US20080091068A1 - Endoscope assembly - Google Patents

Abstract

A locomotive endoscope assembly including a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably inflatable balloon associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably inflatable balloon associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably positionable portion relative to the main portion and selectable inflation of the first and second selectably inflatable balloons.

Description

REFERENCE TO RELATED APPLICATIONS
• Reference is made to U.S. Provisional Patent Application 60/542,680, filed Feb. 9, 2004 entitled “MICRO-ROBOT AND ACCESSORIES FOR ENDOSCOPY AND IN-PIPE LOCOMOTION” and to U.S. Provisional Patent Application 60/559,461, filed Apr. 6, 2004 entitled “DEVICES, ACCESSORIES AND METHODS FOR ENDOSCOPY AND IN-PIPE PROPAGATION”, the disclosures of which are hereby incorporated by reference and priority of which is hereby claimed pursuant to 37 CFR 1.78(a) (4) and (5)(i).
FIELD OF THE INVENTION
• The present invention relates to endoscopy generally and more particularly to locomotive endoscopes.
BACKGROUND OF THE INVENTION
• The following U.S. Patent Documents are believed to represent the current state of the art:
• U.S. Pat. Nos. 4,040,413; 4,176,662 and 5,662,587 and
• U.S. Patent Application Publication No. 2002/0156347
SUMMARY OF THE INVENTION
• The present invention seeks to provide an improved locomotive endoscope.
• The terms “endoscope” and “endoscopy” are used herein in a manner somewhat broader than their customary meaning and refer to apparatus and methods which operate within body cavities, passageways and the like, such as, for example, the small intestine, the large intestine, arteries and veins. Although these terms normally refer to visual inspection, as used herein they are not limited to applications which employ visual inspection and refer as well to apparatus, systems and methods which need not necessarily involve visual inspection.
• There is thus provided in accordance with a preferred embodiment of the present invention a locomotive endoscope assembly including a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably inflatable balloon associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably inflatable balloon associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably positionable portion relative to the main portion and selectable inflation of the first and second selectably inflatable balloons.
• In accordance with a preferred embodiment of the present invention at least one of the first and second selectably inflatable balloons includes a stretchable balloon. Preferably, the locomotive endoscope assembly also includes an endoscope body associated with the locomotive endoscope head. Optionally and preferably, an instrument channel at least partially extends through the locomotive endoscope head and the endoscope body.
• In accordance with another preferred embodiment of the present invention the locomotive endoscope head has a fixed length. Preferably, the endoscope body includes a multi-lumen tube. Alternatively or additionally, the endoscope body interfaces with the locomotive endoscope head controller.
• In accordance with yet another preferred embodiment of the present invention the locomotive endoscope assembly also includes an endoscopy system to which the locomotive endoscope head controller is connectable.
• In accordance with still another preferred embodiment of the present invention the multi-lumen tube includes at least one lumen operative for at least one of balloon inflation; positioning of the selectably positionable portion of the locomotive endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle and fluid communication. Preferably, the multi-lumen tube includes at least one lumen operative for each of balloon inflation; positioning of the selectably positionable portion of the locomotive endoscope head and passage therethrough of at least one of an optical fiber and an electrical conductor bundle. Typically and preferably, the at least one lumen includes at least one first lumen operative for inflation of the first selectably inflatable balloon and at least one second lumen operative for inflation of the second selectably inflatable balloon.
• In accordance with a further preferred embodiment of the present invention the selectably positionable portion is slidably positionable with respect to the main portion. Preferably, the locomotive endoscope head includes at least one light source and at least one imaging sensor. Additionally or alternatively, the first selectably inflatable balloon includes at least two independently inflatable balloon portions. As a further alternative, the second selectably inflatable balloon includes at least two independently inflatable balloon portions. Preferably, the at least two independently inflatable balloon portions of the second selectably inflatable balloon are azimuthally offset with respect to the at least two independently inflatable balloon portions of the first selectably inflatable balloon.
• In accordance with a still further preferred embodiment of the present invention the locomotive endoscope head controller provides locomotive functionality adapted to sequentially displace the locomotive endoscope head through a generally tabular body portion. Preferably, the locomotive functionality includes functionality providing the following sequential operations: inflating the first selectably inflatable balloon, thereby anchoring the first selectably inflatable balloon to an interior surface of the generally tubular body portion; axially repositioning the selectably positionable portion and the second selectably inflatable balloon relative to the first selectably inflatable balloon; inflating the second selectably inflatable balloon, thereby anchoring the second selectably inflatable balloon to an interior surface of the generally tubular body portion; deflating the first selectably inflatable balloon, thereby unanchoring the first selectably inflatable balloon from the interior surface of the generally tubular body portion; and axially repositioning the first selectably inflatable balloon relative to the selectably positionable portion and the second selectably inflatable balloon. Optionally, the first selectably inflatable balloon is arranged with respect to the generally tubular body portion to be forward of the second selectably inflatable balloon. Alternatively, the second selectably inflatable balloon is arranged with respect to the generally tubular body portion to be forward of the first selectably inflatable balloon.
• There is also provided in accordance with another preferred embodiment of the present invention a locomotive endoscope assembly including a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably radially extendible element associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably radially extendible element associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably positionable portion relative to the main portion and selectable extension of the first and second selectably radially extendible elements.
• In accordance with a preferred embodiment of the present invention at least one of the first and second selectably radially extendible elements includes a selectably inflatable balloon. Preferably, the selectably inflatable balloon includes a stretchable balloon.
• In accordance with another preferred embodiment of the present invention the locomotive endoscope assembly also includes an endoscope body associated with the locomotive endoscope head. Preferably, an instrument channel at least partially extends through the locomotive endoscope head and the endoscope body. More preferably the locomotive endoscope head has a fixed length.
• In accordance with yet another preferred embodiment of the present invention the endoscope body includes a multi-lumen tube. Preferably, the endoscope body interfaces with the locomotive endoscope head controller. Additionally and preferably, the locomotive endoscope assembly also includes an endoscopy system to which the locomotive endoscope head controller is connectable.
• In accordance with still another preferred embodiment of the present invention the multilumen tube includes at least one lumen operative for at least one of radially extending element extension; positioning of the selectably positionable portion of the locomotive endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle; and fluid communication. Preferably, the multi-lumen tube includes at least one lumen operative for each of radially extending element extension; positioning of the selectably positionable portion of the locomotive endoscope head; and passage therethrough of at least one of an optical fiber and an electrical conductor bundle. Typically and preferably, the at least one lumen includes at least one first lumen operative for extension of the first selectably radially extendible element and at least one second lumen operative for extension of the second selectably radially extendible element.
• In accordance with yet a further preferred embodiment of the present invention the selectably positionable portion is slidably positionable with respect to the main portion. Preferably, the locomotive endoscope head includes at least one light source and at least one imaging sensor.
• In accordance with yet a further preferred embodiment of the present invention the first selectably radially extendible element includes at least two independently extendible element portions. Additionally or alternatively, the second selectably radially extendible element includes at least two independently extendible element portions. Preferably, the at least two independently extendible element portions of the second selectably radially extendible element are azimuthally offset with respect to the at least two independently extendible element portions of the first selectably radially extendible element.
• In accordance with still a further preferred embodiment of the present invention the locomotive endoscope head controller provides locomotive functionality adapted to sequentially displace the locomotive endoscope head through a generally tubular body portion. Preferably, the locomotive functionality includes functionality providing the following sequential operations: extending the first selectably radially extendible element, thereby anchoring the first selectably radially extendible element to an interior surface of the generally tubular body portion; axially repositioning the selectably positionable portion and the second selectably radially extendible element relative to the first selectably radially extendible element; extending the second selectably radially extendible element, thereby anchoring the second selectably radially extendible element to an interior surface of the generally tubular body portion; retracting the first selectably radially extendible element, thereby unanchoring the first selectably radially extendible element from the interior surface of the generally tubular body portion; and axially repositioning the first selectably radially extendible element relative to the selectably positionable portion and the second selectably radially extendible element. Optionally, the first selectably radially extendible element is arranged with respect to the generally tubular body portion to be forward of the second selectably radially extendible element. Alternatively, the second selectably radially extendible element is arranged with respect to the generally tubular body portion to be forward of the first selectably radially extendible element.
• There is further provided in accordance with yet another preferred embodiment of the present invention an endoscope assembly including an endoscope head extending along a longitudinal axis and having a first plurality of selectably inflatable balloons associated therewith at least one first axial location therealong and a second plurality of selectably inflatable balloons associated therewith at least one second axial location therealong and an endoscope head controller being operative for controlling selectable inflation of the first and second pluralities of selectably inflatable balloons for selectable positioning of the endoscope head.
• In accordance with a preferred embodiment of the present invention the endoscope head controller is operative for controlling selectable inflation of the first and second pluralities of selectably inflatable balloons for selectable parallel off-center orientation of the endoscope head. Preferably, the endoscope head controller is operative for controlling selectable inflation of the first and second pluralities of selectably inflatable balloons for selectable tilted orientation of the endoscope head. Optionally and preferably, at least one of the first and second pluralities of selectably inflatable balloons includes a plurality of balloons distributed generally azimuthally about the endoscope head. More preferably, at least one balloon of the first and second pluralities of selectably inflatable balloons includes a stretchable balloon.
