Abstract:
An apparatus, system and methods that comprise adding a removable or detachable carrier containing a camera and illumination to a TEE probe, thereby allowing the user to view the placement of the probe and minimize or reduce the risk of esophageal and pharyngeal complications during the positioning of the TEE probe into the patient&#39;s esophagus. The reduction or minimization of complications occurs by allowing the cardiologist direct visualization of pharyngeal and esophageal structures during intubation. This device and procedure eliminate any “blind procedure”, whereby direct visualization of the pharyngeal structures and esophagus present a possible solution to these mechanical complications. Once the TEE probe has been properly positioned in the esophagus, the carrier is removed from the esophagus. The removable or detachable camera of the present disclosure can be used in other industries.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    The application is a continuation of International Application No. PCT/US2015/062701, filed Nov. 25, 2015, entitled “Apparatus, System And Methods For Proper Transesophageal Echocardiography Probe Positioning By Using Camera For Ultrasound Imaging,” which claims priority to and the benefit of U.S. Provisional Patent Application Ser. No. 62/084,969, filed Nov. 26, 2014, entitled “Apparatus, System And Methods For Proper Transesophageal Echocardiography Probe Positioning By Using Camera For Ultrasound Imaging,” the disclosures of which are incorporated herein in their entirety. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present disclosure relates generally to a Transesophageal Echocardiography Endoscopic Camera Assist Device (TEECAD) for adding direct visualization to Transesophageal Echocardiography intubation (TEE), without having to develop a completely new TEE probe nor without the need to revamp existing echocardiography machines. In particular, the present disclosure comprises an attachable TEECAD probe, which is configured to be attached to an existing TEE probe prior to intubation. The TEECAD probe contains a camera and a light source, which will feed into a video monitor and allow the user or practitioner to visualize the path of the TEE probe as it is inserted into the esophagus and moved into position for the procedure. The TEECAD probe would add minimal width or girth to the TEE probe, and would be completely detachable and easily retractable after successful intubation of the esophagus, while leaving the probe in the proper location. 
       BACKGROUND OF THE INVENTION 
       [0003]    Echocardiography, is a diagnostic modality that utilizes a transducer to transmit ultrasound waves to the heart, which deflect or rebound off the structures of the heart. A computer converts the resulting waves and displays them on a screen as 2 dimensional, 3 dimensional, or doppler wave images, which allow assessment of cardiac structure and function. The majority of echocardiograms are obtained from a transthoracic approach (TTE), which generally gives an excellent assessment of left ventricular and valvular structure and function. Transesophageal echocardiography similarly takes echocardiographic pictures of the heart, but the images are obtained behind the heart from the esophagus, rather than across the chest wall. The TEE approach is advantageous over TTE&#39;s in many circumstances, most commonly for optimal imaging of heart valves, assessing for left atrial appendage thrombus, examination of intracardiac tumors, and assessment for intracardiac shunting. 
         [0004]    The TEE procedure offers a much clearer image of certain heart structures versus a standard TTE. The TEE probe is comprised of a flexible endoscope with ultrasound transducer at the tip. The probe is inserted into the mouth and advanced into the esophagus. From the esophageal position, the ultrasound beam does not have to travel through the chest wall, and therefore offers a much clearer image of several key heart structures, especially the atria and valves, that may not be seen as clearly with a TTE. During the procedure, the cardiologist can rotate the endoscope and examine the heart from different angles. 
         [0005]    An example of an optical TEE probe is disclosed in U.S. Pat. No. 6,884,220, titled Optical Transesophageal Echocardiography Probe (Aviv, et al.), where the proposed probe contains an optical imaging element, a suction channel, and a light channel for illumination, among other elements. The disclosure relates to an optical Transesophageal Echocardiography probe having an optical fiber bundle to allow real-time visualization of the structures that are transverse as the device is passed via the mouth into the esophagus, wherein the probe has a unique profile which allows passage into the esophagus with a minimum amount of trauma to the patient. 
         [0006]    Another disclosure, U.S. Pat. No. 4,327,738, titled Endoscopic Method &amp; Apparatus Including Ultrasonic B-Scan Imaging (Green, et al.), discloses an endoscopic method and apparatus for the simultaneous visual and ultrasonic imaging of internal body parts through the use of a probe insertable into a body cavity. The probe includes a rectilinear transducer array acoustically coupled to the body through a cylindrical focusing lens having an outer face that conforms to the probe contour. An optical illuminating and viewing system is provided for optically viewing internal body parts through the probe, which includes an objective lens and illuminating means adjacent the distal ends of the probe and the transducer array. A removable eyepiece at the housing is used for direct viewing by the operator while guiding the probe into desired position in the body cavity. Means also are provided for viewing the optical image by a video camera having an output connected to a monitor adjacent the ultrasonic image display. Consequently, both the optical and ultrasonic images are simultaneously displayable and viewable by the operator. 
