US20020133077A1 - Transesophageal ultrasound probe having a rotating endoscope shaft - Google Patents

Abstract

A transesophageal ultrasound probe is provided for imaging internal structures via an imaging element located on the distal end of a rotating endoscope shaft. The probe includes a rotating endoscope having an imaging element, such as a transducer, mounted on the distal end of the rotating endoscope shaft. The probe also includes a control handle for controlling the imaging controls and a rotation tube that extends through the rotating endoscope shaft and into the control handle. The rotating shaft rotates relative to, and independently of, the control handle. Preferably, the rotating shaft is rotated via a rotation control wheel located at the distal end of the control handle. The rotation control wheel is fastened or bonded to the rotating tube so that manual rotation of the control wheel causes the rotation tube to rotate, and therefore, the rotating shaft to rotate. Because the rotating endoscope shaft rotates, an imaging element located on, or within, the rotating shaft also rotates. The rotating shaft may also be set in a locked position so that the rotating shaft may be configured, or preset, to various rotated positions. Alternatively, the rotation of the rotating endoscope shaft may be fully automated. By including a motor fixed to a fixed portion of the shaft, or to the control handle. The motor also includes a driving cog wheel, or gear system, that operatively engages a driven cog wheel, or gear system, attached to a rotating portion of the shaft. The rotation of the rotating shaft may then be controlled by levers, potentiometers, or other such devices located on the control handle.

