Tip cleaning accessory for rigid endoscopic instrument

A tip cleaning accessory for enhancement in the utility of rigid endoscopic instruments is hereinafter disclosed. This accessory includes a complimentary tubular member adapted for use with a rigid endoscope. The endoscope contemplated for use with such an accessory includes a handset or handle, a rigid tubular shaft, having a plurality of functional channels adapted for acceptance of at least two fiber optic bundles, the first bundle for illuminating the operative field and a second bundle for visualization of the operative field, either directly through an eye piece (located within the instrument handset) or upon a video screen by coupling a video camera to the imaging bundle. The tip cleaning accessory of this invention comprises an adaptive and complimentary tubular member for use in conjunction with the endoscope to provide and direct a source of cleansing fluid to the tip of the endoscope so as to enable removal of debris from the optical windows associated with both the light and imaging bundles of the instrument. This accessory can be supplied along with new endoscopic instruments and is also compatible with endoscopic instruments of existing design.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
This invention is directed to an apparatus and to a method. More 
specifically, this invention is directed to a tip cleaning accessory for 
endoscopic instruments, the combination thereof with an endoscopic 
instrument and to a method for removal of fluids and other debris from the 
tip of an endoscopic instrument--specifically the optical windows 
associated with the tip of the endoscopic instrument. 
2. Description of the Prior Art 
Endoscopic instruments can generally be classified into two distinctive 
categories: the so-called "flexible" class of instruments (represented by 
sigmoidscopes); and, the so-called "rigid" class of endoscopic instruments 
(represented by cystacope, arthroscope and laproscopes). Each genera or 
class of instrument is unique unto itself, both in respect to design and 
operation; and, such differences are related to the specific and highly 
specialized uses for which each has been designed. 
The rigid endoscope is generally designed for both diagnosis (biopsy) and 
for performance of surgical procedures utilizing what has become to be 
known as "least invasive surgical" techniques and procedures (or LIS). In 
accordance with such techniques, a small incision is made into the abdomen 
(laparoscopic procedure) or joint (arthroscopic procedure), the instrument 
introduced through such incision into the patients body by means of a 
trokar and a surgical procedure performed. Typically, the endoscope is 
provided with a series of internal channels to allow for introduction of 
one or more accessories (snares, electrodes and micro-surgical devices) 
into the patients body; and, means for illumination and visualization of 
the operative field. It is also possible to provide for aspiration and 
suction of an irrigant to and from the operative field through internal 
channels provided for such purpose. Under certain conditions it may be 
necessary or appropriate to use one or more endoscopes in combination to 
effect the desired surgical procedure. 
As is evident from the foregoing, the limited size of the incision into the 
patient's body precludes direct observation of the operative field by the 
surgeon and, thus, the surgeon must rely upon the visual access provided 
by the instrument to effect the operative procedure. Traditional visual 
access to the operative field has been provided through a combination of 
fiber optic bundles incorporated into the endoscope; one such fiber optic 
bundle optically coupled to a light source and a second fiber optic bundle 
optically coupled to an eye piece or video camera. Each of the fiber optic 
bundles are shielded or capped at the end of the endoscope with a window 
which can become obscured with blood, fecal matter, bodily fluids and/or 
tissue fragments in the course of the performance of a surgical procedure. 
In such event, the instrument need be withdrawn, the tip of the endoscope 
cleaned of obscuring matter and reinserted. This interruption of the 
surgical procedure both prolongs the surgical procedure and subjects the 
patient to additional risk. Accordingly, there is a continuing need to 
provide for enhancement of existing endoscopic instruments to minimize 
and/or avoid the limitations thereupon imposed by current design. 
OBJECTS OF THE INVENTION 
It is the object of this invention to remedy the above as well as related 
deficiencies in the prior art. 
More specifically, it is the principal object of this invention to provide 
an accessory for use in conjunction with rigid endoscopic instruments of 
existing design to effect removal of obscuring debris from the tip thereof 
to ensure continuity of observation of the operative field through the 
fiber optics bundles of the endoscope provided for that purpose. 
It is another object of this invention to provide an accessory for use in 
conjunction with rigid endoscopic instruments of existing design to 
deliver a stream of cleansing fluid to the tip of the endoscopic 
instruments for removal of obscuring matter. 
It is yet another object of this invention to provide a method for delivery 
of the cleansing fluid to the tip of the endoscopic instrument in the 
course of performance of a surgical procedure so as to avoid interruption 
thereof. 
SUMMARY OF THE INVENTION 
The above and related objects are achieved by providing a tip cleaning 
accessory for an endoscopic instrument which includes a tubular member 
having a cylindrical wall, an instrument channel having a defined size and 
shape which conforms in overall dimension to the cross-sectional area and 
length of an endoscopic instrument; a fluid channel running the length of 
the tubular member, said fluid channel being associated with and/or 
incorporated into the cylindrical wall thereof; means associated with one 
end of the fluid channel for fluid coupling to a source of cleansing 
fluid; and, means associated with the opposite end thereof for directing 
cleansing fluid onto the tip of the endoscope associated therewith to 
effect removal of blood, fecal matter, bodily fluids and/or tissue debris 
from the optical window associated with the instrument so as to preserve 
essentially unobstructed optical coupling of the light and imaging fiber 
optics bundles (associated with the endoscope) and the operative field. 
In one of the preferred embodiments of the invention, the end of the tip 
cleaning accessory (which is physically associated with the tip of the 
endoscope) is provided with one or more nozzles of jets for directing 
cleansing fluid onto the tip of the endoscope. 
