US3261350A

US3261350A - Endoscope

Info

Publication number: US3261350A
Application number: US308954A
Authority: US
Inventors: Frederick J Wallace
Original assignee: American Cystoscope Makers Inc
Current assignee: American Hospital Supply Corp
Priority date: 1963-09-16
Filing date: 1963-09-16
Publication date: 1966-07-19
Anticipated expiration: 1983-07-19

Description

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ENDOSCOPE 3 Sheets-Sheet 1 Filed Sept. 16, 1963 July 19, 1966 F, 1 WALLACE 3,261,350

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July 19, 1966 F. J. WALLACE ENDOSCOPE 5 Sheets-Sheet 5 Filed Sept. 16, 1963 United States Patent O 3,261,350 ENDOSCOPE Frederick J. Wallace, New York, N.Y., assignor to American Cystoscope Makers, Inc., Pelham Manor, N .Y., a corporation of New York Filed Sept. 16, 1963, Ser. No. 308,954 3 Claims. (Cl. 12S-6) This application is a continuation-impart of application Serial No. 305,304, filed August 29, 1963.

This invent-ion relation to endoscopic instruments for examination of internal body orifices, and more particularly relates to laryngoscopes and bronchoscopes which utilize optic fibers for illumination of the larynx and bronchi.

An endoscope must meet limitations of size and shape dictated by the anatomical structure of the orifice in which it is to be used. Also, an endoscope must provide for light, vision and operating instruments or high frequency electrodes. For precision in diagnosis or other procedure, a fine, brilliant image that is accurate in regard to both color and definition is essential to the operator. Within the relatively small lumen or space inside the tubular portion of known endoscopes, there is a complete electrical circuit of which a lamp is a part. The lamp circuit requires an insulated conductor or wire to carry current from a contact near the proximal end, to the lamp frequently located at the distal end. The circuit must function perfectly under water and must not be affected by other solutions during sterilization, a requirement most diicult to fulfill in any electrical structure. While the instruments are water-tight when they leave the factory, due to the fact that they must be opened for the replacement of lamps, their ability to exclude moisture is almost entirely dependent upon the care exercised by the user in again sealing the instruments.

In known endoscopic instruments most premature burning out of lamps results from attempts to obtain unusually brilliant illumination. The extent of illumination is limited by the filament of the lamp itself. It is the practice to make use of a current regulator and observe the lamp filament closely while gradually increasing the current. The limit of safe current is reached when the definite reddish tint of the lamp suddenly becomes white. Further increase in illumination by increasing the current beyond this point results in premature burning out of the lamp. Once the lamp burns out it is necessary to remove it, thus introducing the possibility of the problems described above.

Problems also arise from the disinfection -of parts of the endoscope containing lamps or lenses. It is not practicable to boil or autoclave any part of the endoscope which contains lamps. The usual chemical disinfectants may not be used or leaks and short circuits in the wiring may follow. As a result it is necessary to use special disinfectant lmethods and solutions in cleaning known endoscopes.

It is an object of the present invention to provide means for illuminating internal orifices which means provide significantly brighter illumination than was heretofore possible and may be sterilized by boiling, autoclaving or chemicals without deleterious results.

It is another object of the present invention to provide endoscopic instruments having illuminating means with an expected life, equivalent to that of the rest of the instrument, which means do not require maintenance or replacement of parts in normal use.

It is still another object of the present invention to provide particular endoscopic instruments utilizing as an illuminating means a bundle of optic fibers which may be shaped at its distal end to configurations especially adapted to the particular use of the instrument.

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It is another object of this invention to provide a fiber optic bundle for the illumination of internal orifices which is in a form rigid enough for insertion into such orifices.

It is yet another object of this invention to provide endoscopic instruments for the examination of the larynx and bronchi which provide a high level of illumination.

