Endoscopic instrument having reduced diameter flexible shaft

• US 20050250983A1
• Filed: 04/18/2005
• Published: 11/10/2005
• Est. Priority Date: 04/16/2004
• Status: Active Grant

• Current Assignee: Gyrus ACMI, Inc. (Olympus Corporation)
• Original Assignee: Gyrus ACMI, Inc. (Olympus Corporation)
• Inventors: Castro, Salvatore, Tremaglio, Anthony
• Granted Patent: US 8,517,921 B2
• Time in Patent Office: Days
• US Class Current: 600/101
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/0676 at distal tip of an endoscope
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

A medical instrument comprising a flexible, filamentous shaft slideably disposed in a sheath, the instrument including an electronic imaging system comprising an image sensor carried on a distal end portion of the instrument. The shaft may be used as a guidewire for a complementary guided device, or it may be used to carry a functional element for performing a procedure at a target site in a patient'"'"'s body. In other embodiments, the present invention contemplates a flexible sheath, preferably having a simple tubular construction, with an electronic imaging system at its distal end. The sheath is adapted to slideably receive a shaft, preferably a filamentous shaft, that closely fits the sheath. The shaft carries functional element at its distal end. The instruments according to the present invention may include one or more filaments along their length for deflecting an insertable portion of the instrument.

Claims

1. A medical instrument comprising a flexible, filamentous shaft slideably housed in a flexible sheath, the instrument including an image sensor carried on a distal end portion of the instrument.

2. The instrument of claim 1 wherein the insertable portion of the sheath comprises a flexible polymer tube.

3. The instrument of claim 1 further comprising a functional element disposed on the distal end of the shaft.

4. The instrument of claim 3 wherein the functional element has a first configuration for being carried in the sheath and a second configuration when deployed from the distal end of the sheath.

5. The instrument of claim 4 wherein the functional element comprises a device for capturing an object or manipulating tissue at a target site in a patient'"'"'s body.

6. The instrument of claim 1 further comprising at least one filament is carried along a length of the instrument and is operatively coupled to the instrument so as to allow a user to control the deflection of at least a distal portion of the instrument.

7. The instrument of claim 6 wherein the filament is slideably disposed in a channel along at least a portion of the length of the sheath.

8. The instrument of claim 1 further comprising at least one pullable filament that has a distal portion operatively coupled to a distal end portion of the instrument and a proximal end portion operatively coupled to a tension mechanism at the proximal end of the instrument, the tension mechanism being controllable by a user to cause a distal end of the instrument to deflect.

9. The instrument of claim 8 wherein the tension mechanism comprises a slide mechanism disposed on the handle of the instrument.

10. The instrument of claim 2 further comprising at least one solid-state illumination source carried at the distal end of the instrument.

11. The instrument of claim 10 wherein the solid state light source is carried on the shaft or the sheath and the image sensor is carried on the whichever of the shaft and sheath the light source is not carried.

17. The instrument of claim 1 wherein the image sensor comprises a CMOS image sensor.

19. The instrument of claim 17 wherein the image sensor has an imaging surface oriented non-perpendicularly to the optical axis of the shaft.

21. The instrument of claim 19 wherein the image sensor has an active imaging surface that is longer than the inner diameter of the sheath.

23. The instrument of claim 1 wherein the image sensor is carried at the distal end of the shaft.

24. The instrument of claim 1 wherein the image sensor is carried at the distal end of the sheath.

39. The shaft of claim 1 wherein the shaft comprises a plurality of filaments, one filament being disposed in a sleeve.

40. The shaft of claim 39 wherein the sleeve comprises an electrical insulator and the filament a conductor for communication power or electrical signals to the distal end of the instrument.

41. The shaft of claim 39 wherein the filament is slideably disposed in the sleeve.

12. A medical instrument comprising a flexible, filamentous shaft, the instrument including an imaging system comprising a pixellated image sensor carried on a distal end portion.

13. The shaft of claim 12 wherein the shaft comprises a guidewire capable of receiving a predetermined guided device, the shaft and guidewire forming a functionally complementary assembly so as to enable delivery or placement of the guided device in desired location in a patient'"'"'s body.

