Patent Description:
Visualization systems including video processing apparatus electrically connected to an intrusive medical device are known and are can be used for visual navigation into, and examination and diagnosis of, hollow organs and body cavities, as well as, optionally, to assist in surgery, e.g. for a targeted tissue sampling. Example intrusive medical devices include endoscopes and respiratory tubes. Endoscopes include procedure-specialized endoscopes, such as bronchoscopes, arthroscopes, cystoscopes, ureteroscopes, cholangioscopes, colonoscopes, laparoscopes, gastroscopes, and duodenoscopes. Respiratory tubes include endobronchial tubes, endotracheal tubes, tracheostomy tubes, and other tubes configured to ventilate at least a portion of the respiratory system or lungs of a patient, and may include a laryngeal mask or inflatable cuffs. A visualization system including an endoscope operable with a surgical tool is described in commonly-owned <CIT>. Respiratory tubes are described in commonly-owned <CIT>, <CIT>, <CIT>, and <CIT>. A visualization system including a portable medical monitor having a display screen is described in commonly-owned <CIT> and <CIT>. Document <CIT> describes a signal cable for an endoscope, the signal cable electrically connecting an image pickup section and a subsequent stage signal processing section of the endoscope. The signal cable consists of a bundle of at least four conductors twisted at a pitch of <NUM> to <NUM>.

An electrosurgical instrument may be guided through a lumen of the intrusive medical device to perform medical procedures within the patient's body cavity. Known electrosurgical tools, which are operated by high voltage pulses (e.g. in a range of <NUM> kV to <NUM> kV), may generate high frequency noise in signals and interference in videos apparent to a user during a procedure. An electrosurgical tool, which is configured to perform argon plasma coagulation (APC), is an example of such electrosurgical tool. Argon plasma coagulation is an electrosurgical, monopolar procedure for superficial hemostasis, devitalization and ablation using ionized argon gas, which as an inert gas can be easily ionized. High voltage pulses result in a strong electric field (high frequency) that may be experienced as a high frequency noise on electrical conductors. Electrical noise in video signals can also be caused by high camera clock speeds.

For single-use intrusive medical devices, it is important that the entire device be manufactured economically and inexpensively. Therefore, components of single-use intrusive medical devices are mainly made of polymeric materials to enhance disposability, reduce the size, and reduce costs.

Electrical noise can result in the loss of live images for various reasons, including "freezing" of the camera module (requiring a reset) and because the communication of configuration of control data to the camera goes wrong, i.e. data is written in wrong places, or the wrong data is written, in registers of the camera.

Furthermore, known intrusive medical devices may comprise diameters greater than <NUM> and might have enough space to not impose size or configuration limits on the electrical conductors. However, as the intrusive medical devices become smaller in size, particularly when their distal ends are <NUM> or less in diameter, which is desirable to mitigate tissue damage and facilitate navigation into the patient, it is desirable to reduce the size and configuration of the bundle.

Even further, it is desirable to present images on the display screen in real-time. Known medical monitors may employ image processing algorithms configured to mitigate the effects of electrical noise. For example, medical monitors might average frames of a video stream (e.g. a sequence of frames or images) or exclude frames from the video stream if the frames are defective, e.g. exhibit vertical or horizontal lines, exhibit large over or under-exposed areas, or are defective for other reasons. This may cause a physician to see a frame that is outdated, albeit by a fraction of a second, which is not ideal. If image processing algorithms are modified to present video streams at or closer to real-time, these video stream noise mitigation techniques are removed and the electrical noise in the intrusive medical devices has to be reduced or eliminated to ensure an adequate user experience.

Additionally, image processing algorithms may be modified to add features, such as navigation and tissue/object identification, which if added without removal of code may require larger, more expensive, hardware. Thus, removal of noise mitigation processing instructions may be enabled by improvements in the intrusive medical devices, resulting in overall cost reductions.

For at least the foregoing reasons, it is desirable to incorporate noise mitigation features in intrusive medical devices, particularly in single-use medical devices, to improve their value and, in particular, to improve their effectiveness when noise generating tools are used.

The objectives of the present disclosure are to provide an intrusive medical device with features that eliminate or at least reduce the disadvantages of the prior art intrusive medical devices and suitably deal with the above-described problems. In particular, it is an object of the present disclosure to present an intrusive medical device that exhibits reduced electrical noise relative to prior art intrusive medical devices.

The objectives of the present disclosure are satisfied by an intrusive medical device in accordance with claim <NUM> and by a visualization system in accordance with claim <NUM>. Advantageous embodiments are claimed in the dependent claims and/or are explained below.

In one embodiment according to the first aspect, an intrusive medical device comprises a proximal end and a distal end spaced apart from the proximal end; a tubular member defining a lumen therein, the tubular member extending from the proximal end to the distal end; a camera positioned at the distal end; and a bundle of at least four unpaired conductors, the bundle extending from the proximal end to the distal end and electrically connected to the camera at the distal end, wherein the bundle is twisted at a pitch of <NUM> +/- <NUM>.

