U.S. patent application number 12/104405 was filed with the patent office on 2009-02-26 for imaging systems and methods, particularly for use with medical instrument used in open surgery.
This patent application is currently assigned to C2CURE, INC.. Invention is credited to Doron Adler, Ofer Pillar.
Application Number | 20090054787 12/104405 |
Document ID | / |
Family ID | 40380170 |
Filed Date | 2009-02-26 |
United States Patent
Application |
20090054787 |
Kind Code |
A1 |
Adler; Doron ; et
al. |
February 26, 2009 |
IMAGING SYSTEMS AND METHODS, PARTICULARLY FOR USE WITH MEDICAL
INSTRUMENT USED IN OPEN SURGERY
Abstract
Systems and methods for use in performing an open surgical
procedure on a body of a patient using a working element of a
surgical instrument that has a shaft connected proximally to the
working element; and capturing an image of an area of the body
using a camera that is connected to the shaft.
Inventors: |
Adler; Doron; (Haifa,
IL) ; Pillar; Ofer; (Kiryat Haim, IL) |
Correspondence
Address: |
GANZ LAW, P.C.
P O BOX 2200
HILLSBORO
OR
97123
US
|
Assignee: |
C2CURE, INC.
Wilmington
DE
|
Family ID: |
40380170 |
Appl. No.: |
12/104405 |
Filed: |
April 16, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60912337 |
Apr 17, 2007 |
|
|
|
61016557 |
Dec 24, 2007 |
|
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Current U.S.
Class: |
600/476 |
Current CPC
Class: |
A61B 1/051 20130101;
A61B 90/36 20160201; H01L 2224/4809 20130101; A61B 90/361 20160201;
H01L 31/0203 20130101; H04N 7/183 20130101; A61B 2017/00221
20130101; A61B 2090/373 20160201; A61B 1/0011 20130101; G09B 23/30
20130101; H01L 31/0232 20130101; A61B 17/2812 20130101 |
Class at
Publication: |
600/476 |
International
Class: |
A61B 6/00 20060101
A61B006/00 |
Claims
1. A method of open surgery, comprising: i) making an incision in a
patient to provide direct access to a surgical site; ii)
introducing a surgical instrument to the surgical site, the
surgical instrument comprising a tissue treatment portion for the
modification or manipulation of tissue at the surgical site, and a
non-working portion proximal from the tissue treatment portion, and
an imaging system associated with the non-working portion; iii)
displaying an image of the surgical site obtained from the imaging
system; iv) modifying or manipulating the tissue at the surgical
site by means of the surgical instrument; and v) closing the
incision in the patient at the end of the surgical procedure.
2. A method of open surgery, comprising: i) making an incision in a
patient to provide direct access to a surgical site; ii)
introducing a surgical instrument to the surgical site, the
surgical instrument comprising a tissue treatment portion for the
modification or manipulation of tissue at the surgical site, and a
non-working portion proximal from the tissue treatment portion, and
an imaging system associated with the non-working portion; iii)
acquiring an image of the surgical site in the form of image data
using the imaging system; iv) modifying or manipulating the tissue
at the surgical site by means of the surgical instrument; and v)
closing the incision in the patient at the end of the surgical
procedure.
3. The method of claim 1 wherein the imaging system is associated
with a non-insertion portion of the instrument.
4. The method of claim 2 wherein the imaging system is associated
with a non-insertion portion of the instrument.
5. A method of communicating imaging data comprising providing a
medical instrument, the instrument comprising a distally disposed
working portion for working in a surgical or medical procedure, and
a proximally disposed non-working portion having an associated
imaging system, the non-working portion being on a non-insertion
portion of the instrument; and transmitting the imaging data to a
location remote from the surgical table for viewing or use by
others who are beyond the immediate area of the surgical table or
other surgical platform.
6. The method of claim 2 wherein the imaging system is removably
mounted on the instrument.
7. A method for medical treatment, comprising: performing an open
surgical procedure on a body of a patient using a working element
of a surgical instrument that has a shaft connected proximally to
the working element; and capturing an image of an area of a
surgical site on the body using an image sensor in a camera that is
connected to the shaft.
8. The method of claim 7, wherein performing the open surgical
procedure comprises inserting the working element into the body
while holding a proximal end of the instrument outside the
body.
9. The method of claim 1, wherein capturing the image comprises
clipping the camera onto the shaft.