         [0007]    Another disclosure, U.S. Pat. No. 4,567,882, titled Method For Locating The Illuminated Tip Of An Endotracheal Tube (Heller), discloses a medical tube with a fiber optic light conductor extending lengthwise through the wall of the tube, with the conductor ending in a light emitting and redirecting terminus adjacent the tube&#39;s distal end. In the disclosure, light emitted laterally from the tip of the tube may be visually and externally observed through the body wall of the patient for accurately and quickly determining the anatomical location of that tip. 
         [0008]    One of the disadvantages of the TEE procedure is that the cardiologist inserts the flexible endoscope without being able to see where the scope is going. The procedure is usually done by feel and experience, and although most of these procedures occur without problems, a small percentage of these procedures can result in oropharyngeal, esophageal, or gastric trauma, which can be catastrophic complications with high mortality rates. To the extent a camera or other device for viewing the procedure is used, the device must be modified from its original design, which can be expensive, or the new design might create a scope that is much larger in width or girth, making the procedure more uncomfortable for the patient. 
         [0009]    Thus, there is a need for a camera and light source device or camera system and methods in which the camera system is configured to be attached to a TEE probe or scope and disconnected or detached from the probe once the transducer at the end of the scope has been placed in the proper position for the procedure. Once in the proper location, the camera system can be removed from the patient prior to the procedure. The present disclosure solves these and other disadvantages of the prior art. 
       SUMMARY OF THE INVENTION 
       [0010]    The present disclosure solves the disadvantages of, and improves on, the prior art systems as described herein. The present disclosure pertains to a device, system and methods that comprise adding a removable or detachable camera to a TEE probe, for example, by using a carrier comprised of a proximal component, a mid-section lumen and a distal component, and in which the distal component is configured to removeably attach to the distal end of the TEE probe. The distal component houses a camera and light source or LED and associated wiring back to the proximal component through the mid-section lumen for connection to a video monitor to allow the practitioner to view the placement of the TEE probe in the patient, thereby minimizing or reducing the risk of esophageal and pharyngeal complications during the positioning of the TEE probe into the patient&#39;s esophagus. The reduction or minimization of complications occurs by allowing the cardiologist direct visualization of pharyngeal and esophageal structures during intubation. This device and procedure eliminates any “blind procedure”, whereby direct visualization of the pharyngeal structures and esophagus present a possible solution to these mechanical complications. Once the TEE probe is properly located, the carrier can be removed from the TEE probe and extracted from the patient. 
         [0011]    Currently, during a TEE procedure, the probe is positioned in the patient&#39;s esophagus, usually under conscious sedation and with local anesthetic applied to the oropharynx. Intubation of the esophagus is almost always done without imaging assistance, and is essentially a “blind” procedure, done by operator feel and assisted by the patient swallowing at the appropriate time. Reported complication rates are generally low, with the most catastrophic potential complication being perforation of the esophagus or damage to pharyngeal structures. 
         [0012]    While the reported complication rates appear low, these rates are likely to change as the risk profile of patients undergoing TEE evolves, especially with the advancing age of patients undergoing TEE, which will almost certainly lead to an increase in TEE related complications, such as esophageal and pharyngeal perforation, and accidental tracheal intubation. Current advances in cardiology, most notably catheter based valve interventions for “inoperable” patients, are creating a sizeable pool of elderly, high risk patients who generally need screening TEE&#39;s to qualify for said procedures, as often also pen-procedural TEE&#39;s. 
         [0013]    A device, system and methods that provide the above-noted advantages is the TEECAD, a Transesophageal Echocardiography Endoscopic Camera Assist Device, which offers a way to allow the cardiologist direct visualization for TEE intubation, without having to develop a completely new TEE probe or revamp existing echocardiography machines to accommodate the technology. As detailed herein, the TEECAD device comprises a carrier with a camera and light source device and system that is configured to be attached to, and when necessary, removed from, an existing probe. The carrier or attachment device can be further configured with wiring to transmit information to a video monitor, which may be separate from the echocardiography machine. The device can also be used with an eyepiece for the cardiologists to look into during the placement of the probe. An advantage to the TEECAD device is the minimal added width and/or girth on the TEE probe, and the device is configured to be detachable from the probe and easily retractable after successful intubation of the esophagus. 
