Pneumatic control apparatus for an endoscope

The present invention relates to an apparatus for pneumatic control of an endoscope for ultrasonic examination, the apparatus preferably including a collar, the collar being placed around the endoscope and comprising at least one chamber for receiving a fluid. The apparatus may also include at least one supply for the fluid, and may be provided in combination with an endoscope for ultrasonic examination.

DETAILED DESCRIPTION OF THE ILLUSTRATIVE EMBODIMENTS FIG. 1 shows the possible axes, about which a TEE probe 2 may be moved, wherein the z-axis extends parallel to the longitudinal axis of the probe 2 and/or of the oesophagus 1 (gullet), the x-axis is the axis which emanates perpendicular to the z-axis from the transducer 3 and about which the transducer 3 rotates for a 3D image, and the y-axis is at right angles to the other two axes, i.e. in relation to the diagram, perpendicular to the drawing plane. FIG. 2 shows the sound angle of a currently common transoesophageal representation of the heart as a total organ, wherein the transducer 3 , which is disposed at right angles to the side of the endoscope or gastroscope 2 , rotates in the perpendicular x-axis. The form of construction B shown in FIG. 3 for an apparatus 4 according to the invention for pneumatic control of an endoscope 2 or gastroscope embraces the tip of the endoscope 2 like a cap. In FIG. 3 the illustrated cap-like apparatus 4 includes two separate chambers 4 a, 4 b for receiving a fluid, which is supplied to the individual chambers 4 a, 4 b via supply 5 a, 5 b. The construction B may be used to control, in particular, the tip of the instrument. The endoscope here is moreover provided with a covering 6 , such as is generally used for reasons of hygiene. The portion of an endoscope shown in FIG. 3 usually has a length of around 50 to 80 cm and a diameter of 1 cm although the dimensions may be varied as would be known to one of skill in the art. FIG. 4 shows a further construction A of the invention, in which the apparatus 4 does not surround the tip of the endoscope but is applied in an annular manner around the endoscope body. In each case two chambers 4 a, 4 b and 4 c, 4 d lying opposite one another embrace the endoscope body so as to form two rings at different levels. The two upper chambers 4 a, 4 b in the drawing each have a supply 5 a, 5 b for supplying the fluid. Charging of the two lower chambers 4 c, 4 d in the drawing is effected via connecting lines 7 . For the embodiment of FIG. 4 , the chambers lying opposite and at different levels to one another, namely 4 a, 4 c and 4 b 4 d, are connected to one another. In FIG. 4 only the connection between the chambers 4 b and 4 d is shown the connection of chambers 4 a and 4 c being the same. In the construction of the invention shown in FIG. 4 , the chambers are disposed on the covering 6 and may be separately formed and connected to the covering 6 or be formed as a unitary component with the covering 6 . In principle, the number of chambers 4 a, b etc., their size, shape and their arrangement on the endoscope may be selected in any desired manner as would be known to those of skill in the art. For example, the chambers may be disposed at one level only or alternatively at more than two different levels, at the same time one or more chambers, which embrace the tip e.g. in the manner shown FIG. 3 , may be provided. All or some of the chambers may be disposed on covering 6 and/or be connected to the covering. The covering 6 or an additional covering may be drawn over the apparatus 4 to sheath part or all of the apparatus 4 . The nature of the fluid supply may also be selected in accordance with the requirements and purpose for each case. In principle, each chamber may be provided with a separate supply 5 a, b. Individual chambers may communicate with one another e.g. via connecting lines 7 , and may have a single common supply. The supply 5 a, 5 b may run within the endoscope. In such a case a connection hole in the wall of the endoscope to allow the supply to be connected with the interior of the apparatus 4 , or chamber to be provided with fluid, is preferably provided. According to a further construction, the apparatus 4 in the application situation may, in the filled state, form a balloon which encloses the tip of the endoscope including the transducer 3 . This construction is particularly suitable for taking images of the heart from the stomach. To this end, the endoscope 2 plus transducer 3 , which is provided with the apparatus 4 is introduced into the stomach and there the apparatus 4 is filled with fluid. The apparatus 4 surrounding the front end of the endoscope 2 and transducer 3 expands like a balloon and in this manner, enables the introduction of a suitable stand-off-pad. The tip of the probe is in this instance positioned in the stomach in such a way that the heart may be exposed to ultrasonic waves through the diaphragm. The construction as a balloon may also be used in combination with the previously described suitable constructions. FIGS. 5A and 5B show a front and side view of a particularly preferred embodiment of the apparatus. In this embodiment, the apparatus 4 includes four individual chambers 8 , 9 , 10 , 11 which are linked with each other to form an annular structure. In use, this annular structure is put on an endoscope to embrace the endoscope. The apparatus of this embodiment preferably comprises two longer chambers 10 , 11 and two shorter chambers 8 , 9 . The two shorter chambers 8 , 9 each being preferably positioned between the longer chambers 10 , 11 to separate the longer chambers 10 , 11 from each other. In this embodiment, each of the shorter chambers 8 , 9 is preferably located at an opposite end of the longer chambers 10 , 11 . The longer chambers 10 , 11 may have a length in the range of from 5 to 10 cm and the shorter chambers 8 , 9 of from 1 to 2 cm, the diameter of both may vary in the range of from 1 to 4 cm. However it is to be understood that the length as well as the diameter may vary from said ranges, if desired or needed, as would be known to one of skill in the art. The embodiment of FIGS. 5A and 5B is particularly suited for obtaining improved ultrasonic images of the heart. For obtaining qualitatively good and diagnostically useful images the transducer 3 has to be pressed against the oesophagus 1 which is done by bending the transducer into the direction of the heart. By this movement the oesophagus 1 is pushed into the direction of the left ventricle of the heart (the ventricle next to the oesophagus), and the mediastinal connective tissue is compressed resulting in good conditions for a homogenous spreading of the ultrasonic sound. In order to provide the above advantageous conditions, the embodiment shown in FIG. 5 is applied to the endoscope in such a manner that the short chamber 8 (front chamber) is in a position in front of the transducer (Ultrasonicflash). In this case, the second short chamber 9 (rear chamber) is directed towards the mouth of the patient. By filling completely and/or partly the chambers, or individual chambers, the desired motion of the transducer can be obtained. By filling the front chamber 8 it is possible to elongate the stand-off-pad of the ultrasonic waves. Filling the rear chamber 9 enhances the retroflexion of the transducer 3 and allows a sound angle sloping into the direction of spreading of the ultrasonic sound. The long chambers 10 , 11 having the form of a cylinder are positioned on the left and right side when applied to the endoscope and serve to stabilize the apparatus and to prevent lateral bending of the flexible endoscope. For individually filling the chambers 8 , 9 , 10 , 11 with a suited fluid, e.g. water, each chamber is provided with a supply (not shown). Preferably, the supplies may run along the outside the tube of the endoscope and leave the oesophagus through the mouth of the patient and may be connected to a manometer. They can be fixed to the tube by any suitable device such as rubber rings. With respect to further arrangement and design, in principle the same is valid as set out above with respect to the other embodiments of the apparatus. According to a further embodiment, the invention encompasses an endoscope for ultrasonic examination comprising an apparatus as disclosed above as well as the use of such an apparatus for pneumatic control of an endoscope suited for ultrasonic examination. Because of the many different ways of constructing and arranging the apparatus according to the invention for pneumatic control of an endoscope, the range of possible movements of such probes may be markedly widened. It will be understood that various modifications may be made to the embodiment disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of a preferred embodiment. Those skilled in the art will envision other modifications within the scope spirit of the invention.