U.S. patent application number 16/836118 was filed with the patent office on 2020-07-16 for endoscope bending section control mechanism.
This patent application is currently assigned to AMBU A/S. The applicant listed for this patent is AMBU A/S. Invention is credited to Lasse Kjeld Gjoeske PETERSEN, Louise Wagner PETERSEN.
Application Number | 20200221926 16/836118 |
Document ID | / |
Family ID | 41693476 |
Filed Date | 2020-07-16 |
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United States Patent
Application |
20200221926 |
Kind Code |
A1 |
PETERSEN; Lasse Kjeld Gjoeske ;
et al. |
July 16, 2020 |
ENDOSCOPE BENDING SECTION CONTROL MECHANISM
Abstract
An endoscope (1) having a handle (2), an insertion portion (3)
arranged at the distal end of the handle, a bending portion (4)
arranged at the distal end of the insertion portion, and two
control wires (40, 41) used to control the bending of the bending
portion via control inputs made at the handle. The handle includes
at least one lever member (21) pivotable about a pivot axis (22), a
pulley element (42) located between the proximal end of the handle
and the pivot axis of the lever member.
Inventors: |
PETERSEN; Lasse Kjeld Gjoeske;
(Frederiksvaerk, DK) ; PETERSEN; Louise Wagner;
(Copenhagen SV, DK) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
AMBU A/S |
Ballerup |
|
DK |
|
|
Assignee: |
AMBU A/S
Ballerup
DK
|
Family ID: |
41693476 |
Appl. No.: |
16/836118 |
Filed: |
March 31, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16135986 |
Sep 19, 2018 |
10624529 |
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16836118 |
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14922196 |
Oct 26, 2015 |
10149605 |
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16135986 |
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14275744 |
May 12, 2014 |
10165931 |
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14922196 |
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13133704 |
Aug 22, 2011 |
8790250 |
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PCT/EP09/66727 |
Dec 9, 2009 |
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14275744 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/003 20130101;
A61B 1/0014 20130101; A61B 1/015 20130101; A61B 1/00078 20130101;
A61B 1/012 20130101; A61B 1/267 20130101; A61M 16/0488 20130101;
A61B 1/0057 20130101; A61B 1/00114 20130101; A61B 1/00066 20130101;
A61B 1/05 20130101; A61B 1/0052 20130101 |
International
Class: |
A61B 1/00 20060101
A61B001/00; A61B 1/005 20060101 A61B001/005; A61B 1/012 20060101
A61B001/012; A61M 16/04 20060101 A61M016/04; A61B 1/015 20060101
A61B001/015; A61B 1/05 20060101 A61B001/05; A61B 1/267 20060101
A61B001/267 |
Foreign Application Data
Date |
Code |
Application Number |
Dec 10, 2008 |
DK |
PA200801758 |
Claims
1-15. (canceled)
16. A method of manufacturing an endoscope, the method comprising:
providing a housing having a proximal end opposite a distal end,
the housing having a support pillar affixed thereto; attaching a
control lever to the housing, the control lever rotatable about a
pivot axis, wherein the support pillar is affixed intermediate the
pivot axis and the distal end of the housing; attaching an
insertion portion to the housing, wherein the insertion portion
extends from the distal end of the housing and has a proximal end
with an entrance opening; attaching a bending portion to the
insertion portion; attaching a rigid tip portion to the bending
portion; arranging a camera in the rigid tip portion; operably
connecting steering control wires to the bending portion and the
control lever, the control wires at least partially enclosed by
wire sheaths having proximal ends and distal ends, wherein rotating
the control lever about the pivot axis bends the bending portion;
and affixing each of the wire sheaths to the support pillar such
that the proximal ends of the wire sheaths are longitudinally
aligned with portions of the steering control wires extending
between the control lever and the support pillar to thereby
minimize friction between the steering control wires and the wire
sheaths.
17. The method of claim 16, wherein affixing each of the wire
sheaths to the support pillar forms arcuate wire sheath portions
between the support pillar and the entrance opening of the proximal
end of the insertion portion after the endoscope is finally
assembled.
18. The method of claim 16, wherein the support pillar has a
proximal surface proximal of a distal surface and lateral surfaces
extending between the proximal surface and the distal surface, and
wherein affixing each of the wire sheaths to the support pillar
comprises affixing the wire sheaths to the support pillar between
the lateral surfaces.
19. The method of claim 18, further comprising attaching a tube
defining a working channel to a working channel inlet in the
housing located distal of the support pillar and proximal of the
entrance opening of the insertion portion, the tube extending
through the insertion portion to the rigid tip portion.
20. The method of claim 16, further comprising attaching the wire
sheaths to the proximal end of the bending portion.
