Patent Description:
Imaging instruments, such as endoscopes, can be used to provide a view of a subject site at a location remote from the subject site. Images of a remote visual field that may not be directly viewable can be transmitted to a display device (e.g., electronic display) outside the remote visual field and so are viewable by a user. One example of such a use for an imaging instrument is during minimally invasive surgical, diagnostic, therapeutic, sensing, and/or other treatment procedures (collectively referred to as "surgical procedures" herein), which can be carried out through manual, laparoscopic tools or via teleoperated systems. During such a procedure, a lens, viewport, or other viewing portion of the imaging instrument through which the remote site is viewed can become partly or fully occluded by tissue, fluids, or other materials. As a result, a user's view of the remote site may be partly or fully obscured, and the instrument may need to be removed, cleaned, and reinserted to continue the operation. The process of removing, cleaning, and reinserting the imaging instrument can be time-consuming, which is undesirable in surgical procedures.

A need exists for devices, and for related systems and methods, that facilitate clearing a viewing portion of an imaging instrument during a procedure at a remote site without requiring removal of the imaging instrument from a location accessing the remote site. In other words, a need exists for cleaning of the viewing portion of an imaging instrument in situ while the imaging instrument is at a location for imaging the remote site.

<CIT> discloses an endoscope lens cleaning apparatus used for removing surgical debris from an objective lens of an endoscope. The endoscope lens cleaning apparatus includes an elongated sheath and a connection assembly. The elongated sheath includes an endoscope lumen and an irrigation channel, configured in parallel and adjoining, each extending between an inlet end and an outlet end. At least one stand-off is formed within the elongated sheath along the outlet end. The endoscope lumen and the irrigation channel are fluidly open to one another when the endoscope lumen is in an empty state and the irrigation channel is fluidly sealed from the endoscope lumen between the at least one stand-off and the inlet end when the endoscope lumen is in an occupied state. A fluid passageway extends from a fluid port of the connection assembly and is configured to align and fluidly connected with the irrigation channel.

Further aspects and preferred embodiments of the invention are defined in the dependent claims. Any aspects, embodiments and examples of the present disclosure which do not fall under the scope of the appended claims are provided for illustrative purposes.

It is to be understood that the following detailed description is exemplary and explanatory only and is not restrictive of the claims; rather the claims should be entitled to their full breadth of scope.

The present disclosure can be understood from the following detailed description, either alone or together with the accompanying drawings. The drawings are included to provide a further understanding of the present disclosure and are incorporated in and constitute a part of this specification. The drawings illustrate one or more embodiments of the present teachings and together with the description serve to explain certain principles and operation. In the drawings,.

The present disclosure contemplates various embodiments of cleaning devices that can be used for cleaning of an imaging instrument in situ, for example, while the instrument is at a location to image a remote site, such as during a remote surgical procedure or other remote procedure, for example. For example, according to various embodiments of the disclosure, a cleaning device is configured to enable in situ cleaning (such as, for example, de-fogging, de-misting, removing biological material, biological fluids, etc.) of an imaging instrument, such as an endoscope. Various embodiments of the disclosure also can facilitate an unobstructed view of the remote site and mitigate (e.g., reduce or eliminate) a need to remove the imaging instrument from the remote site for cleaning. In some embodiments, the cleaning device includes a proximal manifold portion having one or more fluid inlets for connection to one or more fluid sources. In an embodiment, the manifold includes two fluid inlets. One fluid inlet is configured to receive a supply of cleaning fluid such as, for example, a saline solution or other cleaning solution, and the other inlet is configured to receive a supply of pressurized gas, such as, for example, carbon dioxide or other gas suitable for use during surgery. In some embodiments, the cleaning fluid is used in combination with the pressurized gas to clear tissue, or other materials incident to the surgical procedure, from the distal viewing portion (e.g., lens) of the imaging instrument, and the gas is used to flush the cleaning fluid from the imaging instrument and/or dry the distal lens, thereby partly or completely clearing the distal viewing portion of the endoscope.

The cleaning device includes a tubular member, such as a sheath, coupled to and rotatable relative to the manifold and extending to or slightly beyond the distal end of the imaging instrument viewing portion. The sheath can include one or more fluid passages fluidically coupling the manifold and one or more nozzles that direct the flow of fluid (e.g., cleaning fluid and/or gas) over the distal viewing portion of the imaging instrument. In some embodiments, the cleaning device is configured so that the sheath does not obscure a field of view of the viewing portion of the imaging instrument. In some embodiments, the imaging instrument provides an asymmetrical field of view and has an axial roll degree of freedom (i.e., rotatable along its longitudinal axis) to provide flexibility in viewing different areas or view angles of the remote site being imaged. In such embodiments, the sheath has a configuration that that avoids occlusion of the field of view as the imaging instrument, regardless of the roll orientation of the imaging instrument shaft. In some embodiments, the cleaning device comprises an optically transparent material so that if a portion of the cleaning device is positioned in the field of view, light still passes through the material of the cleaning device, thereby avoiding obscuring the field of view.

The manifold is coupled to the sheath and rotatable relative to the sheath. One or more seal members can optionally be included between the manifold and the sheath to prevent liquid and/or gas from escaping between the sheath and the manifold while permitting roll rotation of the sheath, together with the imaging instrument, relative to the manifold. Maintaining the manifold in a stationary position enables connection of hoses or other conduits to the cleaning device for supply of cleaning fluids, such as, for example, saline solution and carbon dioxide gas, without twisting or tangling the hoses as the cleaning device sheath is rotated with the imaging instrument to prevent the sheath from occluding the field of view.

In some embodiments, the cleaning device includes a sheath with a distal portion defining a fluid path to direct a flow of cleaning fluid toward the imaging instrument distal viewing portion without obstructing the field of view. In one embodiment, the sheath comprises a distal opening through which a distal end of the imaging instrument is exposed. The distal opening of the sheath has a diameter equal to or larger than a diameter of the distal viewing portion of the imaging instrument. For example, the sheath can be dimensioned such that it does not protrude radially inwardly beyond an outer periphery of the viewing portion.

