WO2010043961A1

WO2010043961A1 - A thoracoscope

Info

Publication number: WO2010043961A1
Application number: PCT/IB2009/007145
Authority: WO
Inventors: Serita Barnard
Original assignee: University Of Cape Town
Priority date: 2008-10-17
Filing date: 2009-10-16
Publication date: 2010-04-22
Also published as: ZA201102875B

Abstract

A thoracoscope (1) is provided having an elongate, rigid body (2) with an ocular end (4) and an objective end (6) and with a line to sight therethrough. The objective end (6) is shaped to be suitable for insertion through an incision into a thoracic cavity and configured to displace the line of sight substantially normally at the objective end. The body is made of a stainless steel which permits it to be sterilised for re-use.

Description

A THORACOSCOPE

FIELD OF THE INVENTION

This invention relates to a thoracoscope.

BACKGROUND TO THE INVENTION

There is a high prevalence of inflammatory lung diseases in third world countries. Operations relating to these diseases are associated with great blood loss from the thoracic wall and it can be very difficult to visualise the areas from which blood loss occurs.

The only commercially produced scopes are straight rigid scopes, flexible scopes and small endoscopes for closed procedures. Straight scopes and small endoscopes give a limited view distal to the site of entrance and flexible scopes require both hands for usage. Also, some training is normally required to competently work with flexible endoscopes.

The visual aids currently available thus do not provide adequate assistance to the surgeon during a thoracotomy.

OBJECT OF THE INVENTION

It is an object of this invention to provide a thoracoscope which will at least partially alleviate some of the abovementioned problems. SUMMARY OF THE INVENTION

In accordance with this invention there is provided a thoracoscope comprising an elongate, rigid body with an ocular end and an objective end and providing a line to sight therethrough, with the objective end shaped to be suitable for insertion through an incision into a thoracic cavity and configured to displace the line of sight substantially normally at the objective end.

Further features of the invention provide for a light source to be provided which emits light in the line of sight of the objective end; for the light source be externally secured to the body; and for the light source to include a fibre optic bundle securable to the body with a battery and bulb housing releasably securable thereto.

According to one aspect of the invention the body is tubular with a reflector provided internally thereof adjacent the objective end to reflect light from an opening in the side up the length of the tube.

Further features according to this aspect of the invention provide for a tubular projection to extend normally about the opening in the body at its objective end; for a lens to be provided over each of the open ends of the tube; and for a dove prism to be provided internally thereof.

Still further features of the invention provide for the tube to be made of stainless steel; and for the thoracoscope to be reusable.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be described, by way of example only, with reference to the drawings in which: Figure 1 is a perspective view of a thoracoscope; and

Figure 2 is a sectional side elevation of the thoracoscope in Figure 1.

DETAILED DESCRIPTION OF THE INVENTION

A thoracoscope (1 ) is shown in Figures 1 and 2 and includes an elongate tubular body (2) having a rectangular cross section. In this embodiment, the body is made of stainless steel and has an ocular end (4) and an objective end (6). The ocular end (4) is covered by a clear glass lens (8) while the objective end (6) is blind but has an opening in the side of the body about which a tubular projection (10) extends normally from the side of the tube (2). The free end (12) of the projection (10) is similarly covered by a clear glass lens (14).

A reflector (16), in this embodiment a mirror, is secured in the tube (2) at the objective end (6) at a 45° angle so that light entering through the lens (14) at the end (12) of the projection (10) is displaced through 90° and along the length of the tube (2). A dove prism (18) is secured centrally within the body (2) to invert images visible through the lens (8).

The thoracoscope (1 ) also has a light source (20) which includes a housing (22) containing a battery and a bulb (not shown) which is releasably securable to a stainless steel tube (24) in which is secured a fibre optic bundle (not shown). The tube (24) is releasably secured through clips (26,

28) to the side of the body (2) and projection (10) and has a bend (30) at the juncture of the body (2) and projection (10). This type of light source is well known in the art. In use, the light source (20) is operated by securing the housing (22) to the tube (24) and switching it on. This causes light to be emitted in the direction of the projection (10). In a thoracotomy, the patient lies on his or her side with one arm raised and an incision made in the skin of the ribcage. Hereafter the muscle layers are cut, and a rib may be removed to gain access to the chest cavity. Retractors are generally used to hold the ribs apart, exposing the lung. With one hand a surgeon (not shown) can then insert the objective end (6) of the tube (2) into the incision of the thoracotomy and view the interior of the chest cavity by looking through the lens (8) at the ocular end (4) while moving the objective end (6) about. The surgeon's other hand remains free to use other instruments. For example, the surgeon could attend to areas of bleeding with one hand while using the other hand to hold the thorascope and view the area. This is very difficult or impossible to achieve with scopes requiring the use of two hands, whilst straight endoscopes do not permit adequate visualisation of the entire area.