         [0014]    In the preferred embodiment, the TEECAD device would consist of a carrier comprising a proximal component, a mid-section lumen and a distal component, and in which the distal component is of a shape and form to removeably attach to a TEE probe. The proximal component would be configured as a handle for the practitioner to hold or as a clip to be attached to the proximal end of the TEE probe. The distal component is configured to house a camera and light source and allow the associated wiring for those items to snake back through the mid-section lumen and the proximal component for connection to a video chip, video monitor or image processor as understood by one having ordinary skill in the art. 
         [0015]    This configuration allows the practitioner to view the placement of the TEE probe in the patient as the TEECAD device would be configured to feed video of the probe placement (in the esophagus) on a separate portable monitor, which can be placed near the device dependent on the operator&#39;s preference. The distal component would be configured to be held in place on the back end of the TEE probe and could be removed with the correct amount of axial tension, once the TEE probe was successfully located in the esophagus. Once detached from the TEE probe, the TEECAD device could be retracted and removed from the patient&#39;s esophagus. 
         [0016]    In the preferred embodiment, the distal component would be configured to house the small video camera, lens, and light source, such as an LED. The internal wiring will comprise of a video feed wire, a power source for the camera and LED. A control handle at the end of the device would provide any needed controls for the video feed and for the LED. The camera can also be wireless, and the light source and camera may contain an internal power supply, to reduce the need for some or all of the wires. 
         [0017]    The removable or detachable carrier and camera of the present disclosure can be used in other industries. For example, in the construction industry, a similar detachable device can be used to visualize the placement of wires in a wall, where the wires are left behind and the camera is detached from the wires and pulled back to the user. 
         [0018]    Other objects and advantages of the present invention will become apparent to one having ordinary skill in the art after reading the specification in light of the drawing figures, however, the spirit and scope of the present invention should not be limited to the description of the embodiments contained herein. For example, electromagnetic straps or a detachable sleeve can be used instead of the preferred embodiment to attach the carrier to the TEE probe during intubation. The electromagnetic straps could be de-energized once the TEE probe was in the proper location for removal of the carrier. Further, a sleeve could be configured to encase the TEE probe. The sleeve can be detached and withdrawn from the patient after intubation has occurred. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0019]      FIG. 1  is a functional block diagram view of an embodiment of a system for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure; 
           [0020]      FIG. 2  illustrates an embodiment of an apparatus for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure; 
           [0021]      FIG. 3  illustrates an embodiment of an apparatus for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure; 
           [0022]      FIG. 4  illustrates an alternative embodiment of an apparatus for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure; 
           [0023]      FIG. 5  illustrates an alternative embodiment of a system for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure; and 
           [0024]      FIG. 6  illustrates an alternative embodiment of a system for proper transesophageal echocardiography probe positioning by using a camera in accordance with the present disclosure. 
       
    
    
     DETAILED DESCRIPTION 
       [0025]    The present disclosure is an apparatus, system and related methods pertaining to an attachable and detachable TEECAD or Transesophageal Echocardiography Endoscopic Camera Assist Device. The TEECAD device increases the functionality of currently existing probes by transmitting video information to a video monitor during the placement of the probe. The video information can be displayed on a video monitor, which may or may not be separate from the echocardiography machine. In particular, the display monitor used during the transesophageal echocardiography procedure, allows the practitioner or cardiologist to see or visualize the path of the TEE probe as it is inserted into the esophagus and moved into position for the TEE procedure. The TEECAD device has minimal circumference or girth and would not create an issue during intubation. Further, the TEACAD device is configured to be completely detachable, and easily retractable after a successful intubation of the esophagus, while leaving the TEE probe in place, as described in detail herein. 
         [0026]    Referring to the drawings, wherein like reference numerals refer to the same or similar features in the various views,  FIG. 1  is a functional block diagram view of an exemplary TEECAD system  10  which is used to assist in proper Transesophageal Echocardiography (TEE) probe positioning with the use of a detachable camera system in accordance with the present disclosure. The TEECAD system  10  comprises a TEECAD probe  12 , which is combination of a TEECAD device  14 , as shown in  FIG. 2 , and a TEE probe  16 , for which the distal end is partially shown in  FIG. 3 , but which generally are about 80 cm in length. The TEECAD probe  12  also comprises, a lens  18 , a camera  20 , for a video feed, and a light source  22 , such as an LED, along with the associated wiring  24  for the camera  20  and light source  22 , along with any necessary controls  26  to control the camera  20 , the light source  22 , and any other devices or systems, as necessary. 
