Catheter guided endotracheal intubation
The present invention relates to a guided endotracheal intubation endoscope. A guide catheter is used to position an endoscope and a tube for intubation of a patient. The endoscope can include a steering device for steering the endoscope in at least two directions, as well as suction, irrigation and retraction devices for maintaining a clear field of view.
1. An endotracheal intubation endoscope system comprising:
an imaging endoscope having a proximal end and a steerable distal end;
an actuator to control displacement of the steerable distal end of the imaging endoscope relative to an endoscope axis in a first direction and a second direction that is orthogonal to the first direction;
a guide device for insertion into a subject's airway using the imaging endoscope, the actuator being used to steer the imaging endoscope to position a distal end of the guide device within the subject's airway, the guide device being positioned within, or mounted to, the imaging endoscope during insertion of the guide device and the imaging endoscope into the subject's airway, the guide device further being separable from the imaging endoscope upon insertion into the subject's airway and movable relative to the imaging endoscope such that the distal end of the guide device is moveable in a distal direction into a trachea of the subject, the distal end of the imaging endoscope being positioned to view a tracheal entry region of the subject's airway; and
an endotracheal tube for delivery into the trachea over the guide device upon separation of the guide device from the imaging endoscope without removal of the imaging endoscope from the airway, the separated guide device being located at an endotracheal tube delivery position within the subject's airway such that the guide device and the endotracheal tube are external to, and extend alongside, the imaging endoscope within the airway, the endotracheal tube including an inflation cuff configured to be inflated within the subject's airway to form a seal with an interior wall of the trachea.
2. The system of claim 1 further comprising a release actuator that separates the distal end of the guide device from the imaging endoscope such that the distal end of the guide device is attached to the imaging endoscope during insertion into the airway and is detached with the release actuator from the imaging endoscope such that the guide device extends alongside the imaging endoscope within the airway for delivery of the endotracheal tube over the guide device.
3. The system of claim 1 further comprising an imaging detector mounted in a proximal section of the endoscope.
4. The system of claim 1 further comprising a fluid exchange system coupled to an endoscope channel.
5. The system of claim 1 wherein the imaging endoscope comprises an outer tube such that the guide device extends along a longitudinal opening in the outer tube.
6. The system of claim 1 wherein the imaging endoscope comprises an outer tube for insertion within a body cavity having a length in a range of 20 cm to 50 cm.
7. The system of claim 1 wherein the endoscope comprises a tubular body having a diameter in a range of 8 to 14 mm.
8. The system of claim 1 wherein the endoscope further comprises a light source.
9. The system of claim 2 wherein the release actuator comprises an outer tubular wall of the imaging endoscope that can be moved to open a working channel in which the guide device is positioned during insertion of the imaging endoscope into the airway.
10. The system of claim 1 further comprising a fluid delivery system coupled to a guide device lumen.
11. The system of claim 1 further comprising a light transmissive distal cap on the distal end of the imaging endoscope.
12. The system of claim 1 further comprising a retraction catheter to manipulate tissue at the distal end of the endoscope.
13. The system of claim 1 wherein the guide device comprises a second endoscope.
14. The system of claim 13 wherein the imaging endoscope provides a first image and the second endoscope provides a second image and further comprising a display that displays the first image and the second image.
15. The system of claim 1 wherein the guide device comprises a catheter.
16. The system of claim 15 wherein the catheter is steerable.
17. The system of claim 15 wherein the catheter comprises a fiber optic channel and a fluid channel.
18. The system of claim 1 wherein the inflation cuff is extendable over the guide device to a position distal to the distal end of the imaging endoscope within the airway.
19. The system of claim 1 wherein the guide device comprises a tubular body that slides within an endoscope channel prior to separation of the guide device from the endoscope channel.
20. The system of claim 1 further comprising a retraction catheter.
21. An endotracheal intubation endoscope system comprising:
an imaging endoscope having a first imaging device, the endoscope being operative to view a patient's airway;
an actuator operable to bend a distal end of the imaging endoscope relative to an axis of the imaging endoscope;
a guide endoscope movable relative to the imaging endoscope such that a distal end of the guide endoscope can be moved distally relative to the distal end of the imaging endoscope, the guide endoscope including a second imaging device to visualize entry of the guide endoscope into the trachea, the guide endoscope being positioned within, or mounted to, the imaging endoscope during insertion into the patient's airway and separated from the imaging endoscope in the patient's airway; and
an endotracheal tube having a cuff for inflation within the trachea, the endotracheal tube being configured for insertion into the patient's airway along the guide endoscope to position a distal end of the endotracheal tube within a trachea of the patient such that the cuff is inflatable to form a seal with an interior wall of the trachea, the endotracheal tube being inserted over the separated guide endoscope that is external to the imaging endoscope.