• In accordance with another preferred embodiment of the present invention the endoscope head includes a locomotive endoscope head. Preferably, the locomotive endoscope head includes a main portion extending along a longitudinal axis and associated with the first plurality of selectably inflatable balloons, and a selectably positionable portion, selectably axially positionable along the main portion and associated with the second plurality of selectably inflatable balloons.
• In accordance with still another preferred embodiment of the present invention the endoscope assembly also includes an endoscope body associated with the endoscope head. Preferably, an instrument channel at least partially extends through the endoscope head and the endoscope body. Optionally and preferably, the endoscope head has a fixed length.
• In accordance with a further preferred embodiment of the present invention the endoscope body includes a multi-lumen tube. Additionally or alternatively the endoscope body interfaces with the endoscope head controller. Preferably, the endoscope assembly also includes an endoscopy system to which the endoscope head controller is connectable.
• In accordance with yet a further preferred embodiment of the present invention the multi-lumen tube includes at least one lumen operative for at least one of balloon inflation; positioning of the selectably positionable portion of the endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle; and fluid communication. Preferably, the multi-lumen tube includes at least one lumen operative for each of balloon inflation; positioning of the selectably positionable portion of the endoscope head; and passage therethrough of at least one of an optical fiber and an electrical conductor bundle.
• In accordance with a still further preferred embodiment of the present invention the selectably positionable portion is slidably positionable with respect to the main portion. Preferably, the endoscope head includes at least one light source and at least one imaging sensor. Additionally or alternatively, the first plurality of selectably inflatable balloons includes at least two independently inflatable balloon portions. As a further alternative, the second plurality of selectably inflatable balloons includes at least two independently inflatable balloon portions. Preferably, the at least two independently inflatable balloon portions of the second plurality of selectably inflatable balloons are azimuthally offset with respect to the at least two independently inflatable balloon portions of the first plurality of selectably inflatable balloons.
• In accordance with an additional preferred embodiment of the present invention the endoscope head controller provides locomotive functionality adapted to sequentially displace the endoscope head through a generally tubular body portion. Preferably, the locomotive functionality includes functionality providing the following sequential operations: inflating at least part of the first plurality of selectably inflatable balloons, thereby anchoring the first plurality of selectably inflatable balloons to an interior surface of the generally tubular body portion; axially repositioning the selectably positionable portion and the second plurality of selectably inflatable balloons relative to the first plurality of selectably inflatable balloons; inflating at least part of the second plurality of selectably inflatable balloons, thereby anchoring the second plurality of selectably inflatable balloons to an interior surface of the generally tubular body portion; deflating the first plurality of selectably inflatable balloons, thereby unanchoring the first plurality of selectably inflatable balloons from the interior surface of the generally tubular body portion; and axially repositioning the first plurality of selectably inflatable balloons relative to the selectably positionable portion and the second plurality of selectably inflatable balloons. Optionally, the first plurality of selectably inflatable balloons is arranged with respect to the generally tubular body portion to be generally forward of the second plurality of selectably inflatable balloons. Alternatively, the second plurality of selectably inflatable balloons is arranged with respect to the generally tubular body portion to be generally forward of the first plurality of selectably inflatable balloons.
• There is additionally provided in accordance with still another preferred embodiment of the present invention an endoscope assembly including an endoscope head extending along a longitudinal axis and having a first plurality of selectably radially extendible elements associated therewith at least one first axial location therealong and a second plurality of selectably radially extendible elements associated therewith at least one second axial location therealong and an endoscope head controller being operative for controlling selectable extension of the first and second pluralities of selectably radially extendible elements for selectable positioning of the endoscope head.
• In accordance with a preferred embodiment of the present invention the endoscope head controller is operative for controlling selectable extension of the first and second pluralities of selectably radially extendible elements for selectable parallel off-center orientation of the endoscope head. Preferably, the endoscope head controller is operative for controlling selectable extension of the first and second pluralities of selectably radially extendible elements for selectable tilted orientation of the endoscope head. Additionally or alternatively, at least one of the first and second pluralities of selectably radially extendible elements includes a plurality of radially extendible elements distributed generally azimuthally about the endoscope head.
• In accordance with another preferred embodiment of the present invention the endoscope head includes a locomotive endoscope head. Preferably, the locomotive endoscope head includes a main portion extending along a longitudinal axis and associated with the first plurality of selectably radially extendible elements, and a selectably positionable portion, selectably axially positionable along the main portion and associated with the second plurality of selectably radially extendible elements.
• In accordance with yet another preferred embodiment of the present invention least one of the first and second pluralities of selectably radially extendible elements includes a plurality of selectably inflatable balloons. Typically and preferably, at least one balloon of the plurality of selectably inflatable balloons includes a stretchable balloon.
• In accordance with still another preferred embodiment of the present invention the endoscope assembly also includes an endoscope body associated with the endoscope head. Preferably, an instrument channel at least partially extends through the endoscope head and the endoscope body. Additionally or alternatively, the endoscope head has a fixed length.
• In accordance with a further preferred embodiment of the present invention the endoscope body includes a multi-lumen tube. Preferably, the endoscope body interfaces with the endoscope head controller. Additionally or alternatively, the endoscope assembly also includes an endoscopy system to which the endoscope head controller is connectable.
• In accordance with a still further preferred embodiment of the present invention the multi-lumen tube includes at least one lumen operative for at least one of: radially extending element extension; positioning of the selectably positionable portion of the endoscope head; passage therethrough of at least one of an optical fiber and an electrical conductor bundle; and fluid communication. Preferably, the multi-lumen tube includes at least one lumen operative for each of: radially extending element extension; positioning of the selectably positionable portion of the endoscope head; and passage therethrough of at least one of an optical fiber and an electrical conductor bundle.
• In accordance with an additional preferred embodiment of the present invention the selectably positionable portion is slidably positionable with respect to the main portion. Preferably, the endoscope head includes at least one light source and at least one imaging sensor. Additionally or alternatively, the first plurality of selectably radially extendible elements includes at least two independently selectably radially extendible elements. As a further alternative, the second plurality of selectably radially extendible elements includes at least two independently selectably radially extendible elements. Preferably, the at least two independently selectably radially extendible elements of the second plurality of selectably radially extendible elements are azimuthally offset with respect to the at least two independently selectably radially extendible elements of the first plurality of selectably radially extendible elements.
• In accordance with another preferred embodiment of the present invention the endoscope head controller provides locomotive functionality adapted to sequentially displace the endoscope head through a generally tubular body portion. Preferably, the locomotive functionality includes functionality providing the following sequential operations: extending at least part of the first plurality of selectably radially extendible elements, thereby anchoring the first plurality of selectably radially extendible elements to an interior surface of the generally tubular body portion; axially repositioning the selectably positionable portion and the second plurality of selectably radially extendible elements relative to the first plurality of selectably radially extendible elements; extending at least part of the second plurality of selectably radially extendible elements, thereby anchoring the second plurality of selectably radially extendible elements to an interior surface of the generally tubular body portion; retracting the first plurality of selectably radially extendible elements, thereby unanchoring the first plurality of selectably radially extendible elements from the interior surface of the generally tubular body portion; and axially repositioning the first plurality of selectably radially extendible elements relative to the selectably positionable portion and the second plurality of selectably radially extendible elements. Optionally, the first plurality of selectably radially extendible elements is arranged with respect to the generally tubular body portion to be generally forward of the second plurality of selectably radially extendible elements. Alternatively, the second plurality of selectably radially extendible elements is arranged with respect to the generally tubular body portion to be generally forward of the first plurality of selectably radially extendible elements.
• There is also provided in accordance with another preferred embodiment of the present invention apparatus for fluid supply to the interior of a portion of a tubular body portion including an element extending along a longitudinal axis and having at least one first selectably extendible tubular body portion sealing element associated therewith at a first axial location therealong and at least one second tubular body portion sealing element associated therewith at a second axial location therealong, a controller for selectably extending the at least one first and second tubular body portion sealing elements within a tubular body portion to define a sealed region therebetween and a fluid supply functionality supplying a fluid to the sealed region.
• In accordance with a preferred embodiment of the present invention at least one of the first and second tubular body portion sealing elements includes a selectably inflatable balloon. Preferably, the selectably inflatable balloon includes a stretchable balloon. More preferably, the selectably inflatable balloon includes a plurality of selectably inflatable balloon portions.
• In accordance with another preferred embodiment of the present invention the apparatus includes a locomotive endoscope head. Preferably, the apparatus for fluid supply also includes at least one fluid supply reservoir which is operative to supply the fluid to the sealed region. More preferably, the apparatus for fluid supply also includes fluid suction functionality for suctioning fluid from the sealed region.