21. The method of claim 16, wherein the support pillar includes two
holes and the wire sheaths consist of two wire sheaths, the method
further comprising inserting each proximal end of the two wire
sheaths through one of the two holes to allow individual adjustment
of end positions of the proximal ends of the two wire sheaths.
22. The method of claim 16, further comprising attaching a tube
defining a working channel to a working channel inlet in the
housing located distal of the support pillar and proximal of the
entrance opening of the insertion portion, the tube extending
through the insertion portion to the rigid tip portion.
23. The method of claim 16, wherein affixing each of the wire
sheaths to the support pillar comprises adjustably attaching the
wire sheaths to the support pillar to control tensions in the
control wires, and wherein affixing each of the wire sheaths forms
arcuate wire sheath portions between the support pillar and the
entrance opening of the proximal end of the insertion portion after
the endoscope is finally assembled.
24. The method of claim 23, further comprising attaching a
fastening device adjacent the proximal end of the insertion
portion, the fastening device comprising a body and two parallel
longitudinal portions connected to and extending from the body; and
passing a wire connected to the camera through the insertion
portion and one of the two longitudinal portions into the housing
and out of the housing through the other of the two longitudinal
portions, wherein the wire is adapted to electronically connect the
camera to a control device.
25. The method of claim 23, wherein the support pillar includes two
holes and the wire sheaths consist of two wire sheaths, the method
further comprising inserting each proximal end of the two wire
sheaths through one of the two holes and adjustably attaching the
wire sheaths to the support pillar to control tensions in the
control wires.
26. A method of manufacturing an endoscope, the method comprising:
providing a housing having a proximal end opposite a distal end,
the housing having a support pillar affixed thereto; attaching a
control lever to the housing, the control lever rotatable about a
pivot axis, wherein the support pillar is affixed intermediate the
pivot axis and the distal end of the housing; attaching an
insertion portion to the housing, wherein the insertion portion
extends from the distal end of the housing and has a proximal end
with an entrance opening; attaching a bending portion to the
insertion portion; attaching a rigid tip portion to the bending
portion; arranging a camera in the rigid tip portion; operably
connecting steering control wires to the bending portion and the
control lever, the control wires at least partially enclosed by
wire sheaths having proximal ends and distal ends, wherein rotating
the control lever about the pivot axis bends the bending portion;
and affixing each of the wire sheaths to the support pillar forming
arcuate wire sheath portions between the support pillar and the
entrance opening of the proximal end of the insertion portion after
the endoscope is finally assembled.
27. The method of claim 26, wherein the support pillar includes two
holes, the method further comprising inserting proximal ends of the
steering wire sheaths through the two holes to allow individual
adjustment of end positions of the proximal ends of the two
steering wire sheaths.
28. The method of claim 26, wherein attaching the two steering wire
sheaths to the support pillar comprises adjustably attaching the
two steering wire sheaths to the support pillar to control tensions
in the control wires.
29. The method of claim 26, wherein the wire sheaths have proximal
ends, the method further comprising attaching the proximal ends to
the support pillar such that the proximal ends are longitudinally
aligned with portions of the control wires extending between the
user control member and the support pillar to thereby minimize
friction between the control wires and the wire sheaths.
30. The method of claim 26, further comprising attaching a
fastening device adjacent the proximal end of the insertion
portion, the fastening device comprising a body and two parallel
longitudinal portions connected to and extending from the body; and
passing a wire connected to the camera through the insertion
portion and one of the two longitudinal portions into the housing
and out of the housing through the other of the two longitudinal
portions, wherein the wire is adapted to electronically connect the
camera to a control device.
31. The method of claim 26, wherein the support pillar has a
proximal surface proximal of a distal surface and lateral surfaces
extending between the proximal surface and the distal surface, and
wherein affixing each of the wire sheaths to the support pillar
comprises affixing the wire sheaths to the support pillar between
the lateral surfaces.
32. The method of claim 31, further comprising attaching a tube
defining a working channel to a working channel inlet in the
housing located distal of the support pillar and proximal of the
entrance opening of the insertion portion, the tube extending
through the insertion portion to the rigid tip portion.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a division of U.S. patent application
Ser. No. 16/135,986, filed on Sep. 19, 2018, which is a
continuation of U.S. patent application Ser. No. 14/922,196, filed
on Oct. 26, 2015, which was issued as U.S. Pat. No. 10,149,605 on
Dec. 11, 2018 and is a division of U.S. patent application Ser. No.
14/275,744, filed on May 12, 2014, which was issued as U.S. Pat.
No. 10,165,931 on Jan. 1, 2019 and is a continuation of U.S. patent
application Ser. No. 13/133,704, having a filing or 371(c) date of
Aug. 22, 2011, which was issued as U.S. Pat. No. 8,790,250 on Jul.