10. The method of claim 7, wherein the camera comprises a chassis
having an open cylindrical groove formed therein, an image sensor
assembly mounted in the chassis, wherein the image sensor assembly
comprises an electronic image sensor, a plurality of lenses that
are fitted into the groove in respective positions so as to direct
an image onto the image sensor, and a cover, which closes over the
image sensor assembly and the lenses in the chassis.
11. The method of claim 7 further comprising displaying the image
during the open surgical procedure.
12. The method of claim 11, wherein the image is presented to a
location remote from the surgical table for viewing or use by
others who are beyond the immediate area of the surgical table or
other surgical platform.
13. The method of claim 7, wherein the camera is not inserted into
the body.
14. The method of claim 1 wherein the imaging system comprises a
pixellated, electronic image sensor.
15. The method of claim 5 wherein the imaging system comprises a
pixellated, electronic image sensor.
16. The method of claim 7 wherein the imaging system comprises a
pixellated, electronic image sensor.
17. The method of claim 14 wherein the instrument includes a
solid-state light source for illuminating a surgical site.
18. The method of claim 15 wherein the instrument includes a
solid-state light source for illuminating a surgical site.
19. The method of claim 16 wherein the instrument includes a
solid-state light source for illuminating a surgical site.
20. The method of claim 12 wherein the one or more persons are not
in the same room as the patient.
21. The method of claim 12 wherein the data are communicated via a
data or telecommunications network.
22. The method of claim 12 wherein data representing acquired
images are communicated to a data storage medium for on-demand
presentation to a viewer.
23. The method of claim 7 further comprising using the data in one
or more of the following respects: medical or surgical training;
participation or collaboration in the medical procedure being
performed; participation or collaboration in a medical procedure
for the same patient subsequent to the one being performed;
modification of the imaging data, enhancements or derivations;
archiving of procedures; for compliance with established rules or
policies; for use in regulatory submissions.
24. A surgical instrument, comprising: a working element for
performing an open surgical procedure on a body of a patient, and a
shaft connected proximally to the working element; and a camera
that is connected to the shaft so as to capture an image of an area
of the body.
25. The surgical instrument of claim 24, wherein the camera is
configured to capture the image of the area that is in a vicinity
of the working element.
26. The surgical instrument of claim 24, wherein the camera
comprises a clip for fastening the camera onto the shaft.
27. The surgical instrument of claim 24, wherein the camera
comprises a chassis having an open cylindrical groove formed
therein, an image sensor assembly, which comprises an electronic
image sensor and is mounted in the chassis, a plurality of lenses
that are fitted into the groove in respective positions so as to
form an image on the image sensor, and a cover, which closes over
the image sensor assembly and the lenses in the chassis.
28. The camera of claim 24 further comprising a solid-state light
source for illuminating a surgical site.
Description
RELATED APPLICATIONS
[0001] This application claims the benefit of and priority to U.S.
Provisional Application Ser. No. 60/912,337, filed Apr. 17, 2007,
entitled METHODS AND INSTRUMENTS FOR IMAGING IN MEDICAL OR SURGICAL
PROCEDURES and U.S. Provisional Application Ser. No. 61/016,557,
filed Dec. 24, 2007, entitled COMPACT CAMERA, the contents of which
are hereby incorporated by reference as if recited in full herein
for all purposes.
BACKGROUND
[0002] This inventive subject matter generally relates to imaging
systems and methods for surgical or other medical procedures. More
particularly, it relates to compact imaging systems for use on
instruments for open surgery.
[0003] When a surgeon is performing an open surgery, the area of
interest may be too small for more than one surgeon to observe. Or
the area of the surgical table may be too crowded and not easily
viewed by other medical personnel who may be interested in viewing
the surgical site and procedure. Some surgical rooms have overhead
cameras that allow others to view a surgical site, but the movement
of persons around the table and angle of viewing may preclude a
view of the area of interest. Accordingly, there is a need for
improved imaging systems and methods of dissemination of imaging
data that facilitate collaboration, participation, and surgical and
medical training.
[0004] There are several types of surgery. The first is endoscopic
surgery, such as laparoscopic surgery, in which a small incision is
made in order to insert working instruments and an endoscopic
viewing instrument. Imaging systems for endoscopic surgery are well
known and are typically located either on the distal end of the
insertion portion of an instrument or on its proximal end (using
rod lens or fiber based endoscope). A second type of surgery is
endoluminal (natural orifice) surgery, in which no external
incision is required. U.S. Pat. No. 4,905,670, by Adair, discusses
a cervical speculum with a clip-on camera, and therefore belongs to
this second category of surgery. Other prior art includes U.S. Pat.
