US20040249247A1

US20040249247A1 - Endoscope with panoramic view

Info

Publication number: US20040249247A1
Application number: US10/836,614
Authority: US
Inventors: Gavriel Iddan
Original assignee: Given Imaging Ltd
Current assignee: Given Imaging Ltd
Priority date: 2003-05-01
Filing date: 2004-05-03
Publication date: 2004-12-09
Also published as: JP2006527012A; EP1620012A2; EP1620012A4; ATE553690T1; WO2004096008A2; US7801584B2; JP4550048B2; WO2004096008A3; EP1620012B1; US20060052708A1

Abstract

An endoscope capable of capturing images of an in-vivo area behind a distal end of the endoscope's tube. The endoscope may have an imaging unit that may, for example, include a reflective surface that reflects an image of an area surrounding such tube onto an image sensor. Other optical systems may be used for imaging behind one end of an endoscope or imaging device.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims benefit from U.S. provisional application Ser. No. 60/466,729, filed on May 1, 2003, entitled “CIRCULAR FIELD-OF-VIEW IMAGING DEVICE” which is incorporated in its entirety by reference herein.[0001]

FIELD OF THE INVENTION

The invention relates to an endoscope, and more specifically, to an endoscope capable of capturing panoramic images of areas of a body lumen surrounding a tube of such endoscope.

BACKGROUND OF THE INVENTION

Endoscopes, such as that depicted in FIG. 1, may be used for visual examination of a body lumen and may generally include a

flexible tube

12 that may be inserted into a body lumen Such tube 12 may include an end 10 that may be for example flat, rounded or dully pointed. Such distal end 10 may include for example a lens 16 connected to an imaging sensor, an illuminating device 18 for illuminating an in-vivo area to be viewed by the image sensor, and a tool channel 14 through which various tools, such as for example a biopsy tool, or other elements such as water or air, may be passed into an in-vivo area. Other items may terminate or be situated on a distal end 10 of an endoscope tube 12. In general an endoscope may capture images of in-vivo areas that are in front of 20

distal end

10 of au endoscope tube 12. In general an endoscope will not capture images of in-vivo areas that are behind 22

distal end

10 and parallel to an endoscope be 12.

SUMMARY OF THE INVENTION

An endoscope and method of endoscopy that may include for example introducing an endoscope tube into a body lumen, such endoscope tube including an imaging unit capable of capturing images of an in-vivo area that are for example behind a distal end of such tube, or that may be for example adjacent to and surrounding an outside perimeter of such tube.

The endoscope may include for example a reflector and lenses suitable or capturing images of an in-vivo area onto an image sensor, such in-vivo area surrounding a tube of such endoscope. In addition, corresponding radial illumination may also be used in the present invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts a prior aft endoscope; [0006]
FIG. 2 depicts an endoscope capable of capturing images from in-vivo areas surrounding an endoscope tube in accordance with an embodiment of the invention; [0007]
FIGS. 3A to [0008] 3E are schematic illustrations helpful to understanding some aspects of the operation of an in-vivo imaging device in accordance with embodiments of the invention;
FIG. 4 is a flow chart of a method in accordance with embodiments of the invention; [0009]
FIG. 5 is a schematic illustration of an in-vivo imaging device including a rotating mirror in accordance with embodiments of the invention; [0010]
FIG. 6 is a flow chart of a method of endoscopy in accordance with an embodiment of the invention; and [0011]
FIG. 7 is a flow chart of a method of reflecting onto an image sensor an image of an in-vivo area behind a distal end of an endoscope and surrounding a perimeter of a tube of the endoscope in accordance with an embodiment of the invention.[0012]

