CN1602166A - 可操纵的分段内窥镜及其插入方法 - Google Patents
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Abstract
一种可操纵的内窥镜(100),具有一细长的主体(102),该细长的主体带有一个可选择性操纵的远端部分(104)和一个可自动控制的近端部分(106)。内窥镜主体被插入到病人体内,所说可选择性操纵的远端部分(104)被用于在病人体内选择出一条期望的路径。当内窥镜主体前进时,一电子移动控制器(140)就操作所说的自动的近端部分(106),使所说的可选择性操纵的远端部分(104)呈现为所选定的弯曲。利用所说的可选择性操纵的远端部分来选择另外的期望路径,然后使内窥镜主体再次前进。当内窥镜主体进一步前进时,所选定的弯曲就会沿着内窥镜主体向近端传播。而当内窥镜主体被朝近端撤回时,所选定的弯曲就会沿着内窥镜主体向远端传播。这样就在内窥镜主体中产生一种迂回移动,从而允许内窥镜主体沿着体内器官之间和器官周围的期望路径通过迂回曲折的弯曲。
Description
交叉引用其它申请
本申请是于2001年2月20日提交的申请号为09/790204、发明名称为“可操纵的内窥镜及其改进的插入方法”的美国专利申请的系列继续申请,所说的这篇美国专利申请要求享有于2000年4月3日提交的申请号为60/194140的美国临时专利申请的优先权。
技术领域
本发明总体上涉及内窥镜和内窥镜的医疗过程。更具体地说,本发明是涉及有利于把一柔性内窥镜沿着曲折的路径插入的方法和装置,例如用于结肠镜检查和治疗。
发明背景
内窥镜是一种用于观看病人身体内部的医疗装置。内窥镜能用于各种不同的诊断和检查过程,包括结肠镜检查、支气管镜检查、胸腔镜检查、腹腔镜检查、视频内窥镜检查。
结肠镜检查是一种医疗过程,在这个过程中,把一柔性的内窥镜或结肠镜插入到病人的结肠内,以便对结肠进行诊断检查和/或手术处理。一个标准的结肠镜,通常其长度为135-185厘米,直径为12-19毫米,并且包括:位于装置远端的一光纤成像束或一微型照相机;照明纤维;一条或两条装置通道,所说装置通道也可以被用于吹入过程或冲洗过程;空气和水通道;真空通道。这种结肠镜经由病人的肛门插入,并穿过结肠,以便可以对结肠、回盲瓣、和终端回肠部分进行直接的视觉检查。由于结肠所形成的路径是曲曲折折和回旋盘绕的,因此,结肠镜的插入是非常复杂的。把结肠镜穿入到结肠内通常需要大量的操纵,这就使得这个过程更加困难,并且很耗时,而且会增加发生诸如肠穿孔等并发症的可能性。已经设计出了这样一些可操纵的结肠镜,即,这些操纵的结肠镜有利于选择正确的路径来穿过结肠。然而,结肠镜插入结肠内的深度越深,就越难以使结肠镜沿着所选定的路径前进。在每个弯曲处,结肠的壁必须使结肠镜保持弯曲。结肠镜会沿着每个弯曲的外侧刮擦结肠的粘膜表面。在每个弯曲处结肠镜的磨擦和松弛累积,这就使得结肠镜的前进和撤回都变得越来越困难。此外,作用于结肠壁上的作用力也会随着磨擦的增大而增大。在极其弯曲盘绕的情况中,结肠镜将不可能穿过结肠。
在美国专利US4753223、US5337732、US5662587、US4543090、US5383852、US5487757和US5337733中公开了一些用于对身体内部进行医学检查或治疗的可操纵的内窥镜、导管和插入装置,在此引用这些美国专利的全文作为参考。
发明概述
鉴于前面的描述,本发明提供了一种用于穿过病人身体内曲折路径的可操纵的内窥镜。这种内窥镜能被用于各种不同的诊断和检查过程,包括结肠镜检查、上部内窥镜检查、支气管镜检查、胸腔镜检查、腹腔镜检查、视频内窥镜检查。这种可操纵的内窥镜特别适合用于穿过那些在执行内窥镜检查过程中所遇到的曲曲折折的弯曲。
这种可操纵的内窥镜具有一细长主体,该细长主体带有一可人工或选择性操纵的远端部分和一自动控制的近端部分。所说的可选择性操纵的远端部分能被选择性的操纵或能被沿任何方向弯曲达180度。一光纤成像束和一根或多根照明纤维从所说的近端穿过所说的细长主体延伸到所说的远端。或者是,内窥镜能被构造成一视频内窥镜,它带有诸如CCD照相机的一微型视频照相机,视频照相机通过传递缆或通过传递或通过采用CMOS成像技术把图像传递到一视频监视器。可选择的是,内窥镜可包括:一条或两条装置通道,所说装置通道也可以被用于吹入过程或冲洗过程;一些空气和水通道;一些真空通道。
连接到细长主体上的一近端手柄包括:一目镜,用于直接观察和/或用于与一视频照相机相连接;一接头,用于与一照明源相连接;一个或多个路厄氏锁定接头,所说路厄氏锁定接头与所说的装置通道相连。该近端手柄与一操纵控制器以及一电子移动控制器相连,所说操纵控制器用于沿着的方向选择性地控制或弯曲所说的可选择性操纵的远端部分,所说的电子移动控制器控制所说的自动控制的内窥镜近端部分。设置了一轴向移动传感器,以便在内窥镜主体前进或撤回时对内窥镜主体的轴向移动进行测量。可选择的是,内窥镜可包括一马达或线性驱动器,用于以自动方式前进或撤回所说的内窥镜,或者用于自动地前进和被动地撤回所说的内窥镜。
在一个优选的实施例中,内窥镜是分段的内窥镜,该分段的内窥镜具有多个可单独控制的分段,这些分段可以被单独地用马达驱动,并且由一些接头相互连接起来。每个单独的相邻的分段可以绕两根独立的轴线转动,以便在把内窥镜插入到病人体两期间提供一个移动范围。
正如所描述的那样,这个特定的实施例可具有一些单独的马达,例如,小的带刷的直流马达,以便驱动每个单独的分段。此外,每个分段最好具有一支柱段,该支柱段限定出一腔,该腔贯穿所说的支柱段,使得一连续的腔可以延伸穿过整个内窥镜器械,以便提供一处理通道,一些丝线、光纤、空气和/或水通道、各种内窥镜工具或各种装置和丝线可穿过所说的处理通道。整个组件,即,马达、支柱、缆绳等等可以被包裹或覆盖在生物相容的材料内,所说的生物相容的材料例如是聚合物,这种材料最好是光滑的,以便在内窥镜插入和进入病人体内期间可使磨擦阻力很小。这种生物相容的覆盖物可以从内窥镜主体上拆卸下来,从而使马达和支柱组件暴露出来,以便可以直接接近这些元件。这样还可以在病人体内使用之后,能容易地对所说的盖进行更换和处理。
本发明中的方法包括:通过一天然孔或通过一切口把内窥镜主体的远端插入到病人体内;操纵所说的可选择性操纵的远端部分,以便选择一条期望的路径。当内窥镜主体被进一步前进或插入到病人体内时,电子移动控制器就操纵所说细长主体的自动控制的近端部分,使得所说的可选择性操纵的远端部分呈现为所选定的弯曲。通过利用所说的可选择性操纵的远端部分来选择另外的期望路径以及使内窥镜主体再次前进,从而重复执行这个过程。随着内窥镜主体进一步前进,所选定的弯曲就会沿着内窥镜主体向近端传播。类似地,当内窥镜被向近端撤回时,所选的弯曲就会沿着内窥镜主体向远端传播,这可以以自动的方式或被动的方式来实现。这样就在内窥镜主体中形成了一种迂回弯曲的移动,从而使得内窥镜主体可以沿着通过体内器官之间和通过或绕过器官周围的期望路径穿过迂回曲折的弯曲。
这种方法能被用于执行结肠镜检查或其它的内窥镜检查过程,例如支气管镜检查、胸腔镜检查、腹腔镜检查和视频内窥镜检查。此外,本发明中的装置和方法还能被用于沿着体内的期望路径插入其它类型的仪器,例如手术仪器、导管或插管器。
附图简述
图1表示用于病人结肠的结肠镜检查的一现有技术中的结肠镜。
图2表示本发明可操纵内窥镜的第一实施例。
图3表示本发明可操纵内窥镜的第二实施例。
图4表示本发明可操纵内窥镜的第三实施例。
