Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
1998-11-20
2001-04-17
Jaworski, Francis J. (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
Reexamination Certificate
active
06217519
ABSTRACT:
DESCRIPTION
The present invention concerns an apparatus and a process for viewing vessels, in particular blood vessels, on the body, in body cavities and hollow organs.
It is known from the state of the art, for the purposes of inspecting body cavities or hollow organs in the interior of the body, for example the stomach or the intestinal tract, to introduce an endoscope in order to obtain a visual impression of a condition to be diagnosed in the respective region of the body, by virtue of the image representation afforded by the endoscope. The technology, structure and mode of operation of endoscopes of that kind are known, in which respect in particular the more modern endoscopes have an endoscope conduit which is afforded by means of optical fibers, for being inserted into the body, and the image which is produced in that way is detected by way of an electronic image sensor and electronically processed for display on a (video) screen. There are also endoscopes which have the image sensor (for example a CCD) at the operational insertion end.
Performing endoscopy in a practical context however frequently involves the problem that (blood) vessels are present at locations, for example an ulcer or sore, which are specifically relevant for diagnosis or treatment, and such vessels require particular attention or extreme care when carrying out interventions or when performing a targeted treatment in order to reduce the risk of bleeding. As moreover blood vessels of that kind are surrounded by tissue or organ walls of the respective body cavity being viewed, they are generally not visually perceptible by purely endoscopic inspection.
It is admittedly also known from the state of the art to use ultrasound sonography procedures generally for investigating blood flows and thus also for the detection of blood vessels, but this involves quite serious difficulties in particular when working in the interior of the body, and for that reason it has hitherto not been possible to implement it in terms of clinical practice.
Therefore the object of the present invention is to add to apparatuses or procedures in endoscopy or, generally, visual viewing of body cavities or hollow organs, a function which makes it possible to detect blood vessels—which are usually concealed or invisible—at the viewing or intervention location. In that respect, the invention seeks to provide both a suitable viewing apparatus and also an associated working or operational process.
That object is attained by the apparatus as set forth in claim
1
and the process as set forth in claim
17
.
Advantageously in that respect the provision of an ultrasonic probe for a (preferably multi-channel) Doppler ultrasonic evaluation at the intervention end of the carrier which is preferably in the form of an endoscope conduit or guide permits simultaneous monitoring for (blood) vessels and the production of suitable, flow-dependent image information in regard to viewing the detected image, and the video output unit which is provided in accordance with the invention allows simultaneous visual monitoring of those procedures with a single glance at a common output display screen.
Accordingly, viewing and treatment of two diagnostically interrelated situations is permitted and promoted in a manner which is significant in terms of clinical practice, without a plurality of items of equipment having to be simultaneously operated and viewed, and without attention being distracted by virtue of additional attention having to be paid to operation of the equipment.
Admittedly, it is preferable in accordance with the invention for it to be used in conjunction with an endoscopy device in which it is also used as a carrier device for the ultrasonic transducer; the invention however is not limited to that embodiment. It is thus generally in accordance with the invention to use any electrical image pick-up device on a suitable carrier, together with the ultrasonic transducer. For example the invention is also suitable for use in conjunction with an operational microscope in which the image detection element, for transmission of the microscope image, is associated with the microscope optical system while, at the intervention end, the ultrasonic transducer can be carried on the microscope (or is disposed externally thereof); in that respect the microscope acts as the carrier device according to the invention.
Further regions of use which go therebeyond would then be for example laparoscopy or neurosurgery. In general therefore the invention extends to correspondingly associated video or graphics sources.
The arrangement of the ultrasonic transducer on the carrier device is admittedly also particularly preferred; nonetheless however the invention also embraces a construction in which the ultrasonic transducer can be guided independently and separately from the image element or an associated carrier, for example by way of a hand-held probe. That configuration would also be possible for example with an operational or video microscope.
Advantageous developments of the invention are described in the appendant claims.
Thus in particular the multi-channel resolution, which is graduated or staggered in respect of depth, of ultrasonic Doppler monitoring, permits depth detection of a respective blood vessel, and that is extremely useful in a practical context. More specifically, it is precisely in implementing possible operative interventions that it has been found important to be certain in advance whether there is a blood vessel present and if so, at what depth such a blood vessel is to be found.
It is precisely by virtue of the combination according to the invention of the Doppler probe with an endoscope tip which establishes the viewing plane for the visual endoscopy image that the ultrasonic probe is in a fixedly defined position and thus permits reliable imaging of the possible (blood) flow conditions in the organ tissue or the wall relative to the endoscope head.
Advantageously, the invention also permits switching over as required between a pure endoscopy representation and a mixed or hybrid representation which is specified in the manner according to the invention, in particular for the situation where a vessel is assumed to occur at an intervention position which is considered to be particularly relevant.
In accordance with a further development of the invention, the video output unit is also based on a digital video mixer. That can then not only provide in a simple manner for simple processing of the Doppler image—which is in any case digital by virtue of the evaluation or computation procedure involved—; in addition, this also permits simple adaptation as required of the endoscope image, for example with the scaling unit which is to be provided in accordance with the development of the invention for a reduction or increase in size respectively.
The apparatus according to the invention is further advantageous for the supply or output of image signals of a plurality of different current image standards, in particular TV-picture standards. In that respect, in accordance with the development of the invention, image signals can be outputted in particular also in parallel, that is to say simultaneously, using different standards.
In accordance with a further preferred embodiment of the invention it is also possible for the ultrasonic transducer itself, that is to say the probe head, to be changed in regard to its position at the intervention end of the carrier (for example of the endoscope tube). That advantageously provides for signal optimisation or adaptation to respectively specific viewing circumstances.
It is advantageously also in accordance with the invention to arrange for the probe head to rotate and/or to fit a lens for varying the sound field or to make the probe head movable in the form of a controllable probe.
Overall therefore the invention affords completely new options in regard to for example endoscope-aided (or generally: micro-invasive) exploration, diagnosis and therapy. Now, for the first time, an operator is enabled in one glance to
Denner Dieter
Grund Karl-Ernst
Kimmel Martin
Widenhorn Gerold
Zolondz Jürgen
DWL Elektronische Systeme GmbH
Jaworski Francis J.
Piper Marbury Rudnick & Wolfe
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