US 3261351 A
Descripción (El texto procesado por OCR puede contener errores)
July 19, 1966 F. J. WALL.: CE
ENTL SCOPE Filed 0G12. 10, 1965 Cm 1N. mam
United States Patent O 3,261,351 ENDUSCPE Frederick l. Wallace, New York, NSY., assigner to American Cystoscope Makers, liuc., icllrarn Manor, NX., a corporation of' New York Filed Oct. l0, 1963, Ser. No. 315,197 2 Claims. (Cl. 12B-6) This application is a continuation-in-part of copending application Serial No. 305,304, tiled August 29, 1963.
This invention relates to endoscopic instruments which utilize optic fibers for the illumination of internal body orifices for the purposes of examination and treatment, and more particularly relates to a choledochoscope.
An endoscope must meet limitations of size and shape dictated by the anatomical structure of the orifice in which it is `to be used. Also, an endoscope must provide for light, vision and operating instruments or high frequency electrodes. For precision in diagnosis or other procedure, a fine brilliant image that is accurate in regard to both color and definition is essential to the operator. Within the relatively small lumen or space inside the tubular portion of known rigid endoscopes, there is a complete electrical circuit of which a lamp is a part. The lamp circuit requires an insulated conductor or wire to carry current from a Contact near the proximal end, to the lamp frequently located at the distal end. The circuit must function perfectly under water and must not be affected by other solutions during sterilization, a requirement most difficult to fulfill in any electrical structure. While the instruments are water-tight when they leave the factory, due to the fact that they must be opened for the replacement of lamps, their a-bility to exclude moisture is almost entirely dependent upon the care exercised by the user in again sealing the instruments.
In known endoscopic instruments most premature burning out of lamps results from attempts to obtain unusually brilliant illumination. The extent of illumination is limited by the filament of the lamp itself. It is the practice to make use of a current regulator and observe Athe lamp filament closely while gradually increasing the current. The limit of safe current is reached when the definite reddish tint of the lamp suddenly becomes white. Further increase in illumination by increasing the current beyond this point results in premature burning out of the lamp. Once the lamp burns out it is necessary to remove it, thus introducing the possibility of the problems described above.
Problems also arise from the disinfection of parts of the endoscope containing lamps. It is not practicable to boil or autoclave any part of the endoscope which contains lamps. The usual chemical disinfectants may not be used or leaks and short circuits in the wiring may follow. As a result it is necessary to use special disinfectant methods and solutions in cleaning known endoscopes.
It is an object of the present invention to provide means for illuminating7 internal orifices which means provide significantly brighter illumination than was heretofore possible.
It is another object of the present invention to provide endoscopic instruments having illuminating means with an expected life, equivalent to that of the rest of the instrument, which means do not require maintenance or replacement of parts in normal use.
It is still another object of the present invention to provide an improved endoscopic instrument utilizing as an illuminating means a bundle of light-conducting fibers which may be shaped at its distal end to a configuration especially well suited for the inspection of the common bile duct.
Further objects as Well as advantages of the present 3,261,351 Patented July I9, 1966 l CC' invention will be apparent from the following description and the accompanying drawings, in which:
FIGURE 1 is a longitudinal sectional View of a choledochoscope constructed in accordance with the present invention;
FIGURE 2 is an enlarged distal end View thereof; and
FIGURE 3 is a cross-sectional View taken generally along lines 3-3 of FIGURE l.
A choledochoscope is utilized for the visualization of the interior of the common bile duct through a surgically prepared orifice. An elongated distal portion of the choledochoscope is disposed at an angle to the proximal portion of the instrument to aid insertion into the duct. Within the instrument are located a telescope lens system, a channel for irrigating fluids, and means for illuminating the interior of the duct.
The objects of this invention may be accomplished by forming a choledochoscope of proximal and distal sheath sections joined together to form a sheath having an obtuse angle by a mounting member. A telescope system cornprising two rigid tubular members is disposed within the proximal and distal sheath sections and optically coupled by a prism located in the mounting member. A continuous bundle of a plurality of light-conducting fibers extend in the space between the respective telescope tubular members and sheath sections from adjacent the proximal end of the sheath to the distal end thereof for conducting light from the proximal to the distal end of the instrument. The sheath is also provided with an irrigation channel extending from adjacent to the proximal end ofthe sheath to the distal end thereof.
Within the proximal sheath section the telescope tubular member is eccentrically disposed and forms a crescentshaped chamber with it. In this portion ofthe instrument the bundle of light-conducting fibers and the irrigation conduit are disposed within the crescent-shaped chamber.
In the distal sheath section the telescope tubular member is concentrically disposed Within the sheath and a concentric middle tube is disposed between the telescope tubular member and the sheath, and forms two annular chambers, one with each of them. The light-conducting fibers are disposed within the annular chamber adjacent the telescope tubular member. The annular chamber adjacent the sheath forms the distal portion of the irrigation channel.