Embodiments of cleaning devices of the present disclosure facilitate reliable and an unobstructed view through an imaging instrument, regardless of a roll orientation of the imaging instrument, while permitting in situ cleaning of the viewing portion of the imaging instrument.

Referring now to <FIG>, a schematic view of a cleaning device according to an embodiment of the present disclosure is shown. In the embodiment of <FIG>, the cleaning device <NUM> includes a sheath portion that is a tubular member <NUM> having a distal end <NUM> and a proximal end <NUM>. The sheath portion is dimensioned to fit around a shaft of an imaging instrument, such as imaging instrument <NUM> shown in <FIG>. The proximal end <NUM> of the tubular member <NUM> is coupled to and rotatable relative to a manifold portion <NUM> that receives a proximal end portion of the shaft of the imaging instrument. The manifold portion <NUM> comprises one or more fluid inlets <NUM> configured to be fluidically coupled with one or more supplies of cleaning fluid (e.g., a liquid or gas) (not shown). One or more fluid outlets (not shown in <FIG>) are fluidically coupled to the fluid inlets <NUM> by one or more fluid passages (also not shown). In some embodiments, the fluid passages are defined at least partially by the shaft of the imaging instrument when the shaft of the imaging instrument is received within the tubular member <NUM>, such as between the shaft and the tubular member <NUM>. The fluid passages can optionally be integrated with the tubular member <NUM>, such as being formed partially or completely within the wall of the tubular member <NUM>. The one or more fluid outlets are positioned such that when the imaging instrument shaft is within the tubular member <NUM>, the one or more fluid outlets are positioned proximate a distal viewing portion of the imaging instrument. Fluid flowing into the one or more fluid inlets <NUM> is directed through the one or more fluid passages and from the one or more fluid outlets to clear material from the viewing portion of the imaging instrument.

Referring now to <FIG>, an embodiment of a cleaning device <NUM> is shown installed on an imaging instrument <NUM>. The cleaning device <NUM> includes a tubular member <NUM> that covers the imaging instrument shaft <NUM>, as described with reference to <FIG> of the imaging instrument <NUM>. A manifold <NUM> of the cleaning device is positioned around a proximal end portion of the imaging instrument shaft <NUM> and is optionally configured to permit mating engagement of the imaging instrument <NUM> with an instrument carriage <NUM> configured to be operably coupled to the imaging instrument <NUM> to impart motion such as roll and/or other degrees of freedom to the shaft <NUM> of the imaging instrument <NUM>. The instrument carriage <NUM> can optionally be coupled to a teleoperated manipulator (such as manipulator arms <NUM>, <NUM>, <NUM>, <NUM>, <NUM> in <FIG> and <FIG> described below) that positions the imaging instrument <NUM> relative to a patient's body and, optionally, positions one or more other surgical instruments such as instruments <NUM>, <NUM>, <NUM> in <FIG> and <FIG>. A connector portion <NUM> of the imaging instrument <NUM> is configured to couple with the instrument carriage <NUM> through a sterile instrument adaptor <NUM>, and the connector portion <NUM> can optionally include various controls and connection components (such as a wire bundle <NUM>) for connection to other portions of a surgical system (not shown) such as manipulator controls or other input devices, display devices, power supplies, or other components. The imaging instrument shaft <NUM> includes a distal end portion <NUM>, at which a distal viewing portion such as a lens, window, or other imaging aperture is located.

The system shown in <FIG> further depicts a sterile adaptor surrounding the instrument carriage <NUM>. In the system of <FIG>, the sterile adaptor comprises a boot portion <NUM> coupled with an adaptor portion <NUM> that can optionally include intermediary drive devices, such as rotatable drive discs, to transfer drive forces from a teleoperated manipulator to the instrument carriage <NUM> across a sterile barrier formed by the sterile adaptor. The sterile adaptor can further include a sterile drape (not shown) attached to the boot portion <NUM> and used to maintain sterility of the subject site.

The cleaning device <NUM> extends from the connector portion <NUM> of the imaging instrument <NUM> to the distal end portion <NUM> of the shaft <NUM>. The manifold <NUM> is positioned proximate the instrument carriage <NUM> when the imaging instrument <NUM> is coupled to the instrument carriage <NUM>, and the tubular member <NUM> extends from the manifold <NUM> to the distal end portion <NUM> of the endoscope shaft <NUM>. The manifold <NUM> includes one or more fluid inlet ports <NUM>, <NUM> (two being shown in <FIG>) that are each configured to accept a flow of a cleaning fluid, such as one or more of saline solution and carbon dioxide, as discussed above. The one or more inlet ports <NUM>, <NUM> can optionally be configured to attach to hoses or other fluid supply tubes of a surgical system (such as manipulating system <NUM> shown in <FIG>) or supporting components of such a system. In an embodiment, the one or more inlet ports <NUM>, <NUM> are configured with Luer-type fittings (not shown); however, various other types of fluid connectors, or a direct attachment, also may be utilized.

The cleaning device <NUM> is configured to direct fluid introduced at the one or more inlet ports <NUM>, <NUM> to the distal end portion <NUM> of the shaft <NUM>. In various embodiments, the manifold <NUM> and tubular member <NUM> comprise one or more fluid passages extending between the one or more inlet ports <NUM>, <NUM> to a nozzle (e.g., nozzle portion <NUM> in <FIG>) located at a distal end of the tubular member <NUM> proximate the distal end portion <NUM> of the endoscope shaft <NUM>. In use, fluid travels from the one or more inlet ports <NUM>, <NUM>, through the one or more passages in the manifold portion <NUM> and the tubular member <NUM>, and exits the nozzle. Flow of fluid from the nozzle is directed adjacent (e.g., across) the distal viewing portion of the instrument, thus washing away bodily fluids, tissue, or other debris from the distal viewing portion and removing the debris from the distal viewing portion of the imaging instrument.

