Endoscope system and method of operation thereof

An endoscopic microinstrument may include a substantially rigid body having first and second ends, a channel between the first and second ends; a substantially rigid end portion movably coupled to the body and having first and second ends; a tool located at the first end of the end portion and including first and second anvils; first and second handles coupled to the body, at least one of the handles further coupled to the tool and configured to control actuation of at least one of the first and second anvils; a camera coupled to, and situated to a side of, the substantially rigid end portion, the camera configured to obtain images of a region-of-interest; and an end portion controller coupled to the body and configured angulate and/or rotate the substantially rigid end portion relative to the substantially rigid body.

The present system relates to a surgical endoscopic microinstrument system and, more particularly, to surgical microinstruments with a camera for minimally-invasive surgical procedures and a method of operation thereof.

Typically, minimally-invasive endoscopic surgical procedures require several openings such as an opening for insertion of a viewing scope to view a region of interest (ROI) and a separate opening for insertion of a surgical tool such as a cutter, etc. Unfortunately, this necessitates additional surgical openings to access the ROI which is undesirable. Additionally, it is difficult for a surgeon to view a desired portion or view of the ROI while manipulating the surgical tool. Accordingly, the present systems and methods overcome deficiencies of the prior art endoscopes.

The system(s), device(s), method(s), arrangements(s), user interface(s), computer program(s), processes, etc. (hereinafter each of which will be referred to as system, unless the context indicates otherwise), described herein address problems in prior art systems.

In accordance with embodiments of the present system, there is disclosed an endoscopic microinstrument, comprising a substantially rigid proximal body having first and second ends, a channel between the first and second ends; a substantially rigid distal end portion movably coupled to the body and having first and second ends; a tool located at the first end of the substantially rigid distal end portion and comprising first and second anvils; first and second handles coupled to the body, at least one of the handles further coupled to the tool and configured to control actuation of at least one of the first and second anvils; a camera coupled to, and situated to a side of, the substantially rigid distal end portion, the camera configured to obtain images of a region-of-interest; and an end portion controller coupled to the proximal body and configured to rotate the substantially rigid distal end portion relative to the substantially rigid proximal body to angulate and/or rotate the tool and the camera together or separately so that a line of sight of the camera is along a tool axis passing through the tool.

The endoscopic microinstrument may include a flexible portion which couples the substantially rigid distal end portion to the substantially rigid proximal body and is situated between the substantially rigid body and the substantially rigid end portion. Further, the end portion controller may be further configured to rotate the camera relative to the substantially rigid distal end portion. It should be understood that a device that is configure to perform a function is also able to actually perform the function. Thus for example, the controller which is configured to rotate the camera also actually rotates the camera, such by providing electronic signals (thought wired and/or wireless signal links) to actuators that rotate the camera and/or provide a force though mechanical cable connected between the controller and camera through couplings or other mechanical links.

The camera may be a wireless-type camera and may be situated outside of an exterior periphery of the substantially rigid distal end portion, where a longitudinal axis of a lens of the camera is parallel to and offset from a longitudinal axis of the substantially rigid distal end portion. Further, the camera may have a rotational mount to rotate the camera and/or the substantially rigid distal end portion about a longitudinal axis of the substantially rigid distal end portion independent of rotation of the tool, which may be any desired tool, such as a surgical gripper, a cutter, a coagulator, a dissector, a laser, laparoscope, and/or an ultrasonic tool including for ablation, pulverization, aspiration or otherwise.

The end portion controller may be further configured to rotate the camera relative to the distal end portion. Further, several controllers may be provided at the proximal end of the endoscopic microinstrument on and/or integral with the proximal body for example, such as a tool controller configured to control a function and/or a movement of the tool; a camera controller configured to control a function and/or a movement of the camera; and/or an end portion controller configured to control a movement of the distal end portion.

The camera may be configured to provide 2-dimensional (2D) and/or 3-dimensional (3D) images of the region-of-interest, where the endoscopic microinstrument may further comprise a rail-guide system for slidably receiving an imaging endoscope having a further camera and a further camera controller for controlling a function and/or a movement of the further camera to provide further 2D and/or 3D images of the region-of-interest. The camera may be extendable and retractable from a storage well of the distal end portion under control of one of the end portion controllers.

In another embodiment, an endoscopic microinstrument comprises a body having a channel; an end portion at a distal end of the endoscopic microinstrument, the end portion having a first end for being movably coupled to the body; a tool located at a second end of end portion distal from the first end of the end portion for being located at the distal end for manipulating a region-of-interest; a camera coupled to the end portion, the camera being configured to obtain images of the region-of-interest; and a plurality of controllers located at a proximate end of the endoscopic microinstrument, opposite the distal end, and being configured to control a function and/or a movement of the tool and/or the camera for synchronous movement together or independent movement.

The camera may be extendable and retractable from a storage well of the end portion under control of one of the plurality of controllers, which may include a tool controller configured to control a function and/or a movement of the tool; a first camera controller configured to control a function and/or a movement of the camera; a second camera controller configured to control extension and/or retraction of the camera from the storage well; and an end portion controller configured to control a movement of the end portion.

The camera may further comprise a rotational mount to rotate the camera or the distal end portion about a longitudinal axis of the end portion independent of rotation of the tool. Further, the camera may be a wireless-type camera and may be situated outside of an exterior periphery of the end portion for capturing and providing one of 2-dimensional (2D) and 3-dimensional (3D) images of the region-of-interest.

The following are descriptions of illustrative embodiments that when taken in conjunction with the following drawings will demonstrate the above noted features and advantages, as well as further ones. In the following description, for purposes of explanation rather than limitation, illustrative details are set forth such as architecture, interfaces, techniques, element attributes, etc. However, it will be apparent to those of ordinary skill in the art that other embodiments that depart from these details would still be understood to be within the scope of the appended claims. Moreover, for the purpose of clarity, detailed descriptions of well known devices, circuits, tools, techniques, and methods are omitted so as not to obscure the description of the present system. It should be expressly understood that the drawings are included for illustrative purposes and do not represent the entire scope of the present system. In the accompanying drawings, like reference numbers in different drawings may designate similar elements.