图5表示本发明可操纵内窥镜的第四实施例。
图6表示在中性或者直线位置中的一部分内窥镜主体的线框模型。
图7表示图6所示的内窥镜主体穿过病人结肠中的弯曲的线框模型。
图8表示另一种可选择的内窥镜主体的代表部分,该内窥镜主体具有利用接头相互连接的许多分段。
图9表示图8所示的可绕两根轴线转动的两个分段的示意图。
图10表示一优选的内窥镜实施例,该内窥镜具有马达驱动的分段接头。
图11A-11B分别表示图10所示实施例中的两个相邻分段和一个单独分段的零件分解示意图。
图12-17表示本发明的内窥镜正在被用于对病人结肠进行结肠镜检查。
图18-20表示一内窥镜正在穿过病人的结肠,同时,一基准点正在测量内窥镜进入病人体内的距离。
图21表示一个控制系统的一个实施例的示意图,该控制系统可被用于控制和命令图8-11B所示类型的分段内窥镜装置中的单独的分段。
图22表示主控制器算法的一个流程图实施例,在内窥镜插入病人体内期间,该主控制器算法可以被用来控制全部的功能。
图23表示分段控制器算法的一个流程图实施例。
图24-26表示内窥镜的非接触式的跟踪和测量方法,这种方法利用了诸如全球定位系统的一外部导航系统。
发明的详细描述
图1表示出了现有技术中用于检查病人结肠C的结肠镜500。结肠镜500具有一近端手柄506和带有一可操纵远端部分504的一细长主体502。结肠镜500的主体502被润滑并且经由病人的肛门A被插入结肠C内。结肠镜500的主体502利用可操纵远端部分504作向导,从而被操作穿过病人结肠C中的若干弯曲段至上行结肠G。通常,这包含大量的操作,即:通过从近端进行推、拉和转动结肠镜500,从而使得结肠镜500前行穿过结肠C的若干弯曲段。在可操纵远端部分504通过以后,随着结肠镜500的柔性主体502的前进,结肠C的壁保持着结肠镜500柔性主体502中的弯曲。当主体502被插入时,就会沿着结肠镜500的主体502产生磨擦,尤其在结肠C中的每个弯曲处产生磨擦。由于这种摩擦的缘故,当使用者试图使结肠镜500前进时,主体502’倾向于在每个弯曲处向外移动,从而倚着结肠C的壁推进,这样就会因增大了磨擦而更加不利,并且使得结肠镜500更难以前进。另一方面,当结肠镜500被撤回时,主体502”倾向于在每个弯曲处向内移动,从而占据了当结肠镜500前进时所产生的游隙。当病人结肠C极其弯曲时,主体502的远端变得对使用者操作反应迟钝,并最终使得结肠镜500不能再继续前进。除了给使用者带来困难之外,病人结肠的扭曲还会增加并发症的危险,例如:会发生肠穿孔的危险。
图2表示本发明可操纵内窥镜100的第一实施例。内窥镜100具有一细长主体102,所说细长主体102带有可人工操纵或者选择性操纵的远端部分104和一自动控制近端部分106。可选择性操纵的远端部分104能被选择性地操纵或者能沿任何方向弯曲满180度。一光纤成像束112和一根或更多根照明纤维114从近端110至远端108延伸穿过主体102。可选地是,内窥镜100能被构造成带有诸如CCD摄像机等微型摄像机的视频内窥镜,该微型摄像机被安置在内窥镜主体102的远端108。来自于摄像机的视频能通过一传送电缆或者通过无线传送被传送到一视频监视器上,从而使视频可以被实时观察到,也可以通过一记录装置被记录在诸如磁带的模拟记录媒体上,也可以被记录在诸如光盘、数字磁带等等的数字记录媒体上。可选地是,内窥镜100的主体102可包括:一条或两条仪器通道116,118,该仪器通道116、118可以被用于吹入或冲洗;一些空气和水通道;一些真空通道。内窥镜100的主体102具有很高的柔性,从而能够在不折损或扭结的情况下围绕小的直径曲度弯曲,同时能保持各种通道完好无损。当内窥镜100的主体102被构造成用作一结肠镜时,其长度通常为135-185厘米,其直径大约为12-13毫米。内窥镜100能以各种其它尺寸和结构制造,以便用于其它医疗和工业应用。
一近端手柄120与细长主体102的近端110相连接。该近端手柄120包括一目镜124,该目镜124与光纤成像束112相连接,以便直接观察和/或便于与一摄像机126或一记录装置127相连接。近端手柄120通过一照明电缆134与一照明源128相连接,所说照明电缆134与照明纤维114相连接或者说是照明纤维114的延续部分。在近端手柄120上的第一路厄氏锁定接头130和第二路厄氏锁定接头132与仪器通道116、118相连接。
近端手柄120经由一控制器电缆136与一电子移动控制器140相连接。一操纵控制器122经由第二电缆138与电子移动控制器140相连接。操纵控制器122允许使用者沿期望方向选择性地操纵或弯曲所说主体102的可操纵远端部分104。如图所示,操纵控制器122可为一操纵杆控制器或者其它已知的操纵控制机构。电子移动控制器140控制着自动控制主体102的近端部分106的移动。电子移动控制器140可以通过在微机上运行的移动控制程序来执行或者利用专用移动控制器来执行。可选地是,电子移动控制器140可以利用一神经网络控制器来执行。
设置一轴向移动传感器150,以便当主体102前进和后退时测量内窥镜主体102的轴向移动。轴向移动传感器150能被制造成许多可能的构型。例如,图2所示的轴向移动传感器150被构造成一环152,该环152圈住内窥镜100的主体102。轴向移动传感器150与一参考固定点相连接,该参考固定点例如为:手术台或者内窥镜100在病人身体上的插入点。当内窥镜100的主体102滑过轴向移动传感器150时,传感器150就产生一个信号,该信号代表内窥镜主体102的相对于参考固定点的轴向位置,并且通过遥测术或通过一电缆(图中未示)把信号发送至电子移动控制器140。轴向移动传感器150可使用光学、电子或机械方式来测量内窥镜主体102的轴向位置。下面将对轴向移动传感器150的其它可能的构型进行描述。
图3表示本发明内窥镜100的第二实施例。与图2的实施例一样,内窥镜100具有一细长主体102,所说细长主体102带有一可选择性可操纵的远端部分104和一自动控制的近端部分106。操纵控制器122在形式上与近端手柄120结合成一体,或者与用于可选择性操纵内窥镜100的可选择性操纵远端部分104的一个或两个盘结合成一体。可选的是,电子移动控制器140可以被微型化,并且也与近端手柄120形成一个整体。在这个实施例中,轴向移动传感器150设置有可连接到参考固定点的一基底154,该参考固定点例如为手术台。一第一辊156和一第二辊158与内窥镜主体102的外部相接触。一个多圈电位计160或其它的移动传感器与第一辊156相连,以便测量内窥镜主体102的轴向移动,并且产生代表轴向位置的一信号。
使用者可以通过握紧位于轴向移动传感器150远端的所说主体102以人工方式使内窥镜100前进或撤回。或者是,第一辊156和/或第二辊158可以与至少一个马达例如马达162相连,以便自动地前进和撤回所说内窥镜100的主体102。
图4表示出了本发明的内窥镜100的第三实施例,该实施例采用一细长壳体170来组织和容纳内窥镜100。壳体170具有一基底172,该基底172带有一线性轨道174,以便引导内窥镜100的主体102。壳体170可具有一轴向移动传感器150’,该轴向移动传感器被构造成结合在线性轨道174内的一线性移动传感器。或者是,壳体170可具有这样一轴向移动传感器150”,即,该轴向移动传感器被构造成类似于图2或图3所示的轴向移动传感器150。使用者可握紧位于壳体170远端的主体102以人工方式前进使内窥镜100前进或撤回。或者是,壳体170可包括一马达176或其它的线性移动驱动器,以便以自动方式来前进和撤回所说内窥镜100的主体102。在另一种可选的结构中,可以把带有磨擦轮的一马达结合到轴向移动传感器150”内,所说的马达类似于结合图3所描述的马达。