In one variation according to the present embodiment, the at least four unpaired conductors include a ground conductor, a camera power conductor, a clock conductor and a data conductor, wherein the at least four unpaired conductors are arranged cross-sectionally with the data conductor positioned between two of the at least four unpaired conductors, and wherein the two of the at least four unpaired conductors does not include the clock conductor.

In one example of the present variation, the at least four unpaired conductors consist of five unpaired conductors including the ground conductor, the camera power conductor, the clock conductor, the data conductor, and a light power conductor, and the data conductor is positioned immediately next to the ground conductor and/or the camera power conductor and/or the light power conductor.

In some examples of the present embodiment, each of the conductors is insulated, and each of the conductors, without the insulation, comprises a diameter of between <NUM> and <NUM>.

In some examples of the present embodiment, at least three of the at least four conductors are coaxial.

In one variation of the present embodiment, the intrusive medical device comprises an endoscope including a positioning interface having a distal end; an insertion cord connected to and extending from the distal end of the positioning interface and comprising an insertion tube, a bending section, and a distal tip, the camera positioned in the distal tip, the tubular member extending from the positioning interface through the insertion tube to the distal tip, wherein the bundle extends from the positioning interface to the distal tip.

In one example according to the present variation, the bundle of at least four unpaired conductors is enclosed in an electrical shield. The distal tip may comprise a diameter smaller than <NUM>.

In one example according to the present variation, the bundle of at least four unpaired conductors is enclosed in an electrical shield and the electrical shield is electrically disconnected at the distal end of the bundle. The distal tip may comprise a diameter smaller than <NUM>.

In one example according to the present variation, the bundle of at least four unpaired conductors is enclosed in an electrical shield, the bundle has a proximal end, and the electrical shield is only grounded at the proximal end of the bundle. The distal tip may comprise a diameter smaller than <NUM>.

In further examples according to the present variation, the distal tip comprises a diameter smaller than <NUM>.

In further examples according to the present variation, the distal tip comprises a diameter smaller than <NUM>, the bundle of at least four unpaired conductors is enclosed in an electrical shield, and the electrical shield is electrically disconnected at the distal end of the bundle.

In another variation according to the present embodiment, the intrusive medical device comprises a tubular member having a circumferential wall defining a lumen therein; and an illumination lumen within the circumferential wall, wherein the camera and the bundle of at least four unpaired conductors are positioned in the illumination lumen.

In one example according to the present variation, the intrusive medical device comprises an inflatable cuff positioned at the distal end. The intrusive medical devise may comprise a dual-lumen tube comprising a medial wall dividing the lumen into a first lumen and a second lumen. The at least four unpaired conductors may include a ground conductor, a camera power conductor, a clock conductor and a data conductor, the at least four unpaired conductors are arranged cross-sectionally with the data conductor positioned between two of the at least four unpaired conductors, and the two of the at least four unpaired conductors does not include the clock conductor. The at least four unpaired conductors may consist of five unpaired conductors including the ground conductor, the camera power conductor, the clock conductor, the data conductor, and a light power conductor, and the data conductor may be positioned immediately next to the ground conductor and/or the camera power conductor and/or the light power conductor. At least three of the at least four conductors are coaxial.

In one example according to the present variation, the at least four unpaired conductors may include eight conductors including two pairs of twisted pair conductors. The at least four unpaired conductors may include eight conductors including a video out conductor positioned in a center of the bundle and surrounded by the other of the eight conductors.

In an embodiment according to the second aspect, a visualization system comprises an intrusive medical device according to the first aspect and any of the variations and examples thereof, and a video processing apparatus configured to communicatively connect with the intrusive medical device to receive a video stream therefrom.

A person skilled in the art will appreciate that any one or more of the above aspects of this disclosure and embodiments thereof may be combined with any one or more of the other aspects of this disclosure and embodiments thereof.

Embodiments of this disclosure will be described in more detail in the following with regard to the accompanying figures. The figures are not to be construed as limiting other possible embodiments falling within the scope of the attached claim set.

The term "distal," as used herein, refers to a direction or position that is generally towards a target site, and the term "proximal," as used herein, refers to a direction or position that is generally away from the target site.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. In case of conflict, the present document, including definitions, will control. Preferred apparatuses and materials are illustrated below, although apparatuses, and materials similar to those illustrated herein may be used in practice or testing. The materials, and examples disclosed herein are illustrative only and not intended to be limiting.

As described herein, an intrusive medical device may comprise a proximal end and a distal end spaced apart from the proximal end; a camera positioned at the distal end; and a bundle of at least four unpaired conductors, the bundle extending from the proximal end to the distal end and electrically connected to the camera at the distal end, the at least four unpaired conductors including a ground conductor, a camera power conductor, a clock conductor and a data conductor, the bundle twisted at a pitch of <NUM> +/- <NUM>. The intrusive medical device may comprise an endoscope.