• There is further provided in accordance with a further preferred embodiment of the present invention apparatus for fluid supply to the interior of a portion of a tubular body portion including a multi-lumen tube including at least first, second and third lumens extending therethrough, a forward selectably inflatable balloon in fluid communication with the first lumen, the forward selectably inflatable balloon being operative to seal the tubular body portion when inflated, a rear selectably inflatable balloon in fluid communication with the second lumen, the rear selectably inflatable balloon being operative to seal the tubular body portion when inflated, a fluid supply outlet, located intermediate the forward and rear selectably inflatable balloons, the outlet being in fluid communication with the third lumen and a controller for selectably inflating the first and second selectably inflatable balloons within a tubular body portion to define a sealed region therebetween and for supplying a fluid to the sealed region.
• There is additionally provided in accordance with still another preferred embodiment of the present invention an endoscope assembly including an endoscope tube having an instrument channel an endoscope tool arranged to travel along the instrument channel to a utilization location forward of the endoscope tube, the endoscope tool being slidably and sealingly located within the instrument channel and a fluid endoscope tool positioner for selectably pressurizing the instrument channel for providing fluid driven desired positioning of the endoscope tool along the instrument channel.
• In accordance with a preferred embodiment of the present invention the endoscope tool includes a piston-defining portion sealingly and slidably engaging the instrument channel.
• There is provided in accordance with a preferred embodiment of the present invention an endoscope assembly including a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool including a stretchable selectably inflatable anchoring balloon.
• There is also provided in accordance with another preferred embodiment of the present invention an endoscope assembly including a tube having at least one lumen and an endoscope tool arranged to travel along the at least one lumen to a utilization location forward of the tube, the endoscope tool being selectably bendable forwardly of the tube.
• There is additionally provided in accordance with yet another preferred embodiment of the present invention an endoscope assembly including a tube having at least one lumen and an endoscope tool arranged to travel along the at least one lumen, the endoscope tool including a tool head and a multi-lumen tube connected to the tool head.
• In accordance with a preferred embodiment of the present invention the tube includes an endoscope tube. Preferably, the at least one lumen includes instrument channel. Additionally or alternatively, the multi-lumen tube includes at least a first lumen for inflation and deflation of the stretchable selectably inflatable anchoring balloon and a second lumen.
• In accordance with another preferred embodiment of the present invention the endoscope assembly also includes a tensioning wire which extends through the second lumen and which is operative for selectably bending the endoscope tool forwardly of the tube. Preferably, the endoscope tool is generally more flexible than the tube. Additionally or alternatively, the endoscope assembly also includes an endoscopy system to which the endoscope tube is connectable. As a further alternative, the endoscope assembly also includes an endoscope tool positioning control device and a balloon inflation/deflation control.
• In accordance with yet another preferred embodiment of the present invention the endoscope assembly also includes a tool port associated with the tube which is operative for insertion and removal of the endoscope tool.
• There is further provided in accordance with a further preferred embodiment of the present invention an endoscope assembly including an endoscope tube, the endoscope tube having a first stretchable selectably inflatable anchoring balloon adjacent a forward end thereof and an endoscope tool arranged to travel relative to the endoscope tube to a utilization location forward of the endoscope tube, the endoscope tool having a second stretchable selectably inflatable anchoring balloon adjacent a forward end thereof.
• In accordance with a preferred embodiment of the present invention the endoscope tool is selectably bendable forwardly of the endoscope tube. Optionally and preferably, the endoscope tool includes a tool head and a multi-lumen tube connected to the tool head. Additionally or alternatively, the multi-lumen tube includes at least a first lumen for inflation and deflation of the second stretchable selectably inflatable anchoring balloon and a second lumen.
• In accordance with another preferred embodiment of the present invention the endoscope assembly also includes a tensioning wire which extends through the second lumen and which is operative for selectably bending the endoscope tool forwardly of the endoscope tube. Preferably, the endoscope tool is generally more flexible than the endoscope tube. Additionally or alternatively, the endoscope assembly also includes an endoscopy system to which the endoscope tube is connectable. Additionally or alternatively, the endoscope assembly also includes an endoscope tool positioning control device and at least one balloon inflation/deflation control. As a further alternative, the endoscope assembly also includes a tool port associated with the endoscope tube which is operative for insertion and removal of the endoscope tool.
• There is yet further provided in accordance with yet another preferred embodiment of the present invention an endoscope assembly including a locomotive endoscope including a locomotive endoscope head and an endoscope body adapted for locomotion through a tubular body portion and for anchoring at a desired location in the tubular body portion and an endoscopy tool adapted for displacement along the endoscope body to a desired tool operation location.
• In accordance with a preferred embodiment of the present invention the endoscope assembly also includes at least one selectably radially extendible element associated with the locomotive endoscope head and adapted for anchoring the locomotive endoscope head at a desired location in the tubular body portion. Preferably, the at least one selectably radially extendible element includes a selectably inflatable anchoring balloon. Additionally or alternatively, the locomotive endoscope head includes at least one light source and at least one imaging sensor.
• In accordance with another preferred embodiment of the present invention the endoscope assembly also includes an overtube which is slidable along the endoscope body. Preferably, the overtube is associated with the endoscopy tool. Additionally or alternatively, the endoscope body is adapted to function as a guide wire for the overtube.
• In accordance with yet another preferred embodiment of the present invention the endoscopy tool includes a therapeutic tool. Alternatively, the endoscopy tool includes a diagnostic tool. As a further alternative, the endoscopy tool includes a surgical tool.
• There is also provided in accordance with another preferred embodiment of the present invention a locomotive endoscopy method including providing a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably radially extendible element associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably radially extendible element associated therewith and providing locomotion of the locomotive endoscope head by selectably positioning the slidable portion relative to the main portion and selectably extending and retracting the first and second selectably radially extendible elements.
• In accordance with a preferred embodiment of the present invention at least one of the first and second selectably radially extendible elements includes a selectably inflatable balloon. Preferably, the locomotive endoscopy method also includes positioning the locomotive endoscope head in a selectably non-parallel orientation relative to a tubular body portion by selectably non-identically extending at least two independently radially extendible element portions of the first selectably radially extendible element and at least two independently radially extendible element portions of the second selectably radially extendible element. Additionally or alternatively, the locomotive endoscopy method also includes positioning the locomotive endoscope head in a selectably off-center parallel orientation relative to a tubular body portion by selectably non-identically extending at least two independently radially extendible element portions of the first selectably radially extendible element and at least two independently radially extendible element portions of the second selectably radially extendible element.
• In accordance with another preferred embodiment of the present invention providing locomotion includes sequentially displacing the locomotive endoscope head through a generally tubular body portion. Preferably, providing locomotion includes sequentially displacing the locomotive endoscope head through at least one of a large intestine, a small intestine, an artery and a vein. More preferably, the sequentially displacing includes the following sequential operations: extending the first selectably radially extendible element, thereby anchoring the first selectably radially extendible element to an interior surface of the generally tubular body portion; axially repositioning the selectably positionable portion and the second selectably radially extendible element relative to the first selectably radially extendible element; inflating the second selectably radially extendible element, thereby anchoring the second selectably radially extendible element to an interior surface of the generally tubular body portion; deflating the first selectably radially extendible element, thereby unanchoring the first selectably radially extendible element from the interior surface of the generally tubular body portion; and axially repositioning the first selectably radially extendible element relative to the selectably positionable portion and the second selectably radially extendible element.
• There is additionally provided in accordance with yet another preferred embodiment of the present invention an endoscope positioning method including providing an endoscope head extending along a longitudinal axis and having a first plurality of selectably radially extendible elements associated therewith at least a first axial location therealong and a second plurality of selectably radially extendible elements associated therewith at least a second axial location therealong and selectably positioning the endoscope head by selectable extension of the first and second pluralities of selectably radially extendible elements.
• In accordance with a preferred embodiment of the present invention at least one of the first and second pluralities of selectably radially extendible elements includes a plurality of radially extendible elements distributed azimuthally about the endoscope head and the positioning the endoscope head includes selectable extension of individual ones of the plurality of radially extendible elements. Preferably, at least one selectably radially extendable element of the first and second pluralities of selectably radially extendible elements includes an inflatable balloon.
• There is further provided in accordance with still another preferred embodiment of the present invention a method for fluid supply to the interior of a portion of a tubular body portion including providing an element extending along a longitudinal axis and having at least one first selectably extendible tubular body portion sealing element associated therewith at a first axial location therealong and at least one second tubular body portion sealing element associated therewith at a second axial location therealong, extending the at least one first and second tubular body portion sealing elements within a tubular body portion to define a sealed region therebetween and supplying a fluid to the sealed region.
• In accordance with a preferred embodiment of the present invention the supplying a fluid includes supplying a therapeutic fluid. Alternatively, the supplying a fluid includes supplying a contrast enhancing fluid. As a further alternative, the supplying a fluid includes supplying an antiseptic fluid.
• In accordance with another preferred embodiment of the present invention the supplying a fluid includes supplying an acidic solution. Alternatively, the supplying a fluid includes supplying a basic solution.