22. The system of claim 21 further comprising a directional actuator to position the distal end of the imaging endoscope in a first direction and a second direction orthogonal to the first direction.
23. The system of claim 21 further comprising a release actuator that separates the guide endoscope from the imaging endoscope upon the insertion into the patient's airway, the guide endoscope being released to a position separated from an external wall of the imaging endoscope.
24. The system of claim 21 wherein the first imaging device further comprises an imaging detector mounted in a proximal section of the imaging endoscope.
25. The system of claim 21 further comprising a fluid exchange system coupled to a channel of the guide endoscope.
26. The system of claim 21 wherein the imaging endoscope comprises an outer tube such that a guide channel extends along a longitudinal opening in the outer tube.
27. The system of claim 21 wherein the imaging endoscope comprises an outer tube for insertion within a body cavity having a length in a range of 20 cm to 50 cm.
28. The system of claim 21 wherein the imaging endoscope comprises a tubular body having a diameter in a range of 8 to 14 mm.
29. The system of claim 21 wherein the imaging endoscope further comprises a light source such that the cuff can be illuminated at a distal position relative to the distal end of the imaging endoscope.
30. The system of claim 23 wherein the release actuator comprises an outer tubular wall that can be moved to open a working channel in the imaging endoscope, the guide endoscope being positioned within the working channel.
31. The system of claim 21 further comprising a fluid delivery system coupled to a lumen of the guide endoscope.
32. The system of claim 21 further comprising a light transmissive distal cap on a distal end of the imaging endoscope.
33. The system of claim 21 further comprising a retraction catheter to manipulate tissue at the distal end of the endoscope.
34. The system of claim 21 wherein the imaging endoscope provides a first image and the guide endoscope provides a second image.
35. The system of claim 21 wherein the guide endoscope comprises a fiber optic catheter.
36. The system of claim 35 wherein the catheter is steerable.
37. The system of claim 35 wherein the catheter comprises a fiber optic channel and a fluid channel.
38. The system of claim 34 further comprising a display that simultaneously displays the first image and the second image.
39. The system of claim 21 wherein the distal end of the guide endoscope is attached to the distal end of the imaging endoscope during insertion of the imaging endoscope into the patient's airway.
40. An endotracheal intubation endoscope system comprising:
an imaging endoscope having a channel extending from a proximal end to a steerable distal end;
an actuator to control displacement of the steerable distal end of the imaging endoscope in two orthogonal directions relative to an endoscope axis;
a guide device having an imaging device for insertion into a subject's airway with the imaging endoscope, the guide device being positioned within the channel of the imaging endoscope and being separable from the imaging endoscopic upon insertion into the airway such that the guide device extends alongside the imaging endoscope within the airway without removal of the imaging endoscope after separation, the guide device being movable relative to the imaging endo scope such that a distal end of the guide device can translate in a distal direction into a trachea of the subject, the distal end of the imaging endoscope being positioned with the actuator to view tracheal entry; and
an endotracheal tube having an inflation cuff configured for inflation within the trachea, the endotracheal tube being moveable over the guide device upon separation of the guide device from the imaging endoscope to a position within the subject's airway that is external to the channel of the imaging endoscope such that inflation of the cuff forms a seal with an interior wall of the trachea.
41. The system of claim 40 wherein the actuator positions the distal end of the endoscope in a first direction and a second direction orthogonal to the first direction.
42. The system of claim 40 further comprising a release actuator that separates the distal end of the guide device from the channel of the imaging endoscope.
43. The system of claim 40 further comprising an imaging detector mounted in a proximal section or a distal section of the endoscope.
44. The system of claim 40 further comprising a fluid exchange system coupled to a second endoscope channel.
45. The system of claim 40 wherein the channel comprises an outer tube such that the guide device extends along a longitudinal opening in the outer tube during insertion into the airway.
46. The system of claim 40 wherein the imaging endoscope comprises an outer tube for insertion within a body cavity having a length in a range of 20 cm to 50 cm.
47. The system of claim 40 wherein the endoscope comprises a tubular body having a diameter in a range of 8 to 14 mm.
48. The system of claim 40 wherein the endoscope further comprises a light source.
49. The system of claim 42 wherein the release actuator comprises an outer tubular wall that can be moved to open the channel in which the guide device is positioned during insertion into the airway.
50. The system of claim 40 further comprising a fluid delivery system coupled to a guide device lumen.
51. The system of claim 40 further comprising a light transmissive distal cap on the distal end of the imaging endoscope.
52. The system of claim 40 further comprising a retraction catheter to manipulate tissue at the distal end of the endo scope.