Device for examining a body cavity
20200384215 ยท 2020-12-10
Inventors
Cpc classification
A61B1/31
HUMAN NECESSITIES
A61B1/04
HUMAN NECESSITIES
A61B1/32
HUMAN NECESSITIES
International classification
A61M13/00
HUMAN NECESSITIES
Abstract
A portable device (500) for examining a body cavity, the device (500) adapted to allow air to be introduced into the body cavity, the device comprising: a tubular probe (1) having a first, forward end (4) and a second, rearward end (5); and a sealing element (506) disposed adjacent to the forward end (4) of the tubular probe (1), the sealing element (506) including a self-tightening sleeve portion (508) to engage the tubular probe (1), the sealing element (506) adapted to act as a seal for the body cavity to reduce egress of fluid therefrom by sealing against a circumferential zone of the internal tissue defining an orifice of the body cavity, the tubular probe (1) having a first lateral entry port (14) that allows for an elongate implement to be removably mounted in the device (500) and to be passed through the tubular probe (1) for introduction into the body cavity, such that the implement is manipulable by a user, the portable device (500) being connectable to an odour evacuation system having a filter (56) to remove the build-up of air in the body cavity, and wherein fluid being introduced into said body cavity via the tubular probe (1) is delivered via a conduit (51) from a pump (52), and a regulator (54) fluidly connected to the conduit (51) regulates the fluid to be within at least one predetermined range of pressure between at least an upper limit and a lower limit.
Claims
1. A portable device for examining a body cavity, the device adapted to allow air to be introduced into the body cavity, the device comprising: a tubular probe having a first, forward end and a second, rearward end; and a sealing element disposed adjacent to the forward end of the tubular probe, the sealing element including a self-tightening sleeve portion to engage the tubular probe, the sealing element adapted to act as a seal for the body cavity to reduce egress of fluid therefrom by sealing against a circumferential zone of the internal tissue defining an orifice of the body cavity, the tubular probe having a first lateral entry port that allows for an elongate implement to be removably mounted in the device and to be passed through the tubular probe for introduction into the body cavity, such that the implement is manipulable by a user, the portable device being connectable to an odour evacuation system having a filter to remove the build-up of air in the body cavity, and wherein fluid being introduced into said body cavity via the tubular probe is delivered via a conduit from a pump, and a regulator fluidly connected to the conduit regulates the fluid to be within at least one predetermined range of pressure between at least an upper limit and a lower limit.
2. A portable device as claimed in claim 1, wherein a pressure gauge is in fluid communication with the conduit for setting the predetermined range of pressures.
3. A portable device as claimed in claim 1, wherein the upper limit is just below where over-pressuring of air occurs in the vagina, and the lower limit is just above a pressure needed to keep the body cavity inflated for viewing.
4. A portable device as claimed in claim 1, wherein the tubular probe includes a guide means disposed adjacent the second, rearward end of the probe, the guide means adapted to guide the implement within the tubular probe to stay adjacent a top section of the probe, and wherein the guide means is a substantially V-shaped guide member.
5. A portable device as claimed in claim 1, further including an imaging device having an associated light source for emitting green, white, or ultraviolet blue light onto the body cavity.
6. A portable device as claimed in claim 1, wherein the device is battery-operable.
7. A portable device as claimed in claim 6, wherein the device is rechargeable by a 5V power source such as a laptop or tablet computer.
8. A portable device as claimed in claim 6, wherein the device is rechargeable by a solar charging device.
9. A portable device as claimed in claim 1, further including one or more actuation members adapted to take images and/or video of the body cavity being examined.
10. A portable device as claimed in claim 1, wherein the self-tightening sleeve portion is biased to a diameter that is smaller than a diameter of the tubular probe.
11. A portable device as claimed in claim 10, wherein the self-tightening sleeve portion is stretchable to fit over the tubular probe.
12. A portable device as claimed in claim 1, wherein the sealing element has a contoured outer profile with a gradually increasing diameter from a front end to a rear end, with an indentation located therebetween.