An intrusive medical device may comprise a proximal end and a distal end spaced apart from the proximal end; a tubular member defining a lumen therein, the tubular member extending from the proximal end to the distal end; a camera positioned at the distal end; and a bundle of at least four unpaired conductors, the bundle extending from the proximal end to the distal end and electrically connected to the camera at the distal end, the at least four unpaired conductors including a ground conductor, a camera power conductor, a clock conductor and a data conductor, the bundle twisted at a pitch of <NUM> +/- <NUM>.

Advantageously, whether with or without a tubular member defining a lumen therein, the intrusive medical device as described above mitigates electrical noise. The electrical noise might be cross-talk and/or generated by an electro-surgical tool (EST) or other electromagnetic field, while reducing the cost of a bundle as compared to use of paired twisted wires or coaxial cables. The data conductor may transfer digital or analog video data. The data conductor may also transfer control signals in addition to video signals.

The at least four unpaired conductors may be arranged cross-sectionally with the data conductor positioned between two of the at least four unpaired conductors, where the two of the at least four unpaired conductors do not include the clock conductor.

The bundle of at least four unpaired conductors may be enclosed in an electrical shield. The electrical shield may be electrically disconnected at the distal end of the bundle. The bundle has a proximal end. The electrical shield may only be grounded at the proximal end of the bundle.

Having described intrusive medical devices generally, attention is now directed to more detailed descriptions of embodiments of said intrusive medical devices.

<FIG> are schematic diagrams of an embodiment of a visualization system <NUM> including a video processing apparatus <NUM> electrically connected to an intrusive medical device <NUM> by a cable <NUM> and a cable connector <NUM>. Examples of the intrusive medical device <NUM> include endoscopes (described with reference to <FIG>), dual-lumen tubes (described with reference to <FIG>), and any other device configured for insertion into the body of a patient, human or animal, and containing illumination means at a distal end thereof. An electrosurgical tool EST useable with the visualization system <NUM> is also shown. Some of the features of the intrusive medical device <NUM> shown in <FIG> illustrate optional features and components. Embodiments of illumination means include light emitting diodes (LEDs) and fiber lightguides extending from the proximal end 40p to the distal end 40d and connected, at the proximal end, to an illumination source such as an LED.

As shown in <FIG> and described in detail further below, the video processing apparatus <NUM> comprises a cable connector receptor <NUM>, an input circuit <NUM>, and a processor <NUM>. Optionally, the VPA <NUM> may include a housing supporting a display screen connected to the processor <NUM> and operable to present images provided by the processor <NUM>. A VPA with a display screen is described with reference to <FIG>. A VPA without display screen is described with reference to <FIG> and <FIG>. The input circuit <NUM> may comprise a deserializer circuit to convert the data or signals provided by an image sensor of a camera from serial to parallel format. The processor <NUM> may comprise an FPGA, CPU, GPU, and combinations thereof. An FPGA may be programmed to conduct video processing to improve the images and a CPU may be provided to configure a graphical user interface (GUI) and superimpose the GUI onto the images. The combined content may be supplied to the FPGA, which may be connected to a video output circuit.

The intrusive medical device <NUM> has a proximal end 40p and a distal end 40d spaced apart from the proximal end 40p and comprises the cable <NUM> and the cable connector <NUM>, an optional positioning interface <NUM>, an optional circuit board <NUM>, a tubular member <NUM> having a proximal end 50p, a distal end 50d, and a tubular member wall <NUM> defining a lumen <NUM> configured to receive therethrough the EST. The tubular member <NUM> extends from the proximal end 40p to the distal end 40d.

The intrusive medical device <NUM> also comprises a camera <NUM>, an optional circuit board <NUM>, optional light emitting diodes (LED) <NUM>, a bundle <NUM> of electrical conductors, an optional electrical shield <NUM>, and an optional proximal-end shield ground <NUM> (e.g. a connection of the electrical shield <NUM> to ground). The camera may include an image sensor, lenses and a lens support coupled with the image sensor. The image sensor may have a cross-section of less than <NUM> on each side, preferrably less than <NUM> on each side. The bundle <NUM> of electrical conductors extends from the distal end 50d to at least the proximal end 50p. The bundle <NUM> comprises at least four unpaired conductors <NUM> connected to the camera <NUM> at the distal end 50d. In some embodiments, the at least four unpaired conductors <NUM> include a ground conductor, a camera power conductor, a clock conductor and a data conductor. The bundle <NUM> is twisted at a pitch P. In some embodiments, the pitch P is in a range of <NUM> +/- <NUM>. In some embodiments, the pitch P is in a range of <NUM> to <NUM>.

