U.S. patent number 3,900,022 [Application Number 05/423,489] was granted by the patent office on 1975-08-19 for endoscope with uninterrupted flow purging system.
Invention is credited to Jerrold Widran.
United States Patent |
3,900,022 |
Widran |
August 19, 1975 |
Endoscope with uninterrupted flow purging system
Abstract
An endoscope characterized by two separate yet generally
coextensive fluid conduits disposed along the length thereof,
thereby making feasible the establishment of a continuous,
uninterrupted tissue-irrigating flow of fluid to and from a zone of
examination and treatment into which the lead portion of the
endoscope is introduced, so as to purge the zone to enhance the
viewing therewithin and to facilitate treatment including surgical
procedures carried out in the zone. Sensing means, pressure
indicator means, and regulator means are provided for monitoring
and controlling the fluid flow rate and for setting and limiting
fluid pressure in the system.
Inventors: |
Widran; Jerrold (Glencoe,
IL) |
Family
ID: |
23679081 |
Appl.
No.: |
05/423,489 |
Filed: |
December 10, 1973 |
Current U.S.
Class: |
600/105; 600/158;
137/391; 604/118; 604/31; 606/46 |
Current CPC
Class: |
A61B
1/12 (20130101); A61M 1/0058 (20130101); A61B
1/307 (20130101); Y10T 137/7303 (20150401) |
Current International
Class: |
A61B
1/12 (20060101); A61B 1/307 (20060101); A61M
1/00 (20060101); A61B 001/06 (); A61M 001/00 () |
Field of
Search: |
;128/6,7,303.15,305,311,2B,276-278,240,241,302,4
;137/565,566,391 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Attorney, Agent or Firm: Kegan, Kegan & Berkman
Claims
What is claimed is:
1. In an endoscope including conduit means insertable
longitudinally into a restricted passage communicating with a body
cavity for transmittal of a fluid stream through said passage and
into and from a zone of treatment subjected to a surgical
technique,
tissue treatment means including means for removing tissue from
said zone,
optical means for viewing said zone,
means for illuminating said zone,
means for selectively manipulating said tissue treatment means in
carrying out said surgical technique,
pump means for driving fluid through said conduit means for said
zone of treatment, thereby to establish a continuous fluid flow
circuit for passage of fluid into and discharge of fluid from said
zone of treatment in an uninterrupted stream, and
fluid impelling means distinct from said pump means
the improvement comprising:
flow rate synchronization means operable functionally in a series
flow path including a zone of treatment to synchronize said fluid
impelling means volume-wise with said pump means to preclude
pressure buildup in said zone of treatment by reason of fluid
forced into said zone of treatment, and to obviate collapse of said
body cavity as a result of fluid evacuation therefrom.
Description
The present invention relates to an endoscope or similar instrument
finding utility in the examination of the interior of a hollow
organ, as, for example, the urethra, and the bladder. More
particularly, the invention is directed to a resectoscope with a
markedly improved fluid transmitting system characterized in that
it includes two separate yet generally coextensive fluid conduits
disposed along the length of the device, one conduit constituting a
fluid input channel or passage and the other a fluid return or
exhaust passage, both in communication with an internal body cavity
or medical treatment zone.
It is an important feature of the invention that the fluid conduit
system makes it feasible to establish a continuous, uninterrupted
tissue-irrigating flow of fluid to and from a zone of examination
and treatment into which the lead portion of the endoscope is
introduced. The technique which is made possible through the use of
the improved apparatus of the invention enables one to purge the
zone of treatment to enhance the viewing therewithin and to
facilitate surgical procedures which may be required.
In a preferred embodiment of the invention the apparatus includes
fluid pressure sensing and indicator means together with pressure
regulating means and guage means for monitoring and controlling the
fluid flow rate and for adjusting and limiting the fluid pressure
in the system.
It will be appreciated by those skilled in the art that the subject
invention is a marked, significant improvement over the prior art
related devices which utilize but a single fluid conduit or passage
running through the probe or sheath of the endoscope. The art is
replete with descriptions of prior art diagnostic and surgical
instruments including cystoscopes which function with the benefit
of only a single fluid transmission duct. Such a cystoscope is
described in Wallace U.S. Pat. No. 2,487,498, and the entire
disclosure of that patent is hereby incorporated herein by
reference to the extent that it is not inconsistent herewith.