         [0027]    As understood by one having ordinary skill in the art, the camera can be wireless, and the light source and camera may contain internal power supplies, thereby reducing the need for some or all of the wires. Further, the video feed from the camera  74  could be transmitted through the wire to a video monitor  30 , which could be separate from the ultrasound display  28 , although it is not required. The video monitor  30  can be placed near the device dependent on the cardiologist&#39;s preference, although the video feed can be transmitted remotely for access to viewing the procedure offsite or for educational purposes, among others 
         [0028]    In the preferred embodiment, the camera  20  is a NanEye 2D sensor by AWAIBA, which provides a system-on-chip camera head  20 . The proprietary data interface technology permits cable length&#39;s up to 3 meters without any additional components at the distal end. Further, due to the low energy dissipation on the interface, no complicated shielding is required to meet EMC norms. Also, a small lens  18  can be assembled to the chip without increasing the total diameter of the sensor  20 , making it one of the most compact digital cameras  20 . 
         [0029]    The exemplary TEECAD system  10  further comprises a display  28  for showing the ultrasonic results of the TEE probe  16  during a procedure, and a video monitor  30  for showing the video from the camera  20  as the TEECAD probe  12  is inserted into the esophagus and travels through the esophagus to the intended location. As described herein, the video monitor  30  allows the cardiologist to see the location of the TEECAD probe  12  as it travels through the patient&#39;s esophagus and as the TEECAD probe  12 , and in particular the TEE probe  16 , as it is moved into the proper location for the ultrasonic portion of the procedure. The monitor  30  and display  28  could be a single unit. 
         [0030]    The present disclosure further contemplates that the camera  20  could send signals wirelessly to the monitor  30  or to a receiver (not shown) that could connect to a monitor  30 , as understood by those having ordinary skill in the art. Further, as stated herein, the signals received from the camera could be transmitted remotely for teaching or analysis purposes. 
         [0031]      FIG. 2  shows the preferred embodiment of the TEECAD device  14 , which comprises a carrier  40 . The carrier  40  comprises three separate components, a distal component  42 , a proximal component  44  (both preferably molded components), and a midsection lumen  46 , preferably consisting of an extruded segment of polymer tubing  48 . Although the carrier  40  comprises three separate components, any one or more of these components can be combined to perform the same function as described herein. For example, the mid-section lumen  46  and the proximal component  44  can be combined into an integral section and used with a non-integral distal component  42  to perform the same function as three separate components. 
         [0032]    In the preferred embodiment, the distal component  42  comprises a concave section  50  configured to accept and support the distal portion of the TEE probe  16 , and in particular, the distal component  42  is designed and configured to be removeably attached to and partially envelop the back side  52  of the TEE probe  16 , opposite the ultrasound transducer  54 , as shown in  FIG. 3 . The ultrasonic transducer  54  at the distal end is connected to the shaft  56  of the TEE probe  16 . The shape and material of the distal component  42  of the carrier  40  shall be designed to provide sufficient mechanical stability to maintain communication with the back side  52  of the TEE probe  16  at the distal end, during TEACAD probe  12  intubation. 
         [0033]    During the intubation procedure, while the TEE probe is inserted into the esophagus, the carrier will also be inserted into the esophagus. At least the distal component  42  and a portion of the mid-section lumen  46  will be inserted into the esophagus during intubation. The design and configuration of the distal component  42  of the carrier  40  shall allow the distal component  42 , with minimal axial tension or pull, to detach from the back side  54  and distal end of the TEE probe  16 , and to be retracted along the shaft  52  of the TEE probe  16  until the distal component  42  is effectively removed from the patient&#39;s esophagus, or removed to a distance that does not influence the TEE probe  16  performance. The distal component  42  of the carrier  40  can be attached to the back side  54  of the TEE probe  16  in a number of ways, as long as it can be detached after the TEE probe has been properly located, and removed from the patient. 
