System and method for endoscopic imaging and endosurgery

• US 6,221,007 B1
• Filed: 02/01/1999
• Issued: 04/24/2001
• Est. Priority Date: 05/03/1996
• Status: Expired due to Fees

• Current Assignee: Green, Philip S.
• Original Assignee: Green, Philip S.
• Inventors: Green, Philip S.
• Primary Examiner(s): Leubecker, John P.
• Application Number:
  US09/241,321
• Time in Patent Office: 813 Days
• Field of Search: 600/101, 600/102, 600/104, 600/106, 600/109, 600/112, 600/160, 600/114, 348/65, 348/71, 348/74, 348/75
• US Class Current: 600/160
• CPC Class Codes: A61B 1/00052 positioned at proximal end of the endoscope body
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00183 for variable viewing angles
• CPC Class Codes: A61B 1/00193 adapted for stereoscopic vision
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/0607 for annular illumination
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

An endoscopic surgical system for use in endoscopic surgery including an endosurgical instrument having an elongated shaft and an end-effector operably mounted to a distal end of the shaft. A video endoscope device includes an elongated telescope portion containing a distal viewing face, and a coupling device couples the instrument to the endoscope device. This coupling substantially maintains the relative position of the elongated shaft adjacent the telescope portion such that the endoscope viewing face is rearward of the distal end effector to view the distal end-effector from a position along the shaft. A handle portion is provided operably coupled to the coupling device in a manner enabling the distal end-effector and the viewing face to be manually positioned as a single unit during endoscopic surgery. The handle portion is further configured to manually operate the end-effector. A video display device is operably coupled to the coupling device at a viewing angle and location therealong wherein an image of the end-effector displayed on the display device appears to be a substantially direct view of the end-effector that is positioned in-line with the insertion shaft.

Claims

1. An endoscopic surgical system for use in endoscopic surgery comprising:

an endosurgical instrument having an elongated shaft and an end-effector operably mounted to a distal end of said shaft;

a video endoscope device having an elongated telescope portion containing a distal viewing face;

a coupling device coupling the instrument to the endoscope device in a manner substantially maintaining the relative position of the elongated shaft adjacent the telescope portion such that the endoscope viewing face is rearward of the distal end effector to view the distal end-effector from a position along said shaft;

a handle portion operably coupled to the coupling device in a manner enabling said distal end-effector and said viewing face to be manually positioned as a single unit during endoscopic surgery, and said handle portion being further configured to manually operate the end-effector, and

a video display device operably coupled to and fixed relative to the endoscope device at a viewing angle and location therealong wherein an image of the end-effector displayed on said display device appears to be a substantially direct view of said end-effector that is positioned in-line with the insertion shaft.

2. The endoscopic surgical system according to claim 1 further including:

a rotation preventing mechanism coupled between the end-effector and the coupling device to substantially prevent axial rotation thereof relative to the distal viewing face.

3. The endoscopic surgical system according to claim 1 wherein,

the video display device is a flat panel display.

4. The endoscopic surgical system according to claim 1 wherein,

said coupling device includes a securing device mounting the instrument shaft, the handle portion and the telescope portion together for manipulation as a single unit.

5. The endoscopic surgical system according to claim 4 wherein,

said handle portion is integrally formed with said endosurgical instrument, and said securing device is adapted to rigidly mount the handle portion to the instrument shaft.

6. The endoscopic surgical system according to claim 5 wherein,

said securing device includes a pair of opposed securing elements formed to releasably engage the handle portion and the telescope portion therebetween.

7. The endoscopic surgical system according to claim 5 further including:

an adapter device coupled to the telescope portion of the endoscope and providing a bore portion formed and dimensioned for receipt of the instrument elongated shaft therethrough for alignment of the end-effector in the field of view of the distal viewing end.

8. The endoscopic surgical system according to claim 7 further including:

a guide tube in axial communication with said bore portion for guided insertion of said elongated shaft through said guide tube and into said bore portion.

9. The endoscopic surgical system according to claim 8 further including:

said guide tube is supportively coupled to the securing device.

10. The endoscopic surgical system according to claim 9 further including:

a joint device releasably mounting the display device to the securing device.

