DE10052679A1 - Endoskop und Verfahren zu seiner Herstellung - Google Patents

Endoskop und Verfahren zu seiner Herstellung

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DE10052679A1
DE10052679A1 DE10052679A DE10052679A DE10052679A1 DE 10052679 A1 DE10052679 A1 DE 10052679A1 DE 10052679 A DE10052679 A DE 10052679A DE 10052679 A DE10052679 A DE 10052679A DE 10052679 A1 DE10052679 A1 DE 10052679A1
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slots
tube
pattern
different
shaft
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Gregory S Konstorum
Edward A Grabover
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Gyrus ACMI Inc
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Circon Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
    • G02B23/2476—Non-optical details, e.g. housings, mountings, supports
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part

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  • Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Optics & Photonics (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Astronomy & Astrophysics (AREA)
  • Biophysics (AREA)
  • General Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)

Abstract

Es wird ein Endoskop mit einem Steuerungsabschnitt und einem sich ausgehend von diesem erstreckenden Schaft angegeben, das durch Folgendes gekennzeichnet ist. Der Schaft weist einen Rahmen mit einem einstückigen Rohr (40) entlang dem Hauptteil der Länge des Schafts auf, wobei das Rohr aus einer superelastischen Legierung besteht und Schlitze (46) in es hinein zumindest über einen Abschnitt (52, 54, 56, 59) aufweist, und wobei es die superelastischen Eigenschaften der superelastischen Legierung ermöglichen, dass sich das Rohr in der Nähe der Schlitze ohne wesentliche dauerhafte Verformung verbiegt, und sie dafür sorgen, dass der Schaft mit angemessener Knickfestigkeit, Flexibilität und Drehmomentfestigkeit versehen ist, um in einen Patientenkörper eingeführt werden zu können.

Description

Die Erfindung betrifft medizinische Instrumente, spezieller Endoskope.
UK-A-2 130 885 offenbart einen flexiblen distalen Endab­ schnitt eines Endoskops. Dieser Endabschnitt besteht aus Kunststoff mit Wirbeln, die durch ein langgestrecktes Ele­ ment oder ein Rückgrat verbunden sind. US-A-5,938,588 offen­ bart ein Endoskop mit Drahtumhüllungen in Form durchgehender Rohre aus einer superelastischen Legierung.
Der Erfindung liegt die Aufgabe zu Grunde, ein Endoskop mit verbesserter Flexibilität zu schaffen.
Diese Aufgabe ist hinsichtlich des Endoskops durch die Leh­ ren der beigefügten unabhängigen Ansprüche 1, 15 und 20 so­ wie hinsichtlich des Verfahrens durch die Lehren der beige­ fügten unabhängigen Ansprüche 25 und 32 gelöst.
Weitere Gesichtspunkte und Merkmale der Erfindung werden in der folgenden Beschreibung unter Bezugnahme auf die beige­ fügten Zeichnungen erläutert.
Fig. 1 ist eine Seitenansicht eines Endoskops gemäß einer Ausführungsform der Erfindung;
Fig. 2 ist eine Schnittansicht des Schafts des in Fig. 1 dargestellten Endoskops;
Fig. 3 ist eine Seitenansicht des Rohrs, das für den Rahmen des in Fig. 2 dargestellten Schafts verwendet ist;
Fig. 4A ist eine Schnittansicht des in Fig. 3 dargestellten Rohres entlang der dortigen Linie 4A-4A;
Fig. 4B ist eine Schnittansicht des in Fig. 3 dargestellten Rohrs entlang der dortigen Linie 4B-4B;
Fig. 4C ist eine vergrößerte Ansicht eines Teils des ersten Abschnitts des in Fig. 3 dargestellten Rohrs;
Fig. 5 ist eine Teilseitenansicht des in Fig. 3 dargestell­ ten Rohrs in gebogenem Zustand;
Fig. 6A bis 6D sind Schnittansichten des dritten Abschnitts des in Fig. 3 dargestellten Rohrs, wobei vier verschiedene Schlitzrichtungen im Rohr dargestellt sind;
Fig. 7A bis 7E sind Schnittansichten eines Rohrs gemäß einem alternativen Ausführungsbeispiel der Erfindung und
Fig. 8 ist eine Schnittansicht eines alternativen Ausfüh­ rungsbeispiels eines Schafts.
Nun wird die Erfindung unter Bezugnahme auf die in den Zeichnungen dargestellten Ausführungsbeispiele näher ge­ schrieben, jedoch ist zu beachten, dass die Erfindung auf viele alternative Weisen realisiert werden kann. Dabei kön­ nen jeweils geeignete Größen, Formen oder Arten von Elemen­ ten oder Materialien verwendet werden.