The proximal end portion of the light-conducting fiber bundle is formed into a solid rod which is of a suitable configuration, preferably cylindrical, for coupling to a source of light. Because endoscopes are shaped to con form to the orifice being examined, the distal end portions of the bundles may be formed into a variety of shapes. A preferred shape is that of an annulus substantially coextensive with the distal end of the distal sheath. Preferably the ends of the fiber bundle are optically polished to provide better light dissemination, and protective transparent plates may be placed over the polished ends of the bundle, if desired. Using an annular distal configuration, light is transmitted through the bundle to provide high intensity, cold illumination in an annular pattern at the distal end, permitting ready observation of internal areas.
High intensity illumination is possible using the present invention. Intensities up to 2,000 foot candles or more at `a Working distance of one-half inch and up to 400 foot candles or more at four inches may be obtained by connecting the device to a fiber optic light source by means of a fiber optic light carrying bundle. Typically the illumination produced by the optic fiber bundle is fifteen times greater than that produced by an incandescent lamp commonly used in the same size of endoscope.
Other features of the present invention are the elimination of wires and the elimination of rotating contacts which were necessary in prior art instruments in order to provide electrical connections for the internal lamp circuit. A particular advantage of the present invention is the adaptability of the instrument to small size.
The annularly disposed fiber optics may be prepared by the following procedure. First, using the method described in the application of Lawrence E. Curtiss, Serial No. 76,868, filed December 19, 1960, continuous strands of glass-coated glass fiber are wound on a Mylar (polyethylene terephthalate) sheet which is disposed around a drum. As each successive layer of fibers is laid on the drum, a layer of thermosetting resin is placed upon it. The resin is allowed to dry -but is not cured; thus it remains tacky but does not become hard and stiff. The sheet is then cut parallel to the axis of the cylinder, and a flat sheet of Mylar having well oriented fibers is obtained.
Second, the distal telescopic tubular member of the endoscope is brought into contact with the flat sheet, and the flat sheet is rolled onto the inner tube in an integral number of revolutions sutiicient to produce the thickness of the annular bundle that is desired. Because the resin that was applied is tacky, the sheet sticks readily to the tube, and successive convolutions stick to each other.
Third, the telescopic tubular member and the fiber bundle are inserted into the middle tube which is shorter than both the telescopic tubular member and the fibers used. The distal ends of the fibers are coextensive with the distal ends of both. The telescope lens system may be inserted within the inner tube and the entire assembly disposed within the distal sheath.
The remainder of the optic fibers extending from the distal sheath section are pulled together and inserted through a mounting member and between the proximal telescopic tubular member and proximal sheath. The proximal end portions are formed into a rod by pulling the bers together. If necessary a solvent is used to soften the resin. After forming, the rod is inserted through a supporting terminal fitting, and resin is added to the rod end and also to the annular distal ends. Final- 1y, the entire assembly is baked to ycure the resin and produce a hard, rigid endoscopic tube.
Turning now to the drawings, choledochoscope is made up of a proximal sheath 12 and distal sheath 14 which are joined at an angle to each other by annular mounting members 16, 18 and 20. The mounting member 16 is connected to the distal end of the proximal sheath 12 and is also connected to the mounting member 18 which in turn is connected to the mounting member 20 which is connected to the proximal end of the distal sheath 14. The mounting member 20 is positioned and 'connected to the mounting member 18 by a set screw 22. The mounting member 18 supports a middle tube 24. A telescope tube 26 is concentrically supported inside the middle tube 24 by optic fibers 28. The optic fibers 28 are substantially coextensive with the distal end of the middle tube 24 and the telescope tube 26. Middle lenses 36 are supported within the telescope tube 26 and are spaced apart from each other and an objective lens 52 by spacers 32. Irrigation channel 34 is formed by the annular space between distal sheath 14 and middle tube 24. Irrigation fluid finds its course through the mounting members by way of a chamber 36 between the mouting members 18 and 20. Conduit 38 communicates with the `channel 34 in the distal sheath 14 which is otherwise sealed by the mounting member 18.
A prism 40 is positioned on a mounting made up of a base 42 connected to a support member 44 which is in turn connected to the mounting member 16 by means of a set screw 46. The set screw 46 and other set screws (not shown) provide a means for adjusting the position of the prism. A plug 48 threadably engages the mounting member 16 and provides a liquid tight seal. The plug may be removed for access to the prism, etc.
The distal end portion of the distal sheath 14 terminates in a smoothly curved rim 50. The irrigation channel 34 is open at its distal end to provide for the introduction and removal of uids.