Nos. 5,667,473, 5,667,478 and 5,735,792. In these patents, the
instruments are endoscopic instruments rather than instruments for
open surgery, and one or more optical fibers are run along the
instruments in order to view the surgical site without the need for
a separate endoscope.
[0005] A third type of surgery is open surgery, in which a larger
incision is made in order to view the site directly and to maneuver
the working instruments. This type of surgery can be observed
without an insertion of an imaging system.
[0006] Although many video cameras and imaging systems have been
developed for endoscopic applications, the range of video imaging
systems for open surgical applications is much more limited. For
example, some operating rooms have overhead cameras, but the view
provided by the camera may be blocked by the hands or instruments
of the surgical personnel. Furthermore, the camera may not have
sufficient magnification to give observers and other members of the
surgical team a clear picture of the surgical site.
[0007] Accordingly, the prior art does not disclose or suggest
imaging systems or methods that are suitable for use in the viewing
environment of open surgery. Nor does the prior art disclose
methods for extending the audience in open surgery or methods of
dissemination of the imaging data or methods of collaboration in
response to imaging data.
SUMMARY
[0008] The inventive subject matter overcomes problems in the prior
art by providing a camera system and methods with the following
qualities, alone or in combination:
[0009] In certain respects, the inventive subject matter is
directed to permanently or removably mounted cameras that are
mounted on a non-insertion portion of a medical instrument, and to
methods of making and using the same. The medical instrument with
associated camera may be used in open surgery. Open surgery is a
method of surgery in which an incision is made to enable direct
viewing of and access to the surgical site, an instrument is
introduced into the surgical site, and a camera attached to or
integrated in the instrument is used to provide a displayed image
in addition to the direct viewing of the site by the surgeon. Some
times structural pathology prevents direct visualization, and the
only means to see the operated site would be through a camera
mounted on a tool. By placing the camera on the instrument, the
site of interest may be kept in clear, direct view, unobstructed by
hospital personnel or objects. Accordingly, the inventive subject
matter allows for better-informed judgments from consulting
personnel, such as specialist physicians or surgeons, or for better
training of students in an educational setting, for example. The
inventive subject matter is particularly advantageous at allowing
participation of remotely located persons, who may be participating
via a telecommunications or data network.
[0010] Various methods are within the scope and contemplation of
the inventive subject matter. For example, in one possible
embodiment, the inventive subject is directed to a method of
imaging in open surgery comprising providing an instrument with an
associated imaging system and acquiring imaging data with the
camera and presenting it on a presentation device, such as a
computer monitor, television, or via a printer.
[0011] In another possible embodiment, the inventive subject matter
is directed to a method of communicating imaging data comprising
providing a medical instrument, the instrument comprising a
distally disposed working portion for working in a surgical or
medical procedure, and a proximally disposed non-working portion
having an associated imaging system, the non-working portion being
on a non-insertion portion of the instrument.
[0012] In other embodiments, the inventive subject matter is
directed to a compact video camera that is particularly suited to
give a close, unobstructed view of the surgical site in open
surgery. The camera may be attached to a shaft of a surgical
instrument so as to image the area of the working element at the
distal end of the instrument. The camera may be self-contained,
requiring no intervening fiberoptics or modification of the
instrument to which it is to be attached.
[0013] In another possible embodiment, the inventive subject matter
is directed to a method of open surgery, comprising: making an
incision in a patient to provide direct access to a surgical site;
introducing a surgical instrument to the surgical site, the
surgical instrument comprising a tissue treatment portion for the
modification or manipulation of tissue at the surgical site, and a
non-working portion proximal from the tissue treatment portion, and
an imaging system associated with the non-working portion;
displaying an image of the surgical site obtained from the imaging
system; modifying or manipulating the tissue at the surgical site
by means of the surgical instrument; and closing the incision in
the patient at the end of the surgical procedure.
[0014] In another possible embodiment, the inventive subject matter
is directed to a method of open surgery, comprising: making an
incision in a patient to provide direct access to a surgical site;
introducing a surgical instrument to the surgical site, the
surgical instrument comprising a tissue treatment portion for the
modification or manipulation of tissue at the surgical site, and a
non-working portion proximal from the tissue treatment portion, and
an imaging system associated with the non-working portion;
acquiring an image of the surgical site in the form of image data
using the imaging system; modifying or manipulating the tissue at
the surgical site by means of the surgical instrument; and closing
the incision in the patient at the end of the surgical
procedure.