29, 2014 and is a National Stage filing of International
Application Serial No. PCT/EP09/066727, filed Dec. 9, 2009, which
claims the benefit of Denmark Patent Application No. PA 2008 01758,
filed Dec. 10, 2008. The disclosures of the foregoing patent
applications are expressly incorporated herein by reference in
their entirety.
FIELD OF THE INVENTION
[0002] The current invention relates to an endoscope having a
distal end being arranged to be inserted into a body cavity of a
patient to be examined and a proximal end which is arranged to be
held by a user of the endoscope. The endoscope further comprises a
handle arranged at the proximal end of the endoscope, an insertion
portion arranged at the distal end of the handle, a bending portion
arranged at the distal end of the insertion portion, and two
control wires arranged between the handle and the bending portion,
said control wires being used to control the bending of the bending
portion via control inputs made at the handle.
[0003] The type of endoscope described in the opening paragraph is
well known to the person skilled in the art and comes in many
different shapes and sizes. The opening paragraph should therefore
be construed as broadly as possible.
DESCRIPTION OF RELATED ART
[0004] An example of such an endoscope is disclosed in U.S. Pat.
No. 5,976,075. In this case a very simple mechanism is provided to
control the bending of the bending portion of the endoscope.
Another example of a simple mechanism is disclosed in EP 1,804,639.
Another example is WO 94/10897. This example shows a more complex
arrangement whereby the bending portion can be better controlled
with more degrees of freedom. Many other examples can be found in
the patent literature.
[0005] We note that the current invention is, as mentioned above,
related to endoscopes. However, the main focus of the application
is on the handle portion and the mechanism within the handle
portion for controlling the bending of the bending portion of the
endoscope, i.e. the mechanism for controlling the motion of the two
control wires. The remaining structure of the endoscope is not so
important for the current invention and as such, the remaining
structure will not be discussed in great detail in the current
specification. The person skilled in the art should however be able
to see how the current handle/control mechanism can be integrated
into endoscopes of different forms without any great
difficulties.
[0006] We note that in the current application, the example
endoscope shown is an endoscope used to help in establishing
artificial respiration for patients. At the start of the procedure
an endotracheal tube is placed over the flexible insertion portion
of the endoscope. Once the endotracheal tube is placed on the
insertion portion, the flexible insertion portion is inserted into
the airway of a patient. The vision system in the tip of the
endoscope allows the endoscope to be guided into place without
danger for the patient. Once the endoscope is in place, the
endotracheal tube can be pushed down along the insertion portion of
the endoscope. Once the endotracheal tube is in place, the
endoscope can be withdrawn leaving the endotracheal tube in place
in the airway of the patient. While this is the only concrete
embodiment disclosed in this specification, it should be understood
that the teachings of the current specification can apply to many
other types of endoscopes as well. Two non limiting examples are an
endoscope used during surgery to view the surgical procedure and an
endoscope used in industry to inspect machinery or other
structures.
[0007] Furthermore the endoscopes can have a different form than
the one discussed in this application. For example, the endoscope
shown in the figures comprises a flexible insertion portion.
However, a handle/control mechanism according to the current
invention could also be used with an endoscope having a stiff
insertion portion and a bending portion arranged at the end of the
stiff insertion portion.
SUMMARY OF THE INVENTION
[0008] It is a first aspect of the current invention to provide an
endoscope which is better than the prior art endoscopes. In
particular, an aspect of the current invention is to provide an
endoscope handle/control mechanism having a reduced cost and
complexity.
[0009] This aspect is in part provided by an endoscope as specified
in the opening paragraph and further comprising at least one lever
member arranged to be pivotable about a pivot axis, a pulley
element located between the proximal end of the handle and the
pivot axis of the lever member, and wherein the two control wires
are attached to the at least one lever member, a first of said two
control wires being arranged such that it travels from the at least
one lever member in the direction towards the bending portion and
the second of said two control wires being arranged such that it
travels from the at least one lever member in the direction towards
the pulley element, it then travels around the pulley element and
then forwards towards the bending portion. In this way, a simple
and effective control mechanism can be achieved.
[0010] It should be mentioned that according to the current
specification, the term "pulley element" should be interpreted as
any element which allows the direction of a flexible element, such
as a string or control wire, to change direction. This could be a
pulley with a rotatable wheel as a support surface for the flexible
element, or it could be a fixed surface around which the flexible
element is arranged. It could also be a wire sheath which changes
directions, for example a thin metal or stiff plastic tube bent
into a U shape, the wire being arranged inside the tube. This could
for example be a Bowden cable.
[0011] The term "lever member" according to this specification
should be understood as any element which allows a leverage force
to be applied to an element. Two non-limiting examples are a stiff
rod pivotable about a pivot axis and a cylinder pivotable about a
pivot axis and around which a flexible member is arranged. The
person skilled in the art will be able to provide equivalent
structures. Furthermore, more than one lever members could be
connected together and each control wire could be connected to a
different lever member.