Description

BACKGROUND OF INVENTION
• A preferred embodiment of the present invention generally relates to transesophageal probes, and more particularly relates to an improved transesophageal ultrasound probe having a rotating endoscope shaft.[0001]
• Various medical conditions affect internal organs and structures. Efficient diagnosis and treatment of these conditions typically require a physician to directly observe a patient's internal organs and structures. For example, diagnosis of various heart ailments often requires a cardiologist to directly observe affected areas of a patient's heart. Instead of more intrusive surgical techniques, ultrasound imaging is often utilized to directly observe images of a patient's internal organs and structures.[0002]
• Transesophageal Echocardiography (TEE) is one approach to observing a patient's heart through the use of an ultrasound transducer. TEE typically includes a probe, a processing unit, and a monitor. The probe is connected to the processing unit which in turn is connected to the monitor. In operation, the processing unit sends a triggering signal to the probe. The probe then emits ultrasonic signals into the patient's heart. The probe then detects echoes of the previously emitted ultrasonic signals. Then, the probe sends the detected signals to the processing unit which converts the signals into images. The images are then displayed on the monitor. The probe typically includes a semi-flexible endoscope that includes a transducer located near the end of the endoscope.[0003]
• Typically, during TEE, the endoscope is introduced into the mouth of a patient and positioned in the patient's esophagus. The endoscope is then positioned so that the transducer is in a position to facilitate heart imaging. That is, the endoscope is positioned so that the heart or other internal structure to be imaged is in the direction of view of the transducer. Typically, the transducer sends ultrasonic signals through the esophageal wall that come into contact with the heart or other internal structures. The transducer then receives the ultrasonic signals as they bounce back from various points within the internal structures of the patient. The transducer then sends the received signals back through the endoscope typically via wiring. After the signals travel through the endoscope, the signals enter the processing unit typically via wires connecting the endoscope to the processing unit.[0004]
• Often, in addition to the heart, it may be desirable to image other internal structures within the body of a patient. Imaging other internal structures may require re-positioning of the probe in order to view the internal organs. Additionally, viewing the heart and/or other internal structures from various angles and perspectives may require re-positioning of the probe.[0005]
• FIG. 1 illustrates a conventional[0006]transesophageal ultrasound probe100 according to one embodiment of the prior art. Theprobe100 includes acontrol handle110, afixed endoscope shaft120 fastened to the distal end of thecontrol handle110, and asystem cable130 attached to the proximal end of thecontrol handle110. Thefixed endoscope shaft120 includes ascanhead122 located at the distal end of the fixedendoscope shaft120. Thescanhead122 includes animaging element124, such as a transducer (not shown). Thecontrol handle110 includesimaging controls112 mounted on thecontrol handle110. Theimaging controls112 include imaging control wheels114 and scan plane push buttons116 that control the orientation of thescanhead122. Theimaging element124 is connected to a processing unit (not shown) via wiring (not shown) that extends through thescanhead122 and throughout the length of the body of theprobe100. The wiring in theprobe100 is then connected via thesystem cable130 to the processing unit. The processing unit is then connected via wiring to a monitor (not shown) for display of the image.
• In operation, the[0007]fixed endoscope shaft120 of theprobe100 is introduced into the esophagus of a patient. Thefixed endoscope shaft120 is then positioned via thecontrol handle110 so that the internal structure to be imaged is within the field of view of theimaging element124 located on, or within, thescanhead122. Typically, theprobe100 is axially rotated to position the desired internal structure in the field of view of theimaging element124. In order to rotate theendoscope shaft120, theentire probe100 must be rotated. That is, thecontrol handle110 must be rotated so that theimaging element124 may image internal structures from different angles and perspectives. For example, to rotate the direction ofview124 of the imaging element of thescanhead122 by 30°, thecontrol handle110 typically needs to be rotated 30° because the fixedendoscope shaft120 is firmly fixed to thecontrol handle110. Thus, thefixed endoscope shaft120 is not allowed to rotate independently of thecontrol handle110. Therefore, as thecontrol handle110 is rotated by 30°, theimaging controls122 will also be rotated by 30°. Unfortunately, rotating theimaging controls122 often may cause confusing and/or counter-intuitive operation of theprobe100. That is, because theimaging controls112 are fixed, it may be difficult or impossible for an operator to obtain the images he/she desires. Further, observing the resulting images from the physically rotated probe may be confusing. The confusion may lead to misdiagnosis, risks of injury and/or increased time to perform the imaging procedure.
• Therefore, a need has existed for a transesophageal ultrasound probe that provides greater and easier access to images of a patient's internal structures. Further, a need has also existed for a transesophageal ultrasound probe that facilitates more intuitive imaging of internal structures from various angles and perspectives.[0008]
