Patent ID: 12232702

The same elements or elements with the same function have been provided with the same reference signs in the figures.

DETAILED DESCRIPTION

FIG.1aillustrates an endoscope10with a rotating drum20on a distal end14of an elongate rigid shaft tube12, wherein the rotating drum20is mounted at the distal end14of the shaft tube12by means of a bearing fork16so as to be rotatable about a first axis of rotation18. An optical imaging system22, which preferably comprises an electronic image recorder24, an imaging optical unit26and an illumination device28as shown in detail inFIG.2b, is arranged in the rotating drum20. The rotating drum20is illustrated from an upper side62of the shaft tube12, wherein a viewing direction64of the imaging system22is pivotable through an angle α with respect to the longitudinal axis30and the bearing fork16does not restrict the viewing direction64of the imaging optical unit26. By pivoting the rotating drum20, and hence the viewing direction64, it is possible to cover an angle α of preferably more than 130° and an observation region β′ as perFIG.2b. By rotating the shaft tube12about the longitudinal axis30, it is possible to extend the observation region β′. With a flexible distal end14of the shaft tube12, as perFIG.6, the entire operation region around the endoscope10is observable.

The first axis of rotation18runs approximately transversely to a longitudinal axis30of the shaft tube12, wherein the endoscope10, as illustrated inFIG.1b, has at least one, preferably one, control line32on a lower side63of the shaft tube12. This at least one control line32is guided on an outer side36of the shaft tube12and fastened to the rotating drum20at a lever distance a from the first axis of rotation18. The rotating drum20is rotatable, preferably by way of a linear movement of the at least one control line32parallel to the longitudinal axis30of the shaft tube12.

As an alternative, or in sections, the shaft tube12as perFIG.6can also be flexibly equipped, preferably at the distal end14, with a multiplicity of steering members82and can be pivotable by means of control lines, not shown in any more detail, at an outer edge84of the steering members82.

As shown inFIG.2b, a work channel34in the interior of the shaft tube12and preferably the internal diameter of the shaft tube12are not restricted by the at least one control line32.

The rotating drum20preferably has a spherical or cylindrical embodiment, with the rotating drum20preferably being flattened in a direction perpendicular to a viewing direction64of the imaging system22in order to receive the imaging optical unit26and the illumination device28, preferably in the form of two LEDs, in a flattened region66.

The at least one control line32is preferably windable on at least one winding curve38along the outer circumference of the rotating drum20. Particularly preferably, the at least one control line32is windable such that the rotating drum20is rotatable from a viewing direction64along the longitudinal axis30of the shaft tube12through at least an angle α of 0° to 180° and hence the viewing direction64is alignable in the interior of the shaft tube12and a work channel34. The viewing angle β of the imaging system22is preferably 50° to 70°, particularly preferably 60°. As a result, a preferred observation region β′, in which the imaging system with a viewing angle β can record an operation region by pivoting the rotating drum20through an angle α, is between −35° and 215°, particularly preferably between −30° and 210°, wherein the angle of the observation region β′, just like the angle α, relates to a 0° direction along the longitudinal axis30of the shaft tube12. For the purposes of pivoting the rotating drum20, the at least one control line32has an at least partly flexible embodiment, as indicated inFIG.1bby transverse lines, in order to wind said control line on the at least one winding curve38of the rotating drum20. In this case, the at least one winding curve38along the outer circumference can preferably have a circular or oval embodiment.

Particularly preferably, the at least one control line32of the rotating drum20forms a supply line for the imaging system22, which preferably is embodied as a flexible printed circuit board68illustrated inFIG.1b, for supplying electronic circuits in the interior of the rotating drum20, for example the electronic image recorder24and/or an electronically adjustable imaging optical unit26and/or the illumination device28. Particularly when using the flexible printed circuit board68as a control line32, the corresponding winding curve38is designed such that the bending radius is greater than 0.5 mm. Alternatively, the imaging system22can also be electrically supplied by way of a cable71, as illustrated inFIG.2d.