As described with reference to <FIG>, the intrusive medical device may comprise a tubular member defining a lumen extending from the proximal end to the distal end. However, the intrusive medical device may be devoid of such a lumen. For example, some endoscopes are used for inspection and can be introduced into the patient through a lumen of another intrusive medical device that has one or more lumens. The advantages of the electrical noise mitigation features described herein are equally applicable to such an endoscope because electrosurgery may be conducted with different tools and systems. In some systems the EST is introduced through the lumen of the intrusive medical device <NUM>. In some systems the EST is not introduced through the lumen of the intrusive medical device <NUM>.

<FIG> illustrates an example of an electrosurgery system <NUM> comprising two electrodes, <NUM> and <NUM>, that form an electrical path <NUM> via the patient's body. The EST, e.g. electrode <NUM>, may be introduced into the patient through a lumen of a tubular member (not shown). A separate bundle <NUM> connected to the camera <NUM> and the cable <NUM> is shown to illustrate that the bundle <NUM> does not necessarily form part of an intrusive medical device having the tubular member through which the EST is introduced into the patient. The cable <NUM> is connected to a VPA <NUM>, which is described with reference to <FIG> and includes a separable display screen <NUM> and a display screen support <NUM>, which is configured, in normal use, to be detachable from the VPA <NUM> and the display screen <NUM>. The display screen is operable to present images and video streams generated and transmitted by the camera <NUM>. A VPA <NUM> (described below) may be used instead of the VPA <NUM>.

<FIG> show an embodiment of an intrusive medical device <NUM>, exemplified by an endoscope <NUM>, comprising a positional interface exemplified by a handle <NUM>, which includes a steering control <NUM> operable to steer the distal end of the endoscope <NUM>, as is known in the art, by alternativelly pulling on steering cables <NUM>, shown in <FIG>, responsive to movement of the steering control <NUM>. The endoscope <NUM> comprises an insertion cord <NUM> having a proximal end 150p and a distal end 150d, the insertion cord <NUM> including an insertion tube <NUM> and a bending section <NUM>. A distal tip comprising a tip housing <NUM> extends from the bending section <NUM>. The camera <NUM> is positioned in the tip housing <NUM>. The camera <NUM> may at least partly be positioned in the tip housing <NUM>. The bending section <NUM> may comprise a single-piece polymeric structure comprising a plurality of segments <NUM> intermediate a proximal segment <NUM> and a distal segment <NUM> that is connected to the tip housing <NUM>. The segments are interconnected by polymeric strips <NUM>, or hinges, which form part of the one-piece structure and bend upon tensioning of the steering cables <NUM>. A working channel tube <NUM>, which is an example of the tubular member <NUM>, provides the lumen <NUM> for introduction of the EST.

Instead of a single-piece polymeric structure, the bending section can also be assembled from multiple pieces. Such assemblies may be formed from two single-piece polymeric structures that elongate and form two, opposing, longitudinal halves of the finished bending section. Such assemblies may also be formed from individual segments assembled via hinges.

The endoscope <NUM> may be a single-use device. Single-use devices are designed to be low cost and disposable, not to be cleaned and sterilized after use and not to be used after cleaning.

A positioning interface functions to control the position of the insertion cord. A handle is an example of a positioning interface and, unless stated otherwise, the terms are used interchangeably. The handle also functions to provide the steering control, e.g. knobs, levers, buttons, and the like, to steer the field of view of the camera. Alternatively, a different positioning interface can be provided that is connected to the insertion cord and is detachably connected to a robotic arm. The insertion cord thus extends from the robotic arm, and the intrusive medical device is detachable from the robotic arm. The robotic arm responds to signals, including voice commands from an operator, to rotate, translate, and otherwise position the proximal end of the insertion cord, as an operator would do manually. The positioning interface can include control actuators, including manual control actuators. Alternatively or additionally, control actuators can be provided in or on the robotic arm or by the robotic system including the robotic arm, thereby potentially reducing the cost of the intrusive medical device. Example control actuators include single axis actuators, including linear motion actuators. A linear motion actuator may comprise a threaded rod coupled to a threaded nut portion, in which a motor rotates the rod to translate the nut portion.

<FIG> is a schematic view of a cross-section A-A of the bending section <NUM> showing a cross-section of one of the segments, a cross-section of the working channel tube <NUM>, the lumen <NUM>, or working channel lumen, the steering cables <NUM>, steering cable guide tubes <NUM>, and the bundle <NUM> of electrical conductors <NUM>. The steering cable guide tubes <NUM> surround the steering cables <NUM>, which are connected to the tip housing <NUM> at one end and to the steering control <NUM> at the opposite end. A wall of the segment <NUM> (not shown in <FIG>) comprises cut-outs or apertures through which the steering cable guide tubes <NUM> pass. Examples of the cut-outs or apertures are shown and described with reference to <FIG>. A sleeve (not shown) may be provided over the bending section <NUM> to fluidly seal the spaces between adjacent segments <NUM>. The outer diameter of a segment <NUM> may be substantially similar or the same as the outer diameter of the tip housing <NUM>. In some embodiments the outer diameter is less than <NUM>, less than <NUM>, less than <NUM>, less than <NUM>, and even less than <NUM>.