13. A portable device as claimed in claim 1, wherein the sealing element is provided in a variety of sizes to suit a variety of body cavity sizes.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0035] Preferred embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings, in which:
[0036]
[0037]
[0038]
[0039]
[0040]
[0041]
[0042]
[0043]
[0044]
[0045]
[0046]
[0047]
[0048]
[0049]
[0050]
[0051]
[0052]
[0053]
[0054]
[0055]
[0056]
[0057]
[0058]
[0059]
[0060]
[0061]
[0062]
[0063]
[0064]
DETAILED DESCRIPTION OF THE EMBODIMENTS
[0065]
[0066] The sealing element 6 is similar to sealing element 13 depicted in FIG. 1 of U.S. Pat. No. 6,719,687 and functions in a similar fashion. The sealing element 6 is preferably formed from a disposable material, for example, a thick walled hemisphere (dome-shaped shell) formed from a closed cell, dense polyethylene foam. The sealing element 6 includes a hole at its centre through which the tubular probe 1 extends. It is envisaged that the tubular probe 1 and the hole of the sealing element 6 has a tight fit. A circular rib 20 is disposed on the tubular probe 1 to limit the rearward travel of the sealing element 6 relative to the tubular probe 1.
[0067] The handpiece 2 has a detachable mounting spigot 7 for mounting the tubular probe 1. The handpiece 2 also has an illumination assembly (not shown) and a digital imaging acquisition means (camera) for viewing and/or capturing an image (not shown), therein. As will be described in further detail below, the handpiece 2 is also adapted to be connected to a computer 60 or the like and transformer (not shown), from which a low voltage power source of approximately 3 to 12 volts to power the illumination assembly and the digital imaging acquisition means, is provided. As best shown in
[0068] As best shown in
[0069] A tubular guide member 14 projects externally from the lateral entry port 11 in a substantially rearward direction (i.e. towards the second (rearward) end 5 of the tubular probe 1). The tubular guide member 14 has a longitudinal axis L2 that is at an acute angle, preferably less than 45, to the longitudinal axis L1 of the tubular probe 1. This arrangement allows for an elongate implement, such as a sampling implement 15 with a flexible plastic stem or the like (cervical brush), to be inserted through the first (forward) end 4 of tubular probe 1 and bent such that a rear end 18 of the implement 15 passes through the lateral entry port 11 and the tubular guide member 14, thereby guiding the rear end 18 of implement 15 away from the tubular probe 1 (as best shown in
[0070] In order to keep the stem of the implement 15 centralised in the bore 1a of the tubular probe 1, a guide means may be located at or adjacent the second (rearward) end 4 of the tubular probe 1. It should, however, be understood that other shapes could be utilised for different types of applications or procedures. The guide means may, for instance, be a substantially V-shaped guide member 16 projecting from an inner surface or wall of the bore 1a of the tubular probe 1, as best shown in
[0071] It should be understood that whilst this embodiment is described with reference to a sampling implement 15, it should be understood that the implement 15, may, in a different embodiment, be a surgical implement or other medical instrument or the like.
[0072] The examination device 50 is typically supplied to a user as separate unassembled components, i.e. the tubular probe 1, the handpiece 2 and the mounting spigot 7. In one example, the examination device 50 may be assembled for use by attaching the tubular probe 1 to handpiece 2 via the mounting spigot 7. Alternatively, the tubular probe 1 may be directly mounted to the handpiece 2 without the use of the mounting spigot 7. The separation of components at least allows the flexibility of use, depending upon the type of patient, and also ensures that the components may be disposed of and replaced for hygiene reasons. The various components of the examination device 50 may be connected by way of threaded engagement, snap fitting, or other forms of corresponding mechanical features.
[0073] The operation of the examination device 50 will now be described.