Referring now to <FIG>, an enlarged perspective view of the distal end portion <NUM> of the imaging instrument <NUM> with the cleaning device <NUM> of <FIG> is shown. A perimeter of the viewing portion <NUM> of the imaging instrument <NUM> is surrounded by the tubular member <NUM> of the cleaning device <NUM>. The tubular member <NUM> includes a nozzle portion <NUM> extending distally from the tubular member <NUM>. The nozzle portion <NUM> includes an outlet that is configured to direct a flow of fluid (e.g., fluid flowing into the one or more inlet ports <NUM>, <NUM> and along the fluid passages of the tubular member <NUM>) across the viewing portion <NUM> of the imaging instrument. For example, in the embodiment of <FIG>, the nozzle portion <NUM> includes a slotted outlet <NUM> that directs fluid flow over the viewing portion <NUM>. As shown in <FIG>, the nozzle portion <NUM> extends distally from the tubular member <NUM> such that it is positioned distally beyond the viewing portion <NUM> of the imaging instrument <NUM>. In some embodiments, the position and shape of the nozzle portion <NUM> are based on the size and shape of the field of view presented by the viewing portion <NUM> to a display or operator, and the nozzle portion <NUM> is positioned and configured to prevent obscuring any portion of the field of view of the viewing portion <NUM>.

In some embodiments in which the endoscope shaft <NUM> is configured to roll, the nozzle portion <NUM> could obscure at least a portion of the field of view if the imaging instrument has an asymmetrical field of view, and the imaging instrument is rotated relative to the nozzle portion <NUM> of the tubular member <NUM>. In some embodiments, the cleaning device <NUM> (<FIG>) optionally includes a rotatable coupling between the manifold portion <NUM> and the tubular member <NUM> to prevent the nozzle portion <NUM> from obscuring the viewing field. In this way, the tubular member of the cleaning device can rotate with the instrument shaft while the manifold remains stationary.

For example, referring now to <FIG>, a cross-sectional view of the manifold <NUM> and a proximal portion of the tubular member <NUM> of the cleaning device <NUM> is shown. The imaging instrument shaft <NUM> (shown in perspective in <FIG> and <FIG>) extends through the manifold <NUM> and the tubular member <NUM>. The manifold <NUM> is coupled with a proximal end of the tubular member <NUM> by a rotatable coupling <NUM>. In the embodiment of <FIG>, the tubular member <NUM> includes an inner sleeve <NUM>, an outer sleeve <NUM>, and a spacer member <NUM> between the inner sleeve <NUM> and the outer sleeve <NUM>. The inner sleeve <NUM> extends through the manifold <NUM> to a proximal collar <NUM> at a proximal end of the manifold <NUM>. The inner sleeve <NUM> is welded, swaged, or otherwise affixed to the proximal collar <NUM>. The outer sleeve <NUM> of the tubular member <NUM> extends at least partially into an annular relief <NUM> in the manifold <NUM> to maintain concentricity between the tubular member <NUM> and the manifold <NUM>. A distal collar <NUM> is affixed (such as by welding, an interference fit, or integrally formed with the outer sleeve <NUM>) around the outer sleeve <NUM>, and the manifold <NUM> is captive on the inner sleeve <NUM> between the distal collar <NUM> and the proximal collar <NUM>.

The rotatable coupling <NUM> optionally includes one or more seal members that ensure cleaning fluids do not leak from the cleaning device between the tubular member <NUM> and the manifold <NUM>. For example, in the embodiment of <FIG>, seal members <NUM> and <NUM> between the manifold <NUM> and the tubular member <NUM> prevent leakage of cleaning fluid through the rotatable coupling <NUM> while permitting rotational movement between the tubular member <NUM> and the manifold <NUM>.

In the embodiment of <FIG>, the seal members <NUM> and <NUM> are O-rings. In other embodiments, the seal members <NUM> and <NUM> can be or include other annular seal members such as, for example, a gasket or other suitable sealing structures. The seal members <NUM> and <NUM> can comprise materials such as, without limitation, natural or synthetic rubber, silicone, or other polymer materials. The seal members <NUM> and <NUM> are positioned between respective sealing surfaces of the manifold portion <NUM> and the tubular member <NUM>. In the embodiment of <FIG>, the seal member <NUM> is located between the distal collar <NUM> and the manifold <NUM>, and the seal member <NUM> is located between the proximal collar <NUM> and the manifold <NUM> to seal the tubular member <NUM> and the manifold <NUM> and prevent leakage of cleaning fluid from between components of the cleaning device.

In the embodiment of <FIG>, the endoscope shaft (e.g., shaft <NUM> in <FIG>) is inserted through the inner sleeve <NUM> to assemble the endoscope with the cleaning device. In other embodiments, the cleaning device can optionally be configured without an inner sleeve, and the shaft <NUM> of the endoscope device is inserted directly through the manifold <NUM> and spacer member <NUM>. In such embodiments, an outer surface of the endoscope shaft <NUM> functions in generally the same way as an outer surface of the inner sleeve <NUM>.

In various embodiments, the manifold <NUM> and tubular member <NUM> include features configured to facilitate flow of cleaning fluid from the manifold <NUM> and along the tubular member <NUM> to the nozzle portion <NUM> (<FIG>). Such features may be configured, for example, to reduce (e.g., minimize) turbulent flow as the fluid flows from the manifold <NUM> to the tubular member <NUM>. Additionally, such features may be configured to ensure that flow conditions between the manifold <NUM> and the tubular member <NUM> remain similar (e.g., the same) regardless of the rotational roll orientation of the tubular member <NUM> with respect to the manifold <NUM>. For example, referring still to <FIG>, the manifold <NUM> can include a portion with an interior diameter sized to create an annular relief <NUM> around the inner sleeve <NUM>. The annular relief <NUM> is in fluid communication with the one or more inlet ports <NUM>, <NUM>. Fluid flowing into the inlet ports <NUM>, <NUM> enters and fills the annular relief <NUM> surrounding the imaging instrument shaft <NUM>.