SUMMARY OF INVENTION
• The present invention relates to an internal imaging probe for use in a medical imaging system. The probe includes a rotating shaft, such as a rotating endoscope shaft, having an imaging element, such as a transducer, mounted on the distal end of the rotating shaft. The probe also includes a control handle for controlling the imaging element. Preferably, a rotating tube within the probe extends through the rotating shaft into the control handle. The rotation of the rotating tube causes the rotating shaft to rotate. The rotating shaft rotates relative to, and independently of, the control handle to which it is connected. Washers and O-rings provide low friction connections between the rotating tube located in the probe and the control handle.[0009]
• Preferably, the rotating shaft is rotated via a rotation control wheel located at the distal end of the control handle. The rotation control wheel is fastened or bonded to the rotating tube so that manual rotation of the control wheel causes the rotating tube, and therefore the rotating shaft, to rotate. Because the rotating shaft rotates, an imaging element located on, or within, the rotating shaft also rotates. The rotating shaft may also be set in a locked position so that the rotating shaft may be configured, or preset, to various rotated positions.[0010]
• Alternatively, the rotation of the rotating shaft may be fully automated. The automated probe may include a motor fixed to a fixed portion of the shaft, or to the control handle. The motor also includes a driving cog wheel, or gear system, that operatively engages a driven cog wheel, or gear system, attached to a rotating portion of the shaft. The rotation of the rotating shaft may then be controlled by levers, potentiometers, or other such devices located on the control handle.[0011]
BRIEF DESCRIPTION OF DRAWINGS
• FIG. 1 illustrates a conventional transesophageal ultrasound probe according to one embodiment of the prior art.[0012]
• FIG. 2 illustrates a transesophageal ultrasound probe according to a preferred embodiment of the present invention.[0013]
• FIG. 3 illustrates a transverse cross-sectional view of the transesophageal ultrasound probe of FIG. 2 according to a preferred embodiment of the present invention.[0014]
• FIG. 4 illustrates an axial cross-sectional view through the rotation control wheel of the transesophageal ultrasound probe of FIG. 2 according to a preferred embodiment of the present invention.[0015]
• FIG. 5 illustrates a transverse cross-sectional view of the transesophageal ultrasound probe of FIG. 2 with a braking mechanism according to an alternative embodiment of the present invention.[0016]
• FIG. 6 illustrates a transverse cross-sectional view of a transesophageal ultrasound probe segment according to an alternative embodiment of the present invention.[0017]
• FIG. 7 illustrates an cross-sectional axial view of the transesophageal ultrasound probe segment of FIG. 6 according to an alternative embodiment of the present invention.[0018]
• FIG. 8 illustrates a flow chart of a preferred embodiment of the present invention.[0019]
DETAILED DESCRIPTION
• The foregoing summary, as well as the following detailed description of the preferred embodiments of the present invention, will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the invention, there are shown in the drawings, embodiments which are presently preferred. It should be understood, however, that the present invention is not limited to the precise arrangements and instrumentality shown in the attached drawings.[0020]
• FIG. 2 illustrates a[0021]transesophageal ultrasound probe200 according to a preferred embodiment of the present invention. Theprobe200 includes acontrol handle210, arotating endoscope shaft220 extending from the control handle210, and asystem cable230 connecting the control handle210 to a processing unit (not shown). The control handle210 includes imaging controls212 mounted on thecontrol handle210. The imaging controls212 includeimaging control wheels214 and scanplane push buttons216 for controlling the movement of animaging element224 located on, or within, the distal end of theimaging probe200. Therotating endoscope shaft220 includes ascanhead222. Thescanhead222 includes theimaging element224, such as a transducer. Preferably, the imaging element is located at the distal end of therotating endoscope shaft220. Additionally, therotating endoscope shaft220 includes arotation control wheel226 fastened to therotating shaft220 and located at the distal end of thecontrol handle210.
• FIG. 3 illustrates a transverse[0022]cross-sectional view300 of thetransesophageal ultrasound probe200 of FIG. 2 according to a preferred embodiment of the present invention. The crosssectional view300 includes the control handle210, therotating endoscope shaft220, arotating tube325 having an extendedproximal end326, therotation control wheel226, a threadedinterface320, aninner cavity322, awheel stop area335, awasher338, O-rings334, atube stop area337, and awasher339. Therotating tube325 extends throughout the body of therotating shaft220 and into thecontrol handle210. Theinner cavity322 is formed within therotating tube325. Therotating tube325 is fastened to therotation control wheel226 at the threadedinterface320. Therotation control wheel226 abuts thewheel stop area335 via thewasher338. Thewasher338 in turn abuts thecontrol handle210. The control handle210 is connected to therotation tube325 via the O-rings334. The control handle210 abuts thetube stop area337 via thewasher339. Thewasher339 in turn abuts the extendedproximal end326 of therotation tube325. Thewasher338 and O-rings334 provide a low-friction connection between the control handle210 and therotation control wheel226. Similarly, thewasher339 and O-rings334 provide a low-friction connection between the control handle210 and the extendedproximal end326 of therotation tube325. Additionally, the O-rings334 provide a sealing connection between the control handle210 and therotating tube325.
