) of aspherical lens 105, just as
light beams along paths L11 and L12 will pass through different
sections (S1 and S2, respectively) of lens 105. Just as described
above, use of an aspherical lens defined by multiple radii will
minimize or remove image distortion for viewers at point OT and OB.
FIG. 19 also illustrates how light beams along paths L9 and L10
will pass through the same, center section, S1, of lens 105, thus
not experiencing distortion.
[0123] FIG. 20 shows one example of how the present invention can
be used in the context of a computer monitor. The system is used
most advantageously by disposing the prismatic screen and lens at
close distance from the computer screen by keeping the optical
housing dimensions as small as possible and extending the housing
from the front of the computer monitor screen at a small distance.
For example, FIG. 20 shows a conventional CRT display combined with
aspherical lens ASPL, which is similar to lens 105 described above,
and prismatic screen PRS. In this example, the lens and screen are
placed at a distance of 3 inches in front of the computer screen
CS, though distances as great at 12 inches, and perhaps more, could
be utilized. Computer screen CS is housed in computer housing CH,
which also houses the CRT and associated circuitry (not shown) of
the conventional computer display. Such circuitry is well known in
the art and will not be further described here.
[0124] In the example shown in FIG. 20, image a is generated by the
CRT within housing CH in a conventional manner and is transmitted
along axis O-O1. The image can be seen from many different viewing
points, including the point designated VE shown positioned above
the top edge of the computer's screen and inclined at an angle of
30 degrees. Note that different viewing angles are possible by
tilting the computer on its base SB. In the example shown,
prismatic screen PRS and aspherical lens ASPL compensate for the
looking down viewing angle in the manner described above with
respect to FIG. 19.
[0125] FIG. 21 shows an aspherical lens ASPL constructed of 50 or
more radii that blend one into the other, as described above. The
radius "A" changes into radius "B" from the center of the lens to
its edge, with each intermediate radius being measured from a
different one of the steps S shown. When the invention is used in
the computer monitor context, radius "B" is advantageously chosen
to be approximately 10% to 40% longer than radius "A" due to the
desire to make the system as compact and lightweight as
possible.
[0126] FIG. 22 shows the aspherical lens ASPL magnifying computer
image S1 so that it appears as virtual curved image S2. Curving the
image S1 into S2 separates the images focus from convergence.
Combined with the effects of the prismatic screen PRS, described
above, this allows a viewer to perceive computer image depth cues
with much greater clarity. The aspherical lens in this example is
designed to magnify the computer image 25% or more with no
distortion. The prismatic screen PRS reduces the scanning lines, or
the pixel elements of the computer image, and enhances the
resolution of the image, which helps to eliminate eyestrain. Thus,
images are not only magnified but contain more detail.
[0127] A method of making an aspherical lens of the above-described
type, hereafter referred to as a stepped aspherical lens SASPL,
will now be described with reference to FIGS. 29-36. First, a
material from which the stepped aspherical lens SASPL is to be
manufactured is formed into a block using a mold. Exemplary
materials for forming the stepped aspherical lens SASPL may
include, but are not limited to, BK7 glass (having a refraction
index of 1.5163) and SK16 glass which has a higher refraction index
of 1.6204. However, it is preferable and may be advantageous to use
high-purity acrylic or polycarbonate plastic materials having a
relatively high index of refraction.
[0128] In one embodiment, a vertical mold M, having a glass lining
(not shown) to minimize contamination, is preferably used to form a
block B, as illustrated by FIG. 29. A selected material is poured
into the mold M and allowed to set from approximately 20-50 days,
depending on the material. This step allows for any impurities to
settle to the bottom of the mold M. The block B is then removed
from the mold M and cut according to the dimensions of a video
image screen with which the stepped aspherical lens SASPL is to be
used.
[0129] Referring next to FIG. 30, the block B is then secured to a
table T for milling by a cutting tool. While illustrated in a
vertical position, the block B may alternatively be milled
horizontally or otherwise. The table T is preferably a computer
numeric control (CNC) table, and the tool a CNC cutting tool CT
controlled by a CNC milling machine (not shown). As will be
appreciated by those skilled in the art, the CNC milling machine
may be programmed as desired to carry out cutting of each of a
plurality of radii steps RS to be cut in the surface of the block
B, thereby forming a stepped aspherical lens SASPL, as hereinafter
described.