In another of the preferred embodiments of the invention, indexing means 
are associated with the tubular member to permit and/or to effect 
alignment of the nozzles or jets of the tubular member with the optical 
window in the tip of the endoscopic instrument.

DESCRIPTION OF THE INVENTION INCLUDING PREFERRED EMBODIMENTS 
The preferred embodiments of this invention are, for ease of description 
and understanding, described in reference to one or more of the 
accompanying figures. Where an element or component is common to more than 
one of these figures, it is assigned a common reference numeral to aid in 
understanding and to provide continuity in description. 
FIG. 1 depicts, in perspective view, an endoscopic instrument of 
traditional design in combination with the cleaning accessory of tiffs 
invention. In brief, such endoscopic instrument includes an eyepiece (12) 
to which is connected an optical train (not shown) which permits the 
clinician to observe the operative field through a fiber optic bundle or 
imaging bundle which extends from the handset (14) through a shaft (16) to 
the area of surgical interest. In addition to the imaging bundle, a second 
fiber optic bundle or light carrier (18) is also provided. The light 
carrier is connected through the hand set to a light source which 
illuminates the operative field, thereby permitting its visualization 
through the imaging bundle. In addition to the fiber optic bundles or 
elements, additional channels can be provided through the shaft for 
various accessories and surgical instruments (i.e. electrodes, snares, and 
micro surgical devices). 
In the conventional instrument design of the type described in FIG. 1, the 
shaft can be provided with additional passageways to permit the 
aspiration, or infusion, of an irrigant in the operative field and removal 
of such irrigant either through the same channel or through a separate 
channel provided for that purpose. In practice, the infusion, sequential 
or concurrent, with suction of an irrigant into the operative field may, 
under certain conditions, assist in clearing debris from the window (20) 
which seals the fiber optic elements within the shaft, thus preventing 
direct contact of fluid therewith. Where an endoscopic instrument does, in 
fact, make provision for such internal irrigation and suction channel, the 
utility of the instrument is somewhat limited due to the fact that the 
overall cross-sectional area of such instrument is limited (both by custom 
and practice) to approximately 10-12 min. Accordingly, it is preferable to 
eliminate such internal irrigation channel in favor of additional 
accessory channels or elimination thereof in favor of a instrument of 
smaller cross-sectional area. 
In rite smaller diameter instruments, and in older instruments, which are 
lacking in such irrigation, the aspiration and suction of an irrigant is 
not generally possible through the same endoscope which is used to perform 
the operative procedure; thus, necessitating a second incision and a 
second endoscope to perform the irrigation and suction functions. Where 
this latter protocol is prevalent, the irrigant cannot effectively clean 
the optical window through which the imaging and light bundles rely for 
access to the operative field. 
In accordance with this invention, a tip cleaning accessory is herein 
provided as shown in FIG. 2. This tip cleaning accessory (40) comprises 
(in the embodiment shown), a tubular member (42) comprising two concentric 
tubes (44, 46), one of which is somewhat smaller in diameter than the 
other. These two tubes are joined together at their respective ends so as 
to provide a channel therebetween (48) for infusion of an irrigant or 
cleaning fluid from a source external to the operative field to the tip of 
the endoscopic instrument associated therewith. In practice, the 
endoscopic instrument is inserted, or nested within the tip cleaning 
accessory and the resulting assembly inserted in the conventional manner 
through a trokar positioned in the abdominal cavity of the patient. In 
order to present a pressurized operating environment, (as is requisite in 
laparoscopic surgery wherein the abdominal cavity is distended by 
pressurization thereof with an inert gas), the distal end (52) of the 
instrument channel (61) of the tip cleaning accessory is preferably 
provided with means for sealing engagement (62) of the distal end of such 
channel (52) and the distal end of the instrument shaft (16). The tip 
cleaning accessory is and remains in passive engagement with the 
endoscopic instrument until such time as the tip of the instrument becomes 
obstructed by materials which adhere to the optical window covering the 
imaging fiber optic bundles. At that time, the clinician simply energizes 
a pump (not shown) which forces irrigant (generally saline or other 
equivalent fluid) through an inlet (50) provided in the proximal end of 
the tip cleaning accessory. Fluid passes through the channel (48) provided 
in the tip cleaning accessory from the inlet (50) to the distal end or the 
tip of the cleaning accessory (52) where it is deflected by one or more 
nozzles or jets (54) onto the window (20) which covers the channel housing 
the fiber optic elements. The frequency and amount of irrigant deflected 
onto the window at the tip of the fiber optic channel is carefully 
controlled by the clinician and can be removed from the operative field 
through a suction channel provided for that purpose either in the tip 
cleaning accessory or by simply reversing the flow of fluid through the 
tip cleaning accessory by means of suction applied to the proximal end of 
the tip cleaning accessory. 
In the preferred embodiment of this invention as illustrated in FIG. 3, the 
tip cleaning accessory is provided with a series of jets (54) integral 
with the distal end thereof, which is associated with the tip of the 
endoscope shaft. The endoscope shaft and the tip of the cleaning accessory 
are further provided with an index mark or detente (63) which assures the 
orientation of the jets in the tip cleaning accessory relative to the 
window which covers the fiber optic bundle channel and thereby assuring 
accurate and directive placement of cleansing fluid relative to the 
optical window at the tip of the endoscopic instrument. 
As is apparent to one skilled in the art, the foregoing figures are simply 
illustrative of the concept of this invention and not intended as 
delineating in scope which is set forth in the following claims.