• FIG. 4 illustrates an axial cross-sectional view[0023]400 through therotation control wheel226 of thetransesophageal ultrasound probe200 of FIG. 2 according to a preferred embodiment of the present invention. FIG. 4 includes therotation tube325 defining theinner cavity322, the threadedinterface320, areference line420 illustrating the circumference of the extended control handle210 and thecontrol wheel226.
• Referring to FIG. 3, the[0024]rotating tube325 is fastened to thecontrol wheel226 via the threadedinterface320. Preferably, therotating tube325 is securely fastened to therotation control wheel226 via the threadedinterface320 with a fastening agent, such as glue or some other fastening agent, that forms a fluid-tight seal. Thecontrol wheel226 is separated from the control handle210 by thewasher338. For example, the washer may be a low friction plastic washer that fits over therotating tube325. Alternatively, thewasher338 may be a locking washer. In addition to providing a low friction interface between therotation control wheel226 and the control handle210, thewasher338 also provides a seal between therotation control wheel226 and thecontrol handle210. Additionally, the O-rings334 form a fluid-tight seal between the control handle210 and therotating endoscope shaft220.
• The control handle[0025]210 is separated from theproximal end326 of therotating tube325 by thewasher339. Preferably, the diameter of theproximal end325 of therotating tube325 is greater than the diameter of the internally introduced portion of therotating tube325. Preferably, theproximal end325 of therotating tube325 abuts thetube stop area337 when theprobe200 of FIG. 2 is fully assembled.
• During assembly, the[0026]rotation control wheel226 is rotated on the thread of therotating rube325 while therotating tube325 does not rotate, thus introducing theproximal end326 of therotating tube325 into contact with thetube stop area337 as therotation control wheel226 comes into contact with thewheel stop area335. Thewasher338 cushions and seals a low-friction connection between therotation control wheel226 and the control handle210 as therotation control wheel226 and the control handle210 come together. Similarly, thewasher339 cushions and seals a low-friction connection between theproximal end326 of therotation tube325 and the control handle210 as theproximal end326 of therotation tube325 and the control handle210 come together.
• Once the[0027]rotation control wheel226 has been rotated to its fullest extent, therotation control wheel226 is sealed to therotating tube325 at the threadedinterface320. Thus, thewasher338 forms a compressive seal between therotation control wheel226 and the control handle210; and thewasher339 forms a compressive seal between theproximal end326 of therotation tube325 and the control handle210 at thetube stop area337. Washers and O-rings may be integrated as part of therotation control wheel226,rotating tube325 or the control handle210 if necessary. For example, if therotation control wheel226 is composed of hard plastic, then thewasher338 may not be necessary.
• In general, the[0028]probe200 of FIG. 2 may be included in a medical imaging system. Such a medical imaging system may include theprobe200, a processing unit (not shown), and a monitor (not shown). In operation, an internal structure is imaged by theprobe200 and the resultant image is sent to the processing unit for processing and display on the monitor.
• Referring again to FIG. 2, in operation, the[0029]rotating endoscope shaft220 is introduced into the patient's esophagus via the patient's mouth in a similar fashion as that of theconventional probe100 of FIG. 1. Once therotating endoscope shaft220 is introduced, therotating endoscope shaft220 is positioned such that an internal structure to be imaged is within the field of view of theimaging element224. Theimaging element224, such as a transducer, located within thescanhead222 is controlled via the imaging controls212 located on thecontrol handle210. Theimaging element224 is connected to the imaging controls212 via wiring (not shown) within theinner cavity322 of theprobe200. During imaging, theimaging element224 of thescanhead222 sends and receives signals through wiring (not shown) located within theinner cavity322 of theimaging probe200 to a processing unit (not shown) via thesystem cable230. The processing unit receives the signals via thesystem cable230, which is in turn connected to wiring located within theprobe200.
• During imaging, the[0030]rotating endoscope shaft220 may be rotated relative to, and independent of, thecontrol handle210. That is, the control handle210 may remain in one orientation while therotating endoscope shaft220 is rotated about an axis that is common to both therotating endoscope shaft220 and thecontrol handle210. In order to rotate therotating endoscope shaft220 about the common axis, therotation control wheel226 is turned. Because therotating tube325 is fastened to therotation control wheel226, rotation of therotation control wheel226 causes a corresponding rotation in therotating tube325. The rotation of therotating tube325 causes therotating endoscope shaft220 to rotate. The independent rotation of therotating endoscope shaft220 allows the control handle210 to remain in the same orientation throughout the imaging process while therotating endoscope shaft220 rotates to allow theimaging element224 of thescanhead222 to image internal structures from different angles and perspectives.