[0130] In the exemplary embodiment, the stepped aspherical lens
SASPL will have 50 radii steps RS cut into the surface thereof, as
indicated by each `x` in FIG. 31. The radii steps are then cut by
the CNC cutting tool CT of the CNC milling machine, as seen in FIG.
32. As the radii steps RS may be cut directly into block B after
cutting the same to a desired size, it is not necessary that the
block B first be cut into a shape of a spherical lens.
Alternatively, as suggested by FIG. 31, the radii steps RS may be
cut into a previously-formed lens.
[0131] As can be better seen in FIG. 33, the CNC milling machine is
preferably programmed to cut the radii steps RS such that the
stepped aspherical lens SASPL, while termed aspherical, will
possess pseudo-spherical qualities as well. As indicated by a
dotted line 330, the radii steps RS, cut into the surface of the
stepped aspherical lens SASPL along a predefined curved path, will
further define a spherical surface having a radius Rs. This
pseudo-spherical quality will persist upon a polishing of the
steps, discussed below.
[0132] Concurrently, the stepped aspherical lens SASPL will possess
an aspherical quality resulting from the radii steps RS cut into
the surface thereof. Once the pluarlity of radii steps RS have been
cut into the surface of the stepped aspherical lens SASPL, the
steps are then polished, rounding them and blending the radii steps
RS together such that the individual radii steps RS are no longer
visible. The polishing is preferably achieved on a large, 40 inches
for example, polishing machine, with the stepped aspherical lens
SASPL preferably in a horizontal position, as seen in FIG. 35. The
polishing tool PT preferably uses an aluminum oxide polishing disc
having approximately a 0.5 micron surface, but may alternatively
use any suitable polishing implement. Polishing the individual
radii steps RS reduces them to curved portions. As discussed above
with reference to FIG. 21, these curved portions have gradually
increasing radii which are encountered with travel from a center of
the stepped aspherical lens SASPL to its edge. These curved
portions of varying radii provide the aspherical quality of the
stepped aspherical lens. Referring again to FIG. 34, this SASPL
aspherical quality, in conjunction with the pseudo-spherical
quality, leads to a separation of the focus and convergence
features of a flat image, as perceived by the human brain, leading
to enhanced perception of depth cues from the flat image, as
previously discussed in detail.
[0133] Referring to FIG. 34, a radius Rs of the spherical nature of
the stepped aspherical lens SASPL is illustrated. Also shown is a
radius Ra of one of the plurality of steps that define the
aspherical nature of the stepped aspherical lens SASPL
[0134] While the radii steps RS are illustrated as being cut and
polished in a single plane in FIG. 30, it should be recognized that
the radii steps RS are formed about a full surface of the stepped
aspherical lens SASPL, as can better be seen by reference to FIG.
33.
[0135] FIG. 23 shows the prismatic screen and aspherical lens
placed in front of the computer's monitor screen. It has been
discovered that these elements work as a UV shield, stopping UV
radiation which is harmful for the viewers eyes. This shield also
contributes to the elimination of eyestrain. The light beam OL from
the computer's screen CS, passing through the rear window RW, the
prismatic screen PRS, the aspherical lens AL and the front window
FW and is UV radiation free, before reaching the viewers eyes.
[0136] The system of the present invention can be used in
conjunction with all types of computer monitors, including digital
high definition and flat liquid crystal models. FIG. 24, for
example, shows the liquid crystal screen LQS, framed in the flat
computer screen housing FR, without the rear cone shaped tube,
which is typical for regular computer screens. The computer housing
DCH attached to the liquid crystal screen LQS is designed to be
narrow and to fit the flat liquid crystal screen. The liquid
crystal computer screen is characterized with better contrast of
the image and better image resolution. The computer screen system
of the present invention raises the liquid crystal image to a
higher quality level, where the image appears in depth, is
magnified and has higher image resolution.
[0137] Referring now to FIG. 25, there is shown an embodiment 1000
of the endoscope of the present invention. Endoscope 1000 consists
of tube portion 1004, sometimes referred to as a "guide." Tube 1004
is formed to be hollow in that it has a passageway running
longitudinally down its length. The passageway includes a
sub-passage or smaller tube referred to as the "working channel,"
described in more detail below. Tube portion 1004 may be a rigid
steel tube roughly 30 cm long having an outer diameter of
approximately 1.2 mm. For some procedures, it is more appropriate
to have a shorter rigid guide, such as one approximately 10 cm
long. Tube portion 1004 may alternatively be a flexible tube made
of flexible plastic, or some other suitable material, and having a
length of approximately 110 cm. This longer, flexible tube is
useful in procedures requiring insertion into, for example, blood
vessels of the body. The various guides are formed to be
interchangeable on endoscope 1000 by unscrewing one guide from hub
1001 and screwing in another.