[0074] Once the components of the examination device 50 have been assembled, the sealing element 6 of the tubular probe 1 is located at a front (i.e. distal) end of the examination device 50. In one example, a physician wishing to examine a patient's vagina may bring the first (forward) end 4 of the tubular probe 1 towards the opening of the vagina and insert the tubular probe 1 in a like manner to that shown in FIG. 5 of U.S. Pat. No. 6,719,687, thereby effecting a seal between the sealing element 6 and the annular zone of the normally internal surface of the vaginal orifice (or the vaginal cavity/barrel). Then, in a similar fashion to that described in U.S. Pat. No. 6,719,687, the vaginal orifice or cavity/barrel may be inflated by air (or another fluid, for example CO.sub.2 or the like) introduced into the examination device 50 via the fluid entry port 12. Referring to
[0075] It is envisaged that the illumination assembly within the handpiece 2 projects light into the vaginal barrel. As the handpiece 2 is connected to the computer 60 and the monitor 61, and the digital imaging acquisition means (camera) for viewing and/or capturing an image is incorporated within the handpiece 2, the physician may examine the patient by viewing an image of the vaginal interior and cervix shown on the monitor 61, and may capture such images thereof for storage on the computer 60 or other storage media.
[0076] In the event that the examination device 50 is required to introduce an implement into the vagina, such as the sampling implement 15 as depicted in
[0077] The arrangement of the implement 15 extending through the lateral entry port 11 and tubular guide member 14 may at least enable the implement 15 to be far more easily manipulated than the arrangement of the earlier mentioned prior art. The present arrangement may at least allow for sampling devices or surgical instruments to be passed through the examination device 50 and into the vagina for taking samples or conducting minor surgery more easily than the prior art devices. An advantage of such an arrangement is that the physician can manipulate such sampling or surgical devices laterally of the examination device 50 and his/her hands do not block their field of vision, as is sometimes the case when using known colposcopes. Also, as the guide member 16 is offset from the longitudinal (i.e. central) axis of the tubular probe 1, the guide member 16 also does not have a large impact on the physician's field of vision.
[0078]
[0079]
[0080] It is envisaged that the substantially keyhole-shaped guide member 16 and the substantially ring-shaped guide member 16 may at least allow for the implement 15 to be dead-centered within the tubular probe 1, such that the removal of the implement 15 from the vagina may occur without any issues. For example, when an implement such as a spatula is utilised, this arrangement at least allows the spatula to be centralised such that when the spatula is removed from the tubular probe 1 (i.e. pulled back into the tubular probe 1), the head of the spatula does not get left behind in the vagina, as is sometimes the case with prior art devices.
[0081] As best shown in
[0082] The pressure gauge 53 may be either digital or analog, and adapted to display air pressure in a suitable pressure unit, such as mmHG. The pressure gauge 53 may, for example, be similar to those used in medical devices such as in blood pressure monitors, and may be integrally housed with the pressure regulator 54. In some circumstances, there may be a loss of air pressure due to air passing through the pressure gauge 53. To overcome this problem, a pressure gauge bypass tube or line (not shown) may be introduced, which is manually operable by the physician to turn to pressure gauge on or off.
[0083] The pressure regulator 54 allows for the adjustment of air pressure between at least a first, upper limit and a second, lower limit. It is envisaged that the pressure range that the pressure regulator 54 operates within, is a range required to keep a typical vaginal barrel inflated when the sealing element 6 of the examination device (speculum) 50 is held sealingly against the PC muscle of a patient, i.e. the upper limit is below a pressure which causes air to escape from the sealing element 6, and the lower limit is above a minimal pressure to sufficiently inflate the typical vaginal barrel so that the cervix and surrounding area can be viewed by the camera.
[0084] The pressure regulator 54 may be a manual turn knob regulator, whereby the turn of the knob allows the adjustment of the pressure between the desired upper limit and the lower limit. In such an arrangement, the physician would insert the tubular probe 1 and abut the sealing element 6 against the vaginal vulva with sufficient force to affect the seal. Air would be then be introduced into the vagina from the pump 52, and with the physician looking at the pressure gauge 53, adjust the air pressure to a suitable level between the upper limit, i.e. just below where typical over-pressuring occurs that leads to air escaping the seal zone, and the lower limit which is just above the pressure needed to keep the vaginal barrel inflated.
