Imaging stylet for intubation
10576231 ยท 2020-03-03
Assignee
Inventors
Cpc classification
A61M2205/3375
HUMAN NECESSITIES
A61B1/00135
HUMAN NECESSITIES
A61B1/267
HUMAN NECESSITIES
A61M2205/505
HUMAN NECESSITIES
A61M16/0418
HUMAN NECESSITIES
A61B1/05
HUMAN NECESSITIES
International classification
A61B1/00
HUMAN NECESSITIES
A61B1/05
HUMAN NECESSITIES
A61B1/267
HUMAN NECESSITIES
Abstract
An imaging stylet is provided, including a deformable outer housing having a proximal end and a distal end with a longitudinal axis, and an opening provided at the distal end, an imaging device disposed at the distal end of the outer housing, a deformable support member disposed in the outer housing, and an actuator disposed in the outer housing and coupled to the imaging device. The imaging device is movable by the actuator from an inactivated position, in which the imaging device is substantially aligned with the longitudinal axis of the distal end, to an activated position, in which the imaging device extends out of the opening at an angle relative to the longitudinal axis of the distal end.
Claims
1. A method of intubating a patient with a medical intubation device, comprising the steps of: deforming a deformable support member to a shape corresponding to a shape of a patient's airway; inserting into the patient's airway an imaging stylet deformed to the shape corresponding to the patient's airway, the deformed imaging stylet comprising an outer housing having the deformed support member therein such that said outer housing is deformed to the shape corresponding to the shape of the patient's airway by the deformed support member, the outer housing having a proximal end and a distal end with a longitudinal axis, and an opening provided at the distal end; an imaging device disposed at the distal end of said outer housing and coupled to the deformable support member; and an actuator disposed in said outer housing and coupled to said imaging device; moving said imaging device from an inactivated position, in which said imaging device is substantially aligned with the longitudinal axis of said distal end, to an activated position, in which said imaging device extends out of the opening at an angle relative to the longitudinal axis of said distal end, to visualize surrounding tissue in the airway passage; and inserting an outer tube into the patient's airway by advancing said outer tube over said outer housing deformed to the shape corresponding to the shape of the patient's airway by the deformed support member.
2. The method according to claim 1, further comprising the step of transmitting image data from said imaging device to a display coupled to said imaging stylet for display to a user.
3. The method according to claim 1, wherein said imaging stylet further comprises a control device positioned at the proximal end of said stylet, and wherein the method further comprises the step of rotationally moving said imaging device via the control device.
4. The method according to claim 1, wherein the outer tube comprises an inflatable balloon positioned adjacent the distal end of the tube, and wherein the method further comprises the step of inflating said balloon by supplying fluid thereto.
5. The method according to claim 1, wherein said imaging stylet further comprises at least one illumination device, and wherein the method further comprises the step of illuminating surrounding tissue via the at least one illumination device.
6. The method according to claim 1, further comprising the step of inserting said support member into said outer housing of said imaging stylet after the step of deforming said support member.
7. The method according to claim 1, wherein the step of deforming said deformable support member comprises deforming said support member while said support member is in said outer housing of said imaging stylet.
8. The method according to claim 1, wherein said imaging stylet further comprises a control device positioned at the proximal end of said imaging stylet, and wherein the method further comprises the step of moving said imaging device from the inactivated position to the activated position via said control device.
9. The method accordingly to claim 8, wherein said control device is removably coupled to said imaging stylet, and wherein the method further comprises the step of removing said control device from said imaging stylet prior to the step of advancing said outer tube over said imaging stylet.
10. The method according to claim 9, wherein: said control device comprises a sleeve disposed over the proximal end of said outer housing and movable relative to said outer housing; and said actuator comprises a wire connected to said sleeve, such that movement of the sleeve relative to said outer housing causes said actuator to move said imaging device.
11. The method according to claim 10, wherein: the proximal end of said outer housing has a wall with an aperture therein; and said actuator is connected to said sleeve through said aperture.
12. The method according to claim 11, wherein: said aperture is a slit having a first end and a second end; said actuator is connected to said sleeve by a stop member extending through said slit; and said stop member is movable between the first end of said slit and the second end of said slit to move said imaging device between the inactivated and activated positions.
