Endoscopic instrument having reduced diameter flexible shaft

Abstract

A medical instrument comprising a flexible, filamentous shaft slideably disposed in a sheath, the instrument including an electronic imaging system comprising an image sensor carried on a distal end portion of the instrument. The shaft may be used as a guidewire for a complementary guided device, or it may be used to carry a functional element for performing a procedure at a target site in a patient's body. In other embodiments, the present invention contemplates a flexible sheath, preferably having a simple tubular construction, with an electronic imaging system at its distal end. The sheath is adapted to slideably receive a shaft, preferably a filamentous shaft, that closely fits the sheath. The shaft carries functional element at its distal end. The instruments according to the present invention may include one or more filaments along their length for deflecting an insertable portion of the instrument.

1 . A medical instrument comprising:
 a flexible, filamentous shaft slideably housed in a flexible sheath;   an image sensor carried on a distal end portion of the instrument;   at least one solid-state illumination source carried at the distal end of the instrument and   wherein the solid state light source is carried on the shaft or the sheath and the image sensor is carried on the whichever of the shaft and sheath the light source is not carried.   
     
     
         2 . The instrument of  claim 1  wherein the insertable portion of the sheath comprises a flexible polymer tube. 
     
     
         3 . The instrument of  claim 1  further comprising a functional element disposed on the distal end of the shaft;
 wherein the functional element has a first configuration for being carried in the sheath and a second configuration when deployed from the distal end of the sheath. 
 
     
     
         4 . (canceled) 
     
     
         5 . The instrument of  claim 3  wherein the functional element comprises a device for capturing an object or manipulating tissue at a target site in a patient's body. 
     
     
         6 . The instrument of  claim 1  further comprising at least one filament is carried along a length of the instrument and is operatively coupled to the instrument so as to allow a user to control the deflection of at least a distal portion of the instrument;
 wherein the filament is slideably disposed in a channel along at least a portion of the length of the sheath. 
 
     
     
         7 . (canceled) 
     
     
         8 . The instrument of  claim 1  further comprising at least one pullable filament that has a distal portion operatively coupled to a distal end portion of the instrument and a proximal end portion operatively coupled to a tension mechanism at the proximal end of the instrument, the tension mechanism being controllable by a user to cause a distal end of the instrument to deflect. 
     
     
         9 . The instrument of  claim 8 , wherein the tension mechanism comprises a slide mechanism disposed on the handle of the instrument. 
     
     
         10 .- 11 . (canceled) 
     
     
         12 . A medical instrument composing:
 a flexible, filamentous shaft, and   an imaging system comprising a pixellated image sensor carried on a distal end portion;   wherein the image sensor has an imaging surface oriented non-perpendicularly to the optical axis of the shaft; and   wherein the shaft further includes an illumination source for emitting light from the distal end and the shaft comprises between 2 to 5 filaments, at least on filament providing structural support of predetermined rigidity and flexibility, and at least one filament operatively coupled to the image sensor and comprising an electrical conduit for power and/or signals.   
     
     
         13 . The shaft of  claim 12  wherein the shaft comprises a guidewire capable of receiving a predetermined guided device, the shaft and guidewire forming a functionally complementary assembly so as to enable delivery or placement of the guided device in desired location in a patient's body. 
     
     
         14 . The guidewire of  claim 13  further comprising the guided device, forming an assembly of guidewire and guided device. 
     
     
         15 . The assembly of  claim 14  wherein the guided device comprises a catheter or stent. 
     
     
         16 . The instrument of  claim 12  wherein the shaft has proximal portion with a first set of predetermined properties and a distal portion with a second set of predetermined properties, the first set of properties aimed at providing pushability for the shaft and the second set aimed at providing steerability for the instrument so as to facilitate the delivery of an insertable portion of the instrument to a desired target site in a patient's body. 
     
     
         17 . (canceled) 
     
     
         18 . The instrument of  claim 12  wherein the image sensor comprises a CMOS image sensor. 
     
     
         19 . (canceled) 
     
     
         20 . (canceled) 
     
     
         21 . The instrument of  claim 18  wherein the image sensor has an active imaging surface that is longer than the inner diameter of the sheath. 
     
     
         22 . (canceled) 
     
     
         23 . The instrument of  claim 1  wherein the image sensor is carried at the distal end of the shaft. 
     
     
         24 . The instrument of  claim 1  wherein the image sensor is carried at the distal end of the sheath. 
     
     
         25 - 33 . (canceled) 
     
     
         34 . A medical instrument comprising:
 a flexible, filamentous shaft slideably housed in a flexible sheath;   an image sensor carried on a distal end portion of the shaft, the shaft including one or more filaments constructed and arranged to provide pushability and steerability to the instrument sufficient to deliver the distal end of the instrument to a predetermined target site in a patient's body, the shaft including one or more conductors operatively coupled to the image sensor so as to communicate power and signals between the sensor and a location proximal to the insertable portion of the instrument.   
     
     
         35 . The instrument of  claim 34  wherein the instrument comprises a guidewire capable of receiving a predetermined guided device, the shaft and guidewire forming a functionally complementary assembly so as to enable delivery of the guided device to a target location in a patient's body. 
     
     
         36 . (canceled) 
     
     
         37 . (canceled) 
     
     
         38 . The instrument of  claim 35  wherein the guided device comprises a catheter or stent. 
     
     
         39 .- 44 . (canceled) 
     
     
         45 . The instrument of  claim 34 , wherein the instrument includes a capsule on the distal end portion of the shaft and the image sensor is housed within the capsule.