[0012] In one embodiment, the first and second control wires could
be attached to the at least one lever member on the same side of a
plane passing through the pivot axis.
[0013] In a preferred embodiment, the pivot axis of the at least
one lever member could be arranged perpendicular to the
longitudinal axis of the insertion portion of the endoscope. In
this way, the motion of the wires will be essentially aligned with
the axis of the insert portion. It should be noted that since the
insertion portion is flexible, the longitudinal axis of the
insertion portion can change. However for the understanding of this
paragraph, the longitudinal axis of the most proximal part of the
insertion portion should be used.
[0014] In order to ensure that the control wires move in relatively
the same direction and in relatively the same amount, the angle
formed between a first vector defined by the attachment point of
the first control wire to the at least one lever member and the
pivot axis of the at least one lever member and a second vector
defined by the attachment point of the second control wire to the
at least one lever member and the pivot axis of the at least one
lever member could be less than 120.degree.. The smaller the angle,
the more the two points will follow the same path. In a preferred
embodiment the angle could be less than 45 degrees. In another
preferred embodiment the angle is essentially zero. It should be
noted that the angle is measured by projecting the vectors onto a
plane which is perpendicular to the pivot axis.
[0015] Furthermore, the attachment points of the control wires
could be arranged such that the distance from the attachment point
of the first control wire on the at least one lever member to the
proximal end of the handle and the distance from the attachment
point of the second control wire on the at least one lever member
to the proximal end of the handle could be essentially the
same.
[0016] In order to control the lever member, the control handle
could comprise a housing which comprises an opening through which a
control element protrudes. The control element could be connected
to the at least one lever member. The control element for the sake
of this specification should be understood as an element whereby
the user of the endoscope can control the motion of the at least
one lever member. This could for example be a slideable button or a
turnable knob. The person skilled in the art will be able to
provide additional possibilities.
[0017] In one embodiment, the opening in the housing could be
arranged as a slot. In this case, the at least one lever member
could comprise a shield member arranged on the inner side of the
housing of the handle which covers said slot from the inside of the
housing of the handle. The shield member could furthermore be
displaceable together with the at least one lever member. In this
way a nice finish is achieved without any open holes in the
housing. In addition, the shield member will close the housing, so
foreign matter can be prevented from getting inside the housing.
The shield member could also be provided with seals in order to
completely seal the opening.
[0018] In another embodiment, the handle could comprise a spring
member connected to the at least one lever member and arranged to
return the at least one lever member to a neutral position. By
neutral position it should be understood as a position where the
bending portion is in a straight position, as shown by the solid
lines in FIG. 1. The lever member will typically be arranged to be
able to be displaced to either side of this neutral position.
[0019] In a preferred embodiment, the handle could further comprise
a second spring member and in that the first and second spring
members are arranged one on either side of a plane which is
arranged perpendicular to the pivot axis of the at least one lever
member. In this way, the two springs will be able to provide a
balanced torque on the lever member.
[0020] The spring member could advantageously be formed as a leaf
spring comprising at least one leaf.
[0021] In a particularly simple embodiment, the spring member could
be arranged to pass through the pivot axis of the at least one
lever member.
[0022] The at least one lever member could furthermore be at least
partially supported in the handle via an axle arranged co-axially
with the pivot axis of the at least one lever member and supported
in a support member arranged in the handle. The axle could be
directly connected with the spring member.
[0023] In a specific embodiment, the handle could comprise two leaf
springs, each leaf spring comprising at least one leaf and being
arranged on either side of a plane which is arranged perpendicular
to the pivot axis of the a least one lever member, said leaf
springs being arranged to pass through the pivot axis of the at
least one lever member and said at least one lever member being
connected to the leaf springs in the middle of the leaf springs,
the ends of the leaf springs being fixedly supported within the
handle.
[0024] The ends of the leaf springs could furthermore be sandwiched
between a top cover portion of a housing of the handle and a bottom
cover portion of the housing of the handle. This will provide a
simple assembly procedure.
[0025] In a preferred embodiment, the control wires could be a part
of two Bowden cable assemblies and the ends of the sheaths of the
Bowden cable assemblies could be adjustably arranged within the
handle of the endoscope. In this way, the control wires can be
arranged more flexibly in the handle and the tension in the control
wires can be easily adjusted.
[0026] It should be emphasized that the term
"comprises/comprising/comprised of" when used in this specification
is taken to specify the presence of stated features, integers,
steps or components but does not preclude the presence or addition
of one or more other features, integers, steps, components or
groups thereof. For example in the introductory paragraph it is
mentioned that the endoscope comprises two control wires. However,
this should also include any additional number of control
wires.
BRIEF DESCRIPTION OF THE DRAWINGS
[0027] In the following, the invention will be described in greater
detail with reference to embodiments shown by the enclosed figures.