The length of the body should be sufficient to avoid excessive bending or stretching of a surgeon to see through the ocular end. Also, it should be long enough to enable a surgeon to hold onto it and extend it into the chest cavity, and potentially attach a retractor to it. If it is too short it is not possible to angle the objective end optimally under the chest cavity. The length of the body could thus range between about 100 mm and 150 mm for children and 200 and 400 mm for adults. It has been found that a convenient length for the body is approximately 300mm.

The objective end is shaped to be suitable for insertion through the incision into the thoracic cavity and thus should be fairly compact and with rounded edges which avoid causing damage to tissue should they come into contact with the patient's body. Also, it is preferable for the projection to be as short as possible to enable the surgeon to get the objective end as close to an area under scrutiny as possible. The close the surgeon is able to get the more control there is over the work being performed in that area. It has been found that the projection should conveniently be less than 30 mm long, preferably about 20mm long and 10mm in height. This is about as short as the projection can be and still accommodate a suitable prism.

The circumference of the body is such that it can be comfortably held in one hand and also easily inserted into the thoracic cavity and rotated within the incision.

The thoracoscope is constructed to be reusable and can be sterilised. Gas sterilisation and radiation sterilisation is preferably to autoclaving or liquid sterilisation as the heat from the autoclave causes differential expansion of the lenses and body of the thoracoscope which can result in damage. The liquids used for sterilisation can also result in discolouration of adhesives used, for example, in the fibre optics of the light source. Even where the thorascope is not intended for reuse, it is critical that it be capable of being sterilised priorto use in surgery.

The thoracoscope has been found to be highly effective in use and can be cost effectively manufactured. It will be appreciated, however, that many other embodiments of a thoracoscope exist which fall within the scope of the invention particularly as regards the configuration thereof. For example, it is not necessary to have a dove prism to rectify the image viewed through the ocular end and a prism could also be used as a reflector. Also, provision could be made for rectifying or inverting the reflected image. Alternatively, the tube could contain a fibre optic bundle or a single suitably thick optical fibre. Provision could also be made for magnifying the image and the lenses could be treated to prevent fogging. Still further, the tube need not be rectangular but could be round or have any suitable shape. It will be appreciated however that the rectangular tube with a 10 mm height provides a larger image than does a round tube with a 10 mm diameter.

Claims

1. A thoracoscope (1 ) capable of being sterilised prior to use comprising an elongate, rigid body (2) with an ocular end (4) and an objective end (6) and providing a line to sight therethrough, with the objective end shaped to be suitable for insertion through an incision into a thoracic cavity and configured to displace the line of sight substantially normally at the objective end.

2. A thoracoscope as claimed in claim 1 wherein a light source (20) is provided which emits light in the line of sight of the objective end

3. A thoracoscope as claimed in claim 2 wherein the light source is externally secured to the body.

4. A thoracoscope as claimed in claim 2 or claim 3 wherein the light source includes a fibre optic bundle securable to the body with a battery and bulb housing (22) releasably securable to the fibre optic bundle.

5. A thoracoscope as claimed in any one of the preceding claims wherein the body is tubular with a reflector (16) provided internally thereof adjacent the objective end to reflect light from an opening in the side up the length of the tube.

6. A thoracoscope as claimed in claim 5 wherein a tubular projection (10) extends normally about the opening in the body at its objective end.

7. A thoracoscope as claimed in claim 6 wherein the tubular projection is less than 30 mm long.

8. A thoracoscope as claimed in one of claims 5 to 7 wherein a lens (8, 14) is provided over each of the open ends of the tube.

9. A thoracoscope as claimed in any one of claims 5 to 8 wherein a dove prism is provided internally thereof.

10. A thoracoscope as claimed in any one of claims 5 to 9 wherein the tube is made of stainless steel.

11. A thoracoscope as claimed in any one of the preceding claims wherein the thoracoscope is reusable.

12. A thoracoscope as claimed in any one of the preceding claims wherein the body has a length of between 100mm and 400mm.