[0085] In a series of air pressure trials at room temperature, it was shown that the air pressure does not go over 46 mmHg (about 6.13 kPa). As such, the range of suitable pressure is relatively low. It is therefore important to finely regulate the air between the upper and lower limits of the suitable pressure range.
[0086] In an alternative configuration, the pressure regulator 54 may be automated via the use of a pressure sensor (not shown) and an electronic control unit (not shown) integral with the pressure regulator 54. Such an automated pressure regulator 54 can automatically adjust the pressure so that it remains regulated between the upper limit and lower limit. It is envisaged that such an automated version of the pressure regulator 54 may be powered by the same power source as the air pump 52. It may also be possible, via the electronic control unit, to select between two or three predetermined pressure ranges, each with its own upper and lower limit, to allow the user different options to select from. This may at least allow for the adjustment of the actual pressure range, with slightly different ranges to accommodate patients with different vaginal barrel size and shape. Such an automated pressure regulator 54 may also have an alarm that is either a visual alarm or an audible alarm, operably connected to the electronic control unit, which sounds (e.g. beeps) or lights up, when the air pressure is sensed as being outside the predetermined range.
[0087] It is envisaged that the simplified regulation of air by the pressure regulator 54 described above may at least significantly improve a patient examination procedure in at least the following ways.
[0088] Firstly, the arrangement described above may at least minimise the risk of embarrassing patients by the noise caused by over-pressurised air escaping the sealing element 6 of the examination device (speculum) 50. Secondly, by simplifying and/or automating air pressure regulation, the user of the examination device (speculum) 50 has an easier task of conducting the patient examination procedure. By allowing for the patient examination procedure to be carried out in an easier and quicker manner, the patient examination procedure does not necessarily need to be carried out by a highly trained physician. The examination device 50 may thus be more cost effectively integrated into a telehealth system or the like.
[0089] In one example, by using the digital camera (not shown) in the handpiece 2 of the examination device 50 connected to the computer 60, in combination with the above-mentioned air pressure regulation by the pressure regulator 54, the patient examination procedure does not need to be carried out in the immediate presence of a physician. For example, a health professional other than a physician, such as a nurse, could readily operate the examination device 50. The simplified air pressure regulation via the pressure regulator 54 allows the nurse to concentrate on the image being shown on the monitor 61 via the computer (i.e. the central processing unit) 60. In one example, once the monitor 61 shows an image of the inflated vagina (with the cervix being shown at the centre of the monitor 61), the physician or nurse may turn down the pressure by observing the pressure gauge 53 and adjusting the pressure regulator 54 accordingly. The pressure may be maintained at any desired level by the physician or nurse. This may at least eliminate issues for the patient, such as embarrassing noise problems as a result of air escaping past the seal zone.
[0090] As the computer 60 may be connected to other computers in a local network, or to a remote database 62 and remote computer 63 via the internet 64 (as best shown schematically in
[0091] It is also envisaged that the images captured may not be limited to being stored on the computer 60 or an associated storage device, but the images can additionally or alternatively be stored in the remote database 62 at a remote location. It is envisaged that the images may also be stored on a portable storage device such as a USB, hard drive or the like. As such, the physician or other health professional may examine the images at a later time, after the patient examination procedure had taken place. This may be used, for example as a tool for comparison and analysis from a patient's previous visit. It is also envisaged that a database of images may be collected over time, and with the use of an appropriate software, this may enable to identification of pre cancers (and potentially full cancers), in a similar manner to face recognition capabilities. Based on this database of images, it may be possible for physicians to identify problems with future patients in real time. In relation to court proceedings for rape victims, for example, the capture of images (from a relatively gentle procedure) may also allow for the collection of evidence to be presented in court. Another possible use of such a database would be for medical training purposes. For example, a medical professor may utilise the database of images to formulate tutorials and walk-throughs, whereby the images may be presented together with a voice-over explanation from the professor. As such, students may no longer be required to visit numerous patients in a hospital for training purposes, where in typical circumstances, only about 20 students may have the opportunity to look through a tool such as a bi-valve speculum for a limited number of examples of clinical situations available on the day. Using the database of images, it may be possible for an unlimited number of students to study a possible 50,000 (or more) examples available to them on any given day.