It should be emphasized that the embodiments shown are used for
example purposes only and should not be used to limit the scope of
the invention.
[0028] FIG. 1 shows a complete perspective view of an endoscope
according to the invention together with a schematic representation
of its supporting hardware.
[0029] FIG. 2 shows a more detailed perspective view of the handle
of the endoscope of FIG. 1 with a top cover portion of the housing
removed.
[0030] FIG. 3 shows a perspective exploded view of the handle of
the endoscope of FIG. 1.
[0031] FIG. 4 shows a cross section of the handle of the endoscope
of FIG. 1 showing the path of the control wires.
[0032] FIG. 5 shows the same cross section as FIG. 4, however
without the control wires, but showing the injection tube and the
electrical signal wire.
DETAILED DESCRIPTION OF THE EMBODIMENTS
[0033] The endoscope 1 shown in FIG. 1 comprises a control handle
2, a flexible insertion portion 3, a bending portion 4 and a rigid
tip portion 5. The control handle comprises a control member 6
arranged on the outside of the housing of the handle. The control
member in the current embodiment is in the form of a joystick 6
which is connected to the bending portion 4 via Bowden cables (not
shown in FIG. 1) arranged partly within the control handle, the
flexible insertion portion and the bending portion. When the
joystick is displaced, the bending portion bends as shown by the
dashed lines in FIG. 1.
[0034] The control handle further comprises an electrical cable 7
which is used to connect the endoscope to a control module 8. In
the current embodiment, the control module comprises a power source
and a video monitor. The control handle also comprises an injection
port 9 which is in communication with an opening (not shown) at the
distal end of the rigid tip portion of the endoscope via a flexible
tube (or working channel) arranged partly within the control
handle, the flexible insertion portion and the bending portion. The
injection port 9 can be used to inject fluids into the endoscope
which will be sprayed out at the opening at the tip of the
endoscope. This could for example be a local anaesthetic or the
like.
[0035] The flexible insertion portion 3 is arranged as a hollow
tube which is flexible and bendable about directions perpendicular
to the longitudinal axis of the insertion portion. However, the
flexible insertion portion is stiff in the torsional direction and
in the longitudinal direction. In this way, rotation of the control
handle is transferred directly to the tip and allows the user of
the endoscope to control the rotational position of the tip of the
endoscope by twisting the control handle. A camera and a light
source (not shown) are arranged in the rigid tip portion 5 of the
endoscope. The electrical signals from the camera and the power to
the camera and the light source art are transferred via wires 51
(shown in FIG. 5) partly arranged within the control handle, the
flexible insertion portion and the bending portion of the
endoscope. The electrical signals are transferred from the rigid
tip to the control handle where after they are further transferred
to the control module for displaying on the video monitor.
[0036] It should be noted that endoscopes comprising the above
mentioned features are very well known to the person skilled in the
art and further details will not be required by the person skilled
in the art to understand and implement the current invention. The
main invention disclosed in the current application is directed to
the mechanism in the control handle used to control the bending of
the bending portion. This specification will therefore focus on
this invention.
[0037] FIG. 1 does however show two features which are not directly
related to the main invention and which are different from prior
art endoscopes. These features are described in the context of the
current invention, but it should be clear to the person skilled in
the art that these two features could become the subject matter of
two separate divisional applications.
[0038] The first feature relates to the injection port 9. In the
current embodiment, the injection port 9 is formed as a swivel
which is able to rotate about a rotation axis 10. In the current
embodiment, the rotation axis is arranged on a plane which is
parallel to the plane of symmetry of the control handle. However
the rotation axis could also be arranged along a different plane in
another embodiment. Furthermore, the connection part of the
injection port extends at an angle .alpha. of between 10 and 90
degrees to the rotation axis. By providing the connection part of
the injection port at an angle to the rotation axis, it is possible
to rotate the connection part such that it will point to either
side of the handle. In this way it is easier for an assistant to
assist the user of the endoscope when something needs to be
injected into the injection port. In prior art type endoscopes, the
injection ports are typically arranged to protrude from the control
handle at a fixed orientation. In contrast, the injection port of
the current invention can be swivelled towards the direction of the
assistant to the user. The details of the swivel can be better seen
in FIG. 4.
[0039] As can be seen in FIG. 5, the flexible tube or working
channel 50 which is connected to the injection port is arranged as
a loop within the handle. In this way, the portion of the tube
connected to the injection port is able to be fixed to the
injection port and the loop absorbs the rotation of the tube due to
the rotation of the injection port. In order not to stress the tube
too much, the injection port can be arranged such that it can only
rotate a certain amount in either direction for example
approximately 90.degree. in either direction. An embodiment where
the motion is limited to approximately 60.degree. in either
direction is also imagined.