[0138] Endoscope 1000 also includes a hub portion 1001 coupled to a
tube portion 1002, and instrument port 1003. Portions 1001 and 1002
and port 1003 can be made of metal or plastic, or some other
suitable material, as is known in the art. Each includes a
longitudinally formed hollow passageway down its length. Through
the hub this passageway, or biopsy channel, is coupled to the
working channel of the endoscope. These portions together allow the
physician to utilize, for example, a biopsy tube, described in more
detail below, inserted through the biopsy channel and the working
channel of endoscope 1000 in order to perform various medical
procedures, some of which are described in further detail
below.
[0139] Although not necessary for every embodiment of the
invention, FIG. 25 shows endoscope 1000 as including tube portion
1005 coupled to mini-hub 1001a, which is coupled to tube portion
1002, and to irrigation port 1006. In one embodiment, tube portion
1005 is approximately 1 foot long. Portion 1005, mini-hub 1001a and
irrigation port 1006 may also be made from any suitable material,
such as plastic or metal, though forming them of a flexible
material, such as a flexible plastic, makes them somewhat easier to
work with. Portion 1005, mini-hub 1001a and irrigation port 1006
are formed such that a passageway runs down their middle, referred
to here as the "irrigation channel," which passageway is coupled to
the biopsy channel of tube portion 1002 and, thereby, to the
working channel of endoscope 1000. (By proper formation of the hub
1001, the irrigation channel could also be coupled directly to the
working channel.)
[0140] These portions of endoscope 1000 allow the physician to
irrigate the area of the body being treated. For example, through
the irrigation channel liquids or air may be injected into the
working channel and thereby to the area of the body being treated.
Such liquids can include water, saline, anesthetics, or
antiseptics. The injection can occur through the operation of a
syringe or other similar instrument coupled to irrigation port
1006. Moreover, the irrigation channel can also be used as a port
through which a laser, such as an Eximer laser, could be utilized.
In that situation, the laser is inserted through the irrigation
channel and into the working channel until it reaches the area of
interest internal to the patient. The laser can then be used, for
example, as a means for clearing a blocked passageway.
[0141] Although again not necessary for every embodiment, FIG. 25
also shows endoscope 1000 as including tube portion 1007 coupled
between hub 1001 and video port 1008. As one skilled in the art
will appreciate, the video port 1008 may be any suitable video
coupler, and will preferably include magnification means. Tube
portion 1007, in one embodiment, is approximately 2.5 feet long and
is formed most advantageously with some flexible material, such as
a flexible plastic, so that it can be easily connected to video
equipment and the like. Tube 1007 and video port 1008 are formed
such that they include a passageway in their interior capable of
holding numerous fiber optic strands. Such strands run from video
port 1008, through tube portion 1007 into hub 1001. The strands run
through hub 1001 into the inner passageway of tube portion 1004,
though outside of the working channel, as described in more detail
below. These strands provide both a light source to the area of
interest and a video source to the video port, allowing the
physician to see an image of the area of interest while treatment
is occurring. Video port 1008 is therefore formed such that it
includes a light source connector 1009 and can be coupled to a
video camera, monitor and raster screen, as described in more
detail below. As a result of the improved magnification and viewing
qualities achieved using aspherical lenses of the type discussed
above, it has been found that a video coupler having a lower
magnification than in conventional endoscope systems may be
used.
[0142] A cross-sectional view of a stainless steel guide 1004, as
seen from viewpoint A-A on FIG. 25, is shown in detail in FIG. 26.
In FIG. 26, the rigid, steel tube option is depicted, although the
figure could just as readily depict the flexible tube option. More
specifically, FIG. 26 shows tube portion 1004, which contains
working channel 2001, a plurality of optical light fibers 2002 and
lens 2003. Guide 1004 has an outer diameter of approximately 1.2
mm. Working channel 2001 has an outer diameter of approximately
0.35 mm and an inner diameter of approximately 0.25 mm. Tubing for
such a channel can be obtained from, for example, Solos Endoscopy
Co. of Braintree, Me.
