U.S. patent application number 16/290105 was filed with the patent office on 2019-06-27 for balloon guided endoscopy.
The applicant listed for this patent is SMART Medical Systems Ltd.. Invention is credited to Gad Terliuc.
Application Number | 20190191983 16/290105 |
Document ID | / |
Family ID | 37727699 |
Filed Date | 2019-06-27 |
![](/patent/app/20190191983/US20190191983A1-20190627-D00000.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00001.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00002.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00003.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00004.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00005.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00006.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00007.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00008.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00009.png)
![](/patent/app/20190191983/US20190191983A1-20190627-D00010.png)
View All Diagrams
United States Patent
Application |
20190191983 |
Kind Code |
A1 |
Terliuc; Gad |
June 27, 2019 |
BALLOON GUIDED ENDOSCOPY
Abstract
An endoscope assembly including an endoscope, a selectably
inflatable balloon mounted onto a distal portion of the endoscope
and an external tube extending alongside the endoscope and
traversing the selectably inflatable balloon.
Inventors: |
Terliuc; Gad; (Ra'anana,
IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
SMART Medical Systems Ltd. |
Ra'anana |
|
IL |
|
|
Family ID: |
37727699 |
Appl. No.: |
16/290105 |
Filed: |
March 1, 2019 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
15230436 |
Aug 7, 2016 |
|
|
|
16290105 |
|
|
|
|
11990194 |
Feb 6, 2008 |
9427142 |
|
|
PCT/IL2005/000849 |
Aug 8, 2005 |
|
|
|
15230436 |
|
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 1/005 20130101;
A61B 1/31 20130101; A61B 1/00082 20130101; A61B 1/018 20130101 |
International
Class: |
A61B 1/31 20060101
A61B001/31; A61B 1/018 20060101 A61B001/018; A61B 1/00 20060101
A61B001/00; A61B 1/005 20060101 A61B001/005 |
Claims
1-20. (canceled)
21. An endoscopy apparatus for use with an endoscope for viewing an
intestine, the endoscopy apparatus comprising: a peripheral balloon
configured to be mounted rearward of a distal end of an endoscope,
the peripheral balloon configured for inflation and deflation; a
guiding element configured to be positioned on an exterior of the
endoscope and configured to extend along a length of the endoscope;
and a distal balloon connected to the guiding element and
configured for inflation and deflation, the distal balloon
configured to be positionable forward of the distal end of the
endoscope; wherein the guiding element is configured to move
axially relative to the endoscope to axially advance or withdraw
the distal balloon relative to the peripheral balloon when the
endoscopy apparatus is positioned within an interior of an
intestine; and wherein inflation of the peripheral balloon and the
distal balloon when the endoscopy apparatus is positioned within
the interior of the intestine creates a sealed region between the
peripheral balloon and the distal balloon.
22. The endoscopy apparatus of claim 21, further comprising the
endoscope to which the peripheral balloon is configured to be
mounted.
23. The endoscopy apparatus of claim 22, further comprising an
instrument channel extending through the length of the endoscope,
the instrument channel configured to deliver an instrument to the
sealed region.
24. The endoscopy apparatus of claim 23, wherein the instrument
channel is configured to deliver fluid to the sealed region.
25. The endoscopy apparatus of claim 23, further comprising an
instrument configured to be inserted through the instrument channel
to the sealed region.
26. The endoscopy apparatus of claim 21, further comprising an
external tube configured to be attached to the endoscope along its
length, wherein the guiding element extends through the external
tube.
27. The endoscopy apparatus of claim 21, further comprising a
peripheral tube, the peripheral tube configured for inflation and
deflation of the peripheral balloon.
28. The endoscopy apparatus of claim 21, wherein the guiding
element comprises a guiding tube.
29. The endoscopy apparatus of claim 21, wherein the guiding
element extends through a passageway between the peripheral balloon
and the exterior of the endoscope when the peripheral balloon is
mounted to the endoscope.
30. The endoscopy apparatus of claim 21, wherein the peripheral
balloon is configured to be mounted to the exterior of an endoscope
defining a circular cross-section and the guiding element is
configured to extend along the length of the endoscope outside the
circular cross-section.
31. The endoscopy apparatus of claim 30, wherein the guiding
element is configured to extend along the length of the endoscope
outside the circular cross-section along a length of the peripheral
balloon and rearward of the peripheral balloon.
32. The endoscopy apparatus of claim 21, wherein the guiding
element is configured to move and inflate the distal balloon to
create the sealed region without utilizing any passageway within
the endoscope.
33. The endoscopy apparatus of claim 21, wherein the peripheral
balloon is configured to mount to the endoscope using a tubular
sleeve that is configured to be fixed over a distal portion of the
endoscope, wherein the peripheral balloon is associated with the
tubular sleeve.
34. An endoscopy method, comprising: advancing the endoscopy
apparatus of claim 21 with the peripheral balloon mounted to a
distal portion of an endoscope within an interior of an intestine;
and inflating the peripheral balloon and the distal balloon to
create the sealed region between the peripheral balloon and the
distal balloon; wherein the guiding element is moved axially
relative to the peripheral balloon prior to inflation of the distal
balloon to adjust a relative distance between peripheral balloon
and the distal balloon within the interior of the intestine.
35. The endoscopy method of claim 34, further comprising delivering
a fluid to the sealed region.
36. The endoscopy method of claim 34, wherein the peripheral
balloon is inflated before the distal balloon.
37. The endoscopy method of claim 34, wherein the guiding element
is advanced axially to move the distal balloon distally away from
the peripheral balloon before the distal balloon is inflated.
38. The endoscopy method of claim 34, further comprising delivering
an instrument through an instrument channel of the endoscope to the
sealed region when the peripheral balloon and the distal balloon
are inflated.
Description
INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS
[0001] Any and all applications for which a foreign or domestic
priority claim is identified in the Application Data Sheet as filed
with the present application are hereby incorporated by reference
under 37 CFR 1.57.
BACKGROUND OF THE INVENTION
Field of the Invention
[0002] The present invention relates to endoscopy generally and
more particularly to endoscope guiding accessory.
Description of the Related Art
[0003] The following U.S. Patent Documents are believed to
represent the current state of the art:
[0004] U.S. Pat. Nos. 4,195,637; 4,616,652 and 6,663,589
SUMMARY OF THE INVENTION
[0005] The present invention seeks to provide an endoscope guiding
accessory.
[0006] There is thus provided in accordance with a preferred
embodiment of the present invention apparatus for fluid supply to
the interior of a portion of a tubular body portion including at
least one first selectably extendible tubular body portion sealing
element adapted to be located at a first location along a length of
the tubular body portion and at least one second selectably
extendible tubular body portion sealing element adapted to be
located at a second location along the length, the at least one
first selectably extendible tubular body portion sealing element
and the at least one second selectably extendible tubular body
portion sealing element being adapted to define an intermediate
region of the length of the tubular body portion therebetween, a
controller adapted for selectably sealing the at least one first
and second tubular body portion sealing elements to the tubular
body portion and fluid supply functionality adapted for supplying a
fluid to the intermediate region.
[0007] Preferably, the apparatus for fluid supply also includes an
endoscope at least partially extending along the tubular body
portion. Preferably, the at least one first and second tubular body
portion sealing elements are movable relative to each other along
the length.
[0008] Preferably, at least one of the at least one first and
second tubular body portion sealing elements includes a selectably
inflatable balloon. Additionally, the selectably inflatable balloon
includes a stretchable balloon. Alternatively, the selectably
inflatable balloon includes a polyurethane balloon.
[0009] Preferably, the selectably inflatable balloon includes an
anchoring balloon.
[0010] Preferably, at least one of the at least one first and
second tubular body portion sealing elements is mounted on a distal
portion of the endoscope. Alternatively or additionally, at least
one of the at least one first and second tubular body portion
sealing elements is located forward of the endoscope.
[0011] Preferably, the apparatus for fluid supply also includes
fluid suction functionality for suctioning fluid from the
intermediate region.
[0012] Preferably, the fluid supply functionality employs an
instrument channel of the endoscope.
[0013] There is also provided in accordance with another preferred
embodiment of the present invention apparatus for fluid supply to
the interior of a portion of a tubular body portion including at
least one tube including at least first, second and third lumens, a
forward selectably inflatable balloon in fluid communication with
the first lumen, the forward selectably inflatable balloon being
adapted to seal the tubular body portion when inflated, a rear
selectably inflatable balloon in fluid communication with the
second lumen, the rear selectably inflatable balloon being adapted
to seal the tubular body portion when inflated, a fluid supply
outlet, located intermediate the forward and rear selectably
inflatable balloons, the outlet being in fluid communication with
the third lumen, a controller being adapted for selectably
inflating the forward and rear selectably inflatable balloons
within the tubular body portion, thereby to define an at least
partially sealed intermediate region therebetween and fluid supply
functionality adapted for supplying a fluid to the at least
partially sealed intermediate region.
[0014] Preferably, the fluid supply functionality includes an
external tube.
[0015] Preferably, the fluid supply functionality includes an
external tube extending internally of the rear selectably
inflatable balloon.
[0016] Preferably, the fluid is air.
[0017] Preferably, the fluid supply functionality is adapted to
inflate the intermediate region of the tubular body portion.
[0018] There is further provided in accordance with yet another
preferred embodiment of the present invention an endoscope assembly
including an endoscope, an external tube extending alongside the
endoscope and defining at least one lumen and an endoscope tool
adapted to travel through the at least one lumen of the external
tube, the endoscope tool including a selectably inflatable
balloon.
[0019] Preferably, the selectably inflatable balloon is an
anchoring balloon.