         [0034]    As also shown in  FIG. 2 , contained within the distal component  42  of the carrier  40  will be an aperture  58  in which the camera  20 , lens  18  and light source  22  will be located. The camera  20  will have coincident illumination  22  (built in), or in an alternative embodiment, an aperture in which only a camera  20  will be located and which will receive ancillary illumination  22  from a source not coincident to the camera  20 . The ancillary illumination  22  may be located adjacent to the aperture  58  or be contained within the distal component  42 . The built in lens  18  of the camera  20  and the illumination  22  will be arranged at the furthest most segment  60  of the distal component  42 . 
         [0035]    Although the preferred embodiment comprises a camera  20  and light source or LED  22  built directly into the carrier  40 , an alternative embodiment comprises a separate camera sheath (not shown) which comprises the camera  20 , the light source  22 , and the associated wiring  24 , that inserts through the mid-section lumen  46  of the carrier  40 . In this embodiment, the camera sheath can be reused, while the carrier  40  is discarded after use. 
         [0036]      FIG. 2  also shows the mid-section lumen  46  of the carrier  40 , which in the preferred embodiment, which will run alongside the shaft  56  of the TEE probe  16  during intubation. The mid-section lumen  46  will have a smaller diameter, approximately 5 to 6 mm in diameter, than the shaft  52  of the probe  16 . However, the mid-section lumen  46  shall be sufficiently thick to withstand the tensile force required to detach and withdraw the distal component  42  from the back end  54  of the TEE probe  16  and about the TEE probe shaft  52 . The inside of the lumen  46  shall be sized and configured such that it shall contain the wiring  24  for the digital camera  20 , or in some embodiments, the digital camera  20  and the illumination mechanism  22 . In some embodiments, the lumen  46  shall be reinforced such that the cross-section of the lumen  46  may be minimized, but which still can provide adequate tensile force, such that the distal component  42  may be retracted safely and effectively. 
         [0037]    The proximal component  44  of the carrier  40  comprises a handle or clip  64  that is configured to be removeably attached to the proximal component  44  of the TEE probe  16 . Although it is not necessary that the proximal component  46  attach to the TEE probe  16 , the handle or clip  64  may partly or fully encircle the proximal component  44 , if it does. The proximal component  44  may attach and, if a clip, be removed with a spring mechanism  66 . Either way, the proximal component  44  will be configured with an opening  68  to accommodate the wiring  24  for the camera  20  and LED  22 . 
         [0038]    The carrier  40 , which is constructed of the three components, the distal component  42 , the lumen  46 , and the proximal component  44 , shall be continuous, and constructed such that the components may be attached to each other by conventional methods of cold vulcanization as well as using heat or solvent bonding, as understood by one having ordinary skill in the art. 
         [0039]    The camera component in the preferred embodiment, such as the NanEye 2D sensor by AWAIBA, shall include a video chip, LED lighting, and a clear polymer lens covering the assembly. Although the NanEye 2D is the preferred embodiment, the LED lighting may also be a separate component from the camera embodiment, and possibly integrated directly into distal component  42  of the carrier  40 . Regardless, the digital camera  20  and illumination system  22  shall attach to an image processor (if necessary) and viewing monitor  30  which is located proximal to but not integral to the carrier  40 . 
         [0040]    The present disclosure contemplates other embodiments in which a carrier similar that described herein can be attached to a TEE probe  16  and, as such, a TEACAD probe  12  can be inserted into the esophagus. Once the TEE probe  16  is properly positioned (as viewed in the monitor  30 ), the distal component  42  or equivalent of the carrier can be removed from the distal portion of the TEE probe  16  opposite the ultrasonic transducer  54  and the TEECAD device  14  can then be removed or withdrawn from the esophagus. 
         [0041]    The present disclosure contemplates that the entire carrier  40 , along with the camera  20  and light source  22 , can be disposable once used, or the camera  20  and light source  22  can be reused as described herein. Whether the entire device is discarded or a portion is reused will depend on the overall cost and the possibility of sterilizing any part of the device after each use. In particular, the carrier  40 , which is the least expensive item, will be disposable. However, the camera  20  and light source  22  may or may not be reusable. The camera  20  and LED  22  may be incorporated directly into the carrier  40  if they are to be disposed of after use. If the camera  20  and LED  22  are to be sterilized and reused, then a separate thin camera sheath (not shown) containing the camera  20  and the LED or light source  22 , can be thread through the lumen  46  of the carrier  40 , and then removed, sterilized or disinfected, and reused. 