[0015] In another possible embodiment, the inventive subject matter
is directed to a method of communicating imaging data comprising
providing a medical instrument, the instrument comprising a
distally disposed working portion for working in a surgical or
medical procedure, and a proximally disposed non-working portion
having an associated imaging system, the non-working portion being
on a non-insertion portion of the instrument; and transmitting the
imaging data to a location remote from the surgical table for
viewing or use by others who are beyond the immediate area of the
surgical table or other surgical platform.
[0016] In another possible embodiment, the inventive subject matter
is directed to method for medical treatment, comprising: performing
an open surgical procedure on a body of a patient using a working
element of a surgical instrument that has a shaft connected
proximally to the working element; and capturing an image of an
area of a surgical site on the body using an image sensor in a
camera that is connected to the shaft.
[0017] In another possible embodiment, the inventive subject matter
is directed to A surgical instrument, comprising: a working element
for performing an open surgical procedure on a body of a patient,
and a shaft connected proximally to the working element; and a
camera that is connected to the shaft so as to capture an image of
an area of the body.
[0018] In the embodiments of methods, systems, and apparatuses
disclosed herein: the imaging system may be associated with a
non-insertion portion of the instrument; the imaging system may be
removably mounted on the instrument; the performing the open
surgical procedure may comprise inserting the working element into
the body while holding a proximal end of the instrument outside the
body; the capturing the image may comprise clipping the camera onto
the shaft; the camera may comprise a chassis having an open
cylindrical groove formed therein, an image sensor assembly mounted
in the chassis, wherein the image sensor assembly comprises an
electronic image sensor, a plurality of lenses that are fitted into
the groove in respective positions so as to direct an image onto
the image sensor, and a cover, which closes over the image sensor
assembly and the lenses in the chassis; there may be a displaying
of the acquired image during the open surgical procedure; the image
may be presented to a location remote from the surgical table for
viewing or use by others who are beyond the immediate area of the
surgical table or other surgical platform; an image may be acquired
without inserting the camera into the body; the imaging system may
comprise a pixellated, electronic image sensor; the instrument may
include a solid-state light source for illuminating a surgical
site; the image may be displayed or otherwise presented to one or
more persons who are not in the same room as the patient; the
acquired image data may be communicated via a data or
telecommunications network; the data representing acquired images
are communicated to a data storage medium for on-demand
presentation to a viewer; the camera may be configured to capture
the image of the area that is in a vicinity of the working element;
the camera may comprise a clip for fastening the camera onto the
shaft.
[0019] In the embodiments of methods, systems, and apparatuses
disclosed herein: the acquired image data may be used in one or
more of the following respects: medical or surgical training;
participation or collaboration in the medical procedure being
performed; participation or collaboration in a medical procedure
for the same patient subsequent to the one being performed;
modification of the imaging data, enhancements or derivations;
archiving of procedures; for compliance with established rules or
policies; for use in regulatory submissions.
[0020] In some embodiments, the camera is produced using novel
components and methods of manufacture that facilitate small size,
high reliability and low cost. Although the camera is described
below with particular reference to surgical applications, the novel
features that are described below may similarly be implemented in
cameras and imaging systems for other uses.
[0021] These and other embodiments are described in more detail in
the following detailed descriptions and the figures. The foregoing
is not intended to be an exhaustive list of embodiments and
features of the present inventive subject matter. Persons skilled
in the art are capable of appreciating other embodiments and
features from the following detailed description in conjunction
with the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] The following figures show embodiments according to the
inventive subject matter, unless noted as showing prior art.
[0023] FIG. 1 is a schematic, pictorial view of a system for
surgery using an instrument of open surgery with an integrated,
compact camera;
[0024] FIG. 2 is a schematic, pictorial illustration of a video
camera attached to a medical instrument;
[0025] FIG. 3 is a schematic, pictorial illustration of a video
camera usable with a medical instrument for open surgery;
[0026] FIG. 4 is a schematic, transparent view of the video camera
of FIG. 3;
[0027] FIG. 5 is a schematic, exploded view of the video camera of
FIG. 3;
[0028] FIG. 6 is a schematic, sectional view of the video camera of
FIG. 3;
[0029] FIG. 7 is a schematic, exploded view of a video camera, in
accordance with another embodiment of the inventive subject matter;
and
[0030] FIG. 8 is a schematic, sectional view of the video camera of
FIG. 7.