[0020] Preferably, the endoscope tool is bendable forwardly of the
external tube. Additionally or alternatively, the endoscope tool is
inflatable forwardly of the endoscope. Preferably, the endoscope
tool is generally more flexible than the endoscope.
[0021] Preferably, the endoscope assembly also includes endoscopy
functionality cooperating with the endoscope. Preferably, the
endoscope assembly also includes a balloon inflation/deflation
controller. Preferably, the external tube is adapted for insertion
and removal of the endoscope tool therethrough.
[0022] Preferably, the endoscope tool includes a tube portion and a
tip portion. Additionally, the tip portion is generally more
flexible than the tube portion.
[0023] There is even further provided in accordance with still
another preferred embodiment of the present invention an endoscope
tool including a tube portion, a tip portion and a selectably
inflatable balloon, the endoscope tool being adapted to travel
through a lumen of an external tube.
[0024] Preferably the tip portion is generally more flexible than
the tube portion. Additionally or alternatively, the inflatable
balloon is mounted on the tube portion. Preferably, an interior
portion of the inflatable balloon communicates with an interior
portion of the tube portion in order to enable inflation of the
inflatable balloon via the tube portion. Alternatively or
additionally, the balloon is an anchoring balloon.
[0025] There is also provided in accordance with yet another
preferred embodiment of the present invention an endoscope assembly
including an endoscope, a selectably inflatable balloon mounted
onto a distal portion of the endoscope and an external tube
extending alongside the endoscope and traversing the selectably
inflatable balloon.
[0026] Preferably, the external tube passes between the selectably
inflatable balloon and the distal portion of the endoscope.
[0027] Preferably, the endoscope assembly also includes a tubular
sleeve mounted onto the distal portion of the endoscope underlying
the selectably inflatable balloon. Preferably, the external tube
extends at least partially through a tubular passageway fixed to
the distal portion of the endoscope. Additionally, the external
tube is slidable within the tubular passageway.
[0028] Preferably, the tubular passageway extends through the
tubular sleeve. Additionally or alternatively, the tubular
passageway includes at least one relatively rigid reinforcement
element which permits predetermined bending of the tubular
passageway. Preferably, the reinforcement element includes a
plurality of mutually spaced relatively rigid elements.
Additionally, the mutually spaced relatively rigid elements are
tubular.
[0029] Preferably, the endoscope assembly also includes a balloon
inflation tube communicating with the selectably inflatable
balloon. Additionally or alternatively, the selectably inflatable
balloon is an anchoring balloon.
[0030] Preferably, the endoscope assembly also includes an
accessory which is slidably insertable through the external tube to
a location forward of the endoscope.
[0031] Preferably, the endoscope assembly also includes an
endoscope tool at least part of which extends through the external
tube, the endoscope tool including a selectably inflatable balloon.
Additionally, the endoscope tool is slidably insertable through the
external tube. Alternatively, the endoscope tool is not insertable
through the external tube.
[0032] Preferably, the endoscope tool is slidably insertable
through the tubular passageway. Alternatively, the endoscope tool
is not insertable through the tubular passageway.
[0033] Preferably, the selectably inflatable balloon of the
endoscope tool is an anchoring balloon. Additionally or
alternatively, the selectably inflatable balloon of the endoscope
tool is inflatable forward of the endoscope.
[0034] Preferably, the endoscope assembly also includes fluid
supply functionality adapted for supplying a fluid via the external
tube.
[0035] There is yet further provided in accordance with still
another preferred embodiment of the present invention apparatus for
medical interaction with a tubular body portion including at least
one tube including at least first and second lumens, a forward
selectably inflatable balloon in fluid communication with the first
lumen, the forward selectably inflatable balloon being adapted to
engage the tubular body portion when inflated, a controller being
adapted for selectably inflating the forward selectably inflatable
balloon and an accessory which is slidably insertable through the
second lumen to a location rearward of the forward selectably
inflatable balloon.
[0036] The term "medical interaction" includes for example,
inspection, treatment, diagnosis, sampling, removal, marking and
any other suitable medical activity.
[0037] Preferably, the at least one tube includes an endoscope.
Additionally, the endoscope includes an instrument channel which
defines the second lumen.
[0038] Preferably, the apparatus for medical interaction with a
tubular body portion also includes an external tube through which
slidably extends one of the at least one tube which defines the
first lumen.
[0039] Preferably, the at least one tube includes an endoscope and
an external tube and a balloon inflation tube defining the first
lumen which slidably extends through the external tube.
Additionally, the balloon inflation tube is generally more flexible
than the endoscope.
[0040] Preferably, the forward selectably inflatable balloon is an
anchoring balloon. Additionally or alternatively, the forward
selectably inflatable balloon is selectably positionable forwardly
of the endoscope. Alternatively or additionally, the apparatus for
medical interaction with a tubular body portion also includes a
rear selectably inflatable balloon. Additionally, the rear
selectably inflatable balloon is an anchoring balloon.
Alternatively, the rear selectably inflatable balloon is
peripherally mounted on a distal portion of an endoscope.
BRIEF DESCRIPTION OF THE DRAWINGS
[0041] The present invention will be understood and appreciated
more fully from the following detailed description, taken in
conjunction with the drawings in which:
[0042] FIG. 1 is a simplified pictorial illustration of an
endoscopy system constructed and operative in accordance with a
preferred embodiment of the present invention;
[0043] FIGS. 2, 3A, 3B, 4A and 4B are respective simplified
pictorial and sectional view illustrations of a portion of an
endoscope and an auxiliary assembly constructed and operative in
accordance with a preferred embodiment of the present
invention;
[0044] FIG. 5 is a simplified pictorial illustration of an
endoscopy system constructed and operative in accordance with
another preferred embodiment of the present invention;
[0045] FIGS. 6, 7A, 7B, 8A, 8B, 8C and 8D are respective simplified
pictorial and sectional view illustrations of a portion of an
endoscope and an auxiliary assembly constructed and operative in
accordance with another preferred embodiment of the present
invention;
[0046] FIG. 9 is a simplified pictorial illustration of an
endoscopy system constructed and operative in accordance with yet
another preferred embodiment of the present invention;
[0047] FIGS. 10, 11A, 11B, 12A, 12B and 12C are respective
simplified pictorial and sectional view illustrations of a portion
of an endoscope and an auxiliary assembly constructed and operative
in accordance with yet another preferred embodiment of the present
invention;
[0048] FIG. 13 is a simplified pictorial illustration of an
endoscopy system constructed and operative in accordance with
further another preferred embodiment of the present invention;
[0049] FIGS. 14, 15A, 15B, 16A and 16B are respective simplified
pictorial and sectional view illustrations of a portion of an
endoscope and an auxiliary assembly constructed and operative in
accordance with further another preferred embodiment of the present
invention;
[0050] FIGS. 17A, 17B, 17C, 17D, 17E, 17F, 17G, 17H, 17I and 17J
are simplified illustrations of various functionalities which may
be provided by the systems of FIGS. 13-16B; and
[0051] FIGS. 18A and 18B are simplified illustrations of a
functionality which may be provided by the system of FIGS.
13-16B.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0052] The terms "endoscope" and "endoscopy" are used throughout in
a manner somewhat broader than their customary meaning and refer to
apparatus and methods which operate within body cavities,
passageways and the like, such as, for example, the small
intestine, the large intestine, arteries and veins. Although these
terms normally refer to visual inspection, as used herein they are
not limited to applications which employ visual inspection and
refer as well to apparatus, systems and methods which need not
necessarily involve visual inspection.
[0053] The term "distal" refers to the remote end of an endoscope,
accessory or tool furthest from the operator.
[0054] The term "proximal" refers to the end portion of an
endoscope, accessory or tool closest to the operator, typically
outside an organ or body portion of interest.
[0055] Reference is now made to FIGS. 1-4B, which illustrate an
endoscopy system constructed and operative in accordance with a
preferred embodiment of the present invention and respective
simplified pictorial and sectional view illustrations of an
auxiliary assembly constructed and operative in accordance with a
preferred embodiment of the present invention.
[0056] As seen in FIGS. 1-4B a conventional endoscopy system 100,
such as a console including a CV-100 video system center, a CLV-U20
light source, a SONY PVM-2030 video monitor, and an OFP flushing
pump, all commercially available from Olympus America Inc. of 2
Corporate Center Drive, Melville, N.Y. 11747, USA, is being
employed. The system preferably includes a conventional endoscope
101, which forms part of conventional endoscopy system 100 such as
a CIF-100 video enteroscope or a CF-Q160AL video colonoscope which
is commercially available from Olympus America Inc. of 2 Corporate
Center Drive, Melville, N.Y. 11747, USA.
[0057] In accordance with a preferred embodiment of the invention,
an endoscopy auxiliary assembly 102 comprising a peripheral balloon
103 may be mounted onto endoscope 101 as shown, by means of a
tubular sleeve 104 which is fixed over the distal portion of
endoscope 101, and is associated with peripheral balloon 103.
[0058] It is appreciated that the tubular sleeve 104 may be
constructed of a flexible and stretchable material, such as
flexible and stretchable silicon, latex or rubber, thereby enabling
it to conform with bending of endoscope 101. It is further
appreciated that tubular sleeve 104 may have an untensioned inner
diameter slightly smaller than the diameter of endoscope 101,
thereby allowing it to be pulled and slid over the endoscope 101
when being stretched, while ensuring firm positioning at the
desired location on the distal end of endoscope 101.
[0059] Alternatively, tubular sleeve 104 may be constructed of a
less stretchable material, such as polyurethane or nylon, and of an
inner diameter slightly larger than that of endoscope 101, thereby
allowing it to be pulled and slid over endoscope 101. Preferably
tubular sleeve 104 is formed with a relatively thin wall allowing
it to be compliant with the bending of endoscope 101. It is
appreciated that once positioned at a desired location, tubular
sleeve 104 may be fastened to endoscope 101 by any suitable
conventional means, such as a medical adhesive tape.