Further objects as well as advantages in the present invention will be apparent from the following description and the accompanying drawings, in which:

FIGURE l is a side elevational view of a laryngoscope utilizing the rigid light carrying sheath of the present invention;

FIGURE 2 is an elevational view of the proximal end of the laryngoscope of this invention taken generally along lines 2-2 of FIGURE l;

FIGURE 3 is a longitudinal cross-sectional view of the rigid light carrying sheath of this invention partly broken away for convenience;

FIGURE 4 is an end view taken generally along lines 4-4 of FIGURE 3;

FIGURE 5 is a transverse cross-sectional view taken generally along lines 5--5 of FIGURE 3;

FIGURE 6 is a transverse cross-sectional View taken generally along lines 6 6 of FIGURE 3;

FIGURE 7 is a side elevational view of the rigid light carrying sheath of the laryngoscope of this invention;

FIGURE 8 is a side elevational view lof a bronchoscope utilizing the rigid light carrying sheath of this invention;

FIGURE 9 is a longitudinal cross-sectional View of the bronchoscope of this invention partly broken away for convenience;

FIGURE 10 is an end view of the bronchoscope of this invention taken generally along lines 10-10 of FIG- URE 9;

FIGURE l1 is a transverse cross-sectional View taken generally along lines 11-11 of FIGURE 9;

FIGURE l2 is a transverse cross-sectional view taken generally along lines 12-12 of FIGURE 9.

The objects of this invention may be accomplished by forming an endoscope tubular member from two concentric, coaxial rigid tubes. The concentric tubes may be circular in cross-section but for some applications are preferably slightly elliptical. For some applications it is desirable to taper the concentric tubes. A bundle containing a large number of optic fibers is placed lin the annular space between the two tubes.

The proximal end of the optic fiber bundle is formed into a solid rod which is of a suitable configuration, preferably cylindrical, for coupling to a source of light.

Because endoscopes are shape-d to conform to the orifice being examined, the distal end of the bundle may be formed into one of a variety of shapes. A preferred shape is that of -an annu-lus substantially coextensive with the ends of the concentric tubes. Preferably the ends of the fiber bundle are optically polished to provide better light dissemination and a protective lens may be placed over the polished end of the bundle, if desired. Using an annular distal configuration, light is transmitted through the bundle to provide high intensity, cold illumination in an `annular pattern at the distal end, permitting ready observation of internal areas. If desired, the distal end of the bundle may be adapted to illuminate an internal orifice by forming the fibers into a solid rod or other shape.

High intensity illumination is possible using the present invention. Intensities up to 2,000 foot candles or more at a working -distance of one-half inch and up to 400 foot candles or more at four inches :may be obtained by connecting the device to a fiber optic light source, for instance, by ymeans of a fiber optic light carrying bundle. Typically the illumination produced by the optic liber bundle is fifteen times greater than that produced by an incandescent lamp commonly used in same `size of endoscope.

Other features of the present invention are the elimination of wires and the elimination of rotating contacts on the instruments which were necessary in prior art instruments in order to provide electrical connections for the internal lamp circuit. The present invention may be .made `applicable to all types of endoscopic equipment, particularly examining, operating and catheterizing endoscopes. A particular advantage of the present invention i-s the adaptability of the instrument to small size, for instance, for use in an infant cystoscope.

Rigid endoscopes having annularly disposed fiber optics may be prepared by the following procedure. First, using the method described in the application of Lawrence E. Curtiss, Serial No. 76,868, filed December 19, 1960, continuous strands of fiber optics are wound on a Mylar (polyethylene terephthalate) sheet whi-ch is disposed around la drum. As each successive layer of fibers is laid on the drum, a layer of thermosetting resin is placed upon it. The resin is allowed to dry but is not cured; thus it remain tacky but does not become hard and stiff. The sheet is then cut parallel to the axis of the cylinder, and a fiat sheet of Mylar having well oriented fibers is obtained.

Second, the inner tube of the endoscope is brought into contact with the fiat sheet, and the flat sheet is rolled onto the inner tube in an even number of revolutions sufiicient to produce the thickness of the annular bundle that is desired. `Because the resin that was applied is tacky, the sheet sticks readily to the tube, and successive convolutions stick to each other.