DETAILED DESCRIPTION
[0031] Representative embodiments according to the inventive
subject matter are shown in FIGS. 1-8.
[0032] In a most general sense, the inventive subject matter is
directed to the use of an imaging system. As used herein, "imaging
system" typically means an objective optic element or elements and
a device on which the objective optics convey the image for
capture. There are many known cameras that are representative of
imaging systems. The imaging system illustrated in the figures is
an electronic imaging system comprising an objective lens and a
pixellated, electronic image sensor, such as a CCD or CMOS
sensor.
[0033] The imaging system may capture an image in an open surgical
procedure to provide additional viewing opportunities beyond the
restricted view generally presented to only the operating
surgeon.
[0034] The camera may be attached, integrated in, or otherwise
connected to one of the instruments used in the operation in such a
way that it will not complicate any technical procedure done by the
instrument from one end, and will allow anyone in the operating
room, or in a remote location, to see the working area from a
different angle or point of view on a monitor or other through
another output device, such as printer. As used herein, an
instrument "associated" with a camera means an instrument with a
camera that is physically coupled to the instrument, in a removable
or non-removable manner, such as by mounting or attaching the
camera on or within a known instrument or making an instrument with
an integrated camera feature on or in the instrument.
[0035] Typically, the instrument on which the imaging system is
associated will have a distally disposed working portion for
working in a surgical or medical procedure, and a proximally
disposed non-working portion having an associated imaging system,
the non-working portion being on a non-insertion portion of the
instrument. As used herein, "non-insertion portion" means a portion
that is generally kept above the plane of a body surface; however,
if there is a wide opening or recess below the plane, the
non-insertion portion may be used below the plane of the body
surface, if such use is consistent with open-type surgery.
[0036] The camera may be configured with a battery or coupled to a
remote power source. The power source may be the same one
associated with a medical instrument with which the camera is
mounted or otherwise used. The camera may be configured with a
configuration for wireless transmission of image data to a
received, such as camera control unit (CCU), such communication
interfaces including hardware and/or software components and
protocols, as are well known to persons skilled in the arth.
[0037] In some embodiments the camera and/or the instrument may be
disposable in the context of the medical arts, namely a camera
intended for one time use. As used herein, "camera" means a video
or still camera.
[0038] Generally, known camera systems may be adapted for use in
the inventive subject matter. Example systems are disclosed in
WO2006066022, US2006173242 and US20050250983 which are hereby
incorporated by reference in their entireties. Other known systems
that have a form that may be adapted for use in the inventive
subject matter disclosed herein include capsule-form endoscopic
cameras, such as those disclosed in US2006253004 and US2006004256,
which are hereby incorporated by reference in their entireties.
[0039] The following sections provide details of an illustrative
camera system according to the inventive subject matter. The
examples are strictly for illustrative purposes and are not
intended to be limiting of the scope of the inventive subject
matter, unless specifically indicated to such (as well as
equivalents) in a claim now or in the future appended hereto.
[0040] FIGS. 1 and 2 schematically illustrate a system 10 for
surgery, in accordance with an embodiment of the present invention.
FIG. 1 shows a surgeon 12 operating on a patient 14 in open
surgery, using a surgical instrument 21. FIG. 2 is a pictorial
illustration of instrument 21 showing a miniature camera 20, which
is attached to a shaft 22 of the instrument. The term "shaft" as
used herein generally means a portion of the instrument between a
proximal end 23 of the instrument, which is typically grasped by
the operator, and a working element 25 at the distal end. The shaft
typically comprises an elongate structure proximal to the working
element. The shaft may be cylindrical, as in FIG. 2, but may
alternatively have any other suitable profile. The shaft itself may
be configured to provide space to house a camera. Alternatively,
camera 20 may be attached to shaft 22 by a suitable connecting
means, such as a clip 27, or alternatively by any other suitable
sort of fastening, such as a screw, adhesives or adhesive strips,
straps, hook/loop fasteners (e.g., Velco.TM.). The attachment may
be such that the camera may be removed and attached to other
instruments, or it may be fixed and substantially permanent.