FIG. 1shows a partially cutaway side view of a portion of an endoscopic microinstrument100operating in accordance with embodiments of the present system. The endoscopic microinstrument100may include one or more of a body102, a support portion105, a flexible portion122, a distal end portion106, a tool108, and a camera110.

The body102may define a longitudinal axis La and may include proximal and distal ends103and101, respectively. The body102may include a channel109situated between the proximal and distal ends103and101, respectively, and which extends along the longitudinal axis La of the body102. At least one control cable138may pass through the channel109. Further, in accordance with some embodiments, the endoscope may be and/or include different types of instruments, such as without limitation, a laparoscope, an ultrasonic aspirator, a coagulator, a laser(s), a gripper, a cutter, a dissector, and/or other devices configured to perform desired operations at the ROI. Control of the various tools and/or cameras located at the tip or distal end of the instrument may be via wired or wireless connections to a controller located at the proximal end, where such controls include activation such as turning devices on/off or moving cutters to perform a scissor action, tip movement such as angulation of the tool(s) and camera(s), alone and/or in combination(s), that are located at the endoscopes tip or distal end to sweep in a desired 3D direction, e.g., up, down, right, left, rotation along instrument axis such as rotating a pair or scissors for cutting vertically and horizontally and in any other position therebetween.

The distal end portion106may be coupled to the body102using any suitable method so that it articulates, e.g., about at least a 120 degree arc (relative to a longitudinal axis La of the body102) as illustrated by arrow115to provide side and/or rear views which are other than a front view provided by the camera when it is directed along the longitudinal axis La. Accordingly, the distal end portion106may be coupled to the body102using a flexible and/or elastic member such as the flexible portion122as will be discussed herein below. The distal end portion106may include a channel107through which the at least one control cable138may pass. The distal channel107communicates with the body channel109of the body102, and may be of different size and/or shape to accommodate and/or go around objects, such as a camera storage bin or well (1676shown inFIGS. 17-18) for storing the camera110, in the case of a retractable/extendable camera as will be described in connection with the embodiments shown inFIGS. 12-18, where similar distal and body channels are provided.

The distal end portion106may further be coupled to the tool108and the camera110using any suitable method such as screwable mounts, friction fits, slip rings, etc. Additionally the tip may further rotate 360 degrees circumferentially around the La. The tip may be rotatable on its own, and/or may be rotated by rotating the entire endoscope which is typically located in a channel or lumen inserted in the incision opening and pushed toward the ROI, where various instruments may be inserted, retracted, and otherwise moved, e.g., rotated in this channel as necessary to perform a desired procedures. Such various hybrid instruments include the endoscopic microinstruments according to the present systems that include both at least one tool and at least one camera.

The tool108may include any suitable surgical tool such as a gripper, a cutter (shown), a dissector, an ultrasonic aspirator, a coagulator, a laser(s), etc. In accordance with some embodiments, the tool may include first and second anvils which may be configured for gripping, cutting, dissecting, coagulating, etc., as may be desired. For example, in accordance with some embodiments, the cutter may include first and second cutting anvils124-1and124-2, respectively, (generally124-x) at least one of which may articulate and/or rotate relative to the other (as illustrated by arrow127) and which may be coupled to a base131. The base131of the tool108may be coupled to the distal end portion106using any suitable method. In yet other embodiments, it is envisioned that at least one of the anvils (e.g., at least one of the first and second anvils124-1and124-2, respectively may be fixedly attached to the base131. Further, it is also envisioned that in accordance with some embodiments, the first and second anvils may be rotatably coupled to each other using a simple- or complex-type hinge assembly (e.g., providing simple or compound tool actions, respectively). Thus, at least one of the first and second anvils may be rotatably coupled to the base via the hinge assembly. Further, at least one of the first and second anvils124-xwhich is movably coupled to the base131may be further coupled to the at least one control cable138so that the at least one control cable138may transfer an activation force to the anvil coupled thereto as will be described herein below. However, in yet other embodiments, an opening or closing assembly (e.g., for a compound action type tool) may be provided to open and/or close at least one of the first and second anvils124-x.

The flexible portion122may include first and second ends123and125, respectively. The first end123of the flexible portion122may be coupled to the distal end101of the body102. The second end123of the flexible portion122may be coupled to the distal end portion106. The flexible portion122may include at least one channel through which the at least one control cable138may pass. Further, the flexible portion122may include one or more simple or complex hinges (e.g., simple or compound hinges) which may provide for a desired amount of articulation and/or rotation of the second end125relative to the first end123of the flexible portion122. In yet other embodiments, the flexible portion122may be formed integrally with at least one of the body102and the distal end portion106. In yet other embodiments, it is envisioned that the flexible portion122may include an elastic hinge. Further, it is also envisioned that some embodiments may provide a biasing member to bias the flexible portion122in a desired direction and/or orientation relative to the body102. Thus, for example, the biasing members may provide a returning mechanism to the distal end portion106.

The support portion105may include a channel109through which the at least one control cable138may pass. The support portion105may be coupled to the body102using any suitable method or methods such as using a screwable mount. However, in yet other embodiments, it is envisioned that the support portion105may be coupled to the body102using any suitable method such as a bayonet-type mount, a friction fit, etc. However, in yet further embodiments, it is envisioned that the support portion105may be formed integrally with the body102. The support portion105may include at least one gripping members such as first and second handles112and116, respectively. The first and second handles112and116may each include an opening suitable for receiving at least one digit (e.g., finger) of a user, if desired, such as openings114and118. At least one of the gripping members112,116may be coupled to a corresponding one of the at least one control cable138so as to transfer a force thereto. This force may then be transferred to open or close at least one of the first and second anvils124-1,124-2which is coupled to the at least one control cable138. Thus, when a user opens or closes the first and second handles112,116, the first and second anvils124-1,124-2may be opened or closed, respectively, or vice versa. Thus, a scissor action of the first and second handles112and116, respectively (as shown by arrow137), may be used to open and close the first and second anvils of the tool108. This movement may provide a pinching force and/or a cutting force, depending upon a type of the tool108(e.g., scissors, pinchers, grippers, dissectors, etc.) provided.