14. The guidewire of claim 13 further comprising the guided device, forming an assembly of guidewire and guided device.

15. The assembly of claim 14 wherein the guided device comprises a catheter or stent.

16. The instrument of claim 12 wherein the shaft has proximal portion with a first set of predetermined properties and a distal portion with a second set of predetermined properties, the first set of properties aimed at providing pushability for the shaft and the second set aimed at providing steerability for the instrument so as to facilitate the delivery of an insertable portion of the instrument to a desired target site in a patient'"'"'s body.

18. The instrument of claim 12 wherein the image sensor comprises a CMOS image sensor.

20. The instrument of claim 18 wherein the image sensor has an imaging surface oriented non-perpendicularly to the optical axis of the shaft.

22. The instrument of claim 12 wherein the shaft further includes an illumination source for emitting light from the distal end and the shaft comprises between 2 to 5 filaments, at least one filament providing structural support of predetermined rigidity and flexibility and at least one filament operatively coupled to the image sensor and comprising an electrical conduit for power and/or signals.

42. The shaft of claim 12 wherein the shaft comprises a plurality of filaments, one filament being disposed in a sleeve.

43. The shaft of claim 42 wherein the sleeve comprises an electrical insulator and the filament a conductor for communication power or electrical signals to the distal end of the instrument.

44. The shaft of claim 42 wherein the filament is slideably disposed in the sleeve.

25. A medical instrument device, comprising:

a flexible sheath adapted to slideably receive a flexible, filamentous shaft having a functional element at the distal end for performing a procedure on an object or tissue at a target site in a patient'"'"'s body;

a deflection system comprising at least one filament with a distal end portion operatively coupled to a distal end portion of the instrument and proximal end operatively coupled to a proximal end portion of the instrument, and a control mechanism at the proximal end portion of the instrument enabling a user to pull the filament and deflect the distal end portion; and

an imaging system comprising an image sensor carried on a distal portion of the instrument.

26. The instrument of claim 25 wherein the sheath comprises a polymer tube.

27. The instrument of claim 25 where the tube has a substantially uniform composition along a majority of the insertable, distal portion.

28. The instrument of claim 27 further comprising at least one solid-state illumination source disposed at the distal end of the instrument.

29. An assembly of the sheath of claim 25 and the shaft, the shaft having an outer diameter that closely matches the inner diameter of the sheath so that overall outer diameter of the instrument is minimized.

30. The assembly of claim 29 wherein the wherein the insertable portion of the sheath consists essentially of a polymer tube.

31. The instrument of claim 25, wherein the functional element comprises a device that has a first configuration when disposed in the sheath and a second configuration when deployed from the distal end of the sheath.

32. The instrument of claim 30 wherein the functional element comprises a device for capturing or manipulating tissue or objects at a surgical site in a patient'"'"'s body.

33. A medical instrument device, comprising:

a flexible sheath comprising a polymer tube that is adapted to slideably receive a flexible, filamentous shaft having a functional element at the distal end for performing a procedure on an object or tissue at a target site in a patient'"'"'s body;

a deflection system comprising at least one filament with a distal end portion coupled to a distal end portion of the instrument and proximal end portion coupled to a proximal end portion of the instrument, and a control mechanism at the proximal end portion of the instrument enabling a user to manipulate the filament and deflect the distal end portion of the instrument; and

the shaft has an outer diameter that closely matches the inner diameter of the sheath so that overall outer diameter of the instrument is minimized.

34. A medical instrument comprising a flexible, filamentous shaft slideably housed in a flexible sheath, the instrument including an image sensor carried on a distal end portion of the shaft, the shaft including one or more filaments constructed and arranged to provide pushability and steerability to the instrument sufficient to deliver the distal end of the instrument to a predetermined target site in a patient'"'"'s body, the shaft including one or more conductors operatively coupled to the image sensor so as to communicate power and signals between the sensor and a location proximal to the insertable portion of the instrument.

35. The instrument of claim 34 wherein the instrument comprises a guidewire capable of receiving a predetermined guided device, the shaft and guidewire forming a functionally complementary assembly so as to enable delivery of the guided device to a target location in a patient'"'"'s body.

36. The instrument of claim 35 wherein the instrument is adapted to deliver the guided device to a region comprising the ureter, bladder or kidney of a patient.

37. The instrument of claim 35 wherein the instrument is adapted to deliver the guided device to a region comprising the esophageal tract or gastrointestinal tract of a patient.

38. The instrument of claim 36 wherein the guided device comprises a catheter or stent.