• Optionally, the[0031]rotating endoscope shaft220 may be set, or locked, into position at any point throughout its rotation by a locking mechanism (not shown). The locking mechanism may be controlled via therotation control wheel226, or additional controls located on thecontrol handle210. For example, therotating endoscope shaft220 may be locked, or set, into a position corresponding to a position that is comfortable and intuitive to a particular physician, cardiologist, or other user of theprobe200. For example, an individual may prefer to position theimaging element224 fixed to therotating endoscope shaft220 at a 30° radial rotation with respect to the imaging controls212 positioned on the control handle210 before, and throughout, the imaging process. Alternatively, the rotation of therotating endoscope shaft220 may be sufficiently stiff so that a locking mechanism is not necessary.
• Also, a physical end-stop may be located on the[0032]proximal end326 of therotating tube325. The end-stop may limit the rotation of therotating tube325 and therefore, therotating endoscope shaft220, to 180° or less in order to prevent twisting the various wires and cables (not shown) located in theinner cavity322 of theprobe220. The end-stop may be a pin, block, notch, or other stopping mechanism attached to theproximal end326 ofrotating tube325 that comes into contact with another pin, block, notch, or other stopping mechanism, attached to the interior of thecontrol handle210.
• FIG. 5 illustrates a transverse[0033]cross-sectional view800 of thetransesophageal ultrasound probe200 of FIG. 2 with a low friction braking mechanism805 according to an alternative embodiment of the present invention. Thecross-sectional view800 includes the control handle210, therotating endoscope shaft220, therotating tube325 having the extendedproximal end326, therotation control wheel226, the threadedinterface320, theinner cavity322, thewheel stop area335, a single O-ring370, thetube stop area337, thewasher339, and a low friction braking mechanism805. The braking mechanism805 includes abrake handle810, abrake limit820, anflanged cylinder brake830, and a series ofthreads835 between thebrake handle810 and thebrake830. Thelow friction washer338 of FIG. 3 is replaced by the low friction braking mechanism805. Thebrake830 is threadably fastened onto the rotating braking handle810 via thethreads835. Thebrake limit820 is preferably a spring-ball configuration that limits, or restricts, the rotation of thebrake handle810. Thebrake limit820 is positioned within the main body of the control handle210 and extends into therotating braking handle810.
• In operation, the[0034]brake handle810 is engaged to brake, or lock, the rotation of therotating tube325. Preferably, thebrake handle810 is rotated to brake therotating tube325. Because thebrake830 is threadably fastened onto thebrake handle810, thebrake830 moves linearly towards, or away from, therotation control wheel226 as thebrake handle810 is rotated. As thebrake handle810 rotates in a locking direction, thebrake830 is compressed into therotation control wheel226. Thebrake830 brakes therotation control wheel226 as thebrake830 is compressed into therotation control wheel226. As the rotation of therotation control wheel226 is braked, the rotation of therotating tube325 is also braked. Thebrake limit820 limits the rotation of thebrake handle810. For example, thebrake limit820 may include pre-defined locked positions that stop the rotation of the brake handle810 as thebrake handle810 rotates into one of the locked positions. As thebrake handle810 rotates away from the locking direction, thereby disengaging thebrake830, thebrake830 moves away from therotation control wheel226. As thebrake830 is disengaged, therotation control wheel226 is able to rotate; thus, therotating tube325 is able to rotate.
• Alternatively, the brake mechanism[0035]805 may include a screw that may be positioned perpendicular to the surface of therotating tube325 via a threaded hole in thecontrol handle210. As the screw is engaged, the screw moves toward therotating tube325. The screw restricts the rotation of therotating tube325 as the screw is threaded through the control handle210 towards, and into, therotating tube325. Therotating tube325 may include notches that may receive the screw. As the screw enters the notches on therotating tube325, the rotation of the rotating tube is restricted.
• Alternatively, the rotation of the[0036]rotating endoscope shaft220 may be controlled in various ways. For example, theprobe200 may be fully automated. That is, the rotation of therotating endoscope shaft220 may be controlled through the use of motors, gears, and/or cog wheels.
• FIG. 6 illustrates a transverse cross-sectional view of a transesophageal[0037]ultrasound probe segment500 according to an alternative embodiment of the present invention. The transverse cross-sectional view includes a fixedendoscope shaft510, arotating shaft540, bearings532, aninner cavity530, and an O-ring534. The fixedendoscope shaft510 includes amotor520 mounted to the interior of the fixedendoscope shaft510. Themotor510 includes anaxle524 extending toward the distal end of theprobe segment500 and a drivingcog wheel526 attached at the opposite end of theaxle524 from themotor510. Therotating shaft540 includes a drivencog wheel546 extending into theinner cavity530. The bearings532 encircle the fixedendoscope shaft510 and provide a low-friction connection between the fixedendoscope shaft510 and therotating shaft540. Theinner cavity530 is formed within theprobe segment500 and extends through the fixedendoscope shaft510 and therotating shaft540. The O-ring534 encircles the fixedendoscope shaft510 and provides a fluid-tight seal between the fixedendoscope shaft510 and therotating shaft540.