The tubular member <NUM> includes various features that facilitate flow of fluid from the manifold <NUM> to the nozzle portion <NUM> (<FIG>). Referring now to <FIG>, a partially hidden perspective view of the imaging instrument shaft and cleaning device according to the embodiment of <FIG> are shown to better illustrate a configuration of the tubular member <NUM>. The tubular member <NUM> includes the inner sleeve <NUM>, the outer sleeve <NUM>, and the spacer member <NUM> between the inner sleeve <NUM> and the outer sleeve <NUM> as discussed in connection with <FIG>. The spacer member <NUM> extends only partially around the circumference of the inner sleeve, leaving a longitudinally-oriented fluid passage <NUM> defined between the inner sleeve <NUM> and the outer sleeve <NUM>. Stated another way, the spacer member <NUM> has a longitudinal opening that together with the inner sleeve <NUM> and outer sleeve <NUM> forms the fluid passage <NUM> along the length of the tubular member <NUM> between the inner sleeve <NUM> and outer sleeve <NUM>. In embodiments in which the inner sleeve <NUM> is not included, the fluid passage <NUM> is at least partly defined by the shaft <NUM> (<FIG>) of the imaging instrument, the spacer member <NUM>, and the outer sleeve <NUM>. A proximal end <NUM> of the spacer member <NUM> features a sloped profile <NUM> that directs fluid from the annular relief <NUM> (<FIG>) to the fluid passage <NUM>. The sloped profile <NUM> can assist in reducing turbulence in the fluid flow and facilitates transition of the fluid flow from the annular relief <NUM> into the fluid passage <NUM>. Additionally, in some such embodiments, one or more of the inlet ports <NUM>, <NUM> are positioned offset relative to a longitudinal axis of the cleaning device to induce a rotational flow through the annular relief <NUM>. Offset inlet portions <NUM>, <NUM> can optionally be included in embodiments with a straight fluid passage, such as passage <NUM>, or with an annular passage extending to the distal end of the tubular member <NUM> and can reduce turbulent flow in the manifold and tubular member.

Referring now to <FIG>, a partially hidden view of a distal end portion of the cleaning device <NUM> (<FIG>) is shown. The distal end portion includes the nozzle portion <NUM>. As shown in <FIG>, the fluid passage <NUM> defined between the inner sleeve <NUM> and the outer sleeve <NUM> terminates at the nozzle portion <NUM>, with the outlet <NUM> being oriented to direct the flow from the fluid passage <NUM> across the face of the distal viewing portion <NUM> (<FIG>) of the imaging instrument. In some embodiments, the nozzle portion <NUM> can optionally include contours that smooth the flow of fluid and facilitate changing the direction of the cleaning fluid flow from the flow along the fluid passage <NUM> to the flow across the face of the endoscope viewing portion. In various other embodiments, the nozzle portion <NUM> can optionally include a sloped profile similar to the sloped profile <NUM> of the spacer member <NUM>, and the fluid passage can optionally have an annular shape along the length of the cleaning device.

In use, when the imaging instrument shaft <NUM> (<FIG>) is rolled, e.g., by activation of the instrument carriage <NUM> (<FIG>), the tubular member <NUM> rotates with the shaft <NUM> while the manifold <NUM> remains stationary with respect to the instrument carriage <NUM>. Relative rotation between the manifold and the tubular member permitted by the rotatable coupling <NUM> thus allows the tubular member to maintain a fixed rotational orientation relationship with the instrument as the shaft is rotated, thereby preventing occlusion of the field of view of the imaging instrument by the nozzle portion.

Various embodiments further provide for an equalization of an electrical potential that may exist at the imaging instrument shaft and an electrical potential of the body of the patient (e.g., a body electrical ground potential). In some embodiments, the tubular member <NUM> of the cleaning device can provide an electrically conductive path between the imaging instrument shaft <NUM> and an external surface of the tubular member <NUM>. In some embodiments, the inner sleeve <NUM> and outer sleeve <NUM> comprise an electrically conductive material, such as, for example, stainless steel. The nozzle portion <NUM> also can comprise an electrically conductive material arranged to be in electrically conductive contact with both the inner sleeve <NUM> and the outer sleeve <NUM>. The conductive material thereby forms an electrically conductive path from the instrument shaft <NUM>, which is in contact with the inner sleeve <NUM>, to the patient's body, which is in contact with the outer sleeve <NUM> through, e.g., a conductive cannula inserted through an incision in the patient's body. In other embodiments, the nozzle portion <NUM> comprises an optically transparent polymer, and other components of the cleaning device create an electrically conductive path between the imaging instrument shaft and the external surface of the tubular member <NUM>.

For example, a conductive element can be provided to conductively couple the inner sleeve <NUM> to the outer sleeve <NUM>. Referring now to <FIG>, a cross-sectional view of a tubular member <NUM> of a cleaning device according to another embodiment of the disclosure is shown. A conductive pin <NUM> is in conductive contact with inner sleeve <NUM> and outer sleeve <NUM>. The conductive pin <NUM> can be provided at any location between the inner sleeve <NUM> and outer sleeve <NUM> to provide conductive contact between the inner sleeve <NUM> and outer sleeve <NUM>. In other embodiments, the conductive pin <NUM> could be replaced by a conductive ring extending circumferentially around the tubular member <NUM>, or, alternatively, multiple conductive pins <NUM>. The conductive pin <NUM> or other conductive components can comprise materials such as metals or metal alloys, such as stainless steel, titanium or aluminum alloys, conductive composite materials such as carbon-impregnated polymers, or other electrically conductive materials.

