Surgery – Endoscope – With tool carried on endoscope or auxillary channel therefore
Patent
1996-06-11
1999-07-13
Mancene, Gene
Surgery
Endoscope
With tool carried on endoscope or auxillary channel therefore
600105, 600129, 600135, 600182, A61B 1736
Patent
active
059219165
DESCRIPTION:
BRIEF SUMMARY
DESCRIPTION
The invention relates to an endoscope, especially for urological applications, comprising a hollow shaft, an optical viewing system which has a fiber optical source of illumination and which is positioned inside the hollow shaft, and an optical fiber which is preferably positioned inside the hollow shaft together with the optical viewing system, which is connected to an external laser light source at its proximal end and the distal end of which is bent away from the axis of the shaft.
During urological applications, the endoscope is initially inserted with its hollow shaft, which has a rounded mandrin at its distal end, through the urethra into the vicinity of the area of irradiation in the region of the prostata or the bladder. After the removal of the mandrin, the optical viewing system and the optical fiber are inserted into the hollow shaft from the outside. In order to enable an irradiation which is angled with respect to the axis of the shaft, it is hitherto known to bend the optical fiber at its distal end with respect to the axis of the shaft with the aid of a suitable lever mechanism of the type of an Albarrans's lever. It is then possible to direct the laser beam in different directions during the surgery. In order to avoid damaging the optical fiber, a predetermined, relatively large radius of bending of the optical fiber may not be fallen below. In keeping with this, the optical fiber and a part of the lever mechanism protrude over jacket of the shaft in the angled state, so that an operation when tissue is directly adjacent to the shaft, as for instance in the region of the urethra or prostata, is not possible. In order to avoid this disadvantage, irradiation techniques employing reflective or refractive laser beam deflection have been suggested. The mirror- and prisma-arrangements necessary for these techniques are technically complicated and sensitive with respect to contamination, though, and they require a higher power density due to an unavoidable defocussing of the laser beam. Urological irradiations of this type are hitherto performed under a general anaesthesia of the patient.
Based on this, it is the object of the invention to develop an endoscope of the type desribed above, which enables an irradiation also of tissue which is in close contact with the shaft.
In order to solve this object, the combination of features stated in patent claim 1 is suggested. Advantageous embodiments and further developments of the invention result from the dependent claims.
The solution according to the invention is based on the idea that the optical fiber, which is composed of a fiber core and at least two cover layers, can be bent also about a relatively small radius of bending, if it is supported in the region of the bend sufficiently rigidly with respect to unwanted multiple bending. In order to achieve this, there is suggested according to the invention a rigid holding tube for accepting the optical fiber, which extends through the hollow shaft in parallel to the optical viewing system and the distal end of which is bent away from the axis of the hollow shaft by a fixed angle of 10.degree. to 110.degree. and positioned fully within the cross section of the hollow shaft. In this, the radius of bending of the holding tube is substantially smaller than the average diameter of the shaft, preferably one quarter to one half of the average diameter of the shaft. Advantageously, the optical fiber protrudes with its free distal end over the free end of the holding tube within the cross section of the hollow shaft.
In view of the small radius of bending of the holding tube in the region of the bend, the optical fiber cannot simply be pushed through the tube, since the deformation of the fiber together with the bend would certainly lead to a braking of the fiber. Advantageously, provisions are therefore made to lead the optical fiber through the tight bend within the holding tube without braking the fiber. To this end, the holding tube has a jacket slit for laterally inserting the end of the optic
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Aeikens Bernhard
Ahrens Thorsten
Scholz Clemens
Schwagler Rudiger
Hatton Ira
Mancene Gene
Ueth & Haug GmbH
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