[0040] The second feature relates to a fastening device 11 for
fastening the endotracheal tube to the end of the handle of the
endoscope while inserting the endoscope into the airway of the
patient. The fastening device 11 (dashed part in FIG. 5) includes a
body supported by the housing (13,14) and two elongate portions
connected to and extending from the body. The fastening device is
arranged at the proximal end of the insertion portion (and/or at
the distal end of the handle). The fastening device comprises at
least one flexible ring 12 arranged around the outer diameter of
the insertion portion on one of the two elongate portions. In this
particular embodiment the fastening device comprises four flexible
rings 12, but any other number of rings is possible. The rings 12
are formed from a suitable flexible material, for example rubber.
The rings are co-axial with the axis of the insertion portion at
the proximal end of the insertion portion.
[0041] The rings have an outer diameter which is slightly larger
than the inner diameter of a standardized connector at the end of
an endotracheal tube. In this way, the endotracheal tube (not
shown) which is placed over the insertion portion before the
endoscope is inserted into the airway of a patient, can be pushed
towards the handle whereby the connector of the endotracheal tube
is pushed towards the fastening device whereby the rings of the
fastening device are pressed into the opening in the connector due
to their flexibility. The rings then hold on to the endotracheal
tube via friction between the rings and the connector on the
endotracheal tube. When the endotracheal tube is to be released,
the user can apply a light force to the endotracheal tube to
disengage the tube from the rings.
[0042] Endotracheal tubes come in many different sizes typically
between 2 and 10.5 mm in internal diameter. In order to use the
different sized endotracheal tubes with the same equipment,
standard connectors have been developed which are mounted at the
end of the endotracheal tubes. The outer surface of the connector
is a standardized cone shape with a nominal diameter of 15 mm. The
inner diameter of the connector is not standardized, but is in most
of these connectors around 11 mm. Since the inner diameter of the
connector is not standardized, there will be slight variations in
the inner diameter of the connectors of different manufacturers.
However with the arrangement of the fastening device as disclosed
herein, the flexible nature of the rings of the fastening device
will flex and work with a large number of different sizes.
[0043] It should also be mentioned that the rings could be arranged
in many different manners. For example, the rings in a certain
embodiment could be arranged to taper in the direction towards the
control handle. In this way, the wedging effect of the fastening
device could be increased. In another embodiment, the rings of the
fastening device could be arranged to have a non-circular
periphery. For example, the rings could be arranged in a star like
shape. In this way, the points of the star would hold onto the
inner surface of the endotracheal tube. Using a star like shape
would allow the rings to accept a larger variation of connector
sizes without making the rings too soft.
[0044] The control handle 2 further comprises a housing which
comprises a main housing part 13 and a cover part 14. An on/off
push button 15 is arranged on the cover part of the housing. The
main part of the housing and the cover part are formed from a
plastics material in an injection moulding process in the current
embodiment. The main part of the housing furthermore comprises two
areas 16,17 which are covered in a softer and more gripable
material when compared to the rest of the housing and cover part.
This material could for example be a rubber like material. This
type of covering is known from power tools such as power drills,
etc. and provides the user with a better and more comfortable grip
on the handle. The same type of covering is also applied to the
joystick 6.
[0045] FIGS. 2-4 show the handle in more detail so that the
internal mechanical details of the control mechanism can be seen.
It should be noted that the control wires are not shown in FIGS. 2
and 3, but are shown in the cross section of the handle shown in
FIG. 4.
[0046] The handle 2 comprises a joystick mechanism 6 which
comprises a displaceable button 20 which is arranged on the outer
side of the housing of the control handle. The user controls the
joystick mechanism via this displaceable button. In the current
embodiment, the button is arranged to be able to move along a
curved path arranged on a plane. In the current embodiment, said
plane is arranged along the plane of symmetry of the handle. The
button is connected to a lever member 21. The lever member is
arranged to be pivotable about a pivot axis 22. The path of the
motion of the button is therefore determined by the dimensions of
the lever member and the location of the pivot axis 22. The lever
member has a first portion 23 arranged on a first side of a plane
which passes through the pivot axis and a second portion 24
arranged on the other side of said plane. The first portion of the
lever member is arranged to protrude out of the housing via a slot
25 (see FIGS. 3 and 4) in the top cover part of the housing. The
button 20 is connected to the first portion of the lever
member.
[0047] The lever member 21 is supported within the housing of the
handle via a suspension mechanism 30. The suspension mechanism is
comprised of two leaf springs 31. In the current embodiment, each
leaf spring comprises a single leaf. In other embodiments, the leaf
springs could comprise additional leaves. The two leaf springs are
arranged an equal distance on either side of a plane which is
parallel to the plane of symmetry of the handle. The two leaf
springs are connected to the lever member via an axle 32 which is
co-axial with the pivot axis 22 of the lever member. The leaf
springs are furthermore arranged such that they pass through the
pivot axis of the lever member. The ends 33 of the leaf springs are
mounted/supported in mounts 34 firmly connected to the housing of
the control handle. The mounts prevent the ends of the leaf springs
from moving up or down, but do not prevent sideways displacement
(according to the orientation as shown in FIG. 4).