Other components of a cleaning device can comprise materials chosen for ease of manufacturing and assembly. With reference to the embodiment of <FIG>, the spacer member <NUM> and the manifold <NUM> are made from a polymer such as, for example and not limitation, high density polyethylene (HDPE) or polycarbonate. In other embodiments, such components can comprise composite materials, plastics, metals or metal alloys, or other materials.

Referring now to <FIG>, a cleaning device tubular member <NUM> according to another embodiment of the disclosure is shown in perspective view. In the embodiment of <FIG>, a fluid passage <NUM> is enclosed by a conduit <NUM> located between an inner sleeve <NUM> and an outer sleeve <NUM>. As a non-limiting example, in the embodiment of <FIG>, the conduit <NUM> comprises a metal or a metal alloy, such as a stainless steel (e.g., iron alloy including nickel and/or chromium alloying elements), titanium alloy, or other metal. The inner sleeve <NUM> and outer sleeve <NUM> can comprise the same material as the conduit <NUM> or material different from the conduit <NUM>. In some embodiments, the inner sleeve <NUM>, outer sleeve <NUM>, and conduit <NUM> are welded to one another. The embodiment of <FIG> can optionally include a spacer device similar to spacer member <NUM> to direct fluid from the annular relief <NUM>, discussed above with reference to <FIG>, into the conduit <NUM>. In the embodiment of <FIG>, however, such a spacer would not be required to extend to the distal end of the tubular member <NUM>, because the fluid passage <NUM> is defined by the conduit <NUM>. In other words, in such an embodiment, the spacer only functions to direct fluid into the conduit <NUM> and does not extend along the length of the tubular member <NUM>.

<FIG> show another cleaning device according to an embodiment of the disclosure. Referring to <FIG>, a portion of a cleaning device <NUM> is shown with partially hidden lines to illustrate the interior portions of the cleaning device <NUM>. The cleaning device <NUM> includes a manifold <NUM> and a tubular member <NUM>, generally as described above with reference to the other embodiments. The manifold <NUM> and tubular member <NUM> are rotationally decoupled from one another, and the cleaning device <NUM> can optionally include a seal member (not shown), for example, similar to the seal member <NUM> shown in the embodiment of <FIG>. The manifold portion <NUM> comprises a central bore <NUM> configured to receive an imaging instrument shaft, such as shaft <NUM> (<FIG>). Surrounding the central bore <NUM> and extending longitudinally through a lateral wall <NUM> of the manifold <NUM> is a fluid passage <NUM> (also referred to as manifold fluid passage <NUM>) having a circumferential width W<NUM>. The fluid passage <NUM> is in fluid communication with a fluid inlet <NUM>. The tubular member <NUM> includes a plurality of fluid passages <NUM> (also referred to as tubular member fluid passages <NUM>) that each extend longitudinally through the tubular member <NUM> and have a width W<NUM> along the tubular member's circumference. The fluid passages <NUM> are in fluid communication with the fluid passage <NUM> at a junction between the manifold <NUM> and the tubular member <NUM>.

The width W<NUM> of the fluid passage <NUM> in the manifold <NUM> and the width W<NUM> of the fluid passages <NUM> in the tubular member <NUM> are chosen to facilitate fluid flow between the manifold fluid passage <NUM> and the tubular member fluid passages <NUM>. For example, the width and number of the respective fluid passages can be chosen and arranged so that the flow characteristics of the fluid flow from the manifold <NUM> to the tubular member <NUM> are similar for all rotational orientations of the tubular member <NUM> with respect to the manifold <NUM>. In the embodiment of <FIG>, the width W<NUM> of the manifold fluid passage <NUM> is larger than the width W<NUM> of the tubular member passages <NUM>. With the arrangement of the embodiment of <FIG>, regardless of the rotational orientation of the tubular member <NUM> relative to the manifold <NUM>, the manifold fluid passage <NUM> is always in fluid communication with one or more of the tubular member fluid passages <NUM>. In some embodiments, the manifold fluid passage <NUM> is always in fluid communication with at least two of the tubular member fluid passages <NUM>, at least three of the tubular member fluid passages <NUM>, or more than three of the tubular member fluid passages <NUM>. For example, as shown in the embodiment of <FIG>, the manifold fluid passage <NUM> is in communication with at least four of the tubular member fluid passages <NUM> regardless of the rotational orientation between the manifold <NUM> and the tubular member <NUM>.

Other arrangements and numbers of fluid passages in the manifold <NUM> and tubular member <NUM>, such as the tubular member fluid passages <NUM> having a width W<NUM> greater than a width W<NUM> of the manifold fluid passage <NUM>, multiple manifold fluid passages <NUM>, or other variations of the arrangement shown in <FIG>, are within the scope of the disclosure.

Referring now to <FIG> and <FIG>, a distal end portion of the imaging instrument cleaning device <NUM> shown in <FIG> is shown. A distal viewing portion <NUM> of the imaging instrument is exposed through an aperture <NUM> in the tubular member <NUM>. Referring to <FIG>, a cross-sectional view of the distal end portion of the cleaning device <NUM> of <FIG> and <FIG> is shown. Ridges <NUM> defined between the tubular member fluid passages <NUM> include portions <NUM> that extend radially inwardly and space the instrument shaft <NUM> from an annular lip <NUM> of the tubular member <NUM>, leaving a gap G between the distal viewing portion <NUM> and the annular lip <NUM> of the tubular member <NUM>. Fluid flowing down the tubular member fluid passages <NUM> exits the passages <NUM> and is redirected across the distal viewing portion <NUM> by the annular lip <NUM>. In the embodiment of <FIG>, the fluid flows radially inwardly across the imaging instrument's distal viewing portion <NUM> from locations around substantially the entire inside perimeter of the tubular member <NUM>, and the particular fluid passages <NUM> from which the fluid flows are determined by the rotational orientation between the tubular member <NUM> and the manifold <NUM>. In the embodiment of <FIG>, the tubular member <NUM> does not protrude radially inwardly beyond a perimeter of the viewing portion <NUM>, thereby preventing obstruction of the viewing portion <NUM> and the field of view thereof. In other embodiments, the tubular member <NUM> can optionally comprise a clear material, such as a transparent polymer, to mitigate obstruction of the viewing portion <NUM>, even if the tubular member <NUM> extends at least partly over the viewing portion <NUM>.