• There is also provided in accordance with a further preferred embodiment of the present invention an endoscopy method including providing an endoscope tube having an instrument channel and an endoscope tool arranged to travel along the instrument channel to a utilization location forward of the endoscope tube, the endoscope tool being slidably and sealingly located within the instrument channel and selectably pressurizing the instrument channel for providing fluid driven desired positioning of the endoscope tool along the instrument channel.
• There is additionally provided in accordance with a still further preferred embodiment of the present invention an endoscopy method including providing a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool including a stretchable selectably inflatable anchoring balloon and anchoring the endoscope tool forward of the tube within a tubular body portion by inflating the anchoring balloon into anchoring engagement with an interior wall of the tubular body portion.
• There is also provided in accordance with another preferred embodiment of the present invention an endoscopy method including providing a tube having at least one lumen and an endoscope tool arranged to travel through the at least one lumen, the endoscope tool being selectably bendable forwardly of the tube and selectably bending the endoscope tool forwardly of the tube.
• In accordance with a preferred embodiment of the present invention the endoscope tool includes a stretchable selectably inflatable anchoring balloon and the method also includes anchoring the endoscope tool forward of the tube within a tubular body portion by inflating the anchoring balloon into anchoring engagement with an interior wall of the tubular body portion. Preferably, the endoscopy method also includes sliding the tube forwardly along the endoscope tool, thereby employing the endoscope tool as a guide.
• In accordance with another preferred embodiment of the present invention the endoscopy method also includes, prior to sliding the tube forwardly, the step of tensioning the endoscope tool. Preferably, the endoscopy method also includes the steps of sequentially repeating at least two of the anchoring, tensioning and sliding steps.
• In accordance with yet another preferred embodiment of the present invention the tube includes an endoscope tube. Preferably, the at least one lumen includes an instrument channel.
• There is also provided in accordance with a still further preferred embodiment of the present invention an endoscopy method including providing an endoscope tube having a first stretchable selectably inflatable anchoring balloon adjacent a forward end thereof and an endoscope tool having a second stretchable selectably inflatable anchoring balloon adjacent a forward end thereof and positioning the endoscope tool at a utilization location forward of the endoscope tube.
• In accordance with a preferred embodiment of the present invention the endoscopy method also includes prior to the positioning, inflating the first selectably inflatable anchoring balloon on the endoscope tube within a tubular body portion for anchoring the endoscope tube to an inner wall of the tubular body portion, subsequent to the positioning, inflating the second selectably inflatable anchoring balloon on the tool forward of the endoscope tube within the tubular body portion for anchoring the endoscope tool to the inner wall of the tubular body portion, thereafter, deflating the first selectably inflatable anchoring balloon and advancing the endoscope tube over the endoscope tool by employing the endoscope tool as a guide.
• In accordance with another preferred embodiment of the present invention the endoscopy method also includes bending the endoscope tool when it is forward of the endoscope tube and prior to inflating the second selectably inflatable anchoring balloon. Preferably, the endoscopy method also includes the step of sequentially repeating at least two of the inflating, positioning, deflating and advancing steps.
• In accordance with yet another preferred embodiment of the present invention the endoscopy method also includes the step of sequentially repeating at least two of the inflating, positioning, bending, deflating and advancing steps. Preferably, the positioning of the endoscope tool includes passing the endoscope tool through an instrument channel of the endoscope tube.
• There is further provided in accordance with another preferred embodiment of the present invention an endoscopy method including providing a locomotive endoscope including a locomotive endoscope head and an endoscope body, providing locomotion of the locomotive endoscope head through a tubular body portion, anchoring the locomotive endoscope head at a desired location in the tubular body portion and displacing an endoscopy tool along the endoscope body to a desired tool operation location.
• In accordance with a preferred embodiment of the present invention the endoscopy method also includes tensioning the endoscope body following the anchoring of the locomotive endoscope head and prior to the displacing the endoscopy tool. Preferably, the endoscopy method also includes, prior to the anchoring, the step of detecting the desired location in the tubular body portion by use of at least one light source and at least one imaging sensor associated with the locomotive endoscope head.
• In accordance with another preferred embodiment of the present invention the endoscopy method also includes, prior to the displacing the endoscopy tool, the step of detecting the desired tool operation location in the tubular body portion by use of at least one light source and at least one imaging sensor associated with the locomotive endoscope head. Preferably, the displacing the endoscopy tool includes sliding an overtube associated with the endoscopy tool over the endoscope body.
BRIEF DESCRIPTION OF THE DRAWINGS
• The present invention will be understood and appreciated more fully from the following detailed description, taken in conjunction with the drawings in which:
• FIG. 1 is a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with a preferred embodiment of the present invention;
• FIGS. 2 and 3 are respective simplified exploded and assembled view illustrations of a locomotive endoscope head constructed and operative in accordance with a preferred embodiment of the present invention;
• FIGS. 4A, 4B and4C are simplified sectional illustrations taken along respective lines IVA-IVA, IVB-IVB and IVC-IVC inFIG. 3;
• FIGS. 5A, 5B,5C,5D,5E,5F and5G are simplified sectional illustrations, taken along lines IVB-IVB inFIG. 3 of the locomotive endoscope head ofFIGS. 2-4C at various stages of forward motion through an intestine;
• FIGS. 6A, 6B,6C,6D,6E,6F and6G are simplified sectional illustrations, taken along lines IVB-IVB inFIG. 3 of the locomotive endoscope head ofFIGS. 2-4C at various stages of rearward motion through an intestine;
• FIGS. 7A, 7B and7C are side view illustrations of selectable tilting orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway;
• FIGS. 8A, 8B and8C are simplified rearward facing views corresponding toFIGS. 7A, 7B and7C, taken along planes VIIIA-VIIIA, VIIIB-VIIIB and VIIIC-VIIIC inFIGS. 7A, 7B and7C respectively;
• FIGS. 9A, 9B and9C are simplified forward facing views corresponding toFIGS. 7A, 7B and7C, taken along planes IXA-IXA, IXB-IXB and IXC-IXC inFIGS. 7A, 7B and7C respectively;
• FIGS. 10A and 10B are side view illustrations of selectable parallel orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway;
• FIGS. 11A and 11B are simplified rearward facing views corresponding toFIGS. 10A and 10B taken along planes XIA-XIA and XIB-XIB inFIGS. 10A and 10B respectively;
• FIGS. 12A and 12B are simplified forward facing views corresponding toFIGS. 10A and 100B taken along planes XIIA-XIIA and XIIB-XIIB inFIGS. 10A and 10B respectively;
• FIG. 13 is a simplified pictorial illustration of an accessory which is adapted to travel through the instrument channel in the locomotive endoscope head of any ofFIGS. 1-12B;
• FIG. 14 is a simplified partially block diagram, partially schematic illustration of part of the endoscopy system ofFIGS. 1-13, constructed and operative in accordance with a preferred embodiment of the present invention;
• FIG. 15 is a simplified pictorial illustration of the locomotive endoscope head ofFIGS. 1-12B in an intestine fluid treatment mode of operation;
• FIGS. 16A, 16B and16C, are simplified pictorial illustrations of the locomotive endoscope head ofFIGS. 1-12B in a guide wire mode of operation.
• FIG. 17 is a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with another preferred embodiment of the present invention;
• FIGS. 18, 19A and19B are respective simplified pictorial and sectional view illustrations of an accessory constructed and operative in accordance with a preferred embodiment of the present invention;
• FIGS. 20A, 20B,20C,20D,20E,20F,20G,20H and20I are simplified illustrations of various functionalities which may be provided by the system ofFIG. 17.
• FIG. 21 is a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with another preferred embodiment of the present invention;
• FIGS. 22, 23A and23B are respective simplified pictorial and sectional view illustrations of an accessory constructed and operative in accordance with a preferred embodiment of the present invention; and
• FIGS. 24A, 24B,24C,24D,24E,24F,24G,24H,24I,24J,24K and24L are simplified illustrations of various functionalities which may be provided by the system ofFIG. 21.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
• Reference is now made toFIG. 1, which is a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with a preferred embodiment of the present invention.
• The terms “endoscope” and “endoscopy” are used throughout in a manner somewhat broader than their customary meaning and refer to apparatus and methods which operate within body cavities, passageways and the like, such as, for example, the small intestine, the large intestine, arteries and veins. Although these terms normally refer to visual inspection, as used herein they are not limited to applications which employ visual inspection and refer as well to apparatus, systems and methods which need not necessarily involve visual inspection.
• As seen inFIG. 1, aconventional endoscopy system100, such as a console including a CV-160 video system center, a CLC-160 light source, an OEV-203 video monitor, and an OFP flushing pump, all commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, N.Y. 11747, USA, is being employed. Alocomotive endoscope head102, constructed and operative in accordance with a preferred embodiment of the present invention is located within the large intestine of a patient and is coupled tosystem100 by amulti-lumen tube104, also constructed and operative in accordance with a preferred embodiment of the present invention, which interfaces withlocomotive head controller106 and anoperator control108, both of which are also constructed and operative in accordance with a preferred embodiment of the present invention.
• Reference is now made toFIGS. 2 and 3, which are respective simplified exploded and assembled view illustrations of a locomotive endoscope head constructed and operative in accordance with a preferred embodiment of the present invention and toFIGS. 4A, 4B and4C, which are simplified sectional illustrations taken along respective lines IVA-IVA, IVB-IVB and IVC-IVC inFIG. 3.
• As seen inFIGS. 2-4C, amulti-lumen tube104, having acentral passageway202, defining an instrument channel useful inter alia for tool insertion, inflation and suction, and a plurality ofperipheral lumens204, typically ten in number, is seated in a suitably configuredrecess206 formed in ahousing portion208.Housing portion208, which is generally symmetric about alongitudinal axis210, includes a relatively widerrear portion212, which definesrecess206 and a relatively narrowermain portion214.
• Rear portion212 is formed with threepairs220 of axial slits which extend to the rear ofrear portion212 and which are mutually separated along the circumference ofrear portion212 by 120 degrees. Intermediate eachpair220 of axial slits, there is provided aninflation passageway222, each of which communicates with acorresponding inflation passageway224 formed inmulti-lumen tube202, which in turn communicates with a respective one of three rearballoon inflation lumens226, which are included in the nine multipleperipheral lumens204. Rearballoon inflation lumens226 are sealed forwardly ofinflation passageways224 byseals228.
• Main portion214 is formed with threeaxial slots230 which extend to the rear ofrear portion212 and which are mutually separated along the circumference ofrear portion212.