• FIG. 7 illustrates an axial cross-sectional view[0038]600 of the transesophagealultrasound probe segment500 of FIG. 6 according to an alternative embodiment of the present invention. The cross-sectional axial view600 includes the fixedendoscope shaft510, themotor520, the drivingcog wheel526, theinner cavity530, the bearing532, therotating shaft540 and the drivencog wheel546.
• In operation, the[0039]rotating shaft540 is engaged by controls (not shown), such as buttons, levers, or potentiometers, located on thecontrol handle210. Themotor520 is electrically connected to the controls via wiring. When activated, themotor520 rotates theaxle524, which in turn, rotates the drivingcog wheel526. The drivingcog wheel526 operatively engages the drivencog wheel546. Therefore, as the drivingcog wheel526 rotates, the drivencog wheel546 rotates in the same direction as that of the drivingcog wheel526. The rotation of the drivencog wheel546 in turn causes therotating shaft540 to rotate in the same direction as that of the drivencog wheel546. Thescanhead222 located on the distal end ofrotating shaft540 therefore rotates as therotating shaft540 rotates.
• The interface between the[0040]rotating shaft540 and the fixedendoscope shaft510 may be located at various points of theprobe segment500. For example, the interface between therotating shaft540 and the fixedendoscope shaft510 may be located near the control handle210, near thescanhead222, or positioned at various points between the control handle210 and thescanhead222. Alternatively, the fixedendoscope shaft510 may be part of the control handle210 of theprobe200 of FIG. 2. Thus, themotor520 may be attached to the interior of thecontrol handle210.
• FIG. 8 illustrates a[0041]flow chart700 of a preferred embodiment of the present invention. First, atstep710, a physician rotates theendoscope shaft220 relative to the control handle210 to suit the physician's preference. That is, the physician rotates theendoscope shaft220 atstep710 for optimal comfort. Next, atstep720, the physician introduces therotating endoscope shaft220 into a patient's esophagus. The physician then adjusts, or positions, therotating endoscope shaft220 to a suitable position for viewing atstep730. That is, the physician adjusts, or positions, therotating endoscope shaft220 to a suitable position for viewing a particular internal structure.
• The physician then rotates the[0042]endoscope shaft220 so that theimaging element224 points towards an internal structure of interest. The physician may either rotate theendoscope shaft220 relative to the control handle210 via therotation control wheel226 atstep740, or the physician may rotate theendoscope shaft220 together with thecontrol handle210. Next, atstep760, the physician positions therotating endoscope shaft220 so that an internal structure to be imaged is within the field of view of theimaging element224 located on thescanhead222 of therotating endoscope shaft220. Atstep760, therotating endoscope shaft220 is positioned via imaging controls212 or other controls on the control handle210 so that an internal structure is within the field of view of theimaging element224 located on thescanhead222. After the physician positions therotating endoscope shaft220 so that an internal structure is within the field of view of theimaging element224, the internal structure is imaged. Finally, atstep770, the physician removes therotating endoscope shaft220 from the esophagus of the patient after imaging is complete.
• Alternatively, the physician may rotate the[0043]rotating endoscope shaft220 via therotation control wheel226 during the imaging process to view different internal structures within the body of the patient. Also, the physician may rotate therotating endoscope shaft220 via therotation control wheel226 during the imaging process to view the original internal structure from a different perspective.
• Thus the present invention provides an improved transesophageal ultrasound probe that provides greater and easier access to images of internal structures within a patient because the probe includes a rotating shaft that rotates independently of the probe's control handle. The independent rotation of the rotating shaft provides greater imaging access. Further, the transesophageal ultrasound probe having a rotating endoscope shaft facilitates more intuitive images of internal structures from various angles and perspectives. Additionally, various other imaging methods, such as live video, may be used with the present invention. Also, the present invention is not limited to imaging. For example, the present invention may also be utilized in surgical applications such as trans-rectal prostate treatment.[0044]
• While particular elements, embodiments and applications of the present invention have been shown and described, it is understood that the invention is not limited thereto since modifications may be made by those skilled in the art, particularly in light of the foregoing teaching. It is therefore contemplated by the appended claims to cover such modifications and incorporate those features which come within the spirit and scope of the invention.[0045]