In the embodiments described above in connection with <FIG>, the tubular member and manifold of the cleaning devices are configured to rotate with respect to one another based on rotation of the endoscope shaft, e.g., driven by teleoperated manipulator (such as a teleoperated manipulator operatively coupled to instrument carriage <NUM> shown in <FIG>). Such an arrangement can enable rotation of the imaging device to provide different views of a remote site without the field of view being obscured by the cleaning device.

In other embodiments, imaging instrument cleaning devices are configured to avoid obscuring the field of view by configuring the distal end portion of the cleaning device such that no portion of the cleaning device enters the field of view of the imaging instrument, regardless of the roll orientation of the imaging instrument relative to the cleaning device. In such embodiments, the cleaning device can optionally comprise a sheath portion and a manifold portion that are fixedly coupled to one another, such as being integrally formed as a single monolithic piece or formed from two or more components affixed or otherwise joined to one another. Such embodiments can be used, for example, in arrangements in which the direction and orientation of fluid flow across the endoscope tip does not have to be at a fixed rotational orientation with reference to the endoscope.

For example, referring now to <FIG>, another embodiment of a cleaning device for an imaging instrument is shown. In the embodiment of <FIG>, the cleaning device <NUM> includes a tubular member <NUM> and a manifold <NUM> that are coupled in a non-rotatable manner, such as being integrally formed, or formed from multiple components and secured together, such as by adhesive, welding, or other securing mechanism. A distal end <NUM> of the tubular member <NUM> includes an aperture <NUM> with an inner diameter Din.

An imaging instrument shaft <NUM> extends through the tubular member <NUM>, and a distal viewing portion <NUM> of the imaging instrument is exposed through the aperture <NUM>. The shaft <NUM> has an outer diameter Dout. The inner diameter Din of the aperture <NUM> is equal to the outer diameter Dout of the shaft <NUM>. In some embodiments, the inner diameter Din of the aperture <NUM> is greater than the outer diameter Dout of the shaft <NUM>. As discussed above with reference to the embodiment of <FIG>, the tubular member <NUM> also does not protrude radially inwardly beyond the perimeter of the viewing portion <NUM> of the imaging instrument, thereby preventing obstruction of the field of view of the viewing portion <NUM>.

As shown in <FIG>, the tubular member <NUM> includes a fluid passage <NUM> through which fluid flows from the manifold portion <NUM> to a nozzle <NUM>. An annular lip <NUM> defined by the aperture <NUM> and extending radially inward at the distal end of the tubular member <NUM> redirects the fluid flow radially inwardly across the distal viewing portion <NUM> to wash debris or other matter from the distal viewing portion <NUM>.

In the embodiment of <FIG>, an inner sleeve <NUM> of the tubular member <NUM> includes a flared portion <NUM> that flares radially outward near the distal end of the tubular member <NUM>. The flared portion <NUM> flares away from the imaging instrument shaft <NUM> near the distal end of the shaft <NUM> to facilitate locating the nozzle <NUM> radially outward from the outside diameter of the shaft <NUM>. The nozzle <NUM> can optionally extend around the entire perimeter of the shaft <NUM> as an annulus, or alternatively, can comprise any number of discrete fluid flow paths located at any desired locations so as to be positioned around the perimeter of the shaft <NUM> as needed to facilitate flow of the fluid for cleaning the viewing portion <NUM>. In other embodiments, the tubular member <NUM> does not include the flared portion <NUM>, and the fluid passage <NUM> is positioned further radially outward, or with a gradual taper outward along the length of the tubular member <NUM>, to facilitate the inner diameter Din of the aperture <NUM> being greater than the outer diameter Dout of the shaft <NUM>.

In some embodiments, the imaging instrument may be operably coupled to a display device configured to receive data from the imaging instrument. For example, the display device may be part of a surgical system and display an image of the remote site, e.g., in a patient's body or target of interest, captured by the imaging instrument. The imaging instrument may also be operably coupled to a fluid control system to control flow of fluid introduced to the cleaning device, such as flow of one or both of saline solution and carbon dioxide or other fluids. A control system may further be configured (e.g., programmed) to control the display based on a status of the cleaning device. For example, because the fluids used to clear the viewing portion potentially disrupt or obscure view of the remote site of interest, the control system can optionally be configured to indicate to the viewer that the imaging instrument is undergoing a cleaning process. Such indication may be visual, auditory, haptic, and/or other suitable feedback. Additionally or alternatively, the control system can optionally be configured to modify the image displayed based on the cleaning device being in use. For example, in one embodiment the display changes from color to greyscale or other monochrome or alternative color scale to indicate that the imaging instrument is undergoing a cleaning process. In another embodiment, the display presents a blank screen or displays a message indicating the cleaning procedure is occurring.

In some embodiments, the control system is optionally configured to move the imaging instrument in a specified manner during cleaning to facilitate the cleaning process. For example, the control system may be configured to automatically roll the imaging instrument during a cleaning process. Such a process can optionally include rolling the imaging instrument a predetermined amount from an initial position while supplying a flow of cleaning fluid to the imaging instrument, and then rotating the imaging instrument back to the initial position while the cleaning fluid is flowing or after ceasing flow of the cleaning fluid. In some situations, rotation of the imaging instrument enables the cleaning fluid to clean the viewing portion more thoroughly by ensuring all portions of the viewing portion are exposed to the flow of cleaning fluid.