         [0042]      FIG. 4  shows an alternative embodiment of the present disclosure. In the alternative embodiment, a TEECAD device  70  comprises a shaft  72 , which contains within the wires or cabling for a camera  74 , light  76  and control wires  78 . The shaft  72  is a thin, mini-endoscope or lumen, which contains the wiring or cabling, and which would be attached to a standard TEE probe  16  during intubation. The shaft  72  comprises adjustable straps  80  that would be configured to secure the TEECAD device  70  to the TEE probe  16 . 
         [0043]    In the embodiment, the straps  80  would be held in place with small electromagnets  82  that could be activated and deactivated from controls  84 . In doing so, the electromagnets  82  could be energized to attach the TEECAD device  70  to the TEE probe  16  prior to insertion into the esophagus. As before, the combination of the TEE probe  16  with the attached TEECAD device  70  creates a TEECAD probe  12 . Once the TEECAD probe  12  is successfully located in the proper position in the esophagus for ultrasonic imaging, the electromagnets  82  could be de-energized, thereby allowing the TEECAD device  70  to detach from the TEE probe  16 , and be extracted from the patient&#39;s esophagus. 
         [0044]    In an embodiment, there would be four straps  80 , two near the distal end for stability of the camera  74 , and two attached to the middle area of the shaft  72  of the TEECAD device  70 . The straps  80  would be thin, and have rounded edges, to assure minimal trauma to the esophagus during intubation and removal of the TEECAD device  70 . As shown in  FIG. 5 , cross-sectional view B-B, the distal end of the TEECAD device  70  would comprise a small video camera  74 , a lens  75 , and an light source or LED  76 . 
         [0045]    As shown in  FIG. 6 , cross-sectional view A-A, the internal wiring in the shaft  72  comprises a video feed wire  90  from the camera  74  to the monitor  30 , a power source  92  for the light source or LED  76 , and a power line  94  for the control wires  78 , to control the energizing and de-energizing of the electromagnets  82  on the straps  80 . The controls  84  at the end of the TEECAD device  70  would provide the controls for the video feed  74 , LED  76 , and ability to activate and deactivate the electromagnets  82  on the straps  80 . As understood by one having ordinary skill in the art, the camera can be wireless, and the light source may contain an internal power supply, and the electromagnets may be controlled remotely, to reduce the need for some or all of the wires, similar to all of the embodiments herein. 
         [0046]    Similar to the discussion above, the video feed from the camera  74  could be transmitted through the wire to a video monitor  30 , which could be separate from the ultrasound display  28 , although it is not required. The video monitor  30  can be placed near the device dependent on the cardiologist&#39;s preference, although the video feed can be transmitted remotely for access to viewing offsite or for educational purposes, among others. 
         [0047]    In accordance with the alternative embodiment, by using the straps  80  and energizing the electromagnets  82  with the controls  78 , the shaft  72  of the TEECAD device  70 , with the integral camera  74  and lights  76 , can be attached to the TEE probe  16 . The resulting TEECAD probe  12  can be inserted into the esophagus to reduce or minimize the risk of esophageal and pharyngeal complications, by allowing the cardiologist to directly visualize the pharyngeal and esophageal structures on the video monitor  30  during intubation. Once the TEECAD probe  12  has been properly inserted into the esophagus, the electromagnets  82  can be de-energized using the controls  84 , thereby allowing the TEECAD device  70  to detach from the TEE probe  16 , so that the TEECAD device  70  can be removed from the patient and the ultrasonic imaging on the display  28  can take place. 
         [0048]    In an alternative embodiment, the TEECAD device can be a detachable sleeve, used instead of the electromagnetic straps  80 . The sleeve could be configured to encase the TEE probe  16  and an endoscope and be detached and withdrawn from the patient after intubation has occurred. 
         [0049]    Various embodiments are described herein to various apparatuses, systems, and/or methods. Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. It will be understood by those skilled in the art, however, that the embodiments may be practiced without such specific details. In other instances, well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. Those of ordinary skill in the art will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and do not necessarily limit the scope of the embodiments, the scope of which is defined solely by the appended claims. 
         [0050]    Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment,” or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation given that such combination is not illogical or nonfunctional. 
         [0051]    Although a number of embodiments have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the spirit or scope of this disclosure. For example, all joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other. As used herein, the phrased “configured to,” “configured for,” and similar phrases indicate that the subject device, apparatus, or system is designed and/or constructed (e.g., through appropriate hardware, software, and/or components) to fulfill one or more specific object purposes, not that the subject device, apparatus, or system is merely capable of performing the object purpose. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the spirit of the disclosure as defined in the appended claims. 
         [0052]    Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.