13. The method according to claim 1, wherein said actuator comprises a nitinol wire.
14. The method according to claim 1, wherein said actuator comprises a stainless steel wire.
15. The method according to claim 1, wherein said outer housing comprises an extruded cylinder having a support lumen for receiving said support member, an actuation lumen for receiving said actuator, and an imaging lumen for receiving said imaging device.
16. The method according to claim 1, wherein said outer housing comprises polyether block amide.
17. The method according to claim 1, wherein said outer housing has an outer diameter of less than about 5 mm.
18. The method according to claim 17, wherein said outer housing comprises an outer diameter of less than 3 mm.
19. The method according to claim 1, wherein said support member comprises a semi-rigid material.
20. The method according to claim 19, wherein said support member comprises aluminum.
21. The method according to claim 1, wherein the angle at which said imaging device extends from the outer shaft is in the range of from about five degrees to about forty degrees.
22. The method according to claim 1, wherein said imaging device comprises a CMOS device.
23. The method according to claim 1, wherein said imaging device comprises a CCD device.
24. The method according to claim 1, wherein said at least one illumination device comprises at least one light emitting diode.
25. The method according to claim 24, wherein said at least one light emitting diode comprises a plurality of light emitting diodes positioned around a lens of said imaging device.
26. The method according to claim 1, further comprising the step of wirelessly transmitting image data from said imaging device to a processor.
27. The method according to claim 1, further comprising the step of transmitting image data from said imaging device to a processor via a cable connection.
28. The method according to claim 1, further comprising the step of storing image data from said imaging device.
29. The method according to claim 1, wherein said outer housing comprises at least two telescoping sections, and wherein the method further comprises the step of extending said outer housing from an inactivated position to an activated position by extending at least one said section out of at least one other said section.
30. The method according to claim 1, wherein said outer housing comprises at least two foldable sections, and wherein the method further comprises the step of moving said outer housing from an inactivated position to an activated position by unfolding the at least two foldable sections.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
(13) The basic components of one embodiment of an imaging stylet in accordance with the invention are illustrated in
(14) As shown in
(15) In one advantageous embodiment shown in
(16) Referring back to
(17) An imaging device (26) is further disposed in the outer housing (12), preferably via an imaging device lumen (22). The imaging device includes an imaging device head (27) positioned adjacent the opening (16) at the distal end of the outer housing (12). Any suitable type of imaging device may be used in accordance with the present invention. In one exemplary embodiment, the imaging device (26) is a camera provided with a fiber optic image bundle introduced through the imaging device lumen (22) of the outer housing (12) via a port provided at the proximal end to image the surrounding area. The fiber optic image bundle may be made of coherent imaging fibers at the core, and a lens provided at the distal end of the camera head (27). The camera may incorporate various types of object lenses at the distal tip for different fields of view (i.e. 50, 130, etc.) and various depths of field. At the proximal end of the fiber optic bundle, the coherent imaging fibers may be interfaced to any suitable type of digital imaging device, including, but not limited to, a CMOS device or a CCD.
(18) In some advantageous embodiments, the imaging device (26) further includes at least one illumination device for illuminating surrounding tissue during the intubation process. For example, as shown in
(19) The imaging device head (27) is attached to a distal end of the support member (18) by a resilient member (30). The resilient member (30) is made with any type of suitable material that returns to its original form after being deformed. In one advantageous embodiment, the resilient member (30) is a leaf-spring.
(20) The imaging device head (27) is further connected to an actuator (31) disposed in an actuation lumen (24) of the outer housing (12). In the exemplary embodiment shown in
(21) In its inactivated position, the imaging device head (27) is aligned with the longitudinal axis of the distal end (14) of the outer housing (12) such that it lays flat on the cup-shaped distal portion of the support member (18). When the push/pull wire (31) is pulled by the user via the control device, the imaging device head (27) is brought from its inactivated position to an activated position, wherein it extends out of the opening (16) in the outer housing (12) at a certain angle relative to the longitudinal axis of the housing, as shown in
(22) It is noted that, in certain advantageous embodiments, the outer housing (12) includes imaging markers, such as radio opaque rings, located throughout the length of, or at or near, the distal end (14). Such markers can be selected and appropriately positioned in order to reflect the relevant waves of various imaging modalities (e.g., x-ray) in order to allow the use of such modalities to assist with the precise positioning of the imaging stylet (10) within the patient's airway passage.