DETAILED DESCRIPTION OF TEE INVENTION

In the following description, various aspects of the present invention will be described. For purposes of explanation, specific configurations and details are set forth in order to provide a thorough understanding of the present invention. However, it will also be apparent to one skilled in the art that the present invention may be practiced without the specific details presented herein. Furthermore, well known features may be omitted or simplified in order not to obscure the present invention. [0013]
Reference is made to FIG. 2, an endoscope capable of capturing images from in-vivo areas surrounding and/or behind the distal end of an endoscope tube in accordance with an embodiment of the invention. [0014] Endoscope tube 200 may include a distal end 202 that may be for example flat, rounded or dully pointed. Other suitable shapes or endings may be used In some embodiments distal end 202 may include a lens, image sensor and illumination units (not shown) that may capture images of in-vivo areas in front of 204 such distal end 202. Behind distal end 202 may be situated an imaging unit 206 that may include an imaging sensor 208, one or more lenses 210, one or more illumination units 212 and a possibly one or more reflective surface(s) 214. Imaging sensor 208 may be, for example a CCD, CMOS or other suitable image device. Along or maintaining up part of an outside perimeter wall of tube 200 in the area of illumination units 212, there may be included transparent segments 216 such as suitable optical windows that may permit light to exit and enter a portion of tube 200 and that may make up part of the outside wall of tube 200 so that such segments 216 of tube 200 form a shape of a ring or part of a ring or belt of an outside perimeter of tube 200. Other suitable shapes may be used. The transparent segments 216 may be fashioned from for example plastic, fiberglass or other suitable materials.
Outside of a patient's body, the endoscopy system may include for example an [0015] image receiver 232 that may include a processor 234, a data storage unit 236 and a display 230. In some embodiments image receiver 232 may be connected by wires or wirelessly to endoscope 201. In some embodiments image receiver 232 may be included in a personal computer or other workstation. In some embodiments, image receiver 232 may be part of an endoscope unit. In some embodiments, processor 234 may include an image processor or other processor capable of collecting images and displaying such images on display 230. In some embodiments processor 234 may collect one or more images that make up a panoramic view of an in-vivo area and may display such view on display 230. Display 230 may be or include a computer screen or other image or video display monitor. Data storage unit 236 may be or include a hard drive or other electronic storage medium that may store images or other electronic data
In an exemplary embodiment of the present invention, an [0016] endoscope 201 may be introduced into a body lumen 205. One or more illumination unit(s) 212 may face outward from a perimeter of tube 200 and may illuminate an in-vivo area 218 behind distal end 202, such area possibly being adjacent to and surrounding tube 200. Light guides, mirrors, or other structures may direct light; in such cases illumination units need not face outward. Light that may be directed outward by illumination unit 212 from tube 200 onto one or more in-vivo area(s) or object(s) 220A or 220B to be observed that is located in an in-vivo area 218 behind distal end 202 and adjacent to tube 200, may be reflected back onto reflecting surface 214. Note while areas or objects 220A and 220B are separate in the figure, in one embodiment a contiguous ring or band is imaged; in other embodiments the area imaged need not be a band or ring, but rather one or more distinct areas. Reflecting surface 214 may be curved and/or angled so as to deflect light coming back through transparent segments 216 through lens 210 and onto image sensor 208. Other configurations for reflecting surfaces may be used. Image sensor 208 may capture images from in-vivo area surrounding an outside perimeter 222 of tube 200. In some embodiments, imaging unit 206 may capture images of areas substantially perpendicular to and surrounding tube 200. In other embodiments, reflecting surface need not be used.
In one embodiment the area(s) imaged is to the side of the imaging device, and the imager is directed (e.g., via a mirror or by being appropriately positioned) to the side, to image areas adjacent to the device. For example, in FIG. 2, the imager units may be considered to be imaging in a direction perpendicular to the longer axis of the device. While in one embodiment the area imaged is behind the distal tip of the device, in other embodiments the area imaged may include both areas behind the distal tip and in front of the distal tip. For example, the device may be partially forward looking. In such a case, one imager may collect images, the images including both areas behind and in front of the tip. In other embodiments, more than one imager or imaging system may be used, for example one forward looking and one side looking. In some embodiments, a conventional, forward looking imager may also be included. [0017]
In one embodiment, as [0018] tube 200 of endoscope 201 traverses a body lumen 205, imaging unit 206 may capture images of a slice 207 of body lumen 205. For example, a ring shaped slice of a portion of tissue located behind the distal tip of the endoscope 201 may be imaged. The ring shaped slice may encompass a 360 degree view surrounding the circumference of the endoscope. Illumination unit 212 may illuminate the slice 207 of body lumen 205. The light from the illuminated slice 207 may be reflected by reflective surface 214, focused by lens 210, and received by imager 208 which may capture an image of the slice 207 of body lumen 205 from an area surrounding tube 200 of endoscope 201. In an embodiment, since tube 200 may include transparent segments 216 in the shape of a ring of tube 200, the captured image may include a reflected image of a ring-shaped slice 207 of body lumen 205. It is noted that lens 210 may be configured, placed and/or aligned to filter and/or focus fight from body lumen 205, such that only light from a desired portion of body lumen 205, for example, a ring-shaped slice 207, falls on image sensor 208. The image captured by image sensor 208 may include a substantially complete 360 degrees image of a slice of body lumen 205. Alternatively slices may include other configurations, for example, a 270 degree image, a 210 degree image, a 180 degree image, or any other number of degrees between 0 and 360.