11. The endoscopic surgical system according to claim 9 wherein,

said securing device includes a pair of opposed securing elements formed to releasably engage the handle portion and the telescope portion therebetween.

12. The endoscopic surgical system according to claim 11 further including:

a spherical joint member positioned between the opposed securing elements for movably mounting the display device to the securing device at one of a plurality of positions.

13. The endoscopic surgical system according to claim 12 wherein,

the video display device is a flat panel display.

14. The endoscopic surgical system according to claim 8 further including:

a latching arrangement for releasably latching the received elongated shaft to one of the endoscope and the guide tube such that the received elongated shaft rotates freely about its axis within the guide tube and bore portion, but cannot be advanced or withdrawn therefrom.

15. The endoscopic surgical system according to claim 1 wherein,

said coupling device is configured to position the elongated shaft of the instrument substantially parallel to and adjacent to the telescope portion.

16. The endoscopic surgical system according to claim 1 wherein,

said coupling device is integrally formed with said handle portion.

17. The endoscopic surgical system according to claim 16 wherein,

said handle portion defines a bore formed and dimensioned for receipt of the instrument elongated shaft therein.

18. The endoscopic surgical system according to claim 17 wherein,

said bore extends longitudinally through said handle portion from a proximal end to a distal end thereof.

19. The endoscopic surgical system according to claim 17 further including:

a latch assembly releasably mounting the instrument to the handle portion.

20. The endoscopic surgical system according to claim 19 wherein,

said latch assembly is adapted for movement between an unlatched condition, enabling removal of said elongated shaft from said bore, and a latched condition, releasably latching the instrument to the handle portion.

21. The endoscopic surgical system according to claim 20 wherein,

said latch assembly is adapted to rotate between the unlatched condition and the latched condition.

22. The endoscopic surgical system according to claim 21 wherein,

said latch assembly includes a n engagement latch mounted to one of the elongated instrument and the handle portion, and a pin member mounted to the other of the handle portion and the elongated instrument for latched coupling between the latched and unlatched conditions.

23. The endoscopic surgical system according to claim 20 further including:

a linkage assembly operably coupling the end-effector of the instrument to an actuation device of the handle portion for actuation of the end-effector when said latch assembly is moved to said latched condition.

24. The endoscopic surgical system according to claim 23 wherein,

said linkage assembly includes an actuation rod disposed longitudinally along said elongated shaft, and coupled to said end-effector for movement between a first position and a second position.

25. The endoscopic surgical system according to claim 24 wherein,

said linkage assembly further includes a boss member coupled to said actuation rod which operably engages said actuation device when said instrument is moved from the unlatched condition to the latched condition.

26. The endoscopic surgical system according to claim 24 wherein, latch assembly is adapted to rotate between the unlatched condition and the latched ondition.

27. The endoscopic surgical system according to claim 26 wherein,

said linkage assembly further includes a boss member coupled to said actuation rod which operably engages said actuation device upon rotation of said instrument from the unlatched condition to the latched condition,

said latch assembly includes an engagement latch mounted to one of the elongated instrument and the handle portion, and a pin member mounted to the other of the handle portion and the elongated instrument for latched coupling upon rotation of said instrument from the unlatched condition to the latched condition.

28. The endoscopic surgical system according to claim 24 further including:

a biasing device operably coupled to said actuation rod to bias said end-effector toward one of the first position and the second position.

29. The endoscopic surgical system according to claim 28 wherein, said biasing device is provided by a compression spring.

30. The endoscopic surgical system according to claim 1 further including:

a wrist mounted electronic module operably coupled, to said endoscope device and containing at least a portion of the optical electronics thereof.

31. The endoscopic surgical system according to claim 16 wherein,

the video display device is a flat panel display mounted to a distal portion of the integral handle portion and coupling device.

32. The endoscopic surgical system according to claim 1 further including:

a latching arrangement for releasably latching the elongated shaft of the instrument to one of the endoscope device and the coupling device such that the elongated shaft rotates freely about its axis, but cannot be advanced or withdrawn therefrom.