[0048] The axle 32 is supported within the housing via supports 35
in the handle. The supports 35 in the handle are formed as two
complementary elements, an upper support element 35a connected to
the cover part 14 of the housing of the handle and a lower support
element 35b connected to the main portion 13 of the housing of the
handle. The two complementary elements 35a,35b are formed with two
semicircular openings which when put together form a complete
circle. During assembly the axle can be laid in the lower support
element and then held in place with the upper support element when
the cover part is mounted on the main portion of the housing. In
this way, any motion of the button causes the lever member to pivot
about the pivot axis. The leaf springs force the lever member to
return to a centred/netural position when the user releases the
button.
[0049] As can be seen from FIG. 4, the two control wires 40, 41 are
connected to the second portion of the lever member. In other
words, the control wires are connected to the lever member on the
opposite side of a plane passing through the pivot axis as the
button 20. The first control wire 40 is connected to the end of the
lever member and then runs forwards towards the distal end of the
handle and ends up at the distal end of the bending portion. Note
the direction "forwards" should be understood as a direction from
the proximal end of the endoscope towards the distal end. The term
"backwards" should be understood as a direction from the distal end
of the endoscope towards the proximal end. The second control wire
41 is connected to the end of the lever member at essentially the
same position as the first control wire. By essentially the same,
is meant close together such that the motion of the two connection
points is roughly the same. From its attachment to the lever member
the second control wire runs backwards and then passes around a
pillar 42 arranged in the housing. The pillar 42 acts as a sort of
pulley element allowing the control wire to change direction and
run forwards in the housing. As with the first control wire, the
second control wire then runs to the distal end of the bending
portion.
[0050] When the button is displaced in a direction towards the
distal end of the handle, the lever member will rotate in a
clockwise direction (according to the orientation of the handle as
shown in FIG. 4) and tension will be applied to the first control
wire 40 and the second control wire 41 will be slackened. When the
button is displaced in a direction towards the proximal end of the
handle, the lever member will rotate in a counter clockwise
direction and tension will be applied to the second control wire 41
and the first control wire will be slackened. In the second case,
the end of the second control wire 41 which is attached to the
lever member will be pulled forwards, .i.e. towards the distal end
of the handle. The second control wire will then transfer this pull
via the pillar 42 into a pull backwards on the portion of the
second control wire which is arranged between the pillar and the
distal end of the bending portion.
[0051] The two control wires 40,41 are arranged to pass through
holes 46 in a support pillar 43 firmly fixed in the housing in
order to control the paths of the control wires. In the current
embodiment, in order to better control the travel of the control
wires, the control wires are formed as parts of Bowden Cables. A
Bowden cable is well known from other endoscope systems and more
commonly from bicycle cable arrangements. A Bowden cable is
comprised of an active cable part arranged inside a sheath. The
sheath is arranged to be relatively incompressible in the
longitudinal direction. In this way the path of the control wires
can be controlled very well and allow the pull to change
directions. In addition, the sheaths protect the cables from
kinking and reduce the friction against movement of the control
cables.
[0052] In the current embodiment, the sheath 44 of the first
control cable 40 and the sheath 45 of the second control cable are
both attached at one end to a support pillar 43 in the handle and
are both attached at the other end to the proximal end of the
bending portion. The support pillar 43 is furthermore arranged such
that the proximal ends of the sheaths point at the lever member,
and essentially in the direction towards the point where the
control wires are attached to the lever member. In this way, each
control wire, coming from the lever member, enters its respective
sheath at the best possible angle to reduce friction. The sheaths
then proceed from the support pillar in a smooth arc to the
entrance of the insertion portion. The sheaths continue all the way
to the proximal end of the bending portion. The support pillar 43
is furthermore formed to allow the end positions of the sheaths to
be independently adjusted. By adjusting the end position of the
sheaths, the same effect is achieved as if the sheaths were
lengthened. In this way the tension on the control cables 40,41 can
be adjusted. This could for example be made by providing two holes
46 in the support pillar with internal threads and arranging a
hollow screw (not shown) in each hole. The hollow screw would be
arranged to allow the control wire to pass through the hollow
portion of the screw but prevent the sheath from passing the screw.
By adjusting the screw, the position of the end of the sheath could
be adjusted. This sort of adjusting mechanism is known from bicycle
cables systems, for example brake or shifter cables.