In some embodiments, the panoramic image of a [0019] slice 207 of body lumen 205 may be ring-shaped. Such an image may be recorded as or converted into a rectangular image or into other shapes. In one embodiment, the conversion may be performed, for example, by a processor that may be included in endoscope 201 or that may be housed in a separate unit. In some embodiments, processor 234 or another processor may convert images into a rectangular image. The conversion may be performed, for example, using methods as known in the art to “flatten” a ring-shaped image into a rectangular image. The conversion may be applied to one image, or to a group or a batch of sequential or non-sequential images. In some embodiments, one or more of a series of panoramic images of slices 207 of body lumen 205 may be connected to form a moving image of body lumen 205 or a sequential chain of images of slices 207 of body lumen 205. In some embodiments a video image may be captured. In some embodiments, depending on the configuration of one or more reflecting surfaces, the image as recorded on an imager may be substantially rectangular.
Additionally or alternatively, images of [0020] slices 207 of body lumen 205, may be placed, aligned and/or combined together, for example, side by side, to create a combined image or several combined images from a plurality of images of slices 207. The combination of images of slices 207 may be performed, for example, by a processor as is discussed herein.
In some embodiments, one or [0021] more tool channels 224 may end, exit or have an opening along an outside wall or perimeter of tube 200 at a point closer to a proximate portion of tube 200 and below imaging unit 206.
In one embodiment, in use, a medical practitioner such as, for example, a doctor may introduce [0022] tube 200 into a body lumen 205 (e.g., the GI tract, circulatory system, abdomen, or other cavity or other lumen) of a human or animal patient. The hand piece of an endoscope (not shown) may remain partially or completely outside the body, and may provide the interface and controls (e.g., pulleys, air/water controls, suction controls) which the medical practitioner may operate. In some embodiments, the hand piece may provide control for external supplies, monitors, or other equipment that may be passed through, for example, tool channel 224.
The [0023] imaging unit 206 may include an image sensor, such as a CCD or a CMOS image sensor 208. Image sensor 208 may capture still or video images of an in-vivo area and transmit such images to a display 230 outside of the body. Illumination unit 212 may be a light such as for example an LED, optical fiber or other suitable illumination device. In some embodiments, illumination unit 212 may provide, for example, ultra-violet light, infra-red light, or other desired light or spectral range. In an embodiment, illumination unit 212 may include a laser source and/or may provide one or more laser beams. In some embodiments, illumination units 212 may be situated around a perimeter of tube 200 to illuminate a ring or band of body lumen 205 in the area surrounding transparent segments 216. Other arrangements of illumination units 212 are possible. One or more mirrors (not shown) such as curved mirrors may be used to reflect light from illumination units 212 onto an in-vivo area.
[0024] Holder 213 may include a suitable structure to bold illumination units 212. In some embodiments, holder 213 may be formed and/or shaped such that it reduces glare. In some embodiments, holder 213 may be formed and/or shaped such that it blocks stray light from reaching and/or flooding image sensor 208 with light.
[0025] Wires 226 or a pulley system may be included in tube 200 to control for example lateral movements of the distal end 202 of tube 200.
In some embodiments, [0026] lens 210 may include an optical system of one or more lenses or lens assemblies that may focus light firm reflecting surface 214 onto image sensor 208. Other suitable optical elements may be used.
In embodiments of the invention, imaging unit may provide a broad field of view or panoramic view and may capture images of a body lumen or in-vivo area substantially transverse or perpendicular to the direction of a tubular axis of [0027] tube 200.
[0028] Reflective surface 214 may be for example a carved mirror to capture a panoramic view of an in-vivo area. Some embodiments may use a rotating mirror or reflective element to capture a panoramic image. Reflective ice 214 may be made of or include a glass, metallic or plastic element or other suitable material. In some embodiments a plurality of image sensors 208 may be used to capture a broad field of view, for example, by placing multiple image sensors 208 so that they face in different or overlapping directions. In some embodiments, reflective surface 214 may be oval, elliptical, spherical, radial or may take on other shapes. It is noted that in some embodiments, reflective she 214 may have a shape, size and/or dimensions to allow a desired reflection of light and/or to allow a desired range and/or field-of-view. In an embodiment, reflective surface 214 may be manufactured using suitable optical design software and/or ray-tracing software, for example, using “ZEMAX Optical Design Program” software.
Reflective element may be shaped and/or contoured such that it allows light reflected onto it from a particular area of a body lumen such as for example object [0029] 220A to be reflected off of reflective surface 214, through lens 210 and onto a known area of image sensor 208. In some embodiments, a processor may be able to establish a position, direction or orientation of a subject captured in an image based on the portion of image sensor 208 that captured the image of the object 220A.