The support portion105may further include an end portion controller120which may be movably (e.g., rotatably, slidably, etc.) mounted to the support portion105(e.g., using any suitable method such as a support pin) so as to control movement of the distal end portion106in 3-dimensions (3D). Accordingly, the end portion controller120may be coupled to the distal end portion106via a link such as at least one end portion control cable134,135(shown inFIG. 2A) or the like which can transmit a force from the end portion controller120to the distal end portion106so as to deflect the distal end portion106. For example, if the end portion controller120is moved along arrow121to be positioned in position A, the distal end portion106may be correspondingly positioned in position A′, and if the end portion controller120is positioned in position B, the distal end portion106may be correspondingly positioned in position B′.

A friction and/or locking mechanism may be provided to hold the distal end portion106in a desired position during use. For example, in accordance with some embodiments, the end portion controller120may be depressed slightly (in the position shown by arrow133) to unlock it and may be automatically locked when no longer depressed. Further, friction may be provided by a clutch (e.g., mechanical, electromechanical, etc.) if desired. Moreover, the at least one end portion control cable134,135may include a casing which may be configured to engage the at least one end portion control cable134,135to provide a desired amount of friction, if desired. It is also envisioned that a biasing member may provided to bias the end portion controller120and/or the distal end portion106coupled thereto to a desired position.

In one embodiment, a micro-motor may be provided to provide movement, such as articulation and/or rotation, of the flexible portion120. For example, in addition to rotation, the flexible portion120may also be extended or retracted under the control of the controller120for more precise positioning of the tool108and/or camera110. The motor may be operably coupled, e.g., via wire(s) and/or wireless communication link(s), to the controller120for controlling the motor to provide movement, articulation, and/or rotation of the flexible portion120. Thus, mechanical linkages maybe replaced with electronic wired or wireless linkages as in ‘fly by wire’ systems using sensors, actuators, motors, servos and the like. For example, the motor may be located at the distal end101of the body102, and may be any type of motor such as a continuous or stepper motor, for example.

The camera110may include any suitable imaging camera such as a video camera, a still camera, etc. which may obtain image information and transmit the image information to a controller of the endoscopic microinstrument100for further processing. The image information may include raw image information, processed image information, and/or metadata (e.g., time stamps, etc.). The camera includes a processor to process received images to form image signals or data and transmit the image signals or data to the system controller. The camera110may communicate with the system controller using any suitable wireless communication method. For example, the camera110may use a WiFi, Bluetooth™ communication methods or the like to transmit and/or receive information from a central controller and/or display for rendering. However, in yet other embodiments, a wired communication method such as using conductive wires and/or an optical fiber communication method may be used. The camera110may have a line-of-sight (LOS) which may extend in the direction of the longitudinal axis (La) of the body102. The camera110may be fixedly or movably coupled to the distal end portion106via at least one camera support132. However, in yet other embodiments, it is envisioned that the camera110may be coupled directly to the distal end portion106. In yet other embodiments, a user interface (UI) may be provided to control orientation of the camera110relative to the distal end portion106.

The camera110may include any suitable two-dimensional (2D) or three-dimensional (3D) image capture devices such as that shown and described in U.S. Pat. No. 7,601,119 to Shahinian, entitled “Remote Manipulator with Eyeballs,” and issued on Oct. 13, 2009; U.S. Pat. No. 8,323,182 to Manohara, et al., entitled “Endoscope and System and Method of Operation thereof,” and issued on Dec. 4, 2012; U.S. Patent Application Publication No. 2014/0088361 to Shahinian, et al., entitled “Multi-Angle Rear-Viewing Endoscope and Method of Operation thereof,” and published on Mar. 27, 2014; U.S. Patent Application Publication No. 2014/0085420 to Shahinian, et al., entitled “Programmable Spectral Source and Design Tool for 3D Imaging Using Complementary Bandpass Filters,” and published on Mach 27, 2014; and U.S. Patent Application Publication No. 2011/0115882 to Shahinian, et al., entitled “Stereo Imaging Miniature Endoscope with Single Imaging Chip and Conjugated Multi-Bandpass Filters,” and published on May 19, 2011, the contents of each of which are incorporated herein by reference in their entirety. Further, the camera110may include an internal power supply, a memory, and/or at least one light source configured to provide illumination.

FIG. 2Ashows a partially cutaway detailed side view of a portion of an endoscopic microinstrument100operating in accordance with embodiments of the present system. The flexible portion122may include an accordion-type cover152and at least one hinge154. The at least one hinge154may include first and second hinge plates158and160coupled to each other by a hinge pin156. Accordingly, the first and second hinge plates158and160may rotate relative to each other about the hinge pin156. However, in yet other embodiments, it is envisioned that the flexible portion may include a plurality of hinge members. Regardless of type of hinge used, it is desirable that the hinge provide at least 120-180 degrees of motion, articulation and/or rotation. However, in yet other embodiments, other ranges are also envisioned.

The end portion controller120may have a shaft130that extends through an opening119(shown exaggerated inFIG. 2Afor clarity) in the support portion105and may include a locking mechanism155provided to lock the end portion controller120in a desired position and may include any suitable locking mechanism, such as a biasing member153, a toothed plate159, an elongated slot157, and a pin129. The support pin129may extend through the elongated slot157so that the end portion controller120may move in the up-down directions shown by arrows133,133′ (relative to the position of the end portion controller120, such as relative the longitudinal axis La). However, the biasing member153may bias the end portion controller120in a direction shown by up arrow133′ to mesh the pin129into (teeth of) the toothed plate159so as to lock the pin129and thus, lock the end portion controller120in a desired (rotational) position along arrow121. Depressing on the end portion controller120in the direction shown by down arrow133causes the end portion controller120to move down in the same direction and the pin129to disengage from the toothed plate159. Accordingly, the end portion controller120may then be moved (e.g., rotatably along arrow121) to a desired position. Then, when the end portion controller120is no longer depressed, it may be biased by the biasing member153(e.g., a coil spring) in the direction of up arrow133′ and locked in position by the pin129which engages the toothed plate159.

The at least one end portion control cable may include first and second end portion control cables134,135, respectively, which may couple the end portion controller120to the end portion106so as to transfer a force from the end portion controller120to the end portion106.