[0060] As illustrated in FIGS. 1-4B, peripheral balloon 103 at
least partially overlays tubular sleeve 104, and is fixed thereon
at both edges by any suitable conventional means such as an
adhesive in order to define a sealed volume therebetween.
Preferably inflation and deflation of peripheral balloon 103 is
provided via a tube 106 communicating with the interior thereof.
Tube 106 may be attached to endoscope 101 at multiple locations
along its length by any suitable conventional means such as a
medical adhesive tape. Alternatively, tube 106 may be detached from
endoscope 101.
[0061] It is appreciated that in accordance with a preferred
embodiment of the present invention peripheral balloon 103 is
generally stretchable, and can be inflated to a diameter about 3-10
times larger than its diameter when not inflated. In accordance
with a preferred embodiment of the present invention, useful for
small intestine endoscopy, the diameter of peripheral balloon 103
when fully inflated is in the range of 3-4 centimeters.
[0062] In a specific embodiment, useful for small intestine
endoscopy, the diameter of the peripheral balloon, when it is fully
inflated is four centimeters. Preferably, inflation of the
peripheral balloon 103 to a diameter less than four centimeters may
be achieved using relatively low pressure, such as in the range of
30-70 millibars.
[0063] In another specific embodiment, useful for large intestine
endoscopy, the diameter of the peripheral balloon, when it is fully
inflated is in the range of 4-6 centimeters. In a further
embodiment, also useful for large intestine endoscopy, diameter of
the peripheral balloon, when it is fully inflated is six
centimeters. Preferably, inflation of the peripheral balloon 103 to
a diameter less than six centimeters may be achieved using
relatively low pressure, such as in the range of 30-70
millibars.
[0064] It is appreciated that in accordance with a preferred
embodiment of the present invention, useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, the expansion diameter range of
peripheral balloon 103 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded peripheral balloon 103 with the interior
surface of the generally tubular body portion, and anchoring of the
endoscope 101 thereto. Preferably, peripheral balloon 103 is a
relatively soft, highly compliant balloon, operative to at least
partially conform to the shape of the interior surface of the
generally tubular body portion when in engagement therewith.
[0065] It is appreciated that peripheral balloon 103 may be formed
of suitable well-known stretchable materials such as latex,
flexible silicon, or highly flexible nylon. Alternatively,
peripheral balloon 103 may be formed of polyurethane, which is less
stretchable and conforming than latex, flexible silicon or highly
flexible nylon. Preferably, the diameter of peripheral balloon 103
is sufficient to ensure tight anchoring at any part of the
generally tubular body portion.
[0066] In a preferred embodiment of the present invention,
endoscopy auxiliary assembly 102 may comprise at least one external
tube 108. External tube 108 may be attached to the endoscope 101 at
multiple locations along its length by any suitable conventional
means such as a medical adhesive tape. Alternatively, external tube
108 may be detached from the endoscope 101.
[0067] It is appreciated that external tube 108 may be flexible and
highly bendable, allowing it to be compliant with the bending of
endoscope 101. It is further appreciated that external tube 108 may
be constructed of a low friction material, such as TEFLON.RTM..
[0068] In a preferred embodiment of the present invention, external
tube 108 may be inserted through a tubular passageway 109, which
extends longitudinally within tubular sleeve 104. Alternatively,
the tubular passageway may be located interiorly of the sleeve but
external to the endoscope 101. External tube 108 may be inserted
fully or partially through tubular passageway 109, and may be fixed
to tubular sleeve 104 by any conventional means, such as by
friction or by use of a suitable adhesive. Alternatively, external
tube 108 may be slidable with respect to tubular passageway
109.
[0069] An endoscope tool 110, constructed and operative in
accordance with a preferred embodiment of the present invention,
extends through external tube 108. Endoscope tool 110 preferably
comprises a guiding tube 112, which includes at least a first lumen
114 for inflation and deflation of a balloon 116 via an inflation
aperture 118. Preferably, the cross-sectional area of guiding tube
112 is sufficiently smaller than that of external tube 108, so as
to allow generally free passage of guiding tube 112 through
external tube 108, particularly when the external tube 108 is in a
bent or curved state, and to allow supply of fluid for inflation or
other uses and draining of fluid therethrough.
[0070] It is appreciated that guiding tube 112 may be flexible and
highly bendable, so as to allow its compliance with the bending of
endoscope 101 and with the curves of the intestine. It is further
appreciated that guiding tube 112 may be constructed of a low
friction material, such as TEFLON.RTM..
[0071] Preferably, guiding tube 112 is sealed at its distal end
forward of balloon 116 in any suitable manner such as by mechanical
sealing or use of an appropriate adhesive, to facilitate inflation
and deflation of balloon 116 through guiding tube 112.
[0072] Preferably, endoscope tool 110 comprises a tip portion 119
located distally of balloon 116. The tip portion 119 may be made of
a highly flexible tube, such as a TYGON.RTM. tube, with a diameter
of 1.5 millimeters. The tip portion 119 may be connected to the
distal end of guiding tube 112 by any conventional means such as a
suitable adhesive. In a preferred embodiment of the present
invention the length of tip portion 119 is 20-30 millimeters.
[0073] It is appreciated that the high bendability of tip portion
119 prevents endoscope tool 110 from getting stuck in obstacles and
bends as it advances through the generally tubular body portion,
forward of endoscope 101.
[0074] It is appreciated that in accordance with a preferred
embodiment of the present invention the endoscope tool 110 and the
guiding tube 112 are substantially more flexible than endoscope
101.
[0075] It is further appreciated that in accordance with a
preferred embodiment of the present invention the tube 106 is
substantially more flexible than endoscope 101.
[0076] It is appreciated that in accordance with yet another
preferred embodiment of the present invention the external tube 108
is substantially more flexible than endoscope 101.
[0077] It is appreciated that in accordance with a preferred
embodiment of the present invention balloon 116 is generally
stretchable, and can be inflated to a diameter about 5-20 times
larger than its diameter when not inflated. In a specific
embodiment, useful for small intestine endoscopy, the balloon
diameter when fully inflated is in the range of 3-4 centimeters. In
a specific embodiment, useful for small intestine endoscopy, the
balloon diameter when fully inflated is four centimeters.
Preferably, inflation of the balloon 116 to a diameter less than
four centimeters may be achieved using relatively low pressure,
such as in the range of 30-70 millibars. In accordance with another
preferred embodiment of the present invention, useful for large
intestine endoscopy, the balloon diameter when fully inflated is in
the range of 4-6 centimeters. In another specific embodiment,
useful for large intestine endoscopy, the balloon diameter when
fully inflated is six centimeters. Preferably, inflation of the
balloon 116 to a diameter less than six centimeters may be achieved
using relatively low pressure, such as in the range of 30-70
millibars.
[0078] It is appreciated that in accordance with a preferred
embodiment of the present invention which is particularly useful
for in vivo inspection of a generally tubular body portion having a
variable cross-sectional diameter, the expansion range of the
diameter of balloon 116 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded balloon 116 with the interior surface of the
generally tubular body portion, and anchoring of the endoscope tool
110 thereto. Preferably, balloon 116 is a relatively soft, highly
compliant balloon, operative to at least partially conform to the
shape of the interior surface of the generally tubular body portion
when in engagement therewith.
[0079] It is appreciated that balloon 116 may be formed of
well-known stretchable materials such as latex, flexible silicon,
or highly flexible nylon. Alternatively, balloon 116 may be formed
of polyurethane, which is less stretchable and conforming than
latex, flexible silicon or highly flexible nylon. Preferably, the
diameter of balloon 116 is sufficient to ensure tight anchoring at
any location in the generally tubular body portion.
[0080] As seen in FIG. 1, the endoscope tool 110 preferably
includes a balloon inflation/deflation control interface 122 which
communicates with guiding tube 112 at a proximal portion 123
thereof which extends outwardly of a proximal end 124 of external
tube 108 and governs inflation and deflation of balloon 116.
Additionally, there is preferably provided a peripheral balloon
inflation/deflation control interface 125, which communicates with
tube 106 and governs inflation and deflation of peripheral balloon
103.
[0081] Preferably, proximal end 124 of external tube 108 is fixed
to the proximal portion of endoscope 101 adjacent to an operator
control 129 of endoscope 101, by a band 132 or by any other
suitable conventional means, such as a clips or medical adhesive
tape.
[0082] Preferably, the operator positions balloon 116 at a desired
location forward of the distal end of endoscope 101 within the
generally tubular body portion, by controlled pulling or pushing of
the proximal portion 123 of guiding tube 112, relative to the
proximal end 124 of external tube 108.
[0083] FIG. 4A shows rearward positioning of endoscope tool 110 in
which the balloon 116 is located just ahead of the distal end of
endoscope 101. The rearward positioning is preferably accomplished
by pulling the proximal portion 123 of guiding tube 112 rearwardly
relative to the proximal end 124 of external tube 108.
[0084] FIG. 4B shows forward positioning of endoscope tool 110 in
which the balloon 116 is located a substantial distance forward of
the distal end of endoscope 101. The forward positioning is
preferably accomplished by pushing the proximal portion 123 of
guiding tube 112 forwardly relative to the proximal end 124 of
external tube 108.
[0085] It is appreciated that controlled positioning of the
endoscope tool 110 at desired distances forward of the distal end
of endoscope 101 may be achieved by suitable controlled positioning
of the proximal portion 123 of guiding tube 112 relative to the
proximal end 124 of external tube 108.