In some embodiments, an imager in such endoscope may be situated perpendicular to the area being imaged. In some embodiments, an area of a [0030] parent segments 216 may be concave, tapered, narrowed or ‘pinched’ so that the imaging portion of the endoscope may have a shape resembling a peanut, Such concave area may for example include transparent ring, segment or viewing window. Though which light may enter and be reflected off of reflective surface 214 onto an image sensor 208. In some embodiments, reflective surface 214 may be in a parabolic shape, such that for example light rays striking reflective surface 214 from various directions will be reflected towards image sensor 208. In some embodiments, the peanut shape may minimize the backscatter light that reaches the image sensor 208 directly from illumination units 212 rather than after being reflected off of endo-luminal wall.
In some embodiments, illumination controls may be added to, for example, avoid dark spots appearing in images of the body lumen. Illumination sources may include, for example, UV light, VIS and IE light, or other suitable sources. [0031]
FIG. 3A schematically illustrates the combination of a plurality of images of [0032] slices 311, 312, 313, 314, 315, 316, 317 and 318, into a combined image 320 in accordance with embodiments of the invention.
FIG. 3B schematically illustrates the conversion of a plurality of circular slice or ring shaped [0033] images 331, 332, 333, 334, 335, 336 and 337 into a plurality of rectangular images of slices 341, 342, 343, 344, 345, 346 and 347 in accordance with embodiments of the invention as described above. FIG. 3B further schematically illustrates the combination of a plurality of rectangular images of slices 341, 342, 343, 344, 345, 346 and 347 into a combined image 350 in accordance with embodiments of the invention as described above.
In one embodiment a 3D model of a lumen is created by capturing a plurality of rectangular images of [0034] slices 341, 342, 343, 344, 345, 346 and 347.
In some embodiments, [0035] imaging unit 206 may be controlled and/or programmed, for example, to allow capturing a sequential chain of panoramic images depicting a body lumen 205. In one embodiment, consecutive images may partially cover one area of the body lumen 205, for example, such that images may partially overlap. In some embodiments, for example, image capture rate may be pre-defined and/or controlled in real-time, to allow image sensor 208 to capture a continuous “chain of images”. In one embodiment, a suitable image correlation technique may be used, for example, to detect and/or process overlapping areas among images, or to combine a plurality of images into a combined image. In some embodiments, image sensor 208 may capture video images.
FIG. 3C schematically illustrates a “chain of images” of [0036] body lumen 366 in accordance with some embodiments of the invention. In one embodiment, images 361, 362, 363 and 364 may be captured by image sensor 208. As illustrated schematically in FIG. 3C, the images may partially overlap. For example, image 362 may include a portion of body lumen 366 captured in image 361 and/or a portion of body lumen 366 captured by image 363. Image 362 may additionally include an image of item 367, for example, a body organ, material, blood, a pathology, etc.
FIG. 3D schematically illustrates an alignment of images in accordance with some embodiments of the invention. For example, in one embodiment, the four [0037] images 361, 362, 363 and 364 of FIG. 3C may be processed, correlated and/or aligned, to produce four aligned images 371, 372, 373 and 374, respectively. It is noted that aligned image 372 may include, for example, the image of item 367.
FIG. 3E schematically illustrates a combination of images in accordance with some embodiments of the invention. For example, in one embodiment, the four [0038] images 361, 362, 363 and 364 of FIG. 3C, and/or the four images 371, 372, 373 and 374 of FIG. 3D, may be processed, correlated and/or aligned, to produce a combined image 380. It is noted that combined image 380 may include, for example, the image of item 367.
It is noted that FIGS. 3A to [0039] 3E include exemplary illustrations only, and that the present invention is not limited in this regard. In alternate embodiments, other suitable methods for capturing, converting, combining, matching, aligning, processing, correlating and/or displaying images may be used; for example, a relatively continuous “spiral” image or series of images may be captured and/or displayed, a discontinuous series of “slices” may be captured and/or displayed, etc.
FIG. 4 is a flow chart diagram of a method of capturing images of an in-vivo area that is behind a distal end of an endoscope in accordance with embodiments of the invention. In an embodiment, and as indicated in [0040] block 400, tube 200 of endoscope 201 may be introduced into a body lumen 205, A distal end 202 of a tube 200 of endoscope 201 may traverse body lumen 205 and, as is indicated in Block 402, image sensor 208 may capture images of slices 207 or other portions of body lumen 205 that are behind the distal end of tube 200 of endoscope 201. The images may be processed and/or converted and/or combined, for example using a processor 234, Other operations or series of operations may be performed. The images may include areas that are not behind the distal end of the endoscope. For example, the images may include an area surrounding a band behind the distal tip of the endoscope and in addition an area in front of the distal tip; for example the device may be partially forward looking.
Captured images may be received by [0041] receiver 232, and images may be transferred to processor 234. The images may be displayed and/or stored in storage unit 236.