In a variation A of the present embodiment, the wall thickness of the wall of the working channel tube is between, and including, <NUM> and <NUM>, preferrably between, and including, <NUM> and <NUM>, and more preferrably about <NUM>, and the external diameter of the working channel tube is between, and including, <NUM> and <NUM>, preferrably between, and including, <NUM> and <NUM>, and more preferrably between, and including, <NUM> and <NUM>.

In a variation B of the present embodiment, a diameter of the camera cable, which includes the conductors and may comprise the shield, is between, and including, <NUM> and <NUM>, preferrably between, and including, <NUM> and <NUM>, and more preferrably between, and including, <NUM>, and the external diameter of the working channel tube is between, and including, <NUM> and <NUM>, preferrably between, and including, <NUM> and <NUM>, and more preferrably between, and including, <NUM> and <NUM>.

In a variation C of the present embodiment, an internal diameter of the insertion tube is less than <NUM>, or less than <NUM>, or less than <NUM>.

Variations of the present embodiment may be combined to form additional variations of the embodiment. Thus, variation A may be combined in a new variation with variation B, variation A may be combined in a new variation with variation C, variation A may be combined in a new variation with variations B and C, and variation B may be combined in a new variation with variation C.

<FIG> provide examples of segment walls provided to maintain separation of the steering cables <NUM> and secure the bundle <NUM> in the bending section <NUM>. <FIG>, for example, shows a common opening <NUM> defining a working channel tube aperture <NUM>, steering cable cut-outs <NUM> (cut out from the periphery of the working channel tube aperture <NUM>), and a bundle cut-out <NUM>. Providing the cut-outs around the working channel tube aperture <NUM> allows for reduction of the diameter and increased flexibility of the bending section <NUM>. <FIG> shows another example of the opening <NUM> in a bending section <NUM>. The opening <NUM> in this example includes, as in <FIG>, three cut-outs for the steering cables <NUM> and the bundle <NUM>. Additional tubes may be provided in the cut-out <NUM> due to its relatively larger cross-sectional area relative to the cross-section of the bundle <NUM>. <FIG> shows an example of a common opening <NUM>' in a bending section <NUM>. The opening <NUM>' in this example includes, as in <FIG>, a cut-out for the the bundle <NUM>, and perhaps for other tubes or components, and apertures <NUM>' for steering cables <NUM>. Additional tubes may be provided in the cut-out <NUM> due to its larger, relative to the cross-section of the bundle <NUM>, cross-sectional area. <FIG> shows an example of the common opening <NUM> in a bending section <NUM>. The bending section <NUM> differs from the bending section <NUM> in that cut-outs are provided for the steering cables <NUM> instead of openings. As used herein, common opening refers to an opening that accomodates a working channel tube and one or more of steering cables and a bundle. As shown, accomodation of the steering cables and bundle is provided by cut-outs. Openings for the working channel tube, steering cables and the bundle can also be provided, size permitting, via individual openings instead of a common opening.

The camera <NUM> may have a cross-section of less than <NUM> on each side. The outside diameter of the tip housing <NUM> may be about <NUM>, and preferrably about <NUM>, and more preferrably <NUM> or less. The term "about" is intended to define a range of +/- <NUM>% from the specified numeral.

As the dimensions of the camera and the bending section are continuously reduced for the benefit of the patient, the size of the wires and cables increase as a percentage of the cross-section. It is valuable, to continue reductions in size and cost, to identify cable configurations, the cables comprising the wires, shielding, jacket, etc., that use smaller wires while still avoid the negative effects of electrical noise. The success of the mitigation effort is dependent on the image sensor and deserializer used, the length of the bundle, and the structure surrounding it.

<FIG> show another embodiment of an intrusive medical device <NUM>, exemplified by a dual-lumen tube <NUM>. <FIG> shows a cross-section B-B of the tube <NUM>. The dual-lumen tube <NUM> comprises a tubular member 200a having a peripheral (or circumferential) wall <NUM> defining a first lumen <NUM> and an illumination lumen <NUM> therein. The camera <NUM> and LEDs <NUM> are positioned in the illumination lumen <NUM> located in the wall of the tube <NUM>.