[0041] Camera 20 is positioned, as can be seen in the figures, to
capture images of an area in the vicinity of working element 25
within the body of patient 14. The camera may have a communications
interface for communicating with remote systems. For example, a
cable 24 conveys signals from the camera to a video console and
display 16. Typically, during use of instrument 21 in open surgery,
surgeon 12 makes an incision in the patient's body to provide
direct access to the surgical site. The surgeon inserts working
element 25 through the incision into the patient's body, while
holding proximal end 23 outside the body, and uses the working
element in operating on tissue in the body. Camera 20 may remain
outside the body during the procedure. At the end of the procedure,
the surgeon closes the incision.
[0042] In contrast to endoscopic procedures, working element 25 in
open surgery generally remains directly visible to the surgeon
during the surgery. On the other hand, other members of the
surgical team, as well as observers, may be unable to see the area
of the working element because their view is blocked by the surgeon
himself or by other objects or personnel. These team members and
observers are able to observe the images captured by camera 20 on
display 16 in real time. The display may be at a location remote
from the patient, including locations in the operating room that
are not directly adjacent to the operating table, as well as
locations in other rooms or buildings.
[0043] Additionally or alternatively, the output of camera 20 may
be transmitted over a communications network or fed to a video
recorder or other video processing equipment (not shown). The image
data produced by the camera may be used in various ways, including
medical or surgical training; participation or collaboration in the
surgical procedure in progress or in a subsequent procedure on the
same patient; review of recorded procedures; editing, enhancement,
image extraction or other modifications on the image data;
archiving; and ensuring compliance with rules or policies, such as
in regulatory submissions.
[0044] In open surgery there is generally sufficient light cast by
overhead lamps and, in some cases, by the surgeon's headlamp to
permit camera 20 to capture clear images without supplemental
lighting. Optionally, camera 20 may also comprise an integrated
light source, such as a suitable light-emitting diode (LED), for
illuminating the area under view. Alternatively, a separate light
source may be attached to one of the shafts of instrument 21.
(These optional additional light sources are not shown in the
figures.) FIGS. 3-6 schematically show details of camera 20, in
accordance with an embodiment of the present invention. FIG. 3 is a
pictorial external view of the camera, while FIG. 4 shows some of
the internal elements of the camera in a transparent view. FIG. 5
is an exploded view, and FIG. 6 is a sectional view taken in a
vertical plane containing the line VI-VI in FIG. 3. Insets in FIG.
6 also show enlarged views of certain details of the construction
of the camera.
[0045] The components of camera 20 are contained in a case, which
comprises a chassis 26 that is closed by a cover 28. For the
application illustrated in FIG. 2, for example, the case may have
an outer diameter of approximately 5 mm and a length of 15 mm, but
larger or smaller dimensions are also possible depending on
application requirements. Chassis 26 contains a lens assembly 30,
which forms an image of the area of interest on a sensor assembly
40. The sensor assembly comprises an electronic image sensor 44,
such as a pixellated CCD or CMOS integrated circuit device
comprising an array 42 of sensor elements. In the configuration
shown in FIG. 2, lens assembly 30 may have a total field of view of
about 60.degree. in the object space, with a working distance
(depth of field) from 100 to 250 mm, but other optical
configurations may alternatively be used as appropriate.
[0046] Lens assembly 30 in this example comprises lenses 32, 34 and
36. These lenses typically have a diameter of about 2 mm or less.
Accurate assembly of such small optics to within design tolerances
is understandably difficult when conventional methods of assembly
are used. Typically, careful alignment and testing are required to
ensure that the lenses are properly positioned.
[0047] In camera 20, however, for ease and accuracy of assembly,
chassis 26 comprises a lens holder 52, which has an open
cylindrical groove 58 for receiving the lenses. In the context of
the present patent application and in the claims, the term "open
cylindrical groove" refers to a groove having the shape of an inner
surface of a cylinder but extending in angle around only part of
the circumference of the cylinder, leaving an opening at one side
of the cylinder for insertion of the lenses. The groove may
advantageously be hemi-cylindrical, as illustrated in the figures.
The groove is shaped and sized precisely to receive the lenses.
Proper spacing between the lenses, in accordance with the optical
design of assembly 30, is maintained by spacers 38 and 56. These
spacers may be separate components, such as spacer 38, that are
inserted into groove 58, or they may alternatively be built into
the groove, as is spacer 56, in the form of a step in the groove
diameter. Spacer 56 effectively creates a slot 54 for accommodating
lens 32.