• A slidableforward balloon support238 is slidably mounted ontomain portion214 ofhousing portion208.Forward balloon support238 is formed with threepairs240 of axial slits which extend to the rear offorward balloon support238 and which are mutually separated along the circumference offorward balloon support238 by 120 degrees. Intermediate eachpair240 of axial slits, there is provided aninflation passageway242, each of which communicates with acorresponding inflation passageway244 which extends rearwardly into slidable sealing engagement with a respective one of three forwardballoon inflation lumens246, which are included in the nine multipleperipheral lumens204. It is appreciated thatinflation passageways244 are typically relatively rigid and sealingly slide within suitably configuredlow friction liners248 which are inserted into forwardballoon inflation lumens246 at the forward end of themulti-lumen tube104.
• A pair ofpiston rods250 are fixed to or integrally formed withforward balloon support238 and extend inwardly and rearwardly thereof into slidable sealing engagement with a respective one of two forward balloon supportaxial positioning lumens252, which are included in the ten multipleperipheral lumens204. It is appreciated thatpiston rods250 are typically relatively rigid and sealingly slide within suitably configuredlow friction liners254 which are inserted into forward balloon supportaxial positioning lumens252 at the forward end of themulti-lumen tube104.
• The relativelyrigid inflation passageways244 and thepiston rods250 are preferably located withinaxial slots230.
• Afront housing portion260 is fixedly mounted onto aforward end262 of themain portion214 of thehousing portion208. Front housing portion includes acap portion264 which is fixed to or integrally formed with acylindrical portion266 which extends through acentral bore268 of slidableforward balloon support238. A rearward end ofcylindrical portion266 is seated in arecess270 and against ashoulder272 defined incentral passageway202 ofmulti-lumen tube104. Aninterior bore274 ofcylindrical portion266 defines a continuation of the instrument channel defined bycentral passageway202.
• At a forward end ofcap portion264 there are preferably provided alight emitting diode280 and one ormore imaging sensors282. Electrical current is supplied to thelight emitting diode280 and imaging data is received fromsensors282 via an optical fiber andelectrical conductor bundle284 which extends from the forward end ofcap portion264, through aperipheral lumen286 inmulti-lumen tube104 to locomotive head controller106 (FIG. 1).
• An additionalperipheral lumen290 is provided inmulti-lumen tube104 for fluid communication with the interior of the intestine viaslots230 inhousing portion208. Liquids or pressurized gas may be introduced or drained through this lumen.
• Aninflatable balloon cylinder300 is mounted ontorear portion212 ofhousing portion208. As seen clearly inFIG. 2,inflatable balloon cylinder300 has a uniform cross section which includes threepairs320 of axial walls which extend along the longitudinal length thereof and engage correspondingaxial slits220 which extend to the rear ofrear portion212. Eachpair320 of axial walls is joined by acircumferential wall portion322. Axial walls pairs320 are mutually separated along the circumference ofinflatable balloon cylinder300 by 120 degrees.
• Intermediate pairs320 of axial walls there are defined threeinflatable balloon portions324, each of which separately communicates with aseparate inflation passageway222.Balloon portions324 are sealed with respect to therear portion212 at forward and rearward ends thereof and atslits220 by adhesive or in any other suitable manner to define three separate and independently controllably inflatable and deflatable balloon portions, distributed about the periphery ofrear portion212. It is appreciated that any suitable smaller or larger number of separate and independently controllably inflatable and deflatable balloon portions may be alternatively employed, although at least three such separate and independently controllably inflatable and deflatable balloon portions are preferred.
• Aninflatable balloon cylinder350 is mounted ontoforward balloon support238. As seen clearly inFIG. 2,inflatable balloon cylinder350 has a uniform cross section which includes threepairs370 of axial walls which extend along the longitudinal length thereof and engage correspondingaxial slits240 which extend to the rear offorward balloon support238. Eachpair370 of axial walls is joined by acircumferential wall portion372. Axial walls pairs370 are mutually separated along the circumference ofinflatable balloon cylinder350 by 120 degrees.
• Intermediate pairs370 of axial walls there are defined threeinflatable balloon portions374, each of which separately communicates with aseparate inflation passageway242.Balloon portions374 are sealed with respect to theforward balloon support238 at forward and rearward ends thereof and atslits240 by adhesive or in any other suitable manner to define three separate and independently controllably inflatable and deflatable balloon portions, distributed about the periphery offorward balloon support238. It is appreciated that any suitable smaller or larger number of separate and independently controllably inflatable and deflatable balloon portions may be alternatively employed, although at least three such separate and independently controllably inflatable and deflatable balloon portions which are 60 degrees out of phase with the balloon portions onrear portion212 are preferred.
• It is appreciated that in accordance with a preferred embodiment of the present invention theballoon cylinders300 and350 are generally stretchable, and can be stretched to accommodate expansion to a radius up to about 5-20 times greater than the radius ofcylinders300 and350, when uninflated. Preferably inflation ofballoon cylinders300 and350 may be achieved using relatively low pressure, such as in the range of 10-50 millibars.
• It is appreciated that in accordance with a preferred embodiment of the present invention useful for in vivo inspection of a generally tubular body portion having a variable cross-sectional diameter, the expansion diameter range ofballoon cylinders300 and350 is larger than the maximum cross-sectional diameter of the generally tubular body portion, thereby ensuring engagement of expandedballoon cylinders300 and350 with the interior surface of the generally tubular body portion, and anchoring of thelocomotive endoscope head102 thereto. Preferably,balloon cylinders300 and350 are relatively soft, highly compliant balloons, operative to at least partially conform to the shape of the interior surface of the generally tubular body portion when in engagement therewith.
• It is appreciated thatballoon cylinders300 and350 may be formed of well-known stretchable materials such as latex, flexible silicon, or highly flexible nylon. Alternatively,balloon cylinders300 and350 may be formed of polyurethane which is less stretchable and conforming than latex, flexible silicon, or highly flexible nylon. Preferably,balloon cylinders300 and350 have diameters which are sufficient to ensure tight anchoring at any part of the generally tubular body portion.
• Reference is now made toFIGS. 5A, 5B,5C,5D,5E,5F and5G, which are simplified sectional illustrations, taken along lines IVB-IVB inFIG. 3, of the locomotive endoscope head ofFIGS. 2-4C at various stages of forward motion through an intestine. As seen inFIGS. 5A-5G, locomotion of thelocomotive endoscope head102 ofFIGS. 2-4C is achieved by a combination of sequential inflations and deflations of balloons, here respectively designated byreference numerals500 and502 mounted onto thehousing portion208 and theforward balloon support238, combined with relative axial displacement offorward balloon support238 vis-à-vishousing portion208. It is appreciated that each ofballoons500 and502 preferably includes multiple separate and independently controllably inflatable and deflatable balloon portions as described hereinabove.
• Turning toFIG. 5A, it is seen thatballoon500 is inflated, thus engaging an inner wall of an intestine and fig the position of thehousing portion208 relative thereto. In this orientation, theforward balloon support238 is shown in a rearward axial orientation, adjacentrear portion212. ConsideringFIG. 5B, it is seen thatforward balloon support238 has moved axially forward relative tohousing portion208, while thehousing portion208 remains axially fixed relative to the intestine.
• Turning toFIG. 5C, it is seen that with theforward balloon support238 in itsFIG. 5B axial orientation, theballoon502 is inflated, thus engaging the inner wall of the intestine and fixing the position of theforward balloon support238 relative thereto.
• Thereafter, as shown inFIG. 5D,balloon500 is deflated.
• Turning toFIG. 5E, it is seen that subsequent to deflation ofballoon500, theforward balloon support238 is moved axially rearward relative tohousing portion208, while theforward balloon support238 remains axially fixed relative to the intestine.
• This results in axial forward movement of thehousing portion208 and thus of thelocomotive endoscope head102.
• Turning toFIG. 5F, it is seen that with theforward balloon support238 in itsFIG. 5E axial orientation, theballoon500 is inflated, thus engaging the inner wall of the intestine and fixing the position of thehousing portion208 relative thereto. Thereafter, as shown inFIG.5G balloon502 is deflated.
• It is thus appreciated that in this manner, forward displacement of thelocomotive endoscope head102 is effected.
• Reference is now made toFIGS. 6A, 6B,6C,6D,6E,6F and6G, which are simplified sectional illustrations, taken along lines IVB-IVB inFIG. 3, of the locomotive endoscope head ofFIGS. 2-4C at various stages of rearward motion through an intestine. As seen inFIGS. 6A-6G, rearward locomotion of thelocomotive endoscope head102 ofFIGS. 2-4C is achieved by a combination of sequential inflations and deflations of balloons, here too respectively designated byreference numerals500 and502 mounted onto thehousing portion208 and theforward balloon support238, combined with relative axial displacement offorward balloon support238 vis-à-vishousing portion208. It is appreciated that each ofballoons500 and502 preferably includes multiple separate and independently controllably inflatable and deflatable balloon portions as described hereinabove.
• Turning toFIG. 6A, it is seen thatballoon500 is inflated, thus engaging an inner wall of an intestine and fixing the position of thehousing portion208 relative thereto. In this orientation, theforward balloon support238 is shown in a rearward axial orientation, adjacentrear portion212. ConsideringFIG. 6B, it is seen that with theforward balloon support238 in itsFIG. 6A axial orientation, theballoon502 is inflated, thus engaging the inner wall of the intestine and fixing the position of theforward balloon support238 relative thereto. Thereafter, as shown inFIG. 6C,balloon500 is deflated.
• Turning toFIG. 6D, it is seen thatforward balloon support238 has moved axially forward relative tohousing portion208, while theforward balloon support238 remains axially fixed relative to the intestine.
• Turning toFIG. 6E, it is seen that with theforward balloon support238 in itsFIG. 6D axial orientation, theballoon500 is inflated, thus engaging the inner wall of the intestine and fixing the position of thehousing portion208 relative thereto. Thereafter, as shown inFIG. 6F,balloon502 is deflated.
• Turning now toFIG. 6G, it is seen thatforward balloon support238 has moved axially rearward relative tohousing portion208, while thehousing portion208 remains axially fixed relative to the intestine.
• It is thus appreciated that in this manner, rearward displacement of thelocomotive endoscope head102 is effected. Alternatively, bothballoons500 and502 may be deflated and thelocomotive endoscope head102 may be pulled out of the intestine by pulling on themulti-lumen tube104.
• Reference is now made toFIGS. 7A-9C, which illustrate various different orientations of thelocomotive endoscope head102 ofFIGS. 2-4C which may be realized by suitable selectable inflation of individual balloon lobes ofballoons500 and502. These illustrations are examples of non-parallel, tilted orientations achieved by any suitable non-identical inflation of balloon lobes ofballoon500 as well as a corresponding non-identical inflation of theballoon lobes502 in an opposite sense, taking into account the phase difference in the rotational orientations of the balloon lobes ofballoons500 and502.