Additionally or alternatively, if desired, a captured image or a plurality of captured images may be converted, for example, from a circular and/or ring shape into a rectangular shape. Additionally or alternatively, if desired, a plurality of captured images and/or converted images may be combined into one or more combined images of [0042] body lumen 205.
Additionally or alternatively other operations may be performed with the captured images, the converted images and/or the combined images, for example, to store such images using various types of storage devices, to print such images using a printer, to perform operations of image manipulation and/or enhancement, to perform operations of video manipulation and/or enhancement, or the like. [0043]
FIG. 5 is a schematic illustration of an imaging unit near distal end of a tube of an endoscope in accordance with an embodiment of the invention. [0044] Imaging unit 503 may be an implementation or variation of imaging unit 206 described in this application, and may be used, for example, in conjunction with the system of FIG. 1. For example, imaging unit 503 may be used in conjunction with receiver 232 and/or processor 234. In an embodiment of the invention, imaging unit 503 may include an image sensor 506, a lens assembly 508, a mirror 510 or reflective device, one or more illumination sources 512, and one or more holders 514. Imaging unit or tube 500 of endoscope 501 may further include a motor 516 and a shaft 518 or another suitable rotation device that may rotate mirror 510 or another portion of imaging unit 503.
A segment of outside wall of [0045] tube 500 may be partially or entirely transparent. For example, a portion of tube 500 adjacent to imaging unit 503 may include one or more areas and/or portions, such as a transparent shell 520 or portion, which are transparent and which allow components inside imaging unit 503 to have an unobstructed field-of-view of the environment external to tube 500 behind distal end 502. In alternate embodiments, transparent areas and/or portion may have different shapes.
[0046] Lens assembly 508 may include, for example, one or more lenses or optical systems or lens assembly 508 which allow images reflected by mirror 510 to be focused on image sensor 506. Additionally or alternatively, lens assembly 508 may include a combination of lenses able to zoom in and/or zoom out on an image or on several parts of an image reflected by mirror 510. Lens assembly 508 may include one or more optical elements, for example, one or more lenses and/or optical filters, to allow or to aid focusing reflected light onto image sensor 506 and/or performing other light processing operations.
[0047] Mirror 510 may include, for example, a glass and/or metal mirror or any other suitable reflective surface. Mirror 510 may be placed, positioned and/or aligned to allow a slice or other portion 522 of a body lumen 524 to be reflected by mirror 510, through lens assembly 508, and onto image sensor 506. For example, mirror 510 may be placed at a 45 degree angle to the plane of image sensor 506 or to the plane of transparent shell 520. It is noted that other suitable angles may be used to achieve specific functionalities and/or to allow imaging unit 503 a broader or narrower field-of-view. Further, in some embodiments, other arrangements and/or series of optical elements may be used, and functionalities, such as reflecting and/or focusing, may be combined in certain units.
[0048] Illumination sources 512 may include one or more illumination sources or light sources to illuminate body lumen 524 and/or a slice 522 of body lumen 524. In one embodiment, illumination sources 512 may include one or more Light-Emitting Diodes (LEDs), for example, one or more white LEDs. Such LEDs may be placed, aligned and/or positioned to allow a desired illumination of body lumen 524, for example, using a ring-shaped arrangement of LEDs able to illuminate body lumen 524 through transparent shell 520.
[0049] Motor 516 may include an electromechanical motor able to rotate shaft 518 which may be attached to motor 516, and mirror 510 which may be attached to shaft 518. The rotation rate of motor 516 may be constant or variable. The rotation rate of motor 516 may be, for example, 250 rotations per minute; other constant and/or variable rotation rates may be used. It is noted that when motor 516 rotates shaft 518 and mirror 510, the field-of-view of image sensor 506 may change respectively, such that the instantaneous field-of-view of image sensor 506 may include a part of slice 522 of body lumen 524. Additionally or alternatively, in one rotation of mirror 510, the field-of-view of image sensor 506 may include substantially an entire ring-shaped slice 522 of body lumen 524. Motor 516 may be controlled by, for example a controller that may be operatively connected to endoscope.
In one embodiment, as [0050] tube 500 traverses body lumen 524, image unit 503 may capture images of a slice 522 of body lumen 524. Illumination sources 512 may illuminate slice 522 of body lumen 524 when slice 522 is in the field-of-view of image sensor 506. The light from illuminated slice 522 may be reflected by mirror 510, focused and/or transferred using lens assembly 508, and received by image sensor 506 which may thereby capture an image of slice 522. In alternate embodiments, other suitable methods for capturing images and/or displaying images may be used; for example, a relatively continuous “spiral” image or series of images may be captured, a discontinuous series of “slices” may be captured, etc;
Reference is made to FIG. 7, a flow chart of a method of reflecting onto an image sensor images of an in-vivo area behind a distal end of an endoscope and surrounding a perimeter of a tube of the endoscope, in accordance with an embodiment of the invention. In [0051] block 700, an endoscope may for example be introduced into an in-vivo area. In block 702, there may be reflected onto an image sensor an image of an in-vivo area that surrounds a tube of the endoscope and that is behind a distal end of the endoscope.
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. Alternate embodiments are contemplated which fall within the scope of the invention. [0052]