Other and further features and advantages of the invention will
become apparent from the following description considered in
conjunction with the drawings in which:
FIG. 1 is a side elevational view of a resectoscope incorporating
the present invention, portions of the instrument being cut away to
show the components contained within the outer sheath;
FIG. 2 is a cross-sectional view taken substantially on the line
2--2 of FIG. 1 and showing the arrangement of the fluid input and
the fluid exhaust passages extending through the sheath of the
resectoscope;
FIG. 3 is a cross-sectional view similar to FIG. 2 but showing a
second arrangement of the fluid input and exhaust passages;
FIG. 4 is a cross-sectional view, similar to FIG. 3 but showing
still another arrangement of the fluid input and fluid exhaust
passages; and
FIG. 5 is a schematic representation of the fluid pumping and
control system used in conjunction with the improved resectoscope
of the invention.
The aims and objects of the invention are accomplished by
providing, in an endoscope, a pair of fluid conduits communicating
between a fluid supply reservoir and an internal body zone of
medical treatment to establish a continuous, uninterrupted purging
flow of fluid into and from the zone of treatment. In addition to
the fluid reservoir and the pump for impelling the fluid through
the conduit system, there is provided auxiliary equipment to
enhance the procedure and to serve as controls and protective
devices ensuring proper operation under all conditions. Included in
this auxiliary equipment are valves for regulating the fluid flow
rate, pressure control elements for setting the required pressure
in the fluid system, gauge means for monitoring the pressure in the
system, and automatically-operating limit controls to ensure that
no pressures above those desired are established in the system,
particularly in the critical zone of treatment. All of the above
structures are in addition to the conventional components of an
endoscope, including the viewing or optical system, the
illuminating system, and surgical elements such as a wire loop and
the mechanical means for manipulating the loop.
For purposes of illustration, the endoscope of the invention will
be described with specific reference to a cystoscope. Since the
component elements of the device other than the fluid flow system
and its associated components do not constitute part of the subject
invention, no detailed description of these parts is provided
herein.
Referring now to the drawing, and particularly to FIGS. 1 to 4, for
purposes of illustrative disclosure, a preferred embodiment of one
form of the invention is shown incorporated in a cystoscope 20. As
depicted, the cystoscope 20 includes a tubular endoscopic sheath 24
of substantially rigid construction and preferably composed of a
plastic composition. Extending lengthwise through the sheath 24 is
a probe assembly 26 carrying a viewing device constituting a
surgical telescope 28 terminating at its forward end in a viewing
lens 30. Also extending linearly through the sheath 24 as part of
the probe assembly are electrical conductors 32 contained in a pipe
34 and used to supply power from a power supply (not shown) to an
illuminating bulb 40, in the conventional manner. The probe
assembly 26 also carries a pipe-encased surgical device or excising
wire 42 which, as shown, terminates at its forwardly extremity in a
loop 44.
The wire 42 and its terminal loop 44 are manipulable forwardly and
rearwardly through a longitudinally extending sleeve 46 by means of
an assembly including a gear 48 and a ratchet 50 controlled by a
hand lever 52. The wires 42 are connected to an electrical jack 54
whereby electric current may be plugged in and fed to the loop
44.
Contained within and extending lengthwise through the sheath 24 are
a pair of fluid conduits 56 and 58 terminating at the forward end
of the cystoscope in ports or openings communicating with the zone
in which the viewing lens 30, the light 40 and the wire loop 44
function when the instrument is put to use. The first conduit 56
constitutes the fluid input passage while the second conduit 58 is
the fluid exhaust or return conduit.
In the particular embodiment of the invention illustrated, the
conduits are demarked interiorly of the sheath 24 by means of a
pair of longitudinally extending radial ribs or flanges 60 and 62
projecting between the inner wall surface 68 of the sheath 24 and
the outer wall surface 72 of the probe assembly 26 passing through
the sheath 24, all as indicated in FIG. 2. While in the specific
form of the invention illustrated in FIG. 2 the ribs 60 and 62 are
formed integrally with the sheath 24, preferably as a unitary
extrusion, and the inwardly directed ends 80 and 82 of the ribs 60
and 62 ride upon and engage the surface 72 of the probe assembly 26
in fluid sealing engagement therewith, it will be appreciated that
other mechanical arrangements are possible. For example, as
indicated in the cross sectional view of FIG. 3 the radial ribs 90
and 92 which demark the two longitudinally extending passages 56
and 58 may be made of steel as part of the outer shell 34 of the
probe assembly 26 and may bear upon the inner wall 68 of the sheath
24 in fluid sealing engagement. Many other suitable variations are
possible including an arrangement in which the in-put conduit 56
and the exhaust conduit 58 are carried entirely by and constitute
an integrally formed part of the sheath 24. Such an arrangement is
indicated schematically in FIG. 4 in which internal webs 94 and 96
cooperate with the sheath 24 to form the conduits.
