Endoscope system for treatment of sinusitis
An endoscope includes a substantially rigid shaft having a distal end and a proximal portion, the shaft having a first lumen and a second lumen separate from the first lumen, the second lumen containing one or more objective lenses disposed at the distal end thereof. A housing is mounted on the proximal portion of the shaft, the housing including an eyepiece mount and a light input port. An image fiber bundle is disposed in the second lumen, the image fiber bundle extending proximally from adjacent the one or more objective lenses to the eyepiece mount. An illumination fiber bundle is disposed in the second lumen, the illumination fiber bundle extending proximally from the distal end of the shaft to the light input port.
1. A method for treating sinusitis comprising:
forming an artificial passageway into the maxillary sinus with an access sheath assembly comprising a shaft and an extendable handle, the handle having a slot dimensioned to receive a rim of an extension element open on one side thereof, the shaft traversing the canine fossa region of the subject;
advancing an endoscope into the shaft of the access sheath assembly, the endoscope having a substantially rigid shaft comprising a distal segment that defines a working lumen and a separate optics lumen separate from the working lumen, wherein the distal segment includes a distal tip having a beveled portion and a perpendicular portion, wherein the perpendicular portion is perpendicular to a longitudinal axis of the shaft and the beveled portion is not perpendicular to the longitudinal axis of the shaft, and wherein the beveled portion covers a distal end of the working lumen and the optics lumen terminates in the perpendicular portion of the distal tip, and wherein the substantially rigid shaft of the endoscope is partially held within a housing including an eyepiece and a light input port operatively connected to a light source wherein said endoscope is advanced until the housing abuts the handle;
advancing a balloon catheter along the working lumen of the endoscope so as to place the balloon into the maxillary sinus outflow tract; and
dilating the balloon of the balloon catheter.
2. The method of claim 1 , wherein advancement of the endoscope abuts the endoscope housing with the extension element.
3. The method of claim 2 , wherein the removable extension comprises a semi-tubular length of material that is open on one side and wherein the removable extension is removed from the handle by laterally sliding of the removable extension.
4. The method of claim 1 , wherein the extension element is removed prior to advancement of the endoscope into the shaft of the access sheath.
5. The method of claim 4 , wherein forming an artificial passageway into the maxillary sinus comprises inserting a trocar into the access sheath assembly and advancing the trocar and access sheath through the canine fossa region and into the maxillary sinus.
6. The method of claim 5 , further comprising removing the trocar prior to advancing the endoscope through the lumen the access sheath assembly.
7. The method of claim 4 , wherein the endoscope is advanced through the lumen of the access sheath assembly until the endoscope abuts a proximal end of the handle.
8. The method of claim 4 , further comprising viewing the sinus cavity via an eyepiece coupled to the endoscope.
9. The method of claim 4 , further comprising viewing the sinus cavity via a camera coupled to the endoscope.
10. The method of claim 4 , wherein the endoscope and coupled access sheath assembly are held with one hand while the balloon catheter is advanced with another hand.
11. The method of claim 1 , wherein the substantially rigid shaft of the endoscope includes a proximal segment connected to a proximal end of the distal segment and defining a proximal portion of the working lumen.
12. The method of claim 11 , wherein the proximal segment of the shaft does not define any other lumens other than the working lumen.
13. The method of claim 12 , wherein a distal portion of the proximal segment defines a semi-circular outer profile and a proximal portion of the proximal segment defines a circular outer profile.
14. The method of claim 13 , wherein optics lumen has a semi-circular cross-sectional shape and wherein an image fiber bundle extends through the optics lumen, wherein the image fiber bundle has a circular cross-sectional shape.
15. The method of claim 14 , wherein an illumination fiber bundle extends through the optics lumen, the illumination fiber bundle positioned around an outer periphery of the image fiber bundle.