Endoscopic system

Surgery – Endoscope – With means for indicating position – depth or condition of...

Reexamination Certificate

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C600S103000, C600S109000, C606S130000, C348S075000

Reexamination Certificate

active

06656110

ABSTRACT:

FIELD OF THE INVENTION
The present invention relates to an endoscopic system in accordance with the introductory clause of Patent claim
1
.
The endoscopic systems of the claimed general type may be real systems for the application on the human or animal body or in the engineering field but they may also be simulation or training systems which a physician can use, for instance, for training endoscopic operations.
PRIOR ART
In minimal-invasive surgery (MIC) for instance surgical operations are performed with video assistance. When the endoscope or endoscopes is/are introduced together with the associated endoscopic camera system and the instrument or instruments, the physician does initially not dispose of the visual orientation of the instrument or instruments relative to the endoscope(s). This is true at least as long as the instruments are not visible in the coverage field of the endoscope or endoscopes.
But even when the physician sees the instrument with the endoscope he or she obtains only a two-dimensional image so that the information about the orientation of the instrument or the position of the distal end of the instrument relative to the focal plane, respectively, is initially missing.
A similar situation prevails with the endoscopic training or simulation systems mentioned already. Advanced systems merely comprise a housing which simulates the patient's body. Operating elements or handles, respectively, are mounted on the housing, which correspond to the proximal elements of the endoscopes or the handles of the instruments, respectively. The movements which the physician performs with the operating or control elements or handles, respectively, are detected by means of position sensors and supplied to a computer. The computer displays on a screen the movement of the distal functional elements, which do not exist in reality in advanced simulation systems, in an “apparently real” environment, i.e. the respective body cavity, for instance, with a simultaneous representation of organs and the process of their treatment, etc. In this manner it is possible to simulate the course of a real surgical operation on the screen in (almost) all details.
As a (presumed) solution to the aforementioned problem of lack of information about the orientation of the instruments endoscopic systems have been proposed in which the positions of the instruments are represented on a monitor:
An endoscopic system which the wording of the introductory clause of Patent claim
1
starts out from is known from the U.S. Patent U.S. Pat. No. 5,503,320. The system disclosed in that prior art reference comprises at least one endoscope the objective of which generates an image of the area to be subjected to diagnosis or a surgical operation.
This system is recorded by a video recorder and represented on a monitor. Moreover, at least one instruments such as a pair of scissors, an HF instrument, a clip applicator or the like is provided which is used to perform the treatment or diagnostic process proper. For a determination of the position of the instrument or instruments a position sensing means is provided. For the illustration of the position of the instrument or instruments symbols are displayed on the monitor which represent the positions of the instrument or instruments. The term “position” is to be understood here to denote the co-ordinates of a particular “point”, as a rule the distal end of the respective instrument.
Similar systems are known from the European Patents EP 0 495 351 B1, EP 0 672 389 A2, the U.S. Patents U.S. Pat. No. 5,253,647, U.S. Pat. No. 5,383,454 and U.S. Pat. No. 5,417,210.
By the way, as far as the explanation of all terms not described here in details is concerned, as well as the implementation in engineering terms, i.e. the sensors, assessment and controller units used, etc., explicit reference is made to the aforementioned prior art documents.
In accordance with the present invention the applicant has become aware of the fact that the system known from the U.S. Pat. No. 5,503,320, which discloses the prior art of the claimed general type, entails the disadvantage that merely the position of the distal end is displayed, rather than the orientation of the instrument in space. As a result, it is difficult for the operator to determine the orientation of the instrument on the merely two-dimensional image. The orientation is, however, decisive for the manipulation of the instruments:
When the instrument is moved forward, for instance, the orientation determines the site which the instrument will “hit next”.
BRIEF DESCRIPTION OF THE INVENTION
The present invention is therefore based on the problem of improving an endoscopic system according to the introductory clause of Patent claim
1
in such a way that the operator will be able to lead the instruments or instruments more rapidly into the field of vision of the endoscope, and that the operator will furthermore obtain information about the orientation of the instruments.
One inventive solution to this problem is defined in Patent claim
1
. Improvements of the invention are the subject matters of the claims
2
et seq.
The invention starts out from an endoscopic system which comprises at least one endoscope the objective of which generates an image of the area to be observed, (at least) one video recorder which records the image of the objective of the endoscope, at least one instrument such as a pair of scissors, an HF instrument, a (technical) manipulator or the like, a position sensing means which detects the position of the instrument or instruments or the endoscope or endoscopes, respectively, and an assessment and control unit to which the output signal of the video recorder and of the position sensing means are applied and which displays an image of the operation field projected by the endoscope objective on a monitor, and furthermore symbols representing the position of the instrument (e.g. surgical instrument).
In accordance with the present invention this endoscopic system is improved by the provisions that the position sensing means comprises sensors which detect not only the position but also the orientation of both the endoscope(s) and the instrument(s), and that the displayed symbols reflect the orientation of the instrument or instruments and possibly of the further endoscopes relative to the displayed image. With endoscopes having a viewing direction which encloses an angle different from 0° relative to the longitudinal axis of the endoscope, i.e. so-called inclined-view endoscopes, it is, of course, also possible to fade in some information about their orientation. Moreover, it is also possible to display information about the orientation and particularly the rotational position of the instruments.
The endoscopic instrument set consisting of at least one endoscope with a video recorder system and at least one instrument is hence extended to the effect that each of the endoscope(s) and the instrument(s) comprises a position sensor which detects both the position and the direction or orientation of the instrument or the endoscope, respectively. The local information and the additional positional information are supplied to a processor unit which computes a so-called direction marker which is displayed in the video image on the monitor, preferably in the marginal image area of the endoscopic image or in an (additional) electronic frame which may be disposed around the tube in particular. As will be described-still below, the fading-in of the (local and) directional information is performed preferably on when the instruments are not in the field of vision of the endoscope. The directional marker at the margin of the endoscopic image on the monitor is coded in terms of position, direction, and/or spacing from a reference point, e.g. on the line of sight of the endoscope.
In parallel or possibly also as an alternative an acoustic guiding signal may be used as well.
In particular, the symbol represented by the assessment and control unit or the acoustic signal can indicate the direction of entry and the site of

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