Third, the inner tube and optic bundle are inserted in the outer tube which i-s shorter than the inner tube and the fibers used. The ydistal ends of the fibers are coextensive with the distal ends of both inner and outer tubes. The proximal end is formed into -a rod by pulling the fibers together. I'f necessary a solvent is used to soften the resin. After forming, the rod is inserted through a terminal fitting which supports it, and epoxy resin is added to the rod end and also to the annular distal end. Finally the entire assembly is baked to cure the resin and produce a hard, rigid endoscopic tube.

Where a bend is to be produced in the tube, the fibers may be inserted as above and the bend made after the outer tube is applied, but before baking. The presence of the fibers between the two tubes aids in maintaining the tubes concentric. The resin is soft enough to permit the bundle to bend without breaking the fibers.

Turning now to the drawings, the laryngoscope embodiment of this invention is shown in FIGURES 1-7. Laryngoscope 18 is comprised of rigid light carrying sheath 12, handle 14 and telescopic eyepiece 16, as best shown in FIGURE 1. Rigid light carrier 12 is further comprised of metal sheath 18 which is biased at its distal end 20 and formed into shoulder 22 at its proximal end. Shoulder 22 contains recess 24 into which are inserted upper split ring 26 and lower split ring 28. At their proximal ends split rings 26, 2S are encircled by annular mounting ring 30 which is connected to upper split ring 26 by bolts 32. Annular ring 33 is pressed into the proximal end of ring 30 and has the same size inner diameter as inner tube 60. Mounting bracket 34 is connected to mounting ring 38 and is a-dapted to receive sleeve 36 which slides on mounting bracket 34 and may be secured in position by thumb screw 38. Mounting arm 48 is pivotally connected to sleeve 36 and serves to support telescopic eyepiece 16. Breath deflector 42 is supported in mounting ar-m 40 and arranged for connection to a source of gas (not shown).

Sleeve 44 is connected to lower split ring 28 and mounting ring 30, and is adapted to receive and support jack 46. Jack 46 contains recess 48 into which spring 56 is inserted which coacts with a corresponding recess 52 on connector 54 to removably couple jack 46 to flexible light 4 carrier 56 which may have a jack, recess and spring similar to those described.

Disposed within rigid light carrier 12 are outer tube 58 and inner tube 66 coaxial with outer tube 58 and defining an annular space 62 therewith. Optic fibers 64 are disposed within the annular space 62 and are substantially coextensive at their distal end with the distal ends of outer tube 58 and inner tube 60. The proximal end `of inner tube 60 is coextensive with the proximal end of upper split ring 26 and lower split ring 28. Outer tube 58 is shorter than inner tube 68 and ends short of jack 46. The difference in length between the tubes is provided so that the proximal ends of optic fibers 64 may be gathered into proximal end bundle 66 which is formed, as described above, into a hard substantially cylindrical rod which is supported inside jack 46. The proximal end of bundle 66 is optically ground and is protected by glass plate 68 from mechanical damage. lhe distal end portion 70 of optic fibers 64 is formed into a substantially annular ring and hardened by the use of resins, as described above. As seen in FIGURE 4, rigid light carrier 12 is substantially elliptical at its distal end but is substantially circular at its proximal end, FIGURE 5 showing a typical transitional conformation of the light carrier between the two positions.

As is best shown in FIGURE 6, handle 14 is removably connected to rigid light carrier 12. Winged staybolt 72 threadably engages tapped channel 74. Arcuate portion 76 of handle 14 engages upper and lower split rings 26, 28, and arcuate member 78 is removably brought into contact with upper and lower split rings by manipulation of staybolt 72. Springs 77 (FIGURE 3) urge member 78 into the open position 79 shown in phantom.