[0086] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, balloon 116 may be controllably
positioned in a range of 0-45 centimeters forward of the distal end
of endoscope 101.
[0087] As seen in FIGS. 4A and 4B, balloon 116 is fixed to guiding
tube 112 via a forward balloon sleeve portion 144 and via a rear
balloon sleeve portion 146, both of which are preferably integrally
formed with balloon 116. As seen in FIG. 4A, the outer cross
sectional diameter of rear sleeve portion 146 is larger than the
inner cross sectional diameter of external tube 108 and larger than
the inner cross sectional diameter of tubular passageway 109,
thereby preventing balloon 116 from being inserted through external
tube 108 and through tubular passageway 109.
[0088] It is appreciated that rear sleeve portion 146 may function
as a stopper that prevents further pulling of guiding tube 112 when
rear sleeve portion 146 is in contact with tubular sleeve 104 or
with external tube 108.
[0089] Reference is now made to FIGS. 5-8D, which are respectively
a simplified pictorial illustration of an endoscopy system
constructed and operative in accordance with another preferred
embodiment of the present invention and respective simplified
pictorial and sectional view illustrations of an auxiliary assembly
constructed and operative in accordance with another preferred
embodiment of the present invention.
[0090] As seen in FIGS. 5-8D a conventional endoscopy system 200,
such as a console including a CV-100 video system center, a CLV-U20
light source, a SONY PVM-2030 video monitor, and an OFP flushing
pump, all commercially available from Olympus America Inc. of 2
Corporate Center Drive, Melville, N.Y. 11747, USA, is being
employed. The system preferably includes a conventional endoscope
201, which forms part of conventional endoscopy system 200 such as
a CIF-100 video enteroscope or a CF-Q160AL video colonoscope which
is commercially available from Olympus America Inc. of 2 Corporate
Center Drive, Melville, N.Y. 11747, USA.
[0091] In accordance with a preferred embodiment of the invention,
an endoscopy auxiliary assembly 202 comprising a peripheral balloon
203 may be mounted onto endoscope 201 as shown, by means of a
tubular sleeve 204 which is fixed over the distal portion of
endoscope 201, and is associated with peripheral balloon 203. It is
appreciated that the tubular sleeve 204 may be constructed of a
flexible and stretchable material, such as flexible and stretchable
silicon, latex or rubber, thereby enabling it to conform with
bending of endoscope 201. It is further appreciated that tubular
sleeve 204 may have a an untensioned inner diameter slightly
smaller than the diameter of endoscope 201, thereby allowing it to
be pulled and slid over the endoscope 201 when being stretched,
while ensuring firm positioning at the desired location on the
distal end of endoscope 201.
[0092] Alternatively, tubular sleeve 204 may be constructed of a
less stretchable material, such as polyurethane or nylon, and of an
inner diameter slightly larger than that of endoscope 201, thereby
allowing it to be pulled and slid over endoscope 201. Preferably
tubular sleeve 204 is formed with a relatively thin wall allowing
it to be compliant with the bending of endoscope 201. It is
appreciated that once positioned at a desired location, tubular
sleeve 204 may be fastened to endoscope 201 by any suitable
conventional means, such as a medical adhesive tape.
[0093] As illustrated in FIGS. 5-8D, peripheral balloon 203 at
least partially overlays tubular sleeve 204, and is fixed thereon
at both edges by any suitable conventional means such as an
adhesive in order to define a sealed volume therebetween.
Preferably inflation and deflation of peripheral balloon 203 is
provided via a tube 206 communicating with the interior thereof.
Tube 206 may be attached to endoscope 201 at multiple locations
along its length by any suitable conventional means such as a
medical adhesive tape. Alternatively, tube 206 may be detached from
endoscope 201.
[0094] It is appreciated that in accordance with a preferred
embodiment of the present invention peripheral balloon 203 is
generally stretchable, and can be inflated to a diameter about 3-10
times larger than its diameter when not inflated. In accordance
with a preferred embodiment of the present invention, useful for
small intestine endoscopy, the diameter of peripheral balloon 203
when fully inflated is in the range of 3-4 centimeters. In a
specific embodiment, useful for small intestine endoscopy, the
diameter of the peripheral balloon diameter when it is fully
inflated is four centimeters. Preferably, inflation of the
peripheral balloon 203 to a diameter less than four centimeters may
be achieved using relatively low pressure, such as in the range of
30-70 millibars.
[0095] In another specific embodiment useful for large intestine
endoscopy, the diameter of the peripheral balloon when it is fully
inflated is in the range of 4-6 centimeters. In a further
embodiment, also useful for large intestine endoscopy, diameter of
the peripheral balloon, when it is fully inflated is six
centimeters. Preferably, inflation of the peripheral balloon 203 to
a diameter less than six centimeters may be achieved using
relatively low pressure, such as in the range of 30-70
millibars.
[0096] It is appreciated that in accordance with a preferred
embodiment of the present invention, useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, the expansion diameter range of
peripheral balloon 203 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded peripheral balloon 203 with the interior
surface of the generally tubular body portion, and anchoring of the
endoscope 201 thereto. Preferably, peripheral balloon 203 is a
relatively soft, highly compliant balloon, operative to at least
partially conform to the shape of the interior surface of the
generally tubular body portion when in engagement therewith.
[0097] It is appreciated that peripheral balloon 203 may be formed
of suitable well-known stretchable materials such as latex,
flexible silicon, or highly flexible nylon. Alternatively,
peripheral balloon 203 may be formed of polyurethane, which is less
stretchable and conforming than latex, flexible silicon or highly
flexible nylon. Preferably, the diameter of peripheral balloon 203
is sufficient to ensure tight anchoring at any part of the
generally tubular body portion.
[0098] In a preferred embodiment of the present invention,
endoscopy auxiliary assembly 202 may comprise at least one external
tube 208. External tube 208 may be attached to the endoscope 201 at
multiple locations along its length by any suitable conventional
means such as a medical adhesive tape. Alternatively, external tube
208 may be detached from the endoscope 201.
[0099] It is appreciated that external tube 208 may be flexible and
highly bendable, allowing it to be compliant with the bending of
endoscope 201. It is further appreciated that external tube 208 may
be constructed of a low friction material, such as TEFLON.RTM..
[0100] In a preferred embodiment of the present invention, external
tube 208 may be inserted through a tubular passageway 209, which
extends longitudinally within tubular sleeve 204. Alternatively,
the tubular passageway may be located interiorly of the sleeve but
external to the endoscope 201. External tube 208 may be inserted
fully or partially through tubular passageway 209, and may be fixed
to tubular sleeve 204 by any conventional means, such as by
friction or by use of a suitable adhesive. Alternatively, external
tube 208 may be slidable with respect to tubular passageway
209.
[0101] An endoscope tool 210, constructed and operative in
accordance with a preferred embodiment of the present invention,
extends through external tube 208. Endoscope tool 210 preferably
comprises a guiding tube 212, which includes at least a first lumen
214 for inflation and deflation of a balloon 216 via an inflation
aperture 218. Preferably, the cross-sectional area of guiding tube
212 is sufficiently smaller than that of external tube 208, so as
to allow generally free passage of guiding tube 212 through
external tube 208, particularly when the external tube 208 is in a
bent or curved state, and to allow supply of fluid for inflation or
other uses and draining of fluid therethrough.
[0102] It is appreciated that guiding tube 212 may be flexible and
highly bendable, so as to allow its compliance with the bending of
endoscope 201 and with the curves of the intestine. It is further
appreciated that guiding tube 212 may be constructed of a low
friction material, such as TEFLON.RTM..
[0103] Preferably, guiding tube 212 is sealed at its distal end
forward of balloon 216 in any suitable manner such as by mechanical
sealing or use of an appropriate adhesive, to facilitate inflation
and deflation of balloon 216 through guiding tube 212.
[0104] Preferably, endoscope tool 210 may comprise a tip portion
219 located distally of balloon 216. The tip portion 219 may be
made of a highly flexible tube, such as a TYGON.RTM. tube, with a
diameter of 1.5 millimeters. The tip portion 219 may be connected
to the distal end of guiding tube 212 by any conventional means
such as a suitable adhesive. In a preferred embodiment of the
present invention the length of tip portion 219 is 20-30
millimeters.
[0105] It is appreciated that the high bendability of tip portion
219 prevents endoscope tool 210 from getting stuck in obstacles and
bends as it advances through the generally tubular body portion,
forward of endoscope 201.
[0106] It is appreciated that in accordance with a preferred
embodiment of the present invention the endoscope tool 210 and the
guiding tube 212 are substantially more flexible than endoscope
201.
[0107] It is further appreciated that in accordance with a
preferred embodiment of the present invention the tube 206 is
substantially more flexible than endoscope 201.
[0108] It is appreciated that in accordance with yet another
preferred embodiment of the present invention the external tube 208
is substantially more flexible than endoscope 201.
[0109] It is appreciated that in accordance with a preferred
embodiment of the present invention the balloon 216 is generally
stretchable, and can be inflated to a diameter about 5-20 times
larger than its diameter when not inflated. In a specific
embodiment useful for small intestine endoscopy, the balloon
diameter when fully inflated is in the range of 3-4 centimeters. In
a specific embodiment, useful for small intestine endoscopy, the
balloon diameter when fully inflated is four centimeters.
Preferably, inflation of the balloon 216 to a diameter less than
four centimeters may be achieved using relatively low pressure,
such as in the range of 30-70 millibars.
[0110] In another preferred embodiment of the present invention,
useful for large intestine endoscopy, the balloon diameter when
fully inflated is in the range of 4-6 centimeters. In another
specific embodiment, useful for large intestine endoscopy, the
balloon diameter when fully inflated is six centimeters.