In other embodiments, the end portion controller120may operate as a joystick and moved in four directions along two perpendicular joystick axis, such as right, left, back and forward, to move the flexible portion122and thus the distal end portion106that includes both the tool108and camera110four directions, such as right, left, up and down. Alternatively or in addition, the joystick may move unconstrained about a joystick longitudinal passing through the joystick to move both the tool108and camera110in desired 3-dimensional directions following movements of the joystick. Alternatively or in addition, the end portion controller120may articulate and/or rotate about a shaft longitudinal axis of the shaft130to effectuate rotation by at least 120° and up to 180° of the flexible portion122, and thus also of the distal end portion106that includes both the tool108and camera110. The endoscopic microinstrument100may include for example, endoscopes, laparoscopes, etc.

FIG. 2Bshows a cross sectional view of a portion of the endoscopic microinstrument100taken along lines2B-2B ofFIG. 2Ain accordance with embodiments of the present system. The hinge pin154may be split (as shown to provide room for passage of cables, etc.) or may be a single continuous hinge pin, if desired.

FIG. 3shows a cross sectional view of a portion of the endoscopic microinstrument100taken along lines3-3ofFIG. 1in accordance with embodiments of the present system. The at least one control cable138may pass through the channel107.

FIG. 4shows an end view of a portion of the endoscopic microinstrument100ofFIG. 1in accordance with embodiments of the present system. The first and second anvils124-1and124-2, respectively, may be coupled to the base131(FIG. 1). The camera110may have at least one lens111or aperture through which an image may be captured of the ROI. In the case the camera110is a 3-D camera, then two openings or pupils are provided such as including a single lens dual aperture lens having filters such as the Conjugated Multi-Bandpass Filters (CMBFs) for 3D-visualization, such as described in U.S. Patent Application Publication Nos. 2011/0115882 and 2014/0085420 to Shahinian, et al., which are incorporated herein by reference in their entirety. It is further envisioned that the base131may include a cam to adjust the line-of-sight of the camera110, if desired. Although the camera110is positioned at top of the distal end portion106, in accordance with some embodiments, it may be positioned in various positions such as at the sides and/or bottom of the distal end portion106, if desired.

FIG. 5shows a side view of a portion of the endoscopic microinstrument100ofFIG. 1in accordance with embodiments of the present system. Moving the second handle116relative to the first handle112as illustrated by arrow137may open or close at least one of the anvils as illustrated by arrow127. Accordingly, at least one of the first and second handles112and116, respectively, may act as a trigger to open or close the tool108. Further, moving the end portion controller120along arrow121into position indicated by A causes the end portion106to move to position A′ and moving the end portion controller120into position indicated by B causes the end portion106to move to position B′, as shown. However, in some embodiments, the movement may be reversed, if desired.

FIG. 6shows a top perspective view of a portion of the endoscopic microinstrument100ofFIG. 1in accordance with embodiments of the present system.

FIG. 7shows a side view of a portion of an endoscopic microinstrument700, such as a laparoscope, operating in accordance with embodiments of the present system. The laparoscope700may be similar to the endoscopic microinstrument100and may include a body702, a distal end portion706and a camera710supported on the distal end portion706by a camera support732, which may be similar to the body102, the distal end portion106, and the camera110. However, a flexible portion722which flexibly couples the distal end portion706to the body702may be formed integrally with the body702and may include a plurality of cutouts757and/or openings759which may provide for the flexing of the flexible portion722in a desired manner when subject to a force from the end portion controller120. Further, the distal end portion706may be formed integrally with the body702and the flexible portion722.

FIG. 8shows a top perspective view of a portion of an endoscopic microinstrument800in accordance with embodiments of the present system. The endoscopic microinstrument800is essentially similar to the endoscopic microinstrument100ofFIG. 1and may include a body802, a distal end portion806, a flexible portion822, a tool808(e.g., a surgical instrument or any other instrument that performs a designated function(s)), a camera810, a support portion805, and an end portion controller120, which may be similar to the body102, the distal end portion106, the flexible portion122, the tool108endoscopic microinstrument, the camera110, the support portion105, and the end portion controller120of100ofFIG. 1. However, the distal end portion806may provide for rotational movement of the camera810and/or tool808about a longitudinal axis Lp of the distal end portion806, as illustrated by arrow871.

The camera810and tool808may be rotated together in unison or rotated independently/separately of each other. For example, the rotational movement of the camera810may be controlled by rotational movement of the end portion controller820about a longitudinal axis LAof the body802, as shown by arrow876′. The tool808may also be rotated independently of the camera rotation876, such as using rotational couplers near the distal tool808and the proximal end portion controller820that rotate the tool800about the longitudinal axis, LP871, or LA877, similar to the rotational couplers1390,1391that will be described in connection with the further embodiments below, such as shown inFIG. 12for example.

For example, the distal rotational coupler (e.g., shown as reference numeral1390inFIG. 12) may rotate in response to rotation of the proximal rotational coupler (e.g., shown as reference numeral1391inFIG. 12). Alternatively, the distal and proximal rotational couplers1390,1391may each be independently controlled, such as in response to control signals from a UI or a moving joystick(s), for example.

Returning toFIG. 8, the end portion controller820may be moved about a transverse axis TAas illustrated by arrow875, which motion may control movement of the distal end portion806similarly to that described with reference to the endoscopic microinstrument100ofFIG. 1and described above. For example, moving the end portion controller820along arrow875moves the distal end portion806by moving the flexible portion822, e.g., to move between positions A′ and B′ shown inFIG. 1, in response to moving the end portion controller820along arrow875(FIG. 8), similar to arrow121inFIG. 1. Alternatively, rotation of the end portion controller820about its transverse axis TA(as shown by arrow875) may cause the camera810to articulate and/or rotate about its longitudinal axis Lcp as illustrated by arrow871as will be described in connection withFIG. 10.

Further, the distal tip may rotationally move independently of the shaft and the camera. At least one control cable or link may be provided to translate movement of the end portion controller820parallel to the transverse axis TA(as illustrated by arrow876′) to a corresponding movement of the camera810relative to the distal end portion806as illustrated by arrow876. Further, a locking mechanism may be provided to lock the camera into a desired position. It should be noted that the one or more control cables or links maybe mechanical (e.g., using cable, linkages, gears, pivots, levers, etc.) or electronic links, such as using wired or wireless communication among transceivers of control devices (e.g., end portion controller820, retraction controller1370, joystick, etc.) and controlled devices (e.g., camera810and or tool808).