Das in Seitenansicht in Fig. 1 dargestellte Endoskop 10 ver­ fügt im Wesentlichen über einen Griff oder einen Steuerungs­ teil 12 und einen flexiblen oder halbflexiblen Schaft 14, der mit dem Griff 12 verbunden ist. Der Schaft 14 verfügt über einen passiven Auslenkabschnitt 16 und einen aktiven Auslenkabschnitt 18 an seinem distalen Ende. Ausgehend vom Griff 12 erstreckt sich ein Steuerungssystem 22 zum Steuern des aktiven Auslenkabschnitts 18 zu diesem. Wie es auch aus Fig. 2 erkennbar ist, verfügt das Steuerungssystem 22 im We­ sentlichen über ein Paar Steuerungsdrähte 24a, 24b, zwei Drahthüllen 50a, 50b und ein Betätigungselement 28. Die Drähte 24a, 24b sind an einem Ende mit dem Betätigungsele­ ment 28 und am anderen Ende mit dem aktiven Auslenkabschnitt 18 verbunden.
Beim bevorzugten Ausführungsbeispiel verfügt der Griff 12 über einen vom Benutzer bedienbaren Schlitten oder Hebel 30. Der Hebel 30 ist mit dem Betätigungselement 28 verbunden. Das Betätigungselement 28 ist so ausgebildet, dass es an den zwei Drähten 24a, 24b des Steuerungssystems 22 zieht oder diesen nachgibt. Wenn der Hebel 30 vom Benutzer bedient wird, wird das Betätigungselement 28 verstellt. Das Betäti­ gungselement 28 kann eine drehbar mit dem Griff 12 verbundene Trommel oder Scheibe sein, um an einem Draht 24a, 24b zu ziehen, während der andere gelockert wird. Bei einem alter­ nativen Ausführungsbeispiel kann das Betätigungselement eine beliebige geeignete Einrichtung sein, wie ein Kipphebelarm, der so ausgebildet ist, dass er die Drähte des Steuerungs­ systems 22 anzieht oder lockert. Bei einem anderen alterna­ tiven Ausführungsbeispiel, bei dem das Steuerungssystem zwei oder mehr Paare von Steuerungsdrähten aufweisen kann, ver­ fügt der Griff über zusätzliche Betätigungselemente und ent­ sprechende Steuerungsteile zum Betreiben der zusätzlichen Paare von Steuerungsdrähten. Bei noch anderen alternativen Ausführungsbeispielen kann der Griff über Knöpfe mit Zahn­ stangenmechanismen oder über andere geeignete, vom Benutzer bedienbare Steuerungsteile für das Steuerungssystem verfü­ gen.
Der Schaft 14 ist einseitig am Griff 12 eingespannt. Beim bevorzugten Ausführungsbeispiel verfügt der flexible Schaft 14 über einen Durchmesser von ungefähr 8 Fr (1 Fr = 1 Charrière = 1/3 mm). Bei alternativen Ausführungsbeispielen kann der flexible Schaft jeden geeigneten Durchmesser auf­ weisen. Der flexible Schaft 14 enthält die Steuerungsdrähte 24a, 24b des Steuerungssystems 22, ein faseroptisches Bild­ erzeugungsbündel 37, ein faseroptisches Beleuchtungsbündel 36 und einen Arbeitskanal 38. Am Griff 12 befindet sich eine Öffnung 60 zum Einführen von Instrumenten (nicht darge­ stellt) in den Kanal 38. Der Griff 12 verfügt auch über ei­ nen Lichtquellenhalter 62 zum Verbinden einer Lichtquelle (nicht dargestellt) mit dem Beleuchtungsbündel 36. Außerdem verfügt der Griffel 12 über ein Okular 63, mit dem ein Be­ nutzer das durch das Bilderzeugungsbündel 37 vom Vorderende 20 übertragene Bild betrachten kann. Bei alternativen Aus­ führungsbeispielen kann der flexible Schaft verschiedene Systeme enthalten. Der Schaft 14 verfügt im Wesentlichen über einen Rahmen 26, einen Mantel 32 und einen Objektivkopf 34. Es wird auch auf Fig. 3 Bezug genommen, gemäß der der Rahmen 26 im Wesentlichen über ein einstückiges Rohr 40 ver­ fügt. Jedoch kann der Rahmen bei alternativen Ausführungs­ beispielen aus mehr als einem Rohr bestehen, wie aus mehre­ ren hintereinander angeordneten Rohren, und er kann zusätz­ liche Elemente aufweisen. Das Rohr 40 besteht vorzugsweise aus einer Legierung mit Formgedächtnis wie Tinel oder Niti­ nol. Dieses Material mit Formgedächtnis wird wegen seiner superelastischen Eigenschaften verwendet, die sich in der Fähigkeit des Materials zeigen, selbst dann ausgelenkt zu werden und elastisch in seine natürliche oder vorbestimmte Stellung zurückzukehren, wenn die Materialspannungen unge­ fähr 4% erreichen, d. h. eine Größenordnung mehr als die ty­ pische Streckgrenze von 0,4%, die in üblichen Metallen zu plastischer Verformung führt. So wird der Begriff "super­ elastische Legierung" zum Bezeichnen dieses Materialtyps verwendet. Die Drahthüllen 50a, 50b können ebenfalls aus diesem Materialtyp bestehen, wie es in US-A-5,938,588 offen­ bart ist.