In operation rigid light carrier 12 is inserted into the larynx of the patient with the aid of handle 14. The rigid light carrier is connected to a light source by means of liexible light carrier 56, and telescopic eyepiece 16 is rotated into position for view down the length of the rigid light carrier. Focusing of the telescopic eyepiece may be accomplished by manipulation of knurled ring 8f). To prevent fogging of the lenses of the telescopic eyepiece by the patients exhaled breath, a source of gas, such as air under moderate pressure, may be connected to breath defiector 42.

The bronchoscope embodiment of this invention is shown in FIGURES 8 through l2. Bronchoscope 188 is comprised of rigid light carrier 162 and telescope 164. Rigid light carrier 182 further is comprised of outer sheath 106 which is biased at its distal end 108 and has rim 110 attached thereto which aids in the smooth insertion of the bronchoscope into the body orifice. At its proximal end outer sheath 188 is connected to annular mounting member 112. Sleeve 114 is connected to mounting member 112 and is in turn connected to and supports jack 116. Jack 116 has a recess 118 for receiving spring 12@ which coacts with a corresponding recess 122 in connector 124 to removably couple jack 116 to a flexible light carrier 126. The flexible light carrier is connected to a source of light (not shown) and may at its end portion have a similar jack, recess and spring for coacting with connector 124.

First annular ring 128 and second annular ring 13G encircle annular mounting member 112, aid in supporting sleeve 114, and provide access for the insertion of various conduits, (not shown), such as air, oxygen and exhaust conduits. Insert 132 is connected inside and adjacent the proximal end of annular mounting member 112 and forms the proximal end support for the inner tube as will be described below.

Disposed within outer sheath 186 are outer tube 134 and inner tube 136 defining an annular space 138 between them. Optic fibers 141B are disposed in the annular space. The distal ends of the optic fibers are substantially coextensive with the distal ends of outer tube 134 and inner tube 136. The proximal ends of optic fibers 14@ are gathered and formed into a hard, substantially cylindrical rod 142, the end of which may be optically ground and protected by glass plate 144. The distal end portion 146 of optic fibers 140 is similarly formed into a `ring which is, however, substantially circular in configuration.

The transistion of the bundle of optic fibers from substantially annular to a rod-like form is facilitated by the inner tube 136 being substantially longer than the outer tube 134, thus providing gathering space for the optic fibers. Inner tube 136 is substantially coextensive with the proximal end of insert 132, while the proximal end of outer tube 134 stops on the distal side of sleeve 114. The gathering of the substantially annularly disposed optic fibers into rod-like form is best shown in FIG-- URE 12.

In operation the bronchoscope is inserted into the bronchus of the patient and the rigid optic fiber light carrier is coupled to a source of light through use of a exible light carrier. The telescope may then be mounted on the rigid light carrier with stem 148 and objective lens 150 extending beyond distal end 108, and gases such as oxygen, etc., may be connected. The bronchi of the patient are thus brightly illuminated, aiding in the thorough examination and diagnosis of their condition.

The terms and expressions which have been employed are used as terms of description and not of limitation, and there is no intention in the use of such terms and expressions of excluding any equivalents of the features shown and described or portions thereof, but it is recognized that various modifications are possible within the scope of the invention claimed.

What is claimed is:

1. In an endoscopic instrument for examining interior portions of the thorax comprising a cylindrical endoscopic sheath and telescopic inspection means, the improvement comprising a rigid light carrier conforming to the internal shape of the endoscopic sheath and further comprising an outer tube, an inner tube defining an elongated cavity therewith, said outer and inner tubes being mounted in and extending from adjacent the proximal end to adjacent the distal end of said sheath and a plurality of optic fibers disposed within said cavity and extending about and along substantially the entire length of said tubes, said optic fibers being bonded together and substantially rigid from end-to-end thereof, the proximal end portions of said optic fibers being formed into a rigid rod and adapted for connection to an external light source, whereby the portions of the .thorax may be brilliantly illuminated thereby aiding diagnosis and treatment.