Preferably, inflation of the balloon 216 to a diameter less than
six centimeters may be achieved using relatively low pressure, such
as in the range of 30-70 millibars.
[0111] It is appreciated that in accordance with a preferred
embodiment of the present invention which is particularly useful
for in vivo inspection of a generally tubular body portion having a
variable cross-sectional diameter, the expansion range of the
diameter of balloon 216 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded balloon 216 with the interior surface of the
generally tubular body portion, and anchoring of the endoscope tool
210 thereto. Preferably, balloon 216 is a relatively soft, highly
compliant balloon, operative to at least partially conform to the
shape of the interior surface of the generally tubular body portion
when in engagement therewith.
[0112] It is appreciated that balloon 216 may be formed of
well-known stretchable materials such as latex, flexible silicon,
or highly flexible nylon. Alternatively, balloon 216 may be formed
of polyurethane, which is less stretchable and conforming than
latex, flexible silicon or highly flexible nylon. Preferably, the
diameter of balloon 216 is sufficient to ensure tight anchoring at
any location in the generally tubular body portion.
[0113] As seen in FIG. 5, the endoscope tool 210 preferably
includes a balloon inflation/deflation control interface 222 which
communicates with guiding tube 212 at a proximal portion 223
thereof which extends outwardly of a proximal end 224 of external
tube 208 and governs inflation and deflation of balloon 216.
Additionally, there is preferably provided a peripheral balloon
inflation/deflation control interface 225, which communicates with
tube 206 and governs inflation and deflation of peripheral balloon
203.
[0114] Preferably, the proximal end 224 of external tube 208 is
fixed to the proximal portion of endoscope 201 adjacent to an
operator control 229 of endoscope 201, by a band 232 or by any
other suitable conventional means, such as a clips or medical
adhesive tape.
[0115] Preferably, the operator positions balloon 216 at a desired
location forward of the distal end of endoscope 201 within the
generally tubular body portion, by controlled pulling or pushing of
the proximal portion 223 of guiding tube 212, relative to the
proximal end 224 of external tube 208.
[0116] FIG. 8A shows rearward positioning of endoscope tool 210 in
which the balloon 216 is located just ahead of the distal end of
endoscope 201. The rearward positioning is preferably accomplished
by pulling the proximal portion 223 of guiding tube 212 rearwardly
relative to the proximal end 224 of external tube 208.
[0117] FIG. 8B shows forward positioning of endoscope tool 210 in
which the balloon 216 is located a substantial distance forward of
the distal end of endoscope 201. The forward positioning is
preferably accomplished by pushing the proximal portion 223 of
guiding tube 212 forwardly relative to the proximal end 224 of
external tube 208.
[0118] It is appreciated that controlled positioning of the
endoscope tool 210 at desired distances forward of the distal end
of endoscope 201 may be achieved by suitable controlled positioning
of the proximal portion 223 of guiding tube 212 relative to the
proximal end 224 of external tube 208.
[0119] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, balloon 216 may be controllably
positioned in a range of 0-45 centimeters forward of the distal end
of endoscope 201.
[0120] As seen in FIGS. 8A-8D, balloon 216 is fixed to guiding tube
212 via a forward balloon sleeve portion 244 and a rear balloon
sleeve portion 246. As seen in FIG. 8C, the cross sectional
diameters of balloon 216 in a deflated state and of rear sleeve
portion 246 are smaller than the inner cross sectional diameter of
external tube 208 and of tubular passageway 209, thereby allowing
balloon 216 to be inserted through tubular passageway 209 and
through external tube 208. It is appreciated that the distal
portion of endoscope tool 210, including balloon 216 and tip
portion 219, may be entirely or partially positioned within tubular
passageway 209 and external tube 208. It is further appreciated
that endoscope tool 210 may be partially or entirely pulled out and
be extracted from external tube 208 if applicable. It is yet
further appreciated that endoscope tool 210 may be inserted or
re-inserted through external tube 208 if applicable, such as for
positioning or re-positioning of balloon 216 forward of the distal
end of endoscope 201.
[0121] As seen in FIG. 8D, an accessory 250 may be inserted through
external tube 208 for medical interaction with a location in the
generally tubular body portion forward of the distal end of
endoscope 201.
[0122] The term "medical interaction" includes for example,
inspection, treatment, diagnosis, sampling, removal, marking and
any other suitable medical activity.
[0123] Accessory 250 may include any conventional accessory such as
biopsy forceps, polyp cutter, injection needle, or ultrasound
device. It is appreciated that accessory 250 may be inserted
instead of or alongside endoscope tool 210. It is further
appreciated that accessory 250 may be inserted through an
additional external tube (not shown) in case that endoscopy
auxiliary assembly 202 comprises more than one external tube
208.
[0124] Reference is now made to FIGS. 9-12C, which are respectively
a simplified pictorial illustration of an endoscopy system
constructed and operative in accordance with a preferred embodiment
of the present invention and respective simplified pictorial and
sectional view illustrations of an auxiliary assembly constructed
and operative in accordance with a preferred embodiment of the
present invention.
[0125] As seen in FIGS. 9-12C a conventional endoscopy system 300,
such as a console including a CV-100 video system center, a CLV-U20
light source, a SONY PVM-2030 video monitor, and an OFP flushing
pump, all commercially available from Olympus America Inc. of 2
Corporate Center Drive, Melville, N.Y. 11747, USA, is being
employed. The system preferably includes a conventional endoscope
301, which forms part of conventional endoscopy system 300 such as
a CIF-100 video enteroscope or a CF-Q160AL video colonoscope which
is commercially available from Olympus America Inc. of 2 Corporate
Center Drive, Melville, N.Y. 11747, USA.
[0126] In accordance with a preferred embodiment of the invention,
an endoscopy auxiliary assembly 302 comprising a peripheral balloon
303 may be mounted onto endoscope 301 as shown, by means of a
tubular sleeve 304 which is fixed over the distal portion of
endoscope 301, and is associated with peripheral balloon 303.
[0127] It is appreciated that the tubular sleeve 304 may be
constructed of a flexible and stretchable material, such as
flexible and stretchable silicon, latex or rubber, thereby enabling
it to conform with bending of endoscope 301. It is further
appreciated that tubular sleeve 304 may have an untensioned inner
diameter slightly smaller than the diameter of endoscope 301,
thereby allowing it to be pulled and slid over the endoscope 301
when being stretched, while ensuring firm positioning at the
desired location on the distal end of endoscope 301.
[0128] Alternatively, tubular sleeve 304 may be constructed of a
less stretchable material, such as polyurethane or nylon, and of an
inner diameter slightly larger than that of endoscope 301, thereby
allowing it to be pulled and slid over the endoscope 301.
Preferably tubular sleeve 304 is formed with a relatively thin wall
allowing it to be compliant with the bending of endoscope 301. It
is appreciated that once positioned at a desired location, tubular
sleeve 304 may be fastened to endoscope 301 by any suitable
conventional means, such as a medical adhesive tape.
[0129] As illustrated in FIGS. 9-12C, peripheral balloon 303 at
least partially overlays tubular sleeve 304, and is fixed thereon
at both edges by any suitable conventional means such as an
adhesive in order to define a sealed volume therebetween.
Preferably inflation and deflation of peripheral balloon 303 is
provided via a tube 306 communicating with the interior thereof.
Tube 306 may be attached to endoscope 301 at multiple locations
along its length by any suitable conventional means such as a
medical adhesive tape. Alternatively, tube 306 may be detached from
endoscope 301.
[0130] It is appreciated that in accordance with a preferred
embodiment of the present invention peripheral balloon 303 is
generally stretchable, and can be inflated to a diameter about 3-10
times larger than its diameter when not inflated. In accordance
with a preferred embodiment of the present invention, useful for
small intestine endoscopy, the diameter of peripheral balloon 303
when fully inflated is in the range of 3-4 centimeters.
[0131] In a specific embodiment, useful for small intestine
endoscopy, the diameter of the peripheral balloon when it is fully
inflated is four centimeters. Preferably, inflation of the
peripheral balloon 303 to a diameter less than four centimeters may
be achieved using relatively low pressure, such as in the range of
30-70 millibars.
[0132] In another specific embodiment, useful for large intestine
endoscopy, the diameter of the peripheral balloon when it is fully
inflated is in the range of 4-6 centimeters. In a further
embodiment, also useful for large intestine endoscopy, diameter of
the peripheral balloon when it is fully inflated is six
centimeters. Preferably, inflation of the peripheral balloon 303 to
a diameter less than six centimeters may be achieved using
relatively low pressure, such as in the range of 30-70
millibars.
[0133] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, the expansion diameter range of
peripheral balloon 303 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded peripheral balloon 303 with the interior
surface of the generally tubular body portion, and anchoring of the
endoscope 301 thereto. Preferably, peripheral balloon 303 is a
relatively soft, highly compliant balloon, operative to at least
partially conform to the shape of the interior surface of the
generally tubular body portion when in engagement therewith.
[0134] It is appreciated that peripheral balloon 303 may be formed
of suitable well-known stretchable materials such as latex,
flexible silicon, or highly flexible nylon. Alternatively,
peripheral balloon 303 may be formed of polyurethane, which is less
stretchable and conforming than latex, flexible silicon or highly
flexible nylon. Preferably, the diameter of peripheral balloon 303
is sufficient to ensure tight anchoring at any part of the
generally tubular body portion.
[0135] In a preferred embodiment of the present invention,
endoscopy auxiliary assembly 302 may comprise at least one external
tube 308. External tube 308 may be attached to the endoscope 301 at
multiple locations along its length by any suitable conventional
means such as a medical adhesive tape. Alternatively, external tube
308 may be detached from the endoscope 301.