FIG. 9shows an end view of a portion of the endoscopic microinstrument800ofFIG. 8in accordance with embodiments of the present system. The camera810may be positioned relative to the distal end portion806and/or the tool808by moving the end portion controller820in a similar direction as illustrated by arrow876.

FIG. 10shows a partially cutaway detailed side view of a portion of the endoscopic microinstrument800operating in accordance with embodiments of the present system. The end portion controller820may extend through an opening819in the support portion805and/or the body802. A cover845may be provided to seal the opening819, if desired. A dual motion linkage857may provide for motion of the end portion controller820about the longitudinal axis LAof the body802(which corresponds with the longitudinal axis LAof the at end portion controller820for the sake of clarity) as illustrate by arrow877, and about the transverse axis TAof the end portion controller820as illustrated by arrow875. The motion of the end portion controller820about the longitudinal axis LAof the body802may be translated to movement of the end portion806as discussed with respect to the laparoscope100ofFIG. 1. However, the motion of the end portion controller820about its transverse axis TA(as shown by arrow875) may cause the camera810to articulate and/or rotate about its longitudinal axis Lcp as illustrated by arrow871. This latter motion may be accomplished by transferring a force from the end portion controller820to the camera810via a linkage881(e.g., a cable) which coupled the camera110to the end portion controller820. Further, the camera810may include a rotational support such as a cylinder880which may slidably and rotationally engage an interior portion of the end portion806so as to locate the camera810in a desired rotational position about the camera longitudinal axis Lcp. Control linkages and/or cables may pass through the cylinder880. At least one control cable838(only a portion of which is shown for the sake of clarity) may pass through a channel of the body802and/or end portion806and may be similar to the at least one control cable138and may be operative to control operation of a tool of the endoscopic microinstrument800.

FIG. 11shows a cross sectional view of a portion of the endoscopic microinstrument800taken along lines11-11ofFIG. 10in accordance with embodiments of the present system. The at least one control cable838may pass through the channel807of the distal end portion806.

In accordance with other embodiments, the camera may be attached to the distal end portion using hook-loop fasteners such as snap ties, Velcro™, and the like. Further, more than one tool may be coupled simultaneously to the distal end portion for providing different functions, such as cutters for cutting, lasers or bipolar electricity for cauterizing, ultrasonic aspiration for example.

Further, the endoscopic microinstrument800may include a light source and/or light guide (e.g., a light ring891which may be placed in the vicinity of the tool808and/or camera810to provide illumination of a working area) to provide illumination for the camera810. Moreover, a power source such as an internal and/or external power source, e.g., a battery which may be rechargeable, may be provided to operate various portions of the endoscopic microinstrument such as the camera810, the light source, communication links, the coagulator, lasers, etc. The light source may be provided at the proximal end103of the body102where a light guide, e.g., fiber optic cable, may be connected between the proximal light source and distal light ring891, where the light ring891is a termination of the light guide outcoupling the light traveling in the light guide for exit from the light ring891.

In accordance with yet other embodiments, the camera may be stored within a camera well of the distal end portion and may extend out of the camera well (e.g., pop up) for use, and retract within the camera well to minimize size for or during insertion through a minimally-invasive surgical opening and retrieval from the surgical opening as may be desired. This may reduce the diameter of the endoscopic microinstrument of the present system for insertion through the minimally invasive surgical opening and/or channel which may be pre-inserted in the opening to the ROI, which desired instruments including the present endoscopic microinstrument may be inserted and moved in the channel. For example, during minimally invasive brain surgery, no channel is used where the endoscopic microinstrument and a further instrument(s), as necessary, are inserted through an opening made in the skull. By contrast, in other types of surgery, a channel in inserted in an opening or incision, where the channel may extend up to the ROI and where the present endoscopic microinstrument and further instrument, as necessary, are inserted through the channel.

Illustratively, the surgical opening and/or channel may have a diameter of about 12 mm-15 mm, the camera may have a diameter of about 4 mm with a light ring around the camera, and less than 3 mm (such as 2.89 mm) without a light ring. Thus there is at least 8 mm-11 mm left for other instruments, including the hybrid instrument that the camera attaches to in accordance with the present endoscopic microinstruments and systems. If the instrument has its own light ring for illumination, then there is no need for the camera to also have a light ring. Of course, in the embodiment where the camera is retractable inside the instrument (seeFIG. 15), more space is available in the channel for insertion of other instruments. For example, a retraction assembly such as a scissor jack assembly, a parallel arm jack assembly or non-parallel (e.g., short-long) arm jack assembly, a rotatable assembly, or the like may position the camera to a desired location from storage within a camera storage area.

In a further embodiment, an imaging endoscope having only the camera is inserted in the opening and/or channel/cannula and located at the 12 o'clock position, and below the imaging endoscope, the hybrid endoscopic microinstrument as described, having a combination of both a tool and its own camera, is inserted. In this case, as the hybrid endoscopic microinstrument has its own light ring for providing illumination of the ROI, the camera of the imaging endoscope does not need a light ring, thus further reducing its size, such as from 4 mm to less than 3 mm in diameter, for example.

The imaging endoscope and the hybrid endoscopic microinstrument may be coupleable together, such as through a guide/rail system, where one of the imaging endoscope or the hybrid endoscopic microinstrument, e.g., the imaging endoscope, has a guide and the other of the imaging endoscope or hybrid endoscopic microinstrument, e.g., the hybrid endoscopic microinstrument, has a complementary rail that fits in the guide of the imaging endoscope and slides along the guide until the flexible part of the hybrid endoscopic microinstrument reaches and extends past the guide at the distal end of the imaging endoscope so that the flexible part allows movement of the combination of both tool and camera of the hybrid endoscopic microinstrument, as described, for viewing and performing a desired operation, such as cutting, ablation via heat, radio frequency (RF) or laser, aspiration, ultrasound agitation, etc.