33. A video endoscope system for use by a surgeon in endoscopic surgery:

a surgical instrument having an elongated shaft and an end-effector;

an elongated endoscope device including a telescope portion having a distal viewing face;

a coupling device securably coupling the instrument to the endoscope device in a manner substantially maintaining the relative position of the elongated shaft adjacent the telescope portion to facilitate viewing of the end-effector of the surgical instrument by said viewing face;

a video display mounted to the coupling device and adapted to display an image of the end-effector viewed by the distal viewing face; and

a handle portion operably coupled to the surgical instrument for actuation of the end effector, and rigidly coupled to the coupling device for simultaneous positioning of end-effector and said endoscope viewing face as a unit, independent of the operation of the end-effector and in a manner substantially maintaining said end-effector in the field of view of said viewing face during operation and manipulation of the handle such that a surgeon operating the endoscope system by the handle will view and perceive the image of the end-effector on the video display as being directly viewed at a true position of the end-effector from the perspective of the surgeon, enabling the surgeon to effectively perform remote surgery with the hand-eye coordination approximating that of open surgery.

34. The video endoscope system according to claim 33 wherein,

said coupling device includes a pair of opposed securing elements formed to releasably engage the handle portion and the telescope portion therebetween.

35. The video endoscope system according to claim 34 further including:

an adapter device coupled to the telescope portion of the endoscope and providing a bore portion formed and dimensioned for receipt of the instrument elongated shaft therethrough for alignment of the end-effector in the field of view of the distal viewing end.

36. The video endoscope system according to claim 35 wherein,

a guide tube in axial communication with said bore portion for guided insertion of said elongated shaft through said guide tube and into said bore portion.

37. The video endoscope system according to claim 36 further including:

said guide tube is supportively coupled between the securing elements.

38. The video endoscope system according to claim 37 further including:

a joint device releasably mounting the display device between the securing elements.

39. The video endoscope system according to claim 38 wherein,

the video display device is a flat panel display.

40. The video endoscope system according to claim 33 wherein,

said coupling device is integrally formed with said handle portion.

41. The video endoscope system according to claim 40 wherein,

said handle portion defines a bore formed and dimensioned for receipt of the instrument elongated shaft therein.

42. The video endoscope system according to claim 41 further including:

a latch assembly releasably mounting the instrument to the handle portion.

43. The video endoscope system according to claim 42 wherein,

said latch assembly is adapted for movement between an unlatched condition, enabling removal of said elongated shaft from said bore, and a latched condition, releasably latching the instrument to the handle portion.

44. The video endoscope system according to claim 43 wherein,

said latch assembly includes an engagement latch mounted to one of the elongated instrument and the handle portion, and a pin member mounted to the other of the handle portion and the elongated instrument for latched coupling between the latched and unlatched conditions.

45. The video endoscope system according to claim 44 further including:

a linkage assembly operably coupling the end-effector of the instrument to an actuation device of the handle portion for actuation of the end-effector when said latch assembly is moved to said latched condition.

46. A method of performing endoscopic surgery comprising the steps of:

providing an endosurgical instrument having an elongated shaft and an end-effector operably mounted to a distal end of said shaft;

providing a video endoscope device having an elongated telescope portion containing a distal viewing face;

coupling the endosurgical instrument to the endoscope device through a coupling device in a manner substantially maintaining the relative position of the elongated shaft adjacent the telescope portion such that the endoscope viewing face is rearward of the distal end effector to view the distal end-effector from a position along said shaft;

inserting the end-effector and the distal viewing face simultaneously into a body part through a natural orifice or incision;

displaying an image of the end effector from the endoscope distal viewing face on a video display operably coupled to and fixed relative to the endoscope device; and

operating a handle portion operably coupled to the surgical instrument for actuation of the end effector, and rigidly coupled to the coupling device for simultaneous positioning of end-effector and said endoscope viewing face as a unit, independent of the operation of the end-effector and in a manner substantially maintaining said end-effector in the field of view of said viewing face during operation and manipulation of the handle such that a surgeon operating the instrument by the handle will view and perceive the image of the end-effector on the video display as being directly viewed at a true position of the end-effector from the perspective of the surgeon, enabling the surgeon to effectively perform remote surgery with the hand-eye coordination approximating that of open surgery.