The proximal sheath 12 is connected at its distal end t0 the mounting member 16 an-d at its proximal end to a mounting member 54. A proximal telescope tube 56 is eccentrically disposed within the proximal sheath 12 and is supported adjacent its proximal end by a mounting member 53 which is connected to the mounting member 54- by a set screw 60. Disposed within the telescope tube 56 are the middle lenses 3i) which are spaced apart from each other by the spacers 32. An eyepiece 6) of the telescope system is connected to the mounting member 58 and contains an ocular element which may be of any well known type, such as that shown in FGURE l.
The conduit 38 extends from the mounting member 18 through the proximal sheath 12 adjacent to the telescope tube 56 as is best shown in FIGURE 3, and passes through and is supported by the mounting member S4. The conduit 33 terminates in a coupling 62 which is threadably connected to the mounting member 54 by sleeve 64,
The optic fibers 28 are gathered from the annular conguration which they occupy between the telescope tube 26 and the middle tube 24 and in a bundle are threaded through the mounting members and through the proximal sheath 12. At the proximal end of sheath 12, the fibers are gathered into a rod 66 which is disposed within a sleeve 63 supported by a jack 70. The jack 79 is connected to the mounting member 58 by a sleeve '72 and positioned by a set screw 74. The jack 79 contains an annular groove '76 in which a spring 78 is disposed. A connector Si? contains an annular groove 82 which coacts with the spring 78 to removably couple the choledochoscope to a iiexible light carrier 84, which may have a sleeve, jack, grooves and spring as described. The ends of the optic fiber bundle are optically polished and preferably are protected by fiat glass plates 86.
ln operation, the choledochoscope is inserted through a surgically prepared orice into the common bile duct. A source of light is connected to the choledochoscope by means of the jack 70 and provides brilliant illumination at the distal end of the choledochoscope, illuminating the interior of the duct. lf desired, irrigation fluids may be introduced and removed through the irrigation channel by coupling an external source of irrigation iiuid or a drain to the coupling 62.
The terms and expressions which have been employed are used as terms of description and not of limitation, and there is no intention in the use of such terms and expressions of excluding any equivalents of the features shown and described or portions thereof, but it is recognized that various modifications are possible within the scope of the invention claimed.
What is claimed is:
1. An endoscope for use in examining and treating an internal body orifice comprising first and second tubular sheaths; said first tubular sheath extending from adjacent the proximal end of said endoscope to adjacent the proximal end of said second tubular sheath and said second tubular sheath extending from adjacent the distal end of said first tubular sheath to adjacent the distal end of said instrument; a first mounting member connecting the distal end of said first sheath to the proximal end of said second sheath with said sheaths forming an acute angle; first and second telescope systems disposed within said first and second sheaths, a plurality of light-conducting fibers extending 4along and between said first and second telescope systems and said rst and second sheaths from adjacent the proximal end of said tirst sheath to adjacent the distal end of said second sheath and arranged to transmit light from the proximal end of said first sheath to the distal end of said second sheath for illuminating the internal orifice; means forming an irrigation channel within said first and second sheaths and adapted to conduct irrigation uids therethrough; and a telescopic eyepiece connected to the proximal end of said iirst sheath and adapted for visualizing the internal orice.
2. A choledochoscope comprising a mounting member; a proximal sheath and a distal sheath connected to and extending from opposite sides of said mounting member; a rst telescopic tube eccentrically disposed within said proximal sheath and connected to said mounting member; a second -telescopic tube concentrically disposed within said distal sheath; a middle tube concentrically disposed between said distal sheath and said second telescopic tube and connected to said mounting member and forming first and second annular chambers therewith, a plurality of light-conducting bers disposed between said proximal sheath and said first telescopic tube and within said rst annular chamber and supporting said second telescopic tube within said middle tube, said light-conducting bers being substantially coextensive with the distal end of said distal sheath and extending adjacent the proximal end of said proximal sheath, the proximal ends ot said light-conducting fibers being disposed at an angle to the proximal end of said proximal `sheath and being adapted for connection to a source of external light whereby the internal oriice may be illuminated; an irrigation conduit disposed between said first telescopic tube and said proximal sheath and communicating with said second annular chamber, coupling means connected to the proximal end of said conduit whereby irrigation lluids may be introduced into and removed from the internal orice; first and second telescopic lens systems disposed respectively within said first and second telescopic tubes, a prism adjustably mounted within said mounting member and optically connecting said lens systems, and a telescopic eyepiece connected to the proximal end of said proximal sheath and disposed in operative relation with said telescopic systems.
References Cited by the Examiner UNITED STATES PATENTS 598,787 2/1898 Kelling 128-8 2,599,662 6/1952 Rosenbaum 128--6 3,089,484 5/1963 Hett 12S-6 FOREIGN PATENTS 23,821 11/1901 Great Britain.
RICHARD A. GAUDET, Primary Examiner.
DALTON L. TRULUCK, Examiner.
Citas de patentes