[0136] It is appreciated that external tube 308 may be flexible and
highly bendable, allowing it to be compliant with the bending of
endoscope 301. It is further appreciated that external tube 308 may
be constructed of a low friction material, such as TEFLON.RTM..
[0137] In a preferred embodiment of the present invention, external
tube 308 may be inserted through a tubular passageway 309 which
extends longitudinally within tubular sleeve 304. Alternatively,
the tubular passageway may be located interiorly of the sleeve but
external to the endoscope 301. External tube 308 may be inserted
fully or partially through tubular passageway 309, and may be fixed
to tubular sleeve 304 by any conventional means, such as by
friction or by use of a suitable adhesive. Alternatively, external
tube 308 may be slidable with respect to tubular passageway
309.
[0138] An endoscope tool 310, constructed and operative in
accordance with a preferred embodiment of the present invention,
extends through external tube 308. Endoscope tool 310 preferably
comprises a guiding tube 312, which includes at least a first lumen
314 for inflation and deflation of a balloon 316 via an inflation
aperture 318. Preferably, the cross-sectional area of guiding tube
312 is sufficiently smaller than that of external tube 308, so as
to allow generally free passage of guiding tube 312 through
external tube 308, particularly when the external tube 308 is in a
bent or curved state, and to allow supply of fluid for inflation or
other uses and draining of fluid therethrough.
[0139] It is appreciated that guiding tube 312 may be flexible and
highly bendable, so as to allow its compliance with the bending of
endoscope 301 and with the curves of the intestine. It is further
appreciated that guiding tube 312 may be constructed of a low
friction material, such as TEFLON.RTM..
[0140] Preferably, guiding tube 312 is sealed at its distal end
forward of balloon 316 in any suitable manner such as by mechanical
sealing or use of an appropriate adhesive, to facilitate inflation
and deflation of balloon 316 through guiding tube 312.
[0141] Preferably, endoscope tool 310 may comprise a tip portion
319 located distally of balloon 316. The tip portion 319 may be
made of a highly flexible tube, such as a TYGON.RTM. tube, with a
diameter of 1.5 millimeters. The tip portion 319 may be connected
to the distal end of guiding tube 312 by any conventional means
such as a suitable adhesive. In a preferred embodiment of the
present invention the length of tip portion 319 is 20-30
millimeters.
[0142] It is appreciated that the high bendability of tip portion
319 prevents endoscope tool 310 from getting stuck in obstacles and
bends as it advances through the generally tubular body portion,
forward of endoscope 301.
[0143] It is appreciated that in accordance with a preferred
embodiment of the present invention the endoscope tool 310 and the
guiding tube 312 are substantially more flexible than endoscope
301.
[0144] It is further appreciated that in accordance with a
preferred embodiment of the present invention the tube 306 is
generally more flexible than endoscope 301.
[0145] It is appreciated that in accordance with yet another
preferred embodiment of the present invention the external tube 308
is substantially more flexible than endoscope 301.
[0146] It is appreciated that in accordance with a preferred
embodiment of the present invention balloon 316 is generally
stretchable, and can be inflated to a diameter about 5-20 times
larger than its diameter when not inflated. In a specific
embodiment, useful for small intestine endoscopy, the balloon
diameter when fully inflated is in the range of 3-4 centimeters. In
a specific embodiment, useful for small intestine endoscopy, the
balloon diameter when fully inflated is four centimeters.
Preferably, inflation of the balloon 316 to a diameter less than
four centimeters may be achieved using relatively low pressure,
such as in the range of 30-70 millibars.
[0147] In another preferred embodiment of the present invention,
useful for large intestine endoscopy, the balloon diameter when
fully inflated is in the range of 4-6 centimeters. In another
specific embodiment, useful for large intestine endoscopy, the
balloon diameter when fully inflated is six centimeters.
Preferably, inflation of the balloon 316 to a diameter less than
six centimeters may be achieved using relatively low pressure, such
as in the range of 30-70 millibars.
[0148] It is appreciated that in accordance with a preferred
embodiment of the present invention which is particularly useful
for in vivo inspection of a generally tubular body portion having a
variable cross-sectional diameter, the expansion range of the
diameter of balloon 316 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded balloon 316 with the interior surface of the
generally tubular body portion, and anchoring of the endoscope tool
310 thereto. Preferably, balloon 316 is a relatively soft, highly
compliant balloon, operative to at least partially conform to the
shape of the interior surface of the generally tubular body portion
when in engagement therewith.
[0149] It is appreciated that balloon 316 may be formed of
well-known stretchable materials such as latex, flexible silicon,
or highly flexible nylon. Alternatively, balloon 316 may be formed
of polyurethane, which is less stretchable and conforming than
latex, flexible silicon or highly flexible nylon. Preferably, the
diameter of balloon 316 is sufficient to ensure tight anchoring at
any location in the generally tubular body portion.
[0150] As seen in FIG. 9, the endoscope tool 310 preferably
includes a balloon inflation/deflation control interface 322 which
communicates with guiding tube 312 at a proximal portion 323
thereof which extends outwardly of a proximal end 324 of external
tube 308 and governs inflation and deflation of balloon 316.
Additionally, there is preferably provided a peripheral balloon
inflation/deflation control interface 325, which communicates with
tube 306 and governs inflation and deflation of peripheral balloon
303.
[0151] Preferably, proximal end 324 of external tube 308 is fixed
to the proximal portion of endoscope 301 adjacent to an operator
control 329 of endoscope 301, by a band 332 or by any other
suitable conventional means, such as a clips or medical adhesive
tape.
[0152] Preferably, the operator positions balloon 316 at a desired
location forward of the distal end of endoscope 301 within the
generally tubular body portion, by controlled pulling or pushing of
the proximal portion 323 of guiding tube 312, relative to the
proximal end 324 of external tube 308.
[0153] FIG. 12A shows rearward positioning of endoscope tool 310 in
which the balloon 316 is located just ahead of the distal end of
endoscope 301. The rearward positioning is preferably accomplished
by pulling the proximal portion 323 of guiding tube 312 rearwardly
relative to the proximal end 324 of external tube 308.
[0154] FIG. 12B shows forward positioning of endoscope tool 310 in
which the balloon 316 is located a substantial distance forward of
the distal end of endoscope 301. The forward positioning is
preferably accomplished by pushing the proximal portion 323 of
guiding tube 312 forwardly relative to the proximal end 324 of
external tube 308.
[0155] It is appreciated that controlled positioning of the
endoscope tool 310 at desired distances forward of the distal end
of endoscope 301 may be achieved by suitable controlled positioning
of the proximal portion 323 of guiding tube 312 relative to the
proximal end 324 of external tube 308.
[0156] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, balloon 316 may be controllably
positioned in a range of 0-45 centimeters forward of the distal end
of endoscope 301.
[0157] As seen in FIGS. 12A-12C, balloon 316 is fixed to guiding
tube 312 via a forward balloon sleeve portion 344 and a rear
balloon sleeve portion 346. As seen in FIG. 12C, the cross
sectional diameter of rear sleeve portion 346 is larger than the
inner cross sectional diameter of external tube 308, thereby
preventing balloon 316 from being inserted through external tube
308. As further seen in FIG. 12C, the cross sectional diameters of
balloon 316 in a deflated state and of rear sleeve portion 346 are
smaller than the inner cross sectional diameter of tubular
passageway 309, thereby allowing balloon 316 to be inserted through
tubular passageway 309. It is appreciated that the distal portion
of endoscope tool 310, including balloon 316 and tip portion 319,
may be entirely or partially positioned within tubular passageway
309.
[0158] It is appreciated that rear sleeve portion 346 may function
as a stopper that prevents further pulling of guiding tube 312 when
rear sleeve portion 346 is in contact with external tube 308,
inside tubular sleeve 309.
[0159] Reference is now made to FIGS. 13-16B, which are
respectively a simplified pictorial illustration of an endoscopy
system constructed and operative in accordance with a preferred
embodiment of the present invention and respective simplified
pictorial and sectional view illustrations of an auxiliary assembly
constructed and operative in accordance with a preferred embodiment
of the present invention.
[0160] As seen in FIGS. 13-16B a conventional endoscopy system 400,
such as a console including a CV-100 video system center, a CLV-U20
light source, a SONY PVM-2030 video monitor, and an OFP flushing
pump, all commercially available from Olympus America Inc. of 2
Corporate Center Drive, Melville, N.Y. 11747, USA, is being
employed. The system preferably includes a conventional endoscope
401, which forms part of conventional endoscopy system 400, such as
a CIF-100 video enteroscope or a CF-Q160AL video colonoscope which
is commercially available from Olympus America Inc. of 2 Corporate
Center Drive, Melville, N.Y. 11747, USA.
[0161] In accordance with a preferred embodiment of the invention,
an endoscopy auxiliary assembly 402 comprising a peripheral balloon
403 may be mounted onto endoscope 401 as shown, by means of a
tubular sleeve 404 which is fixed over the distal portion of
endoscope 401, and is associated with peripheral balloon 403. It is
appreciated that the tubular sleeve 404 may be constructed of a
flexible and stretchable material, such as flexible and stretchable
silicon, latex or rubber, thereby enabling it to conform with
bending of endoscope 401. It is further appreciated that tubular
sleeve 404 may have an untensioned inner diameter slightly smaller
than the diameter of endoscope 401, thereby allowing it to be
pulled and slid over the endoscope 401 when being stretched, while
ensuring firm positioning at the desired location on the distal end
of endoscope 401.