Furthermore, provision can be made for the at least one control line32, as illustrated inFIG.2candFIG.2d, to comprise at least one first fluid line69. Here, this at least one first fluid line69is preferably provided in addition to an electronic supply line of the imaging system22and is windable on the winding curve38; seeFIG.2d.

The at least one control line32is guided on the circumference of the rotating drum20in interlocking fashion, preferably in a depression70, as perFIG.2candFIG.2d, so that said control line is protected but at the same time the external diameter of the rotating drum20is not increased further, and so injury to tissue in an operation region can also be reduced.

As illustrated inFIG.1b,FIG.2aorFIG.2b, the at least one control line32is guided in a recess50on the outer side36of the shaft tube12, with the cutout50preferably running parallel to the longitudinal axis30of the shaft tube12and thus forming a protective collar52, preferably in the region of the distal end14of the shaft tube12. As a result, the at least one control line32is protected and injury of tissue in an operation region as a result of the movable control line32is prevented. Preferably, the protective collar52prevents the at least one control line32from being able to detach from the outer side36of the shaft tube12in a direction perpendicular to the longitudinal axis30.

Preferably a torsion spring55as a reset means54is arranged in the region of the bearing point56, as perFIG.2b, for the purposes of resetting a rotated rotating drum20, wherein the torsion spring55preferably keeps the rotating drum20in a cleaning position with an angle α of approximately 180° between the viewing direction64and the longitudinal axis30of the shaft tube12.

Alternatively, the rotating drum20is also able to be reset by means of a second control line, not shown, on the upper side62of the shaft tube12, or the control line32is guided in dimensionally stable fashion and in the recess52, like a Bowden cable with a supporting sleeve, such that the control line32is also adjustable by means of a compression force.

Preferably at least one second fluid line39, preferably an air line39,40and/or preferably a liquid feed line39,42and a liquid extraction line39,44, is arranged in the work channel34of the shaft tube12. The air line39,40and the liquid lines39,41,44are illustrated inFIG.2bandFIG.3b. In an observation position of the rotating drum20, as perFIG.2b, the at least one second fluid line39can be used for back-side cooling/temperature control of the imaging system22.

Especially for cleaning the imaging system22of endoscopes10in a dry operation region, the rotating drum20is preferably rotatable into a cleaning position as perFIG.3a, wherein the rotating drum20with the viewing direction64is inclined in the direction of the work channel34. In this cleaning position, contamination is preferably able to be rinsed from the flattened region66of the rotating drum20, and hence the field of view β of the imaging system22is cleanable, preferably by means of an air line39,40in combination with the liquid feed line39,42. Preferably, the rinsing fluid is a rinsing liquid from the liquid feed line39,42for rinsing the imaging system22, wherein the rinsing liquid is removable by means of the liquid extraction line39,44, and hence a leakage of rinsing liquid into a dry operation region can be minimized. Preferably, the air line39,40is used to remove the rinsing liquid from the imaging system22and the flattened region66in order to prevent a disturbance in the field of view β of the imaging system22by drop formation. Further preferably, the liquid feed line39,42and preferably also the air line39,40can be designed as a spray nozzle in order to improve the cleaning effect.

Preferably for endoscopes10with wet ambient conditions or in a wet operation region, the at least one second fluid line39can be used to rinse an operation region in addition to the back-side cooling and the cleaning of the rotating drum20, in particular in order to rinse the operation region in the viewing direction64of the imaging system22in an observation position. To this end, a sterile and physiological rinsing fluid is preferably used for a medical application. To remove a rinsing fluid from an operation region, use is preferably made of a liquid extraction line39,44with at least one hole46on the circumferential side or a slot-shaped opening47at the distal end14of the shaft tube12, as illustrated inFIGS.4atoFIG.4c. The holes46and the opening47connect the liquid extraction line39,44, preferably on the lower side64of the shaft tube12, to the operation region. Particularly for a bubble-shaped operation region78with tissue79to be operated, as perFIG.4a, it is possible to rinse around the rotating drum20in a flow direction80, wherein the circumferential holes46and the opening47promote the extraction of the rinsing fluid from the bubble-shaped operation region78. Preferably only the liquid lines39,42,44are required for this rinsing use since an air line39,40is preferably not required in a wet operation region and the imaging system22is able to be cleaned at the same time as the operation region is rinsed, without needing to be pivoted into a cleaning position in the process.