[0143] The use of a working channel 2001 having a reduced working
channel outer diameter, such as 0.35 mm allows for a corresponding
increase in the number of optical or light fibers 2002 and/or an
increase in the size of the lens 2003 in the image fiber optical
channel (see e.g., FIG. 26). In addition, because of the decrease
in overall size of the endoscopes of the present invention,
countless medical procedures can be performed in a less invasive
and less traumatic manner than was previously known. For example,
in many cases, ducts may be utilized as entry points to a body, as
opposed to a surgical incision. Moreover, ductules, such as those
of the female breast, which previously were inaccessible due to the
size of conventional endoscopic devices, can now be analyzed and
diagnosed for diseases, such as cancer, well before such diagnoses
would be available with conventional systems.
[0144] In the embodiment shown in this figure there are 16 optical
fibers running down the length of guide 1004, each having a
diameter of approximately 0.125 mm. These fibers act to provide
light to the area of interest, although a different number of
fibers and/or fibers of different diameters may also be used. Lens
2003 also runs longitudinally down the inner passage of guide 1004
and has a diameter of 0.35 mm.
[0145] Referring now to FIG. 27, there is shown a sectional
elevation of a biopsy tube 3000 to be used with the endoscope of
the present invention. The biopsy tube 3000 includes tube portion
3001, which includes a hollow passageway down its length, coupled
to syringe 3002, or some other similar instrument, and having an
end portion 3003. The tube has an outer diameter of approximately
0.135 mm which allows it to be inserted into the working channel of
guide 1004 of endoscope 1000, as shown in FIG. 3A.
[0146] In one embodiment, end portion 3003 does not include a
scraper or biopsy brush for the extraction of biopsy cells,
although in other embodiments it could. Rather, the distal end of
the biopsy tube has no brush or medical instrument whatsoever
attached and is more like the end of a tube or needle. Because the
tube is of such a small outer diameter, the physician can
manipulate the biopsy tube from the proximal end in order to scrape
cells free of the tissue. The physician can then irrigate the
location by ejecting water under pressure through the irrigation
channel through the operation of syringe 3002. This causes the
water injected into the patient to mix with the scraped biopsy
cells. Such water and cells can be drawn into the biopsy tube 3000
by withdrawing the plunger of the syringe 3002. Once the endoscope
is removed from the patient's body, the plunger of syringe 3002 can
be pushed back in and the biopsy cells disgorged onto a slide or
into a transmission medium for later testing.
[0147] Biopsy tube 3000 can be made of stainless steel, flexible
plastic, or some other suitable material, depending on the guide
with which it will be used. A biopsy tube suitable for use in the
present invention may be obtained from United Machines, Inc. of
Bohemia, N.Y.
[0148] In further exemplary embodiments, it will be preferable to
utilize a biopsy tube 3000, or other instrument to be inserted into
an endoscope working channel, such as a scraper or cytology
instrument having a roughened end portion. Particularly for use in
a relatively small working channel, such as the 0.35 mm channel as
discussed above or smaller, a composition of the cytology
instrument will be important. In one embodiment, a cytology
instrument is contemplated which has a 0.25-0.30 mm diameter for
use in a 0.33-0.35 mm working channel. Because of the relatively
small proportions, the cytology instrument must be formed of a
material having sufficient strength to allow effective scraping and
cell removal. Since the end portion 3000 will be used within the
body, the end portion 3000 is further preferably formed of, or at
least coated by, a suitable biocompatible material.
[0149] One material that meets these requirements is Nitinol
(NiTi), an alloy of nickel and titanium. It is contemplated that
forming further alloys by combining Nitinol with other elements or
compounds may lead to suitable materials as well. Nitinol has been
found to exhibit favorable strength and biocompatibility
characteristics in numerous surgical applications. For example,
Nitinol enjoys a high tensile strength and resistance to lateral
deformation, as well as resilience to an environment of the human
body, such that a device formed thereof can be used repeatedly
without degradation. Importantly, Nitinol has further been
classified as biologically inactive, indicating that internal use
of Nitinol elicits a minimal, if any, negative response from the
human body. Further information regarding the biocompatibility of
Nitinol may be obtained by reference to the following dissertation
which is hereby incorporated herein by reference in its entirety:
Ryhanen, Jorma, "Biocompatibility Evaluation of Nickel-Titanium
Shape Memory Metal Alloy," presented at the University Hospital of
Oulu, Finland, May 7, 1999 (presently available at
http://herkules.oulu.fi/issn03553221/).