[0053] It should be noted that in FIG. 4, the paths of the control
wires 40,41 and the wire sheaths 44,45 are shown schematically in
order to show the paths of the two wires separately. In a real
device, the control wires would be arranged at the same height in
the holes 46 in the support pillar 43 and as such would follow two
paths which are closer to each other than shown in the figure.
[0054] As can be seen from FIG. 4, the joystick mechanism is also
provided with a shielding portion 47. The shielding portion is
fixed to the lever member and is formed from a semi circular
element which is slightly wider than the slot 25 in the cover of
the housing of the handle. The centre point of the semi circular
element of the shielding portion is arranged co-axial with the
pivot axis of the lever member. The semi circular portion is also
arranged such that it covers the slot in both the position in which
the joystick is pushed fully forward or pushed fully backwards.
This means that the shielding portion is both longer and wider than
the slot in the housing. As can be seen from FIG. 4, the shielding
portion is quite large and would conflict with the control wires,
if the control wires were mounted to the first portion of the lever
member. Furthermore, it can be seen from FIGS. 3 and 4 that the
area 48 of the top cover part 14 of the housing of the handle
around the slot is also formed to fit with the curvature of the
shielding portion 47.
[0055] The current embodiment of the handle mechanism is assembled
by first forming the lever member 21 and the axle 32 as a single
integrated plastic injection moulded component. The leaf springs
31,32 are separate plastic injection moulded components and are
assembled together with the ends of the axle. According to the
figures, the leaf springs are formed with an attachment portion in
the middle of the leaf springs which fits into a corresponding
recess in the ends of the axle. The ends 33 of the leaf springs are
the placed in the mounts 34 in the bottom part of the housing and
the axle 32 is arranged in the lower support elements 35b. The
control wires are attached to the second portion 23 of the lever
portion and the control wires arranged in the housing. The
shielding portion 44 is then slid over the first portion of the
lever member where after the top part 14 of the housing of the
handle is mounted on the bottom part. The ends 33 of the leaf
springs are then held in position in the housing by being
sandwiched between protrusions 45 of the top cover part 14 and the
mounts 34 of the bottom 13 of the housing of the handle and the
axle is held in place by the support mounts 35a,35b. This can be
seen in FIG. 4. Once the cover is in place, the button 20 is
mounted to the first portion of the lever portion. The different
components can be glued together to achieve a more firm
assembly.
[0056] In order not to complicate FIG. 4 unnecessarily, the
flexible tube or "working channel" connecting the injection port 9
and the opening (not shown) at the distal end of the endoscope and
the wire connecting the camera electronics in the rigid tip of the
endoscope and the control module have not been shown in FIG. 4.
FIG. 5 however, shows how the tube 50 and the wire 51 are arranged
to avoid the risk of kinking. Wire 51 passes through the insertion
portion and one of the two elongate portions into the housing
(13,14) and out of the housing through the other of the two
elongate portions. It should furthermore be noted that not all the
components of the endoscope have been shown in the figures. This is
to avoid complicating the figures unnecessarily. For example, a
printed circuit board comprising control electronics for the
endoscope could be arranged within the handle as well.
[0057] It is to be noted that the figures and the above description
have shown the example embodiments in a simple and schematic
manner. The internal electronic and mechanical details have not
been shown since the person skilled in the art should be familiar
with these details and they would just unnecessarily complicate
this description.
[0058] It should also be noted that the above described embodiments
only disclose a small number of different embodiments which should
be covered within the scope of the claims. For example in the
embodiments shown, the control wires have been directly connected
to the lever member. However, the person skilled in the art will
understand that the control wires do not have to be directly
attached to the lever member, but could be connected via a
connection element, for example a stiff rod or the like. As such,
the scope of the claims should not be limited by the embodiments
unnecessarily.
[0059] It should also be noted that the disclosure of the
arrangement of the leaf springs has only been described with
regards to the embodiment shown in the figures, ie an embodiment
where the control wires attached to the lever member go in opposite
directions away from the lever member. However, the arrangement of
the leaf springs as described in this specification could also be
used together with other types of lever members. For example,
consider the case of two cylindrical lever members arranged one on
either side the shielding element shown in FIGS. 2 and 3 and
co-axial with the axle. A first control wire is attached to a first
cylindrical lever member and the second control wire is attached to
the second cylindrical lever member. The second portion 24 of the
lever member as shown in FIG. 2-4 could in this case be neglected.
The pulley element 42 could also be neglected. As will be clear to
the person skilled in the art, the leaf spring arrangement could
therefore be used with embodiments which do not fall into the scope
of the claims as currently filed. This is therefore a separate
invention which might be claimed in a divisional application
directed to this feature.
[0060] It can also be mentioned that the current embodiments have
disclosed embodiments where the control input member has been a
displaceable button. However other options as control input members
should also be included, for example a turnable knob.
* * * * *