图5表示出了本发明的内窥镜100的第四实施例,该实施例采用一转动壳体180来组织和容纳内窥镜100。该壳体180具有一基底182,该基底182带有一转鼓184,以便引导内窥镜100的主体102。壳体180可具有一轴向移动传感器150”,该轴向移动传感器被构造成一电位计,该电位计与转鼓184的转轴186相连。或者是,壳体180可具有这样一个轴向移动传感器150”,该轴向移动传感器150”类似于图2或图3中轴向移动传感器150。使用者可以通过握紧位于壳体180远端的主体102以人工方式来使内窥镜100前进或撤回。或者是,壳体180可包括一马达188,该马达与转鼓184相连,以便以自动的方式来前进或撤回内窥镜100的主体102。在另一种可选的结构中,可以把带有一些磨擦轮的一马达结合到轴向移动传感器150”内,所说的马达类似于结合图3所描述的马达。
图6表示出了位于中性或笔直位置的内窥镜100的一段主体102的线框模型。为了清楚起见,图中已除去了内窥镜102的大部分内部结构。内窥镜主体102被分成一些分段1,2,3…10,等等。每个分段的几何形状由沿着a,b,c,d轴线的四个测量长度来限定的。例如,分段1的几何形状是由四个测量长度l1a,l1b,l1c,l1d来限定的,分段2的几何形状是由四个测量长度l2a,l2b,l2c,l2d来限定的,等等。优选地是,每个测量长度由一线性驱动器(图中未示)单独控制。这些线性驱动器可利用若干种不同工作原理中的一种。例如,每个线性驱动器可以是一自热NiTi合金线性驱动器或一电-流变塑性驱动器,或其它书籍的机械式的、液压式的或机械式的驱动器。可以利用这些线性驱动器来改变每个分段的几何形状,从而改变沿着a,b,c,d轴线的四个测量长度。优选地是,这些测量长度以互补成对的方式被改变,以便选择性地使内窥镜主体102沿着期望方向发性弯曲。例如,为了使内窥镜主体102沿着a轴线发生弯曲,那么,就要缩短测量长度l1a,l2a,l3a…l10a,并且把测量长度l1b,l2b,l3b…l10b拉长一相等的量。这些测量长度的变化量确定了最终的弯曲半径。
在内窥镜主体102的可选择性控制的远端部分104中,这些用于控制每个分段的沿着a,b,c,d轴线的测量长度的线性驱动器可被使用者通过操纵控制器122进行选择性地控制。因此,通过对a,b,c,d轴线测量长度进行适当控制,就能对内窥镜主体102的可选择性控制的远端部分104进行选择性地控制,也能将该远端部分沿着任何方向弯曲满180度。
然而,在自动控制的近端部分106中,每个分段沿a,b,c,d方向的测量长度由电子移动控制器140自动控制,该电子移动控制器采用一种弯曲传播方法来控制内窥镜主体102的形状。为了解释这种弯曲传播方法是怎样进行的,图7中表示出了图6所示的内窥镜主体102的自动控制的近端部分106的一部分的线框模型正在穿过病人的结肠C中的一弯曲。为了简明起见,图中表示出了一个两维弯曲的例子,并且只考虑了沿a,b轴线方向的弯曲。在三维弯曲中,a,b,c,d四个轴线都被考虑了,并且都发挥作用。
在图7中,有利地采用了可选择性操纵的远端部分104的优点来使内窥镜主体102通过了结肠C的弯曲(这部分过程将在下面被详细描述),并且此时的自动控制的近端部分106位于所说弯曲处。分段1和2位于结肠C的相对笔直部分中,因此,l1a=l1b,并且l2a=l2b。然而,由于分段3-7位于S形的弯曲段中,因此,l3a<l3b,l4a<l4b,l5a<l5b,但是,l6a>l6b,l7a>l7b,l8a>l8b。当内窥镜主体102向远端前进一个单元,那么,分段1就移入到标有1’的位置内,分段2移入到先前由分段1所占据的位置内,分段3移入到先前由分段2所占据的位置内,依此类推。轴向移动传感器150产生一个代表内窥镜主体102相对于参考固定点的轴向位置的信号,并把该信号发送到电子移动控制器140,在电子移动控制器140的控制下,内窥镜主体102的每前进一个单元,位于自动控制的近端部分106中的每个分段就被发以信号,以便使每个分段形成先前占据其所在空间的分段的形状。因此,当内窥镜主体102被前移到标有1’的位置时,l1a=l1b,l2a=l2b,l3a=l3b,l4a<l4b,l5a<l5b,l6a<l6b,l7a>l7b,l8a>l8b,l9a>l9b,当内窥镜主体102被前移到标有1”的位置时,l1a=l1b,l2a=l2b,l3a=l3b,l4a=l4b,l5a<l5b,l6a<l6b,l7a<l7b,l8a>l8b,l9a>l9b,l10a>l10b。因此,S形弯曲就沿着内窥镜主体102的自动控制的近端部分106的长度向近端传播。当内窥镜主体102向远端前移时,该S形弯曲好象固定不动。
类似地,当内窥镜主体102向近端撤回时,内窥镜主体102每次向近端移动一个单元,位于自动控制的近端部分106中的每个分段就被发送以信号,以便使每个分段形成先前占据其所在空间的分段的形状。该S形弯曲就沿着内窥镜主体102的自动控制的近端部分106的长度向远端传播,并且当所说内窥镜主体102向近端撤回时,所说S形弯曲看起来象是固定不动。
每当内窥镜主体102被前移或撤回时,轴向移动传感器150就会监测到内窥镜主体的位置变化,并且,电子移动控制器140使得所选的弯曲沿着内窥镜主体102的自动控制的近端部分106向近端或远端传播,以便使这些弯曲在空间上保持在固定位置。这就允许内窥镜主体102可以有通过转弯抹角的弯曲,而且不会在结肠C的壁上施加无必要的作用力。
图8表示出了内窥镜主体的另一实施例190中的具有代表性的一部分。这种内窥镜主体实施例190具有多个分段192,这些分段192通过接头194相互连接。在这个实施例中,利用接头194能使相邻的分段192发生相对移动或斜移,所说的接头194具有至少一个自由度,优选地是具有多个自由度,且这些自由度最好是绕着图中所示的两条轴线的自由度。从图9中还可以看出,图中表示出了实施例190的示意性的代表部分196,其中,两个分段192可以绕着以两条独立轴线为中心的接头194转动。移动的范围可在球坐标轴线198中用角度α和β来表示。
如上所述,这种分段的主体可以由各种方法来驱动。一种优选的方法是采用一些机电马达,这些机电马达被单独地安装在每个单独的分段上,以便使这些分段相对移动。图10表示出了一个优选的实施例200,该实施例具有一些机动化的分段接头。每个分段192优选地由一支柱段202组成,该支柱段202最好限定出至少一个腔,该腔通过所说的支柱段,以便提供一处理通道,使得缆线、光纤、空气和/或水通道、各种内窥镜工具或各种装置和缆线可以从该处理通道通过。支柱段可由各种材料制成,所说材料最好是生物相容的,并且具有足够的强度以便能支撑各种工具和其它部件,例如不锈钢。尽管只对一单独的分段192进行了描述,但是,除了位于远端尖部的分段(或前几个分段)以外,每个分段192最好是相同的,因此,这些描述也适合于至少大多数分段192。