As an alternative or in addition thereto, it is also possible for the distance between the rotating drum20and the shaft tube12, and hence the opening47, to be increased in order to facilitate access to the liquid extraction line39,44inFIG.4a.

Furthermore, it is preferable for the shaft tube12, in particular the bearing fork16, to also have an opening47on the upper side62in order to open the shaft tube12behind the rotating drum20and thus ensure a clear emergence of rinsing fluid, in particular from the liquid feed line39,42.

As illustrated inFIG.5a, the work channel34can be designed to receive an instrument48and/or contain an instrument48as an alternative or in addition to the at least one second fluid line. This instrument48can have a tool72, for example a cutting tool or a punching tool, at a distal end, which tool is adaptable for the respective medical operation.

Preferably, the shaft tube12is open in a section60on the upper side62such that an instrument48, preferably a flexible instrument, is adjustable or bendable past the rotating drum20in a direction perpendicular to the longitudinal axis30of the shaft tube12.

FIG.5ashows a further preferred embodiment of the endoscope10, in which the bearing fork16is fastened to the shaft tube12so as to be pivotable about a second axis of rotation58and the work channel34is open along the longitudinal axis30in a pivoted state of the bearing fork16so that preferably a rigid instrument48is able to be guided from the work channel34into the operation region. The bearing fork16is preferably controllable by means of a second control line, not illustrated, or another operating mechanism, preferably an operating mechanism for flexible shaft tubes as is known for example from US 2015/0359420 A1 cited at the outset. As illustrated inFIG.5b, a flexible instrument48, in particular, is adjustable with this pivotable bearing fork16by means of the rotating drum20in the direction of the upper open section60. Thus, the tool72at the distal end of the instrument48can be moved into an operation region, with this tool72remaining in the field of view β of the imaging system22as a result of a simultaneous rotation of the rotating drum20.

As an alternative or in addition thereto, the bearing fork16can also be connected to the shaft tube12by means of a flexible or elastically deformable element, preferably a rubber element, wherein the flexible element develops a passive restoring force in order to pivot the bearing fork16about the second axis of rotation58and open the work channel34for an instrument48.

In addition to guiding the instrument48, the work channel34can contain further channels for fluid guidance such that the rotating drum20is able to be cooled or cleaned and/or the operation region is able to be rinsed, even if an instrument48is used. Thus, the rinse of the operation region advantageously also acts to clean the instrument48. By way of example, the work channel34to guide the instrument48can simultaneously be a liquid feed channel41and the shaft tube12can contain a further liquid extraction channel44.

As illustrated inFIG.6, the pivotable bearing fork16can reduce the bending radius of a flexible shaft tube12, or increase the ability to be curved, even without an instrument, or can facilitate the bending radius of a rigid endoscope, for example in order to even capture a field of view of the imaging system22that is covered by the shaft tube12itself or in order to be able to see behind corners or obstacles. Thus, if the rotating drum20is rotated and the bearing fork16is rotated at the same time, the observation region is extended to an angle β′ greater than 180° since the observation region is not restricted by the shaft tube12itself. The shaft tube12which is flexible at least in sections is configured as perFIG.6with a multiplicity of steering members82and is pivotable at an outer edge84of the steering members82by means of further control lines, not illustrated.

As illustrated inFIG.7a, the at least one control line32is adjustable parallel to the longitudinal direction30of the shaft tube12by an operator by means of a handle74at a proximal end of the shaft tube12and a linearly displaceable operating element76. The handle74preferably also transfers an electronic cable guidance to the flexible printed circuit board68, which preferably as a control line32is linearly displaceable by an adjustment travel S in order to rotate the rotating drum20at the distal end14of the shaft tube12inFIG.7b.

Preferably, the tool72of the instrument48, as perFIG.5aandFIG.5b, is also operable by means of the handle74.