Claims (45)

1. An internal imaging probe including: a rotating shaft having an imaging element and a rotation control; and a control handle, said rotation control for rotating said imaging element relative to said control handle.

2. The probe ofclaim 1 wherein said probe is a transesophageal echocardiography probe.

3. The probe ofclaim 1 wherein said rotation control includes a rotation control wheel.

4. The probe ofclaim 1 further including:

a rotating tube extending through said rotating shaft into said control handle; and

a rotation control wheel, wherein said rotation control wheel is fastened to said rotating tube.

5. The probe ofclaim 4 further including at least one washer located between said rotating tube and said control handle for decreasing friction between said rotating tube and said control handle.

6. The probe ofclaim 4 further including at least one O-ring forming a seal between said rotating tube and said control handle.

7. The probe ofclaim 1 further including:

a fixed endoscope shaft;

a rotating shaft;

a motor fixed to said fixed endoscope shaft;

a driving cog wheel attached to said motor; and

a driven cog wheel attached to said rotating shaft,

said driving cog wheel operatively engaging said driven cog wheel to rotate said rotating shaft relative to said control handle.

8. The probe ofclaim 7 further including a bearing for decreasing the friction between said fixed endoscope shaft and said rotating shaft.

9. The probe ofclaim 7 further including an O-ring forming a seal between said rotating shaft and said fixed endoscope shaft.

10. The probe ofclaim 1 wherein said imaging element is a transducer.

11. The probe ofclaim 1 wherein said control handle includes imaging controls for controlling said imaging element.

12. The probe ofclaim 1 further including a braking mechanism, wherein said braking mechanism may lock said rotating shaft into a rotated position.

13. A medical imaging system including a probe for imaging internal structures of a patient, said probe including:

a rotating shaft having an imaging element and a rotation control; and

a control handle, said rotation control for rotating said imaging element relative to said control handle.

14. The system ofclaim 13 wherein said probe is a transesophageal echocardiography probe.

15. The system ofclaim 13 wherein said rotation control includes a rotation control wheel.

16. The system ofclaim 13 further including:

a rotating tube extending through said rotating shaft into said control handle; and

a rotation control wheel, wherein said rotation control wheel is fastened to said rotating tube.