根据所期望的结果和具体的应用,可以把一个单一的马达或多个马达连接到至少大多数分段上。图10中表示出了在一分段上具有一单一马达的实施例,在这个实施例中,优选地是把一单独的马达204连接到支柱202上,并且该马达足够小足够紧凑,以致于具有一个相当小的直径,该直径足够小,以便于足够舒服地将其插入到病人体内,而且不会对病人造成损伤。图中所表示出的马达204是一个小带电刷的直流马达,马达204可以用于驱动相邻的分段192,并且可以以与其它马达相独立的方式被控制。除了小的带电刷的直流马达以外,还可以采用各种马达,例如,交流马达、线性马达等等。优选地是,每个马达204不仅把机电马达组件EM本身安装在壳体内,而且还把一齿轮减速台GR和一位置编码器PE安装在壳体内。连接到马达组件EM上的齿轮减速台GR通过把高速度、低力矩操作条件改变成更有用的低速度、高力矩输出,从而使得马达204可以在优化的速度和力矩范围进行使用。位置编码器PE可以是传统的编码器,以便使得控制计算机能通过跟踪马达204的输出轴的角形转动移动来读取分段接头194的位置。
每个马达204具有从马达204的一端延伸的一转动轴,以便提供动力传递,从而驱动所说的这些分段192。一个卷筒206被可转动地连接在所说转动轴上,缆绳208的第一端被缠绕在该卷筒206上。缆绳208可以从卷筒206通过位于缆绳引导件210中的一通道212,然后通过开口214(更详细地参见图11A-11B)穿出,再到缆绳固定件216,缆绳208的第二端最好被连接到所说的缆绳固定件216上,例如通过卷边和/或焊接来进行连接。缆绳引导件210用于抓住缠绕在卷筒206上的缆绳208。缆绳固定件216通过一个销218并横贯一个万向接头枢轴220被连接到一个相邻的分段192上,并且该缆绳固定件216的可以被做成象传统的电子环连接器的形状,该电子环连接器具有一圆形断面,该圆形断面限定出一个穿过该圆形断面的孔,用于安装到分段192和一个从固定件216突出的延伸部分上,以便连接缆绳的第二端。缆绳208可包括各种各样的长丝、股线、金属丝、链、编织带等等,它们可以由各种各样的生物相容的材料制成,例如由不锈钢、聚合物如塑料和尼龙制成。
在操作过程中,当马达204被运作,使得转动轴沿第一方向转动,例如沿顺时针方向转动,所说的卷筒206就相应地进行转动,并且所说的缆绳208沿着相应的方向牵引相邻的分段192,从而进行力矩传递,随后便沿着第一轴线驱动所说的分段。当马达204被运作,使得转动轴沿着与第一方向即顺时针方向相反的第二方向转动时,所说的卷筒206就被再次进行相应的转动,于是,缆绳208就会沿着相应的相反方向牵引相邻的分段192,随后便沿着该相反的方向传递力矩并驱动所说的分段。
图11A和图11B分别表示出了图10所示实施例中的两个相邻的分段和一个单独分段的零件分解立体示意图。如图11A所示,可以看出,支柱202具有一腔221,该腔可用于提供前面所述的工作通道。从图中还可以看到在缆绳引导件210中限定出的通道212以及开口214,以便供所说的缆绳从中穿过。在相互连接的相邻分段中,为了在这些分段中提供必要的自由度,采用一种优选的方法,这种方法利用万向接头枢轴220。然而,在其它的一些实施例中,可以不采用这种万向接头枢轴220,而是可以采用各种各样的连接方法,例如利用柔性管在两个分段的对应中心处连接这两个分段,利用一系列单一自由度的接头,这些接头可以被接近地间隔开,等等。在与其它分段相邻的支柱202的端部,一对万向轭元件224可以设置有一对对应的销钉开口226。当万向接头枢轴220与一个分段上的第一对轭元件224相连接时,对应的一对轭元件224也可以从相邻的分段被连接到该接头枢轴220上。
从图11B中还可以看出,在这个实施例中,万向接头枢轴220是一个圆筒形环,该圆筒形环具有两组对置的接收孔228,用于可转动地接收对应的轭元件224。尽管图中所表示出的这些接收孔228间隔90度,但是,在其它的一些变型中,这些接收孔可以以其它的角度被间隔开,这取决于所期望的自由度和具体的应用。从图中还可以看出卷筒206,该卷筒206从马达204上拆卸下来,从而使驱动轴205暴露出来。当把马达204从支柱202拆下来时,就可以暴露出设置在支柱202中的槽230。这条槽230可以凹陷在支柱202中,以便能与马达的半径更好地配合,这样不仅有助于把马达204安置在支柱202附近,而且还有助于减小组装成的分段的总体直径。马达204可以利用各种方法例如胶粘剂、夹卡、绑带、机械紧固件等被连接到支柱202上。如图所示,在缆绳引导件210中还可以设置一缺口部分232,以便有助于进一步减小分段的直径。
在内窥镜200插入到病人体内之前,如图5所示,该内窥镜200可以被卷绕在转动壳体180内的转鼓184上,以方便存储。在使用期间,内窥镜200可以被构造成能自动执行诊断检查。当内窥镜200被卷绕到转鼓184上时,相邻的分段192相互之间具有一预定的角度,该预定的角度最初是由转鼓184的直径和安置内窥镜200的存储单元的初始结构决定的。在把内窥镜插入之前所进行的诊断检查期间,可以利用一计算机自动地监测或测量每个相邻分段192之间的角度。如果监测出相邻分段192的所成的角度测量值超出了预定的可接受的角度范围,那么,就指示出分段192处于不正确的位置,并且指示出在内窥镜200使用期间可能会产生问题的位置。因此,计算机可以随后发出一可听得见或可看得见的警报,并且还可以把每个分段192放入到中性位置,从而能自动地防止这些分段被进一步使用,也能防止对病人造成损伤。
图12-17表示出了利用本发明中的内窥镜200对病人的结肠进行结肠镜检查。在图12中,内窥镜主体102已被润滑并且通过肛门A被插入到病人的结肠C内。内窥镜主体102的远端108通过直肠R前进,直到到达结肠C中的第一弯曲,这可以通过目镜124来观察或在视频监视器上进行观察。为了处理这个弯曲,使用者通过操纵控制器122以人工方式对可选择性操纵远端部分104进行操纵,使得该远端部分104朝向乙状结肠S。利用电子移动控制器140来监测从操纵控制器122发送到可选择性操纵远端部分104的控制信号。当能使内窥镜主体102的远端108进入乙状结肠S内的正确弯曲被选定时,该弯曲就被记录到电子移动控制器140的存储器内,并作为参考。这个步骤能以人工模式来执行,在这种人工模式中,使用者利用键盘指令或语音指令向电子移动控制器140发出一个命令,命令电子移动控制器把选定的弯曲记录下来。或者是,这个步骤也能以自动模式来执行,在这种自动模式中,使用者通过使内窥镜主体102向远端移动从而向电子移动控制器140发出这样的信号,即,已选定了期望的弯曲。通过这种方式,就可以形成结肠的三维图像或路径,并且把该三维图或路径保存起来以便将来使用。
无论是采用人工模式还是自动模式,一旦利用可选择性操纵远端部分104使得期望弯曲被选定,内窥镜主体102就向远端前进,并且象上面所描述的那样,利用电子移动控制器140使得选定的弯曲沿着内窥镜主体102的自动控制的近端部分106向近端传播。所说的弯曲在空间上保持固定不动,而内窥镜主体102则通过乙状结肠S向远端前进。在极其扭曲的结肠中,必须对所说可选择性操纵远端部分104进行操纵,使其通过多个弯曲,从而穿过所说乙状结肠S。
如图13所示,使用者可以把内窥镜100停止在任何位置,以便对粘膜表面或结肠C内的其它特征进行检查或治疗。所说的可选择性操纵远端部分104可以被沿任何方向操纵,以便对结肠C的内部进行检查。当使用者完成对乙状结肠S的检查时,就对所说可选择性操纵远端部分104进行操纵,使其朝向下行结肠D。一旦利用所说可选择性操纵远端部分104来选定了所期望的弯曲,内窥镜主体102就向远端前进,并进入到下行结肠D内,第二弯曲和第一弯曲都沿着内窥镜主体102的自动控制近端部分106向近端传播,如图14所示。