• Turning toFIGS. 7A, 8A and9A, there are seen illustrations of a first, downward facing, selectable tilting orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway. This orientation is achieved by relatively low inflation of one balloon lobe ofballoon500, here designated byreference numeral510 and relatively high inflation of balloon lobes ofballoon500 designated byreference numerals512 and514, at the same time as there is provided relatively low inflation of one balloon lobe ofballoon502, here designated byreference numeral520 and relatively high inflation of balloon lobes ofballoon502 designated byreference numerals522 and524. It is noted that in the orientation ofFIGS. 7A-7C,balloon lobes510 and520 are respectively at the top and the bottom oflocomotive endoscope head102, in the sense ofFIGS. 7A-7C.
• Turning toFIGS. 7B, 8B and9B, there are seen illustrations of a second, parallel orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway. This orientation is achieved by generally identical inflation ofballoon lobes510,512 and514 ofballoon500 as well as identical inflation ofballoon lobes520,522 and524 ofballoon502.
• Turning toFIGS. 7C, 8C and9C, there are seen illustrations of a third, upward facing, selectable tilting orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway. This orientation is achieved by relatively high inflation ofballoon lobe510 ofballoon500 and relatively low inflation ofballoon lobes512 and514 ofballoon500, at the same time as there is provided relatively high inflation ofballoon lobe520 ofballoon502 and relatively low inflation ofballoon lobes522 and524 ofballoon502.
• Reference is now made toFIGS. 10A and 10B, which are side view illustrations of selectable parallel, off-center orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway, toFIGS. 11A and 11B, which are rearward facing views corresponding toFIGS. 10A and 10B taken along planes XIA-XIA and XIB-XIB inFIGS. 10A and 10B respectively and toFIGS. 12A and 12B, which are forward facing views corresponding toFIGS. 10A and 10B taken along planes XIIA-XIIA and XIIB-XIIB inFIGS. 10A and 10B respectively. These illustrations are examples of parallel orientations achieved by any suitable non-identical inflation ofballoon lobes510,512 and514 ofballoon500 as well as a corresponding non-identical inflation ofballoon lobes520,522 and524 ofballoon502, taking into account the phase difference in the rotational orientations of the balloon lobes ofballoons500 and502.
• Turning toFIGS. 10A, 11A and12A, there are seen illustrations of a first off center parallel orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway. This orientation is achieved by relatively low inflation ofballoon lobe510 and relatively high inflation ofballoon lobes512 and514 ofballoon500 as well as a corresponding relatively high inflation ofballoon lobe520 and relatively low inflation ofballoon lobes522 and524 ofballoon502, which takes into account the phase difference in the rotational orientations of the balloon lobes ofballoons500 and502.
• Turning toFIGS. 10B, 11B and12B, there are seen illustrations of a second, off center parallel orientation of the locomotive endoscope head ofFIGS. 1-6G within a body passageway. This orientation is achieved by relatively high inflation ofballoon lobe510 and relatively low inflation ofballoon lobes512 and514 ofballoon500 as well as a corresponding relatively low inflation ofballoon lobe520 and relatively high inflation ofballoon lobes522 and524 ofballoon502.
• It may be appreciated from a consideration ofFIGS. 7A-12B that in practice any desired, geometrically permitted, orientation of thelocomotive endoscope head102 may be realized if at least three balloon lobes are provided on bothballoons500 and502. This includes, for example up-down and side-to-side tilts and combinations thereof as well as desired up-down and side-to-side off-center parallel orientations and combinations thereof.
• It is appreciated that various desired, geometrically permitted, orientations of thelocomotive endoscope head102 may be realized if at least two balloon lobes are provided on each ofballoons500 and502, and in particular if the at least two balloon lobes ofballoons500 and502 are azimuthally offset.
• It is a particular feature of the present invention that due to the fact that the locomotive endoscope is moved other than by a push mechanism,multi-lumen tube104 may be substantially more flexible than other endoscope tubes.
• Reference is now made toFIG. 13, which is a simplified pictorial illustration of anaccessory600 which is adapted to travel through the instrument channel defined in thecentral passageway202 of themulti-lumen tube104 and ininterior bore274 ofcylindrical portion266 oflocomotive endoscope head102. Theaccessory600 may be selected from among any suitable accessories, such as biopsy forceps, polypectomy snares, foreign body retrieval devices, heat probes and needles, some of which are well known in the art. In accordance with a preferred embodiment of the invention, apiston602 is associated with the accessory along itsbody604 and upstream of itshead606. Thepiston602 is configured for slidable sealed motion along the instrument channel in response to pressure differences upstream and downstream thereof, such as provided by suitable positive or negative pressurization of the instrument channel, which may be carried out for example, by conventional insufflation and suction functionalities that are provided in conventional endoscope systems.
• Reference is now made toFIG. 14, which is a simplified partially block diagram, partially schematic illustration of part of the endoscopy system ofFIGS. 1-13, constructed and operative in accordance with a preferred embodiment of the present invention.
• As seen inFIG. 14, aconventional endoscopy system100, such as a console including a CV-160 video system center, a CLC-160 light source, an OEV-203 video monitor, and an OFP flushing pump, all commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, N.Y. 11747, USA, is being employed.Conventional endoscopy system100 includes an inflation/suction generator700 and aliquid supply702 which communicate via aflow control valve704 with the instrument channel defined bycentral passageway202 of themulti-lumen tube104 and byinterior bore274 ofcylindrical portion266 oflocomotive endoscope head102. Theconventional endoscopy system100 also preferably includes animaging system710 and anLED controller712 which communicate via electrical data and power lines preferably embodied in optical fiber andelectrical conductor bundle284 which extend throughlumen286 inmulti-lumen tube104.
• Operator control108, preferably including ajoystick722, tilt/non-tiltfunctionality selection switch724 and abutton725 for governing the direction (forward/backward) and speed of motion, governs the operation oflocomotive head controller106. In a preferred embodiment of the present invention, as shown, theoperator control108 provides control inputs to locomotivehead control circuitry726, which operates anair pressure generator728, avacuum generator730 and a hydraulic positive/negative pressure supply732.
• Air pressure generator728 andvacuum generator730 are coupled tolumens226 and246 for selectable inflation ofballoon lobes510,512,514,520,522 and524 viasuitable manifolds734 and736 and via individual flow valves for each of the lumens, the flow valves being designated byreference numerals740,742,744,746,748 and750. Hydraulic positive/negative pressure supply732 is coupled via aflow valve752 tolumens252 for drivingpiston rods250. Additionally aflow valve754 governs supply of a treatment fluid to lumen290 from atreatment fluid reservoir756. Afurther fluid valve758 governs removal of the treatment fluid vialumen290 from the intestine to a discard fluid location (not shown) which is maintained under vacuum.
• Flow valves704,740,742,744,746,748,750,752,754 and758 are controlled byoperator control108 via locomotivehead control circuitry726 to suitably inflate and deflateballoon lobes510,512,514,520,522 and524 for providing selected positioning and/or tilt of thelocomotive endoscope head102 within the intestine; to suitably displaceforward balloon support238 for locomotion of thelocomotive endoscope head102 and for selectably supplying treatment fluid to the intestine as described hereinbelow with reference toFIG. 15.
• Reference is now made toFIG. 15, which is a simplified pictorial illustration of the locomotive endoscope head ofFIGS. 1-12B in an intestine fluid treatment mode of operation. As seen inFIG. 15, tubular body portion sealing elements such asballoon lobes510,512 and514 ofballoon500 andballoon lobes520,522 and524 ofballoon502 are preferably all inflated, so as to seal the volume of the intestineintermediate balloon lobes510,512 and514 andballoon lobes520,522 and524 from the remainder of the interior volume of the intestine.
• Once sealing is achieved, atreatment fluid760 is supplied fromtreatment fluid reservoir756 viavalve754,lumen290 andslots230 to the sealed portion of the intestine. Following treatment, thetreatment fluid760 may be suctioned from the sealed portion of the intestine viaslots230,lumen290 andvalve758 to a fluid discard location (not shown). Optionally and preferably,treatment fluid760 includes at least one of a therapeutic fluid, a contrast enhancing fluid, an antiseptic fluid, an acidic solution, a basic solution or any other suitable fluid.
• Reference is now made toFIGS. 16A-16C, which are simplified pictorial illustrations of the locomotive endoscope head ofFIGS. 1-12B in a guide wire mode of operation. As seen inFIG. 16A,balloon lobes510,512 and514 ofballoon500 andballoon lobes520,522 and524 ofballoon502 are preferably all inflated, so as to anchor thelocomotive endoscope head102 to the intestine. Once anchoring is achieved at a desired location,multi-lumen tube104 is tensioned, as seen inFIG. 16B.
• It is appreciated that respective diameter ofballoons500 and502 are sufficient to ensure tight anchoring at any part of the intestine.
• As seen inFIG. 16C, anovertube800 is slid overmulti-lumen tube104, using it as a guide wire. Theovertube800 preferably includes, at aforward portion802 thereof, anendoscopy tool804. Preferably,endoscopy tool804 may be a therapeutic, diagnostic or surgical tool, and may be selectably positioned along themulti-lumen tube104. In a preferred embodiment of the present invention,endoscopy tool804 is an ultrasonic transducer. In another preferred embodiment of the present invention,endoscopy tool804 is an X-ray radiation source/generator.
• Reference is now made toFIGS. 17-19B, which are respectively a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with another preferred embodiment of the present invention and respective simplified pictorial and sectional view illustrations of an accessory constructed and operative in accordance with a preferred embodiment of the present invention.
• As seen inFIGS. 17-19B, aconventional endoscopy system1000, such as a console including a CV-160 video system center, a CLC-160 light source, an OEV-203 video monitor, and an OFP flushing pump, all commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, NY 11747, USA, is being employed. Aconventional endoscope1002, which forms part ofconventional endoscopy system1000 may be employed, such as a CF-Q160AL video colonoscope which is commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, NY 11747, USA.
• Anendoscope tool1010, constructed and operative in accordance with a preferred embodiment of the present invention extends through theinstrument channel1011 of theconventional endoscope1002.Endoscope tool1010 is characterized in that it includes amulti-lumen tube1012 which includes at least afirst lumen1014 for inflation and deflation of aballoon1016 via aninflation aperture1017, and asecond lumen1018. Preferably thesecond lumen1018 may accommodate a tensioning orcompression wire1020. Alternatively or additionally, thesecond lumen1018 may have other functionality. As a further alternative, themulti-lumen tube1012 forming part of theendoscope tool1010 may include more than two lumens. Preferably, the cross-sectional area of themulti-lumen tube1012 is sufficiently less than that of theinstrument channel1011, so as to allow supply of fluid for insufflation and draining of fluid therethrough.
• It is appreciated that in accordance with a preferred embodiment of the present invention theendoscope tool1010 and themulti-lumen tube1012 are generally substantially more flexible thanconventional endoscope1002 and an endoscope tube thereof.