It should be understand that the locations of guide and rail may be variable where the imaging endoscope having one of the guide and rail slides along the other of the guide and rail located at a side or bottom of the hybrid endoscopic microinstrument, instead of being located at a top of the endoscopic microinstrument. Similarly, the locations of the imaging endoscope and the hybrid endoscopic microinstrument may be variable, such as having the hybrid endoscopic microinstrument being above, instead of below, the imaging endoscope. Similarly, in the hybrid endoscopic microinstrument including the combination of tool and camera, the number and locations of the tool(s) and camera(s) may vary, such as having one or more cameras located (or extended from) below or at side(s) of the tool(s), instead of being located, or extended from, above the tool. Thus, the imaging device including a camera, optics, filters, detectors and processors, maybe hanging on the underside of the hybrid endoscopic microinstrument, including having the camera storage at this underside.

The two imaging devices, such as the stand-alone camera-1 on the imaging endoscope and camera-2 on the hybrid endoscopic microinstrument that includes a combination tool and camera, maybe be 2D and/or 3D cameras in any combination, such as to provide 2D or 3D birds-eye or panoramic reference images using camera-1 and to provide 2D or 3D working images using camera-2 that are more detailed than the panoramic reference images and/or more directed towards or more focused on the ROI where the tool is to be used.

The imaging device(s) at the distal end of the imaging endoscope and/or the hybrid endoscopic microinstrument may include optics, detectors, filters such as the Conjugated Multi-Bandpass Filters (CMBFs) for 3D-visualization, CMOS or CCD detectors and processors to process images detected by the detectors and provide video signals to a display(s) or monitor(s) for 2D and/or 3D display of images captured by the imaging device(s) for viewing by a viewer(s). Imaging devices for capturing 3D images include those having CMBFs such as described in U.S. Patent Application Publication Nos. 2011/0115882 and 2014/0085420 to Shahinian et al., which are incorporated herein by reference in their entirety.

During a surgical procedure, the imaging endoscope may be fixed to provide a birds-eye or panoramic reference view, while the camera and tool combination of the hybrid endoscopic microinstrument are moved in a 3-dimensional (3D) direction, e.g., up, down, right left, front, back. Both images from the camera of the imaging endoscope and the camera of the endoscopic microinstrument are displayed on a screen in any desired format, such as a picture-in-picture format (PIP), for example, where the birds-eye or panoramic reference view provided by the camera of the imaging endoscope shows the tool or the combination of the tool and camera of the endoscopic microinstrument.

With regard to a scissor jack assembly,FIG. 12shows a top perspective view of a portion of an endoscopic microinstrument1300including a scissor jack assembly1374in accordance with embodiments of the present system. The endoscopic microinstrument1300may be essentially similar to the endoscopic microinstrument100ofFIG. 1and may include a body1302, a distal end portion1306, a flexible portion1322, a tool1308, a camera1310, a support portion1305, and an end portion controller1320, which may be similar to the body102, the distal end portion106, the flexible portion122, the tool108, the camera110, the support portion105, and the end portion controller120, respectively, of the endoscopic microinstrument100ofFIG. 1. However, the distal end portion1306may include a scissor jack assembly1374which may position the camera1310into a desired location for storage within a camera storage well1376within the distal end portion1306. A retraction control cable1372may couple a retraction controller1370(which may be located on the body portion1302or support portion1305, as may be desired) to the scissor jack assembly1374to controllably extend or retract the camera1310from the camera storage well1376by sliding the retraction controller1370as shown by arrow1371. The scissor jack assembly1374may include at least two support arms such as first and second support arms1375and1377, respectively, which may be pivotably coupled to each other at pivot1379. As shown inFIG. 13, one end of the first support arms1375may be pivotably coupled to a camera base1378by a pin, while the other end has a pin for pivotably sliding through a slot in the distal end portion1306. Similarly, one end of the second support arms1377may be pivotably coupled to the distal end portion1306by a pin, while the other end has a pin for pivotally sliding through a slot in the camera base1378. Alternately or in addition, both ends of both first and second support arms1375and1377may have pins for pivotally sliding through slots in the distal end portion1306and the camera base1378.

FIG. 13shows a side view of a portion of an endoscopic microinstrument1300ofFIG. 12in accordance with embodiments of the present system. As shown inFIGS. 12-13, the tool1308may include a base1331which may include a rotational coupler1390which may provide for the tool1308, such as the anvils1324-1and1324-2(generally1324-x) to rotate about a longitudinal axis (LAT) of the tool1308while the body portion1302may remain rotationally stationary, thus providing for rotation of the tool1308which is independent from the rotation of the optics or visualization system collectively referred to as the camera1310. Similarly, the support portion1305may include a rotational coupler1391which allows the support portion1305to rotate about a longitudinal axis (LAS) of the support portion1305while the body portion1302may remain rotationally stationary about its longitudinal axis LAS, when the distal and proximal couplers1390,1391are in an uncoupled state. In a coupled state, the distal and proximal couplers1390,1391are coupled to each other, such as via electronics or mechanical linkage systems including, e.g., signal wires and/or mechanical cables coupled to couplings, actuators, motors, sensors, and/or controllers for wired or wireless communication between the distal and proximal couplers1390,1391, such as for synchronous operation of the two couplers1390,1391.

For example, rotation of the proximate coupler1391causes rotation of the distal coupler1390, wither by the same amount or by different amounts, such as using gears and/or actuators controlled by control signals to provide desired fine or course rotation of the distal coupler1390in response to an rotation of the proximal coupler1391, whose rotation granularity may be adjustable, such as by control signals from an input source, e.g., knob, button, user interface to provide fine or course turning of the proximal coupler1390to rotate the tool1308. For fine turning, a high rotation ratio value, e.g., 10 or higher, is provided for a ratio of rotation of the distal coupler1391to the rotation of the proximal coupler1390, where a 100° rotation of the proximal coupler1390, rotates the distal coupler1390by 10°, for example. For course turning, the ratio value maybe less than 9, for example. For the sake of clarity, LATand LASmay correspond with the LA. The support portion1305may then be rotationally coupled to the tool1308by at least one rotational link (e.g., a cable, etc.) so that rotation of the support portion1305relative to the body1302may correspondingly rotate the anvils1324-xor tip of the tool relative to the body1302. Rotating the anvils1324-xor tip (e.g., work portion) of the tool1308may be performed to obtain a desired orientation of the tool1308relative to a work area.