如果在某一时刻,使用者断定出所说内窥镜主体102所经的路径需要被修改或修正,那么,就可把把内窥镜100向近端撤回,并且命令所说的电子移动控制器140删除先前所选择的弯曲。这可以利用键盘指令或语音指令以人工方式来执行,也可以利用对电子移动控制器140进行编程使得当内窥镜主体102被撤回一定距离时进入到修改模式,从而实现自动执行。利用所说的可选择性操纵的远端部分104来选定经修改和修正的弯曲,然后,就象前面描述那样使内窥镜主体102前进。
内窥镜主体102穿过下行结肠D前进,直到到达结肠的左(脾)曲部分Fl。在许多情况下,在该左曲部分处,内窥镜主体102必须进行几乎为180度的发夹式转弯。与前面所描述的那样,利用所说可选择性操纵的远端部分104来选定所期望的弯曲,然后使内窥镜主体102通过横向结肠T向远端前进,如图15所示。每个先前所选定的弯曲都沿着内窥镜主体102的自动控制部分106向近端传播。在结肠的右(肝)曲Fr处,执行相同的步骤,于是,内窥镜主体102的远端108就穿过上行结肠G前进到盲肠E,如图16所示。从这个位置,利用内窥镜主体102的所说可选择性操纵的远端部分104就能对盲肠E、回盲瓣V和回肠I的终端部分进行检查。
图17表示出了内窥镜100正在通过结肠C被撤回。如前所述,随着内窥镜100被撤回,所说的一些弯曲就沿着自动控制的近端部分106传播,从而使得内窥镜主体102按照先前所选定的弯曲移动。在任何位置,使用者都可以把内窥镜100停下来,以便利用内窥镜主体102的所说可选择性操纵的远端部分104对粘膜表面或结肠内的其它任何特征进行检查或治疗。在任何给定时间,都可以把内窥镜100撤回或拉回一期望距离。
在根据本发明的一个优选方法中,电子移动控制器140包括一电子存储器,在该存储器内,形成病人结肠或其它解剖组织的一个三维数学模型,按照这个数学模型来操纵所说的窥镜主体102。手术人员能用这个三维数学模型进行注释,以便记录解剖界标、损害、息肉、活组织检查样本的位置以及其它重要特征的位置。病人的解剖三维模型能被用于帮助在后续步骤中把内窥镜主体102插入。此外,所说的注释能被用于迅速地找到要找特征的位置。例如,能用该三维模型来注释出在内窥镜探察期间抽取活组织检查样本的位置。在后续步骤中能再次可靠地确定出活组织样本的位置,以便跟踪潜伏病的病变过程和/或在所说位置执行治疗。
在这种方法的一个特别优选的变型中,电子移动控制器140能根据电子存储器中的三维模型被编程,从而使得内窥镜主体102会自动地形成正确的形状,以便当内窥镜主体通过病人的解剖组织移动时会沿着所期望的路径移动。在把可操纵的内窥镜100构造成能自动地前进或撤回内窥镜主体102的一些实施例中,如上面参照图3,4,5所描述的那样,能命令所说的内窥镜主体102自动地通过病人的解剖组织前进到先前根据电子存储器中的三维模型所注释出的损害位置或其它有关位置。
成像软件使得利用可操纵的内窥镜100所获得的病人解剖组织的三维模型能在计算机监测器或类似装置上被看到。这就有利于对三维模型和利用其它成像方式所获得的图像进行对比,所说的其它成像方式包括例如萤光屏检查、放射照相、超声波检查、磁共振成像(MRI)、计算机体层扫描(CT扫描)、电子束线体层照相或结肠镜检查。相反,从这些其它成像方式所获得的图像能被用于制订出适当的路径或轨迹,以便有利于内窥镜主体102的插入。此外,从这些其它成像方式所获得的图像有利于利用可操纵的内窥镜100来确定出可能损害的位置。例如,利用结肠的钡对比放射成像法(barium-contrast radiograph)所获利的图像能被用于制订出适当的路径,以便有利于把内窥镜主体102插入到病人的结肠内。在放射照片上看到的任何可疑的损害所在的位置和深度都能被注释出,以便所说内窥镜主体102能被迅速且可靠地引导到所说损害之处附近。
用于提供三维信息的成像方式,例如平面萤光镜透视检查、CT、或磁共振成像(MRI),能被用于对电子移动控制器140进行编程,从而使得内窥镜主体102可自动地形成正确的形状,以便当内窥镜主体通过病人的解剖组织时能沿着期望的路径移动。在可操纵的内窥镜100被构造成能自动地前进和撤回内窥镜主体102的实施例中,可命令所说的内窥镜主体102自动地通过病人的解剖组织沿着由三维成像信息所确定出的期望路径前进。类似地,也能命令内窥镜主体102自动地移动地可疑损害之处或其它在图像上被标注出的位置。
如上所述,轴向移动传感器150能被制造成许多种结构,例如,如图2所示的环152。它的部分功能是用作参考固定点或基准点(datum),以便形成一个表示内窥镜主体102相对于固定参考点的轴向位置。该轴向移动传感器150可以采用光学方法、电子方法或机械方法来测量内窥镜主体102的轴向位置。图18-20中表示出了该基准点234的一个优选实施例,该基准点是一个窥器,该窥器可以被部分地放置到病人的直肠内,或至少旋转到病人的肛门A附近。在把分成段的内窥镜主体238插入肛门A内之前,最好将该窥器首先穿过基准点234的基准通道236。在该基准点234可以安装测量插入深度所需的一些电子元件和一些机械组件,这将在下面被描述,该基准点234还提供一固定的坚实的基底,以便有助于共同把内窥镜主体238定位在肛门A或身体孔附近,并且还可以提供这样一个基底,该基底能使内窥镜主体238保持稳定并且有助于把该内窥镜主体238插入到所说的孔内。所说的窥器可以由生物相容的材料例如注模塑料制成,并且该窥器能安装一些不昂贵的电子元件,这是因为该窥器最好是被做成一次性的。
当内窥镜主体238穿过基准通道236时,测量插入深度和轴向位置的一种优选的光学方法涉及到了利用安装在该基准点234上的反射红外传感器来进行。内窥镜主体238的外表面可具有一些舱口标记或一些其它的指示或反射标记,这些标记以已知的间隔沿着所说主体238设置。当内窥镜主体238通过肛门A和基准通道236前进或撤回时,一光学传感器能读取或监测所说的舱口标记以及内窥镜主体相应移动距离的增加量或减小量。这样,一个传感器读取例如这些标记就可以具有一个输出,当一标记被监测到时,该输出就被标注为逻辑值“1”或“开”,当没有监测到标记时,逻辑值就为“0”或“关”。通过对传感器的输出进行计数或跟踪从1到0的转变次数,就可以相应地测量出深度。这样,在这个实施例中深度测量值的精度可由舱口标记之间的间距确定。
图18中简单地表示出了怎样利用距离来使所说装置前进的。内窥镜主体238前进直到远端到达一个深度L1,该深度L1是相对于基准窥器234的中点测得的。在这个深度处,使用者需要选择性地操纵所说远端,使该远端跟随着乙状结肠S,从而使得内窥镜主体形成曲率半径R1。一旦这个特征的位置和深度被该远端所限定,就可以命令到达这个深度L1的任何分段将其自身以与远端分段相同的方式成形,直到获得正确的弯曲组合,以便通过所说的弯曲。随着主体238的进一步前进,如图19所示,主体将到达第二个主要弯曲,该第二个主要弯曲的深度为L1+L2。相应地,对于L1,任何前进并到达深度L1+L2的分段都将被命令以执行当远端第一次通过第二弯曲并进入下行结肠D时所限定的弯曲。主体238继续前进,如图20所示,任何前进到深度L1+L2+L3的后继分段将被命令执行和通过所说的弯曲,以便跟随着横向结肠T前进,在横向结肠处,原始弯曲已由所说的可选择性操纵的远端来确定。