(23) As shown in
(24) In certain advantageous embodiments, the imaging stylet (10) further includes a storage device (not shown), which is provided to store, for example, the image data captured by the imaging device (26). The storage device may comprise virtually any type of storage device and may be internal or external to the control device (34). For example, suitable storage devices include a magnetic, high density hard drive, a writable medium including a CD/DVD, or a card inserted into the screen casing including, for example, a removable drive, such as a thumb drive, volatile or non-volatile memory, etc. It is further contemplated that the storage device may have saved thereon configuration data for configuration of the control device (34) so that control device may properly process the received image data and control the imaging device (26).
(25) As shown in
(26) The processor (40) may be coupled to a remote storage, which may comprise virtually any type of memory device, as described above. Additionally, virtually any type of digital data may be saved on remote storage, such as, but not limited to, configuration data, update information, image data, etc. The processor (40) is further connected to a display (42) via a cable or wireless connection (44), for displaying the processed image data to the user. The display (42) may be any suitable type of display, such as a computer monitor or a television screen.
(27) It is noted, however, that in some embodiments, the image data generated by the imaging device (26) may also be processed by the control device (34) positioned on the imaging stylet (10). In such embodiments, the processed image data may then be transmitted from the control device (34) to the processor (40) via cable or wirelessly. The processor (40) may be used to further process the information and/or transmit the image data to the display (42).
(28) It should further be noted that connection (46) coupling the imaging stylet (10) to the processor (40) is illustrated with a two-way arrow, which is provided to indicate two-way communication. For example, in addition to the imaging data captured by the imaging device (26), the imaging stylet (10) may transmit stylet information, such as, for example, identification/use/maintenance data, to the processor (40). The processor (40) may then use this information to automatically configure to function properly with the imaging stylet (10). Additionally, command and control data may be transmitted to the imaging stylet (10) from the processor (40), which may include commands for moving the imaging device head (27) or bending the stylet (10). In such embodiments, an input device, such as keyboard, mouse, track pad, microphone, etc., may be coupled to the processor (40) and used by a user to provide input commands for the imaging stylet (10). It is further contemplated that, rather than having a separate input device, the display (42) may be provided as a touch screen control device, which may be used to both display image data and provide for control/command inputs.
(29) The imaging stylet (10) may include a power cable for providing electrical power to the electronics and illuminating device, or electrical power may be provided via battery power (such as a rechargeable battery) positioned on the stylet or removably connected to the stylet. Alternatively, it is contemplated that the imaging stylet (10) may be wirelessly powered via any known coupling devices.
(30) As shown in
(31) As shown in
(32) The outer tube preferably includes an inflatable balloon (56) positioned adjacent the distal end opening (52). The inflatable balloon may be made of latex, Yulex, polyethylene, nylon or other suitable material, and may come in a variety of sizes and diameters, depending, as described above, on a particular type of patient being intubated. In some advantageous embodiments, the balloon (56) has a wall with a textured outer surface that provides a gripping surface to facilitate anchoring the balloon (56) on the patient's airway passage. The textured outer surface of the balloon (56) may be formed by a fiber mesh affixed to the surface of the balloon during the molding process. The fiber mesh may be made of elastane, latex, lycra, polyurethane, nylon, nylon coated with other materials such as cotton, composite springs, or other appropriate material. In other embodiments, dimensional surface structures or inflatable sinuses that are encapsulated in the surface substrate of the balloon (56) may be used to produce the textured surface.
(33) The outer tube (50) further includes a port (58) for connection to a fluid source (62), as shown in
(34) It is contemplated that, in certain advantageous embodiments, the imaging stylet (10) is first inserted into a person's airway passage with the guidance of the imaging device (26), as shown in
(35) In these embodiments, it is advantageous to have a control device that has an outer diameter that is substantially the same as the outer diameter of the stylet housing, or at least smaller than the inner diameter of the outer tube (50), such that the outer tube (50) can be easily slid onto the stylet (10).