[0048] Thus, all that is necessary to assemble optical assembly 30
in camera 20 is to fit lens 32 into slot 54, and to fit lenses 34
and 36, separated by spacer 38, into groove 58 behind spacer 56.
Alternatively, spacer 38 may be replaced by a fixed, built-in step
like spacer 56. Lens holder 52 is produced with sufficient accuracy
so that the lenses, once inserted in this manner, are in the proper
positions without requiring additional alignment or testing. The
lenses may be glued into the lens holder in these positions. When
cover 28 is then closed over chassis 26, it holds the lenses
securely in place.
[0049] Image sensor 44 is mounted on a non-conducting substrate 46.
To minimize the diameter of camera 20, it is desirable that the
diameter of substrate 46 be as small as possible, while still
containing sufficient through-wires 48 to convey the necessary
signals to and from sensor 44. For this reason, the inventors have
found it advantageous to make substrate 46 from glass, with
through-wires 48 molded into the glass at the time of fabrication
of the substrate. In other words, instead of drilling vias through
the substrate and then filling the vias with metal, as is common in
methods of printed circuit production that are known in the art,
through-wires 48 are held in place while substrate 46 is molded, so
that no subsequent drilling is required. As a result, the
through-wires may have narrow diameter, typically on the order of
100 .mu.m, and may be spaced close together without compromising
the strength and integrity of the substrate.
[0050] To produce sensor assembly 40, image sensor 44 is aligned
and fixed to the front side of substrate 26, using a suitable glue,
for example. The image sensor is then connected to wires 48 by
bonding fine wires 60 between contact pads (not shown) on sensor 44
and forward ends 50 of wires 48, which are typically cut so as to
protrude slightly above the surface of substrate 46. Alternatively,
printed circuit traces (not shown) may be formed on the front side
of the substrate to connect the sensor to wires 48. The rear ends
of wires 48, at the back side of substrate 46, are connected to the
appropriate conductors in cable 24 (FIG. 2). Optionally, one or
more additional circuit components 62 may be attached to the back
side of the substrate and connected to wires 48 by wire bonding or
printed circuit traces.
[0051] As shown in FIGS. 5 and 6, the shape and inner diameter of
chassis 26 are chosen so that substrate 46 fits snugly into the
chassis. Thus, to complete the assembly of camera 20, the assembled
sensor assembly 40 is mounted in the chassis and is aligned so that
lens assembly 30 casts a focused image onto array 42. The substrate
is then glued or otherwise fastened in place, and cover 28 is
closed over the lens assembly and sensor assembly. Clip 27 (FIG. 2)
may be added (to either chassis 26 or cover 28), and the camera is
ready for use.
[0052] The use of a substrate with molded-in through-wires is
advantageous not only for mounting image sensors, but also for
mounting other types of circuit components in narrow spaces.
Although substrate 46 is described above as comprising glass, other
types of non-conducting moldable materials, such as certain
plastics, may alternatively be used for this purpose.
[0053] FIGS. 7 and 8 schematically illustrate a camera 70, in
accordance with an alternative embodiment of the present invention.
FIG. 7 is an exploded view, while FIG. 8 is a sectional view,
similar to the views of camera 20 shown in FIGS. 5 and 6. Camera 70
includes a chassis 72 and cover 74, as well as other optical and
image sensing components as in camera 20. Chassis 72, however,
comprises a lens holder 76 that contains a smooth open cylindrical
groove, without built-in spacers. Instead, the optical assembly in
camera 70 uses an additional spacer 78 between lenses 32 and 34.
This arrangement simplifies the manufacture of chassis 72, at the
expense of minor additional complication in assembly of the
camera.
[0054] Although cameras 20 and 70 are described hereinabove with
particular reference to surgical system 10 and instrument 21, the
principles of the design and construction of these cameras may
similarly be applied in other imaging applications, and
particularly applications that require a very compact camera. By
the same token, although the method of intra-operative video
imaging for open surgery that is illustrated in FIGS. 1 and 2 is
described with specific reference to camera 20, miniature video
cameras of other types may likewise be attached to the shaft of a
surgical instrument for the purposes of this method. Furthermore,
instrument 21 itself is shown purely for the sake of illustration,
and cameras may also be attached in this fashion to surgical
instruments of other types.