[0150] A cytology instrument of this embodiment advantageously has
a working end adapted for any of a variety of biopsy functions,
such as scraping. Therefore, the working end may be roughened or
otherwise made abrasive for this purpose.
[0151] A roughened working end may be formed in a variety of ways.
For example, a laser energy source may be directed at a Nitinol
instrument, thereby removing an oxide layer at the surface. This
will leave behind an abrasive surface that is suitable for
scraping. Alternatively, the oxide layer may be removed by
sandblasting, which will also leave a roughened surface.
[0152] In another embodiment, a Nitinol surface may be roughened to
form an abrasive surface by stone grinding, such as with a stone
wheel. The degree of abrasiveness may be controlled by varying an
amount of stone grinding. Alternatively, a tool and die can be used
to impart a controllable amount of roughness to a Nitinol surface.
In this method, the tool and die are used to score the surface
creating a desired abrasiveness.
[0153] A method of using a Nitinol cytology instrument to retrieve
biopsy cells or other bodily materials will now be described. As
discussed above with respect to FIGS. 26 and 27, the endoscope 1000
is first used to locate an area of the body to be biopsied. The
area may be a cell, tissue or other abnormality, such as a
papilloma or other tumor, or alternatively an area of normal,
healthy cells, such as in preventative and/or diagnostic
procedures.
[0154] The Nitinol cytology instrument will then be inserted
through the working channel 1003, and manipulated with the visual
assistance of the endoscope 1000 to scrape a portion of the area,
perhaps a number of cells, a sample of lining, etc., from the area
to be biopsied or studied. A syringe or other means is used to
inject a fluid, such as saline solution, through the irrigation
channel 1005, such that the fluid and biopsied material mix.
Alternatively, the fluid may be injected prior to the scraping.
Next, to remove the biopsied material, it is preferable in this
embodiment to aspirate the injected fluid and biopsied material
through the working channel following removal of the Nitinol
cytology instrument. Once the mixture of biopsied material and
fluid has been aspirated, samples thereof may be tested in any of a
variety of ways, or placed on a slide for viewing under a
microscope.
[0155] It is also an advantageous feature of the present invention
that, because the above-described procedure is carried out
endoscopically, as compared to a biopsy via an open incision for
example, biopsied materials, such as papillomas, have a reduced
tendency to migrate within the body prior to aspiration. This
feature is important not only in obtaining a complete sample, but
also in preventing contamination of other areas of the body with
biopsied material. For example, the spread of tumor cells within
the body, particularly if cancerous, can be highly detrimental to a
patient.
[0156] FIG. 28 depicts endoscope 1000 used in conjunction with a
video monitor and prismatic screen as described above. For example,
in FIG. 28 the video port 1008 is coupled to a video camera 4001,
the output of which is coupled to video monitor 4002 having as an
attachment prismatic screen 4003. Prismatic screen may also include
an optical element, such as a spherical or aspherical lens or other
device, as described above.
[0157] Video camera 4001 may be of many different commercially
available models, although CCD cameras are particularly useful in
this type of application. Specifically, a Panasonic GS9900-NTSC
medical video endoscopy camera, from Matsushita Electric
Corporation of America, has been found to be useful. Moreover, it
has been found that in such a camera a 1/4 inch CCD chip is more
advantageous than a 1/2 inch CCD chip, because it provides an image
with smaller pixels. Such chips are included in CCD cameras and
also are commercially available from many sources such as, for
example, the Sony Corporation of America. Video monitor 4002 may be
any of a number of commercially available video monitors.
[0158] Referring now to FIGS. 37 and 38, there are shown a
conventional endoscope employing a 1/2 inch CCD chip 37b and a
preferred embodiment of the present invention employing a 1/4 inch
video CCD chip 38b, respectively. As can be seen by comparing FIGS.
37 and 38, the present invention provides for a closer focus
distance X. Such a shortened focus distance is achieved by
refocusing the coupler 37c to a shorter optical distance and by
reducing the size of the CCD chip to 1/4". Exemplary focus
distances are from about 1.0 to about 2.0 mm as compared to about
4.0 mm for a 3.0 diameter conventional endoscope. Such short focal
lengths are advantageous for performing medical procedures in, for
example, but not limited to, small ductules, like those present in
the human breast and other areas of the human body as described
herein.