Das Rohr 40 verfügt über einen mittleren Kanal 42 mit je­ weils offenem Vorder- und Hinterende 44, 45 und mit Schlit­ zen 46 entlang zumindest eines Teils seiner Länge. Bei die­ sem Ausführungsbeispiel weisen die Schlitze entlang ver­ schiedenen Abschnitten oder Stücken des Rohrs verschiedene Muster auf. Genauer gesagt, sind die Schlitze 46 bei diesem Ausführungsbeispiel in drei Abschnitten 52, 54, 56 konfigu­ riert. Jeder Abschnitt weist ein anderes Muster der Schlitze 46 auf. Das mindestens eine Muster der Schlitze 46 können auf Grundlage z. B. der folgenden Variablen konfiguriert sein:
  • - Abstand zwischen benachbarten Schlitzen;
  • - Richtung(en) der Schlitze in das Rohr 40 hinein;
  • - Tiefe der Schlitze in das Rohr hinein;
  • - Breite der Schlitze;
  • - Form der Schlitze und
  • - Mischen verschiedener Richtungen der Schlitze entlang ei­ nem Stück des Rohrs.
Bei alternativen Ausführungsbeispielen kann das Rohr 40 mehr oder weniger als drei Abschnitte mit verschiedenen Schlitz­ mustern, wie nur einen oder zwei Abschnitte, aufweisen.
Außerdem könnte das Rohr mit allmählichen oder gemischten Schlitzübergangszonen zwischen Abschnitten versehen sein, anstatt dass abrupte Übergänge zwischen Abschnitten mit ver­ schiedenen Schlitzmustern vorhanden sind. Bei diesem Ausfüh­ rungsbeispiel verfügt das Rohr 40 auch über zwei Abschnitte 58, 59 ohne Schlitze.
Nun wird auch auf die Fig. 4A und 4B Bezug genommen, gemäß denen der erste Abschnitt 52 der Schlitze 46 entlang dem ak­ tiven Auslenkabschnitt 18 des Schafts vorhanden ist. Bei diesem Ausführungsbeispiel ist der aktive Auslenkabschnitt 18 in zwei Richtungen auslenkbar, wie es durch die gestri­ chelten Linien in Fig. 1 dargestellt ist. Bei alternativen Ausführungsbeispielen könnte der aktiven Auslenkabschnitt 18 nur in einer Richtung oder in mehr als zwei Richtungen aus­ lenkbar sein. Beim aktiven Auslenkabschnitt 18 für zwei Richtungen ist der Rahmen mit zwei Schlitzrichtungen A und B in die Seite des Rohrs 40 hinein versehen, die um 180° ge­ geneinander versetzt sind. Es wird auch auf Fig. 4C Bezug genommen, gemäß der die Schlitze 46 eine Tiefe Y in das Rohr 40 hinein aufweisen, jedoch in entgegengesetzten Richtungen für die zwei Arten von Schlitzen 46a, 46b relativ zur Mit­ telachse 64 des Rohrs 40. Die Schlitze verfügen über einen Mittellinienabstand X zwischen benachbarten Schlitzen 46a, 46b; außerdem weisen sie eine Breite W auf. Bei diesem Aus­ führungsbeispiel sind die Werte von W, X und Y entlang dem Stück des ersten Abschnitts 52 gleich. Jedoch könnten sie bei alternativen Ausführungsbeispielen variieren. Es wird auch auf Fig. 5 Bezug genommen, in der ein Teil des ersten Abschnitts 52 in gebogener Stellung dargestellt ist. Die Schlitze 46 versehen das Rohr 40 mit erhöhter Flexibilität entlang der Länge des ersten Abschnitts 52. Außerdem begren­ zen die zwei Richtungen A, B der Schlitze 46 im ersten Ab­ schnitt 52 diese erhöhte Flexibilität auf zwei entgegenge­ setzte Richtungen. Der erste Abschnitt könnte für begrenzte erhöhte Flexibilität in nur einer Richtung Schlitze nur in einer Richtung aufweisen, oder er könnte für erhöhte Flexi­ bilität in vier Richtungen oder allen Richtungen Schlitze in vier oder mehr Richtungen aufweisen.