图21表示出了一控制系统的一个实施例的示意图,该控制系统可被用来控制和命令图8-11B所示的分段的内窥镜装置的单独的一些分段。从图中可以看出,在内窥镜242被插入到一病人256体内时,利用一主控制器248来控制和监视深度测量值,该主控制器248最好位于一个远离分段的内窥镜242的一个位置。主控制器248还可以被用于通过在通信通道252中保持电通信来管理和传递每个接头和分段2421至242n的驱动努力,所说的通信通道252可包括一些电缆线、光纤、无线传输等。在这个实施例中还表示出,主控制器248还通过基准通信通道254与基准点244相连通,以便象上面所描述的那样,在内窥镜穿过基准通道246时测量和跟踪内窥镜242的插入深度。
这个分段的实施例242可由大量的单独分段2421至242n组成(为了简明起见,图中只表示出了分段2421至2425)。分段2421至2425中的每个分段最好分别具有自身的分开的控制器2501至250n,这些分开的控制器被容纳在每个分段内部。可用的各种类型的控制器包括微控制器。控制器2501至250n可用于实现若干种功能,例如,如前面所述的测量两轴线中每根轴线α和β中每个分段接头的角度,驱动容纳在分段2421至242n内的一些马达以便驱动内窥镜242移动,接收和处理那些发自主控制器248的命令。在每个对应的分段2421至242n中设置有单独的控制器2501至250n,这就使得每个分段能在控制器水平对于结构的要求进行就地管理,而无需在发出一命令之后从主控制器248进行监视。
相应地,图22中表示出了主控制器算法260的一个流程图,该流程图可被用于在内窥镜主体插入病人体内期间控制总体功能。在开始步骤262期间,整个系统(例如图21所示的系统)可以被初始化,其中,全部的传感器都被调零。然后,主控制器248进入一个等待状态,在该等待状态中,主控制器持续地监视位于身体孔附近的基准点244所收集的深度测量值。一旦在步骤264中监测到移动,即监测到深度测量值,主控制器248就判断出内窥镜主体242的移动方向,即是插入还是撤回。如图中步骤266所示,如果内窥镜主体242正在被插入,并且插入深度正在增大,那么,当前的深度就被增加,如图中步骤268所示;否则,在步骤270中当前深度减小。一旦深度被确定,主控制器248就把与每个分段2421至242n单独通信,并且对于当前深度而言,命令每个分段进行调节或修正其相对于相邻分段的位置,如图中步骤272所示。之后,主控制器248就继续监视深度变化,并且重复地执行图中所示的过程。
为了保持每根轴线α和β的朝向,每个分段2421至242n的深度、数据组、或类似的数据结构可以由主控制器248使用,以便对这些信息进行组织,如后面的表1所示。深度指标D1至Dn被用于表示单独的舱口标记,如图21所示,这些舱口标记之间的距离是已知的值。因此,内窥镜242所能保持的精度至少部分取决于深度指标D1至Dn之间的间距。此外,D1至Dn的数目和间距可以根据具体的应用和所需的要求被确定和调节。可以利用附加平滑算法来形成分段2421至242n之间或测试2测量指标D1至Dn之间的逐渐过渡。
表1.一些单独分段的数据组.
深度指标 | 分段1α/β | 分段2α/β | … | 分段Nα/β |
D1 | αD1/βD1 | αD1/βD1 | … | αD1/βD1 |
D2 | αD2/βD2 | αD2/βD2 | … | αD2/βD2 |
D3 | αD3/βD3 | αD3/βD3 | … | αD3/βD3 |
… | … | … | … | … |
Dn | αDn/βDn | αDn/βDn | … | αDn/βDn |
图23表示出了分段控制器算法280的流程图实施例。尽管主控制器248用于管理内窥镜242的总体插入深度的测量值并且确定总体形状,但是,该主控制器还与每个分段2421至242n中的单独的控制器2501至250n相连通,以便使得管理整个系统的移动的计算任务最好被分配开。
如上所述,这些单独的控制器2501至250n可用于完成各种功能,包括:接收来自主控制器248的命令,必须时管理与其它控制器的通信,测量和控制这些单独分段2421至242n的位置,执行诊断,检查错误等等。对于每个分段而言,用于控制每个分段2421至242n的算法最好相似;虽然引领分段2421或前几个分段在医师的引导下选择性地控制和操纵,从而使得确定出要遵循的适当的路径。
首先系统的起始步骤282开始执行,其中,所有的讯息、驱动器(或马达)、位置传感器和朝向都被初始化。然后,在步骤284中,控制器2501至250n就等待接收来自主控制器248的讯息。如果未收到讯息,那么,控制器2501至250n就进入到一个主循环,等待命令。当接收到一命令时,控制器2501至250n中的每个控制器都可以请求诊断数据,如图中步骤286所示。如果诊断数据被请求,那么,在步骤288中执行适当的诊断,并且在步骤290中把结果送回到主控制器248。如果在步骤286中诊断数据未被请求,那么,在步骤292中,控制器2501至250n中的每个控制器就判断主控制器248是否请求了驱动或移动。如果未请求驱动或移动,那么,相关的分段就可以继续接收命令;否则,在步骤294中,相关的分段就判断是否发出了影响分段轴线α的命令,如图中步骤294所示,或是否发出了影响分段轴线β的命令,如图中步骤300所示。如果分段轴线α要被改变,那么,就在步骤296中,把命令以送到α轴线PID控制器(或发送到一超级控制系统),并且随后启动适当的驱动器,以便影响α轴线中的分段的驱动,如图中步骤298所示。同样,如果分段轴线β要被改变,那么,在步骤302中,要么以单独的方式,要么与α同线相结合的方式,把命令发送到β轴线PID控制器(或发送到一超级控制系统),并且如图中步骤304所示,随后启动适当的驱动器,以便影响β轴线中的分段的驱动。一旦执行完适当的命令,控制器2501至250n就再次进入到主循环中,以便等待其它的命令。
尽管本发明中已描述了用作结肠镜的内窥镜,但是,内窥镜能被构造成用于其它许多医疗应用和工业应用。此外,利用本发明的原理还可把本发明构造成导管、插管、手术仪器或喉管插入器鞘,以便用于穿过弯曲的身体通道。
在特别适用于腹腔镜检查或胸腔镜检查方法的一种变型中,可操纵的内窥镜100能沿着病人体腔内的一些器官周围和器官之间的期望路径被选择性地操纵。内窥镜100的远端108通过一天然孔或通过一手术切口或通过一手术插管或通过喉管插入器或套针被插入到病人体腔内。所说的可选择性操纵的远端部分104能被用于探测和检查病人体腔,并且能选择病人身体器官周围和器官之间的一条路径。所说的电子移动控制器140能被用于控制内窥镜主体102的可自动控制的近端部分106,以便使内窥镜主体沿着选择的路径移动,如果需要的话,还能利用电子移动控制器140的电子存储器中的三维模型返回到一个期望的位置。
图24至26表示出了另外一种变型,这就变型涉及到可操纵内窥镜的非接触式测量和跟踪方法。这种变型与基于传感器的系统或询答机例如线圈或磁性传感器结合使用,以便采用一个类似于全球定位系统(GPS)的系统,通过磁性监测技术或病人体外的导航系统或装置来跟踪所说的内窥镜。可以采用磁性传感器,但优选地是采用线圈,这是因为线圈能在不同的频率发生共振,并且能具有独特的“标记”,该独特的标记允许同时采用若干不同的线圈。如图24所示,内窥镜主体238可以肛门A插入到病人体内。询答机310至318被安置在内窥镜主体238上,这些询答机被放置在预定的位置,例如旋转在可选择性操纵的远端。