[0159] These shortened focus distances are also achieved by
reconfiguring the video camera housing and coupling the video CCD
chip at a closer distance (depicted as Y in FIGS. 37 and 38) to the
coupler 37c. The video camera is optically redesigned with a new
housing and shorter distance bracket than conventional systems
which allows the distance between the video chip 38b and the front
of the video camera to be much shorter than conventional systems
(see Z in FIGS. 37 and 38). It should also be apparent to one
skilled in the art that refocusing lens 37a can be any suitable
lens, for example, but not limited to, a spherical, drum,
aspherical, or stepped aspherical lens, as described herein.
[0160] The present invention allows the image magnification to be
maintained at the prior level of much larger endoscopic systems
without degradations in image quality which are inherent in
conventional microendoscopic systems. The same number of scanning
lines can be achieved with shorter focal lengths and larger depths
of field (e.g., about 50% larger for a focus distance of about 1 to
about 2 mm) by dividing each scanning line into three or more
lines, thereby increasing projected image quality by reducing the
visibility of the scanning lines. Larger depths of field are
achieved because of the shortened optical focal length of the
coupler as shown in FIG. 39. As a result, smaller, less visible
scanning lines are present thereby facilitating numerous medical
procedures which were previously unattainable given the image and
quality limitations of conventional microendoscopic systems.
[0161] It is not necessary to include a prismatic screen to use the
endoscope of the present invention. However, the use of such a
screen is advantageous because, as described above, the screen
provides an image with increased clarity and perception of depth by
causing the brain of the viewer to interpret depth cues present in
the image. This increased perception of depth is particularly
advantageous in medical procedures like those that employ
endoscopes because of the small dimensions involved and the limited
lighting available in the interior of a patient's body. Moreover,
because the fiber optic elements of any endoscope are necessarily
small, the image generated by them is also small, limiting its
usefulness to the physician and its practicality during the
procedure. The prismatic screen described in the patents and
application above, when used conjunction with the endoscopic
instrument described above, produces an image anywhere from 25% to
100% larger than use of the instrument without the screen. Thus,
the endoscope of the present invention coupled with the prismatic
screen of the above referenced patents and patent application
permit the physician to perform the biopsy, or other procedure,
while actually viewing the progress and operation of the instrument
and to do so in a much more advantageous manner.
[0162] Operation of endoscope 1000 will now be described briefly in
order better to explain various uses of the invention in some
situations. Generally speaking, endoscope 1000, using either the
flexible or rigid guides 1004, is inserted into an orifice or
incision in the patient's body. The physician can view the areas of
the body through which the endoscope passes on its way to the area
of interest and can view the area of interest once it is reached by
watching the screen 4003 attached to video monitor 4002. Once at
the appropriate place in the patient's body, the physician can
manipulate the biopsy tube 3001 in order to retrieves cells from
that area or perform some other medical procedure. For example, the
physician can inject water into the area of interest through the
working channel using a syringe coupled to the biopsy tube. He can
then aspirate the water and sample cells through the operation of
the syringe. The cells are then retrieved with the water, through
the working channel, poured into a sterilized plastic container,
for example, and taken to pathology for diagnostic testing.
[0163] Occasionally the lens of endoscope 1000 may need to be
cleared of blood and cell particles as a procedure is being
performed. The irrigation channel and the working channel may be
used in performing this function by, first, applying a liquid under
pressure through the use of a syringe attached to the irrigation
port. This has the effect of both widening the viewing area and
clearing the viewing area of blood. However, it is important to
apply the fluid using a pressure higher than that of the blood.
[0164] Second, because liquids will often become quickly colored
with blood, air pressure is applied through the working channel by
a syringe coupled to the irrigation port. This creates a small
cavity around the end of the endoscope and pushes the fluids in the
patient's body out of the viewing area. This, consequently, clears
the way for the light emitted from the light source optical fibers
and for the resulting light entering the lens, thereby creating a
much clearer image for the physician.
[0165] The present invention can be used in many different
specialized procedures. For example, the endoscope of the present
invention can be used in a breast duct diagnostic procedure whereby
the guide is inserted through the dilated nipple of the breast and
the area of interest is viewed on the screen. A biopsy may be
performed if necessary. Thus, the present invention allows a
non-invasive procedure useful in detecting breast cancer through
direct visualization by the treating physician.