(36) A control device (430) is removably coupled to the proximal end of the connector (420). The control device includes an actuator (440), which is coupled to the push/pull wire (460) via the connector (420). The actuator (440) may be a lever, as shown in this figure, or any other suitable device. By moving the lever (440), the user can move the head of the imaging device between the inactivated and activated positions to visualize the internal anatomy of a patient's airway passage. The proximal end (450) of the control device (430) may include connections (not shown) to the external processor and/or display. The control device (430) is removable such that it can be temporarily disconnected in order to allow an outer intubation tube (50) to be slid on or off the stylet (10).
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(38) When in use, the slidable sleeve (520) is positioned over the stylet housing (510), such that the stop member (550) corresponds to the aperture (540) in the housing, and the push/pull actuating wire (560) is connected to the stop member (550). Then, the user slides the sleeve (520) towards the proximal end of the stylet, thereby pulling the wire and moving the imaging device head at the distal end of the stylet into the activated angled position. The proximal motion of the sleeve (520) is limited by the stop member (550) once it reaches the proximal end of the slit (540).
(39) When desired, the user can move the sleeve (520) in the distal direction of the stylet, thereby pushing the wire (560) and moving the imaging device head back into the inactivated position. The distal movement of the sleeve (520) is again limited by the stop member (550) once it comes into contact with the distal end of the slit (540). It is understood that the sleeve (520) may be moved in smaller increments to achieve the desired degree of angulation of the imaging device head.
(40) The outer diameter of the slidable sleeve (520) shown in
(41)
(42) This intubation assembly (100) is then inserted into a patient's mouth (110) and is guided through the patient's larynx into the trachea. The distal end (14) of the imaging stylet (10) is extended out of the distal end opening (52) of the outer tube (50), such that the anatomy of the larynx and trachea can be visualized by the physician during the intubation. In other advantageous embodiments, the stylet (10) may be inserted into the patient's airway passage first with the guidance of the imaging device (26). Once the stylet (10) is positioned at a desired location in the patient's trachea, the control device (34) may be removed from the stylet, and the outer tube (50) may be slid over the stylet and positioned within the patient's trachea.
(43) The imaging device (26) is actuated by the control device (34) to bring the imaging device (26) into an angled position with respect to the longitudinal axis of the imaging stylet housing, as shown in
(44) Image data collected by the imaging device (26) is transmitted to the processor (40) either wirelessly or via a cable connection. The image data is processed and displayed to the user via the display (42). The illumination device provided on the distal end of the imaging stylet (10), as described above, provides light to illuminate the surrounding tissue to facilitate the visualization.
(45) After the intubation assembly (100) is placed at a desired location within the person's airway passage, the balloon (56) provided at the distal end of the outer tube (50) is inflated by the fluid source via the port (58) to anchor the outer tube (50) within the airway passage, as illustrated in
(46) In some embodiments, it may also be desirable to remove the outer tube (50) from the person's airway passage while leaving the imaging stylet (10) in place in order to replace the tube (50) or to perform other medical procedures. In this case, the control device (34) may be disconnected from the proximal end of the imaging stylet outer housing (12) so that the outer tube (50) may be slid off the imaging stylet (10) and removed from the patient's mouth.
(47) It should be noted that, although
(48)
(49) Thereby, the imaging stylet (200) can be extended from an inactivated compact position shown in
(50) Although only three outer housing sections are illustrated in
(51) When a user extends the outer housing (210) from the inactivated position shown in
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(53) When in use, the imaging stylet (300) can be quickly and easily unfolded from its inactivated position shown in
(54) In some advantageous embodiments, such as shown in
(55) It should be understood that the foregoing is illustrative and not limiting, and that obvious modifications may be made by those skilled in the art without departing from the spirit of the invention. Although the invention has been described with reference to embodiments herein, those embodiments do not limit the scope of the invention. Accordingly, reference should be made primarily to the accompanying claims, rather than the foregoing specification, to determine the scope of the invention.