The dual-lumen tube can be an endobronchial or an endotracheal tube, for example. The dual-lumen tube <NUM> may also have a second lumen <NUM>. The peripheral wall <NUM> may consist of a first portion <NUM> and a second portion <NUM> divided by a medial wall <NUM>. An inflatable cuff <NUM> is provided at the distal end and is connected via an inflation lumen (not shown) to an inflation tube <NUM> that can be connected to a pump to inflate the cuff <NUM>. As with the endoscope <NUM>, it is desirable to reduce the size of the device and increase its flexibility, for example by reducing the wall thickness of the tube, which requires reductions in the size of the camera <NUM> and the bundle <NUM>. Although not shown, the bundle <NUM> is positioned in the illumination lumen <NUM> and communicativelly connects the camera <NUM> with the cable connector <NUM>. A single-lumen tube can also include the features described herein, including the first lumen <NUM>, the camera <NUM>, the LEDs <NUM>, and the bundle <NUM>, positioned in the illumination lumen <NUM> located in a wall of the tube <NUM>.

A VPA <NUM> with a display screen <NUM> is shown in <FIG>. The VPA <NUM> includes a housing <NUM> and one or more cable connector receptor <NUM> configured to receive the cable connector <NUM>. The housing <NUM> supports and is assembled in one-piece with the display screen <NUM>, referred to as an "integral" display screen, by contrast with a "separable" display screen. The terms "integral" and "separable" reflect a device in its assembled form, as it is in use, by contrast with a device in its unassembled or disassembled form. A VPA <NUM> without a display screen <NUM> is shown in <FIG> and was previously shown in <FIG> with a separable display screen <NUM>. The VPA <NUM> includes a housing <NUM> and one or more cable connector receptacles <NUM> configured to receive the cable connector <NUM>. In both the VPA <NUM> and the VPA <NUM>, a separable display screen can be communicativelly connected thereto, as is known in the art, via an ethernet, wireless, AVI, HDMI, or other data interfaces. Upon connection of an intrusive medical device <NUM>, the VPA <NUM> or <NUM> present images or video streams on the integral and/or the separable display screen, as is known in the art.

In the foregoing description intrusive medical devices were described, the intrusive medical devices comprising: a proximal end and a distal end spaced apart from the proximal end; a camera positioned at the distal end; and a bundle of at least four unpaired conductors, the bundle extending from the proximal end to the distal end and electrically connected to the camera at the distal end, the bundle twisted at a pitch of <NUM> +/- <NUM>. In some embodiments but not others, the intrusive medical devices include a tubular member defining a lumen therein, the tubular member extending from the proximal end to the distal end of the device. In some embodiments but not others, the at least four unpaired conductors include a ground conductor, a camera power conductor, a clock conductor and a data conductor. Embodiments of the bundle <NUM> are described below.

Attention is now directed to an embodiment of the bundle <NUM>, shown in <FIG>, which is denoted by numeral <NUM>. <FIG> is a schematic depiction of the position of conductors <NUM> in the bundle <NUM>. Each conductor may be a wire, illustrated by a stranded wire comprising <NUM> strands. Each conductor is surrounded by an insulator <NUM>. The bundle <NUM> includes four wires <NUM>. A filler <NUM> of standard materials may be included. Each wire might also be a solid wire or a stranded wire with more or less than <NUM> strands. The insulator might be a plastic sheath or a coated insulator. The wires are selected based on their current carrying capacity and physical strength and therefore may be larger or smaller depending on their function. To reduce size and increase flexibility of the tubular member, it is desirable to use the smallest wire that can perform the selected function. Therefore, one of the wires might be larger than another of the wires. The voltage drop across the length of a wire is another limiting factor in some functions. For example, too much voltage drop, due to too small wire diameter, can cause image degradation in the data conductor of the bundle. The bundle <NUM> may be enclosed in a protective sleeve, or jacket, <NUM> that provides strength to the bundle, permitting use of smaller gauge wires, and which also maintains the pitch of the bundle. The inventors have found that particular combinations of wires, wire positions, and pitch result in surprisingly good electrical noise mitigation, for example, but not necessarily exclusivelly, of cross-talk between the clock onto the video signal.

A <NUM>-wire bundle as depicted in <FIG> is operable with image sensors comprising four connection pads. Such image sensors and pad arrangements have been developed to reduce the size of the image sensor. Reductions in bundle cross-section area are thus beneficial to reduce the cross-section area of the intrusive medical device <NUM> and benefit from use of smaller cameras. The power conductor in a <NUM>-wire bundle may provide power to both the camera and the LEDs. The LED's may, alternatively, be powered by a <NUM>th conductor.

In a variation A of the present embodiment, the bundle <NUM> of wires, which is denoted by numeral <NUM> in <FIG>, is surrounded by an electrical shield <NUM> in addition to a jacket <NUM>. The wires are not coaxial wires and thus are not individually shielded.