[0162] Alternatively, tubular sleeve 404 may be constructed of a
less stretchable material, such as polyurethane or nylon, and of an
inner diameter slightly larger than that of endoscope 401, thereby
allowing it to be pulled and slid over endoscope 401. Preferably
tubular sleeve 404 is formed with a relatively thin wall allowing
it to be compliant with the bending of endoscope 401. It is
appreciated that once positioned at a desired location, tubular
sleeve 404 may be fastened to endoscope 401 by any suitable
conventional means, such as a medical adhesive tape.
[0163] As illustrated in FIGS. 13-16B, peripheral balloon 403 at
least partially overlays tubular sleeve 404, and is fixed thereon
at both edges by any suitable conventional means such as an
adhesive in order to define a sealed volume therebetween.
Preferably inflation and deflation of peripheral balloon 403 is
provided via a tube 406 communicating with the interior thereof.
Tube 406 may be attached to endoscope 401 at multiple locations
along its length by any suitable conventional means such as a
medical adhesive tape. Alternatively, tube 406 may be detached from
endoscope 401.
[0164] It is appreciated that in accordance with a preferred
embodiment of the present invention peripheral balloon 403 is
generally stretchable, and can be inflated to a diameter about 3-10
times larger than its diameter when not inflated. In accordance
with a preferred embodiment of the present invention, useful for
small intestine endoscopy, the diameter of peripheral balloon 403
when fully inflated is in the range of 3-4 centimeters.
[0165] In a specific embodiment, useful for small intestine
endoscopy, the diameter of the peripheral balloon diameter when it
is fully inflated is four centimeters. Preferably, inflation of the
peripheral balloon 403 to a diameter less than four centimeters may
be achieved using relatively low pressure, such as in the range of
30-70 millibars.
[0166] In another specific embodiment, useful for large intestine
endoscopy, the diameter of the peripheral balloon when it is fully
inflated is in the range of 4-6 centimeters. In a further
embodiment, also useful for large intestine endoscopy, diameter of
the peripheral balloon when it is fully inflated is six
centimeters. Preferably, inflation of the peripheral balloon 403 to
a diameter less than six centimeters may be achieved using
relatively low pressure, such as in the range of 30-70
millibars.
[0167] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, the expansion diameter range of
peripheral balloon 403 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded peripheral balloon 403 with the interior
surface of the generally tubular body portion, and anchoring of the
endoscope 401 thereto. Preferably, peripheral balloon 403 is a
relatively soft, highly compliant balloon, operative to at least
partially conform to the shape of the interior surface of the
generally tubular body portion when in engagement therewith.
[0168] It is appreciated that peripheral balloon 403 may be formed
of suitable well-known stretchable materials such as latex,
flexible silicon, or highly flexible nylon. Alternatively,
peripheral balloon 403 may be formed of polyurethane, which is less
stretchable and conforming than latex, flexible silicon or highly
flexible nylon. Preferably, the diameter of peripheral balloon 403
is sufficient to ensure tight anchoring at any part of the
generally tubular body portion.
[0169] In a preferred embodiment of the present invention,
endoscopy auxiliary assembly 402 may comprise at least one external
tube 408. External tube 408 may be attached to the endoscope 401 at
multiple locations along its length by any suitable conventional
means such as a medical adhesive tape. Alternatively, external tube
408 may be detached from the endoscope 401.
[0170] It is appreciated that external tube 408 may be flexible and
highly bendable, allowing it be compliant with the bending of
endoscope 401. It is further appreciated that external tube 408 may
be constructed of a low friction material, such as TEFLON.RTM..
[0171] In a preferred embodiment of the present invention, external
tube 408 may be inserted through a tubular passageway 409 which
extends longitudinally within tubular sleeve 404. Alternatively,
the tubular passageway may be located interiorly of the sleeve but
external to the endoscope 401. External tube 408 may be inserted
fully or partially through tubular passageway 409 and may be fixed
to tubular sleeve 404 by any conventional means, such as by
friction or by use of a suitable adhesive. Alternatively, external
tube 408 may be slidable with respect to tubular passageway
409.
[0172] An endoscope tool 410, constructed and operative in
accordance with a preferred embodiment of the present invention
extends through the external tube 408. Endoscope tool 410
preferably comprises a guiding tube 412, which includes at least a
first lumen 414 for inflation and deflation of a balloon 416 via an
inflation aperture 418. Preferably, the cross-sectional area of
guiding tube 412 is sufficiently smaller than that of external tube
408, so as to allow generally free passage of guiding tube 412
through external tube 408, particularly when the external tube 408
is in a bent or curved state, and to allow supply of fluid for
inflation or other uses and draining of fluid therethrough.
[0173] Preferably, a plurality of short hollow cylinders 420 may be
disposed longitudinally within tubular passageway 409, as shown in
FIGS. 16A and 16B. Adjacent hollow cylinders 420 may be separated
by spaces 421.
[0174] It is appreciated that hollow cylinders 420 may be
relatively flexible and bendable, so as to comply with the bending
of endoscope 401 and of tubular sleeve 404. Alternatively, hollow
cylinders 420 may be relatively rigid. It is appreciated that
hollow cylinders 420 may be constructed of a low friction material,
such as TEFLON.RTM..
[0175] Preferably, hollow cylinders 420 lead guiding tube 412
within tubular passageway 409 and allow smooth and low friction
passage of guiding tube 412.
[0176] It is appreciated that hollow cylinders 420 support the
inner walls of tubular passageway 409 and prevent the collapse of
the inner walls of tubular passageway 409 towards guiding tube 412,
especially in a bent state of endoscope 401 and tubular sleeve
404.
[0177] In accordance with a preferred embodiment of the present
invention, the length of hollow tubes 420 may be in the range of
5-25 millimeters, and the length of spaces 421 may be in the range
of 2-10 millimeters.
[0178] It is appreciated that guiding tube 412 may be flexible and
highly bendable, so as to allow its compliance with the bending of
endoscope 401 and with the curves of the intestine. It is further
appreciated that guiding tube 412 may be constructed of a low
friction material, such as TEFLON.RTM..
[0179] Preferably, guiding tube 412 is sealed at its distal end
forward of balloon 416 in any suitable manner such as by mechanical
sealing or use of an appropriate adhesive, to facilitate inflation
and deflation of balloon 416 through guiding tube 412.
[0180] Preferably, endoscope tool 410 comprises a tip portion 419
located distally of balloon 416. The tip portion 419 may be made of
a highly flexible tube, such as a TYGON.RTM. tube with a diameter
of 1.5 millimeters. The tip portion 419 may be connected to the
distal end of guiding tube 412 by any conventional means such as a
suitable adhesive. In a preferred embodiment of the present
invention the length of tip portion 419 is 20-30 millimeters.
[0181] It is appreciated that the high bendability of tip portion
419 prevents endoscope tool 410 from getting stuck in obstacles and
bends as it advances through the generally tubular body portion,
forward of endoscope 401.
[0182] It is appreciated that in accordance with a preferred
embodiment of the present invention the endoscope tool 410 and the
guiding tube 412 are substantially more flexible than endoscope
401.
[0183] It is further appreciated that in accordance with a
preferred embodiment of the present invention the tube 406 is
substantially more flexible than endoscope 401.
[0184] It is appreciated that in accordance with yet another
preferred embodiment of the present invention the external tube 408
is substantially more flexible than endoscope 401.
[0185] It is appreciated that in accordance with a preferred
embodiment of the present invention balloon 416 is generally
stretchable, and can be inflated to a diameter about 5-20 times
larger than its diameter when not inflated. In a specific
embodiment, useful for small intestine endoscopy, the balloon
diameter when fully inflated is in the range of 3-4 centimeters. In
a specific embodiment, useful for small intestine endoscopy, the
balloon diameter when fully inflated is four centimeters.
Preferably, inflation of the balloon 416 to a diameter less than
four centimeters may be achieved using relatively low pressure,
such as in the range of 30-70 millibars.
[0186] In another preferred embodiment of the present invention,
useful for large intestine endoscopy, the balloon diameter when
fully inflated is in the range of 4-6 centimeters. In another
specific embodiment, useful for large intestine endoscopy, the
balloon diameter when fully inflated is six centimeters.
Preferably, inflation of the balloon 416 to a diameter less than
six centimeters may be achieved using relatively low pressure, such
as in the range of 30-70 millibars.
[0187] It is appreciated that in accordance with a preferred
embodiment of the present invention which is particularly useful
for in vivo inspection of a generally tubular body portion having a
variable cross-sectional diameter, the expansion range of the
diameter of balloon 416 is larger than the maximum cross-sectional
diameter of the generally tubular body portion, thereby enabling
engagement of expanded balloon 416 with the interior surface of the
generally tubular body portion, and anchoring of the endoscope tool
410 thereto. Preferably, balloon 416 is a relatively soft, highly
compliant balloon, operative to at least partially conform to the
shape of the interior surface of the generally tubular body portion
when in engagement therewith.
[0188] It is appreciated that balloon 416 may be formed of
well-known stretchable materials such as latex, flexible silicon,
or highly flexible nylon. Alternatively, balloon 416 may be formed
of polyurethane, which is less stretchable and conforming than
latex, flexible silicon or highly flexible nylon. Preferably, the
diameter of balloon 416 is sufficient to ensure tight anchoring at
any location of the generally tubular body portion.
[0189] As seen in FIG. 13, the endoscope tool 410 preferably
includes a balloon inflation/deflation control interface 422 which
communicates with guiding tube 412 at a proximal portion 423
thereof which extends outwardly of a proximal end 424 of external
tube 408 and governs inflation and deflation of balloon 416.
Additionally, there is preferably provided a peripheral balloon
inflation/deflation control interface 425, which communicates with
tube 406 and governs inflation and deflation of peripheral balloon
403.