Gemäß den Fig. 3 sowie 6A bis 6D ist der zweite Abschnitt 54 entlang dem passiven Auslenkabschnitt 16 vorhanden (siehe Fig. 1). Jedoch muss der passive Auslenkabschnitt 16 über seine Länge des Rahmens keine Schlitze 46 aufweisen. Bei diesem Ausführungsbeispiel ist das Rohr 40 mit Schlitzen 46a, 46b, 46c und 46d in das Rohr 40 hinein in vier Richtun­ gen A, B, C und D versehen, die um 90° gegeneinander ver­ setzt sind. Die Schlitze 46a, 46b, 46c, 46d sind mit sich wiederholendem Muster der Reihe nach angeordnet, jedoch könnte jede geeignete Mischung der Muster der Schlitze 46a, 46b, 46c, 46d vorhanden sein. Bei diesem Ausführungsbeispiel ist der Abstand X' zwischen benachbarten Schlitzen 45 im zweiten Abschnitt 54 größer als der Abstand X zwischen be­ nachbarten Schlitzen 46 im ersten Abstand 52. Jedoch könnte für X' jeder geeignete Abstand, oder beliebige geeignete Ab­ stände, gelten, einschließlich verschiedener Abstände von X' entlang der Länge des zweiten Abschnitts 54. Auch ist bei diesem Ausführungsbeispiel die Tiefe Y' der Schlitze 46a, 46b, 46c und 46d im zweiten Abschnitt 54 kleiner als die Tiefe Y im ersten Abschnitt 52. Bei diesem Ausführungsbei­ spiel beträgt die Tiefe Y' ungefähr 1/2 des Durchmessers des Rohrs 40, und die Tiefe Y entspricht ungefähr 2/3 des Durchmessers des Rohrs 40. Jedoch können Y und Y' jede geeignete Tiefe aufweisen. Außerdem kann Y' in verschiedenen der Schlitze 46a, 46b, 46c, 46d entlang der Länge des zweiten Abschnitts 54 verschieden sein, wie zum Vorderende des Rohrs hin tiefer. Die Breite der Schlitze 46a, 46b, 46c und 46d entlang dem zweiten Abschnitt 54 könnte dieselbe wie die Breite W im ersten Abschnitt 54 sein, sie könnte aber auch verschieden von dieser Breite W sein und/oder sie könnte entlang der Länge des zweiten Abschnitts 54 variieren oder unterschiedlich sein, wie zum Vorderende des Rohrs hin brei­ ter. Der zweite Abschnitt 54 verfügt vorzugsweise über grö­ ßere Knickfestigkeit, größere Steifigkeit (oder geringere Flexibilität) und größere Drehmomentstabilität als der erste Abschnitt 52, was für passive Auslenkung eher als für aktive Auslenkung geeignet ist. Durch Anbringen der Schlitze weiter entfernt voneinander und mit kleinerer Tiefe Y' weist der zweite Abschnitt 54 größere Knickfestigkeit und Drehmoment­ stabilität als der erste Abschnitt 52 auf. Die vier Richtun­ gen A, B, C, D der Schlitze sorgen auch für die Fähigkeit einer Auslenkung des zweiten Abschnitts 54 in vier Richtun­ gen statt nur einer Auslenkbarkeit in zwei Richtungen wie im ersten Abschnitt, um bessere Fähigkeiten passiver Auslenkung zu erzielen.
Der dritte Abschnitt 56 des Rohrs 40 ist zwischen dem zwei­ ten Abschnitt 54 und dem nicht geschlitzten Abschnitt 59 am Hinterende vorhanden. Jedoch muss der dritte Abschnitt bei einem alternativen Ausführungsbeispiel keine Schlitze auf­ weisen. Bei diesem Ausführungsbeispiel erstreckt sich der dritte Abschnitt 56 entlang dem größten Teil der Länge des Rohrs 40. Das Muster der Schlitze 46 entlang dem dritten Ab­ schnitt 56 weist einen anderen Abstand X" auf, stimmt jedoch ansonsten mit dem Muster der Schlitze im zweiten Abschnitt 54 überein. Bei einem alternativen Ausführungsbeispiel kön­ nen die Variablen Y und W verschieden sein, die Richtungen der Schlitze 46 im dritten Abschnitt 56 können verschieden sein und der Abstand X" kann entlang der Länge des dritten Abschnitts variieren. Die Fig. 7A bis 7E zeigen eine derar­ tige Variation, bei der der dritte Abschnitt 56" des Rohrs 40 über Schlitze 56 in fünf Richtungen M, N, O, P, Q in das Rohr hinein verfügt. Der dritte Abschnitt weist vorzugsweise eine größere Knickfestigkeit, größere Steifigkeit (oder ge­ ringere Flexibilität) und größere Drehmomentstabilität als der erste und zweite Abschnitt 52, 54 auf. Bei diesem Aus­ führungsbeispiel ist dies durch den größeren Abstand X" be­ werkstelligt, jedoch könnte alternativ eine der anderen Va­ riablen oder eine Kombination derselben verwendet werden, die für Knickfestigkeit und Drehmomentstabilität sorgen. Wenn bei einem Ausführungsbeispiel der dritte Abschnitt 56 keine Schlitze aufweist, wird die Dicke der Rohrwand so aus­ gewählt, dass sie ohne Verwendung von Schlitzen für ausrei­ chende Schaftflexibilität sorgt.
