Surgery – Endoscope – With camera or solid state imager
Reexamination Certificate
1999-06-17
2002-07-16
Leubecker, John P. (Department: 3739)
Surgery
Endoscope
With camera or solid state imager
C600S103000, C600S117000, C600S104000
Reexamination Certificate
active
06419626
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention pertains to an apparatus and method for endoscopic and open surgery and, more particularly, to a surgical device carrying an endoscopic instrument with a solid-state image sensor and physical parameter sensor for sensing a physical parameter such as temperature.
2. Discussion of the Prior Art
Various procedures are accomplished in both open surgery and endoscopic surgery, and generally include multiple steps requiring various operating instruments. Open surgery refers to surgery wherein the surgeon gains access to the surgical site by a relatively large incision and endoscopic surgery refers to minimally invasive surgery wherein the surgeon gains access to the surgical site via one or more portals through which an endoscope is introduced to view the surgical site and through which instruments having end effectors, such as forceps, cutters, needle holders, cauterizers, and the like, are introduced to the surgical site.
The performance of an endoscopic procedure typically involves creation of one or more puncture sites through a wall of an anatomical cavity using a penetrating instrument including an obturator, such as a trocar, disposed within a portal sleeve. After the penetrating instrument has penetrated into the anatomical cavity, the obturator is withdrawn, leaving the sleeve in place to form a portal in the cavity wall for the introduction of instruments such an endoscopes, scissors, forceps, needle holders and the like, into the anatomical cavity. The various end effectors at the distal end of the instrument are manipulated by the surgeon using controls disposed at the proximal end of the instrument while viewing the end effectors using the endoscope.
Endoscopes have included a variety of transducers such as vidicons (i.e., closed circuit television camera tubes) and solid-state Charge Coupled Devices (CCDs) for converting image light into electrical image signals for transmission to a viewing screen in the operating room (OR). CCD solid-state image sensors provide the benefits of small size and flexibility in image sensor placement, but are relatively difficult and expensive to implement in medical instruments, since CCD sensor signals require processing through complex and expensive ancillary equipment, if a usable image is to be displayed.
There are a number of situations, particularly when performing endoscopic surgery, in which it is desirable to measure temperature, pressure, pH or other physical parameters, while visualizing an object in the body. A number of surgical instruments have included diverse sensors for taking physical parameter measurements. CCD image sensors are produced using a technology unlike that used in fabricating other, high volume solid-state devices such as analog and digital signal processing transistor circuits, and so any attempt to combine a CCD image sensor with another kind of physical parameter sensor necessarily requires a separately fabricated device for installation near the CCD device. See, for example, U.S. Pat. No. 5,508,740 (to Miyaguchi et al.) disclosing a CCD image sensor for use in an analytical instrument and packaged with a separately fabricated temperature sensing thermistor; this pieced-together structure is necessary because there is no practical CCD fabrication method for combining an image sensor and a physical parameter sensor onto a single chip or substrate.
Endoscopic instruments, in general, also have been so expensive to use, sterilize and maintain that only surgeons in well-funded medical facilities have had access to instruments providing visualization in the body. There has been a long-felt need to move the site of medical care out of the OR to the hospital bed side or to an out-patient care facility. Endoscopic visualization could become an important component of patient-side care, were it available at a manageable price, and could be used for monitoring, as opposed to diagnosis, since endoscopic visualization and physical parameter monitoring could be performed daily or weekly, at bed side. If an economical, disposable alternative were available, endoscopic instruments for use at the bed side, in out-patient care, in ambulances or in the home could be provided for use in wide variety of medical and dental applications.
OBJECTS AND SUMMARY OF THE INVENTION
Accordingly, it is an object of the present invention to provide an economically implemented solid-state color image sensor and physical parameter sensor for generating an image ready signal and a physical parameter signal in an endoscopic instrument adapted to view organ or tissue structures or foreign objects, in the body.
Another object is to integrate a solid-state image sensor with a second physical parameter sensor on a single semiconductor substrate.
It is also an object of the invention to provide an endoscopic device having a Complimentary Metal Oxide Semiconductor (CMOS) solid-state image sensor with a physical parameter sensor, such as a temperature sensor, integrally fabricated onto a single substrate.
Another object of the present invention is to fabricate an economical, disposable endoscope having a solid state color image sensor and inexpensively manufactured objective optical lenses, incorporated into an easily manipulated form, for use at patient side.
Yet another object of the present invention is integrating a disposable endoscope into a surgical instrument having an end effector (e.g., forceps) of a selected length, and optics adapted to provide a useable image for the selected end effector length, providing visibility in the body during surgical instrument use.
The aforesaid objects are achieved individually and in combination, and it is not intended that the present invention be construed as requiring two or more of the objects to be combined unless expressly required by the claims attached hereto.
The present invention is generally characterized in an instrument for visualizing anatomical tissue and organ structures or foreign objects, in the body, and usually including an elongate hollow tubular shaft and an endoscope having a housing carrying a proximal end. The tubular shaft distal end is adapted to be inserted through a portal and into the body and includes a complementary metal oxide semiconductor (CMOS) image sensor carried on the shaft. By portal, it is meant either incised or natural openings in the body.
The CMOS image sensor substrate may also include a second physical parameter. sensor such as a thermistor temperature sensor. A thermistor (i.e., thermal resistor) is a semiconductor-based temperature measurement device for measuring a change in resistivity in a semiconductor with changing temperature, in which resistance decreases with increasing temperature. MOS current mirror circuits are used to provide an output voltage varying with sensed temperature (see, e.g., U.S. Pat. No. 5,347,149, to Kimura, the entire disclosure of which is incorporated herein by reference). In the present invention, a single semiconductor substrate or chip has a CMOS imaging sensor and a temperature sensing thermistor fabricated thereon with, preferably, a microprocessor and the associated signal processing circuitry for generating image signals and temperature measurement signals for transmission to a display and/or a data logging computer, outside the body.
CMOS image sensor and physical parameter sensor are preferably simultaneously fabricated using the economical CMOS process, an Integrated Circuit (IC) fabrication technology combining enhancement mode N-channel (NMOS) and enhancement mode Pchannel (PMOS) Field Effect Transistors (FETs) on a single substrate to form logic gates, memory cells, or other devices. CMOS image sensors are readily fabricated using the CMOS process and incorporate, on a single substrate (or chip), image sensing pixels and the required image signal processing circuitry for converting periodically sampled pixel voltage levels into an image ready signal adapted for display on, preferably, a color image display.
Examples of CMOS image sensors,
Blank Rome Comisky & McCauley LLP
Leubecker John P.
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