In a variation B of the present embodiment, some of the wires of the bundle <NUM>, which is denoted by numeral <NUM> in <FIG>, are individually shielded. The bundle <NUM> differs from the bundle <NUM> in that one of the wires, denoted by numeral <NUM>, is not coaxial and the other wires, denoted by numeral <NUM>, are coaxial and include an insulation <NUM>, an electrical shield <NUM> surrounding the insulation, and a jacket <NUM> surrounding the electrical shield. A binder tape <NUM> is provided to maintain the pitch of the twisted bundle, which may be a <NUM>, <NUM>, <NUM>, <NUM>, or <NUM> pitch or between <NUM> and <NUM>. The bundle <NUM> is devoid of an electrical shield surrounding the bundle. If space allows, a jacket can be provided instead of in addition to binder tape. However, because tape is thinner, tape is preferrable as space limitations increase.

In an example of variation B, the wire <NUM> is larger than the wire <NUM>. In one example, the wire <NUM> is at least a <NUM> American Wire Gauge (AWG) wire and may be larger, e.g. a <NUM> AWG wire, and the wire <NUM> is at most a <NUM> AWG wire, preferrably a <NUM> AWG wire. The bundle <NUM> together with the binder tape may be referred to as a "image sensor cable". Generally, the term "image sensor cable" refers to the combination of conductors, shield(s), and jackets that are assembled together and extend through the insertion tube as a unit. Wire gauge may also be based on the length of the cable. If the image sensor cable (inside the device) is <NUM> or less a thinner gauge may be used than if the cable is longer.

In another variation, C, of the present embodiment, all the wires are coaxial and the image sensor cable is devoid of an electrical shield surrounding the entire bundle.

In a further variation, D, of the present embodiment, the conductors comprise the same type and size of conductor.

Variations of the present embodiment may be combined to form additional variations of the embodiment. Thus, variations A and B may be combined in new variations with variations C, D, and C and D.

In a further example, the image sensor cable comprises three coaxial insulated cables and a non-coaxial conductor. The non-coaxial conductor may be the LED power conductor. The coaxial cables may be for image sensor power, signal out, and clock/data.

In a yet further example, the image sensor cable comprises three coaxial uninsulated cables and a non-coaxial conductor. The non-coaxial conductor may be the LED power conductor. The shields of the coaxial cables in this example may touch. The advantages of avoiding the insulation is reductions in size and cost.

Another embodiment of the bundle <NUM>, which is denoted by numeral <NUM>, will now be described with reference to <FIG>, which is a schematic depiction of the position of the wires <NUM>. The bundle <NUM> differs from the bundle <NUM> in that it includes a separate power wire for the LEDs. Provision of a separate power wire enables control of the LED power via a current source without the provision of a voltage regulator or other power division means to divide the power provided by the camera power wire to the camera and LEDs. Avoidance of power division means at the distal end of the intrusive medical device also enables reduction of the size of the intrusive portion, e.g. the distal end, of the intrusive medical device. In the present embodiment, the at least four unpaired conductors consist of five unpaired conductors including the ground conductor, the camera power conductor, the clock conductor, the data conductor, and a light power conductor, and the data conductor is positioned immediately next to the ground conductor and/or the camera power conductor and/or the light power conductor. In other embodiments, the at least four unpaired conductors may comprise five unpaired conductors including the ground conductor, the camera power conductor, the clock conductor, the data conductor, and a light power conductor, and the data conductor is positioned immediately next to the ground conductor and/or the camera power conductor and/or the light power conductor.

In a variation A of the present embodiment, an electrical shield surrounds the bundle of conductors and a sheath or jacket surrounds the electrical shield. The bundle, electrical shield and jacket may be referred to, collectivelly, as a cable.

In a variation B of the present embodiment, the conductors comprise the same type and size of conductor. In one example of the present variation, the conductors are <NUM> AWG conductors. In another example of the present variation, the conductors are <NUM> AWG conductors.

In a variation C of the present embodiment, at least some of the wires are coaxial and the cable is devoid of an electrical shield that surrounds the bundle of wires.

Variations of the present embodiment may be combined to form additional variations of the embodiment. Thus, variation A may be combined in a new variation with variation B. Variations A and B may be combined with variation C in a new variation.

In the embodiments of the bundles described in the preceeding two paragraphs, e.g. bundles <NUM>, <NUM>, <NUM> and <NUM>, the data conductor and the clock conductor are arranged cross-sectionally with the data conductor positioned between two of the at least four unpaired conductors, the two of the at least four unpaired conductors not including the clock conductor. In other words, the power or ground conductors are positioned next to the data conductor, and the clock conductor is positioned next to the power or ground conductors but separated from or opposite the data conductor. Clockwise, the conductors may be arranged in the following orders: (A) data, ground, clock, and power, (B) data, power, clock, and ground, (C) data, ground, clock, camera power, and LED power, (D) data, ground, clock, LED power, and camera power, (E) data, camera power, LED power, clock, and ground, or (F) data, LED power, camera power, clock, and ground. If more conductors are present, they may be positioned in between any conductors in the foregoing orders. The conductors, without the insulation, may comprise a diameter greater than <NUM> and smaller than <NUM>. The conductors, with the insulation, may comprise a diameter greater than <NUM> and smaller than <NUM>. Separation of the data and clock wires/conductors has resulted in sufficient electrical noise mitigation from cross-talk from the clock signal. The data cable may be used to transfer an analog out signal from the camera and control signals between the camera and the VPA. The analog out signal includes the video frames and images. The control signals may be provided via a serial peripheral interface (SPI) and multiplexed with the analog signals and may include gain and exposure camera settings.