当内窥镜238通过下行结肠D和横向结肠T前进时,询答机可以被外部导航单元320监测到,导航单元320可具有一显示器322,以便显示出内窥镜238在病人体内的位置。随着内窥镜238的进一步深入到病人体内,如图26所示,导航单元320可以相应地显示出对对应的移动。采用导航单元320,就可实现对诸如内窥镜238等装置进行非接触式导航的方法,这种方法可以用于测量和确定病人体内的相对于诸如肛门A或结肠瓣的解剖标记的一些不同位置。此外,这种实施例还可以被单独使用,也可以与前面所描述的基准目镜234仪器结合使用。
导航单元320还可以被用于在除了结肠以外的人体内的空间中所进行的前面所描述的腹腔镜检查胸腔镜检查的过程中。例如,内窥镜238还可以通过所说的孔口进入到病人体内,并按照前面所描述的那样沿着病人体腔中的器官周围和器官之间的期望路径被操纵。尽管内窥镜238可以被操纵以使其穿过体腔,但是,也可以利用设置在外部的导航单元320来引导和跟踪内窥镜238,而内窥镜238的相对于预定参考点例如相对于基点的位置或相对于解剖标记的位置可以按照前面所描述那样以电子方式被标记和注释。
尽管已经通过示例性的一些实施例以及本发明的最佳实施方式对本发明进行了描述,但是,本领域普通技术人员都会知道,可以对本发明作出许多种变型、改进,也可以对本发明的各个实施例、改变或变型进一步进行组合,这些均未脱离本发明的构思和范围。
Claims (66)
1、一种用于插入到体腔内的装置,包括:
一细长主体,该细长主体具有一近端和一可选择性操纵的远端,并且在近端和可选择性操纵的远端之间限定出至少一个腔,该细长主体包括利用一些接头相互连接的许多分段;以及
至少一个马达,所说马达被连接到至少大多数分段中的每个分段上,用于驱动一相邻的分段,其中,每个马达都是可以独立控制的,
其中,当所说远端呈现为一选定的弯曲时,利用每个马达选择性地驱动相邻的分段,使得所说的许多分段沿着细长主体传播所选定的弯曲。
2、根据权利要求1所述的装置,其中,每个分段还包括支柱段,该支柱段限定出至少一个腔,所说腔穿过该支柱段,该支柱段被构造成使得该支柱段的第一端或第二端可转动地与相邻分段相连接。
3、根据权利要求1所述的装置,其中,每个接头被构造成可转动地将所说的这些分段相互连接。
4、根据权利要求3所述的装置,其中,所说的这些接头选自下列接头组成的组:万向接头、柔性管、许多单自由度的接头、以及它们的任何组合。
5、根据权利要求1所述的装置,其中,每个接头都被构造成具有至少两个自由度。
6、根据权利要求1所述的装置,其中,所说马达包括选自下面所列出的一组马达中的一种马达,这组马达为:气动马达、液压马达、以及机电马达。
7、根据权利要求1所述的装置,其中,所说马达还包括:
一机电马达,该机电马达具有一可转动的输出轴,用于驱动相邻的分段;
一齿轮减速台,该齿轮减速台与机电马达相连接;以及
一位置编码器,该位置编码器与机电马达电连接,以便对输出轴的角动进行监测。
8、根据权利要求7所述的装置,还包括许多缆绳,每根缆绳都具有第一端和第二端,所说的第一端与输出轴相连,所说的第二端与相邻的分段相连,使得沿着第一方向转动所说的输出轴会通过缆绳沿着第一方向驱动相邻的分段,并且沿着第二方向转动所说的输出轴会通过缆绳沿着第二方向驱动相邻的分段。
9、根据权利要求8所述的装置,其中,所说的缆绳选自下列这组材料:长丝、股丝、金属丝、链及编织带。
10、根据权利要求8所述的装置,其中,所说的缆绳由生物相容的材料制成,所说生物相容的材料选自下列这组材料:不锈钢、聚合物、塑料、以及尼龙。
11、根据权利要求1所述的装置,在每个分段中还包括一个一次性的微控制器,该微控制器用于监测相邻分段的相对位置,并且选择性地控制所说的马达。
12、根据权利要求11所述的装置,其中,所说的微控制器与一个远离所说细长主体的主控制器相连。
13、根据权利要求12所述的装置,其中,所说的微控制器与所说的主控制器电连接。
14、根据权利要求12所述的装置,其中,所说的微控制器与所说的主控制器光学连接。
15、一种用于将一装置插入到体腔内的系统,包括:
一细长主体,该细长主体具有一近端和一可选择性操纵的远端,并且在近端和可选择性操纵的远端之间限定出一腔,该细长主体包括利用一些接头相互连接的许多分段;
至少一个马达,所说马达被连接到至少大多数分段中的每个分段上,用于驱动一相邻的分段,其中,每个马达都是可以独立控制的,并且,当所说远端呈现为一选定的弯曲时,利用每个马达选择性地驱动相邻的分段,使得所选定的弯曲可以沿着细长主体传播;以及
一主控制器,该主控制器与每个分段相连接,当所选定的弯曲被沿着细长主体传播时,该主控制器用于选择性地控制每个马达,以便改变相邻分段的相对位置。
16、根据权利要求15所述的系统,还包括:一深度测试装置,该深度测试装置具有一传感器用于测量所说细长主体前进到体腔内或从体腔撤回的距离。
17、根据权利要求16所述的系统,其中,所说的传感器利用非接触式的方法或接触式的方法来测量所说的距离。
18、根据权利要求17所述的系统,其中,所说的传感器包括一非接触式传感器,该非接触式传感器选自下列这组传感器:光学传感器、红外线传感器、电磁传感器。
19、根据权利要求17所述的系统,其中,所说的传感器包括一接触式传感器,该接触式传感器选自下列这组传感器:轴向移动传感器、辊、以及磨擦轮。
20、根据权利要求15所述的系统,还包括一操纵控制器,该操纵控制器与可操纵的远端相连,以便选择所选定的弯曲。
21、根据权利要求20所述的系统,其中,所说的操纵控制器包括这样一控制器,该控制器选自下列这组控制器:操纵杆和控制轮。
22、根据权利要求15所述的系统,还包括一成像系统,该成像系统用于把一图像从细长主体的所说远端传送到近端。
23、根据权利要求22所述的系统,其中,所说的成像系统包括一光纤成像束,该光纤成像束从细长主体的所说远端延伸到近端。
24、根据权利要求22所述的系统,其中,所说的成像系统包括一CCD或CMOS相机。
25、根据权利要求15所述的系统,还包括至少一个照明源,该照明源位于细长主体上,用于提供光源。
26、根据权利要求25所述的系统,其中,所说的照明源包括至少一根照明纤维,该照明纤维从细长主体的远端延伸到近端。
27、根据权利要求15所述的系统,还包括一记录装置,该记录装置与细长主体相连,用于记录从细长主体远端传来的图像。
28、根据权利要求15所述的系统,其中,细长主体被构造成一个内窥镜,用于插入到病人体内。
29、根据权利要求15所述的系统,其中,所说的细长主体被构造成一结肠镜,用于插入到病人结肠内。
30、一种使一装置沿着一选定路径移动的方法,包括:
提供一细长主体,该细长主体具有一近端和一可选择性操纵的远端,该细长主体包括利用接头相互连接起来的许多分段和至少一个马达,所说马达与至少大多数分段中的每个分段相连接,用于驱动相邻的分段,其中,每个马达可以被单独控制;
选择性地操纵所说的远端,使得该远端沿着一期望路径呈现为第一选定弯曲;
使细长主体向远端移动,同时控制所说装置的近端,使得近端呈现为所说远端的所说第一选定弯曲。
31、根据权利要求30所述的方法,还包括:在使所说装置向远端前进的同时,测量细长主体的深度变化。
32、根据权利要求31所述的方法,还包括:把当前的深度加上所说的深度变化。
33、根据权利要求32所述的方法,还包括:在使细长主体前进的同时,向每个分段进行通信,以调节每个分段的位置。