Additionally or alternatively, the control system can be configured to control a sequence of flow of the cleaning fluids input into the one or more fluid inlets (e.g., inlet ports <NUM>, <NUM> in <FIG>). In some embodiments, the control system is configured to flow saline solution (or another liquid) over the distal viewing portion to wash away tissue, body fluids, or other matter from the distal viewing portion. After the matter is removed by the liquid, the control system then flows a gas, such as nitrogen or carbon dioxide, across the distal viewing portion to clear the liquid to restore a clear view from the viewing portion.

The control system can optionally be further configured to prevent operator manipulation of the instrument and other surgical instruments during the cleaning process. In some embodiments, the control system is programmed to interrupt the ability of one or more user-controlled input devices from controlling corresponding teleoperated manipulators and associated surgical instruments, such as surgical instruments <NUM>, <NUM>, <NUM> in <FIG>. Since the cleaning process potentially interferes with operator view of the remote site of interest through the imaging instrument, this control interruption prevents the operator from operating the surgical instruments with an obstructed view of the remote site. In some embodiments, the control system automatically reestablishes the control relationship when the cleaning is complete. In other embodiments, the control system automatically reestablishes the control relationship on one or more conditions, such as a control input device has not moved beyond a predefined translation or orientation while the control relationship is interrupted. In still other embodiments the control system does not automatically reestablish a control relationship between an input device and its associated teleoperated manipulator until the input device operator commands the control system to do so.

Referring now to <FIG>, an embodiment of a workflow <NUM> for in situ cleaning of an imaging instrument is shown. At <NUM>, with an imaging instrument at a position of a remote site being imaged through a viewing portion of the imaging instrument, and in response to initiation of a cleaning process, the workflow <NUM> includes providing feedback indicative of the imaging instrument being in a cleaning state. The feedback can include, for example, changing an image displayed by a display device operably coupled to the imaging device from an initial state, e.g., to an indicating state in which the cleaning state is indicated. The initial state can include, for example, a full-color display of an image captured by the imaging device. The indicating state can include an indication that a cleaning process is being carried out. Such an indication can include, for example, one or both of changing the color scale of the display to, for example, grey scale, displaying an indicator, notice, or message on the display, blanking part or all of the display, or other indications. At <NUM>, a cleaning fluid is flowed across the viewing portion of the imaging device. The workflow <NUM> can further include returning the display device from the indicating state to the initial state. The display device can include, for example, display devices <NUM>, <NUM> discussed below in connection with <FIG> and <FIG>. Those having ordinary skill in the art would understand that the indication need not be a visual indication at the display, but can include or alternatively be auditory, haptic, and/or other types of feedback.

Embodiments of the disclosure provide cleaning devices that enable in situ cleaning of an imaging device viewing portion while the imaging instrument viewing portion is located to capture images of a remote site of interest without the need to remove the imaging device to access the viewing portion. Such devices are configured to prevent obscuring a field of view of the imaging instrument, thereby providing consistent and reliable visualization of a remote site of interest.

Embodiments incorporating inventive aspects described herein may be used, for example, with remotely operated, computer-assisted systems (such, for example, teleoperated surgical systems) such as those described in, for example, <CIT>, entitled "Multi-Port Surgical Robotic System Architecture", <CIT>, entitled "Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator", and <CIT>, entitled "Surgical System Instrument Mounting". Further, embodiments incorporating one or more aspects described herein may be used, for example, with a da Vinci® Surgical System, such as the da Vinci Si® Surgical System (model number IS3000) or the da Vinci Xi® Surgical System, both with or without Single-Site® single orifice surgery technology, all commercialized by Intuitive Surgical, Inc. Although various embodiments described herein are discussed with regard to imaging instruments used with a manipulating system of a teleoperated surgical system, the present disclosure is not limited to use with imaging instruments for a teleoperated surgical system. Various embodiments described herein can optionally be used in conjunction with hand-held, manual imaging instruments, or other imaging instruments that are configured to provide images of remote sites to assist in performing procedures remotely at such remote sites. For example, various space exploration and other remote inspection and/or sensing applications are considered within the scope of the present disclosure.

As discussed above, in accordance with various embodiments incorporating one or more aspects, devices of the present disclosure are configured for use in teleoperated, computer-assisted surgical systems (sometimes referred to as robotic surgical systems). Referring now to <FIG>, an embodiment of a manipulating system <NUM> of a teleoperated, computer-assisted surgical system, to which surgical instruments are configured to be mounted for use, is shown. Such a surgical system may further include a surgeon console (not shown) for receiving input from a user to control instruments of manipulating system <NUM>, as well as an auxiliary system, such as a control/vision cart (not shown), as described in, for example, <CIT> and <CIT>.

As those having ordinary skill in the art would appreciate, either or both of the surgeon console and the auxiliary system can include a display for displaying the images obtained from the imaging instrument.

As shown in the embodiment of <FIG>, manipulating system <NUM> includes a base <NUM>, a main column <NUM>, and a main boom <NUM> connected to main column <NUM>. Manipulating system <NUM> also includes a plurality of arms <NUM>, <NUM>, <NUM>, <NUM>, which are each connected to main boom <NUM>. Arms <NUM>, <NUM>, <NUM>, <NUM> each include an instrument mount portion <NUM> to which an instrument <NUM> may be mounted, which is illustrated as being attached to arm <NUM>. Portions of arms <NUM>, <NUM>, <NUM>, <NUM> may be manipulated during a surgical procedure according to commands provided by a user at the surgeon console. In an embodiment, signal(s) or input(s) transmitted from a user control system are transmitted to the auxiliary system, which may interpret the input(s) and generate command(s) or output(s) to be transmitted to the manipulating system <NUM> to cause manipulation of an instrument <NUM> (only one such instrument being mounted in <FIG>) and/or portions of arm <NUM> to which the instrument <NUM> is coupled at the manipulating system <NUM>.