In the embodiments of the bundles described in the preceeding three paragraphs, e.g. bundle <NUM> and bundle <NUM>, the bundle of at least four unpaired conductors may be enclosed in an electrical shield. The electrical shield may be electrically disconnected at the distal end of the bundle. The bundle has a proximal end. The electrical shield may only be grounded at the proximal end of the bundle. The electrical shield may be comprised by a foil or braid. Other types of electrical shields may be used as well.

The uninsulated wires range in size (e.g. diameter) from <NUM> AWG to <NUM> AWG. As is well known, AWG denotes the American Wire Gauge standard. Dimensions of the wires are given in ASTM standard B <NUM>. The AWG tables are for a single, solid and round conductor. The AWG of a stranded wire is determined by the cross-sectional area of the equivalent solid conductor. Because there are also small gaps between the strands, a stranded wire will always have a slightly larger overall diameter than a solid wire with the same AWG. <NUM> AWG wire, for example, has an outer diameter of <NUM>. <NUM> AWG wire has an outer diameter of <NUM>. <NUM> AWG wire has an outer diameter of <NUM>. <NUM> AWG wire has an outer diameter of <NUM>. <NUM> AWG wire has an outer diameter of <NUM>. <NUM> AWG wire has an outer diameter of <NUM>. In one example, the <NUM> AWG wire insulation thickness is <NUM>, bringing the total outer diameter of the insulated wire to <NUM>.

In some embodiments, the bundle of conductors comprises eight conductors, as shown in the cable <NUM> depicted in <FIG>. Each of the conductors <NUM> is surrounded by an insulation <NUM> and the bundle is surrounded by a jacket <NUM> without an electrical shield. The conductors, depicted as A1-A8 in <FIG>, are ordered with the A8 conductor in the center of the bundle. The conductors may be as follows. The function names are based on a serial camera control bus (SCCB) interface:.

In one embodiment, the A8 conductor is the Vout conductor.

In some embodiments, at least four of the wires comprise two twisted pairs of wires. The twisted pairs may comprise Vout and ground, and clock and ground. The twisted pair including Vout is positioned in the perimeter of the bundle, not in the center. Additional wires may be twisted or untwisted. In one example, four of eight wires are untwisted.

Generally, all the wires are at most <NUM> AWG wires in size, and may be <NUM>, <NUM>, <NUM><NUM> or <NUM> AWG wires. Smaller gauge wires can aid in reducing the cross-sectional size of the intrusive portion of the intrusive medical device and increasing bending flexibility but at the expense of noise sensitivity. When size reduction is not needed heavier gauge wires may be preferrable.

Although some embodiments have been described and shown in detail, the invention is not restricted to them but may also be embodied in other ways within the scope of the subject matter defined in the following claims. In particular, it is to be understood that other embodiments may be utilised and structural and functional modifications may be made without departing from the scope of the present invention.

In device claims enumerating several means, several of these means can be embodied by one and the same hardware components. The mere fact that certain measures are recited in mutually different dependent items or described in different embodiments does not indicate that a combination of these measures cannot be used to advantage.

The terms "first," "second," "third," "fourth," and the like in the description and in the claims, if any, are used for distinguishing between similar elements and not necessarily for describing a particular sequential or chronological order. It is to be understood that any terms so used are interchangeable under appropriate circumstances such that the embodiments described herein are, for example, capable of operation in sequences other than those illustrated or otherwise described herein.

It should be emphasized that the term "comprises/comprising" are generally interpreted to be open ended terms which specify the presence of stated features, integers, steps or components but do not preclude the presence or addition of one or more other features, integers, steps, components or groups thereof. The terms "consisting of" or "consists of" are closed terms, and include only the components, structures, steps, or the like specifically listed in conjunction with such terms, as well as that which is in accordance with U. Patent law.

Claim 1:
An intrusive medical device (<NUM>, <NUM>, <NUM>) comprising:
a proximal end (40p) and a distal end (40d) spaced apart from the proximal end;
a tubular member (<NUM>) defining a lumen (<NUM>) therein, the tubular member extending from the proximal end to the distal end;
a camera (<NUM>) positioned at the distal end; and
a bundle (<NUM>) of at least four unpaired conductors, the bundle extending from the proximal end to the distal end and electrically connected to the camera at the distal end,
wherein the bundle is twisted at a pitch of <NUM> +/- <NUM>.