The rearward end 100 of the sheath 24 is sealed into or otherwise
affixed to a collar 104 sleeved on an annular neck 106 in fluid
tight engagement therewith to fasten the sheath on the
resectoscope. A pair of stub pipe connectors 108 and 110 are sealed
through the wall 114 of the collar 104 and communicate interiorly
of the collar with the rearward ends of the fluid conduits 56 and
58 completing the connection between the interior of the sheath and
the connections 108 and 110 to which flexible hoses (not shown) may
be attached. Thus, the controlled introduction of isotonic fluid
through the stub 108 causes the fluid to flow linearly through the
conduit 56 and to discharge in the treatment zone 116 and,
thereafter, to continue its path to return through the conduit 58
and to be discharged through the stub 110 exteriorly of the
cystoscope 20.
The basic features and the inventive concepts of the subject
development having been set forth, there is depicted in FIG. 5 a
schematic representation of exemplary control apparatus used in
ensuring that the fluid stream is properly introduced through the
cystoscope, to the zone of treatment, and thence from that zone
back through the cystoscopic device, to be discharged. The
apparatus described includes various safety devices and controls,
all directed to making the entire procedure safe and reliable under
all contingencies.
Referring now more particularly to FIG. 5 there is shown, in
conjunction with the improved cystoscope of the invention, the
fluid pumping and irrigation system together with pressure
regulators, valves, other controls, safety devices, and gauges. A
motor 120 is coupled to a fluid pump 124 by means of a mechanical
coupling 126 connecting the output shaft 128 of the motor to the
in-put drive shaft 132 of the pump 124, whereby actuation of the
pump is effective to transfer an isotonic solution 140, e.g. 1.1%
glycine, or any other desired liquid preparation, from a reservoir
142 through a pick-up tube 146 for delivery into a cystoscopic
fluid feed line 150. Connected between the pump 124 and the
cystoscope 20 is a fluid pressure regulator 154, a control valve
156, a fluid pressure gauge 160, and a fluid pressure limiting
control 164. At its discharge end 166 the fluid in-put lead line
150 is connected directly to fluid in-put stub 108 of the
cystoscope 20, all as shown. After delivery of the irrigating fluid
through the conduit 56 of the cystoscope 20 into the zone of
treatment 116, the fluid is removed through the passage 58 leading
to an input end 170 of a discharge tube 174 connected to the output
lead 110 of the cystoscope. Finally, the fluid is discharged to a
collecting vessel 180 or drain provided with a discharge valve 182.
The flow rate may be varied as the physician determines, and rates
of up to about 1000 cc/min. have been used effectively. Connected
between the fluid discharge port 110 of the cystoscope 20 and the
drain 180 in the discharge line 174 is a pressure limit control
184, a pressure gauge 186, and a valve 188.
Those skilled in the medical art involved will appreciate that the
pressure regulators, gauges, and limit controls for the fluid
pressure serve important safety and control functions and enable
the physician to know at all times the precise conditions in the
treatment system. The pressure limit controls 164 and 184 are
automatic in operation and ensure that a pressure in excess of a
predetermined, selectable value does not develop in the zone of
treatment. The gauges 160 and 186 provide a constant visual
indication of the actual pressure in the system, and the pressure
regulator 154 and the control valves 156 and 188 impart desirable
versatility to the apparatus.
Optionally, a filter 190 may be coupled into the pick-up tube 146
so that fluid 140 transmitted through the input line from the
reservoir 142 will be free of objectionable solids. In a preferred
operational technique, the flow rate through the input line or
passage 56 to the operation zone 116 will be greater than the
lineal flow rate in the return line 58. The greater cross sectional
area of the return line will facilitate the removal of solids from
the operational zone. It is also a feature of the operational
techniques contemplated that the input fluid discharge port will be
sufficiently close to the viewing lens 30 so that a constant flow
of fluid will wash the surface of the lens and enhance viewing
capabilities. An additional feature of the preferred embodiment of
the invention illustrated is the incorporation of a second pump
194, located in the fluid discharge line 174 of the fluid pumping
apparatus depicted in FIG. 5. The pump 194 is functionally
synchronized, volume-wise with the fluid input pump 124 so that
there will be no pressure buildup in the treatment zone 116, and no
tendency for collapse of the organ due to evacuation.
While several different mechanical arrangements have been described
for the fluid input and the fluid exhaust lines in the endoscope of
the invention, those skilled in the art will appreciate that still
other mechanical variations are possible, including coaxial
passages such as one tube wholely within the other to provide a
system in which the input passes through a tube while the exhaust
is discharged through an annular passage surrounding that tube.
While there have been described what are considered to be preferred
embodiments of the invention, it will be obvious to those skilled
in the art that various changes and modifications may be made
without departing from the invention, and it is intended that the
appended claims cover all such modifications as fall within the
spirit and scope of the invention.
* * * * *