• It is appreciated that in accordance with a preferred embodiment of the present invention theballoon1016 is generally stretchable, and can be stretched to a diameter about 5-20 times larger than its diameter when not inflated. In a specific embodiment, useful for small intestine endoscopy, the balloon diameter when fully stretched is four centimeters. Preferably, inflation of theballoon1016 to a diameter less than four centimeters may be achieved using relatively low pressure, such as in the range of 10-50 millibars. In another specific embodiment, useful for large intestine endoscopy, the balloon diameter when fully stretched is seven centimeters. Preferably, inflation of theballoon1016 to a diameter less than seven centimeters may be achieved using relatively low pressure, such as in the range of 10-50 millibars.
• It is appreciated that in accordance with a preferred embodiment of the present invention useful for in vivo inspection of a generally tubular body portion having a variable cross-sectional diameter, the expansion diameter range ofballoon1016 is larger than the maximum cross-sectional diameter of the generally tubular body portion, thereby ensuring engagement of expandedballoon1016 with the interior surface of the generally tubular body portion, and anchoring of theendoscope tool1010 thereto. Preferably,balloon1016 is a relatively soft, highly compliant balloon, operative to at least partially conform to the shape of the interior surface of the generally tubular body portion when in engagement therewith.
• It is appreciated thatballoon1016 may be formed of well-known stretchable materials such as latex, flexible silicon, or highly flexible nylon. Alternatively,balloon1016 may be formed of polyurethane, which is less stretchable and conforming than latex, flexible silicon or highly flexible nylon. Preferably, the diameter ofballoon1016 is sufficient to ensure tight anchoring at any part of the generally tubular body portion.
• As seen inFIGS. 17-19B, theendoscope tool1010 preferably includes a toolpositioning control device1024 and a balloon inflation/deflation control interface1026. It is appreciated thatmulti-lumen tube1012 and theentire endoscope tool1010 may be inserted and removed via aconventional tool port1030 on aconventional operator control1032 which forms part ofconventional endoscope1002.
• Reference is now made toFIGS. 20A, 20B,20C,20D,20E,20F,20G,20H and20I, which are simplified illustrations of theendoscope tool1010 ofFIGS. 17-19B in various operative orientations. In the illustrated embodiment, desired directional orientation of the forward end of theendoscope tool1010 is obtained by suitable axial displacement of the tool through theinstrument channel1011 of theendoscope1002 combined with suitable tensioning ofwire1020 and with suitable rotational orientation of theendoscope tool1010 relative to the intestine.
• As seen inFIG. 20A,endoscope tool1010 is principally located within theinstrument channel1011 ofendoscope1002, and hasballoon1016 protruding therefrom, while in a deflated state.
• FIG. 20B shows theendoscope tool1010 extending further from theinstrument channel1011, whileFIG. 20C shows theendoscope tool1010 having been rotated by 180 degrees relative to its orientation inFIG. 20B by suitable twisting ofmulti-lumen tube1012, as indicated byarrow1022.
• FIG. 20D shows bending of the forward end of theendoscope tool1010 resulting from tensioning ofwire1020, when the tool is in itsFIG. 20C orientation having been pushed forward in a conventional manner.
• FIG. 20E shows further progress of theendoscope tool1010 through the intestine resulting from forward pushing of the tool coupled with release the tension on thewire1020 by operation of toolpositioning control device1024.
• FIG. 20F shows inflation of theballoon1016 by operation of the balloon inflation/deflation control interface1026. In accordance with a preferred embodiment of the invention, this inflation anchors the forward end of theendoscope tool1010 to the intestine at the location of theballoon1016.
• FIG. 20G shows tensioning of theendoscope tool1010 including themulti-lumen tube1012 by pulling on themulti-lumen tube1012.
• FIG. 20H shows theendoscope1002 having been pushed forward along themulti-lumen tube1012, using the multi-lumen tube as a sort of guide wire.Endoscope1002 may be pushed forward in a conventional manner. Thereafter, as shown inFIG. 19I, theballoon1016 may be deflated.
• Further forward progress of the endoscope through the intestine, preferably to a position where the forward end of theinstrument channel1011 lies just behind theballoon1016, similarly to the orientation shown inFIG. 20A, may be achieved by repeating some or all of the steps described hereinabove with reference toFIGS. 20A-20I, as required by the geometries encountered.
• Reference is now made toFIGS. 21-23B, which are respectively a simplified pictorial illustration of an endoscopy system constructed and operative in accordance with another preferred embodiment of the present invention and respective simplified pictorial and sectional view illustrations of an accessory constructed and operative in accordance with a preferred embodiment of the present invention.
• As seen inFIGS. 21-23B aconventional endoscopy system1300, such as a console including a CV-160 video system center, a CLC-160 light source, an OEV-203 video monitor, and an OFP flushing pump, all commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, N.Y. 11747, USA, is being employed. Aconventional endoscope1302, which forms part ofconventional endoscopy system1300 may be employed, such as a CF-Q160AL video colonoscope which is commercially available from Olympus America Inc. of 2 Corporate Center Drive, Melville, N.Y. 11747, USA. In accordance with a preferred embodiment of the invention, aperipheral balloon1304 may be mounted ontoendoscope1302 as shown. Preferably inflation and deflation ofperipheral balloon1304 may be provided by atube1306 communicating with the interior thereof.
• Anendoscope tool1310, constructed and operative in accordance with a preferred embodiment of the present invention extends through theinstrument channel1311 of theconventional endoscope1302.Endoscope tool1310 is characterized in that it includes amulti-lumen tube1312 which includes at least afirst lumen1314 for inflation and deflation of aballoon1316 via aninflation aperture1317, and asecond lumen1318. Preferably thesecond lumen1318 may accommodate a tensioning orcompression wire1320. Alternatively or additionally, thesecond lumen1318 may have other functionality. As a further alternative, themulti-lumen tube1312 forming part of theendoscope tool1310 may include more than two lumens. Preferably, the cross-sectional area of themulti-lumen tube1312 is sufficiently less than that of theinstrument channel1311, so as to allow supply of fluid for insufflation and draining of fluid therethrough.
• It is appreciated that in accordance with a preferred embodiment of the present invention theendoscope tool1310 and themulti-lumen tube1312 are generally substantially more flexible thanendoscope1302 and an endoscope tube thereof.
• It is appreciated that in accordance with a preferred embodiment of the present invention theballoon1316 is generally stretchable, and can be stretched to a diameter about 5-20 times larger than its diameter when not inflated. In a specific embodiment, useful for small intestine endoscopy, the balloon diameter when fully stretched is four centimeters. Preferably, inflation of theballoon1316 to a diameter less than four centimeters may be achieved using relatively low pressure, such as in the range of 10-50 millibars. In another specific embodiment, useful for large intestine endoscopy, the balloon diameter when fully stretched is seven centimeters. Preferably, inflation of theballoon1316 to a diameter less than seven centimeters may be achieved using relatively low pressure, such as in the range of 10-50 millibars.
• It is appreciated that in accordance with a preferred embodiment of the present invention useful for in vivo inspection of a generally tubular body portion having a variable cross-sectional diameter, the expansion diameter range ofballoon1316 is larger than the maximum cross-sectional diameter of the generally tubular body portion, thereby ensuring engagement of expandedballoon1316 with the interior surface of the generally tubular body portion, and anchoring of theendoscope tool1310 thereto. Preferably,balloon1316 is a relatively soft highly compliant balloon, operative to at least partially conform to the shape of the interior surface of the generally tubular body portion when in engagement therewith.
• It is appreciated thatballoon1316 may be formed of well-known stretchable materials such as latex, flexible silicon, or highly flexible nylon. Alternatively,balloon1316 may be formed of polyurethane, which is less stretchable and conforming than latex, flexible silicon or highly flexible nylon. Preferably, the diameter ofballoon1316 is sufficient to ensure tight anchoring at any part of the generally tubular body portion.
• As seen inFIGS. 21-23B, theendoscope tool1310 preferably includes a toolpositioning control device1324 and a balloon inflation/deflation control interface1326. Additionally, there is preferably provided a peripheral balloon inflation/deflation control interface1328, which communicates withtube1306 and governs inflation and deflation ofperipheral balloon1304. It is appreciated thatmulti-lumen tube1312 and theentire endoscope tool1310 may be inserted and removed via aconventional tool port1330 on aconventional operator control1332 which forms part ofconventional endoscope1302.
• Reference is now made toFIGS. 24A, 24B,24C,24D,24E,24F,24G,24H,24L24J,24K and24L, which are simplified illustrations of theendoscope tool1310 ofFIGS. 21-23B in various operative orientations. In the illustrated embodiment, desired directional orientation of the forward end of theendoscope tool1310 is obtained by suitable axial displacement of the tool through theinstrument channel1311 of theendoscope1302 combined with suitable tensioning ofwire1320 and with suitable rotational orientation of theendoscope tool1310 relative to the intestine.
• As seen inFIG. 24A,endoscope tool1310 is principally located within theinstrument channel1311 ofendoscope1302, and hasballoon1316 protruding therefrom, while in a deflated state. As seen,peripheral balloon1304 is in a deflated state.
• FIG. 24B showsendoscope tool1310 being principally located within theinstrument channel1311 ofendoscope1302, and hasballoon1316 protruding therefrom, while in a deflated state. As seen,peripheral balloon1304 is in an inflated state in engagement with an interior wall of the intestine, thereby anchoring theendoscope1302 thereat.
• FIG. 24C shows theendoscope tool1310 extending further from theinstrument channel1311, whileFIG. 24D shows theendoscope tool1310 having been rotated by 180 degrees relative to its orientation inFIG. 24C, by suitable twisting ofmulti-lumen tube1312, as indicated byarrow1340.
• FIG. 24E shows bending of the forward end of theendoscope tool1310 resulting from tensioning ofwire1320, when the tool is in itsFIG. 24D orientation having been pushed forward in a conventional manner.
• FIG. 24F shows further progress of theendoscope tool1310 through the intestine resulting from forward pushing of the tool coupled with release the tension on thewire1320 by operation of toolpositioning control device1324.
• FIG. 24G shows inflation of theballoon1316 by operation of the balloon inflation/deflation control interface1326. In accordance with a preferred embodiment of the invention, this inflation anchors the forward end of theendoscope tool1310 to the intestine at the location of theballoon1316.
• FIG. 24H shows tensioning of theendoscope tool1310 including themulti-lumen tube1312 by pulling on themulti-lumen tube1312.
• FIG. 24I shows deflation ofperipheral balloon1304.
• FIG. 24J shows theendoscope1302 having been pushed forward along themulti-lumen tube1312, using the multi-lumen tube as a sort of guide wire.Endoscope1302 may be pushed forward in a conventional manner.
• FIG. 24K shows inflation ofperipheral balloon1304 into engagement with an interior wall of the intestine, thereby anchoring theendoscope1302 thereat.
• Thereafter, as shown inFIG. 24L, theballoon1316 may be deflated.
• Further forward progress of the endoscope through the intestine, preferably to a position where the forward end of theinstrument channel1311 lies just behind theballoon1316, similarly to the orientation shown inFIG. 24B, may be achieved by repeating some or all of the steps described hereinabove with reference toFIGS. 24B-24L, as required by the geometries encountered.
• It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of various features described hereinabove as well as modifications thereof which would occur to persons skilled in the art upon reading the foregoing specification and which are not in the prior art.