Der Abschnitt 59 erstreckt sich in den Griff 12 und ist fest mit dessen Rahmen verbunden.
Es wird erneut auf die Fig. 1 bis 3 Bezug genommen, gemäß denen der Mantel 32 vorzugsweise aus einem elastischen Kunststoff- oder Polymermaterial besteht. Der Mantel könnte auch eine Aufbauverstärkung enthalten, wie in der am 29. Mai 1998 mit dem Titel "Flexible Pressure Resistant Cover For The Articulation System Of A Medical Instrument" eingereich­ ten US-Patentanmeldung Nr. 09/087,305 offenbart. Der Mantel 32 ist vorzugsweise direkt am Rohr 40 befestigt, jedoch nicht durch einen Kleber. Jedoch kann bei alternativen Aus­ führungsbeispielen jede geeignete Maßnahme dazu verwendet werden, den Mantel 32 am Rohr 40 zu befestigen, einschließ­ lich eines Klebers. Der Mantel 32 kann entlang der gesamten Länge des Rohrs 40 befestigt werden, oder er kann nur an vorbestimmten, begrenzten Orten befestigt werden, wie lediglich in den Abschnitten 58, 59, wobei er ansonsten an keiner anderen Stelle befestigt ist. Daher können Stücke entlang dem Schaft 14 vorhanden sein, an denen sich der Mantel rela­ tiv zum Rohr 40 bewegen kann. Beim Stand der Technik wurde Kleber mit verschiedenen Dicken entlang der Länge des Schafts verwendet, um für verschiedene Knickfestigkeiten und Schaftflexibilitäten entlang der Länge des Schafts zu sor­ gen. Zum Hinterende des Schafts hin wurde eine dickere Kle­ beschicht verwendet, um die Knickfestigkeit des Schafts dort höher zu machen, jedoch mit dem unerwünschten Problem, dass das Hinterende des Schafts einen größeren Außendurchmesser als das Vorderende aufwies. Es ist bevorzugt, dass der Au­ ßendurchmesser klein ist, wie dann, wenn das Endoskop durch kleine Öffnungen eingeführt wird, wie den Harnleiter oder die Harnröhre eines Patienten. Bei der Erfindung ist es nicht erforderlich, die Knickfestigkeit und die Steifigkeit unter Verwendung einer erhöhten Dicke einer Kleberschicht zu erhöhen, da das Rohr 40 mit ausreichender Knickfestigkeit und Steifigkeit versehen ist. Daher kann der Schaft 14 ent­ lang seiner Länge einen gleichmäßigen Außendurchmesser auf­ weisen. So kann die Dicke oder die Außenabmessung des Schafts minimiert werden.
Beim Stand der Technik wurde der Objektivkopf an einer Aus­ lenkanordnung befestigt, die wiederum an einer Schaftanord­ nung befestigt wurde. Die Erfindung ermöglicht es, ein En­ doskop zu schaffen, das nicht über eine aktive Auslenkanord­ nung und eine gesonderte Schaftanordnung verfügt. Statt des­ sen ermöglicht es die Erfindung, dass sich das Rohr 40 über die gesamte Länge des Schafts erstreckt, wobei dieses ein­ zelne Rohr 40 Funktionen ausübt, die im Stand die Technik durch die zwei Anordnungen ausgeführt wurden. Unter Verwen­ dung des einzelnen Rohrs 40 kann der Schaft 14 in weniger Zeit und mit geringeren Kosten hergestellt und zusammenge­ baut werden als der Schaft im Stand der Technik aus zwei Anordnungen, und er kann zuverlässiger arbeiten, da weniger Teile verwendet sind, da die superelastische Legierung zu­ verlässiger ist und da geringere Gefahr eines Ausfalls oder einer Ermüdung des Schafts 14 als beim Stand der Technik be­ steht. Der Objektivkopf 34 kann innerhalb des Vorderendes des Rohrs 40 positioniert werden, wobei es sich um dasselbe Rohr handelt, das sich über den Rest des Schafts erstreckt und nicht nur über die aktive Auslenkanordnung, wie beim Stand der Technik.