2. A laryngoscope Vcomprising an elongated conical endoscopic sheath which is substantially cylindrical at its proximal end and elliptical at its distal end, first and second split rings connected to the proximal end of said sheath, an annular mounting ring encircling the proximal portions of said split rings and being connected thereto, a first mounting member connected to said annular ring, a second mounting member slidably connected to said first mounting member, a third mounting member rotatably connected to said second mounting member, a telescopic eyepiece connected to said third mounting member, a breath deector connected to said third mounting member in spaced relation to said telescopic eyepiece; a substantially cylindrical sleeve connected .to said first split ring and said annular mounting ring, a jack connected to said sleeve and having a channel therethrough; an outer tube conforming to the internal configuration of said sheath and being coaxial therewith, an inner tube coaxial with said outer tube and said sheath and forming an annular space with said outer tube, a plurality of optic fibers disposed within said annular space, the distal ends of `said optic fibers being substantially coextensive with the distal ends of said inner and outer tubes and being formed into a solid annulus, the proximal ends of said optic fibers being formed into a substantially cylindrical solid rod and disposed within said channel and supported by said jack, whereby said optic fibers are adapted for coupling to an external source of light and are thereby adaptable to illuminate the larynx; and a handle connected to said first and second split rings.

3. A bronchoscope comprising an elongated cylindrical endoscopic sheath having a proximal and a distal end, an annular mounting member connected to said Sheath adjacent said proximal end, first and second annular mounting rings disposed about said mounting member, a sleeve inserted in said mounting member and said first and second mounting rings adjacent the proximal ends thereof and forming a channel therewith, a jack connected to said sleeve and forming a continuation of said channel, a third annular mounting ring inserted within said mounting member adjacent the proximal end of said mounting member; an outer tube disposed within said sheath and being coaxial therewith, an inner .tube disposed within said outer tube and defining an annular space therewith the proximal end of said inner tube being substantially coextensive with the proximal end of said third mounting member, said outer tube being shorter than said inner tube, a plurality of optic fibers disposed within said annular space, the distal ends of said optic fibers being substantially coextensive with the distal ends of said inner `and outer rtubes and being formed into a solid annulus, the proximal ends of said optic fibers being formed into a substantially cylindrical rod and being disposed within said channel, and adapted for connection to an external source of light; and a telescope adapted to be connected to said endoscopic sheath and inserted therethrough, whereby examination and diagnosis of the bronchi may be accomplished.

References Cited by the Examiner UNITED STATES PATENTS 3/1941 Brown 128-6 5/1963 Hett l286

Claims

1. IN AN ENDOSCOPIC INSTRUMENT FOR EXAMINING INTERIOR PORTION OF THE THORAX COMPRISING A CYLINDRICAL ENDOSCOPIC SHEATH AND TELESCOPIC INSPECTION MEANS, THE IMPROVEMENT COMPRISING A RIGID LIGHT CARRIER CONFORMING TO THE INTERNAL SHAPE OF THE ENDOSCOPIC SHEATH AND FURTHER COMPRISING AN OUTER TUBE, AN INNER TUBE DEFINING AN ELONGATED CAVITY THEREWITH, SAID OUTER AND INNER TUBES BEING MOUNTED IN AND EXTENDING FROM ADJACENT THE PROXIMAL END TO ADJACENT THE DISTAL END OF SAID SHEATH AND A PLURALITY OF OPTIC FIBERS DISPOSED WITHIN SAID CAVITY AND EXTENDING ABOUT AND ALONG SUBSTANTIALLY THE ENTIRE LENGTH OF SAID TUBES, SAID OPTIC FIBERS BEING BONDED TOGETHER AND SUBSTANTIALLY RIGID FROM END-TO-END THEREOF, THE PROXIMAL END PORTIONS OF SAID OPTIC FIBERS BEING FORMED INTO A RIGID ROD AND ADAPTED FOR CONNECTION TO AN EXTERNAL LIGHT SOURCE, WHEREBY THE PORTIONS OF THE THORAX MAY BE BRILLIANTLY ILLUMINATED THEREBY AIDING DIAGNOSIS AND TREATMENT.