Alternatively, instead of the distal rotational coupler1390rotating in response to rotation of the proximal rotational coupler1391, each of the distal and proximal rotational couplers1390,1390may be independently controlled, such as in response to control signals from a UI or a moving joystick, for example, such as one more of the end portion controller(s). Illustratively, a tool joystick-1 may control rotation of the distal coupler1390to rotate the tool1308about the tool longitudinal axis LATand/or move the distal end to any desired position, such as positions A′, B′ shown inFIG. 1, while another tool joystick-2 may control movement of the anvils1324-1,1324-2, e.g., to open and close them for scissor cutting or snipping action. It should be noted that one or more physical joysticks may be provided that can be configured by a processor to operate in different modes, under the control of the processor. For example, instead of having two physical joysticks, one physical joystick may be provided that has a first mode to operate as joystick-1, and a second mode to operate as joystick-2 of the above described example.

FIG. 14shows a cross sectional view of a portion of the endoscopic microinstrument taken along lines14-14ofFIG. 13in accordance with embodiments of the present system. The camera1310is shown in the extended position (e.g., to capture image information). The endoscopic microinstrument may include control and/or data cables such as at least one cable1338which may be similar to the at least one cable138.

FIG. 15shows a cross sectional view of a portion of the endoscopic microinstrument taken along lines14-14ofFIG. 13in accordance with embodiments of the present system. The camera1310is shown in the retracted position.

FIG. 16shows a top perspective view of a portion of an endoscopic microinstrument1600including a scissor jack assembly1674in accordance with embodiments of the present system. The endoscopic microinstrument1600may be essentially similar to the endoscopic microinstrument800ofFIG. 8and may include a body1602, a distal end portion1606, a flexible portion1622, a tool1608, a camera1610, a support portion1605, a cylinder1680, and an end portion controller1620, which may be similar to the body802, the distal end portion806, the flexible portion822, the tool808, the camera810, the support portion805, the cylinder880, and the end portion controller820, respectively, of the endoscopic microinstrument800ofFIG. 8. However, the support portion1605may include a scissor jack assembly1674which may position the camera1610into a desired location from storage within a camera storage well1676within the cylinder1680of the end portion1306. A retraction control cable1672may couple a retraction controller1670(which may be located on the body portion1602or support portion1605, as may be desired) to the scissor jack assembly1674to controllably extend or retract the camera1610from the camera storage well1676by sliding the retraction controller1670as shown by arrow1671. The scissor jack assembly1674may include at least two support arms, such as first and second support arms1675and1677, respectively, which may be pivotably coupled to each other at pivot1679. Further, ends of the support arms1675,1677may be pivotably coupled by pins passing through holes or slots in the distal end portion1606and camera base1678, similar to that described in connection withFIG. 13.

At least one cable1638in a channel1607(shown inFIG. 18and being similar to channels107,807described in connection with other embodiments) may couple the end portion controller1620to the cylinder1680and/or to the scissor jack assembly1674such as two cables, one cable to control an instrument or a tool, such as control and/or effectuate movement of the scissor jack assembly1674or any other type of assembly and/or surgical tools, and another cable to control and/or effectuate movement of imaging device(s) such as to rotate the cylinder1680, e.g., to rotate the camera1610about a longitudinal axis of the cylinder1680and/or extend/retract the camera1610.

The imaging device(s) at the distal end of the endoscopic microinstrument may include optics, detectors, filters such as the Conjugated Multi-Bandpass Filters (CMBFs) for 3D-visualization, CMOS or CCD detectors and processors to process images detected by the detectors and provide video signals to a display(s) or monitor(s) for 2D and/or 3D display of images captured by the imaging device(s) for viewing by a viewer(s). Imaging devices for capturing 3D images include those having CMBFs such as described in U.S. Patent Application Publication Nos. 2011/0115882 and 2014/0085420 to Shahinian et al., which are incorporated herein by reference in their entirety.

FIG. 17shows a partially cutaway detailed side view of a portion of an endoscopic microinstrument1600ofFIG. 16in accordance with embodiments of the present system. The camera1610is shown in the extended position. Further, a biasing member may be provided to extend and/or retract the camera1610, if desired. Further, a locking mechanism may be provided to lock the camera1610in the extended and/or retracted position, if desired. The scissor jack assembly1674may include a base portion1693which is coupled to the cylinder1680. The base portion1693may include at least one extended opening1695or slot to provide for slidable motion of at least one of the first and second support arms1675and1677, respectively, such as the first support arms1675.

FIG. 18shows a cross sectional view of a portion of the endoscopic microinstrument taken along lines18-18ofFIG. 17in accordance with embodiments of the present system. The at least one cable1638may be coupled to at least one of the first and second support arms1675and1677, respectively, such as the first support arms1675via a coupler1697. Further, a linkage1681, similar to the linkage881(FIG. 11) may be provided to couple the camera1610to the end portion controller1620. In some embodiments, the first and second support arms may each comprise a single arm formed in an X configuration.

FIG. 19shows a portion of a system1900in accordance with embodiments of the present system. For example, a portion of the present system may include a processor1910(e.g., a controller) operationally coupled to a memory1920, a rendering device such as a display1930, sensors1940, and a user input device1970. The memory1920may be any type of device for storing application data as well as other data related to the described operation. The application data and other data are received by the processor1910for configuring (e.g., programming) the processor1910to perform operation acts in accordance with the present system. The processor1910so configured becomes a special purpose machine particularly suited for performing in accordance with embodiments of the present system.

The user input1970may include a keyboard, a mouse, a trackball, or other device, such as a touch-sensitive display, which may be stand alone or be a part of a system, such as part of a personal computer, a personal digital assistant (PDA), a mobile phone (e.g., a smart phone), a monitor, a smart- or dumb-terminal or other device for communicating with the processor1910via any operable link. The user input device1970may be operable for interacting with the processor1910including enabling interaction within a user interface (UI) as described herein. Clearly the processor1910, the memory1920, display1930, and/or user input device1870may all or partly be a portion of a computer system or other device such as a client and/or server.