Rohre aus einer superelastischen Legierung können derzeit leicht von Herstellern erworben werden. Die Rohre werden derzeit mit gleichmäßiger Wanddicke hergestellt, jedoch ist es möglich, die Wanddicke für verschiedene Steifigkeiten entlang der Rohrlänge zu variieren. Jedoch enthalten derzeit von Herstellern verkaufte Rohre aus superelastischen Legie­ rungen keine Schlitze. Um das Endoskop 10 herzustellen, müs­ sen die Schlitze 46 in das Rohr aus einer superelastischen Legierung eingearbeitet werden. Rohre können mit vorge­ schnittenen Längen erworben werden. Ein Verfahren zum Her­ stellen der Schlitze 46 kann eine Laserschneidvorrichtung verwenden. Der Laser der Vorrichtung sollte die Schlitze 46 in das geschlossene Rohr einarbeiten, während die Vorrich­ tung das Rohr und den Laser relativ zueinander bewegt. Bei einem bevorzugten Ausführungsbeispiel wird eine programmier­ bare Computersteuerung dazu verwendet, die Vorrichtung zum Herstellen der Schlitze 46 mit dem gewünschten Muster oder den gewünschten Mustern entlang der Länge des Rohrs herzu­ stellen. So kann das mindestens eine Muster durch geeignete Computerprogrammierung ausgewählt oder geändert werden, um Rohre mit verschiedenen Schlitzmustern herzustellen. Diese verschiedenen Rohrtypen können dazu verwendet werden, Endos­ kope mit verschiedenen Schafteigenschaften herzustellen, wie mit verschiedenen Steifigkeiten entlang ihrer Länge und ver­ schiedenen Fähigkeiten zur aktiven Auslenkung innerhalb ihrer Abschnitte für aktive Auslenkung (für eine Richtung, zwei Richtungen, vier Richtungen, usw.). Bei einem alterna­ tiven Verfahren kann elektrische Entladungsbearbeitung (EDM = electrical discharge machining) mittels eines Drahts zum Herstellen der Schlitze verwendet werden. Jedoch kann zum Herstellen der Schlitze jedes geeignete Verfahren genutzt werden.
Einer der Vorteile der Erfindung besteht in der Möglichkeit, Endoskope mit verschiedenen Schafteigenschaften dadurch her­ zustellen, dass Rohre mit verschiedenen Schlitzmustern ver­ sehen werden, wie mit einfach mehr oder weniger Schlitzen 46 im Rohr 40. Durch diesen Vorteil kann ein Benutzer ein En­ doskop mit gewünschtem Verlauf der Schaftsteifigkeit aus ei­ ner Anzahl von Endoskopen auswählen, die ansonsten praktisch gleich sind. Der Hersteller kann auch ein Endoskop kunden­ spezifisch mit einem gewünschten Verlauf der Schaftsteifig­ keit dadurch für einen Benutzer herstellen, dass er ledig­ lich die Schlitzherstellvorrichtung für ein geeignetes Schlitzmuster umprogrammiert. Die Erfindung ermöglicht es auch, einen Schaft abzubauen und das Rohr 40 mit mehr Schlitzen zu versehen, um dessen Schafteigenschaften zu än­ dern.
Endoskope müssen nach ihrem Gebrauch gereinigt werden. Zu einem Reinigungsverfahren gehört das Sterilisieren mit einem Gas und das Absenken des Drucks. Ein Problem bei Gassterili­ sation besteht darin, dass der Druck innerhalb des Schafts nach außen drückt, wenn der Druck außerhalb des Schafts ab­ gesenkt wird. Bei Endoskopen mit Belüftungsventilen ist dies im Allgemeinen kein Problem. Jedoch erhöhen Belüftungsventi­ le die Kosten des Endoskops, und wenn ein Benutzer das Be­ lüftungsventil für den Reinigungsvorgang zu öffnen vergisst, kann der Schaftmantel reißen. Es existieren Endoskope ohne Belüftungsventile. Statt dessen verfügen sie über verstärkte Mäntel. Ein verstärkter Mantel, wie in der oben angegebenen Patentanmeldung erwähnt, kann dieses Problem eines Zerrei­ ßens überwinden. Eine andere Art zum Überwinden dieses Prob­ lems besteht darin, innerhalb des Rohrs 40 ein dünnwandiges Verstärkungsrohr anzubringen. Gemäß Fig. 8 besteht eine an­ dere Art zum Überwinden dieses Problems darin, den Schaft 14' innerhalb des Bereichs 42 des Rohrs 40 mit einem Rohr 41 mit mehreren Gängen zu versehen. Das Rohr 41 mit mehreren Gängen kann aus einem flexiblen Polymermaterial bestehen und Kanäle 70, 72, 74, 76 für die Auslenkungs-Steuerungskabel und die Faseroptik sowie einen Kanal 78, der einen Arbeits­ kanal bildet, beinhalten. Das Rohr kann auch ein solches mit einem einzelnen Hohlraum sein, wie das oben genannte dünn­ wandige Rohr.