[0092] In the prior art, the disposable sealing element 6 has typically been manufactured from polyethylene foam, as it is relatively effective for sealing purposes and inexpensive. By utilising more effective air regulation via the pressure regulator 54 as described above, it may be possible to make the sealing element 6 from an even more cost-effective material, such as soft polystyrene foam or the like, and still provide an effective seal.
[0093]
[0094] It is further envisaged that the gynecologist's speculum may include a port component 71 attached to the tubular probe extension 1. The port component 71 includes an air entry port 72, which extends from the body of the port component 71 to allow for the introduction of air or the like into the vaginal barrel. An air exit port 74 also extends from the port component 71 to allow for contaminated air to exit the tubular probe extension 1, and subsequently be directed to the air filter 56 located behind the air pump 52. An air outlet 76 and associated tap member 78 extending from the port component 71 is also provided as the outlets from the tubular probe extension 1. It should be appreciated that in one arrangement, the port component 71 may be adapted to replace the mounting spigot 7 of the examination device as shown in
[0095] In the embodiment shown in
[0096] In an alternative embodiment, the arrangement shown in
[0097] With reference to
[0098]
[0099] In this embodiment, the examination device 500 includes actuation member 502 (zoom in and out) on the top of the device and 504 on both sides of the device for taking images and video, which are preferably in the form of dials or buttons, but may be any other form of actuation mechanism. The actuation members 502 and 504 are operable by the user to control the examination device 500. The examination device 500 also includes a sealing element 506 (cup) disposed adjacent to the forward end 4 of the tubular probe 1, whereby the sealing element 506 includes a self-tightening sleeve portion 508 to engage the tubular probe 1. It will be appreciated that the sleeve portion 508 is biased to a diameter that is smaller than the diameter of the tubular probe 1, and the sleeve portion 508 may be stretched to fit over the tubular probe 1. Upon engagement with the tubular probe 1, the sleeve portion 508 tightens over the tubular probe 1 to secure it in place relative to the tubular probe 1. The device 500 may also have a conduit 1002 which houses the air out, air in tubes and the camera, light and power cables 1004. In the preferred embodiment as shown in
[0100] In
[0101] Further in
[0102] It is envisaged that the examination device 500 may be associated with an odour evacuation system. In embodiments, the odour evacuation system includes the air filter 56 described above to evacuate or eliminate unwanted odours from the patient's vagina. The odour evacuation system and the air filter 56 is operable by the practitioner using an on-off switch that is disposed either directly on the examination device 500, or remote from the examination device 500.
[0103] The examination device 500 may also further be associated with the pressure gauge 53 and the pressure regulator 54 described above, which are connected to the conduit 51 and the air pump 52. The pressure gauge 53 is operable by the practitioner to set the air pressure, e.g. in the predetermined range of pressure as required. The pressure regulator 54 is operable to regulate the air pressure inside the patient's vagina. In embodiments, the examination device may be further associated with one or more pressure valves that allow the practitioner to select a predetermined pressure according to the size of the patient's vagina. For example, the practitioner may select a predetermined pressure A which corresponds to size A of the sealing element 506. This may at least provide ease of usability and convenience for the practitioner, as they would no longer need to manually set the pressure for each patient. It will be appreciated that the selection of the predetermined pressure using the one or more pressure valves by the practitioner overrides any existing pressure that was previously set.