[0190] Preferably, proximal end 424 of external tube 408 is fixed
to the proximal portion of endoscope 401 adjacent to an operator
control 429 of endoscope 401, by a band 432 or by any other
suitable conventional means, such as a clips or medical adhesive
tape.
[0191] Preferably, the operator positions balloon 416 at a desired
location forward of the distal end of endoscope 401 within the
generally tubular body portion, by controlled pulling or pushing of
the proximal portion 423 of guiding tube 412, relative to the
proximal end 424 of external tube 408.
[0192] FIG. 16A shows rearward positioning of endoscope tool 410 in
which the balloon 416 is located just ahead of the distal end of
endoscope 401. The rearward positioning is preferably accomplished
by pulling the proximal portion 423 of guiding tube 412 rearwardly
relative to the proximal end 424 of external tube 408.
[0193] FIG. 16B shows forward positioning of endoscope tool 410 in
which the balloon 416 is located a substantial distance forward of
the distal end of endoscope 401. The forward positioning is
preferably accomplished by pushing the proximal portion 423 of
guiding tube 412 forwardly relative to the proximal end 424 of
external tube 408.
[0194] It is appreciated that controlled positioning of the
endoscope tool 410 at desired distances forward of the distal end
of endoscope 401 may be achieved by suitable controlled positioning
of the proximal portion 423 of guiding tube 412 relative to the
proximal end 424 of external tube 408.
[0195] It is appreciated that in accordance with a preferred
embodiment of the present invention useful for in vivo inspection
of a generally tubular body portion having a variable
cross-sectional diameter, balloon 416 may be controllably
positioned in a range of 0-45 centimeters forward of the distal end
of endoscope 401.
[0196] As seen in FIGS. 16A and 16B, balloon 416 is fixed to
guiding tube 412 via a forward balloon sleeve portion 444 and a
rear balloon sleeve portion 446. As seen in FIG. 16A, the cross
sectional diameter of rear sleeve portion 446 is larger than the
inner cross sectional diameter of external tube 408 and larger than
the inner cross sectional diameter of tubular passageway 409,
thereby preventing balloon 416 from being inserted through external
tube 408 and through tubular passageway 409.
[0197] It is appreciated that rear sleeve portion 446 may function
as a stopper that prevents further pulling of guiding tube 412 when
rear sleeve portion 446 is in contact with tubular sleeve 404 or
with external tube 408.
[0198] In accordance with a preferred embodiment of the present
invention useful for in vivo inspection of a generally tubular body
portion, an additional accessory 450 may be inserted through an
instrument channel 460 of endoscope 401 for medical interaction
with the generally tubular body portion at a location forward of
the distal end of endoscope 401. Accessory 450 may incorporate any
conventional accessory such as biopsy forceps, polyp cutter,
injection needle, or ultrasound device.
[0199] It is appreciated that accessory 450 may be provided instead
of or in addition to endoscope tool 410. Accessory 450 may be
operative within the generally tubular body portion at the same
time or alternating with the operation of endoscopy auxiliary
assembly 402 and endoscope tool 410.
[0200] Reference is now made to FIGS. 17A, 17B, 17C, 17D, 17E, 17F,
17G, 17H, 17I and 17J, which are simplified illustrations of the
endoscopy auxiliary assembly 402 and endoscope tool 410 of FIGS.
13-16B in various operative orientations within an intestine. In
the illustrated embodiment, desired orientation of the forward end
of the endoscope tool 410 is obtained by suitable axial
displacement of the tool through the external tube 408 of endoscopy
auxiliary assembly 402.
[0201] As seen in FIG. 17A, endoscope tool 410 is located adjacent
the distal end of the endoscope 401, and balloon 416, in a deflated
state, protrudes a short distance forward of the distal end of
endoscope 401. As seen, peripheral balloon 403 is in a deflated
state.
[0202] FIG. 17B shows peripheral balloon 403 in an inflated state
in engagement with an interior wall of the intestine, thereby
anchoring the endoscope 401 thereat.
[0203] FIG. 17C shows forward progress of the endoscope tool 410
through the intestine resulting from pushing of the tool forward
relative to the endoscope in a conventional manner.
[0204] FIG. 17D shows inflation of the balloon 416. In accordance
with a preferred embodiment of the invention, this inflation
anchors the forward end of the endoscope tool 410 to the intestine
at the location of the balloon 416.
[0205] FIG. 17E shows tensioning the guiding tube 412 of the
endoscope tool 410 by pulling on the guiding tube 412.
[0206] FIG. 17F shows deflation of peripheral balloon 403.
[0207] FIG. 17G shows the endoscope 401 having been pushed forward
along the guiding tube 412, using the guiding tube 412 as a guide
wire in a conventional manner. Alternatively to pushing endoscope
401 or in parallel to pushing endoscope 401, endoscope tool 410 may
be pulled by pulling on the guiding tube 412 while balloon 416 is
in an inflated state and thereby anchored to the intestine.
[0208] FIG. 17H shows inflation of peripheral balloon 403 into
engagement with an interior wall of the intestine, thereby
anchoring the endoscope 401 thereat.
[0209] Thereafter, as shown in FIG. 17I, the endoscope 401 and the
endoscope tool 410 may be pulled together, while anchored to
interior walls of the intestine. This pulling action may bunch
together a portion of the intestine over part of the endoscope 401,
as shown.
[0210] Thereafter, as shown in FIG. 17J, the balloon 416 may be
deflated.
[0211] Further forward progress of the endoscope through the
intestine, preferably to a position where the distal end of
endoscope 401 lies just behind the balloon 416, similarly to the
orientation shown in FIG. 17B, may be achieved by repeating some or
all of the steps described hereinabove with reference to FIGS.
17B-17J, as required by the geometries encountered.
[0212] Similarly, backward progress of the endoscope through the
intestine may be achieved by repeating some or all of the steps
described hereinabove with reference to FIGS. 17B-17J in a
different order and preferably in a reversed order, as required by
the geometries encountered.
[0213] It is appreciated that air for inflation may be supplied to
the interior of the intestine intermediate peripheral balloon 403
and balloon 416 in some or all of the operative orientations which
are described hereinabove, corresponding to FIGS. 17A-17J.
Specifically, air for inflation may be supplied to the interior of
the intestine intermediate peripheral balloon 403 and balloon 416
in operative orientations corresponding to FIGS. 17D, 17E, 17H and
17I, in which the intestine is generally sealed intermediate the
two inflated balloons. Air for inflation may be supplied to the
interior of the intestine intermediate peripheral balloon 403 and
balloon 416 in operative orientations corresponding to FIGS. 17B,
17C, 17F, 17G and 17J, in which the intestine is generally
partially sealed intermediate the two balloons.
[0214] It is appreciated that inflation of the intestine in the
region between the two balloons may assist in realization of the
operative orientations which are described hereinabove,
corresponding to FIGS. 17A-17J, and in the overall propagation of
endoscope 401 and endoscope tool 410 within the intestine.
[0215] Air flow may be provided to the intestinal volume between
the two balloons through the instrument channel 460 of endoscope
401 as well known and commonly practiced in conventional endoscopy,
or via the external tube 408, through the volume between the
guiding tube 412 and external tube 408. Alternatively, endoscopy
auxiliary assembly 402 may include more than one external tube 408
and in such a case air flow may be provided to the intestinal
volume between the two balloons through an additional external tube
(not shown).
[0216] It is appreciated that in any apparatus comprising two
inflatable balloons which propagate relative to each other along a
generally tubular body portion and specifically within an
intestine, inflation of the generally tubular body portion and
specifically the intestine intermediate the two balloons may assist
in the propagation of the balloons.
[0217] It is appreciated that any other fluid may be supplied to
the intestine intermediate the two balloons. For example, a liquid
may be supplied intermediate the two balloons while the balloons
are inflated and engaging the interior walls of the intestine, as
seen in FIGS. 17D, 17E, 17H and 17I, thereby confining the liquid
within the volume of the intestine intermediate the two balloons.
Such a liquid may be a medicine or other treatment liquid, a
rinsing solution, a marking agent, an ultrasound medium, or another
suitable type of liquid.
[0218] It is appreciated that vacuum may be applied to the
intestine intermediate the two balloons instead of a fluid, if
applicable, such as for suctioning a previously inserted fluid, for
assisting in the propagation of endoscope 401 or endoscope tool
410, or for cleaning body fluids during an endoscopy procedure.
[0219] Reference is now made to FIGS. 18A and 18B, which are
simplified illustrations of the embodiment of FIGS. 13-16B in a
mode of operation useful for in-vivo inspection, diagnosis,
sampling or treatment of a generally tubular body portion. As seen
in FIG. 18A, peripheral balloon 403 is inflated and engaged with an
interior wall of the generally tubular body portion, thereby
anchoring the endoscope 401 thereat. Similarly, balloon 416 is
inflated and engaged with an interior wall of the generally tubular
body portion, thereby anchoring the endoscope tool 410 thereat.
[0220] FIG. 18A further shows a target location 470 at an interior
wall of the generally tubular body portion, located intermediate
peripheral balloon 403 and balloon 416. As seen in FIG. 18B,
endoscope tool 410 may be pulled while still anchored to the
interior wall of the generally tubular body portion by pulling
guiding tube 412, thereby relocating the generally tubular body
portion intermediate peripheral balloon 403 and balloon 416 towards
the distal end of endoscope 401. This movement is operative to
facilitate access of accessory 450 to target location 470, thereby
enabling accessory 450 to perform medical interaction with target
location 470, as applicable.
[0221] It will be appreciated by persons skilled in the art 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 various
features described hereinabove as well as modifications thereof
which would occur to persons skilled in the art upon reading the
foregoing specification and which are not in the prior art.
* * * * *