Claims (32)

1. Endoskop mit einem Steuerungsabschnitt (12) und einem sich ausgehend von diesem erstreckenden Schaft. (14), dadurch gekennzeichnet, dass der Schaft einen Rahmen (26) mit einem einstückigen Rohr (40) entlang dem Hauptteil der Länge des Schafts aufweist, wobei das Rohr aus einer superelastischen Legierung besteht und es Schlitze (46) in es hinein zumin­ dest über einen Abschnitt (52, 54, 56, 59) aufweist, und wobei es die superelastischen Eigenschaften der superelasti­ schen Legierung ermöglichen, dass sich das Rohr in der Nähe der Schlitze ohne wesentliche dauerhafte Verformung ver­ biegt, und sie dafür sorgen, dass der Schaft mit angemessen­ er Knickfestigkeit, Flexibilität und Drehmomentfestigkeit versehen ist, um in einen Patientenkörper eingeführt werden zu können.
2. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass ein erster der Abschnitte einen ersten Abstand (X) zwischen den Schlitzen und ein zweiter der Abschnitte einen zweiten, anderen Abstand (X') zwischen den Schlitzen aufweist.
3. Endoskop nach Anspruch 2, dadurch gekennzeichnet, dass ein dritter der Abschnitte einen dritten Abstand (X") zwi­ schen den Schlitzen aufweist, der verschieden vom ersten und zweiten Abstand (X, X') ist.
4. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass sich die Schlitze (46) entlang einem ersten der Abschnitte (52, 54, 56) mit einem ersten Muster mehrerer verschiedener Richtungen in das Rohr (40) hinein erstrecken.
5. Endoskop nach Anspruch 4, dadurch gekennzeichnet, dass das erste Muster der Schlitze (46) solche Schlitze aufweist, die in verschiedenen Richtungen entlang dem Ersten Abschnitt in gemischtem Muster angeordnet sind.
6. Endoskop nach Anspruch 4, dadurch gekennzeichnet, dass sich die Schlitze (46) im ersten Abschnitt über mehr als die Hälfte durch das Rohr erstrecken.
7. Endoskop nach Anspruch 4, dadurch gekennzeichnet, dass sich die Schlitze (46) entlang einem zweiten der Abschnitte (52, 54, 56) mit einem zweiten, anderen Muster von Richtun­ gen in das Rohr hinein erstrecken.
8. Endoskop nach Anspruch 4, dadurch gekennzeichnet, dass der erste Abschnitt einen ersten Abstand (X) zwischen den Schlitzen (46) und ein zweiter der Abschnitte einen zweiten, anderen Abstand (X', X") zwischen den Schlitzen aufweist.
9. Endoskop nach Anspruch 8, dadurch gekennzeichnet, dass sich die Schlitze (46) entlang dem zweiten Abschnitt mit einem zweiten, anderen Muster von Richtungen in das Rohr (40) hinein erstrecken.
10. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass sich das Rohr (40) über die gesamte Länge des Schafts (14) erstreckt.
11. Endoskop nach Anspruch 1, gekennzeichnet, durch einen Objektivkopf (34), der innerhalb des Rohrs (40) an dessen distalem Ende liegt.
12. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass der Schaft (14) ferner einen mit dem Rohr (40) verbundenen Mantel (32) aufweist und er im Wesentlichen über seine ge­ samte Länge einen im Wesentlichen gleichmäßigen Außendurch­ messer aufweist.
13. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass der Rahmen (26) ferner ein Rohr mit einem einelnen oder mit mehreren Hohlräumen innerhalb des einstückigen Rohrs (40) aufweist.
14. Endoskop nach Anspruch 1, dadurch gekennzeichnet, dass sich mindestens zwei der Schlitze (46) mit zwei verschiede­ nen Tiefen in das Rohr (40) hinein erstrecken.
15. Endoskop mit einem Schaft (14), einem diesen durchdrin­ genden faseroptischen System (36, 37) und einem ihn eben­ falls durchdringenden Auslenksteuerungssystem (22), dadurch gekennzeichnet, dass der Schaft einen Rahmen (26) mit einem Rohr (40) aus superelastischem Material aufweist, wobei sich Schlitze (46) in mindestens zwei verschiedenen Richtungen in das Rohr hinein erstrecken.
16. Endoskop nach Anspruch 15, dadurch gekennzeichnet, dass das Rohr (40) in einem ersten Abschnitt einen ersten Abstand (X) zwischen den Schlitzen (46) und in einem zweiten Ab­ schnitt einen zweiten, anderen Abstand (X', X") zwischen den Schlitzen aufweist.
17. Endoskop nach Anspruch 15, dadurch gekennzeichnet, dass die Schlitze (46) mit anderer Richtung entlang einem ersten Abschnitt des Rohrs (40) mit einem gemischten Muster ange­ ordnet sind.
18. Endoskop nach Anspruch 17, dadurch gekennzeichnet, dass sich die Schlitze (46) entlang einem zweiten Abschnitt des Rohrs (40) mit einem zweiten, anderen Muster von Richtungen als die Schlitze im ersten Abschnitt in das Rohr hinein er­ strecken.