Claims

I claim:

1. A method of imaging an in-vivo area comprising intruding an endoscope into a body lumen and capturing images of an in-vivo area behind a distal end of said endoscope.

2. The method as in claim 1, comprising illuminating said in-vivo area.

3. The method as in claim 1, comprising capturing images reflected from a reflecting surface onto an image sensor.

4. The method as in claim 1, comprising identifying a position of a subject of said images.

5. The method as in claim 1, comprising displaying a panoramic image of an in-vivo area.

6. The method as in claim 1, comprising capturing a plurality of panoramic images and combining said panoramic images into a chain of images depicting a body lumen.

7. A method of endoscopy comprising capturing images from an in vivo area surrounding a tube of an endoscope.

8. The method as in claim 7, comprising reflecting light from said area onto an imager situated perpendicular to said area.

9. The method as in claim 7, comprising identifying a direction of a source of said image.

10. The method as in claim 7, comprising illuminating an area around a perimeter of said tube.

11. The method as in claim 7, comprising displaying a panoramic image of said area.

12. The method as in claim 7, comprising passing a tool through a channel ending on said perimeter of said tube.

13. The method as in claim 7, comprising rotating a mirror within said tube of said endoscope.

14. An endoscope comprising a reflector to reflect onto an image sensor images from an in-vivo area, said in-vivo area surrounding a tube of an endoscope and behind a distal end of said endoscope.

15. The endoscope as in claim 14, comprising a tool channel with an exit on a perimeter of said endoscope tube.

16. The endoscope of claim 14, comprising a reflective surface capable of reflecting images of said area onto an image sensor.

17. The endoscope of claim 16, where said reflective element is a curved mirror.

18. The endoscope of claim 14, comprising illumination units facing outwards from a perimeter of said tube.

19. The endoscope of claim 14, comprising a rotating reflective element.

20. A system comprising an endoscope to capture images of an in-vivo area behind a distal end of said endoscope.

21. A system as in claim 20, comprising a reflective surface to reflect images onto an image sensor.

22. A system as in claim 21, wherein said image sensor is to capture panoramic images of an area surrounding an outside perimeter of a tube of said endoscope.

23. A system comprising an endoscope to capture images of an in-vivo area surrounding a tube of said endoscope.

24. The system as in claim 23, comprising a channel ending on a perimeter of said tube.

25. The system as in claim 23, comprising a rotating mirror within said tube.

26. A method comprising reflecting onto an image sensor an image of an in-vivo area surrounding a tube of an endoscope and behind a distal end of said endoscope.

27. The method as in claim 26, comprising illuminating said area with illumination directed outward from a perimeter of said tube.

28. The method as in claim 26, wherein said reflecting comprises reflecting said image off of a curved mirror.