The external diameter d of the shaft tube12is preferably 3 mm to 6 mm. Such a shaft tube12is suitable for a multiplicity of non-invasive medical operations in adult humans. Here, the bearing fork16is preferably rounded off at a distal end and the diameter of the rotating drum20preferably does not exceed this external diameter d in a direction perpendicular to the longitudinal axis30of the shaft tube12in order to minimize injury during medical use.

Preferably, when using a plurality of control lines32, these are windable on different winding curves38, not illustrated here, of the rotating drum20, in particular at different distances a from the axis of rotation30in order to carry out different rotational adjustments through an angle α in the case of the same adjustment travel S of the control lines32in the longitudinal direction30of the shaft tube12. These different winding curves38are also preferable if a small distance a is required but the supply line, in particular as a flexible printed circuit board68, is limited by a maximum radius of curvature.

The invention also relates to a method for operating an above-described endoscope, wherein the rotating drum20is rotated through an angle α from an observation position as perFIG.2bto a cleaning position as perFIG.3asuch that the imaging system22is aligned with the distal end16of the shaft tube12and the work channel34, wherein in this position the at least one second fluid line39is used to rinse the imaging optical unit26and/or the illumination device28. During the rinsing procedure, the rotating drum20can be pivoted in order, in particular, to clean the field of view β of the imaging system22. For applications in which no rinsing fluid should penetrate into the operation region, in particular for a dry operation region, the rinsing fluid is preferably removed using a liquid extraction line39,44. Following the rinsing with the rinsing fluid, preferably a rinsing liquid, the rotating drum20can preferably be dried by means of an air flow from the air line39,40before the rotating drum20is pivoted back into the observation position, preferably the previously departed observation position.

For a dry operation region in particular, it is alternatively often sufficient to clean an imaging optical unit that has steamed up as a result of humidity using an air flow. Here, the use of a rinsing liquid is advantageously not required.

Furthermore, the invention relates to a method for guiding an instrument48from the shaft tube12, wherein the shaft tube12, at least the distal end14of the shaft tube12, is initially guided into an operation region. Subsequently, the rotating drum20is pivoted by means of the pivotable bearing fork16about a second axis of rotation58, as perFIG.5a, at least until the rotating drum20exposes the work channel34along a longitudinal axis30of the shaft tube12. Then, the instrument48is pushed out of the work channel34, in particular in the direction of an operation site. In a next step, the rotating drum20is pivoted by means of the control line32and about the first axis of rotation18in order to track and observe the instrument48, in particular a tool72, and the operation region with the field of view β of the imaging system22. Especially for flexible instruments, the instrument48can be bent as perFIG.5bby pivoting the bearing fork16about a second axis of rotation58. In this method, the bearing fork16can be actively pivoted or the bearing fork16can be passively pivotable by means of a flexible or elastically deformable element as a result of a cooperation with the instrument.

LIST OF REFERENCE SIGNS

10Endoscope12Shaft tube14Distal end of the shaft tube16Bearing fork18First axis of rotation20Rotating drum22Optical imaging system24Electronic image recorder26Imaging optical unit28Illumination device30Longitudinal axis of the shaft tube32At least one control line34Work channel36Outer side of the shaft tube38Winding curve39Second fluid line40Second air line42Liquid feed line44Liquid extraction line46Holes in the shaft tube47Opening in the shaft tube48Instrument50Recess52Protective collar54Reset means55Torsion spring56Bearing point of the rotating drum58Second axis of rotation60Open upper section of the shaft tube62Upper side of the shaft tube63Lower side of the shaft tube64Viewing direction of the imaging system66Flattened side of the rotating drum68Flexible printed circuit board as a control line69First fluid line70Depression on the rotating drum71Cable72Tool74Handle76Operating element78Bubble-shaped operation region79Tissue80Flow direction82Steering members84Outer edge of the steering membersa Distance between the first axis of rotation and the winding curved External diameter of the shaft tubeα Angle of the viewing direction of the imaging systemβ Viewing angle or viewing fieldβ′ Observation regionS Adjustment travel