19. Endoskop nach Anspruch 15, dadurch gekennzeichnet, dass sich mindestens zwei der Schlitze (46) mit zwei verschiede­ nen Tiefen in das Rohr (40) hinein erstrecken.
20. Endoskop mit einem Steuerungsabschnitt (12) und einem sich ausgehend von diesem erstreckenden Schaft (14) mit ei­ nem im Wesentlichen rohrförmigen Rahmenelement (26, 40), dadurch gekennzeichnet, dass der Schaft im Wesentlichen über seine gesamte Länge im Wesentlichen gleichmäßige Außenabmes­ sungen aufweist und das rohrförmige Rahmenelement den Schaft entlang seiner Länge mit mindestens zwei Abschnitten (52, 56, 56) mit zwei verschiedenen Steifigkeiten versieht.
21. Endoskop nach Anspruch 20, dadurch gekennzeichnet, dass das Rahmenelement (26, 40) über einen ersten Abschnitt mit einem ersten Muster von Schlitzen (46) und einen zweiten Ab­ schnitt mit einem zweiten Muster von Schlitzen verfügt.
22. Endoskop nach Anspruch 21, dadurch gekennzeichnet, dass das erste Muster einen ersten Abstand (X) zwischen den Schlitzen aufweist und das zweite Muster einen zweiten, an­ deren Abstand (X', X") zwischen den Schlitzen aufweist.
23. Endoskop nach Anspruch 21, dadurch gekennzeichnet, dass das erste Muster Schlitze (46) aufweist, die sich mit einem ersten sich wiederholenden Muster verschiedener Richtungen in das Rahmenelement (26, 40) hinein erstrecken, und das zweite Muster Schlitze aufweist, die sich mit einem zweiten sich wiederholenden Muster verschiedener Richtungen in das Rahmenelement hinein erstrecken, wobei die letztgenannten Richtungen zumindest teilweise verschieden gegenüber dem ersten sich wiederholenden Muster von Richtungen sind.
24. Endoskop nach Anspruch 21, dadurch gekennzeichnet, dass das erste Muster Schlitze (46) mit einer ersten Tiefe auf­ weist und das zweite Muster Schlitze mit einer zweiten, an­ deren Tiefe aufweist.
25. Verfahren zum Herstellen eines Endoskopschaftrahmens mit dem folgenden Schritten:
  • - Bereitstellen eines Rohrs (40) aus einer superelastischen Legierung und
  • - Herstellen von Schlitzen (46) im Rohr, um mindestens einen Abschnitt des Rohrs mit erhöhter Flexibilität zu versorgen.
26. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass die Schlitze (46) durch einen Laser in das Rohr (40) eingeschnitten werden.
27. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass die Schlitze (46) durch eine elektrische Entladungsma­ schine (EDM) in das Rohr (40) eingeschnitten werden.
28. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass das Rohr (40) zwischen dem Herstellen mindestens zweier der Schlitze (46) verdreht wird.
29. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass die Schlitze in einem ersten der Abschnitte (52, 54, 56) mit einem ersten Abstand (X) zwischen den Schlitzen und in einem zweiten der Abschnitte mit einem zweiten, anderen Abstand (X', X") hergestellt werden.
30. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass ein erster der Schlitze (46) mit einer Tiefe in das Rohr (40) hinein hergestellt wird und ein anderer der Schlitze mit einer zweiten, anderen Tiefe in das Rohr hinein hergestellt wird.
31. Verfahren nach Anspruch 25, dadurch gekennzeichnet, dass Schlitze in mindestens zwei der Abschnitte (52, 54, 56, 59) hergestellt werden, wobei in jedem Abschnitt ein anderes Muster der Schlitze hergestellt wird.
32. Verfahren zum Herstellen von Endoskopen, gekennzeichnet durch die folgenden Schritte:
  • - Bereitstellen einer ersten Art eines Schaftrahmens mit ei­ nem ersten Rohr mit einem ersten Muster von Schlitzen in dieses erste Rohr hinein;
  • - Bereitstellen einer zweiten Art eines Schaftrahmens mit einem zweiten Rohr mit einem zweiten Muster von Schlitzen in dieses zweite Rohr hinein, wobei das zweite Muster vom ersten Muster verschieden ist; und
  • - Zusammenbauen eines ersten der Endoskope mit dem ersten Schaftrahmentyp und eines zweiten der Endoskope mit dem zweiten Schaftrahmentyp;
  • - wobei das erste und zweite Endoskop verschiedene Knickfes­ tigkeitsmuster entlang ihrer Länge aufweisen, die durch die verschiedenen Schlitzmuster im ersten und zweiten Rohr ge­ schaffen sind.
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