17. The system ofclaim 16 further including at least one washer located between said rotating tube and said control handle for decreasing friction between said rotating tube and said control handle.

18. The system ofclaim 16 further including an O-ring forming a seal between said rotating tube and said control handle.

19. The system ofclaim 13 further including:

a fixed endoscope shaft;

a rotating endoscope shaft,

a motor fixed to said fixed endscope shaft;

a driving cog wheel attached to said motor; and

a driven cog wheel attached to said rotating shaft,

said driving cog wheel operatively engaging said driven cog wheel to rotate said rotating shaft relative to said fixed endoscope shaft.

20. The system ofclaim 19 further including a bearing for decreasing the friction between said control handle and said fixed endoscope shaft.

21. The system ofclaim 19 further including an O-ring forming a seal between said rotating shaft and said fixed endoscope shaft.

22. The system ofclaim 13 wherein said imaging element is a transducer.

23. The system ofclaim 13 wherein said control handle includes imaging controls for controlling said imaging element.

24. The system ofclaim 13 wherein said rotating shaft may be locked in a preconfigured rotated position.

25. A system for imaging internal structures of a patient including an internal imaging probe including:

a rotating shaft having an imaging element and a rotation control;

a control handle connected to said rotating shaft, said rotation control located at the distal end of said control handle, and said rotation control operable to rotate said imaging element relative to said control handle.

26. The system ofclaim 25 wherein said probe is a transesophageal echocardography probe.

27. The system ofclaim 25 further including at least one washer located between said rotating tube and said control handle for decreasing the friction between said rotating tube and said control handle.

28. The system ofclaim 25 further including an O-ring forming a seal between said rotating tube and said control handle.

29. The system ofclaim 25 wherein said imaging element is a transducer.

30. The system ofclaim 25 wherein said control handle includes imaging controls for controlling said imaging element.

31. The system ofclaim 25 further including a braking mechanism, said braking mechanism including:

a brake;

a brake handle threadably fastened to said brake; and

a brake limit restricting said brake handle, said brake handle rotating to linearly move said brake towards said rotation control.

32. The system ofclaim 25 further including a braking mechanism having a screw, said braking mechanism threading said screw into a rotation tube of said rotating shaft to restrict the rotation of said rotating shaft.

33. An internal imaging system including:

a rotating shaft having an imaging element;

a fixed endoscope shaft;

a motor fixed to said fixed endscope shaft;

a driving cog wheel attached to said motor; and

a driven cog wheel attached to said rotating shaft, said driving cog wheel operatively engaging said driven cog wheel to rotate said rotating shaft relative to said fixed endoscope shaft.

34. The system ofclaim 33 further including a bearing located between said fixed endoscope shaft and said rotating shaft for decreasing the friction between said fixed endoscope shaft and said rotating shaft.

35. The system ofclaim 33 further including an O-ring forming a seal between said rotating shaft and said control handle.

36. The system ofclaim 33 wherein said imaging element is a transducer.

37. The system ofclaim 33 wherein said control handle includes imaging controls for controlling said imaging element.

38. In a probe including a control handle and an imaging element, a method for positioning the imaging element of said probe relative to said control handle including the step of rotating said imaging element relative to said control handle.

39. The method ofclaim 38 further including the step of imaging an internal structure via said imaging element.

40. The method ofclaim 38 wherein said rotating step includes rotating said imaging element to image an internal structure from a different perspective.

41. The method ofclaim 38 wherein said rotating step includes rotating said imaging element to image a different internal structure.

42. The method ofclaim 38 wherein said rotating step includes rotating said imaging element relative to said control handle for optimal comfort.

43. The method ofclaim 38 wherein said rotating step includes the step of rotating an imaging element located on a distal end of a rotating endoscope shaft relative to said control handle.

44. The method ofclaim 43 further including the step of rotating said rotating endoscope shaft via a rotation control.

45. The method ofclaim 38 wherein said rotating step includes rotating said imaging element automatically via a motor attached to said control handle.

Images