[0055] In one possible embodiment, the inventive subject matter is
directed to a camera for a surgical instrument wherein the camera
has a compact shape so as not to substantially impede the use of
the surgical instrument, which shape includes a length not
exceeding the length of the non-working portion of the surgical
instrument to which the camera is associated and a width or
diameter not exceeding about 3 times the width or diameter of the
shaft portion of the instrument to which the camera is mounted or
otherwise associated.
Methods of Use
[0056] Various methods are within the scope and contemplation of
the inventive subject matter. For example, in one possible
embodiment, the inventive subject is directed to a method of
imaging in open surgery comprising providing an instrument with an
associated imaging system and acquiring imaging data with the
camera and presenting it via a standard data communications
interface to a presentation device, such as a computer monitor,
television, or via a printer.
[0057] In another possible embodiment, the inventive subject matter
is directed to a method of open surgery that includes the steps of:
making an incision in a patient to provide direct access to a
surgical site; introducing a surgical instrument to the surgical
site, the surgical instrument comprising a tissue treatment portion
for the modification or manipulation of tissue at the surgical
site, and a non-working portion proximal from the tissue treatment
portion, and an imaging system associated with the non-working
portion; displaying an image of the surgical site obtained from the
imaging system; modifying or manipulating the tissue at the
surgical site by means of the surgical instrument; and closing the
incision in the patient at the end of the surgical procedure. The
steps of this and other methods described herein need not be
performed in the exact order listed. For instances the displaying
of the image step may be performed, for example, after the
modification or manipulation of the tissue, as well as before
it.
[0058] In another possible embodiment, the inventive subject matter
is directed to a method of open surgery that includes the steps of:
making an incision in a patient to provide direct access to a
surgical site; introducing a surgical instrument to the surgical
site, the surgical instrument comprising a tissue treatment portion
for the modification or manipulation of tissue at the surgical
site, and a non-working portion proximal from the tissue treatment
portion, and an imaging system associated with the no-working
portion acquiring an image of the surgical site in the form of
image data using the imaging system; modifying or manipulating the
tissue at the surgical site by means of the surgical instrument;
and closing the incision in the patient at the end of the surgical
procedure.
[0059] In another possible embodiment, the inventive subject matter
is directed to a method of communicating imaging data comprising
providing a medical instrument, the instrument comprising a
distally disposed working portion for working in a surgical or
medical procedure, and a proximally disposed non-working portion
having an associated imaging system, the non-working portion being
on a non-insertion portion of the instrument; and transmitting the
imaging data to a location remote from the surgical table for
viewing or use by others who are beyond the immediate area of the
surgical table (or other platform). "Beyond the immediate area of
the surgical table," generally means an area that is sufficiently
far from the surgical table that viewing of the details of the
surgical site are obscure or blocked to the naked eye
[0060] In the foregoing embodiments, imaging system may be
removably mounted on the instrument; the imaging system may
comprise a pixellated imaging sensor, such as a CCD or CMOS sensor;
and/or the instrument may include a solid state light source, such
as an LED for illuminating the a site of interest.
[0061] In the foregoing embodiments, the data representing acquired
images may be communicated to a display device and presented (e.g.,
on a computer or television monitor or via a printer) in
substantially real time to one or more persons beyond the adjacency
of a patient support for the patient with the site of interest; the
one or more persons are not in the same room as the patient; and/or
the data is communicated via a digital data or telecommunications
network. Representative examples of such networks include LANs,
WANs, Intranets, and the Internet.
[0062] In the foregoing embodiments, the data representing acquired
images may be communicated to a data storage medium for on-demand
presentation to a viewer.
[0063] In the foregoing embodiments, the data may be used in one or
more of the following respects: medical or surgical training;
participation or collaboration in the medical procedure being
performed; participation or collaboration in a medical procedure
for the same patient subsequent to the one being performed;
modification of the imaging data, such as to provide editing,
enhancements or derivations; archiving of procedures; for
compliance with established rules or policies; for use in
regulatory submissions.
[0064] It will thus be appreciated that the embodiments described
above are cited by way of example, and that the present invention
is not limited to what has been particularly shown and described
hereinabove. Rather, the scope of the present invention includes
both combinations and subcombinations of the various features
described hereinabove, as well as variations and modifications
thereof which would occur to persons skilled in the art upon
reading the foregoing description and which are not disclosed in
the prior art.
[0065] All patent and non-patent literature cited herein is hereby
incorporated by references in its entirety for all purposes.
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