34、根据权利要求30所述的方法,还包括:使细长主体向近端移动,同时对装置的近端进行控制,使得近端呈现为所说远端的所说第一选定弯曲。
35、根据权利要求34所述的方法,还包括:在使所说装置向近端移动的同时,测量所说细长主体的深度变化。
36、根据权利要求35所述的方法,还包括:把当前的深度减去所说的深度变化。
37、根据权利要求36所述的方法,还包括:在使所说细长主体移动的同时,与每个分段通信,以调节每个分段的位置。
38、根据权利要求30所述的方法,还包括:在使所说细长主体向远端移动的同时,驱动一第一分段上的至少一第一马达,从而驱动所说的第一分段。
39、根据权利要求38所述的方法,还包括:在使所说细长主体向远端移动的同时,驱动一第二分段上的至少一第二马达,从而驱动所说的第二分段。
40、根据权利要求30所述的方法,还包括:在对所说远端进行选择性操纵之前,测量每个分段之间的角度,并且把所测得的角度与预定的角度范围进行对比。
41、根据权利要求40所述的方法,还包括:一旦表明所测得的角度不在预定的角度范围内时,就向使用者发出提示。
42、根据权利要求40所述的方法,还包括:一旦表明所测得的角度不在预定的角度范围内,就把每个分段互相放置到中性位置。
43、一种用于确定一装置在体腔内的位置的系统,包括:
一细长主体,该细长主体具有一近端和一可选择性操纵的远端,并且在近端和可选择性操纵的远端之间限定出一个腔,该细长主体包括利用一些接头相互连接的许多分段;
至少一个马达,所说马达被连接到至少大多数分段中的每个分段上,用于驱动一相邻的分段,其中,每个马达都是可以独立控制的,并且,当所说远端呈现为一选定的弯曲时,利用每个马达选择性地驱动相邻的分段,使得所说的选定弯曲可沿着细长主体传播;以及
至少一个询答机,所说询答机被沿着所说主体设置,该询答机可由一外部导航监测器进行监测。
44、根据权利要求43所述的系统,其中,所说询答机包括一线圈,该线圈具有预定的共振频率。
45、根据权利要求43所述的系统,其中,所说的询答机包括一磁铁。
46、根据权利要求43所述的系统,其中,所说询答机被设置在细长主体的远端。
47、根据权利要求43所述的系统,还包括许多附加的询答机,这些附加的询答机沿着细长主体被设置在预定的位置。
48、根据权利要求43所述的系统,其中,所说的外部导航监测器包括一全球定位装置,用于从远方来确定所说传感器在体腔内的位置。
49、一种装置,包括:
一细长的器械主体,该装置主体具有一可选择性操纵的远端部分和一可自动控制的近端部分,所说的可选择性操纵的远端部分被构造成能选择性地沿着一期望路径呈现为一选定的弯曲,所说的可自动控制的近端部分被构造成能随着所说细长的器械主体向远端移动而沿着细长的器械主体的近端部分向近端传播所选定的弯曲。
50、根据权利要求49所述的装置,其中,所说的可自动控制的近端部分还被构造成能随着所说细长的器械主体向近端撤回而沿着所说细长的器械主体的近端部分向远端传播所选的弯曲。
51、根据权利要求49所述的装置,还包括:
一成像系统,用于把一图像从所说细长的器械主体的远端传送到近端。
52、根据权利要求51所述的装置,其中,所说的成像系统包括一光纤成像束,该光纤成像束从所说细长的器械主体的远端延伸到近端。
53、根据权利要求51所述的装置,其中,所说细长的器械主体被构造成用于插入到病人体内的一内窥镜。
54、根据权利要求51所述的装置,其中,所说细长的器械主体被构造成用于插入到病人结肠内的结肠镜。
55、根据权利要求49所述的装置,还包括:
一电子移动控制器,用于控制所说的可自动控制的近端部分,以便沿着所说细长的器械主体的近端部分向近端或向远端传播所选定的弯曲。
56、根据权利要求55所述的装置,还包括:
一轴向移动传感器,用于测量所说细长的器械主体的轴向移动。
57、根据权利要求49所述的装置,还包括:
一轴向移动传感器,用于测量所说细长的器械主体的轴向移动。
58、一种装置,包括:
一细长的器械主体,该装置主体具有许多可控制的分段,包括一第一分段、一第二分段和一第三分段,每个分段代表一个单位长度;以及
一电子移动控制器,被构造成用于控制所说的第一分段、第二分段和第三分段中的每个分段,以便在所说细长的器械主体处于初始位置时,分别呈现为一选定弯曲的第一部分、第二部分和第三部分,并且该电子移动控制器被构造成,在所说细长的器械主体从所说初始位置向远端移动大约一个单位长度的距离时,控制第二分段以呈现所选定弯曲的第一部分,并控制第三分段以呈现所选定弯曲的第二部分。
59、根据权利要求58所述的装置,其中,所说的电子移动控制器还被构造成,当所说细长的器械从初始位置向近端撤回大约一个单位长度时,控制所说第一分段以呈现所选定弯曲的第二部分,并控制所说的第二分段以呈现所选定弯曲的第三部分。
60、根据权利要求58所述的装置,其中,所说细长的器械主体还包括一可选择性操纵的远端部分。
61、根据权利要求58所述的装置,还包括:
一轴向移动传感器,用于测量所说细长的器械主体的轴向移动。
62、根据权利要求58所述的装置,还包括:
一成像系统,用于把一图像从所说细长的器械主体的远端传送到近端。
63、根据权利要求62所述的装置,其中,所说的成像系统包括一光纤成像束,该光纤成像束从所说细长的器械主体的远端延伸到近端。
64、根据权利要求58所述的装置,还包括:
一成像系统,用于把一图像从所说细长的器械主体的一远端传送到一视频监视器。
65、根据权利要求58所述的装置,其中,所说细长的器械主体被构造成用于插入到病人体内的一内窥镜。
66、根据权利要求58所述的装置,其中,所说细长的器械主体被构造成用于插入到病人结肠内的一结肠镜。
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CN112294236A (zh) * | 2020-10-14 | 2021-02-02 | 北京大学 | 内窥镜前端弯曲部形态检测系统及其检测方法 |
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US20020062062A1 (en) | 2002-05-23 |
US20030191367A1 (en) | 2003-10-09 |
WO2003028547A2 (en) | 2003-04-10 |
EP1432344A2 (en) | 2004-06-30 |
US20150005576A1 (en) | 2015-01-01 |
US20040019254A1 (en) | 2004-01-29 |
JP2005503882A (ja) | 2005-02-10 |
US7087013B2 (en) | 2006-08-08 |
US20110065993A1 (en) | 2011-03-17 |
US20080045794A1 (en) | 2008-02-21 |
CA2462544A1 (en) | 2003-04-10 |
US8845524B2 (en) | 2014-09-30 |
US6610007B2 (en) | 2003-08-26 |
IL161225A0 (en) | 2004-09-27 |
WO2003028547A3 (en) | 2003-07-31 |
US9808140B2 (en) | 2017-11-07 |
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