Instrument mount portion <NUM> comprises a drive assembly <NUM> and a cannula mount <NUM>, with an instrument carriage <NUM> of the instrument <NUM> connecting with the drive assembly <NUM>, according to an embodiment. Cannula mount <NUM> is configured to hold a cannula <NUM> through which a shaft <NUM> of instrument <NUM> may extend to a surgery site during a surgical procedure. Drive assembly <NUM> contains a variety of drive and other mechanisms that are controlled to respond to input commands at the surgeon console and transmit forces to the instrument carriage <NUM> to actuate the instrument <NUM>, as those skilled in the art are familiar with.

Although the embodiment of <FIG> shows an instrument <NUM> attached to only arm <NUM> for ease of viewing, an instrument may be attached to any and each of arms <NUM>, <NUM>, <NUM>, <NUM>. An instrument <NUM> may be a surgical instrument with an end effector as discussed herein. A surgical instrument with an end effector may be attached to and used with any of arms <NUM>, <NUM>, <NUM>, <NUM>. The embodiments described herein are not limited to the embodiment of <FIG>, and various other teleoperated, computer-assisted surgical system configurations may be used with the embodiments described herein.

Other configurations of surgical systems, such as surgical systems configured for single-port surgery, are also contemplated. For example, with reference now to <FIG>, a portion of an embodiment of a manipulator arm <NUM> of a manipulating system with two surgical instruments <NUM>, <NUM> in an installed position is shown. The schematic illustration of <FIG> depicts only two surgical instruments for simplicity, but more than two surgical instruments may be received in an installed position at a manipulating system as those having ordinary skill in the art are familiar with. Each surgical instrument <NUM>, <NUM> includes an instrument shaft <NUM>, <NUM> that at a distal end has a moveable end effector or, if the instrument is an imaging instrument, an endoscope, camera, or other sensing device, and may or may not include a wrist mechanism (not shown) to control the movement of the distal end.

In the embodiment of <FIG>, the distal end portions of the instruments <NUM>, <NUM> are received through a single port structure <NUM> to be introduced into the patient. Other configurations of manipulating systems that can be used in conjunction with the present disclosure can use several individual manipulator arms. In addition, individual manipulator arms may include a single instrument or a plurality of instruments. Further, an instrument may be a surgical instrument with an end effector or may be a sensing instrument utilized during a surgical procedure to provide information, (e.g., visualization, electrophysiological activity, pressure, fluid flow, and/or other sensed data) of a remote site. Thus, one or more of the instruments may be an imaging instrument in accordance with various embodiments of the present disclosure.

The systems of <FIG> and <FIG> also may include an operably coupled display device, generally labeled as <NUM>, <NUM>. The display device <NUM>, <NUM> can include one or more displays that are part of the user control interface (now shown), and/or the auxiliary cart (not shown), and/or as a stand-alone component. The display device <NUM>, <NUM> may be operably coupled to receive image data from an imaging instrument operably coupled to one of the manipulator arms <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> to display images of the remote site, for example, real-time images, as those having ordinary skill in the art are familiar. The display device <NUM>, <NUM> also may be operably coupled to the control system of the teleoperated system and be configured to display various graphical user interface images that can be controlled based on system use parameters and to provide additional information regarding system status to a user.

This description and the accompanying drawings that illustrate various embodiments should not be taken as limiting. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the scope of the invention as defined by the appended claims.

In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Furthermore, elements and their associated features that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element may nevertheless be claimed as included in the second embodiment.

For the purposes of this specification and appended claims, unless otherwise indicated, all numbers expressing quantities, percentages, or proportions, and other numerical values used in the specification and claims, are to be understood as being modified in all instances by the term "about," to the extent they are not already so modified. Accordingly, unless indicated to the contrary, the numerical parameters set forth in the following specification and attached claims are approximations that may vary depending upon the desired properties sought to be obtained. Each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.

It is noted that, as used in this specification and the appended claims, the singular forms "a," "an," and "the," and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein, the term "include" and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.

Further, this description's terminology is not intended to limit the invention. For example, spatially relative terms-such as "beneath", "below", "lower", "above", "upper", "proximal", "distal", and the like-may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as "below" or "beneath" other elements or features would then be "above" or "over" the other elements or features. Thus, the exemplary term "below" can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated <NUM> degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.

Further modifications and alternative embodiments will be apparent to those of ordinary skill in the art in view of the disclosure herein. For example, the devices may include additional components or steps that were omitted from the diagrams and description for clarity of operation. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the present teachings. It is to be understood that the various embodiments shown and described herein are to be taken as exemplary. Elements and materials, and arrangements of those elements and materials, may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the present teachings may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of the description herein. Changes may be made in the elements described herein without departing from the scope of the invention as defined by the appended claims.

It is to be understood that the particular examples and embodiments set forth herein are non-limiting, and modifications to structure, dimensions, materials may be made without departing from the scope of the claims.

Claim 1:
A device for cleaning an instrument, the device comprising:
a manifold (<NUM>, <NUM>, <NUM>) comprising one or more fluid inlets (<NUM>, <NUM>, <NUM>, <NUM>); and
a tubular member (<NUM>, <NUM>, <NUM>, <NUM>) coupled to and rotatable relative to and extending distally from the manifold, the tubular member (<NUM>, <NUM>, <NUM>, <NUM>) comprising:
a proximal end (<NUM>),
a distal end,
a fluid outlet (<NUM>) at the distal end, the fluid outlet being configured to direct a flow of fluid generally across the distal end of the tubular member, and
one or more fluid passages (<NUM>, <NUM>, <NUM>) fluidically coupled to the fluid outlet (<NUM>), the one or more fluid passages (<NUM>, <NUM>, <NUM>) extending from the fluid outlet to the manifold (<NUM>, <NUM>, <NUM>);
wherein the manifold (<NUM>, <NUM>, <NUM>) and tubular member (<NUM>, <NUM>, <NUM>, <NUM>) are configured to receive a shaft of an imaging instrument extending through the manifold to the distal end of the tubular member.