Claims (11)

1-198. (canceled)

199. An endoscope assembly comprising:

a locomotive endoscope, including a locomotive endoscope head and an endoscope body, adapted for locomotion through a tubular body portion and for anchoring at a desired location in said tubular body portion; and

an endoscopy tool adapted for displacement along and over said endoscope body to a desired tool operation location.

200. An endoscope assembly according toclaim 199 and also comprising at least one selectably radially extendible element associated with said locomotive endoscope head and adapted for anchoring said locomotive endoscope head at a desired location in said tubular body portion

201. An endoscope assembly according toclaim 200 and wherein said at least one selectably radially extendible element comprises a selectably inflatable anchoring balloon.

202. An endoscope assembly according toclaim 199 and also comprising an overtube which is slidable along said endoscope body and is associated with said endoscopy tool and wherein said endoscope body is adapted to function as a guide for said overtube.

203. An endoscope assembly according toclaim 200 and also comprising an overtube which is slidable along said endoscope body and is associated with said endoscopy tool and wherein said endoscope body is adapted to function as a guide for said overtube.

204. An endoscopy method comprising:

providing a locomotive endoscope including a locomotive endoscope head and an endoscope body;

providing locomotion of said locomotive endoscope head through a tubular body portion;

anchoring said locomotive endoscope head at a desired location in said tubular body portion; and

displacing an endoscopy tool along said endoscope body to a desired tool operation location.

205. An endoscopy method according toclaim 204 and also comprising tensioning said endoscope body following said anchoring of said locomotive endoscope head and prior to said displacing said endoscopy tool.

206. An endoscopy method according toclaim 204 and also comprising, prior to said anchoring, the step of detecting said desired location in said tubular body portion by use of at least one light source and at least one imaging sensor associated with said locomotive endoscope head.

207. An endoscopy method according toclaim 204 and also comprising, prior to said displacing said endoscopy tool, the step of detecting said desired tool operation location in said tubular body portion by use of at least one light source and at least one imaging sensor associated with said locomotive endoscope head.

208. An endoscopy method according toclaim 204 and wherein said displacing said endoscopy tool comprises sliding an overtube associated with said endoscopy tool over said endoscope body.

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