The methods of the present system are particularly suited to be carried out by a computer software program, such program containing modules corresponding to one or more of the individual steps or acts described and/or envisioned by the present system. Such program may of course be embodied in a non-transitory computer-readable medium, such as an integrated chip, a peripheral device or memory, such as the memory1920or other memory coupled to the processor1910.

The program and/or program portions contained in the memory1920may configure the processor1910to implement the methods, operational acts, and functions disclosed herein. The memories may be distributed, for example between the clients and/or servers, or local, and the processor1910, where additional processors may be provided, may also be distributed or may be singular. The memories may be implemented as electrical, magnetic or optical memory, or any combination of these or other types of storage devices. Moreover, the term “memory” should be construed broadly enough to encompass any information able to be read from or written to an address in an addressable space accessible by the processor1910. With this definition, information accessible through a network is still within the memory, for instance, because the processor1910may retrieve the information from the network for operation in accordance with the present system.

The processor1910is operable for providing control signals and/or performing operations in response to input signals from the user input device1970as well as in response to other devices of a network and executing instructions stored in the memory1920. The processor1910may include one or more of a microprocessor, an application-specific or general-use integrated circuit(s), a logic device, etc. Further, the processor1910may be a dedicated processor for performing in accordance with the present system or may be a general-purpose processor wherein only one of many functions operates for performing in accordance with the present system. The processor1910may operate utilizing a program portion, multiple program segments, or may be a hardware device utilizing a dedicated or multi-purpose integrated circuit. Embodiments of the present system may provide fast imaging methods to acquire images and generate corresponding image information.

In accordance with some embodiments, electronic actuators may be provided to extend, retract, and/or rotate the camera in accordance with inputs from a user interface such as including one or more joysticks which may replace, at least partially, functions of the end portion controller and/or dispense with having the scissor type controls having the handles112,116. Thus, a tool joystick may replace the scissor type controls for controlling 3D movement of a distal tool. Such a tool joystick may be in addition to other joysticks for providing 3D movement controls of other devices such as one or more 2D and/or 3D cameras located at the distal end of an any instrument such as an endoscope, near further devices such as tools configured to provide desired functions, such as grippers, cutters, dissector, ultrasonic aspirators, light sources, communication links, coagulators, lasers, imagers including 2D and/or 3D cameras with optics, CMBF's and processors that provide video signals for rendering 2D and/or 3D images, etc. For example, the endoscopic microinstrument system may include a joystick-1 for controlling camera-1, a joystick-2 for controlling camera-2, a joystick-3 for controlling tool-1, a joystick-4 for controlling tool-2, etc.

The further joysticks or controls may provide movement control (e.g., in any desired 3D direction, such as articulation, rotation, translation in any desired 3D direction, such as right, left, front (extension), back (retraction) directions) to move the distal tool independently of the camera control, if desired. For example, additional joysticks and/or user interfaces (e.g., hard or soft), such knobs, buttons, keys, may be provided to activate further devices, such as further tools and cameras, etc. The controllers (e.g., joysticks) and the controlled devices (e.g., tools, cameras) may be operationally coupled and connected to communicate with each other (e.g., via wired or wireless links) such that the controllers and the controlled devices may be reconfigured, e.g., by a processor, under the control of computer instructions stored in a memory or any non-transitory computer readable medium for effectuating 3D movement of the tools and desired operations of the tools, cameras, and/or controller (e.g., joysticks). Accordingly, a versatile endoscopic microinstrument that includes a combination distal tool(s) and distal camera(s) is provided that can ‘see’ an ROI where a distal tool may be manipulated. Different tools or tools with different functions and/or camera(s) can be independently and/or synchronously controlled via one or more controllers, such as joysticks, knobs, buttons, couplers and the like, which may be a combination of hard and soft buttons on a UI, such as a displayed UI displayed on a touch sensitive screen, for example.

Further, having a camera(s) at the distal end of the endoscopic microinstrument near the tool(s) (instead of having the camera at the proximal end) allows for camera movement that tracks movement of the tool and thus have the camera ‘see’ what the tool is looking at, including providing a rear view, such as when the tool is also rotated to point to the rear which maybe pointing 180° or directly backwards relative a front direction and/or any angle relative the front view between 0 and 160°, between 0 and 140° and/or between 0 and 120°, for example. In addition to such synchronous movements between the camera and tool, the camera or a further camera may be decoupled for independent control to move independently of the tool movement and point to a desired direction different from a direction the tool is pointing to. A decoupled camera-tool combination maybe re-coupled or re-syncronize, such as in response to a synchronization (sync) signal from a controller or processor to re-syncronize the camera and tool together, again, where the camera follows the tool or moves together with the tool and/or the distal tip of the endoscopic microinstrument including the tool, for example.

While the present invention has been shown and described with reference to particular exemplary embodiments, it will be understood by those skilled in the art that present invention is not limited thereto, but that various changes in form and details, including the combination of various features and embodiments, may be made therein without departing from the spirit and scope of the invention.

Further variations of the present system would readily occur to a person of ordinary skill in the art and are encompassed by the following claims.

The section headings included herein are intended to facilitate a review but are not intended to limit the scope of the present system. Accordingly, the specification and drawings are to be regarded in an illustrative manner and are not intended to limit the scope of the appended claims.

In interpreting the appended claims, it should be understood that:

d) several “means” may be represented by the same item or hardware or software implemented structure or function;

e) any of the disclosed elements may be comprised of hardware portions (e.g., including discrete and integrated electronic circuitry), software portions (e.g., computer programming), and any combination thereof;

f) hardware portions may be comprised of one or both of analog and digital portions;

h) no specific sequence of acts or steps is intended to be required unless specifically indicated;

i) the term “plurality of” an element includes two or more of the claimed element, and does not imply any particular range of number of elements; that is, a plurality of elements may be as few as two elements, and may include an immeasurable number of elements; and

j) the term and/or and formatives thereof should be understood to mean that only one or more of the listed elements may need to be suitably present in the system in accordance with the claims recitation and in accordance with one or more embodiments of the present system.