[0166] The present invention may also be used in techniques similar
to angiograms and angioplasty, whereby the endoscope 1000 utilizing
a flexible guide is inserted into an artery. The treating physician
can see the inside of the artery on the screen and can determine
the extent and type, if any, of blockage in the artery. This
technique can also be used with respect to smaller veins and
arteries that carry blood to and from much more difficult parts of
the body to reach, such as the lungs, neck and chest.
[0167] Glaucoma investigation and other ocular procedures can also
be accomplished with the present invention, most usefully using a
shorter, rigid guide. Such procedures include inserting the guide
of the endoscope into the tear duct of the eye, viewing its
interior on the screen and performing a medical procedure, such as
aspiration, for example, or clearing of a blocked passageway
through the utilization of an Eximer laser.
[0168] In addition, the present invention can be used to traverse
the optical nerve such that the alignment between the optical nerve
and the brain can be checked prior to, and following, for example,
a corneal transplant or other ocular transplant or surgery. In
addition to alignment between the optical nerve and the brain, the
present invention allows for identification and treatment of other
abnormalities that might exist within the optical nerve that were
previously undetectable using conventional systems.
[0169] Indeed, a particularly advantageous use of the present
invention is in the treatment of cancer in various parts of the
body. Cancer is generally treatable in three ways: surgery,
radiation and chemotherapy. Surgery and radiation, of course, have
risks and disadvantages well known to those of skill in the art.
Chemotherapy also can be particularly disadvantageous as, for
example, when the drugs involved cause sickness to the patient when
they enter the blood stream. One advantage of the present invention
is that, due to its size and the quality of image obtainable, the
physician can inject liquids directly into a cancerous tumor,
minimizing the collateral damage or exposure to chemotherapeutic
chemicals to other portions of the body.
[0170] Because of the microscopic size of the endoscope of the
present invention, papillomas or other cancerous growths can be
diagnosed well in advance of when they were able to be detected and
treated using conventional open breast surgeries or the like. For
example, using the system of the present invention, the endoscope
can be used to traverse a breast ductule up to a papilloma or other
abnormality. A laser, such as an Eximer laser, or other suitable
device can then be inserted into the small working channel of the
endoscope and positioned adjacent the abnormality. In this fashion,
the laser can be used to burn or otherwise break up the abnormality
whereupon it can be removed from the body. Through use of the
present invention, microprocedures such as those described herein
provide an invaluable ability to both view cancerous growths in
their infancy and provide a means by which to remove the cancerous
growths before they are allowed to spread to other parts of the
body. Indeed, such procedures can be accomplished without the more
invasive techniques of open breast surgeries and the like.
[0171] Further, the present invention is useful in the diagnosis
and treatment of prostate cancer that often requires surgery or an
extremely invasive endoscopic procedure through the penis or anus.
The endoscopic system of the present invention permits a much less
invasive procedure and allows the physician to visualize, by seeing
on the screen, exactly what is happening as it happens.
[0172] This invention is also particularly useful in pediatric
applications, such as a drainage of the lacrimal sinus of an infant
in order to aspirate any pools of mucus that have built up in the
underdeveloped sinus of the child, thereby halting any developing
infection.
[0173] Indeed, procedures in which physicians must invade any
cavity of the body whether in children or adults, and in which
physicians have been visually limited in the past, may be performed
with the present invention in a much less invasive manner and with
the physician able to see exactly what he or she is doing. Such
procedures include, for example, laryngeal and esophagus related
procedures, peritoneal and abdominal cavity procedures, obstetrics
and gynecological procedures, sigmoid-colon procedures, parotid
gland procedures, oral surgery, including root canals, spinal cord
procedures, procedures directed to the lymph nodes, small joint
procedures and even medical procedures on animals.
[0174] The principles, embodiments and modes of operation of the
present invention have been described in the foregoing
specification. The invention that is sought to be protected herein,
however, is not to be considered as limited to the particular forms
disclosed, since these are to be regarded as illustrative rather
than restrictive. Variations and changes may be made by those
skilled in the art without departing from the spirit and scope of
the invention. For example, the present invention is not limited to
the particular dimensions or uses described, except as explicitly
defined in the claims.
* * * * *
References