[0104] In embodiments, it is envisaged that the examination device 500 may further include an imaging device having an associated light source for emitting green, white, or ultraviolet blue light onto the vaginal walls or cervix. The imaging device may be a standard (2D) camera or camera with 3D imaging capabilities. It will be appreciated that the emission of green or blue light on to the vaginal walls or cervix may enable the identification of cancerous spots on the vaginal walls after acetic acid (mild vinegar) is sprayed onto the vagina (e.g. via the port 12 or 14). Following the application of acetic acid, cancerous spots typically show up as white spots on the vaginal walls or cervix. The green or blue light assist with making these white spots stand out for better identification.
[0105] It is envisaged that the identification of cancerous spots on the vaginal walls or cervix may be enhanced by incorporating machine learning capabilities, such that the identification from the image capture of the cancerous spots may be automated. Such automation may also allow tiny pixels of cancerous spots from as littles as 18 pixels of white (which are not visible to the human eye) to be picked up by the associated software, thus improving the efficiency and accuracy of identifying the cancerous spots. By incorporating such automation capabilities, the identification of cancerous spots may be performed without involving pathology, which is highly beneficial in remote areas where a pathology lab may not be available for hundreds of kilometers. The automatic detection of the cancerous spots may at least allow a nurse (instead of a trained gynecologist) to operate the examination device 500 and confirm the presence of cancerous spots, without necessarily having to submit samples for testing or having a trained gynecologist inspect the captured images. It is envisaged that the image capture may be overlaid with a grid to assist the practitioner with locating the cancerous spots.
[0106] The image capture may also be localised, or alternatively transmitted as real-time images to a practitioner in a different location. It is also envisaged that the image capture may be associated with Virtual Reality (VR) technology to allow for more accurate viewing and analysis. For example, the imaging device may be connectable to a VR headset or screen to allow the practitioner to have a closer and more realistic view of the cervix and/or vaginal walls, which would assist with locating and identification of any potential issues (e.g. cancerous spots or other anomalies).
[0107] It will be appreciated that the automated detection of cancerous spots may be enhanced by the collection of data of images that have confirmed presence of cancer on the cervix or vaginal walls, or even STDs. The collection and compilation of images may allow for the machine to continually learn the patterns associated with the confirmed cancerous spots and increase its identification accuracy.
[0108] It will also be appreciated that the incorporation of the imaging device into the examination device may also be utilised to examine the vagina to assist with forensic rape cases and to produce evidence of assault or physical trauma. The imaging device may also be used to produce photographic or videographic case studies for educational purposes, e.g. for medical students to study and learn how to treat the various types of cancers, STDs and to identify and locate foreign objects inside the vagina.
[0109] It is envisaged that the portability and ease of operation of the examination device described above may allow a patient to purchase and use the device in their own home, and to send the results to their practitioner for evaluation. As such, both the patient and practitioner can save time and costs associated with the initial screening process. The practitioner may then be able to determine if it is necessary for that patient to travel to the clinic for treatment.
[0110] As embarrassment is a major issue in the above patient examination procedures, it is envisaged that robotic arms or the like may be introduced in conjunction with the examination device and systems described above. This would ideally be designed such that the robotic arms may be operated remotely by the physician (so that they are not required to be in the same room as the patient). The robotic arms would ideally have a human touch and operate hand-in-glove. This may at least eliminate the embarrassment obstacle, for example with patients who undergo cervical cancer tests and procedures.
[0111] It is further envisaged that the examination device and system described above may also be adapted to facilitate x-rays or other scanning methods. The examination device and system may also be made in a compact form so as to be portable, e.g. transported around in a suitcase or the like, such that the device and system may be mobile and implemented in remote areas.
[0112] It is also envisaged that the examination device and system described above may be custom-fit, depending on the type of examination procedure taking place, and also the type of patient being examined. For example, the tubular probe and sealing element described above may be adjusted such that they are smaller in diameter and overall size for women with smaller vaginal cavities, or for examining patients of a younger age. With reference to
[0113] Although the invention has been described with reference to preferred embodiments, it will be appreciated by persons skilled in the art that the invention may be embodied in many other forms.